Background: Older adults have the lowest activity and fitness levels of any age group in the United States and generate the most health care expenditures. Increasing the amount of physical activity among older adults could potentially improve health and decrease health care costs. The need for specific recommendations for this group became apparent as the American College of Sports Medicine and the American Heart Association updated activity recommendations for adults up to 65 years of age.
Recommendations: The new guidelines apply to adults 65 years and older, and to adults who are 50 to 64 years of age with chronic conditions or functional limitations that affect movement ability and physical activity. The recommendations mirror those for younger adults, with some specific additions and clarifications. The accompanying table highlights the updated recommendations.
Table Specific Activity Recommendations for Older Adults
| Activity | Frequency | Duration | Intensity level* | |
|---|---|---|---|---|
| Aerobic exercise | ||||
| Moderate | At least five times per week | At least 30 minutes each session | 5 | |
| Vigorous | At least three times per week | At least 20 minutes each session | 7 to 8 | |
| Resistance or weight training | At least two times per week on nonconsecutive days | Eight to ten exercises involving the major muscle groups; 10 to 15 repetitions per exercise | 5 to 8 | |
| Flexibility training | At least two times per week | At least 10 minutes each session | — | |
note:These activities are in addition to the routine activities of daily living. There is probably a dose response to increasing activities above these minimums, but the upper limit is not known.
*— To determine exercise intensity based on the individual's fitness level, use a 10-point effort scale, where 0 is sitting still and 10 is maximal effort. Moderate effort is around 5; vigorous effort is 7 to 8.
The guideline strongly encourages instituting aerobic, strength and resistance, and flexibility training for all older adults, as possible, and balance training for community-dwelling adults at risk of falls. Activity plans are suggested, and include when, where, and how each activity should be performed, recognizing that unfit older adults may need to exercise in smaller bouts of activity over longer periods to slowly build up physical fitness.
Conclusion: The recommendations reflect the differing needs of older persons when determining exercise intensity, and by incorporating flexibility and balance training to maintain health in this population. As with the younger-adult recommendations, the guidelines represent minimal activity levels; further increases in activity levels may be needed to improve health and decrease morbidity from chronic diseases.
