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Fit for Duty. . . Fit for Life!
“Fit for Duty…Fit for Life!” is a lifestyle-based column provided by USPHS Dietitians
Title: Physical Activity Guidelines for Americans, Chapter 5: Active Older Adults
Submitted by: Therapist Professional Advisory Committee Healthy Lifestyles Subcommittee’s
CAPT Scott Gaustad, USPHS

Chapter 3 was the beginning of a three chapter series highlighting the benefits of physical activity across the lifespan of Americans. Chapter 3 described physical activity guidelines for children and adolescents, Chapter 4 addressed adult physical activity guidelines, and Chapter 5 concludes the series with physical guidelines for adults 65 years and older.

Chapter 5 is titled Active Older Adults. This chapter provides guidance about physical activity for adults age 65 and older. According to the Administration on Aging (2007 data), one in every 8 Americans are 65 years or older. Physical activity is especially important for this population of adults because they are found to be the least active of any age group. Chapter 5’s central themes are that older adults should be as physically active as their abilities and conditions allow, perform exercises that maintain or improve balance if they are at risk of falling, determine their level of effort for physical activity relative to their level of fitness, and adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.

Older adults are a complex group. Many adults over the age of 65 have medical conditions which may significantly impair their ability to maintain or increase their physical fitness. Chapter 5 recommends types and amount of physical activity appropriate for the older adults’ abilities and health conditions. It focuses on two types of activity: aerobic and muscle strengthening, but also includes a section on balance. Chapter 5 also mentioned that physical activity guidelines for older adults are also recommended for adults younger than age 65 who have chronic conditions or a low level of physical fitness.

The Guidelines recommend the same aerobic activities for adults age 65 and older without limiting chronic conditioning as they do for active adults (Chapter 4). Moderate-intensity activity requires a medium level effort. On a scale of 0 to 10, where sitting is 0 and greatest effort possible is 10, moderate-intensity activity is a 5 or 6 and produces noticeable increases in breathing and heart rate. Vigorous-intensity activity is a 7 or 8 on this scale and produces large increases in an individual’s breathing and heart rate. For optimal health benefits, individuals who fall in this category should do at least 150 minutes ( 2 hours 30 minutes) a week of moderate-intensity or 75 minutes a week of vigorous- intensity aerobic activity. For more extensive health benefits, older and younger adults should increase their aerobic physical activity to 300 minutes a week of moderate-intensity, or 150 minutes a week of vigorous-intensity. Older adults should also perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week.

Aerobic activity specific to older adults or younger adults whose health and/or function is compromised should perform physical activities as their abilities and conditions allow. Older adults with chronic conditions should understand and appreciate how their conditions affect their ability to do regular physical activity safely. Impaired older adults, who are able to, should aim to do at least 150 minutes of moderate-intensity physical activity a week or 75 minutes of vigorous-intensity activity. Similar to all age categories, older adults should appreciate that greater amounts of physical activity will provide additional and more extensive health benefits. The Guidelines encourage a variety of activities and recommend that aerobic activity should be spread throughout the week. This approach can make activity more enjoyable and may reduce the risk of overuse injury. In fact, research studies consistently show that aerobic activities should be performed at least 3 days a week. Aerobic activities should last at least 10 minutes and be performed at moderate or vigorous-intensities. Examples of aerobic activities for older adults include walking, dancing, swimming, water aerobics, golf (without a cart), tennis, bicycle riding, and aerobic exercise classes.

Muscle-strengthening activities are just as important for the older adult population as for the younger adults. Muscle-strengthening activities are recommended at least 2 days a week and should involve all major muscle groups. These muscle groups include the legs, hips, chest, back, abdomen, shoulders, and arms. No specific amount of time is recommended for muscle-strengthening. Muscle-strengthening exercises should be performed to the point at which it would be difficult to perform another repetition without help. If resistance training is part of a muscle-strengthening program, one set of 8-12 repetitions is effective, although two or three sets may be more effective. Examples of muscle-strengthening activities include exercise bands, weight machines, hand-held weights, calisthenic exercises, digging in a garden, lifting, carrying groceries, some yoga and Tai chi exercises.

Older adults are at greater risk of injury from falls. The Physical Activity Guidelines sites strong evidence that regular physical activity is safe and reduces the risk of falls. Reduction in falls is seen for participants in programs that include balance and moderate-intensity muscle-strengthening for 90 minutes a week plus moderate-intensity walking for approximately 60 minutes a week. The Guidelines recommend that older adults who are at risk for falls should perform balance training 3 or more days a week and do exercises from a program demonstrated to reduce falls. Examples of exercises demonstrated to reduce falls include backward walking, sideways walking, heel walking, toe walking, and standing from a seated position.

The Physical Activity Guidelines recommend that older adults who are sedentary should increase their amount of physical activity gradually. To reduce injury risk, inactive or insufficiently active adults should avoid vigorous-intensity aerobic activity at first. Rather, inactive older adults should gradually increase the number of days a week and duration of moderate-intensity aerobic activity. Inactive older adults who don’t yet meet the Guidelines should aim for at least 150 minutes a week or relatively moderate-intensity physical activity. Getting at least 30 minutes 5 days a week is a recommended way to begin to meet the Guidelines.

The Guidelines recommend that adults with chronic health conditions should talk with their health-care provider to determine whether their condition(s) limit their ability to perform regular physical activity in any way. Such dialogue may also help people learn about appropriate types and amounts of physical activity.

The chapter concludes with informative special considerations. So, for additional information on what is known from research studies about the specific health benefits of physical activity for older adults and how much physical activity is needed to get the health benefits, please visit the Web site http://www.health.gov/paguidelines/guidelines/chapter5.aspx . REMEMBER ---- GET OUT AND GET ACTIVE!

Note: The series “Fit for Duty. . .Fit for Life!” is a lifestyle-based column that has been provided by the USPHS Dietitian/Nutritionist Professional Advisory Committee (D/N-PAC). Look for “Fit-for-Duty. . .Fit for Life!” articles throughout 2010 addressing various issues related to weight management including diet and exercise tips.

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