Higher Fitness Level Can Determine Longer Lifespan After Age 70

Researchers have uncovered one more reason to get off the couch and start exercising, especially if you’re approaching your golden years. Among people over age 70, physical fitness was found to be a much better predictor of survival than the number of traditional cardiovascular risk factors in a study being presented at the American College of Cardiology’s 68th Annual Scientific Session.

While high blood pressure, high cholesterol, diabetes and smoking are closely linked with a person’s chance of developing heart disease, these factors are so common in older people that the total number of risk factors becomes almost meaningless for predicting future health, researchers said. The new study suggests doctors can get a better picture of older patients’ health by looking at how fit they are, rather than how many of these cardiovascular risk factors they have.

“We found fitness is an extremely strong risk predictor of survival in the older age group—that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit,” said Seamus P. Whelton, MD, MPH, assistant professor of medicine at Johns Hopkins School of Medicine and the study’s lead author. “This finding emphasizes the importance of being fit, even when you’re older.”

Doctors use cardiovascular risk factors to help guide decisions about preventive measures and medications. Previous studies have shown that quitting smoking and controlling blood pressure, cholesterol and diabetes can reduce heart disease risk. However, most studies of cardiovascular risk factors have focused on middle-aged people, leaving a knowledge gap regarding the importance of these risk factors in older people, Whelton said.

The team analyzed medical records from more than 6,500 people aged 70 years and older who underwent an exercise stress test at a Henry Ford Health Systems-affiliated medical center between 1991 and 2009. They assessed fitness based on patients’ performance during the exercise stress test, which required patients to exercise on a treadmill as hard as they could. They divided patients into three groups reflecting their fitness based on the number of METs (metabolic equivalents, a measure of exercise workload) they achieved during the test: most fit (10 or more METs), moderately fit (six to 9.9 METs) and least fit (six or fewer METs). For this study, the researchers grouped patients with zero, one, two, or three or more cardiovascular risk factors.

On average, participants were 75 years old when they underwent the stress test. Researchers tracked the patients for an average of just under 10 years, during which time 39 percent of them died. Over this period, the researchers found higher fitness was associated with significantly increased rates of survival. The most fit individuals were more than twice as likely to be alive 10 years later compared with the least fit individuals.

In contrast, a patient’s total number of cardiovascular risk factors was not associated with their risk of death and patients with zero risk factors had essentially the same likelihood of dying as those with three or more risk factors.

Whelton said the findings demonstrate that fitness level is an important indicator of an older patient’s health that doctors could benefit from considering more often. While an exercise stress test using a treadmill or stationary bicycle provides the most precise way to measure fitness, doctors can also get a general idea of a patient’s fitness level by asking about their exercise routine.

“Assessing fitness is a low-cost, low-risk and low-technology tool that is underutilized in clinical practice for risk stratification,” Whelton said.

The study did not account for any changes in fitness level that the participants may have experienced over time. However, previous studies have suggested that improving fitness can help improve heart health, even late in life.

“People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first,” Whelton said.

Source: American College of Cardiology


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Which Type of Exercise Might Lower Your Diabetes Risk?

Boosting your muscle strength could help ward off type 2 diabetes, a new study suggests.

Even moderate amounts of resistance exercise may help prevent type 2 diabetes, said the study’s corresponding author, Duck-chul Lee. He’s an associate professor of kinesiology at Iowa State University.

For the study, Lee’s team tracked more than 4,500 adults, aged 20 to 100. The investigators found that moderate muscle mass was associated with a 32 percent reduced risk of type 2 diabetes, regardless of problems such as smoking, drinking, obesity or high blood pressure.

The reduced diabetes risk associated with moderate muscle mass was also independent of heart/lung fitness, the findings showed.

Higher levels of muscle strength did not provide additional protection against diabetes. And Lee said there are no standardized measurements for muscle strength, so it’s difficult to recommend the ideal amount of resistance exercise.

“Naturally, people will want to know how often to lift weights or how much muscle mass they need, but it’s not that simple,” Lee said in a university news release.

“As researchers, we have several ways to measure muscle strength, such as grip strength or bench press. More work is needed to determine the proper dose of resistance exercise, which may vary for different health outcomes and populations,” he explained.

Getting started with resistance training doesn’t require a gym membership or expensive equipment. You can begin at home by doing body-weight exercises, said lead author Angelique Brellenthin, a postdoctoral researcher in kinesiology at Iowa State.

“We want to encourage small amounts of resistance training and it doesn’t need to be complicated,” Brellenthin said. “You can get a good resistance workout with squats, planks or lunges. Then, as you build strength, you can consider adding free weights or weight machines.”

Thirty million Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention. The overwhelming majority suffer from type 2, which is linked to being overweight and sedentary.

The study was published in the Mayo Clinic Proceedings.

Source: HealthDay


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Exercise Can Improve Non-motor Symptoms of Parkinson’s Disease

Exercise has potential to improve non-motor as well as motor symptoms of Parkinson’s disease (PD), including cognitive function, report investigators in a review published in the Journal of Parkinson’s Disease.

PD is a slowly progressive disorder that affects movement, muscle control, and balance. While traditionally regarded as a movement disorder, it is now known to be a heterogeneous multisystem disorder — in recognition of the significant impact that non-motor symptoms have on the quality of life of individuals affected by PD. It is widely acknowledged that physical exercise improves motor symptoms such as tremor, gait disturbances, and postural instability. However, the effect of exercise on non-motor symptoms in PD, especially cognitive function, is less clear.

The number of older people with and without PD that experience cognitive impairment is steadily increasing worldwide. It is associated not only with a substantial rise in healthcare costs, but also affects the quality of life of both patients and relatives or carers. Up to 57% of patients suffering from PD develop mild cognitive impairment within five years of their initial diagnosis, and if they survive more than ten years, the majority will eventually develop dementia. The underlying neurophysiological mechanisms for cognitive decline in PD are not completely understood, but an accumulation of amyloid plaques, mitochondrial dysfunction, and neurotransmitter changes are all suggested to contribute.

A comprehensive literature review was conducted by investigators from the Institute of Movement and Neurosciences, German Sport University, Cologne, Germany, and the VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia. The studies reviewed included investigations of the effects of coordination exercise, resistance exercise, and aerobic exercise on domain-specific cognitive function in patients with PD. “Physical exercise is generally associated with increased cognitive function in older adults, but the effects in individuals suffering from PD are not known,” explained lead investigator Tim Stuckenschneider, MA.

The researchers identified relevant studies published before March 2018. There were 11 studies included with a combined total of over five hundred patients with PD with a disease severity from stages 1 to 4 on the Hoehn & Yahr scale, which is used to describe the symptom progression of PD. In four studies, positive effects of exercise on cognition (memory, executive function, and global cognitive function) were shown with no negative effect of exercise on any cognitive domain. Furthermore, disease severity was generally improved by exercise interventions.

The investigators concluded that all modes of exercise are associated with improved cognitive function in individuals with PD, however, no clear picture of which exercise mode is most effective emerged as they may influence cognitive function differently. Aerobic exercise tended to improve memory best, but different forms of exercises such as treadmill training or stationary bike training may have different effects, although both are considered aerobic exercise. Future studies are needed that directly compare the effects of different exercise modes, as the number of high-quality research projects is still limited.

“The potential of exercise to improve motor and non-motor symptoms is promising and may help to decelerate disease progression in individuals affected by PD,” observed Stuckenschneider. “Exercise therapy needs to be, and often already is, an essential part of therapy in individuals with PD. However, it is mostly used to treat motor symptoms. As part of a holistic therapy, the potential of exercise to maintain or improve non-motor symptoms such as cognitive function in individuals with PD needs to be acknowledged, and the most effective treatment options need to be defined. This will not only help practitioners to recommend specific exercise programs, but also ultimately improve the quality of life of the individual. Our work shows that ‘exercise is medicine’ and should routinely be recommended for people with PD to help combat both the physical and cognitive challenges of the disease.”

Source: Science Daily


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Study: People with Osteoporosis Should Avoid Certain Spinal Poses in Yoga

Rhoda Madson wrote . . . . . . . . .

Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones, according to research from Mayo Clinic. The results appear in Mayo Clinic Proceedings.

Researchers at Mayo Clinic and elsewhere have described injuries from yoga. This study examines injuries in people with osteoporosis and osteopenia — conditions characterized by low bone density.

Osteoporosis is a disease in which bones become thinner and more porous from loss of mineral content. Bone loss that has not reached the stage of an osteoporosis diagnosis is called osteopenia.

Researchers reviewed the health records of 89 people — mostly women — referred to Mayo Clinic from 2006 to 2018 for pain they attributed to their yoga practice. Some were new to yoga. Others had practiced for years. They had pain in the back, neck, shoulder, hip, knee or a combination.

Patients identified 12 poses they said caused or aggravated their symptoms. The most common postures involved extreme flexing or extending of the spine. Researchers used patients’ health records, medical exams and imaging to confirm and categorize the injuries as soft tissue, joint or bone injuries.

Researchers identified 29 bony injuries, including degeneration of disks, slippage of vertebrae and compression fractures. The latter appeared to be related to postures that put extra pressure on the vertebra and disks.

“Yoga has many benefits. It improves balance, flexibility, strength and is a good social activity,” says Mehrsheed Sinaki, M.D., a Mayo Clinic physical medicine and rehabilitation specialist and the study’s senior author. “But if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition. As people age, they can benefit by getting a review of their old exercise regimens to prevent unwanted consequences.”

Patients who incorporated recommendations to modify their movements reduced their pain and improved their symptoms.

In a separate commentary, Edward Laskowski, M.D., co-chair of Mayo Clinic Sports Medicine, called on providers, patients and yoga teachers to work together to produce an individualized exercise prescription that considers the yoga student’s medical history to protect against injury and provide optimal benefit.

The authors noted study limitations. The patients were seen in a musculoskeletal clinic at a tertiary care center, which makes generalizations difficult. Researchers received follow-up reports on 22 patients, as most lived out of state.

Source: Mayo Clinic


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For the Best Health, Does the Intensity of Your Workout Matter?

Jog for long enough or engage in just about any physical activity that gets the heart pumping, and the result can be a feeling of euphoria commonly known as a runner’s high.

Sure, it feels good, but does higher-intensity exercise lead to better health?

It can. Recently released federal physical activity guidelines emphasize the importance of any movement, but optimal health benefits require a little more effort. For adults, that means at least 75 to 150 minutes per week of vigorous activity, or 150 to 300 minutes per week of moderate-level physical activity.

What constitutes high-intensity versus moderate exercise? It’s all about the heart rate relative to your fitness level, said Dr. Meagan Wasfy of the cardiovascular performance program at Harvard-affiliated Massachusetts General Hospital.

“With low-intensity activities, most people will still be able to sing and converse,” Wasfy said. “At moderate intensity, you can still speak but can’t sing, and at high intensity, you can’t speak in full sentences anymore.”

The new guidelines reflect a large and growing list of studies suggesting physical activity of any kind is healthyl.

In a JAMA Internal Medicine study, researchers pooled data from six studies and found that over a 14-year period, people who never exercised were at the highest risk of death. But it didn’t take much activity to start seeing the benefits. Those who did just a little exercise lowered their risk of death by 20 percent.

“If you go from being totally sedentary to getting even a portion of the recommended 150 minutes of moderate to vigorous exercise every week, that’s when your health outcomes improve the most,” Wasfy said.

The more time you put in, the better, the study suggests.

People who completed at least 150 minutes per week of moderate exercise were 31 percent less likely to die than inactive people during the 14-year follow-up period. And the people who had the best health outcomes engaged in at least 450 minutes of moderate exercise each week; they were 39 percent less likely to die.

Kicking it up a notch with high-intensity interval training — or short, intense bouts of exercise — is undeniably superior for improving fitness, Wasfy said. People preparing to run a race or who just want to bike faster in spin class could benefit from incorporating higher-intensity exercises into their routine.

“It can give you an incremental gain on how long you can comfortably sustain vigorous exercise,” Wasfy said.

Increasing exercise intensity can be as simple as adding a short sprint into a longer walk or run, said Mercedes Carnethon, vice chair of preventive medicine at Northwestern University’s Feinberg School of Medicine.

“High-intensity interval training provides variety and challenges that appeal to some types of personalities,” Carnethon said. “Some people enjoy the sedative experience of jogging or walking briskly for a period of time. Others want to do short bursts of activity.”

Research suggests exercise is both healthy and safe for the vast of majority of people, said Dr. Michael Joyner, a researcher at the Mayo Clinic in Rochester, Minn., who studies how stress impacts the nervous system and its impact on blood pressure, heart rate and metabolism.

“Most people can find an activity that they can enjoy no matter what coexisting medical conditions they have,” Joyner said. “There are very few exceptions.”

Staying active is important throughout the lifespan, Joyner said, citing evidence that children who engage in regular physical activity have less attention deficit hyperactivity disorder, improved academic performance and other developmental benefits.

For example, in a study by the Centre for Brain Research at The University of Auckland, researchers found that children ageg 7 to 13 who were randomly assigned to do high-intensity training showed improvements in cognitive control and working memory.

In fact, the new federal guidelines recommend that children aged 3 to 5 should stay active all day and those aged 6 through 17 should get at least one hour of moderate to vigorous physical activity daily.

“The bottom line is to find an activity that you like, and do it religiously,” Joyner said. “That’s message one through 10.”

Source: HealthDay


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