The Aging Population and

Optimal Living
A Fitness Guide to the
Fountain of Youth

Alex Tieri
Advanced Health and Fitness Specialist
American Council on Exercise
Highest certification, 1 of 1000 in U.S.
Specializing in:
CVD, CAD, CHD
Hypertension and Dyslipidemia,
Diabetes and The Metabolic Syndrome
Asthma
Arthritis and Osteoporosis
Elderly Optimal Living
Nutritional Consultant (AFPA)

To Be Discussed:
Physical changes associated with aging
Balance and gait challenges in older
adults
Assessments
Functional training
Arthritis
Osteoporosis
Physically elite
Nutritional considerations

Studying Aging
The National Institute of Health(NIH) created the
National Institute of Aging(NIA), which studies
gerontology the processes of Aging, with a goal to close
the gap between Lifespan(122 years) and life
expectancy.
80% of older Americans live with 1 chronic condition,
and 50% are living with at least 2 (CDC, 2003).
CDC 2007 study revealed:
43% aged 65-75 reported very good health, compared
to 34% aged 75-84; and 28% aged 85 and older.
Functional age differs from chronological age in that it
takes into account; biological, psychological, and social
characteristics to create a profile of age as a whole.
Senesence term used to describe loss of function that
increases risk of disability or death with aging.

Physical changes associated with

aging
Cardiovascular aging, CHD, and hypertension stress
the heart muscle to supply muscles with oxygen and
nutrients need to perform tasks.
the left ventricle of the heart increases in thickness
by 30% between the ages of 25 and 80 (lakatta,
1990).
The aorta and arterial tree become thicker and
stiffer, noncompliant vessels and increased
peripheral resistance are the major contributors of
hypertension in older adults (Safar, 1990).
Maximum heart rate declines 5-10 beats per minute
per decade (Shepard, 1997).
Reactivity to catecholamine (epinephrine and
norepinephrine) which acts to increase heart

Respiratory System
With aging elasticity of the chest wall and the joints
about the rib stiffen requiring increased effort for
breathing, elevating respiratory work rate (Crapo,
1993).
Residual volume also increases to about 40% in
older adults compared to 20% in younger adults,
resulting in dyspnea during exercise (Spirduso,
2005).
Bronchial tree decreases in ciliary function, and an
increased risk of aspiration due to impaired
swallowing and coughing reflexes, can increase the
risk of viral and bacterial infections, but does not
seem to affect physical performance (Tockman,
1994).

Aerobic Capacity
Maximal oxygen consumption declines by 1%
each year of a sedentary adults life. By 65 it is
30-40% less than a young adult (Shepard,
1987).
Very low aerobic capacity leads to constant
fatigue in the elderly. It is estimated that 4
METs is needed for independent living
(shepard, 1987).
Reduction in heart rate, muscle tissue and its
ability to use oxygen, and a diminished ability
to redirect blood flow from organs to working
muscles, all decrease aerobic capacity
(Spiraduso, Francis, & MacRae, 2005).

Musculoskeletal System
Sarcopenia natural atrophy that occurs with aging,
decreasing muscle fiber size and specifically number of
muscle fibers (Aoyagi & Shepard, 1992).
In sedentary individuals muscle mass decreases about
23% between the ages of 30 and 70 (NIH, 2006).
Strength decreases by 15% in the 6 th and 7th decades of
life, and 30% thereafter (Danneskoild-Samoe et al,
1984).
This decrease in muscle mass, decreases the ability to
maintain dynamic balance, walk, prevent falls, move
quickly, produce power, and slows metabolism.
Isometric strength and eccentric strength are better
maintained than dynamic and concentric strength.

Bone Loss
Women are more prone to the effects of bone
loss than men, because they reach a lower
lifetime peak calcium content and have an
accelerated loss of calcium for five years
around the time of menopause (Riggs &
Melton, 1992).
55% of Americans aged 50 and older have
osteopenia or osteoporosis (NOF, 2008).
Bone loss and fracture prevention is greatly
reduced by those who have consumed
adequate calcium and performed vigorous load
bearing exercises from youth into later life.

Osteoporosis
An estimated 50% women and 20% of men over 50 will suffer an
osteoporotic fracture (U.S. Dept. of Health and Human Services, 2004).
During young adulthood bone formation (osteoblasts) activity is greater
than bone resorption (osteoclasts), leading to greater bone density.
However, as we age resorption becomes dominant leading to weaker
bones.
Risk factors having a small frame, being Caucasian or Asian;
postmenopausal; family history; cancer or thyroid medication or
glucocorticoids for three or more months; diet low in calcium; lack of
physical activity; excessive smoking or drinking.
Exercise and bone response those who regularly engage in high force
and loading magnitudes, such as plyometrics and weight lifting, display
higher bone mineral density(BMD), than those who participate in lowintensity, or non-weightbearing exercises (Bellew & Gehrig, 2006).
These exercises must be done for 6-9 months to see a benefit, and
continued to maintain increases in BMD (Khan et al., 20001).
Clients diagnosed with osteoporosis should not engage in: jumping
activities, or deep forward truck flexion exercises such as rowing, toe
touches, and full sit-ups (Beck & Snow, 2003)
ADA recomends calcium intakes of calcium between 1000-1200mg per
day; and vitamin D intakes of 200-600IU.

