How Can Veterans Build Strength and Balance as They Age?

Personal Trainer Helping Senior Male Boxer In Gym To Put On Boxing Gloves In Gym

By Heidi Godman, ContributorMarch 9, 2018, at 9:00 a.m.

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Exercise and education classes are making a big difference for many older veterans.

YEARS OF HARD WORK AND heavy lifting took a toll on James Burton, 79, of Durham, North Carolina. He served 12 years in the Army as a tank driver and gunner, and then had a career as an auto mechanic. By 2014, in his mid-70s, he developed a painful hernia in his groin. “It reached the point where I couldn’t lift anything for close to two years,” Burton recalls.

Burton was like many older veterans struggling with debilitating health conditions.

“On average, older veterans have more health problems than non-veterans,” says Dr. Leslie Katzel, director of the Baltimore Veterans Affairs Medical Center’s Geriatric Research, Education and Clinical Center and associate professor at the University of Maryland School of Medicine.

It’s unclear why veterans have more health issues than non-veterans. The increase could be the result of military service, or it might be linked to socioeconomic status and lifestyle.

But here’s what we do know:

  • Older veterans have more than twice the rate of depression than older non-veterans, according to the U.S. Department of Veterans Affairs.
  • Research suggests that older veterans also experience more heart disease, obesity and musculoskeletal disorders, such as arthritis and lower back, hip and knee pain, compared to non-veterans. These conditions can lead to disability and lost mobility.
  • There are about 9 million veterans age 65 or older in the U.S., according to the Census Bureau. It’s a sizable group with health issues that are attracting increasing attention from the VA.

Fighting Back

The VA is combating the wave of health decline among veterans with a firepower that has repeatedly demonstrated an ability to stave off chronic disease and relieve pain. It’s not some high-tech weapon; it’s exercise, and it’s the centerpiece of a program for older veterans called Gerofit.

“When the veterans come to us, they’re physically out of shape. We measure them regularly for cardiovascular health, fitness, strength, balance and mobility,” says Miriam Morey, associate director of research for the Durham GRECC and a professor of medicine at Duke University School of Medicine.Play Video

Gerofit tailors exercise offerings to each veteran’s health needs. Activities range from gym workouts and weight machines to group classes on tai chi, line dancing, balance or core strengthening.

The program’s goals include:

  • Improved strength: crucial for everyday activities, such as lifting a bag of groceries, getting up out of a chair, climbing stairs and opening a car door.
  • Better endurance: important for walking down a hallway or climbing stairs.
  • Better balance: necessary to avoid falls and injuries. According to the Centers for Disease Control and Prevention, 1 out of 4 older adults suffers a fall.

“In addition to supervised exercise programs, we do a lot educational counseling relevant to health such as nutrition, medication use, managing chronic diseases, tai chi and how to deal with sleep apnea or urinary incontinence in our Gerofit Learning Opportunities for Wellness series,” Morey says.

Gerofit Results

Morey, an epidemiologist and exercise physiologist, helped develop Gerofit at the Durham GRECC in 1986. She’s watched each year as more veterans have benefited from a healthier lifestyle.

One documented benefit of Gerofit: It’s associated with increased longevity. “We’ve found that veterans who come to the program for at least six months have a 25 percent lower mortality rate 10 years later, compared to people who come to the program and drop out,” Morey says.

Another published finding: “Veterans who participate in Gerofit are physically performing well five years after starting the program,” Morey says. “So instead of their expected decline in different dimensions, they’re sustaining or improving. There aren’t too many things you can give someone age 70 or 75 and say you’ll be better five years from now.”

Burton began working out regularly at the Durham GRECC Gerofit program about 15 months ago, just after undergoing hernia surgery. “When I came here, I could do maybe two pushups. Now I can do 20 easily. And I can lift 70 pounds on the leg machine,” he says. After taking some balance classes, Burton notices he no longer has an occasional misstep as he’s walking, which should help reduce his risk for a fall.

And what about lifting? “I can lift just about anything I want,” Burton says.

“Mr. Burton is a good example of someone who late in life can start an exercise program and completely turn around his physical capabilities,” Morey says.

The perks of Gerofit may go beyond physical results. For Burton, a widower, exercising is also a positive social experience. “I really enjoy the program and the people. I can’t wait to get here in the morning,” he says. He works out at the Durham GRECC every Monday, Wednesday and Friday morning and has no plans to stop.

Branching Out

Morey says the success of the Durham Gerofit has inspired the VA to add Gerofit programs to GRECCs across the country in the last five years. Gerofit is now available in Rochester and Canandaigua, New York;, Los Angeles; Honolulu; Miami; Baltimore; Little Rock, Arkansas; Cincinnati; Salem, Virginia; and Pittsburgh. “Three more Gerofit programs are set to start this year in Tacoma, [Washington]; Denver; and Ann Arbor, [Michigan],” Morey notes.

And if you can’t make it to one of those locations, the VA can beam a televideo version of the program, called Tele-Gerofit, to rural communities. “Patients go to the community-based clinic, and one of our experts in another location is on TV in real time, leading them in chair exercises or strength training,” Morey explains. She says veterans who take part are experiencing improved gait speed, improved mobility, improved chair stands and improvements in endurance.

Morey says the VA is now trying to work with people who can’t make it to the rural clinics. “Can we call you by phone and set up communication in your own home and lead some exercises that way? This is just being piloted,” she says. “It’s not up and running, it’s just in the works.”

Beyond Gerofit

GRECC experts are exploring new ways to help older veterans. Katzel and his team in Baltimore are conducting two studies. One is looking at whether an exercise program combining walking, strength training and other exercises (like maneuvering through an obstacle course that involves stepping and lateral movement) is superior to tai chi for improving balance and mobility among older adults.

Another trial will study if weight loss added to exercise is better than exercise alone to improve mobility and balance in obese older mobility-challenged veterans. “Some of these people have lost too much muscle and gained too much fat. So if you take someone who’s 300 pounds and using a cane, can we improve their balance and gait with exercise if they lose 30 or 40 pounds?” Katzel asks. “We can export our results and put them into routine practice.”

But you don’t have to take part in a formal study or Gerofit to start reaping the rewards of exercise. “We advise people to do low-intensity walking. Get evaluated by a health care provider, and do some physical therapy if it’s appropriate. Try to exercise with a buddy or in groups when possible,” Katzel says. “The hope is that you’ll improve your balance and mobility, you’ll have a better quality of life and reduce your risk of falls.”

Burton agrees with the many benefits. “I’m a happy person, and by coming here and my strength being better now, it makes me even happier,” he says. “And I feel better about myself.”

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