Exercise: A Guide from the National Institute On Aging


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"The good news...is that people can benefit from even moderate levels of physical activity."
-Surgeon General of the United States

"I walk, garden, and do housework. Exercise keeps me limber. Most people don't think I'm my age."
-Darrell Randall, 81, Washington, D.C.

Together, lack of exercise and poor diet are the second-largest underlying cause of death in the United States. (Smoking is the #1 cause.)


Welcome to one of the healthiest things you can do for yourself. Exercise! Regular exercise and physical activity are very important to the health and abilities of older people. In fact, studies suggest that not exercising is risky behavior. That is why we wrote this book. We are the National Institute on Aging, part of the National Institutes of Health, and our research is aimed at improving the health of older people.

For the most part, when older people lose their ability to do things on their own, it doesn't happen just because they have aged. More likely, it is because they have become inactive. Older inactive adults lose ground in four areas that are important for staying healthy and independent: endurance, strength, balance, and flexibility.

Fortunately, research suggests that you can maintain or at least partly restore these four areas through exercise -- or through everyday physical activities (walking briskly or gardening, for example) that accomplish some of the same goals as exercise. What may seem like very small changes resulting from exercise and physical activity can have a big impact.

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Getting Past the Barriers
You may be reluctant to start exercising, even though you've heard that it's one of the healthiest things you can do. You may be afraid that physical activity will harm you; or you might think you have to join a gym or buy expensive equipment in order to exercise. Or, you may feel embarrassed to exercise because you think it's for younger people or for people who look great in gym clothes. You may think exercise is only for people who are able to do things like jogging.

In fact, just about every older adult can safely do some form of physical activity at little or no cost. And you don't have to exercise in a public place or use expensive equipment, if you don't want to.

Even household chores can improve your health. The key is to increase your physical activity, by exercising and by using your own muscle power.

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Who Can Exercise?
Studies show that, in the long term, older adults in all age groups hurt their health far more by not exercising than by exercising. As a rule, older people should stay as physically active as they can.

Chapter 2 of this book explains that there are certain situations in which you should check with your doctor before starting to exercise. You will also find out about a couple of conditions that prohibit exercise. More than likely, though, reading Chapter 2 will reassure you, but if you still have any doubts about exercise, talk to your doctor before you start.

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About This Book
The first three chapters of this book explain what exercise and physical activity can do for you, how to exercise safely, and how to stay motivated to exercise. If you already know the material in Chapters 1 and 2 -- for example, if your doctor already has talked to you about the benefits of exercise and has advised you how to exercise safely -- skip to the summary at the end of each chapter to make sure that you aren't missing any important information, then go to Chapter 3, which discusses motivation.

Chapter 4 is a "how-to" chapter. It shows how to exercise to improve or maintain endurance, strength, balance, and flexibility. You certainly aren't restricted to these exercises. We show you these examples to help you get started.

Chapter 5 also is a "how-to" chapter. It gives examples of ways you can check your progress. The last chapter is about nutrition. Each chapter summary lists important points to remember.

At the end of the book, you will find resources to contact for more information about exercise and special programs for older exercisers. Some of the resources are for people with diseases or disabilities. You will also find charts to record your progress and a form you can fill out and send to us after you have been exercising for at least a month. We will send you a National Institute on Aging certificate that acknowledges your commitment to improving your health through exercise. In addition, there is an order form for our 48-minute exercise video, which shows you how to do the exercises described in Chapter 4.

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A Word About Words

Terms used to discuss exercise can be confusing. We want to explain a few key words used in this book.

  • You probably have heard the term "aerobics" or "aerobic exercises." We call them "endurance exercises" or "endurance activities." These activities increase your heart rate and breathing for an extended period of time.
  • The term "cardiovascular" refers to your heart and circulatory systems.
  • The word "frailty" has more than one meaning. We use it here to mean the physical condition that results, in part, from severe muscle loss -- the kind of muscle loss seen in people who have been inactive for many years. Frail people have severe loss of strength and often cannot perform everyday tasks.
  • We frequently use the word "independence"; in this book, it means older adults' ability to live and do things on their own. Being independent doesn't necessarily mean doing things alone; it means being able to do for yourself, in your everyday tasks and your leisure activities, to the greatest extent possible.
  • Exercises that build muscle have a variety of names, including "strength-training," "resistance-training," "weight-training," or "weight-lifting." In this book, we call them "muscle-building" or "strength" exercises.
  • What is considered a physical activity and what is considered an exercise? A physical activity is any voluntary body movement that burns calories. Exercise is physical activity that follows a planned format. It's done with repeated movements, with the goal of improving or keeping up one or more specific areas of physical fitness.

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The National Institute on Aging, part of the National Institutes of Health, brought together some of the nation's best-informed experts on the topic of exercise for older adults to discuss the writing of this book. They include:

Panel co-chairpersons: Chhanda Dutta, Ph.D., and Marcia Ory, Ph.D.; Health Scientist Administrators; National Institute on Aging, National Institutes of Health
David Buchner,M.D., M.P.H.; Professor, Department of Health Services, University of Washington
Marie Elaine Cress, Ph.D.; Associate Professor, Department of Exercise Science and Gerontology Center, University of Georgia
William Evans, Ph.D.; Director of Nutrition, Metabolism, and Exercise Laboratory at Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences
Maria Fiatarone Singh, M.D.; Associate Professor, School of Nutrition and Science Policy, Tufts University
Alan Jette, Ph.D.; Dean, Sargent College of Health and Rehabilitation Sciences, Boston University
Thomas R. Prohaska, Ph.D.; Director, Center for Research on Health and Aging, University of Illinois at Chicago
Anita Stewart, Ph.D.; Professor in Residence, Institute for Health & Aging, University of California San Francisco

We also extend special thanks to Steven N. Blair, P.E.D., Director of Research at the Cooper Institute for Aerobics Research; and to Roger Fielding, Ph.D., Assistant Professor of Health Sciences and Brookdale National Fellow at the Sargent College of Health and Rehabilitation Sciences, Boston University, for their contributions.

Each of these experts is a major force in research devoted to improving the health and independence of older adults through exercise. We are grateful to them and to other leaders in the field whose work is reflected in these pages for sharing their expertise.

We are also grateful to Jerome L. Fleg, M.D., and Edward G. Lakatta, M.D., of the Gerontology Research Center; the American College of Sports Medicine; the American Heart Association; the American Physical Therapy Association; the National Center for Medical Rehabilitation and Research; the National Heart, Lung and Blood Institute; the National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Child Health and Human Development; the Office of Disease Prevention of the National Institutes of Health; and the National Aeronautics and Space Administration; and the Public Health Service Office on Women's Health.

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