How to stay strong, healthy and balanced in old age

by Nicky Pellegrino / 14 May, 2018

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Health experts advise taking every exercise opportunity life offers to stay strong and balanced as you grow old.

When Ngaire Kerse brushes her teeth, she stands on one leg. Hanging out her laundry provides an opportunity to do a few squats. And she is a fan of crazy walking: weave about, balance on one foot – there are no rules.

Kerse, the head of the University of Auckland’s School of Population Health, views doing these few simple strength and balance exercises during her everyday activities as a key part of future-proofing against the falls and injuries associated with being elderly and frail.

“We’re actually supposed to start thinking about it when we’re 30,” she says. “We reach our peak young, and then, if we stop doing things, we lose muscle strength. That’s where it begins – you have all of the morbidity when you’re 70, 80 or 90, which is when you’re more likely to fall over and break your hip.”

Kerse is an expert in the area of helping older people remain as healthy as possible. Not only is she exposed to all the latest international research on fall prevention, but, at 57, she’s already starting to see for herself how easy it is for people to become less active as the years go by.

“I used to get up at 6am and go running before work, and I played hockey, which is really vigorous exertion, but I don’t do either anymore,” she says.

Kerse is well aware that inactivity is the first step on a slippery slope. The less muscle strength you have, the shorter your stride and the clumsier your gait becomes. The more unsteady your gait, the more chance you have of falling. There is also a link with cognitive decline as our ability to dual-task declines.

“We know that if you’re walking along and you have to slow down to talk to someone, then you’re a high fall risk,” says Kerse.

Ngaire Kerse.

Every year, one in three people aged over 65 will fall, and for those over 80, that risk increases to one in two. A bad fall may have serious consequences, including loss of independence and even death. Even a small fall dents confidence and can cause people to start restricting their activities, ironically putting themselves at a greater risk of falling again.

The positive news is that improving strength and balance can reduce falls and injury by at least a third, and even the very elderly can benefit. With population projections showing the number of those aged 85-plus will more than triple in the next 30 years, encouraging people to be active is more important than ever. Hence, people over 65 (younger if Māori or Pasifika) who have had a fall in the past year, fear falling, or can’t get out of a chair without using their hands are urged to join community-based strength and balance classes.

Those who can’t get to a class may be able to access in-home help, such as the Otago Exercise Programme, which was developed to prevent falls and has been shown to be effective. To get more information, visit livestronger.org.nz or ask a GP or other health professional.

Kerse was part of a Cochrane Review into preventing falls in older people, which concluded that vitamin D supplements are also helpful for those not mobile enough to get outdoors and top up their levels naturally. For the rest of us, she says, part of the secret is to make life less convenient.

“If you’re watching television, hide the remote and get up to change the channel,” she says. “Try to build things into your everyday life. Don’t make things easy; make them hard.”

The message to be taken from recent research is that the ideal exercise should present some challenge. It should also be stimulating and enjoyable and involve social connection – so activities such as yoga and tai chi are beneficial. But the simplest fall-prevention exercise is sit-stands – sitting down in a chair then moving to a standing position repeatedly, ideally without using your hands.

Elderly people may need to be more cautious, but any effort they make is worth it.

“Never write anybody off. If you’ve got an older relative, go walking with them. Keep everybody moving,” says Kerse. “And I think now we would also say that having mind challenges is just as important as having body challenges.”

This article was first published in the April 14, 2018 issue of the New Zealand Listener.

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