Exercise for Healthy Aging
Ponce de Leon did more to stay young by searching for the Fountain of Youth than he ever could have had he actually found the mythical waters. Regular physical activity can help keep you healthy, strong and flexible. It can also help reverse some of the physiologic changes that otherwise come with aging.
“Our physiology does change as we age, and that’s OK,” says Edward Laskowski, M.D., co-director of the Mayo Clinic Sports Medicine Center, Rochester, Minn., and a specialist in physical medicine and rehabilitation. “The good news is that we can compensate for those changes by integrating exercise or activity into our life. When we do so, we can preserve a high quality of life as we grow older.”
Changes that come with aging include loss of:
- Lean muscle tissue
- Aerobic capacity
- Bone density
- Cognitive functions, specifically the speed of your memory
Regular physical activity can prevent and in some cases reverse some of these changes. It can also help prevent many conditions associated with aging, such as coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancers.
Staying active also often helps if you have an activity-limiting condition — such as arthritis or osteoporosis — that impairs your ability to perform important daily activities such as driving, walking up stairs and lifting groceries more comfortably.
According to the National Institutes of Health, most people lose 20% to 40% of their muscle tissue as they age. This loss isn’t inevitable, though. In 1988, Walter Frontera and associates found that men ages 60 to 72 years who trained with weights for 12 weeks had significant increases in both muscle strength and endurance. Their results were published in the March 1988 issue of the Journal of Applied Physiology. Two years later, Maria Fiatarone and colleagues published their now famous study showing that even frail adults in the 90s can benefit from weightlifting.
That study, published in the June 1990 Issue of the Journal of the American Medical Association, followed nine men and women between the ages of 86 and 96 years who lived in a long-term care facility and completed an 8-week weight training program. The strength gains of the participants averaged 174%. The range of all strength gains was 61% to 374%.
“The important thing was not so much the gain in strength,” says Dr. Laskowski, “but that these gains could be translated into functional improvement and improved quality of life. For instance, stronger muscles enable us to walk across the street more quickly, before the light turns red, and get up out of chairs that previously were difficult (to get out of).”
Another effect of aging is reduced aerobic capacity, which is a measure of the ability of your heart, lungs and blood vessels to deliver adequate oxygen to your muscles during physical activity. Reduced aerobic capacity may manifest as less energy to carry out activities, including activities of daily living.
In most people, aerobic capacity peaks at about age 20 and decreases about 1% a year thereafter. By the time people are 80 years old, their aerobic capacity is about half of what it was at age 20. For those who remain physically active, however, this decrease is significantly diminished.
“Trained Individuals, according to a 1987 study by Michael Pollock and colleagues [Journal of Applied Physiology, February 1987] have little or no decline in aerobic capacity over a decade or more,” says Dr. Laskowski. “Even those who do modest levels of physical activity have significant increases in cardiovascular efficiency in older age.”
If you can easily do all your normal daily activities at a reasonable pace without becoming breathless or dizzy, breaking into a sweat — unless weather is hot or humid — or having chest pain, you’re reasonably fit. But if you sit most of the day or feel tired most of the time or are unable to keep up with others your age, you probably need to improve your aerobic capacity.
How much physical activity do you need to improve your aerobic capacity? “You don’t need to become an elite athlete,” says Dr. Laskowski. “You should aim for a fitness level sufficient to perform daily activities and decrease your risk of developing or worsening the consequences of aging.”
According to the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine, you should perform an aerobic exercise or some form of physical activity at least:
- Three to five times a week
- For 30 minutes or longer which can be broken up into smaller 10-minute sessions.
However, according to the National Academies’ Institute of Medicine, you may need to exercise more than that for weight control.
Staying Flexible and Balanced
As you age, the elasticity of your joints and ligaments decreases. This decrease in flexibility and range of motion may be greater if you are physically inactive. You may be able to reverse some of this loss of flexibility and inactivity by increasing your activity level.
