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Ulcerative Colitis Dementia Resource Back Health Resource Dermatology Resource
August 27, 2014

1,2Darren M. Roffey PhD; 1Simon Dagenais DC, PhD, MSc; 3Ted Findlay DO, CCFP; 4,5Travis E. Marion MD, MSc; 6Greg McIntosh MSc; 7,8Mohammed F. Shamji MD, PhD, FRCSC; 1,2,4,5Eugene K. Wai MD, MSc, FRCSC

1University of Ottawa Spine Program, The Ottawa Hospital, Ottawa, ON, 2Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON,

3
Department of Family Medicine, University of Calgary, Calgary, AB, 4Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, 5Department of Surgery, Faculty of Medicine, University of Ottawa, ON, 6CBI Health Group, Toronto, ON, 7Division of Neurosurgery, Toronto Western Hospital, Toronto, ON,

8Department of Surgery, University of Toronto, Toronto, ON.

Abstract

Obesity and low back pain are equally complex medical conditions with multi-factorial etiologies. Their clinical practice guidelines both include recommendations for screening and examination that can be easily implemented. There is sufficient information to compile a framework for the primary care provider, partnering with the patient and appropriate specialists, to manage obesity and low back pain in a structured fashion. Weight loss and exercise are paramount and should be recommended as the first options. Cognitive behavioural therapy, pharmacological treatment and bariatric surgery may then be implemented sequentially depending upon the effectiveness of the initial interventions.

Key Words: Obesity, low back pain, exercise, nutrition, cognitive behavioural therapy, bariatric surgery, weight loss, pharmacological, evidence-based guideline.

Untitled Document

1,2Darren M. Roffey PhD; 1Simon Dagenais DC, PhD, MSc; 3Ted Findlay DO, CCFP; 4,5Travis E. Marion MD, MSc; 6Greg McIntosh MSc; 7,8Mohammed F. Shamji MD, PhD, FRCSC; 1,2,4,5Eugene K. Wai MD, MSc, FRCSC

February 1, 2009

Susan B. Jaglal, PhD, Toronto Rehabilitation Institute Chair, Associate Professor, Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, ON.

A wrist fracture is associated with an increased risk of another fracture and should prompt investigation for osteoporosis in both men and women. If the fracture was caused by low trauma (a fall from a standing height or less), a bone density test should be ordered. If the T score is <–1.5, pharmacological treatment with a bisphosphonate and calcium (1,500 mg/d) and vitamin D3 (≥800 IU/d) is recommended. Management should also include balance, posture, and muscle-strengthening exercises and walking, as well as a review of fall-prevention strategies.
Key words: wrist fracture, osteoporosis, diagnosis, treatment, exercise, falls.

Susan B. Jaglal, PhD, Toronto Rehabilitation Institute Chair, Associate Professor, Faculty of Medicine, Department of Physical Therapy, University of Toronto, Toronto, ON.

October 1, 2006


Kristine E. Pringle, Ph.D., Health Care Consultant, First Health Services Corporation/PAPACE, Harrisburg, PA, USA.
Frank M. Ahern, Ph.D., Senior Research Associate, Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA.
Debra A. Heller, Ph.D., Senior Health Care Consultant, First Health Services Corporation/PA-PACE, Harrisburg, PA, USA.

Many medications have the potential to interact with alcohol, and older patients may be at greater risk of experiencing adverse effects due to issues of comorbidity and polypharmacy. Even small amounts of alcohol consumed by an older person who is taking multiple medications can have serious consequences. A retrospective analysis linked prescription claim records with self-reported alcohol use. Results showed that 77% of older adults used at least one alcohol-interactive medication, and 19% of alcohol-interactive drug users reported concomitant alcohol use. Because many individuals are unaware of the risks posed by alcohol and medications, it is important for clinicians to warn patients about potential interactions.
Keywords: older adults, alcohol, prescription drug use, alcohol-drug interactions, concomitant use of alcohol and prescription drugs.


Kristine E. Pringle, Ph.D., Health Care Consultant, First Health Services Corporation/PA-PACE, Harrisburg, PA, USA.
Frank M. Ahern, Ph.D., Senior Research Associate, Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA.
Debra A. Heller, Ph.D., Senior Health Care Consultant, First Health Services Corporation/PA-PACE, Harrisburg, PA, USA.

