Participants: Don Morgan
Series Code: WM
Program Code: WM000388
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00:01 The following program presents principles
00:03 designed to promote good health 00:04 and is not intended to take the place 00:05 of personalized professional care. 00:08 The opinions and ideas expressed 00:09 are those of the speaker. 00:11 Viewers are encouraged to draw their own 00:13 conclusions about the information presented. 00:40 Satchel Paige, a hall of fame pitcher who was still 00:43 effective in the major leagues at the age of 59, 00:48 once posed this rather provocative question. 00:52 He asked how old would you be 00:54 if you didn't know how old you were. 00:59 Hello and welcome to Wonderfully Made. 01:02 My name is Don Morgan and I am an 01:05 Exercise Physiologist who teaches at 01:07 Middle Tennessee State University. 01:10 This is the 10th in a series of programs highlighting 01:14 the Importance of Physical Activity 01:16 as a means of achieving Optimal Health. 01:20 In my role as a teacher and researcher 01:23 for over 20 years, I have seen first hand 01:26 the physical benefits and blessings which come 01:30 from adopting a physically active lifestyle. 01:34 In today's program I am going to be talking about 01:38 the vital role that regular physical activity 01:41 can play in improving 01:43 the health status of older adults. 01:48 What does it mean to grow older? 01:52 When we talk about aging, we are really talking about 01:56 a series of biological changes that are impacted 02:00 by our genetics, the environment 02:02 and the lifestyle we lead. 02:05 The process of aging takes place over the course 02:09 of a lifetime, but declines in health status, 02:13 physical function and quality of life often become 02:17 more noticeable during the later stages of life. 02:22 As shown in this graphic old age 02:25 can be classified in three ways. 02:28 The young old are those with little overt 02:32 loss of function and who typically 02:35 vary in age from 65 to 75. 02:40 The middle old are the individuals who display 02:43 some physical limitations in daily activities 02:46 and often range in age from 75 to 85. 02:52 The last classification the very old encompasses 02:58 persons who are severely incapacitated 03:00 confined to institutions 03:03 and are typically 85 years or older. 03:08 While this classifications scheme can be useful, 03:12 it's important to note that it 03:15 does have some limitations. 03:17 For instance, there are people in their late 60's 03:21 that have considerable difficulty performing 03:24 basic activities of daily living. 03:28 Conversely, other adults who are in their 03:32 8th or 9th decade of life still demonstrate 03:35 good physical and mental function. 03:37 These 2 examples illustrate the important point 03:42 that Satchel Paige was trying to make that in a very 03:48 real sense ages is just a number and it doesn't 03:54 necessary reflect once health status or their 03:58 ability to function in an effective manners. 04:03 Did you know that there are over 36 million 04:05 people in the United States 04:07 who are 65 years of age and older. 04:10 It's estimated that by the year 2030 04:13 when all of the baby boomers will be at least 65 04:17 the number of older American will reach 71 million 04:22 or about 20 percent of the total population. 04:27 Interestingly the fastest growing segment 04:30 of the population is the 85 and older age group, 04:33 who by the year 2030 will number 8.5 million people. 04:41 Furthermore, a baby born today can expect to live 04:46 almost 78 years, a figure that's expected to exceed 04:51 82 years by the middle of the century. 04:56 As the percentage of older adults rises 04:59 over the coming decades, a greater emphasis 05:02 will be placed on helping seniors to age successfully. 05:07 According to the Department of Health and Human 05:09 Services about 83 percent of our lives is spent 05:13 in a healthy state, while 17 percent 05:17 is spent in an unhealthy state, 05:20 characterized by disability, disease and injury. 05:26 Recent data from the Centers for Disease Control 05:28 have shown that heart disease, high blood pressure, 05:31 cancer and diabetes are chronic health conditions 05:36 which can negatively impact the elderly. 05:40 In addition, osteoporosis or low bone mass 05:44 can lead to a greater risk of bone fracture 05:48 in persons 45 years of age and older. 05:52 Aging adults can also have more 05:54 difficulty performing everyday tasks. 