Alison Collings is dressed in her everyday blouse, skirt and sensible shoes. She is 85 and today she is working out in her cluttered living room with her personal trainer. They sit facing each other on two antique chairs. "Heel, toe, heel toe," says trainer Sally Barrett, urging her client to mirror the small movements she is making with her ankle. "Now side bends." Collings grumbles but complies, preferring to chat about the history of the chairs. She is able to do much more than her physical condition suggested when she shuffled to open the door to us.
Sometimes Barrett brings along boxing gloves for boxercise, or a step for a low-impact version of step aerobics, but today she wants Collings to use bands to improve her muscle tone. She produces a set of stretchy, long, thick bands in fluorescent pink, a staple of any gym, to provide resistance during stretching exercises. She helps her client place a band across her back, pulling both ends in front of her as far as they will stretch.
"I don't like those creepy, rubbery things," says Collings, again managing to pull them further in front of her than her appearance suggests.
Barrett, who gave up her job as a psychologist a few years ago and qualified as a personal trainer, says that she is being asked to provide workouts for an increasing number of clients in their 70s and 80s. Once the preserve of the young and the relatively affluent in pursuit of a body honed to an (often Hollywood) version of physical perfection, personal trainers are now expanding their client base to older people, many of whom understand the health benefits of keeping fit and active and have the disposable income to pay out £25-£30 for a one-to-one session with a trainer.
"Not all my older clients contact me because they're keen to exercise, though," says Barrett. "In about 50% of cases, their sons or daughters get in touch and ask me to work with their parents. The older generation haven't grown up with messages about the importance of formal exercise the way we have. And even if they can afford to pay for a personal trainer, a lot of them don't like the idea of spending that sort of money on themselves."
The benefits of exercise have been broadcast from every loudhailer in the land, but less well publicised are some very specific health benefits of exercise for older people. Exercise prolongs length and quality of life, reduces coronary heart disease, hypertension, non-insulin-dependent diabetes, colon cancer and depression. And the really good news is that even for 80somethings who have never pressed up, squatted or star-jumped in their lives, it isn't too late to start. What is particularly encouraging is that specific kinds of exercise can improve particular medical conditions such as cardiac problems and osteoporosis and can even reverse the physical decline associated with ageing.
Last week, a government progress report on services to promote wellbeing in older people called for a diverse range of physical activities to be made available to older people to improve their health. Any kind of exercise, including gentle walking for 30 minutes a day five times a week, is beneficial, but for those who can afford, it a personal trainer has some specific advantages for older people.
Taking joints through their full range of movement with squats, circling of ankle, elbow and wrist joints, knee lifts and exercises with light weights can improve strength and flexibility, and improving balance through exercises such as standing on one leg can help prevent falls. A trainer can demonstrate the safest, most effective way to do these exercises and can motivate older people to push themselves further than they might do if left to their own devices.
Anne Segal, a personal trainer who has several clients in their 70s, says: "The trouble with a gym is that some older people might feel embarrassed about going there or to a keep-fit class for older people. One exercise prescription doesn't fit everyone and with a trainer in a one-to-one situation, an older person can start slowly and get a lot of personal attention."
Barrett agrees. "If you put a class full of two-year-olds together for a baby gym session, they will more or less be able to do the same sort of things because they haven't been alive for long enough for much to have happened to their bodies. By the time someone is in their 60s, 70s or 80s an awful lot has happened and they are more in need of a programme that is personalised to the needs, abilities and limitations of their particular body."
Marion McMurdo, professor of ageing and health at the University of Dundee, says that whether older people choose to enlist the services of a personal trainer, go to a keep-fit class or arrange regular walks with a friend doesn't matter, as long as they are doing something.
"If there was a pill on the market that reduced the risk of heart disease, falls and depression, people would buy it. But it's not something you can buy, it's exercise, and you have to do it. The good news is that the amount of physical exercise required to benefit health is reassuringly little.
"Large studies have shown that older women who walk for one and a half hours a week have almost half the risk of heart disease of those who don't walk for that amount of time."
She says that as a nation we are "astoundingly unfit", but, while younger people get away with it, only noticing if they get badly out of breath when they run for a bus, older people find it much harder to function when they're unfit. "Older people are living on much narrower margins. They're on a knife-edge, and a small problem can knock them completely off kilter."
It was Alison Collings's son, Richard, who got in touch with Barrett on behalf of his mother after she was hospitalised a few times after falls. "She had some physiotherapy after she was discharged from hospital, which really helped her, but she was only allocated this treatment for a certain amount of time. I wanted her to continue and contacted Sally.
"My mother was resistant at first, but the sessions have been of enormous benefit to her in building up her physical confidence. Her various hospital stays must have been costly for the NHS, but since she started working out with Sally she hasn't had any falls. A small investment in personal trainers for older people could save the NHS a fortune," he says.
Collings seems to tolerate rather than enjoy her sessions with Barrett, but she doesn't refuse to cooperate.
"I enjoy Sally's personality as much as anything," she says. "I feel tired after the sessions but I know they're helping me. If it wasn't for Sally I'd just sit reading the paper all day."
Gwen Williamson, 73, feels more tangible benefits from her sessions with a personal trainer. "I used to be very active, cycling, playing tennis and doing Canadian Air Force exercises every morning. Then my husband died six and a half years ago and I became less active. I do a whole range of exercises now, including squats and working out with hand weights, and I feel so much better. Without a personal trainer to give me a push I would never have had the confidence to get started on exercise again. Now that I have, I want to do more, and am looking into going along to my local gym."
Philip Kramer, 80, a retired doctor, has been using a personal trainer for the past month, again at the instigation of his son. "It's good because my trainer gets me to use all my muscle groups. She wrote to my cardiologist, who encouraged me to start doing this. He said all his patients should be doing some sort of aerobic exercise. I don't have any particular ambitions for my training sessions, except to keep well. There's no doubt that elderly people do best when they exercise."
Barrett says it's important for older people to get the go-ahead from their doctors before embarking on sessions with a personal trainer or any other form of exercise. "A lot of the exercises I do with older people are gentler adaptations of what younger people do at the gym. I enjoy working with my clients of all ages, but what's rewarding about working with the older clients is that you can see real improvements very quickly when they start exercising."
For Williamson, exercising has opened up a whole new world. "My friends laugh at me for having a personal trainer, but if I hadn't had a push start I never would have done anything. I used to shuffle along, but those days are long gone. I walk properly now. The other day I was walking towards the bus stop. I used to watch the bus pass by me and say: 'Oh I'll wait for the next one.' But this time I ran for the bus and I caught it. It was a wonderful feeling."
