Yes, octogenarians can benefit from increasing physical activity (movement activities of everyday life) or exercise (structured and planned ways to move more). The following studies show of the benefits that older people can enjoy from getting more physical activity or exercise.
Frailty
While there’s no universally accepted definition of frailty, one that's widely used includes the presence of three of the following: low grip strength, low energy, low physical activity, slow walking speed, and unintentional weight loss. Frailty increases older adults’ risk of disability, other chronic health conditions, reduced quality of life, and increased health care costs. Happily, frailty can be reversed in its early stages.
Researchers in Spain developed a multi-component program that sought to improve frailty, functionality, cognitive and emotional status, social networking, and biological markers of frailty. The program included warm-up, proprioception and balance exercises, stretching, aerobic training, and strength training. Supervised sessions lasted for 65 minutes 5 times per week for 24 weeks. Patients in regular care comprised the control group. One hundred participants with an average age of 80 years were randomized to the exercise group or the control group.
At the end of the program, participants in the exercise group improved 15 of the 26 outcome variables compared to the control group. Frailty was reversed in 31 percent of the exercise program participants but none in the control group. In addition, exercise group participants improved in the following ways: fewer hospital visits, 7 out of 9 functional attributes, both frailty attributes, all 4 cognitive, emotional, and social tests, and 1 (lower fat mass) out of 7 bodily characteristics. Thus, octogenarians can potentially reduce frailty and improve their functionality and quality of life.
High-intensity interval training
Cardiorespiratory fitness (CRF) and muscle mass typically decline in older age and predict increased risk of chronic diseases and dying. High-intensity interval training (HIIT) maintains or increases CRF and muscle mass for younger seniors. Would HIIT do the same for older seniors?
Researchers in the UK recruited 28 community-dwelling volunteers with a mild to systemic disease and with an average age of 81 years to address this question. Participants had a total of 12 HIIT sessions (thrice weekly for 4 weeks) with each lasting 16.5 minutes. The study included an initial 4-week control period (participants continued their usual activities) immediately followed by a 4-week HIIT period. Cardiopulmonary exercise tests for VO2 peak occurred at time 0, week 4 (before HIIT) and at week 8 (after HIIT). Additional tests occurred for blood pressure, body composition, mitochondrial function, muscle architecture, muscle protein synthesis, and quality of life occurred before and after HIIT.
Compared to the control period, the 4-week HIIT program significantly improved CRF, increased muscle mass, reduced systolic blood pressure and resting heart rate, and increased muscle protein synthesis and mitochondrial oxidation capacity. Habitual activity levels and quality of life did not change significantly compared to the control period. Thus, a mere month of HIIT improved octogenarians’ CRF and other metabolic factors. If octogenarians with health problems can do this, you can, too.
Types and amounts of physical activity and/or exercise
The growing number of American seniors represents an enormous challenge to the US medical care system. A new review summarized existing research regarding the amount and type of physical activity and/or exercise needed to reduce the risks of older Americans losing their physical function, mobility, and independence. The authors distinguished between physical activity (any level of moving about that requires muscle contraction and increases energy expenditure) and exercise (planned and structured movement designed to boost health). Frequency, duration, and intensity comprise key aspects of both physical activity and exercise. In general, more is better, but any amount helps. Increasing levels of each aspect produce better results in a graded manner.
Activities, such as brisk walking, jogging, and cycling, that increase heart rate help build aerobic capacity, often measured as peak oxygen processing capacity (VO2 max). Lifelong runners and other endurance athletes can greatly reduce age-related declines in VO2 max. But even sedentary seniors who begin an aerobic exercise program can meaningfully increase their aerobic fitness and physical functioning. Aerobic activity benefits multiple organ systems and reduces seniors’ risk of crossing over the threshold of losing their independence. Resistance training complements aerobic activity by building muscle strength and endurance. Ideally, seniors will engage in some form of resistance training for 30 minutes at least two days per week.
Alas, only 14.5 percent of American seniors aged 75-84 and 10.4 percent of seniors aged 85 and older regularly participate in some kind of muscle-strengthening activity. Seniors who want to limit the effects of aging, such as decline in physical function, loss of mobility, and loss of independent living, will do well to find ways to build their aerobic capacity and muscle strength. It’s not too late to begin.
Can octogenarians handle high levels of physical activity?
Take a guess: Do Swedish lifelong competitive, endurance athletes in their 80s exhibit higher cardiorespiratory fitness than age-matched untrained counterparts in Muncie, Indiana? More realistically, how big is the difference?
Researchers in Sweden and the US measured cardiorespiratory fitness as VO2max in 9 Swedes and 6 Americans. In addition, leg muscle samples were analyzed for mitochondrial activity. Unsurprisingly, when expressed as ml of O2 consumed per kg of body weight, the Swedish athletes had 80 percent higher cardiorespiratory fitness that the untrained Americans (38 vs. 21 mL O2 per kg of body weight). The average fitness of the Swedish athletes was the highest ever reported for octogenarians and comparable to that of non-endurance trained men 40 years younger. Note that the fitness of the untrained Americans approached the threshold of 17 mL O2 per kg body weight below signifies frailty. Mitochondrial function was 54 percent higher for the Swedish athletes than the Americans. The risk of mortality for the Swedish athletes was about half that of the Americans. Octogenarians are certainly capable for high levels of physical activity.
Octogenarians typically exhibit evidence of declining health such as high blood pressure, cardiovascular disease, and frailty. Cardiac rehabilitation following surgery lasts from several months to a year and is widely prescribed. But only half of UK cardiac surgery patients enroll in cardiac rehab. The prospect of cardiac rehab can reflect real or perceived limitations for physical activity. Researchers in the UK conducted 35-minute interviews with 20 patients (average age 85 years) with aortic stenosis (narrowed aorta) due to undergo or had recently undergone corrective surgery.
The interviews sought to understand the patients’ perspectives about cardiac rehabilitation, which typically features increased physical activity. Four themes merged from the interviews: 1) perceptions and understanding of cardiac rehab, 2) delivery and accessibility of cardiac rehab programs, 3) perceived impact of life factors on cardiac rehab and health, and 4) transportation concerns. Patients often did not understand cardiac rehab, thinking that the surgery was cardiac rehab and that everything would soon return to normal after surgery. Patients were often deterred by group sessions, thinking that they might be embarrassing. The prospect of using technology to access rehab classes frightened some participants. Patients commonly wanted rehab to occur in a hospital and delivered by professional staff. Patients who were also caregivers wondered if they would have time for rehab, given their other duties. Patients who lived in rural areas were concerned about convenient transportation to the rehab location.
Overall, many patients did not understand the nature of cardiac rehab or its potential benefits and were concerned with practical issues of having enough time for rehab or getting to and from the rehab site. As I read this study, it seemed that octogenarians might not appreciate the benefits of greater physical activity during cardiac rehabilitation and would be disinclined to get more physical activity, thinking that it competed with other priorities.
What to do
These studies indicate that octogenarians are capable of being physically active and can participate in exercise programs. The healthy lifestyle choice, Keep Moving, can benefit just about everyone. Can you find one type of physical activity or exercise that you’d enjoy doing, such as after-meals walks from your home? My wive and I starting our after-meal walks 20 years ago (thanks to prodding from out dog, Amelia) and are still at it (although Amelia is no longer with us).
