Overview Older Adults

Gerokinesiology - area of study of how PA affects health and well being in elders and aging process

Demographics: The life expectancy is getting longer, we are begininng to pay attention to our lifestyle

Curriculum for preparing PA instructors for older adults: Sociol, physiol, psych, screen&goal setting, how to teach, safety and first aid, leadership, communicate and market, ethics

Physiological Changes with Older Adults

Decreased Oxygen transpt (5 ml/kg/min starting at 25)

-can counter this w/training

Incr body fat from lack of exercise

-fat is subcutaneous- inward (muscles, organs) deep below skf test - DEXA ideal

Glucose tolerance decreased

Decreased blood lipid profile

Decreased insulin sensitivity

Lose peak muscle force and lean tissue age 40-65

Flexibility decreases, lack of mvmt

Peak O2 decreases

Bone mineral density decreases ( Osteoblasts break down)

-counter with nutrition and phys. act

Balance declines, NS slows down, polypharmacy, loss of strength

Decreased reaction time, mvmt speed, slower signals

Decreased function of senses (see, hear , smell)

Impaired memory

Poor sleeping patterns & depression from death increasing

Older Adults Barriers to Physical Activity

It is not being made understandable to them

Communities are not encouraging people to just go out

few models of integrated community approaches to PA

lack of community resources (disconnected)

health orgs not collaborating

SO.....

Older adults do not know where to start

Intimidated and need to be taught

Lack of transportation

Health care pros lack adequate, age apprpriate patient education materials - sickness not wellness

Medical professions don't have info to make referrals to community resources

Many messages / info about PA are unclear, inconsistent, confusing

Older Adults Exercise Response 

Know their complete medical history and individualize tests based on info
Ask q's, easy language

They take longer to reach steady state

Watch stage lengths, ramp good, 30sec

Dehydration or insulin sensitivity is possible 

Exercise Training for Older Adults

When older adults train, it protects against heart disease, diabetes, cancer
Helps their performance of ADL - avoid  going to nurse home

Sport/recreational things are easier (groceries, take out trash)

Less depression and ansiety, more emotional well being and brain functioning

Know the side effects and impacts of typical meds (Polypharmacy) 

Exercise Testing for Older Adults

Aerobic

Cycle: ramp protocol

Treadmill: naughton/Balke

Endurance

6-12 minute walk

Strength 

Dynomometer, 1RM (they have no sense of how lifting feels so take them beyond their limits and push them)

Flexibility

Sit and reach, goniometer

Neuromuscular

20foot walk, chair stand (lower body only), one legged stance for balance, 8 step tandem gait

The Senior Fitness Test

Assess core 5 physical abilities on a scale - safe - not too exhausting.

Convenient, several countries norm referenced standards

1. Chair stand with no arm support - stand and sit for 30sec

2. Arm curl (monitor this to see they do a full curl)

3. 2 minute step - lift legs to a certain height

4. Back Scratch

5. Sit and reach (they will want to bend knee)

6. Foot up and go - walk around cone timed

Exercise Prescription for Older Adults

So much Individual variability 

ACSM GUIDELINES

Broad Program

Strength 2x a week

Walking, stretching

Weight transfers

Accumulate 30 minutes of moderate-vigorous or 3 bouts of 10 throughout the day 

NIA

well rounded- similar guidelines

Fiatarone at tuft university strength trained for 8 weeks at 80% 1RM

age 90years

Strength increased 174% and gait increased 48%