Exercise, Aging and Health

Overcoming Barriers to an Active Old Age

Sandra O'Brien Cousins

• Publisher: Taylor & Francis
• Year: 2014
• Print ISBN:
  9781560324133
• eBook ISBN:
  9781317763451
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Appropriate for professionals in gerontology, sports psychology, health psychology, physical education and social science programs that deal with older populations and community resources, this book first discusses the pros and cons of physical activity for older persons. It then explores the theoretical reasons for which older people do not pursue physical activity and how to overcome this reluctance. There is a model included, as well as implications for future social policy.

Part One

Living Longer and Aging Better

Exploring the Issues

In order to effectively implement older adult exercise systems, it is necessary to first garner an understanding of the history of both the incidence of and beliefs regarding exercise among this population. In addition, the facts about the benefits of exercise must be realized, and the perceptions of older adults explored.

Chapters 1 and 2 explore the social and personal impact of sedentary lifestyles, and present demographic information which paints a historic background of today’s elderly population. Chapters 3 and 4 provide a look at past and present activity patterns, and present new information regarding perceived and actual risks of older adult exercise. Chapter 5 includes a summary of the benefits of exercise for this population. Chapter 6 further examines barriers to an active old age, and Chapter 7 presents an inspiring case study which illustrates the positive effects of physical activity among older adults. Finally, Chapter 8 introduces specific exercise skills that focus on the maintenance of mobility and strength.

Chapter 1

Aging Poorly with Sedentary Living

Types of Aging

Differences in the way individuals age have intrigued scientists for years. The contemporary search for perpetual health and immortality has failed to find any “fountain of youth,” but we know that people do age with remarkable variation (Nelson & Dannefer, 1992). The range of aging possibilities is probably best seen in people’s unique day-to-day lifestyle behaviors and the effects of these behaviors over the life span. Individual experiences of aging depend on the interrelationships among biology, behavior, and the environment. Together these factors place a person at some point on “The Health Continuum” (Figure 1.1).

Figure 1.1 The health continuum. Reprinted with permission by Michael L. Teague, 1995. In Teague, M. L. (1992). Health promotion: Achieving high-level wellness in the later years (p. xiii). Indianapolis, IN: Benchmark Press, Inc.

The health continuum represents the range of an individual’s possibilities for health from premature morbidity and death to optimal fitness and health (Teague, 1987). Considering that individual behavior has an impact (positive or negative) on one’s health, the purpose of the health spectrum is to have people realize that they can move “away” from the illness side of the spectrum toward optimal wellness. The health continuum concept views health with the complexity that it deserves, and serves to counter the notion that health is a discrete entity that you have or do not have. Rather, the health continuum depicts the idea that, with knowledge, motivation, and personal action, one can distance oneself from some diseases by taking up positive behaviors directed at health promotion.

For at least three decades, gerontologists have suggested there are two ways of growing old: “usual” aging and “successful” aging (Butler, 1988; Dermody, Saxon, & Sheer, 1986; Havighurst, 1963; Meusel, 1991; Nowlin, 1985; Palmore, 1989; Rowe & Kahn, 1987). In recent decades, increased longevity has illuminated the problems of “usual” aging, clarified and differentiated between normal and abnormal aging, and compelled societies to “rethink how we age” (Prado, 1986). Evidence is rapidly accumulating that regular and moderate forms of physical activity are a health benefit for adults, fostering opportunities for improved survival and life quality and more successful aging (O’Brien & Vertinsky, 1991; Stewart & King, 1991).

Although knowledge about how to age better is improving, population disability levels are climbing because of the relative aging and inactivity of the population (Verbrugge, 1994). In a chapter in Aging and Quality of Life (Abeles, Gift, & Ory, 1994), Verbrugge writes a section titled, “Prevention of Disability.” She outlines the classic triumvirate of prevention strategies, which include primary prevention (efforts to avert the onset of pathology), secondary prevention (early detection and management of pathology), and tertiary prevention (reduction of disease impact). Recent research reported in person by Stephen Blair (from the Cooper Institute in Dallas) shows that when controlling for all other possible explanations, the best predictor for full physical function and avoidance of disability in one’s later years is physical fitness (Blair, lecture at the University of Alberta, November, 1995).

Habitual exercise has major implications for the quality, if not the quantity, of life. Enough scientific support exists to suggest that moderate and frequent exercise may be the “best preventive medicine” for old age. Regular exercise is prescribed by the Centers for Disease Control and Prevention and the American College of Sports Medicine (Pate et al., 1995), first to prevent premature aging (Spirduso, 1986), and second, to prevent premature disease by controlling hypertension, heart disease, bowel and breast cancer, the immune response, osteoporosis, obesity, arthritis, diabetes, insomnia, and depression (see Chapter 5 for a complete review of benefits). Exercise scientists are beginning to understand the significant role exercise can play in controlling aging decline and delaying mortality (Blair, Kohl, III, Paffenbarger, Clark, Cooper, & Gibbons, 1989; Donahue, Abbott, Reed, & Yano, 1988; Grand, Grosclaude, Bocquet, Pous, & Albarede, 1990; Kaplan, Seeman, Cohen, Knudsen, & Guralnik, 1987; Linstead, Tonstad, & Kuzma, 1991; Rakowski & Mor, 1992).

