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Critical reviews of the literature on the factors that influence physical activity among older adults have argued that existing theoretical frameworks should be extended by integrating those that deal with the complex processes of socialisation and social learning. This paper explores some of the social processes that influence older people's participation in physical activity (beyond that associated with everyday domestic tasks). A questionnaire with items on personal, social and environmental characteristics was completed by a random sample of older adults in the Madrid Autonomous Region (Spain). Significant relationships were found between the type of physical activity participation and: being physically active at earlier life stages, socio-economic status, the encouragement of others or social support in being active, and the knowledge and availability of local facilities. Some cases were observed of re-socialisation into physical activity among those who had been inactive earlier in life, and both appropriate environmental and supportive social conditions appeared instrumental. The findings could usefully inform the design of future social programmes to promote active lifestyles in later life, but given the complexity of the socialisation processes, it would be advisable for future studies to examine other than the four factors featured in the presented analysis, such as the role of cultural differences. KEY WORDS--physical activity, older adults, participation, socio-economic status, life course, social support, sports facilities, resocialisation. doi: 10.1017/S0144686X10000358

Background. This study explored the associations between various types of activities, their underlying physical components, and recurrent falling in community-dwelling older persons. Methods. This study included 1,329 community-dwelling persons ([greater than or equal to]65 years) of the Longitudinal Aging Study Amsterdam (LASA). The time spent in walking, cycling, light and heavy household activities, and two sports was measured using the LASA Physical Activity Questionnaire (LAPAQ). Physical activity components included strength, intensity, mechanical strain, and turning. Time to second fall in a 6-month period was measured during 3 years with fall calendars. Cox proportional hazards models were adjusted for confounders and stratified for physical performance and sex in case of significant (p < .10) interaction. Results. During 3 years, 325 (24.5%) persons became recurrent fallers. In women, doing light (hazard ratios [HRs] = 0.40, 95% confidence intervals [CIs] = 0.20-0.79) or heavy household activities (HR = 0.63, CI = 0.44-0.79) was associated with a decreased risk of recurrent falling. In persons with good physical performance, doing sports (HR = 1.56, CI = 1.07-2.28), high intensity (HR > 1.75, CI = 1.09-3.16), and high mechanical strain (HR = 1.70, CI = 1.01-2.83) activities was associated with an increased risk of recurrent falling. Conclusions. The results suggest that the relationship between physical activity and recurrent falling differs per type of activity and is modified by physical performance. Doing household activities was associated with a decreased risk of recurrent falling in women. In physically fit older persons, doing sports or activities with high intensity or mechanical strain demands was associated with an increased risk of recurrent falling. Key Words: Physical activity--Physical performance--Accidental falls--Aged. doi: 10.1093/gerona/glq013

J Strength Cond Res 24(1): 251-256, 2010--Reportedly, muscle fatigue in older individuals is greater, less than, or similar to young individuals, potentially because of differences in muscle groups studied, type of contraction, continuous vs. intermittent contractions, exercise duration, duty cycle, and contraction speed. During a single set of isokinetic mode knee extensions, muscle fatigue is similar between older and younger individuals. However, repeated sets may favor the more oxidative nature of muscle from older adults and may be necessary to reveal age-associated enhanced fatigue resistance. The purpose of this investigation was to compare muscular fatigue induced by repeated sets of intermittent isokinetic mode knee extensions in older and younger males. Nineteen older (mean [+ or -] SD) (66 [+ or -] 6 yr) and 16 younger (21 [+ or -] 2 yr) men completed 5 sets of 30 isokinetic mode knee extensions at 180 degrees/second. In the analysis of absolute fatigue, both groups significantly decreased torque production during each set, with young men having significantly higher torque production during all 5 sets. Relative fatigue was significantly greater in young participants during sets 2 through 5 (old vs. young: set 2:1 7.1 vs. 26.6%; set 3:25.5 vs. 39.7%; set 4:28.1 vs. 45.1%; set 5:29.3 vs. 46.4%; overall relative fatigue: old 22.2%; young 38.1%). These data indicate enhanced fatigue resistance in older men, which was revealed using repeated sets of intermittent contractions. Resistance to muscle fatigue is only one component of healthy aging muscle, and perhaps exercise interventions targeted toward prevention of falls in the elderly should focus on improved muscle power rather than fatigability/sustainability of contractions. KEY WORDS sarcopenia, muscle endurance, elderly, isokinetic, aging, exercise, Biodex

