Updated: Mar 24, 2021
With an ageing population, the proportion of Singapore residents who are elderly (>65 years old) is rising. The elderly population bear the largest burden of diseases (high cholesterol, high blood pressure and diabetes) most easily prevented and treated with exercise, but yet have the least access and opportunity for health promotion efforts related to physical activity.
This article is aims to
1. debunk some of the myths associated with exercise in the elderly
2. provide some tips on exercise for the elderly population
Firstly, lets talk about some of the benefits of increased physical activity and exercise in the elderly.
Slowing down the ageing process
Promoting psychological and cognitive well being
Preventing and even slowing down the progression of chronic diseases
Reduce the risk of falls
Increasing longevity and quality of life
Is it safe for me to start exercise?
Will I get a heart attack or stroke if I exercise too vigorously?
Generally for most elderly, it is NOT required for an exercise test prior to starting light to moderate intensity exercise. But do remember to start slow first and slowly increase the intensity. If you experience any chest discomfort, severe shortness of breath, palpitations, or lightheadedness, do see a doctor quickly.
However, for elderly with multiple chronic medical issues, it is advisable for these segment of the population to undergo a formal medical examination and exercise testing prior to starting moderate to vigorous intensity exercise.
So what does exercise testing include?
Exercise testing by a trained doctor includes a thorough medical history and physical examination to determine any cardiovascular contraindications to exercise. These can include severely high cholesterol, blood pressure and sugar issues, as well as past heart attacks and stroke which are not controlled.
If deemed safe, the doctor may organise both a resting ECG (electrocardiogram), and a treadmill ECG. The resting ECG is done when the patient is lying flat and the treadmill ECG is a stress test of the heart when engaging in physical activity.
Do consult your friendly neighbourhood doctor, preferably one who is both Geriatric Medicine and Exercise Medicine trained, for advice on this.
So now let's talk about some tips for exercise in the Elderly
Using the FITT (Frequency Intensity Time Type) principle according to EIMS Singapore guidelines, here is some general tips.
Exercise programs for the elderly should be designed with the intention of having these domains of aerobic capacity, muscle strengthening, flexibility and balance training.
Frequency: Most days of the week
Intensity: Start slow first, but progress according to individual preference and tolerance. Start with low intensity first, but slowly increase the intensity. Exercise need not be vigorous and continuous to be beneficial, a daily accumulation of 30 minutes of moderate intensity physical activity can provide health benefits
Time: 30 minutes daily, to accumulate at least 150 minutes per week of moderate intensity exercise
Type: Brisk walking, aquatic exercise (swimming, aquatic running), stationary cycling, recumbent stepper exercise
Muscle Strengthening / Resistance Training
Frequency: 2 sessions per week
Intensity: Perform each lift with a resistance that allows for 10 to 15 repetitions per exercise
Time: Complete 1 to 3 sets of each exercise, but allow adequate rest (at least 2 to 4 min) between exercises
Type: 8 to 10 exercises involving the major muscle groups.
Flexibility and Balance Training
Flexibility and balance are essential components of elderly exercise. Poor flexibility and balance has been associated with a diminished ability to perform activities of daily living, and can increase the incidence of falls. It is recommended that balance training be performed 3 days per week for 10 to 15 minutes per session. It can be integrated into the various phases of the exercise session, including the warm-up and cool-down segments.
Resistance, flexibility and balance training exercises are best taught in a physical session and so, please consult an EIMS (Exercise is Medicine Singapore) Primary Care Physician to advise you on what exercises are suitable for you.
It is clear that exercise has many health benefits for the elderly!
Start your exercise routine today!
Dr Lee Joon Loong
Graduate Diploma in Geriatrics Medicine (Singapore)
Exercise is Medicine Singapore Primary Care Physician
Medical Director, Paddington Medical