Anabolic responses to resistance training in older men and women: a brief review

Resistance training has been shown to be the most effective exercise mode to induce anabolic adaptations in older men and women. Advances in imaging techniques and histochemistry have increased the ability to detect such changes, confirming the high level of adaptability that remains in aging skeletal muscle. This brief review presents a summary of the resistance-training studies that directly compare chronic anabolic responses to training in older (>60 years) men and women. Sixteen studies are summarized, most of which indicate similar relative anabolic responses between older men and women after resistance training. Relatively small sample sizes in most of the interventions limited their ability to detect significant sex differences and should be considered when interpreting these studies. Future research should incorporate larger sample sizes with multiple measurement time points for anabolic responses.     

Use of endocrine hormones for treating depression

Disturbances in some endocrine hormones have been implicated in the pathophysiology of depression. Some of these hormones (and drugs that affect hormone function) have been used as therapeutic agents for the treatment of depression, especially adrenal, thyroid, and gonadal axis hormones. Open-label and controlled studies of various drugs that directly suppress or inhibit adrenal axis function have shown some benefit for the treatment of major depression, including treatment-resistant depression. Thyroid hormone augmentation is effective for nonresponders to antidepressant agents, although it has not been studied extensively. Estrogen may improve mild mood symptoms in perimenopausal women but may not be effective alone for major depression. Evidence of the antidepressant effects of testosterone in men is inconsistent, with mixed results from controlled studies. The adrenal steroid hormone dehydroepiandrosterone has an important role in mood regulation and may have significant antidepressant effects.     

Estrogen treatment affects brain functioning after menopause

Sex hormones have powerful neuromodulatory effects on functional brain organization and cognitive functioning. This paper reviews findings from studies investigating the influence of sex hormones in postmenopausal women with and without hormone therapy (HT). Functional brain organization was investigated using different behavioural tasks in postmenopausal women using either estrogen therapy or combined estrogen plus gestagen therapy and age- and IQ-matched postmenopausal women not taking HT. The results revealed HT-related modulations in specific aspects of functional brain organization including functional cerebral asymmetries and interhemispheric interaction. In contrast to younger women during the menstrual cycle, however, it seems that HT, and especially estrogen therapy, after menopause affects intrahemispheric processing rather than interhemispheric interaction. This might be explained by a faster and more pronounced age-related decline in intrahemispheric relative to interhemispheric functioning, which might be associated with higher sensitivity to HT. Taken together, the findings suggest that the female brain retains its plasticity even after reproductive age and remains susceptible to the effects of sex hormones throughout the lifetime, which might help to discover new clinical approaches in the hormonal treatment of neurological and psychiatric disorders.     

Improving quality of life in old age: the role of regular physical activity

Physical activity in old age has been shown to produce considerable physiological, psychological and social benefits. However, many older adults take very little exercise. Lack of facilities or meaningful role models together with social and cultural expectations concerning the appropriateness of physical activity for older adults have been cited as reasons for lack of involvement. The development of intergenerational programs is suggested as a potential means of increasing the proportion of older individuals who participate in regular physical exercise.     

Community exercise program for older adults recovering from hip fracture: a pilot study

Community-based rehabilitative exercise programs might be an effective means to improve functional outcomes for hip-fracture patients. The purpose of this study was to evaluate the effectiveness of a community exercise program (CEP) for older adults recovering from hip fracture. Twenty-five older adults (mean age 80.0 +/- 6.0 years; 24 women; 71 +/- 23 days post-hip fracture) participated in this pilot study (17 exercise, 8 control). The CEP involved functional stepping and lower extremity-strengthening exercises. Control participants received only standard outpatient therapy. Measures of functional mobility, balance confidence, falls efficacy, lower extremity strength, and daily physical activity were evaluated at baseline and at 16 weeks. Improvements for self-reported physical activity, mobility, balance, and knee-extensor strength were observed for the CEP group. This study demonstrated that a CEP is beneficial for community-dwelling older adults post-hip fracture.     

