1. Older Adults l By the year 2030, the number of individuals 65 yrs. and over will reach 70 million in the US alone (~20% of all Americans)

2. Older Adults l Persons 85 yrs. and older will be the fastest growing segment of the population.

4. Graying of America l From 1950 to 2004, the proportion of the population age 75 and older rose from 3% to 6%. l It is projected that by 2050, 12%, or about 1 in 8 Americans will be 75 years of age and older (~35 million)

5. OFD l Based on the latest data (2006) from the National Center for Health Statistics: l 37.3 million > 65 l 18.3 million > 75

6. Life Expectancy l Men 75.2 l Women 80.4

7. Baby Boomers l They were born between 1946 and 1964 l Currently they are 45 to 63 years old l As of 1-1-05, there were 78.2 million of them

8. Baby Boomers l 8000 – Number of baby boomers turning 60 every day in 2006. l About 330 per hour l 57.8 million will be alive in 2030 with 55% of them being female.

9. Live Longer? l Increased longevity is accompanied by increased prevalence of chronic conditions and their associated pain and disability.

13. Older Adults l No one is too old to enjoy the benefits of regular physical activity.

14. Older Adults l Of special interest to older adults is evidence that muscle strengthening exercises can reduce the risk of falling and fracturing bones and can improve the ability to live independently.

15. Older Adults Physiologic decline with aging: l VO 2 max (5-15% per decade after 25) l Maximal cardiac output. l Maximal a-vO 2 difference. l Maximal heart rate.

16. Older Adults l Stroke volume during maximal exercise. l Plasma, red blood cell, and total blood volumes decrease. l Left ventricle compliance.

17. Older Adults l Lower ejection fractions. l Blood pressure and vascular resistance increase. l Bone density.

18. Older Adults l Connective tissue elasticity. l Muscle atrophy.

19. Older Adults l 1. Performance and aging. l a. Individuals with CVD and men over 45 or women over 55 years of age with multiple risk factors should have a medical evaluation prior to embarking on a vigorous exercise program.

20. Older Adults l 2. Trainability of the older athlete. l 3. General performance and physiological function.

21. Exercise Prescription l The general principles of exercise prescription apply to all individuals. l However, the wide range of health and fitness levels observed among older adults make generic exercise prescription more difficult.

22. Exercise Prescription l Care must be taken in establishing the type, intensity, duration, and frequency of exercise.

23. Mode l The exercise modality should be one that does not impose significant orthopedic stress.

24. Mode l The activity should be accessible, convenient, and enjoyable to the participant -- all factors directly related to exercise adherence.

25. Mode l Consider walking, stationary cycling, water exercise, swimming, or machine-based stair climbing.

26. Intensity l Intensity must be sufficient to stress (overload) the cardiovascular, pulmonary, and musculoskeletal systems without overtaxing them.

27. Intensity l High variability exists for maximal heart rates in persons over 65 years of age; thus it is always better to use a measured maximal heart rate rather than age-predicted HR max whenever possible.

28. Intensity l For similar reasons, the HR reserve method is recommended for establishing a training HR in older individuals, rather than a straight percentage of HR max.

29. Intensity l The recommended intensity for older adults is 50 to 70% of HR reserve.

30. Intensity l Since many older persons suffer from a variety of medical conditions, a conservative approach to prescribing aerobic exercise is initially warranted.

31. Duration l During the initial stages of an exercise program, some older adults may have difficulty sustaining aerobic exercise for 20 minutes; one viable option may be to perform the exercise in several 10-minute bouts throughout the day.

32. Duration l To avoid injury and ensure safety, older individuals should initially increase exercise duration rather than intensity.

33. Frequency l Alternate between days that involve primarily weight bearing and non-weight bearing exercise.