Regular physical activity helps prevent obesity, heart disease, hypertension, diabetes, colon cancer, and premature mortality 36.  Since physical activity is able to prevent the onset of many diseases/disabilities which are apart of the risk factors for causing tiredness, it is extremely important to incorporate physical activity in your every day schedule.  Even people who start exercising between the ages of 60 and 75 can reduce their risk of mortality 10.  Elderly patients can benefit tremendously from a comprehensive exercise prescription 10.

Exercise Prescription for Seniors

• ACSM reports that frail older people who are starting to exercise should begin with strength training before they launch an aerobic regimen 50
• The recommendation is to undertake progressive resistance training of major muscle groups at least 2, preferably 3, days per week, with two to three sets of each exercise 50
• Moderate-intensity aerobic training can begin after frail individuals have improved their muscle strength, joint stability, and balance - walking is preferred, but exercise machines and water activities are also approved 50
• Frail individuals should strive for three days of activity before working up to a duration of at least 20 minutes, then to an intensity of 40-60% of maximum heart rate reserve 50

Strength and Flexibility Training Guidelines for Older Patients 10

(Before beginning any exercise program first consult a physician.)

• Warm-up with a  5-10 minute walk (with active arm swinging), a 5-10 stretching of major muscles (legs, back)
• Focus on working large muscle groups such as the quads (thighs), gluteus muscles (buttocks), hamstrings, hip muscles, deltoids (shoulders), biceps, triceps, back, and abdominals
• When lifting weights, chose weights that can be lifted 12 to 15 times with fairly light to somewhat hard exertion.  Do NOT strain or hold the breath.  Work muscles through their normal range of motion
• Rest for 1 to 2 seconds between repetitions and 1 to 2 minutes between sets of exercises.  Eventually work up to 2 to 3 sets of each exercise
• Allow 1 to 2 days' rest between workouts so that muscles can rebuild and recover
• Stop immediately and sit or lie down if experiencing chest pain or pressure, dizziness, abnormal heartbeats, or unusual shortness of breath.  Emergency services (911) should be called if after 1 or 2 minutes of rest symptoms do not recede.  Report these symptoms to a physician even if they get better quickly before resuming exercise
• Train with a partner to promote continued exercise: motivational aid
• Drink plenty of fluids before, during, and after resistance training
• Be creative and try different exercises to avoid boredom

Tai Chi For Seniors
Tai chi exercise is a non-pharmacologic, low-impact, exercise approach for managing chronic illnesses.  Tai chi exercises directly improve elements of balance, muscular strength and endurance, and flexibility.  Tai chi exercises can be used by older adults to maintain physical function that often declines with age and chronic health conditions. 55
 
Number of seniors who participate in physical activity

• 24% of elderly people are sedentary 10
• 54% are suboptimally active 10

Strength and Flexibility Training Guidelines for Older Patients 10

(Before beginning any exercise program first consult a physician.)

Physiologic changes accompanying aging

• After 25, maximum oxygen uptake (VO2 max) by exercising muscles decreases by 5% to 25%  each decade 10
• This normal change will impair elderly people's abilities to tolerate an aerobic exercise challenge 10
• The most notable changes include the musculoskeletal system (lean body mass decreases and interstitial fat content increases) 10
• Other changes that occur with aging are: 10

1. Neuronal cell loss
2. Decrease in reaction time
3. Decrease in overall balance
4. Decrease in nerve conduction speed
5. Aging decreases estrogen, androgen, and growth hormone levels
6. Depression increases
7. Motivation decreases

Regular exercise can improve physical and mental health of elderly people although it cannot halt the anatomic changes that occur with aging. 10

For more information on seniors and the benefits of exercise refer to these sources:

• Physical Activity and Fundamental Status in Community-Dwelling Older Women 6

• Nutrition, Physical Activity, and Quality of Life in Older Adults: Summary 17.  

• Relationship between age-associated endocrine deficiencies and muscle function in elderly women: a cross-sectional study 8

• Patterns of functional decline at the end of life 34

• Muscle function in 75 years old men and women: A longitudinal study 3

• Quality of the last year of life of older adults: 1986 vs 1993 26

• Can obesity be a risk factor in elderly people? 28

• Recent trends in disability and functioning among older adults in the United States: A systematic review 22

• Barriers to and Benefits of Leisure Time Physical Activity in the Elderly: Difference Across Cultures 15