Sorry about those audio problems we're going to take it from the top
So hello I'm Dr. Marie Bernard I'm the Deputy Director of the National
Institute on Aging and I'm a geriatrician which means I specialize in
the care of older adults I have been a regular exerciser since my 40s when I
became really impressed with the data from the National Institutes of Health
showing that exercise process if there was anything perhaps so I'm going to
talk with you a bit about the science that's behind that sense of mind I'm
going to talk to you about how much and what types of exercise are desirable and
then I'm going to demonstrate some exercises the four domains that are
important for older adults and talk a bit about modifications I've made
personally given the COVID -19 pandemic so what is the science show there's one
study that very specifically looked at the role of exercise and otherwise style
modifications to decrease the likelihood of diabetes in that study they had young
people middle-aged individuals and older adults all were at risk for developing
diabetes and they were given one of three approaches one who was what's
called the control group they didn't really truly have an intervention then another
group got medications and then the third group got exercise and weight lost and
what was found was that for the young people and for the middle-aged people
the exercise and weight loss was just as effective as medication but when you
started looking at the older adults the only thing that was affected was
exercise and weight loss and in fact when you looked people ten years later
the people who got the exercise and weight loss continued to have a
lower risk for developing diabetes than the people who got the other sort of
intervention so one great example the benefit of exercise still another study
that's very impressive to me is a study that was supported by our Institute that
looked at whether or not exercise could truly prevent disability and when I was
seeing patients on a daily basis they frequently said Dr. Barnard
I really am afraid of developing disability and becoming a burden for my
family well this study was asking that question can you prevent that and it
took people who were 70-89 years of age and they had some sort of baseline
problem they had trouble getting up from a chair or they couldn't walk at a very
fast pace and they were either assigned to getting to a control group in this case
they got education about healthy aging or an intervention group which consisted
of exercise it was moderate intensity endurance exercise walking it was
strength training and was flexibility and in the end of the study it was found
that the people who were in that exercise intervention were much less
likely to become disabled than those who had the healthy aging intervention 20%
decrease in other words one out of five people who would otherwise have become
disabled did not become disabled so another example of some benefits of
exercise and we have lots of other research supported by NIH that's
demonstrated that exercise can decrease likelihood of breast cancer or colon
cancer heart disease as I said it is anything that might be about youth
exercise may be it so if we know that do we know how much exercise well the
Department of Health and Human Services in their recent physical activity
guidelines recommends 150 minutes per week of moderate physical activity or 75
minutes per week of vigorous activity what's that so moderate activity is
getting out getting a heart rate going etc but
while you're doing that you can carry on a conversation where as vigorous
activity you're out you're really pushing hard and you can only get in a
few words before you need to stop and take a breath another component of the
Department Health and Human Services that puts out guidelines for Public
Health group that does what's called the
healthy people guidelines they put up guidelines for every decade they had
healthy people 2000 2010 2020 for the 2030 guidelines as they are recommending
that all older adults be physically active because it's recognized that
there's some older adults who may truly be disabled or may have cognitive
problems who really aren't able to get to that goal of 150 minutes per week of
moderate degree physical activity but it's clear that being active is
important to the aging process again our Institute has supported research that
has demonstrated that even people who were 80 and 90 years old in a nursing
home if they're put into a program where they get physical activity and strength
training they're less likely to have falls and other complications so bottom
line as an older adult it's important to be physical important to do as much as
you can if you can get to that 150 minutes per week basically 30 minutes
per day 5 days per week that's great but you do what you can and you should give
yourself credit for what you do like working out in the garden or
cleaning the house or chasing after your grandchildren they all count so what
types of activity should one have there are basically four domains that our
research has demonstrated are really important to the health of older adults
one is endurance training that's that getting out and getting the
heart rate up people also call it aerobic exercise another component is
strength training a third component is balance training and the last is
flexibility so let me elaborate on those endurance rains pretty event and it's
something that you see some people going out jogging
and climbing and biking and for other people just fast walking can get their
heart beat up whatever works for you whatever it's best for your body
strength training is really important because of the issue of changes and the
muscles with aging we hit our maximal muscle size and strength not 30s and 40s
and then from there it's a progressive down golf course
