Plan & Deliver Exercise for Older Adults With a Managed Condition

1. Plan & Deliver Exercise for Older Adults With a Managed Condition Unit #SISFFIT314A

2. Growing Old Gracefully

3. Ageing World Population People Over 65 Years , worldwide 1950 131 million 1994 357 million 2000 420 million 2050 1 billion = Growth Rate of 800,000 per month.

4. Defining Old Age • Chronological age: • The passing of time birth in years eg • Mature 55-65 years • Senior 66-85 years • Frail/Old 86-99 years • Centenarians 100 +

5. Ageing Definition “Ageing is a continuum that begins at birth; both psychologically and a physical condition; influenced by a lifestyle,heredity and environment “ Sager,K. “ Senior & Fitness” The Physician and Sportsmedicine Vol 11, No 10

6. Ageing Australia census figures 2005 • Number of people aged over 65 years will increase from 2.5 million to around 7.2 million by 2051 • Proportion of people aged over 65 years will grow from the current 13% to 25% of the population by 2051 • Proportion of people over 85 years will grow from thee current 1.4 % to approx. 6 % by 2051 • Proportion of the population aged between 15-64 years ( labour force age) will fall from the current 67% to around 59% by 2051

7. Defining Old Age • Biological Age: People age at different rates due to differing bodily processes that lead to loss of adaptability, functionality, increased disease etc. Body cell deterioration due to : • Heredity • Nutrition • Lack of O2 related circulation around body • Lack of exercise/ physical activity PA • DNA breakdown/cell reproduction error.

8. Longevity Readings & Video : Old Age is Not for Sissies written by Art Linkletter and was first published in 1989 From Average Longevity To Maximum Life Expectancy- What Does it Take ? July 2010 Gerontology Health & Ageing Lifestyle Longevity Live Long and Proper: Genetic Factors Associated with Increased Longevity Identified July 2010 Scientific American author Nicolette Zeliadt Longevity Okinawa Intro. 3.26 min http://www.youtube.com/watch?v=csa3EQw-wIs Complete Questions on Longevity and submit to teacher via email.

9. Facts About Exercise and Older Adults Australia locked into top heavy ageing population >A sedentary lifestyle is a major health risk >People do not retain health benefits >49% of NSW population fail to meet recommended levels of physical activity >Evidence indicates physical activity is best prevention of most diseases. >It is never too late to start exercising >Need to reduce health, social, family, government & economic cost.

10. Common Issues Encountered When Ageing • General fragility & reduced mobility • Loss of balance & proprioception • Loss of eye sight, hearing and other senses • General deterioration of health- osteoporosis, blood pressure cond, hair, senses,teeth, skin, posture, bones, lungs ,muscles, immune function, vital organs, reproduction etc.

11. Important Functional Changes • Decrease in peak oxygen transport to body & organs • Increase in body fat content • 25% decrease in peak muscle force & lean tissue from age 40 to 65 accelerating loss thereafter. • Atrophy of fast twitch muscle fibre- less co ordination of muscle contraction • 7% loss of flexibility per decade • Progressive decrease in bone calcium & deterioration of bone density beginning at age 25 • Decrease in balance, slowing of reaction speed & movement time • Deterioration of function in special senses ( vision, hearing, smell & taste) ,impaired memory ,poor sleep patterns & increased depression.

12. Ageing and Exercise Implications • Circulatory & Respiratory System Aerobic Capacity • Musculoskeletal System Strength & Mobility • Neurological System Memory & Co ordination • Other Changes Balance, skin, senses.

13. Role of Exercise “ Those who cannot find the time for exercise will sooner or later have to find time for illness” Dr. John Ticknell

14. Circulatory & Respiratory System

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16. Aerobic Capacity Changes Exercise Implications * Cardiac fitness declines approx.10% per decade per adulthood * Coronory arteries harden * Less forceful heart contractions * Increase in blood pressure * Circulation slows • Heart & lung capacity decrease during physical activity. • Chest wall stiffens, • 50 % of VO2 max lost by age 75 • Decreased ability to transport oxygen Cardiorespiratory fitness decreased Physical work capacity reduced Fatigue quicker, longer recovery Sustained intense activity should be avoided or increase risk of disability or death. Emphasis on adequate warm up & cool down during exercise Regardless of age, lung capacity can be improved with regular low to moderate exercise program.

