The Current - Want to age well? A prescription for exercise might help

Episode Date: February 10, 2025

Doctors should prescribe exercise to elderly patients more often in order to stave off chronic conditions and mortality, according to a recent study. We hear from a 93-year-old, her trainer and the study’s author about why age and frailty are a reason to keep moving, rather than avoid exercise.

Viking. Committed to exploring the world in comfort. Journey through the heart of Europe on a Viking longship with thoughtful service and cultural enrichment on board and on shore. Learn more at Viking.com. This is a CBC Podcast. Hello, it's Matt here. Thanks for listening to The Current, wherever you're getting this podcast. Before we get to today's show, wonder if I might ask a favour of you if you could hit the follow button on whatever app you're using. There is a lot of news that's out there these days.

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And on to today's show. Harry Renault has been active his whole life. Mostly it was for fun. Now he exercises for a different reason. He's 86 and his doctor says he has symptoms of Parkinson's. I don't do fitness, I don't do workouts now. I don't exercise for fitness anymore. Right. Too old for that. I've been there, done that. But it's already been a little while. That's why I'm here. Vincent does a good job for me.

Our producer, Emma Poska, joined Harry and his trainer, Vincent D'Aleo, at a gym in Stouffville, Ontario, north of Toronto Vincent runs Harry through a series of resistance exercises It's hard work, but Vincent says that it helps Harry and he helps him through the moves First of all, I've always been an athlete. I've always played tennis and golf You know, I was a back rink backink, wintertime back rink hockey player. And then in my senior life I played golf, a lot of tennis. And two years ago it started hurting. I'd take pills for aches and pains at my golf game, which I didn't enjoy. Just progressively got worse.

What does this exercise do for you? Well, first of all it's the commitment to come and get it done because otherwise if I didn't do it I would just be curling up like a petzel and I just fell in love with it. I love it. What do you like about it? It's easy. You just called it torture. It's easy torture believe me. So I come because if I didn't come I don't think I'd be able to walk. I'd be riding a wheelchair by now. Inhale.

Vincent's next client is Anne Summers. She's 93. Yeah, press it. Exhale, that's it. And look up and down. Inhale, exhale. I've always exercised, even when I was younger, when my kids were little. It does feel like I'm more mobile this way because I used to do maximum effort day for

the waistline. My kids were running around and I cracked one poor kid on the head. Yikes, that can happen sometimes when you're working out with kids under foot. A paper published in the Canadian Medical Association Journal last month says that doctors should prescribe exercise more often, especially to their oldest patients. That that physical activity as you age can help with more than 30 chronic diseases and reduce mortality. We'll talk more about that in just a moment. First, I'm joined in studio by physical trainer Vincent DeLeo and Anne Summers is on the line from her home in Stouffville. Good morning to you both. Good morning. Good morning. Anne, we heard you exercising there with Vincent.

Sounded like hard work. Tell me why you do that. Why do you exercise? I exercise because I've done it all my life and I do physically march around the house every day after every meal, not immediately after. And it's helped me a lot. And I did break my hip and had surgery on Halloween of 23. I'm actually walking without a walker and I still exercise. You sound pretty fit. No, I'm okay. Like I have medications because I had atrial fib. I was diagnosed with severe spinal stenosis and that caused sciatic pain. You said that you were always active. What role has exercise played in your life over time?

Well, it's always been part of my life. Like it's not maybe, you know, when I was younger, I did more exercises with programs that were on TV. After my first child, they didn't want you to be in the workforce, so I stayed home and I was a stay-at-home mom. And it's always been part of my life. You know, now since breaking my hip when it was nice weather outside, my daughter Cathy, who lives with me, took me, we walked around the the block. Don't like the cold so it's been walking inside the house now. Vincent, we heard you

with Ann there in that little clip. Tell me about the exercises that you do with her. We basically work with the gyro-tononic method to work with the seniors. What's that? It's a different type of exercise system that focuses on joint decompression, more so than just muscular strengthening. It does strengthen the muscles, but the whole point is to be able to move the body. So what are the kind of exercises that you would do to get a client like Anne to that place?

So first of all, we start with the spinal mobility portion. There's a pulley tower that is designed mechanically so that when the load is applied, it's very gradually loaded on and off. So not like the normal gym equipment where it's a very abrupt kind of like, you really got to brace your core and strengthen your muscles to move. This one allows for a very gradual movement, which is great for seniors. So we'll work on their spinal ability, decompression, some basic techniques, and then once they have that, then we apply their extremities, their

arms, their legs, their neck, and full body all together. You work with a lot of older clients. Yeah, I do. What is that like? Well, it's very interesting. I wasn't used to it before this job, but since I've been working with them, it's like talking with my grandparents every day. What have you learned?

