Exercise for Older Adults : Is It Safe for Me to Exercise?

by National Institute on Aging

(Page 4 of 12)

If you have a chronic condition, you need to know how you can tell whether your disease is stable; that is, when exercise would be OK for you and when it wouldn't.

Chances are good that, if you have a chronic disease, you see a doctor regularly (if you don't, you should, for many reasons). Talk with your doctor about symptoms that mean trouble - a flare-up, or what doctors call an acute phase or exacerbation of your disease. If you have CHF, you know by now that the acute phase of this disease should be taken very, very seriously. You should not exercise when warning symptoms of the acute phase of CHF, or any other chronic disease, appear. It could be dangerous.

But you and your doctor also should discuss how you feel when you are free of those symptoms - in other words, stable; under control. This is the time to exercise.

Diabetes is another chronic condition common among older people. Too much sugar in the blood is a hallmark of diabetes. It can cause damage throughout the body. Exercise can help your body "use up" some of the damaging sugar.

The most common form of diabetes is linked to physical inactivity. In other words, you are less likely to get it in the first place, if you stay physically active.

If you do have diabetes and it has caused changes in your body - cardiovascular disease, eye disease, or changes in your nervous system, for example - check with your doctor to find out what exercises will help you and whether you should avoid certain activities. If you take insulin or a pill that helps lower your blood sugar, your doctor might need to adjust your dose so that your blood sugar doesn't get too low.

Your doctor might find that you don't have to modify your exercises at all, if you are in the earlier stages of diabetes or if your condition is stable.

If you are a man over 40 or a woman over 50, check with your doctor first if you plan to start doing vigorous, as opposed to moderate, physical activities. Vigorous activity could be a problem for people who have "hidden" heart disease - that is, people who have heart disease but don't know it because they don't have any symptoms.

How can you tell if the activity you plan to do is vigorous? There are a couple of ways. If the activity makes you breathe hard and sweat hard (if you tend to sweat, that is), you can consider it vigorous. Charts in Chapter 4 explain more about how to tell if your exercise is moderate or vigorous.

If you have had a heart attack recently, your doctor or cardiac rehabilitation therapist should have given you specific exercises to do. Research has shown that exercises done as part of a cardiac rehabilitation program can improve fitness and even reduce your risk of dying. If you didn't get instructions, call your doctor to discuss exercise before you begin increasing your physical activity.

For some conditions, vigorous exercise is dangerous and should not be done, even in the absence of symptoms. Be sure to check with your physician before beginning any kind of exercise program if you have: abdominal aortic aneurysm, a weakness in the wall of the heart's major outgoing artery (unless it has been surgically repaired or is so small that your doctor tells you that you can exercise vigorously), critical aortic stenosis, a narrowing of one of the valves of the heart.

Most older adults, regardless of age or condition, will do just fine in increasing their physical activity. You might want to show your doctor this book, to open the door to discussions about exercise.

Every Crisis Is an Opportunity

Dr. Andrew Puckett is a busy man with an impressive list of titles after his name. The 60-year-old associate dean for medical education at Duke University, in Durham, North Carolina, has a Ph.D. in adult education and a minor in clinical psychology, and he has been a counselor for years. He also has Parkinson's disease, a chronic condition that causes muscles to tremble and become rigid. He was diagnosed with it a few years ago.

Has his chronic condition slowed down his activities? It doesn't appear that way. In addition to his regular activities, 2 years ago, Dr. Puckett volunteered to take part in a study of how stretching exercises affect people with Parkinson's disease. He enjoyed the feeling of stretching so much that he kept doing the exercises after the 10-week study ended, and now does them at least 3 days a week for 40 minutes at a time.

It's not yet clear whether or not stretching exercises have an effect on Parkinson's disease specifically, but it's very clear to Dr. Puckett that they have helped him feel better overall.

"I literally feel so much better from doing the exercises," he told us. "I'm more flexible than I've been in 20 years. Stretching has given me so much ease of movement. It's a fluid feeling," he said. In addition, Dr. Puckett finds that stretching exercises give him a sense of well-being. He likens it to the "runner's high" that some joggers experience.

Dr. Puckett noted another positive aspect of his stretching exercises: the feeling that he is nurturing himself. He described it as a secure feeling; a feeling that he is doing something good for himself.

Another motivator for keeping up with his stretching exercises is "the fear of being stiff and rigid; bent over. I want to keep that from happening," he told us.

Besides working at the university, Dr. Puckett splits his own firewood, plays tennis, gardens, mows his lawn with a push mower, and walks a mile or more at least 3 days a week.

"But people shouldn't feel that physical activity has to be some super-human or highly disciplined effort," he said. "I don't want them to be scared off from the idea of exercising. I think once they experience how much better they feel, they'll want to keep on doing it. It has so many built-in benefits."

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.