Mix and match

The older adult population is increasingly becoming “top heavy”. At the last census 6 million people are aged between 50 and 89 years. Over 2 million live in NSW (962,800 over 65 years old living on the mid north coast). The average age for retirement is now 64 years. 1.3 million older adults provide unpaid care for another person with older women taking on more responsibilities with child care. More women than ever before, who are over 50, are in the workforce

People arrive at their later years with a variety of backgrounds, experiences and circumstances. We all have different needs, wants, expectations, aspirations and different prospects of what we want and can achieve. We still are individuals with many variables in ages having differences in health conditions and abilities yet the older adult is often “lumped into one category” with exercise programs often planned and delivered accordingly

Age Related Changes

General mobility for free and easy movement. Physical activity levels play an important role in maintaining flexibility. Not all older adults lose flexibility at the same rate. Muscle strength and elasticity diminish gradually, by 7% from 30 onwards into middle age but becomes more noticeable after 60, especially in women (15% decrease). Joint ranges of movement and flexibility declines gradually from approximately the same age onwards, with greater decline after age 40 and more frequently used joints exhibit less decline.
Joint stiffness is a result of:

1. Increased viscosity (thickening) of the joint synovium.
2. Calcification of articular cartilage
3. Stiffening of soft tissue (capsule & ligaments)

General strength for free and easy movement – Muscle Power and Potential

A reduction in muscle strength is part of normal ageing and inactivity. The collective result of changes in the muscle is reduced muscle strength, power, endurance and flexibility. This may eventually fall below the level required for everyday activities. There is also an increase in fat and connective tissue within older muscle. Between ages of 50 -70 muscle strength declines 30%. The most dramatic loss occurs after 70. Even more after 80 and is more pronounced in women.
The changes in muscle mass (decrease in size and numbers) is a result of:

1. A gradual reduction and selective loss of muscle fibers.
2. A reduction in the number of functioning motor units… the greatest reduction is in fast twitch fibers used for faster movements and activity

Physiological and conditions changes

There are many conditions and associated linkages that present problems with being able to undertake free and easy movement. The following are some examples why movement can become harder.
Conditions and issues such as:

1. Musculoskeletal changes in joint and bone structure as in arthritis (reduced range of movement, increased pain and stiffness) and osteoporosis – (bone fragility, changes in posture).
2. Neurological changes involving hearing and vision e.g. glaucoma, cataracts, deafness and sensory system changes such as vestibular and kinesthetic issues that monitor changes of body sensation associated with balance and body control. Conditions such as Stroke, Parkinson’s disease
3. Metabolic changes involving poor or malabsorption –resulting in mal-nutrition / dehydration, conditions such as Diabetes/osteoporosis (calcium and Vitamin D issues)
4. Cardiovascular changes that involve the overall functioning of the heart and circulation including: cardiac output, arrhythmia, syncope, alterations in blood pressure changes etc.
5. Respiratory volume changes and conditions such as Asthma, COAD
6. Mental health changes and cognitive processing resulting in issues relating to anxiety, mental alertness often associated with conditions such as Depression, Dementia
7. Other changes and issues such as sleeping problems, incontinence etc.

With all the above examples and reasons it important to recognize there is a need for different exercises, grades and modalities to accommodate all these variables in age changes and conditions. There are multiple exercise recommendations to select from but one program does not and should not suit all. Key issues to consider are that programs are accessible, relevant and realistic with the end result being an ongoing life-long involvement in appropriate physical activity. We need to know and apply what exercise is suitable for us. Deciding on what program is right can depend on recommendation, referral and personal preference. There are many modalities available most of which can assist with maintaining movement.