Facts of Life

Facts of Life:
Issue Briefings for Health Reporters
Vol. 11, No. 5
May 2006

Aging Well: Why Exercise Is Essential

The Issue

A Little Encouragement

The Facts

Cross-Cultural Lessons in Elder Exercise

Expert Sources

References

The Issue:

We all hope to spend a prosperous old age of retirement and relaxation in good health. But this doesn’t -- and shouldn’t -- mean putting our feet up for good. Exercise is important at any age, but encouraging and assisting older Americans in their quest to become or remain active involves special challenges.

Barriers to Movement

“We’ve learned that so many things can interrupt physical activity at this age range,” says Brian Martinson, Ph.D., a researcher at the HealthPartners Research Foundation who studies aging and health. “We started out thinking that it would be medical events and health declines, but what we’ve seen just as much of is social life, family life and work life interrupting and causing [older people] problems with being physically active.”

Despite the distractions, people who are sedentary in late middle age may be poised to become more active, according to Martinson. “If you can get people to be active at this time, empty nesters with a little more time to focus on taking care of themselves, the habits they establish in their 50s and 60s can carry them into their 80s or 90s,” he says.

A Little Encouragement

Research shows that encouragement -- in the form of counseling, expanded exercise programs and even health-plan financial incentives -- can play a powerful part in improving the health of older adults. “There’s an appetite out there for just a little bit of assistance for activity,” Martinson says.

The Facts:

• Fewer than 40 percent of men and 30 percent of women age 65 and older met the government-recommended levels of weekly physical activity in 2000.¹

• Low-income older adults are less likely than their peers to engage in physical activity, with 40 percent reporting no activity within the past month. ²

• Walking was the most common physical activity reported in a 2000 survey of older Americans, followed by gardening, bicycling, home exercises and golf. ¹

• A Swedish study of 3,206 individuals age 65 and older found that by the end of the 12-year study, those who exercised at least once a week reduced their risk of death by 40 percent.³

• Exercising three times a week or more on a regular basis could delay the onset of dementia and Alzheimer’s disease, according to a 2006 analysis of adults over age 65. ⁵

• Americans age 55 and older say “lack of motivation” is the main barrier keeping them from becoming more physically active, according to a 2005 survey. ⁷

• In a recent study of 345 married couples age 70 to 79, men who were highly physically active were three times more likely than men with low activity levels to have a highly physically active spouse. ⁸

• In a 2003 study, phone calls and mailed reminders helped older women add an extra 37 minutes of exercise to their weekly routines. Women who participated in the study but did not receive reminders increased their weekly exercise by only 12 minutes. ⁹

• A recent survey by the Centers for Disease Control and Prevention found that existing physical activity programs for older adults only meet half the demand for such programs, with significant gaps in strength training programs and programs in minority communities.¹⁰

Cross-Cultural Lessons in Elder Exercise

According to a 2003 national survey, one-third of Americans 65 and older and a majority of those over age 75 had not done any exercise during their leisure time in the past month.¹¹ The statistics make it sound like a sedentary existence is simply the lot of old age, but how do elderly citizens of the rest of the world compare to Americans when it comes to physical activity?

It’s difficult to say, mostly because few other countries measure physical activity the way Americans do, according to Wojtek Chodzko-Zajko, Ph.D., head of the department of kinesiology and community health at University of Illinois at Urbana-Champaign. “There are very few cross-cultural studies, because there is no sense yet of the relevant variables to be measured,” Chodzko-Zajko says.

Chodzko-Zajko says that the American standards for physical activity are driven by the Centers for Disease Control and Prevention criteria of minutes of exercise per week at a particular maximum heart rate, concepts that are not formally tracked or even sometimes culturally shared in other countries.

“We have only approximate numbers for other countries compared to the CDC numbers,” Chodzko-Zajko says.

This is not to say that other countries are less worried about the fitness of their older citizens, he adds. “There are probably no cultures in the world in which people are not concerned about inactivity and obesity levels and their society becoming more sedentary.”

