Unlike other exercise researchers in the 1980s who were focusing on heart health, the geriatrician Archie Young, who has died aged 73, was interested in strength and balance. To live independently and avoid falls, it is fundamental to have sufficient balance to stand upright and the muscle strength to get up from the toilet or a low chair, but before Young’s discoveries many assumed that deteriorating muscle strength was both inevitable and irreversible in elderly people.
In the early 80s Young was a doctor in a rehabilitation unit in Oxford, where among other things he introduced ultrasound imaging to physiotherapy. In 1985 he became a consultant and then professor and head of geriatric medicine at the Royal Free hospital in London, where he helped set up Queen Mary’s, a rehabilitation facility for elderly people. In both Oxford and London he conducted experiments with elderly volunteers, for example measuring their quadriceps (thigh muscle) and studying the effect of strengthening exercises.
His research, which he reported in a key article, Exercise Physiology in Geriatric Practice (1986), showed that it was possible for elderly people to get stronger, keep frailty at bay and delay the point at which they could no longer live independently. He called this point “the functional threshold”, and wrote: “Not only can exercise reverse the effects of immobilisation, it can readily produce a 10 to 20% improvement in strength and aerobic power, effectively postponing functionally important thresholds for some 10 to 20 years.”
Today strength training is widely accepted as a vital tool for helping elderly people stay independent and recover from illness, and is universally included in official guidance such as the Nice guidelines for preventing falls and the UK Chief Medical Officers’ physical activity guidelines.
Young remained at the Royal Free until 1998, when he moved to Edinburgh to become professor and head of geriatric medicine at the university, and a consultant at the Royal Infirmary. As well as treating patients, Young continued to research sarcopenia (loss of muscle mass) and frailty, and conduct experiments with volunteers. He also guided a new generation of geriatric medicine and physiology trainees and exercise professionals, and wrote and contributed to more than 200 articles and books.
He was a great believer in collaboration and disseminating research findings to practitioners. Throughout his career he worked with an ever-expanding interdisciplinary team of physiotherapists, physiologists and other exercise professionals, and in 2005 wrote Activity in Later Life with his second wife, Dr Susie Dinan-Young, a specialist clinical exercise practitioner, to give practical guidelines on exercise for older people.
Born in Maryhill, Glasgow, Archie was the eldest of three children of Archibald Young, a doctor, and Mamie (nee Fleming) a nurse. He attended Glasgow high school and, aged 14, went to see a play put on jointly with the local girls’ school. There he met Sandra Clark, who became his first wife in 1973; the couple went on to have two children, Sula and Archie.
Swimming was a passion from an early age, and Young became a member of the Scottish national swimming and waterpolo teams. At 21 he was the Scottish amateur breaststroke champion.
In order to continue working with his swimming coach, Young decided to study at Glasgow University. He studied physiology and then medicine, qualifying in 1971.
After several house officer jobs, he moved to Oxford in 1973, where he worked in rheumatology and rehabilitation. In caring for older patients, he became interested in the effect of muscle ageing. He corresponded with the leading British researcher in social medicine at the time, Jerry Morris, who was the first to demonstrate the connection between exercise and health. Young set about developing the work of other geriatricians in the field, including William MacLennan and Tom Arie, as well as building the evidence for the ability of exercise to mitigate illness in elderly people and restore function.
He lectured and taught widely, both in the UK and worldwide, giving memorable talks. At his inaugural lecture at Edinburgh, while describing 85-year-old weightlifters, who were as strong as people 20 years their junior, to the delight of his audience he squatted down in his official regalia to demonstrate their technique.
As well as swimming, he excelled at other sports – he played rugby, competed in triathlons and took part in running, hill walking and mountaineering. He took his children trekking to Everest base camp, as well as camping in the remote wilds of the Hebrides, fishing for their supper.
Young retired from medicine in 2007. He and Sandra had divorced in 1995 and in 2005 he married Susie. The couple lived in Edinburgh, where Young continued to enjoy sporting activities. He was diagnosed with Lewy body dementia but remained active to the end.
He is survived by Susie, Sula and Archie, and by four grandchildren.
• Archie (Archibald) Young, geriatrician, born 19 September 1946; died 17 March 2020