Arterial distensibility, particularly central arterial distensibility, decreases with age-related changes in the arterial wall and, as a result, systolic blood pressure and/or pulse pressure (difference of systolic pressure and diastolic pressure) may increase in the elderly. Systolic hypertension, increased pulse pressure, and decreased central arterial distensibility are known to be independent risk factors for cardiovascular and cerebrovascular diseases. Decreased arterial distensibility may also cause the deterioration of physical ability in the elderly. Several previous studies, as well as the current investigation, have shown that daily physical activity is positively related to arterial distensibility in not only young but also elderly people and that relatively short-term and low-intensity aerobic exercise training could improve arterial distensibility even in the elderly. It has been shown, however, that the effect cannot be maintained without continued physical exercise. Some presumable biological mechanisms and the appropriate amount and/or intensity of physical activity and aerobic exercise for improving arterial distensibility have also been revealed. Thus, habitual physical activity and exercise may have the effect of retarding age-related changes to the arteries and establishing higher quality of life by preventing cardiovascular and cerebrovascular diseases and by improving physical ability in the elderly.

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Exercise training suppresses cardiovascular risk factors by improving lipid/glucose metabolism, insulin resistance and hypertension. There is an optimum amount and intensity of exercise that will suppress each risk factor, although limited information is currently available on this area. For instance, the level of high-density lipoprotein cholesterol seems to be dependent more on the amount than on the intensity of exercise training; the situation with exercise-induced suppression of triglyceride levels is less clear. It is notable that the ability of mild intensity or a low amount of exercise to suppress or prevent cardiovascular risk factors is largely unknown. This knowledge is essential for prescribing safe and effective exercise training to elderly people. At the same time, very few studies on the associations between cardiovascular risk factors in response to exercise can be found. For example, improvement in lipid metabolism or insulin resistance seems to be related to the weight loss seen during exercise training but weight-independent effects could also be observed. The optimal intensity and amount of exercise training for each cardiovascular risk factor and the relationships between the effects of exercise training on each risk factor need to be clarified in the near future in order to establish guidelines that can be applied to the majority of elderly people at risk of cardiovascular diseases.

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Regular exercise training brings about desirable physical effects, including an increase in both endurance capacity and muscle strength/volume and an improvement in arterial stiffness that regulate blood pressure. However, these effects vary greatly between individuals. In addition to environmental factors, the genetic backgrounds causing those individual variations are inferred. Research exploring genes which regulate physical capabilities and training-induced effects is widely being implemented. These studies will encourage an individually tailored prescription of lifestyle/exercise for health. This review focused on individual variations of exercise training-induced effects on physical endurance capacity, muscle strength/volume and arterial stiffness. The relation between these effects and the gene and genetic factors, and future perspectives were discussed. Concerning endurance capacity, many studies have been carried out on ACE genotype, and also the relation to polymorphisms of mtDNA, UCP gene or HIF1A gene. In our studies, the polymorphisms of mitochondria-related genes were explored, revealing a suggestion that polymorphism is related to the endurance capacity and the phenotypes in skeletal muscles. Regarding muscle strength and volume, polymorphisms in myostatin, AMPD and CNTFR have been investigated. Our study observed genes that indicated expression dynamics related to exercise training effects on muscle strength and volume. As a result of investigation of genes concerned with arterial stiffness improvements by exercise training, changes in many gene expressions were found. Moreover, using the genes regulated by the training as candidates, training-induced effects on arterial stiffness and polymorphisms of these candidate genes were studied. The results suggest the possibility of genetic factors influencing training-induced effects on arterial stiffness. Genetic factors are clearly involved in exercise training-induced effects on endurance capacity, muscle strength/volume and arterial stiffness. Considering the effects of exercise training, the time is approaching when genetic factors will be taken into consideration.

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Oxidation produces reactive oxygen species (ROS), which cause peroxidation, enzyme inhibition and genetic damage in muscle cells. Genetic damage to cells and tissues caused by ROS facilitates aging. Therefore, the functional capacity of the antioxidant system against ROS is important to protect cells and tissues. The health benefits of regular exercise are well documented in a large number of reports. Moderate exercise can result in greater health benefits than vigorous exercise, because intense activity may be more susceptible to producing oxidative damage. Evidence would appear, as an indirect sign of muscle cell damage, such as an increase in lipid peroxidation, glutathione oxidation, and oxidative protein damage. During exercise, increased aerobic metabolism is a potential source of ROS in mitochondria. In muscle cells, mitochondria are one important source of reactive intermediates that include superoxides, hydrogen peroxide, and possibly hydroxyl radicals. Furthermore, a recent report suggested the occurrence of inter-mitochondrial complementation through exchange of genetic contents. This complementation could be a mitochondria-specific mechanism for avoiding expression of deletion-mutant mitochondria DNA from oxidative stress. Unfortunately, because research focusing on oxidative stress and antioxidants following exercise has up to now been narrow in scope, the mechanism linking oxidative stress and antioxidants in muscle tissue during exercise is not fully understood. Knowledge of the mechanism of ROS formation during exercise will be useful for health promotion for elderly as well as young exercise enthusiasts and may lead to the prevention of oxidative stress and damage associated with physical activity. This review paper provides a brief account of how exercise leads to oxidative stress and the link with antioxidants, and implys appropriate exercise regmen as prevention of oxidative stress for elderly individuals.

