Exercise for older adults: the weekly targets after 65, and the balance work that prevents falls
After 65, the weekly targets stay close to those for younger adults, with one important addition. The World Health Organization recommends 150 to 300 minutes of moderate activity a week, muscle strengthening on at least two days, and, for older adults specifically, varied multicomponent activity that emphasises functional balance and strength on three or more days a week, to improve functional capacity and prevent falls. The NHS adds two simple rules: be active every day, even lightly, and break up long periods of sitting. The reason balance matters so much is that falls are common and serious. A Cochrane review of 108 randomised trials found that exercise programmes reduced the rate of falls in older people living at home by 23%. Strength also protects independence, since muscle and strength decline with age. Begin at your own level, progress gradually, and talk to your doctor first if you have a heart condition, dizziness or recent falls.
Your week against the targets after 65
Enter a typical week. One vigorous minute counts as two moderate minutes. After 65, WHO also asks for balance and strength work on three or more days.
- Moderate-equivalent minutes per week
- 80
- Aerobic activity
- Below the WHO range of 150 to 300 minutes
- Muscle strengthening
- Below the two days a week WHO recommends
A comparison with general targets, not a medical assessment. After a fall, or with a heart condition, ask your doctor which level suits you.
The targets after 65
The World Health Organization's 2020 guidelines apply the adult targets to older adults: 150 to 300 minutes a week of moderate-intensity aerobic activity, or 75 to 150 minutes of vigorous activity, and muscle-strengthening activities on two or more days a week. They then add a recommendation specific to this age group: varied multicomponent activity, combining balance and strength training at moderate or greater intensity, on three or more days a week. Unlike the previous 2010 guidelines, this applies to all older adults, not only those with poor mobility.
The NHS translates this for adults aged 65 and over:
- be physically active every day, even if it is only light activity;
- do activities that improve strength, balance and flexibility on at least 2 days a week;
- do at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity if you are already active;
- reduce time spent sitting or lying down, and break up long periods without moving.
The calculator on this page compares your usual week with these figures. Any step towards them counts: WHO stresses that some activity is better than none. The general logic is explained in how much exercise per week.
Falls: why balance training comes first
According to WHO, falls are the second leading cause of unintentional injury deaths worldwide, with an estimated 684,000 deaths a year, and adults older than 60 suffer the greatest number of fatal falls. The Cochrane review by Sherrington and colleagues recalls that at least a third of people over 65 living in the community fall each year.
The same review gives the most solid evidence on prevention. It pooled 108 randomised trials and 23,407 participants with an average age of 76. Compared with control groups, exercise:
- reduced the rate of falls by 23%, with high-certainty evidence;
- reduced the number of people who fell by 15%;
- may reduce the number of people with fall-related fractures, with lower-certainty evidence.
The programmes that work are those that train balance, walking and strength together. The NHS puts it simply: if you have fallen, or are worried about falling, strength, balance and flexibility exercises will make you stronger and more confident on your feet.
Strength: the muscle you keep is independence you keep
Muscle mass and strength decline with age, and the European consensus on sarcopenia places low muscle strength at the centre of its definition. Strength is what lets you rise from a chair, carry shopping, climb stairs and catch yourself when you trip.
The NHS lists many ways to train it: carrying heavy shopping bags, yoga, pilates, tai chi, lifting weights, resistance bands, bodyweight exercises and heavy gardening. A structured routine is easier to progress. Our guide to strength after 40 explains the principles, and the squat form guide shows the movement behind getting up from a chair, which can be practised with a chair behind you.
A week to begin with
An illustrative plan for someone who is not currently active, to adapt to your health and your doctor's advice:
- Every day: a walk, even a short one, and getting up every half hour when sitting for long.
- Monday, Wednesday, Friday: 20 to 30 minutes combining balance and strength. For example, sit-to-stand from a chair, heel raises holding a worktop, standing on one leg near a support, walking heel to toe along a wall, and rows with a band.
- Tuesday and Saturday: 30 minutes of brisk walking, cycling, swimming or dancing.
- Each week: add a few minutes or a few repetitions, never both at once.
For the flexibility part, our mobility exercises give a short routine for the hips, back and shoulders, and daily steps helps you set a realistic walking target.
Supervision helps, especially at the start
A meta-analysis by Lacroix and colleagues compared supervised and unsupervised balance and strength programmes in healthy adults aged 65 and over. Supervised training improved balance and muscle strength more than unsupervised training, and the authors recommend that about two of three weekly sessions be supervised. A qualified coach or a group class can correct technique, choose the right level and make progress safe. Our guide on the benefits of a personal trainer explains what to expect, and a personal trainer at home covers the format that avoids travel.
If you have a heart or lung condition, have had a fall, feel dizzy or unsteady, or have not been active for a long time, talk to your doctor before starting. Stop and seek advice in case of chest pain, unusual breathlessness, palpitations or dizziness during exercise.
Keep moving every week with Never Skip Club
Never Skip Club is a free app that builds guided sessions in a minute: choose a body area, the Easy level, 20 or 30 minutes and your place, at home with or without equipment, and follow five or six exercises shown in animation. You log your sets and see your progress.
The crews are what keep people going: three to seven friends, or family members, agree a rhythm, for example three sessions a week for a month, and the ranking rewards regularity rather than intensity. A grandchild and a grandparent can be in the same crew. Create your free account or sign in, and if you would like a professional by your side for the balance work, book a coach from our network for a session at home.
Questions
Is it too late to start strength training at 75?
No. The WHO guidelines recommend muscle strengthening on at least two days a week for all older adults, and the trials in the Cochrane review on falls had participants with an average age of 76. Start with bodyweight movements such as rising from a chair, use a support for balance, and progress slowly. Check with your doctor first if you have a heart condition or have fallen recently.
Does tai chi count as balance training for older adults?
Yes. The NHS lists tai chi, yoga and pilates among activities that build strength, and WHO recommends multicomponent activity emphasising balance and strength on three or more days a week. Tai chi works balance, coordination and leg strength at the same time. Combine it with walking for the aerobic part of the week, and with some resistance work using bands or light weights.
Can a grandparent safely join a fitness challenge with family members?
Yes, if each person trains at their own level. In a challenge built on regularity, what counts is completing the sessions you planned, not lifting more than others. An older adult can choose Easy sessions of twenty or thirty minutes focused on balance and strength while younger members choose harder ones. Agree the plan with a doctor first if there is a heart condition or a recent fall.
How many minutes a day should someone over 65 walk?
There is no single figure, but the NHS asks adults over 65 to be active every day and to reach 150 minutes of moderate activity a week. That works out at a little over twenty minutes of brisk walking a day, or thirty minutes on five days. If that is too much at first, start with ten minutes and add a few each week.
Sources
- Bull et al.: World Health Organization 2020 guidelines on physical activity and sedentary behaviour (Br J Sports Med, 2020)
- World Health Organization: every move counts towards better health (2020 guidelines launch)
- NHS: physical activity guidelines for older adults
- Sherrington et al.: exercise for preventing falls in older people living in the community (Cochrane Database Syst Rev, 2019)
- World Health Organization: falls, key facts
- Lacroix et al.: supervised vs unsupervised training on balance and muscle strength in older adults, a meta-analysis (Sports Med, 2017)
- Cruz-Jentoft et al.: sarcopenia, revised European consensus on definition and diagnosis (Age Ageing, 2019)