title: Relationship between physical functioning and physical activity in the lifestyle interventions and independence for elders pilot. Dose Response to Exercise in Women aged 45-75 yr (DREW): design and rationale. Effectiveness of a Targeted Exercise Intervention in Reversing Older People's Mild Balance Dysfunction: A Randomized Controlled Trial Genetic and lifestyle predictors of 15-year longitudinal change in episodic memory. Dose-response relationship between moderate-intensity exercise duration and coronary heart disease risk factors in postmenopausal women. Heart Rate Variability Characteristics in Sedentary Postmenopausal Women Following Six Months of Exercise Training: The DREW Study Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing Exercise to Enhance Mobility and Prevent Falls After Stroke Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. Physical activity social support and middle- and older-aged minority women: results from a US survey. What is the benefit of a high-intensive exercise program on health-related quality of life and depression after stroke? A randomized controlled trial Physical activity and risk of cognitive impairment and dementia in elderly persons. Healthy behaviors and onset of functional disability in older adults: results of a national longitudinal study. Moderators and mediators of exercise-induced objective sleep improvements in midlife and older adults with sleep complaints. Associations between low levels of serum estradiol, bone density, and fractures among elderly women: the study of osteoporotic fractures. Incidence of and predictors for chronic disability in activities of daily living among older people in Taiwan. Improved Physical Fitness Among Older Female Participants in a Nationally Disseminated, Community-Based Exercise Program Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: results of a randomized controlled trial. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease Effects of a regular walking exercise program on behavioral and biochemical aspects in elderly people with type II diabetes. Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. Influence of exercise on mood in postmenopausal women. A randomized controlled clinical trial of the Seattle Protocol for Activity in older adults. A 2-year follow-up of a lifestyle physical activity versus a structured exercise intervention in older adults. Physical activity, menopause, and quality of life: the role of affect and self-worth across time 3 Different types of strength training in older women. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Health behaviors as predictors for declines in higher-level functional capacity in older adults: the Ohasama study. Long-term follow-up of physical activity behavior in older adults. Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. Postural control in elderly women with osteoporosis: comparison of balance, strengthening and stretching exercises. A randomized controlled trial Heart rate variability and exercise in aging women.
abstract: OBJECTIVES To determine whether participation in usual moderate-intensity or more-vigorous physical activity ( MVPA ) is associated with physical function performance and to identify sociodemographic , psychosocial , and disease-related covariates that may also compromise physical function performance . DESIGN Cross-sectional analysis of baseline variables of a r and omized controlled intervention trial . SETTING Four academic research centers . PARTICIPANTS Four hundred twenty-four older adults aged 70 to 89 at risk for mobility disability ( scoring < 10 on the Short Physical Performance Battery ( SPPB ) ) and able to complete the 400-m walk test within 15 minutes . MEASUREMENTS  Minutes of MVPA ( dichotomized according to above or below 150 min/wk of MVPA ) assessed according to the Community Healthy Activities Model Program for Seniors question naire , SPPB score , 400-m walk test , sex , body mass index ( BMI ) , depressive symptoms , age , and number of medications . RESULTS The SPPB summary score was associated with minutes of MVPA ( ρ=0.16 , P=.001 ) . In multiple regression analyses , age , minutes of MVPA , number of medications , and depressive symptoms were associated with performance on the composite SPPB ( P<.05 ) . There was an association between 400-m walk time and minutes of MVPA ( ρ=-0.18 ; P<.001 ) . In multiple regression analyses , age , sex , minutes of MVPA , BMI , and number of medications were associated with performance on the 400-m walk test ( P<.05 ) . CONCLUSION Minutes of MVPA , sex , BMI , depressive symptoms , age , and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability INTRODUCTION AND PURPOSE Physical inactivity in postmenopausal women contributes to a rise in atherogenic risk factors associated with the metabolic syndrome . Although regular physical activity positively contributes to health , inactivity progressively increases with age . The Dose Response to Exercise in Women aged 45 - 75 yr ( DREW ) study is design ed to investigate the effect of different amounts of exercise training on cardiorespiratory fitness and risk factors for cardiovascular disease ( CVD ) in postmenopausal women at moderately increased risk of CVD . METHODS DREW will recruit 450 sedentary , healthy , postmenopausal women with a body mass index of 25 - 40 kg.m-2 , resting systolic blood pressure ( BP ) of 120 - 159 mm Hg , and a resting diastolic BP of < or = 99 mm Hg . Laboratory and self-report measures completed at baseline and 6 months include maximal oxygen consumption ( .VO2max ) , resting BP , anthropometry , dietary habits , physical activity history , medication use , menstrual history , personal and family medical history , and fasting HDL cholesterol , LDL cholesterol , triglycerides , and glucose . Eligible participants are r and omly assigned to a nonexercise group or one of three exercise groups . Participants exercise 3 to 4x wk-1 at a heart rate equivalent to 50 % of .VO2max expending 4 , 8 , or 12 kcal.kg-1.wk-1 , depending on group assignment . This study will allow quantification of possible dose-response relations ( 50 % , 100 % , and 150 % of the consensus physical activity recommendation ) between exercise training and study outcomes . CONCLUSION DREW can make important contributions to our underst and ing of the effects of physical activity in postmenopausal women and help refine public health and clinical recommendations for this group Background Previous research has mainly targeted older people with high risk of falling . The effectiveness of exercise interventions in older people with mild levels of balance dysfunction remains unexplored . Objective This study evaluated the effectiveness of a home balance and strength exercise intervention in older people systematic ally screened as having mild balance dysfunction . Design This was a community-based , r and omized controlled trial with assessors blinded to group allocation . Participants Study participants were older people who reported concerns about their balance but remained community ambulant ( n=225 ) . After a comprehensive balance assessment , those classified as having mild balance dysfunction ( n=165 ) were r and omized into the trial . Intervention Participants in the intervention group ( n=83 ) received a 6-month physical therapist – prescribed balance and strength home exercise program , based on the Otago Exercise Program and the Visual Health Information Balance and Vestibular Exercise Kit . Participants in the control group ( n=82 ) continued with their usual activities . Outcome Measures Laboratory and clinical measures of balance , mobility , and strength were assessed at baseline and at a 6-month re assessment . Results After 6 months , the intervention group ( n=59 ) significantly improved relative to the control group ( n=62 ) for : the Functional Reach Test ( mean difference=2.95 cm , 95 % confidence interval [CI]=1.75 to 4.15 ) , the Step Test ( 2.10 steps/15 seconds , 95 % CI=1.17 to 3.02 ) , hip abductor strength ( 0.02 , 95 % CI=0.01 to 0.03 ) , and gait step width ( 2.17 cm , 95 % CI=1.23 to 3.11 ) . There were nonsignificant trends for improvement on most other measures . Fourteen participants in the intervention group ( 23.7 % ) achieved balance performance within the normative range following the exercise program , compared with 3 participants ( 4.8 % ) in the control group . Limitations Loss to follow-up ( 26.6 % ) was slightly higher than in some similar studies but was unlikely to have biased the results . Conclusions A physical therapist – prescribed home exercise program targeting balance and strength was effective in improving a number of balance and related outcomes in older people with mild balance impairment OBJECTIVES To reveal distinct longitudinal trajectories in episodic memory over 15 years and to identify demographic , lifestyle , health-related , and genetic predictors of stability or decline . DESIGN Prospect i ve cohort study . SETTING The Betula Project , Umeå , Sweden . PARTICIPANTS One thous and nine hundred fifty-four healthy participants aged 35 to 85 at baseline . MEASUREMENTS Memory was assessed according to vali date d episodic memory tasks in participants from a large population -based sample . Data were analyzed using a r and om-effects pattern-mixture model that considered the effect of attrition over two to four longitudinal sessions .  Logistic regression  was used to determine significant predictors of stability or decline relative to average change in episodic memory . RESULTS Of 1,558 participants with two or more test sessions , 18 % were classified as maintainers and 13 % as decliners , and 68 % showed age-typical average change . More educated and more physically active participants , women , and those living with someone were more likely to be classified as maintainers , as were carriers of the met allele of the catechol-O-methyltransferase gene . Less educated participants , those not active in the labor force , and men were more likely to be classified as decliners , and the apolipoprotein E ~4 allele was more frequent in decliners . CONCLUSION Quantitative , attrition-corrected assessment of longitudinal changes in memory can reveal substantial heterogeneity in aging trajectories , and genetic and lifestyle factors predict such heterogeneity PURPOSE This study was design ed to investigate whether , in a dose-response manner , there would be greater health benefits in a group of postmenopausal women completing 45 minute- vs. 30 minutes of moderate intensity ( 50 % maximal oxygen uptake reserve , VO2R ) exercise 5 days . wk(-1 ) . METHODS Apparently healthy but sedentary postmenopausal women ( n = 33 ) were r and omized to a nonexercise control group , a 30-minute exercise duration group , or a 45-minute exercise duration group . Exercise training was performed 5 days . wk(-1 ) for 12 weeks at 50 % VO2R . Participants were instructed to not change their usual diet throughout the study . RESULTS Twenty-six women completed the study . After 12 weeks , VO2max increased significantly ( p < 0.05 ) in both 30-minute ( 0.20 + /- 0.21 L . min(-1 ) ) and 45-minute ( 0.41 + /- 0.10 L . min(-1 ) ) groups . Repeated measures ANOVA identified a significant interaction between exercise duration and VO2max values ( F = 4.72 , p < 0.05 ) , indicating that VO2max responded differently to 30-minute and 45-minute exercise duration s. Trend analysis showed that body mass , body composition , waist circumference , and high-density lipoprotein cholesterol ( HDL-C ) changed favorably ( p < 0.05 ) across control , 30-minute , and 45-minute groups . CONCLUSIONS Although most health organizations agree that 150 min . wk(-1 ) of physical activity will reduce the risk of all-cause and cardiovascular mortality , few r and omized , controlled studies have examined whether completing more physical activity than the recommended amount will yield additional benefits . Findings from the present study suggest that there is a dose-response relationship between exercise duration and numerous health outcomes in postmenopausal women , including cardiorespiratory fitness , body mass , body composition , waist circumference , and Background Decreased heart rate variability ( HRV ) is associated with a higher risk of mortality . Overall , postmenopausal women have lower levels of HRV than premenopausal women , which may be additionally complicated by lifestyle related behaviors such as physical inactivity and obesity . Though cardiorespiratory exercise training increases HRV , little is known regarding the exercise dose necessary to promote this improvement . Methodology /Principal Findings Our primary aim was to measure HRV in post-menopausal women following 6-months of exercise training . We examined supine resting HRV in 373 post-menopausal women ( 45–75 y ) after 6-months of r and omly assigned and double-blinded administered exercise training exercise training at 50 % , 100 % and 150 % of the NIH Consensus Development Panel 's recommended minimal physical activity level . This corresponded to 4 , 8 , or 12 kcal/kg per week ( KKW ) of energy expenditure . At baseline , we observed no significant differences in HRV or hormone replacement use between treatment groups . However , we did observe that Caucasian women and those taking antidepressant medications had lower levels of baseline HRV . After 6-months of exercise intervention , we observed a dose dependent increase in all parasympathetically derived time and frequency domain measurements across exercise groups after adjustment for age , ethnicity , antidepressants , and baseline rMSSD ( all , P<0.001 ) . For example , the parasympathetic index rMSSD was greater than control ( 23.19±1.0 ) for the 4-KKW ( 25.98±0.8 ; P = 0.14 ) , 8-KKW ( 27.66±1.0 ; P<0.05 ) , and 12-KKW ( 27.40±0.0 ; P<0.05 ) groups at follow-up . Conclusions / Significance Moderate intensity exercise training exercise is sufficient to improve HRV in previously sedentary postmenopausal women in a dose-dependent manner , as 4-KKW is insufficient to improve parasympathetic indices of HRV , while 12-KKW conferred no greater improvement than 8-KKW . Trial Registration Clinical trials.gov NCT Background Physical activity is associated with improved overall health in those people who survive to older ages , otherwise conceptualised as healthy ageing . Previous studies have examined the effects of mid-life physical activity on healthy ageing , but not the effects of taking up activity later in life . We examined the association between  physical activity  and healthy ageing over 8 years of follow-up . Methods Participants were 3454 initially disease-free men and women ( aged 63.7±8.9 years at baseline ) from the English Longitudinal Study of Ageing , a prospect i ve study of community dwelling older adults .  Self-reported physical activity was assessed at baseline ( 2002–2003 ) and through follow-up .  