Exercise And Ageing

Question 1

Sarcopenia: definition, how to assess, why it it important, pathology

Answer 1

• definition: loss of muscle mass, strength and function (age-associated decline)
• assess via SARC-F questionnaire: HGS, TUG
• functional decline leads to increase in mortality
• fat infiltrates into the muscle and FA block the insulin pathway to mobilise GLUT4 channels for energy intake

Question 2

Age-associated decline: VO2 max, muscle fibers and motor units, strength/power

Answer 2

• reduction in VO2 max, muscle fibers (especially type II- associated with strength), decline in motor units
• although inevitability in some decline- can also mitigate degree of loss with exercise and increase healthspan

Question 3

Lessons from master cyclists

Answer 3

• although decrease VO2 max with age, at 80 can have a better function than sedentary 45 year old
• although low FEV1 still better than would expect for their age
• ventilatory thresholds very high which means they would be fitter for elective surgery
• CD4 count and IL6/TNFa comparable to younger healthy individuals

Question 4

Lessons from master weight lifters

Answer 4

• although strength and power does decline with age, still 35% stronger than healthy volunteers

Question 5

Physical activity is equivalent to exercise in terms of benefit

Answer 5

• bus drivers had 2x greater risk of MI versus conductors (due to walking)
• daily sitting is an independent risk factor for mortality

Question 6

The set point theory of ageing

Answer 6

• there is an optimal amount of activity we need to do each day which declines to with age
• less than this will compromise healthspan
• more than this will have athletic benefits

Question 7

Fitness versus fatness

Answer 7

• fitness ameliorates the impact of overweight and obesity on mortality
• being a healthy weight but unfit has a negative impact on mortality
• being obese or overweight and fit does not impact mortality