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In order to exercise safely, proper exercise prescription based on each individual's physical fitness and health status is needed. An intensity equivalent to the ventilatory threshold level has been recommended in terms of safety of aerobic exercise, and we confirmed its safety in very elderly subjects (older than 75 years) if they had no contraindications to exercise. More than 20% of the subjects with sedentary lifestyles and lower physical fitness had deleterious symptoms such as excessive blood pressure elevation, dangerous arrhythmias, and myocardial ischemia during exercise testing. Therefore, evaluation of physical fitness level enables optimal exercise prescription for aerobic exercise in the elderly, and low-level intensity (40% of VO₂max) is recommended for those subjects. Excessive blood pressure elevation was frequent in greater than 60% of 1RM lower-leg resistance exercise in the elderly subjects. Therefore, 40% of 1RM intensity is recommended in terms of safety in very elderly-aged people or those with hypertension. Proper breathing technique avoiding the Valsalva effect is effective to minimize blood pressure rise during resistance exercise. Aerobic exercise training could have a lowering effect on blood pressure rise during resistance exercise in the elderly subjects. It is noteworthy that the frequency of deleterious symptoms during exercise could not decrease after short-term aerobic exercise training in the elderly.

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Pre-participation medical screening is widely used to ensure against potential exercise-related risks. It is reported that the most common underlying cause of cardiac sudden death associated with exercise is coronary artery disease in the adult population. Therefore, the evaluation of coronary risk factors is essential in medical screening for the elderly. In the present study, more than 50% of elderly subjects had one or more coronary risk factors such as hypertension, hyperlipidemia and about 10% of elderly subjects had more than 2 risk factors. Some novel coronary risk factors, such as total plasma homocysteine, and high-sensitivity C-reactive protein, while proposed in the literature, has not had the risk potential significance in medical screening established. Risk stratification based on medical screening is needed to optimize the safety of exercise, and high risk subjects who have signs or symptoms suggestive of cardiovascular diseases, or any coronary risk factor, should undergo further evaluation. Since pre-participation medical screening cannot ensure safety of exercise completely, physical condition check on the day of exercise is effective to enhance safety of exercise. More efficient medical screening systems will be needed to cope with increasing numbers of participants in exercise.

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Physical activity (PA) plays an important role in the public health-care strategies related to the control of obesity and related non-communicable chronic diseases such as coronary heart disease, type 2 diabetes, hypertension and some types of cancers. PA also results in multiple beneficial effects on the prolongation of healthy and independent lives among the elderly. This review provides a brief overview of the recently available techniques and important methodological issues related to the assessment of free-living PA. The recommended daily PA proposes increasing/maintaining the level of PA in terms of “duration”, “intensity” and “frequency”. Accordingly, objective and practical means of assessing PA (in these 3 aspects) and the energy expenditure due to structured activities (i.e. level walking) as well as non-structured activities, are thus indeed necessary for designing effective preventive strategies and being able to accurately monitor the effects. Activity monitoring based on the accelerometry technique constitutes a potentially useful modality for quantifying the PA in both epidemiological research and clinical settings. This method can objectively assess the activity patterns (i.e. intensity and duration) over short and long-term durations, and the energy expenditure can thus be estimated, however, the present available algorithm using accelerometry signals should be improved in order to minimize the inherent limitations in the application of this technique. Further investigations in assessing free-living PA using non-invasive techniques based on physiological and/or biomechanical means thus remains a challenge.

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Until the idea of the “health promotion” was advocated by the Ottawa charter in 1986, the purpose of health care was only seen as the improvement of an individual's health. Up to that time, social environmental factors and the processes involved in carrying out health projects and physical fitness promotion — its practice, evaluation, public participation and so on — had not been appreciated. In keeping with the basic concept of health promotion, and with the effort of individuals, it is essential to establish public policy for the support of health care. This implies that specialist groups, including administration, must respond to the demands of health care and physical fitness promotion. Furthermore, we can say that health care and physical fitness promotion must be carried out with regard for social policy. However, the ideals of health promotion have not been achieved so far. We examined the actual status of Health Japan 21 health promotion in two surveys, a basic survey in October 2003 and the main examination in October 2004. All local governments were examined in order to propose a community system for promoting life function and social participation for the elderly. We analyzed and assessed the questionnaire including 1) the planning and practice of Health Japan 21 strategies (a concrete assessment of the status of each of the nine items and of the details of each sub-item of plans in administrative divisions, government-designated major cities, special districts, and cities, towns, and villages); 2) the level of recognition of public participation in and opinion of projects, during execution and evaluation, and the level of cooperation with civilian organizations; 3) ways of spreading awareness of projects; 4) project evaluations (intermediate evaluation); and 5) the importance of and prospects for the future of health care Health Japan 21 projects. It is thought that research into these factors will become a reference point for an intermediate evaluation of Health Japan 21, and will help solve various problems facing health improvement in our country.

