Exercise beneficial and safe for older people with multiple chronic conditions or risks

A recent study shows exercise is also beneficial and safe for older people with multiple chronic conditions or risk factors. Exercise can improve physical fitness despite chronic diseases. However, exercise should be started safely and at an intensity appropriate for your starting level.

A study conducted at the University of Jyväskylä, Finland, found that physical activity increased while aerobic endurance, muscle strength, and power improved during a year-long multicomponent exercise intervention in older people between the ages of 70 and 85 who had previously been sedentary. Chronic diseases and their risk factors explained up to 12% of the differences in physical activity and fitness between participants at baseline, but no more than 3% of the changes during the exercise program.

It was great to see that the benefits of exercise were not much affected by multimorbidity."

Tiina Savikangas, postdoctoral researcher 

Increased physical activity and improved fitness can in turn improve overall health and functional capacity despite chronic diseases.

Typically, multimorbidity is considered as the presence of two or more chronic diseases or their risk factors in the same individual. However, this does not take into account the differential impact of different diseases on, for example, general health and mobility. In this study, all chronic diseases and their risk factors were investigated as a cluster. This new approach allowed the researchers to consider not only the overall impact of multimorbidity but also the independent importance of diseases and risk factors.

"We found that the effects of different diseases on physical activity and fitness varied," says Savikangas. "However, most of the diseases did not significantly affect the development of physical activity or any of the domains of physical fitness during the study, which was a positive surprise for us."

The physical activity recommendations for people over 65 urge everyone to be as active as their health and functioning allow. However, when starting to exercise, it is important to take chronic conditions into account and to ensure that you start at a safe level of activity that is appropriate for your starting level. Participants in the study had a health examination before starting to exercise and the strength, endurance and balance training program was deemed safe for them.

"Everyday physical activity is good for everyone, and everyone can find a rewarding way to exercise," says Savikangas.

"Before you start exercising, however, be sure to ask for support from a health care professional. Some municipalities may even have a sports advisory service to help you get started."

The PASSWORD study was conducted at the Faculty of Sport and Health Sciences and the Gerontology Research Centre at the University of Jyväskylä, Finland, from 2017 to 2020. The study involved 314 men and women aged 70 to 85 years who were less active than recommended before the study started. All participants took part in a progressive exercise program that included muscle strength, aerobic endurance, balance, and mobility training. Half of the subjects participated in a computerized executive functions training program in addition to the exercise program. Physical activity was assessed by questionnaires at baseline, then after six and twelve months of training, and, finally, one year after the end of the intervention. In terms of physical fitness, aerobic endurance was measured by the six-minute walking test, muscle strength by the maximal isometric knee-extension strength test, and muscle power by the five-time chair-stand time. Aerobic endurance and muscle power were measured before the start of the exercise program, after six and after twelve months of training. Muscle strength measurements were taken at baseline and after the end of the intervention. Professor Sarianna Sipilä, Professor of Exercise Gerontology, led the PASSWORD study. The study has been funded by the Academy of Finland.