It’s no secret that people are living longer than they used to. It is estimated that by the year 2030 there will be 70 million people aged 65 and over in the US. With that knowledge, people must now give more attention to quality of life. There are many variables that affect how one ages. Some variables are out of our control: genetics, chronic diseases. However, some, such as lifestyle factors like smoking, eating and exercise habits, can be controlled.
Decreased function and strength as well as degenerative conditions are often considered a normal part of aging. However, regular physical activity is an effective way to reduce and prevent the decline of many functions as we age.
Endurance training can have positive effects on cardiovascular function. Strength training has benefits of decreasing loss of muscle mass and strength that many experience with aging. Reducing risk factors for heart disease, diabetes, etc. not only improves the person’s health status, but also contributes to an increase in life expectancy. Regular exercise improves bone health which, in turn, reduces risk for osteoporosis, improves postural stability, increases flexibility and range of motion. These benefits reduce the risk of falling and potential resulting injuries and fractures, providing additional improvement in the quality of life.
Additionally, some evidence suggests exercise can also provide improvement in psychological benefits such as preserving cognitive function, relief of depression and an overall improvement in feelings of personal control and self-efficacy.
While exercise in older adults does not always result in improvement of the traditional measures of physical fitness (such as body composition or oxidative capacity), it does improve health by the reduction of disease factors and the improvement of functional capacity. Therefore, the benefits of regular exercise and physical activity help aging adults maintain a healthier and more independent lifestyle.
So, it may be surprising that despite the known benefits of physical activity, older adults tend to be less active. Less activity overall leads to a reduction in total capacity for activity. Therefore, even daily activities utilize a larger percentage of energy. When older adults participate in physical activities, they tend to do so at a lower rate of intensity. Additionally, sedentary time tends to increase as we age. This contributes to the increase in risk of diabetes and death as well as several other chronic issues.
However, research has demonstrated that simply reducing sedentary time, even if not actually increasing exercise per se, can provide cardiovascular, metabolic, and functional benefits. They stated:
“Any amount of exercise is better than being sedentary, even if the individual’s health status prevents the achievement of recommended goals.”
Starting a new exercise regimen can be intimidating for anyone. For a person whose body is already showing signs of aging such as weakness or balance issues, this can be even more daunting. But it doesn’t have to be an all or nothing approach!
Setting both short and long term goals tends to help people stay motivated. For the maximum benefit of an activity typically involves increasing intensity, frequency and duration. However, this must be balanced with the individual’s current health status, and risk factors.
What does an “Exercise Prescription” for an older adult look like?
There is a wide range of physical ability among older adults. While many are able to live active, independent lives, others are dealing with normal aging along with one or more chronic diseases and/or geriatric conditions. When researchers were reporting on the benefits of exercise for older individuals, they noted that while exercise recommendations “should be of sufficient intensity, volume, and duration in order to achieve maximal benefits,” they should also “be individually tailored to the abilities, precautions, and goals of each person.”
The researchers’ recommendations for older adults include the following:
- Some activity is better than no activity.
- Start with low intensity and short duration. Increase gradually according to how your body tolerates the activity.
- Consider muscle strengthening activities and balance training before adding aerobic activities, especially for those who are very frail.
- Those who have higher fall risks for whatever reason, should focus on balance training three or more days a week.
- Include muscle-strengthening activities 2 days a week.
- Try to work up to 2 hours and 30 minutes of moderate intensity aerobic activity or 1 hour and 15 minutes of vigorous intensity aerobic activity, (or some combination of moderate and vigorous activities totaling the equivalent) each week.
- Work up to moderate intensity flexibility exercises twice a week
Once an individual has determined what their current activity levels are, they can start setting goals to improve those levels.
Targeting an increase in activity time or reducing sedentary time are great places to make those initial goals (for example: Short term goals may include things like 15 minutes of low intensity activity each day.) As goals are met, increase time. Then, begin setting goals that include higher intensity.
As you start this process, talk to your health care provider about your health goals as well as your concerns about current health conditions. Your doctor can help you evaluate how to safely start increasing your activity and possibly suggest specific activities to include, or avoid, based on your health.
For example, those with arthritis may benefit from starting their exercise program with aquatic exercise to reduce pain and increase mobility. Then, as their condition improves, they may move to land-based activities.
Additionally, some may need to have testing before (such as a stress test before starting vigorous exercise for those who have known cardiac issues) or specific monitoring of your progress (those who take diabetes medications may find their needs change as their health improves).
As an expert in the musculoskeletal system, your chiropractor is knowledgeable about how various activities may affect your body and can help you design and navigate a path to better health that will be the most beneficial to you. Ask about which activities may be helpful for you at your next appointment. Don’t have a chiropractor? Find a doctor at tnchiro.com.
American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 1998 Jun;30(6):992-1008. PMID: 9624662.
Lee PG, Jackson EA, Richardson CR. Exercise Prescriptions in Older Adults. Am Fam Physician. 2017 Apr 1;95(7):425-432. PMID: 28409595.
Galloza J, Castillo B, Micheo W. Benefits of Exercise in the Older Population. Phys Med Rehabil Clin N Am. 2017 Nov;28(4):659-669. doi: 10.1016/j.pmr.2017.06.001. PMID: 29031333.