Tuesday, March 16, 2010
Find a way to exercise safely
Dr. Michael Camardi
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About Dr. Michael Camardi
Dr. Michael Camardi is a geriatrician at Carilion's Center for Healthy Aging. Age Matters is his new Roanoke Times column, appearing the third Tuesday of every month.
Camardi has been with Carilion for about three years and was one of the experts who reporter Beth Macy spoke to for her series, “Age of Uncertainty.” He wanted to start this column to help answer questions he’s often heard as part of his job.
Camardi was founder and past medical director of the geriatric liaison program for Jacobi Medical Center (Albert Einstein College of Medicine) in Bronx, N .Y.
Camardi trained at Winthrop University Hospital (Stony Brook University Medical School), where he was chief medical resident. He has received numerous commendations for his contributions to education, patient advocacy, community relations and hospital administration.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014, or e-mail them to extra@roanoke.com with “Age Matters” in the subject line.
Dear Dr. Camardi:
I'm 77 and I was watching TV where they said that if you're older than 50 and you're not doing some exercise that you're letting your brain and your body rot away.
Well, what do they want me to do? They were selling these rubber band things to pull and stretch and so on, that didn't look all that hard so I don't know what that's going to do.
And another thing, with my back and legs all full of the arthritis the way they are, why should I do it at all if I hurt so bad as it is?
-- Bent Mountain
Thank you for really bringing together, in a very human way, the struggle to reach a common-sense approach to geriatric exercise.
First things first: Discuss with your provider your desire for an exercise program and work closely with him or her to do one safely.
Next, find an exercise program that lets you exercise without pain. To get the help you may need, I would join the local YMCA and work with the good people there and seek their professional advice on finding a regimen that gives you cardio-conditioning, muscular strength and flexibility without injury.
Some key points: Please do not think that in order to get the benefits we will discuss that you have to buy expensive equipment. The good news is that when you begin, for the price of a pair of properly fitted sneakers, these benefits can be achieved.
The other issue is what "mild, moderate or intense physical exercise" means to a geriatric patient. The answer is: Nobody really knows.
Exercise tolerance has so many variables to it in age, gender, medications, co-morbid diseases, weight and substance use and abuse history, that health care professionals have had trouble defining different exercise levels.
My rule of thumb is this: It should be vigorous enough to make you feel good while you are doing it and easy enough to make you want to go to the next challenge level. Finally, in order to gain any real benefit, you must be consistent.
What I have seen in my practice is that patients who find the right exercise routine tend to do it every day. My best advice is to do some form of exercise every day.
With this background in mind, I would like to present the findings in last month's Archives of Internal Medicine, where researchers in Germany found an important correlation between exercise and maintaining cognition, or the ability to reason in situations.
In an observational study, 3,903 patients in various stages of cognition were followed over a two-year period. One group did moderate exercise -- defined as periods of one to three sessions (lasting at least 20 minutes a session) per week -- that worked the large muscle groups (walking, hiking, etc.). A second group did high-activity exercise with sessions of three or more per week. The third group did no exercise at all.
The conclusion of this study was that exercise lowered the incidence of cognitive decline by more than 50 percent (in both exercise groups) over those who did no exercise -- meaning the more you exercise, the more you will preserve your ability to think.
Those who did not exercise showed steady decline each year they did not exercise. Let me point out that these benchmarks were achieved without drugs, fad diets, etc.
By exercising your body to maintain its function, you will preserve your mind's agility and allow you to continue to enjoy the world around you while those who are "leaving a deep dent in the La-Z-Boy" may be losing theirs.
So this is the great news for all of us: Get up, get out and keep going!
Dr. Michael Camardi, assistant professor of medicine of the Virginia Tech-Carilion School of Medicine, is a geriatrician at the Carilion Center for Healthy Aging. His columns run on the third Tuesday of each month in Extra.
If you have questions for Dr. Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014 or e-mail them to extra@roanoke.com with "Age Matters" in the subject line.
