Activity for older adults: aerobic, strength and balance

What changes after 65

The Physical Activity Guidelines for Americans keep the same weekly aerobic and strength amounts for older adults as for younger adults, and add one more ingredient: balance. The CDC's overview says that if you are 65 or older, you need aerobic, muscle-strengthening and balance activities each week. The CDC uses 65 and older as its definition of older adults.

The reasons are practical. The CDC says regular physical activity can help older adults live independently, have a better quality of life, and prevent or manage chronic disease. It lists additional benefits for older adults: a reduced risk of falling, more years of independent living and improved brain health. HHS's summary of the second edition names a lower risk of falls, and of injuries from falls, as one of the benefits for older adults. HHS's Move Your Way campaign puts it simply: being active can make everyday tasks such as cleaning and grocery shopping easier.

The CDC's benefits page adds that physically active middle-aged and older adults have a lower risk of functional limitations, meaning being unable to do everyday activities such as climbing stairs, grocery shopping or cleaning, and that physically active people have a lower risk of hip fracture than inactive people.

Aerobic activity

Each week, the CDC says adults 65 and older need:

• at least 150 minutes of moderate-intensity aerobic activity, such as brisk walking (for example, 30 minutes a day on 5 days, or about 22 minutes every day), or
• 75 minutes of vigorous-intensity activity, such as hiking, jogging or running, or
• an equivalent mix of the two.

Effort is personal. On the CDC's 0 to 10 scale, moderate activity is a 5 or 6 and vigorous activity a 7 or 8, and the CDC stresses that walking may feel moderate to one person and vigorous to another. The CDC's examples for older adults include mowing the lawn or raking leaves, learning a new dance, walking to the store, hiking a trail, active forms of yoga, riding a bike indoors or outside, and joining a water aerobics class.

The CDC advises doing a variety of activities, which can make activity more enjoyable and reduce the risk of injury. Even if some activities, such as climbing stairs or walking, are hard, the CDC says you can safely do other types, and suggests stretches and chair exercises as a way to start.

Muscle-strengthening

Older adults need muscle-strengthening activities on at least 2 days a week, working all the major muscle groups: legs, hips, back, chest, abdomen, shoulders and arms. The CDC's description is the same as for younger adults: do each activity until another repetition would be hard without help, aim for 8 to 12 repetitions as one set, do at least one set, and two or three for more benefit.

The CDC's examples for older adults are lifting weights, working with resistance bands, digging in a garden, some yoga postures, and body-weight exercises such as push-ups or sit-ups. Its benefits page explains why this matters more with age: people lose muscle mass and strength as they get older, and muscle-strengthening helps maintain or increase it. The strength guide covers the details.

Balance activity

Balance is the part of the older-adult guidance that is easiest to miss. The CDC says balance activities help prevent falling, which reduces the risk of injuries such as broken bones. It gives these examples:

• walking heel-to-toe;
• standing up from a sitting position;
• walking backward;
• standing on one leg;
• using a wobble board.

The CDC adds that strengthening the back, abdomen and leg muscles also improves balance, so strength work and balance work support each other. MedlinePlus describes balance exercises as one of four main types of exercise for older adults, alongside endurance (aerobic), strength and flexibility, and notes that doing all of them gives more benefits.

Balance practice carries its own risk if done carelessly. If you are unsteady, ask a health professional how to practice safely before you start.

Activities that do more than one job

Some activities combine aerobic, strengthening and balance work. The CDC calls these multicomponent physical activities and gives yoga, tai chi, gardening and many sports as examples. It says doing all three types is important for improving physical function and lowering the risk of falls or injury from a fall, and that multicomponent activity can be done at home or in a community setting as part of a structured program.

Lowering the risk of falls

The CDC describes falls as a threat to the health of older adults and to their ability to stay independent, and also says falls do not have to be an inevitable part of aging. Its fall prevention advice for older adults includes:

• Ask your doctor or health care provider to evaluate your risk of falling and talk about specific things you can do.
• Ask your doctor or pharmacist to review your medicines, including over-the-counter ones, to see whether any might make you dizzy or sleepy.
• Do exercises that make your legs stronger and improve your balance. The CDC names tai chi as a good example.
• Have your eyes checked by an eye doctor at least once a year and update your glasses if needed. The CDC notes that bifocal or progressive lenses can make distances look different, and that some people use distance-only glasses for outdoor activities such as walking.
• Make your home safer, for example with grab bars in the bathroom and brighter lighting.

The CDC also mentions a Falls Free CheckUp for learning about your own risk, and STEADI, its set of fall prevention tools for health care providers. These are worth asking your provider about.

Health conditions and abilities

The CDC says that having a health condition such as arthritis, diabetes or heart disease does not mean you cannot be active, and that regular activity can improve quality of life and may reduce the risk of developing other conditions. Its advice is to ask your doctor whether your condition limits your ability to be active, and then work with your doctor on a plan that matches your abilities. The National Institute on Aging similarly says you can still exercise with most health conditions and benefit from it, after talking with your doctor.

Other points from the CDC's guidance for older adults:

• If you cannot meet the recommended amounts, be as physically active as your abilities and conditions allow. Some activity is better than none.
• If you have been inactive, have overweight or have concerns, talk to your doctor before starting vigorous activity such as jogging.
• If you take a break because of illness or travel, start again at a lower level and work back up slowly.
• If it is too hot, cold or wet outside, try walking in a mall or an online fitness program at home. The weather guide also notes that people over 65 may need extra steps on hot days.

For people with disabilities, the CDC suggests talking with a doctor before beginning a routine, and says a professional with experience in physical activity and disabilities can advise on suitable amounts and types.

Places and programs nearby

The City of Pittsburgh's CitiParks department lists Healthy Active Living senior centers among its services, and the city, Allegheny County and the Commonwealth all run public parks. The public places guide summarizes what their official pages say, without hours or prices, which you should check directly.

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