Exercise: It’s Never Too Late

You’ve undoubtedly heard it many times: Exercise improves the health and well-being of people of all ages. Yet there have been very few large, long clinical trials on exercise in older people.

Sure, many observational studies have linked exercise with better health in people over 65, though that doesn’t prove causation. It may simply be that healthy older folks are more likely to exercise. Moreover, countless small, short intervention studies have shown that exercise can improve specific parameters of healthy aging—such as muscle strength, aerobic capacity, or blood pressure levels—in people in their seventies or eighties. But these don’t present the big picture. That’s why researchers have been excited about the impressive clinical trial on the benefits of exercise for sedentary older people that was recently published in the Journal of the American Medical Association.

The multicenter study involved 1,635 people ages 70 to 89 who were largely sedentaryand borderline-frail. That is, at the start they scored low on a standard assessment of physical functioning but were still able to walk a quarter mile in 15 minutes. Half were assigned an exercise program involving supervised group walking on a track (about 150 minutes a week), plus strength, flexibility, and balance training done at home (30 minutes a week). The other half, the control group, simply attended weekly (then monthly) health education classes, where they did brief upper-body stretches.

Over the course of 2.6 years, on average, the exercisers were 18 percent less likely to experience “major mobility disability”—defined as no longer being able to do that quarter-mile walk—than the control group. And they were 28 percent less likely to experience persistent disability. Those improvements, while not that large, are “clinically relevant,” according to the authors. There were no statistically significant differences in rates of heart attacks, strokes, or other serious adverse events, however.

One strength of the study was that it focused on that large swathe of vulnerable older people on the verge of frailty—with diminished physical abilities, but still able to get around. Another plus is that the exercise was mostly walking and simple home-based workouts. Most of it was done in groups, so the social interaction may also have contributed to the benefits.