Flexibility
When muscle fibers atrophy, they are
replaced by fatty fibrous collagen tissue,
and 15% of body water is lost between
ages 30 80, contributing to body
stiffness (ACE, 2005).
Greatest flexibility loss is found in the
spine and ankle joints, increasing the
likelihood of falling (Einkauf et al., 1987).
Flexibility of the ankle is lost by, 50% in
women; while men lose 35% between the
age of 55 85 (Vandervoort et al., 1992).

Osteoarthritis(OA)
Results from a degeneration of synovial fluid and generally progresses into a
loss of articular cartiliage, which typically presents itself as localized joint
pain and a reduction of range of motion (Buckwater & Martin, 2006).
Rheumatoid arthritis(RA) is an autoimmune disease that inflames the
synovium, leading to long term joint damage, chronic pain, and loss of
function or disability.
3 stages: 1st swelling of the synovial lining, pain, stiffness, warmth, redness, and
swelling of the joint; 2nd synovium thickens from rapid division and growth of cells; 3rd
inflamed cells release enzymes that break down bone and cartilage, causing the
affected joint to lose structure and alignment.

OA occurs when a joint becomes injured, the once pristine articular cartilage
surface does not receive sufficient blood supply or nutrients to get it back to
normal. Cartilage is also free of pain fibers, allowing wear and tear of the
joint to continually degenerate it until the subchondral bone which is full of
pain fibers experiences friction and swelling.
Symptoms are next day discomfort and stiffness from chemical synovitis, and
will continue to progress as the joint degenerates leading to intense pain for
longer durations until the pain is constant, as the joint become bone on bone.
Exercise increases muscular strength and endurance, enhancing stability of
the joints, improving ROM, and reducing passive tension of tissues
surrounding the joints, helping to improve function and quality of life.

Nervous System
Aging declines cerebral function, vision,
hearing, reaction time, short-term memory,
cognition, and information processing .
Habitual physical activity enhances cognitive
performance in older adults (Chodzko-Zajko
& Moore, 1994).
Neuromuscular coordination is the ability to
activate large and small muscle groups with
the correct amount of force in the most
efficient sequence to accomplish a task, such
as running or lifting something diminishes.

Balance Challenges
Reduced stability limits is caused by weak ankle muscles,
reduced ROM in the ankle, neurological disturbances, and
fear of falling.
Falls cause 90% of hip fractures, and 50% of spine
fractures. Exercise to improve muscle weakness, postural
instability, and functional mobility.
Dynamic balance is maintaining center of gravity(COG) as
it moves across the base of support(BOS), such as
reaching for something or walking.
The central nervous system(CNS) holds the key to balance.
It receives input from visual, vestibular, and
somatosensory systems, all of which decline with age.
However, one system can be trained to compensate for
the loses of another system.
Confidence can detract from balance, causing older adults
to avoid places where they risk falling, moving less on

Gait Challenges
The gait cycle which is the time between the first heel
contact of one foot and the next time that heal strikes,
declines with age.
Older adults move 20% slower than younger adults
(Elble et al.,1991)
Strength losses in the lower body, result in failure to
lift the foot high enough during the swing phase of gait
resulting in tripping.
A strong relationship between quadriceps and ankle
strength and habitual gait speed has been found
(Fiatarone et al., 1990).
Slower gait speeds have been correlated with shorter
stride lengths to preserve motion economy (Larish,
Martin & Mungiole, 1988).

Assessing
Physically elite sports competition; Senior Olympics;
high risk and power sports.
Physically fit moderate physical work; endurance
sports, games, and hobbies.
Physically independent very light physical work and
hobbies (gardening, walking, social dance, golf, and
driving).
Physically frail light house keeping; food preparation;
grocery shopping; may be homebound.
Physically dependant walking, bathing, dressing,
eating, needs home or institutionalized.
Disabled needs medical attention.
Take medications into account they can impede balance and
function.

Functional Training
Cardio 3-5 days of 60-90% HRMax; greater than 30 min
daily.
Resistance 2-3 days of 8 exercises for different muscle
groups, with 8-15 reps.
Flexibility 3-7 days stretching all major muscles groups
2-4 times to tightness but not to pain for 15-30 seconds.
Functional exercises should mimic those of daily
movements and chores, they should be done standing,
but can be done seated or in the water.
Weight bearing exercises and resistance are preferred for
increasing bone strength.
Exercise can be sport specific or mimic sport movements
such as golf, tennis, cycling, rowing.
See a Fitness Specilist for safe exercise prescription and
monitoring of safe and proper form!

Why Now?
The sooner the better, as diseases progress it may
become harder to exercise.(physical capabilities,
medications, etc.)
As the theoretical model would state, you are in the
contemplation stage, maybe even in the preparation
stage, this leads to the taking action stage. So strike
while the iron is hot!!!
You have the information.
You have a willing leader to guide you along the way.
All you have to do is make the commitment to
yourself. Your body, family, and friends will thank you.

Physician Clearance Needed

If
Older than 69
Doctor stated you have a heart condition and should
only engage in physical activity recommended by
your doctor.
Chest pain with physical activity.
Had a chest pain in the past month without engaging
in physical activity.
Ever lost balance or consciousness, feeling dizzy or
nauseous.
Bone or joint problem that may worsen with increased
physical activity.
Currently taking prescription drugs for blood pressure,
or a heart condition.
Blood pressure greater than 144/94

Continued:
Risk factors for cardio vascular
disease:
Less than 30 min of physical activity
most days of the week.
Current smoker, or quit within last 6
months.
High blood pressure or high cholesterol
reported by physician.
Excessive accumulation of fat around
the waist.
Family history of heart disease.