Introduction According to the last Census 13.3% of the population is over the age of 65 and that percentage is continuing to rise Consequently, the health, fitness and well-being of the senior population are of increasing concern in today's society.
Aging Aging is a normal biological process in human beings involving the gradual alteration of body structure, function, and tolerance to environmental stress However, physiological aging does not occur at the same rate throughout the population. The reasons could be from advancing age, deconditioning from physical inactivity, disease, or any combination of them.
Biological vs. Chronological There is a biological and a chronological age. Biological age focuses on senescent changes in biological and physiological processes. Chronological age focuses on elements of calendar time. Biological age may be reduced by regularly participating in a well-designed physical fitness program.
Physiological Changes cardiovascular system there is a 20 to 30% decrease in cardiac output by the age 65 Maximal oxygen uptake decreases approximately 9% and 5% per decade a loss in elasticity of the major blood vessels which contributes to a 10 to 40 mm Hg elevation in systolic and diastolic blood pressure Maximum heart rate decreases approximately 10 beats per minute per decade respiratory system undergoes a 40 to 50% loss in forced vital lung capacity muscular system undergoes a 40% loss of muscle mass and 30% decrease in strength by age 70
Benefits Improves/Maintain cardiorespiratory function Reduces risk factors for coronary artery disease Maintains endurance, strength, and joint mobility Reduces the incidence and severity of hypertension, osteoporosis, obesity, and diabetes mellitus.
Precautions It is crucial to have knowledge of the physiological changes of aging in order to have a safe and effective exercise program for older individuals With advancing age, there are gradual decreases in basal metabolic rate (BMR), bone density, maximum oxygen consumption (VO2 max), muscle mass, muscle strength, and range of motion (ROM). Decreased amount of body water leads to easier dehydration
Goals Maintain functional capacity for independent living Reduce risk factors for heart disease Slow the progression of chronic disease Promote psychological well-being Provide opportunities for social interaction. Special care must be given when setting up a fitness program for older individuals. Exercise programs for older individuals should be tailored to combine endurance, muscle strength, and flexibility to promote the quality of their life.
FITT Principle Frequency Intensity Time Type
Frequency Three to five days per week Five to seven days per week with seniors if they exercise very low intensity with short duration The greater frequency may enhance compliance and lead to a greater probability of the subject assimilating physical activity in the daily routine.
Intensity Start out low since elderly people are more prone to exercise-related injuries. Exercise intensity should be sufficient to overload the cardiovascular, pulmonary, and musculoskeletal systems without overstraining them. For older adults is 50 to 70% of heart rate reserve The intensity level of exercise should be regularly monitored by heart rate, or rating of perceived exertion
Time Start with short periods and gradually progress in length shorter sessions of 5 to 10 minutes repeated several times throughout the day. Elderly people need additional warm-up and cool down time, perhaps as much as 10 minutes or more.
Type • low-impact on their joints • The activities include • Walking • stationary cycling • water exercise • Swimming • machine-based stair climbing. • The activity needs to be accessible, convenient, and enjoyable to the participant.
Progression Gradual The initial stage, usually four to six weeks, should include low intensity exercise to permit adaptation with minimal risk for injury. It is better to increase exercise duration initially rather than intensity in order to avoid injury and ensure safety Based on how well the individual is responding to the current regimen Exercise programs should be reviewed on a regular basis to ensure they are meeting the needs of the participant.
Motivating Set realistic goals Identify the benefits Make exercises appropriate Make it a social event Offer support Make sure they know it is safe
Practice Exercise Warm up Chair squats Toe stands Wall Push-ups Bicep curl Overhead Press Hip Abduction Knee extension seated Standing hamstring curl holding chair Cool Down