Aging: Active Aging Tips (cont.)

Moderator: Let's discuss strength training.

Dr. Chodzko-Zajko: Strength training is very interesting. Twenty years ago, we discouraged older adults from lifting weights. Now we encourage weight training for older adults because we know it's safe, and we know that loss of muscle strength is a major factor in loss of independence in older adults. Strength training can slow the loss of muscle strength very significantly. And more and more senior centers, retirement homes, and other aging facilities are introducing strength training programs. You can use weight machines, or more simple systems, such as elastic bands, which are often called Thera-Bands. And there's evidence that all sorts of different strength training programs are quite effective in older adults.

Moderator: How should one determine their weight limits?

Dr. Chodzko-Zajko: Weight limits apply mostly to machines where people are lifting stacks or doing free weights. Ideally, I would encourage older adults to try to get advice from an exercise professional who can help them set up an appropriate training schedule. If that is not possible, I would encourage people to life weights that they can lift comfortably for ten to 15 repetitions, and gradually build up. Part of the challenge with designing a weight training program, is to be sure to exercise the muscles of the body in a balanced way. For example, if you do an exercise that exercises the bicep in the arm, you also need to exercise the triceps, which is the antagonist muscle. If you don't have a balanced program, you can actually increase the risk of injury. For that reason, I encourage all older persons to get straightforward advice before they start to lift weights. That is not difficult to do, and almost all fitness centers or gyms have people who can advise older people how to lift weights sensibly. I know many people 80 or 90 years of age who enjoy lifting weights, and benefit greatly from doing so.

Moderator: Are there qualifications one should look for in a fitness professional?

Dr. Chodzko-Zajko: That's a very difficult question. There are many, many different kinds of professionals, ranging from people with PhDs in exercise physiology, to individuals who set themselves up as personal trainers with no formal education. There's a huge debate in our field whether or not we should demand licenses or certifications for fitness professionals. At present, there are no conclusions in this area, so I would warn people to ask the fitness professional you're working with to tell you about their training. Often on TV, you find people advertising different products, and not always are the claims made by these individuals appropriate and sensible. It's a kind of a buyer beware situation.

Moderator: Can strength training help to prevent osteoporosis?

Dr. Chodzko-Zajko: There's relatively little evidence that says that once you have it, which is loss of bone mass, that strength training alone can reverse osteoporosis. There's better evidence that physical activity is very important early in life. And there's some evidence that physical activity can help manage osteoporosis in old age, by strengthening muscle groups, reducing the likelihood of falls. I would encourage all older persons with osteoporosis to follow the advice of their physician, and to stay as active as possible so that they can minimize the consequences of osteoporosis, while staying healthy and improving their quality of life.

Moderator: Are there particular types of injuries that seniors should watch for when strength training?

Dr. Chodzko-Zajko: I think that in the area of strength training, if an activity is painful while you're doing it, that's a good sign to ease off. But in general, injuries for older people are similar to injuries in younger people. By far the major side effect of strength trainings is muscle soreness, and that usually goes away within a few days of strength training.

Moderator: Let's move on to aerobic exercise.

Dr. Chodzko-Zajko: Aerobics is exercise that stimulates the heart and cardiovascular system. Basically any form of physical activity that increases heart rate for a significant amount of time can be described as aerobic. This can be done many different ways, walking, riding a stationary bike, or actually bicycling, running, rowing, swimming, aerobics dance. No one form of aerobic exercise is best. What is important is that people should be aerobically active on most days, and the means that they choose should be the ones that they are most comfortable with. For older people, many, many people like to walk. Walking is an excellent form of aerobic exercise. When people have conditions that limit their ability to walk, for example, arthritis, very often aqua aerobics, or exercise done in a pool is a good substitute.

Moderator: What kind of target heart rate (THR) should one aim for?

Dr. Chodzko-Zajko: That's a good question. THR is one way to evaluate exercise intensity, and is common used by exercise physiologists.  In the older adult population there are some difficulties with THR. Some seniors use medications which influence the heart rate. THR equations need to be adjusted for medication. Some studies have shown that tactile sensitivity decreases with age, so some older persons may have difficulty monitoring their own heart rate. Many seniors might want to use a much more simple method to monitor exercise intensity, and I call that the Talk Test. And that is simply to exercise with a partner, and carry out a conversation. Usually, if you are able to talk comfortably, you are not exercising too hard.

Moderator: Speaking of talking, what have you learned about the connection between social activity and health?

Dr. Chodzko-Zajko: In the older adult population, successful aging, or high quality of life, is dependent upon being able to play a meaningful role in society. As we age, many of the roles that are important to us, jobs, spouse, children, car, income, these roles get taken away from us as we get older. Finding ways to replace roles with new meaningful roles assists greatly in adjusting to old age. For example, many seniors participate in the university of the third age, or senior hostels at programs for older people to continue their education to become involved in social groups, and there's good evidence that this kind of social activity is associated with increased quality of life in old age. How does physical activity relate to this? If older people are too frail to participate in social, cultural, intellectual, and religious programs, very often they become isolated at home, they adopt a sedentary lifestyle, and are at risk for a cycle of decline in health, activity, increased depression. Recently, the World Health Organization has begun to focus on active aging as an initiative that goes beyond physical activity, but really looks at the whole spectrum of being active, rather than treating physical, educational, social activities as being independent from one another An example of this would be, a few years I consulted for a sporting goods company in Japan. They own a large number of commercial gyms and fitness centers throughout Japan. They were very interested in attracting older people into their facilities, and they developed special programs for seniors where seniors could participate in physical activity, social activity, educational programs, they could do calligraphy, read poetry, have tea together, so the idea was to attract people to come for perhaps two hours to a site, and get many forms of activity. On days when older persons were not feeling well, they did not have to exercise, but could still come to their activity center and do something else. I think this kind of broader perspective on activity is very promising, and is the way to go in the future.