Have you ever known a person in their 50’s who was unable to independently perform all of the activities of daily living (ADL) and/or who was dependent to some degree upon others to assist them in basic tasks such shopping, cooking, household cleaning etc?
Possibly this person also needed a cane, crutches or wheelchair to get around due to chronic disease, injury or simply very poor health and fitness?
Or, on the flip side, do you know anyone in their late 80’s or 90’s that has the energy of someone half their age and still regularly completes challenging fitness routines or participates in athletic events on a competitive level?
The point of these questions is that there is a wide range of fitness, health and functional ability amongst people over the age of 50 and up through their 90’s and beyond.
A person’s chronological age is, at best, only a rough guideline of what their “functional age” or physical capabilities are. And yes, as all of us age chronologically our functional capacity does decrease gradually bit by bit over the years and decades.
But the rate and degree of decline is highly variable and something that each of us has the ability to significantly positively effect. For example, 100 year old Ida Keeling recently set a new worlds record for women in the 100 yard dash (see video link below) and the men’s world records for push-ups and pull-ups are both held by guys who set those records in their mid-50’s.
To address this wide range of functional capabilities of people over the age of 50, Dr. Waneen Spirduso created “Five Functional Age Categories” of older adults.
Before you read them however, please keep this in mind. These five categories do not only apply to “older adults”.
I know several people in their 30’s, sadly, who fall into some of the less functional categories.
Furthermore, none of the less functional categories need to be permanent or become part of your identity or legacy of how you lived your life.
The exciting truth is that if a person is in one of the less functional categories, they can “upgrade” into one of the more functional categories.
How so? Simple. By progressively becoming more functionally strong, mobile and fit.
Having said that, if a person is currently in one of the more functional categories and begins to neglect their functional strength and mobility, they can “degrade” into a lower level of functional capacity.
This could happen for a variety of reasons including disease, injury, family emergency or apathy. In such cases the degrade does not need to be permanent as the person can always decide to recommit to functional strength and move back up into a more functional capacity.
Which brings us to the question, which category are you currently in?
According to Doctor Spirduso, these are the five functional categories of adults over the age of 50:
1.Elite. The person in the elite category has reached the top category of physical functional capacity. And they are generally much more fit than many people decades younger! A current example would be Ida Keeling in the video below. After recently winning the 100 meter dash, she celebrated by cranking out numerous push-ups with very good form.
At the other end of the spectrum is Herschel Walker who at 54 years old is still competing as an MMA fighter against beating much younger opponents. What sets the elite category apart is that they train daily, and at relatively higher levels of intensity and duration and regularly compete in Masters tournaments,
Senior Olympics and anything else (as Herschel shows) they can find to keep themselves motivated and challenged. And while many of those in the elite category have been competing athletically for 30+ years, there are just as many who didn’t start doing so until after they retired from their jobs in their 60’s.
2.Physically Fit. People in this category exercise primarily for overall fitness, health and wellness although they may occasionally enter athletic competitions. Their fitness training program is usually not as intense or as long as those of the elite, but they consistently exercise 3-7 days per week and have been doing so faithfully for years.
As a result they are usually much healthier overall, have a superior quality of life in all aspects and are often guessed to be far younger than their actual chronological age by others.
3.Independent. This category may be the largest of all in that these men and women do not “exercise” as a regular part of their lifestyle. They may be “physically active” however and participate in things like golfing, gardening and walking the dog, etc. They usually have an average level of health and are not experiencing any serious debilitating disease.
Nonetheless, because they are not intently focused on the future of their health, fitness and wellness, they are at a greater risk of disease and are setting themselves up for multiple chronic disease risk factors. Though they may currently have few functional limitations, they are at an increased risk of life compromising frailty and disability because of a lowered “physiologic reserve”.
Physiologic reserve is the excess capacity in organs and biological systems which we are born with. It tends to decrease over time and the effects can sneak up on a person. A secret of successful aging is to slow down the loss of physiologic reserve and a consistent effective exercise program is possibly the best way to do that.
Unfortunately, the people in this category are currently letting their physiologic reserve leave their bodies at an increased rate while also missing out on the benefits and joy of purposeful and intentional exercise.
4.Frail. Researchers Campbell and Buchner define frailty as “condition or syndrome that results from a multi-system reduction in reserve capacity to the extent that a number of physiological systems are close to, or past, the threshold of symptomatic clinical failure. As a consequence the frail person is at increased risk of disability and death from minor external stresses”.
Frail people over 50 often already have a debilitating disease and condition but are still able to perform most of the activities of daily living like bathing, dressing, using the restroom, and feeding themselves.
Nonetheless, because of their physical frailty and challenges they may be limited in their ability to perform all of what are known as “instrumental activities of daily living”. These include shopping, doing laundry, preparing meals and doing light housework.
5.Dependent. People who are in the dependent category are not able to perform all of the ADL’s and have to rely on others and/or physical aids (e.g. canes, walkers, wheelchairs) to complete their daily tasks. The degree of their physical disability is determined by the extent to which they unable to perform ADL’s and IADL’s.
Disability rates do increase with chronological age and are higher in women, African Americans and the poor. People can move in and out of the dependent category such as following a stroke (where function is lost) and during rehabilitation (where function is often regained).
So if you saw yourself or someone you care about as currently being in the independent, frail or dependent category, the goal would be to change the direction and speed of your aging trajectory towards the physically fit and possibly even elite category.
Every step and move upward in your functional aging capacity is a good step and a step you should feel good about and congratulate yourself on! And the truth and good news is that it is possible for everyone to improve their functional aging capacity.
For example, I recall reading about a nursing home where many of the elderly people participated in a six week strength training program. After just six weeks they had nearly doubled their strength and many of the participants were able to permanently give up their canes, crutches and even wheelchairs.
We, however, should do our best not to get to the place where we lose our functional capacity to the degree that we require any physical aids to get through our day. No, our goal is to not accept “getting old” status quo and to join the fully active, healthy and strong age-defying folks in the physically fit or elite categories of functional aging capacity.
Stay Strong! Fred
Fred Schafer, MS, CFT
Putting the Boom Back in Boomers!
100 Year Old Ida Keeling Push-Up video: