What is the effect of physical activity in residential aged care on the risk of all-cause mortality, cardiovascular disease (CVD) mortality, incident hypertension, site-specific cancers, and type 2 diabetes mellitus (T2DM)?

From the Guidelines

Physical activity in residential aged care significantly reduces the risk of all-cause mortality, cardiovascular disease mortality, and the incidence of hypertension, site-specific cancers, and type-2 diabetes, with the most recent evidence suggesting at least 150–300 min per week of moderate-intensity physical activity, or 75–150 min of vigorous-intensity physical activity, or an equivalent combination of both, spread throughout the week 1.

Key Recommendations

• Regular, structured exercise programs should be implemented in all aged care facilities, including a combination of aerobic activities, resistance training, balance exercises, and flexibility work.
• These activities should be performed for at least 150 minutes per week of moderate-intensity exercise, spread across multiple days, with resistance training at least twice weekly.
• Programs should be tailored to individual capabilities, starting at lower intensities and gradually increasing.

Physiological Benefits

• Physical activity improves cardiovascular function by enhancing heart efficiency, reducing blood pressure, and improving lipid profiles.
• It helps maintain muscle mass and bone density, improves insulin sensitivity, reduces inflammation, enhances immune function, and promotes better sleep quality.
• These physiological improvements directly contribute to reduced mortality risk and lower incidence of chronic diseases.

Special Considerations

• Even frail older adults can benefit from appropriately modified exercise programs.
• Any increase in physical activity, even if below recommended levels, provides health benefits compared to sedentary behavior.
• A gradual increase in activity level is recommended for sedentary individuals, with physical activity accumulated in bouts of even <10 min associated with favourable outcomes, including mortality 1.

From the Research

Effects of Physical Activity on Health Outcomes

• Regular physical activity is associated with a decrease in all-cause mortality and morbidity, and is proven to reduce disease and disability, and improve quality of life in older persons 2.
• Exercise is essential for healthy aging and offers many health benefits, including reduced risk of all-cause mortality, chronic disease, and premature death 3.
• Adequate levels of physical activity can reduce the risk of health problems in older adults, including cardiovascular disease, type 2 diabetes, and certain types of cancer 4, 5.

Specific Health Benefits

• Muscle-strengthening activities have been associated with reduced risk of:
  • Cardiovascular disease (approximately 20%-25% reduction) 5
  • Type 2 diabetes (approximately 30% reduction) 5
  • Cancer mortality (approximately 15%-20% reduction) 5
  • All-cause mortality (approximately 20%-25% reduction) 5
• Regular physical activity can also help prevent or mitigate falls, pain, sarcopenia, osteoporosis, and cognitive impairment 6.

Recommendations for Physical Activity

• Older adults should aim to participate in at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination of each per week 2.
• Muscle-strengthening activities should be performed 1-2 times per week, with a duration of approximately 60-150 minutes per week 5.
• A well-balanced exercise program should include daily aerobic, strength, balance, and flexibility components 6.