safe summer exercise for older adults with chronic conditions: how to be 'mindful' of your body’s needs
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older adults often have less fluid stores, do not feel thirst as much and experience less sweating, making it much harder to exercise in the heat safely.
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exercise is vital for older adults. according to a research article, move more, age well: prescribing physical activity for older adults in the canadian medical association journal (cmaj), it can help encourage functional independence, help manage or prevent chronic conditions and keep people healthier longer.
“i always say to my patients, move it or lose it,” said dr. samir sinha, geriatrician and clinician scientist, who was part of the research.
but how do you ensure that you get enough exercise in the summer months when the heat, which can make it easier to engage in physical activity outdoors, can be a drawback?
“we know that some of these mechanisms that we rely upon to help us regulate our temperature, our internal body temperatures, they don’t work as effectively as when we were younger,” said dr. sinha.
for example, older adults tend to have a decreased sense of thirst, so staying hydrated isn’t always as easy because their bodies don’t alert them to dehydration as well. they can also experience overheating due to a diminished sense of heat, so they don’t know how hot they actually are because of differences in how the body functions with age. age is also associated with lower overall body fluid, making these factors dangerous when it comes to heat.
“when you don’t have as much fluid circulating around your body, you can’t effectively sweat as much as, say, a younger person could,” said dr. sinha.
when you add in chronic conditions, things only get more challenging from there.
how chronic conditions affect exercise in older adults
as age-related changes make it more difficult for older adults to regulate body temperature and thirst cues, exercising in the heat can be more dangerous. but compound that with chronic conditions, and “older people have a few things kind of stacked against them.”
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there are many chronic conditions that can make it more difficult to exercise without the heat, but when heat is added into the equation, it makes it all the more difficult. for example, older adults have lower muscle and bone mass as a normal part of aging, but when a person experiences arthritis or another chronic illness that causes pain or fatigue, that weakness can feel next-level.
respiratory conditions can limit lung capacity, like emphysema or chronic obstructive pulmonary disease (copd), which can make it hard to exercise efficiently. circulation can also be affected, which limits how much oxygen makes it around the body, in conditions such as diabetes. diabetes may also lead to nerve damage that hinders physical activity as well.
“many chronic health issues can affect our ability to stay active and engage in exercise,” said dr. sinha. “exercising is more challenging for older adults in the first place, and then doing it particularly in the heat, where you may not have the same levels of reserve and response mechanisms that younger people have.”
the dangers of heat for older adults
heat can be detrimental for many people, but older adults in particular are the most likely to experience worse health outcomes.
“a number of heat waves that have been occurring in europe and elsewhere, i’ve seen stats that show that 90 per cent of the people who’ve been unfortunately dying during these heat waves are actually older adults,” said dr. sinha.
“most of the casualties that are happening due to heat, you know, heat stroke and these other things aren’t necessarily happening outside and not due to older adults running marathons in the heat. ninety per cent of the deaths that are happening in the heat are actually happening in people’s own houses.”
so, if the heat reaches dangerous levels and the physical body isn’t equipped to alert a person to what they need to regulate their temperature, even inside, exercising on top of that is throwing fuel on the fire.
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when does the heat become dangerous? above 26 degrees, noted dr. sinha.
“having an environment where that temperature is creeping above 26 degrees, for example, in your own household, that’s where you start seeing the real negative impacts of heat in an older person.”
but since physical exercise is so important, knowing which temperatures are too high, as well as ways to avoid the heat while still being active, is crucial to overall health in older adults.
minimizing heat risk while staying active
one of the most important aspects of both combating heat-related illness and complications and adequately exercising is, “first and foremost,” staying hydrated and getting enough fluid.
then you have to be aware of the temperatures and the dangers, and plan your routine accordingly. for example, dr. sinha notes that for older adults who get their physical activity from long walks and want to continue their routine, but it’s well above that 26-degree threshold, changing where they walk is a good way to go.
“go to a mall, for example, and walk in an air-conditioned space where you also have ready access to water fountains and other things to stay hydrated,” he said.
indoor fitness classes geared toward older adults are also available in many places and can be great options for people who want to continue their routines without exposing themselves to dangerous heat.
that said, if exercising indoors isn’t possible, changing when you exercise outdoors can help, too.
“maybe earlier in the morning, maybe later in the evening, so you’re not doing it at the peak heat, during peak temperatures,” said dr. sinha.
when it comes to the best form of exercise in the heat, there is no single golden option. it’s about choosing the exercise that you’re able to do and, more importantly, the type of activity that you want to do.
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for older adults, low-impact options are always best, depending on their fitness level, such as chair yoga and tai chi, especially when it’s hot out, since it’s easier to overheat when you’re exerting yourself. dr. sinha also mentions swimming at an indoor pool as another great, low-impact option.
however, some conditions that affect the cardiovascular or respiratory systems may call for a more strength-based approach. it depends on a person’s condition and what would be best for them.
“for example, someone who has osteoporosis, we recommend strength training and balance training. someone who has falls, we want to make sure that we’re working on their balance and we’re working on their strength,” said dr. sinha. “i always say if you’re not sure what type of exercise would be appropriate for you, best to speak to your healthcare provider to see if they can give you some guidance.”
but it’s more about being cognizant of the heat and a chronic condition that can make things harder, rather than the exercise, when it comes to staying safe while being active this summer—especially because heat illness isn’t always obvious.
“it’s just being really practical and mindful because what i find is that for older people in particular, what’s deadly about the heat is the consequences tend to sneak up on people,” said dr. sinha. “people say i feel fine one minute and then all of a sudden they’re having heat stroke the next.”
there are no general guidelines on exercising in the heat “other than being really mindful of the strenuous nature of the exercise that you might be performing,” notes dr. sinha. but even without guidelines, knowing how vigorous the exercise is and paying attention to the heat are the best ways to ensure you give your body what it needs to stay healthy without putting your health in danger.
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“people often underestimate how hot it is outside, so it’s just being more actively conscious that we’re not built as well as we were when we were younger; there are things that make us more vulnerable,” said dr. sinha.
“that’s why we have to stay on top of our fluids. that’s why we have to be mindful of our chronic health issues and just our older bodies and just be more mindful of what we’re doing outdoors in the heat or indoors in the heat as well.”
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