Good health acquired from regular exercise provides older adults with the opportunity to enjoy quality time with their grandchildren.

Decreased stamina, memory loss, poor balance...these are a result of "old" age, right? Or are they? Test your knowledge about the effects of the aging process and exercise on your body and mind with this quiz. You may be surprised as to what is really within your control.

A. Falls are an inevitable occurrence as you age.

1. True
2. False 

B. Individuals who are 65 years-of-age and older are too old to gain benefits from an exercise program.

1. True
2. False

C. Regular exercise will have no effect on cognitive decline later in life.

1. True
2. False

D. Older adults can gain health benefits from bouts of exercise that are as short as 10 minutes in duration.

1. True
2. False

E. Healthy older adults can safely participate in vigorous-intensity exercise.

1. True
2. False

ANSWERS:

A. False. Personal and lifestyle choices can greatly impact your risk for a fall, according to the National Institutes of Health Senior Health website (NIH Senior Health). In fact, the first line of defense in the prevention and treatment of falls and fractures is to engage in regular endurance, strength, balance and flexibility exercises. More...

B. False. Older adults at any age can benefit from regular exercise. The American College of Sports Medicine reports that individuals who are 65 years-of-age and older are able to experience a similar increase in their aerobic capacity (about 10 to 30 percent) from regular exercise, such as walking, compared to their younger counterparts. More...

C. False. The National Institute on Aging states that regular exercise can help you to coordinate and switch between tasks, formulate plans of action and disregard irrelevant information. Routine physical activity can also help you to keep your "working" memory (i.e., the ability to retain and process information over a short period of time). More...

D. True. The 2008 Physical Activity Guidelines for Americans issued by the federal government reports that health benefits can be obtained from exercise sessions that are only 10 minutes in duration; however, the guidelines stress that sessions of longer duration (e.g., 30 minutes) provide greater benefits. More...

E. True. The 2008 Physical Activity Guidelines for Americans states that healthy and fit adults who are 65 years-of-age and older are able to safely engage in vigorous-intensity exercises, such as jogging. The federal government recommends that older adults participate in vigorous-intensity exercises for approximately 75 minutes per week. (Note: individuals whose fitness levels and health conditions preclude participation in intense exercise can still obtain benefits by engaging in moderate-intensity exercises for 150 minutes per week. More...

Note: A physician's approval should be obtained prior to initiating an exercise program or increasing the intensity level of a current exercise regimen.

Fitness levels are affected by age. A new study in the October 26th issue of Archives of Internal Medicine notes that an age-related decline occurs in fitness levels for both men and women. This decrease accelerates after the age of 45 years and is more pronounced in men. However, the results of the study indicate that those individuals who remain physically active, maintain a normal body mass index, and abstain from smoking have significantly greater fitness levels and better health across the adult life span than those persons who do not follow these lifestyle habits.

In their report, the researchers reiterate that low levels of cardiorespiratory fitness are associated with an increased risk of morbidity and mortality, impaired ability to function, decreased levels of independence, and poor quality of life. They add that the loss of independence, which is correlated with a fitness level of 5.1 METs or less as designated by the US Social Security Administration, will occur at a younger age due to the increasing prevalence of obesity and physical inactivity in the general population.

The researchers indicate that a strength of their investigation was the use of large subject samples characterized by a diverse age range. The data was collected from 3, 429 women and 16, 889 men, aged 20-96 years, who participated in the Aerobics Center Longitudinal Study from 1974-2006. Subjects underwent between 2 to 33 health examinations and performed graded exercise treadmill tests to determine cardiorespiratory fitness levels. A limitation of the study, as noted by the investigators, was that the cohort was comprised mostly of participants who had access to health care, were white, well-educated, and of middle-to upper-socioeconomic status.

The results of the study confirm the necessity of engaging in regular physical activity, smoking cessation efforts, and measures to maintain body weight throughout adulthood.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resource

Arch Intern Med. 2009;169{19}:1781-1787.

     Exercise makes sense, literally.  There is a growing body of evidence, from both human and animal studies, that routine aerobic exercise can boost brain power.  Cognitive decline was once thought to be inevitable as one aged.  Over recent years, however, investigators are discovering that regular exercise is associated with a reduced risk for and/or delayed onset of dementia in the aging population.  It appears that acquiring "brain fitness" is possible and is as important as achieving cardiovascular fitness for optimal health and well-being in the later years.

