Exercise as therapeutic agent to improve intrinsic capacity in older adults

Abstract

Frailty has emerged as one of the most relevant clinical syndromes, due to its direct relationship with adverse health effects such as physical and functional decline and institutionalization. Physical inactivity has been argued to be a key factor contributing to the onset of muscle mass and function decline (i.e. sarcopenia), which in turn appears to be a vital aspect related to frailty. Deterioration in muscular strength and mass, cardiovascular resistance and balance leads to a decrease in daily life activities, a higher risk of falling and a loss of independence, among other consequences. The effects of exercise are potentially similar to those that can be achieved with medication and are even better, with barely any adverse effects when aiming to prevent cardiovascular disease, decrease the risk of death, prevent diabetes and obesity and improve muscular function and quality of life. Multicomponent physical exercise programs and, in particular, strength training are the most effective interventions for delaying disability and other adverse events. Likewise, their use has been proven in other fields which are frequently associated with this syndrome such as falls, cognitive deterioration and depression.

La fragilidad se ha convertido en uno de los síndromes clínicos más relevantes y es un buen predictor de eventos adversos de salud como reducción de la capacidad física y funcional y la institucionalización. Para reducir la fragilidad hay que actuar sobre su principal factor de riesgo, la inactividad. La inactividad es un elemento nuclear en el desarrollo de la fragilidad, puesto que es esencial para determinar el estado cardiovascular, la resistencia insulínica y el deterioro musculo-esquelético (sarcopenia), al tiempo que contribuye al deterioro cognitivo y la depresión. El entrenamiento de fuerza y los programas multi-componente, en particular, cada vez tienen más resultados favorables en este grupo poblacional y sus efectos son más destacados en otros dominios del síndrome, como las caídas y el deterioro cognitivo.