05:58 Age related limitations and activities like 06:01 climbing stairs, walking, bathing, dressing 06:04 and shopping make it much more difficult 06:07 to function and to live independently. 06:11 On the other hand avoiding diabetes, 06:15 not smoking and keeping major risk factors 06:19 like cholesterol and blood pressure under control 06:23 can lead to lower death rates 06:26 and a greater life expectancy. 06:29 Well daily physical activity can help prevent 06:33 and treat many common health problems 06:35 associated with old age, more then 60 percent 06:39 of older adults are physically inactive. 06:43 Some common reasons given by the elderly for not 06:46 engaging in activity are that it doesn't feel good, 06:51 it takes too much time or it's boring. 06:56 If you have listened to some of the earlier programs 06:58 in this health series, you will remember that all 07:01 these reasons are typical barriers to starting 07:05 and maintaining an active lifestyle regardless of age. 07:10 And that we identified strategies for overcoming 07:13 this road blocks to living an active life. 07:18 When discussing the effects of physical activity 07:21 and exercise on the health status of older adults, 07:24 it's useful to examine how aging affects 07:28 various aspects of physical function. 07:32 Peak aerobic power, a measure of cardiorespiratory 07:36 fitness declines about 8 to 10 percent per decade 07:41 for both men and women after the age of 25; 07:45 this age related decline is partly attributable 07:48 to reductions in physical activity 07:52 as well as increased body fat levels. 07:55 However reductions in heart function and the ability 07:59 of skeletal muscles to process oxygen also contribute 08:04 to lower peak aerobic function in the elderly. 08:07 In one study comparing sedentary and highly 08:12 conditioned older woman whose average age was 73. 08:17 The active older woman displayed a maximal aerobic 08:20 fitness level that was 67 percent higher then their 08:24 sedentary counterparts and comparable to that 08:29 of sedentary women who were 35 years of age. 08:34 In describing the effects of physical training 08:37 in the elderly, there is a growing consensus 08:41 that older adults can improve cardiorespiratory 08:44 fitness at rate similar to that seen in younger adults. 08:50 For instance in one study of 70 to 79 year old men 08:55 and women who walked or walked and jogged 08:59 three times per week for nearly 7 months, 09:03 peak aerobic fitness rose by over 20 percent, 09:07 a rate of improvement similar to that seen 09:10 in much younger adults. 09:14 What is the relationship between aging 09:17 and various components of body composition? 09:21 With aging, body fat accumulates and fat free 09:26 mass can decrease 15 to 30 percent by the age of 80. 09:32 National surveys have reported that over 60 percent 09:36 of adults 51 and older are either obese 09:40 or over weight. For the older adult being obese 09:46 is linked to higher incidents of illness related 09:49 symptoms like fatigue, headaches and swelling 09:54 of the feet or ankles. 09:57 Older adults who are obese are also more likely 10:00 to report symptoms of depression, 10:03 as well as exhibit chronic health conditions 10:06 like heart disease, diabetes, high blood pressure, 10:10 arthritis, stroke and cancer. 10:16 One of the wonderful benefits of an active lifestyle 10:19 is that it can really help to reduce 10:22 extra body fat and excess weight. 10:26 In the study of sedentary and highly conditioned 10:29 women in their 70's that I mentioned earlier, 10:33 overall fat levels were 38 percent lower 10:36 in the highly conditioned women 10:38 compare to the older inactive females. 10:43 A program of regular physical activity can be 10:46 helpful in decreasing levels of abdominal fat, 10:50 which is being tie to insulin resistances 10:52 and the metabolic syndrome. 10:56 Older adults can also benefits from performing 10:59 muscles strengthening activities having adequate 11:03 muscles strength is vital because it enables 11:06 older adults to meet the demand of daily living. 11:11 In general muscles strength is well preserved 11:15 until about 45 years of age, at which point 11:19 muscles strength decreases by about 5 to 10 percent 11:23 each decade due to a loss in muscle 11:26 fiber number and muscle fiber size. 11:30 This condition known as Sarcopenia can lead 11:35 to muscle weakness and make it difficult for older 11:39 individuals to perform everyday tasks 11:42 such as bathing, shopping and cleaning. 11:47 A lack of muscle strength in the legs 11:49 can also increase the risk of falling. 11:53 For the older adult, the maintenances of muscles 11:57 strength is absolutely critical 11:59 to living independently. 12:02 In fact a recent study involving more then 3000 12:06 men and nearly 600 women showed that 12:10 men and women with good muscle strength 12:13 displayed fewer functional limitations 12:16 over a 5 year period compare to those 12:19 who exhibited low strength levels. 12:24 Older adults can receive many, many benefits 12:27 from engaging in resistance training. 12:30 Resistance training can increase strength by 12:33 building muscle mass, thus countering the effects 12:36 of Sarcopenia that occur with normal aging. 12:41 In addition resistance training can increase 12:45 resting metabolic rate and reduce the chance 12:49 of falling, because Skeletal Muscle is the largest 12:54 mass of insulin sensitive tissue in the body, 12:58 the increase in muscle size that results 13:00 from strength training can also improve the ability 13:04 of insulin to clear sugar from the blood, 13:08 thus lowering insulin resistance. 13:13 I want to shift gears a little now, 13:17 and talk next about the impact that physical activity 13:20 can have in promoting bone strength. 13:24 According to the 2004 Surgeon General's report 13:28 on bone health, osteoporosis or reduce bone strength 13:34 is a major public health threat to 44 million 13:38 Americans, 68 percent of whom are women. 13:42 Of this number 10 million have osteoporosis, 13:48 and about 34 million have low bone mass or osteopenia, 13:54 and though I risk for developing osteoporosis. 13:58 Each year about 1.5 million people suffer a fracture 14:03 due to bone disease and 20 percent of senior citizens 14:08 who suffer a hip fracture die within one year. 14:14 One out of every two women, and one in four men 14:19 over the age of 50 will have an osteoporosis 14:23 related fracture some time in their lives. 14:27 From a financial perspective, study show that the 14:31 annual direct care expenditure for osteoporotic 14:34 fractures ranges from 12 to 18 billion dollars. 14:40 Indirect costs like lost productivity at work 14:44 probably add billions of dollars 14:47 more to these figures. 14:51 Given the aging trend of our population 14:54 and the relative lack of attention paid in the past 14:57 to attaining good bone health. 15:00 It's estimated that the number of hip fractures 15:03 in the United States could double 15:05 or even triple by the year 2020. 15:11 What is the role of physical activity 15:14 in maximizing bone strength and minimizing 15:17 age related losses in bone mass? 15:20 To answer this question, let's consider how bones 15:25 respond to physical inactivity. 15:29 With prolong bed rest or a sedentary lifestyle; 15:33 bone mineral content can be lost due to the lack 15:38 of muscle or gravitational forces acting upon bones. 15:43 The magnitude of this loss can be 15:45 as much as one percent per week. 15:49 In healthy individuals restricted to complete 15:51 bed rest for a period of one to nine months. 15:56 Conversely accumulating daily doses 15:59 of moderate physical activity 16:02 can result in bigger and more dense bones. 16:07 The 2004 Surgeon General's report provides 16:12 a number of recommendations 16:14 for achieving stronger and healthier bones. 16:17 Accumulating at least 30 minutes of moderate 16:21 physical activity on a daily basis and performing 16:25 a variety of weight bearing, strength training 16:28 and balance enhancing activities two or more times 16:32 per week can be a quite effective 16:35 in promoting bone health. 16:38 Activities such as walking, hiking, jogging, 16:41 stair climbing, skipping and jumping, 16:44 all of these activities can provide 16:47 skeletal health benefits. 16:50 There is also good evidence showing that 16:53 the risk of hip fracture can be lowered by 20 to 40 16:56 percent by simply maintaining an active lifestyle. 17:01 As with any exercise program the approach should 17:06 be to start off with easier activities like lifting 17:09 lightweights or walking for 5 to 10 minutes 17:12 and slowly increasing duration 17:15 and intensity to avoid injury. 17:19 When discussing the use of resistance training 17:22 as a means to improve bone strength. 17:25 The implicit assumption is that everyone has access 17:28 to some type of strength or resistance equipment. 