Memory Lapses Among Highly Educated May Signal Higher Stroke Risk

(American Heart Association) People with a high level of education who complain about memory lapses have a higher risk for stroke, according to new research in the American Heart Association journal Stroke.

“Studies have shown how stroke causes memory complaints,” said Arfan Ikram, M.D., associate professor of neuroepidemiology at Erasmus University Rotterdam in The Netherlands. “Given the shared underlying vascular pathology, we posed the reverse question: ‘Do memory complaints indicate an increased risk of strokes?’”

As part of the Rotterdam Study (1990-93 and 2000-01), 9,152 participants 55 or older completed a subjective memory complaints questionnaire and took the Mini-Mental State Examination.

By 2012, 1,134 strokes occurred: 663 were ischemic, 99 hemorrhagic and 372 unspecified.

Subjective memory complaints was independently associated with a higher risk of stroke, but a higher MMSE score wasn’t.

Furthermore, those with memory complaints had a 39 percent higher risk of stroke if they also had a higher level of education. The finding is comparable to the association between subjective memory complaints and Alzheimer’s disease among highly educated people.

“Given the role of education in revealing subjective memory complaints, we investigated the same association but in three separate groups: low education, medium education and high education,” Ikram said.

“We found that the association of memory complaints with stroke was strongest among people with the highest education. If in future research we can confirm this, then I would like to assess whether people who complain about changes in their memory should be considered primary targets for further risk assessment and prevention of stroke.”

Researchers categorized level of education into three groups: low education – primary education only; intermediate education – primary education plus some higher education, lower vocational education, intermediate vocational education, or general secondary education; and high education – higher vocational education or university training.

The study results apply evenly to men and women. With more than 95 percent of study participants being Caucasians living in Rotterdam, future studies should include more racially diverse groups, Ikram said.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die. According to the American Stroke Association, about 795,000 Americans had a new or recurrent stroke each year. For more about stroke risk and prevention, visit strokeassociation.org.

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Can Poor Sleep Lead to Dementia?

(American Academy of Neurology) People who have sleep apnea or spend less time in deep sleep may be more likely to have changes in the brain that are associated with dementia, according to a new study published in the December 10, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study found that people who don’t have as much oxygen in their blood during sleep, which occurs with sleep apnea and conditions such as emphysema, are more likely to have tiny abnormalities in brain tissue, called micro infarcts, than people with higher levels of oxygen in the blood. These abnormalities are associated with the development of dementia.

In addition, people who spent less time in deep sleep, called slow wave sleep, were more likely to have loss of brain cells than people who spent more time in slow wave sleep. Slow wave sleep is important in processing new memories and remembering facts. People tend to spend less time in slow wave sleep as they age. Loss of brain cells is also associated with Alzheimer’s disease and dementia.

For the study, 167 Japanese American men had sleep tests conducted in their homes when they were an average age of 84. All were followed until they died an average of six years later, and autopsies were conducted on their brains to look for micro infarcts, loss of brain cells, the plaques and tangles associated with Alzheimer’s disease and Lewy bodies found in Lewy body dementia.

The researchers divided the participants into four groups based on the percentage of time spent with lower than normal blood oxygen levels during sleep, with the lowest group spending 13 percent of their time or less with low oxygen levels and the highest group spending 72 to 99 percent of the night with low oxygen levels. Each group had 41 or 42 men. Of the 41 men in the lowest group, four had micro infarcts in the brain, while 14 of the 42 men in the highest group had the abnormalities, making them nearly four times more likely to have brain damage.

Previous studies have also shown a link between sleep stages and dementia. For this study, the participants were again divided into four groups based on the percentage of the night spent in slow wave sleep. Of the 37 men who spent the least time in slow wave sleep, 17 had brain cell loss, compared to seven of the 38 men who spent the most time in slow wave sleep.

The results remained the same after adjusting for factors such as smoking and body mass index and after excluding participants who had died early in the follow-up period and those who had low scores on cognitive tests at the beginning of the study.

“These findings suggest that low blood oxygen levels and reduced slow wave sleep may contribute to the processes that lead to cognitive decline and dementia,” said study author Rebecca P. Gelber, MD, DrPH, of the VA Pacific Islands Health Care System and the Pacific Health Research and Education Institute in Honolulu, Hawaii. “More research is needed to determine how slow wave sleep may play a restorative role in brain function and whether preventing low blood oxygen levels may reduce the risk of dementia.”

Gelber noted that a previous study showed that use of a continuous positive airway pressure machine (CPAP) for obstructive sleep apnea may improve cognition, even after dementia has developed.

There was no association between the sleep measures and the level of plaques and tangles. The study was supported by the National Institute on Aging, Alzheimer’s Association, Hawaii Community Foundation and Department of Veterans Affairs Pacific Islands Health Care System. To learn more about sleep and brain health, please visit www.aan.com/patients.

The American Academy of Neurology, an association of more than 28,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

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Old and Overmedicated: The Real Drug Problem in Nursing Homes

Dear Readers:

Do you know what drugs your parents are taking?

If you have a parent in a nursing home, please read this posting from the National Public Radio (NPR.org). It is about the dangers of giving anti-psychotic drugs to patients with dementia.

The science has shown that giving anti-psychotics to dementia patients significantly increases the risk of death.

Check out NPR’s interactive database to see the history of antipsychotic drug usage at nursing homes in your area and how they compare to national and state averages.

Protect your loved ones by being informed.

~ Jennifer


(NPR.org) It’s one of the worst fears we have for our parents or for ourselves: that we, or they, will end up in a nursing home, drugged into a stupor. And that fear is not entirely unreasonable. Almost 300,000 nursing home residents are currently receiving antipsychotic drugs, usually to suppress the anxiety or aggression that can go with Alzheimer’s disease and other dementia.

Antipsychotics, however, are approved mainly to treat serious mental illnesses like schizophrenia and bipolar disorder. When it comes to dementia patients, the drugs have a black box warning, saying that they can increase the risk for heart failure, infections and death.

None of this was on Marie Sherman’s mind when her family decided that her mother, 73-year-old Beatrice DeLeon, would be better off in a nursing facility near her home in Sonora, Calif. It wasn’t because of her Alzheimer’s disease, explains Sherman — it was because her mother had had some falls.

“We didn’t want my dad to try to lift her, and we wanted to make sure she was safe,” says Sherman.

It wasn’t long before the nursing home staff told Manuel DeLeon, Beatrice’s husband, that his wife was agitated and they wanted to give her some medication for that. So he said OK.

“They kept saying she was making too much noise, and that they give her this medicine to quiet her down,” he says.

Federal law prohibits the use of antipsychotics and other psychoactive drugs for the convenience of staff. It’s called a “chemical restraint.”

There has to be a documented medical need for the drugs. “But they just kept giving her more and more,” says DeLeon, “and I noticed when I used to go see her, she’d just kind of mumble, like she was lost.”

The DeLeon’s daughter, Marie Sherman, says that when her mother wasn’t “lost” she was “out of her skin.”

“I mean, she was calling for help,” Sherman says. “She was praying, ‘Our Father, who art in heaven, please, please help me. Please, take me, please, get me out!’ “

It turned out Beatrice DeLeon was given Risperdal and Seroquel, which are approved to treat bipolar disorder and schizophrenia. But professor Bradley Williams, who teaches pharmacy and gerontology at the University of Southern California, says antipsychotics should only be used as a last resort, and just for a month or so, before gradually being eliminated.

Antipsychotic drugs change behaviors, Williams says.

“They blunt behaviors. They can cause sedation. It increases their risk for falls.” And in the vast majority of cases, the drugs aren’t necessary. “If you want to get to the very basic bottom line,” he says, “why should someone pay for something that’s not needed?”

But residents or their guardians may not know that the drug is not needed. And they’re rarely told about the serious risks, says attorney Jody Moore, who specializes in elder law. She has sued nursing homes in California for failing to get informed consent when they use antipsychotic drugs, as required by law.

“We learned that the families really weren’t told anything other than, ‘The doctor has ordered this medication for you; please come sign a form,’ ” says Moore. “And families did.”

One of her clients is Kathi Levine, whose mother, Patricia Thomas, had Alzheimer’s. Despite her dementia, Thomas had been doing fine in 2010: living in a memory care facility near Santa Barbara, walking and talking, dressing and feeding herself. Levine remembers visiting her mother at the facility one day when there was a party going on, with a Hawaiian theme.

“My mom was standing up with a lot of the other ladies, doing the hula,” recalls Levine. “And she pulled me up off the chair and said, ‘Hula with me. It’s fun.’ And I think that was the last time I remember her having that ‘I love my life’ kind of look on her face.”

Not long after that, Patricia Thomas fell and fractured her pelvis. After a brief hospital stay, she went to a nursing home for rehab.

“But within a week,” says Levine, “she was in a wheelchair, slumped over, sucking on her hand, mumbling to herself, completely out of it, not even aware that I was there.”

Her mother was so “out of it,” she couldn’t do the rehabilitation work that was the reason she went to the nursing home in the first place. So they discharged her. That’s when Levine first saw a list of her mother’s medications.

“I literally freaked out,” says Levine. “I couldn’t believe all of these drugs on a list for my mother.”

Among them were Risperdal and Haldol, both powerful antipsychotics. Levine tried to slowly wean her mother from the drugs, but Patricia Thomas remained in her wheelchair. She never had another conversation. She was dead in two months.

“When you are your parent’s caretaker and their guardian, and things like this happen, you feel terribly guilty,” says Levine. “I know the medications they gave her weren’t my fault. But the guilt’s still there. It’s always going to be there.”

So Levine and her attorney, Jody Moore, brought a class-action lawsuit — the first of its kind — against the nursing home, charging wholesale violation of informed consent. Moore is a seasoned attorney but says she was amazed at a deposition she took from one of the doctors, who said “not only do I not get informed consent, but I don’t know of any doctor who does, and you’re crazy to think that that’s my job.”

