Exercise: Seniors and Older Adults
Special Section by Karl Knopf Ed.D
Clinically speaking, we begin to age from the moment of conception. As we approach our middle years, if our bodies are not well cared for, the effects of normal aging begin to become apparent. Various organs and systems begin to display deterioration. The effects of this deterioration present themselves as heart disease, arthritis, elevated blood pressure and low back problems to name a few. Other changes that occur include decreases in hormone production and elasticity begins to diminish in muscles, skin and blood vessels. Many of these adverse effects of aging can be reversed or slowed with the intervention of a proper and regular exercise routine. No matter how well one maintains oneself, the physiological process of aging will take its toll. Exercise does not stop the biological clock, but it can slow it considerably. Proper exercise is imperative in maximizing physiological capacity.
Most researchers believe that the maximum life span in humans is slightly over 110 years. This life span has remained unchanged for 300 years in spite of tremendous advances in public health. Scientists suggest that we should not experience a steady decline in health starting in our 30s, but rather live successfully into our 80s before bodily systems start to break down.
Average life expectancy in the United States has increased dramatically in this century, from about 47 years in 1900 to about 75 years in 1990. This increase is mostly due to improvements in sanitation, the discovery of antibiotics, and advancements in medical care; but as scientists make headway against chronic diseases such as cancer and heart disease, some think it can be extended even further.
Maximum human life span seems to be another matter. There is no evidence that it has changed in thousands of years despite fabled fountains of youth and biblical tales of long-lived patriarchs. However, the dream of extending life span has shifted from legend to laboratory in recent years as more gerontologists than ever are exploring the genes, cells and organs involved in the aging process. With each passing day they uncover more secrets to healthy living and longevity. Physical activity is one of them.
According to a study done at Stanford University, longtime runners live longer lives and have less pain, disability and disease than their sedentary peers. The longtime runners in this study were leaner, needed less medication and had fewer joint problems than non-runners of the same age. This evidence is proof positive that living an active life is beneficial.
The past surgeon general has estimated that close to 85% of our most dreaded diseases could be prevented with appropriate lifestyle changes, including a good diet and regular exercise. Healthy lifestyles behaviors and sensible exercise would not only prevent disease and untimely death but would improve the quality of one’s life! No one wants to just survive; everyone wants to live fully. Regular exercise will foster that goal!
Being Sedentary Can Be Hazardous To Your Health
The following list includes information and facts regarding the adverse effects associated with physical inactivity.
- Inactivity and poor diet cause at least 300,000 deaths a year in the United States.
- Adults who are less active are at greater risk of dying of heart disease and developing diabetes, colon cancer and high blood pressure.
- More than 60% of U.S. adults do not engage in the recommended amount of physical activity.
- Approximately 40% of U.S. adults are not active at all.
- Physical inactivity is more common among women than men, African American and Hispanic adults than whites, older than younger adults, and the less affluent than more affluent individuals.
- Social support from family and friends is consistently and positively related to regular physical activity.
- Inactivity increases with age. By age 75, about one in three men and one in two women engage in no physical activity.
- People with disabilities are less likely to engage in regular moderate physical activity than people with no physical disabilities, yet they have similar needs to promote health and prevent lifestyle-related diseases.
Age Is No Excuse for Infirmity
Dr. DeVries of USC has shown that men and women in their 70s and 80s can achieve levels of vigor associated with people 30 years younger. This means that assuming there are no underlying disorders, exercise can make an 85-year-old as strong as a 55-year-old person. Regular participation in physical activity can raise the fitness level of an active 64-year-old to that of an average, sedentary 30-year-old. Dr. Alex Lief of Harvard Medical School believes that exercise is the closest thing we have to an anti-aging pill. He states, “Regular daily physical activity has been a way of life for virtually every person who has reached the age of 100 in sound condition.” By the year 2050, the expected life span will be 82 years of age. Nowadays, it is not surprising to hear of people celebrating their 70th birthdays, but that was not the case 40 years ago.
In 1980, the number of Americans older than 65 years of age was approximately 25 million. Researchers predict that by the year 2030 that number will grow to over 63 million. Currently the fastest growing segment of the population in the United States is the age group of 85 years and over. With regular exercise there is no reason for this increasingly large group of older adults to experience a significant decline in health.
