Physical Exercise

Healthy and even more so chronically ill older adults are candidates for physical exercise strategies that will lessen the burden of comorbidity, disability, and premature death caused by incident disease. Individualized tailored-multicomponent exercise training, including the combination of resistance training, balance, and/or gait retraining, may be a cornerstone for reducing the incidence of falls in older adults with physical frailty. Besides being safe for both healthy and physiologically vulnerable, frail older adults, a properly designed exercise program is free of the potential unwanted side effects caused by common medications that are prescribed in patients with multiple comorbidities. Dose–response relationships between changes in fitness and better health outcomes have been defined for some, but certainly not for all, diseases and syndromes. Some modalities or doses of exercise that are promoted for older adults (mild calisthenics, slow-paced walking) have little or no discernible effects on physical fitness but may possibly yield benefits in some domains. Such a pilot program, The Vivifrail Project (an EU-funded Project as part of the Erasmus+ program), with rapid screening for physical frailty and sarcopenia, tries to provide training on how to promote and prescribe physical exercise in older adults to maintain a level of function that provides the highest degree of autonomy possible ( http://www.vivifrail.com ).