17:32 For some this may not be the case. 17:36 As I noted in an earlier program if you don't have 17:40 access to home based resistance equipment 17:43 or if you are not a member of a fitness center 17:46 and excellent alternative is to watch 17:49 Dick Nunez who hosts Body and Spirit, 17:52 a program shown daily on the 3ABN network. 17:57 He does an excellent job of presenting a wide variety 18:00 of strengthening and stretching routines 18:02 that anybody young or old can safely perform. 18:08 Next I want to talk about arthritis. 18:13 Arthritis is catch-all term for over 100 types 18:17 of diseases and conditions that effects joints, 18:20 muscles, and connective tissue. 18:24 Common types of arthritis include osteoarthritis 18:28 which often affects the feet, knees, hips and fingers. 18:32 Fibromyalgia syndrome a condition that affects 18:36 muscles, ligaments and tendons, 18:39 and is characterized by generalized muscle pain, 18:42 fatigue and difficulty sleeping. 18:45 And rheumatoid arthritis, which is an auto immune 18:50 disease that starts slowly and often affects 18:53 the small hand joints and the knee joint. 18:57 An estimated 46 million adults in the United States 19:01 have arthritis and it's projected that this disease 19:05 will affect 67 million Americans by the year 2030. 19:11 Arthritis is the number one cause of disability 19:15 in America, because it can interfere 19:17 with the performance of daily living tasks 19:20 such as dressing, climbing stairs, 19:23 getting in and out of bed, and walking. 19:29 Among the elderly, about 51 percent of adults 75 years 19:33 and over have reported an arthritic diagnosis. 19:39 A factor that can spur the development and 19:42 progression of knee osteoarthritis is obesity. 19:47 According to the Centers for Diseases Control 19:49 about 35 percent of adults 19:51 with doctor diagnosed arthritis are obese. 19:56 In addition almost 44 percent of adults 19:59 with doctor diagnosed arthritis do not report 20:02 engaging in any leisure time physical activity. 20:06 Almost 8 million adults whose activities are limited 20:10 due to arthritis also reports severe difficulty 20:14 in stooping, kneeling or bending. 20:18 In fact 6 million adults with arthritis 20:21 cannot even walk a quarter of a mile. 20:26 As you might imagine a sedentary lifestyle can place 20:30 individuals who suffer from arthritis at even 20:33 greater risk for health problems related to 20:39 physical inactivity such as heart diseases, 20:40 diabetes and obesity. 20:43 The older adult who has arthritis can receive 20:47 numerous health benefits from being physically active. 20:51 This include better joint function and 20:54 range of motion, increased muscle strength 20:58 and aerobic fitness, and elevation in mood state, 21:02 less loss of bone mass, and a reduction in the risk 21:06 of heart disease, diabetes and high blood pressure. 21:10 The physical activity program for the person with 21:13 arthritis should include a combination of exercises 21:17 that promote range of motion and stretching. 21:20 Muscle strengthening, aerobic exercise 21:23 and recreational pursuits. 21:27 This activity prescription should be individualized 21:30 to meet each persons needs, as well as balance 21:34 with rest to avoid over exertion or severe pain. 21:39 Prior to beginning a physical fitness program, 21:41 each person should have a detailed medical evaluation 21:45 to assess overall functional capacity, 21:49 severity and extent of joint involvement 21:52 and the presence of other medical conditions 21:55 which may limit the ability to exercise. 21:59 The focus of all range of motion and stretching 22:02 exercises should be to maintain 22:04 and restore joint mobility. 22:08 If joint are inflamed, gentle range of motion exercise 22:12 should be performed several times a day, 22:15 with the assistance of a trained 22:16 family member or therapist. 22:20 Once the joints are less swollen, 22:22 number of daily stretching and range of motion 22:25 exercises can be gradually increased. 22:29 Both isometric exercises in which muscles 22:33 are tightened but not move through their 22:35 range of motion and typical weight lifting 22:39 exercises that involve moving joints limited 22:42 or full range of motion can be performed. 22:46 A person currents strength levels along 22:50 with the extent of joint inflammation and pain 22:52 should be taken into account 22:54 prior to starting a muscle straightening program. 22:58 Aerobic exercise is also being demonstrated 23:01 to be a safe and effective treatment for individuals 23:05 with arthritis who are not in flare-up situations, 23:09 characterized by a worsening 23:11 or reappearance of symptoms. 