What have I learned? I learned a lot of patience, taking time with them, learning to get rid of some of their fears that they might have about movement, some ideas they have, like they think they cannot move this way or they can't do this or they can't do that. I dispel those. I come from a dancer background as well before I started this job. And one thing I like to do with everyone is to show them that their body can move in ways that they previously thought they could not. What have you seen in terms of how your older clients have improved with this sort of exercise? Oh, they're moving so much better. Like some people, they come in walking, they're hobbling in slow.

They look like they're ready to just they're hobbling in, slow. They look like they're ready to just sit down and stay down all day. But after a few months of working with them, they're walking in with a pep in their step. And it's great. Their speech is improved. They're thinking more clearly, all these kinds of things.

And does that sound familiar? Have you seen those sorts of improvements in yourself? Yes, for sure. I agree with Vincent, for sure. I do. Like, my mind is much clearer. I'm glad that I'm still with it. But, you know, the workout that I had with Vincent, it was excellent. I felt so good after that I thought, oh, I've got to do this more often. I am so blessed, I really am. You have 32 great grandchildren, is that right? 32, yes.

Do you exercise in part so that you can keep up with them? Some of them are very far away and some of them are close, but I have, you know, I visit with the ones that are further away once a year, and even though I see, you know, pictures of them, it's so good to see them in person, and I truly believe my great-grandchildren are going to save the world. 12 I hope you're right. Tell me more… Julie I hope so. It sure needs saving.

Pete Yes. Tell me more about why you do this. I mean, why at the young age of 93, you feel that exercise is still really important for you? Julie Oh, it is because if you don't exercise and you sit around, then you don't want to get up and exercise. I mean, I'm not, you know, there are times when I think, oh, I better do my marching. And I may not really be that interested in starting, but once I've started, then I'm better, you know, I'm okay. And I think if I didn't do that, that I would be sitting on the couch watching TV and I don't wanna do that.

Vincent, that must make you really proud to hear something like that. Oh, yeah, it always does. For seniors who think, you know, I couldn't afford a personal trainer, that that's something that I'm just not able to do, what sort of exercises should they be doing just in their own home? I mean, Anne talked about marching, for example. Yeah, they should... They can easily go to any store, get a light resistance band and start training with a resistance band at home. It's that simple. And a Swiss ball would be great as well, because it can train their stability and balance, which is very crucial for older people. You don't

really need much. You don't need to go to a gym. You don't need a lot of weights. Your body weight can be just enough, especially at that age. And if there's somebody who is listening, who needs a little inspiration to get them started on an exercise routine, what would you say to them? I think it's important for seniors not to think because they're old, they can't do things. Like you can do things that you think you can't do. And with somebody like Vincent, I just think that every older person could do that. Pete Slauson That's a really powerful message. You can do things you thought you couldn't do. Ruth Bader Right. Exactly. Because, you know, I think sometimes in our mind,

we limit what we can't do and think, oh, I can't do that, I'm this old, but I never expected to live this long. I didn't want to live this long because when my husband died in 2006, I didn't want to be here. My children and my grandchildren convinced me to stay. And now that I have so many great-grandchildren that are going to save the world, I want to be here. And I thank God every day for all my blessings. There's a really good lesson in that for all of us, I think. And I'm really glad to talk

to you. Thank you very much. I'm really, really grateful that you did this. Thank you. Stay healthy as well. I mean, you're an inspiration to a lot of people in how active you are. So thank you very much. I don't know about that. Thank you very much. Vincent, thank you. Thank you. Thank you. Vincent DeLeo is a personal trainer at PT Movement in Stouffville, Ontario. He specializes in geratonics and summers, is one of his clients. She's 93 years old. Viking. Committed to exploring the world in comfort. Journey through the heart of Europe on a Viking longship with thoughtful service and cultural enrichment on board and on shore. Learn more at Viking.com.

I'm Dena Temple-Raston, the host of the Click Here podcast from Record of Future News. Twice a week, we tell true stories about the people making and breaking our digital world. And these days, our digital world is being overrun by hackers. I was just targeted by a nation state. And they range from reflective. It's a crime, bro. And I live with that every day. To ruthless.

Do you feel guilty about it? No, not really. Click here from Recorded Future News. You can find us wherever you get your podcasts. Jane Thornton is a Canada research chair in injury prevention and physical activity for health at Western University, also an associate professor in family medicine,

lead author of a paper in the Canadian Medical Association Journal that talks about the value of exercise in older people. She's also a sports medicine physician. Jane, good morning to you. Good morning, Matt. Thank you for having me. It's kind of inspirational to hear a 93-year-old talk about being active like that, isn't it? Absolutely. I'm sitting here smiling and my heart is warmed. It's just you can't do better than having a patient advocate for themselves, an older adult talking about the benefits of physical activity. It's wonderful to hear.