Background. Aging is associated with a decline in exercise capacity that may be attributable to maladaptations in both skeletal muscle perfusion and metabolism; yet very little is known regarding the real-time, within-muscle interplay between these parameters during physical activity. Therefore, we utilized an unique nuclear magnetic resonance sequence to concomitantly examine changes in lower leg skeletal muscle perfusion and metabolism. Methods. In young (26 [+ or -] 5 years, n = 6) and older (70 [+ or -] 5 years, n = 6) healthy volunteers, arterial spin labeling measurements of muscle perfusion were combined with 31 Phosphorous ([sup.31]P) nuclear magnetic resonance spectroscopy to monitor high-energy phosphate metabolites during and after 5 minutes of moderate-intensity ([approximately equal to]5W) plantar flexion exercise. Results. Compared with young, end-exercise perfusion was diminished in older participants (43 [+ or -] 10 mL/100 g/minute, old, 60 [+ or -] 7 mL/100 g x minute, young), accompanied by greater phosphocreatine (PCr) depletion (-28% [+ or -] 12%, old; -19% [+ or -] 7%, young) and elevated inorganic phosphate/PCr (0.41 [+ or -] 0.2, old: 0.24 [+ or -] 0.09, young); yet the time constant for PCr recovery ([tau], an index of muscle oxidative capacity) was similar between groups (51 [+ or -] 17 seconds, old; 48 [+ or -] 7 seconds, young). Conclusions. Together, these preliminary data provide evidence of an age-related decline in tissue perfusion and increased 'metabolic stress' during exercise but demonstrate that overall oxidative capacity in the elderly does not appear negatively affected by this relatively hypoperfused state. Key Words: [sup.31]P spectroscopy--Oxidative capacity--Exercise--Aging.

The purpose of this investigation was to examine the effects of a 5-week, low-cost unstable surface balance training program in sexagenarians. Nineteen men and women (60-68 years; 83.7 [+ or -] SD kg) were randomly assigned to a control or training group. The training group performed various balance activities on air-filled rubber disks for 5 weeks. Each thrice-weekly session was supervised, and progression was based on proficiency. While in an upright position, static balance (length of path [LOP] of the center of pressure) was assessed in both eyes-open and eyes-closed states for each leg separately as well as for both legs. Participants also performed the timed up-and-go (TUG) test and completed the Activity-specific Balance Confidence (ABC) questionnaire. A significant group x time effect for the ABC questionnaire was found (p = 0.04). Tukey post hoc analysis indicates that the balance training program increased self-perceived balance confidence (p < 0.01). No significant group x time interactions were noted for TUG or LOP. Because no objective measure of balance or function was changed, the increase in ABC may be spurious. Unstable surface training may not be effective in improving balance among persons for whom balance is not problematic. However, the large number of acute training variables in such a program leaves opportunity for further research in this paradigm. KEY WORDS aging, balance, falls

Objectives. The present study of a representative sample of older adults quantified everyday physical activity (EPA) by having participants wear actigraphs. Our objectives were to examine whether poor health may partly explain why older adults become less physically active with advancing age and whether gender might moderate the extent to which health status predicts EPA. Methods. We performed multiple regression analyses on a sample of older, community-dwelling adults (aged 80-98 years, N = 198; women = 63.1%). Results. The results imply that age-related declines in EPA may be partially accounted for by health (in men) and by living arrangements (in women). Discussion. We consider reasons why poorer health might erode EPA for men (but not women) and why living alone might erode EPA for women (but not men). Key Words: Activity--Actigraph--Gender--Health--Living arrangements.

