Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 207

There is no age above which physical activity ceases to have benefits across a wide range of diseases and disabilities.^20,203 Insufficient physical activity and excess sedentary behaviour are lethal conditions; physical activity is the antidote, and geriatricians and other healthcare practitioners can serve as well‐educated leaders and role models in the effort to enhance functional independence, psychological well‐being, and quality of life through the promotion of exercise for all older adults, whether fit or frail, of any age.^19,20 Exercise should be prescribed, as is all other medical treatment, with consideration of patient risks and benefits; knowledge of appropriate modality and dose (intensity, frequency, volume); monitoring for drug interactions, benefits, and adverse events; and utilisation of the strongest possible behavioural medicine techniques known to optimise adoption and adherence. Given the dose‐response relationships demonstrated between the volume and intensity of physical activity engagement and disease treatment and mortality, recommendations focusing on simply reducing sedentary behaviour are insufficient as a robust treatment for common diseases/syndromes in this cohort, including depression, diabetes, peripheral vascular disease, sarcopenia/wasting syndromes, falls, osteoporosis, arthritis, chronic lung disease, Parkinson’s disease, stroke, cognitive impairment, functional decline, and frailty, for example. By contrast, the evidence is very strong for the benefits of a targeted exercise prescription and high levels of adherence as treatment for these and many other conditions.203 Since most patients will present with more than one disease, an efficient prescription to optimise both safety and efficacy as described in this chapter is required.