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This article presents the results of a field survey on health promotion policies and programs in various countries, including Australia, Sweden and Korea. In order to develop and implement effective health promotion policies and programs, the importance of a trans-organizational system for the close collaboration of various responsible bodies and a financial infrastructure, such as transfer of tobacco tax into health promotion activities, should be underlined. Policies that contribute to capacity building in the community should be more practical to improve the health level of the public, as opposed to an approach that tries to solve specific health problems one by one. Building a comprehensive ecological support system for the community would be a core strategy for health promotion policies and programs.

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The purpose of this study is to investigate the relationships between lumbar intervertebral disc degeneration and muscle volumes of the extremities and trunk and between disc degeneration and lumbosacral spinal alignment in elderly people in Japan.
The subjects were 222 adults who were participating in a health promotion exercise program (82 males and 140 females; mean age, 70.0 years; range, 60-86 years). Disc degeneration, lumbar lordotic angle and sacral inclination angle were evaluated using T2-weighted lumbar sagittal MR images. The thicknesses of the back and abdominal muscles were determined by ultrasonography, and the humeral, forearm, femoral and crural muscle volumes were estimated from the associated muscle thicknesses examined through ultrasonography. The transversal area of the psoas major muscle was also measured with MR images.
Findings determined by a logistic regression analysis adjusted for age and gender, show a decrease of the anterior muscle volume of the femur was statistically significantly associated with disc degeneration (odds ratio=0.80). The lumbar lordotic angle and sacral inclination angle were significantly small in the disc degeneration group. These results suggest that disc degeneration may be associated with the anterior muscle volume of the femur and lumbosacral spinal alignment in the elderly. We suspect that disc degeneration causes a decrease in the lumbar lordotic angle and also a compensatory decrease in the sacral inclination angle.

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Low back pain (LBP) and knee pain are among the most common orthopedic complaints. The factors associated with these pains are various, and their interactions are complicated; therefore, no consensus regarding causes and aggravation factors has emerged. Because LBP and knee pain deteriorate the QOL and ADL for elderly people, we examined the relationships between the experiences of LBP and knee pain and the muscle volumes of the trunk and extremities of 156 people aged 60 years and older participating in an exercise program. We used logistic regression analyses adjusted for age and gender. The decrease of latissimus dorsi muscle thickness was significantly associated with LBP (P=0.048), and the decrease of anterior femoral muscle volume was significantly associated with knee pain (P=0.025). The complication rate between LBP and knee pain was significant (P=0.003). Because our study is a cross-sectional study, there are no certainties about cause-and-effect relationships. However, our results suggest that back muscle exercises for people with LBP and training for strengthening the quadriceps femoris muscle for people with knee pain may be effective in reducing the frequency and intensity of the pain.

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This study investigated the effect of gender on age-related changes in muscle thickness (Mt) in the elderly, with relation to the differences due to the location of muscle groups. Mt values at the forearm, upper arm anterior and posterior, abdomen, subscapular, thigh anterior and posterior, and lower leg anterior and posterior were determined using ultrasonography in 188 men and 204 women aged 65 to 79 yrs. The men had thicker muscles than the women, with a greater relative difference in the upper limb and trunk compared to the lower limb muscles. For the men, Mt values at the upper limb, thigh and abdomen were negatively correlated to age (r =-0.330 to -0.214, p<0.05). For the women, only the Mt at the thigh anterior showed a significant negative correlation with age (r =-0.346, p<0.05). At the thigh anterior, there was no significant difference between both genders in the slope of the regression line for the relationship between age and percentages of Mt to the mean value for the subjects aged 65 to 69 yrs of men and women, respectively, suggesting that the rate of the age-related loss of Mt at this site was independent of gender. These results were the same even when Mt was expressed as the value relative to (body mass)^1/3, calculated to normalize the influence of the difference in body mass. The findings obtained here indicated that, in an age span from 65 to 79 yrs, 1) gender difference in muscle thickness was more apparent in the upper limb and trunk than in the lower limb muscles, and 2) men showed significant age-related losses in muscle thickness at more body sites as compared to women, especially at the upper limb and abdomen.

