Independence: a new reason for recommending regular exercise to your patients

Abstract

There are many good reasons to advise regular and adequate physical activity: longevity seems extended by up to 2 years, and the risk of a wide range of chronic disorders is substantially reduced. However, from the viewpoint of the overall, quality-adjusted lifespan, perhaps the most important reason is the ability of physical activity to counter the relentless, age-related decrease in physical capacity (maximal aerobic power, muscle strength, flexibility, and balance). The case is detailed for maximal aerobic power, which deteriorates by about 5 mL/ [kg x min] for each decade of adult life. Independence is generally at risk when the maximal oxygen intake has dropped to 18 mL/ [kg x min] in men and 15 mL/ [kg x min] in women. A sedentary person typically reaches this threshold between 80 and 85 years old. However, regular physical activity can augment maximal oxygen transport by 5 to 10 mL/ [kg x min], setting back the need for institutional support by 10 to 20 years.