To what extent does physical activity reduce ischemic heart disease incidence among adults over 65?

To what extent does physical activity reduce ischemic heart disease incidence among adults over 65?

Cardiovascular diseases are responsible for around one-third of all deaths globally, a significant threat to sustainable development in the 21st century (Mozaffarian et al.,2016). Many researchers focus on identifying opportunities to promote healthy aging and prolong functional life through increased efforts to prevent CVD.

The burden of ischemic heart disease on elderlies:

In many populations worldwide, life expectancies are increasing, resulting in rapidly aging communities. Because of this, Congestive Heart Failure (CHF) has become the leading cause of hospitalisation due to hypertension and Coronary Artery Disease (CAD) in elderlies. According to the American Heart Association, individuals aged 65 or above have a 75% chance of developing Ischemic Heart Disease (IHD) (Yazdanyar & Newman, 2009). CAD is a disease in which the heart's blood vessels narrow due to atherosclerosis, and the heart becomes stiff, making it difficult to supply blood to the heart and the rest of the body. This will result in a failure of the ejection fraction to meet the systemic circulation demands (Skrzypek et al., 2018).

The burden of CAD chronic disease is globally significant, which can lead to disability, death, and loss of productivity. Many complications can arise from CAD, such as heart failure, stroke, limb ischemia, myocardial infarction, and even death (Khan et al., 2020). Moreover, the costs associated with hospital stays, procedures, urgent care visits, clinic appointments, and medication therapies can put an outstanding financial burden on individuals affected by IHD. Khan and colleagues (2020) noted that the global cost of cardiovascular disease (CVD) was $863 billion in 2010 and is expected to surpass $1 trillion by 2030.

Development of IHD diagnostic tests and treatments:

CHF disease is not recent; it dates back to ancient Egypt, Greece, and India. The Romans were known to have used foxglove as medicine, whereas others believed in evil spirits, angry ghosts, or the will of the gods as the rational explanation. In the 1890s, Rntgen discovered X-rays, and Einthoven developed electrocardiography, which led to a significant breakthrough in investigating heart failure (Davis et al., 2000). Later, cardiac catheterisation played a crucial role in both diagnosing and treating IHD. In the early 1970s, physician Andreas Grntzig revolutionized heart disease treatment with balloon angioplasty (Barton et al.,2014).

Benefits of physical activity on CHF:

Although modern medications and equipment have significantly improved overall survival, many studies have shown that engaging in physical activity can effectively prevent coronary heart disease, improve overall health and increase longevity. An old study conducted in Honolulu revealed that individuals aged 65 and above who lead an active lifestyle, which is planned, structured, repetitive, and goal-oriented activity, are at a lower risk of developing coronary heart disease than those who lead a more sedentary lifestyle (Donahue et al., 1988). Similarly, Ciumrnean and his colleagues (2021) strengthened this observation by referring to the American Centre for Disease Control and Prevention (CDC) and the British National Health Service (NHS) guidelines, which advise adults over 65 to engage in at least 150 minutes of moderate-intensity exercise weekly. This amount of exercise will generate an energy expenditure of at least 1100 kcal per week, which has been shown to impact the mortality rate positively. Furthermore, Winzer and colleagues reported in 2018 the mechanism of exercise training to improve endothelial function by restoring the balance between production and inactivation of nitric oxide (NO) and by restoring the regenerative ability of circulating progenitor cells (CPCs) in cardiovascular disease (CVD). Over and above that, they highlighted the importance of the dose-response relationship in reducing CAD and concluded that more intensive training results in a lower risk of CAD. However, they recommended moderate-intensity physical activity as the ideal workout for people over 65.

Despite numerous studies, no specific physical activity has been identified as a universally considerable practice for elderly individuals suffering from various health conditions. As proven by the Division of Aging and Seniors of Health Canada, seniors are at a higher risk of injury during exercise, and exercise training can be limited by physical health barriers and physical frailty, such as dizziness, poor eyesight, muscle aches, and arthritis (Chen, 2010). Hence, it is crucial to investigate whether a particular exercise training routine is convenient and beneficial for older individuals depending on their age or medical condition. As a matter of course, to promote better health behaviours, it is essential to consider these barriers when engaging in physical activity. Moreover, there was no clarity among the participants included in the research regarding the duration of their regular workouts, which contributed to positive effects, and at what age they initiated exercising to attain positive CAD outcomes. As a result, the findings may not be general for many patients suffering from various diseases.

This led us to suggest a new exploratory study to identify exercises that can benefit seniors with CAD by considering various prevalent health diseases in this age group.

