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Introduction
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You asked for this exercise book for a
reason. Your doctor may have encouraged you to start exercising. Or maybe you
made the decision on your own - you are already in good shape, and you hope
exercise will prevent some of the health problems that seem to come with age.
Maybe you have already noticed changes in what you can do, and you want to become
strong enough to perform certain everyday tasks again.
Whatever the reason you decided to start exercising, you have made a good decision.
Exercise can help you do all of the above, and it can improve mood, too. Welcome to one of the
healthiest things you can do for yourself.
The National Institute on Aging is part of the National Institutes of Health. Our research is aimed at improving
the health of older people. We have found that regular exercise and physical
activity are very important to the health and abilities of older people. In
fact, studies suggest that not exercising is risky behavior. That is why we have
written this book.
For the most part, when older people lose their ability to do
things on their own, it doesn't happen just because they have aged. One major
reason it happens is that they have become inactive. Older adults who become
inactive lose ground in four areas that are important for staying healthy and
independent: endurance, strength, balance, and flexibility.
Fortunately, research suggests that you can maintain or at least partly restore these four
areas through exercise - or through everyday physical activities (walking briskly
to the bus stop, for example) that accomplish some of the same goals as exercise.
What may seem like very small changes resulting from exercise and physical
activity can have a big impact.
Getting Past the Barriers
The fact is that just about every older adult can safely do some form of physical activity at little or no cost.
And you don't have to exercise in a public place or use expensive equipment, if you don't want
to, although some older adults do prefer to do it that way.
Even household chores can improve your health. The key is to increase your physical activity, by
exercising and by giving up today's automated devices and using your own muscle
power.
Many older adults are reluctant to start exercising,
even though they know that it's one of the healthiest things they can do. The
reasons vary: Some older people are afraid that physical activity will harm
them; others might think they have to join a gym or have special equipment and
are concerned that they won't be able to afford it. Still others may feel
embarrassed to exercise because they think it's for younger people or for people
who look great in gym clothes. Some think exercise is only for people who are
able to do things like jogging.
Who Can Exercise?
Chapter 2 of this book explains that there are certain situations in which older adults should check
with a doctor before starting to exercise, and describes what some of those
situations are. You will also find out about a couple of conditions that
prohibit exercise. More than likely, though, reading Chapter 2 will reassure you
about any concerns you might have. If you have any doubts about exercise, talk
to your doctor first, so that you will feel safe and that you are doing the right
thing.
Studies show that, in the long term, older adults in all age groups hurt
their health far more by not exercising than by exercising. Let's get rid of the
old mindset and start a new one: As a rule, older people should stay as
physically active as they can.
Our society protects older people from doing physical tasks.
That mindset has led to poor health and disability for millions. In reality,
there are few health reasons that should keep older adults from exercising and
increasing their physical activity, no matter their age.
About This Book
Chapter 4 is a "how-to" chapter. It shows how to do exercises based
on the four areas of ability that older adults should improve or maintain
(endurance, strength, balance, and flexibility). You certainly aren't restricted
to the exercise examples we show in Chapter 4, though; you can improve these four
areas in a variety of ways. The exercises we show you are just one way of
helping you get started.
Chapter 5 also is a "how-to" chapter. It gives examples
of easy tests you can do every month to find out how much progress you have made.
The last chapter is about nutrition. Each chapter ends with a summary that
lists important points to remember.
At the end of the book is a list of resources
you can call or write to for more information about how and where to exercise,
and about special programs and awards for older exercisers. Some of the
resources are for people with diseases or disabilities. You will also find
charts for recording your exercises, so you can measure your progress. Also
included is a form you can fill out and send to us after you have been exercising
for at least a month. We will send you a National Institute on Aging certificate
that acknowledges your commitment to improving your health through exercise.
The first three chapters of this book are about general topics - what exercise
and physical activity can do for you, how to exercise safely, and how to stay
motivated to exercise. If you feel that you already know the material in
Chapters 1 and 2 - for example, if your doctor already has talked to you about
the benefits of exercise and has given you advice about how to exercise safely -
you might decide to skip these chapters. If you do this, we suggest that you
read the short summary at the end of each of them, just to make sure that you
aren't missing any information that would be important for you, then go to
Chapter 3.
Terms used to discuss exercise can be confusing. We want to explain a few key words that will prepare you to read this book.
- You probably have heard the term "aerobics" or "aerobic exercises." We call them
"endurance exercises" or "endurance activities." They are activities that increase your heart
rate and breathing for an extended period of time.
- The term "cardiovascular" refers to your heart and circulatory systems.
- The word "frailty" has more than one meaning. In this book, we use it to mean the physical
condition that results, in part, from severe muscle loss - the kind of muscle loss seen in people
who have been inactive for many years. Frail people have severe loss of strength, and inability
to perform everyday tasks is often the outcome.
- One of the biggest concerns older adults have is that they will become dependent on other
people and won't be able to live in their own homes. We frequently use the word "independence";
in this book, it means older adults' ability to live and do things on their own. Being independent
doesn't necessarily mean doing things alone; it means being able to do for yourself,in your tasks
of everyday living and your leisure activities, to the greatest extent possible.
- Exercises that build muscle have a variety of names, including "strength-training,"
"resistance-training," "weight-training," or "weight-lifting." In this book, we call them
"muscle-building" or "strength" exercises.
- What is considered a physical activity and what is considered an exercise? A physical activity is any voluntary body movement that burns calories. Exercise is physical activity that follows a planned format. It's done with repeated movements, with the goal of improving or keeping up one or more specific areas of physical fitness.
The National Institute on Aging, part of the National Institutes of Health, brought together some of the nation's best-informed experts on the topic of exercise for older adults to discuss the writing of this book. They include:
Panel co-chairpersons: Chanda Dutta,Ph.D., and Marcia Ory, Ph.D.; Health Scientist Administrators; National Institute on Aging, National Institutes of HealthWe also extend special thanks to Steven N. Blair, P.E.D., Director of Research at the Cooper Institute for Aerobics Research; and to Roger Fielding, Ph.D., Assistant Professor of Health Sciences and Brookdale National Fellow at the Sargent College of Health and Rehabilitation Sciences, Boston University, for their contributions. Each of these experts is a major force in research devoted to improving the health and independence of older adults through exercise. We are grateful to them and to other leaders in the field whose work is reflected in these pages for sharing their expertise. We are also grateful to Jerome L. Fleg, M.D., and Edward G. Lakatta, M.D., of the Gerontology Research Center; the American College of Sports Medicine; the American Heart Association; the American Physical Therapy Association; the National Center for Medical Rehabilitation and Research; the National Heart, Lung and Blood Institute; the National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Child Health and Human Development; the Office of Disease Prevention, of the National Institutes of Health; and the Nation Aeronautics and Space Administration; the Public Health Service Office on Women's Health; and the book's author, Susan Cahill.
David Buchner,M.D., M.P.H.; Professor, Department of Health Services, University ofWashington
Marie Elaine Cress, Ph.D.; Associate Professor, Department of Exercise Science and Gerontology Center, University of Georgia
William Evans, Ph.D.; Director of Nutrition, Metabolism, and Exercise Laboratory at Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences
Maria Fiatarone Singh, M.D.; Associate Professor, School of Nutrition and Science Policy, Tufts University
Alan Jette, Ph.D.; Dean, Sargent College of Health and Rehabilitation Sciences, Boston University
Thomas R. Prohaska, Ph.D.; Director, Center for Research on Health and Aging, University of Illinois at Chicago
Anita Stewart, Ph.D.; Professor in Residence, Institute for Health & Aging, University of California San Francisco