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New Exercise Guidelines for the Elderly

Adults should add flexibility exercises to their fitness regimens, and those over age 65 should follow a regular exercise program to prevent some of the functional decline associated with aging, according to updated exercise guidelines released this week by the American College of Sports Medicine (ACSM). The last ACSM guidelines were released in 1990.

"The recommendations are for 3 to 5 days per week of aerobic exercise, walking, jogging, (or) different types of activities that use the major muscle groups, at moderate to moderately high intensities," said Dr. Michael Pollock, director of the Center for Exercise Science at the University of Florida. "The main thing is that you get out there and burn calories to get the fitness benefits."

The new recommendations place greater emphasis on the total amount of time spent exercising for the elderly and for the first time, they call for flexibility training as a way to maintain joint range and fitness for adults in general. The ACSM recommends stretching of major muscle groups 2 to 3 times a week, exercise that becomes even more important with aging.

Elderly adults need to focus on strength and balance training first, and may work up to moderate intensity aerobic exercise, according to the College.

"When you are older, you may choose different, lower impact activities, such as walking versus running, because of the injury factor," said Pollock. "The higher the impact, the more injuries."
The need for greater physical activity among the elderly was also the subject of a position statement released by the World Health Organization (WHO) this week.

The WHO's "Guidelines for the Promotion of Physical Activity for Older Persons" is based on evidence that suggests that most elderly persons can benefit from a physically active lifestyle, according to Dr. Wojtek J. Chodzko-Zajko, a professor of exercise science at Kent State University in Kent, Ohio. The type of physical activity is less important than simply being active, he noted.

"There are many different kinds of physical activity which are beneficial for older persons," he said. "We know that traditional forms of cardiovascular exercise are very beneficial. Strength training is beneficial, flexibility exercises are helpful, but also physical activity as part of everyday living is useful in the prevention of diseases that are associated with inactivity and sedentary lifestyles."
Exercise should be tailored to meet the needs of individuals, taking into account any ailments or risk factors.

"There is no single physical activity that is optimal," says Chodzko-Zajko. "Most scientists would agree that a balanced program of physical activity would include stretching, calisthenics, strength training, and cardiovascular exercise. The specific combination would depend on the individual case."

 

It's Never Too Late To Exercise

New research shows that if you've reached middle age or have long since passed it, it's still not too late to exercise. According to researchers from the Royal Free Hospital School of Medicine in London, maintaining exercise habits or initiating light to moderate physical activity later in life reduces overall mortality risk as well as lowers the risk of heart attack in older men - including those with existing cardiovascular disease.

The researchers reviewed data collected from middle-aged men who were part of a large study looking at cardiovascular disease. The men answered questionnaires about their health and exercise habits, first in the late 1970s and again in the early 1990s. The 7,735 men who answered the first questionnaire were 40 to 59 years old. Nearly 6,000 participated in the second questionnaire. Their average age at that time was 63. These men were followed for an additional 4 years.

Men who described themselves as inactive or occasionally active in the first questionnaire but who had begun "at least light activity" by the time of the second questionnaire reduced their risk of death by about 45%. Even men with preexisting cardiovascular disease appeared to benefit from exercising. Regular moderate exercise seems to confer the greatest benefit. Light physical activities included walking, gardening, swimming, and cycling.

More vigorous activities, such as participating in sports, "do not appear to give any additional benefit to health for older men, and our findings suggest that frequent light physical activity may be more appropriate," the authors write.
For older men, and, presumably, older women as well, "encouragement... to increase their physical activity gradually and regularly would help to maintain mobility, to prolong independence, and to reduce the risk of heart attacks and mortality," say the researchers.

  1. The Lancet 1998;351:1603-1608.

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