and it's been found that for older adults if you were to look in you know
cut across here and look at the muscle you can do that with x-rays you find
that there's accumulation of fat in the muscle that makes it less strong and
less resilient the weak you see marbling in aged beef other research has
demonstrated that you can lessen those effects on regular strength training so
that's the second component and then there's balance training there are
changes that occur with aging that put one at greater risk for having problems
with balance and then on top of that if you have chronic illnesses and
medications they may cost problems of balance balance problems often or a
reason that older adults are afraid of exercising but there are things that can
be done in terms of training dealt to offset that in particular Tai Chi has
been demonstrated to be really helpful in nuts decrease the likelihood of an
older dog falling and having promised it practice etc and finally this
flexibility training stretching it's really important to do that to keep all
the joints moving many an older adult has trouble looking for blind spots in
the car exercises to keep that flexibility going as important they are
talking reaching up to the top of the cabinet examine lost flexibility in the
joints they're keeping all of joints mobile is important and helps with
issues again catching yourself you're gumming up all that sort of thing so
those are the four domains that are important and I will shortly demonstrate
each of those before I do so however I just want to talk a little bit
safety it's important if you've not been exercising and you want to get started
with an exercise regimen to make sure to consult with your primary care provider
to know that it's a safe thing for you to do and whatever it is that you're
planning to do and then you need to have your water whether you're inside or out
if you're planning to go out you need to make sure that you have a safe route
that you're going to pursue if when you're exercising you develop any
problems with dizziness chest pain or pressure or heartburn you need to get to
the nearest health care facility to get that checked out those are dangerous
lines and when you're going out you need to make sure you laird so that if you
get overheated you can take things off we need to if you're going to do things
like biking have a proper safety equipment helmets to take care of
yourself so prior to the pandemic as I said I've been exercising regularly
since my 40s I went to the gym I took advantage of the elliptical the
stationary bicycle the free weights and I also went to a hot yoga studio that
helped with my balance and flexibility I loved it neither of those have been
available to me since the pandemics I've had to adapt and I have rediscovered
exercise to dance videos it's been a lot of fun got you some free weights after a
lot of difficulty they were really hard to get initially and I'll talk a little
bit about options you don't have something like that that available and
I've been doing my own yoga at home walking in the neighborhood things of
that sort so let me demonstrate some of the things step back I don't know what
you'll be able to hear me as well go step back any out and the first thing
that you should always do before you get started and doing any big wrist exercise
is to stretch to make sure to avoid problems with injuring yourself on the
dance videos it's just gentle movements such as this this and
this of the yoga perspective I love my Islamic and so I will do something like
this and there's something that we call triangle I'm going to turn my side to
you so you can see what I'm doing this
it's really good and there are several minutes of that sort of thing and then
from the standpoint of endurance exercise as I said early on it was hard
to get weights so another option can't they you know you can see what the
weight is if you're accustomed to using weights this may be a little light so
you have to do more repetitions if you might it's a great way to get started I
was finally able to get school o weights on line so I'm going to demonstrate a
little bit of what my routine has been if I can get mine up of course this is
locked out be with patient you please
okay okay I can keep doing that for another three minutes as it's fun but
you only have so much time the whole point is to do something that you find
enjoyable have a variety of activities and do things to get your heart rate up
the back bet we have to do a lot of lifting arms and legs and things like
that it's more likely to get the heart rate up I will say then when I watch
these dance exercise videos the instructors are usually at least half my
age and my number and then doing a lot of jumping I don't do that I do what's
good for my body and that's what I would recommend for you as well then there is
the issue of balance training you need to make sure to have appropriate
supports around I would really encourage you to take a look at our website or the
National Institute on Aging YouTube channel because there are lots of
examples how to go about getting started exercising stretching etc the balance
recommendation would be from some of the videos that you stand on one leg with
the chair needed or did you try to walk in tandem like this again as a yogi I
prefer tree pose you'll see I'm not like the younger Yogi's with my foot on my
thigh I'd do what works me one can even have a foot down slow us
an ankle but the whole point is to work on your balance so I think I've
demonstrated to you all four domains there is flexibility with a stretch now
there is endurance with with the aerobic there is strength training with the
weights there is balance training I would say that the most important thing
is to simply be active do what works for you and keep striving to do more so I
really thank you for your time and I wish for you safety activity and health