1. Physical Activity Recommendations and Evidence-based Programs

2. Physical Activity Recommendations for Older Adults: Aerobics  30 min/5 days per week “moderate intensity”  20 min/3 days per week “vigorous intensity”  Intensity related to fitness level

3. Physical Activity Recommendations for Older Adults: Strengthening  8-10 exercises for major muscle groups 2+ days per week

4. Physical Activity Recommendations for Older Adults  Flexibility Exercises 2+ days for at least 10 min  Balance Exercises

5. The Physical Activity “Plan”  Integrate preventive and therapeutic exercises  Develop a plan to obtain all needed types of physical activity Identify When, Where and How for each type  Variations for capacity and personal preference

6. Benefits of Physical Activity for Older Adults  Preventive  Therapeutic

7. Areas for Emphasis in Physical Activity for Older Adults  Reduce sedentary behavior  Get started by increasing moderate activity  Gradual, stepwise approach  Do all types of recommended exercises  Individual change is supported by community-level change  Use risk management techniques to avoid injury

8. What We Know About Older Adults’ Physical Activity  Many do not engage in any leisure activity 65-74 age group: 30% 75+: 40%  An additional 30% are not active enough  Only 30% achieve recommended activity levels

9. Cost Implications of Older Adults Physical Inactivity  Direct costs estimated $76.6 BILLION in 2000  If 10% of adults began a walking program, medical cost savings = $5.6 BILLION for heart disease alone  $1:4.50 return ratio on physical activity programs for older adults with hip fracture

10. Benefits of Physical Activity for Older Adults  All older adults can benefit for increased physical activity  Physical activity can reduce loss of physical capacity  Loss of strength and stamina attributed to “aging” is really due to ↓ physical activity  Strong muscles prevent falls and help make bones stronger

11. Social Relationships Enhance Physical Activity  Social support has a consistent positive relationship with physical activity  More than 50% of older adults say their physicians have never recommended they exercise

12. Model Evidence-based Physical Activity Programs

13. Enhanced Fitness  Developed at University of WA Health Promotion Research Center in 1994  Multi-component group activity in community classes. Classes are held 3x/week for one hour each  Led by an EF certified instructor

14. Evidence of Effectiveness  Life Time Fitness RCT  At 6 months: the intervention group improved in physical, emotional and social health scores while the control group deteriorated in these measures 13% improvement in social function 52% improvement in depression 35% improvement in physical functioning

15. Additional Evidence  Enhance fitness participants’ healthcare costs were 21% less than those of non- participants' costs after one year  Ethnic community participants: although less physically fit to start with showed greater improvement after four months than those in majority-white sites.

16. EF: The Core Program  5-8 minutes of warm-up activities  20 minutes of cardiovascular endurance/aerobics  3-5 minutes of cardiovascular cool- down  20 minutes of upper- and lower-body strength training  10 minutes of balance, flexibility/posture exercises

17. Participant Characteristics  97% age 60 or older  60% age 75 or older  15% age 85 or older  59% report income as “low” or “very low” and 44% live alone  18% have a disability  6% speak limited or no English and 7% are immigrants or refugees

18. Outcomes from EF Last 9 Years  Maintains or enhances cardio-respiratory fitness, muscle strength, balance, and flexibility  May prevent falls through its balance training  Maintains or improves physical functioning  Results in lower healthcare costs for participants  Dose-response: effects vary according to how often people participate in class

19. Additional Resources  Enhance Fitness at http://www.ncoa.org/resources/prog ram.summary-enhancefitness  www.projectenhance.org/EnhanceFit ness.aspx