Benefits of exercise for older people with no age-bar

Having read in The Sangai Express that the Imphalites are taking morning exercise walks through Kangla Fort, I am reminded of my school days when it was such a pastime for the young to middle-aged people who used to wake up at 4 o’clock in the morning and take a recreational walk.

This internet meme brings back nostalgia and fond memories in this evening warmth as I look back on the vibrating mass that was the summer of my youth, though my memories are hazy after so many years. From Uripok and Sagolband people used to walk up to the ‘BOC’ petrol pump station, which was across the road from the North Gate of Kangla Fort. Some used to walk up to the DM College. I, along with a young school teacher Tourangbam Achoubi who lived across the road at Uripok used to take part in that craze.

Regular exercise helps prevent conditions common in old age such as diabetes, high blood pressure, heart attacks, thinning of the bones and stroke which is a blood clot in a brain artery or the rupture of an artery – known in Meiteilon as ‘Pangthabi’, which is very common in Manipur. By exercise, I mean recreational exercise such as a short walk or a game of badminton or a swim that also offers important opportunities for socialisation.

First, for the benefit of young friends let me explain the meanings of some common albeit technical words we use everyday.

Exercise is loosely defined as ‘a process whereby the body performs work of a demanding nature’. Work means mental and physical activity to achieve a result.

Exercise helps to improve physical fitness by increasing (1) muscular size, strength and endurance; (2) bone strength; (3) heart efficiency; (4) enhanced flexibility; (5) contribution to body leanness; and (6) increased resistance to injury (safer movement in activity).

Even healthy older people lose ‘strength’, which is the ability to exert force while ‘force’ means push or pull, at some 1-2 % a year. They also lose ‘power’ (force x speed) at some 3-4% a year. In addition many older people have further inability because they have chronic diseases like asthma/bronchitis, angina (heart pain on slight exertion) and joint damage (wear and tear arthritis).

The resulting weakness affects the performance of everyday activities and the stamina (endurance capacity).

Regular exercise increases strength, endurance and flexibility. In a recent study, women aged 75-93 training three times a week for 12 weeks increased their strength by 24-30%, equivalent to a ‘rejuvenation’ of strength by 16-20 years.

While it is impossible to relate a given amount of exercise to a clear risk of heart attack or extra numbers of years to be lived as in the case of the risk of smoking may be expressed as 5 minutes’ loss of life per cigarette smoked, it is proven that exercise increases the physical and mental wellbeing.

A combination of recreational brisk walking for an hour every day over a distance of one mile and back in the plain of Imphal will meet most of these criteria for most people, while in the hills of Manipur they have their regular daily exercise because of the terrain. The Chinese do Tai chai for an hour a day. The odds of dying during such an hour of exercise are very remote.

Despite the controversy the one I recommend is a minimum regimen of exercise daily for 20 minutes’ brisk enough to produce sweating or fast breathing or a heart rate of 80-100 maximum. The aim is simply to produce a training effect through exercise beyond what is customary for an individual such as sitting all day at work.

A sedentary (inactive) lifestyle is one of the risk factors for heart disease. There are recognised risk factors of heart disease: (1) male sex; (2) old age; (3) family history of heart diseases; (4) post-menopausal women [pre-menopausal women do not have heart attacks as they are protected by the female hormone oestrogen except those with hereditary high cholesterol in blood]; (5) smoking; (6) excess of low density lipoprotein (LDL) cholesterol and little of high density lipoprotein (HDL) cholesterol; (7) uncontrolled high blood pressure (hypertension); (8) physical inactivity; (9) obesity; (10) uncontrolled diabetes; (11) high C-reactive protein; and (12) uncontrolled stress and anger.

Managing changes in your lifestyle is a proven method of reducing your risk of heart disease. Though there is no guarantee that a heart-healthy lifestyle will keep your heart disease away, these changes will certainly improve your physical and emotional well being.

All sessions should start and finish gradually, known as ‘warm up’ and ‘warm down’ (cooling down). The warm up loosens your joints, stretches muscles, rehearses skills and gradually increases demand on heart and lungs. The warm down incorporates slowly tapering down your activity to preserve the return of venous (oxygen-less) blood as muscles and skin vasodilatation (widening up tiny capillary arteries causing sweating and warm skin) gradually return to resting levels.

Today, cardiologists recommend regular aerobic exercise as a mainstay of any heart-healthy life style. Even for those who have had heart attacks they recommend graduated physical exercise after 6 weeks of a heart attack, which is the time for the damaged part of the heart muscle to recover, using a treadmill, stationary bike and such like.

New information released from Harvard Medical School in the US, sheds light on the many physiological mechanisms by which increased exercise lowers the risk of heart disease. The main reason is that exercise helps lower the bad cholesterol (LDL) that leads to heart disease and raise the good (HDL) cholesterol that protects against heart disease.

Exercise also reduces the damage to the inner lining of the arteries and makes it more difficult for blood to clot and cause blockage of the arteries of the heart (when one of the arteries supplying blood to a part of the heart muscle is blocked it is called heart attack).

Precautions before vigorous exercise regimes apart from walking, which is the best exercise for older people should be understood, such as avoiding vigorous exercise during infections or people with angina [heart pain after an exercise, that disappears soon after stoppage of exercise]. Older people should have a medical check though not for walking.

Risks of exercise should be related to some extent upon the detection of obvious risk factors such as diabetes or hypertension, and to the risk related to the overall hazards of life. For example, the relative risk of death from road traffic accidents in India is 8 per cent per year (WHO, 2009) and women taking oral contraceptives have a 5 times greater risk of dying from blood clots in the brain (stroke), heart and lungs. It is a question of taking risks by weighing the benefit against the possible harm.

According to a WHO (2011) report, people who exercise are 10 percent less likely to die from chronic disease.

In conclusion; recreational exercise for older people living in the Imphal Valley in the form of walking two miles at least three times a week is beneficial for physical activity and psychological wellbeing. It might increase your longevity by lowering your blood pressure and the risk of heart attack as well as making you less prone to accidents from being fit. Memory improvement has been shown in elderly people on a regular exercise programme.

The writer is based in the UK

Email: imsingh@onetel.com

Website: www.drimsingh.co.uk

20-Jan-2013 / 12:55 AM / Dr Irengbam Mohendra Singh / 0 Comments