How to Stay Active as You Age
We hear so much about the importance of staying active as we age and staying active for a good healthy weight, but there are so many other benefits.
Dr. Steven Montague, a concierge primary care physician at Evergreen Signature Care, shares those benefits plus tips on how he motivates his patients to start – and stick with – an exercise program.
Why is it even more important to exercise as we age...and what are some of the other benefits?
Dr. Steven Montague: If I were to compile a top 10 list of the reasons why you want to stay active as you age, I would put weight loss towards the bottom. It wouldn’t even make the top five because there's so many other very important benefits to staying active.
Multiple studies have confirmed that if you take a group of older people and you break them down into the exercisers and the non-exercisers and you study them over a say 10 year period, all-cause mortality is decreased in that group of exercisers. That means that death by all causes is less in the exercising group than in the non-exercising group.
Not to mention the decreased risk of cardiovascular disease, stroke and certain kinds of cancers such as breast, colon and lung cancer. So there's a lot of good reasons other than maintaining a healthy weight to exercise as you age.
What tips and ideas do you have for helping your patients get started and stay motivated?
Dr. Montague: Probably the first thing I share with them is that of all the people that begin exercising and stay exercising, about 75% of them do it at the beginning of their day. That’s often times the last part of our day where we have control. You go on about your day, and often times you're at the beck and call of other people. If you're still working, you go to work and then you completely lose control of your day. So start out by exercising at the beginning of your day when you still have control.
I also try to personalize it. It’s important to try to find out what motivates a person. It might be that maybe they want to try and keep up with their grandkids. Maybe they want to have the endurance that’s required to take their kids to Disneyland or go for a walk in the park or just even pickup grandchildren.
Also, what motivates them? Some people, myself included, really enjoy listening to music when we exercise. Others like listening to books on tape; you can learn so much and kind of multitask as you listen to books on tape while you exercise. Podcasts are also great to listen to while working out. Certainly if you're doing cardiovascular work and you're going for a walk on the trail or you're on a treadmill or whatever, it’s really easy to be listening to a book or listening to a podcast or just enjoying great music. For others, getting out in nature and that’s the thing that really turns them on to exercise and keeps them going.
I find rewards are very helpful. Even older people are basically just big kids. Having a reward really helps perpetuate the whole exercise thing. Sometimes it can be just minor rewards. I was talking to a patient who we were trying to get her to exercise. Finally she just on her own found this Fitbit. Every once in a while if she walked for a certain amount of steps, the Fitbit would tell her, for instance, that she’s crossed the Sahara Dessert or whatever. The number of steps she’d taken would be enough to get her across the Sahara. Now five years later, she’s walked around the world actually because she gets these little messages from her Fitbit of how far she’s walked and how well she’s done with her exercise program. Some people buy themselves little treats. It might be a new book or a new piece of music or meet a certain goal and go on a trip with the family. There are lots of things you can do.
The other thing, of course, is find a good form of exercise that you really enjoy. It might be swimming, or it might be hiking, or it might be dancing. In our concierge practice, we try to do things to encourage our patients to exercise. We have a full time yoga teacher on staff. She teaches two yoga classes for our patients. We have a health and wellness coach who has masters level training in both exercise physiology and nutrition so she can help. I just found out she was actually on the ballroom dance team in college. So now we’re doing some ballroom classes for our patients just to get them active.
One other thing we do to just keep them going—and any medical practice can do this—is once a month we just have this walk with your doc thing where anybody who wants to can come and meet me and my partner and we just go for a half hour walk. It could be on a trail; it could be anything. Just encouraging people to get up and get moving. As we all know, sitting is the new smoking. So we’re trying to get people up and moving.
So besides exercise, what about the importance of social interaction? As people age, they can get lonely. Children and grandchildren live far. There is Facebook and Instagram, but do we get the same benefit from these online social interactions?
Dr. Montague: I wish there was research to give you a definitive answer on that but there isn't. My personal opinion after 27 years of practice is that it’s not the same. You lose a lot when you're looking at someone’s Facebook posts. First of all, it’s not in real time. Second of all, it’s tough to get all the inflections. If we’re talking face to face, I get even a ton more information about how I think you're feeling and how I feel you're thinking about certain things. I can look at your facial expressions. You just don’t get that with social media. I think it’s a poor substitute for socialization.
Socialization, of course, is another way to get back to motivation. Some people really like to do their exercise in groups. You can get the benefit of that socialization as well as your exercise when you find a team of people that exercise together.
The whole idea of getting that social contact has been shown time and time again to correlate with reduced risk of dementia and especially Alzheimer’s type dementia and cognitive decline. So I think it’s important to have that social interaction. I'm not totally sure that you're going to get the kind of social interaction you need if you just rely on social media. Now, of course, social media has it’s benefits. I would also encourage my patients to have face to face time with another human being because I don’t think there's any replacement for that.
If you could give us just one piece of advance on something we can do today to get started, what would it be?
Dr. Montague: I tell my patients that five minutes of exercise is better than zero minutes of exercise. Getting five minutes of a walk or five minutes on the treadmill or the stationary bike, that’s better than zero minutes. I told that to a patient the other day and they said, “Woah, I never thought of that.” It’s like they think it's all or nothing. That’s not the case. You just go out and get started. Pretty soon five minutes turns into seven and seven turns into ten. Then you start to feel stronger. You get not a vicious cycle, but a virtuous cycle going where rewards builds confidence builds more success builds more rewards and you spiral upward instead of downward.