Exercise for Disease Prevention in the Geriatric Population

Old age does not mitigate the importance of disease prevention as a primary therapeutic goal of healthcare practitioners. The rationale for the use of exercise as one way to achieve this goal rests upon the relationship of physical activity to a wide variety of chronic diseases, its role in risk‐factor reduction, its relationship to frailty, and its intersection with psychological health, nutritional status, and other health‐related behaviors. Evidence for the efficacy of exercise as a preventive strategy in the geriatric cohort comes from both large epidemiological studies and randomized clinical trials. The most promising are!as of benefit have to do with falls, type 2 diabetes, stroke,! coronary heart disease, osteoporosis, obesity, and depression. Primary‐prevention trials in healthy elders remain to be conducted for some disease outcomes; the same is true for vulnerable cohorts at high risk of incident disease, as there is a paucity of well‐designed clinical trials in those over the age of 75. Current knowledge suggests that various elements of the exercise prescription for disease prevention in the older adult should be individualized depending on patient profile and treatment goals. Variable emphasis on aerobic, resistive, and balance exercises is recommended, given the physiological specificity of adaptations to these modalities of activity. Concomitant behavioral strategies specific to sedentary elders and adapted to individual pragmatic needs, barriers to exercise adoption, and adherence are critical to the success of the exercise prescription in this setting.