Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel, Laarbeeklaan 10&, 1090 Brussels, Belgium.
Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.
Exp Gerontol. 2021 Apr;146:111236. doi: 10.1016/j.exger.2021.111236. Epub 2021 Jan 13.
Inflammageing - characterized by age-related chronic low-grade inflammation is considered to be positively influenced by physical exercises. The aim of this systematic review is to provide an update of the most recent literature regarding exercise effects on the inflammatory profile in older adults.
This review is an update of an earlier published literature review and was performed according to the NICE guidelines. Databases PubMed and Web-of-Science were systematically searched by two independent authors screening for papers published since 2016. Effect sizes of outcome parameters related to the inflammatory profile were calculated where possible.
RESULTS & DISCUSSION: Twenty-three articles were included. Resistance training (RT) was the most investigated type of exercise (13 articles: 8 in healthy, 1 in frail and 4 in older adults with a specific condition or disease). Aerobic training (AT) was investigated in 8 articles, including 5 studies in older adults with a specific disease or condition. Combined resistance & aerobic training (CT) was investigated in 7 articles: 3 were in healthy, 1 in frail and 3 in older adults with a specific condition or disease. 1 study investigated the effects of Tai Chi in older adults with mild cognitive impairment. In frail older subjects, IGF-1 - sole marker investigated - significantly increased after 8 weeks RT and CT, whereas AT showed no significant effects compared to control. Most consistent exercise effects consisted in lowering of circulating levels of CRP, IL-6 and TNF-α; which seemed more prominent in healthy older adults compared to those with a specific disease or condition. None of the studies reported an exacerbation of inflammation following exercise and all studied exercise protocols were feasible and safe for older adults.
Overall, significant anti-inflammatory effects of exercise in older persons were reported. Literature remains extremely scarce regarding the exercise-induced effects in frail older persons. Therefore, there is an urgent need for more studies focusing on the frail elderly. There is growing literature data on exercise interventions in older adults with a specific condition or disease; however, it appears more challenging to reduce inflammageing through exercise in these specific patient groups. Importantly, the exercise interventions performed in all studies appeared to be feasible and safe for older patients, thus the presence of a specific condition or disease should not be considered as a contra-indication to perform physical exercise.
炎症衰老——其特征是与年龄相关的慢性低度炎症，被认为受到身体锻炼的积极影响。本系统综述的目的是提供最新文献中关于运动对老年人炎症特征影响的更新。
本综述是对早期发表的文献综述的更新，是按照 NICE 指南进行的。两位独立作者通过系统搜索 PubMed 和 Web-of-Science 数据库，筛选出自 2016 年以来发表的论文。在可能的情况下，计算与炎症特征相关的结果参数的效应大小。
共纳入 23 篇文章。抗阻训练（RT）是研究最多的运动类型（13 篇：8 篇在健康人群中，1 篇在虚弱人群中，4 篇在有特定疾病或状况的老年人中）。有氧运动（AT）在 8 篇文章中进行了研究，其中 5 篇研究了有特定疾病或状况的老年人。抗阻与有氧联合训练（CT）在 7 篇文章中进行了研究：3 篇在健康人群中，1 篇在虚弱人群中，3 篇在有特定疾病或状况的老年人中。1 篇研究了太极拳对轻度认知障碍老年人的影响。在虚弱的老年人中，唯一研究的 IGF-1（唯一标志物）在 8 周 RT 和 CT 后显著增加，而 AT 与对照组相比没有显著效果。最一致的运动效果是降低循环 CRP、IL-6 和 TNF-α水平；在健康老年人中，这些效果似乎比有特定疾病或状况的老年人更为明显。没有研究报告运动后炎症加重，所有研究的运动方案对老年人都是可行和安全的。
总体而言，运动对老年人有显著的抗炎作用。关于虚弱老年人运动引起的影响，文献仍然极其缺乏。因此，迫切需要更多的研究关注虚弱的老年人。关于特定疾病或状况的老年患者的运动干预，文献越来越多；然而，通过运动来减轻炎症衰老似乎更具挑战性。重要的是，所有研究中进行的运动干预对老年患者似乎都是可行和安全的，因此特定疾病或状况的存在不应被视为进行体育锻炼的禁忌症。
