Physical Fitness for Elders Part 2: Exercise

Editor’s Note: Physical fitness is the last topic of Diana Boufford’s series of articles describing Comprehensive Geriatric Fitness. She has so much information to share on physical fitness that we’ve divided the article into 3 pieces: this one on exercise, an earlier one on food, and one to follow on laughter and restorative medicine. Other articles in the series cover the overall topic of Comprehensive Geriatric Fitness, as well as the other types of fitness:

• Emotional Fitness
• Social Fitness (along with specific exercises to build social fitness)
• Spiritual Fitness
• Family Fitness
• Physical Fitness (Food)

Author’s NoteThanks to Kathryn Britton for contributing to the section on chair exercises based on her own experiences visiting relatives.

When it comes to physical fitness in the elder community, what about movement? What role does it play in body and mind well-being?

“If your brain is not actively growing, then it is dying. Exercise is one of the few ways to counter the process of aging because it slows down the natural decline of the stress threshold.” Dr. Ratey, author of Spark: The Revolutionary New Science of Exercise and the Brain.

We are physical beings. Our bodies were designed to move. When they don’t move they start to break down.

So often I have seen people become wheelchair-bound and then stop moving. As a result of that lack of mobility, they start experiencing one medical issue after another. Examples include bowel difficulties as a result of internal organs not being stimulated enough. Walking, standing, and transferring from the chair to the bed or the toilet become difficult as muscles atrophy and become too weak to sustain the weight of the person. People then require assistance in getting dressed, in bathing/showering and in other areas of daily living. We’re looking at a slippery slope when it comes to not using our physical bodies.

There is a great deal of evidence that shows that physical exercise is imperative for our mental health as well. Dr. Ratey says that through exercise, you can supercharge your mental circuits to beat stress and sharpen your thinking, lift your mood, boost memory and much more. Through extensive research he has found that regular exercise alters or enhances the various neurons in your brain that help you feel good.

Research by Depp and colleagues found that an increase in exercise training may have antidepressant effects in older adults. There was a 28% reduction in signs of depression compared to those who did not participate in physical activity. Additionally, the more strenuous the exercise, the greater both the reduction in depressive symptoms and improvements in sleep quality.

The study found the best result was a combination was of aerobic and anaerobic exercise. Recommendations emerged to engage in strength or muscle training two times a week and aerobic activity 75 to 250 minutes per week. This combination showed the greatest results in terms of well-being and health for older adults.

The study speculated that exercise helps reduce stress on the cellular, neural, immune, and emotional systems of those who engaged in it regularly. It also helped reduce the overall experience of stress, since the increase in endorphins and dynorphines that occurred during and following exercise could be associated with mood regulation.

Exercise Classes for Elders

This past winter I attended an elder aerobics class at a local community center. I was conducting research on the relationship between happiness and exercise for older adults. Unbeknownst to me at the time, the entire front row of participants in the exercise program were all 90 years old and older. They did not appear to be any different in terms of age presentation, energy, flexibility, or mobility than any of the other participants, who were between the ages of 55 and 95. It was during a break that one of the women came over to me and introduced herself in a most exuberant and joyful way as she proudly boasted that she was 92 going on 93. She informed me that everybody she was exercising with in the front row fell in the age range of 91 to 95. It was truly amazing to see the youth and vitality demonstrated in these older people. She confirmed that yes, indeed, regular exercise made her happier and healthier. She never misses a day.

“Because the aging brain is more vulnerable to damage, anything you do to strengthen it has a more pronounced effect than it would on a young adult” – Dr. Ratey 2009.

Susan Ingraham has written about reasons that elders don’t stay in classes, including fear of failure, feeling inadequate, lacking time to participate, not wanting to see themselves in the mirror, and hating the music. All of these can be mitigated in an exercise class that is designed for the age group. When I sat in on a chair exercise class recently, the leader was watching everybody to adjust what she was demonstrating to fit what they could do and to provide alternatives for any who found certain movements too difficult.

“’No pain, no gain’ is a myth! Don’t believe it! Today’s research is unequivocal: moderate exercise does make a difference. One study assessed two groups of older adults: one group participated in a low-intensity exercise program; the other group did only relaxation exercises. On all assessments, both physical and mental, the exercise group did better than the relaxation group.” Susan Ingraham, referring to the article by Kolbe-Alexander and colleagues

Being confined to a wheelchair, which sometimes happens after a serious accident, does not have to mean the end of exercise. When elders propel their own chairs, they build upper body strength. Chair exercise programs and stretching circles like the one in this picture can help elders maintain flexibility and range of motion by continuing to move muscles from fingers and neck to legs and feet.

Many community senior centers and nursing homes have regular exercise programs to help members keep moving. Some have gyms with machines like the NuStep where even elders in wheelchairs can transfer to exercise arms and legs.

For overall well-being in later years, movement still matters.
 

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References

Ratey, J. (2008). Spark: The Revolutionary New Science of Exercise and the Brain. New York: Little, Brown and Company.

Depp, C. A., Martin, A. S., & Jeste, D. V. (2013, Winter) Successful Aging: Implications for Psychiatry. Focus, XI (1). Abstract.

Ingraham, S. (no date). 7 Reasons Older Adults Don’t Stay in Exercise Classes: And 7 Reasons Why they Should.

Harvard Medical School (2013). Get your heart pumping in the fight against forgetfulness. Harvard Health Publications.

Kolbe-Alexander, T. L., Lambert, E. V., & Charlton, K. E. (2006). Effectiveness of a community based low intensity exercise program for older adults. Journal of Nutrition and Health Aging, 10(1): 21-29. Abstract.

O’Brien, E. (2010). Joyful Blessings Days: Intergenerational Gratitude Experiences. Positive Psychology News.

Image Credits
Elders exercising in pool courtesy of US National Archives
Elaine O’Brien’s exercise class at the Neptune Senior Center, courtesy of Elaine O’Brien
Exercise Class courtesy of Jinx McCombs
Morning chair exercise courtesy of Henry Rabinowitz – sparkle glowplug