References:

Barton, M., Grntzig, J., Husmann, M., Rsch, J. Balloon Angioplasty - The Legacy of Andreas Grntzig, M.D. (2014). Front Cardiovasc Med,1(15). Available: https://doi.org/10.3389%2Ffcvm.2014.00015

Chen, U. (2010). Perceived barriers to physical activity among older adults residing in long-term care institutions. Journal of Clinical Nursing, 19 (3-4), 432439. Available: https://doi.org/10.1111/j.1365-2702.2009.02990.x

Ciumrnean, L., Milaciu, M.V., Negrean, V., Oran, O.H., Vesa, S.C., Slgean, O., Ilu, S., Vlaicu, S.I. (2021). Cardiovascular Risk Factors and Physical Activity for the Prevention of Cardiovascular Diseases in the Elderly. Int J Environ Res Public Health,19(1):207. Available: https://doi.org/10.3390%2Fijerph19010207

Davis, R.C., Hobbs, F.D., Lip, G.Y. (2000). ABC of heart failure. History and epidemiology. BMJ, 320(7226), 39-42. Available: https://doi.org/10.1136/bmj.320.7226.39

Donahue, R.P., Abbott, R.D., Reed, D.M., & Yano, K. (1988). Physical activity and coronary heart disease in middle-aged and elderly men: the Honolulu Heart Program.American Journal of Public Health,78(6), 683-685. Available: https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.78.6.683

Khan, M.A., Hashim, M.J., Mustafa, H., Baniyas, M.Y., Al Suwaidi, S.K.B.M., AlKatheeri, R., Alblooshi, F.M.K., Almatrooshi, M.E.A.H., Alzaabi, M.E.H., Al Darmaki, R.S., Lootah, S.N.A.H. (2020). Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study. Cureus,12(7):e9349. Available: https://doi.org/10.7759/cureus.9349

Mozaffarian, D., Benjamin, E., Go, A., et al., Heart disease and stroke statistics. (2016). American Heart Association. Circulation,133, 38360. Available: https://doi.org/10.1161/CIR.0000000000000350

Skrzypek, A., Mostowik, M., Szeliga, M., Wilczyska-Golonka, M., Dbicka-Dbrowska, D., Nessler, J. (2018). Chronic heart failure in the elderly: still a current medical problem. Folia Med Cracov, 58(4), 47-56. Available: http://www.fmc.cm-uj.krakow.pl/pdf/58_4_47.pdf

Winzer, E.B., Woitek, F., Linke, A. (2018). Physical Activity in the Prevention and Treatment of Coronary Artery Disease. J Am Heart Assoc,8,7(4). Available: https://doi.org/10.1161%2FJAHA.117.007725

Yazdanyar, A., & Newman, A. B. (2009). The burden of cardiovascular disease in the elderly: morbidity, mortality, and costs.Clinics in geriatric medicine,25(4), 563-577. Available: https://www.geriatric.theclinics.com/article/S0749-0690(09)00051-2/abstract

Abstracts:

Balloon Angioplasty:

Chronic heart failure in Elderly: still a current medical problem

Global Epidemiology of Ischemic Heart Disease: Results from the Global Burden of Disease Study.

Heart disease and stroke Statistics -- 2016

Perceived barriers to physical activity among older adults residing in long-term care institutions

History and epidemiology

Physical Activity and Coronary Heart Disease in Middle-Aged Elderly Men : the Honolulu Heart Program

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

The burden of Cardiovascular Disease in Elderly: Morbidity , Mortality and Costss

Cardiovascular Risk Factor and Physical Activity for the Prevention of Cardiovascular Disease in the Elderly

The aim of this assignment is for you to discuss a range of potential methods that might be

applied to address your research question and research gap. This assignment will build on the

research question, brief literature review and research gap identifed in theResearch Question

and Scoping ReviewAssessment.

You are required to select two methods from the list below:

Research methods:

Interviews

Focus groups

Randomised controlled trial

Analysis of secondary data

Survey

The nature of the assignment is an essay. As before, give the essay the title A3: . The essay

should be structured using the subheadings below.

Introduction (approx. 200 words)

Method 1 (approx. 300 words)

Method 2 (approx. 300 words)

Discussion (approx. 900 words)

Conclusion (approx. 100 words)

Reference list (no word limit, in APA style)

In the sections headed Methods 1-2, you will need to provide a concise definition of the method

and how it might be applied to answer your research question and research gap.

In the Discussion section, this is your opportunity to compare the suitability of the two selected

methods by (1) contrasting their relative merits, drawbacks, and ethical implications, which are

relevant to your research question, (2) considering whether participation by specific communities

and stakeholders would be needed, (3) reflect on practical challenges such as timelines,

feasibility and economic costs, and (5) how the findings might be communicated to relevant end-users.

The conclusion should provide a clear statement of which method would, on balance, be the most

suitable to apply to your research question and research gap, with a brief justification.

Assessment Length

1800 words

This was the gap from a previous assignment that we had to build this assignment on: Start with the gaps that I found in the research, refine your question according to that, find besttwomethods.

Gap:

Despite numerous studies, no specific physical activity has been identified as a universally considerable practice for elderly individuals suffering from various health conditions. As proven by the Division of Aging and Seniors of Health Canada, seniors are at a higher risk of injury during exercise, and exercise training can be limited by physical health barriers and physical frailty, such as dizziness, poor eyesight, muscle aches, and arthritis (Chen, 2010). Hence, it is crucial to investigate whether a particular exercise training routine is convenient and beneficial for older individuals depending on their age or medical condition. As a matter of course, to promote better health behaviours, it is essential to consider these barriers when engaging in physical activity. Moreover, there was no clarity among the participants included in the research regarding the duration of their regular workouts, which contributed to positive effects, and at what age they initiated exercising to attain positive CAD outcomes. As a result, the findings may not be general for many patients suffering from various diseases.

