Thomas Gill, MD, is the Humana Foundation Professor of Medicine (Geriatrics) at Yale School of Medicine. This is a lightly edited excerpt from his interview on the Health & Veritas podcast, episode 173, “Secrets to an Active Old Age.” Listen to the whole interview to hear more about his research on maintaining independence while aging.
Q+A
Quick Question: Can I Prevent Physical Decline as I Age?
Can I maintain physical ability as I get older?
Thomas Gill, MD: Probably the single most evidence-based intervention involves physical activity. Physical activity is beneficial across the age range, but it’s been shown in multiple high-quality studies to be beneficial for an array of outcomes among older persons, particularly those that are relevant for maintaining independence.
And the single most effective mode of physical activity is walking. If someone is truly sedentary, they’ll have to start slow. But if someone is ambulatory and can leave their home and if their neighborhood is safe, walking in the neighborhood is often quite effective. They need not go to a gym, although if they have access to a gym, that’s also quite effective.
In addition, we did a trial of a program that we called “prehab” among community-living older persons who were physically frail. The intervention, which lasted six months, was led by a physical therapist and focused on improving muscle strength, balance, and mobility. It was set in a home and was shown to be effective in slowing the rate of decline in day-to-day activities over the course of a year.
Since then, elective surgery has been one of the most common areas in which prehab has been implemented and tested, and the evidence shows some benefit in different types of elective surgery.
You can think of [the effects of prehab] like a gas tank. If you’re running on fumes, you’re going to be highly vulnerable in the setting of an acute event, such as major surgery, whether it’s elective or non-elective. Functional outcomes might then be quite poor. You want to fill up the tank so you have some gas that you can draw upon when that time comes.
Health & Veritas is hosted by Yale School of Medicine’s Howard Forman, MD, MBA, professor of radiology and biomedical imaging, and Harlan Krumholz, MD, SM, Harold H. Hines Jr. Professor of Medicine (Cardiology).