Exercise and Physical Activity for Older Adults

Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for psychological and cognitive benefits accruing from regular exercise participation by older adults . It is not yet possible to describe in detail exercise programs that will optimize physical functioning and health in all groups of older adults. New evidence also suggests that some of the adaptive responses to exercise training are genotype-sensitive, at least in animal studies . Nevertheless, several evidence-based conclusions can be drawn relative to exercise and physical activity in the older adult population:

1) A combination of AET and RET activities seems to be more effective than either form of training alone in counteracting the detrimental effects of a sedentary lifestyle on the health and functioning of the cardiovascular system and skeletal muscles.

2) Although there are clear fitness, metabolic, and performance benefits associated with higher-intensity exercise training programs in healthy older adults, it is now evident that such programs do not need to be of high intensity to reduce the risks of developing chronic cardiovascular and metabolic disease.

However, the outcome of treatment of some established diseases and geriatric syndromes is more effective with higher-intensity exercise (e.g., type 2 diabetes, clinical depression, osteopenia, sarcopenia, muscle weakness).

3) The acute effects of a single session of aerobic exercise are relatively short-lived, and the chronic adaptations to repeated sessions of exercise are quickly lost upon cessation of training, even in regularly active older adults.

4) The onset and patterns of physiological decline with aging vary across physiological systems and between sexes, and some adaptive responses to training are age- and sex-dependent.

Thus, the extent to which exercise can reverse age-associated physiological deterioration may depend, in part, on the hormonal status and age at which a specific intervention is initiated.

5) Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. In addition, individuals who are at risk for falling or mobility impairment should also perform specific exercises to improve balance in addition to the other components of health-related physical fitness. The conclusions of this Position Stand are highly consistent with the recently published 2008 Physical Activity Guidelines for Americans, which state that regular physical activity is essential for healthy aging. Adults aged 65 yr and older gain substantial health benefits from regular physical activity, and these benefits continue to occur throughout their lives. Promoting physical activity for older adults is especially important because this population is the least physically active of any age group.