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Exercise May Improve Health In Elderly people
Results of a recent review of studies investigating the effects of exercise on the health of younger HIV-positive adults and older HIV-negative adults show that a mix of aerobic and strength-training exercises helps to improve heart, metabolic, and muscle health in these populations.
Results of a recent review of studies investigating the effects of exercise on the health of younger HIV-positive adults and older HIV-negative adults show that a mix of aerobic and strength-training exercises helps to improve heart, metabolic, and muscle health in these populations.
Based on these findings, the authors of the review concluded that moderate exercise may also be beneficial for older HIV-positive adults.
“We recommend a combination of endurance and resistance exercises three times per week for at least six weeks to improve cardiovascular, metabolic, and muscle function,” wrote the authors of the review.
“Combined moderate to vigorous aerobic and resistance exercise for 20 to 40 minutes, three times per week, is safe and effective in older adults and has many benefits to decrease symptom burden, decrease disease progression, and increase quality of life,” they added.
However, they noted that more research is necessary on the risks and benefits of exercise in older adults with HIV.
As people with HIV live longer due to the efficacy of combination antiretroviral therapy, HIV-positive adults over the age of 50 represent a growing proportion of the population. According to the review authors, a study from 2006 found that 27 percent of the HIV-positive population is now 50 years old or older.
Due to the effects of HIV and the antiretrovirals used to treat it, people with HIV are more prone to several age-related illnesses, including heart disease, diabetes, unintended weight loss, and others. Studies have shown that people with HIV tend to get these illnesses earlier and at higher rates than people without HIV.
Previous research has shown that exercise can be beneficial in younger HIV-positive adults for preventing or ameliorating these illnesses. However, according to the review authors, little research has been done on the benefits of exercise in HIV-positive adults who are over the age of 50.
In this review, the authors examined exercise research from 20 randomized clinical trials that included either younger HIV-positive adults, frail HIV-negative adults over the age of 65, or HIV-negative adults over the age of 55 with conditions such as pre-diabetes or high cholesterol.
All studies included aerobic and/or resistance training exercises. Aerobic exercises involve activities such as walking, swimming, or bicycle riding that elevate heart and breathing rates. Resistance or strength training involves lifting weights or other activities, such as sit-ups or push-ups, that are intended to increase muscle mass and strength.
Most studies found improvements in participants’ health after implementing an aerobic and/or resistance-based exercise program for all three patient groups,.
In younger HIV-negative adults, all but two of the 12 studies that were reviewed showed that exercise significantly improved participants’ estimated maximum heart rate – a measure of heart health – and muscle strength and size compared to participants who did not exercise.
In frail older adults without HIV results were more mixed. Results from most studies suggested that exercise improved physical performance and strength in study participants; however, some studies found that exercise was not effective, possibly because participants were too frail. The review authors suggested that for highly frail adults, exercise programs may need to be tailored to individuals’ capabilities.
For HIV-negative adults with metabolic conditions such as insulin resistance or high cholesterol, the authors found that all of the studies reviewed indicated that participants who exercised had significantly reduced insulin resistance and improved metabolic factors, such as cholesterol levels, compared to participants who did not exercise.
Based on the study results, the review authors made the following exercise recommendations for HIV-positive adults over the age of 50:
- Aerobic exercises should be performed for 20 to 40 minutes at least three days per week for at least six weeks. Moderate- to high-intensity exercise levels were most effective.
- Individuals should aim for a heart rate during exercise that is between 50 and 90 percent of their estimated maximum heart rate (as calculated based on their weight and age). Exercisers should start at lower intensity and aim for at least a 5 percent increase in intensity each week.
- Individuals should stretch for 5 to 10 minutes before and after aerobic exercises to prevent injury.
- Resistance exercises should be performed following aerobic exercises, on the same days, for at least six weeks, three days per week.
- Exercises should begin with one or two sets of six to eight repetitions for each muscle group, then increase to three sets of eight to 10 repetitions for each muscle group, with 20 to 30 second rest periods between each set.
Finally, the reviewers noted that prolonged, intense exercise can have negative effects on the immune system and make people more susceptible to viral and bacterial infections, which may be particularly risky for people with HIV. As a result, they recommended that adults with HIV refrain from strenuous physical activity for more than 90 minutes at a time.
