fundamentals
Exercise in Older Adults
Introduction
Most people over age 65 do not exercise at recommended levels despite the known health benefits of exercise including Longer survival Improved quality of life (for example, endurance, strength, mood, flexibility, sleep quality, mental function) Furthermore, many older people are not aware of how hard to exercise and do not know how much exercise they are capable of doing. Exercise is one of the safest and most effective ways to improve health. Because of the decline in physical capability due to aging and disorders that are more common among older people, 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 people carry out activities of daily living, such as climbing stairs, or even less taxing activities, including bathing, getting dressed, preparing meals, and going grocery shopping. The largest health benefits occur, particularly with aerobic exercise, when people who are not physically active begin exercising. Strength decreases with age, and decreased strength can compromise function. Strength training can increase muscle mass, meaningfully improving function. With a larger muscle mass, the same degree of muscle work demands less cardiovascular exertion. Increasing leg muscle strength improves walking speed and stair climbing. Older people who exercise are likely to have a better prognosis during a critical illness. Not all older people can exercise safely. Some heart disorders and uncontrolled high blood pressure or diabetes mellitus may make exercise dangerous for some people. Other disorders, such as arthritis, may make exercise difficult. However, most older people, even those with heart disorders, are able to exercise. They may need to follow a specially designed exercise program or exercise under the supervision of a physician, physical therapist, or certified trainer. People should stop exercising and seek medical help if they develop chest pains, light-headedness, or awareness of irregular or rapid heartbeats (palpitations) during exercise. Before beginning an exercise program, older people should be evaluated by their doctors to detect heart disorders and physical limitations to exercise. Electrocardiography (ECG) is not usually needed unless the person's medical history or findings during the physical examination suggest a problem. Exercise 