Exercise Influences Survival, Even in Old age.

While frailty and fitness are important attributes of older persons, samples of their prevalence, attributes, and outcomes are limited. However, new research has shown that among the community-dwelling elderly population, 171 per 1000 were very fit and 12 per 1000 were very frail. Of course frailty increased with age, so that by age 85 years and older, 44 per 1000 were very frail.

At all ages, men reported higher levels of exercise, less frailty, and less morbid obesity, compared with women. 

Fitness and frailty predict survival.
Exercise influences survival, even in old age.
Relative fitness and frailty can be determined quickly in a clinical setting, are potentially useful markers of the risk for adverse health outcomes, and add value to traditional medical assessments that focus on diagnoses.

During the past decade, major advances have been made in vitamin D research that transcends the simple concept that vitamin D is important for the prevention of rickets in children and has little physiologic relevance for adults. Inadequate vitamin D, in addition to causing rickets, prevents children from attaining their genetically programmed peak bone mass, contributes to and exacerbates osteoporosis in adults, and causes the often painful bone disease osteomalacia. Adequate vitamin D is also important for proper muscle functioning, and controversial evidence suggests it may help prevent type 1 diabetes mellitus, hypertension, and many common cancers. Vitamin D inadequacy has been reported in approximately 36% of otherwise healthy young adults and up to 57% of general medicine inpatients in North America and in even higher percentages in Europe. Recent epidemiological data document the high prevalence of vitamin D inadequacy among elderly patients and especially among patients with osteoporosis. Factors such as low sunlight exposure, age-related decreases in cutaneous synthesis, and diets low in vitamin D contribute to the high prevalence of vitamin D inadequacy. Vitamin D production from cutaneous synthesis or intake from the few vitamin D-rich or enriched foods typically occurs only intermittently. Supplemental doses of vitamin D and sensible sun exposure could prevent deficiency in most of the general population.