In 1984, Dr. Bortz, co-chairman of the American Medical Association’s Task Force on Aging and past president of the American Geriatrics Society, took all the information he had gathered over many years and compiled them in a review paper titled “Disuse and Aging” for the Journal of the American Medical Association. Bortz concluded that if you recorded a list of all the changes in the human body that are attributed to aging and then compiled a similar list of changes due to physical inactivity, you would notice a striking similarity between the two lists. For example, changes associated with both aging and inactivity include changes in muscles, bones, brain, cholesterol, blood pressure, sleep habits, sexual performance, psychological inventory and so forth. The near duplication of the lists demonstrates that many of the bodily changes we have always ascribed to the normal aging process may really be caused by disuse. It is imperative that older adults understand the significance of this information and are educated as to how to prevent many of these changes with activity.
The founder of the American Running and Fitness Association, Richard Bohannon, MD, says that more than half of all older adults believe they get enough exercise through minimal walking and routine activities. In truth, more strenuous activities provide greater fitness gains and more preventative benefits; with proper supervision, older adults are perfectly capable of training at higher intensities. Gerontologists tell us that once we reach the age of 50 the need for fitness is even more crucial due to the many physiological changes that occur with age.
Another myth of aging is that as you get older, you naturally become more fragile. However, when we look at the bones of older runners, like the runners mentioned previously, we see minimal loss of bone due to the continual force applied to the bones over many years of running. Wolf’s Law, named for the German pathologist who first proclaimed it, states: “The robustness of a bone is in direct proportion to the physical forces applied to that bone.” In short, if we remain active our bones will remain strong. Participation in vigorous exercise and recreational activities regularly over a lifetime can yield rewards garnered well into the later years of life. Adults who lead a sedentary existence lose bone density and increase their risk of fracturing bones in accidents in their homes or of becoming unable to perform daily living activities. People who continue to lead healthy, active lives into their later years are at less risk for such serious and debilitating injuries. Researchers at UCLA performed a study on 4,300 people. Of that population, only 12% who exhibited few or no unhealthy habits became disabled over the next decade. Nineteen percent of those who had many bad habits paid the price by way of illness, disability and death.
Life involves a continuing series of choices. While advances in medical technology clearly contribute to the decline of many diseases, it is generally accepted that changes in lifestyle and environment have a great impact upon the prevalence and incidence of the major diseases of adulthood. Even the subtlest of changes can result in significant benefit.
Compelling information published in the American Academy of Physical Education Papers (1993), revealed just how much impact the aging process can have on carrying out basic life functions and quality of life. Of those adults 60 to 64 years of age, approximately 19% of men and 40% of women studied were unable to or found it difficult to lift/carry 25 pounds. The information indicated that 25% of men and 24% of women were unable to walk a quarter of a mile and 10% of men and 22% of women had difficulty doing heavy housework. These percentages increased drastically after age 65.
Extending life would not mean much if it simply meant living more years with disease and disability. The same steps that add years to your life can add life to your years. Healthy habits not only reduce the risk of fatal heart attacks and cancer, but also reduce other chronic ailments that can be physically, psychologically and financially debilitating. The bottom line is this: The more exercise has been a constant in your life the better your chances are of living long and well.
Older adults who want to maintain physical and emotional independence must engage in regular exercise. Most older adults fear losing their independence more than they fear death. Proper exercise can help older adults prolong their independence. Unfortunately, many older adults believe they are too old to start exercising. In fact, we are never too old to start an exercise program if it is done prudently and with a physician’s input. Many of the deleterious effects associated with aging are now being found to be the end result of the effects of hypo-kinetic disease (AKA: couch potato syndrome). Unfit people will experience a decline in physiological performance of approximately 2% per year while fit people will only decline by about 0.5% per year. Over a lifetime that makes a significant difference!
