I turn 60 in April next year. For most of my adult life, I have fought a debilitating autoimmune musculoskeletal illness that struck me in my youth. I also carry on a lifelong crusade to make people realise the remarkable health benefits of exercise. In this column, I write about the benefits of exercise, primarily strength training, for older people.
Too old to exercise?
There is a quaint story involving action star Arnold Schwarzenegger that I am fond of telling my friends in the senior population. An older man once came up to Arnold and asked him, “Am I too old to exercise?” “You are too old not to!” retorted Schwarzenegger.
The common perception that exercise is dangerous for elderly people still persists. Nothing could be further from the truth. In fact, there has been a spate of scholarly and clinical research in the recent past that clearly indicates that exercise, in particular strength training and cardiovascular training to build muscle mass and improve VO2 max, is hugely beneficial for both mental and physical health, and is the medicine of choice for enhancing longevity.
Medical standards have improved
Continuing improvements in the management of both acute and chronic ailments have ensured that there are more older people in society today than perhaps at any other time. I tell my senior friends to ask themselves this question: how old would you think you were if you did not know how old you were? In most cases, the gap between your real age and your imagined age will tell you about your fitness level. So, if you are only 50 and feel like you are 60, you have work to do. On the other hand, there are several people in my social and sporting circles who can outrun, out-row, out-ride or even outplay their children.
Time (age) changes everything
A look at some of the major changes that accompany ageing makes it abundantly clear why sticking to a fitness regimen becomes more and more important as you grow older. As you age, your body starts losing muscle mass in a process called sarcopenia. Then there is the deterioration of bone density, or osteopenia. A recent clinical study suggested that as many as 30-40 per cent of urban Indian women across socio-economic and cultural groups suffer from osteopenia or osteoporosis.
The basal metabolic rate, or BMR, the rate at which your body burns the calories you consume as food, also slows down. This leads to the accumulation of dreaded visceral fat, which is a major risk factor for chronic and lifestyle diseases, and even death. Muscles and joints start losing their flexibility and their ability to generate movement. Cardiovascular function also slows down, which means the heart and lungs have to work harder each year to supply blood, oxygen and nutrients to the muscles. Many bodies lose this capacity drastically, and poor blood flow to the heart is a primary cause of ischaemic heart disease, which is responsible for roughly 13 per cent of all deaths worldwide.
Another very common cause of death among older people across the globe is falls. The WHO estimates that around 684,000 people die from falls each year. Falls are the second leading cause of unintentional injury deaths worldwide. Among older adults, falls are responsible for up to 40 per cent of all injury-related deaths, and around one in three people over 65 fall each year. Loss of proprioceptive awareness and a poor sense of balance with advancing age are the primary causes of falls. This makes a very strong case for strength, power, balance and gait training in older adults: the goal is not merely to increase muscle, it is to reduce the chance that a loss of balance becomes a catastrophic event.
Every one of these processes can be arrested, and their effects reduced, through good exercise and a proper diet. Conversely, not exercising, and not eating and sleeping well, will greatly speed up degeneration.
What does research say?
The findings of ‘Resistance training and inter-individual response differences on cardiorespiratory fitness in older adults’, 2024, by George A. Kelley, Kristine S. Kelley and Brian L. Stauffer, are particularly interesting because they show that resistance training does more than preserve or increase muscle mass and strength — it also improves cardiovascular fitness and VO2 max. The study analysed 22 randomised controlled trials involving 552 adults aged 60 and above. Resistance training produced a statistically significant improvement in VO2 max of about 1.8 mL/kg/min, equivalent to roughly a 7.8 per cent increase from baseline.
We know from clinical practice that the human brain gradually loses tissue from the third decade of life onwards, leading to a decline in cognitive and memory performance. However, a 2010 University of Florida dissertation, ‘Neural Correlates of Aerobic Fitness and Aging’, suggested that better aerobic conditioning is directly linked to the health of brain tissue implicated in clinical syndromes such as Alzheimer’s disease and schizophrenia.
A recent study indicated that resistance training could also arrest age-related deterioration in brain tissue density. A systematic review and meta-analysis of the effects of resistance exercise on cognitive function in older adults studied 739 participants aged 60 and above. It found that resistance training significantly improved:
Overall cognitive function
Working memory
Verbal learning and memory
Spatial memory
A balanced training protocol
Cardiovascular training will take care of the heart and lungs (and mind), but the biggest bang for your buck comes from resistance training. Modern research suggests that lifting weights makes your skeletal muscle synthesise and secrete cardioprotective peptides that improve blood flow to the heart, along with special bioactive molecules called myokines that travel to organs such as the liver, brain, bone tissue and pancreas, improving your overall hormonal and metabolic health.
The best exercises for building bone density are squats, lunges and step-ups for the lower body, and military or shoulder presses and heavy dumbbell or barbell rows for the upper body. Remember, loading your bones with free weights is critical; the resistance machines you see in most box-type health clubs and hotel gyms will do precious little to improve bone density.
Proprioception is very important for older people. It is your body’s ability to sense where your joints and limbs are, and how they are moving, without having to look at them. Our proprioceptive sense declines with age, increasing the risk of stumbling, slipping and falling. The best exercises to progressively challenge your balance and strength are:
Single-leg deadlifts
Step-downs and step-ups, both laterally and in the sagittal plane
Squats and lunges
(Fortunately) it’s never too late
Research shows that even people over 80 can strengthen their muscles through regular strength-training workouts. In the Melbourne Collaborative Cohort Study, published in the October 2007 issue of Arthritis Care & Research, researchers studied the effect of physical activity of varying intensity, frequency and duration on knee structures in 257 healthy adults aged between 50 and 79, and found that intense exercise prevents and helps osteoporosis.
Live pain-free
Most common age-related complaints, such as back, neck, shoulder and knee pain, can easily be avoided with regular strength training and proper stretching. The keyword here is regular. You don’t have to push yourself too hard, do a huge amount of exercise or reach athletic levels of fitness. You need only do a little, but you must commit to three to four days a week to achieve proper balance, variety and versatility.
Ranadeep Moitra is a strength and conditioning specialist and corrective eexercise coach