Maintaining Your Health on Mackinac
Senior Citizens Need To Establish Physical Fitness Goals By Yvan Silva, M.D.

Physical exercise and physical activity can help prolong life, enhance the quality of life, and even help in prevention of illness as we grow older. Much has been written about the benefits of exercise and the association of physical activity in younger adults. There has been less by way of specific research and guidelines for fitness advice for older men and women. Many observational studies that have shown that older adults who report low physical activity are at higher risk for mortality, compared with those who reported moderate to high levels of activity. Self-reported activities are frequently subject to bias or inaccuracy, and not objective enough to determine if higher levels of activity are really linked to survival advantage.

It is difficult to label a chronological age level to classify senior, older, elderly, or aged individuals because of the vast differences of physiological aging between individuals, male and female. For purposes of research, older adults are defined as those older than age 70. One recent and important study chose 302 high-functioning, community-living individuals, 70 to 82 years of age, and followed them for a mean of 6.15 years. The scientists used a precise, accurate method to determine energy expenditure. The method used involved stable isotopes of hydrogen and oxygen given to the study group. Use of these isotopes determined free-living activity energy expenditure. The scientific formula captured any form of physical activity, purposeful exercise, or simple physical tasks. There were an equal number of males and females, and an appropriate mix of race and ethnicity. All individuals were able to walk a distance of two-tenths of a mile, or climb a flight of stairs without difficulty, were free from evidence of life-threatening illness, and able to perform independent activities of daily living. The study concluded that energy expenditure was strongly associated with lowered mortality rates in stable older adults. It is apparent from this and several other studies that maintaining or increasing physical activity will positively improve health and influence survival in older individuals.

The positive effects of physical activity continue throughout life, and can, indeed, improve overall health. An active lifestyle helps lower the risk of developing heart disease, diabetes, and high blood pressure. Physical conditioning improves stability and lowers the risk of falls and bone fractures. Physical fitness can be safe for older adults, even those with conditions like heart disease, arthritis, and diabetes, which are being medically treated. It is important to check with your doctor if you're going to start or increase your physical fitness program.

Physical activities generally fall into categories defined as aerobic, strengthening, and flexibility exercises. Aerobic exercises increase oxygen usage and improve heart and lung functions. These activities, which include walking, dancing, gardening, and swimming, help strengthen the heart, and lower blood pressure and cholesterol.

Strengthening exercises are important. Repetitive lifting of appropriate weights, which can even include household items like canned goods, will improve muscle and bone health. Exercises to increase the strength of hip and leg muscles help increase stability and lower risks of falls and injuries. There are several ways you can increase your flexibility and balance; stretching exercises, tai chi, and yoga help in keeping joints supple and free from stiffness.

Here are some guidelines suggested for managing a program of fitness: Start slowly, and gradually build up to a total of 30 minutes a day. Activities can be broken up through the day, and they can be different. Daily exercise is best. It is good to combine a range of activities to include all three types - aerobic, strengthening, and flexibility. Safety is important. Proper comfortable and fitting footwear is important, as is appropriate clothing. Avoid outdoor activities when it is excessively hot or cold. Drink plenty of fluids to make up for the additional loss incurred during exercise. Exercise should be a part of daily living. You can choose activities that you might enjoy; gardening, housecleaning, walking, and playing with children are some of many to choose from. It helps to keep a record of activities as part of your health and fitness plan, especially during health checkups and visits with your doctor.

There are certain symptoms you should be aware of. Stop activity and seek medical attention if you experience pain in the chest, arms, jaw, or neck. Shortness of breath, feeling nauseated, lightheaded or faintness, a sudden rapid heartbeat or palpitations, or pain in the legs, back, or feet are others that warrant attention.

It is becoming clearer, in studies of older adults, that exercise doesn't need to be performed at a high intensity. The study cited above and several others are being used by health care specialists to promote improvements in health by physical exercise activities suited to the individual. There is good scientific evidence that all efforts to maintain, and when required, to increase energy expenditure are likely to improve the health of older adults.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.