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The graying of the health club: health club demographics are shifting to the senior set, as research demonstrates that fitness is a lifelong habit that needs to be ramped up, not cut back, in retirement.

Twice a week around lunchtime, you'll find Barbara Pratt at a health club, working out with other women 45 and older. Pratt falls on the far end of the spectrum. She's 84 but doesn't look it. In fact, if you glance around her exercise class, you'll have a hard time guessing the age of any of the ladies. Their agile and fit bodies betray their years.

Pratt calls her workouts "a blessing." They've increased her stamina and expanded her circle of friends. "It does make you feel better," Pratt explains. "Not only that, it's fun."

Not everyone will agree that working out is fun, considering the time commitment and discipline involved, but there's a growing consensus that exercise is indispensable to healthy aging. As a result, America has entered another fitness boom, one that treats strength training and cardiovascular exercise as lifelong habits that need to be ramped up, not cut back, in retirement. Call it the graying of the health club.

One fourth of the nation's 41.3 million health club members is older than 55. It's the fastest-growing segment in health-club membership, and it shows in both the weight room and aerobics class. From 1998 to 2004, according to American Sports Data (ASD), a fitness industry group, the number of "frequent fitness participants" 55 and older jumped 33 percent, compared with a growth rate of 13 percent for those aged 35 to 54 and zero growth for the under-34 set. The ASD group defines "frequent fitness participant" as someone who exercises at least 100 times a year.

The benefits to individuals are obvious: lower blood pressure, greater flexibility, fewer chronic ailments, longer life. The collective benefits to society are incalculable. If older people can prevent just a fraction of the injuries and ailments that come with old age, imagine what we could save on Medicaid, Medicare, and healthcare costs generally.

Three demographic trends play into the fitness phenomenon. First, the United States population is aging as more Americans live longer. According to The State of Aging and Health in America 2004, published by the CDC and Merck Institute of Aging and Health, almost 70 million Americans--one out of five---will be 65 or older by 2030. The number of people 85 and older will increase fivefold to nearly 20 million by 2050.

Second, the leading cause of death has shifted from infection to chronic disease, such as diabetes or heart disease, which can limit daily functioning and quality of life. Eighty-eight percent of older adults have some chronic condition, the report found. The average 75-year-old has three chronic conditions and takes five prescription drugs.

Third, the elderly population is becoming more culturally diverse. By 2050, racial minorities will comprise 35 percent of those 65 and over. Chronic disease--diabetes, heart disease and cancer, in particular--disproportionately affects African-Americans and Latino-Americans.

These trends would be on a collision course if not for the fact that most chronic illness is preventable. And exercise is the most effective preventive measure. "Although the risk of disease and disability increases with age, poor health is not an inevitable consequence of aging," The State of Aging states. "Adopting healthier behaviors--regular physical activity, a healthy diet, and a smoke-free lifestyle--and getting regular screenings (mammograms and colonoseopies, for example) can dramatically reduce a person's risk for many chronic diseases, including the leading causes of death and disability."

Osteoporosis is a case in point. Often considered the plague of old ladies, osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or left untreated, osteoporosis can progress painlessly until a bone breaks. Especially susceptible: the hip, spine and wrist.

A hip fracture almost always requires hospitalization and major surgery. Even when the surgery is successful, some patients don't fully recover and may find it difficult to walk without assistance. Spinal (or vertebral) fractures also have serious consequences, including loss of height, severe back pain, and deformity.

Prescription drugs help increase bone mass and are a doctor's first line of attack when osteoporosis hits. But taking calcium supplements and exercising regularly may help prevent it.

Two important types of exercises for building and maintaining bone mass and density are weight-bearing and resistance exercises. In weight-bearing exercises, your bones and muscles work against gravity. In other words, your feet and legs do the work. Walking, jogging, dancing, and playing tennis are weight-bearing exercises with different degrees of impact.

Resistance exercises Use muscular strength to improve muscle mass and strengthen bone. These activities include weight-lifting, such as using free weights and weight machines found at gyms and health clubs.

In the same vein, progressive resistance training is touted as a way to reverse sarcopenia, another plague of the elderly years. Sarcopenia is loss of muscle mass and function and, just like osteoporosis, is often blamed for the frailty that causes older people to fall. The Nutrition, Exercise Physiology, and Sarcopenia Laboratory at Tufts University is researching sarcopenia and its effects, as well as the potential for exercise and diet to remedy age-related alterations in hormones and the immune system.

Cathryn Siegrist, 86, attests to the benefits of exercise. She works out almost four hours a week and last year enrolled in a "Lite Fitness" class that combines dumbbells, exercise balls, resistance tubing, and light aerobics. "We need this," Siegrist says. "I couldn't use any weights when I started. This has helped my mobility."

