The need to reduce age-related morbidity and improve functional independence among older adults living with disabling diseases is a major public health priority.
A sedentary lifestyle results in numerous physiologic and functional declines with aging that increase the risk for disease. In addition to a sedentary lifestyle, the propensity for weight gain and obesity with aging in sedentary older people are strongly associated with the development of hypertension, hyperlipidemia, and insulin resistance, which are risk factors for cardiovascular disease (CVD).
The need to reduce age-related morbidity and improve functional independence among older adults living with disabling diseases remains a major public health priority. The ability to ambulate and perform activities of daily living are requisite for independent functioning. Older people who lose mobility have a poorer quality of life, higher rates of comorbidity, nursing home admission, hospitalizations, and death, and higher health care costs. Physical disability is most often caused by chronic diseases with multimorbidity such as Parkinson’s disease, vascular disease, diabetes, and arthritis, or by acute events such as stroke and hip fracture. Regardless of etiology, deconditioning, sarcopenia, cognitive decline, fatigue, and physical inactivity represent common pathways associated with the onset and progression of physical disability in older individuals.
There is ample evidence that exercise training benefits the health of older persons. Exercise improves cardiovascular fitness and body composition (e.g., increasing muscle mass and bone density and reducing fat mass) as well as having numerous metabolic benefits (e.g., reducing blood pressure and cholesterol and improving glucose metabolism). The reduced risk for age-related CVD with regular physical activity suggests that people should sustain activity habits as they age. There also is evidence that in addition to its preventive benefits, regular aerobic exercise effectively rehabilitates older people with chronic cardiovascular and musculoskeletal diseases. Age-related functional decline is accelerated by acute events by disabling conditions (e.g., stroke, hip fracture, arthritis, peripheral arterial disease) and chronic disease (e.g., cardiovascular disease, diabetes). These conditions predispose a multisystem decline that severely reduces functional independence and quality of life.
The University of Maryland Older Americans Independence Center (UM-OAIC), established in 1994 by Dr. Andrew Goldberg, recently was renewed and is going on Year 28, a testament to those involved in this prestigious center. There are 15 OAIC Claude D. Pepper Centers in the country that are supported by the National Institutes of Health’s National Institute on Aging. The overarching goal of UM-OAIC is to accelerate the development of meaningful interventions to improve disability-related functional declines in older individuals.
Evidence from studies by UM-OAIC investigators and others has linked the benefits of exercise to a reduction in the inflammation and endocrine-metabolic dysfunction that accompany disabling conditions in the older adults. These works inform our overarching hypothesis that exercise, activity-based, and multimodal rehabilitation can improve multiple physiological systems in older mobility-limited individuals, which in turn can improve functional performance, reduce cardiometabolic disease risk, and prevent functional decline. UM-OAIC will continue to develop, implement, and evaluate rehabilitative strategies that are designed to improve and restore mobility and functional independence in older persons with disabling conditions.
There are many research studies of aging and exercise rehabilitation occurring at the University of Maryland, Baltimore and the Baltimore Veterans Affairs (VA) Medical Center. These studies include, but are not limited to, exercise rehabilitation for older overweight adults, lung cancer survivors, people living with HIV, those at risk for falls, and stroke survivors.
For more information on UM-OAIC, go to medschool.umaryland.edu/peppercenter.
For additional questions about ongoing aging studies, please contact Anne Sullens at asullens@som.umaryland.edu.
Alice Ryan is a professor of medicine and a VA senior research career scientist in the Division of Gerontology and Geriatric Medicine at the University of Maryland School of Medicine.
Disclaimer: Elm Voices & Opinions articles reflect the thoughts or opinions of their individual authors, and may not represent the thoughts or values of UMB as an institution.