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"Exercise for middle-aged persons."
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The rise of over-40s fitness fanatics
Documents the rise of endurance events taking place around New Zealand, and the large numbers of middle aged people participating in them. Discusses the physical effects of ageing and the mental phenomenon of identity. Notes how certain events may galvanise people to exercise in challenging ways. Profiles multisport athletes Oamaru endurance coach Dougal Allan and Wellington ultra-marathon runner Fiona Hayvice. Covers the issues of addiction, costs, and how the older body seems suited to longer races. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
Newspaper Article
Fitness after 40 : your strong body at 40, 50, 60, and beyond
\"Includes a 6-week total-body workout program.\"
Book
A META analysis and systematic review of the effects of exercise interventions on middle-aged and elderly patients with depression
This study sought to conduct a meticulous systematic review, delving into the efficacy of exercise interventions on depressive symptoms among middle-aged and older adults. Additionally, we aimed to scrutinize the nuanced influence of various intervention factors on the intricate relationship between exercise and depressive symptoms within this demographic.
Our investigation involved an extensive search across multiple databases, including PubMed, Embase, Web of Science, and the Cochrane Library, spanning from the inception of these repositories to December 2023. Following a rigorous screening process, we identified and included 12 papers, encompassing a total of 994 subjects.
The meta-analysis unveiled a compelling overall effect size of exercise interventions on depressive symptoms in middle-aged and older individuals, represented by SMD = -0.41, with a 95% confidence interval of [-0.60, -0.22], and P < 0.0001. This statistical evidence underscores the significant and positive impact of exercise interventions on ameliorating depressive symptoms in this demographic. However, a degree of heterogeneity among studies was observed, with I2 = 48% and P = 0.03.
The comprehensive synthesis of outcomes elucidates the pronounced positive effect of exercise interventions in enhancing depressive symptoms among middle-aged and older adults. Specifically, the gentle and balanced exercise series emerges as particularly efficacious in mitigating depression. Furthermore, individual exercises stand out as more effective, with optimal results noted for moderate exercise sessions lasting 30 to 60 minutes. Our findings also highlight the superiority of short-term interventions, followed by medium- and long-term exercise interventions, in terms of efficacy. Nevertheless, recognizing the inherent heterogeneity and potential limitations of our study, we advocate for future large-scale, comprehensive investigations to validate these findings. Additionally, optimizing exercise intervention protocols necessitates a more nuanced understanding, urging further research endeavors to refine strategies aimed at improving depressive symptoms in middle-aged and older adults.
Journal Article
Pulmonary Rehabilitation in Patients Recovering from COVID-19
Background: In hospitalized patients recovering from the SARS-coronavirus-2 disease 19 (COVID-19), high prevalence of muscle weakness and physical performance impairment has been observed. Objectives: The aim of this study was to evaluate the effectiveness of pulmonary rehabilitation in these subjects in a real-life setting. Methods: Retrospective data analysis of patients recovering from COVID-19, including those requiring assisted ventilation or oxygen therapy, consecutively admitted to an in-patient pulmonary rehabilitation program between April 1 and August 15, 2020. Short Physical Performance Battery (SPPB: primary outcome), Barthel Index (BI), and six-min walking distance were assessed as outcome measures. Results: Data of 140 patients were analyzed. After rehabilitation, patients showed improvements in SPPB {from: (median [IQR]) 0.5 (0–7) to 7 (4–10), p < 0.001} and BI (from 55 [30–90] to 95 [65–100], p < 0.001), as well as in other assessed outcome measures. The proportion of patients unable at admission to stand, rise from a chair and walk was significantly reduced (p < 0.00). Conclusions: Pulmonary rehabilitation is possible and effective in patients recovering from COVID-19. Our findings may be useful to guide clinicians taking care of patients surviving COVID-19 infection.
Journal Article
Walking cadence (steps/min) and intensity in 41 to 60-year-old adults: the CADENCE-adults study
Background
In younger adults (i.e., those < 40 years of age) a walking cadence of 100 steps/min is a consistently supported threshold indicative of absolutely-defined moderate intensity ambulation (i.e., ≥ 3 metabolic equivalents; METs). Less is known about the cadence-intensity relationship in adults of middle-age.
Purpose
To establish heuristic (i.e., evidence-based, practical, rounded) cadence thresholds for absolutely-defined moderate (3 METs) and vigorous (6 METs) intensity in adults 41 to 60 years of age.
