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Physical fitness and health in later life

Professor Archie Young died in March this year, but I did not see his obituary until this week.

I met him during a visit to the small and wonderful rehabilitation hospital in Hampstead. which he ran with Nori Graham. It was one of the most spectacular demonstrations of the benefits of Physicians and Psychiatrists and their teams working together for the benefit of patients. Would it be that there be more. Why is this not routinely part of how services for older people are configured? Why are nurses forced to choose whether to be ‘adult’ or ‘mental’ early in their training, when so many patients have mixed pathologies?

Archie Young was the son of Archie Young – an anatomist in Glasgow, and grandson of Archie Young – Professor of Surgery in Glasgow. A family tradition of excellence – sealed in a name. In addition to his medical studies our Archie Young was an extreme athlete – excelling in sports from swimming to rugby and eventually ice-climbing. Bringing these attributes together his research and clinical interests focussed on improving and maintaining physical fitness and strength in late life. He showed that it is not inevitable that older people lose muscle strength – exercise can reverse the decline – with benefits to general health, including mental health. He co-authored ‘Physical activity for patients: an exercise prescription’ for the Royal College of Physicians 2001 – his chapter 5 (p31-42) addresses health in old age.

Sad to learn that his last years included life with Lewy Body Disorder – despite which he remained active. Lewy Body Dementia was not recognised when I began to practice but was identified in the late 1970s by researchers in Nottingham and Newcastle.

There is no recognised association with previous athleticism – on the contrary – physical activity is held to protect against the development of Parkinsonism and Lewy Bodies characterised by accumulation of alpha-synuclein. The mix of physical and mental symptoms can be ameliorated by regular exercise.

So much to learn. So many good people to be grateful for.

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