Alterations in IGF-I affect elderly: role of physical activity

The growth hormone–insulin-like growth factor I (IGF-I) axis is an important physiological regulator muscle for development. Although there is evidence that aging muscle retains the ability to synthesize IGF-I, there is also evidence that aging may be associated with attenuation of the ability of exercise to induce an isoform of IGF-I that promotes satellite cell proliferation. However, it is clear that overexpression of IGF-I in the muscle can protect against age-related sarcopenia. Strength training appears to be the intervention of choice for the prevention and treatment of sarcopenia. IGF-I has been implicated in the loss of the muscle with age, and IGF-I expression levels change as a consequence of strength training in older adults. However, it seems that advancing age, rather than declining serum levels of IGF-I, appears to be a major determinant of life-time changes in body composition in women and men. We concluded that resistive exercise is a significant determinant of muscle mass and function. Elevated levels of IGF-I have been found in physically active compared to sedentary individuals. Recent work suggests that IGF-I as a mediator plays an important role in muscle hypertrophy and angiogenesis, both of which characterize the anabolic adaptation of muscles to exercise.     

Sex-dependent associations between daily physical activity and leg exercise blood pressure responses

The authors examined interindividual and sex-specific variation in systolic (SBP) and diastolic (DBP) blood pressure responses to graded leg-extension exercise in healthy older (60-78 yr) women (n = 21) and men (n = 19). Maximal oxygen uptake (VO2max), body composition, physical activity (accelerometry), and vascular function were measured to identify predictors of exercise BP. Neither VO2max nor activity counts were associated with the rise in SBP or DBP during exercise in men. The strongest predictors of these responses in men were age (SBP: r2 = .19, p = .05) and peak exercise leg vasodilation (DBP: r2 = -.21, p < .05). In women, the modest relationship observed between VO2max and exercise BP was abolished after adjusting for central adiposity and activity counts (best predictors, cumulative r2 = .53, p < .05, for both SBP and DBP). These results suggest that determinants of variation in submaximal exercise BP responses among older adults are sex specific, with daily physical activity influencing these responses in women but not men.     

Health-related quality of life in old age: preliminary report on the male perspective

Health-related quality of life is a key element of successful aging. With life expectancy increasing, postmenopausal estrogen/gestagen replacement therapy has been under discussion for some time with the aim of achieving a higher quality of life in old age. For a long time, the relevance of hormonal aging was only discussed with reference to women; however, more recent work deals with concepts that affect both sexes. According to recent studies, numerous symptoms and complaints which may impair quality of life, can be attributed to hormonal changes in old age in both women and men. The majority of age-related complaints, such as a decline in physical performance, decreased sexual activity and a deterioration of general well-being, are strongly reminiscent of the symptoms of classical pituitary disorders in adulthood. Since the early 1990s, scientific studies have also been investigating the influence of hormone 'replacement' in elderly men, using, for example, growth hormones. However, until now there has been no suitable measure for assessing the quality of life specifically in elderly men. In a research project aimed at developing a questionnaire (the VITA? questionnaire), roughly equal numbers of elderly men and women were asked about their subjective health and quality of life. It was found that men assessed their health-related quality of life very positively in a number of different dimensions of the questionnaire. In the present article the individual aspects of the quality of life of men are described and examples of gender-related differences are presented and discussed.     

Pilot study comparing physical and psychological responses in medical qigong and walking

Identifying alternative exercise modalities in an effort to stimulate and promote participation in physical activity, especially among older adults, is a critical health consideration. The purpose of this study was to compare physiological and psychological responses to medical qigong with self-paced brisk walking. Older women (55-79 years) performed 22 min of either qigong or walking on two separate days. During exercise performance, heart rate and ratings of perceived exertion were assessed. Psychological affect, blood pressure, and pulse rate were assessed before and after the exercise bouts. Heart-rate data indicated that both forms of exercise were at a moderate level of intensity. In addition, similar values were found for the physiological and psychological variables as a function of the two forms of exercise. Therefore, it was concluded that this form of medical qigong can be considered a moderate-intensity physical activity that should have both physiological and psychological benefits for older women.     

Sex,Endocrines, and Political Behavior

While political behavioral differences between men and women appear to have been exaggerated, some continue to be validly observed. Evidence from several diciplines suggests that such differences may be biological in origin, mediated through the endocrine system. Variance in concentrations of certain hormones may have behavioral consequences. Since an experimental test in which these concentrations would be directly manipulated is not feasible, a design was developed which relies on the naturally-occurring hormonal variance of the female menstrual cycle. Subjects responded to a survey instrument and also supplied physiological data including, for women, location in the menstrual sysle. Hylpothesized differences in the reponses of women experiencing diverse concentrations of key endocrines failed to appear.     

