A male and female older adult walking along a road in autumn with deciduous trees

"If you don't use it, you lose it" - the importance of exercising into your older years


The saying goes, “if you don't use it, you lose it”, meaning that if you don’t continue to practice or use that ability, then you may in fact lose that ability. This can relate to anything in life, really, whether it be a certain skill you use at work, playing an instrument or in this case, inactivity.

Ceasing or reducing the amount of exercise one participates in has been shown to be associated with changes in body composition like, increased fat mass and decreased lean body mass, as well as increased chances of premature onset of ill health, disease and frailty. Atrophy of skeletal muscle has often been associated with ageing populations and inactivity, this can be due to lowered physical ability and decreased physical activities in some older adults' lives.

Ageing is a normal process and a part of life, and unfortunately is something we are unable to avoid, however healthy ageing is something we can all look to achieve through actively engaging in activities that improve your health and wellbeing. Healthy ageing is defined as the ability to lead a socially inclusive and healthy lifestyle that is relatively free from disability and illness. Losses due to ageing seen in muscle fibres and motor neurone decline can unfortunately never be replaced, however including consistent exercise and training, improvements in the structure and function of musculoskeletal, metabolic and cardiorespiratory systems have been seen.

So the saying is true in both aspects, the more often someone is physically active, the better their physical capabilities are. Coordination of movement improves with adaptations to the neuromuscular system, oxygen and nutrients are more effectively distributed throughout the body via the cardiopulmonary system, and metabolic processes of fatty acid metabolism and glucose regulation all increase and improve with physical capacity and aerobic power.

So what is physical activity?
The World Health Organisation defines physical activity (PA) as any bodily movement by skeletal muscles that then results in energy expenditure. Meaning, any and all movement of the body, like walking, cycling, sports, swimming, water aerobics, tai chi, play, yoga, pilates, dancing.

In noncommunicable diseases like cardiovascular disease, stroke, diabetes and some cancers, physical activity has shown to be a protective factor. It has also been associated with an improvement in mental health, quality of life, wellbeing and a delayed onset of dementia.

For people ages 65 years and older, the physical activity and exercise guidelines recommend a minimum of 30 minutes of moderate intensity exercise on most if not every day. The importance of physical activity in older adults can not only contribute to maintaining a quality of life but can also assist in the reduction of falls. This is where specific types of physical activity/exercise is recommended for different age groups, gender, ethnicity and disability. For example, challenging balancing exercises that were included in older adult exercise programs practiced for more than 3 hours per week showed a reduction of 21% of falls. It is also important to note that varying levels of socioeconomic status plays an impact on exercise habits, for example, older adults in a lower socioeconomic position are more likely to be inactive or have low levels of activity, whereas older adults holding a higher socioeconomic status are more likely to maintain higher levels of physical activity.

Continuing and maintaining current health status and physical capabilities are of more interest and importance to older people than improving their health which is why these programmes provided to older adults should reassure them that injuries and harm are unlikely to occur if executed correctly and that the activities they will be doing will be enjoyable and socially inclusive. Group activities are likely to engage more participants and have them return week after week due to the social and fun aspect of them. For example, walking groups or dance classes are among the top favourites for older women, and sports including tennis and golf have been shown to be more favourable for men. Another important aspect of participation is the price that these classes or activities will cost. Ensuring costs are low and that there is a variety of opportunities available for participants to involve themselves in has been shown to have a positive outcome for participation numbers. 

