Exercise in elderly should be part of their daily routines. The number of Malaysian elderly expected to increase up to 80% from 1990 to 2020 totaling 3.33 million.
As we grow older, there is increased risk of getting various medical problems such as diabetes, hypertension, musculoskeletal condition such as osteoarthritis and osteoporosis etc. However, this is not an excuse from preventing elderly to exercise.
The number of elderly who requires medical attention and hospitalization will surely increase healthcare costs.
Although there is no formula of exercise to stop aging process, regular physical activities can minimize the effect. Elderly have a good adaptation to aerobic and resistance if they maintain it regularly.
Generally older adults tend to have similar activities during their younger days but it is usually lower in terms of intensity and impact.
Body composition changes come along with aging process. Redistribution of body fats and gradual accumulation in visceral and central region predisposes us to metabolic and cardiovascular risks.
As we grow old, the bone mass density will deteriorate. Weight bearing exercise can helps improve bone health thus decreasing risk for developing osteoporosis.
Aging processes are complex in which it involves genetic factor, primary aging process itself and also secondary aging effect due to illnesses. Through regular physical activity, it can alter the effect of secondary aging mainly via preventing or controlling disease process.
Being sedentary will obviously make them more risk of getting injured and also developing diseases. There is large evidence that by doing regular exercise can control their disabling condition.
Exercises have to be done regularly to ensure that the beneficial effect takes place. The effect of acute and short bouts of exercise is short living.
Three primary goals of fitness program for older adults.
- Prevent or retard the progression of ohronic diseases
- Maintain or enhance cardiocespiratory fitness level (i.e. functional capacity)
- Prevent functional limitation and disabilities
Ideally, the exercise that should be included in older population are aerobic, resistance and flexibility exercise. In addition, those who have risk of falling due to improper balance or having mobility limitation should include balancing exercise in their exercise program.
There is also evidence to suggest that through physical activity elderly can have some psychological impact. Namely are improving overall wellbeing, boosting self-concept and self-esteem, and by reducing risk of getting depression or anxiety. Quality of life also is enhanced but not in all aspects.
What is the ideal amount, types, duration and intensity of exercise should they involved into?
If your age is above 65 years old, generally fit and have no medical illnesses, you should:
Do aerobic activities for 2 hours and 30 minutes (150 minutes) of moderate intensity and muscle strengthening exercise for 2 days that includes major muscle group (shoulder, chest, back, abdomen, hips and legs) every week.
The duration can be broken into many sessions even into a 10-minutes session accumulated to have the same effect.
Aerobic activity is what will make you heart pounding and breathing faster. A brisk walk should be adequate as long as it met the moderate intensity level. Each individual have different perceived of exertion during their workout. It all depends on you. If you’re not used to, then do it slowly but gradually. Always remember this word “ GO SLOW AND LOW”.
Resistance Training Recommendations for older adults
|Program Component||Program Modification|
|Exercise Mode||Perform 8-10 exercise using the major muscle group. Dynamic muscle strengthening activities include machine and free weights, weight, bearing calisthenics, resistance bands and similan resistance exercises that use major muscle group.|
|Exversice Intension||Perform each lift or movement with a resistance that allows for 10-15 repetitions per exercise. Level of effort for muscle-strengthening activities should be moderate to high. ….10 point scale, where no movement = 0 and maxiimal effort = 10, moderate intensity effort = 5 or 6, and high intensity effort = 7 or 8.|
|Exercise Session Duration||Complete 1-3 sets of each exercise. Allow adequate cest (2-4 minutes) between exercises to prevent carry over fatique.|
|Exercise Pregnancy||Resistance training should be fermomed on two or more non consecutive days per week.|
As we grow older and less using our muscles, it can undergo degenerative process and we’ll start losing our muscle mass that is often called “sarcopenia”. The reduction in muscle force and endurance will jeorpadize function. This is noticeable in men and women of age around 50 years. The losses depend on individual and muscle groups. Muscle strengthening exercise is essential to make sure that we don’t get this.
You don’t have to go to the gym to do strengthening exercises. It can be done at home using simple equipment such as resistance band and dumbbell. Try start with 8 to 12 repetitions first. You can also use your own body weight (such as pushing or sitting up) or doing heavy gardening and shoveling.
Flexibility exercise or stretching is important to enable our joint are in good condition. This should be carried out 2 days a week. Studies have shown that this exercise can improve major joint movement.
Balancing exercise should be carried out regularly preferably everyday. This should be incorporated as well as risk of falling amongst elderly is high because of proprioception problem. Improving lower body strength and walking on difficult terrain can help this. Activities such as standing with one or two legs, with and without closing eyes should be performed daily.
Functional activities such as climbing stairs, gardening, washing clothes and other daily activities helps then in terms of energy usage rather than being sedentary. Maintenance of this activity will improve function according to the specific function.
For those who have physical limitations and deconditioning should tailor their exercise according to their condition and preference. For example, those who have pain over their knees should not do weight bearing exercises.
Older populations have increase risk of dehydration during exercise. It is vital that they do know their hydration status and keep well hydrated.
Before you start, make sure you get a medical clearance from doctors. Not all exercise are suitable for everyone. A tolerated exercise depending on the individual should be the key for them doing exercise.
- Malaysian Journal of Medical Sciences, Vol. 7, No. 1, January 2000 (1-3)