FallsPreventionHealthFairaGreatSuccessOnSeptember27th,theNorthRiverCivicCenterhostedacommunityFallsPreventionAwarenessDayeventwiththethemeReady,Steady,Balance.Theeventhelpedraisedawarenessthatmanyfallsamongolderadultscanbepreventedwithregularphysicalactivity,afallriskassessmentbyahealthcareprovider,asafeandsupportivehomeenvironment,andayearlymedicationreview,eyeexam,andhearingassessment.Activitiesatthehealthfairincludedhealthscreenings,educationalsessions,medicationreviewandtakeback,homesafetystations,andawelcomeceremonycompletewithchairexercising.TheeventwassponsoredbytheChattanooga-HamiltonCountyHealthDepartment,UniversityofTennesseeatChattanooga,CityofChattanoogaYouthandFamilyDevelopment,ErlangerTraumaServices,andBlueCareTennessee,inpartnershipwithadditionalcommunityagenciesandnetworks.Over100studentsfromUTC’sdepartmentsofNursing,PhysicalTherapy,OccupationalTherapy,Psychology,Nutrition,SocialWork,andAthleticTrainingwerepresent."UTChasavestedinterestinahealthyChattanooga.ThroughpartnershipswithmanycommunityagenciesincludingtheChattanooga-HamiltonCountyHealthDepartment,weareabletoofferhealthfairssuchasthisevent.Duringtheassembly,attendeesreceivedinformationaboutspecifichealthcareconcerns.UTCstudentshadtheopportunitytopracticetheirskillsinanauthenticsetting.Thisexperientiallearningallowsstudentstodevelopsaidskillsthroughpracticeandreflection,"reportedBrittCusack,EndowedChairofGerontologyatUTC.“InHamiltonCounty,Tennessee,therewere736fall-relatedhospitalizationsamongolderadultsin2012,resultinginalmost$27millioninhospitalcharges.Inthatsameyear,19olderadultsdiedasaresultofafall,”saidCarleenaAngwin,publichealtheducatorwiththeChattanooga-HamiltonCountyHealthDepartment.Forfurtherdetails,visitwww.FallPreventionChattanooga.com.

Winter2015 Issue1,Volume1

Elderhood Express

University of Tennessee at Chattanooga Fall 2016 Edition

ElderhoodExpresswasdevelopedtodisseminateevidence-basedinformationtocommunityagenciesintheChattanoogaareawhoareintimatelyinvolvedwiththecareofourpopulationwhoare“outgrowingtheiryouth.”Manynewslettersandpublicationsfocusonchildhoodandadulthood,butitisraretofindonesolelyaimedatissuesexperiencedin“elderhood.”Articleselectionswillbechosenfromavarietyofdisciplines.Wewillalsoprovidelistingsofgeriatric-focusedcommunityeventsasavailable.

