Aging
and Fitness - The Shape of Things to Come
Today’s Dietitian
By Jennifer Sisk, MA
Vol. 6 No. 7 p. 34
Exercise can help prevent the physical and mental
deterioration of aging. Older patients who exercise may be swimming
in the fountain of youth.
Most of us dread getting older, associating old
age with aches and pains, disease, loneliness, and senility. Obviously,
the 70-year-old body is quite different from the 25-year-old body,
and we all have to cope with those age-related changes. However,
aging need not be dreaded. Research indicates that regular exercise
can prevent or delay the development of age-related conditions,
such as osteoarthritis and Alzheimer’s disease, and alleviate
depression. And exercise has even been shown to decrease the risk
of developing certain cancers, decrease mortality associated with
cardiovascular disease, and speed recovery following stroke, heart
attack, and cancer.
The Research
Long-term National Institute of Aging studies have revealed that
normal physiological aging varies among individuals, and chronological
age does not always correlate with physiological age.1 Our genes
and lifestyle interact to affect the rate of aging, and while we
cannot change our genes, certain lifestyle modifications—such
as exercising and not smoking—can influence how we age. Regular
physical activities that include strength training, cardiovascular
conditioning, flexibility, and balance training can offset age-related
changes. Researchers have concluded that while normal aging is variable,
in general, the following physiological age-related changes occur:
• The heart muscle thickens and arteries stiffen,
causing a decline in maximal pumping rate and the body’s ability
to use oxygen from the blood.
• Maximum breathing capacity decreases by
approximately 40%.
• Brain function diminishes.
• Bone loss accelerates and often results
in osteoporosis and/or osteopenia.
• Muscle mass, strength, and power decline
significantly.
In addition, body fat typically decreases with age.
Although body fat tends to increase into middle age, we begin to
lose muscle and body fat as we age beyond that—the process
that makes older adults appear to shrink and become frail. However,
the obesity epidemic has affected the older population; a disturbing
recent trend in age-related physiology is an increase in overweight
and obesity. According to 2003 statistics from the National Center
for Health Statistics, more than 70% of men and women aged 50 to
74 are overweight and more than 30% are obese. Approximately 66%
of men aged 75 and older are overweight and 20% are obese; roughly
60% of women this age are overweight and 25% are obese.
Clinical studies support regular physical activity
to improve physiological decline. Brach et al2 studied physical
activity of 3,075 men and women aged 70 to 79 and found that those
who participated in 20 to 30 minutes of moderate-intensity exercise
on most days functioned better than those who engaged in lower-intensity
activities or no activities. Tsang and Hui-Chan3 found that older
adult men who were experienced and active golfers or tai chi practitioners
demonstrated joint movement, standing balance control, and reaction
time comparable to young university students. Brandon et al4 found
that moderate-intensity lower body resistance training two to three
days per week significantly improved mobility and leg strength in
diabetic older adults. Teri et al5 concluded that exercise combined
with behavioral management in 153 Alzheimer’s patients significantly
improved physical functioning and depression.
Research also supports the role of exercise in decreasing
the risk of certain cancers. McTiernan et al6 studied more than
70,000 women aged 50 to 79 to determine the relationship between
physical activity and breast cancer risk. Women who walked briskly
for 1.25 to 2.5 hours weekly had an 18% decreased risk of breast
cancer, and women who exercised for 10 hours or more weekly had
slightly greater risk reduction. In a review of published data on
exercise and cancer risk reduction, Lee7 concluded that 30 to 60
minutes daily of moderate- to vigorous-intensity exercise reduced
the risk of colorectal cancer in men and women by up to 40% and
the risk of breast cancer by 20% to 30%.