This led us to suggest a new exploratory study to identify exercises that can benefit seniors with CAD by considering various prevalent health diseases inthisagegroup.

The question of the previous assignment that I came up with:

How many days per week should a person over 65 years train and be physically active to reduce ischemic heart diseaseincidence?

Submission notes

Word limit includes in-text citations but does not include the reference list (APA style). Refer to

Moodle for submission information.

Assessment information

You will be assessed on your ability to:

Select an appropriate research question

Provide a coherent and accurate thematic account of relevant research (i.e. not just an

annotated bibliography)

Demonstrate your comprehension of the research reported and its limitations

Identify your research gap in the literature

Criteria with marking rubric

Criteria: Structure and Organisation

Fail - Essay is unstructured or over structured with mostly lists. Introduction, sections and

conclusion are lacking or indistinct. Information is poorly organised and essay does not fow

logically.

Pass - Essay has some structure. Introduction, sections and conclusion are distinct. Some

information is poorly organised. Sometimes the essay does not fow logically.

Credit - Essay structure is generally good. Introduction, sections and conclusion are distinct.

Most information is well organised. For some of the essay there is a logical fow.

Distinction - Essay has a good structure. Clear introduction, sections and conclusion. Almost all

information is well organised. For most of the essay there is a logical fow.

High Distinction - Essay is very well structured. Clear introduction, sections and conclusion. All

information is well organised. Flow of the essay is logical.

Criteria: Defnition of methods

Fail - Does not provide defnition of the 2 methods and/or methods were not selected from the

prescribed list.

Pass - Defnitions of each of the 2 methods (selected from the prescribed list) is included but

may not be clear and/or coherent.

Credit - Provides satisfactory defnitions of each of the 2 methods (selected from the prescribed

list).

Distinction - Provides good defnitions of each of the 2 methods (selected from the prescribed

list).

High Distinction - Provides clear and concise defnitions of the 2 methods (selected from the

prescribed list).

Criteria: Application of methods to the research question.

Fail - Does not provide a description of how each method could be applied to answer the

research question and gap.

Pass - Provides a description of how each method could be applied to answer the research

question and gap, but may not be clear and/or coherent.

Credit - Provides a satisfactory description of how each method could be applied to answer the

research question and gap.

Distinction - Provides a good description of how each method could be applied to answer the

research question and gap.

High Distinction - Provides a coherent and concise description of how each method could be

applied to answer the research question and gap.

Criteria: Comparison of the suitability of the methods.

Fail - Comparison of the suitability of the methods is weak or non-existent.

PHCM9132 Applied Research Methods for Public Health - 2023 Printed: 4/10/2023 | 12 of 24

Pass - Includes some comparison of the suitability of the methods, but it is not comprehensive

and/or coherent.

Credit - Includes comparison of the suitability of the methods, addressing most aspects as

specifed in the course outline.

Distinction - Includes a good comparison of the suitability of the methods, addressing almost all

aspects as specifed in the course outline.

High Distinction - Includes a comprehensive and coherent comparison of the suitability of the

methods, addressing all aspects as specifed in the course outline.

Criteria: Identifcation of most suitable method.

Fail - Does not identify most suitable method or identifes most suitable method but does not

include a satisfactory justifcation.

Pass - Identifes most suitable method, but justifcation not sufcient or coherent.

Credit - Identifes most suitable method, including satisfactory justifcation.

Distinction - Identifes most suitable method, including good justifcation.

High Distinction - Identifes most suitable method, including strong and coherent justifcation.

Criteria: Style and Format

Fail - Large number of grammatical, spelling and/or punctuation errors. Essay contains English

construction that is incomprehensible.

Pass - A number of grammatical, spelling and/or punctuation errors. Many problems with English

construction.

Credit - Some grammatical, spelling and/or punctuation errors. English is sound.

Distinction - Essay is well written. Some minor grammatical, spelling and/or punctuation errors.

Good use of English language.

High Distinction - Essay is cohesively written. Clear format. Very few grammatical, spelling or

punctuation errors. Excellent use of English language.

Criteria: Sources and References (APA)

Fail - Uses too few sources, or sources of insufcient quality. Personal anecdotes without

critique. Incomplete acknowledgement of work of others (plagiarism).

Pass - Uses a sufcient number of sources but of varying quality and range. Some sources are

acknowledged and referenced, but at other times they are not.

Credit - Uses a sufcient number and variety of quality sources. Most sources are acknowledged

and referenced throughout the essay.

Distinction - Uses a large number and wide variety of high-quality sources. Almost all sources are

High Distinction - Uses a large number and wide variety of exceptional quality sources. Personal

anecdotes subject to careful critique. All sources are acknowledged and well referenced

throughout the essay.