Physiologists estimate that up to half of what we currently know as usual aging is a phenomenon of disuse (Berger, 1989; Bortz, 1982; DeVries, 1970, 1975; DeVries & Adams, 1972; Smith, 1981)—disuse that predisposes more women than men to experiences of hypokinetic disease (Abdellah, 1985; Butler, 1968; Heckler, 1984; Ostrow, 1989; Verbrugge, 1990b; Vertinsky, 1991). Olshansky, Carnes, and Cassel (1993) noted that women in western societies can expect to live 25 percent of their lives disabled, while men will experience physical limitations for the latter 20 percent of the life span. Government health promotion programs are examples of conspicuous public health campaigns addressing the issue of unfit aging in Canada—an issue targeting women, who appear to have the most to gain from increased participation in physical activity.

Why Exercise? Why Bother?

Several thousand scientific studies from various health disciplines have, in over 200 scientific journals, documented the broad benefits of physical activity for older adults (O’Brien Cousins & Home, in press). When all of the evidence is consolidated, there is abundant support for the idea that elderly individuals can positively affect their mobility, endurance, strength, and balance by, first, reversing the circulatory and neurological deficits they have acquired through sedentary living (MacRae, 1989; Spirduso, 1986), and, second, by elevating their functional capacities to the level of adults decades younger than themselves (Dummer, Clarke, Vaccaro, Vander Velden, Goldfarb, & Sockler, 1985; Fiatarone, Marks, Ryan, Meredith, Lipsita, & Evans, 1990).

The known health advantages for individuals who maintain an active lifestyle are so profound that sedentary living is now considered to be a costly “public health burden” (McGinnis, 1992). For example, Dr. William Foege, former Director of the Centers for Disease Control and Prevention (CDC), has suggested that physical activity has a potency comparable to immunization in repressing disease. The Heart and Stroke Foundations in both Canada and the United States have identified physical inactivity as the fourth major modifiable risk factor for cardiovascular disease, along with smoking, high blood pressure, and high blood cholesterol. In support of these statements, the Alberta Centre for Weil-Being (1995) reported that individuals climbing 36 or more flights of stairs per week had a 28 percent lower relative risk of death from cardiovascular disease than sedentary individuals.

Research indicates that an active lifestyle decreases a person’s risk of many other chronic diseases including hypertension, stroke, cancer, non-insulin dependent diabetes, osteoporosis, osteoarthritis and depression.

Furthermore, physical activity is known to be more than just a preventive and controlling measure; at certain intensities, sustained activity is health-promoting and can lead to a “high-level wellness” (Teague, 1992). Exercise elevates cognitive and physical function to levels which can guarantee more years of independent living (Health & Welfare Canada, 1989; Spirduso, & MacRae, 1991). Regular physical activity places controls on aging decline which, in “usual” aging, contributes to physiological losses of about one percent per year in most body systems (DeVries, 1979). Active living reduces age decline to 0.5%.

A consensus is forming that the health of most adults, including the able elderly, can best be promoted by the start of a walking program at 40 percent to 75 percent of one’s maximal heart rate (MHR = 220 – age) (Bouchard, Shephard, Stephens, Sutton, & McPherson, 1990). Older adults should be informed that three 10-minute walks have about the same impact as one 30-minute walk (Blair, Kohl, Gordon, & Paffenbarger, 1992). Benefits exist for frail elderly too. Adults in nursing homes and lodges should be encouraged to walk at any pace they can for as long as they can (Gueldner & Spradley, 1988). Following Blair et al.’s advice, several walks a day may be just as health-promoting as one bigger walk for the physically frail older person.

The Matter of Being North American

Just under half (48%) of all adults are classified as being involved in “high” levels of activity on the index of leisure-time physical activity. “High” leisure-time physical activity is generally defined as a minimum of 15 to 30 minutes of exercise, three times a week (Stephens & Craig, 1990). But compared to rising activity levels in Finland and Germany, the involvement of North American adults in vigorous exercise is low and in visible decline since 1980 (Figure 1.2). Although almost 25 percent of sedentary North American adults have taken up moderate levels of leisure-time physical activity since 1981, about 40 percent of the general population is still considered sedentary (Pate et al., 1995; Stephens & Caspersen, 1994), and most of these are aging adults.

Figure 1.2 Temporal trends in leisure-time physical activity. Reprinted with permission from T. Stephens and C. J. Caspersen. (1994). The demography of physical activity. In C. Bouchard, R. J. Shephard, & T. Stephens (eds.), Physical activity fitness, and health (p. 207).

The Matter of Being Older

Daily exercise decreases with age through middle adulthood and then increases temporarily after people reach the retirement years (Stephens & Craig, 1990). Even after age 70, there is still a significant gradient in activity level with every passing year, even when health is taken into account (O’Brien Cousins, 1993). This age gradient is clear in the seven-day exercise level of Vancouver women (Figure 1.3). Cohort age differences are also significant for late-life movement confidence, and also for beliefs of physician support for exercise (Figure 1.4). This suggests that chronological age is a powerful force that is somehow linked to physical activity level, movement confidence, and encouragement by society for older people to live their lives actively.

Figure 1.3 Exercise in the past week for Vancouver women over age 70.

Figure 1.4 Perceptions of physician support for exercise by age.

The Health Promotion Survey points out that the Canadians most likely to engage in daily exercise in their leisure time are men ages 65 and older (Stephens & Craig, 1990). However, the proportion who never exercise at all is also greater among older adults. Of interest is the finding that older adults, more than younger adults, feel that they get as much as exercise as they need.

The Matter of Being Female

Until recently, little attention has been given to the mechanisms of women’s aging, health, and activity patterns. Frail elderly women, especially, have been virtually invisible in feminist, sociological, and gerontological literature (Evers, 1985; Vertinsky, 1994). By many accounts, most women can expect to live to the ripe age of...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Preface
• Acknowledgments
• Part One: Living Longer And Aging Better
• Part Two: Toward a Theory of Older Adult Exercise Motivation
• References
• Index