Bewegung, körperliche Aktivität und Alter

Zusammenfassung

Durch den demografischen Wandel und die steigende Lebenserwartung werden altersassoziierte Erkrankungen in den kommenden Jahrzehnten immer präsenter. Körperliche Aktivität und körperliches Training stellen in diesem Kontext wirksame Maßnahmen dar, um die Erkrankungsraten einzudämmen und Betroffene im Umgang mit ihrer Erkrankung zu unterstützen. Gerade bei älteren Menschen, die ein erhöhtes Sturzrisiko besitzen, kann körperliches Training dem Risiko entgegenwirken und darüber hinaus sturzassoziierte Verletzungen und Frakturen reduzieren. Es konnte gezeigt werden, dass Training und körperliche Aktivität auch eng mit der Mortalität assoziiert sind und insbesondere Menschen mit Vorerkrankungen davon profitieren. Um die Effekte der Bewegung zusätzlich zu verstärken, hat sich in vielen Studien die Supervision als wichtiger Moderator herausgestellt. Eine professionelle Betreuung kann also dabei helfen, die positiven Auswirkungen von körperlicher Aktivität und Training weiter zu maximieren.

Abstract

Demographic change and increasing life expectancy are prognosed to lead to more prevalence of age-associated diseases in the coming decades. In this context, physical activity and physical training are effective measures to curb disease rates and support those affected in managing their condition. In particular, older people have an increased risk of falling and physical training can counteract the risk as well as reduce fall-associated injuries and fractures. Data shows that training and physical activity are also closely associated with mortality and people with pre-existing conditions in particular benefit from them. In order to enhance the effects of exercise, supervision has proven to be an important facilitator in many studies. Professional care can therefore help to further maximise the positive effects of physical activity and training.

Publication History

Article published online:
12 October 2023

• Literatur

• 1 DeStatis. Bevölkerung nach Altersgruppen 2011 bis 2021 in Prozent. In. 2023
• 2 Bomsdorf E. Life expectancy in Germany until 2050. Experimental Gerontology 2004; 39: 159-163
• 3 DeStatis. Zusammengefasste Geburtenziffer nach Kalenderjahren. In. 2023
• 4 Bull FC, Al-Ansari SS, Biddle S. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine 2020; 54: 1451-1462
• 5 Marques A, Peralta M, Martins J, de Matos MG, Brownson RC. Cross-sectional and prospective relationship between physical activity and chronic diseases in European older adults. International journal of public health 2017; 62: 495-502
• 6 Manz K, Mensink GB, Jordan S. et al. Predictors of physical activity among older adults in Germany: a nationwide cohort study. BMJ open 2018; 8: e021940
• 7 Richter A, Schienkiwitz A, Starker A. et al. Gesundheitsfördernde Verhaltensweisen bei Erwachsenen in Deutschland–Ergebnisse der Studie GEDA 2019/2020-EHIS. 2021
• 8 Sun F, Norman IJ, While AE. Physical activity in older people: a systematic review. BMC public health 2013; 13: 1-17
• 9 Kleinke F, Penndorf P, Ulbricht S. et al. Levels of and determinants for physical activity and physical inactivity in a group of healthy elderly people in Germany: Baseline results of the MOVING-study. PloS one 2020; 15: e0237495
• 10 Marques A, Peralta M, Martins J, Gouveia ÉR, Valeiro MG. Cross-sectional and prospective relationship between low-to-moderate–intensity physical activity and chronic diseases in older adults from 13 European countries. Journal of Aging and Physical Activity 2018; 27: 93-101
• 11 Marques A, Peralta M, Sarmento H, Martins J, González Valeiro M. Associations between vigorous physical activity and chronic diseases in older adults: a study in 13 European countries. European Journal of Public Health 2018; 28: 950-955
• 12 Hupin D, Roche F, Gremeaux V. et al. Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged≥60 years: a systematic review and meta-analysis. British journal of sports medicine 2015; 49: 1262-1267
• 13 Almeida OP, Khan KM, Hankey GJ. et al. 150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12 201 older Australian men. British journal of sports medicine 2014; 48: 220-225
• 14 Cunningham C, O’Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scandinavian journal of medicine & science in sports 2020; 30: 816-827
• 15 Lee I-M, Shiroma EJ, Lobelo F. et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The lancet 2012; 380: 219-229
• 16 Blair SN. Physical inactivity: the biggest public health problem of the 21st century. British journal of sports medicine 2009; 43: 1-2
• 17 Ekelund U, Tarp J, Fagerland MW. et al. Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals. British journal of sports medicine 2020; 54: 1499-1506
• 18 Jefferis BJ, Parsons TJ, Sartini C. et al. Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?. British journal of sports medicine 2019; 53: 1013-1020
• 19 Millard LAC, Tilling K, Gaunt TR, Carslake D, Lawlor DA. Association of physical activity intensity and bout length with mortality: An observational study of 79,503 UK Biobank participants. PLoS Med 2021; 18: e1003757
• 20 Garcia-Hermoso A, Ramirez-Velez R, Saez de Asteasu ML. et al. Safety and effectiveness of long-term exercise interventions in older adults: a systematic review and meta-analysis of randomized controlled trials. Sports Medicine 2020; 50: 1095-1106
• 21 Sampaio F, Nogueira P, Ascenção R, Henriques A, Costa A. The epidemiology of falls in Portugal: An analysis of hospital admission data. PLoS one 2021; 16: e0261456
• 22 Nilsson M, Eriksson J, Larsson B. et al. Fall risk assessment predicts Fall-Related injury, hip fracture, and head injury in older adults. Journal of the American Geriatrics Society 2016; 64: 2242-2250
• 23 Rupp M, Walter N, Pfeifer C. et al. The incidence of fractures among the adult population of Germany: An analysis from 2009 through 2019. Deutsches Ärzteblatt International 2021; 118: 665
• 24 Hoffmann I, Kohl M, von Stengel S. et al. Exercise and the prevention of major osteoporotic fractures in adults: a systematic review and meta-analysis with special emphasis on intensity progression and study duration. Osteoporosis International 2023; 34: 15-28
• 25 Papalia GF, Papalia R, Diaz Balzani LA. et al. The effects of physical exercise on balance and prevention of falls in older people: A systematic review and meta-analysis. Journal of clinical medicine 2020; 9: 2595
• 26 Grgic J, Garofolini A, Orazem J. et al. Effects of resistance training on muscle size and strength in very elderly adults: a systematic review and meta-analysis of randomized controlled trials. Sports Medicine 2020; 50: 1983-1999
• 27 Bechshøft RL, Malmgaard-Clausen NM, Gliese B. et al. Improved skeletal muscle mass and strength after heavy strength training in very old individuals. Experimental gerontology 2017; 92: 96-105
• 28 Willimczik K, Voelcker-Rehage C, Wiertz O. Sportmotorische Entwicklung über die Lebensspanne. Zeitschrift für Sportpsychologie 2006; 13: 10-22
• 29 Downs S, Marquez J, Chiarelli P. Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review. Journal of physiotherapy 2014; 60: 85-89
• 30 Fiatarone MA, Marks EC, Ryan ND. et al. High-intensity strength training in nonagenarians: effects on skeletal muscle. Jama 1990; 263: 3029-3034
• 31 Radaelli R, Taaffe DR, Newton RU, Galvão DA, Lopez P. Exercise effects on muscle quality in older adults: A systematic review and meta-analysis. Scientific Reports 2021; 11: 21085
• 32 Sherrington C, Michaleff ZA, Fairhall N. et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med 2017; 51: 1750-1758
• 33 Sui X, LaMonte MJ, Laditka JN. et al. Cardiorespiratory fitness and adiposity as mortality predictors in older adults. Jama 2007; 298: 2507-2516
• 34 Huang G, Wang R, Chen P. et al. Dose–response relationship of cardiorespiratory fitness adaptation to controlled endurance training in sedentary older adults. European journal of preventive cardiology 2016; 23: 518-529
• 35 Bouaziz W, Kanagaratnam L, Vogel T. et al. Effect of aerobic training on peak oxygen uptake among seniors aged 70 or older: A meta-analysis of randomized controlled trials. Rejuvenation research 2018; 21: 341-349
