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INSPIRE: Beginning the Physical Dimension

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The Facts: Wellness in the Active Aging Adult

• About 12% of the population (28 to 30 million people) are 65 years of age or older

• The 75 years and older group is now the fastest growing segment of the population

• The average age of those in nursing homes is 82 to 85 years and most have four to five chronic diseases

• 71% of older men live with their wives and an additional 7% live with their children

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The Facts: Wellness in the Active Aging Adult

• Only 36% of the older women live with their husbands and 18% live with children or relatives

• Only 30% of the older adult population lives alone

• Most older adults are not socially isolated and most stay socially active

• 75% are members of a church or synagogue

• 50% belong to volunteer organizations

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The Facts: Wellness in the Active Aging Adult

Only 5% of the of the older adult community is in a skilled nursing facility, this obviously means that 95% of those individuals are still

active citizens within their communities. These active aging adults need to have the opportunities to have their quality of life enhanced by multi-dimensional wellness

services.

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Multiple Dimensions Of Wellness

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MYTHS, STEREOTYPES, BARRIERS

• Negative consequences of aging are inevitable

• High intensity exercise is not for older adults

• Older adults cannot get stronger or faster

• Strength training will injure older adults

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MYTHS, STEREOTYPES, BARRIERS

• Fear of injury

• Fear of falling

• Not knowing what to do to get started

• Not having a place to exercise

• No experience with exercise

• Takes too much time

• Exercise causes incontinence

• Exercise has to be a formal activity

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Differentiate normal aging from changes that occur due to inactivity

Cardiovascular/pulmonary

Musculoskeletal

Neuromuscular

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FUNCTIONAL REQUIREMENTS FOR COMMUNITY-LIVING OLDER ADULTS

• 1000 feet required to complete an errand in the

community 3x

• Turning around

• Negotiating floor/surface transitions

• Gait speed of 3 miles/hour

• Need to carry an average of 7 lb package

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OLDER ADULTS and FITNESS

• Of community dwelling older adults over 75:

– 16% could not lift 10 pounds

– 21% could not walk up 10 steps without stopping

– 29% could not walk 1300 feet

– 28% could not stoop, crouch, and kneel (Vital & Health Statistics National Health Interview Survey 2002

www.cdc.gov/nchs/nhis.htm)

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The good news is..

All of these changes can be improved with exercise!!!!

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TYPES of EXERCISE

• Aerobic/Endurance

• Balance

• Flexibility

• Strengthening/Resistance

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Aerobic Exercises

• Walking, brisk walking, mall walking, treadmill

• Elliptical trainer

• Exercise bicycle (regular, stationary, recumbent, upper arm ergometer)

• Swimming/water aerobics

• Steppers

• Jump rope

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How much and how long?

• Ideally, aerobic exercise should be at least 20-40 minutes long

– Cumulative or continuous

• Minimum 3x/week

• Intensity: should breathe hard but still be able to talk

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BALANCE EXERCISES • Balance exercises move you outside your comfort

zone

• Activities may include

– Narrowing your base of support

– One legged stand

– Standing and moving your head side to side

– Standing with eyes closed

– Standing on uneven surfaces

• Do once a day for a minute

• Progress to 5 minutes

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FLEXIBILITY

• Flexibility is stretching

• Hold each stretch for 30-60s

• Do each stretch 3-4x

• You should feel a little uncomfortable but no pain

• Do not bounce!

• What to stretch: shoulders, chest, calves, hamstrings, hips

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STRENGTHENING EXERCISE

• Requires resistance and should include upper body, lower body and trunk – Weights or a heavy object to lift

– Body weight

– Elastic bands or tubing

• Should be done 2-3x/week on non-consecutive days

• 8-12 repetitions

• Last repetition you do should feel like the last repetition you can do

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Physical Activity Improves Physical Function by:

• Improving balance and reducing risk of falls

• Keeping bones and muscles strong

• Improving endurance and range of motion in joints

• Helping to maintain a healthy weight

• Improving sleep

• Helping to regulate blood pressure,

cholesterol, and blood sugar

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Physical Activity Improves Intellectual Function by:

• Helping maintain cognitive function (e.g. memory and concentration)

• Increases blood flow to the brain

• Decreasing stress and anxiety

• Improving mood

• Reducing depression

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Physical Activity Improves Social Function by:

• Increasing independence

• Creating a stimulating, and often supportive, environment

• Improving family time

• Increasing social networks and involvement

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Physical Activity Improves: YOU! • Helps maintain independence

• Improves quality of life

• Improves health

• Increases energy

• Reduce the use of health care resources

• Useful to help individuals avoid institutionalization or a higher level of care

• Prevent disease and injury

• Manage disabilities

• Deal with chronic illness

• Prevent untimely deaths

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Exercise Essentials

• Good shoes

• Fun or appropriate music- books on tape

• Free weights

• A positive attitude

• Comfortable clothing

• Lots of water

• A supportive sports bra

• Safe, well-made equipment (e.g., cardio machines, heart-rate monitors

• Enough time

• A workout partner

Advocate For the Intellectual Dimension

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Let’s get right into it!

THE MILLION DOLLAR QUESTION

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Is Memory loss a normal part of getting older?

ABSOLUTELY….

NOT!

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Memory as we age

Although we can not control some of the physiological changes that occur within our brain, memory problems and dementia are NOT a normal part of aging! There are several things we can do throughout our daily lives to improve memory and significantly reduce the risk of having any issues all together.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Today’s Presentation

• We will take a very holistic and interconnected approach, discussing a myriad of factors that affect cognition as we age (e.g., cognitive exercise, physical exercise, and nutrition).

• We will discuss several practical ways older adults can maintain their cognitive and social well-being.

• We will understand the Bottom line. Which is, “There are numerous behavioral and lifestyle changes that can and will have a significant impact on the likelihood of developing dementia”.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

A Holistic Approach

Besides age, what determines whether or not we have good memory abilities in older adulthood?

• Genetics (50%)

• Cognitive stimulation

• Other health conditions

• Stress

• Good sleep

• Social support and engagement

• Proper nutrition

• Adequate physical exercise

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How Can I Tell if my Memory Problems Need Attention?

A memory problem is serious when it affects your daily living.

Everyone has experience with memory issues. If you sometimes forget:

• Someone’s name

• To buy a food item at the store

• A Phone number

• An anniversary or birthday

• Where you left your car at a parking lot

• Where you left your keys

• Forgot to take your medications

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How Can I Tell if my Memory Problems Need Attention?

Some forgetfulness is normal.

You may have a more serious problem if memory loss is persistent and you have trouble remembering how to do things you've done many times before, getting to a place you've been to often, repeating phrases or stories in the same conversation, or not being able to keep track of what happens each day.

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What to do about it….

• Participate with Cognitive Exercise and Cognitive Stimulation

• Get Regular Physical Exercise

• Improve Diet and Nutrition

• Engage in Activities Socially

• Manage Stress

• Improve Sleep Habits

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Memory Ability Increased after Three Months of Cognitive Enhancement Training

RiverMead Behavioral Memory Test

(Extended)

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50

55

60

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Time 1 Time 2

Time of Testing

Score

on

RB

MT-E

Cognitive Enhancement

Control Group

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Cognitive Stimulation

What are some ideas that you can do every day to stimulate your brain?

Here is a list….

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Cognitive Stimulation

1. Read a book

2. Order a subscription to a newspaper

3. Do crossword puzzles

4. Participate in a Wellness class

5. Join a club or other organization

6. Visit with friends

7. Take a class at a community college

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Cognitive Stimulation

8. Go to a sporting event

9. Try to develop a new hobby

10. Take different routes to frequent destinations

11. Go to a different grocery store

12. Take a trip to a new place

13. Go dancing or take a dance class

14. Begin using email

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Cognitive Stimulation 15. Volunteer

16. Write a letter

17. Join a book club

18. Try learning a foreign language

19. Part time job

20. Gardening - consider becoming a master gardener

21. Read new magazines

22. Listen to the radio

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Exercise and Cognition

• Kramer et al. (2001) found that participating in a six month walking program led to increased attention in 60-75 year old adults.

• Colcombe & Kramer (2003) found that executive functioning improved more than straight memory functioning.

• The ability to pay attention to relevant stimuli is correlated with cognitive ability in older adults. It appears that exercise affects this ability.

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Physical Activities

• Brain needs blood flow!

• Exercise will do this!

• Study: Subjects who regularly do aerobic exercise perform better on cognitive tests than sedentary individuals of the same age.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Exercise and Cognition

• Scarmeas et al., (2009) found that older adults (mean age 77 years) who were in the top third in terms of getting physical exercise were 61% less likely to get dementia

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© 2010, Dr. Rob Winningham

All Rights Reserved�

What type of exercise is best?

• A mixture of aerobic and strength (or resistance) training

• Liu-Ambrose et al. (2010) reported that either once-a-week or twice-a-week resistance training sessions for 12 months led to improvements in older adults’ cognition and attention.

– 11% improvement for once-a-week

– 13% improvement for twice-a-week

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Nutrition and Cognition

• Eat well!

• Manage Fat intake

• Increase Antioxidants

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© 2010, Dr. Rob Winningham

All Rights Reserved�

“Good Fat” • Omega-3 fatty acids or “good fat” has been

linked to improved cognitive functioning in older adults.

