From the Guidelines
Physical inactivity in residential aged care significantly increases the risk of non-communicable diseases among elderly residents, and thus, regular physical activity should be incorporated into care plans for all capable residents to reduce these risks. The most recent and highest quality study, 1, emphasizes the importance of physical exercise as a therapeutic strategy for prevention of both disease and the associated decline in functional capacity in older adults. According to this study, physical function has been proposed as a biomarker of healthy ageing, and supervised exercise interventions have been proved to be safe and effective in preventing or attenuating functional and cognitive decline.
Key Recommendations
- Residents should aim for at least 150 minutes of moderate-intensity activity per week, or as much as their individual capacity allows, with activities tailored to their abilities such as chair exercises, walking programs, and gentle resistance training 1.
- Care facilities should conduct individual assessments to determine appropriate activity levels and provide adaptive equipment when necessary.
- Implementing structured exercise programs with proper supervision can help prevent falls while improving overall physical function.
- Physical inactivity leads to muscle atrophy, decreased bone density, reduced cardiovascular function, and metabolic changes that increase the risk of conditions like type 2 diabetes, cardiovascular disease, osteoporosis, and certain cancers.
- Additionally, sedentary behavior contributes to obesity, cognitive decline, and depression.
Importance of Physical Activity
The study 1 highlights that health effects already take place when individuals who were entirely physically inactive become somewhat more active, and every step away from physical inactivity is important and promotes health. Furthermore, the study 1 asserts that it is unethical not to prescribe physical exercise for frail older adults, and that physical trainers should be included in health-care systems to help manage physical exercise programmes for older patients.
Implementation
To promote healthy and dignified ageing, it is essential to help health-care systems to more efficiently implement evidence-based exercise programmes for frail older adults in all community and care settings 1. This can be achieved by incorporating physical activity into care plans, providing individualized assessments, and offering supervised exercise programs. Even small increases in physical activity can yield significant health benefits for this vulnerable population, improving quality of life and reducing healthcare utilization.
From the Research
Risk of Non-Communicable Disease
The risk of non-communicable disease due to physical inactivity in residential aged care is a significant concern. Key factors contributing to this risk include:
- Physical health problems and physical frailty 2
- Fear of resultant injury or falling 2
- Past sedentary lifestyle 2
- Insufficient understanding about physical activity 2
- Environmental restriction 2
Barriers to Physical Activity
Barriers to physical activity in residential aged care settings can be personal or environmental. These barriers can be modifiable, and assessment and problem-solving to overcome them could result in positive outcomes 2. Healthcare providers play a crucial role in influencing older residents to adopt regular physical activity and should consider these barriers when developing and maintaining physical activity plans 2.
Recommendations for Physical Activity
Recommendations for physical activity and exercise for older adults living in long-term care facilities have been established by a taskforce of experts 3. These recommendations include reducing sedentary behaviors for all residents and defining specific, evidence-based guidelines for exercise training for subgroups of residents. Promoting residents' motivation and pleasure is essential for successful implementation, and organizational factors related to long-term care facilities and healthcare systems must be considered 3.
Interventions to Enhance Well-Being
Interventions that provide older adults with a sense of purpose, such as assigning a functional role or supporting the development of a new skill, can improve well-being and quality-of-life outcomes 4. These findings have implications for professionals and carers to support older adults in accessing more purposeful social roles and creating opportunities for helping and reciprocation 4.
Physical Activity Guidelines
Adequate levels of physical activity, as specified by current global guidelines, can reduce the risk of health problems in older adults 5. However, the practicality of adherence to these guidelines for older people with complex medical issues is questionable 5.