Aging healthfully

Friday, December 17, 2004

They sit too much instead of playing outside. They spend too much time on the computer or watching television. Their diet is poor, and if they're not careful, they're going to end up with diabetes and other health issues.

But this isn't about children.

Elderly in America, people 60 and over, are also under-exercised and at risk for health problems. The U.S. Department of Health and Human Services has confirmed that senior adults have more to gain from regular exercise than younger Americans.

As society has progressed, innovations designed to make senior citizens' lives easier have also made them less healthy. The good news is the trend can be reversed.

A convenient excuse for not exercising is that most older Americans are busy, said Susan Deusinger, professor of neurology and physical therapy and a physical therapist at Washington University School of Medicine in St. Louis. Some people who have retired are traveling, visiting grandchildren, and taking up hobbies, while others who are retirement age are still employed.

Senior citizens may be busy, but they're not active enough, Deusinger said. Americans should be able to exercise an hour a day, she said, even if it means breaking it into 10-minute increments throughout the day.

"Are we too busy to take care of our health?" she said. "Since we know that 300,000 people a year die from the effects of obesity alone, it's not just a matter of being overweight, it's a matter of life to exercise."

Americans have become more sedentary with the advent of household machines that do the work people used to do, said Deusinger, who was a physical therapist at Southeast Missouri Hospital in the early 1970s.

"Here we are, a very well-informed society that is essentially killing itself with overweight and under-exercised bodies. It's a terrible travesty and it's fueled by industrialization."

As people age, their bodies naturally slow down and muscles shorten, said Sandy Duncan, operations manager for Fitness Plus at Saint Francis Medical Center. Seniors are living longer, and because of programs like Fitness Plus, seniors are learning to live healthier.

"Because they are living longer, if they exercise they can live more independently and can be more mobile," Duncan said.

Extra efforts

Sue Jones, 63, of Jackson, pulled herself out of the pool at Fitness Plus Thursday following a water aerobics session. As she relaxed in the hot tub, Jones described the benefits she gets from starting her day with exercise before she goes to work as office manager at New McKendree United Methodist Church.

"It's a good start to the day," she said. "I've always tried to stay active. If I don't I lose flexibility and it's too hard to move. You don't have to be old and stiff, I don't think."

Jones said her blood pressure is normal and she takes no medications. She exercises for weight control and because it makes her feel good.

"I don't spend too much time at the doctor," she said.

Kenny Windisch, 61, of Cape Girardeau, said he has lost about 30 pounds, is trying to lose 10 more, and routinely swims to manage his weight and keep feeling good.

"I feel so much better whenever I'm at the right weight," he said. "I feel like I'm 20 years younger."

Duncan at Fitness Plus and Laura Sheridan, a trainer at HealthPoint Fitness Center of Southeast Missouri Hospital, have seen people who haven't exercised much come in and, over time, improve their fitness to the point where they no longer need blood pressure or cholesterol medicine, where they can control their type-two diabetes with diet and exercise instead of insulin. Some women with osteoporosis are learning that exercise can improve bone density, and arthritis patients are able to move more comfortably with an exercise regimen.

"It's good not only for their physical health, but emotionally and psychologically," Sheridan said. "They're getting active and getting out of the house."

So many of the elderly feel that once they have retired, they earned the right to take life easy, said Gail Knaup, a licensed physical therapist and wellness coordinator at Saxony Village, a Cape Girardeau retirement center.

"A lot of them learn quickly that they use it or lose it and start doing something," she said.

When some seniors retire, they give up mowing a large yard, tending a big garden and cleaning a house that once held a growing family. They don't get the exercise in retirement they used to get in day-to-day living. The Missouri Department of Health and Senior Services has taken up the cause of senior health and fitness by funding the aging-in-place program. Saxony Village is one of four facilities in the state using the program, said administrator Janice Unger. In addition to Knopf, who is the wellness coordinator, there is also a nurse on staff who monitors health and fitness of the residents, Unger said.Through the state program, Saxony Village is the only retirement community in Cape Girardeau with a structured effort that monitors the health and fitness of its residents, checking foot health of diabetics, bone density and overall nutrition. The objective is to keep the people living there as independent as possible and healthy enough to remain out of a nursing home, Knaup said.

Exercise preferences

Both Cape Girardeau hospital centers and Saxony Village offer not only strength training and exercise machines, which men prefer to use, they also offer classes in various forms of exercise, which more women choose. Duncan and Knopf say they have noticed that women seem to be more interested in the social aspect of exercise as well as the physical benefits. Classes include aerobics for cardiovascular improvement, yoga and tai chi for stretching and toning, and exercise in a swimming pool for people with arthritis who benefit from the movement, but initially find exercise too painful. Seniors who have trouble with their balance or who are not as agile as they once were benefit from classes that allow them to sit or lean on a chair or a walker for support.

Some seniors come to the classes to meet other people, some come because they're recovering from cardiovascular problems or are keeping diabetes in check. Some were active when they were younger, and enjoy remaining active. Knaup said many of the Saxony Village residents come to the fitness center there, but others walk at the mall, play golf, enjoy a tennis match or swim.

One senior who didn't want to slow down when her children left home became a fitness instructor. Now 70, Jane Greening of Jackson leads aerobics classes four times a week, and teaches yoga, tai chi and pilates and aquatics classes locally in the morning. In the afternoons, she works as a licensed physical therapist.

"Why I do it is because it's fun," Greening said. "I just thoroughly enjoy fitness."

For many older women who might balk at joining a class led by a bouncy young thing in a leotard, someone like Greening is an inspiration and a comfort.

"A lot of them don't know how old I am, but they do know I'm not 25 years old," Greening said. "I know I push my people, but if they can't do something, I say don't worry about that. I think probably they appreciate somebody who is a little bit older."

They're also inspired by someone her age who remains active.

"Whenever someone complains 'I'm too old to do this,' that's not an excuse in my class," Greening said.

She can inspire and reassure, but she can't motivate.

"They have to motivate themselves," she said. "I can't make them do anything. I try by my example to show people what they can do. I encourage people like crazy. Once in a while, I get one in who gets going and says 'this is sort of fun.'"

Stronger at 90

More and more seniors are learning what they can do, and they're doing it. Deusinger of Washington University said research is changing the way people look at exercise and senior adults.

"If you're 90, can you get stronger? Yes, you can," she said. "Things can change. Health can improve."

Seniors seem to be getting the message. Sheridan at HealthPoint said several women in their 80s, including one who is 89, regularly enjoy exercise classes.

Knaup said when she went to work at Saxony Village three years ago, one aerobics class was offered twice a week and the participation rate was about 3 percent. Now a variety of programs is offered and the participation rate has jumped to as high as 40 percent of Saxony's population whose age ranges between 66 to 102. Add the people who leave Saxony to exercise, she said, and about half of the village's population is physically active.

Duncan said that about a half dozen of her trainers are in their 50s, and most of the participants who work out at Fitness Plus are 50 and older.

Deusinger said these people are to be admired for their commitment to fitness. Change isn't easy.

"We should not misunderstand the difficulty people have in changing their behavior, but there is a whole lot of potential for people to change," she said. "Otherwise we would have to tell ourselves there isn't any hope. There is hope."

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