The nursing home settled. It’s now required to change its practices. An independent monitor will make sure it follows through.

But this facility was not out of the ordinary when it came to dispensing unnecessary antipsychotic drugs. In 2011, a government study found that 88 percent of Medicare claims for antipsychotics prescribed in nursing homes were for treating symptoms of dementia, even though the drugs aren’t approved for that. So the next year, the federal government started a campaign to get nursing homes to reduce their use of antipsychotics by 15 percent.

That 15 percent reduction was supposed to take less than a year. It took almost two. And it still left almost 300,000 nursing home residents on risky antipsychotic drugs. But Beatrice DeLeon is no longer one of them.

She’s home again with her husband. The family found a state program that sends health aides to the house. And now she can have the kinds of conversations that mean something to her and to her family.

“Can you kiss me?” she asks, apropos of nothing.

“Of course I can, Mama,” says her daughter.

“I love you guys.”

“We love you too.”

Beatrice DeLeon says “thank you.” She says that a lot. Currently, she’s not taking anything but her Alzheimer’s medication. But that seems to be enough, for a life filled with love and gratitude.

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Study Suggests Potential Therapy for Second Most Common Form of Dementia

(University of Alabama) Drugs that boost the function of a specific type of neurotransmitter receptor may provide benefit to patients with the second most common type of dementia, according to research by scientists at the University of Alabama at Birmingham published today in the Journal of Neuroscience.

Frontotemporal dementia, known as FTD, is a devastating disease in which patients have rapid and dramatic changes in behavior, personality and social skills. The age of onset for FTD is relatively young, usually striking patients in their mid- to late 50s. The prognosis is grim; patients quickly deteriorate and usually die within 10 years after onset. Currently, there is no effective treatment for FTD.

The UAB research team’s effort focused on mutations in certain genes, primarily in the Microtubule Associated Protein Tau gene. An accumulation of tau protein is associated with Alzheimer’s disease, the most common form of dementia; but little is known how tau mutations affect specific brain regions and cause FTD.

The UAB researchers used a new mouse model expressing human tau with an FTD-associated mutation. These mice demonstrate physical behaviors similar to those seen in humans with FTD — compulsive, excessively repetitive actions such as grooming, for example. The mice also had impaired synaptic and network function in certain brain network regions.

“We found that mutant tau impairs synapses — the connections between neurons — by reducing the size of the anchoring sites of an essential glutamate receptor called NMDA,” said Erik Roberson, M.D., Ph.D., associate professor in the Department of Neurology and primary investigator for the study. “Reduction of the anchoring sites left fewer NMDA receptors available at the synapse to receive excitatory signals, thus limiting synaptic firing and network activity.”

The team then employed cycloserine, a drug already approved for use by the FDA, which is known to assist NMDA receptor function. This boost of NMDA receptor function was able to restore synaptic firing and thereby restore network activity in the animal model. The restoration of normal network activity reversed the behavioral abnormalities seen in the mice.

“This study provides mechanistic insight into how a tau mutation affects specific brain regions to impair a network,” said Roberson. “It also provides a potential therapeutic target, the NMDA receptor, which appears to correct the network and behavioral abnormalities.”

Roberson’s team hypothesizes that increasing NMDA receptor function may benefit human FTD patients. With further preclinical validation, this hypothesis could be tested in clinical trials using the already available drug cycloserine.

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Warning Signs Can Predict Seniors’ Diminished Ability to Manage Money

(University of Alabama) Many Americans have struggled with the thorny issue of suggesting an elderly loved one should give up the car keys, but experts suggest caregivers may also need to be mindful of seniors’ ability to manage their own money.

“Financial capacity has emerged as a key activity of daily living in understanding functional impairment and decline in patients with mild cognitive impairment — or MCI — and dementia,” said Daniel Marson, Ph.D., J.D., professor in the Department of Neurology and director of the Alzheimer’s Disease Center at the University of Alabama at Birmingham.

“The capacity to manage one’s own financial affairs is critical to success in independent living. Impairments in financial skills and judgment are often the first functional changes demonstrated by patients with incipient dementia. And breakdowns in financial management skills can be devastating.”

Patients with MCI typically still are functioning in the community with focal memory or other cognitive impairments but are beginning to show initial signs of functional decline. Since 2000, Marson and his group have published a number of empirical studies detailing impairments of financial skills in patients with MCI and Alzheimer’s disease.

At an October symposium organized jointly by the Massachusetts Institute of Technology AgeLab and Transamerica called “Financial Planning in the Shadow of Dementia,” Marson presented five clinical warning signs of financial decline that family members and caregivers of elderly persons should recognize. Marson noted that these warning signs should represent changes from the older person’s prior baseline financial skills.