Healthy ageing , assessed at 8 years of follow-up ( 2010 - 2011 ) , was defined as those participants who survived without developing major chronic disease , depressive symptoms , physical or cognitive impairment . Results At follow-up , 19.3 % of the sample was defined as healthy ageing . In comparison with inactive participants , moderate ( OR , 2.67 , 95 % CI 1.95 to 3.64 ) , or vigorous activity ( 3.53 , 2.54 to 4.89 ) at least once a week was associated with healthy ageing , after adjustment for age , sex , smoking , alcohol , marital status and wealth . Becoming active ( multivariate adjusted , 3.37 , 1.67 to 6.78 ) or remaining active ( 7.68 , 4.18 to 14.09 ) was associated with healthy ageing in comparison with remaining inactive over follow-up . Conclusions Sustained physical activity in older age is associated with improved overall health . Significant health benefits were even seen among participants who became physically active relatively late in life Background . Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons . Objective . Investigate whether an exercise intervention can enhance mobility , prevent falls , and increase physical activity among community-dwelling people after stroke . Method . A r and omized trial with blinding of physical outcome assessment was conducted through local stroke clubs . Both groups , on average 5.9 years poststroke , received exercise classes , advice , and a home program for 12 months . The experimental group ( EG ) program ( n = 76 ) aim ed to improve walking , prevent falls and increase physical activity . The control group ( CG ) program ( n = 75 ) aim ed to improve upper-limb and cognitive functions . The primary outcomes were walking capacity , walking speed measured before and after the intervention , and fall rates monitored monthly . Results . At 12 months , the EG walked 34 m further in 6 minutes ( 95 % confidence interval [ CI ] = 19 - 50 ; P < .001 ) and 0.07 m/s faster over 10 m ( 95 % CI = 0.01 - 0.14 ; P = .03 ) than the CG . The EG had 129 falls , and the CG had 133 . There were no differences in proportion of fallers ( relative risk = 1.22 ; 95 % CI = 0.91 - 1.62 ; P = .19 ) or the rate of falls between groups ( incidence rate ratio = 0.96 ; 95 % CI = 0.59 - 1.51 ; P = .88 ) . Conclusion . The experimental intervention delivered through stroke clubs enhanced aspects of mobility but had no effect on falls OBJECTIVES To determine whether cardiovascular exercise training result ed in improved antibody responses to influenza vaccination in sedentary elderly people who exhibited poor vaccine responses .  DESIGN Single-site r and omized parallel-arm 10-month controlled trial . SETTING University of Illinois at Urbana-Champaign . PARTICIPANTS One hundred forty-four sedentary , healthy older ( 69.9 + /- 0.4 ) adults . INTERVENTIONS Moderate ( 60 - 70 % maximal oxygen uptake ) cardiovascular exercise was compared with flexibility and balance training . MEASUREMENTS The primary outcome was influenza vaccine response , as measured according to hemagglutination inhibition ( HI ) anti-influenza antibody titer and seroprotective responses ( HI titer > or = 40 ) . Secondary measures included cardiovascular fitness and body composition . RESULTS Of the 160 participants enrolled , 144 ( 90 % ) completed the 10-month intervention with excellent compliance ( approximately 83 % ) . Cardiovascular , but not flexibility , exercise intervention result ed in improvements in indices of cardiovascular fitness , including maximal oxygen uptake . Although not affecting peak ( e.g. , 3 and 6 weeks ) postvaccine anti-influenza HI titers , cardiovascular exercise result ed in a significant increase in seroprotection 24 weeks after vaccination ( 30 - 100 % dependent on vaccine variant ) , whereas flexibility training did not . CONCLUSION Participants r and omized to cardiovascular exercise experienced improvements in influenza seroprotection throughout the entire influenza season , whereas those in the balance and flexibility intervention did not . Although there were no differences in reported respiratory tract infections , the exercise group exhibited reduced overall illness severity and sleep disturbance . These data support the hypothesis that regular endurance exercise improves influenza vaccine responses BACKGROUND Many American adults remain sedentary despite many known health benefits . Research on the determinants of physical activity have indicated that social support is one of the strongest correlates , but little is known about this relation in important subgroups of middle and older-aged women . OBJECTIVE The purpose of this study was to assess the association of physical activity-related social support on several measures of physical activity in a national sample of minority women . A unique aspect of these measures is the inclusion of vigorous household tasks and occupational physical activities . METHODS The US Women 's Determinants Study was conducted in 1996 - 1997 . The survey was a modified-r and om sample , telephone survey of 2912 Black , Hispanic , American Indian/Alaskan Native , and White women age 40 and older . A composite score of  physical activity social support ( PASS ) was analyzed as the independent variable in logistic regression analyses . Four measures of physical activity levels served as the dependent variables . A separate analysis was done to distinguish PASS from friends versus PASS from relatives . The potential confounding effect of race/ethnicity , marital status , age , income and education were evaluated and adjusted in the models . RESULTS Hispanic women were more likely to have high PASS scores than the other racial/ethnic groups . Odds ratios indicate that subjects with high levels of PASS were significantly less likely to be sedentary than those with low support , even after adjusting for race/ethnicity . While there were significant associations among levels of social support and physical activity , this was not true for the measure of " regular exercise .  " There was no significant difference between the contribution of " friend " support versus " family " support on all four measures on physical activity . DISCUSSION Based on our results , enhancing social support may be an important aspect of interventions aim ed at increasing physical activity in a population of sedentary women of various racial/ethnic background s. Also , " regular exercisers " in this population appear to be less reliant social support to maintain their behavior Abstract The aim of the study was to evaluate the impact of a high-intensive exercise program containing high-intensive functional exercises implemented to real-life situations together with group discussion s on falls and security aspects in stroke subjects with risk of falls . This was a pre-specified secondary outcome for this study . For evaluation , Short Form-36 ( SF-36 ) health-related quality of life ( HRQoL ) and the Geriatric Depression Scale-15 ( GDS-15 ) were used . This was a single-center , single-blinded , r and omized , controlled trial . Consecutive ≥55 years old stroke patients with risk of falls at 3–6 months after first or recurrent stroke were r and omized to the  intervention group ( IG , n=15 ) or to the control group ( CG , n=19 ) who received group discussion with focus on hidden dysfunctions but no physical fitness training . The 5-week high-intensive exercise program was related to an improvement in the CG in the SF-36 Mental Component Scale and the Mental Health subscale at 3 months follow-up compared with baseline values while no improvement was seen in the IG at this time . For the SF-36 Physical Component Scale , there was an improvement in the whole study group at 3 and 6 months follow-up compared with baseline values without any significant changes between the IG and CG . The GDS-15 was unchanged throughout the follow-up period for both groups . Based on these data , it is concluded that high-intensive functional exercises implemented in real-life situations should also include education on hidden dysfunctions after stroke instead of solely focus on falls and safety aspects to have a favorable impact on CONTEXT Dementia is common , costly , and highly age related . Little attention has been paid to the identification of modifiable lifestyle habits for its prevention . OBJECTIVE To explore the association between physical activity and the risk of cognitive impairment and dementia .  