Lifelong Health: Exercising Right Keeps Us Mobile, Independent

Dr. David Lipschitz This has been a big month for the Lipschitz household -- in a three-week period, my mother and father-in-law came to town. At age 83 and 88, they are in excellent health. While each has a razor-sharp mind, the physical effects of aging have started to increase. My mother cannot walk far because of leg pain. My father-in-law also moves slowly and is more bent, now using a cane and worrying about falls. Both of them no longer exercise, and they don't get out as much as they used to. Unfortunately, both my mother and father-in-law are caught in a nasty cycle where walking difficulties make them more sedentary, leading to weakness and worsening gait problems. These signs of frailty may make them dependent on others and unable to live alone.

Can we do anything to improve the situation? Is frailty preventable or simply an inevitable consequence of reaching your 80s? Fortunately, weakness and problems with gait and balance are preventable.

Loss of muscle and bone is an unavoidable consequence of age. At age 80, total muscle mass is 40 percent lower than at age 20. Even if weight is unchanged, muscle is replaced by fat. Regardless of age, muscle cells become damaged and die every day. Special cells called myocytes replenish lost muscle. As we grow older, myocytes preferentially produce fat at the expense of muscle. This is an integral part of nature's plan, making the older animal weaker, less able to procreate and vulnerable to death by predators. Bone loss occurs in tandem with muscle loss, leading to osteoporosis that causes an increased risk of fractures. Although bone loss is greater in women, older men also develop osteoporosis.

Being overweight will make walking more difficult and osteoarthritis worse.




Regardless of the cause, impaired gait and balance will lead to an increased risk of falls and fractures. This can lead to dependency on others and an inability to live alone. Hip fractures are the most serious and frequently prove fatal within a year.

In addition to regular exercise, osteoporosis can be prevented by taking adequate calcium and vitamin D. Men should take 1,000 mg of calcium and 800 units of vitamin D daily, and women, 1,500 mg of calcium with the same amount of vitamin D as men. Where appropriate, consider screening for osteoporosis. My mother and father-in-law refuse to exercise. Excuses abound, and their physical health continues to deteriorate. Fortunately, there is always an exercise program that can improve strength and relieve joint pain. Research has shown that frailty can be improved in those over age 90, even those who have significant pain and serious difficulties with walking. If only all the baby boomers began a program of frailty prevention today, we would all be independent well into our 90s and beyond. If we don't, the future for America, with 72 million frail baby boomers, could be bleak.

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