Exercise for elders: It's never too late
By Aaron Levin, Health Behavior News Service
October 8, 2003
Older Americans need more
motivation to exercise regularly, say a series of studies published in the
American Journal of Preventive Medicine.
Already, 98 percent of Americans over 50 say
that "getting exercise is important to staying healthy,"
according to an AARP survey. But just knowing what's good for them isn't
enough.
"Messages must move beyond conveying
basic health benefits to focus on encouraging and inspiring audience
members to get moving, while being careful not to alienate or turn them
off," say Marcia Ory, Ph.D., M.P.H., of the Texas A&M University
System School of Rural Public Health and colleagues.
Ignoring cliches about older people and
exercise might help, the researchers note. Being old does not mean life is
over, Ory says, adding that elderly people receive as much benefit from
exercising or any healthy behavior as younger people do. Stereotypes of
old age as a time of poor health is a simplistic generalization, she adds,
not an accurate description of the status of individuals.
"The majority of older people are able
to perform functions necessary for normal living and to manage
independently until very advanced ages," she says. "It is never
too late to gain benefits from increasing physical activity."
Social and behavioral factors -- like diet
and exercise -- play the most important role in determining longevity and
quality of life among the elderly. Genetics factors contribute only 25
percent to human longevity, despite familiar injunctions to "choose
your parents wisely."
But older people won't be motivated by stern
lectures about "getting off the couch" or images of exercise as
sweaty, physical labor, Ory says. In fact, even the word
"exercise" should be replaced with something less intimidating
like "physical activity."
"While audiences need motivation and
encouragement to get moving, they are also hungry for specific directions
and guidance," she says. Instead of vaguely suggesting a brisk walk,
she suggests that advocates say: "Get your heart rate up, at least 30
minutes a day, at least five days a week."
Older people say they look for activities
that are moderate in intensity, reasonably inexpensive, simple and
convenient to engage in and, for older women in particular, include
opportunities to socialize.
Motivating older people to get out and move
also means recognizing the obstacles that block their paths. Some are
physical: unsafe streets, absent sidewalks, nasty winters or steamy
summers. But fear of injury and lack of time, energy, skill or motivation
take a toll as well.
One barrier to greater participation in
physical activity, oddly enough, is the familiar injunction to consult a
doctor before starting an exercise program, says
Durham
,
North Carolina
, Veterans'
Affairs
Medical
Center
researcher Miriam C. Morey, Ph.D. Several
national medical organizations tell doctors to take a complete medical
history and do a physical examination, laboratory tests, and a stress test
before prescribing exercise to patients.
But these precautions often fail to predict
cardiac events in patients without symptoms, Morey says. Adverse events
from exercise are rare, but the universal caution to see a doctor creates
an image of exercise as potentially harmful.
"Clinicians [should] shift from a
traditional role of shielding patients from all possible harm and adopt a
role of enabling participation," she says. Doctors should become
advocates for physical activity rather than the gatekeepers they seem to
be at present.
"Medical knowledge and skill are
essential to aggressively seek solutions for those with physical
conditions that limit participation or present impediments," Morey
says.
She suggests facetiously that perhaps medical
guidelines should require a doctor's permission for anyone who intends to
remain sedentary. A "start-low-and-go-slow" approach is a good
way to begin a personal exercise plan, says Morey.
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