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Fitness & Exercise for Senior Citizens
Doctors Should Prescribe Exercise for Older Adults
for Better Health
Less than half report ever getting
suggestion to exercise from doc
 October 8, 2006 Some experts on aging nutrition
are recommending that doctors begin writing prescriptions for exercise
for older people. The rationale is that senior citizens are accustomed
to getting prescriptions from their doctor and using the familiar
concept of a prescription to help physicians incorporate exercise
recommendations into their routine practice will convince more to take
action.
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Senior Citizen Fitness & Exercise |
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This recommendation by Ann Yelmokas McDermott, PhD,
a researcher in the Lipid Metabolism Laboratory at the Jean Mayer USDA
Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts
University, and Heather Mernitz, PhD, now of the Nutrition and Cancer
Biology Laboratory at the USDA HNRCA, is published in the journal
American Family Physician.
McDermott and Mernitz provide clinicians with
explicit guidelines for giving their older patients effective "exercise
prescriptions." Their motto for determining an exercise prescription is
'FITT-PRO':
● Frequency
● Intensity
● Type
● Time
● Progression
According to FITT-PRO principles, an exercise
prescription must explicitly instruct the patient regarding what type of
exercise to do, how often, how hard, and for how long.
The exercises must also progress over time as the
patient becomes more physically fit. McDermott and Mernitz caution that,
as with medication prescriptions, these exercise parameters must be
personalized to suit each patient's health status and goals.
McDermott, who is also a licensed nutritionist,
points out that fewer than half of older adults report ever having
received a suggestion to exercise from their physicians.
"Clinicians shouldn't feel like they have to be
fitness experts to discuss exercise with their patients," she says.
"These guidelines are intended to serve as a how-to
manual for health care providers." The article provides sample
prescriptions, as well as instructive tables and figures for clinicians
to follow in creating individualized exercise prescriptions for their
patients.
The authors explain, "There are four ways to
improve physical fitness: aerobic exercise, resistance training,
flexibility, and lifestyle modification." All programs should include
combinations of these types of activities, and be tailored toward the
individual's fitness goals.
"For example," McDermott says, "when the goal is to
improve functional capacity in activities of daily living, a
cross-training program emphasizing the core muscle groups of the back,
thighs, and abdomen is preferred."
"Only 30 percent of America's senior citizens
engage in regular exercise," notes McDermott, "yet there is compelling
evidence suggesting that people in all conditions of health and at all
fitness levels benefit from regular physical activity.
"In fact, the most de-conditioned individuals have
the greatest and fastest response." Mernitz adds, "Seniors tend to have
less access than other demographic groups to physical activity
information and programming. In contrast, they have relatively more
contact with their health care providers."
"Starting an exercise program later in life can
significantly modify risk factors, even if a person has been sedentary
in prior years," McDermott concludes. "Health care providers can play a
major role in offering effective and inexpensive primary or adjunct
therapies, encourage appropriate physical activity, and dispel myths
that persist as barriers to exercise in the elderly."
Among the useful resources McDermott and Mernitz
reference is a book created by colleagues at the John Hancock Center for
Physical Activity and Nutrition at the Friedman School of Nutrition
Science and Policy at Tufts University, along with experts from the
Centers for Disease Control and Prevention (CDC).
The book (citation below), available as a PDF on
the CDC web site, is called Growing Stronger: Strength Training for
Older Adults, and contains detailed explanations and useful
illustrations of strength-training exercises. It is intended to help
seniors make strength training part of a regular exercise routine.
Editor's Notes:
McDermott AY, Mernitz H. American Family
Physician. (August 1) 2006; 74(3). "Exercise and Older Patients:
Prescribing Guidelines."
Recommended Book: Seguin RA, Epping JN, Buchner DM, Bloch R,
Nelson M. Growing Stronger: Strength Training for Older Adults. 2002.
Also available at:
http://www.cdc.gov/nccdphp/dnpa/physical/growing_stronger/growing_stronger.pdf
The Gerald J. and Dorothy R. Friedman School of
Nutrition Science and Policy at Tufts University is the only independent
school of nutrition in the United States. The school's eight centers,
which focus on questions relating to famine, hunger, poverty, and
communications, are renowned for the application of scientific research
to national and international policy. For two decades, the Jean Mayer
USDA Human Nutrition Research Center on Aging at Tufts University has
studied the relationship between good nutrition and good health in aging
populations. Tufts research scientists work with federal agencies to
establish the USDA Dietary Guidelines, the Dietary Reference Intakes,
and other significant public policies.
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