Active While Aging: The Key to Wellness

When recalling the people I met while working the front desk at a health club, Gabby sticks out vividly in my mind. Gabby always came in with a smile, ready to take on Zumba, spinning class, weights, or the treadmill. Her multiple hour-long workouts paid off though: she was fit and strong. I knew she was older, but imagine my surprise when I looked up her age: 67! Clearly the exercise craze is not only for the young. People like Gabby are becoming less like the exception and more like the rule. It is common knowledge that consistent exercise combined with a healthy diet is conducive for one’s current general well-being, however, there is a growing plethora of information indicating it may also be beneficial for one’s future well-being. Extensive research indicates that exercise can increase longevity and enhance quality of life during the aging process by improving cognitive function, boosting overall physical health, and elevating mood.

            First, it is important to briefly discuss the components of and possibilities within the aging process. According to one group of researchers, aging is defined as a “natural and complex physiological process influenced by many factors, some of which are modifiable” (Gremeaux, Gayda, Lepers, Sosner, Juneau, & Nigam, 2012). They go on to subcategorize aging into three groups: 1) Regular or normal aging, where genes dictate the decline in physiological functions, 2) Pathological aging, which is a result of diseases and impairments such as cardiovascular disease, cancer, and dementia, and 3) Successful aging, referring to physical and mental upkeep and the ability to function without chronic illness or disease (Gremeaux et al., 2012). Most people would ideally prefer to age successfully, which includes not only living longer, but living better. Exercise can help them in several ways.

            One of the most obvious ways exercise can improve the quality of life is by improving overall physical health. As aging occurs, everything in the body naturally and inevitably slows down. By age 60 it is estimated that about 30% of the body’s functional capacity will diminish – both the heart and metabolism become slower, bones lose their density, and muscle mass and strength diminish (Deslandes, 2013). Some of these aging effects can be partially reversed or halted through a combination of cardio and strength-training exercises. One study found that a consistent moderate-intensity workout regime could help in decreasing the risk of falls while increasing mobility, strength and agility. Furthermore, research is encouraging to late starters: those who were not frequent exercisers in their youth can enjoy the full physiological and functional benefits from working out (Seguin, Heidkamp-Young, Kuder & Nelson, 2012).

            In addition to physical fitness and health, exercise has been found to improve cognitive activities such as general cerebral function and memory and reduce the risk of dementia. Due to its positive impact on the hippocampus, exercise has been shown to improve memory and executive function in the brain (Deslandes, 2013). Numerous studies have examined how exercise may help alleviate the onset of dementia. One estimate states that those who engage in higher intensity exercises can lower the risk of dementia by up to 40 percent (Howard, 2012). Another study looking at people with mild cognitive impairment examined exercise as a possible intervention against dementia during a “critical window” period. The results indicated that a consistent and long-term regime of strength and aerobic training can help improve the cognitive decline associated with acquiring dementia (Davis, Bryan, Marra, Sharma, Chan, Beattie, & Liu-Ambrose, 2013).

            Working out can also elevate mood and decrease the intensity of major depressive disorder and other mood disorders. First, the increased mobility, strength, and agility attained from working out can naturally improve mood, because seniors are able to live more independently, fulfill their daily tasks on their own, and potentially engage in new activities (Engels, Drouin, Zhu, & Kazmierski, 2000). Exercise can also benefit those who struggle with more serious maladies, such as depression. One study discovered that when depressed seniors engaged in aerobic activity and resistance training on a regular basis, symptoms of depression were moderately to significantly reduced (Babyak, Blumenthal, Herman, Khatri, Doraiswamy, Moore & Krishnan, 2000). This research has important implications for the mental health treatment elderly receive, not only because it is shown to be effective, but because it seems like it has the potential to be an inexpensive alternative to medication.

            The importance of exercise extends far beyond aesthetic reasons but rather, it serves a much greater purpose: to create a vital life through the enhancement of cognitive function, improvement of physical health, and reduction of depressive symptoms. Society often views avid proponents of exercise as being young-bodied, but this is simply not the case. Older people have as much, if not more, to gain from breaking a sweat – staying strong, staying cognizant, and staying young!

 

 

 

 

 

Resources

Babyak, M., Blumenthal, J. A., Herman, S., Khatri, P., Doraiswamy, M., Moore, K., & … Krishnan, K. (2000). Exercise treatment for major depression: Maintenance of therapeutic benefit at 10 months. Psychosomatic Medicine62(5), 633-638.

