Wednesday, July 30, 2014

Short, Intense Bursts of Exercise May Benefit Seniors’ Health, Fend Off Loss of Muscle


High-intensity training has become extremely popular among fitness enthusiasts in the past few years. There is increased interest in performing challenging workouts to enhance fitness and reap the benefits of short intense exercise. Traditionally, this type of training was reserved for athletes to enhance sports performance, but now it has become a common method of fitness training.

The benefits of this type of training are well documented in research. This short intense workout style can increase aerobic capacity faster then steady-state training, and increase fat utilization for energy causing bigger changes in body composition, just to name a few benefits. This has lead to questions about whether older adults can experience the same benefits in a safe way.

Having just returned from speaking at the annual American Council of Sports Medicine (ACSM) convention in Atlanta, Ga., these questions were addressed and discussed with some very enlightening information. Currently the ACSM Guidelines for Older Adults are based on general resistance training guiding principles for developing strength endurance. ACSM recommends a low-to-moderate intensity range of 65% to 75% of one-repetition maximum to boost strength and reduce the risk of injury.

The current guidelines provide an excellent starting point and will provide health benefits, but new research shows that older adults can train at higher-intensity exercise levels then once believed. Research with older adults in high-intensity exercise programs, specifically heavy resistance and powerlifting exercise, have shown excellent fitness gains and functional strength for many activities of daily living.

The aging process typically causes a decrease in muscle mass at a rate of approximately 5% per decade from the age of 40, with a rapid decrease after the age of 65. There has been much discussion as to whether this is the natural aging process or has it been accelerated due to an increased sedentary lifestyle after the age of 60.

A decrease in muscle mass and diminished neuromuscular efficiency causes a reduction in speed, agility, balance, co-ordination and power. The accumulation of these losses greatly affects overall skills, which significantly increases the risk of falls.

Fitness is lost without exercise, however, the good news is that it’s a renewable resource and can be re-gained with activity. Just as a sedentary lifestyle can threaten health, an exercise program with appropriate levels of strength and power training can provide numerous health benefits and stimulate muscle growth even in the later years.

Higher-intensity exercises not only do wonders for the muscular system, they stimulate hormone production. Research indicates seniors that performed power-training workouts with more explosive movement such as throwing a medicine ball or kettlebell swings, had an increased production of the hormones testosterone, growth hormone and insulin-like growth factors, which all lead to a muscle growth and more youthful appearance.
 
Strength represents the amount of force a muscle can generate, whereas power is the velocity of force being produced. This represents the speed at which a muscular system can be activated to produce the required movement. Strength training exercises are typically executed at a slow and rhythmic tempo, whereas power training requires speed with controlled movement. For people over the age of 60, age-related loss of muscle power can occur approximately twice as quickly as loss of muscle strength, suggesting that muscle power is a more critical variable in age-related functional decline.

As with any exercise program, current health and fitness is critical to the appropriateness of exercise selection. Medication, lifestyle, injuries, illness and health related concerns determine the starting place and progression of exercise. Older adults should consider working with a certified exercise specialist or participating in a group-exercise program that is specifically designed for them. Current movement function or loss of movement, mobility and strength are considerations in exercise choices. Always consult your physician prior to starting an exercise program.

The big message is that healthy active older adults can perform high intensity exercise with great health and fitness benefits. Grey hair and wrinkles are a natural process of aging, however, when it comes to muscles and physical training the body has a great capacity to adapt even as we age. In fact, some experts argue muscles do not know age.

—Helen Vanderburg is a World Champion synchronized swimmer, fitness trainer, and corporate wellness speaker.

Tuesday, July 15, 2014

The New Old Age


My late father had a longtime friend, a retired kosher butcher, who lived down the hall in their South Jersey apartment building. Past 90, Manny was older and frailer than my father; he leaned on a cane and could barely see well enough to recognize faces. But every morning, and again in late afternoon, he walked through my dad’s unlocked front door to be sure he was all right and to kibitz a bit.

Manny made the rounds, also looking in on several other aged residents in their so-called N.O.R.C. (naturally occurring retirement community). Unless he was ill himself, he never missed a day.