There's a big conversation right now around longevity and how to get older, but also how to live well in those years. You looked at the evidence around the benefits of exercising as you get older. What did you find? SHARMA SHARMA It's amazing how what we see. I've studied physical activity now for about 15 years, and the evidence continues to accumulate.

But I think what we're seeing now is that the evidence is more pointing towards the subpopulation, so the aspects of different chronic diseases and even infectious disease and so on. Across the lifespan, how we can see physical activity benefiting in these areas. I think back to about 30 to 40 years plus ago with the medical field, really, if someone had a sore back, they might be prescribed six weeks of bed rest, for example. And the tides are really turning

and we're understanding that in fact, these aspects of age, frailty or other chronic diseases, they used to be a reason not to prescribe exercise, but in fact now it's a reason to prescribe physical activity. And I think that's the real positive message that's coming through this paper. Tell me more about this. This is really interesting that, I mean,

you've written about this and spoken about it, that age or frailty or functional impairments, we used to see them as a reason not to prescribe physical activity. What has changed? Well, I think it's really about the evidence and trying to understand that as we get older, and something that's been becoming really important, I think, to Canadians and others

is this idea to stay functionally independent longer, meaning this ability to perform activities of daily living, but it's also about cognition, social belonging, quality of life. And we see that physical activity can help in each of these areas. So it used to be that we thought that older adults maybe couldn't benefit. But our body responds to exercise all across the lifespan. And those same benefits that we see at a younger age can be seen in an older adult population. And really if someone's just starting to be active, they can reap all of those benefits at a much higher curve. So it really is never too late to become active.

Just the last point on this, before I talk about some of the benefits, one of the other things that you've spoken about is how in past perhaps doctors have worried, and you've hinted at this, doctors that would worry that the benefits of exercise would be outweighed by the concerns around injury. That if somebody is frail,

or they might be at risk of falling, that doctors would not say that they need to be more physically active. Isn't that a reasonable concern to have? Absolutely, and I think part of it is understanding that exercise doesn't need to be a brisk walk or running a marathon. Even though I have patients who are in their 90s doing that as master athletes and but other people who are older who are just trying to be active for the first time, I think it's really understanding where people are at and looking at, you know, ruling out some risk factors if symptoms are controlled and we go through risk factors such as cardiac

events and things like that. We look at those when we do a medical assessment anyway. And so we're starting to just understand that physical activity is an important component of recovery, rehabilitation for many of these aspects. And sure, there's always the risk of injury, but of course, with people who are at high risk of falls, the more that we can use exercise types like Tai Chi, exercise bikes and so on. It's really about tailoring the exercise type to the risk factor or the symptoms that you're

currently experiencing. There are physical benefits to this obviously, but I mean anybody who exercises knows that there's a mental health component to this as well, that you feel better after a workout or going for a run or a walk or riding a bike or what have you. What did you learn about the mental health benefits for exercising for seniors in particular? Oh, absolutely.

It really is protective against depression and also anxiety. And I think one aspect that we perhaps value even more as we age is that aspect of social belonging. So being active with other people, being outside in nature perhaps, all of those can lower blood pressure, lower our cortisol or stress hormones, increase those endorphins or feel-good hormones that come after exercise. So I think that's one aspect that we often underestimate also with loneliness and things like that, that we physical activity in a group or outside can offer even more benefits. But as you say,

it's really it's a mind and mood booster across the lifespan and we heard it from Anne as well that her mind is much clearer after exercise. I thought that was really well said. This matters in part because we are about to become what you call a super-aged country in 2025. At least 20% of the population will be 65 years or older. We're living longer, but are we healthier? Exactly. We hope that, you know, part of a lot of what we do as healthcare researchers when we're looking at older adults is essentially what we talk about, this compression of morbidity, so that the extra years that we gain as a result of better healthcare, better food supply, and so on, that they lead to longer life, but we hope that it also, those extra years are

lived in good health. And so when we think about physical activity, that's where it also helps that we improve quality of life, improve that ability to stay functionally independent longer, to stay in your own home longer, and so on. So, I think those aspects of as we become older as a population, those things will become increasingly important. Because the concern is in the last couple of years of life, that's when you really end up using the healthcare system

to an extreme degree compared to perhaps when you're younger. Yes, that's right. One of the things that you've offered is the idea of prescribing exercise. The doctors, in addition to prescribing any number of other things, would prescribe exercise. What does that mean? Yeah, it's funny.

It's something that I think we lose sight of as physicians. And of course, I went through going through medical school and this was after doing years in research and as an athlete myself that came to sport and physical activity a lot later in life than most, understanding the benefits that we have for physical activity, but it wasn't really mentioned in medical school.

