Choosing to Stay Strong as You Age

From the Summer 2010 issue of Quality Care®, NAFC's newsletter

By Kay Van Norman

Ms. Van Norman has disclosed that she is the owner of Brilliant Aging.

If you're struggling to maintain a healthy weight, tire easily from physical activity, or have trouble climbing stairs, maintaining balance, or lifting your grandchild--I have good news! These things used to be considered an unavoidable result of aging, but the Center for Disease Control and Prevention now lists lifestyle, not age, as the biggest risk factor for premature disability. That may not seem like good news if you don't like the word - exercise - but knowing you can make choices to be healthy and independent is always a gift.

This article focuses on one of the best things you can do for yourself to prevent physical decline and maintain a healthy weight - strength training. Strength training is the use of resistance to build muscular strength, endurance, and size. It makes daily activities easier, improves balance, and increases muscle mass while reducing body fat. It can also help prevent and control many chronic diseases, reduce depression, and improve sleep quality. Strength training works at any age, even if it's been a long time since you challenged your muscles.

The Research
In 1994 Maria Fiatarone, of Tufts University published a strength training study that was really important for older adults. Most previous research used only "young-old" subjects without chronic conditions. Dr. Fiatarone studied 100 frail nursing home residents age 75-98 who had multiple chronic conditions such as osteoporosis, arthritis, heart disease, and cancer. Subjects strength trained for 10 weeks, and as their strength increased the amount of weight they lifted also increased. The results were remarkable. These frail adults increased muscle strength by an average of 113 percent. They also increased walking speed, stair climbing power, and levels of general physical activity. The improvements in strength helped them perform functional tasks, like rising from a chair or walking, more easily. This study suggests that the frail elderly can have favorable outcomes from an exercise regimen.

The Link Between Strength and Function
To understand how strength impacts function, let's look at how leg strength affects the ability to rise from a chair. Figure 1 shows a cross section of two different thighs. The small circle in the center is bone, the light colored tissue surrounding the bone is muscle, and the dark tissue on the outside is fat. The faint white outline is the skin. Although both thighs are about the same size around, the top one has a large amount of muscle (light tissue), and the bottom has less muscle and more fat (dark tissue). Now let's make it personal and say you have the muscle mass shown on top and weigh 150 pounds. To rise from the chair you'll probably use only about 50 percent of your muscle (strength). On the other hand, if you have less muscle (as shown on bottom) you'll need to sue virtually all of it to rise from the chair.

Figure 1 - Thigh cross section

This poses two problems. First, as body weight increases and/or muscle mass decreases it becomes harder and harder to get up. You'll start needing your arms to help rise from the chair and eventually (if nothing is done to prevent further decline) even 100 percent of leg and arm strength isn't going to get you out of that chair. Second, the more effort it takes to perform simple functional tasks, the more easily you become fatigued and the less you'll be interested in physical activity.

When I recommend exercise for de-conditioned adults I try to imagine how excited I would be (not very) about doing something that requires 80-100 percent of my strength every time I did it. So I understand why being more physically active may seem impossible. That's the fork in the road - where you have to decide whether to pull back more and continue losing strength, balance, and mobility; or draw a line in the sand and decide to regain strength.

To download a free strength training brochure from my website at www.kayvannorman.com, go to the seminars link, then use the coupon code, Strength. Ask your physician for a referral to a physical therapist if you're concerned about being injured or have movement restrictions. Most of all take stock on the evidence about strength training and make a choice to stay strong. The National Institute on Health as more strength exercises to try.

If you're not ready or able to lift weights here are some exercises that may help you with basic functional tasks.

Ankle Flexions: Aides walking and maintains ankle strength

While seated, pull toes off the floor by flexing the ankles - keep heels on the floor. Hold this position for four counts then repeat 10-12 times.

Achilles Stretch: Aides walking and maintains leg flexibility

With the hands resting lightly on a chair back, and in a gentle lunge position (as shown), press the right heel toward the floor while keeping the hips facing square to the front and the right leg straight. Hold this stretch for 20-30 seconds (you'll feel it in the right lower leg). Repeat the exercise on the opposite side.

Elevator: Aides rising and walking and maintains leg strength

Start seated with the feet a comfortable distance apart and arms relaxed by the legs. Stand up slowly by imagining you are an elevator rising three floors, stopping briefly (by holding you position for three counts at each "floor"). Don't hold your breath! Return to a seated position making the same "stops" at each "floor." Use caution if you have balance issues.

About the author:

Kay Van Norman is an internationally known speaker, writer, and consultant in the field of older adult wellness. She authored the book Exercise Programming for Older Adults (1995) and its revision Exercise and Wellness for Older Adults (2010), as well as dozens of journal articles on healthy aging. Kay directed the Keiser Institute on Aging, won a Best Practices award from the National Council on Aging for wellness resources, and is a board member of the International Council on Active Aging. She can be reached at www.kayvannorman.com.