• Fish (fish oil), nuts, olive oil, canola oil, and green leafy vegetables are high in Omega-3 fatty lipids.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

The American Journal of Clinical Nutrition (2009)

Albanese et al., (2009) studied 15,000 people in Latin America and Asia found that those who ate fish nearly every day were 20% less likely to get dementia as compared to those who ate it only a few times a week. Those that ate fish a few times per week were 20% less likely to get dementia than those who rarely ate fish.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

Antioxidants

• Over time, our brain cells experience wear and tear from various oxidants known as free radicals (as well as cell division).

• Our bodies use antioxidants to combat the effects of free radicals.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

The Top Antioxidant Fruits and Vegetables

• Food Antioxidant Power • Prunes 5770 • Raisins 2830 • Blueberries 2400 • Blackberries 2040 • Cranberries 1750 • Strawberries 1540 • Spinach 1260 • Raspberries 1230 • Brussels Sprouts 980 • Plums 950

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Good Sleep Habits

Sleep is necessary for memory consolidation.

Sleep disorders like insomnia and sleep apnea leave you tired and unable to concentrate during the day.

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© 2010, Dr. Rob Winningham

All Rights Reserved�

What did we learn? • Participation in cognitively stimulating activities is

associated with improved memory and a decreased likelihood of developing dementia.

• Cognitively stimulating activities may delay the need for more intensive care.

• Proper exercise and nutrition is critical for enhancements with brain function and memory.

• Social support and social engagement is important for physical, cognitive and mental health.

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Long story short….

Medical research has proven that participation in brain fitness and physical activity along with improved diet and socialization WILL help you “Build (and Keep) Your Memory”.

Thank you so much!

Questions??

Serve With Wellness

Opportunities

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Wellness Program Description

• Wellness is often difficult to define and often means something different to everyone.

• “Wellness” is a dynamic process by which individuals become conscious of, and make choices towards, a healthier lifestyle.

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Wellness

American Physical Therapy Association defines “wellness” as:

A lifelong interactive process of becoming aware of and practicing healthy choices to create a more successful and balanced lifestyle.

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Defining Wellness • The objective of a wellness program should simply be to

provide an environment of activities, consultation, and education that allows individuals the opportunity to reach their health and well-being goals.

• The approach should attempt to integrate a multi-dimensional model across available resources within an organization. We maintain a desire to motivate, assist, and support individuals to stay healthy and fit across the physical, occupational, social, spiritual, intellectual, and emotional dimensions of Wellness. In other words create “Optimal Health”.

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Location Specificity:

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Program Components:

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Growth/Change Plans:

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OPTIMAL HEALTH

Optimal Health is defined as the balance of physical, emotional, intellectual, social, occupational

and spiritual health

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Multiple Dimensions Of Wellness

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Physical

• Regular physical activity

– Strength, Flexibility, and Endurance

– Safety

• Knowledge around diet and nutrition

• Ability to monitor your own vital signs

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Occupational

• Enrichment in ones life through work, hobbies, and activities

• Contributing one’s skills and talents

• Convey values through involvement

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Social

• Contribution to one’s environment and community

• Good communication between those around you

• Sense of community

• To have “FUN”

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Spiritual

• Search for meaning and purpose

• Non Denominational

• May consist of Meditation

• Looking “inward” - Reflection

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Intellectual

• Stimulating mental activities

• Use activities and education to maintain or improve abilities

• Explore problem solving, memory, creativity

• Explore history as well as current events

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Emotional

• Acceptance of one’s feelings

• Manage one’s feelings and behaviors

• Assessment of one’s limitations and the ability to cope effectively

• Stress Management

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Wellness Program Offerings

Wellness Program offerings are multi-dimensional. The intent is to offer a wide array of opportunities for individuals to access wellness products.

• Educational Opportunities – “Wellness University”

• Consultative Services, 1:1

• Wellness Activities / Classes

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Program Update • EnerG Wellness program offerings throughout

the campus – Wellness University: Education (over 120

educational opportunities) • Relieving Arthritis, Eating Well as We

Age, Home Safety Tips, Low Vision Facts, Osteoporosis, Medication Management, Walking Your Dog Safely

– Consultative Services • Personal Training, Home Safety

Assessments, Low Vision Assessments, Medication Management, Diabetes Management, Weight Loss, Nutritional Consultation, Health Screening

– Activities/Classes (over 70 class options) • Balance Management, Stretch and Tone,

Nutrition and Weight Loss, Senior Yoga, Arthritis Class, Brain Fitness, Relaxation, and much, much more.

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Why Wellness?

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Wisdom:

• “The one who says it cannot be done should never interrupt the one who is doing it”

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Program Growth – Opportunities

• Medically Oriented Gym – MOG

• SNF “Activities / Rec. Therapy” Service

• Employee Wellness

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Thank You!

Questions?