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This study aimed to investigate the effects of age and gender on the power generation capabilities of lower limb muscles in the elderly aged from 65 to 79 yrs. In addition to isometric knee extension torque (KT) and leg extension power (LP), mechanical power during movements specific to maximal walking (WP) and running (RP) without arm movements were determined using a non-motorized treadmill in 140 men (71.3±4.0 yrs, mean±SD) and 172 women (70.2±3.7 yrs). The measured variables were expressed as relative to body mass and then their percentages to mean values for the subjects aged 65 to 69 yrs of men and women, respectively, were calculated. The percentages of all measured variables except for KT in the women were negatively correlated to age in both men (r=-0.207 to -0.375, p<0.05) and women (r=-0.228 to -0.263, p<0.05). In the slope of regression line for the relationship between age and the percentage for each of LP, WP, and RP, no significant differences were found between the men and women and between the variables. In the sub-sample of the subjects, adjusted by their body height and mass, the men (n=31) showed significantly higher values than the women (n=34) in all variables except for WP, with a greater relative difference in LP and RP than in KT. The findings obtained here indicate that, at least in the elderly aged from 65 to 79 yrs, 1) the rate of age-related loss in the power generation capability of lower limb muscles is independent of gender and movement patterns, and 2) power development in the movement form of maximal walking is less influenced by gender as compared to that of maximal running as well as knee extension torque and leg extension power.

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Exercise training causes some physiological cardiovascular adaptations, which act to enhance cardiac and vascular functions at rest and during exercise. However, the molecular mechanisms of these adaptations are unclear. We investigated gene expression profiles of exercise training-induced cardiovascular adaptations. In the experiment, rats exercised on a treadmill for 4 or 8 weeks (4WT and 8WT). The differences in expression levels of 3,800 genes in the heart and abdominal aorta of sedentary control and exercise-trained rats were compared by the microarray analysis. Of the 3,800 genes analyzed in the microarray analyses, in the heart, a total of 45 genes (upregulation of 3 genes and downregulation of 42 genes) in the 4WT and 74 genes (upregulation of 50 genes and downregulation of 24 genes) in the 8WT displayed altered gene expression with exercise training. In the aorta, a total of 57 genes (upregulation of 35 genes and downregulation of 24 genes) in the 4WT and 31 genes (upregulation of 12 genes and downregulation of 19 genes) in the 8WT displayed altered gene expression with exercise training. Thus exercise training caused an alteration of many genes expression in the heart and aorta. The alteration of many genes expression in the heart observed in 8WT, whereas that in the aorta induced in 4WT. The observed difference in the change of the gene expression in the time course between the heart and aorta suggests that there may be a difference in the time course of exercise-induced physiological adaptation in the heart and aorta (e.g., formation of physiological cardiac hypertrophy and enhancement of arterial compliance).

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Previous studies have indicated that the Angiotensin I converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism could influence human physical performance. Furthermore, a study has suggested that ACE inhibitor treatment might decrease long-term decline in muscle strength in elderly women. Thus we hypothesized that the I allele of ACE gene I/D polymorphism, which relates to lower ACE activity, might be associated with slow-decline of muscle strength in the elderly. One hundred ninety elderly people aged 72 were recruited for this study. We assessed isometric knee extension strength, leg extension power and grip strength every year for 4 years. In the preliminary measurements, physical characteristics and muscle strength were not significantly different among three genotypes. Age-related changes of the isometric knee extension, leg extension power, grip strength were similar among three genotypes. The results of this investigation suggest that ACE gene I/D polymorphism does not affect age-related change of muscle strength in the elderly.

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In our previous study, we demonstrated that an increase in the amount of daily physical activity might produce beneficial effects on aging-induced reduction of systemic arterial compliance. Regular physical activity, especially vigorous activity levels, inhibits age-related decrease in sytemic or central arterial compliance. However, the effect of mild to moderate intensity of physical activity has not been fully elucidated. The purpose of the present study was to investigate which intensity level of physical activity would be effective to improve systemic arterial compliance. We examined the relationship between systemic arterial compliance and intensity levels of daily physical activity (activity time corresponding to <3 METs [low], <3 METs and <6 METs [mild-moderate], and >6 METs [high]) in 413 middle-aged and elderly subjects (46∼85 y). Multiple regression analysis detected age and time of mild-moderate intensity of daily physical activity as significant independent determinants of systemic arterial compliance. The time of mild-moderate intensity of daily physical activity was significantly related to age and amount of daily physical activity. After age and amount of daily physical activity were taken into account (analysis of covariance), systemic arterial compliance was significantly higher in people who had ≥30min/day of the mild-moderate daily physical activity compared with those who had <30min/day of mild-moderate daily physical activity. These findings suggest that increases not only in the amount of total daily physical activity but also in time of daily physical activity of mild-moderate intensity could improve age-induced reduction of systemic arterial compliance.

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The immune function declines in efficiency with advancing age, making the elderly less resistant to pathogenic microorganisms. The effects of walking exercise training (five 30-min walking sessions/week at 80% VT) on salivary secretory IgA (SIgA) and plasma lymphocyte subpopulations were studied in elderly subjects. Thirty sedentary, elderly subjects (8 men, 22 women; age 66.7±7.4 years) performed walking exercise for 3 months. Aerobic power, body composition, and immune function were examined before (Pre) and after training (3 months). Salivary SIgA flow rate were measured by enzyme linked immunosorbent assay (ELISA), while lymphocyte subpopulations were measured by flow cytometry. SIgA flow rate significantly increased at 3 months, especially in 64-year-olds and under (U-64), 65∼85-year-olds (65-85), and female elderly subjects. Number of total lymphocytes, NK cell, and memory-Th cell significantly decreased at 3 months. We conclude that 3 months of walking provides enhancement of mucosal immune function in elderly subjects, although it is not associated with an improvement in lymphocytes.