The Australian Physical Activity and Exercise Guidelines provides excellent examples of different types of activities older adults can incorporate into their daily lifestyle to remain active and assist with their everyday movement. Below are the examples:

Moderate fitness activities
Fitness activities are good for your heart, lungs and blood vessels, and can include:

  • brisk walking
  • swimming
  • golf with no cart
  • aerobics or water aerobics
  • cycling
  • yard and garden work
  • tennis
  • mopping and vacuuming

Strength activities

Strength exercises help maintain muscle and bone strength, and can include:
  • weight, strength or resistance training
  • lifting and carrying (for example, groceries or small children)
  • climbing stairs
  • moderate yard work (for example, digging and moving soil)
  • calisthenics (for example, push-ups and sit-ups

Flexibility activities

Activities that focus on your flexibility help you move more easily, and can include:
  • tai chi
  • bowls (indoor and outdoor)
  • mopping or vacuuming
  • stretching exercises
  • yoga
  • dancing

Balancing activities

Activities that help improve your balance can prevent falls and injuries, and can include:
  • side leg raises
  • half squats
  • heel raises

Building activity into your day

  • Building physical activity into your everyday life doesn’t have to be difficult. You can set aside a specific time each day, or fit some exercises in while waiting for the kettle to boil or watching TV

Stand up and sit down – for strength and balance

  • Sit on a chair with your feet flat on the floor and slightly apart
  • Try to keep your back and shoulders straight
  • Slowly stand up, trying not to use your hands (or as little as possible)
  • Slowly sit back down and pause
  • Do this 8 to 15 times

Shoulder roll – for flexibility

  • Using a gentle circular motion, hunch your shoulders upwards, backwards, downwards and forwards
  • Do this slowly 5 times
  • Reverse the direction, and do the same 5 times

Knee lifts – for strength

  • Sit back in your chair with your back straight
  • Bend your knee and lift your left leg towards your chest
  • Hold for a few seconds then lower slowly
  • Do this 8 to 10 times with each leg

Heels up toes up – for flexibility

  • While seated, start with feet flat on the floor
  • Lift heels as high as you can, keeping the balls of your feet on the floor
  • Slowly lower heels until feet are flat, then lift toes until they point upwards
  • Repeat these up and down movements for 30 seconds

Side leg raises – for strength and balance

  • Stand sideways to a kitchen bench or table and hold on with your right hand to support yourself
  • Slowly take your left leg out to your left side
  • Keep your back and both legs straight
  • Hold the position for 1 second then slowly lower
  • Repeat 8 times at first, increasing to 15
  • Turn around and hold on with your left hand, and repeat with your right leg

Half squats – for leg strength

  • Stand facing a kitchen bench or table with your feet about shoulder width apart, feet facing forward and holding on with both hands
  • Leaning slightly forward, but keeping your back straight, slowly bend both legs, keeping your knees over your feet. Do not go down too far
  • As you return to the up position, squeeze your buttocks together
  • Repeat 8 times at first, increasing to 15

Heel raises – for strength and balance

  • Stand sideways to the bench, feet apart (shoulder width) holding on with your hand for support
  • Slowly rise up onto your toes, hold for a second and lower again
  • Do this 8 times to begin with, increasing to 15
  • Don’t rush your movements

So the takeaway from all of this, It is important to ensure there is variety in the activities and classes available and that the cost is kept low. Enjoyment is key, so not matter your age or type of exercise, if you are moving your body and enjoying it, that is what matters the most!

References:

1. Australian Government - Department of Health. Physical activity and exercise guidelines for all Australians https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians

2. Langhammer, B., Bergland, A., & Rydwik, E. (2018). The Importance of Physical Activity Exercise among Older People. BioMed research international, 2018, 7856823. https://doi.org/10.1155/2018/7856823

3.McPhee, J. S., French, D. P., Jackson, D., Nazroo, J., Pendleton, N., & Degens, H. (2016). Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology, 17(3), 567–580. https://doi.org/10.1007/s10522-016-9641-0

4. Musich, S., Wang, S. S., Hawkins, K., & Greame, C. (2017). The Frequency and Health Benefits of Physical Activity for Older Adults. Population health management, 20(3), 199–207. https://doi.org/10.1089/pop.2016.0071

5. World health Organization - Physical Activity
https://www.who.int/health-topics/physical-activity#tab=tab_1