October 1, 2006

Marie D.Westby, BSc(PT), PhD Candidate, Mary Pack Arthritis Program,Vancouver Coastal Health, School of Rehabilitation Sciences, University of British Columbia,Vancouver, BC.
Linda Li, BSc(PT), PhD, Harold Robinson/Arthritis Society Chair, Assistant Professor, School of Rehabilitation Sciences, University of British Columbia,Vancouver, BC.

Physiotherapy aims to prevent physical impairment and restore functional ability through the use of exercise, education, and physical modalities. While there is solid evidence supporting physical activities in the management of arthritis, inactivity continues to be a problem among both younger and older patients with arthritis as compared to the general population. Current evidence supports the effectiveness and safety of moderate- to highintensity aerobic and strengthening exercises for osteoarthritis and stable rheumatoid arthritis. Participation in recreational activities does not replace the need for therapeutic exercises. Physicians and health professionals should be equipped with strategies to overcome barriers and facilitate treatment adherence when prescribing exercise.
Keywords: osteoarthritis, rheumatoid arthritis, physical therapy, exercise, physical activity.

Marie D. Westby, BSc(PT), PhD Candidate, Mary Pack Arthritis Program, Vancouver Coastal Health, School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC.
Linda Li, BSc(PT), PhD, Harold Robinson/Arthritis Society Chair, Assistant Professor, School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC.

March 1, 2006


Barbara Resnick, PhD, CRNP, FAAN, FAANP, Professor, University of Maryland School of Nursing, Baltimore, MD, USA.
Marcia G. Ory, PhD, MPH, Professor, Social and Behavioral Health; Director, Active for Life National Program Office, School of Rural Public Health, The Texas A & M University System, College Station, TX, USA.
Michael E. Rogers, PhD, CSCS, FACSM, Associate Professor, Department of Kinesiology and Sport Studies, Center for Physical Activity and Aging, Wichita State University, Wichita, Kansas, USA.
Phillip Page, MS, PT, ATC, CSCS, Manager, Clinical Education & Research, The Hygenic Corporation, Akron, OH, USA.
Roseann M. Lyle, PhD, Purdue University, Department of Health and Kinesiology, West Lafayette, IN, USA.
Cody Sipe, MS, Program Director, A.H. Ismail Center, Purdue University, West Lafayette, IN, USA.
Wojtek Chodzko-Zajko, PhD, Professor, Department Head of Kinesiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Terry L. Bazzarre, PhD, Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ, USA.

Physical activity helps to maintain function, health, and overall quality of life for older adults. It is challenging, however, for health care providers and others who work with older adults to know what type of activity to encourage older adults to engage in, and how to motivate them to initiate and adhere to physical activity and exercise over time. The purpose of this piece is to provide an overview of physical activity for older adults and provide the resources needed to evaluate older adults and help them establish safe and appropriate physical activity programs, as well as providing motivational interventions that will eliminate the barriers to exercise and optimize the benefits.
Key words: exercise, screening, motivation, self-efficacy, outcome expectations.


Barbara Resnick, PhD, CRNP, FAAN, FAANP, Professor, University of Maryland School of Nursing, Baltimore, MD, USA.
Marcia G. Ory, PhD, MPH, Professor, Social and Behavioral Health; Director, Active for Life National Program Office, School of Rural Public Health, The Texas A & M University System, College Station, TX, USA.

March 1, 2006


Marian Garfinkel, EdD, Medical Researcher and Adjunct Professor, Temple University, College of Health Professions, Department of Kinesiology; Medical Researcher, University of Pennsylvania, School of Medicine, Department of Rheumatology; Veterans Administration Hospital, Department of Rheumatology; Director, BKS Iyengar Yoga Studio of Philadelphia, Philadelphia, PA, USA.