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The effects of age and daily physical activity (PA) on antioxidant capacity and oxidative stress remains unclear, especially among advanced age population. Thus the present study evaluated antioxidant capacity and oxidative stress status, taking into account age and PA in healthy middle-aged and elderly people (45-92 years, n=436; 166 males and 270 females). The advanced age subjects were classified in groups according to their age. Data collected from young male subjects (18-26 years, n=36) were used as a reference. The scavenging activity against superoxide anions (O₂ ^{· -}) and hydroxyl radicals (HO ^· ), oxidized/reduced glutathione concentrations ([GSSG] and [GSH]) and thiobarbituric acid reactive substances concentration ([TBARS]) were analyzed using blood samples which were obtained at resting condition. The PA of all subjects was determined using a pedometer. By comparing antioxidant and oxidative stress markers between groups, there were not any marked differences except for the fact that elderly subjects had lower [GSH] and higher [TBARS] than young subjects. As a result of multi-regression analysis using factors such as age, sex, life style related disease and smoking habit as explaining variables, the PA did not associate with either antioxidant capacity or oxidative stress status. These data suggested that age and PA may have little influence on antioxidant capacity and oxidative stress among advanced age people.

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The purpose of this investigation was to examine the relationship between physical activity patterns, age and Body Mass Index (BMI) in physically active elderly women. In ninety-four elderly Korean women, the number of steps taken per day and the time spent engaged in physical activity of light-, moderate- and vigorous-intensity were determined. The number of steps did not significantly differ according to age or BMI. However, time spent in moderate-intensity physical activity significantly decreased as BMI increased (P=0.049 F=3.120) and age increased (P=0.002, F=5.035). Thus, active elderly individuals should be encouraged to spend time doing moderate-intensity physical activity rather than worry about the number of steps taken each day in order to prevent obesity and an age-related decline in regular physical activity.

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OBJECTIVE. The purpose of this investigation was to examine the alterations in heart rate, blood lactate accumulation and perceived exertion (RPE) at lactate threshold (LT) as a consequence of exercise training in elderly. METHODS. Thirty-seven elderly aged>65 yr., served as training group (n=20) and control group (n=17). All participants performed the submaximal bench stepping test before and after the twelve-week intervention in order to determine the metabolic equivalents (METs), heart rate, lactate concentration and RPE at LT. The subjects in the training group performed the bench stepping exercise at LT for 20 minutes or more every day during the intervention. RESULTS. After the intervention, METs and heart rate at LT significantly increased compared with those at baseline level in the training group (p<0.01), whereas neither RPE nor lactate concentration at LT changed significantly. Furthermore the increase of heart rate at LT significantly correlated with the increase of METs at LT or heart rate at LT for baseline level (p<0.01). CONCLUSION. The heart rate at LT may increase in association with the increase of the aerobic capacity especially in individuals with lower fitness level and /or at the beginning of the training program, in contrast to RPE and lactate concentration at LT.

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The purpose of this study was to examine the relationships between nutrition intake status, nutritional condition and physical fitness in elderly women. One hundred-seventy seven community-dwelling healthy elderly people (age=68.7±5.0 years) were measured for physical activity, diet, physical fitness, biochemical parameters, and body composition. There were no significant differences between the 60-69 year-old group and the 70+ year-old group in nutrition intake and nutritional condition, which were higher than the national average in each age. Both nutrition intake and blood data satisfied an age standard level, and all subjects were in good nutritional condition. There was a significant positive correlation between protein intake and energy consumption (p<0.05, r=0.17, n=170). There was no significant correlation between energy intake and physical fitness score (r=0.08, n=131). However, there was significant correlation between protein intake (p<0.05, r=0.21, n=131), fat intake (p<0.01, r=0.25, n=131) and physical fitness score. A significant correlation was obtained among total cholesterol concentration (p<0.05, r=0.21, n=147), hemoglobin concentration (p<0.01, r=0.25, n=167), and energy consumption. On the other hand, there were no significant correlations between serum albumin and physical fitness elements. These results suggest that nutrition intake might be correlated with physical fitness in community-dwelling healthy elderly people.

