Exercise training guidelines for the elderly

The capacity of older men and women to adapt to increased levels of physica l activity is preserved, even in the most elderly. Aerobic exercise results in improvements in functional capacity and reduced risk of developing Type II diabetes in the elderly. High-intensity resistance training (above 60% of the one repetition maximum! has been demonstrated to cause large increas es in strength in the elderly. In addition, resistance training result in s ignificant increases in muscle size in elderly men and women. Resistance tr aining has also been shown to significantly increase energy requirements an d insulin action of the elderly. Purpose: We have recently demonstrated tha t resistance training has a positive effect on multiple risk factors for os teoporotic fracture in previously sedentary postmenopausal women. Methods: Because the sedentary lifestyle of a long-term care facility may exacerbate losses of muscle function, we have applied this same training program to f rail, institutionalized elderly men and women. Results: In a population of 100 nursing home residents, a randomly assigned high-intensity strength-tra ining program resulted in significant gains in strength and functional stat us. In addition, spontaneous activity, measured by activity monitors, incre ased significantly in those participating in the exercise program whereas t hew was no change in the sedentary control group. Before the strength train ing intervention, the relationship of whole body potassium and leg strength was seen to be relatively weak (r(2) = 0.29, P < 0.001), indicating that i n the very old, muscle mass is an important but not the only determining fa ctor of functional status. Conclusions: Thus, exercise may minimize or reve rse the syndrome of physical frailty, which is so prevalent among the most elderly. Because of their low functional status and high incidence of chron ic disease, there is no segment of the population that can benefit more fro m exercise than the elderly.