Older Adults

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Older Adults

• By the year 2030, the number of individuals 65
  yrs. and over will reach 70 million in the US
  alone (20 of all Americans)

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Older Adults

• Persons 85 yrs. and older will be the fastest
  growing segment of the population.

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Graying of America

• In 2010, 40 million people age 65 and over lived
  in the United States, accounting for 13 percent
  of the total population.
• The older population grew from 3 million in 1900
  to 40 million in 2010.
• The oldest-old population (those age 85 and over)
  grew from just over 100,000 in 1900 to 5.5
  million in 2010.

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Graying of America

• The older population in 2030 is projected to be
  twice as large as their counterparts in 2000,
  growing from 35 million to 72 million and
  representing nearly 20 percent of the total U.S.
  population.

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OFD

• Based on the latest data (2006) from the National
  Center for Health Statistics
• 37.3 million gt 65
• 18.3 million gt 75

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Life Expectancy (2012)

• Men 76.4
• Women 81.2
• gt65
• W 20.5
• M 17.9

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Baby Boomers

• They were born between 1946 and 1964
• Currently they are 49 to 67 years old
• As of 1-1-05, there were 78.2 million of them

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Baby Boomers

• 8000 Number of baby boomers turning 60 every
  day in 2006.
• About 330 per hour
• 57.8 million will be alive in 2030 with 55 of
  them being female.

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Baby Boomers

• The Baby Boomers (those born between 1946 and
  1964) started turning 65 in 2011, and the number
  of older people will increase dramatically during
  the 20102030 period.

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Live Longer?

• Increased longevity is accompanied by increased
  prevalence of chronic conditions and their
  associated pain and disability.

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Older Adults

• No one is too old to enjoy the benefits of
  regular physical activity.

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Older Adults

• Of special interest to older adults is evidence
  that muscle strengthening exercises can reduce
  the risk of falling and fracturing bones and can
  improve the ability to live independently.

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Older Adults

• Physiologic decline with aging
• VO2max (5-15 per decade after 25)
• Maximal cardiac output.
• Maximal a-vO2 difference.
• Maximal heart rate.

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Older Adults

• Stroke volume during maximal exercise.
• Plasma, red blood cell, and total blood volumes
  decrease.
• Left ventricle compliance.

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Older Adults

• Lower ejection fractions.
• Blood pressure and vascular resistance increase.
• Bone density.

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Older Adults

• Connective tissue elasticity.
• Muscle atrophy.

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Older Adults

• 1. Performance and aging.
• a. Individuals with CVD and men over 45 or women
  over 55 years of age with multiple risk factors
  should have a medical evaluation prior to
  embarking on a vigorous exercise program.

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Older Adults

• 2. Trainability of the older athlete.
• 3. General performance and physiological function.

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Exercise Prescription

• The general principles of exercise prescription
  apply to all individuals.
• However, the wide range of health and fitness
  levels observed among older adults make generic
  exercise prescription more difficult.

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Exercise Prescription

• Care must be taken in establishing the type,
  intensity, duration, and frequency of exercise.

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Mode

• The exercise modality should be one that does not
  impose significant orthopedic stress.

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Mode

• The activity should be accessible, convenient,
  and enjoyable to the participant -- all factors
  directly related to exercise adherence.

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Mode

• Consider walking, stationary cycling, water
  exercise, swimming, or machine-based stair
  climbing.

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Intensity

• Intensity must be sufficient to stress (overload)
  the cardiovascular, pulmonary, and
  musculoskeletal systems without overtaxing them.

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Intensity

• High variability exists for maximal heart rates
  in persons over 65 years of age thus it is
  always better to use a measured maximal heart
  rate rather than age-predicted HR max whenever
  possible.

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Intensity

• For similar reasons, the HR reserve method is
  recommended for establishing a training HR in
  older individuals, rather than a straight
  percentage of HR max.

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Intensity

• The recommended intensity for older adults is 50
  to 70 of HR reserve.

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Intensity

• Since many older persons suffer from a variety of
  medical conditions, a conservative approach to
  prescribing aerobic exercise is initially
  warranted.

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Duration

• During the initial stages of an exercise program,
  some older adults may have difficulty sustaining
  aerobic exercise for 20 minutes one viable
  option may be to perform the exercise in several
  10-minute bouts throughout the day.

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Duration

• To avoid injury and ensure safety, older
  individuals should initially increase exercise
  duration rather than intensity.

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Frequency

• Alternate between days that involve primarily
  weight bearing and non-weight bearing exercise.