# Exercise as it relates to Disease/Does chronic disease reduce physical activity in older adult?

This is a Critique of the Journal article “Older Adults, Chronic Disease and Leisure-time Physical Activity: A study conducted by Maureen C. Ashe1,2, William C. Miller1,2,5, Janice J. Eng1,2, Luc Noreau3,4, and the Physical Activity and Chronic Conditions Research Team

# What is the background to this research?

As we get older the risk of developing chronic disease increases if we are inactive. Participating in regular physical activity is an important part of healthy aging because it can prevent or slow the progression of some chronic diseases. A lot of research has been done showing that there is a link between physical activity reducing the development of chronic disease such as stroke,diabetes,osteoporosis, and heart disease[.A study published in 2009 investigated the relationship between physical activity and chronic disease in people age 60 yrs and older in Canada. The study provided evidence that chronic disease is a major factor contributing to inactivity of older people.The researchers used survey data from the Canadian Community Health Survey(2000/2001), which was a national survey that collected data pertaining to chronic disease, health-related quality of life, health resource utilization, socio-demographics and leisure time physical activity (LTPA). Physical inactivity and sedentary lifestyle are recognized as a serious threat to human health. In 2003, the World Health Organization (WHO) attributed 2 million deaths annually to a sedentary lifestyle and physical inactivity. More than three-quarters (85%)of older people have some form of the chronic disease and are at greater risk of being physically inactive.Yet, despite the potential benefits, the World Health Organization (WHO) issues a warning in 2003 that physical inactivity is a serious Worldwide health problem such that 2 million deaths are attributable to annually to a sedentary lifestyle. Even a small amount of exercise per week can benefit people's health, including people with chronic disease. Regular physical activity can also reduce the impact of some chronic diseases (secondary prevention), such as obesity, depression, osteoporosis, falls and fractures and osteoarthris. Physical activity also plays a role in improving people's quality of life.

# Where is the research from?

This study analyzed data from the Canadian Community Health Survey(2000/2001), which was a population base self-report telephone survey. The study was conducted by researchers from the following institutions:
* Rehabilitation Research Lab, GF Strong Rehab center, BC Canada
* Physical Therapy Department, University of British Columbia, BC, Canada
* Universite Laval, Quebec, Canada
* Center for Interdisciplinary Research in Rehabilitation and social integration (CIRRIS), Quebec, Canada
* Center for Clinical Epidemiology and Evaluation (C2E2), Vancouver Coastal Health, BC Canada

# What kind of research was this?

This study was a Meta-analysis using raw data that was obtained from the Statistics Canada Research Data Center. Univariate logistic regression was used to provide odds ratios (OR) and 95% confidence intervals (CI) within each variable to determine differences in activity and risk for meeting guideline recommendations for leisure time physical activity (LTPA).

# What did the research involve?

The study had two main objectives. The first objective was to determine the proportion of people interviewed in the survey who met the recommended amount of physical activity per week. The second objective was to understand the factors associated with people meeting or not meeting the recommended amount of physical activity, and describe what physical activities were done by people with chronic disease.

# What were the basic results?

The key findings from this study were that 30% of all the people that were interviewed over the age of 65 were not meeting the recommended amount of exercise per week, and people with a chronic disease were 7% less likely to meet the recommended amount of exercise per week. The main risk group were older women, people with low socioeconomic status, smokers, and people with physical disability.

# What conclusions can we take from this research?

The research provides evidence that older Canadians are not active enough and this is a result of having a chronic disease. Chronic disease and physical inactivity in older people is a serious problem which has an impact on quality of life and also cost society a lot of money. However, exercise can help older people manage chronic disease and reduce the risk of developing further chronic diseases. Even a small amount of daily exercise can have benefits. For example,30 minutes of walking a day can improve older people's health. The research showed that walking was the most common LTPA activity for older people.The main recommendation from the study was to develop community-based programs to increase LTPA, in particular for older people with a chronic disease.

# Practical advice

About half of the physical decline associated with aging may be due to a lack of physical activity.To improve health or stay healthy, older adults need to engage in both aerobic and anaerobic training each week. older adult age 65 and over who are physically fit and have no medical issue that limits their ability to move, should be active daily and do 150 minutes of moderate aerobic activity such as walking every week, and strength training two or three days a week that workout all the major muscles.

# Further reading

For further information regarding chronic disease and the benefit of physical activity read below:
* what are the health benefits of physical Activity?:https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
* Reducing the risk of chronic disease in older adult:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124955/
* Exercise for Older Adults with Chronic Disease: http://www.oahct.com/PatientEducation/ExerciseOlderAdults/default.aspx
* How much physical activity do older adult need?:https://www.youtube.com/watch?v=NjCkLunz_U8

# Reference

* 1 2 3 4 U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.
* ↑ Evenson KR, Rosamond WD, Cai J, Toole JF, Hutchinson RG, Shahar E, Folsom AR. Physical Activity and Ischemic Stroke Risk: The Atherosclerosis Risk in Communities Study. Stroke. 1999; 30:1333–9. [PubMed: 10390304]
* ↑ NIH Consensus Development Panel. Physical activity and cardiovascular health. Journal of the American Medical Association. 1996; 276:241–6. [PubMed: 8667571
* ↑ zzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360(9343):1347–60. [PubMed: 12423980]
* ↑ Hoffman C, Rice D, Sung H. Persons with chronic conditions: their prevalence and costs. Journal of the American Medical Association. 1996; 276(18):1478–1479.
* ↑ Buchner DM, Beresford SA, Larson EB, LaCroix AZ, Wagner EH. Effects of leisure-time physical activity on health status in older adults. II. Intervention studies. Annual Review of Public Health. 1992; 13:469–88.
* ↑ Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical Activity/Exercise and Type 2 Diabetes: A consensus statement from the American Diabetes Association. Diabetes Care. 2006; 29:1433–1438. [PubMed: 16732040]
* ↑ . American College of Sports Medicine. Position Stand: Physical Activity and Bone Health. Medicine & Science in Sports and Exercise. 2004:1985–1996. [PubMed: 15514517]
* ↑ NIH Consensus Development Panel. Physical activity and cardiovascular health. Journal of the American Medical Association. 1996; 276:241–6. [PubMed: 8667571]
* ↑ Rimmer JH, Braddock D. Health promotion for people with physical, cognitive and sensory disabilities: an emerging national priority. American Journal of Health Promotion. 2002; 16:220– 4. ii. [PubMed: 11913327]
* ↑ Simonsick EM, Guralnik JM, Volpato S, Balfour J, Fried LP. Just get out the door! Importance of walking outside the home for maintaining mobility: findings from the women’s health and aging study. Journal of the American Geriatrics Society. 2005; 53:198–203. [PubMed: 15673341]