Preserving mobility in older adults.
Preserving mobility in older adults.
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发表时间：
1997-10
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通讯作者：
D. Buchner
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作者：
D. Buchner
与年龄相关的力量丧失会导致行动能力受损，并增加跌倒的风险。最近的研究集中在预防与年龄相关的力量丧失的两种方法上——促进体育活动和锻炼（尤其是力量训练），以及使用营养因子来提高肌肉性能。流行病学证据强烈支持有规律的体育活动通过保持肌肉功能、促进活动能力和减少跌倒风险，在成功衰老中发挥作用。随机对照试验提供了令人信服的证据，证明力量和耐力训练可以改善老年人的肌肉表现。从随机试验中迅速积累的证据表明，耐力、力量和平衡训练可以促进活动能力并降低跌倒风险，尽管运动的效果因运动类型、运动计划的细节和老年人的目标群体而异。因为建议所有老年人终生定期进行体育锻炼，一个合理的策略（尤其是对身体虚弱的成年人）是包括力量训练在内的活动计划。相比之下，没有足够的证据建议长期使用营养因子来保持肌肉性能。一项值得进一步研究的干预措施是避免使用精神活性药物，因为苯二氮卓类药物似乎是缺乏活动的危险因素，可能对肌肉表现有未被认识到的直接影响。由于慢性疾病是不活动和废用性肌肉萎缩的危险因素，比较力量训练与其他干预措施的随机试验将有助于了解力量训练是否在保持肌肉性能和改善各种慢性疾病（如抑郁症）的健康相关生活质量方面具有优势。
Age-related loss of strength contributes to impaired mobility and increases the risk of falls. Recent research has focused on 2 approaches to preventing age-related loss of strength--promoting physical activity and exercise (especially strength training) and using trophic factors to enhance muscle performance. Epidemiologic evidence strongly supports a role of regular physical activity in successful aging by preserving muscle performance, promoting mobility, and reducing fall risk. Randomized controlled trials provide convincing evidence that strength and endurance training improve muscle performance in older adults. Evidence is rapidly accumulating from randomized trials that endurance, strength, and balance training promote mobility and reduce fall risk, though exercise effects differ according to the type of exercise, details of the exercise program, and the target group of older adults. Because lifetime regular physical activity is recommended for all older adults, a reasonable strategy (especially for weak adults) is an activity program that includes strength training. In contrast, insufficient evidence exists to recommend the long-term use of trophic factors to preserve muscular performance. An intervention that merits additional study is avoiding the use of psychoactive drugs because drugs like benzodiazepines appear to be risk factors for inactivity and may have unrecognized direct effects on muscular performance. Because chronic illness is a risk factor for inactivity and disuse muscle atrophy, randomized trials comparing strength training with other interventions would be useful in understanding whether strength training has advantages in preserving muscle performance and improving health-related quality of life in a variety of chronic illnesses such as depressive illness.