May 28, 2014
News Review From Harvard Medical School -- Exercise Cuts Senior Disability Risk in Study
A structured exercise program can help older adults remain able to walk on their own, a new study finds. The study included more than 1,600 adults in their 70s and 80s. They did little or no regular exercise before the study started. All were able to walk one-quarter mile without help. But they were considered at high risk of becoming disabled. People were randomly divided into 2 groups. One group went to a clinic twice a week for group exercises sessions. They also exercised at home 3 to 4 times a week. The program included brisk walking and exercises for strengthening, flexibility and balance. People worked up to a total of 150 minutes each week. The other group went to workshops on healthy aging. They occurred twice a week for 26 weeks and monthly after that. The study lasted an average of 2.6 years. In that time, people in the exercise group were 28% less likely to lose their ability to walk one-quarter mile than those in the education group. The Journal of the American Medical Association published the study. HealthDay News and the New York Times wrote about it May 27.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Our life span continues to increase. But with these added years comes a greater chance that we will not be able to live independently during the last part of life.
Independence can be defined as the ability to perform activities of daily living without help. The basic activities are:
- Bathing or showering
- Getting in and out of bed or a chair
- Using a toilet
Perhaps the most important activity that determines whether you can live on your own in older age is whether you can walk without help.
It's well known that older people who are physically more active and exercise regularly are more likely to walk on their own than those who don't exercise. But which comes first? Are some older adults active because they were already healthier? Or can structured exercise actually improve your chance of maintaining independent walking when you get much older?
According to this study, the answer to the second question is yes. A structured exercise program can make a difference even if the older person was not doing any regular exercise before.
The participants in the study were physically challenged adults, ages 70 to 89. But they could still walk. At the start of the study, they all could walk one-quarter mile without help.
Half of these adults received personal training in a structured exercise program. Half attended workshops on healthy aging and did some stretching only.
The study lasted an average of 2.6 years. By the end, those in the structured exercise program were 28% less likely to lose the ability to walk the quarter mile on their own than the information-only group. The researchers actually expected an even bigger difference between the two groups. One possible explanation is that the people assigned to just the workshops on healthy aging were likely told about the importance of exercise. Many of them probably became more active on their own.
What Changes Can I Make Now?
For older people (and also many younger people), getting started on an exercise program is probably the toughest challenge. You may think you are past the age when exercise will do any good. This study shows that this notion is not true.
Start slowly. When you begin to exercise, keep the amount of time short. Sessions may last only 10 minutes. Try to increase the time and intensity every few days.
I like the goals these researchers outlined for the people in their study who were assigned to structured exercise.
- At least 150 minutes per week of walking or other moderate-intensity exercise
- Resistance training with weights or machines 2 to 3 times per week, but not 2 days in a row
- Stretching and other flexibility activities as often as every day
You're never too old to exercise.
What Can I Expect Looking to the Future?
The lead author, Marco Pahor, M.D., estimated the cost of the exercise program at $1,800 per person per year. In the future, he and his colleagues will examine whether that cost is outweighed by savings on future care.
For example, how much money would need to be spent on similar exercise programs to prevent disability and need for nursing home placement? How might the program be modified to be just as effective at less cost?