Neil B. Alexander, M.D. | Institute of Gerontology

Research Professor, IoG
Professor, Division of Geriatric Medicine
Director, Mobility Research Center
Department of Internal Medicine, Medical School
Acting Director
Research Scientist
Veterans Affairs Ann Arbor Healthcare System
Geriatric Research, Education and Clinical Center

1111 CCGCB
Ann Arbor, MI 48109-0405
Tel: (734) 763-3172
Fax: (734) 763-2064
Email: nalexand@umich.edu

The primary focus of Alexander's work is on assessments and interventions to enhance mobility and physical activity in both able and disabled older adults, with studies of mechanisms underlying aerobic, strength, and balance function. Together with IoG and Division of Geriatric Medicine faculty Caroline Blaum and Peter Vaitkevicius, and using funding from the Veterans Affairs, specific disease groups under study include older adults with type 2 diabetes mellitus and congestive heart failure. These projects focus on using a functional training, functional and submaximal oxygen uptake outcome measures, and special strategies for adherence to maintaining or increasing physical activity. Analyses of the oxygen kinetics of a submaximal treadmill task and of a timed functional mobility task circuit suggest that submaximal aerobic tests, particularly if they are function-based, are better predictors of disability and mobility than peak (maximal treadmill test) measures. Together with IoG faculty Andrzej Galecki and Linda Nyquist, analyses are underway for the recently completed Michigan Older Americans Claude Pepper Center prospective trial comparing dynamic balance versus Tai Chi training in reducing falls. As part of this trial analyses of self-reported losses of balance, thought to be a likely precursor to falls, are also in progress. Other studies such as in trunk control and in developing community-based behavioral interventions to reduce fall risk are also in progress. As part of these studies, clinical tests such as the maximal step length test and trunk repositioning errors are proving to be valid and reliable predictors of falls and mobility. Finally, along with IoG faculty James-Ashton-Miller, Bruce Carlson, John Faulkner, Paul Cederna, and Jeff Horowitz, a randomized trial comparing high velocity versus low velocity training in young versus older adults is underway. Primary goals are compare improvements in leg power, leg muscle fiber characteristics, and biomechanical responses requiring near-falls responses

Select Recent Publications

Alexander NB, Dengel DR, Olson, R, Krajewski K. Oxygen uptake (VO2) kinetics and functional mobility performance in impaired older adults. J. Gerontol. 2003;58A:734-739.

Kozak K, Ashton-Miller JA, Alexander NB. The effect of age and movement speed on maximum forward reach from an elevated surface: a study of healthy women. Clin Biomech. 2003:18:190-196.

Netz Y, Ayalon M, Dunsky A, Alexander N: 'The multiple-sit-to-stand' field test for older adults: What does it measure? Gerontology 2004;50:121-126.

Dean J, Kuo A, Alexander NB. Age-related changes in maximum hip strength and movement speed. J. Gerontol. 2004;29:286-292.

Cho B, Scarpace D, Alexander NB. Tests of stepping as indicators of mobility, balance, and fall risk in balance-impaired older adults. J Am Geriatr Soc 2004;52:1168-1173.

Chapters in Books

Alexander NB. Gait disturbances. In: American Geriatrics Society Geriatrics Review Syllabus-5, 2002.

Ashton-Miller JA, Alexander NB. Biomechanics of mobility in older adults. In: Hazzard WR et al. (eds), Principles of Geriatric Medicine and Gerontology, 5th edition, New York, McGraw-Hill. 2003.