Alice Herb, 88, an intrepid New Yorker, is used to walking miles around Manhattan. But after this year of being shut inside, trying to avoid COVID-19, she’s noticed a big difference in how she feels.

“Physically, I’m out of shape,” she said. “The other day I took the subway for the first time, and I was out of breath climbing two flights of stairs to the street. That’s just not me.”

Emotionally, Herb, a retired lawyer and journalist, is unusually hesitant about resuming activities, even though she’s fully vaccinated.

“You wonder: What if something happens? Maybe I shouldn’t be doing that. Maybe that’s dangerous,” she said.

Failing to address issues that have arisen during the pandemic — muscle weakness, poor nutrition, disrupted sleep, anxiety, social isolation and more — can mean poorer health and increased frailty, experts warn.

What should people do to address such challenges? Experts shared advice:

>> Reconnect with your physician: Many seniors have delayed medical care during the pandemic. Now that most have been vaccinated, it’s time to schedule visits with primary care physicians and preventive care screenings, such as mammograms, dental cleanings, eye exams and hearing checks, said Dr. Robert MacArthur, chief medical officer of the Commonwealth Care Alliance in Massachusetts.

>> Have your functioning assessed: Primary care visits should include a basic assessment of how you are functioning physically, according to Dr. Jonathan Bean, an expert in geriatric rehabilitation and director of the New England Geriatric Research, Education and Clinical Center at the Veterans Affairs Boston Healthcare System.

>> Get a referral to therapy: If you’re having trouble moving around or doing things you used to do, get a referral to see a physical or occupational therapist.

A physical therapist can work with you on strength, balance, range of motion and stamina. An occupational therapist can help you change the way you perform various tasks, evaluate your home for safety and identify needed improvements, such as installing a second railing on a staircase.

>> Start slowly and build steadily: Be realistic about your current abilities. “From my experience, older adults are eager to get out of the house and do what they did a year ago,” said Dr. John Batsis, associate professor of geriatrics at the University of North Carolina at Chapel Hill. “But … you can’t.”

Nina DePaola, vice president of post-acute services for Northwell Health, the largest health care system in New York, agreed. “Pace yourself,” she said. “Listen to your body. Don’t do anything that causes discomfort or pain. Introduce yourself to new environments in a thoughtful and a measured fashion.”

>> Be physically active: Engage regularly in physical activity of some kind. The Go4Life program, sponsored by the National Institute on Aging, is a valuable resource for those getting started. You can find videos of some sample exercise routines on YouTube. Also, the YMCA has put exercise classes online, as have many senior centers. For veterans the VA has Gerofit, a virtual group exercise program that’s worth checking out.

Bienvenido Manzano, 70, of Boston, who retired from the Coast Guard after 24 years and has significant lower back pain, attends Gerofit classes three times a week. “This program, it strengthens your muscles and involves every part of your body, and it’s a big help,” he said.

>> Eat well: Make sure you’re eating a well- balanced diet that includes a good amount of protein. A recent study noted that adequate protein consumption is even more important for older adults during times of stress or when they’re sedentary and not getting much activity.

>> Reestablish routines: “Having a structure to the day that involves social interactions, whether virtual or in person, and various activities, including some time outside when the weather is good, is important to older adults,” said Dr. Lauren Beth Gerlach, a geriatric psychiatrist and assistant professor of psychiatry at the University of Michigan.

End-of-day routines are also useful in addressing sleep problems, which have become more common during the pandemic.

>> Reconnect socially: Mental health problems have also worsened for a segment of older adults, according to the University of Michigan poll: 19% reported experiencing more sadness or depression, while 28% reported being more anxious or worried.

Social isolation and loneliness can contribute to those feelings, and it’s a good idea to start “shoring up social support” and seeing other people in person if you are vaccinated, Gerlach said.

Families have an important role to play in reengaging loved ones with the world, Batsis said. “You’ve had 15 months or so of only a few face-to-face interactions. Make it up now by visiting more often.”

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Kaiser Health News is a national newsroom that produces in-depth journalism about health issues. It is an editorially independent program of the Henry J. Kaiser Family Foundation. It is notaffiliated with Kaiser Permanente.