By the year 2030, the number of Americans 65 years and over will reach 70 million and persons 85 years and older will be the fastest growing segment of the population. As more individuals live longer, it is imperative to determine the extent and mechanisms by which exercise and physical activity can improve health, functional capacity, quality of life, and independence in this population

THE IMPORTANCE OF PHYSICAL ACTIVITY:

Lack of physical activity is a health issue in all segments of the American population. What many may not realize is that exercise may hold a special healing power for aging Americans. Physical activity, with a special emphasis on strength training, plays a critical role in disease prevention and is now recognized by researchers all over the world for its life enhancing benefits. Perhaps the most effective way of stating the importance of strength training for older Americans is through current statistics in this area.

Recent data related to the leisure-time physical activity of Americans shows that only 20% of all adults engage in regular, sustained physical activity (at least 5 times/week, at least 30 minutes per session); and only about 14% engage in vigorous physical activity that is regular and sustained (at least 3 times/week, a minimum of 20 minutes per session)

Research has also shown the positive benefits obtained through strength training. In the United States, lack of physical activity and poor diet, are the second largest factors in the cause of preventable death--smoking is #1. Participation in a regular exercise program is an effective way to reduce/prevent a number of functional declines associated with aging and is vital to the health of all Americans.

STRENGTH TRAINING BENEFITS TO THE ELDERLY:

Gains obtained from strength training are recognized when simple everyday activities such as walking, reaching, bathing and cooking become easier to perform The first results of a strength-training program can be seen in the physiological benefits within the muscle; performance improvements follow. The connecting tissue between nerves and muscles, usually decreased in number with age, can be preserved, while also aiding muscle fiber connections maintain strength and endurance. Loss of muscle mass, called sarcopenia, also contributes to loss of strength, and can be prevented with a regular program of strength training. To a lesser extent, bone loss, also characteristic of advancing age can be prevented by weight-bearing exercise, which increases bone mineral content While the gains of strength training are clear the specifics of strength training programs can often times be elusive and complicated. The following is a summary of recent findings discussing the concept of single and multiple set programs.

Research indicates that for the first 3 to 4 months of strength training, single-set programs are just as effective as multiple-set programs for improving muscle strength in previously inactive individuals. The amount of time required to complete a single-set program is substantially less than one-half the time required to complete multiple-set protocols. Messier and Dill (5) reported that the time required to complete a three-set free weight strength training program averaged 50 minutes compared with 20 minutes for a one-set variable strength program. Since lack of time is one of the most common excuses used for the physically inactive, a one-set program should provide the trainee with ample time to exercise. Considering the similarities in strength gains for single- and multiple-set programs, single-set programs are recommended by current guidelines because they are less time-consuming, more cost-efficient, help ensure program compliance, (4,6) and produce similar health and fitness benefits.

Thanks to its positive benefits on maintenance of strength, muscle mass, bone mineral density, functional capacity, and prevention and/or rehabilitation of musculoskeletal problems (low back pain), strength training is now highly recommended by most health promotion organizations. In the elderly, resistance training is both safe and beneficial in improving flexibility and quality of life (7). The possibilities for a greater quality of life have been researched and proven in the area of strength training, which leads to the final question…what do aging Americans have to lose by not choosing strength training?

Much of the disability, functional decline, and loss of independence in the elderly results from diminished muscle strength as well as low aerobic fitness. In the average person, muscle strength peaks between the ages of 20 to 30 and then gradually decreases. Without strength training, most people experience a 30% loss in overall strength by age 70. Why do you lose strength with age? The prime reason is the reduction in lean muscle mass, which may be the result of inactivity, aging, or, a combination of both

Another major area that plagues the elderly is the risk of injury. Injuries due to falls are a leading cause of morbidity and mortality in the elderly population (8). Approximately 40% of persons over age 65 fall at least once a year, and persons 85 years and older may be more likely to die from falls and hip fractures than from heart disease.

By increasing muscular strength, the number of falls would dramatically decrease, or in some cases could be prevented all together.

The good news is that over the last decade strength training has become quite popular among older adults. The increased popularity can be partially attributed to a growing body of research, which continues to provide positive support and encourages older populations to incorporate resistance exercise into their daily lives. Since the fastest growing segment of the US population consists of those over 65 years of age, exercise professionals are reaching out to senior members of society and educating them on the positive benefits of strength training programs, which may greatly improve bodily function and quality of life (2).

HOW MUCH, HOW OFTEN

Perform strength exercises for all of your major muscle groups at least twice a week. In order to make sure your muscles fully recover from the stress of strength training, do not exercise more than 2 days in a row. Alternate lower-body and upper-body routines using a weight you can comfortably handle the first week, and then gradually increase the weight. Starting out with weights that are too heavy may cause injuries. At the same time, remember that you have to gradually add a challenging amount of weight in order to benefit from strength exercises. If you don't challenge your muscles, you won't benefit from strength exercises.

When doing a strength exercise, do 8 to 15 repetitions in a row, wait a minute, and then do another set of 8 to 15 repetitions of the same exercise. Kathy Watson, an AFAA certified physical fitness trainer, aerobics instructor, and health and fitness columnist recommends that you stretch the muscle you just worked during rest periods, or do a different strength exercise that uses a different set of muscles. Watson also recommends, "take 3 seconds to lift or push a weight into place; hold the position for 1 second, and take another 3 seconds to lower the weight. Don't let the weight drop; lowering it slowly is very important."

