Older age - opportunity and challenge
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Older age - opportunity and challenge
Dr John Searle
Chief Medical Officer
Fitness Industry Association (UK)
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Who are we talking about?
• Transition: 50 - 64
• Older: 65 - 75
• Oldest: > 75
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How many are we talking about?
• In the UK:
2009:
over 65: 9.6m
over 85: 1.4m
2015:
Over 65: 12.7m
Over 85: 1.8m
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EU: ageing population
65+• 2008: 84.6m• 2060: 151.5m
80+• 2008: 21.8m• 2060: 61.4m
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Health of older people in UK
• 65 to 74: 60% have a chronic illness
• 75+ 64% have a chronic illness
• 1:4 men and 1:3 women over 65 have a fall each year
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Physiology of ageing
Decrease in:• aerobic capacity• cardiac output• lung function• renal function• muscle bulk and strength• cognitive function• motor skills
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Diseases in older age
• Heart disease
• Strokes
• Cancer
• Arthritis
• Depression
• Dementia
• Falls - fractures
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Falls
• 30% of 65+ have a fall
• 50% they are recurrent
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Fractured neck of femur
• annual UK: 70,000• Hospital death rate:
4-11%• deaths at 1 year: 30%• 45% need community
support• 14% go to falls
prevention clinic
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Dementia
• 820,000 cases of dementia
• 1:3 >65 will suffer from some form of dementia
• Annual cost of care is £23 billion
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Outcome
• failing health
• decreased mobility
• loss of family and social interaction
• increasing dependence
• increasing demands on health care and social services
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What is the answer?EXERCISE!
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Exercise in older people: general advantages
• maintains independence
• increases social interaction
• maintains cognitive function
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Exercise in older people: specific advantages
Decreases the risk of:• depression• dementia• diabetes• heart attack & stroke• bowel cancer• falls
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Exercise in older people: specific advantages
Improves:• CV fitness• muscle strength &
endurance• motor function• sense of well being
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Exercise in diseases in older age
• Heart disease
• Strokes
• Cancer
• Arthritis
• Depression
• Dementia
• Falls - fractures
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Exercise in older people
• Maintains health and independence
• Plays a vital part in the treatment of long-term disease
• Keeps people out of hospital
• Speeds recovery
• Reduces NHS and social service expenditure
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3 case histories
• Long standing rheumatoid arthritis
• 84 and trained at home
• 73 year old psychiatrist
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Exercise in rheumatoid arthritis
Improves:• aerobic fitness• joint range of movement• muscle strength and endurance• and therefore:
function
activity
independence
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What have you got in the house?
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After cancer
• Surgery x 2 + chemotherapy x 2 over 18 months
• tired• depressed• lethargic
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After cancer - what did we do?
• Walking
• Increasing ADL’s
• Gently in the gym- all the component of fitness
• Increasing volume of exercise (duration x intensity) over 6 months
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ACSM / BASES
Recommendations (2008 / 2010)• 150 minutes/week of moderate intensity
aerobic exercise or 75 minutes of vigorous exercise
• 2-3 strength training sessions per week• motor function exercises• stretching
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Recommendations
How can these be achieved?
Increase in ADL and activity - ‘think outside the box’
Planned, structured, supervised, monitored exercise
Recommendations
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The opportunity: older people
• An ageing population presents the fitness industry with a massive opportunity!
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What does the fitness sector need to do?
• skilled trainers
• good customer service
• appropriate facilities
• provide social interaction
• work with doctors and health professionals
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Key questions
• Will we grab the commercial opportunity which also provides a public service?
• Do we want to?