18. Musculoskeletal System Musculoskeletal Changes • Type 2 Fast Twitch muscle fibres decrease :Type 1 maintains or replaces Type 2 • 5-10% muscle fibre loss bet.25-50 yrs;30%loss from 50-80yrs;rapid after 80 yrs • Tightening of postural muscles eg.erector spinae group,gluts,hamstrings • Weakeneing of phasic muscles eg.abdominal,quads • Sarcopenia (decr.muscle mass) • Decr.muscle power ,strength & endurance • Exercise Implications • Muscle strength,power & endurance diminish with age& lackof use. • Muscle fibre loss impacts on physical mobility,encourage large leg muscle workeg.sit to stand,stair climbing,jogging, trip recovery • Mobility of joints,muscles & stability decr. - encourage flexibility. • Balance & co ordination reduced,promoting fear of falling. • Avoid quick changes of direction or sudden movements • Muscles and joints take longer to warm up & prepare for exercise.

19. Muscle Strength

20. Musculoskeletal System Joint & Bone Mass Changes * Decr.in bone mineral density * Peak BMD is attained by 25 yrs of age, sustaine tll approx.40-50 with signiificant losses from 70 yrs. * Flexibility declines 20-30% bet.ages 30-70 yrs. * Active adults are more flexible than inactive adults. • Joint stiffness from shortness /stiffening of ligiments ,tendons, joint capsule, muscle , fascia & skin around the joint that reduces joint mobility. • * Decr.in production of synovial fluid. • Exercise Implications • Avoid twisting, forward flexion & sudden movements. • Higher incidence of bone fractures. • Activities involving ground related forces such as walking or jogging are recommended. • Crucial joints are moved through full ROM pain free for improvements in flexibility. • Extensive warm up is required to prepare joints.

21. Neurological System

22. Neurological System • Nervous System Changes • Decr. in no nerve cells,their blood supply & capacity to send impulses to/from brain leading to impaired sensory perception. • Short tern memory loss • Slower info. processing speed, especially at points of decision making • Cognitive performance declines, especially when attention is divided. • Slower reaction time. • Exercise Implications • Coordination,vision,hearing, balance & short term memory all decline • Takes longer to react,so keep pace slower • Less accurate with performance • Need simple routines,lots of repetition & clear instructions • Speak slowly & instructions simple • Use visual demonstration or signs

23. Aerobic exercise can increase brain sizeExercise can help both your heart and your head study finds. SMH February 4, 2011

24. Aerobic exercise keeps the ageing brain - as well as the ageing body - in fighting form. • US researchers showed aerobic exercise, over a year, increased the size of the hippocampus – a part of the brain key to memory and spatial navigation - in adults aged 55 to 80. • The hippocampus is known to shrink in late adulthood, leading to memory impairment. • Results back up earlier research that showed a correlation between fitness level and brain function. • Moderate exercise is a particularly cost-effective way to treat a widespread health problem - without the side effects of medication. • And, researchers said, it's never too late. "Starting an exercise regimen later in life is not futile for either enhancing cognition or augmenting brain volume," the team wrote.

25. A Healthy Body can help keep a Healthy Mind with Simple Regular Physical Activity. • In Alzheimer's disease, the hippocampus is one of the first regions of the brain to suffer damage; memory problems and disorientation appear among the first symptoms. • A 2008 review of cognitive enrichment therapies (strategies to slow or reverse cognitive decline) concluded that "physical activity, and aerobic exercise in particular, enhances older adults' cognitive function. Hertzog C, Kramer AF, Wilson S, Lindenberger U. (2008). "Enrichment Effects on Adult Cognitive Development: Can the Functional Capacity of Older Adults Be" (PDF). Psychological Science in the Public Interest 9 (1): 1–65

26. Exercise and Depression • When a person exercises, levels of both circulating serotonin and endorphins are increased. • These levels are known to stay elevated even several days after exercise is discontinued, possibly contributing to improvement in mood, increased self-esteem, and weight management. • Exercise alone is a potential prevention method and/or treatment for mild forms of depression

27. Other Changes • Changes • Decr.in effectiveness of imune system • Decr. In skin elasticity • Weaker abs- back pain • Insecurity,lack of confidence • Deterioration of senses-vision,hearing,smell & taste • Impaired memory, poor sleep patterns • Increased depression • Feel negative & incapable • Implications for exercise • Less resistance to infection • Unable to stretch effectively • Easy bruising, slow healing • Constipation, diarrhoea & stress incontinence • Slower to comprehend what is happening

28. “ If You don’t use it you will lose it” INACTIVITY NOT AGEING IS THE ENEMY

29. Student Discussion Forum on the Exercise and Older Adult moodle forum on: “Importance of Exercise on Longevity, Independence and Healthy Lifestyle” Briefly respond to at least 2 other students comments.