Start with a low amount of weight (or no weight) and increase it gradually. When you are ready to progress, first increase the number of times you do the exercise, and then increase the weight at a later session. Even very small changes in muscle size can make a big difference in strength, especially in people who already have lost a lot of muscle. An increase in muscle that's not even visible to the eye can be all it takes to improve your ability to do things like get up from a chair or climb stairs (9).

It appears that seniors respond to strength training extremely well but that the response may be delayed, compared to younger people. As a result, seniors should not be discouraged if they fail to see improvements during the first four weeks of their training programs.The gains in strength and endurance will come (usually by the eighth week), and they will be on par with improvements obtained by younger individuals (10).

STRENGTH TRAINING RISKS:

Research has shown that the risk and injury associated with strength training and the elderly population is minimal when proper techniques are utilized. At one time it was believed that strength training may increase blood pressure but these reports have been linked to improper technique, not breathing correctly, or holding a contraction too long.

Contrary to traditional thinking, regular exercise helps, not hurts, the elderly. Senior citizens become sick or disabled more often from not exercising than from exercising. Those who have chronic diseases, or risk factors for them, may actually improve with regular exercise, but should check with their physician before increasing their physical activity.

There are few reasons to keep older adults from increasing their physical activity, and "too old" and "too frail" aren't among them. People with conditions called "abdominal aortic aneurysm" or "critical aortic stenosis" should not exercise unless they receive permission from their physician. Almost all older adults, regardless of age or condition, can safely improve their health and independence through strength training and other forms of physical activity.

HOW TO GET STARTED:

• Libraries, bookstores and sporting goods stores are great places to pick up books and videos targeted towards seniors on correct exercise techniques.

SAFETY TIPS

The following tips, provided by the National Institute on Aging (NIA) will help ensure your exercise experience is both enjoyable and safe:

• Start slowly. Build up your activities and your level of effort gradually. Doing too much, too soon, can hurt you, especially if you have been inactive.

• Avoid holding your breath while straining -- when using your muscles, for example. If you have high blood pressure, pay special attention to this tip. It may seem strange at first, but the rule is to exhale during muscle exertion; inhale during relaxation. For example, if you are lifting something breathe out on the lift; breathe in on the release.

• If you are on any medicines or have any conditions that change your natural heart rate, don't use your pulse rate as a way of judging how hard you should exercise. "Beta blockers," a type of blood pressure drug, are an example of this kind of medicine.

• Unless your doctor has asked you to limit fluids, be sure to drink plenty when you are doing endurance activities that make you sweat. Many older people tend to be low on fluid much of the time, even when not exercising.

• When you bend forward, bend from the hips, not the waist. If you keep your back straight, you're probably bending correctly. If you let your back "hump" anyplace, you're probably bending from the waist, which is the wrong way.

• Make sure your muscles are warmed up before you stretch, or you could hurt them. For example, you can do a little easy biking, or walking and light arm pumping first.

• None of the exercises should hurt or make you feel really tired. You might feel some soreness, a slight discomfort, or a bit weary, but you should not feel pain…in fact, in many ways, physical activity and exercise will probably make you feel better.
• If you have had a hip repair or replacement, check with the doctor who did your surgery before doing lower-body exercises.

• If you have had a hip replacement, don't cross your legs, and don't bend your hips farther than a 90-degree angle.

• Muscle soreness lasting up to a few days and slight fatigue are normal after muscle-building exercises, but exhaustion, sore joints, and unpleasant muscle pulling aren't. The latter symptoms mean you are overdoing it.

• Reduces the risk of dying prematurely.
• Reduces the risk of dying from heart disease.
• Reduces the risk of developing diabetes.
• Reduces the risk of developing high blood pressure.
• Helps reduce blood pressure in people who already have high blood pressure.
• Reduces the risk of developing colon cancer.
• Reduces feelings of depression and anxiety.
• Helps control weight.
• Helps build and maintain healthy bones, muscles, and joints.
• Helps older adults become stronger and better able to move about without falling.
• Promotes psychological well-being.

According to a study conducted by American Sports Data Inc., the number of Americans aged 55 and older who joined health clubs grew 145 percent between 1988 and 1995. What this indicates is that older adults realize the importance of exercise and how it enables them to live, work, and function more effectively in their everyday lives.

Without question, steady visits to the fountain of youth, called the gym, helps maintain an independent lifestyle and slows down the aging process. Why not share this great experience with a family member, coworker, or buddy who is also enthusiastic about exercise. Like a fine wine, Jackson gets better with age and his commitment to a lifestyle of physical activity is a great example of the positive benefits one can obtain.

For more information about physical activity and aging, contact:
American Geriatrics Society (AGS)
770 Lexington Ave., Suite 300, NYC, NY 10021
Call 800-247-4779 or visit the AGS website at: www.americangeriatrics.org

National Institute on Aging (NIA)

800-222-2225 or visit the NIA website at: www.nih.gov/nia

The President's Council on Physical Fitness and Sports
DHHS/OS/OPHS
200 Independence Ave., SW
HHH Building
Washington, DC 20201
Phone: 202-690-9000
Internet: http://www.os.dhhs.gov

Rob Wilkins, originally from Linden, New Jersey, is a Technical Sergeant in the US Air Force stationed at AFTAC, Patrick Air Force Base, Cocoa Beach, Florida. Wilkins is also a Special Assistant to the International Federation of Bodybuilders (IFBB) and a recipient of the IFBB Gold Medal (Oct ’00). To contact Wilkins e-mail him at waaszup@yahoo.com.

9. www.nih.gov/nia/health/pubs/nasa-exercise/chapter4_end.htm

10. Canadian Journal of Applied Physiology, Time Course of Strength Gain during Resistance Training in the Elderly, vol. 18(4), p. 441P, 1993