SaveYourself.ca •Sensible advice for aches, pains & injuries
 

What if you hate the music? Susan Ingraham has built a business around making exercise classes a little more pleasant for older adults in downtown Vancouver — so they can actually enjoy getting the many physiological benefits of regular moderate exercise.

7 Reasons Older Adults Don’t Stay in Exercise Classes

And 7 reasons they should stick with it: the science and psychology of maintaining an exercise class habit

by Susan Ingraham, BCRPA-certified Fitness Instructor for the Older Adult (Vancouver, Canada)

So, you’re 55, or maybe 65, 75, or even 85. You already know all the benefits of exercise, and you’ve tried — you have really tried — to be active. You take a daily walk once a week when it’s not raining, but you know that’s not really enough. Friends, relatives, and your doctor — they all say, “Get some exercise!”

So, a little while back, you tried a class. You tried several. Different instructors even. But there is one small problem: You hate it!

What to do? Chances are, you’ve stopped going...or you will soon. You may not be able to say why you hate that class, but it’s likely that when you read through this list, you’ll see yourself at least once:

  1. You’re intimidated: With teenagers, we call it peer pressure. But don’t kid yourself. Older adults are also intimidated by class participants (or even the instructor) who appear to be exceptionally fit and exercise-savvy. A newcomer — you — can feel totally alienated.
  2. You can’t find the time to go regularly so every class feels like the first visit: Finding two or three hours a week to exercise doesn’t seem like a problem, but if you don’t enjoy going, it is easy to schedule a conflicting appointment. The fitness class will most assuredly become the last on the list of your priorities. When you do go, you feel like the new kid on the block every single time.
  3. You’re sure you will fail: You’re amazed at what other people can do! You feel pressured and out-of-sync with everyone else in the class. When the instructor shouts out the commands, you‘re three steps behind and going in the wrong direction. After class you‘re exhausted. I can’t go back, you tell yourself. I‘ll never be able to do it like the others.
  4. Your physical limitations make you feel inadequate: Whether it’s arthritis or a sore knee, a frozen shoulder or osteoporosis, many older adults believe that they’re “too old” or “too injured” to exercise. Besides, you are quite certain that no one can teach this old dog any new tricks.
  5. You can’t stand that mirror! You think you’re too thin, too fat, too old, too tall, too short, too wrinkly. Why do they have those mirrors in the room? Who wants to look at themselves for an entire hour? Scary thought! And a good reason not to go, you tell yourself.
  6. You’re too “down”: You have no will to get out of the apartment and into a fitness class, even though you know it’s a good idea.
  7. You hate the music: You have passed by a zillion fitness classes where the music was blaring out into the hallway and you wondered how anyone could hear the instructor, never mind the sound of their own voice. And what music are they playing, anyway? You can’t understand the words and you haven’t a clue who the singer is. Why on earth would you subject yourself to that noise?

A dreadful list, isn’t it? Not something the fitness industry can be proud of, that’s for sure.

But there’s good news and bad news.

The bad news is obvious: these concerns are tough to overcome.

The good news is, if you can find the right class and the right instructor, you will go to class — and without complaint.

It’s been my experience that most older adults understand that exercise is good for them, but those seven deadly reasons prevent them from doing what they know is best for their body.

What you need is proof. Proof that this exercising stuff really works. And what difference will it make? Research is out there, and the evidence is solid: Exercise does keep us healthier, improves the quality of our lives, and keeps us living on our own longer.

Here are seven good reasons you’ll be glad that you choose to exercise:

Reason #1: It will extend years of active independent life

In health research, doctors attempt to quantify a quality-of-life measurement for an average individual.1

Through discussions with many patients of all ages, they rate on a scale of one-to-ten a person’s physical and mental well-being.

Using such a scale in an Oklahoma study, healthy older adults who participated regularly in moderate physical activity for at least an hour per week had a higher quality-of-life measurement than those who did not exercise.2

The exercisers felt that they led an independent lifestyle.

Take note: one hour per week! That’s not much commitment.

Reason #2: It does not have to be hard, fast, and pounding to reap rewards

“No pain, no gain” is a myth! Don’t believe it! Today’s research is unequivocal: moderate exercise does make a difference. One study assessed two groups of older adults: one group participated in a low-intensity exercise program; the other group did only relaxation exercises. On all assessments, both physical and mental, the exercise group did better than the relaxation group.3

If you are concerned about the risks of starting exercise, you can begin at low intensity and gradually increase your skill level. Most studies suggest that classes for older adults should emphasize moderate-intensity aerobics, muscle-strengthening, balance, and flexibility, as well as instruction on how to avoid injury.45

Reason #3: You must use it or you will lose it.

We lose muscle strength — a minuscule amount each day. Stronger muscles mean we can lengthen independent living considerably. Simple free-weight exercises can improve the odds against muscle loss.

Researchers decided to measure just the hand-grip strength of women over 60. Some women were exercising; some were not. They discovered that non-exercising women lost grip strength at the rate of nearly 3% per year. But physically active women lost much less.6

If hand-grip strength can be improved and/or maintained by simply exercising, you can easily apply this principle to all the muscles. My husband’s grandmother decided, in her late 80’s, that she did not want to walk any more. Within weeks she was bedridden. If we do not use our muscles, they will weaken. It is inevitable.

