Fears of being placed in a nursing home preoccupy a supermajority of older adults as in surveys about their course of aging they consistently ranked memory loss, financial insecurity and losing independence as their top three concerns.¹ Yet, after age 80, the risk of being placed in a nursing home increases significantly. Seniors of advanced age experience what is termed “functional aging”, that is an inevitable, progressively declining continuum in functional ability from having a stable capacity to perform daily activities through a state of physical vulnerability (influenced by cognitive loss) in which the person is losing independence.² At advanced ages, some caregiver support becomes necessary for many, and for some, a nursing home admission. 

Although most seniors accept that the aging process accelerates physical and cognitive decline after age 80, they want to know whether they have any means to control the degree or pace of their functional losses. This article discusses the evidence-base showing that changes in lifestyle, particularly engaging in exercise targeted to improving functional fitness even in seniors who were mostly sedentary, can slow and in some cases reverse functional impairment, which in turn reduces the risk of being placed in a nursing home. In fact, there is strong evidence that long-term habitual exercise is linked to a slowing of the biological aging process, which certainly enhances independence.³: but, studies also show that even sedentary older adults who begin to exercise in later life can see significant improvements in physical and cognitive health.⁴

Functional impairment is caused by not only age, cognitive decline, multiple chronic medical conditions or following an acute medical event, but also from lifestyle choices- a sedentary lifestyle is shown to decrease functional fitness levels which in turn increases functional impairment while engaging in a physically active lifestyle appears to derive a polar opposite effect.⁵ Functional impairment reduces ability to perform activities of daily living, “ADL’s”:⁶ and, consequently, the most common reason that very old adults are placed in a nursing home is loss of ability to perform ADL’s.⁷ (Over 80% of nursing home residents need assistance with 3 or more ADL’s). Thus, when functional fitness is improved through exercise, that is, when an older adult experiences an enhanced ability to the summon strength, energy and executive function needed to carry out basic ADL’s, independence is retained for longer which reduces the risk of being placed in a nursing home.⁸

This month’s topic for Gym Talk is "Heat Safety Awareness".

Hot weather can be dangerous, and seniors over the age of 65 are among those most at risk for heat exhaustion. Now that the hot weather has arrived it's important to know the signs of heat exhaustion and how to stay cool.

The human body regulates temperature through sweating, until exposed to more heat than the body can handle. As you become older the ability to notice changes in your own body’s temperature decreases. Others at risk for heat illness include infants and young children, people who are ill, those with chronic health conditions or on certain medications, and people who are overweight. Health conditions can make the body less able to adapt to the heat. Also, some medicines can contribute to dehydration.

June is Brain Health Month, so we thought we’d focus on one simple way to improve our gray matter – through exercise. 

How does exercise help?

The brain is a collection of neurons that work by sending chemical messages to each other. The movement of the chemical messages between neurons is what dictates memory formation, learning new skills, physical movement, and body function. As we age, these neurons naturally degrade and die. Fortunately, new neurons can be generated through a process called neurogenesis, which occurs from eating a healthy diet, regular exercise, and continued learning of new skills. At Colebrook Village, our Wellness-4 Later Life™ program helps residents create lots of opportunities for neurogenesis.

Nutritional fads come and go. But one fad which seems to have elevated to a gold-standard of credibility has been the so-called "Mediterranean Diet". The Mediterranean diet recommends eating lots of plant-based foods mainly fruits, vegetables, and legumes and foods infused with monounsaturated fat such as olive oil. This popular diet acquired high acclaim in the US as a nutritional best-practice in preventing heart disease after a five-year study by a group of Spanish nutrition scientists caused the New England Journal of Medicine, NEJM, to publish its conclusions suggesting that the Mediterranean diet can decrease risk of heart attack and strokes. The study concluded: prolonged exposure to the Mediterranean diet produced a substantial reduction in risk of major heart disease among high-risk people.

Recently, a statistical sleuth named John Carlisle exposed many flaws in the study namely its claim to have assigned people randomly to the study and other anomalies. Carlisle’s analysis refuted the study’s findings thus discrediting it, causing the NEJM in the summer of 2018, to retract the original publication. This turn of events has re-ignited the debate on what is optimal diet for seniors in later life and whether nutrition can have a positive impact on the health and wellness of very old adults? Ironically, much the Mediterranean diet compares agreeably to nutritional best-practice recommendations of public health organizations and other accredited bodies but without all the feigned notoriety. Yet, to deliver nutritional best-practices in later stages of life requires that special accommodation be made to address health-status changes.