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Threats to a person’s mobility and independence come in various forms. Some are obvious while others develop gradually and have a cumulative effect, such as sarcopenia.
For many older adults, inactivity is a process that develops over decades. The older some people get, the less active they become. It’s not because of physical limitations; it is a pattern of behavior. Others never were physically active. Inactivity, even among younger and healthier people, leads to loss of strength, reduced range of motion, and increased weight, among other things. Among older adults, each of those problems becomes more pronounced.
One specific physical result of inactivity is sarcopenia—age-related loss of muscle mass and strength. It is a consequence of aging that happens even when people do all the right things, but a systematic program of physical activity can lessen the effects of sarcopenia.
Now there is compelling evidence that specific dietary measures, in addition to resistance exercise, are needed to prevent the loss of muscle mass, strength, and performance in older adults. The evidence is documented in a review of studies conducted by the Nutrition Working Group of the International Osteoporosis Foundation, which strongly suggests that four nutritional factors, in addition to resistance training, are needed to address the problem of sarcopenia:
- Adequate intake of protein
- Increased intake of vitamin D
- Avoiding excessive intake of acid-producing foods, such as meats
- Increased intake of vitamin B12 and folic acid
In October 2012, the journal Clinical Nutrition published the results of a study conducted in Italy suggesting that sarcopenia subjects were three times more likely to fall during a follow-up period of two years than participants without the condition.
Poor low-body function appears to be a common denominator among those whose mobility is being threatened. The reference to “function” may apply to both muscles and the vascular system—muscles weakened by age and inactivity, and a vascular system that does not provide adequate circulation of oxygen-carrying blood to muscles and bones in the legs and feet.
The threat also comes from diseases and disorders. In Parkinson’s disease and multiple sclerosis, for example, the connections to balance and mobility are obvious. In other cases, such as hearing or vision impairment and arthritis, the relationship is more subtle or indirect.
Impaired cognition is a risk factor for falls and restricted mobility. Whether the diagnosis is disease-specific, such as dementia or Alzheimer’s disease, or an impairment of a specific cognitive function (one is called executive function), there is strong evidence that all are associated with fall-related injuries and the resulting limited mobility.
Simply being a patient in a hospital increases your risk of falling and limits your mobility during and after your hospital stay. Up to 50 percent of hospitalized patients are at risk for falls, and almost half of those who fall suffer an injury. Between three and 20 percent of hospital patients actually fall at least once while in the hospital (Centers for Medicare & Medicaid Services).
Finally, one of the biggest threats associated with falls and mobility is a history of falls. Any previous fall increases the risk of another fall by three times. A previous fall can reduce mobility in an older adult because it may result in a physical problem that would lead to subsequent falls. The first fall also might produce feelings of fear and helplessness. The final result: restricted mobility.
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