23:14 Low impact activities such as swimming, 23:18 water aerobics, walking, bicycling and rowing 23:22 can improve aerobic fitness without negatively 23:26 effecting one's arthritic condition. 23:29 As with stretching and strength building regiments 23:33 the frequency, duration and an intensity of aerobic 23:35 exercise should be increased in a gradual fashion. 23:39 And each activity session should start and end 23:42 with range of motion exercises. 23:45 Finally recreational pursuits like golfing, gardening, 23:48 aquatic exercise and hiking on gentle terrain 23:52 are activities that persons 23:54 with arthritis often find enjoyable. 23:57 In one study of over 90 percent 24:00 with knee osteoarthritis 47 subjects participated 24:04 in an 8 week walking program that met 24:06 3 times a week for up to 30 minutes per session. 24:10 Following the program the exercising group showed 24:14 an 18 percent increase in distance covered 24:17 during a 6 minute walk without major pain 24:20 or the triggering of flare-up symptoms. 24:23 When results of this investigation are combined 24:26 with those of other studies, there is good evidence 24:30 to show that adults with arthritis 24:32 can become stronger, more aerobically fit 24:36 and experience reduction in symptoms 24:39 all without causing joint damage. 24:42 A point that's worth reemphasizing here is that 24:45 physical activity programs for individuals 24:47 with arthritis should incorporate a gradual 24:50 progression and frequency duration and intensity. 24:55 It's also important to refrain from performing rapid, 24:58 repetitive movements and to modify and adapt 25:01 the physical activity program as needed 25:03 to ensure joint protection and safety. 25:08 In 1998 the American College of Sports Medicine 25:11 issued a possession statement on exercise 25:14 and physical activity for older adults. 25:17 As we approach the end of this program, 25:20 I want to summarize some of the key 25:22 statements from this document. 25:24 Senior citizens who participate in regular program 25:27 of physical activity can receive many health benefits. 25:31 First declines in physical function related to 25:34 aging can be reduced and prevented. 25:37 Second aerobic fitness is improved at the same 25:41 relative rate seen in younger adults. 25:44 Third endurance training performed by older adults 25:48 helps to maintain and improve cardiovascular health, 25:52 reduce high blood pressure, lower high blood 25:56 fat levels and decrease insulin resistance. 26:00 Fourth strength training can counter the loss 26:03 in muscle mass and strength which accompanies 26:06 aging and along with regular endurance training can 26:11 improve bone health and lower the risk for osteoporosis. 26:16 Fifth postural stability is improved which can reduce 26:21 the risk for falls associated injuries 26:24 and subsequent bone fractures. 26:27 Sixth exercise and physical activity can increase 26:31 flexibility and joint range of motion. 26:35 From a psychological perspective, 26:37 exercise training can also help to preserve 26:40 cognitive function and reduce depression. 26:45 Overall for the older adult a regular program 26:50 of physical activity can contribute to a healthy 26:53 and independent lifestyle, improve the capacity 26:57 to function physically and mentally 26:59 and lead to a better quality of life. 27:03 I have seen this benefits manifested first hand 27:08 in the life of my mother who is 77 years old. 27:13 Now retired she spends a major portion of each day 27:17 gardening and working in the yard of a one acre 27:21 homestead on the North Shore of Oahu in Hawaii. 27:25 She has told me on numerous occasions 27:28 that she believes her gardening and outdoor 27:31 pursuits are keeping her fit, healthy and alive. 27:35 In a recent phone conservation, she asked 27:38 whether she needed to supplement her 27:40 yard work with the treadmill workout. 27:43 After she recounted to me how active she was 27:45 in the yard every day I simply told her to keep up 27:48 with what she was doing 27:49 and not worry about treadmill walking. 27:52 My mother has found a way to stay active 27:54 that not only is keeping her body healthy 27:56 but it's also nourishing her inner spirit. 28:00 I only hope that I can follow my mother's 28:03 example when I am in my mid 70's. 28:07 Until next time then keep moving step by step 28:10 towards better health and fitness. |
Revised 2014-12-17