Dear Dr. Roach: I’m a 75-year-old woman in excellent health. I either walk or exercise daily with fitness videos that are great and provide a lot of body science along the way. The only thing I’m unsure about is that the video instructor doesn’t believe in using weights, and feels that using and raising our arms, legs, etc., will offer enough weight for those of us over 50. However, most fitness articles say that using weights is essential for all ages, especially for the elderly. I’ve used two- and five-pound weights in the past for walking and exercise, but even those are uncomfortable. I’ve always had very strong legs but not much upper body strength. What’s the best advice?
A.O.
Weight training has benefits that cannot be obtained with aerobic exercise alone. Resistance training, usually with weights, is particularly important for older women, because when done properly, it increases muscle strength and balance. It also reduces fall risk, as well as bone strength, reducing the risk of fracture even if one does fall. Exercise with a combination of aerobics, stretching and weights is ideal, since each of these offers independent benefits.
However, we sometimes don’t live in an ideal world, and any exercise is better than no exercise. I wouldn’t want you to give up entirely because you think you aren’t getting benefit without the weights. Exercise using body weight also can increase strength. You don’t need to have physical weights in your hand to get the benefits of resistance exercise.
I generally advise against having weights held in the hand (or strapped to limbs) while walking or jogging. It may change your natural gait and put stress on your lower joints, from your toes to your hips. It also can have the potential for upper limb injuries. I advise separating your aerobic activity from your weight-training activity.
Dear Dr. Roach: Three days after receiving a COVID booster, I started a nine-day course of oral prednisone (40 mg tapering down to 10 mg). Since the nurse practitioner who issued the booster also prescribed the prednisone (for psoriasis), I didn’t think there was a problem, but I later read that prednisone might interfere with the booster’s effectiveness. I checked with my doctor, and he said that because I started the prednisone three days after the booster, it was “probably effective.” Do you agree? I’m concerned, because my husband is at very high risk for serious complications from COVID.
G.C.
I agree with your doctor that the vaccine booster dose was probably effective. I know you’d like to hear me say it was absolutely effective, but there is not strong evidence to prove that.
Most experts say that prednisone at greater than 20 mg per day for more than two weeks is enough to reduce effectiveness of the booster, but I think the three days you had of the vaccine before starting prednisone — and the fact that you were not on very high doses nor on them for very long — makes the vaccine very likely to have been effective.
Hopefully, your husband has had four doses of the COVID vaccine. If he is unable to get the vaccine, has a medical condition, or is currently on medications much more concerning than the prednisone doses you were taking, he should consider Evusheld (a combination of anti-COVID antibodies) to give him additional protection for about six months.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
