Older Hispanic woman lifting weights in living room
(Credit: Jose Luis Pelaez / Gettin IMages)

Two new studies are touting the benefits of exercise for assisted living and nursing home residents.

In a study published Thursday in The Lancet, researchers established that just three hours of exercise per week is associated with improved physical function in older adults living in residential care settings and routinely should be promoted in long-term care facilities.

Another study published in the May issue of JAMDA–The Journal of Post-Acute and Long-Term Care Medicine, looked into exercise guidelines and recommendations aimed at maintaining physical autonomy and quality of life in assisted living and other long-term care residents. The researchers found that small changes can significantly improve quality of life.

According to the World Health Organization, healthy aging largely is determined by the ability to preserve physical function, including functional independence for activities of daily living. And evidence supports the effectiveness of planned, structured and repetitive physical activity to head off age-related physical decline in older adults. One of the WHO’s priorities is preventing sedentary lifestyles and physical inactivity, the fourth leading cause of mortality.

ADLs improved with physical activity

In the Lancet study, researchers in Spain noted that older adults in long-term care settings commonly experience a rapid decline in physical function, with more than half losing the ability to independently perform at least one activity of daily living within the first two years of admission.

The study reviewed 147 controlled trials with 12,059 participants living in assisted living communities, nursing homes and other congregate housing for older adults. Participants participated in two or more exercise categories, including mobility, endurance, balance and resistance.

The most consistent beneficial effects were observed with 110 to 225 minutes of exercise per week, with optimal benefits at 170 minutes of exercise per week. 

Their findings revealed that exercise enhances physical function in older adults in residential care, regardless of their functional or cognitive status. Improvements were seen in ADL performance, muscle strength, physical performance, balance and flexibility.

Despite the overall beneficial effects of physical exercise for older adults in residential care, the authors noted controversy regarding the most effective exercise type. They added that More evidence is needed to establish the most effective exercise type, training volume and intensity, they added.

“Given that no consistent differences seem to exist between interventions, our results highlight the possibility of using the form of exercise that best suits the resources, needs and preferences of older adults in residential care, because any exercise type of combination provides greater benefits than usual care,” the authors wrote.

Small changes, significant improvement 

In the JAMDA study, researchers sought to answer the questions of how often should assisted living and other long-term care residents be physically active and what type of activity is most appropriate.

According to the study, long-term care residents typically have more than 10 hours of sedentary time daily, excluding sleeping hours. And more than 30% of residents reported decreased physical activity levels after moving into long-term care. 

“Overall, 85% of LTC residents’ time is sedentary, and very little time is dedicated to physical activity,” the study authors wrote. “Therefore, it is important to find solutions to limit sedentary time and physical inactivity in LTC facilities.”

Start with small changes, the authors advised.

“Small changes can be made to break sedentary cycles in lifestyle to significantly improve the physical and psychological state of LTC residents, as well as their quality of life,” the authors stated. “Therefore it is beneficial to interrupt sedentary time with physical activities of various intensities and modalities.”

An update on physical activity recommendations in long-term care is overdue and should focus on personalized activity programs based on needs, the researchers said. 

Overall, they recommend moderate-intensity combined physical activity training to improve muscle strength and cardiorespiratory endurance. Such exercise includes walking and resistance training. It also is important to add flexibility and balance exercises during each physical activity session, the authors said.