One of the most widely conserved hallmarks of aging is a decline in functional capabilities. Mobility loss is particularly burdensome due to its association with negative health outcomes, loss of independence and disability, and the heavy impact on quality of life. Recently, a new condition, physical frailty and sarcopenia, has been proposed to define a critical stage in the disabling cascade. Physical frailty and sarcopenia are characterized by weakness, slowness, and reduced muscle mass, yet with preserved ability to move independently. One of the strategies that have shown some benefits in combatting mobility loss and its consequences for older adults is physical activity. Here, we describe the opportunities and challenges for the development of physical activity interventions in people with physical frailty and sarcopenia. The aim of this article is to review age-related physio(patho)logical changes that impact mobility in old age and to provide recommendations and procedures in accordance with the available literature.

Objective: to determine the effect of dance‐based aerobic exercise on indices of falling in older women. Design: an exercise intervention trial with participants assigned either to an exercise group or to a control group. Setting: an exercise hall at a community centre for senior citizens. Participants: thirty‐eight healthy women aged 72–87 years, living independently in the community. Intervention: twenty women performed dance‐based aerobic exercise for 60 minutes, 3 days a week, for 12 weeks. The exercise included single‐leg standing, squatting, marching, and heel touching; and targeted balance, strength, locomotion/agility, and motor processing. Main outcome measures: single‐leg balance with eyes open/closed and functional reach as balance, hand‐grip strength and keeping a half‐squat position as strength, walking time around two cones and 3‐minute walking distance as locomotion/agility, and hand‐reaction time and foot tapping as motor processing. Results: at the pre‐test, both exercise and control groups performed similarly in all tests. At the end of the intervention, the exercise group showed significantly greater single‐leg balance with eyes closed, functional reach, and walking time around two cones. In contrast, there were no significant improvements in any of the test measures in the control group. Conclusions: dance‐based aerobic exercise specifically designed for older women may improve selected components of balance and locomotion/agility, thereby attenuating risks of falling.

There are few studies on the long-term associations of physical activity (PA) to cognition. Here, we examine the association of midlife PA to late-life cognitive function and dementia. The sample consisted of a population-based cohort of men and women (born in 1907–1935) participating in the Age Gene/Environment Susceptibility—Reykjavik Study. The interval between the midlife ascertainment of PA and late-life cognitive function was 26 years. Composite scores of speed of processing, memory, and executive function were assessed with a battery of neuropsychological tests, and dementia was diagnosed according to international guidelines. There were 4,761 nondemented participants and 184 (3.7%) with a diagnosis of dementia, with complete data for the analysis. Among the participants, no midlife PA was reported by 68.8%, ≤5 hours PA by 26.5%, and >5 hours PA by 4.5%. Excluding participants with dementia compared with the no PA group, both PA groups had significantly faster speed of processing (≤5 hours, β = .22; >5 hours, β = .32, p trend < .0001), better memory (≤5 hours, β = .15; >5 hours, β = .18, p trend < .0001), and executive function (≤5 hours, β = .09; >5 hours, β = .18, p trend< .0001), after controlling for demographic and cardiovascular factors. The ≤5 hours PA group was significantly less likely to have dementia in late life (odds ratio: 0.6, 95% confidence interval: 0.40–0.88) after adjusting for confounders. Midlife PA may contribute to maintenance of cognitive function and may reduce or delay the risk of late-life dementia.

Background. Low socioeconomic status (SES) has been associated with increased risk of disability in later life. The purpose of this study was to determine if SES has an impact on mobility functioning and to explore which physiological impairments are also associated with SES and may explain its relationship with mobility. Methods. The study sample consisted of 1025 individuals aged 65 years or older residing in the Chianti area (Italy). Number of years of education was used as an indicator of SES. Mobility functioning was assessed using gait speed (400 m) and the Short Physical Performance Battery (SPPB). Mobility-related physiological impairments were assessed with tests of executive functioning, nerve conduction velocity, muscle power, hip–ankle range of motion, Ankle–Brachial Index, and visual acuity. Linear regression models were used to study the association between number of years of education and mobility and to estimate the contribution of each of the selected physiological impairments to this association. Results. Adjusting for age and sex, slower gait speed (1.16 vs 1.26 m/s, p <.0001) and lower SPPB scores (9.55 vs 10.11, p =.006) were seen in persons with ≤5 years of total education compared with those persons with >5 years of total education. Leg power and executive function decreased the strength of the association between educational level and gait speed by more than 15%. Controlling for all selected impairments (full model) decreased the education–gait speed association by 49%. Low education continued to be significantly associated with gait speed (p <.01). Adjusting for all physiological impairments substantially reduced the low education–SPPB score association by 100%, and this association was no longer significant. Conclusions. Low SES is related to multiple physiological impairments, which explain a large amount of the association between education and gait limitations. Further work must be done to understand the mechanisms whereby low SES translates into the impairments that play an important role in mobility.