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A cross-sectional longitudinal questionnaire survey was conducted in order to clarify how age and the duration of participation in a community health promotion program affects participants' mental health status and the motivation to maintain periodical exercise behavior (n=150, male 39, female 111, ages 52 to 82, ). The results were as follows: 1) Participants who had been on the program and had done exercise for 2 years had higher average values than the non-participant group in the motivation factors to maintain periodic exercise and their reinforcement factors, although the average values of some factors varied according to length of participation. 2) “Daily hassles” and “lowered life satisfaction” were decreased in relation to length of participation period. 3) The duration of participation had a negative causal effect on perceived strength of chronic life stress according to an SEM analysis (χ²(23)=29.78, p.=0.156, GFI=0.955, AGFI=0.913, RMSEA=0.048). 4) The perceived strength of chronic life stress had a negative causal effect on the motivation to maintain periodic exercise behavior through the factors that enforce motivation. A different pattern was observed between the junior group (52-64) and the senior group (65-82) in this causal effect (χ²(45)=52.61, p.=0.203, GFI=0.923, AGFI=0.847, RMSEA=0.036).

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‹Objective› To examine the effects of a twelve-week home-based bench step exercise program on aerobic capacity, lower extremity power and static balance in elderly subjects. ‹Methods› Thirty-eight elderly men and women participated in this study (age: 75±4 years, mean±SD). The subjects were randomly assigned, according to the area in which they resided, into either the exercise group (EG: 11 men, 8 women) or the control group (CG: 14 men, 5 women). The EG performed a 12-week home-based bench step exercise program (7 sessions/week, 20-30 minutes/session, bench height 15.0-20cm). They recorded the length of exercise and their physical condition. Before and after the intervention a sub-maximum bench step test, a leg extension power test and a one-leg balance test with eyes open (balance test) were performed to assess the subjects' aerobic capacity, as determined by the lactate threshold (LT), as well as lower extremity power and static balance ability. ‹Results› The LT (3.9 (3.2, 4.9) vs. 5.4 (4.8, 5.6) METs; p<0.01) and leg extension power (7.1 (6.2, 9.9) vs. 10.3 (7.2, 13.7)watts/kg; p<0.05) significantly increased while the balance test (9 (4, 25) vs. 16 (6, 35)) sec; p<0.1) also tended to increase in the EG. Conversely, these parameters did not significantly change in the CG (4.5 (3.9, 5.1) vs. 4.9 (4.3, 5.5) METs; 7.4 (6.7, 12.5) vs. 8.1 (7.3, 12.5) watts/kg, 17 (8, 50) vs. 11 (6, 20) sec, neither N. S.) Based on the diary data, the subjects in the EG exercised an average of 164±56 minutes/week for twelve weeks. ‹Conclusion› This study showed that a bench step exercise program effectively improved not only aerobic capacity but also lower extremity power and static balance ability in elderly subjects.

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The purpose of this study was to examine the effect of bench stepping exercise at a nursing home in an area with cold and snowy winters. Subjects were assigned to two groups (the training group and the control group). The training group participated in bench stepping exercise (ten minutes per session, three sessions per day, and five days per week) at an intensity of RPE 12 or 13. The result of our exercise intervention showed that there were significant differences (P<0.05) in CS-30 test scores compared with the control group. METs at exercise testing were improved significantly (P<0.01) in the exercise group. The adherence rate of this exercise prescription was about 85% for ten months, that is, subjects maintained the same amount of exercise in winter compared with summer. These findings suggest that bench stepping exercise for elderly in nursing homes, especially in a snowy area, is effective and keeps a high adherence rate.

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The purpose of this study was to examine the sensitivity of the Japan Fitness Test for elderly people to assess the effects of aging. The participants were 250 male and 377 female, (627 in total) elderly people in residential care. The Japan Fitness Test consists of 6 test items (Gripstrength, Sit-ups, Sit-and-reach, Single-leg balance with eyes open, 10 m hurdle walk, and 6-min walk). Two-way multivariate analysis of variance (MANOVA), and analysis of variance (ANOVA) were used to determine effects of gender and aging on test performance. To estimate the sensitivity of each test for assessing aging, effect sizes (ES) of between young-old (aged 65-74 years) and old-old (aged over 75 years) were calculated. The criterion of the sensitivity of each test was more than ES=0.50. MANOVA and ANOVA results revealed significant effects for age groups on all test items, and there were no significant interaction for all test items except Sit-ups. ES of Grip strength, Single-leg balance with eyes open, 10 m hurdle walk, 6-min walk were indicated more than ES=0.50. For Sit-ups, while ES was 0.71 in male, it was low value (ES=0.25) in female. From these results, it is concluded that the Japan Fitness Test items are sensitive to assess aging effects with the exception of Sit-up routines performed by elderly women in female.

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This study examines the validity for estimating physical fitness age (PFA) using the Japan Fitness Test through the application of single and multiple regression analyses and principal component analysis. The participants were 484 community-dwelling Japanese elderly men and women. A Physical fitness test consisting of 6 performance tests, namely grip strength, sitting trunk flexion, foot balance with opened eye, 10-m hurdle walk, sit-ups, and 6-min walk were used. Participants were divided into two groups for modeling PFA equations (n=322) and for cross-validation of them (n=162). The equation models for estimating the PFA were a single regression model with a physical fitness test score, a multiple regression model with the 6 performance tests, and the first principal component model obtained from the 6 performance tests. The validity of three PFA models was compared by concurrent validity with chronological age (CHA), cross-validity using shrinkage, and degree of agreement between aging effect for physical fitness and the correlation coefficients of PFA and CHA. Results of statistical analyses reveal that the three PFA models satisfy concurrent validity and cross-validity, but the single regression PFA model detected a greater degree of agreement for aging than the other models.