  • Memory lapses, such as forgetting to pay bills or taxes, or paying bills twice.
  • Poor organization of financial information flow, where a previously neat desk is now in disarray and disorganized. An individual might be confused about when an activity transpired, and mail might not be opened in a timely manner.
  • Math mistakes in everyday life, such as figuring out a tip, balancing a checkbook or needing help with the steps of a calculation.
  • Confusion, such as an erosion in the ability to comprehend basic financial concepts.
  • Impaired financial judgment, particularly a new interest in get-rich-quick schemes. A classic sign is that the person would not have considered the scheme five years ago and is now listening and interested. Another sign is unrealistic anxiety about personal finances.

In response to these changes, Marson suggests that caregivers can oversee an older person’s  checking transactions, contact the bank to detect irregularities such as bills’ being paid twice, or become co-signers on a checking account so that joint signature is required for checks above a certain amount. Online banking and bill-payment services are additional options for families.

In 2009, Marson and his group published a major paper on declining financial capacity in MCI and progression to Alzheimer’s, which involved a tool developed at UAB called the Financial Capacity Instrument. The FCI measures financial skills across 20 tasks, including making investment decisions, understanding a bank statement, balancing a checkbook, paying bills, preparing bills for mailing, and counting coins and currency.

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Diabetes in Midlife Linked to Significant Cognitive Decline 20 Years Later

(Johns Hopkins Bloomberg School of Public Health via ScienceDaily) People diagnosed with diabetes in midlife are more likely to experience significant memory and cognitive problems during the next 20 years than those with healthy blood sugar levels, new Johns Hopkins Bloomberg School of Public Health research suggests.

The researchers found that diabetes appears to age the mind roughly five years faster beyond the normal effects of aging. For example, on average, a 60-year-old with diabetes experiences cognitive decline on par with a healthy 65-year-old aging normally. Decline in memory, word recall and executive function is strongly associated with progression to dementia, a loss of mental capacity severe enough to interfere with a person’s daily functioning.

A report on the research is published in the Dec. 2 issue of the journal Annals of Internal Medicine. The study is believed to be the longest of its kind following a cross-section of adults as they age.

“The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50,” says study leader Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “There is a substantial cognitive decline associated with diabetes, pre-diabetes and poor glucose control in people with diabetes. And we know how to prevent or delay the diabetes associated with this decline.”

For the study, Selvin and the team used data from the Atherosclerosis Risk in Communities Study (ARIC), which in 1987 began following a group of 15,792 middle-aged adults in communities in Maryland, North Carolina, Minnesota and Mississippi. Participants were seen at four visits approximately three years apart beginning between 1987 and 1989, and were seen a fifth time between 2011 and 2013. Cognitive function was evaluated at visits two (1990-1992), four (1996-1998) and at visit five.

The researchers compared the amount of cognitive decline associated with aging with the amount of decline found in the ARIC participants. They determined that there was 19 percent more decline than expected in those participants with poorly controlled diabetes, as well as smaller declines for those with controlled diabetes and pre-diabetes. The outcomes were the same whether the participants were white or black.

Selvin says the results underscore the importance of using a combination of weight control, exercise and a healthy diet to prevent diabetes. Even losing just five to 10 percent of body weight, she says, can keep someone from developing diabetes. Diabetes is a function of elevated sugar (glucose) levels in the blood. This excess glucose can damage tissues and the vascular system throughout the body and diabetes is associated with blindness, nerve damage in the extremities and kidney disease. While diabetes can often be controlled through medication, exercise and changes to diet, disease prevention is the preferred goal.

“If we can do a better job at preventing diabetes and controlling diabetes, we can prevent the progression to dementia for many people,” Selvin says. “Even delaying dementia by a few years could have a huge impact on the population, from quality of life to health care costs.”

Nationwide, dementia costs in 2010 were estimated to be upwards of $159 billion a year and, with the aging of the population, are expected to increase by nearly 80 percent by 2040.

Researchers are increasingly aware of the importance of many other causes of dementia besides Alzheimer’s disease, particularly cognitive impairment linked to abnormalities in blood vessels in the brain.

“There are many ways we can reduce the impact of cerebral blood vessel disease — by prevention or control of diabetes and hypertension, reduction in smoking, increase in exercise and improvements in diet,” says co-author A. Richey Sharrett, MD, DrPH, an adjunct professor at the Johns Hopkins Bloomberg School of Public Health.

“Knowing that the risk for cognitive impairments begins with diabetes and other risk factors in mid-life can be a strong motivator for patients and their doctors to adopt and maintain long-term healthy practices.”

Research has shown that the single best predictor of type 2 diabetes is being obese or overweight and, in the United States alone, more than one-third of adults (more than 72 million people) are obese, defined as having a Body Mass Index of 30 or more about 30 pounds overweight. Meanwhile, the diabetes epidemic has grown rapidly over the past several decades, affecting approximately 10 percent of American adults (21 million people).

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10 Things You Should Know about Lewy Body Dementias

(Lewy Body Dementia Association) Lewy body dementias (LBD) affect an estimated 1.3 million individuals and their families in the United States. At the Lewy Body Dementia Association (LBDA), we understand that though many families are affected by this disease, few individuals and medical professionals are aware of the symptoms, diagnostic criteria, or even that LBD exists. There are important facts about Lewy body dementias that you should know if you, a loved one, or a patient you are treating may have LBD.

  1. Lewy body dementias (LBD) are the second most common form of degenerative dementia; LBD is widely under-diagnosed: The only other form of degenerative dementia that is more common than LBD is Alzheimer’s disease (AD). Many individuals who have LBD are misdiagnosed, most commonly with Alzheimer’s disease if they present with a memory disorder or Parkinson’s disease if they present with movement problems.
  2. LBD can have three common presentations:  Some individuals will start out with a movement disorder leading to the diagnosis of Parkinson’s disease and later develop dementia.  Another group of individuals will start out with a memory disorder that may look like AD, but over time two or more distinctive features become apparent leading to the diagnosis of ‘dementia with Lewy bodies’ (DLB).  Lastly, a small group will first present with neuropsychiatric symptoms, which can include hallucinations, behavioral problems, and difficulty with complex mental activities, leading to an initial diagnosis of DLB. Regardless of the initial symptom, over time all three presentations of LBD will develop very similar cognitive, physical, sleep and behavioral features, all caused by the presence of Lewy bodies throughout the brain.
  3. The most common symptoms of LBD include: Dementia: problems with memory and thinkingHallucinations: seeing or hearing things that are not really presentCognitive fluctuations: unpredictable changes in concentration and attentionParkinson-like symptoms: rigidity or stiffness, shuffling gait, tremor, slowness of movement (bradykinesia)Severe sensitivity to neuroleptics (medications used to treat hallucinations)REM Sleep Behavior Disorder: a sleep disorder where people seemingly act out their dreams
  4. The symptoms of LBD are treatable: Currently there are no medications approved specifically for the treatment of LBD. All medications prescribed for LBD are approved for a course of treatment for symptoms related to other diseases such as Alzheimer’s disease and Parkinson’s disease with dementia and offer symptomatic benefits for cognitive, movement and behavioral problems.
  5. Early and accurate diagnosis of LBD is essential: Early and accurate diagnosis is important because LBD patients may react to certain medications differently than AD or PD patients. A variety of drugs, including anticholinergics and some antiparkinsonian medications, can worsen LBD symptoms.
  6. Traditional antipsychotic medications may be contraindicated for individuals living with LBD: Many traditional antipsychotic medications (for example, Haldol, Mellaril) are commonly prescribed for individuals with Alzheimer’s disease and other forms of dementia to control behavioral symptoms. However, LBD affects an individual’s brain differently than other dementias. As a result, these medications can cause a severe worsening of movement and a potentially fatal condition known as neuroleptic malignant syndrome (NMS). NMS causes severe fever, muscle rigidity and breakdown that can lead to kidney failure.
  7. Early recognition, diagnosis and treatment of LBD can improve the patients’ quality of life: LBD may affect an individual’s cognitive abilities, motor functions, and/or ability to complete activities of daily living. Treatment should always be monitored by your physician(s) and may include: prescriptive and other therapies, exercise, diet, sleep habits, changes in behavior and daily routines.
  8. Individuals and families living with LBD should not have to face this disease alone: LBD affects every aspect of a person – their mood, the way they think, and the way they move. LBD patients and families will need considerable resources and assistance from healthcare professionals and agencies. The combination of cognitive, motor and behavioral symptoms creates a highly challenging set of demands for continuing care. LBDA was formed to help families address many of these challenges.
  9. Physician education is urgently needed: An increasing number of general practitioners, neurologists, and other medical professionals are beginning to learn to recognize and differentiate the symptoms of LBD from other diseases. However, more education on the diagnosis and treatment of LBD is essential.
  10. More research is urgently needed! Research needs include tools for early diagnosis, such as screening questionnaires, biomarkers, neuroimaging techniques, and more effective therapies. With further research, LBD may ultimately be treated and prevented through early detection and neuroprotective interventions. Currently, there is no specific test to diagnose LBD.
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One of the Healthiest Things You Can Do

(HelpGuide.org) As you grow older, an active lifestyle is more important than ever. Regular exercise can help boost energy, maintain your independence, and manage symptoms of illness or pain. Exercise can even reverse some of the symptoms of aging. And not only is exercise good for your body, it’s also good for your mind, mood, and memory. Whether you are generally healthy or are managing an illness, there are plenty of ways to get more active, improve confidence, and boost your fitness.

older-couple-jogging-in-park-350

Exercise is the Key to Healthy Aging

Starting or maintaining a regular exercise routine can be a challenge as you get older. You may feel discouraged by illness, ongoing health problems, or concerns about injuries or falls. Or, if you’ve never exercised before, you may not know where to begin. Or perhaps you think you’re too old or frail, or that exercise is boring or simply not for you.
While these may seem like good reasons to slow down and take it easy as you age, they’re actually even better reasons to get moving. Exercise can energize your mood, relieve stress, help you manage symptoms of illness and pain, and improve your overall sense of well-being. In fact, exercise is the key to staying strong, energetic, and healthy as you get older. And it can even be fun, too.

No matter your age or your current physical condition, you can benefit from exercise. Reaping the rewards of exercise doesn’t require strenuous workouts or trips to the gym. It’s about adding more movement and activity to your life, even in small ways. Whether you are generally healthy or are managing an illness—even if you’re housebound—there are many easy ways to get your body moving and improve your health.

Five Myths about Exercise and Aging

Myth 1: There’s no point to exercising. I’m going to get old anyway.

Fact: Exercise and strength training helps you look and feel younger and stay active longer. Regular physical activity lowers your risk for a variety of conditions, including Alzheimer’s and dementia, heart disease, diabetes, colon cancer, high blood pressure, and obesity.

Myth 2: Older people shouldn’t exercise. They should save their strength and rest.

Fact: Research shows that a sedentary lifestyle is unhealthy for adults over 50. Inactivity often causes older adults to lose the ability to do things on their own and can lead to more hospitalizations, doctor visits, and use of medicines for illnesses.

Myth 3: Exercise puts me at risk of falling down.

Fact: Regular exercise, by building strength and stamina, prevents loss of bone mass and improves balance, actually reducing your risk of falling.

Myth 4: It’s too late. I’m already too old to start exercising.

Fact: You’re never too old to exercise! If you’ve never exercised before, or it’s been a while, start with light walking and other gentle activities.

Myth 5: I’m disabled. I can’t exercise sitting down.

Fact: Chair-bound people face special challenges but can lift light weights, stretch, and do chair aerobics to increase range of motion, improve muscle tone, and promote cardiovascular health

The Whole-body Benefits of Exercise for Older Adults

As you age, regular exercise is more important than ever to your body and mind.

Physical health benefits of exercise and fitness for older adults

  • Exercise helps older adults maintain or lose weight. As metabolism naturally slows with age, maintaining a healthy weight is a challenge. Exercise helps increase metabolism and builds muscle mass, helping to burn more calories. When your body reaches a healthy weight, your overall wellness will improve.
  • Exercise reduces the impact of illness and chronic disease. Among the many benefits of exercise for adults over 50 include improved immune function, better heart health and blood pressure, better bone density, and better digestive functioning. People who exercise also have a lowered risk of several chronic conditions including Alzheimer’s disease, diabetes, obesity, heart disease, osteoporosis, and colon cancer.
  • Exercise enhances mobility, flexibility, and balance in older adults. Exercise improves your strength, flexibility and posture, which in turn will help with balance, coordination, and reducing the risk of falls. Strength training also helps alleviate the symptoms of chronic conditions such as arthritis.

Mental health benefits of exercise and fitness as you age

  • Exercise improves your sleep. Poor sleep is not an inevitable consequence of aging and quality sleep is important for your overall health. Exercise often improves sleep, helping you fall asleep more quickly and sleep more deeply.
  • Exercise boosts mood and self-confidence. Endorphins produced by exercise can actually help you feel better and reduce feelings of sadness or depression. Being active and feeling strong naturally helps you feel more self-confident and sure of yourself.
  • Exercise is good for the brain. Exercise benefits regular brain functions and can help keep the brain active, which can prevent memory loss, cognitive decline, and dementia. Exercise may even help slow the progression of brain disorders such as Alzheimer’s disease.

Exercise and Fitness as You Age: Tips for Getting Started Safely

Committing to a routine of physical activity is one of the healthiest decisions you can make. Before you get moving, though, consider how best to be safe.

  • Get medical clearance from your doctor before starting an exercise program, especially if you have a preexisting condition. Ask if there are any activities you should avoid.
  • Consider health concerns. Keep in mind how your ongoing health problems affect your workouts. For example, diabetics may need to adjust the timing of medication and meal plans when setting an exercise schedule. Above all, if something feels wrong, such as sharp pain or unusual shortness of breath, simply stop. You may need to scale back or try another activity.
  • Start slow. If you haven’t been active in a while, it can be harmful to go “all out.” Instead, build up your exercise program little by little. Try spacing workouts in ten-minute increments twice a day. Or try just one class each week. Prevent crash-and-burn fatigue by warming up, cooling down, and keeping water handy.
  • Commit to an exercise schedule for at least 3 or 4 weeks so that it becomes habit, and force yourself to stick with it.
  • Stay motivated by focusing on short-term goals, such as improving your mood and energy levels and reducing stress, rather than goals such as weight loss, which can take longer to achieve.
  • Recognize problems. Exercise should never hurt or make you feel lousy. Stop exercising immediately and call your doctor if you feel dizzy or short of breath, develop chest pain or pressure, break out in a cold sweat, or experience pain. Also stop if a joint is red, swollen, or tender to touch.

