National physical activity recommendations for older Australians: Discussion Document

1. Introduction

The National Ageing Research Institute was commissioned by The Department of Health and Ageing to review the evidence and develop physical activity recommendations for older people.

Page last updated: 01 February 2011

The older generation is the fastest growing population group (Clare and Tulpul 1994), making older people’s health an increasingly important public health issue. Medical problems occur more frequently with age (Cartwright 1988) and older people are also more prone to adverse effects from medication (Fiatarone Singh 2002). The attendant health care consumption is far in excess of that of other age groups (Clare and Tulpul 1994). It is well established that physically active lifestyles benefit people across the lifespan. Older people can gain health and social benefits from being physically active (Bauman 2004). There are many health benefits associated with increased levels of physical activity: lower incidence of hypertension, heart disease, osteoporosis, degenerative arthritis, colonic cancer and diabetes mellitus, improved mood and memory function, and a better and maintained social network (Pate, Pratt et al. 1995; Mazzeo and Tanaka 2001). In older people, physical activity may also offer a useful alternative to drug management or reduce the need for medication, limiting the problems associated with polypharmacy.

Preventive practice can improve health status and prolong active life expectancy. There is scope for greater targeting of health promotion activities towards older people (Fries, Green et al. 1989; Mahler 1989; Foss, Dickinson et al. 1996). Given the greater absolute risk of ill health in older people, intervening with this population group is vital. It is timely to integrate the growing research and clinical evidence on how ‘positive ageing’ strategies such as physical activity can be supported and implemented broadly to improve older people’s health and well-being. A health promotion approach towards physical activity by health care providers, the individual and the community can usefully be assisted by recommendations specifically tailored for older people.

This discussion document supports a range of associated national policies and strategies, including the National Strategy for an Ageing Australia, the Public Health Action Plan for an Ageing Australia, the Commonwealth, States and Territory Strategy for Healthy Ageing, the Be Active Australia: A Health Sector Framework for Action 2005-2010 and clinical practice guidelines for the management of overweight and obesity. The discussion paper describes and critically analyses existing international and Australian physical activity guidelines/recommendations for older people. The evidence regarding physical activity formats and modalities (e.g. intensity, duration, type) and their relationship to health benefits particularly relevant to older people, such as functional independence and mobility, are reviewed.

The development of the discussion document and the resulting recommendations were guided by the National Institutes of Health (NIH) Consensus Statement’s definition of physical activity (given on page 7 above) and by Li and colleagues (2005) heuristic multilevel model of influences on physical activity (Figure 5.1). Chapter 2 outlines the methods used to produce the discussion document and the draft recommendations. Chapter 3 describes the physical activity patterns of older Australians and compares prevalence rates across time and nations. Chapter 4 briefly reviews the consequences of a sedentary lifestyle and summarises the health benefits ascribed to physical activity with regard to the National Health Priority Areas. It then discusses the risks associated with physical activity in older people. Chapter 5 considers the determinants of physical activity behaviour in older people from an individual, societal and structural perspective. Chapter 6 gives an overview of instruments used to measure physical activity in older people. Chapter 7 describes and critiques the existing national and international physical activity guidelines. Chapter 8 discusses the evidence for different types and amounts of physical activity in older people. Chapter 9 reviews the evidence for using physical activity in the primary, secondary and tertiary prevention of health conditions represented by the National Health Priority Areas. The literature relating to frail older people, Indigenous Australians and people from culturally and linguistically diverse backgrounds is discussed. Chapter 10 contains the draft recommendations and outlines their purpose. In brief, the target audience for the recommendations is older Australians. Chapter 11 considers the planning and policy implications of the recommendations. Areas for future research and directions for progressing the development of the recommendations are outlined.
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