     According to Janet Fletcher Brady, M.S. Director of Medical Programs for LifeSpan (www.lifespanfitness.com), and cofounder/developer of Fitness Forever (www.fitnessforever.com/), "Age doesn't matter.  It is what you do as you age that has a big impact."  Living a healthy lifestyle overall, such as not smoking (smoking restricts blood flow and oxygen supply to the brain thereby impairing brain function), maintaining a healthy body weight, consuming a well-balanced diet that consists of antioxidant rich fruits and vegetables and foods rich in Omega 3's, engaging in intellectually challenging activities (crossword puzzles), and participating in regular physical activity preserve brain function.

     It has been long known and well established that routine exercise is good for the cardiovascular system and chronic disease prevention.  Now there is enough research to support its role in promoting brain health.  "What is good for the heart is great for the brain" states Brady.  "Exercise improves [blood] circulation which improves oxygen circulation, penetration, and pick-up at the cellular level" explains Brady.

     Starting around the third decade of life, decreases in the brain's gray and white matter occur which impair function and result in cognitive decline.  Age-related changes are greatest in the frontal, parietal, and temporal lobes of the brain.  These areas are responsible for the brain's "executive control."  "Executive control" refers to those tasks that entail complex thought and attention.  These areas of the brain function so that you can formulate plans of action, coordinate tasks, switch between tasks, disregard irrelevant information, and retain and process information over a short period of time (working memory).  Declines in the "executive control" processes of the brain threaten independent living in the later years.  Fortunately, research has found that these areas of the brain are spared the greatest as a function of aerobic fitness.

     A study on "Ageing, Fitness and Neurocognitive Function" conducted by Kramer et al. and published in the July 29, 1999 issue of Nature, found that aerobic training in previously inactive adults (ages 60-75 years) led to significant improvements in performance on tasks that relied on the "executive control" processes of the brain.  In another study, conducted by Colcombe et al. and published in The Journals of Gerontology Series A: Biological Sciences and Medical Sciences (58:M176-M180 [2003]), the researchers found that declines in brain tissue density were greatly reduced as a function of cardiovascular fitness when they assessed fitness levels of 55 adults (mean age 66.5 years) and compared their high-resolution magnetic resonance imaging brain scans.  In a subsequent study conducted by Colcombe et al., the investigators found that brain volume increased, particularly in the prefrontal and temporal areas of the brain (those most affected by age), as a result of aerobic fitness training.

     Researchers are still investigating the mechanism by which aerobic exercise leads to improvements in brain function in humans.  However, based on the findings of research conducted on animals, aerobic training appears to lead to the formation of new neurons (brain cells) and blood vessels as well as increases in the number of synaptic connections and levels of neurotransmitters and nerve growth factors.

     Although any form of aerobic activity is better than none, Brady explains that certain types of physical exercise are best for optimal "brain fitness."  First, exercises that incorporate cross-lateral movements (those that cross the midline of your body) are best.  These movements lead to an increase in blood flow to all areas of the brain and result in an increase in the number of synaptic connections formed in the brain.  Second, activities that include "cued-movements" (actions performed after being prompted by a signal or cue to move, such as with an instructor led aerobic dance class) are beneficial.  These help to focus attention.  Your mind needs to be actively engaged in order to retain information.  Brady also states that any physical activity that requires you to develop a new skill is important to enhance brain function.

     So what does this mean  for your exercise routine?  Brady says to "Exercise smarter.  Break-out, don't be repetitive.  Add brain-based activity that involves cross-lateral and cued-exercise movements to your routine."  If you are a runner, for example, add a few sessions per week of aerobic dance class or other exercises that incorporate the above brain boosting movements.  Following these recommendations will not only lead to a fit body, but a fit brain.

Note:  Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

Phone Interview March 25, 2009 with Janet Fletcher Brady, M.S., Director of Medical Programs for LifeSpan (www.lifespanfitness.com); (www.fitnessforever.com/)

ACSM's Health & Fitness Journal March/April 2009 (13)2:27-31; "Exercising the Brain", Brady, J.

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58:M176-M180 (2003) "Aerobic Fitness Reduces Brain Tissue Loss in Aging Humans", Colcombe, S.J. et al.

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61:1166-1170 (2006) "Aerobic Exercise Training Increases Brain Volume in Aging Humans", Colcombe, S.J. et al.

Nature 400, 418-419 (29 July 1999) "Ageing, Fitness and Neurocognitive Function", Kramer, A.F. et al.

Proceedings of the National Academy of Sciences of the United States of America, 2004 March 2; 101(9): 3316-3321, "Cardiovascular Fitness, Cortical Plasticity, and Aging", Colcombe, S.J., et al.

"Nutrition and Brain Function: Food for the Aging Mind", USDA Agricultural Research Service (www.ars.usda.gov/is/AR/archive/aug07/aging0807.htm)