• 36 Wu Z-J, Wang Z-Y, Gao H-E, Zhou X-F, Li F-H. Impact of high-intensity interval training on cardiorespiratory fitness, body composition, physical fitness, and metabolic parameters in older adults: A meta-analysis of randomized controlled trials. Experimental Gerontology 2021; 150: 111345
• 37 Mende E, Moeinnia N, Schaller N. et al. Progressive machine-based resistance training for prevention and treatment of sarcopenia in the oldest old: a systematic review and meta-analysis. Experimental Gerontology 2022; 111767
• 38 Valenzuela PL, Saco-Ledo G, Morales JS. et al. Effects of physical exercise on physical function in older adults in residential care: a systematic review and network meta-analysis of randomised controlled trials. The Lancet Healthy Longevity. 2023
• 39 Heidemann C, Scheidt-Nave C, Beyer A-K. et al. Gesundheitliche Lage von Erwachsenen in Deutschland–Ergebnisse zu ausgewählten Indikatoren der Studie GEDA 2019/2020-EHIS. 2021
• 40 Erdmann F, Spix C, Katalinic A. et al. Krebs in Deutschland für 2017/2018. 2021
• 41 Patel AV, Friedenreich CM, Moore SC. et al. American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Medicine and science in sports and exercise 2019; 51: 2391
• 42 McTiernan A, Friedenreich CM, Katzmarzyk PT. et al. Physical activity in cancer prevention and survival: a systematic review. Medicine and science in sports and exercise 2019; 51: 1252
• 43 Courneya KS, Friedenreich CM, Franco-Villalobos C. et al. Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial. Cancer Causes & Control 2015; 26: 269-276
• 44 Courneya KS, Segal RJ, McKenzie DC. et al. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Medicine & Science in Sports & Exercise 2014; 46: 1744-1751
• 45 Wiskemann J, Kleindienst N, Kuehl R. et al. Effects of physical exercise on survival after allogeneic stem cell transplantation. International journal of cancer 2015; 137: 2749-2756
• 46 Hayes S, Steele M, Spence R. et al. Exercise following breast cancer: exploratory survival analyses of two randomised, controlled trials. Breast cancer research and treatment 2018; 167: 505-514
• 47 Campbell KL, Winters-Stone K, Wiskemann J. et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine and science in sports and exercise 2019; 51: 2375
• 48 Christensen JF, Simonsen C, Hojman P. Exercise training in cancer control and treatment. Comprehensive Physiology 2018; 9: 165-205
• 49 Kreutz C, Schmidt ME, Steindorf K. Effects of physical and mind–body exercise on sleep problems during and after breast cancer treatment: a systematic review and meta-analysis. Breast cancer research and treatment 2019; 176: 1-15
• 50 Yang H, Yang Z, Pan H, Zhou Q. Effects of physical activity on sleep problems in breast cancer survivors: a meta-analysis. Supportive Care in Cancer 2021; 29: 4023-4032
• 51 Hausheer FH, Schilsky RL, Bain S, Berghorn EJ, Lieberman F. Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. In, Seminars in oncology. Elsevier; 2006: 15-49
• 52 Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. Journal of neurology 2002; 249: 9-17
• 53 Guo S, Han W, Wang P, Wang X, Fang X. Effects of exercise on chemotherapy-induced peripheral neuropathy in cancer patients: a systematic review and meta-analysis. Journal of Cancer Survivorship 2023; 17: 318-331
• 54 Lopes S, Afreixo V, Teixeira M. et al. Exercise training reduces arterial stiffness in adults with hypertension: a systematic review and meta-analysis. Journal of hypertension 2021; 39: 214-222
• 55 Doewes RI, Gharibian G, Zaman BA, Akhavan-Sigari R. An updated systematic review on the effects of aerobic exercise on human blood lipid profile. Current problems in cardiology 2023; 48: 101108
• 56 Seidel-Jacobs E, Tönnies T, Rathmann W. Epidemiologie des Diabetes in Deutschland. In: und DDGD, Diabetes-Hilfe dD eds, Deutscher Gesundheitsbericht Diabetes 2023: Die Bestandsaufnahme. Mainz: Kirchheim+Co GmbH; 2023
• 57 Tönnies T, Baumert J, Heidemann C. et al. Diabetes free life expectancy and years of life lost associated with type 2 diabetes: projected trends in Germany between 2015 and 2040. Population health metrics 2021; 19: 1-10
• 58 Moghetti P, Balducci S, Guidetti L. et al. Walking for subjects with type 2 diabetes: a systematic review and joint AMD/SID/SISMES evidence-based practical guideline. Nutrition, Metabolism and Cardiovascular Diseases 2020; 30: 1882-1898
• 59 Pan B, Ge L, Xun Y-q. et al. Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. International Journal of Behavioral Nutrition and Physical Activity 2018; 15: 1-14
• 60 Colberg SR, Sigal RJ, Yardley JE. et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care 2016; 39: 2065-2079
• 61 Hadji P, Klein S, Gothe H. et al. Epidemiologie der Osteoporose: Bone Evaluation Study. Eine Analyse von Krankenkassen-Routinedaten. Dtsch Arztebl Int 2013; 110: 52-57
• 62 Mohebbi R, Shojaa M, Kohl M. et al. Exercise training and bone mineral density in postmenopausal women: An updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators. Osteoporosis International 2023; 1-34
• 63 Mages M, Shojaa M, Kohl M. et al. Exercise effects on bone mineral density in men. Nutrients 2021; 13: 4244
• 64 Zitzmann A-L, Shojaa M, Kast S. et al. The effect of different training frequency on bone mineral density in older adults. A comparative systematic review and meta-analysis. Bone 2022; 154: 116230
• 65 Schinzel E, Kast S, Kohl M. et al. The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis. Frontiers in Physiology 2023; 14: 404
• 66 Bohlken J, von Stillfried D, Schulz M. Prävalenz von leichten kognitiven Störungen und Demenzen in der ambulanten Routineversorgung in Deutschland 2009–2016. Psychiatrische Praxis 2020; 47: 16-21
• 67 Etgen T, Sander D, Bickel H, Förstl H. Leichte kognitive Störung und Demenz. Dtsch Arztebl International 2011; 108: 743-750
• 68 Demurtas J, Schoene D, Torbahn G. et al Physical activity and exercise in mild cognitive impairment and dementia: an umbrella review of intervention and observational studies. Journal of the American Medical Directors Association 2020; 21: 1415-1422 e1416
• 69 Huang X, Zhao X, Li B. et al. Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: a systematic review and network meta-analysis. Journal of sport and health science 2022; 11: 212-223
• 70 Gallardo-Gómez D, del Pozo-Cruz J, Noetel M. et al. Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing research reviews. 2022 101591.