The elderly population in developed countries is growing at an alarming rate. Age-related physiological deterioration together with onset of certain disorders ultimately cause a progressive decrease in the functional capacities of the body. This represents a social problem and an increased demand for resources in response to these requirements. The functional decadence due to aging causes the individual to experience limitations to execute daily activities that require the use of instrumentation: household appliances, walks outside the home, use of public transportation, preparation of meals, management of money, and electronic apparatus use, among others. In the most severe cases, this can give rise to a functional incapacity, where the individual is not self-sufficient to eat, dress, bathe, take proper decisions, etc., ultimately becoming dependent on others to perform the tasks. On the other hand, recent investigations demonstrate the benefits that regular physical exercise can exert in the elderly. For example, it can improve and/or reduce certain pathologies, mainly those that appear due to a sedentary lifestyle, which is the main cause of morbidity and mortality in Europe. These pathologies include obesity, cardiac disease, colon cancer, type 2 diabetes, high cholesterol and triglycerides in blood, muscular and nervous system dysfunction, and bone structure alteration (especially the lower extremities, mainly the hip). Regular physical activity can also help maintain functional skills and preserve physical capabilities, allowing the person to be more independent for a longer period of time and thus have a more acceptable quality of life. All these benefits would also imply a reduction in sanitary costs.
It is the responsibility of the physician and health-takers to evaluate the level of physical-functional capabilities and general state of health of the elderly before initiating a physical program. In these programs, the supervision by professionals of Sports and Physical Activity Sciences is vital, as they possess the necessary knowledge in terms of physical exertion physiology as well as the tools to support and endorse health in adults over 60 years of age.
According to WHO recommendations for the elderly, practicing recreational activities, household tasks, games, sports or programmed exercises in the context of daily activities (walk, bicycle riding, dance, climb stairs) regulates the energetic balance and decreases the risk of developing the disorders previously commented.
It is recommended that adults over 65 years of age dedicate 150-300 minutes a week to moderately aerobic daily activities, or 75-150 minutes of vigorous physical activity, or a combination of both. The activity must be performed in sessions of at least 10 minutes. Finally, the adults of this age group with reduced mobility should perform physical activities that improve their balance and avoid falls, at least 3 days a week. When the individual is not capable of performing certain daily activities due to his/her state of health, it is necessary to perform physical exercises in order to retain the skills they still possess.
In this sense, and considering the general recommendations previously described, the WHO considers that the majority of the elderly are capable of performing an adequate physical program, considering their general state of health, which can be divided into 3 groups:
- Group III. Physically active individuals, theoretically healthy and capable of performing daily activities. They can participate in a large variety of physical activity programs, including those performed during their youth.
- Group II. Individuals that do not perform regular physical activities, but maintain their independence. They are at risk to develop various chronic degenerative disorders that can limit their independence. In this population it is possible to introduce individualized regular intensity programs considering their limitations and disabilities, in order to maintain their independence.
- Group I. These individuals have lost their functional independence due to physical or psychological reasons. In this case, it is possible to develop an appropriate program that can improve their quality of life as well as partially restore lost functionality. Occasionally, it is necessary to implement assisted exercises in their bed or wheelchair.