As any usual FISSAC reader will know, the lifestyle and specifically remain physically active is an cornerstone to achieve healthy aging. There is no doubt: people who remain active throughout life are more likely to age better, including developing less long -term pathologies and maintaining their functional and cognitive independence. For example, we know that athletes called "Master" (people who continue to compete from 40 years or older) manage to slow down the physiological deterioration that occurs in virtually all organism systems with age. These people have a better cardiovascular health and a better cardiorespiratory function - even to that of young people who do not play sports - than people of the same age who are sedentary, a better neuromuscular function, or even a better immune function (1) ( Figure 1 ). Having exercised throughout life provides a kind of elixir of youth that, although it does not avoid the effects of aging, it does serve to mitigate its effects and delay to the extent possible that threshold of fragility that stalks us in recent years of life.

Figure 1. Benefits of physical exercise throughout life at the multi-systemic level.

But not everyone stays active throughout life. Many of us know people who, after decades of sedentary lifestyle and life habits, begin to worry about their health at an already advanced age. That in the best case, since many other older people with the same sedentary lifestyle allude to that it is already too late to change lifestyle. If you have reached old age keeping that lifestyle, is it worth changing it now? Can benefits be obtained at the beginning of an advanced age? I imagine that, if you usually read Fissac, you know the answer: yes resounding.

It is never too late to become active

Although most of the scientific evidence has focused on the effects of physical activity levels at an intermediate age (40-60 years) in the evolution of different health indicators in the subsequent years, more and more studies analyze what They are called physical activity trajectories. That is, they analyze not only what is done at a concrete age, but how these habits evolve over time. This is the case for example of the so -called "longitudinal English Study of Ageing" (2) . This study included more than 3,000 participants with 65 years on average, and not only their levels of physical activity were evaluated at the beginning of the study, but also evaluated at the end of the monitoring period, 8 years later. The most classic analysis found something that does not surprise us at this point: people who were physically active at age 65 were between two and four times more likely to aging healthy (defined in this case as aging without cardiomethabolic pathologies, depression, or deterioration physical or cognitive) that those that were inactive. But the result that interests us most in this case comes from an additional analysis. The authors observed that those people who were physically inactive at age 65, but became physically active in later years, also had three times more likely to aging healthily compared to those that had remained inactive throughout the follow -up ( Figure 2 ).

Figure 2. Association between different physical activity trajectories since the age of 65 and the possibilities of aging in a healthy way. Adapted figure of Hamer et al. (2) .

These results show that it is never too late to reth times more likely than those that had remained inactive). And if becoming active at age 65 you do not think enough, a study by Spanish researchers shows us even more striking results. In this study they analyzed more than 1,600 people with 75 years on average, and observed that those who were physically inactive at the beginning of the study but began to perform physical activity in the subsequent years had less than half of the risk (-62%) of losing their functional independence during the 3 years later compared to those who were and remained physically inactive (3).

You are never too fragile to do physical exercise

And it seems that the benefits of physical exercise do not escape almost any population. That suggests at least numerous studies that have shown that, even at the most advanced age, participating in an exercise program not only attenuates functional deterioration, but can still continue to obtain improvements. One of the most striking examples of improvements to the most advanced age is at the Frenchman Robert Marchand, who with 101 years and after training more than 5,000 km by bicycle for 2 years, managed to improve his record of the time by bicycle in a 11 %, its maximum oxygen consumption by 13%, and its peak power in 39%( Figure 3 ) (4).

Figure 3. Changes in the physical form of Centenary Robert Marchand after two years of training. Adapted figure of Billat et al. (4).

Ok, we can say that the case of Marchand is an isolated example of a "super-connantary", but that at that ages it is normal to have a high level of dependence and fragility. In this sense, there is also evidence that even very old and fragile people can continue to obtain improvements. For example, a study led by researcher Alejandro Lucía and geriatric force, mainly including leg press) was sufficient to increase significantly (10 kg of average increase in maximum force) the strength of these patients, which decreased in the elderly who did not participate in this program ( Figure 4 ) (5). And not only that, that improvement in leg force also resulted in a lower risk of falls. Along the same lines, other studies have shown that in very old people (> 90 years) and fragile physical exercise can also improve strength, power or muscle mass, which has repercussions on functionality (eg, eg, in the ability to walk independently or to get up from the chair) and in the risk of falls (6). Even in very old people (> 85 years on average) and hospitalized, which probably means one of the most risky moments of functional deterioration, physical exercise has been beneficial (7–9).

Figure 4. Effect of an exercise program on the press force of fragile nonagenarians who lived in residences. Adapted from Serra-Rexach et al. (5).

Conclusions

We often alluded to numerous reasons not to be physically active or not have a healthy lifestyle in general: time shortage, economic resources, motivation ... Among these reasons, many people believe that they are already too old or too fragile to obtain Benefits of changing your way of life. As we see, it is never too late to rethink our habits and become physically active, being able to obtain benefits even at the most advanced age or when we are physically dependent.

References:

1. McKendry J, Breen L, Shad BJ, Greig Ca. Muscle Morphology and Performance in Master Athlets: A Systematic Review and Meta-Analys. Ageing Res Rev. 2018; 45 (January): 62–82.
2. HAMER M, LAVOIE KL, BACON SL. Taking Up Physical Activity in Later Life and Healthy Ageing: The English longitudinal Study of Ageing. BR J Sports Med. 2014; 48 (3): 239–43.
3. Sanchez-Sanchez JL, Izquierdo M, Carnicero-Carreño Ja, García-García FJ, Rodríguez-Mañas L. Physical Activity Trabectories, Mortality, Hospitalization, and Disability in the Toledo Study of Healthy Aging. J Cachexia Sarcopenia Muscle. 2020; 11 (4): 1007–17.
4. Billat V, Dhonneur G, Mille-Hamard L, Le Moec L, Momken I, Launay T, et al. Maximal Oxygen Consumption and Performance in A Centenarian Cyclist. J Appl Physiol. 2017; 122 (3): 430–4.
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7. Valenzuela P, Morales J, Castillo-García A, Butler-Cava J, García-Hermoso A, Izquierdo M, et al. Effects of Exercise Interventions on the Functional Status of Acotely Hospitalised Older Adults: A Systematic Review and Meta-Analysis. Ageing Res Rev. 2020; 61: 101076.
8. Martínez-Velilla N, Casas-Herrero N, Zambon-Ferraresi F, López Sáez de Asteasu M, Lucia A, Galbete A, et al. Effect of Exercise Intervention on Functional Decline in Vry Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial. Jama Intern Med. 2019; 179 (1): 28–36.
9. Ortiz-Alonso J, Bustamante -ra N, Valenzuela PL, Vidán M, Rodríguez-Romo G, butler-cava j, et al. Effect of to simple exercise program on hospitalisation-asociated disability in Older Patients: A Randomized Controlled Trial. Jamda 2020; 21 (4): 531–7.