Davis, J. C., Bryan, S., Marra, C. A., Sharma, D., Chan, A., Beattie, B., & … Liu-Ambrose, T. (2013). An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. Plos ONE8(5), doi:10.1371/journal.pone.0063031

Deslandes, A. (2013). The biological clock keeps ticking, but exercise may turn it back. Arquivos De Neuro-Psiquiatria71(2), 113-118. doi:10.1590/S0004-282X2013000200011

Engels, H. J., Drouin, J. J., Zhu, W. W., & Kazmierski, J. F. (1998). Effects of low-impact, moderate-intensity exercise training with and without wrist weights on functional capacities and mood states in older adults. Gerontology44(4), 239-244. doi:10.1159/000022018

Gremeaux, V., Gayda, M., Lepers, R., Sosner, P., Juneau, M., & Nigam, A. (2012). Exercise and longevity. Maturitas73(4), 312-317. doi:10.1016/j.maturitas.2012.09.012

Howard, Beth. (February/March 2012). Age-Proof Your Brain: 10 Easy Ways to Stay Sharp Forever. AARP The Magazine, 53-54, 56.

Seguin, R. A., Heidkamp-Young, E., Kuder, J., & Nelson, M. E. (2012). Improved physical fitness among older female participants in a nationally disseminated, community-based exercise program. Health Education & Behavior39(2), 183-190. doi:10.1177/1090198111426768

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Baby Boomers Behind Bars: The Health Care Concern

 

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Imagine being very old. Not only are you are nearing what appears to be the end of the road, but you are in permanent confinement. Your health is dwindling and you are at the mercy of the “system.” This situation is unfathomable for most people, however, for millions of aging men and women across the United States in correctional facilities, this is an inevitable reality. As the older demographic skyrockets in the general population, so does the number of incarcerated men and women. As these two growing trends converge, correctional facilities are faced with the daunting and unavoidable task of determining what to do regarding the increasing need of health care for older and sicker inmates.

It is no secret that the population of “graying” America is increasing steadily and swiftly. What is not so evident, but no less relevant, is the proportionate growth of inmates in American detention facilities. While in 1900, only about 4% of Americans were ages 65 and older, by 2030, it is projected that 1 in every 5 Americans will be age 65 or older (Himes, 2001). This population surge has not escaped the prison population. Texas saw an increase of 86% in the older inmate population between 1994 and 1998, while California is expected to have a 200% increase in its elderly inmate population by 2020. Futhermore, other projections state that by 2020, older inmates will represent 21%-33% of the total prison population (Rikard & Rosenberg, 2007).

            Identical to the non-incarcerated older population, elderly inmates face numerous health issues. Many times inmates’ lifestyles prior to incarceration include substance abuse and poor self-care, so unsurprisingly many face more significant health issues like chronic conditions and psychological disorders. One study found that older inmates, on average, suffered from three chronic illnesses throughout their incarceration (Rikard & Rosenberg, 2007). Older inmates are also at higher risk for age-related problems such as hearing and vision impairment, falls, cognitive impairment, and urinary incontinence (Hill, Williams, Cobe, & Lindquist, 2006).  In addition to physical illnesses, mental disorders are more prevalent amongst older inmates than younger inmates. In one Utah prison study, of the older mentally ill prisoners, 57% were diagnosed with depression, 25% with schizophrenia, and 18% with bipolar disorder (Caverley, 2006). As the elderly inmate population grows, clearly so will the need for medical and mental health services and clinics within these institutions.   

            The economic implications due to these needs are tremendous. Older inmates are three times as more costly to care for than younger inmates, a disproportionate difference. Elderly inmates require items and services such as “24-hour nursing coverage, infirmary beds, physician availability, pharmacy, laboratory, x-ray, and rehabilitative physical care resources” (Rikard & Rosenberg, 2007). In addition to medical provision, there is an emerging need for senior-specific social programs because they can be conducive for the mental well-being of incarcerated elders. However, much improvement is needed in the area of social programming. In a 2004 study of the Department of Corrections and the Federal Bureau of Prisons, it was discovered that a mere 23 states had policies and programs geared towards aging male inmates and only two for older female inmates (Williams & Rikard, 2004). To create programs such as these though would continue to add financial pressure upon detention facilities on both a statewide and federal level.

            Although there is no single clear-cut solution, there are several ideas of how to improve the health care situation within correctional institutions. First, in one report, researchers asserted that organizational strategies such as “knowledge and skills management, development of effective teams and redesigning and coordination of care processes” would benefit both the quality and cost of the health care system (Hill et al, 2006). Secondly, more emphasis could be placed on programs such as the Project for Older Prisoners (POPS), which examines nonviolent older inmates for early release and thus far has been a significant success (Rikard & Rosenberg, 2007). Third, the notion of having separate assisted living units or off-site correctional nursing homes is being considered for their benefits of reducing costs (Hill et al., 2006). It is urgent that legislators and corrections administration examine the facts and consider these alternatives in order to address the health care issue.

            The visible growth of the general aging population is already creating an awareness and urgency of the emerging need for more health services. With the inmate population in the United States increasing in proportion to their non-incarcerated elderly counterparts, the attainment of medical and mental health services in correctional institutions is one of the most exigent matters facing this specific population.