DESIGN , SETTING , AND SUBJECTS Data come from a community sample of 9008 r and omly selected men and women 65 years or older , who were evaluated in the 1991 - 1992 Canadian Study of Health and Aging , a prospect i ve cohort study of dementia . Of the 6434 eligible subjects who were cognitively normal at baseline , 4615 completed a 5-year follow-up .  Screening and clinical evaluations were done at both waves of the study . In 1996 - 1997 , 3894 remained without cognitive impairment , 436 were diagnosed as having cognitive impairment-no dementia , and 285 were diagnosed as having dementia . MAIN OUTCOME MEASURE Incident cognitive impairment and dementia by levels of physical activity at baseline . RESULTS Compared with no exercise , physical activity was associated with lower risks of cognitive impairment , Alzheimer disease , and dementia of any type . Significant trends for increased protection with greater physical activity were observed . High levels of physical activity were associated with reduced risks of cognitive impairment ( age- , sex- , and education-adjusted odds ratio , 0.58 ; 95 % confidence interval , 0.41 - 0.83 ) , Alzheimer disease ( odds ratio , 0.50 ; 95 % confidence interval , 0.28 - 0.90 ) , and dementia of any type ( odds ratio , 0.63 ; 95 % confidence interval , 0.40 - 0.98 ) . CONCLUSION Regular physical activity could represent an important and potent protective factor for cognitive decline and dementia in elderly persons OBJECTIVES To examine the combined effect of healthy behaviors on the development of functional disability in an elderly cohort . DESIGN Prospect i ve cohort study . SETTING Taiwan Longitudinal Study in Aging from 1989 , 1993 , 1996 , 1999 , and 2003 . PARTICIPANTS A national sample of 1,940 men and 1,247 women aged 60 and older without functional disability at baseline . MEASUREMENTS Functional disability was defined as difficulty with activities of daily living : taking a bath or walking 200 to 300 m. Time to functional disability was the age at midpoint between the first occurrence of disability onset in the survey year and prior survey year . Considering that the onset of disability is probably a precursor of death , for those who died without disability , time to disability onset was set at the midpoint between the last follow-up and death year . Four  healthy behaviors  were measured : not smoking , moderate alcohol consumption  ,  regular exercise , and sleeping 6 to 8 hours per day . A Cox proportional hazards model with time-dependent covariates was used to analyze the association between age at the first functional disability and prior  healthy behavior  , after controlling for sex , time-varying disease status , marital status , and education . RESULTS Healthy behaviors were linked to the onset of functional disability . Participants who performed one or more healthy behaviors were 15 % to 75 % less likely to be disabled than those who performed none . CONCLUSION In the population studied , healthy behaviors  were associated with lower incidence of functional disability . As the number of  healthy behaviors  increased , the likelihood of disability decreased OBJECTIVE Exercise can improve sleep quality , but for whom and by what means remains unclear . We examined moderators and mediators of objective sleep improvements in a 12-month r and omized controlled trial among underactive midlife and older adults reporting mild/moderate sleep complaints . METHODS Participants ( N = 66 , 67 % women , 55 - 79 years ) were r and omized to moderate-intensity exercise or health education control .  Putative moderators were gender , age , physical function , self-reported global sleep quality , and physical activity levels . Putative mediators were changes in BMI , depressive symptoms , and physical function at 6 months . Objective sleep outcomes measured by in-home polysomnography were percent time in Stage I sleep , percent time in Stage II sleep , and number of awakenings during the first third of sleep at 12 months . RESULTS Baseline physical function and sleep quality moderated changes in Stage I sleep ; individuals with higher initial physical function ( p = .01 ) and poorer sleep quality ( p = .03 ) had greater improvements . Baseline physical activity level moderated changes in Stage II sleep ( p = .04 ) and number of awakenings ( p = .01 ) ; more sedentary individuals had greater improvements . Decreased depressive symptoms ( CI:-1.57 to -0.02 ) mediated change in Stage I sleep . Decreased depressive symptoms ( CI:-0.75 to -0.01 ) , decreased BMI ( CI:-1.08 to -0.06 ) , and increased physical function ( CI : 0.01 to 0.72 ) mediated change in number of awakenings . CONCLUSIONS Initially less active individuals with higher initial physical function and poorer sleep quality improved the most . Affective , functional , and metabolic mediators specific to sleep architecture parameters were suggested . These results indicate strategies to more efficiently treat poor sleep through exercise in older adults To evaluate the skeletal effects of endogenous serum estradiol , we measured bone mineral density ( BMD ) at the calcaneus and radius ( single photon absorptiometry ) and at the hip and spine ( dual x-ray absorptiometry ) in 274 women aged 65 yr or more who participated in the Study of Osteoporotic Fractures .  Lateral radiographs of the thoracic and lumbar spine were also taken , and serum was assayed for estradiol . Those who had estradiol levels from 10 - 25 pg/mL had 4.9 % , 9.6 % , 7.3 % , and 6.8 % greater BMD at total hip , calcaneus , proximal radius , and spine than those with levels below 5 pg/mL. After multiple adjustments , BMD differences remained statistically significant and corresponded to about 0.4 SD . Vertebral deformities were less prevalent among women whose estradiol level exceeded 5 pg/mL ; the multiple adjusted odds ratio was 0.4 ( 95 % confidence interval , 0.2 - 0.8 ) . We conclude that physiologically low estradiol has a salutary effect on the skeleton in elderly women , possibly by reducing skeletal remodeling OBJECTIVES To estimate the incidence of chronic activities of daily living ( ADL ) disability and to analyze the sociodemographic , health status , adverse lifestyle , and leisure-time physical activity predictors for chronic ADL disability . DESIGN We recruited a cohort of community-dwelling older people in Taipei , Taiwan , who were not ADL disabled in August 1993 , and we followed them until August 1996 . SETTING S AND PARTICIPANTS The study subjects were 1321 community-dwelling people aged 65 years or older who were ADL intact at the initial interview in August 1993 . The study sample was a subset of a probability sample ( n = 1583 ) r and omly selected from household registration s in the four districts of the Taipei metropolitan area . MEASUREMENTS Baseline information regarding various factors potentially associated with the