By broadening yoga’s application beyond stress-related ailments to include preventative and curative therapies, physicians today have an advantage in treating patients’ illnesses and disorders. Specifically, yoga therapy complements patients’ traditional medical treatment of osteoarthritis and other bone and joint disorders. Following anatomical guidelines, yoga teachers can adapt postures (asanas) to ensure patients’ organs, joints, and bones are aligned to achieve physiologic changes. Recent studies performed by this author assessing the effect of yoga therapy on rheumatic diseases, such as osteoarthritis, and repetitive strain injuries, such as carpal tunnel syndrome, showed that yoga therapy caused physiologic changes, relieved pain, and improved motion.
Key words: osteoarthritis, yoga, Iyengar, exercise, repetitive strain injuries.


Marian Garfinkel, EdD, Medical Researcher and Adjunct Professor, Temple University, College of Health Professions, Department of Kinesiology; Medical Researcher, University of Pennsylvania, School of Medicine, Department of Rheumatology; Veterans Administration Hospital, Department of Rheumatology; Director, BKS Iyengar Yoga Studio of Philadelphia, Philadelphia, PA, USA.

March 1, 2005


Arto Herno, MD, PhD, Senior Consultant, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.

The degeneration of the lumbar spine is strongly associated with aging, but this does not mean that pain is an unavoidable accompaniment (though the recorded incidence of low back pain suggests otherwise). Recently, more attention has been drawn to the problem of changes related to the aging of our musculoskeletal system and the associated socioeconomic implications. We now have advanced equipment to examine patients and our store of knowledge is enormous, but the application of this knowledge to a working practical plan at the individual level is problematic. Understanding the automatism of the normal function of the lumbar spine is essential for treating mechanical low back pain because the main goal is to correct this functional disorder. However, the long-term goal of treatment should be to involve patients in their back disorder management.

Key words: aging, degeneration, lumbar spine, low back pain, exercise.


Arto Herno, MD, PhD, Senior Consultant, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.

February 1, 2005


The accredited CME learning activity based on this article is offered under the auspices of the CE department of the University of Toronto. Participating physicians are entitled to one (1) MAINPRO-M1 credit by completing this program, found online at www.geriatricsandaging.ca/cme.htm

Diabetes mellitus (DM) is a very common condition in the older population. The disease may interact with other medical conditions that increase the degree of frailty in aging adults. Nonpharmacological and pharmacological interventions are the usual steps in managing of DM. In this article, a stepwise treatment strategy will be suggested after a review of the pertinent literature.

Key words: diabetes mellitus, older adult, diet, exercise, pharmacotherapy.

Daniel Tessier MD, MSc, Head of Geriatric Services, Sherbrooke Geriatric University Institute, Sherbrooke, QC.


The accredited CME learning activity based on this article is offered under the auspices of the CE department of the University of Toronto. Participating physicians are entitled to one (1) MAINPRO-M1 credit by completing this program, found online at www.geriatricsandaging.ca/cme.htm

February 1, 2005

Susan Maddock, RPT, Specialized Geriatric Services, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

Susan Gal, BScPE, BHScPT, Specialized Geriatric Services, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

MaryJane McIntyre, BScPT, Specialized Geriatric Services, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

Rory H. Fisher, MB, FRCP(Ed)(C), Division of Geriatric Medicine, Department of Medicine, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

Barbara A. Liu, MD, FRCPC, Division of Geriatric Medicine, Department of Medicine, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto; Program Director, Regional Geriatric Program of Toronto, Toronto, ON.

The Falls Prevention Program at Sunnybrook & Women’s College Health Sciences Centre was developed to provide patients with an evidence-based, multidisciplinary intervention to prevent falls. The goals of the program are to decrease the incidence of falls and improve patient confidence. Participants in the program are 65 or older with a history of falls or near-falls and are living in the community. Participants complete a 45-minute exercise circuit, twice a week for six weeks. In addition, patients undergo geriatric medical assessment and are seen by an occupational therapist for home safety education. Patients report fewer falls during the intervention and at follow-up, and subjectively report that they benefit from the program. The positive effects of this program support existing evidence that multidisciplinary intervention plays an important role in fall prevention.

Key words: falls prevention, older adults, exercise, balance, multidisciplinary, physiotherapy.

Susan Maddock, RPT, Specialized Geriatric Services, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

Susan Gal, BScPE, BHScPT, Specialized Geriatric Services, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, ON.

April 1, 2004

Gustavo A. Cardenas, MD, Carl J. Lavie, MD and Richard V. Milani, MD, Department of Cardiology, Ochsner Medical Institutions, New Orleans, LA, USA.

