MEDICAL PRACTICE Prescribing Exercise for Frail Elders

Background: Frail elders often have chronic illnesses, such as osteoarthritis, hypertension, diabetes, and peripheral vascular disease, for which exercise is a proven means of achieving nonpharmacologic benefits, even at advanced age. Exercise has been shown to enhance the quality of life for these elders. Methods: A literature search of exercise literature applied to older adults and lifestyle modifications was conducted, summarized, and then reviewed with practicing colleagues. Results and Conclusions: Exercise continues to be an underused therapeutic intervention for frail elders as a result of barriers created by patients themselves, their caregivers, and their health care providers. Family physicians can overcome these barriers by prescribing appropriate exercises and by tailoring the exercise to the functional needs and preferences of their patients. An exercise prescription for frail elders is based on a pragmatic strategy that makes therapeutic exercise both sustainable and safe. Such a strategy incorporates motivational elements and knowledge of achievable benefits. (J Am Board Fam Pract 2002;15:218–28.)