What is Proactive Aging?

Proactive ageing involves taking a considered and strategic approach to optimising someone’s long term health.

Once we have established a client’s immediate concerns and goals, we then look at the big picture of their long-term health. This includes working out how we can pre-empt any physical, cognitive or functional declines that are commonly associated with aging.

For example, there is a recognised decline in balance that occurs for women around menopause and for men at around the age of 60. This decline can affect risk of falls and fractures and therefore impact quality of life (and independence) in older age.

Available throughout Brisbane

An occupational therapist works with a senior Caucasian woman They are seated at a table and they are doing a fun exercise that involves putting pegs into a plastic board.

 

Using Data to Improve Service Delivery

At Next Step Physio our clinicians have a comprehensive understanding of age-related norms. We have collated a significant amount of data taken from large-scale studies in order to inform the work we do with our clients.

Upon completion of an initial assessment, the client’s results are compared to normative data for someone their age; we help them to understand their performance alongside what an average person their age should be able to achieve.

We aim to empower our clients with information and skills to comprehensively optimise their ageing process. We work with them to plan how we can achieve better outcomes for them, not just to meet the average for their age, but to get ahead of the curve and exceed their expectations of ageing.

Physiotherapists Experienced with Gerontology

Positive ageing is an area that we are extremely passionate about. At Next Step Physio we devote a significant amount of time to exploring new research to ensure our knowledge is current.

Our practice manager embodies this passion, and has also:

  • Served on national boards such as the Australian Physiotherapy Association National Board
  • Served as the State Gerontology Chair for the Australian Physiotherapy Association in Queensland.
  • Contributed to the Geros Health Podcast and the Geros Health Community (an international collaboration of clinicians who want to better serve older adults).
  • Teaches Australian Physiotherapists who are undertaking advanced courses in gerontology

Health visitor and a senior man during home visit. A nurse or a physiotherapist helping a senior man exercise.

Suitable Clients

There is no right or wrong time to begin proactive ageing planning, but, broadly speaking, it is always better to begin sooner rather than later.

We attract clients in their forties, fifties and sixties. We help them to develop a plan that will keep them in the best possible health well into their eighties and nineties.

Delivery of Service

Our initial consultation is generally a home visit. It can also take place in one of our class venues if that is the client’s preference.

From there we work on an individualised series of recommendations. This may involve:

  • Exercise advice
  • Nutrition advice
  • A schedule to stay on top of regular preventative medical screens or scans (such as a DEXA scan for bone mineral density, or colon screen)

A strategic exercise program may be developed to address specific subtle impairments that are identified in your assessment, and “nip them in the bud” before they become problematic in the future. It would include factors such as balance, bone density, vital functional skills, muscle mass, flexibility,  bladder control & brain health.

Inclusions

At Next Step Physio & Allied Health, we adopt a holistic approach, so a comprehensive proactive ageing plan would be designed to manage and improve upon:

  • Strength
  • Nutrition
  • Balance
  • Cognitive capacity and processing speed
  • Bladder control
  • Bone mineral density
  • Reaction times
  • Functional flexibility
  • Cardiovascular fitness

Pro-Active Ageing Success Story

We have a client who first came to us five years ago when they were in their mid-sixties.

A comprehensive examination revealed many areas of decline and the client was surprised and disappointed at the results. For example, they could not get up from the floor or a chair without using their hands for support. They also struggled with the balance component of the assessment.

They were not previously aware of these deficits because they had not yet impacted daily life, but it was clear that unfortunately they soon would. The client decided to join a group exercise class and began attending twice a week.

Now in their seventies, the client’s functional capacity is dramatically improved. They can run, hop, jump and do many activities that they simply couldn’t do before.

This client now comes to class for fun, and in doing so is supporting their ongoing functional capacity and bone density.

Pro Active Ageing FAQ

  • How many sessions do I need?

    This is dependent upon the individual and their needs.

    We inform the client of what the evidence indicates they should do, and then help them work out what they can fit in their life.

    For some clients, a program based around ten minutes several times a week will be satisfactory for maintenance. For others, it may be more appropriate to undertake two to three hours of strategic exercise each week to address a particular condition or impairment.

    We want people to keep in mind that something is always better than nothing, and the benefits of getting started are immense.

  • Is it possible to shift someone’s performance to younger than their chronological age?

    Yes, it is. Of course, someone’s chronological age does not ever reduce, but the aging process can be ‘outsmarted’ to some extent with the right pre-emptive management.

    Clients in their fifties sometimes first come to us performing functional activities at the level of a sixty or seventy year old. With consistent corrective exercise and education we can improve their performance enough to match their chronological age or even that of somebody a decade younger.

  • What are examples of the functional tests we’ll do?

    We use structured, evidence-based assessment tools that are designed to measure someone’s current strength, agility, balance and mobility. These tests include:

    • Timing the pace of your walking
    • Measuring your “stand up and sit down” endurance
    • Observing how you control your balance when going up and down stairs
    • Capacity to walk backwards over four meters
    • Ability to get on and off the floor independently, with consideration to factors such as how many points of contact they needed with the floor or furniture (do you need to push through your elbow, your forearm, one hand, two hands, nearby furniture etc)
  • What information will I receive?

    You’ll get a comprehensive report which is a snapshot of your functional health at that point in time, with a series of graphs and comparison measures to help you interpret the results. The report will also detail a few individualised exercise recommendations. This tends to relate to assessment tasks you performed the worst on, and we consider those things the obvious “low hanging fruit” that will bring about the most change if you work on them.

    Our main aim is to map and enhance your lifelong ageing trajectory by offering you professional and individualised insight and advice at the right time, before the wheels fall off the cart.

    Our clinicians are committed to ongoing learning; we make sure we are fully informed of new research findings so that our clients can be fully informed too.

    Knowledge is power, and we aim to deliver an empowering service that you will want to continue to engage with at regular intervals in the future.

  • Are there cognitive elements involved in a proactive ageing program?

    Yes. Of course you may decline this aspect of your assessment if you wish, but there is clear evidence that brain health influences physical health and vice versa, so we encourage you to proactively address it.

    Some areas of cognition improve with age, such as intelligence. Some decline subtly with age, often from our 30s onwards. Yes you read that right. Even a 30 year old is on the same ageing trajectory, they just don’t usually know it yet.

    The aspects of cognition that begin subtly and slowly declining in our 30s are relatively inconsequential in midlife but if left to run its course without it can advance to the point where it begins to really affect you in later life. For example, it can make it hard for pay attention to two things at once, and can make it hard for you to walk and talk at the same time.

    Some aspects of cognition slow down your walking speed. Cognitive processing speed, for example, is a strong predictor of falls, and it is one cognitive function that is amenable to training.

    We like to use a few brief screening tools for cognition, and also observe how you manage performing a cognitive skill together with a physical skill concurrently. From there we form a plan with you.

     

  • What happens if the assessment reveals early problems with cognition?

    That is entirely up to you.

    You might like to work on it with our physios to improve your choice reaction times, your dual tasking abilities and your balance, to help you stay fit and agile well into your later life. Physical exercise is proven to enhance brain health and to slow the progression of mild cognitive impairment.

    You might elect for more detailed cognitive assessment, first with our occupational therapist who may then offer you a referral to a specialist medical colleague such as a geriatrician or neuropsychologist.

    Sometimes they find other aspects of your health that are detrimental to your cognition, and when you know about it, you can correct it. For example your doctor might be prompted to investigate your thyroid function, your vitamin B12 levels or sleep apnoea.

    Those factors might have gone unnoticed for years and they can influence your cognitive performance. Once you have the full picture, we can work out the best plan to optimise it, together.

  • How long does the service go for?

    This will vary for each client based upon their individual circumstances. Following our initial assessment report, we will bring together recommendations and work out what kind of commitment will fit in with someone’s life.

    A tailored plan could include options such as:

    • Weekly or twice-weekly exercise appointments with a Physiotherapist or Occupational Therapist at home, to provide motivation and support.
    • An individualised exercise program to be completed independently, unsupervised.
    • Group exercise classes to enable regular and affordable contact with a skilled Physiotherapist
    • Regular (at least annual or biannual) reviews of the proactive ageing assessments to check on functional vital signs and track improvement

    There are many benefits to having regular sessions with a Physiotherapist who can oversee an individualised exercise program and help someone to progress at their own pace.