ThereBARKableEffectThatAnimalsHaveonGeriatricPersons’Health

AlexSnyder,RN,BSN,MSNStudent

Nearlytwo-thirdsofallUScitizensandhalfofelderlyindividualsownapet(Herzog,2011).Theintegrationofthesefour-leggedfriendsintoourhouseholdsprovidesuswithcompanionship,happiness,andsometimesunpredictability.However,doweactuallyunderstandthephysiologicalandpsychologicalbenefitsthatourpetsprovide?TheU.S.CensusBureauestimatesthatbytheyear2050,83.7millionpeoplelivinginAmericawillbeovertheageof65.That’snearlydoubletheestimatedpopulationof43.1millionseniorAmericansthatwerelivingin2012(Ortman,Velkoff,&Hogan,2014).Aspeopleage,theriskofdevelopingphysiologicalandpsychologicaldiseaseprocessesincreases.AnotherissuethatAmericaisfacingistheoverpopulationofanimalshelters.TheAmericanSocietyforthePreventionofCrueltytoAnimals(ASPCA)reportsthat7.6millioncompanionanimalsenteranimalshelterseachyear,and2.7millionoftheseanimalsareeuthanized(2016).Thisarticlewillexamineresearchthathasbeenconductedoverthephysiologicalandpsychologicalbenefitsthatdomesticanimalscanhaveonthegeriatricpopulation’soverallhealthinhopesofproposingasolutiontotwoongoingissuesinAmerica’ssociety.TheCentersforDiseaseControlandPreventionlistscardiovasculardiseaseastheleadingcauseofdeathamongAmericans(2016).Thisdiseaseprocessisoneinwhichcompliancewithatreatmentregimenisessentialforappropriatemanagement.First-linepharmacologicmanagementofheartfailureoftentimesincludesanangiotensin-converting-enzyme(ACE)inhibitororbeta-blocker.Thegoalofbothofthesemedicationsistoreducethebloodpressureandheartrateinordertoeasetheworkloadoftheheart.InthearticleCardiovascularReactivityandthePresenceofPets,Friends,andSpouses:TheTruthAboutCatsandDogs,theauthorsconductedastudytodeterminethereactivityofheartrateandbloodpressuretothatofphysiologicstressors.Theresultsofthisstudyconcludedthat“petownersexhibitedsignificantlylowerrestingheartrates,systolicbloodpressure,anddiastolicbloodpressurethannon-petowners”(Allen,Blascovich,&Mendes,2002).Anon-pharmacologicmanagementtocardiovasculardiseaseisimprovingone’slifestylethroughappropriateamountsofexercise.InthearticleDoesGettingaDogIncreaseRecreationalWalking?,Cutt,Giles-Corti,andBurkeconcludedthatdogownersweremorelikelytoachieverecommendedlevelsofphysicalexercisethroughwalking.Thedurationofwalkingtimesalsoincreasedforthispopulationsegmentfromanywherebetween22to31minutesperweekafteracquiringa

Petownersexhibitedsignificantlylowerrestingheartrates,systolicbloodpressure,anddiastolicbloodpressurethannon-petowners.

dog(2008).Thesearticlespresentevidencethatthroughtheownershipofpets,agonisticeffectsofcardiovascularpharmacologyandimprovedlifestylemodificationcanbeachieved.Cardiovasculardiseaseisaphysiologicaldiseaseprocessthatcanbedevastatingtotheelderly,butpsychologicalillnessisalsoapertinenthealthissueamongthispopulation.Depressionisoneofthemostcommonmentalillnesses,ofwhichagingisariskfactor.Thegeriatricpopulationfrequentlyencountersmanylifestressors,suchaslossofaspouse,retirement,decreasedincome,andchronichealthconditionsthatmayalsopredispose

themtodepression.Animalsareagreatresourcetoprovidethecompanionshipandinteractionthatmanyagingindividualsseekandenjoy.El-Alayietal.wroteanarticleconcerningtheemotionalwell-beingofindividualsandpetownership.Theauthorsofthisarticlenoted“strongevidencetotheeffectthatcompanionanimalsareassociated

withincreasedself-esteem,lifesatisfaction,positivemoodsandlowerlevelsofloneliness”(2006).Decreasingtheriskandincidenceofdepressionthroughpetownershipwillinturnpromoteincreasedenergyandself-esteemallowingolderindividualstoparticipateintheadequatephysicalhealthmaintenancetopreventotherphysiologicaldiseaseprocessesfromoccurringTheownershipofapetdoesnotoccurwithoutthepotentialforminornegativeimpactsamongtheelderly.Increasedresponsibility,certainfinancialrequirements,andincreasedriskoffallsareafewexamplesthatcouldensue.However,theaforementionedpositiveoutcomesofpetownershiponelderlyindividuals’healthfaroutweightherisksofthenegativeconsequences.Theopportunityofamutuallybeneficialrelationshipbetweenpetandowneralsoexistsduetotheplethoraofanimalsinneedofapermanenthome.Ultimately,theownershipofapetisproventoimprovethephysiologicandpsychologichealthaspectsinthegeriatriccommunity.