We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70+ years of age who have deficits in mobility. We randomized a total of 412 adults aged 70-89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months. Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention. Gender, age, and scores on a short physical performance battery did not moderate these effects. Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning. This is an important finding in light of the importance of these process variables in behavior change and quality of life. Key Words: Self-efficacy--Aging--Disability--Mobility--Quality of life.

Background. Reactive oxygen species production increases during aging, whereas protective mechanisms such as heat shock proteins (HSPs) or antioxidant capacity are depressed. Physical activity has been hypothesized to provide protection against oxidative damage during aging, but results remain controversial. This study aimed to investigate the effect of different levels of physical activity during aging on Hsp72 expression and systemic oxidative stress at rest and in response to maximal exercise. Methods. Plasma antioxidant capacity (Trolox equivalent antioxidant capacity, TEAC), thiobarbituric acid-reactive species (TBARS), advanced oxidized proteins products (AOPP), and Hsp72 expression in leukocytes were measured before and after maximal exercise testing in 32 elderly persons (aged 73.2 years), who were assigned to two different groups depending on their level of physical activity during the past 12 months (OLow = moderate to low level; OHigh = higher level). Results. The OHigh group showed higher aerobic fitness and TEAC (both representing 120% of OLow values) as well as lower oxidative damage (50% of OLow values) and Hsp72 expression. Exercise led to a lower increase in oxidative +damage in the OHigh group. Aerobic fitness was positively correlated with TEAC and negatively with lipid peroxidation (TBARS). Hsp72 expression was negatively correlated with TEAC but positively correlated with TBARS levels. Conclusions. The key finding of this study is that, in people aged 60 to 90 years, long-term high level of physical activity preserved antioxidant capacity and limited oxidative damage accumulation. It also downregulated Hsp72 expression, an adaptation potentially resulting from lower levels of oxidative damage.

Many older people refuse to participate in programs of strength and balance training (SBT), limiting their effectiveness for falls prevention. To persuade older people to take up SBT, we need to know whether their intention to undertake SBT is motivated by the perceived threat of falling or the perceived suitability and benefits of SBT. A survey of 558 people aged 60 to 95 years assessed intention to undertake SBT, as well as measures of threat appraisal (concern about falling, perceived risk, and consequences of falling) and coping appraisal (perceived benefits and appropriateness for them of undertaking SBT). Intention to undertake SBT was much more closely related to all elements of coping appraisal than to threat appraisal. The elements of coping appraisal included the belief that it has multiple benefits and is associated with a positive social identity, and the feeling that family, friends, and doctors would approve of taking part.

Background. Previous studies have demonstrated that aerobic exercise training and weight loss have independent effects on insulin-stimulated glucose disposal (ISGD). We hypothesized that ad libitum consumption of a highcarbohydrate diet would result in weight loss and improved ISGD, and that aerobic exercise training would facilitate greater improvements in ISGD compared with diet alone. Methods. Older participants (13 women, 9 men; age = 66 [+ or -] 1 year) with impaired glucose tolerance were randomly assigned to an ad libitum diet alone (18% fat, 19% protein, 63% carbohydrate) or this diet plus aerobic exercise training (4 d/wk, 45 min/d, 80% V[O.sub.2peak]) for 12 weeks. ISGD, abdominal fat distribution, muscle glycogen, and glycogen synthase activity were assessed pre- and postintervention. Results. Consumption of the diet resulted in significant weight loss and an improvement in ISGD. Consumption of the diet plus exercise training also resulted in weight loss and increased ISGD, but results were not significantly different from those in the diet-alone group. Mean abdominal visceral and subcutaneous adipose tissue cross-sectional areas were smaller postintervention compared to baseline with no difference between groups. Exercise training and consumption of the diet increased muscle glycogen content (344.7 [+ or -] 21.3 to 616.7 [+ or -] 34.4 [micro]mol*[g.sup.-1]) and decreased glycogen synthase activity (0.21 [+ or -] 0.02 to 0.13 [+ or -] 0.01) compared to the diet alone. Conclusions. These results demonstrate that consumption of an ad libitum, high-carbohydrate diet alone or in combination with aerobic exercise training results in weight loss and improved insulin sensitivity. Furthermore, exercise combined with this diet appears to limit additional increases in insulin sensitivity due to muscle glycogen supercompensation with a concomitant adaptive response of glycogen synthase.

