New HHS guidelines recommend 3-pronged approach to exercise for older adults

Physical activity for older adults should include balance training as well as aerobic and muscle-strengthening exercises, according to updated physical activity guidelines released Monday by the U.S. Department of Health and Human Services.

“All three aspects are important for this population because older adults are at an increased risk of falls, and strength and balance are needed to prevent falls,” noted the authors of “Physical Activity Guidelines for Americans, 2nd edition,” an update of guidelines issued in 2008. The new recommendations were published in JAMA, the journal of the American Medical Association.

“Older adults who are physically active can engage in activities of daily living more easily and have improved physical function (even if they are frail),” the HHS authors said. “They are less likely to fall, and if they do fall, the risk of injury is lower.”

The guidelines also have suggestions for young children, adolescents and younger adults.

In general, HHS recommends that every week, all adults get a minimum of 150 to 300 minutes of moderate-intensity aerobic physical activity, or 75 to 150 minutes of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Adults also should do muscle-strengthening activities on two or more days a week, according to the guidelines.

Seniors should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities, the guidelines state.

Because most people aged 65 or more years are sedentary for much of the day, the authors said, the guidelines encourage people in this age group to begin increasing their physical activity simply by moving more and sitting less throughout the day.

“Replacing sitting with light-intensity physical activity or, ideally, moderate-intensity physical activity may provide significant benefits,” they wrote.

Other points made in the guidelines:

  • Older individuals should determine their level of effort for physical activity relative to their level of fitness.
  • Those with chronic conditions should understand whether and how their conditions affect their ability to perform regular physical activity safely.
  • Older adults who cannot participate in 150 minutes of moderate-intensity aerobic activity each week because of chronic conditions should be as physically active as their abilities and conditions allow.

“Even individuals in their 90s can improve their quadriceps muscle strength with appropriate exercise training, demonstrating that it is never too late to use physical activity to help ensure that older adults do not outlive their muscles,” noted the authors of an accompanying opinion piece.

In another related editorial, HHS authors encouraged technology companies such as Apple, Google and Fitbit to consider incorporating the guidelines into their fitness apps.