“Frailing”orFailing?DefiningFrailtySyndromevsAdultFailuretoThriveforClinicalPractice

BrittCusack,DNP,ANP-C,APN&ChristianHarbin,BSNStudentPhysicaldeclineandagingoftengohand-in-hand–theyarefrequentlysynonymous.Asoneages,thebodynaturallyundergoesaslowprocessofdeterioration,andsometimesthisprocessresultsinwhatisknownasfrailtysyndrome.Whenmostpeoplehearthistermtheythinkofgeneralfragility.Whilethisistruetoanextent,ithasbeensuggestedthatatleastthreeofthefollowingelementsmustbepresentinordertodeemanindividualasfrail:“unexplainedweightloss,self-reportedexhaustion,weakgripstrength,slowwalkingspeed,andlowactivity.”1Basedonthisdefinition,expertsonagingagreethatfrailtyisaveryimportant,yetcomplex,medicalconditionandonethathasmanycausativefactorsandultimately“increasesthevulnerabilityofapersonforgreaterdependencyand/ordeath.”2Furthermore,Phillips-Burkhart(2016)revealsthatfrailtyiscommonlyfoundamongthoseindividualswhoareolderthan70yearsofage,whileitsprevalencedrasticallyincreasesamongthosewhoareolderthan80yearsofage.3

References•••

Allen,K.,Blascovich,J.,&Mendes,W.B.(2002).Cardiovascularreactivityandthepresenceofpets,friends,andspouses:thetruthaboutcatsanddogs.PsychosomaticMedicine,64,727-739.

AmericanSocietyforthePreventionofCrueltytoAnimals,(2016).Petstatistics.Retrieved

fromhttp://www.aspca.org/animal-homelessness/shelter-intake-and-surrender/pet-statistics

CentersforDiseaseControlandPrevention,(2016).Deathsandmortality.Retrievedfrom

http://www.cdc.gov/nchs/fastats/deaths.htmCutt,H.E.,Knuiman,M.W.,&Giles-Corti,B.(2008).Doesgettingadogincreaserecreational

walking?.InternationalJournalofBehaivoralNutritionandPhysicalActivity,5,17.El-Alayli,A.,Lystad,A.L.,Webb,S.R.,Hollingsworth,S.L.,&Ciolli,J.L.(2006).Reigningcatsand

dogs:apet-enhancementbiasanditslinktopetattachment,pet-selfsimilarity,self-enhancement,andwell-being.JournalofBasicandAppliedSocialPsychology,28(2),131-143.

Herzog,H.(2011).Theimpactofpetsonhumanhealthandpsychologicalwell-being:fact,

fictionorhypothesis?.CurrentDirectionsinPsychologicalScience,20(4),236-239.Ortman,J.M.,Velkoff,V.A.,&Hogan,H.(2014).Anagingnation:theolderpopulationinthe

unitedstates.UnitedStatesCensusBureau,1-28.

Itisimportanttobeabletoscreenfortheexistenceoffrailtyaswellastoprovidestrategiesthatseektomanagethiscondition.AusefulinstrumentthathasbeendevelopedusesthemnemonicFRAIL;fatigue,resistance,aerobic,illness,andlossofweight.Eachofthesepromptsaquestiontodeterminefrailty.Thesequestions,representativeofthewordsthatmakeupthemnemonic,includethefollowing:“Areyoufatigued?Doyouhavedifficultywalkinguponeflightofsteps?Areyouunabletowalkatleastoneblock?Doyouhavemorethanfiveillnesses?Haveyoulostmorethan5%ofyourweightinthelast6months?”3Ifanindividualresponds‘yes’tothreeormoreofthesequestionsitislikelythatheorshemaybefrail,andreferraltoageriatricspecialistforadditionalevaluationandmanagementshouldbeconsidered.

