Training | POSTED October 4, 2022
Ageing Strong: Part 1
It’s no surprise that age catches up with us all. The thought that a steep decline in function is inevitable is simply untrue. We all know individuals who differ in their abilities and function relative to their age. Some are ageing strong. So, what is ageing? Well biologically, ageing results from the molecular and cellular damage accumulated over time. Chronological age is only loosely associated with biological changes. Other major changes such as retirement and changing living conditions also occur (hopefully for the better!)
Although ageing will always occur, health-promoting behaviours, even if adopted late, can result in a positive compression of morbidity. Resistance training is not a time machine, but it can help reduce the onset of conditions that impact quality of life . It’s estimated that between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%. By 2020, the number of people aged 60 years and older has outnumbered children younger than 5 years . For this reason, improving quality of life over the long term for older adults is a key driver behind our work at Ivy Training.
In today’s post we’re covering three key areas related to ageing strong and how adopting strength training can be a key influencer in improving quality of life.
- Managing Musculoskeletal Conditions
- Exercise Prescription for Older Individuals
- Ageism in Healthcare
Managing Musculoskeletal Conditions
Did you know that approximately 1.71 billion people have musculoskeletal conditions worldwide ? That’s huge. Musculoskeletal conditions are the leading contributor to disability worldwide. Low back pain is the single leading cause of disability in 160 countries. These conditions can significantly affect mobility and dexterity. This leads to early retirement from work and therefore lower levels of self-efficacy and ability to participate in society . As population growth and ageing continues, the number of people living with musculoskeletal conditions and associated limitations is increasing. Ageing strong can help prevent this.
Osteoarthritis (OA) is a condition that affects the whole joint including bone, cartilage, ligaments and muscles. Many individuals describe OA as ‘wear and tear’. OA is now thought to be the result of a joint working extra hard to repair itself. Joints themselves are actually similar to a complex organ. They contain multiple different structures like synovium, bone, nerves, muscles, and blood supply. We cannot reduce the cause “degeneration” alone although a further exploration of OA is outside the scope of this article. It is the most common form of arthritis and affects millions of people worldwide. It can include symptoms such as:
- Inflammation of the tissue around a joint
- Damage to the joint cartilage
- Body spurs growing around the edge of a joint
- Deterioration of ligaments
OA affects any joints but commonly affects the knees, hips, finger joints and big toe. Although it can develop at any age but most commonly with people over 40 years. Symptoms can include pain and stiffness in the joints and often these symptoms get worse over time. Risk factors include being overweight, strenuous physical activity (manual labour), family history and previous injuries .
Sarcopenia is a progressive skeletal muscle disorder involving loss of muscle mass and function. Associated with this loss is an increased risk of falls, functional decline, and frailty. The rate of muscle loss is dependent on individual exercise level, comorbidities, nutrition and other factors. Sarcopenia is considered a part of frailty syndrome. Frailty is a common geriatric syndrome that involves a catastrophic decline in health and function among older adults. Associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss are all symptoms. Additionally, frailty increases vulnerability to stressors such as extreme temperatures, infection and changes in medication. Managing sarcopenia can help manage frailty .
Age-related declines in health including result in reduction of functional mobility and self-care of older adults. Individuals with musculoskeletal conditions may also experience further decline when taking bed rest post-fall if advised. Importantly, the ability to perform activities of daily living can determine the quality of life someone has as they age. This quality can include the ability to be independent, social and enjoy hobbies and activities. Lower self-efficacy not only has large implications for someone’s physical health but also mental health. As defined by Zimmerman (2000), “Self-efficacy is a highly effective predictor of motivation and learning in human beings. It is sensitive to changes in context and leads to reactions in activity choices, effort and persistence and also to emotional reactions”. Managing musculoskeletal conditions is critical to maintaining functional mobility .
Exercise Prescription for Older Individuals
Thankfully plenty of research has been performed on this topic and the results are both exciting and optimistic. Ultimately, despite your age or current level of ability, positive changes can be made to improve your quality of life. The National Strength and Conditioning Association has a fantastic position statement on resistance training for older adults. We will cover each of the points listed and how we would approach them at Ivy Training in our companion article here .
Importantly, however, these guidelines state that programs should “follow the principles of individualization, periodization, and progression”. In doing so, they can “enhance the muscular strength, power, and neuromuscular functioning of older adults.” Initial frailty, mobility limitations, cognitive impairment, or other chronic conditions do not have to prevent training from starting. Most importantly we feel “properly designed resistance training program can help improve the psychosocial well-being of older adults.”
Our companion article will cover the 11 position stand points in depth alongside summary recommendations from two other research articles. What’s important to take away here, however, are the following points:
- Heavy slow resistance training between 60-85% of an estimated 1 rep max is appropriate
- Power training, performing lighter movements explosively is appropriate
- Training stress should increase over time
- Older adults will build muscle and strength
- Older adults are not inherently fragile
Ageism in Healthcare
This is an important point that bears stating: age alone shouldn’t decide how able we perceive someone to be. Individuals should be treated with dignity and have the opportunity to live to their fullest extent. Getting under load and getting strong is for everyone. Unfortunately, ageism is an issue that pervades healthcare and culture at large.
As previously discussed, age alone is a poor marker of disability. Decision making in medicine should be based on potential benefit to the individual. Older adults need not participate in tokenistic exercise. This includes arbitrarily light-load resistance training with no emphasis on progression. The absence of effort required might mislead both the trainer and the client about the potential benefits occurring. Although all exercise is good, older adults need heavy loads (relative to their ability) to fight frailty. It will need to be appropriately hard, and we shouldn’t dismiss someone and their potential to improve on the basis of age alone , , . We should instead be encouraging people to start ageing strong.
In conclusion, increasing physical activity and engaging in both aerobic and resistance training for the management of musculoskeletal conditions can have positive effects on the process of ageing. Exercise (and ageing strong) is a powerful intervention that can compress morbidity and improve one’s quality of life .
Most importantly, individuals should feel empowered knowing that they can make effective and meaningful changes by starting to take more control of their health. For older adults, resistance training is absolutely safe. Additionally, older adults should not be stigmatised for their age. Older adults do not need to be doing downscaled resistance training or geriatric training, which is neither hard or challenging. Now admittedly, individuals will bring into their training different levels of abilities.
That being said, older individuals should be challenged to a level appropriate to their current capacity with the view to improve and face harder challenges. They should not just be doing “tokenistic” attempts at exercise that do not involve progression in load, volume, intensity and range of motion. If you would like to know more about how you can start resistance training, exercising in general and ageing strong, you can contact us here.
- Healthy active ageing: How to get active | Queensland Health
- Ageing and health (who.int)
- Musculoskeletal health (who.int)
- Well-Being, Self-Efficacy and Independence in older adults: A Randomized Trial of Occupational Therapy – PubMed (nih.gov)
- Osteoarthritis — Arthritis Australia – the most common arthritis in Australia
- Pathogenesis and Management of Sarcopenia (nih.gov)
- Resistance Training for Older Adults: Position Statement Fro… : The Journal of Strength & Conditioning Research (lww.com)
- Age as a basis for healthcare rationing. Arguments against agism – PubMed (nih.gov)
- [Is ageism a relevant concept for health care practice in the elderly?] – PubMed (nih.gov)
- Geriatric oncology: problems with under-treatment within this population – PMC (nih.gov)
- Benefits of resistance training in physically frail elderly: a systematic review – PubMed (nih.gov)