The Benefits of Better Mobility for Elderly People

Quality of Life

In 2018, for the first time ever, the world’s population in the over-65 age group was higher than the number of children aged under five.

This global trend towards ageing is forecast to accelerate, with the proportion of the population aged over 65 almost doubling from 9 per cent in 2019 to 16 per cent by 2050. In Europe and North America, the proportion of older people is expected to be higher than this, at 25 per cent by 2050, according to the United Nations (1).

In 2018, seven countries – Japan, Italy, Germany, Finland, Portugal, Greece and Bulgaria – were described as ‘super-aged’ with more than 20 per cent of the population over the age of 65 (2). In Japan, the population shrank for the twelfth year in a row in 2018, with deaths exceeding births and the number of births being the lowest since records began in 1899 (3).

Four other countries are expected to become ‘super-aged’ by 2030 – France, Singapore, the UK and the United States (4).

This rapid ageing of the population is creating challenges for every society worldwide, especially in ‘super-aged’ and ‘super-ageing’ countries. These challenges include higher demand for healthcare services and state pensions, as well as the availability of suitable housing and welfare services for older people.

An ageing population is leading to increasing healthcare costs in many countries. A study carried out in the UK by the Office for Budget Responsibility showed that total expenditure on healthcare increases as people age, from approximately GBP 2,000 per person per year at age 65 to GBP 10,000 at age 90 and above (5).

If older people were to remain as active and as mobile as possible for as long as possible, could some of these challenges be alleviated and the burden on healthcare services be reduced? At the same time, would older people enjoy better quality of life for longer?

Here are several ways in which preserving and increasing mobility – the ability to move freely and easily – can benefit older people and society as a whole.

Increase Muscle Mass and Strength

As people age, they lose active muscle mass. Sarcopenia – the loss of muscle mass due to ageing – can begin between the ages of 30 and 40. It accelerates after the age of 60, with around 10 per cent of the over 60s affected. This increases to more than 50 per cent of the over 80s.

At the same time, muscles tend to lose their strength as people get older. Muscle strength in healthy elderly people declines by between 0.8 and 3.6 per cent per year.

Muscle weakness is linked with a wider range of other age-related conditions, including cognitive decline, osteoporosis and diabetes.

The good news is that studies have shown that, for older adults, resistance training brings many benefits (6), including:

  • increased muscle mass
  • slowing down the loss of muscle strength
  • improved bone density
  • a reduced risk of falls and fractures
  • improved metabolic function and insulin resistance
  • enhanced psychological well-being.

A study carried out by the University of Jyvaskyla in Finland found that almost everyone in a group of 81 male and female volunteers aged between 65 and 75 not only gained muscle strength but also improved other health markers after a nine-month programme of resistance training. Even those volunteers who had only trained once a week (after training twice per week for the initial three months) saw an improvement in their strength and health (7).

However, despite the widespread benefits of resistance training, just 8.7 per cent of older people take part in muscle-strengthening activities in the United States. This may be due in part to the perception that lifting weights in gyms is dull and boring, and that weight training is still associated with body builders and images of young men on steroids.

If resistance training could be fun and engaging and not involve repetitions of lifting weights in gyms, more older people would be motivated to join in. Dynamic Devices’ Robotic Personal Trainers make resistance training much more enjoyable for older people, who follow a stimulating, on-screen workout that strengthens their leg muscles and their brain-muscle connection without causing muscle soreness or injury.

Greater Confidence

Older people sometimes avoid going outdoors because they are not very fast on their feet when crossing roads. They may also have impaired vision and/or hearing, which means they are less aware of potential hazards, such as kerbs and traffic. In bad weather, they may be afraid of slipping on icy pavements and falling.

A meta-analysis of 121 studies with 6,700 participants found that progressive resistance training strengthened muscles significantly and increased walking speed moderately (8).

Such improvements in the physical strength of older people also increase their confidence in their abilities to perform certain actions both at home and outdoors.

Using the DD System Pro Robotic Personal Trainers, older people can exercise indoors in comfort and safety, building up their physical and cognitive abilities. This helps them feel more confident when carrying out everyday tasks and they are more willing to go out and about if they know they’ll be able to walk for a certain distance without getting tired or tripping over.

Better Quality of Life

Elderly people with good to excellent mobility have a much better quality of life than those who are confined to their homes. They feel stronger, have more energy and can walk for longer distances.

This means they can lead busy and active lives, doing voluntary or paid work, attending educational courses, travelling, and taking part in social events. Their continued participation in society leads to a greater sense of purpose in life and reduces the risk of depression.

A Happier, Independent Lifestyle for Longer

Elderly people with good mobility can live independently for longer. A key part of this is being strong enough to carry out everyday tasks without assistance.

If older people can cook their own meals, clean their home, go shopping, walk up and downstairs, and take care of themselves physically, they can stay independent for longer and live in their own homes rather than in care homes.

Better Brain Function and Lower Risk of Depression

Cognitive function tends to decline as people age, with many older people noticing that their memory is not as good or reliable as it used to be. But, can exercise reduce or delay this decline? Does exercise boost the brain as well as the body?

A review of 39 randomized controlled trials concluded that exercise improves cognitive abilities in adults aged over 50, both for those with and without signs of mild cognitive impairment (9).

A study of people aged between 55 and 80 found that a morning exercise session followed by several short walks during the day improved the short-term memory and decision-making abilities of the participants throughout the day, compared with a control group who sat down for eight hours a day.

Levels of neurotropic growth factor, a protein that helps information-transmitting neurons to remain and grow in the brain, increased in those who had exercised (10).

It is also possible for older people to improve their mood through exercise. Researchers at McMaster University discovered that, after a 12-week exercise programme, male participants aged over 65, had activated genes in skeletal muscle. This had improved metabolic pathways, ultimately boosting the brain chemicals, including serotonin, that play a key role in maintaining a positive mood and reducing the risk of depression.

Before the study, these effects of exercise had been observed in younger people, but it was not known whether they would also be seen in older people, due to decreased muscle mass because of ageing (11).

Prevent or Delay Falls, Diabetes and Strokes

Falls become increasingly common as people age. In Switzerland, around one- third of people aged over 65 experience at least one fall a year. This increases to almost 50 per cent of those over the age of 80 (12).

Regular exercise can improve an older person’s balance and resistance training can strengthen their muscles and counteract the effects of Sarcopenia (13). This leads to better walking ability, thus reducing the risk of a fall.

A review of 26 trials that used exercise programmes to reduce the risk of falls among elderly people in eight countries found that the incidence of falls was reduced by between 14 per cent and 47.5 per cent.

If a fall is prevented, an older person does not have to go through a period of inactivity after the fall, which may result in a further decline in their mobility.

Preventing a fall also means that an older person doesn’t suffer the psychological effects, which often mean they are afraid of further falls. This in turn dissuades them from being more physically active, reducing their mobility further.

Regular physical activity can also delay or prevent the onset of type 2 diabetes by improving blood glucose control. Two studies showed that increased daily physical activity combined with dietary changes reduced the incidence of diabetes by 58 per cent (14).

A ten-year study of over 16,000 men aged between 40 and 87 years concluded that the men with the highest level of cardiorespiratory fitness had a 68 per cent lower risk of dying from a stroke than those with the lowest level of fitness (15).

If falls, diabetes, strokes, heart disease and other conditions could be prevented or at least delayed by improving the mobility of elderly people, considerable cost savings for healthcare services would result. There would also be less demand for and pressure on these systems.

How Can Robotic Personal Trainers Help?

Improving older people’s mobility is often a challenge, especially if a person has physical conditions and cognitive impairments that adversely affect their ability to exercise. Others may find exercise boring and/or have few opportunities to exercise regularly.

The DD System Pro Robotic Personal Trainers help older people improve their physical fitness, strength, balance and walking speed in a fun and motivating way. An extra advantage is that participants can wear their everyday clothes while training and don’t need to shower afterwards.

The Robotic Personal Trainers carry out an in-depth evaluation of each person’s level of fitness and develop a resistance training plan tailored to their exact needs. This saves time for healthcare professionals because it would take a human personal trainer much longer to evaluate all aspects of a person’s fitness and develop an appropriate training plan.

Robotic Personal Trainers do not put stress on muscles and joints, and, since each training plan is tailored to each person’s level of fitness and ability, there is no risk of over-training or inappropriate training.

References

1. United Nations – Global Issues – Ageing

2. Population ages 65 and above (% of total population)

3. Face challenges of a shrinking, aging population

4. Super aged countries: what policy makers can learn about ageing well

5. Ageing and health expenditure

6. Resistance Training for Older Adults

7. Why Lifting Weights Can Be So Potent for Aging Well

8. Can progressive resistance strength training reduce physical disability in older adults?

9. Physical exercise can improve cognitive function in adults over 50 years of age

10. Morning exercise can improve decision-making across the day in older adults

11. Effectiveness of treatments for depression in older people

12. Basis for a Swiss perspective on fall prevention in vulnerable older people

13. Sarcopenia as a risk factor for falls in elderly individuals

14. Exercise and Type 2 Diabetes

15. Cardiorespiratory Fitness and Stroke Mortality in Men