Somestrategiesthatcanbeimplementedtohelpmanagefrailtyincluderegularexercisetoenhancebothstrengthandmobility,nutritionalsupplementation(particularlyproteinandvitaminD),andtheeliminationofunnecessarymedications.3Whilefrailtysyndromeisconsideredaphysicalconditionamongtheelderly,adultfailuretothrive(AFTT)isrecognizedasadiagnosis.Furthermore,whilefrailtysyndromeisclearlydefinedbythedistinctcriteriadiscussedabove,AFTThasneverappearedtohaveaconsistentdefinition.AccordingtoKumeliauskas,

Fruetel,andHolroyd-Leduc(2013),thecurrentapplicationofthetermfailuretothrive“isoftenusedtodescribeasyndromeofglobaldeclinethatoccursinolderpatientsasanaggregateoffrailty,cognitiveimpairment,andfunctionaldisability,complicatedbymedicalcomorbiditiesandpsychosocialfactors.”4AlthoughthecriteriadefiningAFTTaremorevagueandarenotasclearlyunderstoodasfrailtysyndrome,itisfairtosaythatitisacomprehensivefindingthatencompassesanevenmorecomplexstateofhealththanthatoffrailtysyndromealone.ItisimportantfortheprovidertoknowthatAFTTisrecognizedasadiagnosisandiscodedwithananICD10codeofR62.7.FrailtysyndromedoesnotcurrentlyholdanICD10code,althoughR54isoftenusedforfrailtysinceitisthecodefor“age-relatedphysicaldisability.”ItisthethoughtoftheseauthorsthatauniqueICD10codeshouldbecreatedforfrailtysyndromesoitcanbeclassifiedappropriately.JustasAFTThasexperiencedcontroversyastohowitshouldbedefined,thereisdisagreementrelatedtoitsgeneralapplication.IthasbeenstatedthatanumberofunderlyingillnessesareatriskofbeingoverlookedwhenanindividualisgivenadiagnosisofAFTT.RobertsonandMontagnini(2004)revealthattheseillnessescommonlyinclude“cancer,chroniclungandrenaldiseases,diabetes,stroke,andtuberculosis.”5-6TheargumentagainstthediagnosisofAFTTisthatitultimatelydiminishesthepathophysiologicalprocessesthatmayhaveledtothediagnosisinthefirstplace.Alternatively,RocchiccioliandSanford(2009)statethatthiscomplexhealthcondition“maybeapartofthenaturaldyingprocess,andtheopportunityforprovidingend-of-lifecareshouldnotbeoverlookedbyhealthcare

providers.”6Intheend,whetherthetermsfrailtysyndromeorAFTTareused,theyshouldnotbeusedsynonymously.Healthcareprovidersservingtheelderlyneedtobeeducatedregardingtheseconditionssotheirpatientscanbetreatedinthemostcompleteandholisticmanner.

GetOutdoors:TheBenefitsofOutdoorPhysicalActivityinOlderAdultsRebeccaBrown,RN,BSN,MSNStudent

Chattanoogaisnationallyknownasagreatplaceforoutdoorenthusiasts.Therefore,thereisampleopportunityforindividualswitharangeofphysicalabilitiestoparticipateinoutdooractivitiesinascenicenvironmentlocally.Evenmorecompellingistheresearchthatsuggestsapositiveimpactinrelationtonotonlyphysicalactivity,butphysicalactivitythatisdoneoutside.AstudybyKerretal.(2012)foundthatbiophillia,ortheideathathumanshaveaninnateconnectionandattractiontonature,maycontributetothepositiveimpactoftheoutdoors.Thisarticlefocusesspecificallyonthebenefitsofoutdoorphysicalactivityintheolderadultpopulation.

References

• • •

TouhyTA,JettK.Ebersole&Hess’TowardHealthyAging:Humanneeds&nursingresponse.9thed.St.Louis,MO:Elsevier;2016.

