Western research reveals the holistic benefits of healthcare for bodies and brains
In Canada, Judith and Matthew, both aged 65 and over, embarked on distinct healthcare journeys. Judith, experiencing memory issues, was referred to a physiotherapist, yet her memory problems went largely unnoticed. Matthew, facing mobility challenges, was directed to a memory clinic, but no one inquired about his recent falls or walking difficulties. These contrasting experiences highlight a critical issue in healthcare: fragmented care.
Dr. Manuel Montero-Odasso, a geriatrician and clinician-scientist at Western and St. Joseph’s Health Care London, has dedicated decades to addressing this problem. His research underscores the deep connection between brain health and mobility throughout the aging process. As individuals age, mobility and cognition may decline, exacerbated by mild cognitive impairment and dementia. However, Montero-Odasso asserts that this decline need not be inevitable.
Montero-Odasso advocates for a holistic approach to care, addressing the full spectrum of aging challenges, from dementia to mobility decline, from Alzheimer’s to fall risk. His CIHR-funded research, supported by the Canadian Consortium on Neurodegeneration in Aging (CCNA), has led to significant advancements. One of his projects resulted in a national consensus recommending 10 mobility and cognitive tests to assess a range of functions, from walking speed to multitasking. These recommendations have standardized the diagnosis of physical and cognitive impairments in older adults.
The CCNA’s Mobility, Exercise, and Cognition team, under Montero-Odasso’s leadership, has explored the synergy between physical and cognitive training. Their findings from the SYNERGIC Trial and Synergic at Home Trial revealed that combining aerobic and resistance exercises with cognitive challenges is highly effective. This personalized program, designed to keep the brain fit from memory to executive function, not only slows cognitive decline but also improves mobility and brain health, with benefits lasting up to a year.
Montero-Odasso emphasizes that not all physical activities are equal in protecting cognition. Walking, for instance, is beneficial for cardiovascular health but insufficient to prevent or delay dementia. A mix of aerobic and resistance exercises, combined with cognitive training, is necessary. Building on these findings, the team is developing clinical guidelines to help health professionals prescribe lifestyle-based activities for treating mild cognitive impairment, a condition that can lead to dementia.
Montero-Odasso’s holistic approach also focuses on preventing falls, a major issue affecting one-third of seniors worldwide. After identifying significant gaps in clinical practice, he and experts from 40 countries developed the World Fall Prevention Guidelines, the first to incorporate the patient perspective and consider factors like cognition, walking speed, balance, and fear of falls. These guidelines provide practical tools, such as an algorithm that predicts fall risk and recommends targeted interventions.
Montero-Odasso stresses that prioritizing both brain and body health should be a priority for all Canadians over 65. He states, 'We don’t stop moving and develop mobility disability because we age; we age because we stop moving. But it’s never too late to make some lifestyle changes.'
For more information on Western’s commitment to optimizing health for all, visit https://allin.westernu.ca/optimizing-health-for-all.
