Chapter 1
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The notion that exercise is good for you is something everyone just always seems to have known. Somehow, though, older adults have been left out of the picture - until recently. A clear new picture is emerging from research: Older people of all ages and physical conditions have very much to gain from exercise and from staying physically active. They also have very much to lose if they become physically inactive - some degree of health and ability, for example.
Exercise isn't just for older adults in the younger age range, who live independently and are able to go on brisk jogs, although this book is very much for them, too. Researchers studied the question of whether exercise and physical activity also can improve the health of people who are 90 or older, who are frail, or who have the diseases that seem to accompany aging. We now know from reliable scientific studies that it can help. Staying physically active and exercising regularly can help prevent or delay some diseases and disabilities as people grow older.
In some cases, it can improve health for older people who already have diseases and disabilities, if it's done on a long-term, regular basis.
What Kinds of Activities Improve Health and Ability? Endurance exercises are activities that increase your breathing and heart rate. They improve the health of your heart, lungs, and circulatory system. Having more endurance not only helps keep you healthier; it can also improve your stamina for the tasks you need to do to live and do things on your own - climbing stairs and grocery shopping, for example. Endurance exercises also may delay or prevent many diseases associated with aging, such as diabetes, colon cancer, heart disease, stroke, and others, and have been shown to reduce the overall death and hospitalization rates.
Strength exercises build your muscles, but they do more than just make you stronger. They may improve your independence by giving you more strength to do things on your own. Even very small increases in muscle can make a big difference in ability, especially for frail people. Strength exercises also increase your metabolism, helping to keep your weight and blood sugar in check. That's important, because obesity and diabetes are major health problems for older adults. Studies suggest that strength exercises also may help prevent osteoporosis.
Balance exercises help prevent a common problem in older adults: falls. In older people, falling is a major cause of broken hips and other injuries that often lead to disability and loss of independence. Some balance exercises build up your leg muscles; others improve your balance by requiring you to do simple activities like briefly standing on one leg.
Flexibility exercises are stretching exercises. They are thought to help keep your body limber by stretching your muscles and the tissues that hold your body's structures in place. Although research hasn't proven, yet, that stretching exercises can improve your ability to live on your own and do things independently, studies are under way. Already, physical therapists and other health professionals recommend certain stretching exercises to help their patients recover from injuries and to prevent injuries from happening in the first place. Flexibility also may play a part in preventing falls.
In the introduction, we told you about four types of exercises that are important for helping older adults gain health benefits.
Which Ones Should I Do, and How Much Should I Do? In other words, as much as you can, it's best to increase both the types and amounts of exercises and physical activities you do. Gradually build up to include all four areas: endurance, strength, balance, and flexibility. (We show you how in Chapter 4.)
You might be enthusiastic about getting started, now that you have read about all the benefits exercise can bring. Throughout this book, we emphasize the importance of starting out at a level you can manage and working your way up gradually. That's good advice to follow.
For one thing, if you do too much too quickly, you can damage your muscles and tissues, and that can keep you on the sidelines. For another, your enthusiasm needs to be with you for a lifetime. The benefits listed above come from making exercise and physical activity permanent habits. Starting out with one or two types of exercises that you really can manage and that you really can fit into your schedule, then adding more as you adjust, is one way of ensuring that you will stick with it.
One physician who specializes in exercise for older people puts it this way: "It's like starting out on a journey. You start with a single step."
How much you do depends on you and on your unique situation. For some of you, muscle-building exercise might mean pushing more than a hundred pounds of weight at the local gym to keep your legs in shape for hiking or jogging. For others, it might mean lifting 1 pound of weight to strengthen your arm muscles enough to use a washcloth. That might mean the dignity that comes from being able to wash yourself, instead of having someone else do it for you. That's a good place to start, for some older adults. The goal is to improve from wherever you are right now.
Some people are reluctant to start exercising because they are afraid it will be too strenuous. Researchers have found that you don't have to do strenuous exercises to gain health benefits; moderate exercises are effective, too. (You will read more about the difference between vigorous and moderate exercises later in this book.)
As you read this book, you will learn more about which of these types of exercises will help you meet your health goals and about how you should do them. Some types of exercise improve just one area of health or ability. More often, though, an exercise has many different benefits.
Chapter Summary Four types of exercises are important for older adults:
Research suggests that growing older doesn't mean you have to lose your strength and ability to do everyday tasks and the things you enjoy doing. But an inactive lifestyle does mean that you probably will lose some of your strength and ability, and that you will be at higher risk for diseases and disabilities. Fortunately, researchers have found that even many frail people can improve their health and independence by increasing their physical activity. Challenging exercises and physical activities done on a regular basis can help many older adults improve their health, even when done at a moderate level. They may prevent or delay a variety of diseases and disabilities associated with aging.
"My exercise focus is on gardening," Arthur Canfield, 83, of Fairfax, Virginia, told us recently. "I hate the thought of exercise for exercise's sake. I've never done that," he said.
Mr. Canfield grew up close to the soil. He remembers driving horses pulling hay, sometimes all day, and carrying water down to the garden on his uncle's farm. His wife grew up in a family that made its living in the wholesale florist trade, so she, too, understood gardens.
Mr. Canfield and his wife brought their lifelong affinity for gardening with them into their marriage. When they settled in Fairfax, near Mr. Canfield's job as an economist, the house they bought had about an acre of land, and they worked it - and worked it. "I didn't want to be deskbound when I became a bureaucrat. That's when I decided to become a serious gardener," he said.
Gardening, Mr. Canfield told us, gives you an opportunity to exercise every part of your body and get satisfaction out of it at the same time. He said that gardening does more than build muscle and endurance. "You have to keep your balance. You're reaching up to prune trees, bending over to check your tomato plants. The actual energy output at any given moment may not amount to much, but your whole system is participating the whole time," he said. It adds up.
Mr. Canfield lives on his own and drives himself wherever he needs to go. He works in his garden 3 or 4 hours every day.
"It's got to be fun," he said. "I like to work what I do into a rhythmic pattern. Splitting wood, chopping down trees - the rhythmic pattern of exercise is like music. You're absolutely a free spirit. You forget about it as you're doing it."
Mr. Canfield thinks that the idea of exercise sounds grim to most people - as though they have to do it, because there will be penalties if they don't.
"But raking leaves is not something you should dread; it's a joyous thing. In New England, it's as much of an event as sugaring-off the maples; it's the center of things for a while," he said.
He wants to give other older adults the following message about increasing their physical activity: "Once they start, they'll see that it builds on itself. It feels so good."
Everyday physical activities can accomplish some of the same goals as exercise. But if you decide to do everyday physical activities instead of exercise, just how much should you do to get health benefits?
We can't always give you answers, yet, but we can point you in the right direction by giving examples of what researchers have found out. For instance, bus and taxi drivers, who are physically inactive on the job, were found to have a higher rate of heart disease than were men in other occupations. And studies show that people who remain physically active have a lower death rate than people who don't.
In another study, researchers measured muscle strength in 75-year-olds who regularly did tasks like housework and gardening and in 75-year-olds who were inactive.
The researchers measured muscle strength in the same people 5 years later and found that the active people, who had been using their muscles in everyday tasks, kept more of their strength than did the inactive people.
While we can't yet tell you exactly how much everyday physical activity you should get to gain specific health benefits in areas like strength, the message these types of studies are sending is clear: Whatever your age, stay physically active.
Doing the exercises we show you in Chapter 4 may be helpful to you for several reasons. For one, we give you specific amounts of exercises to do. These exercises are intended to help you not only maintain your current levels of strength and fitness, but also to build them up. For another, our examples might encourage you to exercise muscles and joints that you have stopped using during everyday activities or that you use less without even realizing it.