Fabrício-WehbeSC,RodriguesRA,HaasVJ,FhonJR,DinizMA.(2016).Associationoffrailtyin

hospitalizedandinstitutionalizedelderly(versusthose)inthecommunity-dwelling(setting).RevistaBrasileiraDeEnfermagem.2016;69(4):691-696.doi:10.1590/0034-7167.2016690411i

Phillips-BurkhartK.Frailtysyndrome:Aweaklyaddressedproblem.AmericanNurse

Today.2016;11(7):7-9.KumeliauskasL,FruetelK,&Holroyd-LeducJM.EvaluationofOlderAdultsHospitalizedwitha

DiagnosisofFailuretoThrive.CanadianGeriatricsJournal.2013;16(2),49-53.doi:10.5770/cgj.16.64

RobertsonRG,MontagniniM.Geriatricfailuretothrive.AmericanFamilyPhysician.

2004;70:343-350.RocchiccioliJ,SanfordJ.Revisitinggeriatricfailuretothrive:acomplexandcompellingclinical

condition.JournalofGerontologicalNursing.2009;35(1):18-24.

Despitethecommonstereotype,anationallyrepresentativesampleofadults65yearsorolderprefertowalk,jog,garden,orplaysportsratherthanwatchTV,attendreligiousservices,ortravel.Thequestionsaskedamongthissampleincludedtheabilityoftheindividualtoparticipateintheirfavoriteactivityinthepastmonth.Thefactthatanoverwhelmingproportionofolderadultschosephysicalactivityastheirfavoriteactivity,andthattheyhavebeenabletodoitrecently,providesanoptimisticoutlookfortheagingpopulation(Szantonetal.,2015).Itisknownthatphysicalactivityisimportant,furtheringonthisevidenceistheincreasingamountofstudiessuggestingthatlifestylefactorshaveasignificantimpactonhowwellpeopleage(Bherer,Erickson,&Liu-Ambrose,2013).Chronologicalagingisassociatedwithanincreasedriskofchronicconditionsanddiseasessuchascardiovasculardisease,metabolicsyndrome,andcognitiveimpairment.Threelifestylefactorsarefoundtoplayasignificantroleinslowingtherateofcognitivedeclineandpreventingdementia;asociallyintegratednetwork,cognitiveleisureactivity,andregularphysicalactivity.Inthisreviewaswellasothers,outofthethreelifestylefactorslisted,physicalactivityhasthemostsupportasprotectiveagainstthedeleteriouseffectsofageoncognitionandhealth.Longitudinalstudiesfoundthatolderadultswhohaveparticipatedinphysicalactivityshowlesscognitivedeclineovertwo-toten-yearfollowupperiods.AccordingtotheAlzheimer’sAssociation,late-lifemoderateexerciseisassociatedwitha32%lowerriskformild-cognitiveimpairment(Bhereretal.,2013).Thereisundeniableevidenceregardingtheoverallbenefitsofphysicalactivityintheolderadultpopulationasreferredtoabove.Thereareavarietyofsettingsinwhichthisactivitycantakeplacesuch

asinthehome,ina“built”environmentoutsideofthehome,oroutdoors.Thepositiveimpactofbeingoutdoorsisafairlynewbodyofresearch.Thereisfurtherlackofresearchinreferencetothepositiveimpactofbeingoutdoorsinrelationtotheolderadultpopulation.Commonlyseenadvertisementsareusuallydirectedtowardstheyoungerpopulation,creatingagapinencouragementforolderadultstogetoutdoors.Beingexposedtonaturehasbeenfoundtopromoteanabundanceofhealthbenefits.Experimentalstudieshaveconsistentlyfoundshortterm

positiveeffectsofphysicalactivityinnaturecomparedwithbuiltenvironments(Pasanen,Tyrväinen,&

Thefactthatanoverwhelmingproportionofolderadultschosephysicalactivityastheir

favoriteactivity,andthattheyhavebeenabletodoitrecently,providesanoptimisticoutlookfor

theagingpopulation.

