Exercise for the Elderly: Special Concerns

Regular physical activity in older adults provides many health benefits including improvements in blood pressure, diabetes, osteoarthritis, and heart health. Regular exercise also helps to maintain muscle and bone mass, flexibility and balance. Despite this, nearly 75 % of older Americans fail to remain active enough to experience the health benefits of exercising (Neid and Franklin). While nearly all elderly individuals are able to exercise and can benefit from additional physical activity, there are some concerns that need to be addressed before an exercise program is prescribed or attempted. Before an exercise program is attempted an older adult should always consult with their physician. Their physician can advise them of any physical limitations they may have or of anything they should be concerned about. Exercise for elderly persons can be influenced by loss of muscle mass or strength, orthopedic problems or arthritis, poor balance and frailty, disease and various heart conditions.

Muscle strength declines rapidly with age partly due to a reduction in muscle mass. This reduction in muscle strength can lead to a decline in functional capacity (ACSM 249). The majority of elderly individuals become increasingly less active, therefore reducing their muscle mass and strength further. Resistance training can increase, or at least, maintain muscle strength in elderly individuals, and therefore, has the potential to improve mobility and can decrease the risks of falls and fractures. When beginning a resistance training program one should start with little resistance to allow the connective tissues and muscles to adapt. As a training effect occurs, they should raise the level of repetitions before raising the level of resistance. In addition to its effects on increasing muscle mass and function, resistance training can also have an important effect on the energy balance of elderly men and women (Evans, Cyr-Campbell). Individuals who engage in a resistance program require more energy to maintain their weight than those who do not exercise. Because resistance training can preserve or even increase muscle mass during weight loss, this type of exercise for older men and women who must lose weight may have great benefits (Evans, Cyr-Campbell). Overall, elderly individuals who participate in resistance training can increase muscle strength, function and balance which may enable them to perform daily tasks on their own.

Many elderly individuals suffer from arthritis or other orthopedic problems ranging from a loss of cartilage to complete joint replacements. While flexibility and range of motion naturally decrease with age arthritis or other orthopedic problems simply add to the issue and can be quite disabling. While many may believe exercise is not appropriate or safe for those with arthritis, the contrary is true. Regular exercise can relieve joint stiffness and pain and increase flexibility. Elderly individuals with joint problems should begin a program slowly. One does not need to exercise excessively to reduce the symptoms of arthritis. Walking around the block or swimming a couple laps at the pool can begin to relieve stiffness and increase mobility. Multi-joint exercise should be incorporated as much as possible in order to achieve adequate range of motion in all body parts. This is an important factor in maintaining a good level of musculoskeletal function, balance and agility (ACSM 250). Poor balance and frailty is definitely a wide-spread condition of the elderly. None the less, exercise can still be accomplished by frail elderly and can greatly benefit them as well. Loss of bone and muscle mass plays a large role in the unsteadiness of elderly individuals. Resistance training will especially help to increase strength and balance. When an exceptionally frail or unsteady individual begins an exercise program, they should be closely monitored and supervised. Beginning slow is key for these individuals. Exercises such as lifting soup cans, swimming, or simply doing housework is best and reduces risk of injury. Since many elderly have such a loss in bone mass, known as osteoporosis, it is best to avoid exercises where falling can occur. If an elderly person breaks a bone, it can take quite a while for it to heal, if it heals at all, due to a reduction in bone mineral density (Powers, Howley 337). Strength training will provide the most benefits to the elderly individual suffering from osteoporosis. Resistance training is known to strengthen muscles and bones. While it may not reverse the effects of bone loss, it can aid in slowing the process.

Due to the various medical conditions and diseases an elderly individual may have, exercise should be adjusted accordingly; exercise does not need to be intense to be beneficial. Since elderly individuals are more likely to be taking medications that may influence heart rate, a conservative approach to exercise intensity should be taken. Cardiorespiratory fitness declines rapidly in later life and generally by age 60 most individuals cannot perform normal activities comfortably (Powers, Howley 335). A physical activity program is useful in dealing with the downward spiral of cardiorespiratory fitness and can aid in reducing high blood pressure, heart disease and others. When participating in aerobic exercise, however, elderly individuals need to be cautious of raising their heart rates. A measured peak heart rate is preferable to an age-related peak heart rate due to the variability in peak heart rate in persons over 65 years of age and their greater risk of underlying coronary artery disease (ACSM 248). Aerobic exercise does not need to be continuous to produce benefits. It can be achieved by doing yard work, housework or climbing stairs. Many elderly individuals may not have the means to go for a brisk walk or swim, so these other activities can be used as a substitute or as a starting point.

While there are several exercise concerns for elderly individuals, it is strongly encouraged and not at all impossible. The elderly should consult with their physician before beginning an exercise program and often precautionary measures should be taken. The health benefits that may be reaped from strength training and/or aerobic exercise are tremendous.

Works Cited

American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. 2006.

Evans, William J. and Cyr-Campbell, Deanna. "Nutrition, Exercise and Healthy Aging". Journal of the American Dietetic Association 97.n6 (June 1997).

Nied, Robert J. and Franklin, Barry. Promoting and Prescribing Exercise for the Elderly. American Academy of Family Physician. February 1, 2002.

Powers, Scott and Edward, Howley. Exercise Physiology: Theory and Application to Fitness and Performance. New York: McGraw Hill, 2004.