








key: cord-339292-mhbwjwrg
authors: Aubertin-Leheudre, M.; Rolland, Y.
title: THE IMPORTANCE OF PHYSICAL ACTIVITY TO CARE FOR FRAIL OLDER ADULTS DURING THE COVID-19 PANDEMIC
date: 2020-04-30
journal: J Am Med Dir Assoc
DOI: 10.1016/j.jamda.2020.04.022
sha: 
doc_id: 339292
cord_uid: mhbwjwrg

Summary COVID-19 restrictions could decreased physical and mental health. Simple, adapted and specific physical activities should be implemented and considered as the best solution to care for frail elderly during the COVID-19 pandemic.

health. Simple, adapted and specific physical activities should be implemented and 28

considered as the best solution to care for frail elderly during the COVID-19 pandemic.

Coronavirus disease 2019 (COVID-19) is currently causing devastating impacts globally. As 36 of March 31 st , 2020, 857,165 COVID-19 cases were confirmed around the world, and more 37 than 42,100 people have died. The death rate is estimated at 5%, with older adults making up 38 the vast majority of cases (>80%). Not surprisingly, studies show a decline in the number of pedometer steps taken per week by 50 adults due to restrictions put in place to mitigate COVID-19. European countries showed the 51 most dramatic decline, ranging from a 7% to 38% reduction in steps between March 15 to 22, 52 2020. 1 Hence, it is also important to keep in mind that inactivity is the fourth leading cause of 53 mortality according to the World Health Organization 2 . 54 55 Maintaining functional ability and coping with functional limitations for as long as possible are 56 key healthcare challenges for independent living institutionalized and hospitalized older 57 adults. Thus, although COVID-19 restrictions aim to protect older adults, such social and 58 physical distancing is also likely to negatively impact the physical and mental health of older 59

Furthermore, long-term care residents are characterized by high prevalence of multimorbidity, 61 prescription drug use and dependency in activities of daily living. Hospitalization of older 62 adults is also problematic as it leads to functional decline, also known as iatrogenic decline 3 . 63

In a 10-day hospitalization, an older patient typically loses 16% of muscle strength and 6% of risk of falls (34% within three months of discharge) 5;6 and disability (33% will report functional 66 decline one-year after discharge) 7;8 . The vicious circle of frailty is accelerated by physical 67 inactivity and further increases the need for healthcare services. 68

The negative consequences of hospitalization or living in long-term care are largely due to low 69 physical activity. Older hospitalized patients are often on confined to bed for 17 hours per day 70 According to WHO, healthy aging is largely determined by the ability to maintain both mental 85 and physical capacities 13 . No medications currently exist that help maintain physical capacity, 86 nor will any be commercialized in the foreseeable future. However, physical capacity can be 87 maintained through physical stimulus via adapted physical activity. It is well-known that 88 physical activity is key for the health and well-being of people over age 85 14 . 89 90 Physical activity has been shown to protect against the incidence of activities of daily living 91 disability, but also disability progression or severity 15 Each physical activity color program included 2 specific and adapted exercises (e.g.: seated 156 knee extension; sit to stand; step aside; chair forward bend; bipodal or unipodal static 157 balance; wall squat) and a walking time (Figure 1 ). All programs have been created to 158 improve or at least maintain balance, strength but also mobility and cardio-pulmonary function 159 (aerobic capacities). All program are realized unsupervised, without materials (except room 160 equipment: chair or wall) between 2 to 3 times per day, in seated or standing position. adapted physical activity programs without specific materials and using notebook, TV-screen, 164 video or internet live video can be implement to avoid bed rest and immobilization effects 165 during the COVID-19 pandemic (e.g: SPRINT; MATCH Vivifrail; LaterLifeTraining; Go4Life, 166 MOVE etc.; see Table 1 ). In conclusion, to our knowledge, daily simple, adapted and specific physical activities 177 including strength, balance and walk exercises (see figure 1 & 2 or vivifrail©) should be 178 considered as the best solution to care for frail older adults during the COVID-19 pandemic. 179 

The Impact of Coronavirus on

World Health Organization. Global Recommendations on Physical Activity for

Change in muscle strength and muscle mass in older 191 hospitalized patients: A systematic review and meta-analysis

Effect of 10 days of bed rest on skeletal muscle in healthy older 194 adults

Risk of falls after hospital discharge

A simple tool predicted probability of falling after aged care 198 inpatient rehabilitation

Hospitalization, restricted activity, and the development of disability 200 among older persons

Geriatric conditions in acutely hospitalized older patients: 202 prevalence and one-year survival and functional decline

The underrecognized epidemic of low mobility during hospitalization 205 of older adults

Twenty-four-hour mobility during acute hospitalization in older 207 medical patients

How much exercise are older 209 adults living in long-term cares doing in daily life? A cross-sectional study

Daytime sleeping, sleep disturbance, and 212 circadian rhythms in the nursing home

The world report on ageing and health: a 214 policy framework for healthy ageing

Exercise in people over 85 : Advanced age is no 216 barrier to the benefits of tailored exercise

Effect of physical interventions on physical performance and 222 physical activity in older patients during hospitalization: a systematic review

Can Exergames Contribute to Improving 226

Walking Capacity in Older Adults? A Systematic Review and Meta-Analysis

Program Using Gerontechnology in Assisted Living Communities for Older Adults

Technology Enhance Social Connectedness Among Older Adults? A Feasibility Study

Maintenance 235

Access / details information Type of Resource Specific, simple and adapted program for Older Adults 

