A clinical review from geriatricians at the University of Alabama at
Birmingham suggests physical activity is important for healthy aging and urges
primary care physicians to take a more aggressive role in ascertaining the
mobility of their older patients.The study was published Sept. 18, 2013, in the
Journal of the American Medical Association, as part of their continuing
series, Care of an Aging Patient. The authors, Cynthia J. Brown, M.D., MSPH,
and Kellie Flood, M.D., of the UAB Division of Gerontology, Geriatrics and
Palliative Care, conducted a clinical review of academic papers published
between 1985 and 2012 dealing with mobility issues in a general aging
population. "The review confirmed that increased physical activity and
exercise are extremely important for healthy aging," said Brown.
"We've also identified mobility-limiting risk factors and created an
approach to help medical professionals screen for and treat those risk
factors." Brown said mobility limitations are often an early sign of
impending functional decline in seniors. Recognizing an increase in those
limitations at an early stage creates the opportunity for successful
interventions aimed at warding off functional decline and keeping seniors
living independently for as long as possible. "Mobility limitations are
the edge of that slippery slope that leads to loss of function," said
Brown. "A decline in mobility seems to quickly lead to an across-the-board
decline, including the routine activities of daily living. Mobility is a sort
of barometer for how well an older person ages." The approach that Brown
and Flood recommend suggests that primary care physicians should ask all senior
patients two questions: for health or physical reasons, do you have difficulty
climbing up 10 steps or walking a quarter of a mile; and because of underlying
health or physical reasons, have you modified the way you climb 10 steps or
walk a quarter of a mile? "Any modification of a task such as climbing 10
steps raises a red flag," said Brown. "Asking the right questions can
tell a clinician a great deal about the level of mobility in their older
patients." Brown said that a positive answer to either of the two
questions should lead the primary care provider to dig deeper and identify the
physical, social or environmental components leading to the limitations, and
they should take steps to address those limitations through physical therapy
services and/or prescribing appropriate ambulatory devices. She also said
primary care physicians are the front line of defense against other identified
risk factors like obesity and smoking. Brown, a physical therapist for 10 years
before becoming a physician, suggests greater interaction between doctors and
therapists. "Mobility is one of the cornerstones of healthy aging,"
she said. "With an increasing older population in the United States, it is
incumbent on us to find ways to help older Americans continue to live well and
independently. The major barriers - lack of physical activity, obesity and
smoking - are all risk factors that can be successfully overcome with
appropriate treatment and assistance.
Source-Newswise
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