Research shows that's not all exercise helps. For starters, done regularly, exercise improves heart function, lowers blood pressure and blood cholesterol, and boosts energy. And it's never too late to reap the benefits. In one German study, 73 men with chronic heart failure were assigned to either 20 minutes per day of regular exercise or no exercise at all. At the end of six months, the exercise group had fewer heart failure symptoms. Their heart function measurements showed a 14 times greater increase in the amount of blood pumped by the heart with each beat than what the non-exercisers experienced. The exercisers also had less heart enlargement.

Even for the elderly who can't get to a gym, there's good news in the latest research. You don't have to hire a personal trainer, buy expensive weightlifting equipment, or jog three miles a day to improve your health. You just have to be active.

That's the bottom line of a six-year study carried out by researchers at the U.S. National Institute on Aging and reported in the July 12 issue of the Journal of the American Medical Association. Researchers studied 302 volunteers, aged 70 to 82, and monitored them for six years. The research team concluded that any amount of regular activity was linked to longer lifespan. It didn't matter whether they engaged in formal exercise or daily routines such as gardening, vacuuming, or washing the dishes.

Indeed, the 30 percent most physically active volunteers were 69 percent less likely to die over the study period than the 30 percent least active.

If longer and better lives aren't benefits enough, researchers at the Fred Hutchinson Cancer Research Center in Seattle have identified one more: Regular exercise reduces the risk of contracting the common cold. The center studied 115 sedentary, post menopausal women who were overweight or obese. Half were asked to do 45 minutes of moderate exercise, such as brisk walking, five days a week. The other half was asked just to stretch for 45 minutes once a week. Over the course of a year, the stretchers caught about three times as many colds as the exercisers, a finding published in the November 2006 American Journal of Medicine.

One additional benefit to healthy aging should concern everyone, no matter their age. It costs less. In the next 25 years, federal spending on Medicare, the federal health insurance plan for the elderly and disabled, will continue to rise faster than the rate of inflation. Current annual Medicare costs exceed $265 billion, 12 percent of all federal spending. Accounting for less than one percent of the Gross Domestic Product in 1970, Medicare will consume 13.9 percent of the GDP by 2080, according to a 2004 Medicare board of trustees report. These trends are not sustainable.

Although researchers are just beginning to evaluate the link between healthcare costs and exercise, it's clear that prevention costs less than treatment. A Canadian study attempted to put a figure on savings that could be achieved if "inactivity levels" were cut in that country by 10 percent. The researchers' best estimate was that approximately $2.1 billion, or 2.5 percent, of total direct healthcare costs in Canada were attributable to physical inactivity in 1999. They also estimated that approximately 21,000 lives were lost prematurely because of inactivity. A 10 percent reduction in physical inactivity could potentially reduce direct healthcare expenditures by $150 million a year, they concluded.

"Physical activity has the potential to change the way we age," says the American Society on Aging. "It provides physical, mental and social benefits and helps keep older adults mobile and independent. Much loss of function that was thought to be 'normal' aging is actually the result of not being physically active."

Just because there is a fitness "boom" doesn't mean that most older Americans are a part of it. "By age 75, one in two women and one in three men get no physical activity at all. Given the projected increase in the number of older adults in the coming years, and that 88 percent of older adults over 65 have at least one chronic condition, physical inactivity is a public-health issue, not just a personal problem," the Society on Aging warns.

What keeps older adults from getting the exercise they need? There are many obstacles, including lack of transportation to recreation facilities, age discrimination, family members who disapprove, and the fear of looking foolish in front of others. It can be a tad embarrassing for an older adult to stand side by side in the weight room with the buff teenager getting ready for his next athletic season.

So here's some advice for young and old alike. Get over it!

"I even know people my age who get embarrassed at the gym or won't wear shorts in the gym," says one personal trainer, who started a Lite Fitness class because she wanted to reach out to the older demographic. "A lot of people think other people are watching them. Those people are focusing on the workout just as much as you are."

If we all get over it, we can all age well together. A quote attributed to the physician-poet Oliver Wendell Holmes more than a century ago sums it up this way: "Men do not quit playing because they grow old; they grow old because they quit playing." Advice for the ages--and for the aging.

Eight tips for a more active retirement

1. Find a favorite destination that you can walk to daily, such as the coffee shop or bookstore. If you have to drive or take the bus, park or get off a couple of blocks early.

2. Walk your dog. Get a dog if you don't have one.

3. Whatever your destination, park at the far end of the lot.

4. Walk up stairs instead of riding the elevator.

5. Use a mobile phone and walk around while you talk.

6. Vacuum, dust, or mop every day.

7. Grow plants indoors and out, and keep them watered.

8. Use a push lawn mower instead of a riding one.
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Author:Neal, Andrea
Publication:Saturday Evening Post
Geographic Code:1USA
Date:Jan 1, 2007
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