|April 2015 | Archive|
Move It or Lose It
If we had a dime for every time we’ve told an older adult the importance of exercise and fitness to maintain function … In our evidence-based world, there are more data than ever to support the benefits of exercise.
Benefits of Regular Physical Activity
Regular physical activity provides the following benefits:
How Much Is Enough?
Older adults should engage in at least 30 minutes of moderate physical activity five times per week. Ten-minute bursts of increased intensity, which can include any effort that involves sustained activity, are helpful.
What Should Exercise Target?
Activities should focus on strength, balance, and flexibility.
Dr. Laird’s Top Six Exercises for Older Adults
Does It Work?
Healthy People 2020 guidelines were created after a review of large amounts of detailed research on the impact of physical fitness on overall health and function. Interesting findings include the following:
Before Starting Exercise Routines
Prior to the start of a new exercise routine, encourage older adults to complete the following:
Other Tips for Success
Other activities or routines help older adults adhere to exercise goals, including the following:
The following resources offer guidance on safe exercise for older adults:
Handout for Patients
Aging Successfully: Move It or Lose It!
“I’ve fallen and I can’t get up.” Sadly, this phrase is known all too well. The number of falls, injuries, and fall-related deaths that occur every day is distressing. Each year in the United States, more than one-third of community-dwelling adults aged 65 and older experience falls, according to the Centers for Disease Control and Prevention. Approximately 20% to 30% of falls result in moderate to severe injuries that impair elders’ mobility, reduce their ability to maintain independence, and frequently lead to early death.
In more than 90% of elders whose hip fractures have been caused by falls, 25% die within six months to one year after the fall. Adults aged 75 and older account for nearly 85% of fall fatalities. While older adults may think about this risk as it relates to a loved one, they should realize that caregivers are at risk as well.
What accounts for this increased risk of falls in older adults? A number of changes combine to create an increased risk of falling. Muscle mass decreases, and the efficiency of nerves, especially sensory nerves that detect how soft or hard the ground is, declines, leading to decreased muscle strength and performance particularly when quick movements are necessary. Both men and women lose bone density. The resulting changes to the anatomy of the spine, foot, and joints can alter gait and contribute to unsteadiness while walking. Cardiovascular efficiency at rest is reasonably preserved as we age, but maximal ability when stressed is decreased so we become more susceptible to changes in circulation and dizziness with change of position as in getting up quickly. Vision and hearing changes can limit information the brain needs to adjust properly to the surrounding environment.
How can you avoid this decline? It’s important to remember that if you move it, you won’t lose it. Research has clearly shown that you can improvement your level of physical fitness well into your 90s. Regular exercise is one of the most important ways to reduce fall risk because it builds strength and helps you feel better, both physically and mentally. Thirty minutes per day on at least five days per week of moderate exercise (moderate means you can have a conversation while doing the exercise) is ideal.
Yoga, tai chi, and other exercises focused on improving balance and coordination are most helpful, but any exercise increasing strength, endurance, and flexibility provides improved physical function for balance and coordination. Walking is the universal exercise and walking in a pool or other water-based exercises are effective as well.
What if I am unsteady while walking or afraid of falling? Initially, you should see your primary care provider for a full evaluation. In addition to the effects of aging, there are other causes for falls, including medications that can increase fall risk. Next, don’t be afraid to use a cane or walker if necessary for balance and security. It is critical to stay active. But you need to avoid injury. Elders should use handrails on stairs for guidance and support. Wearing rubber soled, low-heeled shoes that support feet and are not slippery adds to the security of walking with reduced fall risk.
Talk to your doctor before starting any new exercise programs, and keep the intensity low but frequent. Don’t forget, you really do have to “move it or lose it.”
— Rosemary Laird, MD, MHSA, AGSF, is a geriatrician, medical director of the Health First Aging Institute, and past president of the Florida Geriatrics Society. She is a coauthor of Take Your Oxygen First: Protecting Your Health and Happiness While Caring for a Loved One With Memory Loss.