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Physical Activity Does Not Need to be of Overwhelming Intensity for Health Benefit Gains
Aging does not look like it did 50 years ago. Adults are living longer and better thanks to advances in medicine and technology. Seventy really is the new sixty as older adults are staying active longer, are generally healthier, and look and feel younger than same-age adults of decades past. Although most people are living longer, in the US, Hispanics are ahead of the curve when it comes to life expectancy. A Hispanic woman who lives to see her 65th birthday, on average, can plan to live to nearly 88 years of age, while a Hispanic man who makes it to 65 can expect, on average, to celebrate his 85th birthday, according to a recent report from scientists with the United States National Center for Health Statistics.
Although older adults are living longer, the majority are living with age-related chronic diseases, such as arthritis, diabetes, cardiovascular disease, and depression, and/or others. For many, several of these chronic conditions co-exist and threaten the quality of life. Fortunately, research has led to scientific discoveries that have advanced the medical management of older adults with those chronic diseases. Moreover, research findings have established that it is necessary to go above and beyond the treatment of specific chronic diseases to optimize healthy, active aging. For instance, physical activity is of utmost importance in the management of many of these chronic conditions, the improvement of cognitive function and overall well-being.
It is traditionally recommended that older adults should engage in physical activities of moderate intensity at least 150 minutes per week, or in physical activities of vigorous intensity at least 75 minutes per week. Often, however, older adults tell me that they feel overwhelmed with those recommendations. And they ask me: What if I did physical activity, but not that much – is the evidence that less intensive physical activity may result in health benefits?
Keep in mind that it is not only vigorous, high-intensity, every-day exercise that is beneficial but health benefit gains can also be achieved by engagement in less intensive regimens. Even light-intensity activity appears to provide health benefits and is preferable to sitting still. Leisure time activities done at home or in the community may also yield health benefits. Those leisure activities that count as exercise include dancing, doing chores at home or around the neighborhood, raking and gardening. Walking is a great aerobic exercise and, not surprisingly, the most common exercise done by older adults. It is also important to mention that strength training regimen at least two times per week is of utmost importance.
Higher physical activity levels have protective effects against cardiovascular disease, obesity, depressive symptoms, sleep abnormalities, osteoporosis, and other conditions. However, only a small proportion of older adults are physically active. In a recent survey of older adults of Hispanic origin living in South Florida led by the Benjamin Leon Center for Geriatric Research and Education at Florida International University, only 36% reported that they had walked for exercise the recommended 150 minutes per week. That statistic is consistent with recent U.S. nationwide estimates indicating that less than 40% of adults aged 65 years and older engaged in regular physical activity meeting minimum recommend levels, and less than 20% performed recommended muscle-strengthening activities twice or more per week.
Scientists in a study done collaboratively by Johns Hopkins University, Columbia University, and the Benjamin Center for Geriatric Research and Education at Florida International University, evaluated physical activity levels over time in 433 women 70-79 years of age who were living independently and able to care completely for themselves at the beginning of the study. The study followed these women for 12 years. Among those who were consistently inactive, mortality risk during the study period was three times higher than among those women who were always active. Interestingly, as well, was the finding that no differences in mortality risk were observed between those who were always active in comparison to those who were only moderately active (i.e., less than always active). This supports the notion that physical activity does not have to be vigorous to be beneficial.
In another study known as the Lifestyle Interventions and Independence for Elders (LIFE) study, these findings were supported. This was a landmark clinical trial that followed more than 1,600 sedentary men and women 70-89 years of age for an average of 2.5 years. They found that the risk of developing mobility disability was substantially lower among those who participated in a moderate-intensity physical activity program, which included walking, strength training, and flexibility.
Exercise also plays an important role in cognitive health. Research has consistently shown that higher physical activity levels are associated with an increased chance of maintaining brain health as individuals grow older. For example, a recently published study that analyzed data from 182 older adults with an average age of 73.4 years who participated in the Harvard Aging Brain Study, reported that those with higher physical activity levels experienced less pronounced brain tissue loss assessed by magnetic resonance imaging and slower age-related decline in cognition. Another example is a study that followed 716 older individuals without dementia for approximately 4 years and showed that greater total daily activity was associated with a substantially lower risk of Alzheimer’s disease.
Physical activity is key to healthy, active aging, as it provides health benefits that cannot be achieved by taking prescription and/or over the counter medications. Engagement in physical activity has a positive impact that is complementary to that offered by traditional treatments often in place for age-related chronic diseases. Moreover, incorporating strength training is very important for muscle health preservation, physical health maintenance, and disability prevention at older ages. The best way to get started – or to keep going, for those already active – is to talk to your physician and to exercise specialists who are part of wellness programs of excellence, like the Leon Healthy Living Centers, to learn about the most appropriate exercise programs.
Dr. Paulo Chaves, MD, PHd
About the Author
Paulo H. M. Chaves is a geriatrician and clinical epidemiologist who holds the Leon Medical Centers Endowed Scholar Chair in Geriatrics at Florida International University (FIU). He directs the Benjamin Leon Center for Geriatric Research and Education at the FIU Herbert Wertheim College of Medicine, which is committed to the development and implementation of novel approaches to advance active aging promotion, frailty prevention, and healthcare delivery to older adults in the outpatient clinical care and community settings through translational epidemiology research and Geriatrics and Gerontology education.