What doctors wish older adults knew about physical activity

AMA News Wire

Nov 14, 2025

Staying active is one of the most powerful ways older adults can protect their health and independence. Yet less than 15% of adults 65 or older get the recommended amounts of aerobic and muscle-strengthening physical activity, according to the 2023 Physical Activity Guidelines for Americans. Regular movement, whether walking, swimming or chair-based exercise, can help reduce the risk of chronic conditions, preserve mobility and improve mood.

Even small increases in daily movement can make a meaningful difference in strength, balance and overall well-being. Understanding how to exercise safely and consistently is key to maintaining health and quality of life as people age.

The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they want patients to understand about today’s health care headlines and how to take charge of their health through preventive care.

In this installment, two physicians discuss what patients need to know about physical activity. They are:

Aeshita Dwivedi, MD, a cardiologist with Northwell Health in New York City and director of ambulatory cardiac CT at Concorde Medical Center in Manhattan.Philip Solomon, MD, a geriatrician director of geriatric education and clinical integration at Northwell Health in Lake Success, New York.

Northwell Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

Physical activity helps improve health

“There’s actually a lot of data—specifically speaking from a cardiac standpoint, but also from a lung standpoint—that patients who have stents put in or cardiac surgery, such as bypass surgery,” said Dr. Dwivedi, “who are referred to cardiac rehabilitation, which is basically a supervised exercise program, do a lot better than patients who don’t go to cardiac rehab.”

“So, pulmonary rehab for lung patients and cardiac rehab for heart patients where they get enrolled in a two- to three-month supervised exercise program where they learn how to stay active with dealing with the chronic condition, the outcomes are so much better,” she said. “The rehabilitation of cardiac or pulmonary conditions can definitely help patients improve their health status.”

Exercise is a huge stress reliever

“One of my patients once told me that, for him, exercise is not a vanity project—it’s a sanity project,” said Dr. Dwivedi. “And I couldn’t agree more because exercise is such a huge stress reliever.”

“Stress is associated with so many conditions such as heart disease, high blood pressure and neurological diseases,” she said. “When we exercise our body releases helpful hormones such as endorphins and it lowers our stress hormone cortisol.

“All of this combined helps so much with our mental health,” Dr. Dwivedi added, noting “there are some studies that have shown that there’s an improvement in the onset of dementia and it helps to, overall, keep you mentally sharper. So, it definitely has so many benefits for your neurological and brain function.”

Get 150 minutes of moderate activity a week

“The recommendations are 150 minutes a week of moderate intensity aerobic exercise,” said Dr. Solomon. “So, what does that mean? It means if you’re doing some type of brisk walking, that would pretty much qualify. Anything above that is going to be at least moderate intensity.

“Generally, the goal is to reach at least 75 minutes a week of vigorous activity, which would be running or cycling,” he added. Then, “in terms of trying to do strength training, the goal is to reach at least two days a week of that.”

“But these are not blocked time. We’re not looking on Monday to make sure you do 150 minutes of brisk walking. These are things that we like to break into sessions,” Dr. Solomon said. “So, if you can do five 30-minute sessions a week of brisk walking or if you’re doing three 25-minute sessions a week of running or cycling, you’re definitely meeting those thresholds.”

Activity recommendations are suggestions

While there are physical activity recommendations, “those numbers are not going to be practical for everybody, especially for older people who may have some mobility limitations, some limitations due to other underlying diseases like arthritis or chronic things that limit people’s mobility,” said Dr. Solomon. “So those numbers are frameworks, they’re suggestions, they’re not absolutes.

“And it goes back to the idea that moving 10 to 20 minutes a week is still better than zero,” he added, noting, “these are certainly our guidelines and these are some of the numbers that we’ve seen in pretty rigorous studies that lead to those types of benefits to exercise, but we shouldn’t feel bad if our Apple Watch is telling us we only reached 140 minutes a week.”

Tailor physical activity to health status

“The bottom line is that you have to tailor physical activity to your health status and also your mobility status,” said Dr. Dwivedi, “because the number of steps that might be good for a 50-year-old is different from a 70-year-old, which is different from a 20-year-old.”

That is why “it’s always good to ask your doctor about what exercises are safe based on your medical history,” she said. Beyond that, “I always tell my patients, start low and go slow. So, if you’re someone who doesn’t exercise at all, you might want to start with doing three to 4,000 steps and then build up on it over a month or so.”

