EXERCISE PROGRAMS IN THE

ELDERLY:
RISKS AND BENEFITS
EXERCISE PROGRAMS IN
THE ELDERLY
PHYSICAL DECLINE

• Normal Aging
• Disease
• Disuse
 EXERCISE PROGRAMS IN
THE ELDERLY
PHYSICAL FRAILTY

A state of reduced physiological

reserves associated with increased
susceptibility to disability.
EXERCISE PROGRAMS IN
THE ELDERLY
FRAILTY
• Extreme Old Age
• Disability
• Multiple Chronic Disease/Geriatric Syndromes
• Multiple Medications
EXERCISE PROGRAMS IN
THE ELDERLY
FRAILTY
Frail Older Adults:
• Dependent
• Acute Illnesses
• Falls and Other Injuries
• Recover from Illness/Injuries Slowly
• Institutionalized or Hospitalized
EXERCISE PROGRAMS IN
THE ELDERLY
FRAILTY

• Increased Mortality/Morbidity
• Increased Physical Decline
• Functional Impairment
 EXERCISE PROGRAMS IN
THE ELDERLY
• 12.6 million people have coronary heart disease
• 1.1 million people suffer from a heart attack in a given year
• 50 million people have high blood pressure

American Heart Association. 2002 heart and stroke statistical update. Dallas, TX:
American Heart Association, 2001.
 EXERCISE PROGRAMS IN
THE ELDERLY
• 17 million people have diabetes
• 90% to 95% of cases are type 2 diabetes, associated with obesity and physical
inactivity
• approximately 16 million people have “pre diabetes”

Centers for Disease Control and Prevention. National diabetes fact sheet: general
information and national estimates on diabetes in the United States, 2000. Atlanta, GA:
U.S. Department of Health and Human Services, CDC, 2002.
 EXERCISE PROGRAMS IN
THE ELDERLY

• 107,000 people are newly

diagnosed with colon cancer
each year
American Cancer Society. Cancer facts & figures 2002. Atlanta, GA: American
Cancer Society. Inc. 2002
Vainio H, Bianchini F. Eds. Weight control and physical activity. IARC
Handbooks of Cancer Prevention. IARC Press Vol 6, 2002
 EXERCISE PROGRAMS IN
THE ELDERLY

• 300,000 people suffer from hip

fractures each year

Popovic JR. 1999 National Hospital Discharge Survey: Annual summary with detailed
diagnosis and procedure data. National Center for Health Statistics. Vital Health
Statistics 13(151).2001
 EXERCISE PROGRAMS IN
THE ELDERLY

• 50 million adults (age 20-74) are obese

• 61% of the adult population are either
obese or overweight
 EXERCISE PROGRAMS IN
THE ELDERLY
• Research has shown that all individuals, regardless of age can benefit
from regular physical activity, vigorous or moderate
• Mobility and functioning in older adults, including the frail, can be
improved through physical activity
• Regular physical activity reduces morbidity and mortality from
chronic diseases
EXERCISE PROGRAMS IN THE
ELDERLY
PHYSICAL INACTIVITY FOR U.S.MEN AND
WOMEN
EXERCISE PROGRAMS IN
THE ELDERLY
PHYSIOLOGICAL CHANGES
• Cardiovascular
• Respiratory
• Nervous System
• Musculoskeletal
• Renal
• Metabolic Systems
EXERCISE PROGRAMS IN THE
ELDERLY
PHYSIOLOGICAL BENEFITS
• Increased Cardiovascular and Cardiorespiratory
Function
• Increased Muscle Mass, Strength, & Efficiency
• Increased Flexibility,Coordination, and Balance
• Decrease Cholesterol Levels
• Improve Weight Control and Nutrition
• Aides Digestion & Reduces Constipation
EXERCISE PROGRAMS IN
THE ELDERLY
PSYCHOLOGICAL BENEFITS
• Decreased Anxiety and Tension
• Increased Self-Esteem
• Increased Energy Level
• Better Sleeping Patterns
• Improved Socialization
• Improved Quality of Life
EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE TESTS/PHYSIOLOGICAL
• Walk
ASSESSMENTS
• Bicycle
• Strength
• Balance
• Flexibility
• Functional Performance Tests
EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE
TESTS/PSYCHOLOGICAL
• Cognitive Tests
• Depression
• Health Perception
EXERCISE PROGRAMS IN
THE ELDERLY
PURPOSE OF EXERCISE TESTING
• To Establish A Degree of Risk Associated With Exercise
• To Establish Appropriate Intensities For Exercise
• To Review Individual Objectives
EXERCISE PROGRAMS IN
THE ELDERLY
FACTORS INFLUENCING
EXERCISE
• Low Oxygen Capacity (VO2)
• Increased Fatigability
• Increased Need to Monitor
• Poor Balance
• Decreased Strength
• Less Ambulatory Ability
• Poor Coordination
• Decreased Cognitive Status
EXERCISE PROGRAMS IN
THE ELDERLY
MEDICATIONS AND EXERCISE

• Polypharmacy/Self Medication
• Renal Excretion of Chemicals is Reduced

IMPORTANT
• Know Medications and Side Effects
EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE PROGRAM MECHANICS
• Start Low
• Go Slow
• Monitor Signs and Symptoms
• Decrease Workload If Needed
• Monitor Progress
• Provide Variety
• Motivate
• Make Exercise Fun
 EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE PRESCRIPTION
• Reflects Medical Needs
• Reflects Social Needs

Primary Goal:Increase Functional Capacity and

Independence
Program: Individualized and Progressive
Compliance: Important Issue
EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE PRESCRIPTION
• Mode
• Intensity
• Duration
• Frequency
• Rate of Progression
EXERCISE PROGRAMS IN
THE ELDERLY
PARTS OF THE EXERCISE
PROGRAM
• Warm-Up
• Stimulus
• Cool Down
EXERCISE PROGRAMS IN
THE ELDERLY
EXERCISE MONITORING
• Heart Rate
• Blood Pressure
• Weight
• Ratings of Perceived Exertion (RPE)
EXERCISE PROGRAMS IN
THE ELDERLY
RISKS AND CONTRAINDICATIONS
TO EXERCISE
• Abnormal Heart Action
• Pain/Pressure in the Chest
• Dizziness/Lightheadedness
• Poor Coordination
• Flare Up of an Arthritic Condition
• Nausea/Vomiting
• Extreme Breathlessness
• Muscular Pain
• Unusual Fatigue
• Mental Confusion
EXERCISE PROGRAMS IN
THE ELDERLY
ENVIRONMENTAL CONCERNS
• Room Temperature
• Water Intake
• Meal Time
• Clothing
EXERCISE PROGRAMS IN THE
ELDERLY

Men talk of killing

time, while time
silently kills them.
- Dion Boucicault