Many convincing studies show that exercise is a very good idea for everyone, especially in old age when it sharply reduces risk of diabetes, cardiovascular disease and strokes and, by improving blood supply reduces the rate of the gross brain changes that cause decision speed, intelligence and memory to decline. Twenty years ago a growing literature impressed my Manchester and Newcastle colleagues, Nuala Bent and Lynn McInnes and they decided to test its claims by comparing our already atypically healthy and highly motivated old volunteers against exceptional elderly athletes. We thought that it would be hard to find ancient paragons in our smoky wet and windy cold cities but Nuala and Lynn’s charming appearances on local radio brought in more than 300 senior athletes. As usual, Nuala and Lynn wheeled me out to greet all new volunteers, thank them, and answer questions about what we would like them to do and why. They, unintentionally, gave me some of the most embarrassing moments in my career. I had to confront scores of astonishingly bulky old weight trainers, tiny gnarled cyclists, stringy runners and honed senior gym bunnies. A surprising number wore lycra, revealing more muscles than the illustrations in Grey’s anatomy. They were all very, very, very polite, clapped kindly, though at rather random moments, and the memories of smiles they could not suppress when I first walked into the room still hurt.
We measured their peak performance on a stationary bicycle and found that nearly all were as aerobically fit as they thought they were. (the very few others vowed to “train hard for it and come back”). As a group they were also much better at all of the mental tests that we gave them than the more languid volunteers who were already in our longitudinal study. In the end we did not publish these results because many other much better studies gradually came out. Also we had not then learned how best to take account of all of the many confounding socio-economic factors, other than exercise, that might explain the differences we found. (Do socio-economically advantaged and clever old people take more exercise or does persisting with exercise keep you clever?) A fine study by Michael Marmot and colleagues1 and an elegant statistical analysis by Loveden and Ghisella 2 have since showed how this is done and that the chicken and egg problem is solved: as we grow older exercise maintains our mental abilities rather than vice-versa. Even from our early and tentative study it was clear that there is a very strong association of exercise and keeping mental ability in old age. But I was so shocked by the amounts of exercise that these extraordinary people took that I decided that, since I could not possibly manage to do nearly as well and since I was destined to die soon and stupid I might at least enjoy comfortable indolence. This was a very bad decision.
Convincing work shows clear benefits from even very small improvements in the amounts of exercise that older people take 3, 4, 5. For me the costs of lethargy mounted over the years until, in retirement, I found that even mild trundles around flattish Oxford had become laborious, that the South Parks, where I am always happy, remained un-traversed for weeks and that walking distances to shops, pubs and restaurants had become more important than their quality. Recognition of a shrinking life forced me to seek help. The nearest help available was a physiotherapy service that runs drop-in Pilates classes.
I turned up at a Church Hall and we huddled talking timidly to each other. Even embedded in a sample of miscellaneous geriatrics I was an obvious incompetent and so targeted for comfort by a nice Very Senior Lady (“I find it quite beneficial and I am sure that you will too”) and a robust ex-military man (“Take it slowly and don’t do what you can’t”). This seemed excellent advice and I gratefully agreed not to do what I couldn’t. It was also timely reassurance since some especially lithe young people in their 50’s were flaunting their experience, and themselves, by gracefully putting on special socks with rubber grip soles. I hid among others with everyday socks and trousers until a strapping trainer, Jocasta, appeared with mats.
This first visit was near a Christmas and wolf-cubs or similar had pasted the ceiling with silver stars, limbless paper angels with wands, crayons of undiscovered species of flowering plants and, hanging from threads, multiple representations of Santa Claus and what was, perhaps, the planet Saturn.
Jocasta sorted and allocated mats and took us through some “easy stand up things”. I discovered that I could not stand on one leg for longer than 5 sec, that my neck and upper spine made a loud grating noise when I “Stretched for the stars” and that it is hard to recover balance from failing to stand on tip-toes without a shameful crash. Then there was “Mat Work”. I tried to ignore surprising pains in my lower joints by examining angels and stars and planets, squinting to check a clock whenever a movement turned me in the right direction and furtively glimpsing how others were getting on. Some remarkably well; some remarkably bravely; the Military Man stolidly taking his times out. Time went very slowly. Jocasta gave up chirruping “Listen to your body ! Hear what its telling you !” when a delightful mid-West American accent grated: “I’m listening, I’m listening and it’s telling me -Don’t be an old fool. Get up and go home NOW”.
It ended. The scratchy recorded music stopped. Like dutiful school monitors we piled and squared the mats and those who found it hard to get up off the floor once they were on it competed for places to sit erect to put on shoes. A grey Oxford drizzle had started. I began to walk home and suddenly realised that I had forgotten my legs. They no longer reminded me of every step. My knees did not cautiously anticipate steep curbs. I had forgotten what it is like to have a younger, functioning body precisely because that is the sort of body that does things without any fuss so that there is nothing to remember. Naturally this did not last very long but the next day was also good and there is a session every week – or more often if you are willing to risk encounters with Jocasta’s colleague Hera who, according to the Military Man “Really puts you through it when she’s in the mood”
- Singh-Manoux, A., Hillsdon, M., Brunner, E., & Marmot, M. (2005). Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study. American Journal of Public Health,95, 2252-2258.
- Lövdén, M., Ghisletta, P., & Lindenberger, U. (2005). Social participation attenuates decline in perceptual speed in old and very old age. Psychology and aging, 20, 423.
- Dik, M. G., Deeg, D. J., Visser, M., & Jonker, C. (2003). Early life physical activity and cognition at old age. Journal of Clinical and Experimental Neuropsychology, 25, 643-653.
- Hillman, C. H., Erickson, K. I., & Kramer, A. F. (2008). Be smart, exercise your heart: exercise effects on brain and cognition. Nature Reviews Neuroscience,9, 58-65.
- Richards, M., Hardy, R., & Wadsworth, M. E. (2003). Does active leisure protect cognition? Evidence from a national birth cohort. Social science & medicine, 56, 785-792.