Substantial data from epidemologic, lipid intervention and serial coronary angiographic studies have established the importance of high-density lipoprotein cholesterol (HDL-C) on cardiovascular risk. Low levels of HDL-C should be treated with non-pharmacologic therapy, including weight reduction and aerobic exercise training. Persistently low levels of HDL-C can be treated with niacin therapy, fibrates (especially if the triglyceride levels are elevated) and the statin family of medications. For every 1% increase in HDL-C, one would expect a greater than 3% reduction in vascular risk.
Key words: high-density lipoprotein, niacin, fibrates, statins, exercise.

Gustavo A. Cardenas, MD, Carl J. Lavie, MD and Richard V. Milani, MD, Department of Cardiology, Ochsner Medical Institutions, New Orleans, LA, USA.

August 1, 2003

Meghan G. Donaldson, MSc, CIHR Doctoral Scholar, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC.
Karim M. Khan, MD, PhD, Assistant Professor, Department of Family Practice, Faculty of Medicine, University of British Columbia; consultant in the Osteoporosis Programme at B.C. Women's Hospital and Health Centre; CIHR New Investigator, Vancouver, BC.
Stephen R. Lord, PhD, NHMRC, Principal Research Fellow, The University of New South Wales, Sydney, Australia; Author of "Falls in Older People".

Falls are a major health problem in all Western societies. About 30% of community-dwelling seniors fall annually, and of these, half have recurrent falls. This article focuses on fall prevention in community-dwelling older people. It reviews risk factors for falls, addresses the role of exercise to prevent falls, and outlines management tips for physicians who see patients who fall. There is good evidence that strength and balance training should be prescribed to prevent falls. Also, there are many simple things a physician can do to reduce fall risk, such as medication rationalization and treating fall risk factors in a coordinated manner.
Key words: falls, exercise, balance, resistance training, risk factor modification.

Meghan G. Donaldson, MSc, CIHR Doctoral Scholar, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC.
Karim M. Khan, MD, PhD, Assistant Professor, Department of Family Practice, Faculty of Medicine, University of British Columbia; consultant in the Osteoporosis Programme at B.C. Women's Hospital and Health Centre; CIHR New Investigator, Vancouver, BC.
Stephen R.

August 1, 2003

Gareth R. Jones, PhD, Director, Canadian Centre for Activity and Aging, London, ON.
Jessalynn A.B. Frederick, BHK Honors Co-op, University of Windsor, Windsor, ON.
Canadian Centre for Activity and Aging is affiliated with St. Joseph's Health Care, London and the University of Western Ontario, London, ON.

"Homeboundness" is defined as never or almost never leaving one's home except for emergencies, not going beyond one's door without assistance, or going out of one's home less than once a month, and it is estimated to affect as much as 50% of the population who are 85+ years old.1 The older homebound adult is more likely to live alone, have mobility limitations, experience incontinence problems, and be considered at high risk for falling and fear of falling, as well as more likely to receive home support services.2 Frail seniors living at home are particularly difficult to reach and are at high risk for loss of functional independence and for institutionalization.3

Home exercise is an effective means to prevent falls, to maintain functional independence and to promote rehabilitation following injury or illness.4 However, for an older adult faced with mobility challenges and/or other medical problems, attending a traditional community-based exercise program may not be a suitable option.

Gareth R. Jones, PhD, Director, Canadian Centre for Activity and Aging, London, ON.
Jessalynn A.B. Frederick, BHK Honors Co-op, University of Windsor, Windsor, ON.
Canadian Centre for Activity and Aging is affiliated with St.

January 1, 2003

D'Arcy Little, MD, CCFP, Lecturer and Academic Fellow, Department of Family and Community Medicine, University of Toronto; Director of Medical Education, York Community Services; 2002 Royal Canadian Legion Scholar in Care of Elderly, Toronto, ON.

Diabetes is a common disease in the elderly. While pharmacological management is important, the need for and benefits of non-phamacological therapy should not be underestimated in this population. Such therapy includes nutrition therapy, physical activity, smoking cessation and diabetic education. This article reviews, in detail, current recommendations for nutrition therapy and physical activity in elderly patients with Type 2 diabetes, including specific recommendations for all types of food groups and specific recommendations for pre-exercise evaluation.
Key words: elderly, diabetes mellitus Type 2, nutrition therapy, diet, physical activity, exercise.

