What It Means to be Human
INTERESTING STUFF – 15 October 2016

Exercise, Even In Small Doses, Offers Tremendous Benefits For Elders By Judith Graham

RONNI HERE: Remember last month when I told you that my friend Judith Graham, a trustworthy and respected reporter on the “age beat,” had begun a new column at one of the most trustworthy and respected health websites we have, Kaiser Health News?

Yesterday, as I was pulling together links to include in blog post today to harangue you yet again with the latest information about how important even small amounts of exercise are for elder health, Judith's newest column materialized.

She had already written a great deal of what I intended that I don't see any reason to repeat all her good work.

So below is Judith's column in full as Kaiser encourages republishing. Also, Judith is always looking for older adults with aging and health stories to tell. If you’ve got one, send it to her at judithegraham@gmail.com.

One more thing. I realize that I probably write post stories about exercise way too often - that you've got the point by now - and asked myself why it keeps coming up for me. Here's what I think:

I am so astonished that repeated, independent studies from respected researchers all around world keep reaching the same conclusion, that it doesn't take much exercise at all to make an enormous difference in our health.

Most of my life I was told and believed that to have any benefit, exercise needed to be long and hard and lots of it. And that just wasn't in me. But the new studies - the number and continuing flow of them - must be believed and even I can do as much (and even more) than they recommend.

But it's one of those things that amaze me - real, measurable, observable health benefits without having to be a gym rat or marathon runner. I haven't gotten over my astonishment yet. In future, I'll try to keep my enthusiasm under more control
.

* * *

(Republished with permission from Kaiser Health News.)

Retaining the ability to get up and about easily — to walk across a parking lot, climb a set of stairs, rise from a chair and maintain balance — is an under-appreciated component of good health in later life.

When mobility is compromised, older adults are more likely to lose their independence, become isolated, feel depressed, live in nursing homes and die earlier than people who don’t have difficulty moving around.

Problems with mobility are distressingly common: About 17 percent of seniors age 65 or older can’t walk even one-quarter of a mile, and another 28 percent have difficulty doing so.

But trouble getting around after a fall or a hip replacement isn’t a sign that your life is headed irreversibly downhill. If you start getting physical activity on a regular basis, you’ll be more likely to recover strength and flexibility and less likely to develop long-term disability, new research published in the Annals of Internal Medicine shows.

This encouraging finding comes from a study of people at high risk of mobility problems: men and women between the ages of 70 and 89 who were sedentary and had some difficulties with daily activities but were still able to walk a quarter mile without assistance.

Half of the group attended 26 weekly health education classes followed by monthly seminars. The other half spent about an hour getting physical activity — primarily walking — at a clinic twice a week, followed by at-home exercises.

The goal was to have participants meet the government’s recommended standard of 150 minutes of weekly moderate physical activity and sustain that level over time.

Results confirmed the extraordinary benefits of physical activity, which has been shown in previous research to lower an individual’s risk of heart disease, cognitive impairment, diabetes, depression and some cancers.

The group that focused on walking and strength and balance exercises was 25 percent less likely to experience significant problems with mobility than the group that focused on education over a period of almost three years. Specifically, they recovered faster from episodes of being unable to walk and were less likely to have problems getting around after that recovery period.

The program “was a godsend,” said John Carp, 87, who didn’t make it a point to walk regularly before he joined the study. “There was an improvement in physical feeling and also my mental attitude.”

“If there was a pill that offered comparable benefits, it would be a billion-dollar product and people would be all over it,” said Dr. Thomas Gill, lead author of the new paper and a professor of geriatrics at the Yale School of Medicine, as well as director of Yale Program on Aging.

Gill hopes to convince Medicare and other insurers to adopt the intervention he helped create. But older adults don’t need to wait for that to happen. There are plenty of places — YMCAs and senior centers, for instance — where seniors can take classes. Experts’ practical advice:

It’s never too late. “Older adults may think ‘it’s too late for me — I’m too old or too sick for this,’” said Patricia Katz, a professor of medicine and health policy at the University of California, San Francisco. “The message from this study is it’s never too late.”

“Prescribing exercise may be just as important as prescribing medications,” Katz wrote in an editorial accompanying Gill’s report.

Focus on activity, not exercise. “Older adults, if you talk to them about exercise, will say that’s not for me, that’s for my grandchildren,” Gill said. “But if you talk to them about become more physically active, they’ll say ‘okay, I can do that.’”

“Basically, I walk in the park or around the neighborhood and move my arms and legs around at night in different positions, and try to flex my muscles,” Carp said, describing his daily routine. “It’s not hard, and it makes a big difference.”

