Ageing occurs when biological reserve and response demands decrease to restore and maintain homeostasis due to physiological, psychological, physical and social changes.
HOW DOES THE AGEING PROCESS AFFECT QUALITY OF LIFE?
Ageing is a process. It occurs when biological reserve and response demands decrease to restore and maintain homeostasis due to physiological, psychological, physical and social changes.
An expert once said that ageing starts from the fifth decade of life, at about 45 years of age. Here, old age begins at 60 years. In developed country, 65 years old is the starting point of ageing.
Ageing is associated with physical and physiological changes that affect quality of life. The fitness level decreases for about five to 10 per cent per decade after the age of 30. This is due to the decrease of maximum heart rate and a reduced capacity of the heart.
Muscle function and power reduce too. This is due to the reduction in muscle mass. A healthy 80-year-old may lose half of his muscle mass. This could be due to hormonal changes in the body. In contrast, fat mass will increase.
As a result, balance, flexibility of joint and walking ability are reduced by increased age. This is why the risk of fall is high among the elderly.
Ageing is also associated with more incidence of chronic diseases. The most common chronic disease is hypertension. Other common diseases are high cholesterol, osteoarthritis, osteoporosis, back pain, obesity, diabetes, depression and heart disease.
As age advances, people are less physically active. In Malaysia, starting at the age of 50, prevalence of physical activity starts declining. At the age of 60, the prevalence of physical activity is 60.9 per cent compared to 73 per cent at the age of 40.
There are indicators for healthy and successful ageing. They include: survival to a specific age, being free of chronic diseases, autonomy in activity of daily living, good quality of life, high social participation and high level of cognitive function.
HOW MAY BEING PHYSICALLY ACTIVE SLOW DOWN THE AGEING PROCESS?
It is known that regular physical activity is a significant lifestyle factor that may prevent and reduce impact of age-related physical and physiological changes. Regular aerobic exercise will improve fitness and reduce accumulation of fat mass.
Strength exercise will increase muscle strength, bone mass (especially among elderly women) and muscle mass. Studies have shown that muscle mass may increase between five and 10 per cent. Overall, this has a positive effect on body composition.
Flexibility exercises will improve joint flexibility and prevent joint restriction. Balancing exercises will improve balance and prevent falls. Overall, functional capacity will improve and the elderly can maintain a high degree of personal independence and finally, maintain quality of their lives.
Regular exercise will also prevent and control chronic diseases, which is a risk factor of heart disease. It will improve insulin sensitivity, improve blood glucose, decrease blood pressure and improve lipid metabolism. This will prevent diabetes, hypertension and high cholesterol and subsequently will prevent occurrence of cardiovascular disease.
Effects of regular exercise will also be seen in the prevention of mental illness like depression. Cognitive function will improve with regular exercise too. Studies have shown that a physically active person has less risk of developing dementia by 30 per cent compared to a less active person.
WHAT ARE THE RECOMMENDED PHYSICAL ACTIVITIES?
Exercise in the elderly has similar benefits as it does to a young person. This includes aerobics, strength exercise, balance and flexibility exercises. Aerobic exercises should start at low intensity and gradually increase to moderate intensity. Improvement to high intensity will increase cardiovascular function.
According to the Health Ministry’s Physical Activities Guildelines 2017, the duration should be 150 minutes per week (for moderate intensity exercise) or 75 minutes per week (for high intensity exercise).
To know more about intensity during exercise, refer to this column on May 5, “Preventing exercise injury”.
If you want to use heart rate monitor to measure intensity, refer to the May 19 article, “Monitoring Heart Rate”.
The minimum duration of exercise is 10 minutes per session. An individual is encouraged to find what he or she finds enjoyable and comfortable with. Suitable aerobic exercises includes walking, brisk walking, swimming, cycling and running.
Strength training is recommended to improve muscle mass and strength. It should be done 2-3 times per week. This type of exercise should include major muscle group of upper and lower body.
Start with lower weight and lower repetition (8-10) per set, 2-3 set per type of exercise. Gradually increase weight, repetitions and sets over months.
Balance and flexibility are important exercises for the elderly. Balance exercise is to challenge one’s stability. Example of balance exercises are standing on one leg, walking in circles, sideways or over obstacles.
Flexibility exercises help to prevent joint restriction and improve body function. Stretch each joint (neck, back, upper limb and lower limbs) until you feel tightness or slight discomfort and hold for 30-60 seconds. Balance and flexibility exercise can be done before or after each time doing aerobic exercise.
It is recommended that before engaging in any physical activity, refer to a doctor for medical evaluation.
If you have heart condition, please refer to the Aug 1 article, “Why heart disease patients need to exercise” and the Aug 15 article, “Can I exercise after a heart attack?”
An avid sportsman who believes in the healing power of exercise, Assoc Prof Dr Ahmad Taufik Jamil is Universiti teknologi mara’s public health consultant and exercise physician. Reach him at firstname.lastname@example.org.