D'Arcy Little, MD, CCFP, Lecturer and Academic Fellow, Department of Family and Community Medicine, University of Toronto; Director of Medical Education, York Community Services; 2002 Royal Canadian Legion Scholar in Care of Elderly, Toronto, ON.

Diabetes is a common disease in the elderly. While pharmacological management is important, the need for and benefits of non-phamacological therapy should not be underestimated in this population.

February 1, 1999

Barry Goldlist, MD, FRCPC, FACP

Ever since the landmark article by Fries in the 1980 New England Journal of Medicine, entitled 'Aging, natural death, and the compression of morbidity,' investigators, elderly people, and probably many younger people, have wondered whether the progressive frailty and dependency traditionally associated with aging are, in fact, inevitable. Preventive medicine, which originally meant preventing death early in life, is now being applied to preventing disability in the elderly. There is persuasive evidence presented by the MacArthur Foundation Study of Aging in America that the lifestyle choices we make are important factors in how we age. This information is clearly and effectively presented by Rowe and Kahn in the 1998 publication, 'Successful Aging.' They make a persuasive argument that while most of the chronic degenerative diseases of aging have a significant genetic basis, manipulating environmental factors can still be incredibly important.

Rowe and Kahn present their most persuasive argument in touting nutrition and physical exercise in preventing age-related frailty. My reading of the literature over the past few years is that although any exercise is better than no exercise, very vigorous exercise is better than moderate exercise. While early detection of specific diseases is important as well (e.g. cancer screening, diabetes detection, hypertension detection and treatment), I for one am firmly convinced that exercise and diet will provide the 'biggest bang for the buck.' Although lifelong commitment to preventive health care is the optimum, it seems like there is benefit in vigorous exercise and proper nutrition regardless of the age at which it is started.

The maintenance of normal cognitive function with aging is a much more difficult issue. We do know that higher levels of education are associated with less cognitive decline in old age, but it is unsure if there is any causal link. Certainly maintenance of good physical health will help maintain good mental health as well. There is really no evidence at the present time that 'mental gymnastics' such as crossword puzzles, or specific diets (e.g. rich in antioxidants), will help in maintaining cognitive function.

In the textbook 'Principles of Geriatric Medicine and Gerontology,' Professor Hazzard writes a chapter on preventive gerontology that emphasizes the lifelong health practices that promote successful aging. It seems that it is never too early to plan for a healthy old age. Fortunately, it is also never too late to start.

Barry Goldlist, MD, FRCPC, FACP

Ever since the landmark article by Fries in the 1980 New England Journal of Medicine, entitled 'Aging, natural death, and the compression of morbidity,' investigators, elderly people, and probably many younger people, have wondered whether the progressive frailty and dependency traditionally associated with aging are, in fact, inevitable. Preventive medicine, which originally meant preventing death early in life, is now being applied to preventing disability in the elderly.

February 1, 1999

Jaye Waggoner, BAA

Ms.Waltraud Geisler

The day starts bright and early at 5 a.m. for Ms.Waltraud Geisler. An early riser by nature, the first order of business is a little quiet rest; it is a time when she can take in the news or read. At seven it is time for breakfast and then some writing. Recently, Ms. Geisler's daughter-in-law has asked her to document the family's history all the way back to the days when she left her home land, Czechoslovakia. After working on that for a couple of hours it is time to begin her volunteer work. She spends nine to noon on the 'Safety Line' calling members of her community that are shut-in to make sure they are alright. Then there is time for a quick lunch before heading out for the afternoon. Ms. Geisler is a Peer Councilor for other seniors. Right now she has five clients she visits on a rotating basis, or whenever they need her. She wraps up the day returning home around five for dinner, the news, some knitting perhaps, a little reading, listening to music, relaxing and then off to bed at ten.

