The Navigating Aging column focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.
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Retaining the ability to get up and about easily — to walk across a parking lot, climb a set of stairs, rise from a chair and maintain balance — is an underappreciated component of good health in later life.
When mobility is compromised, older adults are more likely to lose their independence, become isolated, feel depressed, live in nursing homes and die earlier than people who don’t have difficulty moving around.
Problems with mobility are distressingly common: About 17 percent of seniors age 65 or older can’t walk even one-quarter of a mile, and another 28 percent have difficulty doing so.
But trouble getting around after a fall or a hip replacement isn’t a sign that your life is headed irreversibly downhill. If you start getting physical activity on a regular basis, you’ll be more likely to recover strength and flexibility and less likely to develop long-term disability, new research published in the Annals of Internal Medicine shows.
This encouraging finding comes from a study of people at high risk of mobility problems: men and women between the ages of 70 and 89 who were sedentary and had some difficulties with daily activities but were still able to walk a quarter mile without assistance.
Half of the group attended 26 weekly health education classes followed by monthly seminars. The other half spent about an hour getting physical activity — primarily walking — at a clinic twice a week, followed by at-home exercises.
The goal was to have participants meet the government’s recommended standard of 150 minutes of weekly moderate physical activity and sustain that level over time.
Results confirmed the extraordinary benefits of physical activity, which has been shown in previous research to lower an individual’s risk of heart disease, cognitive impairment, diabetes, depression and some cancers.
The group that focused on walking and strength and balance exercises was 25 percent less likely to experience significant problems with mobility than the group that focused on education over a period of almost three years. Specifically, they recovered faster from episodes of being unable to walk and were less likely to have problems getting around after that recovery period.
The program “was a godsend,” said John Carp, 87, who didn’t make it a point to walk regularly before he joined the study. “There was an improvement in physical feeling and also my mental attitude.”
“If there was a pill that offered comparable benefits, it would be a billion-dollar product and people would be all over it,” said Dr. Thomas Gill, lead author of the new paper and a professor of geriatrics at the Yale School of Medicine, as well as director of Yale Program on Aging.
Gill hopes to convince Medicare and other insurers to adopt the intervention he helped create. But older adults don’t need to wait for that to happen. There are plenty of places — YMCAs and senior centers, for instance — where seniors can take classes.
“If there was a pill that offered comparable benefits, it would be a billion-dollar product and people would be all over it.”- Dr. Thomas Gill, professor of geriatrics at the Yale School of Medicine and director of the Yale Program on Aging
Experts’ practical advice:
It’s never too late. “Older adults may think ‘it’s too late for me — I’m too old or too sick for this,’” said Patricia Katz, a professor of medicine and health policy at the University of California, San Francisco. “The message from this study is it’s never too late.”
“Prescribing exercise may be just as important as prescribing medications,” Katz wrote in an editorial accompanying Gill’s report.
Focus on activity, not exercise. “Older adults, if you talk to them about exercise, will say that’s not for me, that’s for my grandchildren,” Gill said. “But if you talk to them about become more physically active, they’ll say ‘OK, I can do that.’”
“Basically, I walk in the park or around the neighborhood and move my arms and legs around at night in different positions, and try to flex my muscles,” Carp said, describing his daily routine. “It’s not hard, and it makes a big difference.”
Start slow. Some participants could barely make it around a track at the beginning of the study, so “we started low and increased slowly,” offering remedial help along the way, Gill said.
“I recommend focusing on smaller and achievable goals, initially, and not trying to do everything at once because we know that tends to make people give up,” said Dr. Anne Newman, chair of the department of epidemiology at the University of Pittsburgh and co-author of a new study showing that people who eat healthily, maintain a normal weight and are physically active live longer and spend less time being disabled at the end of their lives.
Even small amounts make a difference. Newman’s study tracked more than 5,000 older adults over the course of 25 years. One conclusion: “There’s no threshold for benefit from physical activity,” she said. “Every little bit helps.”
“You don’t need to get on a treadmill, go to the gym or wear Spandex,” Newman said. “All you need to do is start walking for a few minutes every day and gradually build up your strength and endurance.”
Beware of becoming sedentary. The worst thing seniors can do is “sit down and take it easy,” said Susan Hughes, co-director of the Center for Research on Health and Aging at the University of Illinois at Chicago.
Make a plan. Hughes helped develop Fit & Strong, an evidence-based physical activity program for seniors with osteoarthritis that incorporates health education.
Before participants go off on their own, coaches craft an individualized plan that covers three questions: What are you going to do and how often, where are you going to do it and who are you going to do it with? You can make a plan yourself, but make sure it’s enjoyable, Hughes said. Otherwise, it’s very unlikely you’ll follow it for any length of time.