Reason #4: It may prevent a bad fall

Older adults fear falling. If they break a bone, they may be disabled, in pain, or both, for months. A fall means loss of independence.

More than 20% of participants in a recent study of older adults said they had fallen twice or more in the previous year. About one-third said it was likely they would fall during the upcoming year, yet most believed there wasn’t any way that they could prevent a fall. None of them had even heard of balance training!

Attempting to educate older adults to the advantages of physical activity in preventing falls, researchers explained to the participants of a study that the purpose of balance training was to do “physical activities every day to build up the strength in legs and body and improve balance.” Lead author of the research, Lucy Yardley, Ph.D., concluded this: “Few older people are aware of strength and balance training, or [know] that balance can be improved.”7

The ability to get up from a chair and sit down without assistance requires lower body strength, balance and coordination. Something as simple as a daily chair-stand exercise can improve balance.8

Reason #5: It will improve your health (even with serious conditions)

Older adults may put up with a wide range of medical conditions, but research shows that in nearly all cases, improvements can be made, even in four of the greatest challenges older adults face: diabetes, Alzheimer’s, stroke, and heart disease.

In a very large study of diabetics, doctors compared exercise-only treatments with self-management treatments. Participants who exercised improved their blood glucose twice as much as those who did not. Vicki Conn, PhD., head of the research, said: “It doesn’t matter how overweight you are or how poor your current blood glucose..., the improvements from exercise [are] equal across the board.” In Australia, another research team concluded the very same thing and added: exercise “may be able to reduce the risk of type 2 diabetes and cardiovascular disease.”9

The French studied over 100 Alzheimer’s patients who attended an exercise program for one hour twice a week. This simple program “led to a significantly slower decline in daily living activities in patients...than routine medical care.”10 That’s just two hours a week of exercise to make a difference!

In another study of more than 60 healthy adults over 85 years of age, researchers discovered that after almost five years, women who exercised more than four hours per week had a nearly 90% reduced risk of cognitive impairment compared to less-active women.11

A United Kingdom study worked with more than 60 people over 70 years of age who had a stroke but were still mobile. Participants exercised three times a week for twelve weeks: endurance and strength training along with relaxation were included. The result “Exercise training for ambulatory stroke patients was not only possible, but it could also lead to the patients feeling much better about themselves.”12

And finally, the results of several studies show that people who start regular physical activity after a heart attack have better rates of survival and quality of life than those who don’t.13

Reason #6: It may improve your mood or lessen your need for medication

Exercise can raise endorphins which improve your mood. One participant walked into my fitness class one morning and handed me her ticket, saying, “Here I am. Do your magic.” At the end of class, she told me her mood had improved 100%. I know this can happen because I have experienced it many times myself.

And here’s another plus for exercise: a combination of aerobic activity, strength training, and flexibility exercises may reduce medication dependence while maintaining functional independence and improving quality of life.14

Reason #7: The benefits are the same for both men and women

There is no research (yet) that suggests that men15 or women16 have a health advantage because they exercise. However, we know that how we age is most likely related to “nutrition, stress, smoking, and physical activity.”17 One study concluded, “It is important to emphasize that it takes relatively moderate levels of physical activity — like brisk walking — to attain the associated health benefits.Certainly, one does not need to be a marathon runner. This is the message that we need to convey to the public” (my italics).18

Thus, we have come full circle. You know why you don’t go to class, but you know you should. To resolve the paradox, you must find a class that’s right for you. At the very least, make sure your class has these three elements:

It should be designed for older adults with an instructor who is trained to teach them.

It should include low-impact aerobics, strength and balance training, and flexibility.

Be sure it’s a safe, clean, friendly environment that you enjoy, including the music.

Once you’ve chosen a class, attend at least five sessions before you give up. It’s OK to keep looking until you find the class that you know is the right “fit” for you. Do all the exercises that you can, but don’t worry if you can’t do everything. Learn from the other class participants and from the instructor.

Good luck….and happy exercising!