It is a rigorous and demanding schedule by anyone's standards, never mind the fact that Ms. Geisler is 76 years old. What is her secret to staying so active and participating fully in her life and the lives of others? Well, according to her the answer is in the question. "I am out everyday, seven days a week." She has a routine that she follows and by doing that and through helping others she is fueled to continue doing the same. "If I sat at home with nothing to look forward to I would get depressed," she said. She went on to say, with a smile, just how important it is to "get moving and keep moving" even if it is just a walk around the block.

The pattern is certainly working for her. In the past she has only had to deal with an ulcer, that has since healed and a hip operation, which has somewhat limited what she can do physically. At 76, she is happy to say, she takes no prescription medications. She believes that physicians should put their foot down and try to limit the drugs they prescribe to seniors and in turn seniors should find other ways to feel good. "Doctors should talk to seniors and listen. Everyone relies too heavily on prescription drugs, especially seniors," she said. "This is not to say that drugs are the enemy, obviously in some cases like heart medication they are very necessary. But some," she went on to list, "like sleeping pills, tranquilizers, and those used to treat depression, may not be."

Ms. Geisler takes a multi-vitamin, vitamins E, C, B complex, calcium and magnesium, and drinks a lot of water, as she does not always feel like shopping and cooking. She also recognizes the value of exercise. She believes you can get exercise in a variety of ways. It does not have to be structured classes. "The only exercise I get is walking, and I feel good," she said. Not only does she bus and walk everywhere, she encourages other seniors, even those with limited mobility, to get out.

Ms. Geisler believes that like herself, if other seniors stay active physically, keep their minds busy, eat reasonably healthy and find someone who will listen and understand them, they could significantly improve their overall long-term health. "They may not find themselves needing so many prescription drugs down the road," she said. The recipe for good health, she says, could be as simple as talking, listening and really living, not simply existing.

Jaye Waggoner, BAA

Ms.Waltraud Geisler

The day starts bright and early at 5 a.m. for Ms.Waltraud Geisler.

December 1, 1998

Olya Lechky

The Pro Program, an exercise program for seniors with osteoporosis (OP), is demonstrating that regular exercise, combined with medication and good nutrition, can improve bone mineral density (BMD) if participants stick with the program over a period of two to three years.


A patient with osteoporosis learns the benefits of good posture from Josie Tominac, PRO Program Coordinator at the Rehabilitation Institute of Toronto

Unlike many programs that target younger women as a preventative measure against developing OP, the Pro Program, at the Rehabilitation Centre of Toronto, specifically addresses the special needs of seniors at high risk of life-threatening fractures and whose OP may be complicated by a variety of other serious medical conditions. Started in 1983 by physiatrist Dr. Raphael Chow, the program currently has about 300 regular participants who exercise for 50 minutes, twice a week, in groups with similar levels of disability or fragility.

Participants are referred by their family physicians. Dr.

Olya Lechky

The Pro Program, an exercise program for seniors with osteoporosis (OP), is demonstrating that regular exercise, combined with medication and good nutrition, can improve bone mineral density (BMD) if participants stick with the program over a period of two to three years.


A patient with osteoporosis

June 1, 1998

Kim Wilson, BSc, MSc

Regular exercise is associated with cardiovascular, respiratory, neuromuscular and metabolic benefits. It is also an important factor in improving the immune system and preventing diseases, such as osteoporosis and coronary artery disease, while reducing disability. Physical activity also gives an energy boost, lowers cholesterol, enhances mood, and increases general feelings of well being.1,2,3

Research has shown that regular exercise decreases the mortality rate in middle-aged men and probably in middle-aged women, but whether this occurs in the elderly has not been studied extensively.4 Very little research has been done to determine how much exercise an elderly person needs to do to obtain health benefits.

The intensity of exercise required to promote cardiovascular health among older persons has remained controversial.5 Some studies suggest strenuous activity reduces coronary disease risk while other studies found that less intense activity reduces the risk of coronary disease.4,5 Not surprisingly, physicians are confused about how to prescribe an exercise regimen to their older patients.

Research in the area of exercise and health has traditionally focused on younger individuals.

Kim Wilson, BSc, MSc

Regular exercise is associated with cardiovascular, respiratory, neuromuscular and metabolic benefits. It is also an important factor in improving the immune system and preventing diseases, such as osteoporosis and coronary artery disease, while reducing disability.