b'Medicine & Researchhigh blood pressure, high cholesterol), psychiatricof wellness. It has both physical and mental diseases (depression and anxiety), diabetes,benets. Joining an exercise class for older thyroid disease, and cognitive impairment.adults not only provides exercise but can also Also, symptoms of MS may affect personsoffer social interaction. with MS negatively as they age. Fatigue, pain,Various exercise programs for older persons low vision, weakness, spasticity, decreasingwith MS are available to anyone who wants to mobility, and bladder and bowel dysfunctionbegin. For instance, if a person with MS is can impair the ability of persons with MS todisabled and cannot get to a class, chair yoga get to their primary care provider for diagnosisis a good way to begin, and classes can be and treatment. accessedthroughtheinternet.Duringthe It is vital that older persons with MS completepandemic, many exercise programs for disabled routine age-appropriate screenings for thepeople went online and now YouTube is lled possibility of comorbidities. (See the article bywith free videos for those who want to try. If a Dr. Miravalle on page 24 for more on this.) Theseperson with MS can walk, beginning a program screenings, which include annual physicals,of walking is very benecial. While its safe for bloodwork, and vaccinations are important tomost people to begin an exercise program, all prevent, diagnose, and treat the disease early.new attempts at exercise should begin slowly It is essential that all persons with MS have aand safely. As always, discussing the exercise primary care provider who will order appropriateplan with a healthcare provider is advised.tests. In addition, it is crucial for all healthcare Quuaalliittyyoofflproviders to communicate with each otherQ liiffeeabout any new or underlying diagnosis.Quality of life has been defined as the A degree to which a person or group is healthy, AccttiivviittyyaannddEExxeerrcciisseeSedentary behavior is common in the oldercomfortable, and able to enjoy the activities population. The levels of exercise are very low,of daily living. Good quality of life can be and in a study of older adults, it was found thatchallengingwhenlivingwithanychronic most were engaged in 13 minutes of exercisedisease and older people with MS may be daily compared to 423 minutes of sitting.living with comorbidities. In MS, certain Olderpersons withMShaveevenmorecomorbidities have been shown to decrease sedentary behavior and less exercise thanquality of life. their elder counterparts. Inadequate exerciseDepression is the most common mood is very common and may be the result ofdisorder in the MS population and can affect disability, comorbidities, and other symptomsmore than half of the people with MS at some of MS. Physical inactivity, no matter howpoint of their lifetime. It has been shown to disabledthepersonmaybe,isassociatedbe the main contributor to decreased quality with decreased functioning in the older personsof life. Depression not only affects mental with MS. qualityoflife,butitcanaffectapersons The importance of exercise cannot be over-physical quality of life. It can impair motivation stated. It is well known that exercise increasesto do things and can limit progress physically. endorphins and gives the participant a senseImportantly, depression is often unrecognized msfocusmagazine.org 16'