Manny’s regular reconnaissance missions come to mind when I read about purpose, which is one of those things we recognize without quite knowing how to define. To psychologists, “purpose reflects a commitment to broader life goals that helps organize your day to day activities,” Patrick Hill, a psychologist at Carleton University in Ottawa, told me in an interview.

It’s a hard quality to measure, so researchers rely on how strongly people agree or disagree with statements like these:

“Some people wander aimlessly through life, but I am not one of them.”
“I feel good when I think of what I have done in the past and what I hope to do in the future.”
“I live life one day at a time and do not really think about the future.”
“I sometimes feel as if I have done all there is to do in life.”

It turns out that purpose is, on many counts, a good thing to have, long associated with satisfaction and happiness, better physical functioning, even better sleep. “It’s a very robust predictor of health and wellness in old age,” said Patricia Boyle, a neuropsychologist at the Rush Alzheimer’s Disease Center in Chicago.

She and her colleagues have been tracking two cohorts of older people living independently in greater Chicago, assessing them regularly on a variety of physical, psychological and cognitive measures. The subjects agreed to donate their brains after their deaths.

What have the scientists learned? Let’s start with arguably the most feared disease of old age. Following almost 1,000 people (age 80, on average) for up to seven years, Dr. Boyle’s team found that the ones with high purpose scores were 2.4 time more likely to remain free of Alzheimer's than those with low scores; they were also less likely to develop mild cognitive impairment, often a precursor.

“It also slowed the rate of cognitive decline by about 30 percent, which is a lot,” Dr. Boyle added.

In a subset of 246 people who died, autopsies found that many of the purposeful subjects also showed the distinctive markers of Alzheimer's. “But even for people developing the plaques and tangles in their brains, having purpose in life allows you to tolerate them and still maintain your cognition,” Dr. Boyle said.

Purposeful people were less likely to develop disabilities. And they were less likely to die: a sample of 1,238 people followed for up to five years (average age: 78) by Rush researchers found that thos with high purpose had roughly half the mortality rate of those with low purpose.

This protective effect holds through the years, showed a recent study by Dr. Hill, which relied on a national longitudinal study that enrolled 7,100 Americans aged 20 to 75. Those who died, in all age groups, scored significantly lower on purpose-in-life scales. The researchers looked at whether purpose had less effect after retirement, when “you’re starting to lose those structures you had, a natural way to organize your daily life,” Dr. Hill said. Somewhat to his surprise, work status didn’t matter.

In fact, both the Rush and the Carleton teams controlled for a host of other factors known to correlate with well-being — depression or “negative affect,” social relationships, chronic medical conditions and disability, demographic differences — and report that purpose in life, all by itself, appears to have a potent ability to improve and extend lives.

So how can we help older people hang onto a sense of purpose if their strength and mobility declines and their dependence on others increases? I’d like to hear your ideas. Isn’t that one of the most dispiriting aspect of life in nursing homes or assisted living, after all — the sense some residents develop that there’s no reason to live? Older people can stay busy with activities and multiple medical appointments, but many feel that what they do doesn’t matter.

“They want to make a contribution,” Dr. Boyle said. “They want to feel part of something that extends beyond themselves.” Though what provides purpose in one’s life varies, merely taking care of oneself probably doesn’t qualify. People with purpose “have a sense of their role in the community and the broader world,” Dr. Boyle said. She particularly mentioned mentoring, passing one’s memories or experiences on to younger people, as a way to stoke a sense of purpose.

The Jewish Association Serving the Aging, which provides services in metropolitan New York, takes a different tack. The organization’s Institute for Senior Action has trained more than a thousand older people to be “rabble rousers”; graduates have mobilized to restore city funding cut from a center for the elderly, for example.

Or maybe you adapt the things you’ve done and valued all your life. Manny, my dad’s friend, used to make home deliveries from his butcher shop. He was used to regularly visiting members of the small Jewish community in my hometown, hearing about their families and their lives as he dropped off bundles of kosher meat wrapped in paper.

Decades later, when his world had contracted, he was essentially still at it. He was providing a service (he did actually once find a neighbor on the floor and summoned an ambulance), and he was very diligent about it.

I’d call that purpose, wouldn’t you?


Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions