Live Longer Better
  • Your journey
    • More About the Optimal Ageing Programme >
      • About Muir Gray
      • Muir Gray's publications
    • Coping with Lockdown
    • Using the right words right; ageing, fitness, disease and beliefs >
      • Bad language about older people
    • The Lockdown Wellbeing Programme >
      • The Daily Mail series
    • the Daily Dozen + 30 for 4S fitness
    • What is happening as we live longer >
      • Your monthly briefing
    • LLL for LLB
    • The environment is tough >
      • Retirement has benefits and risks >
        • Join the Challenge Hub
      • Some people got a better start than others
      • the impact of isolation is now recognised
      • The physical environment is the cause of many problems blamed on ageing
      • Poverty affects too many older people
    • the Living Longer Better Programme >
      • what would a good life in your late 80s be likel
      • What do you fear most and want to avoid
      • Start to write your Living Longer Better Plan
      • Think positive
    • How to reduce your risk of a bad death
    • My diary & daily routine
    • My health record
    • My housing
    • Othercare - Supporting someone else
    • About the OxAP >
      • Muir Gray's Bookshop >
        • The Antidote To Ageing
        • Midlife
        • Sod60!
        • Sod70!
        • Get Moving
        • Eatwell!
        • Dr Gray's Walking Cure
      • Here is the news
  • Get physically better
    • Increase strength, stamina, suppleness and skill >
      • Strength
      • Stamina
      • Skill
      • Suppleness
      • Work hard
      • Brisk walking >
        • Virtual Walking
        • Restart Sport >
          • Restart swimming
          • Restart tennis
          • Restart football
          • Restart cycling
          • Virtual Cycling
      • If you have difficulty walking briskly
      • Join a Gym or Wellness Hub >
        • Meet others for fitness >
          • Silver sneakers
          • Age UK Generation games
          • Join a Gym, Fitness Centre or Wellness Hub
          • Find a personal trainer
      • Find a Trainer
    • Reduce your risk of disease >
      • Eat Well
      • Stop smoking
      • Increase activity - physical, cognitive and emotional
      • Watch the alcohol
      • Accept the offers from the NHS screening programmes
      • We need a revolution
    • Look after your body >
      • Happy and Positive Birthday >
        • Sod 60!
        • Sod70!
        • Sod It! Eat Well
        • Sod Sittin, Get Moving!
      • Skin maintenance
      • Teeth and gum maintenance
      • Feet maintenance
      • Bone, joint and muscle maintenance
      • Bowel maintenance
      • Brain maintenance
      • Mind maintenance
      • Heart maintenance
      • Lung maintenance
      • Waterworks maintenance for men
      • Waterworks maintenance for women
      • See as clearly as possible
      • Keep your Hearing as acute as possible
    • If disease occurs - Optimise Your Healthcare >
      • Living with a common condition >
        • Arthritis
        • Cancer
        • COPD _ Bronchitis
        • Diabetes
        • Dementia
        • Heart disease
        • Parkinson's Disease
        • Stroke
      • Making a big decision >
        • Should i have a hip replacement ?
      • Consequences of common conditions >
        • Loss of status
        • Disability and handicap
        • Isolation
        • Depression
        • Frailty
      • Look out for social as well as drug prescribing >
        • Enjoy Activity Therapy
      • What you can do to help the NHS even more
  • Think better
    • Train your brain ; we now know the brain can get fitter at any age
    • Understanding Dementia & Alzheimer's Disease
    • Reduce your risk of dementia >
      • Stimulate your brain more every year >
        • Learning new skills and build on your assets
        • Get even more engaged
      • Protect your brain >
        • Sleep better
        • Get more active
        • Avoid over medication
        • Control stress levels
        • Air pollution and dementia
      • Keep the oxygen flowing
    • Combat depression
  • Feel better
    • Stay engaged and don't lose your sense of purpose
    • Feel even better by helping other people even more
    • Meet others like you
    • Optimise the Internet >
      • My Virtual Reality
    • Join others for a Daily Service
    • Feel better by visiting Great Places >
      • Visit the great Museums
      • Visit the great libraries
      • Visit a National Trust treasure
    • Feel better through music >
      • Join a concert party
      • Your virtual choir
      • Music for Moving
    • Feel better by reading, listening and watching with other people >
      • Kindling Book Club >
        • Crime
        • Classics
        • Health
      • Audible Book Club
      • Your BBC
      • Your Film Club
    • Feel better by learning new skills and ideas
    • Feel better by joining a club to play games and meet others >
      • Chess Club
      • Bingo club
      • Bridge Club
    • Feel better by supporting nature >
      • Visit the great gardens
    • Feeling Better by Going Down Memory Lane >
      • Sporting memories are powerful
  • Understand better
    • Ageing is a normal biological process
    • From 40 to 90 loss of fitness is serious
    • The effects of disease are often compounded by loss of fitness
    • Negative beliefs and attitudes have a huge impact
    • The importance of planning with purpose
    • The Ageing Brain and the Maturing Mind
    • Strength and Power can always be increased
    • Skill and co-ordination can be improved at any age
    • Stamina can be improved by brisk walking
    • Suppleness can always be improved and stiffness always reduced
    • Activity Therapy is of vital importance

