Martin Wegenstein grew up in Switzerland and his parents put him on skis long before he attended his first day of school. He didn't think of it as exercise—it was fun. As he grew older, he added other sports. When a friend suggested Wegenstein try out a new jogging track installed at their workplace, he did. He didn't have the right shoes, but he started going every day at lunch. "All of a sudden, I was in it," Wegenstein said. "I started to run 5ks, 10ks, all the way up to marathons."

In 1992, he and his family moved to Menlo Park, Calif., and later bought a house in the Sierras, which made it easy to ski often. Wegenstein, looking for a way to enjoy the mountains in summer, started mountain biking. A couple of years later, he branched out to road biking, quickly working his way up to more than 100 miles weekly. In 2000, he completed his first Tour de California Alps, one of road cycling's most intense one-day challenges: 129 miles, up and down five mountain passes in the Sierras, with combined climbing of over 15,000 feet, in weather that varies from pouring rain to snow to stultifying heat. His first time, he said, he was a bit cautious, so it took him nearly 12 hours to finish.

Wegenstein will turn 60 next May. While he still skis over 40 days a year, he doesn't do ski jumps any more and he has stopped jogging–two knee injuries repaired by Stanford Hospital & Clinics doctors prompted them to recommend those changes. But he's on a course to increase the chances that in 20 years or more, he'll still be an inspiring representative of how activity influences aging.

Growth in numbers and knowledge

Every other year, the National Senior Games brings together thousands of other representatives of that influence: older athletes, prepared with purpose and intent like Wegenstein, whose continuing physical accomplishments after age 50 are shining proof that using it keeps you from losing it–a basic principle all doctors believe. This year, Stanford Hospital & Clinics is a major sponsor of the Games, which open Aug. 1 in Palo Alto, at venues on the Stanford University campus and elsewhere in the Bay Area.

The Games will host 10,000 senior athletes this year, symbolic not only of its own growth since 1989, when 2,500 competed, but also of the increasing proportion of seniors within total population: one in eight Americans are now 65 or older; in 40 years, the ratio will be one in five. Sixty-five percent of the Games' 2009 participants are 61 and older.

Attitudes about life beyond that age are also changing. Nearly 15 years ago, Stanford Hospital physician Walter Bortz wrote a pioneering self-help book,"Dare to Be 100." Now nearing 80, Bortz ran the New York Marathon in 2008 and many, many other physicians and proponents have joined his advocacy of healthier aging through activity."When I first started on this stuff 30 years ago, everybody poked fun at me," he said."It's no longer a bland platitude, it's science."

Age has no firm rules

The plain biological fact is that muscles don't wear out as we age. Even in the body of a 90-year-old, their strength and flexibility improves within days of increased activity. And when people keep moving, many other good things happen.

Keeping active has comprehensive effects. "It's not that you'll get the way you were at 20," said Stanford Hospital orthopaedist Michael Fredericson, MD, "but every part of your body will benefit your immune system, bone density, cholesterol levels, cardiac parameters."

"Another plus of activity's improvement to bone and cartilage density is that it reduces the likelihood of bone breaks after a minor fall," said Gary Fanton, MD, Chief of the Hospital's Sports Medicine Division. More than 67,000 Californians 65 and older fell and were hospitalized in 2006. In 2007, 27 people in San Mateo County 65 and older died from fall injuries.

Injury doesn't mean stop

Even post-injury treatment philosophy is more driven by the idea of staying active. "On general principal, we do try and get people moving," Fredericson said. "You want to get the body moving as quick as you can. If you have a fracture, we wouldn't recommend that all of a sudden you start putting weight on it. But there's always something you can do."

Fredericson's fellow Stanford orthopaedist, Tim McAdams, MD, did Wegenstein's most recent knee repair and advised him to lay off weight-bearing activity for several weeks, but to keep moving. McAdams recommended to Wegenstein a machine that moved his knee for him. He grabbed his laptop so he could work, too, and kept his knee from stiffening up. Even though Wegenstein had only three weeks to train for that mountain passes event that year, he still completed the grueling course.

As Wegenstein was forced to recognize, sometimes aging means doing things differently. The key to keeping fit with an aging body, Fredericson said, is changing how you exercise. "You need to get smart, not overdo it and come at your body in different directions," he said. "Running is a great exercise, but it loads your body only in one plane of motion. It's important to cross train."

In addition to cycling and skiing, Wegenstein does weight training and plays tennis.

A surefire preventive

Nor are the benefits of activity restricted to anatomic mechanics. "There's good evidence that maintaining activity does have a positive effect on the brain and, in particular, on mood," said Peter Pompei, MD, a Stanford Hospital gerontologist and member of the Improving Doctoring for Elder Americans Task Force of the Society of General Internal Medicine. "People who remain physically and socially active do better."

And it's as close to a fountain of youth as may ever exist. "There is so much evidence and research to support that staying active is one of the biggest preventive methods we have against physical vulnerability to falls and cognitive problems," said Stanford Hospital's Rita Ghatak, PhD, Director, Aging Adult Services.

For people whose motion has been restricted, or who haven't done specific exercises for flexibility and strength, building a helpful routine isn't complicated and can easily be done at home. Stanford Hospital sponsors a free exercise program for seniors called Strong for Life. Staff instructors with trained volunteers visit local senior centers for group classes. The program is so popular that even with 10 trainers, it's hard to keep up with the demand for additional classes.

The evidence-based exercises, said program director Candace Mindigo, are based on specific living skills "important in every day life, like getting out of a chair or picking up a grandchild."

Staff instructor Larkin Lapides, 65, volunteered to lead classes for the program five years ago, "so I would exercise regularly," she jokes. Over and over, she's seen changes happen for class participants. "I see 80- and 90-year-olds improving," she said. "I've seen those who don't exercise and those who do and it's a cautionary tale."

The classes meet weekly, for 35 minutes, and the routine can include anything from stretches with resistant fitness bands to arm circles and deep breathing. The focus is to strengthen the core abdominals, back, legs and arms to improve balance and flexibility. The program distributes DVDs so people carry on the exercise at home.

Being active isn't complicated

That word exercise, however, may be a barrier to understanding that activity doesn't have to be deep knee bends or a trip to the gym. "Just regular activity can have significant positive effect," Pompei said. "I don't even like to call it exercise. It can be those daily activities we would do normally. Doing more walking and recreational activities you like will be beneficial."

Wegenstein's advice builds on Pompei's. "Just start, whatever it is. Do an activity and do it every day or five or six times a week at a certain time, just the way you get up every morning and take a shower. After a while, it becomes a habit that you can't get rid of."

Then, he said, "have fun with it. For me, it's not about being the best 59-year-old biker, for me it's to have fun doing it. I never thought of myself as a senior, although my age qualifies me. I think of myself as who I am."

Bortz is not one to focus too much on age either, except when it comes to his favorite saying on the topic: "It's never too late to start, but it's always too soon to stop."

SEE THE GAMES AND LEARN MORE - Aug. 1-15, Stanford University

As part of the 2009 Senior Games, Stanford Hospital & Clinics will present free talks by some of its senior health experts in aging and performance enhancement. Except as noted, all lectures are at Avery Rehearsal Hall, adjacent to the Avery Aquatic Center. At the nearby Athletes Village, the Hospital's booth will be the location for demonstrations and programs highlighting special Hospital services. On the schedule are visits from the therapy animals of Pet Assisted Wellness at Stanford, performers from the Hospital's music program and organic chef Jesse Cool.

*In the Athletes Village, Stanford Hospital & Clinics booth