Methods
In this cross-sectional study, 80 healthy adults of middle-age (10 men and 10 women representing each 5-year age-group between 41 to 60 years; body mass index = 26.0 ± 4.0 kg/m
2
) walked on a treadmill for 5-min bouts beginning at 0.5 mph and increasing in 0.5 mph increments. Performance termination criteria included: 1) transitioning to running, 2) reaching 75% of age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed (i.e., hand tallied). Intensity (i.e., oxygen uptake [VO
2
] mL/kg/min) was assessed with an indirect calorimeter and converted to METs (1 MET = 3.5 mL/kg/min). A combination of segmented regression and Receiver Operating Characteristic (ROC) modeling approaches was used to identify optimal cadence thresholds. Final heuristic thresholds were determined based on an evaluation of classification accuracy (sensitivity, specificity, positive and negative predictive value, overall accuracy).
Results
The regression model identified 101.7 (95% Predictive Interval [PI]: 54.9–110.6) and 132.1 (95% PI: 122.0–142.2) steps/min as optimal cadence thresholds for 3 METs and 6 METs, respectively. Corresponding values based on ROC models were 98.5 (95% Confidence Intervals [CI]: 97.1–104.9) and 117.3 (95% CI: 113.1–126.1) steps/min. Considering both modeling approaches, the selected heuristic thresholds for moderate and vigorous intensity were 100 and 130 steps/min, respectively.
Conclusions
Consistent with our previous report in 21 to 40-year-old adults, cadence thresholds of 100 and 130 steps/min emerged as heuristic values associated with 3 and 6 METs, respectively, in 41 to 60-year-old adults. These values were selected based on their utility for public health messaging and on the trade-offs in classification accuracy parameters from both statistical methods. Findings will need to be confirmed in older adults and in free-living settings.
Journal Article
Full gas forever : a 40+ cyclist's guide to riding faster and further
Getting older does not mean getting slower. Improving your performance is achievable despite the advance of the years. If you are a midlife rider who wants to ride faster and for longer, 'Full Gas Forever' provides the complete guide. Ed Clancy OBE, a three-time Olympic gold-medal winning cyclist and stretching and flexibility expert Lexie Williamson, are the ideal people to guide you through the strategies, training, benefits and pitfalls of going full-gas in your fourth or fifth decade.
BOOK
Accelerometer-measured physical activity, frailty, and all-cause mortality and life expectancy among middle-aged and older adults: a UK Biobank longitudinal study
Background
Physical activity (PA) is associated with reduced frailty and lower mortality rates among middle-aged and older adults. However, the extent to which total PA volume and specific PA intensities are associated with mortality risk across frailty status remains unclear. We aimed to investigate the interactive effects of accelerometer-measured PA with frailty on all-cause mortality and life expectancy.
Methods
A total of 78,508 participants were sourced from the UK Biobank for analysis. Frailty index (FI) was used to assess frailty status. Physical activity and sedentary behavior were quantified through accelerometer measurements, capturing the total volume of physical activity (TVPA), moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), and sedentary time (ST). Cox proportional hazard models were applied to calculate adjusted hazard ratios (HRs) and predict life expectancy.
Results
During a median follow-up of 6.9 years, 2618 deaths (2.9%) were identified. Compared with robust and physically active counterparts, individuals characterized by frailty, combined with the lowest levels of TVPA (HR 3.05, 95% CI: 2.50–3.71), MVPA (HR 2.65, 95% CI: 2.19–3.21), LPA (HR 2.26; 95% CI: 1.81–2.83), or the highest level of ST (HR 2.08, 95% CI: 1.66–2.61), were found to have the greatest risk of all-cause mortality after comprehensive adjustment. The dose–response relationship, assessed using restricted cubic splines, consistently demonstrated that regardless of frailty categories, higher levels of TVPA, MVPA, and LPA were associated with lower mortality risks, while higher ST level was associated with increased risk. Notably, across the frailty spectrum, individuals in the low tertile of TVPA, MVPA, and LPA, or the top tertile of ST, were associated with reduced life expectancy, with this pattern being more pronounced among frail men compared to frail women.
Conclusions
Our findings highlighted the importance of increasing total PA volume, emphasizing MVPA and LPA, and reducing ST across the frailty spectrum to improve life expectancy.
Journal Article