On Tuesday evening, December 9, the Navigating the Medical System Lecture Series featured a virtual lecture on exercise for adults 65 and older, hosted by Congregation Etz Chaim. Mel Breite, MD, welcomed everyone and introduced the speaker, Ryan King, a physical therapist at NewYork-Presbyterian Queens Hospital Outpatient, Specialty: Lymphedema.
Mr. King began by emphasizing that exercise for older adults is crucial, as it helps ward off chronic disease and maintain a baseline level for successful aging. As we age, there is a higher risk for chronic conditions if we do not engage in some type of exercise. There is also a higher probability of falling due to loss of balance. Exercise can help reduce the risk of falls.
He explained that, physiologically, as we age, muscle mass declines, flexibility decreases, balance and mobility worsen, and cardiovascular and pulmonary functions decline. In addition, metabolism is reduced and body fat increases. Older adults are at risk for osteoarthritis and osteoporosis, but exercise can help reduce these effects. Planned, structured, repetitive movements are needed to improve physical fitness. Physical activity refers to body movement that increases energy expenditure.
The reasons for exercise include improved health and a reduced risk of chronic disease, such as high blood pressure, diabetes, obesity, and colon and breast cancer. Exercise also reduces anxiety, depression, cognitive impairment, and it improves self-esteem.
Aerobic exercise involves the body’s large muscles moving in a rhythmic, continuous manner. Examples include treadmill workouts, elliptical machines, walking, and biking. Resistance exercise means muscles work against something with applied force or weights. This type of exercise increases functionality and includes using barbells, resistance bands, dumbbells, and weights. It is best to start with two- or three-pound weights and gradually work up to ten pounds.
Flexibility training includes stretching exercises to improve range of motion, such as lifting a wand. Balance training is crucial, as it increases lower-body strength and reduces the risk of falling. As mentioned earlier, falling is a major issue as we age. If a fall occurs, it can lead to complications such as broken bones or the need for surgery. Falling can also cause fear, creating a catch-22 situation in which a person becomes afraid to move. Being sedentary increases complications such as high blood pressure, weight gain, and risk of stroke.
Aerobic exercise such as brisk walking is cardiovascular training and should be challenging enough that you are breathing harder but not so difficult that you cannot talk. Swimming is highly recommended, and water aerobics are easy on the joints while improving heart health, muscle strength, and flexibility. In the water, you can march in place and do kicking exercises, with the water providing buoyancy. Dancing, light jogging, aerobic spin biking, and light sports such as golf are also good forms of aerobic exercise for older adults.
Muscle-strengthening exercise includes yoga and tai chi, gardening activities such as digging, and lifting or carrying groceries.
You should always consult a professional, such as your doctor, a physical therapist, or a personal trainer, who can show you the appropriate intensity for your needs. You should also consult your doctor before starting any exercise program.
Mr. King shared that walking reduces the risk of osteoporosis by 30-50 percent. He recommended standing on one foot, alternating feet, and holding for ten seconds, as well as walking heel to toe. If you can perform 25-30 sit-to-stand repetitions in 30 seconds, you are at low risk for falls. If you can only do five sit-to-stand repetitions in 30 seconds, you are at high risk.
He emphasized the importance of incorporating all three types of exercise regimens. Examples include moderate-intensity aerobic exercise, such as brisk walking, for 150 minutes per week – 30 minutes a day, five days a week. Muscle strengthening should be done two or more days a week for all muscle groups. Balance activities, such as standing on one foot, walking backward, or using a wobble board, should be done three days a week. Vigorous activity such as running can be done for 75 minutes per week. Muscle strengthening and balance exercises should be done weekly.
Mr. King advised starting in moderation and gradually increasing activity levels. Adults with chronic health conditions and disabilities should engage in physical activity according to their abilities and be as physically active as their condition allows.
How long should one exercise? Consult your physician, but usually 30 minutes a day is recommended. If you cannot do all three types of exercise, find activities you feel comfortable with. Choose physical activities that are safe for your current fitness level and health status. Increase activity gradually to meet your health needs. Protect yourself by using appropriate gear and sports equipment, choosing a safe environment, and following rules and policies. Make sensible choices about when, where, and how to be active.
All exercise should be pain-free. Do not continue if you experience pain or discomfort. If you are at risk for falling, be cautious with balance exercises and have someone with you while you exercise.
He concluded by stating that a healthy lifestyle for longevity includes a social network, regular exercise, and a positive mental attitude. Exercise demonstrations can be found on the National Institute on Aging website.