Exercise and Fitness as You Age: Tips for Building a Balanced Exercise Plan

Staying active is not a science. Just remember that mixing different types of exercise helps both reduce monotony and improve your overall health. The key is to find activities that you enjoy. Here is an overview of the four building blocks of senior fitness and how they can help your body.

The 1st building block of fitness as you age: Cardio endurance exercise

  • What is it: Uses large muscle groups in rhythmic motions over a period of time. Cardio workouts get your heart pumping and you may even feel a little short of breath. Cardio includes walking, stair climbing, swimming, hiking, cycling, rowing, tennis, and dancing.
  • Why it’s good for you: Helps lessen fatigue and shortness of breath. Promotes independence by improving endurance for daily activities such as walking, house cleaning, and errands.

The 2nd building block of fitness as you age: Strength and power training

  • What is it: Strength training builds up muscle with repetitive motion using weight or external resistance from body weight, machines, free weights, or elastic bands. Power training is often strength training done at a faster speed to increase power and reaction times.
  • Why it’s good for you: Strength training helps prevent loss of bone mass, builds muscle, and improves balance—both important in staying active and avoiding falls. Power training can improve your speed while crossing the street, for example, or prevent falls by enabling you to react quickly if you start to trip or lose balance. Building strength and power will help you stay independent and make day-to-day activities easier such as opening a jar, getting in and out of a car, and lifting objects.

The 3rd building block of fitness as you age: Flexibility

  • What is it: Challenges the ability of your body’s joints to move freely through a full range of motion. This can be done through stationary stretches and stretches that involve movement to keep your muscles and joints supple so they are less prone to injury. Yoga is an excellent means of improving flexibility.
  • Why it’s good for you: Helps your body stay limber and increases your range of movement for ordinary physical activities such as looking behind while driving, tying your shoes, shampooing your hair, and playing with your grandchildren.

The 4th building block of fitness as you age: Balance

  • What is it: Maintains standing and stability, whether you’re stationary or moving around. Try yoga, Tai Chi, and posture exercises to gain confidence with balance.
  • Why it’s good for you: Improves balance, posture, and quality of your walking. Also reduces risk of falling and fear of falls.

Types of activities that are beneficial to older adults:

  • Walking. Walking is a perfect way to start exercising. It requires no special equipment, aside from a pair of comfortable walking shoes, and can be done anywhere.
  • Senior sports or fitness classes. Keeps you motivated while also providing a source of fun, stress relief, and a place to meet friends.
  • Water aerobics and water sports. Working out in water is wonderful for seniors because water reduces stress and strain on the body’s joints.
  • Yoga. Combines a series of poses with breathing. Moving through the poses works on strength, flexibility and balance. Yoga can be adapted to any level.
  • Tai Chi and Qi Gong. Martial arts-inspired systems of movement that increase balance and strength. Classes for seniors are often available at your local YMCA or community center.

Exercise and Fitness as You Age: Tips for Frail or Chair-bound Adults

Even if you are frail or chair-bound, you can still experience the mood-boosting effects of exercise. Chair-bound adults can improve fitness with strength training, flexibility, and even some cardio activities. If being chair-bound has prevented you from trying exercise in the past, take heart knowing that when you become more physically active, the results will amaze you. Like any exercise program, a chair-bound fitness routine takes a little creativity and personalization to keep it fun.

Chair-bound Exercise and Fitness

  • Strength: Use free weights (“dumbbells”) to do repetitive sets of lifting. Don’t have weights? Use anything that is weighted and fits in your hand, like soup cans.
  • Resistance: Resistance bands are like giant rubber bands designed to give your muscles a good workout when stretched and pulled. Resistance bands can be attached to furniture, a doorknob, or even your chair. Use these for pull-downs, shoulder rotations, and arm and leg-extensions.
  • Flexibility: By practicing mindful breathing and slowly stretching, bending, and twisting, you can limber up and improve your range of motion. Some of these exercises can also be done lying down. Ask your doctor or search online for chair-yoga possibilities.
  • Endurance: Check out pool-therapy programs designed for wheelchair-bound seniors. Also, wheelchair-training machines make arm-bicycling and rowing possible. If you lack access to special machines or pools, repetitive movements (like rapid leg lifts or sitting pushups) work just as well to raise your heart rate.

Talk to your doctor or physical therapist about chair-bound exercise programs or see Chair Exercises & Limited Mobility Fitness.

Exercise and Fitness as You Age: Tips for Getting More Active—and Liking It

If you dread working out, it’s time for a mental makeover. Consider physical activity part of your lifestyle instead of a bothersome task to check off your “to do” list. There are plenty of ways for seniors to make exercise a pleasurable part of everyday life—here are just a few.

Choose activities and exercises you enjoy

Think about activities that you enjoy and how you can incorporate them into an exercise routine.

  • Listen to music while lifting weights
  • Window shop while walking laps at the mall
  • Get competitive while playing tennis
  • Take photographs on a nature hike
  • Meet new people at a yoga class
  • Watch a favorite movie while on the treadmill
  • Chat with a friend while walking, stretching, or strength training

Find easy ways to add more physical activity to your day

Being active doesn’t have to be limited to your workout times. There are plenty of ways to become more active as you go about your day.