And despite the formal monitoring by the CDC, “it’s probably true to say that the United States is one of the most sedentary of developed nations,” Chodzko-Zajko says.

For instance, most researchers think that older people in Asian countries are more physically active that their U.S. counterparts, Chodzko-Zajko says. “Older adults are even more active than middle-aged individuals in Asia, which may be a reflection of the cultural expectations that once people have more time available and are not working as many hours, they have greater time for activity.”

In Asian countries in particular, but also in other parts of the world, “exercise” includes a much larger set of activities, from morning tai chi in the park to walking to everyday destinations such as grocery stores and friends’ homes, Chodzko-Zajko says. In the United States, “the challenge is to escape from the lifestyle factors that encourage older Americans to be more dependent,” such as the reliance on cars to get everywhere.

Chodzko-Zajko says one lesson all Americans could learn from other countries is “the idea that it’s important to build physical activity into everyday lifestyle choices” and provide more places for activity such as parks and walking paths.

“In many Western cultures, people have begun to think of physical activity as something to do with special clothes in a special place,” Chodzko-Zajko says.

However, Chodzko-Zajko says he’s “beginning to see a loosening of the definition of physical activity in the United States,” as more doctors advise their elderly patients to get their exercise by walking the dog or gardening. At the same time, he says, “in Asia, we’re seeing a little more of the rigor” that defines American fitness, including an increase in health clubs in Japan and China.

“So maybe we’re meeting in the middle,” Chodzko-Zajko says.

Expert Sources:

References

1. Centers for Disease Control and Prevention and Merck Institute of Aging and Health (2004) The State of Aging and Health in America 2004. Last accessed online 3-xx-xx at http://www.cdc.gov/aging/pdf/State_of_Aging_and_Health_in_America_2004.pdf.
   
   
2. N. Cole and M.K. Fox. Nutrition and Health Characteristics of Low-Income Populations, Volume IV, Older Adults. United States Department of Agriculture Economic Research Service, Food Assistance and Nutrition Research Program. December 2004.
   
   
3. K. Sundquist et al. (2004) Frequent and occasional physical activity in the elderly: a 12-year follow-up study of mortality. American Journal of Preventive Medicine, 27, 22-27.



4. J.T.Chang et al. (2004) Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomized clinical trials. British Medical Journal, 328, 680-687.
   
   
5. . E.B. Larson et al. (2006) Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine, 144, 73-81.
   
   
6. B.C. Martinson et al. (2003) Changes in physical activity and short-term changes in health care charges: a prospective cohort study of older adults. Preventive Medicine, 37, 319-326.
   
   
7. American Public Health Association. New survey finds older adults know how to be healthy, but barriers prevent action. April 4, 2005. Last accessed 04-18-06 at www.apha.org/nphw/survey_release_4405.htm.
   
   
8. K.K. Pettee et al. (2006) Influence of marital status on physical activity levels among older adults. Medicine and Science in Sports and Exercise, 38, 541-546.
   
   
9. V.S. Conn et al. (2003) Randomized trial of 2 interventions to increase older women's exercise. American Journal of Health Behavior, 27, 380-388.
   
   
10. K. Krisberg (2005) Nutrition, exercise essential components for healthy aging: Living longer, stronger in later years. The Nation’s Health, 35, 10-12.
    
    
11. C.A. Schoenborn et al. (2006) Health characteristics of adults 55 years of age and over: United States, 2000–2003. CDC Advance Data, No. 370. Last accessed online 04-18-06 at http://www.cdc.gov/nchs/data/ad/ad370.pdf.

The Center for the Advancement of Health identifies and disseminates state-of-the-science evidence about the influence of behavioral, social and economic factors on disease and well-being. Its purpose is to support health decision-making by the public and strengthen relationships among researchers and policymakers. The Center receives funding from a number of foundations, principally The Annenberg Foundation, the John D. and Catherine T. MacArthur Foundation and the W.K. Kellogg Foundation.

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