Sunday October 14, 2012
Gotta move it
By Dr SELINA KHOO & Prof TONY MORRIS
Physical inactivity causes decline in strength, fitness and flexibility, and it is also linked to premature death, chronic diseases, illness and disability.
DO you know that physical inactivity kills more than three million people a year? According to the World Health Organization (WHO), physical inactivity is the fourth leading risk factor globally for death, after high blood pressure, smoking and high blood glucose.
Physical inactivity causes decline in strength, fitness and flexibility. It is also linked to premature death, chronic diseases, illness and disability.
Physical inactivity is rising in many countries. In Malaysia, according to the Third National Health and Morbidity Survey (2006), 43.7% of Malaysians are physically inactive. More females (50.5%) are inactive compared to males (35.5%).
There is also a higher level of physical inactivity among Malaysians who live in towns and cities (59.4%).
Physical activity also declines with age. There is a trend towards an older and less active population. Inactivity is common among older adults. In the Third National Health and Morbidity Survey (2006), researchers found that more than 50% of Malaysians aged over 65 years were inactive.
No doubt, the trend has continued in the last six years. There is a marked increase in physical inactivity as Malaysians grow older, reaching 80.3% for those aged 80 years old and above. This is a major cause of concern because of the growth in the number of older adults in Malaysia.
Get on with it
Physical activity benefits people of all ages and abilities. It improves physical and mental health, and prevents chronic non-communicable diseases like heart disease, cancer and diabetes.
Physical activity offers protection against diseases that affect older adults. Evidence suggests that participating in physical activity can reduce or prevent functional declines associated with ageing. Researchers have reported that older adults who are more active, have lower rates of mortality, coronary heart disease, high blood pressure, stroke, type 2 diabetes and certain cancers. They are also fitter, and have healthier body compositions.
Regular physical activity also improves bone health. This is important because bone density decreases in older adults. Physical activity reduces the risk of developing osteoporosis. It can help prevent falls, and reduce the incidence of broken bones and fractures in falls.
Physical activity can extend years of active independent living, reduce disability, and improve the quality of life older people experience. It also has psychological benefits for older adults, including lowered risk of dementia.
No amount of physical activity can stop the biological process of ageing. However, researchers have shown that regular physical activity can minimise the physiological effects of a sedentary lifestyle, and increase active life expectancy.
For healthy ageing, older adults should do a combination of aerobic, strengthening and flexibility exercises. Older adults who are at risk of falling should carry out exercises to improve balance. Activities that promote strength, coordination and balance, are especially important for older adults, as these physical capabilities allow them to do their daily activities, eg bathing, dressing and eating.
Physical activity can help older adults live long and productive lives and remain independent. Exercise should be performed consistently in order to gain lasting benefits.
Despite the benefits of physical activity, many people are physically inactive. Research has been conducted to identify barriers to physical activity. One of the most common reasons people give for not doing physical activity is lack of time. We hear that very often, and may even use it ourselves.
Other reasons are lack of money, feeling too tired, and nobody to exercise with.
Some people may dislike exercise or “feel” too old for physical activity. For older adults, concerns about over-exertion, injury and social perception, might also stop them from being physically active.
The reality is that older adults can safely participate in regular physical activity, including aerobic exercise (exercises that require the heart and lungs to work harder) and strength training.
There are examples of older adults who have completed marathons, for example 101-year-old Fauja Singh, who completed the Scotiabank Toronto Waterfront Marathon last year, and 92-year-old Gladys Burrill, who completed the Honolulu Marathon in 2010.
Burrill ran her first marathon when she was 86 years old. Her advice for a long and healthy lifestyle is to “just get out there and walk or run”.
Of course, not all of us want to run marathons, but regular physical activity contributes to healthy ageing.
Older adults can adapt and respond to aerobic and strength training. Aerobic training can help older adults maintain and improve heart and lung function. It also reduces resting blood pressure in those who are hypertensive. Strength training can help reduce loss in muscle mass, which is linked to normal ageing.
How much physical activity do older adults need? The WHO recommends that older adults should do at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity, or a combination of both moderate- and vigorous-intensity physical activity a week. One minute of vigorous-intensity activity is about the equivalent to two minutes of moderate-intensity activity.
Aerobic activity or “cardio” makes you breathe harder and your heart beat faster. Examples of moderate-intensity physical activity are brisk walking, dancing, playing golf, doing housework and gardening. Examples of vigorous-intensity physical activity are jogging, running, swimming laps and hiking uphill. The minutes can be accumulated in short bouts (at least 10 minutes) throughout the week.
In addition to aerobic physical activity, older adults should also do muscle-strengthening exercises on two or more days per week. This is to maintain bone and muscle strength. Choose exercises that work all the major muscle groups in the body (legs, hips, back, chest, abdomen, shoulders and arms).
Older adults can do these exercises either in the gym or at home. Examples of muscle-strengthening exercises are lifting weights, working with resistance bands, push-ups and sit-ups. Try to do eight to 12 repetitions per set of different exercises that target the major muscle groups.
It’s ok if older adults cannot do the recommended amount of physical activity. The important thing is for older adults to be as physically active as they can.
Remember that some physical activity is better than none. Any amount of physical activity older adults participate in will bring some health benefits.
No one is too old to enjoy the benefits of regular physical activity. It is never too late to be active. Older adults should do activities they enjoy. The easiest way to increase physical activity is to incorporate physical activity in their daily life – for example, taking the stairs instead of the lift, playing with grandchildren, doing gardening, washing the car, walking or playing sports with friends.
These simple activities can prevent chronic diseases, increase mobility and make life more enjoyable.
For older adults who have not been active, remember to start slowly and gradually increase the level of physical activity.
Older adults with a chronic health condition should discuss with their doctor ways that they can be active. Regular physical activity is one of the most important things older adults can do for their health.
Dr Selina Khoo is with the Sports Centre, University of Malaya, while Prof Tony Morris is from the School of Sport and Exercise Science and Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne. This article is contributed by The Star Health & Ageing Panel, which comprises a group of panellists who are not just opinion leaders in their respective fields of medical expertise, but have wide experience in medical health education for the public. The members of the panel include: Datuk Prof Dr Tan Hui Meng, consultant urologist; Dr Yap Piang Kian, consultant endocrinologist; Datuk Dr Azhari Rosman, consultant cardiologist; A/Prof Dr Philip Poi, consultant geriatrician; Dr Hew Fen Lee, consultant endocrinologist; Prof Dr Low Wah Yun, psychologist; Datuk Dr Nor Ashikin Mokhtar, consultant obstetrician and gynaecologist; Dr Lee Moon Keen, consultant neurologist; Dr Ting Hoon Chin, consultant dermatologist; Prof Khoo Ee Ming, primary care physician; Dr Ng Soo Chin, consultant haematologist. For more information, e-mail email@example.com. The Star Health & Ageing Advisory Panel provides this information for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star Health & Ageing Advisory Panel disclaims any and all liability for injury or other damages that could result from use of the information obtained from this article.