Exercise is the key to healthy ageing. This became clear at the bestform congress held by the Clinic for Preventive Sports Medicine and Sports Cardiology at the Technical University of Munich (TUM) in October. Experts from the fields of geriatrics, sports medicine and sports science emphasised that targeted training improves the quality of life of older people and can delay the need for care. Dr Stefan Arend from the Institute for Social Management and New Forms of Living: ‘We now know what we need to do to stay fit into old age.’
Fitness into old age: the bestform programme
The bestform programme, a multimodal training concept consisting of strength, coordination and endurance exercises, is specially tailored to the needs of older people. The aim is to maintain mobility and independence. The congress made it clear that exercise not only strengthens physical fitness, but also promotes social contacts and can slow down mental decline. Regular participation in exercise programmes can have positive effects on many levels.
Scientific studies underpin the success
The feasibility of the bestform programme was successfully demonstrated in a pilot study conducted in 2018/19. In two senior citizens' facilities, 42 per cent of residents still participate regularly, reports Stiftsdirektorin Lisa Brandl-Thür, who has been involved with the programme since the pilot phase at KWA Stift Rupertihof. In a subsequent study involving 21 facilities and 400 participants, the positive effects of the programme were scientifically confirmed.
Exercise to prevent falls and improve well-being
[Studies show that up to 92 per cent of residents in care facilities are predominantly inactive. This is exactly where the bestform programme comes in. According to Prof. Dr. Monika Siegrist from TUM, equipment-based training is particularly effective in preventing falls and maintaining physical performance. ‘Even a reduced number of steps over 14 days leads to a significant drop in performance,’ warns Heidelberg geriatrician Prof. Jürgen Bauer. Regular training not only increases safety, but also well-being and independence.
The effects of exercise are far-reaching: in addition to preventing falls, regular activity leads to better balance and can alleviate pain. Especially in care facilities, where lack of exercise is often the norm, a structured exercise programme is an important addition to care. It enables residents to maintain their everyday skills for longer.
How exercise can influence dementia
Regular physical activity plays a crucial role in the care of people with dementia. According to physiotherapist and sports scientist Dr Tim Fleiner, exercise improves blood flow to the brain, has an anti-inflammatory effect and strengthens cognitive functions. Research suggests that dementia-related waste products are removed from cells more effectively when patients exercise more, says Fleiner.
The new dementia guidelines therefore recommend individual exercise programmes, including innovative approaches such as exergaming (a combination of “exercise” and “gaming”, also known as fitness gaming) or mind-body exercises. These approaches can alleviate the symptoms of dementia, slow its progression and significantly improve quality of life. It is particularly important that the exercises are tailored to individual abilities. Even simple movements, when performed regularly, can have a lasting effect.
Innovative care concept: Domino coaching
The Berlin-based care company domino-world™ focuses on a concept that views care as coaching. Instead of traditional nursing homes, the facilities are referred to as ‘clubs’ where residents undergo an individual training and therapy programme. Specialists there are called ‘Domino Coaches.’ After an initial consultation and a geriatric assessment, they create an ‘individual strengths and weaknesses profile,’ from which a set of goals is derived. To achieve these goals, there are group exercises, strength and circuit training, and daily physical exercises that promote independence and well-being.
Lutz Karnauchow, founder of domino-world™ and developer of the domino-coaching care concept, emphasises: ‘It's not about stopping ageing, but about being less dependent and leading a happier life.’ In some cases, patients can return to their own homes after just three to six months. These successes illustrate how important it is to promote innovative care concepts that focus on people and strengthen their resources.
Fall prevention: new guidelines and technologies
The Federal Fall Prevention Initiative (BIS) updated its guidelines in 2023 to minimise falls and their consequences among older people. For seniors with moderate risk, a mix of group training and individual sessions is recommended. For those at high risk, complex interventions are used, including balance training and specific movement sequences such as getting up from the floor independently to minimise lying time in the event of a fall.
In addition, the TH Köln is working on AI-supported fall detection systems. According to project manager Prof. Dr. Axel Wellendorf at the Institute for General Mechanical Engineering at the TH Köln, these sensors can detect falls with 98 per cent accuracy and immediately inform nursing staff. The aim is to detect falls at an early stage and minimise their consequences. In the future, this technology could make a decisive contribution to safety in care facilities while also reducing the workload of nursing staff.
How exercise can influence dementia
The Berlin-based care company domino-world™ is committed to a concept that views care as coaching. Instead of traditional nursing homes, the facilities are referred to as ‘clubs’ where residents receive individual training and
The Federal Fall Prevention Initiative (BIS) updated its guidelines in 2023 to minimise falls and their consequences among older people. For seniors with moderate risk, a mix of group training and individual sessions is recommended. For those at high risk, complex interventions are used, including balance training and specific movement sequences such as getting up from the floor independently to minimise lying time in the event of a fall.
In addition, the Technical University of Cologne is working on AI-supported fall detection systems. According to project manager Prof. Dr. Axel Wellendorf at the Institute of General Mechanical Engineering at the Technical University of Cologne, these sensors can detect falls with 98 per cent accuracy and immediately inform nursing staff. The aim is to detect falls at an early stage and minimise their consequences. In the future, this technology could make a decisive contribution to safety in care facilities while also reducing the workload for nursing staff.
Motion sensors increase safety
Technological aids such as motion sensors are becoming increasingly important in nursing homes. They not only help to detect falls, but also to prevent pressure sores. Pressure sensors in beds detect changes in position and can significantly increase the safety and well-being of residents. ‘Technology is becoming an integral part of modern elderly care,’ emphasises Dustin Feld from Medifox. At the same time, such systems enable more precise care, as they provide relevant data on the movement patterns of residents.
Mobility before aids: preventing pressure ulcers
Immobility is one of the main causes of pressure ulcers. Therefore, before using aids, it should always be checked whether the mobility of residents can be improved, explains care expert Gerhard Schröder. Only when personal mobility is no longer sufficient should aids be used. Movement remains the most important factor in avoiding health complications and increasing quality of life in old age.