Don't suffer death by armchair: A warning to the over-70s as experts say too many decide their exercising days are over
Two years ago, my mother-in-law Doreen passed away. She was 88. For all the years I had known her, she was active – she had been a keep-fit instructor, a keen golfer and something of a party animal.
But a bout of shingles knocked her confidence and she took to her armchair. And apart from going to bed or the bathroom, that is where she stayed until she died after a fall.
Yet her husband Joe, who recently celebrated his 90th birthday, remains determined not to become incapacitated. He still walks regularly to the shops to, as he puts it, ‘keep the old legs going’.
Use it or lose it: Members of the Osprey Clinic exercise class
It’s an attitude that Dr Philip Chapman-Sheath – orthopaedic consultant at Spire Southampton Hospital – wholeheartedly supports. ‘That well-worn phrase “use it or lose it” does mean what it says for the over-70s,’ he says. ‘Many people reach a point where they are happy to take it easy in their favourite chair, thinking that their days of exercise are over.’
Dr Mark Baxter is a orthogeriatrician – an orthopaedic doctor with a special interest in elderly patients – at the hospital and he says such a decision can be lethal.
‘Often, as in Doreen’s case, there is a trigger factor that starts the decline, such as an infection, a fall or a bereavement. This can cause a loss of confidence that in turn leads to a fear of going out.
Dr Baxter says it is vital to keep the
mind active too. Social isolation is one of the most significant reasons
for the high rate of depression in older people
‘The person becomes socially isolated, so there is a further deterioration in mobility and so on. They become increasingly frail, requiring more help with basic functions. Depression becomes extremely common, and so the spiral continues.’
Doreen fell, he says, probably because she had lost the muscle tone in her legs. ‘Lack of exercise leads to a loss of muscle, worsening mobility and an increased chance of falls.’
But Dr Baxter says it is vital to keep the mind active too. Social isolation is one of the most significant reasons for the high rate of depression in older people. ‘An active social life can often be linked with exercise – at special fitness classes for this age group, for example.’
But, he says, it is after one of the ‘trigger events’ that making a concerted effort to get out and meet people becomes crucial.
‘This is the point at which confidence is most likely to be lost but this should not be put down to normal ageing – or the popular concept of losing brain cells.’
In fact, the reverse is true, it is well documented that older individuals who stay fit are less likely to develop dementia. Dr Chapman-Sheath says that many elderly people are put off exercising by hip and knee problems and by the pain of arthritis. ‘Many people over 70 have a degree of articular wear and tear and prefer low-impact sports, although we do see fit and active people of this age participating in high-impact activities.
Get out of the armchair and start exercising
‘For the very old and less energetic, bones and muscles can still be significantly improved with a regular course of either home or gym-based exercise and activity.’
Dr Chapman-Sheath says that even those suffering from the bone-thinning disease osteoporosis should not be afraid of keeping fit. ‘In fact, it is considered to actually reduce the rate of bone loss – particularly in post-menopausal women – and it improves balance and general locomotor skills,’ he says. ‘A patient with severe osteoporosis should avoid high-impact exercises such as jogging – but a bone-density scan will tell you whether this is the case.’
Gina Jones, a trained osteopath and professional Pilates instructor, holds low-impact exercise classes for the over-70s at her Osprey Clinic in St John’s Wood, North-West London. Her clients enjoy the social interaction as well as the opportunity to stay fit and active.
Twenty years ago, former dancer Gina, 46, suffered a debilitating spinal injury. She says the effort to achieve and maintain good mobility after the injury was enormous. ‘It was bad enough for me when I was in my 20s. It made me realise just how difficult it could be to get older people in the mindset to keep fit.’
Now Gina has launched a website dedicated to those who need to exercise at home with easy-to-follow videos designed to gently help improve low back pain, neck pain and a variety of other common conditions.
But what about those worried about their cardiovascular health ‘Even patients with chronic illnesses such as heart disease, high blood pressure and diabetes can exercise safely providing they discuss what they are aiming to do with their GP beforehand,’ says Dr Dhiraj Gupta, consultant cardiologist at the Liverpool Heart and Chest Hospital.
‘I have several patients in their 70s and 80s who remain extremely active in spite of having suffered heart attacks in the past. However, you should seek a medical opinion if you experience any of the following symptoms while exercising: chest pain or pressure, trouble breathing or excessive shortness of breath, light-headedness or dizziness.’
Most people in their 80s are unlikely to be jogging or carrying out a rigorous gym regime but there are other ways to keep fit
Dr Gupta says it is worth noting that beta-blockers – commonly used to treat various heart conditions – can make people feel lethargic.
‘If you are on beta-blockers and feel unable to exercise as much or as well as you would like, see your GP. There are better drugs now that do not have this side effect.
‘It is also becoming increasingly recognised that many older people feel unable to exercise because their heart doesn’t speed up with exercise as it should.
This condition is known as ‘sick sinus syndrome’ and happens when the electrics of the heart become ‘frayed’ with age.
‘Feel your pulse – if it seems slow and does not speed up during exercise, then your GP may refer you to a cardiologist for consideration for a pacemaker.
‘I have several elderly patients whose lives have been transformed by a pacemaker.’
Dr Chapman-Sheath concludes: ‘Most people in their 80s are unlikely to be going jogging or following an exhausting gym regime – but there are other ways to exercise, so they can be more mobile, physically active and have a better quality of life. That’s what using it, not losing it is about.’
Now my husband, two daughters and I always have Doreen in our thoughts, and her husband Joe misses her terribly. If only she had been able to follow his example and get out of that armchair.