It is well documented that while exercise may not cure many of the illnesses and diseases that are brought on by aging, it can definitely help to slow down or even reverse some of the adverse affects that many will face as they enter their twilight years. In fact, regular exercise programs enhance muscular strength and stability, improve joint function, strengthen bones and prevent bone loss and decrease risk factors for heart disease, stroke and type 2 diabetes. Why, then, are so many older adults still apprehensive about beginning an exercise program, which may help them to remain healthy, active and independent well into their later years?

Effects of Aging

            It is common knowledge that our bodies go through many changes as we age, with some being more obvious while others are much more subtle. Many older adults remain very active and vibrant, aging very comfortably throughout their lives. However, many others are not as fortunate and are indeed physiologically much older than their chronological age. Often, these adults are afflicted with osteoarthritis, osteoporosis, chronic pain and other illnesses that are associated with a sedentary lifestyle.
            The physiology of aging causes our muscles to shrink and lose mass, a natural process as we grow older. But a sedentary lifestyle will do nothing to prevent and can, in fact, accelerate this process. Due to these changes, older adults experience a decrease in muscle fiber size and number, taking muscles increasingly longer to react and respond. Furthermore, the heart muscle becomes less able to pump large quantities of blood quickly through the body, causing adults to fatigue more quickly and increasing the recovery time needed from strenuous as well as everyday activities. In fact, the gradual decrease in the body's ability to convert food into energy (metabolic rate) may lead to obesity and other associated dietary illness, such as diabetes, high cholesterol, etc.
            In addition to these changes, our bones also constantly remodel through a process of absorption and reformation as we age. This shift in the balance between formation and absorption of bones causes a loss in the overall amount of bone tissue. Therefore, due to these changes and a decrease in the mineral content of the bone, our bones become less dense and more fragile, making them more vulnerable to stress and injury. This loss in bone mass also leads to osteoporosis in men and, even more so, in women. Osteoporosis is, in fact, responsible for many vertebral fractures and almost all hip fractures in older men and women.

Why Exercise?

            There are many other reasons why older adults need regular exercise in addition to reducing or eliminating many of the health concerns already discussed. Regular activity also helps to maintain and reduce the loss of bones and muscles due to aging. In fact, many types of weight-bearing activities and strength training have a direct connection to preventing a loss in overall bone density. In addition, mobility and balance are also maintained or improved, thus, reducing the risk of falling and sustaining an even more serious injury, such as fractures. Furthermore, studies have also shown a correlation between daily physical activity and the reduction in feelings of anxiety and depression in older adults.  
            Contrary to past beliefs, it is never too late to begin a fitness and exercise program. And physical activity is even more important in the older adult to help maintain both active and independent lifestyles. Even those adults with chronic medical conditions can benefit from a well-planned and appropriate physical activity program. Medical research has shown that physical activity has proven to be both safe and beneficial for individuals with arthritis, osteoporosis and other chronic conditions affecting the bones and joints.

Getting Started…Slowly

            First and foremost, due to the age and potential significance in the past medical history, encourage all those interested in beginning a physical activity program to see their family physician or orthopedist for clearance to begin an exercise program. A full physical evaluation, including a balance screen and vision and hearing tests, will help safely introduce a client or patient into the program.
            Next, work with the client/patient to choose and customize a program that will be fun for him or her and can be comfortably participated in year round. Introduce the initial sessions of exercise or activity as a fun and enjoyable experience without being extremely tiring. It is important to give the individual a chance to adapt and get used to this new level of activity. Remember to incorporate a warm-up and cool-down session using flexibility activities and exercise to help loosen and prepare the body for the new challenges it will face.
            Set realistic and obtainable goals for your clients/patients by discussing their needs and developing a program with which they can be successful. Set the schedule on a weekly basis, which includes days off for rest and recovery. You should begin programs based on the initial assessment of your client / patient, starting with moderate activity levels for 30 minutes a day or less intense activity for shorter 15-minute intervals twice per day. Physicians recommend at least 30 minutes of moderate physical activity daily or every other day. The key here is to have client / patients participate in activity where they feel their muscles, heart and lungs working but are not straining their systems.
            Incorporation of both cardiovascular exercise and strength-related activities are important for a balanced program. These activities should not be limited to the use of standard exercise equipment or weights and can include many enjoyable activities such as walking, swimming or bike riding. In fact, gardening and yard work can meet the initial needs and demands for the older adult.
            Furthermore, it's important to choose activities that produce some increase of stress and demand on the muscles and joints; however, they must not be overly stressful or repetitive in nature. These types of activities in older adults have led to an increasing number of overuse injuries commonly referred to as "boomeritis."
            Any fitness, conditioning or exercise program, in order for it to be successful and effective, must be enjoyable and positively affect the lives of your client / patients. We need to show older adults that even at this late stage in life, some basic lifestyle modifications can have a dramatic effect and improve their quality of life for the future. Emphasizing healthy diet, regular exercise and positive attitudes can help delay the onset and slow the progression of many age-related changes and allow them to live safely and independently for many years to come.
            Joe Scott is an athletic trainer and the clinical team leader for Outpatient Orthopedic Rehabilitation and the SPORT Team at Southcoast Hospitals Group. For more info, email him at