Traditionally, advanced age and frailty have been seen as reasons not to prescribe exercise. However, it now appears that these are among the strongest indications for the promotion of lifelong exercise programs by general practitioners.
- Frailty and functional decline are indications for an exercise prescription in the very old.
- Stable chronic diseases do not generally preclude exercise in very old patients.
- Screen patients for new cardiovascular or musculoskeletal complaints before prescribing exercise.
- Look for deficits in strength, endurance, balance or flexibility and prescribe exercise specifically to correct the most important impairments first.
- Provide behavioural incentives to encourage patients to continue new exercise habits over time.