Experts on aging revealed through research that total bed rest for 21 days shows the same effects seen in 30 years of aging. Scientists suggest that for every one hour of exercise performed, a person will increase his/her life span by one hour. Very few of us die of old age; we die from the result of diseases such as cancer and heart disease often seen in older, unhealthy persons. Many health experts believe we die as a result of making poor health choices. Today we have knowledge and resources available to make healthy choices. It was not too long ago that older adults were discouraged from exercise and told to just sit in their rocking chairs. Today, experts agree that exercise is one of those healthy choices that each of us can make, no matter what our physical condition. Experts are continually discovering that health-related issues ranging from childbirth to heart disease can be improved by the intervention of exercise. Study after study demonstrates that proper exercise, in addition to making us look and feel better, actually lengthens and improves the quality of our lives.
Exercise = Living Longer.
Aging affects the function of all body systems. In the book, We Live Too Short and Die Too Long, Dr. Bortz said, “Almost everything we have been taught about aging is wrong. We now know that a very fit body of 70 can be the same as a moderately fit body of 30.” We are now entering an exciting time, when medical doctors, exercise physiologists and gerontologists are all redefining what aging is. No longer should we expect to get sick, get heart disease, get Alzheimer’s disease or any of the other maladies commonly associated with the passage of time.
Think of an 80-year-old person and what comes to mind? Most of us, when we think of “aging,” imagine becoming more and more disabled. This concept of aging is not what is programmed into our bodies, but rather what has been projected by society. With exercise and proper care, people can and are living longer and more active lives. The next 10 years of scientific breakthroughs will lead to breathtaking increases in human longevity. The sunset years are beginning to see the light of a new day.
The stigma of slow decline associated with aging is no longer an issue for those who show interest in fitness and health. In fact, athletically and nutritionally fit individuals can measure out at 10 to 20 years biologically younger than their chronological age. For decades we have accepted frail and non-energetic persons among the older segment as the norm. Wrinkled skin, stooped shoulders and halting steps have been expected characteristics with each year we grow older. Those expectations are beginning to shift. Those professionals actively involved in exercise programming for older adults strongly believe that stooped shoulders, halting steps and other so-called age related conditions could be prevented or even corrected with proper exercise. Studies done on older athletes have found that their metabolisms do not slow down as much as first thought, nor does their muscle mass decrease as much. Scientists are proving in study after study that when such deterioration does occur, it is not the result of old age, but again, disuse. Increasing research supports the claim that chronological age is no big deal. We now have evidence that a fountain of youth does exist. It exists in the form of your local fitness center, pool, and exercise class.
Until a few years ago, most medical authorities would not have recommended that any of their elderly patients be put on a strength training program. However, with current research showing the ability to increase in muscle strength in persons over 80 years old, some other findings showing an increase in bone density with strength training, increases in leg strength in patients over 90 years old, reductions in cardiovascular risk factors, and a maintenance of strength even after many programs were completed, it is now acceptable to have older adults, even past 90 years old pumping iron. There are experts who speculate that a properly performed strength program may actually inhibit many of the aging-related phenomena that are present in many persons in our society, such as back kyphosis and scoliosis, muscle wasting, glucose intolerance and even weight management problems.
Training Considerations
For our purposes, older adults will be divided into three categories:
Dr. DeVries of USC has shown that men and women in their 70s and 80s can achieve levels of vigor associated with people 30 years younger. This means that assuming there are no underlying disorders, exercise can make an 85-year-old as strong as a 55-year-old person. Regular participation in physical activity can raise the fitness level of an active 64-year-old to that of an average, sedentary 30-year-old. Dr. Alex Lief of Harvard Medical School believes that exercise is the closest thing we have to an anti-aging pill. He states, “Regular daily physical activity has been a way of life for virtually every person who has reached the age of 100 in sound condition.” By the year 2050, the expected life span will be 82 years of age. Nowadays, it is not surprising to hear of people celebrating their 70th birthdays, but that was not the case 40 years ago.
In 1980, the number of Americans older than 65 years of age was approximately 25 million. Researchers predict that by the year 2030 that number will grow to over 63 million. Currently the fastest growing segment of the population in the United States is the age group of 85 years and over. With regular exercise there is no reason for this increasingly large group of older adults to experience a significant decline in health.