Start slow. Some participants could barely make it around a track at the beginning of the study so “we started low and increased slowly,” offering remedial help along the way, Gill said.

“I recommend focusing on smaller and achievable goals, initially, and not trying to do everything at once because we know that tends to make people give up,” said Dr. Anne Newman, chair of the department of epidemiology at the University of Pittsburgh and co-author of a new study showing that people who eat healthily, maintain a normal weight and are physically active live longer and spend less time being disabled at the end of their lives.

Even small amounts make a difference. Newman’s study tracked more than 5,000 older adults over the course of 25 years. One conclusion: “There’s no threshold for benefit from physical activity,” she said. “Every little bit helps.”

“You don’t need to get on a treadmill, go to the gym, or wear Spandex,” Newman said. All you need to do is start walking for a few minutes every day and gradually build up your strength and endurance.”

Beware of becoming sedentary. The worst thing seniors can do is “sit down and take it easy,” said Susan Hughes, co-director of the Center for Research on Health and Aging at the University of Illinois at Chicago.

Make a plan. Hughes helped develop Fit & Strong, an evidence-based physical activity program for seniors with osteoarthritis that incorporates health education.

Before participants go off on their own, coaches craft an individualized plan that covers three questions: What are you going to do and how often, where are you going to do it and who are you going to do it with? You can make a plan yourself, but make sure it’s enjoyable, Hughes said. Otherwise, it’s very unlikely you’ll follow it for any length of time.

* * *

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

KHN’s coverage of late life and geriatric care is supported by The John A. Hartford Foundation.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Comments

I fully agree!

As a 72 year old, I attempt every day to get my 10,000 steps with a combination of walking and swimming. I also do some strength training exercises and 3rd age yoga often. I spend as much of my time as possible outdoors in nature. I do each exercise at my own speed and enjoy every moment of it.

Thanks for posting this valuable information.

Thank you for this.
In 2002 I completed 3 marathons. In 2005 I broke a femur at the hip and since then have used that as an excuse for my sedentary ways, and I know it needs to stop. I can walk, and I haven't broken anything above the hips. A few aches and pains now and then, but that may just be because I don't move enough.

A few years ago, I was a member of a local hospital program that had treadmills and etc. Though originally intended for cardiac patients, they opened it up for anybody 55+.

It was a sort of "managed" program, in that a nurse would suggest the right machines and activities. They started me out at seven minutes on a treadmill, and expanded from there, over time. I went every day, Mon-Fri, and at the end of three or four months, I'd worked up to a full 45-minute routine that included weight training and other floor exercises.

I had to drop out as a new job presented time conflicts, but those few months with that slow and easy routine was super! I felt better than I had in a long time.

Just a few minutes every day really does provide benefit!

Another wonderfully useful article! Many thanks! Two years ago I couldn't move due to polymyalgia rheumatica. Some days, of course, I thought it was all over. Prednisone gave me some movement, but everything was very difficult. This summer I was blessed to be able to climb a small mountain, and dive into the ocean waves once again! This taught me not to sit down and give up on myself, to keep whatever movement possible going. While what we do and think isn't the whole game, it's a big part!

Don't keep your enthusiasm under control. If just one person thinks "I can do a small amount of exercise" and it makes their life better, you have done good in this world. Your posts on exercise that I can remember have the theme of reasonable exercise and ways to do it. I've felt encouraged to continue and maybe someone reading your comments will be inspired. That's what you do so well on this blog.

I agree with Bonnie, we all can benefit from your enthusiasm, Ronni. I am 76 and have always needed to exercise for my genetic disposition to depression...but it helps with many things: weight control, and it lowers cholesterol, as well as reduces stress.

Wednesday I had arthroscopic surgery to repair several tears on my left meniscus. The print-out on after surgery care stated to only walk to the bathroom, no cooking, etc. for 24 hours. I have pain meds which I need to take every 6 hours and when I didn't I was in pain. This morning, 48 hours after surgery, I can walk easily without pain for which I am thankful as I intend to get back into my daily 2 mile walks as soon as I can.

So keep reminding us of the benefits of being active.

Harangue away, Ronni. I know how important exercise is, but pushing myself to get up and MOVE is very difficult. I live alone and lack motivation. Still, being able to walk 1/4 mile in a hilly neighborhood apparently puts me ahead of a lot of 73-year-olds. That little bit of info was encouraging. Thanks.

For years, I walked 1 1/2 to 2 miles daily, early in the morning. The benefits came thru in both exercise and endorphins. Now, my metatarsals holler after a few steps, so I grab a book and climb on the exercise bike for a while. better than nothing, for sure!

Yes yes a thousand times YES!

You folks are my inspiration.

