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Beginning in mid-life and particularly after age 45, people start to lose lean body mass at a rate of 6.6 pounds per decade.¹Often viewed as part of the normal aging process, loss of body mass is actually a form of secondary aging related to lifestyle and behavior. If residents lack baseline strength, they can't perform their ADLs, climb out of a chair or engage in a simple walking program. The only way to prevent rapid loss of muscle mass is through progressive resistance or strength training.

KEEPING SENIORS SAFER

One of the biggest problems facing older Americans is a high risk of falls due to balance issues. In my experience working with seniors, imbalance can result from reaction to medication, poor nutrition, inner ear disease and depression, but most balance issues result from the loss of lean body mass in the lower extremities.

Preventing falls, broken hips and dependency requires a combination of balance exercises and strengthening routines. Keeping residents at optimal physical health should not be left solely to the physical therapy department, limiting residents to receiving assistance only when under prescribed treatment. When the prescription expires and exercises stop, all gains are lost in a matter of weeks or even days. That's where a prevention and wellness program comes into play.

The long-term objective for enhancing quality of life is to compress morbidity, or push chronic disease back to the tail end of life.

Researchers at Tufts University have demonstrated that strength training can improve the 10 common biomarkers of aging: lean body mass, strength, basal metabolic rate, body fat percentage, aerobic capacity, blood sugar tolerance, cholesterol/HD ratio, blood pressure, bone density and internal body temperature.¹

Conditions related to these biomarkers are often treated with pharmaceuticals, despite research that shows that benefits of enhancing lean body mass and strength.¹

PROGRAMMING TIPS

The first step is to get residents motivated to exercise. Most adults, including the elderly, need support getting started with an exercise and wellness program. A heavy dose of education and sample programs can acquaint them with new possibilities for advancing their physical function and health.

To see significant results from any adult age group, one must exercise at sub-maximal levels of 50 to 80 percent of their maximum. When working with seniors, the knee-jerk reaction is to provide activity that's light and easy because older adults are often perceived as weak and frail. However, it has been shown that training older adults at 50 to 60 percent of their maximum capacity produces measurable results. Program leadership must have expertise in exercise science to implement sub-maximal exercise effectively.

If older adults have a choice between strength training and cardio training, strength should come first. However, the best routines integrate both forms of exercise. Residents should attend at least two to three strength-training sessions weekly with professional leadership. The program should be rigorous and progressive. Rigorous means stressing the body between 50 and 80 percent of maximum capacity, and progressive means moving from a 5 lb. hand weight to a 7 lb. hand weight over the course of several weeks. Handheld flexible tubing, hand weights, stability balls and balance tools work well. This equipment is inexpensive and is used primarily by beginners to intermediate exercisers.

GAINING GROUND

Once residents gain baseline strength, confidence and a commitment to exercise, they can graduate to more sophisticated equipment such as weight machines with individualized seating positions for each exercise movement. For a population that has high functional variability, provide a variety of progressive group and individual programs addressing all function levels. Introduce new challenges often, particularly to those who are very active. Older adults respond favorably to opportunities that expand their limits, providing they have confidence in their abilities.

Be sure to track outcomes regularly. This feedback is huge for motivating participants, and objective outcomes will give the program validity. Regardless of age, seniors have the capacity to grow, develop, modify and change, and that means they can increase their strength as well.

Reference

1. Evans W & Rosenberg I. Biomarkers: The 10 Keys to Prolonging Vitality. New York. Simon and Schuster: 1991.

John Rude is President and CEO of Age Dynamics Inc., Eugene, Ore.