Aging Parents: Maintaining Mobility into Old, Old Age–The Dangers of Sitting Too MuchCONTACT SUSAN at: helpagingparents@gmail.com

Sedentary Seniors and Couch-Potato Elders—Walk More. Sit Less

How limiting is life for those with curtailed mobility?

Look around…so many people with canes and walkers as our population ages. Based on the Tufts U. publication–reprinted below–it seems their numbers would lessen if the elderly couch potatoes we care about (as well as those of us who now spend hours sitting at a desk), make it a point to take breaks for a brief walk. What could be easier?

The importance of older peoples’ walking is nothing new to longtime readers of my blog.  “If you begin a daily walking program at age 45, you could delay immobility to 90 and beyond. If you become a couch potato at 45 and remain so, immobility can encroach as early as 60.” So says Mark Lachs, author of Treat Me, Not My Age.   (Dr. Lachs is Chief of the Division of Geriatrics and Gerontology at Weill Medical College in NY among other positions, and first written about in my 2010  post featuring Jane Brody’s NY Times columnWhat to Do Now to Feel Better at 100.) 

Sr. Advisor R, was living proof. She didn’t use a cane (didn’t own one as far as I know) until she was 97–after her broken hip episode. instead R walked daily on a treadmill from age 50 (as written previously–not the plug in kind, your feet make it go). And R continued using that treadmill daily–until she died.

(R’s best friend [93] is the beneficiary of that treadmill and phoned last week, laughingly saying she knew it was bequeathed to her and she’d send a strong young relative over to pick it up if that was OK.)

Further proof was my dad, who was 94 before I ever saw him use a cane….and then he used Mom’s old cane, which probably wasn’t the right fit; but he said he only used it when he felt weak. Out of respect, I never pushed him on the subject. (His mind was good.) That said, he not only walked a lot, he had to walk upstairs to his bedroom and down the basement stairs to get into his car. Thus, many leg muscles were exercised daily and mobility was never an issue other than that he walked slower than in his younger days.

A well-respected chiropractor in Westchester County, NY told me that he could always tell which patients wintered in Florida because they didn’t get the exercise walking stairs provided. Enough said. Here’s the latest  on “sedentary sitters”–

Tufts Health & Nutrition Letter

August 24, 2015

Brief Walks May Counter Health Dangers of Too Much Sitting

Multiple studies have warned about the health risks of sitting too much. Hours spent sitting, whether at desks or in front of the television, have been linked to increased odds of cardiovascular disease, type 2 diabetes and kidney problems. But modern life can make it difficult to stay out of chairs, and alternatives such as “standing desks” don’t appeal to everyone.

A new study may offer hope to sedentary sitters: Using data on more than 3,600 adults, researchers found that brief periods of simply walking around the room substantially reduced mortality risk among people who spent long periods sitting. As little as two minutes of gentle walking per hour was associated with a 33% lower risk compared to non-stop sitting.

“We know that exercise is good for us and yet, despite this, our society has become more sedentary than ever,” says Miriam E. Nelson, PhD, associate dean of the Tisch College and a professor in Tufts’ Friedman School, author of the “Strong Women” series of books. “We are built to move, and when our bodies move on a regular basis, they are healthy; when they don’t, when we’re largely sedentary, our bodies deteriorate.”

MEASURING MOVEMENT: In the study, published in the Clinical Journal of the American Society of Nephrology, Srinivasan Beddhu, MD, of the University of Utah, and colleagues analyzed data from the annual National Health and Nutrition Examination Survey (NHANES). In recent surveys, selected participants have supplemented their questionnaire answers by wearing activity monitors called accelerometers; this gives a more accurate record of a person’s movements than depending on individual recall. Most of the participants were generally healthy, although a subgroup of 383 people had chronic kidney disease.

Researchers divided participants into four groups based on minutes per hour of different levels of accelerometer activity: sedentary/sitting, low (such as standing up but not walking around much), light (such as strolling around a room or walking into another room), and moderate/vigorous (jogging or other exercise). The study then compared activity levels to records of deaths three or four years after the assessment.

ADDITIVE ACTIVITY: There was little difference in mortality between the sedentary and low-activity groups. But people who interrupted their sitting with light activity were at significantly lower mortality risk than those who were completely sedentary; this difference was even sharper among the kidney-disease subgroup (41%). As little as two minutes an hour of light activity was enough to be associated with lower risk.

Boosting activity levels to moderate/vigorous further reduced risk, but the number of such active participants was too low to be statistically significant. Adding additional minutes of light activity, however, did make a significant difference. Getting up from your chair for two minutes or five minutes more light activity rather than sitting time, Dr. Beddhu said, could further reduce risk of premature death.

