special subjects
Exercise in Older Adults
Introduction
Most people age>65 years do not exercise at recommended levels despite the known health benefits of exercise: Longer survival Improved quality of life (eg, endurance, strength, mood, sleep, flexibility,insulinsensitivity, possibly cognitive function, bone density [with weight-bearing exercise]) Furthermore, many older people are not aware of how hard to exercise and also do not appreciate how much exercise they are capable of. Exercise is one of the safest and most effective ways to improve health. Because of the decline in physical capability due to aging and age-related disorders, older people may benefit from exercise more than younger people. Exercise has proven benefits even when begun in later years. Basic, modest strength training helps older patients carry out activities of daily living. Many older patients need guidance regarding a safe and appropriate regular exercise regimen. The largest health benefits occur, particularly with aerobic exercise, when sedentary patients begin exercising. Strength decreases with age, and decreased strength can compromise function. For example, almost half of women>65 and more than half of women>75 cannot lift 4.5 kg. Strength training can increase muscle mass by 25 to 100% or more, meaningfully improving the ability to carry out daily activities. The same degree of muscle work demands less cardiovascular exertion; increasing leg muscle strength improves walking speed and stair climbing. Also, institutionalized older people with more muscle mass have better nitrogen balance, less deconditioning, and a better prognosis during critical illness. 