While growing older is inevitable, with exercise it’s still possible to feel young at heart.
In 2017, 1 in 7 Australians were aged 65 years or older and with the way our population is aging it means in the future, people will be living for much longer than their ancestors.
Life expectancy is increasing with each generation. By 2050 it is estimated that women will live until 89 to 94 years of age while men will be living to be between 83 and 85 years. This increase, due in part to medical advancements, means people are surviving diseases such as cancer and heart disease. However, the down side is that they’re living with treatment side effects and increased co-morbidities.
Physical activity guidelines:
So how much exercise should we be aiming for? The following guidelines are applicable to most populations whether they be healthy individuals or those suffering from an illness or chronic condition.
The World Health Organisation’s Guidelines for Physical Activity in Adults advise to perform 150 mins of moderate intensity exercise per week or 75 minutes of vigorous exercise. What is moderate intensity? You should be able to still converse but be slightly out of breath. Use the “walk and talk” test to gauge the intensity level. If you’re struggling to complete a sentence, then you’re more than likely working beyond a moderate level.
Try to perform a combination of:
- Cardiovascular / aerobic exercise – any activity that gets you out of breath and raises your heart rate
- Strength / resistance exercise – can use body weight for leg exercises e.g. squats, lunges or light hand weights for upper body
- Stretching / flexibility training
After the age of 50 our “sins from the past” start to manifest and the aim of exercise becomes the prevention and management of chronic diseases and illnesses.
From early 40s muscle mass starts to erode making it very important to introduce resistance training into your exercise regime if not already there.
Here are some of the 10 most common illnesses and conditions which affect older adults and some suitable exercises to try and combat them.
1. Obesity
Approximately 75% of adults aged between 55 – 84 are overweight or obese.
Whether it be due to junk food diets or lifestyles focused on convenience, Australia is in the middle of an obesity epidemic.
As adults age it becomes harder to lose weight, this is especially true for females post menopause due to lower levels of oestrogen causing the body to use carbohydrates less effectively, increasing fat stores. Another contributing factor to weight gain in older adults is decreased activity levels especially after retirement.
With medical advancements in bariatric surgery such as gastric sleeves and gastric bypasses, patients can lose weight however without adequate education and lifestyle changes these can sometimes be a “quick fix” that doesn’t address a potential underlying issue.
So, what’s the best type of exercise to help with weight loss? Absolutely anything! It’s honestly a personal preference, the key is to ensure that you are in a calorie deficit. This means that you are burning more calories than you are consuming, either by increasing your activity levels or decreasing your food intake. Best results are often found from combining cardiovascular and resistance exercise.
2. Osteoporosis
This condition is characterised by decreased bone density which results in an increased risk of fractures with impact or falls. Crush fractures can also occur when vertebrae in the spine weaken and crumble. This can be exacerbated by worsening kyphotic posture, more commonly known as a “hunch back.”
To help stimulate bone growth weight bearing (such as walking) and resistance based exercises are essential in the prevention and treatment of osteoporosis. While those already diagnosed also need to incorporate balance training to help prevent falls. Consider Tai Chi or Yoga for low impact, balance building choices.
3. Arthritis
Unfortunately, degeneration occurs at most joints of the body with age and use due to wear and tear. Arthritic joints can cause significant pain and resulting immobility. In severe cases, it results in needing the joint replaced. Joint replacements can give new lease of life to hips and knees however the rehabilitation process can be painful and long.
While arthritis can mean, activity is restricted due to pain there are some exercises which can be tolerated and will even improve the condition. Focus on strengthening the adjacent muscles to take load off the joint and keep it low impact.
Swimming and water running or Aqua Fit classes and using an exercise bike are some of the best options. If you suffer from chronic lower back pain due to degeneration of the joints or intervertebral discs then it’s also important to include core strengthening exercises to provide adequate stability for your spine.
4. Cardiovascular Disease
Claiming the top spot as leading cause of death amongst older Australians, cardiovascular disease includes such events as heart attacks and strokes. While historically patients were told after a heart attack to “rest up,” we now know how harmful that advice can potentially be.
Those who undertake physical activity after a cardiac event are 30% less likely to suffer another event compared to those who remain inactive. For those who suffer cardiac symptoms (e.g. Chest pain) on exertion, exercising might seem terrifying. The National Heart Foundation of Australia use the mantra of “Get physical…. in a moderate way,” encouraging caution but reassuring that regular physical activity can lead to a reduction in symptoms such as lower blood pressure, improved cholesterol levels and reduced angina (chest pain.)
The best type of exercise for heart health is cardiovascular training e.g. Walking, swimming or cycling, starting in small sessions and gradually increasing as tolerated.
5. Lung Disease
Living with a chronic lung disease can cause significant impact on daily activities however by introducing regular exercise you can reduce symptoms and prevent hospital admissions. It may seem counterproductive for respiratory patients to exercise to a point where they’re out of breath however this is how the lungs become stronger and more efficient. Aerobic exercise is useful to improve efficiency of oxygen uptake and secretion (mucous) clearance. Try pacing activities to increase tolerance and endurance. Resistance exercise (especially lower limb) is also important to maintain muscle mass. Consider seated exercises to conserve energy and stretching, especially chest and upper back to improve posture and allow for chest expansion.
6. Diabetes
Diabetes results in a high level of glucose in the blood due to the body not being able to produce enough insulin. While Type 1 Diabetes Mellitus (T1DM) is non-preventable and more commonly associated with a juvenile onset, Type 2 Diabetes Mellitus (T2DM) is often caused by lifestyle factors and can be managed at times without medication. Exercise helps to regulate insulin levels and can even reverse T2DM. All forms of exercise will help this although special attention should be made to maintaining a healthy weight.
