Sports Injuries Rising in the Elderly

Sports Injuries Rising in the Elderly

According to a recent report from the US Consumer Product Safety Commission, sports injuries rose by 54% in Americans age 65 years and older between 1990 and 1996.

The rise in elder sports injuries outstrips the 8% increase in the number of Americans in this age group over the same period, notes the agency. “The increase in injuries is most likely attributable to increasingly active lifestyles and to increased participation in sports activities by older Americans,” according to the report.

The Commission also notes that Americans are remaining physically active into their 70s, 80s, and even 90s. And more elderly people are participating in “more active” sports such as bicycling, weightlifting, and skiing.

The report is based on data from the National Electronic Injury Surveillance System, which samples 101 hospitals nationwide drawn from 5,000 hospitals with 24-hour emergency departments.

The study showed that between 1990 and 1996, sports-related injuries increased much more among older active people than among younger age groups. In contrast to the 54% increase noted in those over age 65, sports-related injuries increased by 18% in the 25 to 64 age group.

In actual numbers, there were 34,000 sports injuries in the 65 and older age group in 1990, rising to 53,000 in 1996. “The increased incidence of injury occurred not only among the youngest of the 65 and older population, but also among those 75 years and older,” according to the report. “Sports-related injuries to persons 75 and older increased by 29%.”

But the Commission report also notes that the average cost for treating sport-related injury in the emergency room fell between 1990 and 1996. “While more injuries are occurring, they appear, on the average, to be less costly and severe,” the report authors write.

While injuries from “less active” sports such as fishing, golf, bowling, and shuffleboard increased only slightly or not at all between 1990-1996, injuries sustained while participating in “more active” sports increased significantly in those 65 and older. Bicycling injuries were most common in this age group, and bike-related injuries increased by 75% in this age group. Most (60%) of these injuries resulted from falls, and 21% were head injuries. More injuries were also noted among older people using weights or other exercise equipment, and in older skiers.

“It is interesting to note that there were a small number of injuries (in those age 65 and older) seen for the first time in 1996 involving ‘extreme’ or more physically challenging sports such as snowboarding and in-line skating,” note the study authors.

The report also notes that in both 1990 and 1996, about 60% of sports injuries in the geriatric age group occurred in men.

The hospitalization rate for sports injuries in the 65 and older age group is 10%, less than the 18% rate for injuries with all consumer products in this age group. “The lower hospitalization rate for sport-related injuries suggests that the population participating in sport activities is healthier overall than those who are not participating in sports,” comments the Commission.

The study authors recommend that individuals participating in sports “use safety gear and take appropriate safety precautions, especially in active sports such as in-line skating and use of exercise equipment and weights.”

They also note that “virtually none” of the elderly people with a head injury following a cycling accident were wearing a helmet at the time of the incident. “Bicycle helmets reduce the risk of serious head injury,” advise the Commission.

“By getting regular exercise – and doing it safely – older Americans can enjoy a healthier life,” they conclude.

Exercise Lowers Death Risk in the Elderly

Regularly walking or cycling for at least 20 minutes 3 times weekly was associated with reduced (death risks from) cardiovascular diseases and all cause(s) in men over the age of 64, according to Dutch and American researchers. The 10-year investigation (1985-1995) examined the death rates of a group of 802 Dutch men, all of whom were at least 64 years of age at the beginning of the study. The authors divided the men into three groups – those who engaged in physical activity for an average of 15 minutes per day, 1 hour per day, or 3 hours per day.

The authors report that nearly half of the men (46.5%) had died by the study’s end. However, they found that after adjusting for various lifestyle factors (smoking and drinking, for example) and the presence of cardiovascular disease, “men in the highest activity (group) had a 30% lower risk compared with men in the lowest activity (group).”

Overall, they estimate that among the men who died during the study, 15% of the deaths due to heart disease and 12% of the deaths as a whole “could have been avoided by a physically active lifestyle.”

Reductions in death risk seemed to rise along with increases in exercise intensity. For example, the authors found that overall risks for fatal stroke were 60% lower among men who regularly engaged in high-energy workouts, compared with men who opted for less strenuous exercise routines. The authors stress that “these heavy-intensity activities did not necessarily include strenuous activities, which is illustrated by the fact that gardening and bicycling at normal speed …were classified into this category.”

They conclude that the same life-prolonging exercise guidelines already recommended for other adult age groups – exercise for at least 20 minutes three times per week – “may also be applicable to elderly men.” The authors believe their “findings may also be extrapolated to elderly women.”

  1. Archives of Internal Medicine 1998;158:1499-1505.

Moderate Exercise Lowers Fracture Risk in the Elderly

Older women who exercise even moderately, and for as little as 1 hour a week, reduce their risk of hip fractures. According to the recent Annals of Internal Medicine study, “Moderately to vigorously active women had statistically significant reductions of 42% and 33% in risk for hip and vertebral fractures, respectively, compared with inactive women.”

