A necessary activity for healthy aging

By Jonathan Ford Hughes, for MDLinx
Published June 14, 2019

Key Takeaways

Spend any amount of time in a gym’s weight area and you’ll notice a big change compared with bodybuilding eras past: Men and women of all ages have embraced resistance training, and for good reason.

Researchers indicate that strength training is a critical component to healthy aging. In addition to keeping people able-bodied in their later years, training with weights or resistance can even prevent cognitive decline.

If doctors want to ensure their patients have an easier transition into their golden years, physicians need to familiarize themselves with the benefits of strength training for longevity, explained Lauren Elson, MD, instructor, Physician Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, in an interview with MDLinx.

“We do know that strength training helps prevent the sarcopenia that’s involved with aging,” Dr. Elson said. “Sarcopenia can have effects on stability, balance, so, therefore, fall prevention. Maintaining strength means maintaining independence to be able to do what they need to do at home.”

In a review published in Dialogues in Clinical Neuroscience, the authors highlighted how exercise appears to leverage the brain’s neuroplasticity to thwart cognitive decline typical in dementia patients. They also noted evidence of reduced cortical atrophy, improved brain function, and enhanced cognitive function in those who exercised.

Improving cognitive and physical health

“Greater amounts of physical activity and higher cardiorespiratory fitness levels are associated with better cognitive function in older adults,” the researchers wrote. “For example, older adult athletes outperform their more sedentary peers on many different cognitive tasks and fitter individuals are faster and more accurate on executive functioning and memory tasks.”

The US population isn’t getting any younger. Health and Aging Policy Fellows project that, by 2030, about 20% of the US population (about 71 million people) will be age 65 or older, meaning that doctors working with the aging population need to familiarize themselves with basic strength-training protocols.

What does a reasonable amount of exercise for this population look like? According to Dr. Elson, most studies have evaluated the efficacy of twice-weekly strength training that includes movements targeting the upper and lower body. Although studies have yet to pinpoint an optimal program, she recommends one that includes core stability, balance, strength training, and cardio.

“There is this normal amount of sarcopenia that happens with aging,” said Dr. Elson. “But the degree of sarcopenia can be prevented with regular strength training. And even if someone is losing muscle mass, they can still get stronger and build muscle.”

Getting patients to exercise

Like any other self-care instructions administered by a doctor, getting a patient to follow through with exercise can be challenging. Dr. Elson recommends getting a read on a patient’s interest and preferences. For example, some might not be comfortable working out in public. If that’s the case, a routine involving elastic resistance bands might be a good option. Workout videos abound on YouTube. Alternatively, you could provide patients with written material, such as the Harvard Health Starting to Exercise pamphlet.

Some people do better in classroom settings, Dr. Elson added. Some senior centers and many YMCAs offer class-based fitness sessions. Personal training is also an option for those who require an added layer of accountability and can afford it. Dr. Elson noted, however, that personal training is not a requirement.

The most critical consideration for recommending strength training or any type of physical activity for your patients is to “match people where they’re at,” advised Dr. Elson.

“If people are already pretty active, having them do resistance band training is probably not going to help much,” she said. “But for someone who hasn’t been active and is weak, we want to meet them where they’re at. Any routine should be tailored to where someone is starting from and what their goals are.”

Another common objection from patients that doctors might encounter is that the patient claims to be too old, or that it’s too late to reverse the decline.

Not so, according to Dr. Elson: “Working within the rehab field, we see people at every stage of life, and every condition: post-traumatic, post-hospitalization, and then people who have just become deconditioned over time. And there is never a point at which you wouldn’t intervene with exercise.”

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