frailtyと身体活動

今日はfrailtyと身体活動の論文を紹介します。

F. Landi et al: Moving against frailty: does physical activity matter? Biogerontology DOI 10.1007/s10522-010-9296-1

基本的にfrailtyに対して身体活動は有効というレビューです。サルコペニアにも不活動による能力障害にも認知機能障害の予防にも抑うつ状態の改善にも、身体活動は有用です。

身体活動によって慢性炎症が改善するという報告があります。サルコペニアの原因の1つとして慢性炎症が考えられていて、そのために身体活動がサルコペニア対策として最も有効なのではないかという仮説があります。

身体活動は定期的な運動であれば有酸素運動でもレジスタンストレーニングでもよいですし、両方組み合わせればなおよいです。有酸素運動は歩行、家事、庭仕事程度でも十分です。

さらなる研究が必要と記載されていますが、個人的には身体活動のエビデンスをさらに検証するよりも、エビデンス-プラクティスギャップをいかに少なくするかのほうが重要な気がしています。高齢者に限らず若い人でも運動習慣がある人は少ないですし、私も他人事ではありません…。

Abstract Frailty is a common condition in older
persons and has been described as a geriatric syndrome
resulting from age-related cumulative declines
across multiple physiologic systems, with impaired
homeostatic reserve and a reduced capacity of the
organism to resist stress. Therefore, frailty is considered
as a state of high vulnerability for adverse health
outcomes, such as disability, falls, hospitalization,
institutionalization, and mortality. Regular physical
activity has been shown to protect against diverse
components of the frailty syndrome in men and
women of all ages and frailty is not a contra-indication
to physical activity, rather it may be one of the most
important reasons to prescribe physical exercise. It has
been recognized that physical activity can have an
impact on different components of the frailty syndrome.
This review will address the role of physical
activity on the most relevant components of frailty
syndrome, with specific reference to: (i) sarcopenia, as
a condition which frequently overlaps with frailty; (ii)
functional impairment, considering the role of physical
inactivity as one of the strongest predictors of
physical disability in elders; (iii) cognitive performance,
including evidence on how exercise and
physical activity decrease the risk of early cognitive
decline and poor cognition in late life; and (iv)
depression by reviewing the effect of exercise on
improving mood and increasing positive well-being.