Monday, December 14, 2009

Immobility and Disease

In the late 90s and early 00s, I did some work in Geriatrics. I took five graduate level courses in Gerontology and worked in an elder care unit at the hospital after doing some work with disabled adults in the community. I do not like the word elderly, because of the connotations, but don't really know what else to say. I prefer the terms that the ACSM is using, active, athletic and frail - because elderly makes me think of frail only.

For some of us, getting older leads to a loss of mobility and function. By mobility I do not mean driving a car or taking a bus, but walking. It is a concern of experts at the Institute of Aging and the American Geriatrics Society. In fact, they are beginning to think that losses in ambulation and balance are harbingers of disease and imminent decline.

It is true that disease can lead to loss of strength and agility but the new view bares study. Is this lack of activity alone leading to adverse outcomes or disease? A new study is being funded from the US stimulus money and the National Institutes of Health. It is referred to as the LIFE study or Lifestyles Interventions and Independence for Elders. Enrollment is to begin soon and will include persons who are between age 70 and 89 who could lose the ability to walk about four blocks distance within the next few years because of disease or inactivity. Notice that being inactive is a HUGE risk factor for loss of ability to get around.

I know that I was a pain in the ass at the hospital with regard to this issue. I asked doctors to write orders for ambulation every so many hours and rarely would ask for wheelchair scripts for patients, walkers and canes YES, wheelchairs - not so much.
I cannot tell you how many people wanted to be discharged with orders for wheelchairs or heaven forbid those motorized scooters. I hope that the study results will have an impact on physicians and insurance companies and the FDA so that we can stop DME (durable medical equipment) companies from trying to get people to call them for those scooter chairs - "and we will bill Medicare for you." AAGH

The article I read in USA Today was disturbing. There has been a recent increase in the number of persons who are not aging with the ability to live independently because of their lack of physical stamina [also some concern that inactivity and obesity are causing cognitive decline that also makes living alone unsafe].

Oh, the study - it will have a research and a control group. The control group will receive an education class only(and I hope they take the advice to get moving) the research group will go to a center twice a week for an exercise program including cardio and weight training AND will be told to exercise at home 3 x a week. YES, that means that these 70 and near 90 year olds will be exercising FIVE TIMES A WEEK, how many times a week do you exercise?

No comments: