Older adults can be defined as men and women 65 years and older and adults aged 50 to 64 years with significant chronic conditions or limitations that affect movement ability, fitness, or physical activity. Senior fitness refers to good health in all categories of physical fitness—heart and respiratory, muscle strengthening, flexibility, and balance.
Poor fitness leads to functional limitations, which means a person cannot move or perform daily activities as well as normal. Ultimately, these limitations can cause loss of ability to care for oneself, poor health, and decreased independence. Chronological age is not always equal to physiological or functional age. People of similar ages can differ remarkably in fitness or function, which in turn affects how they respond to exercise. Although it is inevitable that physiological function will decline with age, the rate and severity of change in fitness depends on a complex mixture of genetics (heredity), individual health, presence of disease or injury, and exercise history. In particular, regular exercise plays a critical role in preserving fitness. Senior exercise offers several important benefits, including preventing various chronic diseases (e.g., type 2 diabetes, cardiovascular disease), maintaining cardiorespiratory fitness, and lessening functional limitations and disabilities.
There is a strong association between physical fitness and function. For example, high levels of cardiorespiratory and muscular fitness permit an individual to more easily perform functions such as stair climbing and lifting. In turn, being able to perform these functions well allows individuals to successfully complete personal hygiene tasks, housework, and other activities of daily living. By comparison, poor muscle fitness or flexibility can lead to impairments in function; for instance, bending and kneeling might be more challenging or restricted. These functional limitations can inhibit tasks such as dressing, gardening, and other related activities of daily living.
The President's Council on Fitness, Sports, and Nutrition says that only about one-third of adults 65 to 74 years old are physically active. Research has highlighted the important link between fitness and functional limitations; it has been shown that for both men and women, individuals with the lowest level of cardiorespiratory fitness have fourfold to fivefold increased prevalence of functional limitations compared to those individuals with the highest levels of cardiorespiratory fitness.
Cardiorespiratory fitness is arguably the most important goal of an exercise program for older adults because low cardiorespiratory fitness can contribute to premature death in middle-aged and older adults. Studies suggest a 15% reduction in mortality for a 10% improvement in cardiorespiratory fitness. Seniors should strive to fulfill recommendations of moderate-intensity aerobic activity for a minimum of 30 minutes, five days a week (or 150 minutes), or vigorous-intensity aerobic activity for a minimum of 25 minutes, three days a week (or 75 minutes), or an equivalent combination of both. If older adults cannot meet these guidelines because of chronic diseases or conditions, they still should be encouraged to be as physically active as their conditions permit. It is also imperative that seniors are counseled to avoid physical inactivity.
Aging is associated with a reduction in muscle mass that contributes to decreased muscle strength and a decline in functional capacity. Undeterred, the process can ultimately result in balance impairments, mobility problems, and lack of independence. Furthermore, decreased muscle mass plays a role in the development of glucose intolerance and type 2 diabetes. For these reasons, seniors should be encouraged to participate in a resistance training program to help slow loss of muscle mass and improve muscular fitness. It is recommended that seniors perform a single set of eight to 10 exercises using the major muscle groups on two to three nonconsecutive days of the week. The level of effort for resistance training activities should be moderate to high; on a 10-point scale, where no movement equates to 0 and maximal effort equates to 10, moderate-intensity effort equals 5 or 6, and high-intensity effort equals 7 or 8. This amount of effort should permit seniors to perform 10–15 repetitions. Various dynamic muscle strengthening activities are recommended for seniors, including machine and free weights, weight-bearing calisthenics, and resistance bands.
Flexibility is an essential component of fitness and decreases with age and physical inactivity. Poor flexibility, coupled with decreased musculoskeletal strength, has been associated with a diminished ability to perform activities of daily living. Consequently, the beneficial effect of static stretching to achieve and maintain flexibility should not be overlooked. For flexibility training, seniors should perform static stretching exercises of the major muscle groups a minimum of two days per week, although stretching daily is even better, if at a moderate intensity (i.e., 5 or 6 on a 0–10 scale). Stretches include the thighs, hips, neck, lower back, and other areas. As flexibility improves, seniors can stretch a little farther until they gain improved flexibility.
Seniors preparing to begin a fitness program can benefit from completing a baseline exercise testing. Those at high risk (who have cardiovascular, metabolic, or pulmonary disease) need a way to ensure it is safe and appropriate to initiate exercise. Results from exercise tests also are useful for establishing a safe and effective fitness program, identifying fitness goals, and interpreting the successfulness of the program at a later point in time. Additionally, it is likely that seniors will require a lower starting exercise-testing workload, and subsequently progress in smaller workload increments throughout the test, relative to their younger adult counterparts.
Researchers have developed a battery of fitness tests specifically for seniors that can be used by fitness and exercise professionals to measure function in different areas of physical fitness, including cardiorespiratory, muscular fitness, flexibility, and balance. These tests include the following:
For seniors who have difficulty adjusting to exercise or fitness testing protocols, the test might need to be either restarted or repeated on a separate day.
Americans have been living longer, but the number of US residents with chronic diseases continues to increase. In the past 100 years, life expectancy at birth in the United States increased from less than 50 years to more than 78 years. The US Census Bureau has projected that by 2030, the number of adults 65 years of age and older will be approximately 70 million. Approximately 80% of individuals aged 65 years or older are living with at least one chronic health problem, and another 50% are living with two. The presence of specific chronic conditions can lead to an even greater propensity of comorbidities. For instance, almost all clients with type 2 diabetes have at least one other chronic condition, and nearly half have three or more comorbidities. These factors make it increasingly likely that fitness and exercise professionals will be interacting with many individuals other than apparently healthy adults.
Before initiating a fitness program, seniors who want to participate in vigorous-intensity exercise should have a medical examination and physician-supervised exercise test. If seniors are only planning to engage in moderate-intensity activities, a medical examination and physician supervised-exercise test is not essential, but can be helpful.
See also Senior fitness testing .
Ehrman, Jonathan K., ed. ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription. 7th ed. Philadelphia, PA: Wolters Kluwer: Lippincott Williams & Wilkins, 2014.
Heyward, Vivian H., and Ann L. Gibson. Advanced Fitness Assessment and Exercise Prescription. Champaign, IL: Human Kinetics, 2014.
McArdle, William D., Frank I. Katch, and Victor L. Katch. Essentials of Exercise Physiology, 5th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health, 2016.
Rikli, Roberta E., and C. Jessie Jones. Senior Fitness Test Manual. 2nd ed. Champaign, IL: Human Kinetics, 2013.
Hamar, B., et al. “Impact of a Senior Fitness Program on Measures of Physical and Emotional Health and Functioning.” Population Health Management 16, no. 6 (2013): 364–72.
Centers for Disease Control and Prevention. “Facts about Physical Activity.” US Department of Health and Human Services. https://www.cdc.gov/physicalactivity/data/facts.htm (accessed March 5, 2017).
Mayo Clinic Staff. “Fitness Basics.” Mayo Foundation for Medical Education and Research. http://http://www.mayoclinic.com/health/fitness/MY00396 (accessed March 5, 2017).
National Centers for Disease Control and Prevention. “Healthy Aging.” US Department of Health and Human Services. http://www.cdc.gov/aging (accessed March 5, 2017).
National Institutes of Health Senior Health. “Exercise: Exercises to Try: Flexibility Exercises.” US Department of Health and Human Services. https://nihseniorhealth.gov/exerciseandphysicalactivityexercisestotry/flexibilityexercises/01.html (accessed March 5, 2017).
President's Council on Fitness, Sports, and Nutrition. “Facts & Statistics: Physical Activity.” US Department of Health and Human Services. https://www.fitness.gov/resourcecenter/facts-and-statistics (accessed March 5, 2017).
American College of Sports Medicine (ACSM), 401 W. Michigan St., Indianapolis, IN, 46202-3233, (317) 637-9200, Fax: (317) 634-7817, http://www.acsm.org .
American Council on Exercise, 4851 Paramount Dr., San Diego, CA, 92123, (858) 576-6500, (888) 825-3636, ext. 782, Fax: (858) 576-6564, https://www.acefitness.org .
American Society on Aging, 575 Market St., Suite 2100, San Francisco, CA, 94105-2869, (415) 974-9600, Fax: (415) 974-0300, (800) 537-9728, http://www.asaging.org .
Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30329, (800) 232-4636, firstname.lastname@example.org, http://www.cdc.gov .
Lance C. Dalleck, BA, MS, PhD
Revised by Teresa G. Odle, BA, ELS