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We researched the medical expenditure of the elderly who participated in exercise group (aerobic exercise and muscle exercise), comparing control subjects who matched sex and birth year with exercise groups in 2 cities and 2 towns. We calculated the cumulative medical expenditures from the previous years. In result, yearly cumulative medical costs of control subjects increased more than exercise groups in all test areas. Similar tendencies were shown in medical costs of each year's May in 2 cities. In another town we compared medical expenditures of elderly people between 3 different types of exercise groups: muscle exercise using their own body weight, quoits, and Swiss ball exercise. Medical costs of muscle exercise group increased less although not significantly. In conclusion, cumulative medical costs are useful for evaluating effects of exercise on medical economy, and the exercise, especially muscle exercise using their own body weight, might reduce the medical costs among the elderly.

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In order to maintain and promote health among elderly people through the effective use of exercise, an “e-Health Promotion System” is proposed as a network-based health promotion system, to manage health conditions and provide evidence-based exercise prescriptions via the Internet. The personal information such as health conditions and exercise prescriptions need to be securely managed as security threats exist in the Internet medium. The aim of this research is to develop a secure data management server for an e-Health Promotion System. The data management server requires a secure system, a fault tolerance database system and an easy-to-use user interface. In order to establish the server which meets the above-mentioned system requirements, We selected a host computer with a Unix type operating system, which contains a robust security features in its core. Since the database system we adopted here has the features such as a fault-tolerance and high-speed access to the stored data, it can maintain much user information both securely and speedily. Moreover, the web-based user interface allows users to provide secure and easy access to the data server by an access control of authentication. The server can therefore manage the user information with both high security and high reliability, and provide easy user interface for the elderly. As a result of applying this system to field experiments, we confirmed the security and the reliability of the proposed system.

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The aim of this study was to assess the usefulness of the break-point in the heart rate/work rate relationship (HRBP). Ninety-seven middle-aged and elderly people performed a ramp-fashion incremental exercise test on a cycle ergometer. Breath-by breath O₂ consumption and CO₂ production data and beat-to-beat systolic blood pressure and heart rate data were obtained during the test, and work rate and heart rate corresponding to ventilatory threshold (VT), double product break point (DPBP), and HRBP were obtained by a linear regression analysis. Work rate and heart rate at HRBP correlated significantly with the corresponding values at VT (r=0.773, r=0.858, both P<0.0001), as work rate and heart rate at DPBP did (r=0.873, r=0.905, both P<0.0001). Work rate at DPBP and HRBP (60±13 and 61±13 watts) did not significantly differ from work rate at VT (61±13 watts), whereas heart rates at DPBP and HRBP (105±14 and 106±13 bpm) were significantly lower than that at VT (108±14 bpm, P<0.05). However, there was no significant difference in error from heart rate at VT between heart rate at DPBP and heart rate at HRBP. These results suggest that, in middle-aged and elderly people, HRBP could be determined as a nearly consistent point with DPBP, and might be a useful marker of VT.

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To maintain physical fitness to perform daily physical activity in the elderly, the circulatory function to perform exercise should be preserved. However, it declines with age and impairs endurance exercise performance in sedentary people. Based upon the concept that exercise capacity should be estimated as ability to continue exercise without serious circulatory stress, a new testing protocol was proposed. It consisted of determining the load for initiation of steeper blood pressure elevation during graded exercise (BP_critical). BP_critical decreased with advancing age in sedentary adult people. The decline in BP_critical was not related to age-associated change in muscle mass, and was considered to be determined by the changes with age in muscle metabolism and peripheral circulation. To continue exercise, oxygen supply is a key factor and blood flow is a major determinant. When the exercising muscle mass was small or the exercise intensity was low, the blood supply to the exercising limb did not differ in older people compared to younger people. In contrast, the vasodilatory response to exercise or to vasodilatory substance was impaired in sedentary older people with concomitant change in vascular structure such as thickening of intima-media thickness, widening of vessel diameter, etc. These age-associated declines in peripheral circulation and vessel structure are prevented by regular exercise, allowing circulatory function to be preserved in the elderly.

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The purpose of this study was to clarify the relationship between blood pressure (BP) response during static handgrip and forearm muscle thickness in 66 elderly women (60-81 years old). They performed static handgrip exercise (right hand) in a supine position. Exercise compromised a 30s static handgrip exercise separated by a 30s recovery. First and second loads were 1kgw and 2kgw, respectively, and thereafter the load was increased by 2kgw every 1min until the BP drifted upward from the previous load-BP relationship. Blood pressure was monitored on the finger of the left hand continuously. The critical load for notable BP elevation (BPcrit) was defined as an intersection point of two regression equations obtained from lower (L1) and higher (L2) intensity. Forearm muscle volume was estimated from muscle thickness measured by B-mode ultrasonography. BPcrit decreased significantly with age (r=-0.263, p<0.05). Forearm muscle thickness did not show a significant decrease in the age range of this study, whereas forearm muscle volume decreased significantly with age (r=-0.331, p<0.001). A negative correlation coefficient was obtained between muscle volume and slope of L2, indicating that the slope of L2 decreased as muscle volume increased. Consequently the blood pressure elevation at the lower intensity below BPcrit was independent of muscle thickness and volume; however, it was revealed that muscle volume affects the degree of BP elevation at the higher intensity.

