Abstract

Chronic conditions are common in the older population and the co-occurrence of multiple conditions increases with increasing age. Ultimately, the consequences of chronic conditions, particularly functional consequences, play a critical role in loss of independence and decline in quality of life. Although a major effort has gone into disease prevention, less attention has been paid to reduction of the impact of chronic diseases on capability and well-being.

There is strong epidemiologic evidence supporting the roles of multiple factors in loss of capability and well-being. In particular, both length and quality of life in the older population may improve with reduction of behavioural risk factors such as smoking, poor nutrition and obesity, heavy use of alcohol, and sedentary life style. This talk will focus on the wide array of epidemiologic evidence linking physical activity and improved physical functioning in older persons. In addition to this evidence from observational studies, epidemiological research has also provided approaches to identifying non-disabled older persons who are at high risk of becoming disabled in the future and are thus prime targets for preventive interventions. An example of the use of a simple battery of objective performance tests to predict disability onset will be presented. Finally, this talk will discuss the reasons why even an abundance of consistent observational findings cannot prove that physical activity prevents disability and will describe a landmark randomised controlled trial in the USA that is, designed to demonstrate the causal relationship between increased physical activity and reduction of disability risk.