Exercise – Women’s Health Adviser
Michele G. Sullivan
Exercise can never be too little or too late. Older women, especially those with sedentary lifestyles, may be surprised to hear that, but the facts are indisputable: Regardless of a woman’s age or health status, exercise reaps a host of physical, mental, and psychosocial benefits.
In fact, a recent follow-up study of physical activity in older women concluded that a long-term moderate exercise program decreased all-cause mortality by 48% and lowered the risk of cardiovascular disease by 36% and cancer by 52%, compared with the risks for sedentary older women (JAMA 289:2379-86, 2003).
The findings were similar for women with and without chronic disease; even women over age 75 benefited from the exercise program, though to a lesser extent.
Here are some things to tell postmenopausal women about exercise:
* Lay out the benefits. Most patients have heard time and again that exercise is good for their health. But it may help to emphasize the ultimate benefit of maintaining independence.
Cardiovascular training strengthens heart and lungs, decreasing the risk of diseases that hasten disability. Balance exercises markedly reduce the falls that can lead to debilitating injuries and nursing home placement. Weight training strengthens hones as well as muscles, making women less vulnerable to fall injuries if they do happen. Stretching preserves flexibility, which can help women maintain their activities of daily living, and therefore care for themselves, as they age. And exercising with friends creates a strong social network that can provide valuable support through good times and bad.
Exercise is particularly important For older women functioning as caregivers for ill family members, since it reduces stress, improves sleep, and reduces the rate of depression in this group.
* Dispel the myths. A moderate exercise program doesn’t require an expensive gym membership, hopping around in spandex, or pumping iron five times a week–these stereo types are some major reasons that older women avoid exercise.
* Recommend a sensible, proven program. The National Institute on Aging recommends at least 30 minutes of exercise most days of the week, including stretching, cardiovascular, balance, and strength training. The program, available in a free book and low-cost video, is evidence-based and tailored to older adults in varying states of fitness and health. These exercises don’t require any special equipment, clothing, or facilities. Instead, commitment and consistency are the keys to success. While the exercises can be performed easily at home, the solidarity of an exercise buddy, or a group of them, greatly improves results. Peer support is key to sticking with an exercise program; local recreation or senior centers offer a low-cost way to form these important bonds.
Cardiovascular exercises (walking rapidly or moderate jogging) should be performed 30 minutes per day 5 days a week to build stamina for activities of daily living. The patient should feel an increase in heart rate and break into a sweat.
Rather than trying to identify target pulse rate, the patient can judge exertional level by her ability to talk. She should be able to speak briefly with an exercise buddy, but not hold a prolonged conversation.
Weight-training exercises should be performed two or three times a week to increase strength and build muscle mass, which may help boost metabolic rate. All major muscle groups should be engaged.
In a fitness center, machine or free weights are used. At home, weights can be as simple as soup cans or jugs filled with water. Many exercises, like calf raises and triceps dips. don’t require any equipment.
Stretching three times a week keeps muscles limber and prevents loss of range of motion.
Balance exercises (standing on one foot, walking heel-to toe, sitting and rising without the use of hands) can and should be performed anywhere, at any time, and are most effective when performed frequently. They can become a regular part of your patient’s routine when she’s standing in line at the grocery store, bank, or bus stop.
* Consider medical history. Generally, there are fewer health risks associated with exercising than with not exercising. But some patients–including those with unexplained chest pain, cardiac arrhythmias, a history of thrombosis, aneurism, hypertension, detached retina, recent cataract surgery, or hernia–need more monitoring and a more gradual induction into exercise. These patients should work with an exercise science professional, who can help create a program lot higher risk patients and monitor their progress.
(For referral information, visit the Web site of the American College of Sports Medicine, www.acsm.org.)
“Exercise: A Guide From the National Institute on Aging” contains evidence based exercise recommendations for older patients. To order the free guide, call 1-800-222-2225, or visit www.nia.nih.gov. The accompanying videotape demonstrating the program costs $7. The guide is also available in Spanish.
Sources: Dr. Judith A. Salerno, deputy director, National Institute on Aging; and JoAnn EickhoffShemek, Ph.D., professor and coordinator, Wellness Leadership, School of Physical Education, Wellness, and Sport Studies, University off South Florida, Tampa.
COPYRIGHT 2003 International Medical News Group
COPYRIGHT 2003 Gale Group