3. In todayâs society, effective fitness is
desperately needed to improve the physical
health of the frail elderly.
4. Benefits
â According to a study performed by The National
Institute on Aging, for the elderly age 75 and older:
âș 40% cannot walk two blocks
âș 32% cannot climb ten steps
âș 22% cannot lift ten pounds
âș 7% cannot walk across a small room
âș 50% of those who fracture hips never walk independently
again, with many dying from complications
5. Benefits
â Staying physically active and exercising regularly
can help prevent and delay many diseases and
disabilities.
â Even moderate exercise and physical activity can
improve the health of people who are frail or who
have age-related diseases.
6. Benefits
â According to the study of adults aged 72 to 80,
elderly âcouch potatoesâ were much more likely to
die within about six years than those whose lives
included regular activity no more strenuous than:
âș washing dishes
âș vacuuming
âș gardening
âș climbing stairs
7. Benefits
â NIA indicates that an inactive lifestyle can cause older
people to LOSE ground in four areas important for
staying healthy and independent:
âș strength
âș balance
âș flexibility
âș endurance
8. Benefits of Exercise in Older Adults
Cardiovascular Osteoporosis Osteoarthritis
âąImproves physiologic âąDecreases bone density loss âąImproves function
parameters in postmenopausal women âąDecreases pain
âąImproves blood pressure âąDecreases hip and vertebral
âąDecreases risk of coronary fractures Cancer
artery disease âąDecreases risk of falling âąPotential decrease in risk of
âąImproves congestive heart colon, breast, prostate, rectum
failure symptoms and decreases Neuropsychologic health âąImproves quality of life and
hospitalization rate âąImproves quality of sleep decreases fatigue
âąImproves lipid profile âąImproves cognitive function
âąDecreases rates of Other
Diabetes mellitus, type 2 depression, improves Beck âąDecreases all-cause mortality
âąDecreases incidence depression scores. âąDecreases all-cause morbidity
âąImproves glycemic control âąImproves short-term memory âąDecreases risk of obesity
âąDecreases hemoglobin levels âąImproves symptoms in peripheral
âąImproves insulin sensitivity vascular occlusive disease
These benefits were presented in the article âPromoting and Prescribing Exercise
for the Elderly,â by Robert J. Nied, M.D., Michigan State University, East Lansing,
Michigan and Barry Franklin, Ph.D., William Beaumont Hospital, Royal Oak,
Michigan of the American Academy of Family Physicians (AAFP).
9. Benefits
A recent Harvard Alumni study found:
â Modest increases in life expectancy were possible
even in those people who did not begin regular
exercise until age 75.
â Compared with people who were active only in
younger years and then stopped exercising, mortality
rates were lower in those people who did not begin
regular exercise until later in life, but who were
exercising.
10. DESPITE THIS PERSUASIVE DATA, up to 75
percent of older Americans are insufficiently
active to achieve these health benefits!
11. Habit is the single best predictor
of inactivity across all age groups.
12. âMany characteristics we associate with older
ageâlike the inability to walk long
distances, climb stairs, or carry groceriesâ
are largely due to a lack of physical activity,â
explains
Dr. John Montgomery, a family
physician, medical epidemiologist and Vice
President of Senior Care Solutions with Blue
Cross and Blue Shield of Florida
(Caregiver.com).
13. There are some common misconceptions about
exercise and the elderly that keep people away
from fitness:
14. Misconceptions
â Frail older adults are unable to exercise.
â It is unwise and unsafe for the frail elderly to begin
an exercise program.
â Frail elderly gain few benefits from exercise.
â It is too difficult to set up exercise programs for the
frail elderly.
15. Increasing Activity
Physicians can have the greatest overall impact by
helping their sedentary patients become active.
â The American Academy of Family Physicians (AAFP)
believes motivating patients to begin exercise is best
achieved by focusing on:
âș individual patient goals
âș concerns
âș barriers to exercise
16. Increasing Activity
â To increase long-term compliance, exercises should
be:
âș straightforward and fun
âș geared toward a personâs individual health needs, beliefs
and goals
â The most successful compliance with long-term
exercise is likely achieved by:
âș identifying and overcoming barriers to activity
âș setting specific goals
âș recruiting spouse/family support
âș providing positive reinforcement
17. Common Barriers to
Exercise in Older Adults
Barrier Approach
Self-efficacy Begin slowly with exercises that are easily accomplished; advance gradually; provide frequent
encouragement.
Attitude Promote positive personal benefits of exercise; identify enjoyable activities.
Discomfort Vary intensity and range of exercise; employ cross-training; start slowly; avoid overdoing.
Disability Specialized exercises; consider personal trainer or physical therapist.
Poor balance/ataxia Assistive devices can increase safety as well as increase exercise intensity.
Fear of injury Balance and strength training initially; use of appropriate clothing, equipment, and supervision;
start slowly.
Habit Incorporate into daily routine; repeat encouragement; promote active lifestyle.*
Subjective norms Identify and recruit influential others; education of patient and influential family/friends.
Fixed income Walking and other simple exercises; use of household items; promote active lifestyle*.
Environmental factors Walk in the mall; use senior centers; promote active lifestyle*.
Cognitive decline Incorporate into daily routine; keep exercises simple.
Illness/fatigue Use a range of exercises/intensities that patients can match to their varying energy levels.
