Health and Fitness Information for Mature Adults 

September 15, 2008              

Table of Contents

  • Work Out to Stay Biologically Younger (The science of telomeres)
  • Recommendations from ACSM and AHA (Senior exercise guidelines)
  • An Rx with Great Side Effects (Doctors prescribing movement)
  • Physical Activity and Atrial Fibrillation (News in cardiology)
  • Plato on Exercise (Wisdom)
  • Savings, Savings, Savings (Now!)

Work Out to Stay Biologically Younger

Be sure to see the last item in today's newsletter for special fall savings on professional training for fitness leaders who serve older adults. Research published in the Archives of Internal Medicine shows that physical activity is exceedingly important -- perhaps more so than was ever before thought -- for slowing the biological aging process. The study, which involved twins as subjects, found that the cells of physically active seniors appear younger at a molecular level than those of their sedentary counterparts. Successful physical activity promotion among older adults calls for well-informed fitness personnel who understand the potential anti-aging effect of regular physical exercise. Details of this investigation, which was conducted at Kings College London, follow:

More than 2,400 British twins were examined with a particular focus on the telomeres in the leukocytes, or white blood cells, of their immune systems. Telomeres are repeated sequences of DNA that are present at the ends of chromosomes and serve to protect them from damage. With aging, telomeres shorten, rendering cells more vulnerable to injury and death. Therefore, telomere length can be viewed as one marker of the rate of biological aging.

Researchers wanted to know whether a relationship existed between the length of the subjects' telomeres and their physical activity level over the previous 10-year period. Indeed, a direct association was detected. The telomeres of subjects who regularly performed approximately three hours of moderate to vigorous physical activity per week appeared to be about nine years younger than the telomeres of those who performed minimal activity (which totaled only about 16 minutes per week). On average, even subjects who performed approximately 100 minutes of physical activity per week had telomeres appearing about five or six years younger than the telomeres of those who performed little physical activity.

The researchers noted, "Our results show that adults who partake in regular physical activity are biologically younger than sedentary individuals."


Recommendations from ACSM and AHA

When the American College of Sports Medicine (ACSM) and the American Heart Association (AHA) join together to publish a paper on physical activity and public health in older adults, you know to expect a set of sound recommendations. Following is a brief overview of the two agencies' joint statement, as published in the AHA journal Circulation.

These recommendations are not so very different from ACSM/AHA recommendations for all adults, except that for older adults several additional considerations and modifications apply. The population addressed by the recommendations includes persons age 65-plus, as well as persons age 50 to 64 who have clinically significant chronic conditions or functional limitations that reduce their fitness level, movement ability, or physical activity.

Editor's note: The American Senior Fitness Association (SFA) recommends that older adults obtain medical clearance to increase physical activity level and that those with health concerns, including chronic conditions and/or functional limitations, follow individualized exercise plans developed in cooperation with their personal physicians.

The ACSM/AHA aerobic exercise recommendation for promoting and maintaining health in older adults is to perform moderate-intensity aerobic activity for at least 30 minutes on five days per week or vigorous-intensity aerobic activity for at least 20 minutes on three days per week. How are the terms moderate and vigorous defined? Moderate effort will produce noticeable increases in breathing and heart rate, whereas vigorous effort will produce large increases in both. On a scale of 1 to 10, with 0 representing sitting and 10 representing all-out effort, moderate intensity will be 5 or 6 while vigorous intensity will be 7 or 8.

Aerobic exercise prescription should take into account an older individual's aerobic fitness level. For example, some older adults will exert a moderate level of effort during a slow walk, but others will need to walk briskly in order to achieve moderate intensity. A combination of moderate and vigorous activity can be undertaken in order to meet the overall goal. When appropriate, low-fit older adults can accumulate exercise time and gradually build up to meeting continuous-duration recommendations by performing multiple exercise bouts as short as 10 minutes apiece.

The ACSM/AHA muscle-strengthening recommendation for promoting and maintaining health and physical independence is to perform 8 to 10 exercises for the major muscle groups, using resistance permitting 10 to 15 repetitions, on two or three nonconsecutive days per week. Intensity level should be perceived as moderate to high. On a scale of 1 to 10, with 0 representing no physical movement and 10 representing the maximal effort of a muscle group, moderate intensity will be 5 or 6 while high intensity will be 7 or 8. While high intensity muscular work is permissible for senior exercisers, preferably it should be conducted in supervised settings or performed by older adults who have adequate fitness, experience, and knowledge of strength training.

Ideally, on days that aerobic or muscle-conditioning activity is performed, flexibility activity will also be undertaken with the goal of maintaining the range of motion needed for daily activities and physical activity. At a minimum, however, flexibility activity is recommended on at least two days per week. Stretching routines should last 10 minutes or longer, engage major muscle and tendon groups, feature static stretches held for 10 to 30 seconds, and include 3 to 4 repetitions of each stretch.