In 1984, Dr. Bortz, co-chairman of the American Medical Association’s Task Force on Aging and past president of the American Geriatrics Society, took all the information he had gathered over many years and compiled them in a review paper titled “Disuse and Aging” for the Journal of the American Medical Association. Bortz concluded that if you recorded a list of all the changes in the human body that are attributed to aging and then compiled a similar list of changes due to physical inactivity, you would notice a striking similarity between the two lists. For example, changes associated with both aging and inactivity include changes in muscles, bones, brain, cholesterol, blood pressure, sleep habits, sexual performance, psychological inventory and so forth. The near duplication of the lists demonstrates that many of the bodily changes we have always ascribed to the normal aging process may really be caused by disuse. It is imperative that older adults understand the significance of this information and are educated as to how to prevent many of these changes with activity.
The founder of the American Running and Fitness Association, Richard Bohannon, MD, says that more than half of all older adults believe they get enough exercise through minimal walking and routine activities. In truth, more strenuous activities provide greater fitness gains and more preventative benefits; with proper supervision, older adults are perfectly capable of training at higher intensities. Gerontologists tell us that once we reach the age of 50 the need for fitness is even more crucial due to the many physiological changes that occur with age.
Another myth of aging is that as you get older, you naturally become more fragile. However, when we look at the bones of older runners, like the runners mentioned previously, we see minimal loss of bone due to the continual force applied to the bones over many years of running. Wolf’s Law, named for the German pathologist who first proclaimed it, states: “The robustness of a bone is in direct proportion to the physical forces applied to that bone.” In short, if we remain active our bones will remain strong. Participation in vigorous exercise and recreational activities regularly over a lifetime can yield rewards garnered well into the later years of life. Adults who lead a sedentary existence lose bone density and increase their risk of fracturing bones in accidents in their homes or of becoming unable to perform daily living activities. People who continue to lead healthy, active lives into their later years are at less risk for such serious and debilitating injuries. Researchers at UCLA performed a study on 4,300 people. Of that population, only 12% who exhibited few or no unhealthy habits became disabled over the next decade. Nineteen percent of those who had many bad habits paid the price by way of illness, disability and death.
Life involves a continuing series of choices. While advances in medical technology clearly contribute to the decline of many diseases, it is generally accepted that changes in lifestyle and environment have a great impact upon the prevalence and incidence of the major diseases of adulthood. Even the subtlest of changes can result in significant benefit.
Compelling information published in the American Academy of Physical Education Papers (1993), revealed just how much impact the aging process can have on carrying out basic life functions and quality of life. Of those adults 60 to 64 years of age, approximately 19% of men and 40% of women studied were unable to or found it difficult to lift/carry 25 pounds. The information indicated that 25% of men and 24% of women were unable to walk a quarter of a mile and 10% of men and 22% of women had difficulty doing heavy housework. These percentages increased drastically after age 65.
Extending life would not mean much if it simply meant living more years with disease and disability. The same steps that add years to your life can add life to your years. Healthy habits not only reduce the risk of fatal heart attacks and cancer, but also reduce other chronic ailments that can be physically, psychologically and financially debilitating. The bottom line is this: The more exercise has been a constant in your life the better your chances are of living long and well.
Older adults who want to maintain physical and emotional independence must engage in regular exercise. Most older adults fear losing their independence more than they fear death. Proper exercise can help older adults prolong their independence. Unfortunately, many older adults believe they are too old to start exercising. In fact, we are never too old to start an exercise program if it is done prudently and with a physician’s input. Many of the deleterious effects associated with aging are now being found to be the end result of the effects of hypo-kinetic disease (AKA: couch potato syndrome). Unfit people will experience a decline in physiological performance of approximately 2% per year while fit people will only decline by about 0.5% per year. Over a lifetime that makes a significant difference!
Experts on aging revealed through research that total bed rest for 21 days shows the same effects seen in 30 years of aging. Scientists suggest that for every one hour of exercise performed, a person will increase his/her life span by one hour. Very few of us die of old age; we die from the result of diseases such as cancer and heart disease often seen in older, unhealthy persons. Many health experts believe we die as a result of making poor health choices. Today we have knowledge and resources available to make healthy choices. It was not too long ago that older adults were discouraged from exercise and told to just sit in their rocking chairs. Today, experts agree that exercise is one of those healthy choices that each of us can make, no matter what our physical condition. Experts are continually discovering that health-related issues ranging from childbirth to heart disease can be improved by the intervention of exercise. Study after study demonstrates that proper exercise, in addition to making us look and feel better, actually lengthens and improves the quality of our lives.
Exercise = Living Longer.
Aging affects the function of all body systems. In the book, We Live Too Short and Die Too Long, Dr. Bortz said, “Almost everything we have been taught about aging is wrong. We now know that a very fit body of 70 can be the same as a moderately fit body of 30.” We are now entering an exciting time, when medical doctors, exercise physiologists and gerontologists are all redefining what aging is. No longer should we expect to get sick, get heart disease, get Alzheimer’s disease or any of the other maladies commonly associated with the passage of time.
Think of an 80-year-old person and what comes to mind? Most of us, when we think of “aging,” imagine becoming more and more disabled. This concept of aging is not what is programmed into our bodies, but rather what has been projected by society. With exercise and proper care, people can and are living longer and more active lives. The next 10 years of scientific breakthroughs will lead to breathtaking increases in human longevity. The sunset years are beginning to see the light of a new day.
The stigma of slow decline associated with aging is no longer an issue for those who show interest in fitness and health. In fact, athletically and nutritionally fit individuals can measure out at 10 to 20 years biologically younger than their chronological age. For decades we have accepted frail and non-energetic persons among the older segment as the norm. Wrinkled skin, stooped shoulders and halting steps have been expected characteristics with each year we grow older. Those expectations are beginning to shift. Those professionals actively involved in exercise programming for older adults strongly believe that stooped shoulders, halting steps and other so-called age related conditions could be prevented or even corrected with proper exercise. Studies done on older athletes have found that their metabolisms do not slow down as much as first thought, nor does their muscle mass decrease as much. Scientists are proving in study after study that when such deterioration does occur, it is not the result of old age, but again, disuse. Increasing research supports the claim that chronological age is no big deal. We now have evidence that a fountain of youth does exist. It exists in the form of your local fitness center, pool, and exercise class.
Until a few years ago, most medical authorities would not have recommended that any of their elderly patients be put on a strength training program. However, with current research showing the ability to increase in muscle strength in persons over 80 years old, some other findings showing an increase in bone density with strength training, increases in leg strength in patients over 90 years old, reductions in cardiovascular risk factors, and a maintenance of strength even after many programs were completed, it is now acceptable to have older adults, even past 90 years old pumping iron. There are experts who speculate that a properly performed strength program may actually inhibit many of the aging-related phenomena that are present in many persons in our society, such as back kyphosis and scoliosis, muscle wasting, glucose intolerance and even weight management problems.
Training Considerations
Category 1: 55-to 60-years-of-age. May participate in most moderate weight training routines, with only slight modifications (for joint problems, decreased ROM, any cardiovascular abnormalities).
Category 2: 65-to 80-years-of-age. Modify programs based on medical recommendations, ROM limitations, signs of fatigue, muscle weakness, and joint pain.
Category 3: 80-years-of-age and above. Closely monitor, set low-exertion levels, emphasize individual muscle group strength, overall posture, strength enhancement and avoiding injury.
As a group in general, older adults have been exposed to many years of inactivity. This may predispose them to metabolic abnormalities, coronary risk factors, hyperlipidemia, hypertension and other problems. Physically they may suffer from decreased range of motion (ROM), muscle strength and function, and elasticity of connective tissue. Orthopedic problems such as kyphosis and arthritis also are prevalent in this group.
A medical clearance is a must for all groups. They should have resting measures performed, such as blood panels, EKGs and neurological assessments. These assessments will help evaluate chronological versus fitness age in participants who, at 75, may be able to participate in the 50 to 65 classes, and vice versa.
Contraindications
Absolute
Severe coronary heart disease, arrhythmia (ventricular, atrial), uncontrolled hypertension 200/105, acute myocarditis and or thrombosis.
Relative
Valvular heart disease, permanent pacemaker, cyanotic congestive heart disease, Marfan Syndrome, chronic obstructive pulmonary disease (COPD), electrolyte imbalance (hypokalemia), uncontrolled myxedema, uncontrolled diabetes, thyrotoxicosis, long Q-T syndrome of the EKG. Strength instructors should understand which conditions may be aggravated by strength training before designing individual programs. Consultation with a physician may be necessary in some instances.
*adapted from Fitness: The Complete Guide by Frederick C. Hatfield
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