Elderly

It's never too late to start!

‘Elderly’ cannot be defined by a specific chronological age, as aging does not occur uniformly across populations. Lifespan depends on genetic factors, environmental factors, the availability of quality medical and health services and individual responsibility for health maintenance. Some of the physical characteristics that elderly experience include graying hair, balding, dry and/or wrinkled skin, loss of joint flexibility and teeth, decreased bone mineral density and depression.

Body Composition

There is a decrease in lean body mass and an increase in body fat. This is due predominantly to the decreased basal metabolic rate and decrease in physical activity. The typical 75-year-old body is made up of 8% bone, 15% muscle and 40% adipose tissue.

Bone Mineral Density

In men, bone mass decreases approximately 10% by the age of 65 and 20% by the age of 80. Men start to lose 1% of bone per year after the age of 50. Women start losing bone in their early thirties. They lose 2-3% per year after menopause. Reasons for the decreased bone mineral density or osteoporosis can be hormonal, genetic or due to immobilization, physical inactivity and/or mechanical factors that place much stress on bone.

Muscle, Strength and Aerobic Capacity

After the age of 25, 3 to 5% of muscle is lost per decade. At the age of 40, strength begins to decline and muscle cross-sectional area decreases. There is a decrease in Type II muscle fibers (recruited in high intensity activities of short duration), particularly in the lower extremities. Muscle functioning decreases and end-plate structures begin to deteriorate.

After the age of 30, VO _{2 max} (maximal oxygen uptake) decreases 8 to 10% per decade. This is caused by genetic factors, decreased skeletal muscle mass and/or decreased aerobic capacity. The lipid deposits in the heart and collagen (fibrous scar tissue that stiffens the heart) increase. The valves become calcified. The left bundle branches atrophy and fibrosis occurs. This means that the heart does not conduct as well.

Training Programs

Training programs for the elderly should be low to moderate intensity. The goals should be increasing strength, balance and flexibility while decreasing the risk of injury, and cardiorespiratory/thermoregulation stress. The American College of Sports Medicine recommends 30 minutes of moderate intensity (50-60% VO_{2 max}) most, preferably all days of the week.

Beginning a strength training program should not be complicated. Beginning with a difficult routine is associated with a higher dropout rate. The goal is to increase physical activity and longevity. Walking around the block, or taking longer walks at the local shopping mall, is a good start. Swimming is also an excellent choice as part of an exercise program for the elderly. It is extremely important to weight train to build strength and increase skeletal muscle mass and bone density. Common household items (such as small canned goods) can be used instead of hand weights.

Studies indicate that people who exercise regularly enjoy increased mental alertness as well as a higher quality of life. Even individuals, who have minor mental impairments after a stroke, have noticed significant improvements in thinking with exercise.

Strength training can also help improve balance. This is important for the elderly who are at risk for falls. Hip muscle strength specifically reduces the risk of falls. Strengthen the hip muscles and improving their anaerobic power, elderly will increase their ability to perform everyday chores, such as rising out of a chair and/or transferring laundry.

Weight-bearing exercises increase bone mineralization in both men and women while helping to build and maintain bone mass. Ingesting at least 1800 mg of calcium per day will also help to decrease the risk of osteoporosis.