Exercise and Physical Activity for Older Adults by Unknown

Author:Unknown
Language: eng
Format: epub
Publisher: Human Kinetics, Inc.

MEDICATION CONSIDERATIONS

Older adults are more likely to be taking one or more medications that may affect exercise performance, safety, and physical activity levels, with approximately 30% of older adults age 65 and older taking five or more medications (Matsuo, So, Sasai, & Ohkawara, 2017; Scholes et al., 2014; Woods, Weinborn, Velnoweth, Rooney, & Bucks, 2012). These effects may be more pronounced in older adults given the way that the aging process changes pharmacodynamics and pharmacokinetics (i.e., the ways that medications are absorbed, excreted, and metabolized). Reductions in lean body mass, total body water content, transit time of the gastrointestinal system, and efficiency of the liver and kidneys all contribute to the increased likelihood of side effects and the potential for toxicity (Matsuo et al., 2017). In addition, some medications may affect exercise responses and alter exercise prescription (Fletcher et al., 2013; Scholes et al., 2014). For example, beta-blockers are a common heart medication given for angina in older adults with CVD, and their primary mechanism of action is to block beta receptors, which are responsive to sympathetic nervous system stimulation. These effects may prevent the predictable rise in heart rate (HR) and blood pressure (BP) expected during an exercise test, which may confound interpretation. Nevertheless, it is routine to continue beta-blockers, and most other cardiovascular medications, during an exercise test, as this is vital for safety (Fletcher et al., 2013). Thus, exercise testing results and exercise prescription usually rely relatively more on ratings of perceived exertion (RPE) or gas exchange assessments rather than HR as an index of exercise intensity.

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