Testimony

Statement by
Judith A. Salerno, M.D., M.S.
Deputy Director; National Institutes of Aging/NIH/HHS
on
Fitness and Nutrition: The Prescription for Healthy Aging
before the
The Special Committee on Aging -- United States Senate

March 11, 2003

Thank you for inviting me to appear before you today to discuss fitness for people over 50, an issue of increasing interest to us all. I am Dr. Judith Salerno, Deputy Director of the National Institute on Aging (NIA), the lead federal agency for exercise and fitness research for older people. I am delighted to be here this morning to tell you about NIA's commitment to promoting exercise and a healthy lifestyle across the lifespan.

One year ago, I took up running and ran my first race—a half-marathon—to honor the memory of my father who died of a stroke due to high blood pressure. I also ran the race to celebrate my 50th birthday. I had the good fortune to find a coach, running partner, and role model, Dixon Hemphill, who at age 77 is fit and active.

I felt elated when I crossed that finish line with my family and my coach cheering on the sidelines. Exercise and lifestyle changes are long-distance goals everyone over 50 can achieve in some measure. It's a matter of making the commitment to start a regular exercise program and reaping the many benefits.

Exercise helps maintain healthy bones and joints. It also helps control weight, and improves our mood and sense of well-being. And, it can strengthen all our muscles, including the really important one—our heart. NIH research continues to demonstrate the phenomenal benefits of exercise across the lifespan. For example:

Compared to their sedentary counterparts, older exercisers are not only more likely to live to an advanced old age, but are more likely than non-exercisers to remain independent right up to the end of their lives, according to a 1999 study by Luigi Ferrucci, now head of the NIA's Baltimore Longitudinal Study on Aging.

Exercise and diet are the most effective ways to reduce the risk of diabetes in high-risk older people, compared to other age groups. These "lifestyle changes" resulted in a 71 percent reduction in diabetes among those 60 and older, according to the Diabetes Prevention Program, a clinical trial supported by National Institute of Diabetes and Digestive and Kidney Diseases, the NIA, and other NIH institutes. Seven million people 65 years and older have diabetes, a disease which disproportionately affects African Americans, American Indians, and Alaskan Natives.

Moderate exercise is an effective way to reduce stress and sleep problems among older women caring for family members with dementia, according to a study by Dr. Abby King at the Stanford Center for Research in Disease Prevention. Family caregivers are at risk of increased rates of depression, serious illness, and mortality, studies show. Dr. King also demonstrated that older persons who exercise are able to fall asleep quickly, sleep for longer periods, and get better quality of sleep after moderate exercise. This is significant given that more than half of people 65 years and older complain of sleep problems.

Exercise, in conjunction with other common sense interventions, was able to reduce falls among older people by 44% in a study by Dr. Mary Tinnetti at Yale University. The intervention strategies cut health care costs for each high risk individual by $3,700, potentially saving millions of dollars in health care costs.

Walking and strength-building exercises by people with knee osteoarthritis can help reduce their pain and maintain their functioning and quality of life. At present there is no cure for osteoarthritis, which affects more than 17.5 million Americans 65 and older. A study showing the benefit of exercise was conducted by the Fitness Arthritis and Seniors Trial at Bowman Gray School of Medicine and the University of Tennessee Older Americans Independence Center.

Several years ago, NIA launched a national exercise campaign for people over 50 years of age because about 28% to 34% of adults ages 65 to 74 and 35% of adults 75 years and older are inactive. Inactivity can lead to frailty, poor health and dependence, universally feared by older people.

Through regular exercise, older adults can stay healthy and maintain independence. Our national exercise campaign addresses the four necessary types of exercise in a book called "Exercise: A Guide from the National Institute on Aging," and in an companion video based on the book:

Endurance exercises, like walking rapidly (while still being able to talk to a walking partner), raise the heart rate and get the heart, lungs and circulatory systems working optimally. Having more endurance can build stamina for tasks like climbing the stairs, shopping for groceries, and biking.

Strength exercises—leg lifts, arm raises, and bicep curls -- build muscles. Just a small increase in muscle mass can reduce frailty, even in 90 year olds. Weight lifting increases one's metabolic rate, helping to keep weight and blood sugar in check.

Balance exercises that build leg muscles can prevent falls—a major cause of broken hips and other injuries that often lead to disability and loss of independence.

Flexibility exercises help keep the whole body limber. Stretching the long muscles in the legs, arms, and across the upper back can improve range-of-motion and the ability to reach things on the top shelf.

The NIA's Exercise Guide is very popular with people 50 and older who want to know how to begin a safe, effective exercise program to maintain their health. All the recommended exercises were developed and chosen based on evidence from research studies. To date, the NIA has distributed almost half a million copies of the free Exercise Guide, which is available in both English and Spanish. NIA is beginning an outreach effort to encourage exercise among older African Americans as well. The exercise guide is available on the NIA website at www.nia.nih.gov/exercisebook/ or by calling 1-800-222-2225. As part of our outreach efforts, the NIA also has created English and Spanish public service announcements for television and radio audiences.

You will hear many words of wisdom about exercise and a healthy lifestyle today. Exercise—and good genes—may ultimately be the wellspring of healthy older age. Evidence shows that even the oldest and frailest among us can improve health and independence by starting an exercise program that suits their physical limits. The message which we want to convey to older Americans is that you're never too old - it's never too late - to make exercise a part of your life. The National Institute on Aging is working to support that goal.

That concludes my testimony. At this time, I would be happy to answer any questions.

Last Revised: March 14, 2003