10 Dec 2017
People are living much longer these days. Sixty is truly the new 40,” states Dr. Yan Li, a cardiologist with Phelps Medical Associates/Northwell Health. As we grow older, there are gradual changes in many of our body systems and structures. Regular physical activity, combined with a proper diet, can delay these changes and slow the progression of many medical conditions.
The amount of blood a person’s heart pumps per minute (cardiac output) decreases with age, making it harder to get oxygen to the brain and organs. Kathleen Siegel, an exercise physiologist and Director of Community Wellness at Burke Rehabilitation Hospital in White Plains, says, “Sedentary behavior or lack of physical activity can accelerate declines in physical function. If you don’t use it, you lose it.”
Mobility also changes as we age. As Jock Avolio, MD, PhD, a physiatrist and Medical Director of Physical Medicine and Rehabilitation at Phelps/Northwell Health suggests, older adults may not exercise if they are in pain due to arthritis. Heart disease or diabetes can also influence someone’s ability to be active. And cognitive changes, such as depression, can rob a person of the energy and the desire to exercise.
Additionally, it is normal to lose muscle mass as we age. Peak bone mass is reached at age 30 and, after that, we start losing bone. This can sometimes lead to osteoporosis, making falls especially dangerous. Since balance starts declining in middle age, falls are more likely as well.
Cardiovascularly, we can become deconditioned if we don’t exercise regularly. “What happens if you are a ‘couch potato’ and you don’t really move about and all of a sudden you have to really exert yourself? It can be very dangerous because the heart is not used to it,” says Dr. Li. A person’s heart rate and blood pressure might shoot up with even slight activity.
Benefits of Exercise
The benefits of exercise are numerous. According to Dr. Avolio, “Physical activity gives people a better likelihood of aging with less impairments and aging – physically and cognitively – with good function.” Physical activity can increase strength and endurance. Exercise improves posture, flexibility, bone density, and balance, which all make falls less likely. This is especially important since of the 300,000 people over age 65 who are hospitalized each year because of hip fractures – 95% of which are due to falling (according to the Centers for Disease Control), 50 percent of them are not able to live independently after their injury.
Exercise helps lower cholesterol, blood pressure, and blood sugar. This decreases the risk for a heart attack or stroke. Dr. Li suggests that people with coronary artery disease, heart failure or heart arrhythmia can keep their conditions in check and might improve them with regular exercise, preventing surgical procedures and reducing medications.
Physical activity can decrease mild depression and anxiety, ease stress and improve sleep quality. It can increase feelings of self-worth and improve cognition. Taking an exercise class can decrease feelings of social isolation.
Types of Exercise
According to Siegel, it is important to have diversity in your exercise program. “Incorporating different modes of exercise not only keeps it interesting but challenges your body to adapt differently.” Below are exercise recommendations from the American College of Sports Medicine. Always check with your doctor before you start an exercise program, especially if you have a medical condition.
1. Aerobic/Cardiorespiratory Exercise
Adults should try to get at least 150 minutes of moderate-intensity exercise each week (either five 30-60 minute sessions or three 20-60 minutes of vigorous intensity exercise). Use the “talk test” to determine the intensity of your exercising. Moderate intensity means you should be slightly out of breath but can hold a conversation. Vigorous intensity means you may only be able to speak a few words before gasping for air. Always make sure to warm up and warm down before and after aerobic exercise to prevent injury. Walking and swimming are good examples of aerobic activity.
2. Strength Training/Resistance Exercise
Adults should train each major large muscle group two to three days per week using exercises or machines. Older adults should start slow and do very light intensity training. Two to four sets of each exercise helps build strength. For each exercise, doing 10-15 repetitions improves strength in middle age and older adults. Doing 15-20 repetitions will improve muscular endurance. Muscles need to recover for 48 hours in between workouts.
3. Flexibility Exercise
Flexibility exercises improve range of motion of joints and helps posture in older adults. They should be done two to three days each week. Each stretch should be held 10-30 seconds until the point of slight discomfort and should be repeated two to four times. Warming up the muscle with light activity or a warm bath will make this training more effective. Yoga and swimming help with flexibility.
4. Neuromotor Exercise or Balance Training
Exercises involving motor skills (balance, agility, coordination, and gait) should be done two to three times weekly (20-30 minutes per session). Using a stability ball, walking “heel to toe,” or standing on one foot are simple exercises to help with balance. Tai Chi and yoga also improve balance, and help prevent falls.
Dr. Avolio believes that people are more likely to stick with an exercise regimen when they actively participant in planning it. States Dr. Avolio, “No matter what your level of activity is and no matter what your previous exercise history has been, if you do physical activity and incorporate those elements [balance, strength training, flexibility and aerobic fitness], you are going to improve [your health].”
- Any increase in physical activity is beneficial.
- Start gradually and build up slowly to prevent injury.
- Stay hydrated.
- Get a simple piece of exercise equipment and watch a favorite movie or television show while exercising.
- Exercise with a buddy. You are more likely to continue an exercise routine if you have the support of family or a friend.
- Use a gadget such as a Fitbit to set goals and to give you incentive to continue.