Exercise for oldies - is it worthwhile?

How do we motivate older people to get off that couch? This is a challenging task for health workers in the pandemic where people have an increasingly sedentary lifestyle. Is regular exercise for older adults healthy and safe, and what is the best recipe or guideline for exercise?

This recently published report in the European Heart Journal from Trondheim, Norway, does not answer the question about how to motivate older adults for exercise. The research group, under the leadership of Jon Magne Letnes, performed a huge randomized controlled study comparing the effects and safety of five years of supervised exercise training (ExComb) twice a week; i.e. high-intensity (HIIT) and moderate-intensity continuous training (MICT) with a control group in 1567 men and women aged 70-77 at baseline (1).

The participants were healthy and able to exercise. The HIIT session aimed at 90% of peak heart rate, the MICT at 70% peak heart rate (together they were ExComb), and the control should follow national physical activity guidelines. The outcomes were a cardiovascular risk score, individual risk factors and peak oxygen uptake (VO_2peak). ExComb and the control group achieved similar cardiovascular risk score and VO_2peak. HIIT showed higher VO_2peak and some better individual risk factors than the control group. Effects were similar in both sexes and the number of cardiovascular events were similar in the three groups. No adverse events occured during the intensive training sessions. The researchers concluded that this healthy and fit group of older adults in one community with contamination of exercise habits between the groups, probably made it impossible to achieve significant differences between the groups.

In an accompanying editorial, Mai-Lis Hellénius concludes that the study results need to be interpreted in the light of the population effects, because many cardiovascular risk factors were improved during the trial. Even small reductions in the individual risk factors at the population level would provide major health benefits (2).

We need to find new, effective methods for exercise in older adults to motivate them. Exercise is worthwhile, it is healthy and safe, and should be fun, enjoyable and possible as well. This challenge is particularly relevant not only for health professionals, but for public health officers, politicians and stakeholders who are planning our environments and communities (3).