Encouraging Physical Activity Among Frail Older Persons

to the editor: In their article, Drs. Elsawy and Higgins present useful information on the positive impact of physical activity in older adults. The authors also recommend strategies that physicians can employ to help older adults become more active and, therefore, healthier. A few additional points can be made on this topic.

First, it is important to realize that physical activity is essential for health and wellness promotion in patients of all ages, including those who are older and frail. A structured fitness program for frail older persons can maintain or improve physical function and prevent loss of independence by preserving activities of daily living.

Although few studies have explored the effects of physical activity in older persons, one study examined the effects of moderate-or high-intensity exercise on physical frailty in older persons (more than 80 percent of participants were wheelchair-bound).¹ The study found that persons in the exercise group had greater improvement in functional activity than those in the control group.

Second, several strategies can be used to encourage physical activity in frail older persons. Exercises should be innovative, fun, social, and sustainable. For example, at the

Atlanta Veterans Affairs Medical Center, veterans who reside in the community living center (nursing home) have access to a Nintendo Wii gaming system. This system has gained popularity in long-term care settings, because the actions are intuitive and easy for residents to do. The residents enjoy the virtual competitive sports, such as tennis and bowling, which permit physical activity and socializing at the same time. Some of these activities are also suitable for those who are wheelchair-bound.²