Yet another benefit of improved flexibility is improved balance, which can reduce your risk of falls. Your risk of falling increases as you age, with falls being a leading cause of death in people over age 65. The hospitalization costs for fall-related injuries total $10 billion each year.
Besides gait and balance issues, poor muscle strength is another cause of falls. Combining stability exercises with weight training helps reduce your risk. “A strong joint is a more stable joint,” says Dr. Laskowski. “And a stable joint is going to be better at protecting people from falling.”
Dr. Laskowski recommends that older people perform activities that increase postural stability. “Unless you challenge your stability system, you really won’t improve it,” he says. “Some of these exercises are very simple. For instance, standing on one leg, even while supporting yourself by holding onto the back of a chair, can help you with balance. Tai Chi and other movement exercises also have proved to be helpful in enhancing balance and stability.”
Yet another benefit of physical activity on the aging body is improved bone density. In osteoporosis your bones slowly lose mineral content, weakening their internal supporting structure. Such bones become fragile and more easily broken. Regular exercise that includes strength training can build bone mass and decrease your rate of bone loss.
Improved Mental Well-Being
The effects of exercise on psychological and mental well-being have been studied extensively. Researchers have shown that exercise can:
- Decrease depression
- Increase self-esteem and sell-confidence
- Decrease stress levels and anxiety
- Enhance mood
- Improve mental health
Regular physical activity may also help prevent or postpone age-related declines in cognition, such as decreased time to react and process new information.
“Some studies suggest that physical exercise and activity can increase mental alertness and thinking skills,” says Dr. Laskowski. “Research is under way to examine whether some elements of dementia may be influenced in individuals who are regular exercisers.”
Where to Start
If you’re healthy and don’t have any significant cardiac risk factors, you can begin moderate exercise, such as walking, without a medical examination.
Check with your doctor about exercising if you:
- Are a man over age 40
- Are a woman over age 50
- Have asthma, arthritis, diabetes, high blood pressure, heart disease or lung disease
- Are unsure about your health
- Have a family history of early onset cardiovascular disease
- Are a smoker
In addition, check with your doctor if, during exercise or mild exertion, you have discomfort in your chest, become more short of breath compared with others your age, experience lightheadedness or are easily fatigued.
The next step is to determine your goals. “You need to answer the question, ‘Why am I exercising?’” says Dr. Laskowski. “Are your goals to lose weight, get stronger, improve muscle tone or heart health? Are you preparing for a sport like golf that you enjoy playing and want to get better at? Or do you want to improve your bone density or be able to keep up with your grandkids?”
“Programs need to be individualized for each senior and suited to the needs, goals, desires and medical condition, if there is a medical condition, of the patient,” says Dr. Laskowski.
Other recommendations include:
- Start slowly. You’re less likely to become injured, sore or discouraged if you start out slowly.
- Progress gradually. If you have unstable joints from an injury or a condition such as arthritis, see your doctor to determine the optimal exercise program for you. In many cases, you can start by improving your muscle strength and joint range of motion first. Then build strength using light weights and exercising the weakest parts of your body.
- Schedule exercise regularly. For your fitness to improve, you need to exercise regularly. Try for a minimum of 30 minutes of low to moderately intense physical activity on most days of the week. Over time you may be able to build up to 30 to 60 minutes of accumulated moderate to vigorous exercise every day. But the greatest health benefits come from doing 30 minutes or more of any physical activity most days of the week.
- Include variety. Any program needs to include all three fitness components — strength training, flexibility and aerobic exercise. Stability training is also important, especially as you grow older or if you play sports or activities that emphasize balance. Engaging in a variety of types of aerobic exercise helps to prevent overload injuries. In addition, you’re less likely to become bored and more likely to keep exercising if you enjoy what you’re doing. You’re also more likely to stick to an exercise program If you do it with someone else.
“You are never too old to start exercising,” says Dr. Laskowski. “People of all ages and abilities can reap health benefits by incorporating physical activity into their daily lives.”
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