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Exercise For Those Over 65 Or With Chronic Conditions

What about exercise for older people?  An article, entitled “Physical Activity and Public Health in Older Adults: Recommendation From the American College of Sports Medicine and the American Heart Association.” (1) published in Circulation in August 2007 provides recommendations for physical activity in those over 65 or those who have chronic medical conditions, low fitness levels or physical limitations. It is similar to that for adults but also takes into account the older adult’s aerobic fitness, and recommends activities that maintain or increase flexibility and those that improve balance to prevent falls. Such an individual may progress more slowly and walking at a slow pace may be the equivalent of moderate intensity activity for them. Their muscle training should consist of more repetitions (10-15) than for their younger counterparts. This suggests that the weights should be light enough to enable them to perform 10-15 repetitions before their muscles fatigue. The flexibility training may take the form of at least 10 minutes of stretching of major muscle groups with 10-30 seconds of static stretch and 3-4 repetitions for each stretch. These should be done on the days when aerobic and strength training are done.

The point is made that exercise programs in these people must take into account the treatment aspects of exercise for many of the chronic conditions such as, hypertension, coronary heart disease, type 2 diabetes and elevated cholesterol to name a few. Fortunately, in many instances the therapeutic recommendations are similar to the preventive ones. However with certain conditions the emphasis may change. For example someone with osteoporosis would follow the preventive recommendation of aerobic, muscle strengthening, and balance activities, but they would emphasize weight-bearing activities and possibly high impact activities, such as jumping if tolerated. Of note, not every aerobic activity is weight-bearing. Swimming and cycling are not and have little, if any, preventive benefit for osteoporosis even though they are aerobic activities. They do benefit the cardiovascular and respiratory systems of the body.

The recommendation also emphasizes the fact that “There is substantial evidence that older adults who do less activity than recommended still achieve some health benefits…For example, lower risks of cardiovascular disease have been observed with just 45-75 minutes of walking per week.” (2)

In the next post I’ll talk about some of the risks of exercise.

For Your Health – Dr. Bob

Footnotes:
(1) M. E. Nelson, et al. Circulation. 2007;116:1094-1105; originally published online Aug. 1, 2007

(2) Ibid. pg. 1101