Section(C)
Exercise for the Old
As a scientist, one of Steven Wolf's favorite questions to ask people at the end of a study is: "Whatcan you do now that you couldn't do before?"One of the best answers he's ever received came from an 86-year-old man who learned the ancientChinese exercise form of tai chi as part of Wolf's study of how exercise can help seniors prevent falls.
"The man smiled at me, then lifted up one foot, bent over, and took off his shoe while balancing on hisother leg," recalls Wolf, a professor and researcher. "Then, still balancing on one leg, the 86-year-oldgentleman stood back up, bent over again, and put his loafer back on. What impressed me the most wasthat he couldn't do this before studying tai chi."Although many people assume that balance and movement problems are inevitable with age, anincreasing body of evidence demonstrates that exercise can help improve balance and strength inelderly individuals and reduce their chance of falling. In Wolf's study, published in May 1996, 215seniors aged 70 to 96 were divided into three groups. One group performed balance exercises on acomputer-controlled platform once a week, one group took a weekly tai chi class, and a control groupmet for a weekly discussion. After 15 weeks, "the tai chi group did the best, and reduced the chance ofhaving a fall by 47 percent," Wolf said.
In addition, the tai chi group also showed significant improvement in the condition of their hearts andquality-of-life measurements, such as a reduced fear of falling and an increased sense of control overtheir lives. "Tai chi has been used in China as an exercise for older individuals for three centuries and asa military art for 2,000 years," Wolf says. "The movements are very slow and careful and involve agreat deal of body movement and standing on a single limb. Practicing these movements is like learningstrategies you can use to avoid falling down."Tai chi is just one form of exercise studied for its fall-preventing benefits as part of a recentlycompleted six-year project by the National Institute on Aging and the National Institute of NursingResearch. More than 1,500 seniors at seven sites around the country participated in the trials. "Thestudies showed that even a low level of exercise can reduce the risk of falls," notes WashingtonUniversity scientist Michael Province, whose analysis of the data on exercise and fall preventionappeared last year in The Journal of the American Medical Association. "Exercise can help older adultsimprove strength, balance, the ability to bend, and prevents them from tiring as easily. Improvementsin one area often carry over into another."In general, "the evidence is increasing that the more older people can do in terms of exercise, thebetter off they are — with two pieces of advice," says Province. First, older exercisers should be sure tocheck with a doctor to make sure any new exercise program is safe and appropriate. Second, seniorsshould start under the guidance of a qualified teacher to make sure they're doing exercises properlyand not doing too much, too soon — especially if they've been inactive.
"The problem is that to improve balance, you've got to challenge balance, which is always risky," saysMary E. Tinetti of the Yale University School of Medicine, who studied 301 men and women aged 70and older with at least one risk factor for falling, such as muscle weakness or use of certain medicines.
To reduce these seniors' risk of falling, Tinetti used multiple methods, including having an exerciseteacher go to a person's home and teach balance exercises. "The teacher wasn't necessarily there withthem every time they did the exercise," Tinetti notes.