coping with LockDown, the second pandemic



Here is the article we published in the British Medical Journal 

THE DECONDITIONING PANDEMIC AND THE RECONDITIONING PROGRAMME 
 
Covid-19 will be followed by a deconditioning pandemic
 
All healthcare does harm. Much publicity is given  to the contribution of poor quality care and errors, but even evidence based healthcare delivered at high quality can cause harm. It is an inevitable consequence of the use of radiation, or the prescription of powerful chemicals,, or interventions such as surgery or requiring people who are ageing to stay in their own homes for three, or possibly more, months.
The Academy of Medical Royal Colleges published a report in 2015 called Exercise the Miracle Cure (1) not only promoting the benefit of activity as a therapy in its own right, but also emphasising the dangers of inactivity. [1] While accepting that rest has a part to play in the acute phase of illness this passes very quickly and what has emerged is that in the high pressure world of the hospital people—, particularly people with multiple health problems—, have their acute problem diagnosed and managed quickly, but are then often tucked into bed, because they cannot be discharged, while the staff have to cope with the next wave of acute cases at the other end of the ward. The result is what has been called the “deconditioning syndrome,” a side effect of hospital admission and a consequence of inactivity. [2] (2)
Although less dramatic, the proposed months of isolation at home as a result of the covid pandemic will have an immense deconditioning effect of epidemic proportions, affecting millions of people. The covid-19 shielding policy was aimed at people over 70 and people under 70 with long term conditions but we now know that 
·        the older you are the more activity you need
·        the more long term conditions you have the more activity you need
It is clear that inactivity has a direct effect on mortality through its direct impact on cardiovascular disease, diabetes,and cancer and we calculated using the WHO HEAT Model that imposed sedentary behaviour for three3 months  in those over the age 70 years or with long term conditions would result in an extra 7000 premature deaths.
But it is the other impacts that isolation and inactivity have on older people that will be a greater burden to society unless addressed urgently.
Spending  months at reduced levels of activity will have an impact on all 4 aspects of physical fitness— – strength, stamina, suppleness, and skill. It is important to appreciate also that there will be a loss of cognitive and emotional wellbeing as a result of isolation and loneliness and this will increase the risk of dementia (3). [3] For those who are already housebound, the impact of quarantine may not be so dramatic physically, but with even fewer visits there will be considerable cognitive and emotional impact. 
All of life requires us tois balanceing risk and people  certainly need advice on how to reduce the risk of coronavirusCorona virus infection. However,but months of isolation and physical, social, and cognitive inactivity,physical, cognitive and social, without giving people information, encouragement, support, and motivation to maintain— orand indeed increase fitness— while at home, will increase the numbers needing social care in the years to come. 
The harm resulting from the constraints on health service resources resulting in increased mortality from heart disease and cancer has received publicity, but the harm from social distancing will shorten healthspan and increase dependency, and this has not been so widely recognised. The cCovid- 19 pandemic will be followed by a deconditioning pandemic and a reconditioning programme needs to be implemented as an emergency to support and facilitate a significant increase in physical, cognitive, and emotional activity particularly among people living alone. [4](4). 
The first aim would be to reverse the effects of deconditioning, and prevent further harm.  but tThis might just lead very many people to rethink what is happening to them as they live longer and take action after the epidemic of Covid- 19 infection is over that will reduce their risk of dementia, frailty, and the need for social care. [5] (5)
 
 
  1. Academy of MedicalMediacl Royal Colleges (2015)
Exercise the Miracle Cure
2 Arora A. (2019)
Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis
https://www.bmj.com/content/366/bmj.l4185/rapid-responses
 
3 Livingston G et al (2017)
The Lancet Commission on ‘Dementia prevention, intervention, and care’ 
Lancet 390: 2673–734 
 
4 Douglas M. et al (2020)
Mitigating the wider effects of covid-19 pandemic response 
BMJ; 369;141-143
 
5 McNally, S. et al (2017) 
Focus on physical activity can help avoid unnecessary social care. 
BMJ Oct 17;359: j4609.
 
 
 
Muir Gray, is a visiting professor in the Nuffield Department of Primary Health Care  at the University of Oxford.  ;
William Bird,  ; is Honorary Senior Lecturer, European Centre of Environment and Human Health, University of Exeter
 
Competing interests: WB is  CEO of Intelligent Health which trains doctors about physical activity, and delivers Beat the Street that gets school children and their families more active.
MG Director of the Optimal Ageing Programme which provides learning programmes for older people and professionals about how to Live Longer BetterPrpgramme

 

Proudly powered by Weebly