Tai Chi-based exercise for older adults with Parkinson's disease: a pilot-program evaluation

The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson's disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.     

The association between mood states and physical activity in postmenopausal, obese, sedentary women

Mood states influence evaluative judgments that can affect the decision to exercise or to continue to exercise. This study examined how mood associated with graded exercise testing (GXT) in sedentary, obese, postmenopausal women (N = 25) was associated with physical activity and predicted VO2max during and after a behavioral weight-loss program (BWLP). Measures of physical activity included planned exercise, calories from physical activity, leisure-time physical activity, and predicted VO2max. Mood before and after pre-BWLP GXT was assessed using the Profile of Mood States. Mood before and after the GXT was more strongly associated with planned exercise than other forms of physical activity, and this effect became stronger over time. Mood enhancement in response to exercise was not related to physical activity. Mood before and after exercise might yield important clinical information that can be used to promote physical activity in sedentary adults.     

Affective and self-efficacy responses to acute aerobic exercise in sedentary older and younger adults

This study examined the psychological responses to an acute bout of aerobic exercise in sedentary older and younger adults. Eighteen young (mean age 24 years) and 15 older adults (mean age 64 years) completed a 20-min bout of stationary cycling at 65% of VO2peak. Affective responses were assessed before, during, and immediately after exercise. Participants'exercise self-efficacy beliefs were assessed before and immediately after exercise. Both groups reported reduced pleasant feeling states and self-efficacy and increased physical exhaustion in response to acute exercise. Older adults also demonstrated a significant decrease in revitalization during and after cycling. Correlation analyses revealed that self-efficacy was related to feelings of fatigue during exercise and postexercise feelings of energy and fatigue. Both groups reported negative shifts in affect and self-efficacy during and 5 min after cycling.Acute affective and self-efficacy responses might influence one's motivation to adopt and maintain regular physical activity. The relationship between these acute responses and physical activity behavior across the life span warrants future inquiry.     

A proposal for a new screening paradigm and tool called Exercise Assessment and Screening for You (EASY)

The Exercise Assessment and Screening for You (EASY) is a tool developed to help older individuals, their health care providers, and exercise professionals identify different types of exercise and physical activity regimens that can be tailored to meet the existing health conditions, illnesses, or disabilities of older adults. The EASY tool includes 6 screening questions that were developed based on an expert roundtable and follow-up panel activities. The philosophy behind the EASY is that screening should be a dynamic process in which participants learn to appreciate the importance of engaging in regular exercise, attending to health changes, recognizing a full range of signs and symptoms that might indicate potentially harmful events, and becoming familiar with simple safety tips for initiating and progressively increasing physical activity patterns. Representing a paradigm shift from traditional screening approaches that focus on potential risks of exercising, this tool emphasizes the benefits of exercise and physical activity for all individuals.     

Sex, age, season, and habitual physical activity of older Japanese: the Nakanojo study

The interactions of sex, age, season, and habitual physical activity were examined in 41 male and 54 female Japanese age 65-83 yr, using a pedometer/accelerometer that determined step counts and amounts of physical activity (<3 and >3 metabolic equivalents [METs]) throughout each 24-hr period for an entire year. All 3 measures were greater in men than in women. In women, age was negatively correlated with step count and activity <3 METs, but in men, it was correlated with step count and activity >3 METs. Irrespective of sex or age, all 3 activity variables were low in the winter, peaking in spring or autumn. In the summer, step counts matched the annual average, but durations of activity <3 and >3 METs were, respectively, longer and shorter than in other seasons. These findings have practical implications for those promoting physical activity for older adults.     

Severe premenstrual syndrome and bipolar disorder: a tragic confusion

Bipolar disorder and severe premenstrual syndrome (PMS) have many symptoms in common, but it is important to establish the correct diagnosis between a severe psychiatric disorder and an endocrine disorder appropriately treatable with hormones. The measurement of hormone levels is not helpful in making this distinction, as they are all premenopausal women with normal follicle-stimulating hormone and estradiol levels. The diagnosis of PMS should come from the history relating the occurrence of cyclical mood and behaviour changes with menstruation, the improvement during pregnancy, postnatal depression and the presence of runs of many good days a month and the somatic symptoms of mastalgia, bloating and headaches. Young women with severe PMS do not respond to the antidepressants and mood-stabilizing drugs typically used for bipolar disorder.     