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We investigated the association between Angiotensin I converting enzyme (ACE) gene insertion (I)/deletion (D) polymorphism and responses of hormonal factors related to vasoconstriction and volume loading of heart, enzyme activities of Renin-Angiotensin system, blood pressure and heart rate during a single bout of exercise. Six insertion homozygous (I/I) and 6 deletion homozygous (D/D) young men participated in this study. Subjects performed a multi-load exercise test at 1/2 lactate threshold (LT), LT, onset blood lactate accumulation (OBLA), and middle point of OBLA to maximum exercise load (OBLA-Peak) intensities. The duration of intensities was 10 minutes. Blood samples, blood pressure and heart rate were obtained at rest, in the last 2 minutes of every intensity, and 3 minutes after finishing exercise (recovery). However the plasma ACE activity in I/I was lower than that in D/D at rest, during exercise and recovery, and Angiotensin II was no different in I/I and D/D. Furthermore, there were no differences in plasma Renin activity, Angiotensin I, plasma aldosterone concentration, atrial natriuretic peptide, brain natriuretic peptide, adrenaline, noradrenalin, dopamine, systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate and double product at rest, during exercise and recovery. No relationship between plasma ACE activity and Angiotensin II existed, but plasma Angiotensin I and Angiotensin II had a positive correlation in I/I and D/D. This data suggests that the ACE gene I/D polymorphism is not associated with plasma Angiotensin II concentration during a single session of exercise.

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The purpose of the present study was to investigate the relationship between the polymorphisms of ATP synthase 8, 6 gene and the individual difference of the endurance capacity or its trainability. Sixty-nine sedentary adult males participated in an 8-week endurance training program and VO₂max and ventilatory threshold (VT) was determined as the index of endurance capacity before and after training. The polymorphisms of ATP synthase 8, 6 genes were determined by direct sequence on total DNA that was extracted from venous blood. The VO₂max increased from 41.7 to 47.8ml/min/kg (P<0.01), and VT increased from 26.9±5.6ml/min/kg to 31.9±6.8ml/min/kg (P<0.01). The polymorphism at 25 sites was detected in ATP 8, 6 gene. At mtDNA 8701, non-Cam group (n=50: VT/w=27.8±5.3ml/min/kg) had higher pre VT/wt than Cam group (n=19: VT/w=24.3±5.5ml/min/kg). The comparison of pre VT/LBM between Cam group and non-Cam group at mtDNA 8701 was also similar. We concluded that mtDNA ATP synthase 8, 6 gene might be associated with the individual difference in initial level of VT.

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This study aimed to clarify whether blood flow response in submaximal exercise differed between young and elderly women. Twelve elderly women (mean age: 67.3 yrs) and 15 young women (mean age: 21.6 yrs) performed static handgrip exercises. The experiment comprised two periods of incremental 30 seconds of static handgrip exercise between a 30 second recovery period. The initial load was 1kg, and the second load was increased to 2kg and thereafter it was increased by 2kg until 10kg was reached. The blood velocity (Doppler ultrasound methods) and diameter (B-mode ultrasound methods) of brachial artery and blood pressure (Finapres) were measured. Blood flow immediately after exercise at 6-10kg in elderly women was significantly (p<0.05) higher than in younger women. Similarly, the regression slope of blood flow in incremental load in elderly was significantly (p<0.05) higher than in younger women. However, when the load was standardized by maximal voluntary contraction (MVC), the regression slopes of blood flow in incremental load did not differ between elderly and young women. The result indicates that blood flow response to submaximal handgrip exercise at a given fraction of MVC in elderly was maintained at similar levels to younger women when the exercise intensity was limited to low and moderate levels.

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A mouse fibroblast cell line, B82, was treated with H₂O₂ for examination of the damage to mtDNA and to respiratory function. The results showed that the copy numbers of intact mtDNA molecules reduced rapidly during 15 minutes H₂O₂ treatment, while reduction of respiratory function was observed after 24 hours. The presence of such a time lag, as observed between the damage to mtDNA and respiratory function, suggested that respiration defects were not due to direct damage to polypeptides consisting of respiratory enzyme complexes, but resulted from damage to mtDNA. Moreover, both the reduced amounts of intact mtDNA and the reduced activity of respiratory enzymes were restored in 2-5 days, suggesting that the mtDNA damage was reversible, and thus were not fixed as pathogenic mutations.

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