Most anyone can
benefit from additional
And it is never
In today’s society, effective fitness is
desperately needed to improve the physical
health of the frail elderly.
■ According to a study performed by The National
Institute on Aging, for the elderly age 75 and older:
► 40% cannot walk two blocks
► 32% cannot climb ten steps
► 22% cannot lift ten pounds
► 7% cannot walk across a small room
► 50% of those who fracture hips never walk independently
again, with many dying from complications
■ Staying physically active and exercising regularly
can help prevent and delay many diseases and
■ Even moderate exercise and physical activity can
improve the health of people who are frail or who
have age-related diseases.
■ According to the study of adults aged 72 to 80,
elderly ―couch potatoes‖ were much more likely to
die within about six years than those whose lives
included regular activity no more strenuous than:
► washing dishes
► climbing stairs
■ NIA indicates that an inactive lifestyle can cause older
people to LOSE ground in four areas important for
staying healthy and independent:
Benefits of Exercise in Older Adults
Cardiovascular Osteoporosis Osteoarthritis
•Improves physiologic •Decreases bone density loss •Improves function
parameters in postmenopausal women •Decreases pain
•Improves blood pressure •Decreases hip and vertebral
•Decreases risk of coronary fractures Cancer
artery disease •Decreases risk of falling •Potential decrease in risk of
•Improves congestive heart colon, breast, prostate, rectum
failure symptoms and decreases Neuropsychologic health •Improves quality of life and
hospitalization rate •Improves quality of sleep decreases fatigue
•Improves lipid profile •Improves cognitive function
•Decreases rates of Other
Diabetes mellitus, type 2 depression, improves Beck •Decreases all-cause mortality
•Decreases incidence depression scores. •Decreases all-cause morbidity
•Improves glycemic control •Improves short-term memory •Decreases risk of obesity
•Decreases hemoglobin levels •Improves symptoms in peripheral
•Improves insulin sensitivity vascular occlusive disease
These benefits were presented in the article ―Promoting and Prescribing Exercise
for the Elderly,‖ 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).
A recent Harvard Alumni study found:
■ Modest increases in life expectancy were possible
even in those people who did not begin regular
exercise until age 75.
■ 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
DESPITE THIS PERSUASIVE DATA, up to 75
percent of older Americans are insufficiently
active to achieve these health benefits!
Habit is the single best predictor
of inactivity across all age groups.
―Many characteristics we associate with older
age—like the inability to walk long
distances, climb stairs, or carry groceries—
are largely due to a lack of physical activity,‖
Dr. John Montgomery, a family
physician, medical epidemiologist and Vice
President of Senior Care Solutions with Blue
Cross and Blue Shield of Florida
There are some common misconceptions about
exercise and the elderly that keep people away
■ Frail older adults are unable to exercise.
■ It is unwise and unsafe for the frail elderly to begin
an exercise program.
■ Frail elderly gain few benefits from exercise.
■ It is too difficult to set up exercise programs for the
Physicians can have the greatest overall impact by
helping their sedentary patients become active.
■The American Academy of Family Physicians (AAFP)
believes motivating patients to begin exercise is best
achieved by focusing on:
► individual patient goals
► barriers to exercise
■ To increase long-term compliance, exercises should
► straightforward and fun
► geared toward a person’s individual health needs, beliefs
■ The most successful compliance with long-term
exercise is likely achieved by:
► identifying and overcoming barriers to activity
► setting specific goals
► recruiting spouse/family support
► providing positive reinforcement
Common Barriers to
Exercise in Older Adults
Self-efficacy Begin slowly with exercises that are easily accomplished; advance gradually; provide frequent
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;
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.
■ The American College of Sports Medicine (ACSM)
presents guidelines for adults over age 65 (or adults
50-64 with chronic conditions, such as arthritis).
■ 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.
■ Basic recommendations from ACSM and American
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 8–10 strength-training exercises,
10–15 repetitions of each exercise, 2–3 times per week
If you are at risk of falling, perform balance exercises
Have a physical activity plan
■ Flexibility is also important:
► Each day aerobic or strength-training activities are
performed, take an extra 10 minutes to stretch the major
muscle and tendon groups, with
► 10–30 seconds for each stretch
► Repeat each stretch 3–4 times
► Flexibility training will promote the ease of performing
When to Stop Exercising
■ A person should consult his or her physician if exercise
► chest pain
► cold sweats
► extreme breathlessness
► very rapid heart rate that lasts longer than 5–10 minutes
after stopping activity
If a movement causes pain, stop!
■ To stay healthy and independent, focus on improving
the magic four areas of fitness:
Strength is central to
daily function, especially
in the very elderly.
■ build muscle
■ increase metabolism
■ keep weight and blood sugar in check
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.
■ Most of the variance in walking speed in the elderly is
related to leg strength. Increased strength has been
shown to improve:
► walking endurance
► stair-climbing power
Strength training also improves nitrogen
balance and can, when combined with adequate
nutrition, prevent muscle wasting in
institutionalized elderly persons.
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.
■ Balance exercises help the elderly stay independent
► building leg muscles
► helping prevent falls
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.
walking, jogging, swimming, raking—increase
heart rate and breathing for an extended period
Build up endurance gradually, starting with as
little as five minutes of endurance activities at a
■ 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:
► walking briskly on a level surface
► gardening, mowing, raking
► cycling on a stationary bicycle
► bicycling on a standard bike
■ 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.
► climbing stairs or hills
► shoveling snow
► brisk bicycling up hills
► digging holes
More Endurance Exercise Tips:
■ Stretch after your activities, when your muscles are
■ Drink water.
■ Dress appropriately for the heat and cold.
■ Use safety equipment such as helmets for biking to
Remember—endurance activities should not
make you breathe so hard that you can’t talk
and should not cause dizziness or chest pain.
Just doing household chores and other
mundane activities of daily living is enough
to help older adults live longer.
Caregiver.com’s “Mobility and Exercise: No
Excuses” article puts it simply: “Exercise is one
of the best gifts of encouragement a caregiver
could share with his or her loved one, and it’s
something that everyone will enjoy and benefit
from, no matter what the level of mobility.”
Exercise is also a top strategy to ward off or
cope with caregiver burnout.
Most older persons can benefit from additional
physical activity! And it is never too late!
For More Information…
■ Contact American Companion Care for more exercise
and good health resources.
► American Companion Care
15461 South Acuff Street, Olathe, KS 66062
■ American Academy of Family Physicians (AAFP)
■ American College of Sports Medicine
■ Fox News
■ National Institute on Aging
■ University of Iowa Hospitals and Clinics