Landin R J, Linnemeier T J, Rothbaum D A, Chappelear J, Noble R J
Cardiovasc Clin. 1985;15(2):201-18.
As an invariable accompaniment of the aging process, cardiac function declines, that is, cardiac output, stroke volume, heart rate, and maximum oxygen consumption all decrease. The vital capacity declines as residual volume increases, and ventilation-perfusion imbalance increases. Muscles atrophy and weaken, joints stiffen, and bones are demineralized. Certainly the aging process per se explains a portion of this functional deterioration. Disease states also account for some deterioration. However, inasmuch as approximately one half of the deterioration in function can be prevented or reversed by an exercise training program, it would seem that disuse or inactivity is responsible for at least a portion of the functional decline characteristic of aging. Special considerations in prescribing exercise training for the elderly include careful cardiovascular assessment; evaluation of orthopedic problems; consideration of heat intolerance; and careful attention to motivation. The exercise prescription should be specific and tailored to the subject's individual cardiovascular status, musculoskeletal limitations, and personal goals. Walking, stretching calisthenics, and other aerobic activities, if of reasonable intensity and duration, and when preceded and followed by an appropriate warm-up and cool-down period, respectively, can result in a substantial, positive training effect in the elderly. In response to such a training program, elderly subjects demonstrate an increase in stroke volume, cardiac output, and maximum heart rate. Respiratory function changes little, yet maximal oxygen consumption is increased. Fat may be replaced by lean muscle mass as muscle strength and endurance improve. Flexibility is improved and bone demineralization retarded or even reversed. Exercise has a tranquilizing effect on elderly subjects so that anxiety and depression may be prevented. The subject develops self-respect as effort tolerance improves. An excessively conservative attitude on the part of physicians, families, and elderly subjects has resulted in inappropriate activity limitations with a consequent decrement in effort tolerance. Elderly individuals can maintain a reasonable level of effort tolerance or can be rehabilitated to this level of activity with an appropriate exercise program. The decline in overall function expected with age can be substantially retarded. Consequently, physicians, families, and the subjects themselves should consider the potential advantages of an exercise program.
作为衰老过程中不变的伴随现象，心脏功能会下降，即心输出量、每搏输出量、心率和最大耗氧量都会降低。肺活量随着残气量增加而下降，通气/血流失衡加剧。肌肉萎缩且力量减弱，关节僵硬，骨骼脱矿质。当然，衰老过程本身解释了这种功能衰退的一部分原因。疾病状态也导致了一些功能衰退。然而，由于大约一半的功能衰退可以通过运动训练计划来预防或逆转，似乎不运动或缺乏活动至少是衰老所特有的部分功能衰退的原因。为老年人制定运动训练时的特殊考虑因素包括仔细的心血管评估；对骨科问题的评估；对不耐热情况的考虑；以及对动机的密切关注。运动处方应该具体，并根据受试者的个体心血管状况、肌肉骨骼限制和个人目标进行调整。步行、伸展体操和其他有氧运动，如果强度和持续时间合理，并且分别在适当的热身和冷却期之前和之后进行，会对老年人产生显著的积极训练效果。针对这样的训练计划，老年受试者的心搏量、心输出量和最大心率会增加。呼吸功能变化不大，但最大耗氧量会增加。随着肌肉力量和耐力的提高，脂肪可能会被瘦肌肉组织取代。柔韧性得到改善，骨骼脱矿质得到延缓甚至逆转。运动对老年受试者有镇静作用，从而可以预防焦虑和抑郁。随着努力耐受能力的提高，受试者会产生自尊。医生、家庭和老年受试者过度保守的态度导致了不适当的活动限制，从而导致努力耐受能力下降。老年个体可以保持合理水平的努力耐受能力，或者通过适当的运动计划恢复到这种活动水平。预期的随着年龄增长的整体功能下降可以得到显著延缓。因此，医生、家庭和受试者自身都应该考虑运动计划的潜在益处。