7. Dementia (Including Alzheimer’s Disease)
Exercise has been shown to lower the risk of dementia and help to improve cognitive function. It is thought that physical activity could play a part by ensuring adequate blood flow to the brain which facilitates new cell growth and survival. In patients with dementia it is recommended that exercise continues as able to maintain muscle strength and prevent mobility problems.
Any physical activity is beneficial to improve cognitive function however for those who are suffering from dementia they may find it easier with repetitive activities such as walking or swimming where decision making is not usually required.
8. Mental Health
Exercise is not only good for physical health but has significant benefits for mental health as well. During physical activity, the brain releases hormones known as endorphins and serotonin which have a positive effect on mood. It can also help to reduce stress levels and is recommended for anyone who suffers from depression and anxiety.
Another added benefit of exercise is it improves the amount and quality of sleep as older adults often experience disturbed sleep patterns and even insomnia.
To get maximum benefit for your mental health, get outside especially with other people for the most effective mood lifter.
9. Cancer
Research confirms that physical activity decreases the risk of developing breast, colon and endometrial cancers. A high Body Mass Index causes increased risk of breast cancer especially in post-menopausal women. This is because overweight adults have increased levels of oestrogen which is the driver to some forms of breast cancer.
It is also safe to exercise throughout cancer treatment and has shown to improve efficacy of treatment as well as help combat side effects. Certain activities are better suited to different patients and should be done under the instruction of a qualified health professional (e.g. a cancer care physiotherapist,) although generally a combination of aerobic, resistance and flexibility training is advised.
10. Continence
Especially common in women who have had multiple children, a hysterectomy or gone through menopause, urinary incontinence affects 13% of men and 37% of women in Australia. Exercise can help prevent and treat incontinence by increasing core strength which includes the pelvic floor muscles and weight loss, resulting in less load on the pelvic floor. If you suffer from urinary incontinence, avoid high impact sports such as jogging or aerobics as they place more downward pressure on the pelvic floor muscles. Avoid lifting weights or exercises that cause you to hold your breath as that also increases pressure and straining.
Instead try swimming, walking and other low impact activities. The most important recommendation is that you are assessed by a continence physiotherapist (also known as a women’s health physio) who can prescribe exercises to strengthen your pelvic floor and reduce symptoms.
Balance & Falls
Another concern that comes with aging is an increased risk of falls. Falls can result in fractures, lacerations and other serious injuries and have a significant impact on an individual’s independence.
To reduce your risk of falls it’s best to perform a combination of strengthening (both core and legs) and balance exercises.
5 Best Exercises to Improve your Balance
1. Sit-to-stand:
- Sitting on the edge of a chair, plant your feet hip width apart and push with your legs to stand up.
- Ensure that you squeeze your bottom muscles at the top.
- Slowly lower back to sitting position.
- Repeat x 10
This exercise can be done with the use of your hands or without to make it harder.
2. Step ups
- Stand at the bottom of a step, facing upwards. Hold onto the railing if there is one.
- Place one foot up and step up to stand on top of the step.
- Place foot down behind to step down backwards.
- Repeat x 10 on each leg
To make more difficult don’t use the hand rail or increase speed to get cardiovascular benefits as well
3. Feet together
- Bring feet together so big toes are touching and try and stand as still as possible for at least 30 secs.
- Try not to sway.
Make it harder by closing your eyes.
4. Tandem stance
- Place feet one in front of the other so the heel of one foot is touching the toes of your other.
- Try to stand as still as possible for at least 30 secs.
Again, to make it harder, close your eyes.
5. Tightrope walking
- Start in same position as tandem stance and then walk forward heel to toe as if you’re walking on a tightrope.
Another consideration for anyone who is at risk of falls is to ensure that they can get up off the floor in the event of a fall.
Safety & Screening
Before starting any new exercise regime, it is advisable to consult a qualified health or fitness professional and you may require clearance from your doctor. If you experience any of the following symptoms while exercising you should stop immediately and seek medical advice:
- Chest pain – any chest discomfort during exertion is a cause for concern.
- Dizziness – can be a sign of dehydration or low blood pressure.
- Shortness of breath – may be of concern if it is more severe than the normal “out of puff” sensation.
Adherence and compliance
The best exercise program to be doing is the one that you can stick to. Exercise should be enjoyable, there’s no point doing something that you find a chore. Make it social by exercising with friends and set yourself some goals so you have something to work towards.
Exercise suggestions
- Parkrun – a free 5km run/walk that takes place on Saturday morning in many parks around the country. A world-wide initiative which started in the UK and now has over 340 venues in Australia alone, it is run by volunteers and welcomes every level of fitness. There’s always a tail walker so you’ll never be last across the finish line.
- Walking groups – The Heart Foundation of Australia have a register of local walking groups which are free to join. If you can’t find a group in your local area or find the Australian summers too hot, try walking laps of your nearest shopping centre where you can exercise in air conditioned comfort.
- Visit your local fitness centre/gym and ask if they have a class or program tailored to older adults.
- Local city councils have been installing “green gyms” in suburban parks. The equipment is a mixture of resistance machines and stretching stations.
- You may be able to use a concession card e.g. Seniors Card or DVA for various programs. Some health funds also have fitness related benefits for members.
References:
- Australian Institute of Health & Wellness
- National Heart Foundation of Australia
- Continence Foundation of Australia
