Optimizing Older Adult Health: The Key to Preventing Injuries, Falls, and Hip Fractures

2024-03-04 12:31:00
Identified as a crucial factor in preventing injuries and falls, good balance implies a lower probability of suffering hip fractures and contributes to greater independence in old age (Illustrative image Infobae)

Comprehensive care for older adults is a key issue. According to a 2022 study by the United Nations Economic Commission for Latin America and the Caribbean (ECLAC), population aging is one of the main demographic phenomena. That same year, a total of 88.6 million people over 60 years of age lived in the region, representing 13.4% of the population, and this figure is expected to rise to 16.5% in 2030.

In turn, according to the document, in 2050, the number of people over 60 years of age will rise to 193 million, which will translate into 25.1% of the inhabitants of Latin America.

Dr. María Clara Perret, a research doctor specializing in Geriatric Medicine at the German Hospital, explained to Infobae in a recent note: “Aging is a permanent process of the life cycle and old age is a stage of it. This last stage is often associated with illness and disability, however, it has been proven that although these seem inevitable, they can be postponed and reduced if one adopts a healthy lifestyle and actively commits to life. Thus, a new concept of aging arises, where it is considered that the individual is capable of determining, at least in part, his or her way of aging. Where not only the needs but the rights of the older adult to autonomy, participation, self-realization, security, equality and good treatment are recognized.”

The World Health Organization defines healthy aging as the process of promoting and maintaining functional capacity that allows well-being in old age. Functional capacity consists of having the attributes that allow all people to be and do what is important to them.

Cardiovascular health is noted as a key indicator of long-term health. Higher levels of aerobic fitness are related to a longer life expectancy (Illustrative image Infobae)

Among the activities that promote healthy aging is exercise. “If we had a pill that did everything that physical activity does for overall health, we would prescribe it for everyone,” said Dr. Donald Hensrud, former medical director of the Mayo Clinic Healthy Living Program. In general, fitness is not just regarding sweat, but four specific areas: aerobic endurance, muscular strength, flexibility and balance, he said.

The following tests, and scoring tables, are based on a series of assessments that the Mayo Clinic health and research center uses to evaluate the health and fitness of its patients based on the four parameters mentioned. They can be done to have a record of one’s physical state.

For the most accurate assessment, try each exercise first and warm up by walking in place for 3 to 5 minutes. If you are just starting to exercise, always consult with a doctor before starting a fitness program for the first time.

Aerobic Fitness

Why it matters: “Aerobic or cardiovascular fitness is one of the best predictors of long-term health and overall mortality,” Hensrud said. “The higher your aerobic level, the more oxygen your heart and muscles can use to produce energy.” Walking pace is a great measure of fitness. A 2019 study of nearly 475,000 people in Mayo Clinic Proceedings found that those who walk faster have longer life expectancies.

Aerobic or cardiovascular physical conditioning, carried out through walking, jogging, cycling, etc. It is one of the best indicators of long-term health (Illustrative Image Infobae)

Measure a mile on a street using the car’s odometer, or find a standard track and drive four laps around it. Using the stopwatch on your smartphone, start the watch and walk as fast as possible. Do not run or jog. Just keep a steady pace, slow down or speed up, but try to finish as quickly as possible. Then stop the clock.

Results at 50 years

• Excellent: In men, less than 13.24 minutes; in women less than 14.42 minutes
• Good: In men 13.24 to 14.24; in women 14.42 to 15:36
• Average: In men 14.25 to 15.12; in women 15.37 to 17
• Insufficient: In men from 15.13 to 16.30; in women 17.01 to 18.06
• Very little: more than 16.30; more than 18.06

Results at 60 years

• Excellent: In men, less than 14.06; in women less than 15.06
• Good: In men 14.06 to 15.12; in women 15.06 to 16:18
• Average: In men 15.13 to 16:18; in women 16:19 to 17:30
• Insufficient: In men from 16:19 to 17:18; in women 17:31 to 19.12
• Very little: more than 17.18; more than 19.12

How to improve the score? “Incorporate at least 150 minutes of moderate-intensity cardiovascular exercise or 75 minutes of high-intensity exercise per week,” Hensrud recommended. Walking, running, biking, stair climbing, swimming, dance classes, and aerobics are just some of the options that work. What counts is raising your pulse to between 60 and 70% of your maximum heart rate and keeping it there throughout the session.

You must do at least 150 minutes of moderate intensity cardiovascular exercise or 75 minutes of high intensity exercise per week (Illustrative image Infobae)

Generally speaking, that means getting enough exercise to be able to carry on a conversation, but with a little difficulty. A device may also be used to measure heart rate. To find your maximum heart rate, simply subtract your age from 220. For example, if you are 60 years old, your maximum heart rate would be 160 (220 minus 60). That means you should keep your pulse between 96 and 112 beats per minute.

Flexibility

Why it’s important: “Staying flexible stimulates blood circulation, promotes better posture, relieves posture-related stress and pain, and allows joints to move through their full range of motion,” Hensrud said. This last benefit alone helps improve overall performance while reducing the risk of injury during any activity.

This simple test measures range of motion in your lower back, hips, and hamstring muscles (the back of your thighs).

Place a ruler on the floor and hold it in place with a piece of tape around the 38cm mark. Sit on the floor with the ruler between your legs, placing your feet even with the 38 cm mark. As you extend your arms, exhale as you gently move forward as far as possible, holding the position for at least one second. Repeat the test three times and record the furthest distance of the three. Flexibility is considered good if the fingers reach the following distances:

Assessment: Sit and Stretch (Illustration Elena Lacey/AARP)

Results at 50 years

• Average in men 42 cm; in women 48

Results at 60 years

• Average in men 39 cm; in women 44

How to improve the score? “Implement a full-body stretching routine two to three times a week,” Hensrud said. Includes stretches for the neck, shoulders, torso, upper back, lower back, hips, hamstrings, quads, calves, and feet.

Muscular strength

Why it’s important: “Your muscles do more than just make you more functional and able to participate in activities throughout the day. The amount of muscle you have also determines your basal metabolic rate, which is the number of calories your body burns at rest,” Hensrud said. These are two ways to evaluate it:

Men: get into a push-up position, spread your hands shoulder-width apart, extend your legs and keep your back straight. Slowly bend your elbows until your chest almost touches the floor and then push up. Do as many push-ups as you can with good form and without resting.

Women: Do the same, but from a push-up position with your knees on the floor.

Aerobic physical conditioning and exercising muscular strength gives the necessary autonomy to carry out all future activities (Illustrative image Infobae)

Stand regarding 30 cm in front of a chair with your feet hip-width apart and your arms extended in front of you. With this posture, slowly push your hips back and bend your knees until your buttocks almost touch the seat of the chair. Get up slowly. Do as many squats as you can without using your arms to help you.

Push-up results at 50 years old

• Excellent: men 21+; women 21+
• Average: men 10-12; women 7-10
• Very little: men 6 or less; women 0-1

Push-up results at 60 years old

• Excellent: men 18+; women 17+
• Average: men 8-10; women 5-11
• Very little: men 4 or less; women 0-1

Squat results at ages 46 to 55

• Excellent: men 36+; women 28 +
• Average: men 22-24; women 14-17
• Very little: men 12 or less; women 4 or less

Strong muscles allow older adults to participate in various activities throughout the day and help protect bones (Illustrative Image Infobae)

Squat results at ages 56 to 65

• Excellent: men 32+; women 25 +
• Average: men 17-20; women 10-12
• Very little: men 8 or less; women 2 or less

How to improve the score? For both the push-up and squat tests, perform a mix of resistance exercises that work both the upper and lower body two to three times a week. Rest 24 to 48 hours between exercise sessions.

Equilibrium

Why it matters: “Most people think that osteoporosis is the main cause of hip fractures when, in reality, it is instability,” Hensrud explained. “Having better balance results in fewer injuries and greater independence.” A study in the British Journal of Sports Medicine recently linked the ability to balance on one leg for at least 10 seconds with a lower risk of mortality in people ages 51 to 75.

Yoga, tai chi, dance and pilates are recommended activities to improve balance (Illustrative image Infobae)

Stand barefoot next to a wall or counter. Lift one foot off the floor to balance on one leg. Check how long you can stay before putting your foot back down or leaning on it. Repeat the test on the other leg. Do the test three times with each leg; record the best time of the three attempts. Now perform the test once more with your eyes closed.

Balance results at age 50

• Average eyes open: men 41.5 seconds; women 40.9 seconds
• Average eyes closed: men 8.6 s; 30.4s.

Balance results at age 60

• Average eyes open: men 33.8 seconds; women 30.4 s.
• Average eyes closed: men 5.1 s; 3.6s.

How to improve the score? Simply repeating this test every day is a great start, but you can easily improve balance by routinely engaging in activities that challenge stability safely, such as walking outdoors (particularly on trails or grass), doing exercises legs that exercise one leg at a time (such as lunges) or take core strengthening classes such as yoga, tai chi, dance, and pilates.

*This text is a reinterpretation of material originally published in AARP, a US non-profit organization dedicated to improving the quality of life and health of people over 50 years of age.

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