Why healthy aging means caring for both brain and body

Judith and Matthew are among the 8 million people in Canada aged 65 years and older. Lately, both had noticed changes in how they moved and how well they remembered things. So they went to see their doctor.

Their experiences took different turns. Judith was referred to a physiotherapist, but her memory problems went unnoticed. Matthew was sent to a memory clinic, yet no one asked him if he had fallen recently or was having difficulty walking.

This type of fragmented care is exactly what Dr. Manuel Montero-Odasso, a geriatrician and researcher at Western University and the Lawson Research Institute of St. Joseph’s Health Care London, has been trying to change for decades. His research shows that brain health and mobility are deeply connected throughout the aging process.

“As we get older, our mobility and cognition may decline, which can be worsened by mild cognitive impairment and dementia,” explains Dr. Montero-Odasso. “But that doesn’t have to be our destiny.”

To improve the physical and brain health of older adults, Dr. Montero-Odasso advocates for a more holistic approach to care—one that addresses the full spectrum of aging challenges, from dementia to decline in mobility, from Alzheimer’s to the risk of falls. His CIHR-funded research on these topics has been supported by the Canadian Consortium on Neurodegeneration in Aging.

One of his projects led to a national consensus that recommended 10 mobility and cognitive tests that assess a range of functions—from walking speed to the ability to walk and talk at the same time. These recommendations have helped make the diagnosis of physical and cognitive impairments in older adults more consistent and standardized.

Under Dr. Montero-Odasso’s leadership, the Mobility, Exercises and Cognition team has looked at how physical and cognitive training together can improve health in older adults. Findings from two major studies, the SYNERGIC Trial and Synergic at Home Trial, showed that combining aerobic and resistance exercises (such as using bands and weights) with cognitive challenges is particularly effective. The team designed a personalized program that keeps the brain fit, from memory to executive function.

This combined approach not only slows cognitive decline but also improves mobility and brain health. Even more encouraging, the benefits lasted for up to a year. The team also found that not all physical activities are equal when it comes to protecting cognition.

“Walking is great for your cardiovascular health, but not enough to prevent or delay dementia. We need a mix of aerobic and resistance exercises combined with cognitive training,” says Dr. Montero-Odasso.

Building on these findings, the Mobility, Exercises and Cognition team is developing clinical guidelines to help health professionals prescribe lifestyle-based activities such as physical and cognitive training to treat mild cognitive impairment, a condition that can lead to dementia.

Dr. Montero-Odasso’s holistic approach to older adult care also focuses on preventing falls, a major issue affecting one-third of seniors worldwide. After identifying significant gaps in clinical practice around the globe, he and experts from 40 countries developed the World Fall Prevention Guidelines.

Endorsed by the Canadian Geriatrics Society and adopted in countries including Australia, Belgium, China, Malaysia, and Norway, the guidelines are the first to incorporate the patient perspective and to consider key factors such as cognition, walking speed, balance, and even fear of falls. These guidelines provide practical tools such as an algorithm that predicts the risk of falls and recommends targeted interventions.

When asked why focusing on both brain and body should be a priority for Judith, Matthew, and the other 18% of Canadians over 65, Dr. Montero-Odasso shares a powerful message: “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.”

At a glance

Issue

As of 2024, 8 million adults in Canada are 65 years and older. As this population ages, many may face both cognitive and mobility decline, but Dr. Manuel Montero-Odasso believes that doesn’t have to be their destiny.

Research

Dr. Manuel Montero-Odasso’s research has helped redefine older adult care by encouraging clinicians to consider both mobility and brain health, treat impairments through combined physical and cognitive training, and prevent falls through comprehensive clinical guidelines.