Exercise for the ages

  • Health
  • Sunday, 26 Jan 2003

The numerical number that states your age should be no barrier when it comes to exercising for good health, writes Dr WILLIAM CHAN. 

MY running friend, Sonny, who is 61 years old, has been involved in many marathons, and even survived a heart attack while running the last Seremban Half-marathon. During the event, he did not feel well but was able to complete the 21 km run. After the run, the doctor diagnosed him as having suffered a heart attack. And he completed the run at a time faster than mine, despite the “minor” inconvenience of a heart attack!  

We have all heard of stories about people dying suddenly while participating in the sport they enjoy. However, this should not stop you from continuing to participate in sports.  

So, is it true that you are too old to exercise? The answer is a resounding No. Regular exercise can lower your risk of dying from cardiovascular diseases by up to 40%. 

Growing older does not mean you have to lose your strength and ability to do exercise and carry out sports that you enjoy. When you decide to slow down or stop, you probably will lose some of the strength and stamina you have built up over the years. Inactivity or not doing any exercise will put you at higher risk for diseases and disabilities. Studies have found that even many old and frail people can improve their health and independence by increasing their physical activity through exercise and sports. A moderate level of sports can prevent or delay many diseases and disabilities associated with ageing.  

The elderly who suffer from heart disease, stroke, diabetes, osteoporosis, arthritis and obesity will benefit from regular exercise activities. Exercise or sports can be broadly described as a form of “medicine” and different types of exercise or sports have different effects, much like different medicines. Swimming will not improve bone mass density like running does. Tai Chi will not improve cardio-respiratory endurance as much as brisk walks. 

What types of exercise? 

There are four basic types of exercises that you can do. These can be categorised to endurance, strength, balance and flexibility.  

In old age, the heart muscle becomes less able to propel large quantities of blood quickly through the body. The body tires more quickly and takes longer to recover from physical exertion. Endurance exercises are activities that increase your breathing and heart rate. They improve the health of your heart, lungs, muscles and joints. Having more endurance not only helps keep you healthier, it can also improve your stamina for daily living activities such as climbing stairs, gardening and shopping.  

Endurance exercises also may delay or prevent many diseases associated with ageing such as diabetes, bowel cancer, heart disease and stroke. Examples of endurance exercises are swimming, brisk walking, jogging, cycling, badminton, tennis and golf.  

As the muscles of the body age, they begin to shrink and lose mass. This is a natural process and a sedentary lifestyle can accelerate it. Strength exercises help build muscles and make you stronger. They may improve your independence by giving you more strength to do things on your own.  

Even very small increases in muscle can make a big difference in ability, especially for elderly people. Strength exercises help to keep your weight and blood sugar in check. This is important, because overweight and diabetes are major health problems for many elderly people.  

As we age, the balance between bone absorption and bone formation changes, resulting in a loss of bone mass. Strength exercises also help prevent osteoporosis and falls. There are many fitness centres and gyms that you can join to start work on your muscles with weights. 

Flexibility exercise is stretching exercises. I always remind my patients to stretch before and after they exercise or do sports. Stretching helps to reduce muscle and joint tightness. Tight muscles and joints can lead to injury during exercise and sports. Flexibility also may play a part in preventing falls. It is a good practice to do stretching and balance exercises before you start your endurance and strengthening exercises, such as fast walking, jogging or workouts in the gymnasium.  

Is it safe? 

It is safe for an elderly individual to continue to exercise if he/she has been exercising for many years without any medical illness or problem. For those in the 50 to 60 age group, there is no reason to slow down unless you have a medical illness that may be aggravated by exercise. There are few reasons to slow down. However there are many reasons for the elderly to continue to exercise to keep healthy and active.  

If you have a medical illness, then it is a good idea to discuss with your doctor or specialist before you start your exercise programme. You may also need to consult a sports specialist to work out the type of exercise you can do safely.  

An exercise stress test may be necessary for people with heart disease. Walking is generally regarded a safe form of exercise. However, before starting a vigorous or moderate programme of exercise in people over the age of 40, you should first be checked by a doctor. 

Traditionally, exercise has been discouraged in people with certain chronic conditions. But studies have found that exercise can actually improve some chronic conditions in some elderly people, as long as it’s done during periods when the condition is under control. Having a chronic medical illness in the heart or lung doesn’t mean you can’t exercise. But it does mean that keeping in touch with your doctor is important if you do exercise. 

Muscles throughout the body tend to waste away in people with chronic illness, leaving them weak, sometimes to the point that a person can’t perform daily work. No medicine has been shown to have a direct muscle-strengthening effect. Muscle-building exercises (lifting weights, for example) have been shown to improve muscle strength in these people.  

How hard do I exercise?  

Start with an exercise activity you can carry out comfortably. As you become more used to exercising, try to keep your heart rate at about 60% to 80% of your “maximum heart rate”.  

When you first start your exercise programme, you may want to use the lower number (0.60) to calculate your target heart rate. Then, as your conditioning gradually increases, you may want to use the higher number (0.80) to calculate your target heart rate.  

To figure out your target heart rate, subtract your age in years from 220, which gives your maximum heart rate. Then multiply that number by 0.60 or 0.80. For example, if you are 60 years old, you would subtract 60 from 220, which would give you 160 (220 - 60=160). Then you would multiply this number by either 0.60 or 0.80, which would give you 96 or 128 (220-60=160; 160 x 0.60=96 and 160 x 0.80=128).  

Check your pulse by gently resting two fingers on the outer side of your wrist and feel for the pulse. You can count the beats for one minute. A heart rate monitor can help you to monitor your heart rate.  

How much exercise? 

Build up your endurance gradually, starting out with as little as 15 minutes of sporting activities at a time. Brisk walks or jogging alternating with slow walks is a good way to start.  

Remember to warm up and cool down for five minutes. Exercise or sporting activities should not make you breathe so hard that you can’t talk. They should not cause dizziness or chest pain.  

Starting out at a lower level of effort and working your way up gradually is especially important if you have been inactive for a long time. It may take three months to go from many years of a sedentary lifestyle to doing regular sports and exercise. Your goal in exercise is to increase your breathing and heart rate. It should feel somewhat hard when you start exerting your body. 

Doing less than 15 minutes at a time won’t give you the desired cardiovascular and respiratory benefits. Your goal is to build up to at least 30 minutes of exercise on alternate days of the week for health benefits.  

The elderly are affected by heat more than young adults. Hence, it is best to exercise in the cooler part of the day, like early mornings and evenings. 

Is there anything I should do before and after exercise?  

Wear light clothing that is comfortable and loose. Get yourself a comfortable and good quality shoes and socks. You should start an exercise session with a warm-up period. Spend about five to 10 minutes doing a slow walk or light jog to warm up your body. The warm-up helps to increase blood flow to your muscles. Following the warm-up, you should slowly stretch your muscles and joints.  

After you are finished exercising, cool down for about five to 10 minutes by doing light activities like a slow walk or slow jog before stopping completely. Again, stretch your muscles and let your heart rate slow down gradually. You can use the same stretches as in the warm-up period. 

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