* Examples of an active lifestyle include using a golf pull cart while golfing, using a push mower,
participating in activities such as stand and cast fishing or gardening, and taking the stairs.
18. Guidelines
â The American College of Sports Medicine (ACSM)
presents guidelines for adults over age 65 (or adults
50-64 with chronic conditions, such as arthritis).
â Older adults or adults with chronic conditions should
develop an activity plan with a health professional to
manage risks and take therapeutic needs into account.
19. Recommendations
â Basic recommendations from ACSM and American
Heart Association:
Do moderately intense OR Do vigorously intense aerobic exercise
aerobic exercise 30 minutes 20 minutes a day, 3 days a week
a day, 5 days a week AND
Do 8â10 strength-training exercises,
10â15 repetitions of each exercise, 2â3 times per week
AND
If you are at risk of falling, perform balance exercises
AND
Have a physical activity plan
20. Recommendations
â Flexibility is also important:
âș Each day aerobic or strength-training activities are
performed, take an extra 10 minutes to stretch the major
muscle and tendon groups, with
âș 10â30 seconds for each stretch
âș Repeat each stretch 3â4 times
âș Flexibility training will promote the ease of performing
everyday activities
21. When to Stop Exercising
â A person should consult his or her physician if exercise
results in:
âș chest pain
âș dizziness
âș cold sweats
âș extreme breathlessness
âș very rapid heart rate that lasts longer than 5â10 minutes
after stopping activity
If a movement causes pain, stop!
22. Beneficial Exercises
â To stay healthy and independent, focus on improving
the magic four areas of fitness:
âș strength
âș balance
âș stretching/flexibility
âș endurance
25. Muscle strength declines by 15 percent per
decade after age 50 and 30 percent per decade
after age 70; however, resistance training can
result in 25 to 100 percent, or more, strength
GAINS in older adults.
26. Walking
â Most of the variance in walking speed in the elderly is
related to leg strength. Increased strength has been
shown to improve:
âș walking endurance
âș stair-climbing power
27. Strength training also improves nitrogen
balance and can, when combined with adequate
nutrition, prevent muscle wasting in
institutionalized elderly persons.
28. Muscle soreness lasting a few days and slight
fatigue are normal after muscle-building
exercises. Exhaustion, sore joints, and painful
muscle pulls are not normal.
29. Balance Exercises
â Balance exercises help the elderly stay independent
by:
âș building leg muscles
âș helping prevent falls
30. While we know hip fractures are one of the
leading causes of death among senior citizens,
Tai Chi, a form of Chinese martial arts, may help
improve balance and avoid the falls that can
break hips and other bones.
32. Build up endurance gradually, starting with as
little as five minutes of endurance activities at a
time.
33. Endurance Exercises
â Examples of moderate endurance activities for the
average older adult are listed below. Older adults
who have been inactive for a long time will need to
work up to these activities gradually:
âș walking briskly on a level surface
âș swimming
âș gardening, mowing, raking
âș cycling on a stationary bicycle
âș bicycling on a standard bike
34. Endurance Exercises
â The following are examples of activities that are
vigorous. People who have been inactive for a long
time or who have certain health risks should not start
out with these activities.
âș climbing stairs or hills
âș shoveling snow
âș brisk bicycling up hills
âș digging holes
35. More Endurance Exercise Tips:
â Stretch after your activities, when your muscles are
warm.
â Drink water.
â Dress appropriately for the heat and cold.
â Use safety equipment such as helmets for biking to
prevent injuries.
37. Just doing household chores and other
mundane activities of daily living is enough
to help older adults live longer.
38. Caregiver.comâs âMobility and Exercise: No
Excusesâ article puts it simply: âExercise is one
of the best gifts of encouragement a caregiver
could share with his or her loved one, and itâs
something that everyone will enjoy and benefit
from, no matter what the level of mobility.â
39. Exercise is also a top strategy to ward off or
cope with caregiver burnout.
40. Most older persons can benefit from additional
physical activity! And it is never too late!
41. For More InformationâŠ
â Contact American Companion Care for more exercise
and good health resources.
âș American Companion Care
15461 South Acuff Street, Olathe, KS 66062
(913) 390-6300
Sheril@AmericanCompanionCare.com
www.AmericanCompanionCare.com
42. Resources
â American Academy of Family Physicians (AAFP)
âș www.aafp.org/afp/20020201/419.html
â American College of Sports Medicine
âș www.acsm.org/AM/Template.cfm?Section=Home_Page&TEMPLATE=/
CM/HTMLDisplay.cfm&CONTENTID=7764
â Caregiver.com
âș www.caregiver.com/channels/mobility/articles/mobility_and_exercise.htm
âș www.caregiver.com/articles/general/exercise%20_for_seniors.htm
â CNN
âș www.cnn.com/HEALTH/for.your.health/2001/10/elderly.exercise/index.html
â Fox News
âș www.foxnews.com/wires/2006Jul11/0,4670,FitnessElderly,00.html
â National Institute on Aging
âș nihseniorhealth.gov/exercise/benefitsofexercise/04.html
âș nihseniorhealth.gov/exercise/benefitsofexercise/06.html
âș nihseniorhealth.gov/exercise/exercisestotry/01.html
â University of Iowa Hospitals and Clinics
âș www.uihealthcare.com/topics/medicaldepartments/
familymedicine/elderlyexercise/index.html