Exercise holds the key to improved physical function in older adults in residential care

A study published in The Lancet Healthy Longevity describes the effects of physical exercise on the physical function of older adults staying in residential care facilities.

Study: Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. Image Credit: belushi / ShutterstockStudy: Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. Image Credit: belushi / Shutterstock

Background

Declining physical function is one of the major challenges experienced by older adults in their daily life. Healthy aging, according to the World Health Organization (WHO), is characterized by the preservation of physical and mental capacities over time.

An inverse correlation exists between physical function and the risk of various age-related health outcomes, including hospitalization, admission to residential care, and mortality. Unfortunately, no pharmacological intervention is available to prevent physical decline in older adults. However, evidence suggests a potential role of routine physical exercise in preventing age-related physical decline and improving physical function.

The proportion of older adults staying in residential care facilities is increasing globally. Functional dependency, multimorbidity, and polypharmacy are common problems among older people. Moreover, they mostly live a sedentary life with minimal physical activity, which further worsens their physical capabilities.

This systematic review and meta-analysis of randomized controlled trials have been done to understand the impact of routine physical exercise on the physical function of older adults staying in residential care facilities.

Study design

Various scientific databases were searched to identify randomized controlled trials investigating the effect of physical exercise on physical function (functional independence, physical performance, and other related parameters) in older adults aged 60 years and above who are staying in residential care facilities. Studies published up to mid-January 2023 were included in the systematic review.

The outcomes of physical function that were reported in at least ten studies were included in the meta-analysis. Moreover, subgroup analyses were conducted to determine the marginal effects of the intervention (exercise type, training volume, and duration of intervention) and the study population (cognitive and functional status) characteristics.

Important observations

A total of 147 randomized controlled trials, with 12,059 participants in total, were included in the systematic review. The participants (age range: 67 – 92 years) were staying in long-term care facilities, assisted living facilities, or congregate housing for older adults.

The participants conducted physical exercises under expert supervision for 4 – 96 weeks. The interventions included 1 – 7 sessions per week, with a session duration of 8 – 90 minutes. In most of the studies, a combined intervention including two or more types of exercises (mobility, balance, endurance, and resistance exercises) was implemented.   

The interventions applied to the control group participants included social, cultural, or musical activities or low-intensity exercises. The overall quality of the included studies was good.

A total of 105 good-quality studies were included in the meta-analysis. The findings revealed that exercise interventions significantly improve the physical function of older adults compared to usual care.   

The findings of subgroup analyses identified the most significant effect of physical exercise among older adults staying in nursing homes. Moreover, a moderate-to-large effect of exercise intervention was observed among older adults with cognitive impairment, functional dependence, or age-related weakness (frailty).

The beneficial effects provided by exercise intervention were comparable across all exercise types. The largest effect size was observed for balance exercises; however, this data suffered a significant degree of inaccuracy.

Among all exercise types, endurance training provided the most consistent benefits. The findings of the ranking analyses indicated that endurance training is the most likely to be effective.       

Exercising for 110 minutes per week provided the most consistent benefits. Similarly, the highest benefit was observed with 170 minutes of exercise per week. However, this data also suffered a significant degree of inaccuracy.

Study significance

This systematic review and meta-analysis highlight the importance of physical exercise in improving the physical function of older adults staying in residential care facilities, irrespective of their functional and cognitive abilities. The benefits they get from exercise include functional independence for daily-life activities and improvements in muscle strength, physical performance, balance, and flexibility.

Based on these findings, scientists recommend routine implementation of exercise interventions in long-term care facilities.

Journal reference:
Dr. Sanchari Sinha Dutta

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.

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