Physical activity, genes, and lifetime predisposition to chronic disease

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts related to the role of genetic factors in studies evaluating the effects of physical activity/exercise therapy on chronic disease prevention/treatment during the life course. Many observational cohort studies have shown that high physical activity during young adulthood or middle age is associated with reduced later life morbidity, mobility limitations and mortality. Physical activity or exercise therapy has a positive effect on health via many disease-specific mechanisms. The most consistent finding of the various randomized controlled studies conducted to date is that aerobic/functional capacity and/or muscle strength can be improved by exercise training among patients with different chronic diseases. Genes are known to play a role in chronic disease predisposition and to contribute to physical fitness levels, physical activity participation and ageing. Physical fitness, physical activity and health outcomes may be partly due to underlying genetic factors that have a favourable effect on all these traits (genetic pleiotropy). This means that in observational studies, the relationship between baseline activity and the later occurrence of diseases may not be interpreted entirely as causal. Increased knowledge on the role of nuclear genome, mitochondrial genome, epigenetics, telomeres and regulation of gene expression will increase our understanding of their relationships with physical activity and morbidity.     

Does physical exercise improve perceptual skills and visuospatial attention in older adults? A review

Neuroimaging studies suggest that when the brain ages, more areas are involved to perform a task in order to obtain the same results. This, together with the increase in crystalized intelligence and wisdom, is usually considered as a compensatory strategy. Research has demonstrated that physical activity might also act as a strategy and be one of the main factors that can slow down age-related perceptual and cognitive decline. Research also suggests that different types of physical exercise and sport lead to different changes in perceptual and cognitive skills as well as in several areas of the brain, especially those involving multiple domains, such as exergaming, dance or some sports. This review summarizes the findings of recent studies with older adults investigating the brain and cognitive benefits of different forms of physical exercise. Visuospatial attention, which plays a critical role in our daily lives, especially for older adults, is a central part of this analysis.     

Effects of androgens in men with the metabolic syndrome

The metabolic syndrome is well recognized as the association between obesity, elevated blood lipids, hypertension, hepatic steatosis, impaired glucose tolerance/diabetes mellitus type II and increased risk for cardiovascular disease. Recently, several publications have demonstrated that uisceral accumulation of fat seems to be more important than general obesity and that several endocrine disturbances should be included in this syndrome. The first observations concerning the importance of body fat distribution and endocrine disturbances, however, were made in the 1940s and later confirmed by further research. Concerning the endocrine disturbances, we have specifically found that abdominal, i.e. visceral, type of obesity is associated with low levels of sex steroids in both men and women, increased Cortisol activity as well as a blunted growth hormone action. In several hormonal intervention studies, we have also demonstrated favorable effects on visceral obesity, insulin sensitivity, blood lipids and blood pressure. Furthermore, recent results from our research group have indicated that this complex of signs and diseases is associated with psychiatric signs such as mental stress, signs of melancholy and decreased life satisfaction. In order to explain better the possible pathogenesis of these risk factors and diseases, the term ‘the neuroendocrine syndrome’ seems to be more adequate. This article willfocus on important biological mechanisms in hormonal intervention strategies, especially androgen treatment, for patients with this syndrome.     

Aging effects on joint proprioception: the role of physical activity in proprioception preservation

Throughout the human life span the functions of several physiological systems dramatically change, including proprioception. Impaired proprioception leads to less accurate detection of body position changes increasing the risk of fall, and to abnormal joint biomechanics during functional activities so, over a period of time, degenerative joint disease may result. Altered neuromuscular control of the lower limb and consequently poor balance resulting from changes in the proprioceptive function could be related to the high incidence of harmful falls that occur in old age subjects. There is evidence of proprioception deterioration with aging. Regular physical activity seems to be a beneficial strategy to preserve proprioception and prevent falls among older subjects. Some studies have demonstrated that the regular physical activity can attenuate age-related decline in proprioception. This paper reviews the evidence of age effects on joint proprioception. We will discuss the possible mechanisms behind these effects and the role of regular physical activity in the attenuation of age-related decline in proprioception.