The physical benefits of a functional exercise circuit are not well known in an elderly population. The purpose of this study was to evaluate the effect of a functional exercise circuit on mobility and perceived health in the elderly. Subjects were 119 men and women (aged 74 [[+ or -] 4.2] years) who received pre-and posttests of mobility (e.g., sit to stand, get up and go, timed walk), flexibility (sit and reach), and balance (standing reach) and who completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). A supervised functional exercise circuit that included 10 different upper- and lower-body exercises performed under time constraints was performed 3 times per week for 12 consecutive weeks. Paired t-tests showed significant differences at posttest for the get up and go (p < 0.001), standing reach (p < 0.001), sit and reach (p < 0.001), and selected items from the SF-36, including physical functioning (p < 0.001), pain (p = 0.001), vitality (p = 0.001), and number of doctor visits (p < 0.001). A functional exercise circuit such as the one employed in this study may offer promise as an effective means of promoting mobility and perceived health in older adults. Key Words. enhanced mobility, perceived health

Byline: V. S. Stel (1), S. M. F. Pluijm (1), D. J. H. Deeg (1), J. H. Smit (2), L. M. Bouter (1), P. Lips (1,3) Keywords: Aged; Cohort study; Disability; Fractures; Physical activity; Risk factors Abstract: Objective: This study examined whether three aspects of functioning (i.e., functional limitations, physical performance, and physical activity) were associated with fractures in older men and women. Design: A 3-year prospective cohort study. Participants and setting: A total of 715 men and 762 women, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam. Measurements: During an interview at home, three aspects of functioning were assessed: functional limitations (what people say they can do), physical performance, i.e., three performance tests and handgrip strength (what people are able to do), and physical activity (what people actually do). Afterward, a follow-up on fractures was conducted for 3 years. Results: 77 patients (5.2%) suffered a fracture during 3-year follow-up. Most patients suffered a hip fracture (1.6%) or a wrist fracture (1.4%). The fracture rate per 1,000 person-years was 20.1. During 3-year follow-up, a fracture was reported by 12%, 10%, 12%, and 6% of the respondents with functional limitations, low performance test score, poor handgrip strength, and low physical activity, respectively. Using Cox proportional hazard analysis, functional limitations (RR=3.5 95%CI, 2.1 to 6.0), low performance test score (RR=1.9 95% CI, 1.1 to 3.3), low handgrip strength (RR=2.5 95% CI, 1.5 to 4.1), and low physical activity (RR=1.9 95% CI, 1.1 to 3.5) were significantly associated with fractures after adjustment for age and sex. Functional limitations (RR=3.2 95% CI, 1.8 to 5.5), low performance test score (RR=1.8 95% CI, 1.0 to 3.3) and low handgrip strength (RR=2.0 95% CI, 1.1 to 3.6) remained significantly associated with fractures after additional adjustment for body composition, chronic diseases, psychosocial factors, life style factors, and the other levels of functioning. No significant interaction terms were found. Conclusions: Functional limitations and poor physical performance were independent risk factors for fractures. Author Affiliation: (1) Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands (2) Department of Sociology and Social Gerontology, VU University, Amsterdam, The Netherlands (3) Department of Endocrinology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands Article History: Registration Date: 27/01/2004 Received Date: 02/05/2003 Accepted Date: 22/01/2004 Online Date: 11/03/2004

The purpose of this study was to characterize the mechanical demands of the lower-extremity musculature during the standing forward lunge (FL) and the standing lateral lunge (LL) exercises performed by older adults. Twenty healthy older adults (9 men, 11 women, mean age 75.0 [+ or -] 4.4 years) performed FL and LL while instrumented for biomechanieal analysis. Lower-extremity net joint moments, powers, impulse, and mechanical energy expenditure were determined using standard inverse dynamics techniques. The FL preferentially targeted the hip extensors, producing a greater flexion angle (12.8%), peak joint moment (13.6%), joint power (56.5%), and mechanical energy expenditure (25.1%). Conversely, LL targeted the ankle plantar flexors, producing greater dorsiflexion angles (19.3%), joint moments (40.9%), impulse (87.0%), and mechanical energy expenditure (61.1%). Kinetic differences at the knee were less consistent. Fitness professionals may use this information to better match the biomechanical attributes of FL and LL activities with the needs of the trainee. KEY WORDS. strength training, functional exercise, mechanical energy expenditure, impulse

Background. As exercise is associated with favorable health outcomes, impaired older adults may benefit from specialized exercise interventions to achieve gains in function. The purpose of this study was to determine the added benefit of a spinal flexibility-plus-aerobic exercise intervention versus aerobic-only exercise on function among community-dwelling elders. Methods. We employed a randomized clinical trial consisting of 3 months of supervised exercise followed by 6 months of home-based exercise with telephone follow-up. A total of 210 impaired males and females over age 64 enrolled in this study. Of these, 134 were randomly assigned to either spinal flexibility-plus-aerobic exercise or aerobic-only exercise, with 116 individuals completing the study. Primary outcomes obtained at baseline, after 3 months of supervised exercise, and after 6 months of home-based exercise included: axial rotation, maximal oxygen uptake [Mathematical Expression Omitted]; functional reach, timed-bed-mobility; and the Physical Function Scale (PhysFunction) of the Medical Outcomes Study SF-36. Results. Differences between the two interventions were minimal. Overall change scores for both groups combined indicated significant improvement for: axial rotation (p = .0011), [Mathematical Expression Omitted], and PhysFunction (p = -.0016). Secondary improvements were noted for overall health (p = .0025) and reduced symptoms (p = .0008). Differences between groups were significant only for [Mathematical Expression Omitted] at 3 months with the aerobic-only group improving twice as much in aerobic capacity as the spinal flexibility-plus-aerobic group. Repeated measures indicated both groups improved during the supervised portion of the intervention but tended to return toward baseline following the home-based portion of the trial. Conclusions. Gains in physical functioning and perceived overall health are obtained with moderate aerobic exercise. No differential improvements were noted for the spinal flexibility-plus-aerobic intervention.

Older persons who are willing to begin exercise programs are often not willing to continue them. At the Atlanta FICSIT (Frailty and Injuries: Cooperative Studies of Intervention Techniques) site, individuals aged 70+ were randomized to Tai Chi (TC), individualized balance training (BT), and exercise control education (ED) groups for 15 weeks. In a follow-up assessment 4 months post-intervention, 130 subjects responded to exit interview questions asking about perceived benefits of participation. Both TC and BT subjects reported increased confidence in balance and movement, but only TC subjects reported that their daily activities and their overall life had been affected; many of these subjects had changed their normal physical activity to incorporate ongoing TC practice. The data suggest that when mental as well as physical control is perceived to be enhanced, with a generalized sense of improvement in overall well-being, older persons' motivation to continue exercising also increases.

The effect of a 9-month vigorous endurance exercise training on the glucose-stimulated insulin response and glucose disposal rate in 60- to 70-yearolds was assessed. Results showed that plasma insulin levels declined after theexercise program. Moreover, insulin action improved at levels usually found in young subjects. Thus, regular exercise can be effective in reducing hyperinsulinemia while improving insulin action.

Sar-co-PEE-nee-ah. It starts to set in around age 45, when muscle mass begins to decline at a rate of about 1 percent per year. This gradual loss has been tied [...]

The perceived psychological benefits and the mechanisms underlying the relation between exercise and psychological well-being are determined for a group of older adults participating in a program of resistance training. Self-efficacy and social interaction are found to be key mechanisms in the relationship between resistance training and enhancement of well-being.