Hello and welcome to The Mobility Brief. This is the weekly podcast from The Gray Centre for Mobility and Activity, part of St. Joseph's Health Care London. Today is Monday, September 22, 2025. For this episode, we have three updates to share from our work here at the centre.

For our first update, we're looking at a recent paper that our colleague, Dr. Manuel Montero-Odasso, engaged with. It addresses the World guidelines for falls prevention from 2022 and asks: how are countries putting these new global guidelines into practice? To get a picture of the situation, the research team contacted experts from 18 countries who had taken part in the guidelines' development and asked about the implementation status in their regions. The responses showed that while many countries are making efforts to put the guidelines into practice, the degree of progress varies. Some have integrated them into national policies, whereas others have taken minimal action. The work also identified several barriers, including limited resources and competing health priorities, that affect how the guidelines are adopted.

Now, let's turn to a study from here at the centre that asks: which combination of common health risks most affects thinking skills? This work was led by Dr. Manuel Montero-Odasso and his colleagues. The research team used data from the Canadian Longitudinal Study on Aging, looking at over 30,000 adults over a three-year period. They identified the most common groupings of 12 modifiable risk factors and then assessed how those combinations were associated with changes in cognitive scores. The findings identified that the combination of hearing loss and physical inactivity had the most detrimental effect on global cognition. For a combination of three factors, hypertension was added to that pair. For four factors, sleep disturbance was also included. The analysis also showed that the combined effect of hearing loss and physical inactivity was greater than what would be expected from their individual effects.

Finally, we'll shift our focus to interventions and ask: does combining exercise for the body and brain help prevent falls in older adults with mild cognitive impairment? Our colleague, Dr. Manuel Montero-Odasso, also contributed to this research from the SYNERGIC trial. This study included 161 older adults with mild cognitive impairment who participated in a 20-week program. Researchers evaluated different combinations of aerobic-resistance exercise, computerized cognitive training, and vitamin D supplementation. They found that combining aerobic-resistance exercise with cognitive training improved gait performance after the intervention and reduced the risk of falls at a 12-month follow-up. The addition of vitamin D did not produce benefits for these outcomes.

And that brings us to the end of this episode. We began today by looking at the global application of fall prevention guidelines and the varied progress across different countries. We then moved to research identifying that the combination of physical inactivity and hearing loss had the most detrimental effect on cognition. We concluded with a study showing how another combination—this time of physical exercise and cognitive training—was effective in reducing falls for older adults with mild cognitive impairment.

Thank you for listening to The Mobility Brief. This has been the weekly podcast from The Gray Centre for Mobility and Activity, part of St. Joseph's Health Care London.