Because data concerning long-term care and hospital settings is scarce, community-dwelling older adults are encouraged to take part in exercises that preserve and/or improve balance in order to decrease their risk for accidental injury resulting from falls. Specific ACSM/AHA guidelines regarding the mode, frequency, and duration of balance exercises have not yet been established. However, performing balance exercise on three days per week has been identified in a series of four fall prevention studies as an effective schedule.

Over time, as with cardiovascular exercise, a gradual or cumulative approach can be used to reach preventive levels of muscle-strengthening activity and other forms of exercise taken up by sedentary seniors. Regarding persons with chronic conditions for which physical activity provides therapeutic benefit, a single activity plan integrating both treatment and prevention is in order. When chronic conditions keep individuals from performing physical activity at the minimum recommended levels for prevention, they should participate in regular physical activity according to their abilities and health conditions. Older adults who are able to do so are encouraged to exceed the minimum recommended levels for prevention in order to increase their physical activity benefits.

In summary, the ACSM/AHA statement recommends that the promotion of physical activity among older adults should emphasize risk management, the reduction of sedentary behavior, and physical activity including both muscle-strengthening and aerobic activity. To view the entire article, click on Physical Activity and Public Health in Older Adults: Recommendation from the American College of Sports Medicine and the American Heart Association.


An Rx with Great Side Effects

Tufts University researchers Ann Yelmokas McDermott, PhD, and Heather Mernitz, PhD, want to make the familiar experience of an older adult receiving a prescription from the doctor much more familiar. Their article "Exercise and Older Patients: Prescribing Guidelines" in the journal American Family Physician provides clinicians with practical assistance for writing healthful exercise prescriptions for their senior patients.

Quoted by Medical News Today, McDermott said, "Only 30 percent of America's senior citizens engage in regular exercise, yet there is compelling evidence suggesting that people in all conditions of health and at all fitness levels benefit from regular physical activity. In fact, the most de-conditioned individuals have the greatest and fastest response." That observation is in agreement with the American Senior Fitness Association's position that there is an appropriate and beneficial form of exercise for everyone, including low-fit and health-challenged older adults.

Mernitz has noted that seniors have a relatively high rate of contact with their health care providers. It follows, then, that physicians can have a positive impact on older patients' health and quality of life by prescribing not only medications as necessary, but also physical activity. To facilitate that process, McDermott and Mernitz published FITT-PRO principles that can assist doctors in prescribing very specific and personalized exercise plans for their patients. The acronym FITT-PRO stands for:

  • Frequency
  • Intensity
  • Type
  • Time
  • Progression
  • By following the FITT-PRO program, physicians can prescribe physical activity that is individualized to suit each patient's health status, fitness level, and goals. This promises to be much more effective than simply suggesting that an older patient get more exercise in general.

    As McDermott told Medical News Today, "Starting an exercise program later in life can significantly modify risk factors, even if a person has been sedentary in prior years. Health care providers can play a major role in offering effective and inexpensive primary or adjunct therapies, encourage appropriate physical activity, and dispel myths that persist as barriers to exercise in the elderly."


    Physical Activity and Atrial Fibrillation

    In atrial fibrillation, which is the most prevalent type of heart rhythm abnormality, the two upper chambers of the heart are seen to twitch instead of beating in a regular, steady manner. Commonly affecting persons over the age of 65, atrial fibrillation can lead to blood pooling and dangerous blood clots. The good news is that light physical exercise may help to prevent atrial fibrillation in older persons, according to recent research findings published in the journal Circulation.

    Led by Dariush Mozaffarian, MD, of Brigham and Women's Hospital in Boston, the researchers studied 5,446 adults, average age 73 years old. "We found that light to moderate exercise, such as walking 10 blocks a week, was associated with a lower incidence of atrial fibrillation," Dr. Mozaffarian told HealthDay.

    Compared to seniors walking fewer than five blocks per week, the occurrence of heart abnormality was lower for the more active individuals, as follows:

  • 22 percent lower in those walking 5 to 11 blocks per week,
  • 24 percent lower in those walking 12 to 23 blocks,
  • 33 percent lower in those walking 24 to 59 blocks, and
  • 44 percent lower in those walking 60-plus blocks.
  • When researchers compared the subjects with the lowest and the highest levels of walking distance and energy expenditure, they found a 50 percent lower risk of developing atrial fibrillation in the more active older adults.


    Plato on Exercise

    As long as we're consulting wise heads about the importance of regular physical activity, why not quote the greatest patriarch of them all? According to that highly-celebrated Greek philosopher thought to live until the year 347 BC:

    "Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it."

                                                               -- Plato


    Savings, Savings, Savings

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