Aging and Exercise: When Are You Too Old to Exercise?

The Miami Herald had a front page article about recreational baseball players who ranged in age from 69 (the baby) to 93. The men, retired doctors, lawyers, teachers, businessman and public officials, meet twice weekly to play. They divide themselves into two teams since they can't find another local team whose ages are similar to theirs. The 93-year-old was quoted as being insulted when asked if he needed a pinch runner and had, before the article was written, just hit his first home run. They played for the joy of it; aches and pains from aging joints forgotten or endured for the sake of the game.

A recent issue of The New England Journal of Medicine published a study showing that older obese adults have to exercise while losing weight in order to maintain their physical strength. The objective of the study, authored by Dennis Villareal, M.D., was to prevent the loss of muscle and bone mass that may occur with dieting. Such losses, according to the report, could result in a deterioration of physical function and frailty and the study was structured to measure changes in a variety of physical tasks such as climbing stairs, bending over to pick up a penny, and being able to turn 360 degrees without losing balance. These may seem like trivial physical tasks to the physically capable of any age but according to the research paper, frailty among older adults is a major reason they may lose their ability to live independently.

The mostly 70-year-old volunteers in the study underwent a vigorous, yearlong exercise regimen. They had three weekly 90 minute workout sessions that included weightlifting to strengthen their muscles, as well as vigorous aerobic exercise using a treadmill, exercise bike and stair climbing equipment. In fact, these older adults probably exercised harder than many people 30 years younger. And it paid off. Not only did every measure of physical stamina and functionality increase, they also maintained their bone and muscle mass.

The results of this study are compelling. Who wants to relinquish one's independence because of difficulty climbing stairs, getting out of a chair or being unable to put on a coat? Who wants to be prevented from strolling through a park or museum because of muscle weakness or fragile bones? Many of us may be vulnerable to nerve or orthopedic problems that limit our mobility or unhappily, degenerative disorders which reduce our physical independence. There is no fortune teller that can predict who among us may be subject to these problems. But one does not need a psychic to predict that as we age, a sedentary life coupled with obesity may cause us to enter the eighth or ninth decade of life unable to carry out the physical tasks of the day-to-day with ease.

The study was not intended as a warning to a younger population to start exercising now. Nor did it make any recommendations as to how to get older adults who rarely exercised when they were younger to start now. It did, however, point out some sobering statistics that I wish I knew when several years ago a 60 ish woman who came to me for weight loss help announced that she was too old to exercise. I would have quoted the statistics noted in the article that 20 percent of adults 65 years of age and older are obese, the obesity among older adults may exacerbate a deterioration in the ability to perform many physical functions, and the frailty that may follow can lead to nursing home admissions. Weight loss alone may exacerbate these problems if it occurs without exercise. This might have motivated her to go to a gym (or at least when she got older).

Most people don't think of dieting without exercise as risky. We tend to think that weight loss more or less equals loss of fat. A few days ago I saw a billboard saying just that, "Lose one pound of fat a week" it proclaimed in advertising some quick weight loss plan. But is fat all that we lose? The older volunteers in this study who dieted without exercise decreased both their muscle mass and bone density. Many diet programs will tell you that you can lose weight without exercise or recommend exercising after the weight has been lost. What these programs do not mention is the potential loss of bone or muscle mass that may exacerbate fragile bones, loss of balance or physical stamina.

There is an apartment for seniors across the street from my gym. I can look out the window at the residents walking in and out of the building or sitting on the wide porch by the front door. Almost all of them have trouble walking up or down the few steps in front of the building and some have needed help getting up from their chairs on the porch. They seem to be the same age as several people I know at the health club who are in their mid-to-late 70s.

I have a friend, almost 75, who is acknowledged as the fastest spinner in her spin class and another who lifts heavier weights than most guys 30 years younger. Might they be living across the street if they did not exercise with such dedication and determination? Would they be frail and suffer from balance problems and muscle weakness? Might I if I don't stop staring out the window and get back to my exercise routine?

Given a choice, I suspect most of us would like to enter older age with the stamina and verve of the Miami baseball team. Whether we do or not depends partly on escaping the physical disabilities associated with many medical problems. But if we are fortunate enough to have our health, then attaining a normal weight and exercise seems a small price to pay for physical independence and may be the chance to hit a home run of our own.

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