Korpela,2014).Previousepidemiologicalstudiesfoundpositivecorrelationsbetweenneighborhoodgreeneryandlongtermhealthindicatorssuchasmorbidity,andmortality(Pasanenetal.,2014).Thereisaneedforfurtherresearchregardingthelongtermbenefitsofparticipatinginphysicalactivityoutdoors,specificallyfocusingontheolderadultpopulation,inordertofurthervalidatethesefindings.Manyexperimentalstudieshavefocusedontheshorttermpositiveeffectsofbeingexposedtonature,suchaschangesinmood,andphysiologicalstressmeasures(Pasanenetal.,2014).Overallgeneralhealthpositivelycorrelateswithphysicalactivityindoorsandoutdoors,whereasemotionalwell-beingshowedmostconsistentpositiveconnectiontophysicalactivitythattookplaceinnature.Thereisalsopromisingevidencewhichsuggestthatbeingphysicallyactiveinnaturecanimprovesleepquality.Thisislikelyduetotheexposuretonaturallight,andphysicalactivity,bothofwhichhavebeenassociatedwithbetterqualityofsleep.Individualsoftencorrelatesleepqualitywiththeirqualityoflife.Anaddedbenefitofbeingoutdoorsistheexposuretosunlight;studiesshowthatevenshortperiodsoftimecanimprovevitaminDlevels,whichisbeneficialforbonehealthinolderadults(Kerretal.,2012).Stayingphysicallyactiveistheclosestadvicethatgerontologistsandgeriatricianshavetoa“silverbullet”topreventandamelioratedepression,heartdisease,andfurtherdisability(Szantonetal.,2015,p.7).Healthcareprovidersthereforehavetheopportunitytoeducatethepublicandhaveapositiveimpactontheirpatients,andthecommunities’,healthrelatedhabits.Providerscanuseverbalcounseling,aswellaswrittenprescriptionsaswaytopromoteoutdoorphysicalactivityinolderadults.AstudyconductedDauenhauer,Podgorski,andKaruza(2006)foundthat41%ofprimarycareprovidersreportnotprescribingexerciseforolderadultsandthat85%ofthesamplereportedhavingnoformaltraininginexerciseprescription.Further,thefewprescriptionsthatprovidersdiddispensewereusuallyinverbalratherthanwrittenformat.Thisidentifiesaneedforfurthereducationofprovidersregardingtheidealformattoprescribephysicalactivity.Inconclusion,beingoutdoorsandbeingactivewerebothrelatedtogreaterself-reportedphysicalfunctioning,lessfearoffalling,andfewerdepressivesymptomsinolderadults.Ifphysicalactivityandoutdoortimebothhaveindependenteffectsonhealth,publichealthguidelinesshouldencourageolderadultstopreformphysicalactivitiesoutdoorsasamoreefficientwaytoobtainbothsetsofheathbenefits(Kerretal.,2012).Thistopicisimportantfromtheperspectivesofcityplanning,individualwell-being,andpublichealth(Pasanenetal.,2014).Healthcareproviderscanpositivelyinfluencetheolderadultcommunitybycounselingandprescribingoutdoorphysicalactivityappropriately.

ExercisingElders:BenefitsofExerciseforBoneHealth

LizHathaway,PhD,MPH,MEdAssistantProfessor,UTCDepartmentofHealthandHumanPerformance

IntheUS,morethan1.5millionosteoporoticfracturesoccurannuallywiththemajorityoftheseoccurringlaterinlifewhenratesofbonelossareattheirhighest(Black&Rosen,2016).Whilenutritionalfactorscanhavedeleteriouseffectsonbonemassandbonestrength,bonelossalsooccurswithlackofweight-bearingphysicalactivities(Booth,Roberts,&Laye,2012).Weight-bearingactivitiesproducebiomechanicalstressesonthebones,beginningacascadeofeventsthatcauseboneremodeling(Castrogiovannietal.,2016).Tomaintainstrength,boneneedsrepeatedstimulation,ofadequatemagnitudetoenableittofunctionproperlyduringactivitiesofdailyliving(Drenjancevic&DavidovicCvetko,2013).Asedentarylifestyle,orphysicalinactivity,causesbonelossduetothelossofstimulationneededtoremodelboneandkeepitstrong(Tremblay,Colley,Saunders,

References

• • •

Bherer,L.,Erickson,K.I.,&Liu-Ambrose,T.(2013).AReviewoftheEffectsofPhysicalActivityandExerciseonCognitiveandBrainFunctionsinOlderAdults.JournalofAgingResearch,2013(657508).http://doi.org/10.1155/2013/657508

Dauenhauer,J.A.P.M.,Podgorski,C.A.P.,&Karuza,J.P.(2006).PrescribingExerciseforOlder

Adults.Gerontology&GeriatricsEducation,26(3),81-99.doi:10.1300/J021v26n03_06Kerr,J.,Marshall,S.,Godbole,S.,Neukam,S.,Crist,K.,Wasilenko,K.,…Buchner,D.(2012).The

RelationshipBetweenOutdoorActivityandHealthinOlderAdultsUsingGPS.InternationalJournalofEnvironmentalResearchandPublicHealth,9(12),4615–4625.http://doi.org/10.3390/ijerph9124615

Pasanen,T.P.,Tyrväinen,L.,&Korpela,K.M.(2014).TheRelationshipbetweenPerceived

HealthandPhysicalActivityIndoors,OutdoorsinBuiltEnvironments,andOutdoorsinNature.AppliedPsychology:HealthAndWell-Being,6(3),324-346.doi:10.1111/aphw.12031

Szanton,S.L.,Walker,R.K.,Roberts,L.,Thorpe,R.J.,Wolff,J.,Agree,E.,...Seplaki,C.(2015).

Olderadults'favoriteactivitiesareresoundinglyactive:FindingsfromtheNHATSstudy.GeriatricNursing,36(2),131-135.doi:10.1016/j.gerinurse.2014.12.008

Healy,&Owen,2010).Twooftheoverarchingbenefitsofexercisepertainingtobonehealthincludeincreasedphysicalfunctioning(Landietal.,2010)anddecreasedriskoffrailty(Petersonetal.,2009).Benefitsofspecifictypesofexerciseareshownbelow(Taylor,2008).BenefitsofDifferentTypesofExercisetoBoneHealthTypeofexercise Benefits

Weight-bearingaerobicexercises

Maintains/buildsbonemass;improvesphysicalfitness,dynamicbalance,corestrength,andfunctionalcapacity

Muscle-strengtheningexercises Improvesfunction,reducesfallandfracturerisk;strengthenslowerextremitymusclesutilizedinweight-bearingposition

Back-strengtheningexercises Improvespostureandenduranceinactivitiesofdailylivingandreducesfractureriskbyreducingcompressionforces

Abdominal-strengtheningexercises*

Improvescorestabilityandstabilizesthespineandpelvis,reducesspinalcompression

Balanceexercises Improvesbalance,reducesfallincidence

Stretching Improvesflexibilityandposture,reducespain

*WithoutspinalflexionAconsensusontheoptimalexerciserecommendationforanindividualregardingbonehealthhasnotbeenreachedasitwouldalsodependontheageofthepersonandtheirbonehealth(Shipp,2006).Anexerciseprogramincludingweight-bearing,muscle-strengthening,andbalanceexercisesdonefor30-40minutesdaily,atleast3daysperweekappeartoachievethepurposeofmaintainingbonemass(Hingorjo,Syed,&Qureshi,2008).Ofcourseeachpersonhastotailortheexercisesaccordingtohisorherown

capabilities,bearinginmindthatsomeexerciseisbetterthannoneatall.Itshouldbenoted,however,thatanyskeletalbenefitacquiredduringexercisewillnotbemaintainediftheindividualreturnstohisorherprevioussedentaryandinactivelifestyle(Winters&Snow,2000).

References

• • •

Black,D.M.,&Rosen,C.J.(2016).ClinicalPractice.PostmenopausalOsteoporosis.NEnglJMed,374(3),254-262.doi:10.1056/NEJMcp1513724

Booth,F.W.,Roberts,C.K.,&Laye,M.J.(2012).Lackofexerciseisamajorcauseofchronic

diseases.ComprPhysiol,2(2),1143-1211.doi:10.1002/cphy.c110025Castrogiovanni,P.,Trovato,F.M.,Szychlinska,M.A.,Nsir,H.,Imbesi,R.,&Musumeci,G.(2016).