I watched my MIL refuse to do the minimal bit of activity her doc told her she needed to stay strong. Not pretty. My own mother the same. She is as weak as they come and getting weaker by the day and runs to the docs several times per week, but would never get active.

My dad, at 85, takes a brisk walk and/or bike ride daily. He is still highly independent and functioning very well. His mother walked to the grocery store regularly into her late eighties, kept active until her late nineties.

I am highly motivated to move, given the contrasts we've witnessed in the family.

Those little under-the-desk machines that are designed for offices work really well - they take up very little room and they keep your legs working while sitting. I've worked my way up to over 100 minutes on the high setting most days, with an additional brisk walk for up to an hour - depending on how the feet handle it (chronic tendonitis). Rounding it out with weights that strap on my wrists, and I'm staying strong. Have lost 26 pounds since May and will start yoga for balance soon.

I discovered water aerobics at the Y. It is fun and a good workout with the reward of a hot tub or steam afterwards. I am addicted!

I've recently been informed that I have osteoporosis (add that to scoliosis and general spinal degeneration). No, thanks, I'd rather not! Seriously, though, the physical therapist has given me 4 pages of exercises. Well, O.K., I'll just add them to my daily walk and normal activities. I'm no athlete but remaining independent is #1 on my to-do list, so I'll do the best I can to stay that way. I've always been fairly active although not a participant in formal "fitness" programs.

I suppose these types of health issues aren't all that unusual for someone closing in on 80 Y/O, but as I've said many times about ageing, I don't much like it! I didn't have any of them until I became "involuntarily retired" from my job of nearly 40 years at the end of 2014. Hmmm. . .wonder if there's a connection?

I'm with you Elizabeth, I don't much like aging either, but I've become a "mall" walker at least 3 times a week for several yrs.. & will resume my water aerobics soon which is really wonderful. The warm water is soooo therapeutic & with only 7 ladies it makes for lots of laughs........love those endorphins.

It's amazing at the mall. People have been going there for years, friendships have been made & renewed & we even do a birthday cake once in awhile. And the best part is it's free & the water aerobics are 5' from home by car & if your insurance plan participates in the Silver Sneakers program, it is either free or $2.50. Thanks Ronni for this reminder. Dee :)

When we talk about even minimal exercise being beneficial, we tend to think of walking as the lowest threshold. I think this does severely limited people a disservice. There are several programs of chair exercises that promote strength and even cardiovascular benefits. You can often find them offered in senior centers, and on DVDs and even YouTube. So if you feel like you just can't walk for your health, start moving anyway.

Diane's statement above "enjoy every minute of it" is important. I walk, I do weekly exercise (it's a combination of yoga. Feldenkraist, qi gong ) and tai chi easy (a trade marked system -- Google it) plus walking are all pleasurable. If they weren't I wouldn't stick to them. Our bodies can give us pleasure at any age -- so many people think the aging body is all about pain and restriction, weakness and foregone pleasures. Not so. Pleasure is what movement is about -- should it be nothing more than a some dance steps round the living room when you hear music you love. It doesn't have to cost anything, you don't have to do it in pubic or travel to a gym or senior center. Move it -- there is joy in moving.

Your reminders about exercise are very helpful. Please don't stop posting them!

I read somewhere - The best exercise for you is the one you'll actually do.

One of my volunteer gigs ended in June so I added more exercise classes. I am now taking 6 exercise classes. 2 of them are really hard. The sweat drips off me. What's interesting is that there are quite a few older women and men in my classes. I have beginning arthritis in my R hip so I must exercise in order to walk pain-free. Our park district offers classes 50% off at age 60. Some classes are free!

Up until about a year ago I would have agreed 100% with June Calendar's comments that we can enjoy our ageing bodies. However, despite all we do to stave off pain, restriction, weakness, etc., they will probably come to almost all of us if we live long enough. I didn't expect adverse physical conditions to affect me yet at near-80, although I suppose I should have been better prepared. That doesn't mean I won't continue to do what I can to stay as healthy as possible. I do NOT want to become dependent or what is described as "frail". I'm seriously motivated to stay "me" although it's harder some days than others.

I agree with Sarah that for some of us, the endless recommendation to walk (for our exercise) is disappointing. For those of us with back ailments especially, walking is exceedingly painful, even in small doses.

In my case, I try to do some calisthenics every day or night (or both) in place of walking, and it seems to help a lot. However, of course, we oldsters have to be careful about how and which ones we do, but I find they're a good replacement for the walking which is so painful. On the internet and elsewhere there are lots of articles with photos for instruction.

I do certainly agree that we must MOVE in whatever way we can. I intend to start spending less time at the computer and more time MOVING. Best to all-- Barbara


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