The 9,704 women aged 65 years and older were contacted by researchers from the Centers for Disease Control and Prevention every 4 months over an average of 7.6 years. Women were questioned on the frequency and duration of their participation in 33 social and recreational activities, plus walking and stair climbing and were also asked whether they had experienced any fractures.

According to the study, “Women who did moderately intense or vigorous activities, such as aerobic and other forms of dance, tennis, and weight training, had greater reductions in hip and vertebral fracture risk than did women who did lighter activities, such as walking and gardening, particularly if they were active for at least 2 hours per week.” The study also stated, “women who did lower-intensity activities, such as walking, gardening, or social dancing, for at least 1 hour per week also had significant reductions in risk for hip fracture.”

Relatively inactive women – sat for at least 9 hours per day -had a 43% higher risk of hip fracture than those who were sedentary for less than 6 hours per day.

The researchers concluded that exercise “may enable a protective response in the event of a fall through enhanced balance, reaction time, coordination, mobility, and muscle strength.”

  1. Annals of Internal Medicine 1998;129:81-88, 133-134.

Exercise Cuts Diabetes Risk in Older Adults

Regular exercise can lead to improved glucose (blood-sugar) tolerance in older adults – which can reduce their risk of developing diabetes, according to researchers.

The effects of moderate levels of aerobic exercise are even more important in older people with high blood glucose levels (hyperglycemia) and insulin resistance, they report.

“Moderate-intensity aerobic training has a favorable effect on glucose tolerance,” conclude investigators at Yale University School of Medicine in New Haven, Connecticut.

Glucose tolerance – the ability of the body to regulate blood sugar levels – decreases with age, but excess weight gain and decreased physical activity also play a role. Decreased glucose tolerance is believed to be a step in the development of type 2 (adult onset) diabetes. Since obesity has been linked to impaired glucose tolerance, many experts have assumed that only those exercise regimens which resulted in weight loss could bring the condition under control.

That may not always be the case, however. In the Yale study, published in the July issue of The Journal of the American Geriatrics Society, researchers placed 16 elderly men and women on a four month regimen of either aerobic exercise or non-aerobic yoga and stretching. Those in the aerobic exercise group were encouraged to walk and run on mini-trampolines equipped with handrails.

Those who participated in the non-aerobic regimen, four months of stretching and yoga, saw no changes in fitness level or glucose metabolism, according to a statement issued by the journal.

The four month aerobic regimen produced no “appreciable weight or fat loss” in elderly participants. However, blood tests revealed that people in the aerobic exercise group who had impaired glucose tolerance at the beginning of the study showed a 25% improvement in the way their body handled glucose.

The researchers also noted that blood levels of free fatty acids fell by 24% in the aerobic exercise group, leading the researchers to suggest that “training-related improvements in glucose regulation… may be modulated by decreases in (free fatty acid) concentrations.”

The study team also conclude that “use of the mini-trampoline allows a safe, enjoyable, and effective mode of exercise for older people, who may otherwise be at risk for musculoskeletal injury from more traditional forms of weight-bearing aerobic exercise.”

  1. The Journal of the American Geriatrics Society 1998;46:875-879.

Low Intensity Exercise Lowers Blood Pressure in the Elderly Hypertensive Patients

According to a recent study, low intensity aerobic training significantly reduced blood pressure in elderly hypertensive (high blood pressure) patients who were receiving antihypertensive (high blood pressure) medication.

A group of elderly patients performed 30 minutes of low intensity exercise on a treadmill 3-6 times per week for 9 months while another group acted as controls – receiving no exercise. The average age of the groups was 75 and 73, respectively.

According to the study, “… blood pressures decreased significantly after 3 months of training and the blood pressure of all participants stabilized at a significantly lower level by the end of the 9 months in the training group, whereas no significant changes in blood pressure were found in the control group.”

  1. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 818-823, 1998.

Exercise Protects Against Alzheimer's Disease

Participating in regular exercise throughout the adult years appears to reduce the chances of developing Alzheimer’s Disease later in life, according to researcher Robert Friedland, M.D.

Alzheimer’s disease is a progressive, degenerative disease of the brain affecting one in 10 persons over the age of 65 and nearly half of those over the age of 85.

Friedland and colleague Arthur Smith, M.D., neurologists with Case Western Reserve University, compared the adulthood exercise habits of 126 elderly Alzheimer’s patients with 315 elderly individuals without Alzheimer’s Disease. Their results indicated that overall the Alzheimer’s patients led far greater sedentary lifestyles and scored much lower on an activity rating scale than did their healthy counterparts. Some of the activities associated with the reduced Alzheimer’s risk included regular participation in biking, swimming, golf, tennis, racquetball, running, ice skating and weight training. The activity periods studied were those between the ages of 20 and 59.

  1. 50th Annual Meeting of the American Academy of Neurology, Minneapolis, Minnesota. April 1998.