He cautioned that the study was observational, and so can’t prove cause and effect. And Tufts’ Nelson notes that a quick walking break from your chair is no substitute for regular physical activity. But if you’ve been worried about the health risks of sitting too much, apparently every little bit helps.”

Last January (2015) Time magazine’s online article discusses the sitting dangers and recommends “standing up and moving around every half hour

Check out “Newsworthy” (right sidebar). Links to timely tips, information and research from top universities and respected professionals–to help parents age well.

Related: Helpful information from his book in ABC 2010 interview with Dr. Lachs.
Jane Brody’s NY Times columnWhat to Do Now to Feel Better at 100
Time Magazine online, 2/
2015 . It Doesn’t Matter How Much You Exercise if You Also Do This
USA Today 2/2014. Don’t just sit there! It could be harmful in later life.

Choosing the Best Walker–101-year-old, Aging in Place: Mobility Continues 4 years After Broken Hip Surgery

The “Best” Walker is the Right Walker
(and can change as needs change)

The right cane and the right walker empower elders, enabling them to continue their routines as before. Reduced mobility, on the other hand, is obviously not empowering, creates neediness, and can lead to less contacts with others–not helpful in aging well independently and not helpful to us if we’re caring adult children.

Having the right “tools” makes everything easier–for any situation actually. (Learned this in a “Home Repair” course; found it a truism.) It’s not rocket science that an easy-to-use, dependable walker is the right “tool” to continue mobility and an active life.

But do we realize that the first walker purchased may not be the ultimate walker? Here’s why–

1. We often select quickly (possibly the one used in rehab).
2. We often select the least expensive.
3. Subsequent factors, like balance and aging parent stability may lead to buying a studier walker.

We see many people using light weight walkers with 4 legs, tennis balls or skis on the back legs. Click link to physical therapists’ video before purchasing. It discusses important limitations (ie. light weight compromises stability. It must be picked up every time a step is taken). The research, time and money to purchase a walker that fits needs and gives parents’ confidence is well-spent.

Our first trip to the surgical supply store after R’s release from rehab yielded two walkers: a basic one with front wheels and skis on back legs, and a more expensive, heavier walker with wheels, skis on back legs and a basket/seat (which she never used).

R used the basic walker in the house…until her cane arrived three days later. Basic walker went into the garage. R says once you’ve fallen you need to feel safe when you walk. Ever since rehab, her cane has given her complete confidence to walk…until a year ago. Then serious vision problems began  affecting her balance and confidence. “Bit by bit, then more and more” she used that basic walker from the garage. Last spring she needed a new walker.

Why and how it’s used–

R wanted a tray attached to her walker, but her walker wasn’t compatible with existing ones. Thus, a new walker, with tray, was purchased . According to R it’s less wide (thus more comfortable), very sturdy and weighs less. The skis on the back legs and wheels on the front work fine on carpets. R only uses it in the house. When she goes out she always uses her cane. She feels safe with that.

She switched to her current walker, this Guardian Signature walker plus extras: the front wheels (attachments): $66.75; the back legs’ ski glides: $15; attached fold-down tray: $39.95. 2014 total: $131.80 

While not covered by Medicare, it’s “worth every penny,” according to her. (She still does her own finances.)

The tray is used daily–for moving food from oven to table, refrig to oven, delivered things to kitchen, bedroom etc. Also, R still has easy-care leafy green plants that need watering. She likes taking these plants to the kitchen sink, but holding a cane and carrying a potted plant doesn’t happen! Her current walker with the 2 recessed holes filled a need.

A friend in her 70’s, who had polio as a child, has purchased countless walkers over decades. She now prefers rollators–walkers with 4 wheels, which make them very sturdy and easy to to use inside and outdoors. (I’d never heard the term before speaking with her.)

Rollators come with seats, baskets, trays, cup-holders and various other options.  She has one for indoors which has different “amenities” than the collapsable one used for going out. The latter has a fold-up seat, offering a place to sit if needed, but no tray. It’s less heavy, making it easier to lift into/out of the car. (Grandkids love to sit on it, she tells me.) That said, I know adult children who don’t like taking parents out because it entails lifting a collapsable walker. Do they need lessons?

My friend says four wheels plus good brake handles are very important if the walker is to be used out of the house (think uneven pavement and inclines). Over the years she has purchased walkers on line or through catalogs and some at stores like CVS and Walgreens, where they “fit” the walker to your measurements. The right height is extremely important. Note walkers for shorter and taller people when checking “Related” below for rollator options. (Site selected because of the excellent pictures and information.)

Great gift: Family members contribute to the purchase the right walker. For seniors who are trying desperately to maintain their independence and age in place, the right walker helps parents age well. It clearly has for R.

Related: Rollator models
              Very good video, excellence hints by 2 physical therapists: Walkers: Wheeled vs Standard

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical information–to help parents age well.