  • Active on the go: Always choose stairs over the elevator, park at the far end of the parking lot when arriving at appointments and meetings, walk down every isle of the grocery store while shopping, practice balancing skills while standing in line, do neck rolls while waiting at a stoplight.
  • Active at home: Do a set of wall pushups while waiting for water to boil, vigorously vacuum, tend to the garden, sweep the sidewalk, rake leaves, lift weights while watching the news, try toe-raises while talking on the phone, do knee bends after sitting for a long period of time.

Focus on the benefits in your daily life

The most rewarding part of beginning a fitness routine is noticing the difference it makes in the rest of your life. Even if you begin exercising with a few simple stretches while seated or a short walk around the block, you’ll notice an improvement in how you feel as you go about your day.

  • House cleaning, gardening, shopping, and errands. Want to feel less winded while vacuuming or rushing to and from appointments? Doing just 15 to 20 minutes of heart-healthy cardio each day, such as walking, biking, swimming, or water aerobics will help give you the stamina you need.
  • Lifting grandchildren, carrying groceries, household chores. Building muscle mass a few times each week through weight lifting, resistance exercises, and weight machines will help give you more strength.
  • Crossing the street before the lights change, catching yourself before you fall. Power exercises such as tricep dips, chair stands, or other strength exercises performed quickly, can improve strength, speed, and reaction times.
  • Tying shoes, looking behind you while driving, navigating steps. Incorporating basic stretching—even while seated—into your fitness routine will make the most ordinary movements easier. Try yoga, Pilates, Tai Chi, or Qi Gong to limber up.

Exercise doesn’t have to break the bank

An exercise plan does not depend on costly gym memberships and fancy exercise equipment. Like the best things in life, staying fit can be completely free. Work out the wallet-friendly way:

  • Do neck rolls and light stretching while watching TV
  • No weights? Use food cans or water bottles
  • Rent exercise videos from the library
  • Mow the lawn, rake leaves, and weed
  • Climb stairs
  • Enjoy a walk in a new park or neighborhood

Exercise and Fitness as You Age: Tips for Staying Active for Life

The more you exercise, the more you will reap the benefits, so it’s important to stay motivated when life’s challenges get in the way.

  • Keep a log. Writing down your activities in an exercise journal not only holds you accountable, but also is a reminder of your accomplishments.
  • Stay inspired. Reading health magazines or watching sports shows can help remind you how great it feels to take care of your body.
  • Get support. It’s easier to keep going with support. Consider taking a class or exercising with your spouse or a buddy.
  • Exercise safely. Nothing derails an exercise plan like an injury. Use common sense and don’t exercise if you are ill. Wear brightly colored clothing to be visible on the roads. When the weather brings slippery conditions, walk at a mall indoors to prevent falling.

 

How To Stay Fit When Your Routine Changes

Adapted from the National Institutes on Aging
You’re on vacation
  • Many hotels now have fitness centers. Check out the facilities where you’ll be staying, and bring along your exercise clothing or equipment (resistance band, bathing suit, or walking shoes).
  • Get out and see the sights on foot rather than just by tour bus.
Caring for an ill spouse is taking up much of your time
  • Work out to an exercise video when your spouse is napping.
  • Ask a family member or friend to come over so you can go for a walk.
Your usual exercise buddy moves away
  • Ask another friend to go with you on your daily walk.
  • Ask other older adults in your area where they go for walks or what physical activity resources are available nearby.
  • Join an exercise class at your local community center or senior center. This is a great way to meet other active people.
You move to a new community
  • Check out the fitness centers, parks, and recreation associations in your new neighborhood.
  • Look for activities that match your interests and abilities.
  • Get involved!
The flu keeps you out of action for a few weeks
  • Wait until you feel better and then start your activity again.
  • Gradually build back up to your previous level of activity.
You are recovering from hip or back surgery
  • Talk with your doctor about specific exercises and activities you can do safely when you’re feeling better.
  • Start slowly and gradually build up your activities as you become stronger.

 

The best thing about working out is that it gives you energy for more activities. When it becomes habit, you’ll never want to give it up.

More Help for Exercise and Fitness as You Age

Healthy lifestyles for older adults

Resources and References

General information about exercise for older adults

Keep Active for a Longer, Healthier Life – Discusses value of exercise and provides tips to help you get started. (AARP)

Fitness plans and exercise instruction for older adults

NIHSeniorHealth: Exercise for Older Adults – Covers the benefits of exercise for seniors, safe exercises to try, an FAQ, and charts to track your progress. (National Institute of Health)

NIH Exercise Guide – Sample exercises and charts. (National Institute of Health)

The Water Well – Discusses the benefits of water exercise for people with medical conditions like osteoporosis, diabetes, and back problems. (Aquatic Exercise Association)

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