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Am Fam Physician. 2008;77(8):1158-1160

Background: Older adults have the lowest activity and fitness levels of any age group in the United States and generate the most health care expenditures. Increasing the amount of physical activity among older adults could potentially improve health and decrease health care costs. The need for specific recommendations for this group became apparent as the American College of Sports Medicine and the American Heart Association updated activity recommendations for adults up to 65 years of age.

Recommendations: The new guidelines apply to adults 65 years and older, and to adults who are 50 to 64 years of age with chronic conditions or functional limitations that affect movement ability and physical activity. The recommendations mirror those for younger adults, with some specific additions and clarifications. The accompanying table highlights the updated recommendations.

ActivityFrequencyDurationIntensity level*
Aerobic exercise
ModerateAt least five times per weekAt least 30 minutes each session5
VigorousAt least three times per weekAt least 20 minutes each session7 to 8
Resistance or weight trainingAt least two times per week on nonconsecutive daysEight to ten exercises involving the major muscle groups; 10 to 15 repetitions per exercise5 to 8
Flexibility trainingAt least two times per weekAt least 10 minutes each session

The guideline strongly encourages instituting aerobic, strength and resistance, and flexibility training for all older adults, as possible, and balance training for community-dwelling adults at risk of falls. Activity plans are suggested, and include when, where, and how each activity should be performed, recognizing that unfit older adults may need to exercise in smaller bouts of activity over longer periods to slowly build up physical fitness.

Conclusion: The recommendations reflect the differing needs of older persons when determining exercise intensity, and by incorporating flexibility and balance training to maintain health in this population. As with the younger-adult recommendations, the guidelines represent minimal activity levels; further increases in activity levels may be needed to improve health and decrease morbidity from chronic diseases.

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