Can Older People Profit From Exercise Testing?

QUESTION: I'm ready to start but cautious. Can older people profit from
exercise testing?
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ANSWER: Exercise testing, the evaluation of how well a person can deal with
the stress of exercise, is a valuable test of the health of your heart. This
test is used to help diagnose arrhythmias and to assess the condition of the
coronary arteries and muscles of the heart. If you have had a heart attack or
heart surgery, an exercise test will help determine how much damage your heart
has sustained and will help you and your physician choose an exercise
rehabilitation program for you.
Because the incidence of cardiac problems increases with age, exercise
testing is done more often on older individuals that those under age 35, but
special considerations do have to be taken with elderly (over age 65)
patients.
In general, exercise testing is done in a physician's office or clinic
using a treadmill, although sometimes a bicycle ergometer (a form of
stationery bicycle) is also used. Before the test begins, you will be asked
about your normal exercise habits so that the technicians can determine what
speeds to start you out on. Your physician will probably take an
electrocardiogram (ECG) before the test begins, a step that may be skipped in
younger individuals.
Most elderly people have never been on a treadmill before. Your
physician or the technicians will show you how to walk on it to make sure you
are comfortable with it and allow you to warm up a bit before starting the
test. While using the treadmill, walk in a relaxed manner and look straight
ahead. Don't lean on the front handrail, because this can throw off the ECG
readings; use the side rails if you need to keep your balance.
To make sure a reliable reading is obtained, your physician may ask you
to stop taking certain heart medications, such as beta-blockers or calcium
blockers, a day or two before the test. He or she will give you instruction
on tapering down your medication and then restarting it.
When the test begins, you will simply be walking on the treadmill at a
speed of about 2 miles an hour. This is a speed most elderly people walk at
normally. At different stages in the test, the front elevation of the
treadmill will be increased, which will make it seem like you are walking up a
gradually steepening hill. If you have any trouble keeping up with the
treadmill or feel you cannot cope with the elevation, tell the technicians.