Adapting exercise as you age

How do you adapt exercise safely as your body changes with age?

Use a mix of exercise types, start with short sessions and build up slowly. Aerobic, strength, flexibility and balance training together are recommended for older adults⁶.

Strength and balance deserve extra attention. Healthy older adults lose about 0.8–3.6% of their strength a year, and resistance training is an effective way to slow that loss, including in very old adults³. Balance and coordination also decline with age, so programmes that combine strength, balance and everyday functional tasks are recommended³.

• Start small. If you haven't been active recently, begin with 10 minutes once or twice a day. After 2 weeks, build up to 15 minutes twice a day⁷.
• Short bouts count. Walking for 10 minutes 3 times a day is just as effective as one longer session, and even a few minutes is beneficial when you're starting out².
• Add strength and balance. Aim for some strength exercises 2 to 3 times a week, and balance activities ideally every day, to help prevent falls and injuries⁷. Increase gradually.

Exercise doesn't have to hurt to work. Soreness isn't needed for progress, and pain during exercise is a signal to stop or ease off.

Which kinds of exercise matter most for longevity?

A mix matters most: aerobic activity plus muscle strengthening and balance work. People who did both strength and aerobic activity tended to have a much lower risk of dying from any cause than people who did neither⁵. This is a link, not proof of cause. Which single type matters most isn't clear yet, which is a good reason to mix them.

Aerobic activity. Adults, including those 65 and over, should aim for at least 150 minutes of moderate-intensity activity a week, or at least 75 minutes of vigorous activity, or an equivalent mix. The WHO ranges are 150–300 and 75–150 minutes¹. Those are minimums to aim for. Going beyond them is fine, and doing less still helps.

Strength. Aim for muscle-strengthening activity on at least 2 days a week⁸. Any strength activity is better than none.

Balance. Balance and functional exercises reduce the rate of falls by about a quarter. Programmes that combine several types of exercise, commonly balance and functional exercises plus resistance exercises, also reduce falls, as does Tai Chi. Programmes of 3 or more hours a week that included balance and functional exercises cut falls the most⁴. An expert guideline names balance plus resistance training as the most effective way to reduce falls⁸. The effects of programmes that mainly involve resistance training, dance or walking aren't clear yet.

A simple weekly plan: some walking or other aerobic activity, some strength work, and some balance practice. Build up gradually rather than doing everything at once.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio. A physio or your doctor can also help you plan activity if you have a long-term condition such as arthritis or a heart condition, have had falls, or are worried about falling. This matters more if you live with a condition such as stroke, Parkinson's disease, multiple sclerosis, dementia, a previous hip fracture or severe vision problems.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

A sore muscle or joint, or soreness a day or two later, is a reason to ease off. See a doctor or other health professional if it persists or gets worse. If you feel unusually tired, get it checked by a doctor.