June 28 - 29, 2007 Advisory Committee Meeting
Dr. Nelson indicated functional health affects all ages, sexes and different
socio-economic subgroups. The review of issues around functional health were
discussed mainly around different age groups but with an emphasis on older
adults as impairment disproportionately affects this age group and they are the
least active and the fastest growing age group.
For the Committee's purposes it will be difficult to define an older adult.
The American College of Sports Medicine and American Heart Association completed
a process that used the approach that anyone 65 and older is an older adult.
However, there are adults that are in their 50's that have impairments that make
them seem older.
Another issue that will be challenging will include defining functional
health. For older adults there is incongruity between what older adults think
they can achieve physically and what they actually can achieve. Also, because
many older adults have a low baseline for normal physical activity, doses of low
activity must be interpreted differently in this age group.
Regarding other age groups, functional health may be a central issue at
earlier ages because of the overall absolute lack of physical fitness.
Discussion following Dr. Nelson's presentation centered around the question
of focusing on fitness as a health outcome and its role in the Committee's
report. Additionally, the question of fitness as an exposure variable as well as
the relationship between fitness and clinical outcomes were raised. The
Committee discussed the importance of addressing functional health as it relates
to persons with disabilities. Balance training was also mentioned as something
to include with fitness parameters. It was verified that the initial database
treats fitness as an exposure and fitness as an outcome should be flagged for
The definition of older adult was again raised. It was noted other agencies
have definitions of an older adult and that the Committee should not contradict
those definitions as it is important the government speak with one voice.