Seniors should incorporate balance workouts

“Stretching, yoga and balance are important for everybody, but that’s so important for older people,” said Dr. Solomon. “The risk of falls increases exponentially with every decade of life, especially when we reach that seventh, eighth, ninth decade of life.”

“Balance training, if anything, takes on an outsized importance to make sure that we reduce the risk of falls,” he said. For example, “there are studies out there that we know if an older adult takes part in Tai chi on a regular basis, it actually reduces the risk of falls.

“So, maintaining that core strength with attention on balance is super important for older adults,” Dr. Solomon added.

Include strength workouts

Beyond aerobic exercises, it is important to also incorporate weightlifting and other strength workouts for seniors, said Dr. Dwivedi, “because strength training helps to support maintaining your muscle mass.

“It can also help to maintain bone density, and it can even aid in daily function for older adults,” she said.

Expanding on that, Dr. Solomon noted that “when we reach our sixth, seventh decade of life, it’s really difficult to build muscle and really easy to lose muscle.

“So, we really do emphasize having some type of strength training, even if it’s very lightweight, even if it’s things that might not be weight bearing exercise—things like gardening,” he added. “Just moving your muscles around for strength, that could help to maintain at least some of that muscle mass that we know we lose.”

“Especially for older adults at risk of things like bone disease and osteoporosis, that strength training is a really important piece,” said Dr. Solomon.

Try low-impact exercises for older adults

When moving from a more sedentary lifestyle to being active, low impact exercises for older adults can be beneficial.

“For example, if you’re someone who wants to eventually go running, I would start with a few walking sessions, a few incline walking sessions, and then maybe do a walk, run, walk, run,” said Dr. Dwivedi. “You walk for a bit, run for a bit until you build up to running more.”

“That’s true for any other exercise too. You want to get into strength training? Body weights are enough,” she said. “So, if you want to do squats with your body or if you want to start with a two-pound dumbbell, that’s totally fine because all of that has additive benefit and then you slowly, gradually graduate to higher weights.”

Chair workouts for seniors can help

With mobility concerns, chair workouts for seniors can help with strength and flexibility. For example, there are knee extensions where you sit in the chair and extend one leg straight out in front of you. There are also arm, core and balance exercises for chair workouts for seniors. But make sure to warm up and cool down properly.

For chair workouts for older adults, “much of the work has been done in long term care settings,” said Dr. Solomon. But chair workouts “can be effective tools for people with mobility impairments.”

“There is some evidence for improvement in depressive and stress symptoms, and potential impact on fall risk,” he explained.

Related Coverage

What doctors wish patients knew about increasing physical activity

Stretching exercises are also key

As older adults, it is also important to include stretching in your exercise plan. This is important because stretching is “certainly thought to help with flexibility, range of motion and balance,” said Dr. Solomon. And the flexibility that is gained from stretching exercises for seniors can protect you from injury.

Before stretching, warm up with five to 10 minutes of light activities. Then, keep stretches gentle and slow without bouncing. And make sure to breathe through your stretches. But if you ever feel pain, stop immediately. Some stretching exercises include calf stretch, hamstring stretch, quadriceps stretch and hip flexor stretch.

Listen to your body

Beyond what physical activity or exercise to choose, it is all about listening “to your body,” said Dr. Dwivedi. “Your body is very intelligent. If doing something doesn’t feel right, your body is going to give you signs

“Don’t push through it. Just listen to your body,” she added. “If something doesn’t feel right when you’re exercising—whether it’s your heart or your joints—get it checked out so that you can continue safely.”

Talk to your doctor before beginning physical activity

“Speaking to your doctor about exercise is important,” Dr. Dwivedi said, noting “your doctor might want to do some basic testing before they recommend physical activity.”

“If you have certain conditions such as lung disease or heart disease, it’s important to get yourself checked out before you start an exercise program,” she said. “Sometimes your doctor might want to do a stress test in the office to see how your blood pressure and heart rate respond with exercise. That’s a good place to start.

“And then, sometimes for some people—especially if you have joint issues—it’s not a bad idea to go see a physical therapist, to get some sort of basic exercises to learn that work with your body and then build upon it,” Dr. Dwivedi said. “So, certainly seeing a physician is helpful because they can do an evaluation and help guide physical activity recommendations.”

What doctors wish older adults knew about physical activity

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