INTRODUCTION

Globally, population dynamics is essentially centred on a phenomenon: population aging, for which the two most important variables are low fertility rate and increased life expectancy; where the aging population increases to the detriment of the other age groups.^1,2 By 2019, one in 11 people in the world (9%) were older adults, and projections indicate that by 2050, one in six people in the world will be older (16%).³ These demographic changes also bring their own problems, which have been addressed since 1982, when the first world assembly on aging was held, where The Vienna International Action Plan of Action on Aging. In said assembly, member countries suggested carrying out specific actions on topics such as health, nutrition, housing and the environment, family, social welfare, income and employment security, education, and the compilation and analysis of research data.⁴

In accordance with the Sustainable Development Goals (SDG), the 2020-2030 decade is established as the decade of healthy aging. Healthy aging "is the process of development and maintenance of functional capacity that allows well-being in old age." ⁵ The World Health Organization (WHO) argues that current demographic changes must be considered and older adults should be given the importance they have in the development of populations, in order to achieve equitable, passive and safe communities.⁶

However, achieving healthy aging is not easy, since in the normal aging process, morphological and functional changes become imminent, often decreasing the ability to function.⁷ One of the most notable and important changes with the physical activity carried out by the elderly is the loss of muscle mass.^8,9 Functional performance is having the physiological capacity to carry out normal daily activities safely and independently without excessive fatigue.¹⁰ But it does not only refer to the capacities characteristic of the person (intrinsic capacity), but also of the environment in which it develops (extrinsic capacity).¹¹

According to the WHO, physical activity in old age consists of recreational activities, displacements, occupational activities, domestic tasks, sports or programmed exercises in order to improve cardiorespiratory functions, functionality and reduce the risk of NCDs, depression, risk cognitive and falls.¹⁰

The promotion of Physical Activity (PA) is a key element to achieve healthier old people. Various studies have been conducted with the aim of recognizing the benefits of PA in older adults. This review aims to update the information that is available.

MATERIAL AND METHODS

A systematic review was performed on the PubMed, Google Scholar, Elsevier, Scielo and Redalyc indexes; about the benefits of physical activity observed in older adults, using as keywords “physical activity”, “exercise”, “older adults” and “quality of life”. As selection criteria, original articles published in English or Spanish, of applied research with older adults (60+ year), regardless of sex and unlimited publication dates. And as exclusion criteria, those investigations applied to children, young people, young adults (<60), review articles, descriptive studies, or don´t provide significant information about the theme of study.

Once the articles were selected, they were classified into three groups according to the area of ​​health in which the benefits of PA were evaluated in: physical / physiological effects, psycho-emotional effects and effects on quality of life.

RESULTS

According to the search criteria, 138 related articles were identified, however, following the criteria determined at the beginning of this review, 120 manuscripts were discarded for not meeting the selection criteria or being within the exclusion criteria. The remaining 18 articles were considered for review and were grouped according to the main variable evaluated. To analyse the results of the studies and compare them, two tables were made. Table 1 includes reference, design, sample, method and instruments (including the time during which the training program or exercise was applied) and main findings. Table 2 describes only 12 of the 18 studies since they are the ones that specifically applied training or exercise programs in older adults and measured their effects at the physical / physiological level. Through this table it is possible to compare the results and identify the types of training that obtained the best results. Table 2 includes reference, method and instruments, results of pre and post evaluations and the value of P. 11% of the investigations report improvements in the psycho-emotional sphere: PA generates positive feelings such as happiness or good self-perception.^12,13 72% of studies showed benefits on a physical level: PA in old age improves strength, balance, flexibility and muscle tone.^14-26 It is also related to a significant reduction in arterial stiffness. And 17% of the articles focused on quality of life: PA favours the perception of a higher quality of life.^27-29 Finally, 66.7% of the studies were carried out applying an exercise or training program, which show important differences in their design and results. Varying in the application time from four weeks to 48 weeks. As shown in Table 2, which describes the results of pre and post evaluations.

DISCUSSION

Aging is very often related to a decline in different human functions, such as cognitive state, strength, balance, the musculoskeletal and cardiovascular systems, among others.³⁰ This deterioration is closely linked to the decrease in PA.³¹ However, according to different investigations, it has been identified that the AF contributes significantly to the health of the elderly, since it promotes strength, flexibility, agility, speed and endurance on a physical level. As Miller KL et al. In a quasi-experimental study of an exercise program with a duration of four weeks applied in older adults, where it was shown that through this type of PA, there are significant improvements in balance confidence, balance performance and walking in weakened .¹⁹ It is important to highlight that not all forms of PA have the same functions or reach the expected results, such is the case of research applied by Wolf SL et al., in which after 48 weeks of Tai Chi training, there was no evidence of statistically significant reduction in the risk of falls in the elderly.²¹

The investigations made by Jorgensen MG et al. and Pluchino A. et al is interesting and innovative, who applied PA programs for older adults using the Nintendo Wii. Both programs were effective as there were substantial improvements in muscle function, muscle performance, and functional performance. ^22,23 Video games can be a new window of opportunity to improve the physical condition of the elderly, as it can be applied at home, providing economic savings, time, transfers and risks.

On an emotional level, PA generates a feeling of happiness, a positive effect on mood and on different mental illnesses such as depression. As evidenced by Bohórquez MR et al. with a descriptive study applied to 104 elderly adults where PA is related to happiness. The results show that the practice of PA in the past, in the present or throughout life, influences in a significant way the mood and feeling of happiness of the elderly.¹³ If we consider that depression as well as the feelings of sadness are very frequent in older adults, PA turns out to be an economic tool and significant tool in mental health care in old age.^32,33

Finally, it is useful to rescue that PA has been studied in its impact on the quality of life of the elderly, as demonstrated by Guallar-Castillón P et al. in a cross-sectional research carried out with 3066 older adults, where it concludes that the higher the PA practiced during free time, the higher the Health-Related Quality of Life (HRQL) reported by the elderly.²⁷

Although strategies aimed at promoting a healthy lifestyle have been created worldwide and policies have been implemented, these have not been sufficient, since although they are aimed at preventing chronic non-communicable diseases (NCDs), this has not been achieved. NCDs lead the prevalence of diseases and are also the main causes of death in the world. The worst thing is that they are diseases that are mostly preventable with the adoption of good lifestyles, such as a healthy and balanced diet and PA. As a result, we have a young and adult population with sufficient risk factors to reach an old age with multiple diseases or premature death, and for those who are already old, it means functional deterioration, disability and premature death.

CONCLUSIONS

According to the revised references, PA improves health in the physical, mental and social spheres of older adults, improving their quality of life and promoting healthy aging. Including PA as part of the activities of daily life of the elderly promotes balance, prevents falls, improves physical strength and flexibility. In addition, it improves the cognitive condition, favours positive attitudes and encourages a feeling of happiness. PA has positive consequences at the vascular level, decreasing arterial stiffness. It also favours social relationships necessary for the well-being of the elderly.

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