Regular physical activity is proven to help prevent and manage communicable disease such as heart disease, hypertension, stroke, diabetes and several cancers. Yet, current global estimates show 1 in 3 adults and 81% adolescents do not do enough. With the recent (August 2024) Summer Olympic Games, we had displayed peak physical performance and endurance. Although these physical achievements were attainable by these athletes, the Olympics provide a universal reminders: we must all move more.
Regular exercise protects against non-communicable diseases and is linked to improved mental health and quality of life. Yet, despite extensive evidence of benefits, physical activity levels are concerningly low globally, with approximately one in four adults not meeting recommended levels. These alarmingly low rates pose a serious health threats; The World Health Organization (WHO) estimates that between 2020 and 2030, 500 million people will develop diseases due to physical inactivity, resulting in US$27 billion in annual healthcare expendidure.
As poor health outcomes in adulthood can be traced back to childhood, it is imperative that physical activity be promoted in children and adolescents. However, physical activity is crucial at all stages of life. Older people often perceive exercise initiatives as disproportionately geared towards younger populations. However, physical activity has substantial benefits for older people, including protection against declines in physical functioning and against rise of falls. Recently, it had been shown a protective effect of moderate-to-vigorous physical activity against sarcopenia. Despite these benefits, physical activity levels are particularly low among older adults and inactivity continues to increase with age. Qualitative research conducted by recent study in older people revealed beliefs of physical activity being inaccessible, unattainable, and futile due to age-related declines in physical functioning. Older people have reported that age-related conditions, such as frailty and comorbidities, act as barriers to participation in exercise programs. For example, a study showed that older people with multimorbidity and frailty perceived resistance as more suitable for younger people and expressed concerns about injury or exacerbating poor physical functioning. Similarly, a reported barrier to engaging in exercise programs was the perceived scarcity of exercise programs was the perceived scarcity of exercise programs tailored to older age groups.
Frailty and multimorbidity are particularly prevalent in residents of long-term care facilities, with residents spending a substantial proportion of their time sitting or lying down. Key barriers to engaging in physical activity were physical health limitations and associated fears of falls or injury, as well as environmental constrictions, such as lack of accessibility. However, exercise has been shown to yield considerable health benefits for care home residents. A recent study showed that exercise interventions in residential care improved functional independence in residents. Thus, promoting physical activity is especially important in this vulnerable population.
As older adults are a heterogenous population, a one-size-fits-all exercise prescription is inappropriate. Instead, interventions must be personalized and regularly monitored and adapted according to response, particularly for older adults with frailty and multimorbidity. The aforementioned research reveal that benefits for mobility and autonomy were more motivating for older adults to engage in exercise than a focus on disease prevention. Physical activity must also be further incorporated into the daily routines of older adults, for which a supportive environment is a prerequisite. Communities must have accessible green areas, walking spaces, and bike lanes, and should prioritize safety, for example by providing adequate street lighting. Similarly, care home environments must facilitate opportunities for physical activity, for example with assistive features for mobility, such as handrails, and by increasing access to outdoor spaces. Tackling the high levels of inactivity in care homes also requires organizational changes, such as integrating exercise into personalized health-care plans, and more broad policy changes, such as specifying the provision of exercise as a quality indicator.
Physical activity is pivotal for health across the life course and initiatives to bolster activity levels must be inclusive of all age groups. Older people must be supported in increasing physical activity through tailored interventions and age-specific messaging and must feel empowered in achieving personal exercise goals by dismantling notions that exercise is reserved for the young and healthy. As we marvel at the feats of Olympic athletes, let us embrace the joy of physical activity as the root of the games – a joy that has no age limit.
Arvind M. Droplet, Ph.D.
Professor Emeritus, Florida Tech