Exercise for elders: It's never too late

sk walk, she suggests that advocates say: "Get your heart rate up, at least 30 minutes a day, at least five days a week."

Older people say they look for activities that are moderate in intensity, reasonably inexpensive, simple and convenient to engage in and, for older women in particular, include opportunities to socialize.

Motivating older people to get out and move also means recognizing the obstacles that block their paths. Some are physical: unsafe streets, absent sidewalks, nasty winters or steamy summers. But fear of injury and lack of time, energy, skill or motivation take a toll as well.

One barrier to greater participation in physical activity, oddly enough, is the familiar injunction to consult a doctor before starting an exercise program, says Durham, North Carolina, Veterans' Affairs Medical Center researcher Miriam C. Morey, Ph.D. Several national medical organizations tell doctors to take a complete medical history and do a physical examination, laboratory tests, and a stress test before prescribing exercise to patients.

But these precautions often fail to predict cardiac events in patients without symptoms, Morey says. Adverse events from exercise are rare, but the universal caution to see a doctor creates an image of exercise as potentially harmful.

"Clinicians [should] shift from a traditional role of shielding patients from all possible harm and adopt a role of enabling participation," she says. Doctors should become advocates for physical activity rather than the gatekeepers they seem to be at present.

"Medical knowledge and skill are essential to aggressively seek solutions for those with physical conditions that limit participation or present impediments," Morey says.

She suggests facetiously that perhaps medical guidelines should require a doctor's permission for anyone who intends to remain sedentary. A "start-low-and-go-slow" approach is a good way to begin a personal exercise plan, say

Contact: Brigid Sanner
Center for the Advancement of Health

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