The geriatric quintet Alterazioni di ordine cognitivo Alterazione motilità

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1 SIO Triveneto 31 Marzo 27 Trento Attività Fisica e Composizione Corporea nell anziano Vincenzo Di Francesco Clinica Geriatrica Università di Verona The geriatric quintet Alterazioni di ordine cognitivo Alterazione motilità Fattori socio-economici Depressione Farmaci e malattie croniche Harper et al, 1978 Modifications of, percent of body fat and muscle mass with aging in men and women (BLSA, cross sectional analysis) 6 4 % fat Men % fat Women % difference muscle mass muscle mass Age (years) Muller et al,

2 Modificazioni della composizione corporea nelle donne (n=97) f-up f 5.5 anni kg/h Basale p <.2 2 anni 5.5 anni FM kg 27,5 27,3 27,1 26,9 26,7 26,5 26,3 26,1 25,9 25,7 25,5 Circonferenza Vita cm p <.1 FFM kg p < F Fantin, 27 in press Modificazioni della composizione corporea negli uomini (n=62) f-up f 5.5 anni kg/h ,9 27,7 27,5 27,3 27,1 26,9 26,7 26,5 Circonferenza Vita cm Basale 2 anni 5.5 anni FM kg FFM kg 24 23, , ,5 21 2, , , ,5 51 5,5 5 p <.1 da F Fantin, 27 in press Body composition in healthy aging: the New Mexico Elder Health Survey and the New Mexico Aging Process Study Median Relative Muscle Mass (kg/m2) Normal Sarcopenic Obese Sarcopenic Obese -2 SD below Young adult mean % Body Fat Baumgartner, Ann N Y Acad Sci 2 2

3 Relationships between leisure-time physical activity, obesity and disability in elderly men. V Di Francesco, Aging 25 Aging Muscle K.S. Nair, 25 Weight change and the conservation of lean mass in old age: The Health ABC Study (n= 2163, f-up 4 yrs) fat lean AB Newman, 25 3

basale Tessuto muscolare (cm 2 ) 1 ns dopo

muscolare a bassa densità metà coscia (cm 2 )

1 4 3 2 1 basale 28,92 dopo calo 25,99 Da G.

Running Distance to and Circumferences in

Obes Res 25 Anthropometric assessment of 1-y

4 basale Tessuto muscolare (cm 2 ) 1 ns dopo calo 5 basale 81 dopo calo 77 Tessuto muscolare a bassa densità metà coscia (cm 2 ) basale dopo calo P< basale 28,92 dopo calo 25,99 Da G.Mazzali 26 Relationships of Age and Weekly Running Distance to and Circumferences in 41,582 Physically Active Women PT Williams, Obes Res 25 Anthropometric assessment of 1-y changes in body composition in the elderly (n= 53men, 78women, f-up 9.4 yrs) V A Hughes, 24 4

5 Effect of Diet and Exercise Therapy on Body Weight and Body Composition Villareal, D. T. et al- 26 Effetti di 1 anni (da 68 a 78 anni) di regolare esercizio fisico in 161 soggetti confrontati con un gruppo di controllo di 136 soggetti col HDL % tg METs waist HOMA-IR ins col LDL col T gluc Pas <,1 <,5 <,5 <,1 <,1 <,2 <, <,1 sedentari attivi RJ Petrella, 25 Exercise is required for visceral fat loss in postmenopausal women with type 2 diabetes Giannopoulou, I. et al. 25 5

Acute disease Aging Unknown reasons Chronic inflammation Stroke Arthritis Heart failure Dementia Inflammatory Cytokines IL-6 IL-1 TNF Muscle catabolism Sarcopenia Disability Physical Activity,

6 Acute disease Aging Unknown reasons Chronic inflammation Stroke Arthritis Heart failure Dementia Inflammatory Cytokines IL-6 IL-1 TNF Muscle catabolism Sarcopenia Disability Physical Activity, Exercise, and Inflammatory Markers in Older Adults: Findings from The Health, Aging and Body Composition Study N = 1371 N = 1585 LH Colbert, 24 Addition of aerobic exercise to dietary weight loss preferentially reduces abdominal adipocyte size 45 obese women age 58+1 Change in adipocyte size (%) abdominal * * gluteal Diet Diet+LE Diet+HE T You, 26 6

7 Relationships between leisure-time physical activity, obesity and disability in elderly men. a % disability st 2nd 3rd tertiles of physical exercise (min/week) b (-42) ( ) (729-23) >= 25 (n=63) < 25 (n=22) V Di Francesco, Aging 25 Type and Intensity of Activity and Risk of Mobility Limitation: The Mediating Role of Muscle Parameters exercise active inactive Association was still significant after adjustment for muscle parameters M Visser, 25 Osteoporosis Prevention, Diagnosis, and Therapy NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, 2 There is strong evidence that physical activity early in life contributes to higher peak bone mass. Some evidence indicates that resistance and high-impact exercise are likely the most beneficial. Exercise during the middle years of life has numerous health benefits, but there are few studies of the effects of exercise on BMD. Exercise during the later years, in the presence of adequate calcium and vitamin D intake, probably has a modest effect on slowing the decline in BMD 7

Hip Fracture Among Postmenopausal Women in the Nurses' Health Study, 1986-1998, by Hormone Use Feskanich, D. et al. JAMA 22;288:23-236.

8 Hip Fracture Among Postmenopausal Women in the Nurses' Health Study, , by Hormone Use Feskanich, D. et al. JAMA 22;288: Hip Fracture Among Postmenopausal Women in the Nurses' Health Study, , by Hormone Use Feskanich, D. et al. JAMA 22;288:

9 Percentuale di soggetti ultra-sessantacinquenni che seguono le raccomandazioni dell NHIS per l attività fisica di potenza in relazione a diverse caratteristiche della popolazione (n=5537) Sesso Donne Uomini 9,5 13,3 > 3 < 25 Salute Scadente Eccellente Scolarità Elementare Universitaria 6,1 6,9 6,6 12,6 2 2, percentuale CDC, 21 The geriatric quartet? Sarcopenia Obesità viscerale SEDENTARIETA Infiammazione 9

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