THE STEPS TO AGILITY IN OLD AGE: “GAIT GUY” NEIL
ALEXANDER IS WORKING TO FIND THEM
By Jane Myers
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| Neil Alexander |
Living forever (or even just into your 120s or 130s) is one
thing. Being able to walk and run and sit and stand and climb
stairs in your 60s, 70s, 80s and 90s, is another.
For Neil Alexander, M.D., associate professor of internal
medicine and a senior associate research scientist in the Institute
of Gerontology, the fountain of youth once associated with dreamy
explorers of the past like Ponce De Leon and now associated
with dreamy explorers of the future, is still just that—dreamy.
Perhaps it’s the giddiness of millennium fever, but when
“The Exploding Science of Superlongevity—Our Life
Span Revealed” is part of the fluorescent orange cover
of the January, 2000, issue of Wired magazine, it’s clear
that living forever is “in.” Never mind forever. Neil
Alexander has more modest hopes. “We’re just trying
to slow the decline in functional ability,” he says of
his research on mobility in older adults. In other words, making
it possible for people to keep moving, to perhaps lift themselves
off their chairs and stand up to blow out those 78 or 84 or
96 candles on the cake, maybe even do a little dance around
the table.
Neil Alexander began his academic career at the University
of Minnesota thinking he’d study child psychology. But
when, for his senior honor’s thesis, he tried to train
a group of junior high school students to do volunteer work
in a nursing home, a whole new field of inquiry, one involving
subjects at least a half-century older than his teen-aged volunteers,
opened up before him. “I didn’t know what to tell
the kids,” he recalls. “There wasn’t a lot of
good information out there that was scientifically-based about
working with older people.”
At first he was simply interested in the whole subject of geriatric
rehabilitation, but when he looked closer and realized how little
true science had been applied to the subject, he headed for
the lab.
Ten years later, he’s pleased that he’s established
a national reputation as a “gait guy” (also a “fall
guy”) and that he and his biomechanician collaborators,
as he calls them, were able to contribute a chapter to a major
geriatrics textbook, Principles of Geriatric Medicine and Gerontology
(McGraw Hill, 1994), establishing themselves as major movers
in the area of geriatric mobility.
The subject of mobility and aging, and the consequences of
time, life habits and disease, is not as simple as it might
at first seem. “There is an accumulation of things over
which you may or may not have control,” Alexander says.
And then there’s the whole psychological component of aging,
one not to be taken lightly in a youth-obsessed culture. “We
want to start looking at people in their peri-menopausal years—their
40s, 50s, 60s,” he says. “Our theory, based on some
anecdotal observations, is that they start giving up stuff.
They express expectations of frailty and decline.” And,
of course, there are the catastrophic events that people fear
as they grow older, the strokes and hip fractures that cause,
at least temporarily, sharp declines in mobility, that, at best,
level out to the earlier rates of slower decline.
The focus of Alexander’s research, really, is to understand
the mechanisms that determine whether or not a person can maintain
good mobility as they age, and, at least, as he puts it, help
to “make a dent in the slow slide.” When he looks
at an act as clear-cut as getting in and out of a chair, Alexander
now sees a sea of complexity involving not only the biomechanics
of such an act, but the cognitive piece as well, which speaks
to such factors as memory, affect, mental flexibility and visual/spatial
acuity. And then there’s the chair itself, which falls
into the large category of “environment.”
His work, and the work of his team in the Mobility Research
Laboratory on the second floor of the Geriatrics Center, focuses
on the key components of such a task, and the interventions
that might help a person more easily get into and out of the
chair. Understanding the mechanisms that underlie common motions
should make it possible, eventually, to give people strategies
that will, for instance, help reduce the number of falls in
older people.
Alexander is keeping an open mind about what might work. He
and his team are now proposing to add to their catalogue of
potential “saves” such regimens as aerobic training,
balance training and tai chi to see if they might help. Tap
dancing perhaps? He doesn’t have that on the list, but
he is presently developing ways to assess and train rapid foot
movement to determine whether rapid stepping is important in
maintaining mobility.
At the moment he and his team have plenty of analysis ahead
of them. “We’re drowning in data right now,”
he says. “But we hope before long we’ll have some
good solid answers that will make a difference in the way people
move and keep moving as they age.” If Alexander succeeds
in his work, those 120-year-olds of the future may not be playing
tennis — but they won’t be falling down either.
Also:
Will
You Still Need Me, Will You Still Feed Me, When I’m a Hundred
and Twenty-Four?
FUNDING
FOR AGING RESEARCH AT THE UNIVERSITY OF MICHIGAN
VETERAN
JOURNALIST DANIEL SCHORR HONORED AT U-M GERIATRICS CENTER CELEBRATION
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