The age-related decline can be at least partially attributed in many cases to lifestyle, behavior, diet and environmental factors and thus influences. For example, aerobic fitness sport can a drop in the maximum performance (O2 consumption per unit of time or V2 max), muscle strength and prevent glucose tolerance in healthy but sedentary elderly voriwegend or make partially reversed (see Fig. Training).
Most age-related biological functions reach their maximum before age 30 and then take it straight (see Table: Selected age-related physiological changes); critical of the reduction in stress may be, but usually it has little or no influence on the Alltägsaktivitäten. Therefore, more interference than the normal aging process, the main reason for a loss of function in old age. The age-related decline can be at least partially attributed in many cases to lifestyle, behavior, diet and environmental factors and thus influences. For example, aerobic fitness sport can a drop in the maximum performance (O2 consumption per unit of time or V2 max), muscle strength and prevent glucose tolerance in healthy but sedentary elderly voriwegend or make partially reversed (see Fig. Training). Only about 10% of older people are regularly 5 times a week> 30 minutes (a common recommendation) physically active. Approximately 35-45% are minimally active. Seniors tend number of reasons to be less than people of other age groups actively, therefore, most frequently because disease limit their physical activity. Physical activity for older people offers many benefits that the risks far exceed (z. B. falls, torn ligaments, sprains). The benefits are Decreased mortality rates, even for smokers and severely obese preservation of skeletal muscle strength, aerobic capacity and bone density that contribute to greater mobility and independence Reduced risk for obesity prevention and treatment of cardiovascular diseases (incl. Rehabilitation after myocardial infarction), diabetes , osteoporosis, colon cancer and psychiatric disorders (particularly mood disorders) prevention of falls and related injuries by improving muscle strength, balance, coordination, joint function and endurance improved functionality opportunities for social interaction improved perception of well-being may improve sleep quality Physical activity is one of the few interventions to How the manufacture of physiological performance after they had already been lost. Training Training is usually made to move, resulting in an aerobic consumption and an increased heart rate result, and because it is an important activity with numerous positive effects for many people means. Older people, in particular> 70 years, benefiting from mild physical activity (such as walking, gardening.); therefore, physical activity, recommended without aerobic consumption or circulatory reaction, even people with limited mobility. At the start of a training program, all elderly patients should have a screening through (interview or questionnaire) to identify those with chronic conditions and establish appropriate activities; However, almost anyone can start with short periods of walking, which is increased to 30 minutes 5 times / week. Physical activity is for only a few elderly people (eg. As with unstable disease) is not suitable. Whether the chronically ill need a complete medical examination before starting the activity will depend on the results already carried out tests and clinical assessment. Some experts recommend such an investigation, possibly with a stress test in patients with ? 2 cardiac risk factors (eg. As hypertension, obesity) who want to start an activity or that is more strenuous than walking. Strengthening the muscles, balance training (. For example, Tai Chi) and motility endurance: Training programs that are harder than walking, any combination of 4 types of exercise may include. The combination of the recommended exercises depends on the patient’s symptoms and his fitness level. An exercise program while sitting, the ankle weights for strength training and repetitive motion used for endurance training, such can. For example, be useful for patients who have difficulty in standing and walking. A water aerobics program can be recommended to all guests for patients with arthritis. Patients should be able to choose activities in which they have fun, but they should be encouraged to include all four types of exercise. Of all the types of exercise has endurance training (eg. As walking, cycling, dancing, swimming, low-impact aerobics) the highest well-documented health benefits for the elderly. Some patients, especially those with heart disease (eg. As angina, myocardial infarction ? 2), require medical supervision during training. Intensive muscle strengthening programs are particularly suitable for frail or elderly patients with sarcopenia. pneumatic exercise machines are more useful for these patients as devices that use weights, because the resistance can be set lower and changes in smaller steps. Intensive programs are safe even for residents> 80 years whose strength and mobility can thus be significantly improved. However, these programs are time-consuming because the participants have detailed care generally. Drugs and Training: doses of insulin and oral hypoglycemic agents in diabetics may need to be adjusted in accordance with the anticipated motion to prevent hypoglycemia during exercise. Dosages of drugs that can cause orthostatic hypotension (z. B. antidepressants, antihypertensives, hypnotics, anxiolytics, diuretics) need to be lowered in order to avoid exacerbation of the orthostasis by fluid loss during exercise. For patients who are taking these drugs, adequate hydration during exercise is crucial. Some sedative hypnotics can reduce the physical performance by reducing the level of activity or by suppressing of muscles and nerves. These and other psychotropic drugs increase the risk of falling. The discontinuation of such drugs or reducing their dose may be necessary in order to make the training safe and helping patients to follow their training schedule. The uncontrollable effects of aging can therefore be less dramatic than expected, and a healthier, more active aging can be possible for many people. Nowadays, people are> 65 years in a better state of health than their ancestors, and they stay longer healthier. Selected age-related physiological changes Affected organ or organ system Physiological changes Clinical manifestations composition of the body ? lean mass of the body ? muscle mass ? Kreatininproduktion ? skeletal mass ? total body water ? percentage of fat (up to the age of 60 years, then ? until death) changes in drug levels (in the rule ?) ? force tendency to dehydration cells ? ? DNA damage and DNA Repar aturkapazität ? Oxidative capacity Beschleuinigte cell aging ? ? fibrosis lipofuscin accumulation cancer risk CNS ? number of dopamine receptors ? ? alpha-adrenergic reactions Muscarinic parasympathetic reactions tendency to Parkinson’s symptoms (eg. B. ? muscle tone, ? arm swing) ear hearing loss for high frequencies ? capability of the voice recognition Endocrine System ? insulin resistance, and glucose intolerance ? incidence of diabetes menopause, ? estrogen and progesterone ? testosterone secretion ? growth hormone secretion ? Vitami-D-absorption and activation ? incidence of thyroid abnormalities in bone demineralization ? ? ADH secretion in response to stimuli osmolar Vaginal dryness, dyspareunia ? muscle mass ? bone mass ? fracture risk lesions tendency to water intoxication eyes ? flexibility of the lens ? pupillary reflex time (narrowing, widening) ? incidence of cataracts presbyopia ? glare and difficulties in adapting to changes in lighting ? acuity gastrointestinal tract ? Splanchnischer blood flow ? transit time tendency to constipation and diarrhea heart ? Intrinsic and maximum heart rate Abgestump fter baroreflex (smaller increase in heart rate in response to a drop in blood pressure) Diastolic ? relaxation ? atrioventricular conduction time ? Atrial and ventricular ectopy tendency to syncope ? ejection fraction ? rate of atrial fibrillation ? rate of diastolic dysfunction and diastolic heart failure immune system ? T-cell function ? B -cell function Increased susceptibility to infections and possibly cancer ? antibody response to immunization or infection, but ? ? autoantibodies joints degeneration of cartilage tissue fibrosis glycosylation and cross-linking of the Kol lagens loss of tissue elasticity stiffening of joints tendency to osteoarthritis kidney ? renal blood flow ? Renal mass ? Glomerular filtration ? renal tubular secretion and reabsorption ? ability to excrete a free Wassermege changes in drug levels with ? risk of adverse drug reactions tendency for the dehydrogenation liver ? liver mass ? blood flow in the liver ? activity of CYP 450 enzyme system changes in drug levels nose ? odor ? taste and consequently ? appetite ? probability of epistaxis (easy) Peripheral Nervous System ? baroreflex responses ? beta-adrenergic Reponsivität and number of receptors ? signal transduction ? Muscarinic parasympathetic reactions Conserved alpha-adrenergic reactions tendency to syncope ? in response to beta-receptor blockers Überschießendne response to anticholinergics respiratory system ? ? vital capacity lung elasticity (compliance) ? ? residual volume FEV1 ? V / Q mismatch ? probability Kurzatmigk ince in strenuous exercise when the people usually located predominantly or if the exercise is done at high altitude ? risk of death from pneumonia ? risk of serious complications (eg. B. respiratory arrest) endothelin-dependent in patients with lung disease vasculature ? ? vasodilation peripheral resistance decreased tendency towards hypertension ? =; ? = increased; FEV1 = forced expiratory volume in 1 s; V / Q = ventilation / perfusion. Adapted from the Institute of Medicine: Pharmacokinetics and Drug Interactions in the Elderly workshop. Washington DC, National Academy Press, 1997, pp. 8-9.