Theimportanceofphysicalactivityinosteoporosis.Fromthemolecularpathwaystotheclinicalevidence.HistolHistopathol,31(11),1183-1194.doi:10.14670/hh-11-793

Drenjancevic,I.,&DavidovicCvetko,E.(2013).Influenceofphysicalactivitytobone

metabolism.MedGlas(Zenica),10(1),12-19.Hingorjo,M.R.,Syed,S.,&Qureshi,M.A.(2008).Roleofexerciseinosteoporosisprevention--

currentconcepts.JPakMedAssoc,58(2),78-81.Landi,F.,Abbatecola,A.M.,Provinciali,M.,Corsonello,A.,Bustacchini,S.,Manigrasso,L.,...

Lattanzio,F.(2010).Movingagainstfrailty:doesphysicalactivitymatter?Biogerontology,11(5),537-545.doi:10.1007/s10522-010-9296-1

Peterson,M.J.,Giuliani,C.,Morey,M.C.,Pieper,C.F.,Evenson,K.R.,Mercer,V.,...Simonsick,E.

M.(2009).Physicalactivityasapreventativefactorforfrailty:thehealth,aging,andbodycompositionstudy.JGerontolABiolSciMedSci,64(1),61-68.doi:10.1093/gerona/gln001

Shipp,K.M.(2006).Exerciseforpeoplewithosteoporosis:translatingthescienceintoclinical

practice.CurrOsteoporosRep,4(4),129-133.Taylor,A.W.J.,MichelJ.(2008).PhysiologyofExerciseandHealthyAging.Champaign,IL:

HumanKinetics.Tremblay,M.S.,Colley,R.C.,Saunders,T.J.,Healy,G.N.,&Owen,N.(2010).Physiologicaland

healthimplicationsofasedentarylifestyle.ApplPhysiolNutrMetab,35(6),725-740.doi:10.1139/h10-079

Winters,K.M.,&Snow,C.M.(2000).Detrainingreversespositiveeffectsofexerciseonthe

musculoskeletalsysteminpremenopausalwomen.JBoneMinerRes,15(12),2495-2503.doi:10.1359/jbmr.2000.15.12.2495

DiscovertheUTCSchoolofNursingTheUTCSchoolofNursingisadynamicforceinprovidingqualitynursingeducationandexcellencebyactivelyengagingstudents,facultyandstaffthroughrespectfulpartnerships;fosteringintegrity;embracingdiversityandinclusion;inspiringpositivechangeandprovidingnursingleadershipforthefutureofperson-centeredhealthcare.Theschoolaspirestobetheleaderintransformingnursingeducationandpromotinghealthbyengagingstudents,facultyandgraduatesinadvancinghealthforallpeople.

TheUTCSchoolofNursingoffersdegreeprogramsattheundergraduateandgraduatelevelsincludingtraditionalBSNandRNtoBSNoptions;MSNFamilyNursePractitioner,AdultGerontologyAcuteCareNursePractitionerandNurseAnesthesiaspecialties.ADNPprogramwithoptionsfortheadvancedpracticenurseandfortheBSNdesiringspecialtyinNursingAdministration.CheckouttheUTCSchoolofNursingonlineathttp://www.utc.edu/nursing.

615McCallieAvenue,Dept.1051Chattanooga,TN37401Formoreinformation,pleasecontactBrittanyCusack,VickyGreggChairofGerontology,atBrittany-Cusack@utc.eduorvisitusonlineatwww.utc.edu/nursing.PublicationNumber:E040950-001-16.UTCisanEEO/AA/TitlesVI&IX/Section504/ADA/ADEAinstitution.UTCisacomprehensive,community-engagedcampusoftheUniversityofTennesseeSystem.