What doctors want older adults to know about physical activity

Regular movement is one of the most effective ways older adults can protect their health, maintain independence and boost quality of life. Yet fewer than 15% of adults 65 and older get the recommended levels of aerobic and muscle-strengthening activity, according to the government’s 2023 Physical Activity Guidelines for Americans. 

Physicians say closing that gap doesn’t require extreme workouts, just steady, safe, and personalized movement.

In a recent discussion, Northwell Health cardiologist Dr. Aeshita Dwivedi and geriatrician Dr. Philip Solomon discussed why exercise matters more with age and how seniors can build routines that support both physical and mental well-being.

Why movement matters

From heart health to mobility, the advantages of regular activity are well-documented. Dwivedi notes that patients who participate in structured cardiac or pulmonary rehabilitation after major procedures consistently fare better than those who don’t. These supervised programs teach patients ways to stay active while working around chronic conditions—skills that translate into long-term health improvements.

Exercise also plays a powerful role in managing stress. 

“For some people, exercise isn’t a vanity project—it’s a sanity project,” Dwivedi said. 

Physical activity triggers the release of endorphins while helping lower cortisol, the body’s primary stress hormone. Emerging research has linked regular movement with sharper cognition and a potential delay in dementia onset.

How much exercise do older adults need?

Health guidelines suggest 150 minutes of moderate-intensity activity per week—such as brisk walking—or 75 minutes of vigorous exercise, including running or fast cycling. Strength-training sessions twice a week are also recommended.

But Solomon emphasizes that these numbers are goals, not strict rules. Mobility challenges, chronic diseases, and age-related limitations mean many older adults can’t – or shouldn’t – jump straight into high-volume exercise.

“Moving 10 to 20 minutes a week is still better than zero,” he said. “These are frameworks, not absolutes.”

Tailoring activity to your health

Because physical abilities vary widely in older age, physicians encourage seniors to choose activities that match their current fitness level. Dwivedi advises beginners to “start low and go slow.” For example, building from 3,000 to 4,000 steps a day over several weeks before increasing intensity.

It’s also important to consult a doctor before starting a new routine, especially for people with lung or heart disease. Basic evaluations – or even a supervised stress test – can ensure that exercise plans are safe and appropriate.

While walking or swimming are great for cardiovascular fitness, specialists say balance and strength training are equally critical. Falling is one of the leading causes of injury among older adults, and the risk rises sharply with each decade.

Practices such as Tai chi, yoga, stretching, and simple balance drills can significantly reduce fall risk, Solomon explained. Strength training – whether through light weights, resistance bands or everyday activities like gardening – helps preserve muscle mass and bone density, both of which decline with age.