How Exercise Related to Aging

January 5, 2008

It is well known that the population of the United States is rapidly aging. As greater numbers get older, there is an increase in the number of people who develop dementia. By far the most common dementia is Alzheimer’s disease and there are also the less frequently occurring dementias, such as those associated with small strokes resulting from arteriosclerosis (so-called hardening of the arteries). The treatment of dementia becomes one that must be approached from many perspectives. The patient, the patient’s family, the family doctor, other medical specialists, social workers, home health providers, and physiotherapists must work together to improve the general outlook for the patient. The goals of treatment include maintaining the physical health of the patient by treating other diseases that may worsen the dementia, alleviating dementia symptoms whenever possible, and providing a social and physical environment that will allow the highest possible level of functioning.

Although there are few specific studies of exercise programs for individuals with dementia, a number of studies have been conducted that show that a routine exercise program benefits people of all ages, particularly older individuals. Although it is optimal to start an exercise program in the younger years and to continue throughout adulthood, it is never too late to begin exercising.

A sedentary lifestyle presents a definite risk for heart and blood vessel disease. There are many areas of normal aging that are really not aging at all but due to inactivity. It has been proven that forced inactivity (illness or incapacity) has many of the same characteristics of so-called normal aging. These include increased loss of bone calcium, decrease in oxygen use, decrease in the output (the amount of blood pumped per beat) of the heart, decrease in red blood cells (anemia), and a decrease in glucose tolerance (tendency to diabetes mellitus). Decreased activity is also associated with increased blood pressure, increased body fat, and elevated cholesterol levels.

It is important to note that health benefits can be shown at relatively low levels of activity. The greatest improvement demonstrated is between the least active individuals and those who are moderately active in other words, from no activity to some activity, however minor. Much less beneficial effect is apparent between the moderately active and the very active. To reach true fitness for the heart and blood vessels, the aging patient should have fifteen to twenty consecutive minutes of exercise at least three times per week. The exercise should be of an intensity that increases the heart rate to 75 percent of its maximum rate. The maximum heart rate can be calculated roughly by subtracting one’s age from 220. The goal is to reach 75 percent of this figure (or 220 - age x .75). There should always be a careful physical evaluation of any individual past the age of forty who undertakes an exercise program. This evaluation is more important as one grows older and even more important for the demented elderly. However, since this level of exercise will be difficult or impossible to attain in the patient with Alzheimer’s disease or multi-infarct dementia, a careful physical examination without a stress test would be acceptable if the patient is unable to take such a test.

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