Running head: EXERCISE IN THE ELDERLY 1

Exercise in the Elderly

Samantha M. Spiker

James Madison University

Abstract

Elderly individuals experience a drastic decrease in physical and mental health as they age. With

the introduction of physical activity in the elderly population, cardiac diseases decrease, body fat

decreases, muscle and bone density increases. In addition, diabetes, cholesterol and hypertension

medications can be ceased due to an increase in the bodies overall health and function. Physical

activity can help increase the brains natural chemicals to ease the effects of depression in the

elderly. With the changes in the elderly populations physical and mental health, their quality of

life can be greatly improved, for a longer, healthier lifestyle.

Key words: elderly, exercise, benefits, mobility, psychosocial, physical activity

Exercise in the Elderly

We as nurses, know that when humans increase in age, many factors of health are

effected. Our health includes physical and mental factors. As we age, our physical body can

deteriorate and make it very difficult for us to sit, stand or move. When elderly individuals are

immobile, it can cause an abundance of issues such as pressure ulcers, malnutrition, cardiac

diseases and depression. Even though it is not thought of very much, the elderly can be effected

greatly by depression. Due to immobility, an individuals emotional and social health is affected.

Regular participation in physical activity and exercise has been shown to be beneficial for

various physiological systems, and in improving the quality of life of adults (Justine, Azizan,

Hassan, Salleh & Manaf, 2013). With all of these factors of health affected, the quality of life of

the elderly is greatly decreased. However, learning the barriers to regular physical activity in the

elderly can help with the introduction of exercise.

With the introduction of physical activity, it promotes an overall improvement in the

body of the elderly, including cardiorespiratory benefits, decreased risk of chronic degenerative

diseases, decrease body fat, increase bone mineral density and muscle volume, avoiding trivial

and serious fractures (da Costa Moreira, de Freias, Maranhao, Patricio & Vasconcelos, 2012).

Physical activity for the elderly is different in terms of intensity, compared to younger adults.

For senior citizens, it is recommended that individuals perform moderate physical activity at an

average of 3-6 metabolic equivalents of task (METs; which is equivalent to brisk walking at a

speed of 3-4 miles/hr) (Justine et al, 2013). Most adults exercise frequently, up to 5-6 times per

week, usually for more than 60 minutes per exercise session. When it comes to elderly

individuals, it is recommended that this population performs an average of 30 minutes of

moderate-intensity activities (Justine et al, 2013).

In addition to increased physical health, drugs can be reduced or even suspended, due to the

improvement of the body compared to programs involving physical activity, as in the case of

diabetes, arthritis, problems with high cholesterol and hypertension (da Costa Moreira et al,

2012). The introduction of physical activity can not only help with physical health, but mental

health as well.

Mental health in association with the elderly, tends to focus on Alzheimers and

dementia. However, the elderly are greatly impacted by depression and self-pity. Depression can

either be the cause of decreased mobility or, decreased mobility can cause depression. Many

wonder how physical activity improves mental health, the following study explains the chemical

association. Exercise can increase the concentration of serotonin, a neurotransmitter in the

brain, and serotonin has been proven as obviously related to depression conditions (Lee, Yang,

Huang, Hsiao, Liu & Wang, 2017). In a study performed by da Costa et al, psychosocial

benefits are the relief of depression, increased confidence, improved self-estimate with the

presence of regular exercise in the elderly (2012). Individuals who participate in physical

activity, are more likely to join social functions because they no longer are conflicted with their

self-confidence. Benefits are sometimes easier to accept when there is biological proof and

evidence, which makes the introduction of physical activity worth it. However, introduction of

physical activity can be implemented easier when barriers are understood.

Introducing physical activity to adults aged 65 and greater, can be challenging. Most

adults are retired or are due to retire at age 65. With these individuals, barriers are easy to list as

excuses for not participating in physical activity and why they do not wish to perform in regular

physical exercise. In a study performed by Justine, Azizan, Hassan, Salleh and Manaf stated,

External barriers refer to factors beyond an individuals control, whereas internal barriers are
EXERCISE IN THE ELDERLY 5

factors determined by an individuals personal decision (2013). Dealing with internal barriers

are a bit more difficult than external barriers. In this study, the most common internal barriers

among elderly respondents were too tired (51.7%), lack of motivation (38.4%) and already

active enough (38.4%) (Justine et al, 2013). Making a change in lifestyle is hard, making the

change to improve participation in physical activity in the elderly, seems near impossible. Proper

education to not only the individual, but to the family or nursing home staff, if applicable, caring

for these individuals is key. Elderly individuals may not be able to fully comprehend the benefits

or be able to make such decisions or plan effectively to implement a new active lifestyle. The

most common external barriers include, not enough time (48.4%), lack of facilities (35.0%)

and no one to exercise with (28.3%) (Justine et al, 2013). Proper referrals to facilities that

specialize in physical activity of elderly can be sought out by physicians at doctor visits. Families

should also reach out to elderly family members and include them in making healthy lifestyle

changes. By having family members participate, can help create a healthy relationship bond, as

well.

In conclusion, physical activity not only is important for children and adults, but

extremely beneficial to adults aged 65 and older. Regular participation in physical activity and

exercise can be beneficial for physical health, as well as psychosocial health. Studies have shown

with physical activity, the quality of life of the elderly is greatly improved. With this knowledge

and information, my nursing practice can be modified to help improve the quality of life of the

elderly. In the role of a bedside nurse, evaluation of the current physical activity level of patients

aged 65 and older on admission, is great start. With this information, the patients plan of care

throughout their hospital stay can include further information and education, prior to the

discharge process.
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The focus of this education and change is lifestyle should be focused on patients before the age

of 80. The sooner the physical activity begins in someones life, the easier it is to continue later

in life. Attempting to introduce physical activity to 80 year olds or greater, can cause more harm

than good. Nurses have the ability to change the lives we care for, use this power to help improve

the lives of others. It is necessary to implement programs that encourage physical activity,

training of health professionals trained to welcome these people and assist them in the best

possible way in all their needs (De Farias Camboim,, Nobrega, Davim, Cleston, Camboin,

Nunes, & Oliveira, 2017). We need to promote physical and mental health in every way possible

for our elderly population.

References

da Costa Moreira, G. ., de Freitas, A C.., Maranho, C. C., Patricio, D., & Vasconcelos, D.

(2012). Elderly and physical activity: Benefits and challenges in search for life

quality. Journal of Nursing, 6(11), 2761-2769. doi:10.5205/reuol.2185-16342-1-

LE.0611201219

De Farias Camboim, F. E., Nobrega, M. O., Davim, R. M., Cleston, J., Camboin, A.,

Nunes, R. M., & Oliveira, S. X. (2017). Benefits of physical activity in the third age for

the quality of life. Journal of Nursing, 11(6), 2415-2422. doi:10.5205/reuol.10827-

96111-1-ED.1106201721

Jancey, J., Holt, A., Lee, A., Kerr, D., Robinson, S., Li, T., & Howat, P. (2017). Effects of a

physical activity and nutrition program in retirement villages: A cluster randomized

controlled trial. International Journal of Behavioral Nutrition & Physical

Activity, 14(92), 1-10. doi:10.1186/s12966-017-0543-6

Justine, M., Azizan, A., Hassan, V., Salleh, Z., & Manaf, H. (2013). Barriers to participation in

physical activity and exercise among middle-aged and elderly individuals. Singapore

Medical Journal, 54(10), 581-586. doi:10.11622/smedj.2013203

Lee, P., Yang, Y., Huang, C., Hsiao, C., Liu, T., & Wang, C. (2017). Effect of exercise on

depressive symptoms and body balance in the elderly. Educational Gerontology, 43(1),

33-44. doi:10.1080/03601277.2016.1260905