And when I found that out, I saw that across Canada, we didn't actually mention it. And I think where it starts to become increasingly important is that if we're looking at the impact of physical activity, the profound effect that it has in these 30-plus chronic conditions, as you mentioned, that it really needs to be part of the treatment strategy. So as important as a medication, as important as another intervention that we might suggest to patients in order to help with their healthcare plan. So it is after having talked to many patients and there's studies on this as well, that there is actually an impact on writing out a physical activity prescription or printing one out

and handing it to the patient so that they might be able to put it on the refrigerator or wall or somewhere to remind them that physical activity is as important often and sometimes can replace medication altogether. So we really want to, it helps us understand the legitimacy of a prescription but also patients to take home and as a reminder to them how useful and important it can be. What would be written out on the thing that you would, you know, stick the refrigerator, what kind of exercise would be prescribed? Yes, it's fun, it's part of what I love talking

to patients about because ideally it would be something that's enjoyable and then it's a shared goal that we talk to about patients. We talk about things like frequency, how often to be active, and again, that's something, what works within their lifestyle. We talk about intensity, is it moderate, is it vigorous? And we talk about the amount of time spent and the type of exercise. So that ends up being a handy acronym called

FIT, the frequency, intensity, time and type. That's just one model that people use, but it is really drilling down to the specifics. And then I also make sure that I follow up with patients to check in and see how they're doing. Give me an example. I mean, what would be a kind of exercise that somebody might be prescribed? Yeah. So for an example, maybe someone with hip pain who has osteoarthritis and maybe some other chronic conditions who's looking to become physically active, and who has probably three days a week where she can spend doing physical activity. Otherwise, she has a number of other activities going on.

So we might say, okay, well, what's reasonable to start with? We'll start frequency of three days a week. Intensity, if she's new to exercise, we might start with light or moderate physical activity. And there's a number of different scales to use that. But moderate is about, let's say, if you're walking beside someone and having a conversation with them, you could hold that conversation. If you start grunting or not being able to carry on a conversation, you're probably in vigorous intensity. And then we think about the time. And it can start at five minutes. Any movement counts. think about the time, and it can start at five minutes, any movement counts. The guidelines would suggest worldwide, something that we all agree on as physicians, is that you're

looking at about 150 minutes a week, and that's about 30 minutes a day, if you want to break it down that way. And that's enough to get the benefit out of this. Exactly. The full benefit for health. You can go more than that, but it is really, of course, a place to start. And then the type, just to – I mean, it could be swimming that has less load on the hip. It could be aerobics in the pool. I find that a lot of – and there's evidence, good evidence for this, but for people with hip pain or osteoarthritis, using Nordic walking poles can really alleviate, so they can go for their brisk

walk and still use those supports. So it's really trying to find solutions and help them think creatively about exercise that they can find enjoyable and safe. Do you think our public health care system should pay for things like that? Should pay for those Nordic poles? Should pay for people to go to see someone like Vincent, a personal trainer, to get them even more of the benefit that that exercise could provide. Yeah, I think we could do a lot more, couldn't we, from a preventive of health care aspect? I do think, you know, it's, I understand that there's a lot of barriers financially for people, particularly older adults, in trying to access exercise, and that's why we try

to make it as simple as possible. So in that, if they can only speak to a physician and it's covered by their health system, then we can look at incorporating some things as Vincent suggested with exercise bands. You can also use tomato soup cans as resistance, as barbells, all sorts of things that, again, there are videos on using these different aspects and trying to be creative. I really endorse the community of practice. So if there are physiotherapists, kinesiologists, exercise scientists, personal trainers, there's a whole host of people out there that can

help. But I really try to meet patients where they're out at and understand their financial barriers so that we can work within the system that we have. But of course, improving access to physical activity would be a welcome addition. Is it ever too late to start? I know, I don't think so. I think our bodies continue to respond, we continue to reap benefits at all ages. And when we look at the global effects on mobility, cognition, quality of

life, social belonging, I think the answer is clear. As you say, the best person to talk about the benefits of exercise are the people that are doing it, patients like Anne who have shown how life-saving it can be. So it's really about not just adding years to our life, but higher quality of life to those years. Dr. Jane Thornton, this is really interesting. And again, a good guide to how to age well, I think, which is all something that we're looking for. Thank you very much.

Thanks for having me. Dr. Jane Thornton is a Canada Research Chair in Injury Prevention and Physical Activity for Health at Western University, and Associate Professor as well in Family Medicine, and the lead author of a study that calls for exercise to be prescribed to seniors. As you get older, how are you staying active?

What are you doing to get active in your older years and how has that helped you? You can let us know. Email us, thecurrent at cbc.ca.