Get Moving to Stay Healthy

If you’ve celebrated more than, say, 50 New Years, you don’t need a newspaper article to tell you how hard it can be to make a resolution and stick to it. The older we get, it seems, the more difficult it is to make real change – to quit a bad habit or start a new routine.

Of course, the irony is, the older we get the more we may need to make changes to stay healthy and head off the sundry problems that can accompany aging. And so, in the interest of keeping things simple, let us consider the myriad benefits of getting up off the couch.

In more than 30 years as a journalist covering health and medicine, I have yet to come across an intervention as powerful, effective and cheap (read: free) as physical activity. I’d call exercise a miracle cure, except there’s nothing miraculous about it. Decades of research have confirmed the health benefits of physical activity and documented its underlying mechanisms.

A significant portion of that research has focused on older adults, including people who have had heart attacks or strokes, were overweight or obese, had Type 2 diabetes, were at increased risk for Alzheimer’s, cancer and other disorders, as well as healthy subjects. Among other things, those studies have shown how regular exercise can reduce the risk of developing 13 different types of cancer, improve sleep, mood and your sex life, and how it can actually change the adult brain, improve cognitive function and reduce the risk of developing cognitive impairments, including memory problems.

At the cellular level, Mayo Clinic researchers concluded in 2017 that high-intensity aerobic training improves the function of mitochcondria, the powerhouses of cells, which normally decline with age.

The bad news is just 20 percent of Americans engage in the minimal recommended amount of regular exercise, and 64 percent don’t do anything at all. The good news is, it’s never too late to start. Here are a few reasons why you should.

Sleep

Insomnia and other sleep issues are common among older adults. While there are a number of over-the-counter and prescription drugs (the class of so-called hypnotics) available to treat sleep disorders, studies have shown that exercise can be an effective alternative.

One randomized, controlled trial involving sedentary adults 55 and older with chronic insomnia, found that “aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life.” (Sleep hygiene education is basically tips about things like going to bed at the same time every night, not taking naps and so on.) The improvements, including better sleep duration and decreased "daytime dysfunction," were documented after just 16 weeks of exercise.

Another paper that reviewed several studies comparing exercise and drug treatment concluded that “improvements after [regular] exercise are similar to improvements after hypnotic drug use.”

Heart Health

The benefits of regular exercise on the cardiovascular system are well documented, and so is the natural decline in aerobic capacity as we age. While healthy older adults can significantly increase their aerobic capacity with regular exercise, research has shown that seniors with heart disease, including those who have had heart attacks, can also benefit.

For example, in one trial, 181 patients with chronic heart failure – and a mean age of 65 – increased their aerobic capacity by 10 percent after just three months of supervised training, and 14 percent after 12 months, compared to non-exercising heart failure patients.

In another trial involving 200 heart failure patients aged 60 to 89, regular aerobic training increased the distance they could walk in six minutes ( a surrogate measure for aerobic capacity) by 15 percent. The patients also reported improvements in quality of life. Given their compromised condition, even small improvements can have a significant impact on patients with chronic heart disease .

Cognitive Function

Arthur F. Kramer, director of the Center for Cognitive and Brain Health at Northeastern University, has been studying the aging brain since the 1970s. In his exploration of the effects of physical activity – “I mostly work with older adults, and we’re basically just getting people off the couch to walk more.” – Kramer has his previously sedentary subjects exercise an hour a day, three days a week for periods of six months to a year. That doesn’t sound like much, because it isn’t. But it gets the job done. “Maybe they’re improving their aerobic fitness 10 or 15 percent, at the outside,” says Kramer. “But those kinds of improvements show pretty dramatic changes. Essentially, in terms of brain function, you can think of it as turning back the clock to a younger age.”

Some of the underlying structural changes responsible for such a response (occurring at a time in life when the brain would normally be expected to shrink) include an increase in the volume of gray matter in the prefrontal cortex, volume increases in the hippocampus, which is involved in memory, learning and emotion, and volume increases in the caudate nucleus, which plays a role in executive function and learning. In addition, exercise-induced changes to the brain’s white matter increase the brain’s signaling efficiency.

As Kramer points out in his oft-cited 2003 meta-analysis “Fitness Effects on the Cognitive Functions of Older Adults,” the largest benefit of improved fitness among people 55 and up was in the area of “executive control,” the complex, goal-directed behavior that involves reasoning and other higher cortical functions.

And speaking of complex, goal-directed behavior, here’s to getting plenty of exercise in 2020.