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Training for seniors/ older adults

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  • Training for seniors/ older adults

    Hi Dr. Jordan and Dr. Austin,

    I'm Chirag and am writing to you from Chennai, India. This is my first forum post, so I apologise if I've not followed the posting guidelines properly and/ or have asked questions which have been answered previously. Also, like many others, just wanted to say that I'm a big fan of Barbell Medicine and am grateful for the content you guys have been putting out through the podcast and seminars. A lot of us from Chennai follow the content regularly.

    My question is - is there something you would change from a training or nutritional standpoint that can help my 83 year old grandmother improve her ability to walk, climb stairs and her general strength? I have described her current training below. I have read BBM forum posts regarding training for older adults here and here.

    My grandmother's goal is to be physically independent. She is 4' 7", weighs 61 kg and has a waist circumference of 42". She has been training at home 3x/week fairly consistently since July 2020 after suffering a fall from the bed and hurting her ankle. Due to the COVID situation, she has stepped out of the apartment on only a handful of occasions since March 2020. Training helps her stay physically active and shows her that she is still capable of doing things on her own. That is why she enjoys training.

    She is currently taking several medicines including those for better managing her thyroid, blood pressure, cholesterol, sleep, gastric distress, breathing, etc. Due to the side effects, we haven't made any nutritional change for worry of making her current conditions worse.

    She has trouble walking but can now walk a few lengths of the hall before needing to catch her breath. She can climb a couple of flights of stairs with assistance from the railing. After the initial 2-3 months of training, she gained the confidence to get down to the floor and back up on her own for the first time in 5-6 years. She can do inchworms and hold a plank for about 15s. She initially wasn't able to stand on one foot but after practicing some in-place marches and holds, she can now stand on one foot for 10s.

    While we don't have access to cable machines, fortunately we have a barbell with plates, adjustable dumbbells, resistance bands and a recumbent exercise bike at home.

    She has been doing some variation of a push, pull, hinge, squat and carry every workout. She really enjoys doing banded rows and carries. In fact she carries all the weights across the hall and puts it back into the cupboard post-workout while refusing any help or assistance. She does goblet sit-to-stands, TRX/ banded rows, 1-arm DB rows, assisted split squats, landmine presses and deadlift variations using the barbell and dumbbells. She practices getting down to the floor every day and does some rolling and rocking from time to time. She has deadlifted 20 kg for 5 reps. She can farmer carry 4 kg dumbbells and goblet carry a 5 kg weight plate. She does the exercise bike at light intensity for 20-30 minutes every day.

    In terms of the program itself, we typically do 2-3 sets of 6-10 repetitions on most exercises and choose weight based on what she's comfortable doing on the given day. If we do a little more than that, the soreness becomes difficult for her to manage. I really want to help her train so that she can walk, move and feel better but am not sure if I should be doing something different from a training standpoint. Her lifting videos had gone viral in India and the subsequent social attention she received, along with slightly improved sleep patterns has made her feel confident about her physical capabilities and has instilled some self-efficacy. If you have any tip or advice on how her training can be modified to improve her quality of life and physical tolerance, I would be extremely grateful.

    Thank you for your time,

  • #2

    This is a really cool story and I'm glad you shared it! I'd love to see some of the videos if you have any of the links handy

    As far as her training goes, it sounds like you're hitting all of the exercise targets we'd recommend for health:
    • training the major muscle groups multiple times per week through a relatively large range of motion
    • using a variety of exercises that an individual can do and prefers
    • using a variety of rep ranges
    • doing conditioning to meet the current guidelines
    • using autoregulation
    I am reticent to change anything given her reported enjoyment and adherence to the program. I just don't feel strongly enough about anything to make a suggestion.

    Nutrition-wise, I think the biggest thing here is likely to be her protein intake. I'd wager there's some sarcopenic-obesity going on here, but would prefer to focus more on supporting (and improving!) lean body mass for improved function and quality of life. At 61kg and her age, I'd be looking for her to get in ~100g of protein per day. This may be difficult to do and a supplement may be beneficial for palatability and reduced volume of food to ingest.

    Hope this helps. Keep up the good work.

    Barbell Medicine "With you from bench to bedside"
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    • #3
      Hi Dr. Jordan,

      Wow, thank you for the quick response! She definitely does not get enough protein in at the moment. Especially considering that she is a vegetarian (no eggs, but has dairy) which limits her options. We're slowly trying to get her to have whey protein but she seems to have issues with digestibility. Thank you for the tip, we'll work on improving her protein intake.

      Here are some video links of her training and story:
      1. Her Instagram account
      2. Brut India
      3. India Today
      Thank you once again,