Resources for Professionals and
Seniors
Keeping up with recent ongoing research can be difficult for busy
professionals. Two organizations dedicated to promoting fitness
in our aging population are rapidly expanding and offer resources
for those interested in working in the growing field of older adult
fitness. In 2001, the International Council on Active Aging (ICAA)
in Vancouver, British Columbia, Canada, was launched with the goal
of uniting professionals in the fitness, rehabilitation, wellness,
long-term care, and assisted-living fields and providing information,
education, and tools for serving our aging population. The ICAA
emphasizes whole-person wellness based on the six dimensions of
wellness for older adults: emotional, intellectual, social, physical,
spiritual, and vocational health.
As the world’s largest senior fitness trade
association, the ICAA ultimately hopes to change the way we age
by encouraging people to make more healthful lifestyle choices through
support of their members involved with the aging population. Colin
Milner, ICAA CEO, says, “We support our professional members
who serve older adults with the information, education, resources,
and tools they need to be more successful with the older adult.”
The ICAA provides publications, a research e-newsletter, conferences,
and online and consultative resources. For example, ICAA members
can access resources to help them design and operate “age-friendly”
fitness centers. “If a professional is serious about serving
their older clients, we offer them the support to do a better job
by helping them stay current on information pertaining to programming,
marketing, operations, and facility design,” Milner says.
This year, the ICAA will sponsor their second national
health initiative—Active Aging Week—supported by the
Presidential Council on Fitness and the Administration on Aging.
Held from September 27 to October 3, this national health observance
boosts awareness of the importance of physical activity for older
adults and features free fitness and wellness classes nationwide.
Active Aging Week coincides with the World Health Organization’s
International Day of the Older Adult (October 1), a day established
to promote the importance of health and productivity for the world’s
increasing older adult population. Information on Active Aging Week
can be found online at www.icaa.cc.
Fifty-Plus Lifelong Fitness in Palo Alto, Calif.
(www.50plus.org) is a 25-year-old nonprofit organization founded
by a group of elite older runners who were participating in research
studies on disease prevention at Stanford University. Since its
launch in 1979, the organization gradually changed its emphasis
from individuals who were already exercising to those who were not.
Fifty-Plus has more than 2,000 members worldwide. Its mission is
to encourage fitness and a longer and more independent lifestyle
for adults by expanding awareness and involvement in health and
fitness activities to prevent illness, disability, and obesity.
On its Web site, the organization emphasizes the need for improving
the physical fitness of older individuals and focuses on disuse
of the mind and body as a significant cause of physical frailty.
To implement its mission, Fifty-Plus has established
a Fitness Ambassador Corps that uses community volunteers to help
older people find local programs to assist them in achieving higher
levels of physical activity. Fitness Ambassadors organize community
activities and provide information to encourage older adults to
enhance their health and quality of life through regular physical
activity.
According to Patricia Ernstrom, chief operating
officer of Fifty-Plus, Fitness Ambassadors serve as catalysts for
change in the lives of individuals and in their communities. “Fitness
Ambassadors either lead activities themselves or advocate and help
start programs that others lead,” says Enstrom. “This
way, the ambassadors expand programs and opportunities for fitness
among seniors in their community.”
Fifty-Plus provides a Fitness Tool Kit to assist
volunteers in implementing local programs, such as group fitness
walks. The ambassadors also collaborate with community organizations
such as YMCAs, fitness clubs, local senior centers, retirement communities,
and physician groups. “This grassroots network provides peer
encouragement, which we believe is the strongest catalyst for getting
people over 50 to exercise more,” Ernstrom says. “Fifty-Plus
really bridges the gap between awareness to action by not only providing
information, but also opportunities and incentives for older adults
to improve their fitness.”
According to Stanford University research on aging
and exercise, Fifty-Plus members have a 70% less death and disability
rate compared with the general older population. Research sponsored
by Fifty-Plus has shown that huge savings in medical costs could
result from simply walking 30 minutes each day. Because walking
two to three hours weekly can reduce the risk of hip fracture by
almost 25%, increasing the number of older adults in walking programs
could potentially save some of the billions of dollars spent on
treating the thousands of new hip fractures that occur each year
in the United States.
