Exercise.(Women's Health Adviser)

Exercise can never be too little or too late. Older women, especially those with sedentary lifestyles, may be surprised to hear that, but the facts are indisputable: Regardless of a woman's age or health status, exercise reaps a host of physical, mental, and psychosocial benefits.

In fact, a recent follow-up study of physical activity in older women concluded that a long-term moderate exercise program decreased all-cause mortality by 48% and lowered the risk of cardiovascular disease by 36% and cancer by 52%, compared with the risks for sedentary older women (JAMA 289[18]:2379-86, 2003).

The findings were similar for women with and without chronic disease; even women over age 75 benefited from the exercise program, though to a lesser extent.

Here are some things to tell postmenopausal women about exercise:

* Lay out the benefits. Most patients have heard time and again that exercise is good for their health. But it may help to emphasize the ultimate benefit of maintaining independence.

Cardiovascular training strengthens heart and lungs, decreasing the risk of diseases that hasten disability. Balance exercises markedly reduce the falls that can lead to debilitating injuries and nursing home placement. Weight training strengthens hones as well as muscles, making women less vulnerable to fall injuries if they do happen. Stretching preserves flexibility, which can help women maintain their activities of daily living, and therefore care for themselves, as they age. And exercising with friends creates a strong social network that can provide valuable support through good times and bad.

Exercise is particularly important For older women functioning as caregivers for ill family members, since it reduces stress, improves sleep, and reduces the rate of depression in this group.