development of chronic ADL disability was assessed and collected at the beginning of the study . Study participants were assessed annually for ADL function by a structured home interview using a six-item scale . Participants who were unable to perform independently at least one of the six items -- eating , bathing , dressing , toileting ,  transfers , and walking inside the house -- for more than 3 months were considered chronically ADL disabled . Cox proportional hazard regression models were utilized to examine the independent effect of the potential predictors on risk of chronic ADL disability . RESULTS During the 3-year study period , 145 ( 11.0 % ) participants developed chronic ADL disability , 58 ( 4.4 % ) participants were lost to follow-up , and 83 ( 6.3 % ) participants died . Multiple hazard regression analysis showed that individuals aged 70 to 79 years or older than age 80 had increased risk of ADL disability ( relative risk : 2.05 ( 95 % confidence interval ( CI ) , 1.35 - 3.11 ) and 3.89 ( 95%CI , 2.33 - 6.50 ) , respectively ) compared with those participants younger than age 70 . Risk of chronic ADL disability was inversely associated with routine exercise ( RR = 0.52 ; 95 % CI , 0.39 - 0.68 ) . CONCLUSIONS Age is the most significant predictor of chronic ADL disability . Lack of routine exercise is also a significant predictor of ADL disability in older adults Background . Strength training ( ST ) is an important health behavior for aging women ; it helps maintain strength and function and reduces risk for chronic diseases . This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders . Method . The StrongWomen Program is a nationally disseminated , research -based , community ST program active in 40 states . The Senior Fitness Test is used to assess upper and lower body strength , upper and lower body flexibility , aerobic fitness , and agility ; data are collected prior to and following program participation . Results . For these analyses , five states provided deidentified data for 367 female participants , mean age 63 ( ±11 ) years .  Attendance in approximately 10 weeks of twice-weekly classes was 69.4 % . Paired t tests were used to analyze pre – post change . Significant improvements were observed ( p < .01 ) in all Senior Fitness Test measures . Data are stratified by age-group and compared with published , age-based norms . Conclusions . This study demonstrates that it is feasible for community leaders to conduct pre – post physical fitness evaluations with participants and that participants experienced improvements across several important domains of physical fitness OBJECTIVES To assess whether a specifically design ed yoga intervention can reduce hyperkyphosis . DESIGN A 6-month , two-group , r and omized , controlled , single-masked trial . SETTING Community research unit . PARTICIPANTS One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40 degrees or greater . Major exclusions were serious medical comorbidity , use of assistive device , inability to hear or see adequately for participation , and inability to pass a physical safety screen . INTERVENTION The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks . The control group attended a monthly luncheon and seminar and received mailings . MEASUREMENTS Primary outcomes were change ( baseline to 6 months ) in Debrunner kyphometer-assessed kyphosis angle , st and ing height , timed chair st and s , functional reach , and walking speed . Secondary outcomes were change in kyphosis index , flexicurve kyphosis angle , Rancho Bernardo Blocks posture assessment , and health-related quality of life ( HRQOL ) . RESULTS Compared with control participants , participants r and omized to yoga experienced a 4.4 % improvement in flexicurve kyphosis angle ( P=.006 ) and a 5 % improvement in kyphosis index ( P=.004 ) . The intervention did not result in statistically significant improvement in Debrunner kyphometer angle , measured physical performance , or self-assessed HRQOL ( each P>.1 ) . CONCLUSION The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable , a critical first step in the pathway to treating or preventing this condition . Larger , more-definitive studies of yoga or other interventions for hyperkyphosis should be considered . Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect BACKGROUND Physical activity may help maintain cognitive function and decrease dementia risk , but epidemiological findings remain controversial . The aim of our study was to investigate the association between leisure-time physical activity at midlife and the subsequent development of dementia and Alzheimer 's disease ( AD ) . METHODS Participants were r and omly selected from the survivors of a population -based cohort previously surveyed in 1972 , 1977 , 1982 , or 1987 . 1449 persons ( 72.5 % ) age 65 - 79 years participated in the re-examination in 1998 ( mean follow-up , 21 years ) . 117 persons had dementia and 76 had AD .  Multiple logistic regression methods were used to analyse the association between leisure-time physical activity and dementia or AD . FINDINGS Leisure-time physical activity at midlife at least twice a week was associated with a reduced risk of dementia and AD ( odds ratio [ OR ] 0.48 [ 95 % CI 0.25 - 0.91 ] and 0.38 [ 0.17 - 0.85 ] , respectively ) , even after adjustments for age , sex , education , follow-up time , locomotor disorders , APOE genotype , vascular disorders , smoking , and alcohol drinking . The associations were more pronounced among the APOE epsilon4 carriers . INTERPRETATION Leisure-time physical activity at midlife is associated with a decreased risk of dementia and AD later in life . Regular physical activity may reduce the risk or delay the onset of dementia and AD , especially among genetically susceptible individuals The present study examined the effects of a regular walking exercise program on behavioral ( daily physical activity , physical strength , energy consumption ) and biochemical ( fasting blood glucose [ FBG ] , glycated hemoglobin [ HbA1c ] , total cholesterol , triglycerides [ TG ] , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol ) aspects of elderly people with type II diabetes . A r and omized and stratified experimental design was used with experimental and control groups . The experimental group was subjected to a 6 month walking exercise program , involving walking exercise three times per week for 50 min , and a 4 week education program on diet control and the prevention of complications , once per week for 20 min . Post-test was conducted after 3 and 6 months to examine short- and long-term behavioral and biochemical effects . The regular walking exercise program effectively increased daily physical activity , physical strength , and energy consumption ( behavioral aspects ) , and decreased FBG , HbA1c , and TG levels ( biochemical aspects ) in elderly people with type II diabetes . The incidence of type II diabetes complications might be reduced by implementing a regular walking exercise program CONTEXT Low levels of cardiorespiratory fitness are associated with high risk of mortality , and improvements in fitness are associated with reduced mortality risk . However , a poor underst and ing of the physical activity-fitness dose response relation remains . OBJECTIVE To examine the effect of 50 % , 100 % , and 150 % of the NIH Consensus Development Panel recommended physical activity dose on fitness in women . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 464 sedentary , postmenopausal overweight or obese women whose body mass index ranged from 25.0 to 43.0 and whose systolic blood pressure ranged from 120.0 to 159.9 mm Hg . Enrollment took place between April 2001 and June 2005 in the Dallas , Tex , area . INTERVENTION Participants were r and omly assigned to 1 of 4 groups : 102 to the nonexercise control group and 155 to the 4-kcal/kg , 104 to the 8-kcal/kg , and 103 to the 12-kcal/kg per week energy-expenditure groups for the 6-month intervention period . Target training intensity was the heart rate associated with 50 % of each woman 's peak Vo2 . MAIN OUTCOME MEASURE The primary outcome was aerobic fitness assessed on a cycle ergometer and quantified as peak absolute oxygen consumption ( Vo2abs , L/min ) . RESULTS The mean ( SD ) baseline Vo2abs values were 1.30 ( 0.25 ) L/min . The mean ( SD ) minutes of exercising per week were 72.2 ( 12.3 ) for the 4-kcal/kg , 135.8 ( 19.5 ) for the 8-kcal/kg , and 191.7 ( 33.7 ) for the 12-kcal/kg per week exercise groups . After adjustment for age , race/ethnicity , weight , and peak heart rate , the exercise groups increased their Vo2abs compared with the control group by 4.2 % in the 4-kcal/kg , 6.0 % in the 8-kcal/kg , and 8.2 % in the 12-kcal/kg per week groups ( P<.001 for each vs control ; P for trend < .001 ) . There was no treatment x subgroup interaction for age , body mass index , weight , baseline Vo2abs , race/ethnicity , or baseline hormone therapy use . There were no significant changes in systolic or diastolic blood pressure values from baseline to 6 months in any of the exercise groups vs the control group . CONCLUSION In this study , previously sedentary , overweight or obese postmenopausal women experienced a grade d dose-response change in fitness across levels of exercise training . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00011193 AIM AND OBJECTIVE To evaluate the influence of an exercise programme on postmenopausal women with symptoms of anxiety and depression .  BACKGROUND The menopause is a period of hormonal changes when mood variations are probably more severe than at any other period of women 's lives . DESIGN Prospect i ve study with control group and pre- and post-treatment measures , after six months treatment . Conducted at two healthcare clinics , in the province of Granada ( Spain ) . METHODS A convenience sample of 60 postmenopausal women aged 60 - 70 years , with symptoms of depression and anxiety , was recruited . The women were r and omly divided into two groups : ( 1 ) control group , no treatment ( n = 30 ) ; ( 2 ) exercise group , which carried out a programme of mixed physical exercises with musical support ( n = 30 ) . All subjects answered question naires for the Hamilton Anxiety Scale and the Brink and Yesavage Geriatric Depression Scale before and after treatment . RESULTS In the exercise group , statistically significant improvements were observed in subjects with moderate and severe depression ( 18 and 22 % , respectively ) and in those with symptoms of anxiety . No such changes were observed in the control group . CONCLUSIONS A controlled programme of physical exercise for postmenopausal women alleviates symptoms of anxiety and depression , and its inclusion in primary healthcare programmes should be considered . RELEVANCE TO CLINICAL PRACTICE Menopausal women may benefit from physical exercise , which attenuates the effects of the physiological and psychological changes associated with the menopause and prevents pathologic changes OBJECTIVES To compare the efficacy of a physical activity program ( Seattle Protocol for Activity ( SPA ) ) for low-exercising older adults with that of an educational health promotion program ( HP ) , combination treatment ( SPA+HP ) , and routine medical care control conditions ( RMC ) . DESIGN Single-blind , r and omized controlled trial with two-by-two factorial design . SETTING Community centers in King County , Washington , from November 2001 to September 2004 . PARTICIPANTS Two hundred seventy-three community-residing , cognitively intact older adults ( mean age 79.2 ; 62 % women ) . INTERVENTIONS SPA ( in-class exercises with assistance setting weekly home exercise goals ) and HP ( information about age-appropriate topics relevant to enhancing health ) , with r and omization to four conditions : SPA only ( n=69 ) , HP only ( n=73 ) , SPA+HP ( n=67 ) , and RMC control ( n=64 ) . Active-treatment participants attended nine group classes over 3 months followed by five booster sessions over 1 year . MEASUREMENTS Self-rated health ( Medical Outcomes Study 36-item Short-Form Survey ) and depression ( Geriatric Depression Scale ) . Secondary ratings of physical performance , treatment adherence , and self-rated health and affective function were also collected . RESULTS At 3 months , participants in SPA exercised more and had significantly better self-reported health , strength , and general well-being ( P<.05 ) than participants in HP or RMC . Over 18 months , SPA participants maintained health and physical function benefits and had continued to exercise more than non-SPA participants . SPA+HP was not significantly better than SPA alone . Better adherence was associated with better outcomes . CONCLUSION Older adults participating in low levels of regular exercise can establish and maintain a home-based exercise program that yields immediate and long-term physical and affective benefits OBJECTIVES To evaluate the long-term effects of a lifestyle intervention and a structured exercise intervention on physical fitness and cardiovascular risk factors in older adults . DESIGN Controlled trial with r and omization between the intervention groups . SETTING Belgium , Vlaams-Brabant . PARTICIPANTS One hundred eighty-six sedentary but healthy men and women aged 60 to 83 . INTERVENTIONS Participants in the lifestyle intervention were stimulated to integrate physical activity into their daily routines and received an individualized home-based program supported by telephone calls . The structured intervention consisted of three weekly supervised sessions in a fitness center . Both interventions lasted 11 months and focused on endurance , strength , flexibility , and postural and balance exercises . MEASUREMENTS Cardiorespiratory fitness , muscular strength , functional performance , blood pressure , and body composition were measured before ( pretest ) , at the end ( 11 months , posttest ) , and 1 year after the end ( 23 months , follow-up ) of the interventions . RESULTS The results from pretest to posttest have already been published . The current study analyzed the results from posttest to follow-up . There was a decrease in cardiorespiratory fitness , muscular fitness , and functional performance from posttest to follow-up in the structured intervention group but not in the control group or the lifestyle intervention group . At 23 months , participants in both groups still showed improvements in cardiorespiratory fitness . In addition , the structured group showed long-term improvements in muscular fitness , whereas the lifestyle group showed long-term improvements in functional performance . No long-term effects were found for blood pressure or body composition . CONCLUSION These results highlight the potential of a structured fitness center-based intervention and a home-based lifestyle intervention in the battle against inactivity in older adults . Lifestyle programs are especially valuable because they require fewer re sources and less time from health institutions and health practitioners Objective : Physical activity has been shown to enhance quality of life ( QOL ) ; however , few investigations of these effects exist in women undergoing the menopausal transition . The present study examined the long-term effects of physical activity on menopause-related QOL and tested the mediating effects of physical self-worth and positive affect in this relationship . Methods : Middle-aged women previously enrolled in a 4-month r and omized controlled trial involving walking and yoga , and a control group completed a follow-up mail-in survey 2 years after the end of the trial . The survey included a battery of psychological and physical activity measures , including measures of menopausal symptoms and menopause-related QOL . Longitudinal linear panel analysis was conducted within a covariance modeling framework to test whether physical self-worth and positive affect mediated the physical activity-QOL relationship over time . Results : At the end of the trial , physical activity and menopausal symptoms were related to physical self-worth and positive affect , and in turn , greater levels of physical self-worth and positive affect were associated with higher levels of menopause-related QOL . Analyses indicated that increases in physical activity  and decreases in menopausal symptoms over the 2-year period were related to increases in physical self-worth ( & bgr;s = 0.23 and −0.52 , physical activity and menopausal symptoms , respectively ) and , for symptoms , also to decreased positive affect ( & bgr ; = −0.47 ) , and both physical self-worth ( & bgr ; = 0.34 ) and affect ( & bgr ; = 0.43 ) directly influenced enhancements in QOL ( R2 = 0.775 ) . Conclusions : The findings support the position that the effects of physical activity on QOL are mediated , in part , by intermediate psychological outcomes and that physical activity can have long-term benefits for women undergoing the menopausal transition The objective of the present study was to evaluate and compare the neuromuscular , morphological and functional adaptations of older women subjected to 3 different types of strength training . 58 , healthy women ( 67 ± 5 year ) were r and omized to experimental ( EG , n=41 ) and control groups ( CG , n=17 ) during the first 6 weeks when the EG group performed traditional resistance exercise for the lower extremity . Afterwards , EG was divided into three specific strength training groups ; a traditional group ( TG , n=14 ) , a power group ( PG , n=13 ) that performed the concentric phase of contraction at high speed and a rapid strength group ( RG , n=14 ) that performed a lateral box jump exercise emphasizing the stretch-shortening-cycle ( SSC ) . Subjects trained 2 days per week through the entire 12 weeks . Following 6 weeks of generalized strength training , significant improvements occurred in EG for knee extension one-repetition ( 1RM ) maximum strength ( + 19 % ) , knee extensor muscle thickness ( MT , + 15 % ) , maximal muscle activation ( + 44 % average ) and onset latency ( -31 % average ) for vastus lateralis ( VL ) , vastus medialis ( VM ) and rectus femoris ( RF ) compared to CG ( p<0.05 ) . Following 6 more weeks of specific strength training , the 1RM increased significantly and similarly between groups ( average of + 21 % ) , as did muscle thickness of the VL ( + 25 % ) , and activation of VL ( + 44 % ) and VM ( + 26 % ) . The onset latency of RF ( TG=285 ± 109 ms , PG=252 ± 76 ms , RG=203 ± 43 ms ) , reaction time ( TG=366 ± 99 ms , PG=274 ± 76 ms , RG=201 ± 41 ms ) , 30-s chair st and ( TG=18 ± 3 , PG=18 ± 1 , RG=21 ± 2 ) and counter movement jump ( TG=8 ± 2 cm , PG=10 ± 3 cm , RG=13 ± 2 cm ) was significantly improved only in RG ( p<0.05 ) . At the end of training , the rate of force development ( RFD ) over 150 ms ( TG=2.3 ± 9.8 N·s(-1 ) , PG=3.3 ± 3.2 N·s(-1 ) , RG=3.8 ± 6.8 N·s(-1 ) , CG=2.3 ± 7.0 N·s(-1 ) ) was significantly greater in RG and PG than in TG and CG ( p<0.05 ) . In conclusion , rapid strength training is more effective for the development of rapid force production of muscle than other specific types of strength training and by consequence , better develops the functional capabilities of older women BACKGROUND Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons . Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables . We determined whether physical activity is associated with cognitive decline in a prospect i ve study of older women . METHODS We studied 5925 predominantly white community-dwelling women ( aged > or = 65 years ) who were recruited at 4 clinical centers and were without baseline cognitive impairment or physical limitations . We measured cognitive performance using a modified  Mini-Mental State Examination  at baseline and 6 to 8 years later .  Physical activity  was measured by self-reported blocks ( 1 block approximately 160 m ) walked per week and by total kilocalories ( energy ) expended per week in recreation , blocks walked , and stairs climbed . Cognitive decline was defined as a 3-point decline or greater on repeated modified Mini-Mental State Examination . RESULTS Women with a greater physical activity level at baseline were less likely to experience cognitive decline during the 6 to 8 years of follow-up : cognitive decline occurred in 17 % , 18 % , 22 % , and 24 % of those in the highest , third , second , and lowest quartile of blocks walked per week ( P < .001 for trend ) . Almost identical results were obtained by quartile of total kilocalories expended per week . After adjustment for age , educational level , comorbid conditions , smoking status , estrogen use , and functional limitation , women in the highest quartile remained less likely than women in the lowest quartile to develop cognitive decline ( for blocks walked : odds ratio , 0.66 [ 95 % confidence interval , 0.54 - 0.82 ] ; for total kilocalories : odds ratio , 0.74 [ 95 % confidence interval , 0.60 - 0.90 ] ) . CONCLUSIONS Women with higher levels of baseline physical activity were less likely to develop cognitive decline . This association was not explained by differences in baseline function or health status . This finding supports the hypothesis that physical activity prevents cognitive decline in older community-dwelling women OBJECTIVES To determine the characteristics of health behaviors related to higher-level functional decline in older community-dwelling adults . DESIGN Prospect i ve . SETTING Ohasama Town , Japan . PARTICIPANTS One thous and fifty residents ( mean age : 67.5 ) free of functional decline at baseline . MEASUREMENTS  Health behaviors including smoking status , alcohol consumption , frequency of exercise , sleep duration , dietary habits ( supplement use , breakfast , late-night snacking , eating regularly , and eating out ) , and self-rated health were obtained from a self-administered question naire at baseline . Higher-level functional decline was examined using the subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence . RESULTS During the 7-year follow-up , 27.5 % of eligible participants reported decline in higher-level functional capacity . After adjustment for putative confounding factors , health behaviors that were significant predictors for declines in higher-level functional capacity at the 7-year follow-up were current smoking ( odds ratio ( OR ) = 1.58 , 95 % confidence interval ( CI ) = 1.06 - 2.36 ) , sleep duration of 9 hours or longer ( OR = 2.15 , 95 % CI = 1.49 - 3.11 ) , and poor self-rated health ( OR = 1.93 , 95 % CI = 1.40 - 2.67 ) . CONCLUSION Several modifiable health behaviors contribute to higher-level functional decline OBJECTIVE To examine the contribution of social-cognitive factors ( self-efficacy and affect ) in predicting long-term physical activity in a sample of older adults ( N=174 ) . DESIGN A prospect i ve design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month r and omized , controlled exercise trial . MAIN OUTCOME MEASURES The primary outcome variable was self-reported physical activity , with previous behavior , self-efficacy , and affect assessed as determinants of physical activity . RESULTS Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up . Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5 , as was original treatment condition . Variables accounted for 35 % of the variance in Year 5 activity . CONCLUSION Older adults with higher levels of physical activity , more positive affect , and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5 . This study is one of the longest follow-ups of exercise behavior in older adults and has implication s for structuring environments to maximize the maintenance of physical activity OBJECTIVES To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community-dwelling elderly sarcopenic women . DESIGN R and omized controlled trial . SETTING Urban community in Tokyo , Japan . PARTICIPANTS One hundred fifty-five women aged 75 and older were defined as sarcopenic and r and omly assigned to one of four groups : exercise and amino acid supplementation ( exercise + AAS ; n = 38 ) , exercise ( n = 39 ) , amino acid supplementation ( AAS ; n = 39 ) , or health education ( HE ; n = 39 ) . INTERVENTION The exercise group attended a 60-minute comprehensive training program twice a week , and the AAS group ingested 3 g of a leucine-rich essential amino acid mixture twice a day for 3 months . MEASUREMENTS Body composition was determined using bioelectrical impedance analysis . Data from interviews and functional fitness parameters such as muscle strength and walking ability were collected at baseline and after the 3-month intervention . RESULTS A significant group × time interaction was seen in leg muscle mass ( P = .007 ) , usual walking speed ( P = .007 ) , and knee extension strength ( P = .017 ) . The within-group analysis showed that walking speed significantly increased in all three intervention groups , leg muscle mass in the exercise + AAS and exercise  groups , and knee extension strength only in the exercise + AAS group ( 9.3 % increase , P = .01 ) . The odds ratio for leg muscle mass and knee extension strength improvement was more than four times as great in the exercise + AAS group ( odds ratio = 4.89 , 95 % confidence interval = 1.89 - 11.27 ) as in the HE group . CONCLUSION The data suggest that exercise and AAS together may be effective in enhancing not only muscle strength , but also combined variables of muscle mass and walking speed and of muscle mass and strength in sarcopenic women Objective : To compare the efficacy of balance training associated with muscle strengthening or stretching , relative to no intervention , in the postural control of elderly women with osteoporosis . Design : A r and omized , controlled trial . Subjects and interventions : Sample consisted of 50 women aged 65 years or older , with osteoporosis , r and omized into one of three groups :  strengthening group ( n = 17 ) performed balance training with muscle strengthening ; stretching group ( n = 17 ) performed balance training with stretching ; and control group ( n = 16 ) , no activities . Interventions lasted eight weeks , twice a week , 60 minutes a day . Main measures : Postural control was evaluated by the modified Clinical Test of Sensory Interaction for Balance ( CTSIBm ) and Limits of Stability Test . Strength was assessed by dynamometry and the shortening of the hamstrings by goniometry . Results : Relative to controls , participants in the strengthening group displayed significantly increased dorsiflexion strength and knee flexion strength , as well as centre of pressure velocity , directional control , and oscillation velocity ( CTSIBm test ) . The stretching group had significantly improvements in hamstring length , knee flexion strength , centre of pressure velocity , and amplitude of movements . Relative to the stretching group , the strengthening group yielded better knee extension strength and directional control . Conclusion : The results suggest that both interventions are effective in improving postural control when compared to the control group , and the strengthening group was superior to the stretching group in knee extension strength and in directional control BACKGROUND Our group has shown a positive dose-response in maximal cardiorespiratory exercise capacity ( VO(2max ) ) and heart rate variability ( HRV ) to 6 months of exercise training but no improvement in VO(2max ) for women ≥60 years . Here , we examine the HRV response to exercise training in postmenopausal women younger and older than 60 years . METHODS We examined 365 sedentary , overweight , hypertensive , postmenopausal women r and omly assigned to  sedentary control or exercise groups exercising at 50 % ( 4 kcal/kg/week , [ KKW ] ) , 100 % ( 8 KKW ) and 150 % ( 12 KKW ) of the National Institutes of Health ( NIH ) Consensus Development Panel physical activity guidelines . Primary outcomes included time and frequency domain indices of HRV . RESULTS Overall , our analysis demonstrated a significant improvement in parasympathetic tone ( rMSSD and high frequency power ) for both age strata at 8 KKW and 12 KKW . For rMSSD , the age-stratified responses were : control , < 60 years , 0.20 ms , 95 % confidence interval (CI)-2.40 , 2.81 ; ≥60 years , 0.07 ms , 95 % CI -3.64 , 3.79 ; 4 KKW , < 60 years , 3.67 ms , 95 % CI 1.55 , 5.79 ; ≥60 years , 1.20 ms , 95 % CI -1.82 , 4.22 ; 8-KKW , < 60 years , 3.61 ms , 95 % CI 0.88 , 6.34 ; ≥60 years , 5.75 ms , 95 % CI 1.89 , 9.61 ; and 12-KKW , < 60 years , 5.07 ms , 95 % CI 2.53 , 7.60 ; ≥60 years , 4.28 ms , 95 % CI 0.42 , 8.14 . CONCLUSIONS VO(2max ) and HRV are independent risk factors for cardiovascular disease ( CVD ) mortality . Despite no improvement in VO(2max ) , parasympathetic indices of HRV increased in women ≥60 years . This is clinical ly important , as HRV has important CVD risk and neurovisceral implication s beyond cardiorespiratory function
target: In this review we found that exercise interventions ( or lifestyle activities ) that improved cardiorespiratory exercise capacity showed the most positive impact on physical health .
  CONCLUSIONS Findings suggest that programs should facilitate and support women to participate in regular exercise by embedding physical activity programs in public health initiatives , by developing home-based exercise programs that require few re sources and by creating interventions that can incorporate physical activity within a healthy lifestyle .
  The review also suggests that clinicians should consider prescribing exercise in a tailored manner for older women to ensure that it is of a high enough intensity to obtain the positive sustained effects of exercise
background: BACKGROUND Participation in regular physical activity is among the most promising and cost effective strategies to reduce physical and cognitive decline and premature death .
  However , confusion remains about the amount , frequency , and duration of physical activity that is likely to provide maximum benefit as well as the way in which interventions should be delivered .
  AIMS This paper aim ed to review research on the impact of leisure-time and general physical activity levels on physical and cognitive decline in postmenopausal women .