From Research to Real Life
Although research undoubtedly supports the benefits of exercise
as we age, little research addresses the actual implementation and
design of age-appropriate exercise. Janet E. Fisher, MEd, director
of the Fitness Business and Senior Fitness Limited in West Chester,
Pa., works with seniors every day, emphasizing functional fitness
to improve their quality of life. A senior herself at the age of
67, Fisher has more than 30 years’ experience in the business
of fitness for older adults. Over the last decade, Fisher has seen
increasing interest and participation in senior exercise. “Ten
years ago, I had five people in a class. Now, I have 35 to 50 in
class,” Fisher notes. She has opened and managed senior fitness
centers and established exercise programs at assisted-living facilities
and community fitness centers.
“There is no pill that can be taken to get
people moving,” says Fisher. She relies on an upbeat attitude
and strong but gentle approach to “get them out of the bingo
hall and moving.” While Fisher is familiar with the research
that supports exercise for older adults, she sees the benefits every
day. “Exercise keeps their bodies functioning and able to
do the things they want to do,” Fisher explains. Her functional
fitness class, which can be performed seated or standing, incorporates
exercises to build strength, cardiovascular endurance, flexibility,
and balance. Lack of strength is a problem as people age, and strength
and balance go hand in hand, according to Fisher. Milner adds, “As
a matter of fact, the loss of leg strength is one of the major factors
for entry into a skilled nursing facility. Stability is a huge issue,
since one out of three people over age 65 fall each year.”
Fisher has seen tremendous improvements in mobility once seniors
begin participating in group exercise. She compares exercise to
car maintenance. “It’s a lube job for the body’s
joints. Exercise keeps the motor running,” Fisher explains.
Milner believes the two most important benefits
of exercise for older adults include the ability to remain independent
through increased strength and cardiovascular capacity and assistance
in warding off chronic conditions such as hypertension, diabetes,
and cardiovascular disease. “Exercise assists in fighting
potentially chronic conditions, and if you happen to have a chronic
condition, exercise will help you deal with it better,” he
says.
Any exercise program that is fun, effective, and
safe is appropriate for seniors, says Fisher. It is important to
find whatever exercise works for them, whether it is tai chi, golf,
water aerobics, group fitness classes, dancing, or chair exercise.
Milner says, “The most helpful exercises are those that relate
to activities of daily living,” says Milner, “like leg
strength for getting out of a chair or climbing stairs.” Practical
exercises such as leg presses, leg extensions, and leg curls can
improve both stability and leg strength, and triceps exercises can
help with getting up out of a chair, Milner adds.
Since beginning their regular exercise routine,
Fisher’s class members have told her they feel more alive
both mentally and physically and can better perform daily activities,
such as climbing the stairs. Although physical benefits are important,
Fisher says the social aspects of senior group exercise are just
as beneficial, and she enjoys watching sociability increase as her
class members continue to participate in regular exercise. “Seniors
tend to isolate themselves. Their ability to communicate with the
outside world diminishes,” Fisher notes. New class members
are usually quiet and withdrawn, but as they continue to exercise
with other seniors, they become more outgoing. “They feel
better about themselves, begin to smile more, and make friends.
Exercise helps them break out of their shells,” Fisher says.
For older adults, the benefits of starting and maintaining
a regular exercise program cannot be ignored. Fitness and nutrition
professionals can provide the knowledge, skill training, and encouragement
many older adults need to reap the benefits of exercise. Milner
advises, “The key thing to remember is that no matter how
old you are, it is never too late to start an exercise program and
to achieve the health benefits derived from it.”
— Jennifer Sisk, MA, is the Today’s
Dietitian monthly fitness columnist, a certified wellness educator/consultant
with the American College of Wellness, and a certified fitness instructor
with the Aerobics and Fitness Association of America.
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