Notes

  1. Measures of disease status alone are insufficient to describe the burden of illness; quality of life factors such as pain, apprehension, depressed mood, and functional impairment must also be considered. Two operational definitions of quality of life are identified—objective functioning and subjective wellbeing. Assessments of objective functioning and subjective wellbeing convey different information, they also present different problems in relation to validation. Assessment of functioning derived from questionnaires must be validated against measures of directly observed behavioural performance. Subjective appraisal of wellbeing may be influenced substantially by psychological factors unrelated to health or to changes over time in patients’ criteria for appraising wellbeing. SOURCE: BMJ 1998;316:542-545 (14 February). BACK TO TEXT
  2. 112 male and female volunteers (between 62 and 78) were recruited from the Norman, Oklahoma area. Subjects were separated into either a higher physically active group and lower physically active group. CONCLUSION: Incorporating more physical activity into the lifestyles of sedentary or slightly active older individuals may improve their quality of life. SOURCE: Health Qual Life Outcomes. 2006; 4: 37. Authors: Acree LS, Longfors J, Fjeldstad AS, Fjeldstad C, Schank B, Nickel KJ, Montgomery PS, Gardner AW. BACK TO TEXT
  3. Two community centres were allocated to the same 20-week, twice-weekly exercise program; and a third to relaxation classes. Various assessment measurements were taken, including static and dynamic balance, gait, upper and lower body strength, a 6-minute walk test, among others. The study concluded that a community-based, low intensity exercise program improved dynamic balance and lower body strength in older adults. It also improved blood pressure, particularly in those who were hypertensive. SOURCE: J Nutr Health Aging. 2006 Jan-Feb ; 10(1): 21-9. Authors: Kolbe-Alexander TL, Lambert EV, Charlton KE. BACK TO TEXT
  4. A panel with expertise in public health, behavioral science, epidemiology, exercise science, medicine, and gerontology wanted to issue a recommendation on the types and amounts of physical activity needed to improve and maintain health in older adults. After studying multiple sources, the panel issued a final recommendation, stating that the promotion of physical activity in older adults should emphasize moderate-intensity aerobic activity, muscle-strengthening activity, reducing sedentary behavior, and risk management. SOURCE: Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C, Circulation. 2007 Aug 28; 116(9): 1094-105. BACK TO TEXT
  5. Practices identified were: (a) A multidimensional program that included endurance, strength, balance, and flexibility training; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement; (c) managing risk by beginning at low intensity but gradually increasing to moderate; (d) an emergency procedure plan; and (e) monitoring aerobic intensity. SOURCE: Cress ME, Buchner DM, Prohaska T, Rimmer J, Brown M, Macera C, Dipietro L, Chodzko-Zajko WJ Aging Phys Act. 2005 Jan ; 13(1): 61-74. BACK TO TEXT
  6. 600 participants, between the ages of 60 and 95 were questioned in the study. SOURCE: Gerontology, 53(3):140 (2007) BACK TO TEXT
  7. “Previous research indicated that most older adults reject the idea that they are ‘at risk’ of falling, even if they have fallen recently, because this does not fit with a self-image of themselves as independent and competent, which is very important to them.” SOURCE: The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 62:P119-P125 (March 2007) BACK TO TEXT
  8. For 66 people 80 years or older who had mobility challenges, exercises were completed every day for 6 weeks. Some repeated the sit-to-stand exercise, while the rest wore ankle weights while performing knee extension exercises. The sit-to-stand significantly improved scores on the Berg Balance Scale, although there were no changes in other measures of gait and function. The authors noted that “while statistically significant, the improvement in Berg Balance Scale score was modest, raising the issue of what extent of change in score is clinically significant in this population.” SOURCE: Age and Ageing, 36(5) (September 2007) BACK TO TEXT
  9. Diabetologia, 50(5):913 (May 2007) and Diabetes Care, 30:1384 (June 2007. BACK TO TEXT
  10. Journal of the American Geriatrics Society, 55(2):158 (February 2007). BACK TO TEXT
  11. Journal of Aging and Health, 19(2):242 (April 2007) BACK TO TEXT
  12. Journal of the American Geriatrics Society, 55(6):892 (June 2007) BACK TO TEXT
  13. From the American Heart Association web site: http://www.americanheart.org/presenter.jhtml?identifier=4563 BACK TO TEXT
  14. McDermott AY, Mernitz H Am Fam Physician. 2006 Aug 1; 74(3): 437-44. BACK TO TEXT
  15. Physical activity has been linked with multiple health benefits, both for healthy adults and those with cardiovascular diseases. 6,749 African-American and 8,911 Caucasian men used a standardized treadmill test. The results were similar for men with and without cardiovascular diseases. Men who achieved very highly fit levels had a 70% lower risk of death compared to those in the low-fit category. “Our findings show that the risk of death is cut in half with an exercise capacity that can easily be achieved by a brisk walk of about 30 minutes per session, 5-6 days per week,” said Peter Kokkinos, PhD, lead author of the study. SOURCE: Circulation, online (January 22, 2008) BACK TO TEXT
  16. In the updated 2007 Guidelines for Preventing Cardiovascular Disease in Women, physical activity recommendations for women who need to lose weight or sustain weight loss were set at 60 to 90 minutes of moderate-intensity activity (e.g., brisk walking) on most, and preferably all, days of the week. “We took a long-term view of heart disease prevention because the lifetime risk of dying of cardiovascular disease is nearly one in 3 for women,” said Lori Mosca, MD, PhD, chair of the American Heart Association expert panel that wrote the guidelines. “This underscores the importance of healthy lifestyles in women of all ages.” SOURCE: Circulation, online (February 19, 2007) BACK TO TEXT
  17. (Bokovy & Blair, 1994; Armstrong et Al, 2001). “The major medical and scientific organizations endorse the importance of physically active lifestyles for older adults (American College of Sports Medicine, 2000; U.S. Department of Health and Human Services, 1996; World Health Organization, 1997; Armstrong et Al, 2001).” BACK TO TEXT
  18. Circulation, online (January 22, 2008). A quotation from Peter Kokkinos, Ph.D., lead author of the study. BACK TO TEXT