Dr. Tannenbaum’s Corner: The Benefit of Exercise for the Elderly

Regular exercise, including walking, significantly reduces the chance that a frail, older person will become physically disabled. Clinical studies have reinforced the necessity of frequent physical activity for our aging parents, grandparents, and, of course, ourselves.

Countless epidemiological studies have found a strong correlation between physical activity in advanced age and a longer, healthier life. Small-scale, randomized experiments have persuasively established a causal link between exercise and healthy aging. The scope of these experiments has generally been narrow, showing that older people can improve their muscle strength with weight training or their endurance capacity with walking.

Recently, a large-scale study was performed by scientists at eight universities and research centers around the country using an unusual set of selection criteria. Unlike many exercise studies, which tend to be filled with people in relatively robust health who can easily exercise, this trial used volunteers who were sedentary and on the cusp of frailty. They recruited 1,635 sedentary men and women, ages 70 to 89 who scored below a nine on a 12-point scale of physical functioning often used to assess older people. Almost half scored an eight or lower, but all were able to walk on their own for a quarter-mile, which is the researchers’ cutoff point for being physically disabled.

The men and women were randomly assigned to either an exercise or an education group. Those in the education assignment were asked to visit the research center once a month or so to learn about nutrition, healthcare, and other topics related to aging. The exercise group received information about aging, but also started a program of walking and light lower-body weight training as well as going to the research center twice a week for supervised group walks on a track with the walks growing progressively longer. They were asked to complete three or four more exercise sessions at home, aiming for a total of 150 minutes of walking and about three 10-minute sessions of weight-training exercises each week. The experiment continued for an average of 2.6 years, which is far longer than most exercise studies.

By the end of that time, the exercising volunteers were about 18 percent less likely to have experienced any episode of physical disability during the experiment. They were also about 28 percent less likely to have become persistently disabled, defined as being unable to walk a quarter of a mile by themselves.

Most of the volunteers tolerated the exercise program very well, and it is an important study because it focuses on an important outcome, which is the prevention of physical disability.  The exercise intervention cost about $1,800 per participant per year, including reimbursement for travel to the research centers. That figure is considerably less than the cost of full-time nursing care after someone becomes physically disabled. Hopefully, the study prompts Medicare to begin covering the costs of group exercise programs for older people. This is not meant to prompt elderly people to begin solo, unsupervised exercise. Medical supervision is important and patients should consult with their doctor and try to find an exercise group because the social aspect is important, as it really keeps you engaged with life.

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