Lexington, KY - In some cultures, the elderly are treated like royalty, but the same cannot always be said for the United States, where senior citizens sometimes fall through the cracks of social circles and can become a strain on the already floundering health care system. 
For some seniors, hanging up the towel is not an option, and the statistics show that fitness programs oriented toward the needs of the elderly like SilverSneakers can actually reduce long-term health care costs. With baby boomers reaching age 65 at the rate of one every seven seconds, coupled with an aging American workforce in general, the need to look at cost-cutting programs is more crucial than ever.
"We have case studies and lots of data that proves that the health care costs are considerably lower for people who participate in SilverSneakers," said Alisha DeMoss, account manager with Healthways Fitness, the governing body of SilverSneakers.
According to the recent study Preventing Chronic Disease, funded by the Centers for Disease Control and Prevention, older adults who have been enrolled in the SilverSneakers Fitness Program for two years are admitted to the hospital less often, have lower inpatient care costs and have significant reductions in their overall health-care costs. 
Louise Goldey, a SilverSneakers member at the Nicholasville-based TammCor Fitness, said she has not been to the doctor in about a year. She joined the program just over two months ago to improve her strength and quality of life.
"I hurt my sciatic nerve and I had a lot of pain in my right leg and back, and that is practically gone," she said, adding that she has severely reduced shoulder pain as well. 
She also has improved her strength and has increased the amount of weight she can use in her SilverSneaker classes. As an added bonus, she has made some friends.
"I already knew a couple of the ladies, but we've been going out Fridays after class, and that's a good thing," she said.  "And I have so much more energy."
Studies show that relationships and usefulness to family and friends go a long way. According to the MacArthur Study of Successful Aging, adults ages 70 to 79 who felt higher usefulness to their loved ones were less likely to suffer from chronic illness or mortality. Loneliness was also a high risk factor for developing Alzheimer's disease. 
Goldey is now trying to get her sister involved in SilverSneakers, since she struggles with health problems. 
A Maysville woman who wrote to DeMoss said she lost 21 pounds and two pant sizes on the SilverSneakers program and went from a sedentary lifestyle with neck and back spasms to playing golf again. She and so many others in the program are proof that regular physical activity can positively impact health even later in life. A healthy elderly population equates to financial savings, as exercise also has been shown to be effective in preventing heart disease, diabetes, osteoporosis and even certain cancers.
The CDC study revealed that money is saved for the 65-and-up crowd in the program, generating an average of $500 less per member in total health-care costs by the second year in SilverSneakers, compared to non-members. Participants who averaged two or more visits per week over two years had costs that were more than $1,200 less than those who averaged less than one visit during the same period. 
These savings could add up and even alleviate some of the staggering price tag of Medicare. Medicare spending accounted for 20 percent of federal spending in the year 2008, and with a new generation about to age into it, this presents a problem. Health-care prices continue to increase dramatically, and the ratio of workers paying Medicare taxes to retired people reaping those benefits is decreasing. 
And the older the population gets, the more costly their insurance gets. According to Centers for Medicare and Medicaid Services, personal health care spending for the 65-and-up crowd was $14,797 in 2004 - 5.6 times higher than spending per child and 3.3 times higher than the average working-age person. Also, average Medicare spending growth is anticipated to be at 63 percent for 2013 through 2020, as baby boomers age into Medicare eligibility.  
But for a generation of baby boomers who are about to age into Medicare and therefore SilverSneaker eligibility, a traditional SilverSneakers class, which is performed primarily in a chair, might not be a good fit. 
"We are changing some of our programming and our approach, because people (at the age of) 65 now are fit, and doing a chair-based class is just not realistic for them," DeMoss said. "So we've added one class called Cardio Fit, and it's a SilverSneakers class that you don't have to use the chair; it's more advanced than the traditional muscular strength and range of motion class."
And rather than just giving members 65 and up a free gym membership to a facility that offers SilverSneaker classes, new enrollees can have other options, like a personal online portal to track their personal health and get new tips and information. Or they can receive a free kit for exercising at home. DeMoss said all of the get-healthy principles are the same; there are just some newer, less "old" options for a new generation of baby boomers. 
"I think a lot of people think, 'I'm healthy,' but then if they go in and start to exercise, or they get their biometrics or their cholesterol, and it's a wake-up call," she said, adding that the SilverSneakers program can be great prevention, and therefore money saving, for a generation of people just now entering their senior years who may not have paid close attention to their health. 
The SilverSneakers program is not automatically free to Medicare members, DeMoss explained. Participants must be Medicare eligible and have an insurance company - Humana is an example of one with a lot of SilverSneaker members - that offers SilverSneakers programs as an insurance benefit. DeMoss said Medicare Advantage plans are common for SilverSneaker enrollees, as they cover membership in the program as well as increased prescription drug coverage and other benefits. 
Kentucky currently has nearly 23,100 SilverSneaker members, and in August, they visited an average of 6.9 times per month. The Greater Lexington area had approximately 7,700 members, with an average monthly visit of 6.9 times. However there are nearly 27,000 people eligible for the program in Lexington and its surrounding counties. 
DeMoss said these numbers are pretty good on a national scale and that the benefits are starting to be recognized. She said Humana is Healthways' biggest client, but others like Anthem and AARP all cover Medicare products and offer SilverSneakers. 
"There are companies who have offered SilverSneakers, and then they decided not to offer it, because it costs a lot for the insurance company to have SilverSneakers," DeMoss said. "Especially with the cuts in Medicare, some of the insurance companies are saying they can't afford it. But then after they drop it (they) see how it affects their membership - doctor visits go up, but then also their members go someplace that still has SilverSneakers."
The program is gaining members as more and more people are clued in to the benefits, and as members like Goldey recruit family and friends to the program after they see the positive impact it can have on their lives. Down the road, this could lead to significant Medicare savings.