Physical exercise, the best medicine

Physical activity is the best medicine to achieve general well-being, and in the elderly it is a priority to integrate exercise into care programs for patients with frailty and in the practice of Geriatric Medicine.

These are the conclusions obtained in an international consensus statement led by Mikel Izquierdo, group head of the CIBER for Frailty and Healthy Aging (Ciberfes) at the Public University of Navarra, in which the main scientific institutions on physical exercise and healthy aging participate. of all the world.

This work provides an evidence-based rationale for the use of exercise and physical activity for health promotion and disease prevention and treatment in older adults. The prescription of physical exercise is discussed in terms of specific modalities and “dosages” that have been studied in randomized controlled trials to evaluate their efficacy in attenuating the physiological changes of aging, disease prevention, and amelioration of chronic conditions. “We propose recommendations to bridge the gaps in the current scientific literature and optimize the use of exercise and physical activity both as preventive medicine and as a therapeutic agent,” explains Ciberfes researcher Mikel Izquierdo.


Insufficient practice of physical activity, exercise and excessive sedentary behaviors are risk factors for mortality.

Cardiovascular ailments, obesity, sarcopenia, frailty and lack of autonomy, among others, are chronic health problems associated with aging. Izquierdo, the first signatory of this declaration, considers that on the contrary “in the presence of adequate and healthy exercise or physical activity, these changes in muscular and aerobic capacity with age are substantially attenuated”.

Physical activity (including participation in structured exercise) influences key aging factors in the elderly as well, (including chronic inflammation, mitochondrial dysfunction, autophagy, oxidative damage, etc.).

Exercise and physical activity improve general body functions and quality of life, reduce the burden of chronic disease, premature overall mortality, and mortality from cardiovascular disease, cancer, and chronic respiratory diseases. Thus, the beneficial effects of exercise are global and act both at the physiological multisystem level and at the functional capacity level.


Scientists believe that an appropriate exercise prescription should be included in all health care recommendations in an effort to improve functional independence, psychological well-being, and quality of life for all older adults, fit or frail, from any age.

This work emphasizes that taking into account the accumulated evidence of the benefits of exercise in frail elderly people over decades, it is not justified not to prescribe it, so one of the main challenges for the future is to integrate exercise programs as a mandatory part of the activity of caring for pre-frail and frail elderly patients in all hospital, outpatient and care settings.


Despite its many benefits, exercise is not fully integrated into the practice of geriatric medicine. It is still absent from the basic training of most geriatricians and other health professionals. Additionally, few studies have explored the potential role of tailored physical activity patterns to maximize exercise-related effects on function, the ability to perform activities of daily living, or other domains of intrinsic ability, such as cognitive deficits. , psychological or sensory, and locomotion or vitality in the elderly, which is probably related to the scarcity of research in this area.


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