aging

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Why To Exercise Today: To Promote Cognitive Health (It’s Official)

(Diabetes Care/Flickr)

(Diabetes Care/Flickr)

The venerable Institute of Medicine came out with a report this week on cognitive aging (yes, that means you…) and a few things that can help avert the inevitable. The panel’s No. 1 recommendation? “Be physically active.” Enough said.

To be clear, “cognitive aging is not a disease,” the report notes. “Instead, it is a process that occurs in every individual, beginning at birth and continuing throughout the life span.”

That process impacts the brain like no other body part, the authors say. And while the extent and quality of cognitive aging (read: decline) varies greatly, many older men and women will experience problems related to the speed at which they process information, the ability to problem-solve and make decisions and, of course, memory. (Lost keys, anyone?)

Putting a little silver lining on things, the IOM news release quotes the chairman of the committee, Dan G. Blazer, the J.P. Gibbons Professor of Psychiatry Emeritus at Duke University Medical Center, saying that “…wisdom and knowledge can increase with age, while memory and attention can decline.”

So what should we do about our aging brains? The report is clear:

· Be physically active.

· Reduce and manage cardiovascular disease risk factors, including high blood pressure, diabetes, and smoking.

· Regularly discuss and review health conditions and medications that might influence cognitive health with a health care professional. A number of medications can have a negative effect — temporary or long term –on cognitive function when used alone or in combination with other medication.

The committee also identifies additional actions for which there is some scientific evidence to suggest positive effects on cognitive health:

· Be socially and intellectually active, and continually seek opportunities to learn.

· Get adequate sleep and seek professional treatment for sleep disorders, if needed.

· Take steps to avoid a sudden acute decline in cognitive function, known as delirium, associated with medications or hospitalizations.

· Carefully evaluate products advertised to consumers to improve cognitive health, such as medications, nutritional supplements, and cognitive training.

Continue reading

Sexual Reality: The Checkup Podcast Debunks A Few Myths (Like Size And Age Matter…)

Possibly our juiciest segment yet, the latest installment of The Checkup podcast, our joint venture with Slate, takes on some sexual myths and offers a bit of reality.

We bring you surprises about penis size, stories of great sex over 70 and new insights on how both men and women are lied to about their sexuality. As we have in past segments, Carey and I offer our fresh take on research-based news that could brighten up your life below the waist. Check it out here:

And in case you missed our last episode, “Grossology” (including a look at the first stool bank in the nation and research on the benefits of “bacterial schmears” from a mother’s birth canal) — you can listen now.

And if you want to hear earlier episodes: “Scary Food Stories” includes the tale of a recovering sugar addict and offers sobering news to kale devotees. And “On The Brain” includes fascinating research on dyslexia, depression and how playing music may affect our minds.

Make sure to tune in next time, when we present: “High Anxiety,” an episode on the (arguably) most prevalent of mental health disorders.

Each week, The Checkup features a different topic — previous episodes focused on college mental health, sex problems, the Insanity workout and vaccine issues. If you listen and like it, won’t you please let our podcasting partner, Slate, know? You can email them at podcasts@slate.com.

Why To Exercise Today: For Long-Term Weight, It May Matter More Than Diet

feetonscale

The usual wisdom goes: You really need to be active for your health, but you can’t count on exercise as a weight-loss method. Some people even gain weight when they ramp up exercise — and not just muscle mass.

But if you look at the big picture and the long haul, people who succeed at long-term weight loss tend to have high levels of physical activity. Now a new study of more than 5,000 Americans in the journal Medicine & Science in Sports & Exercise finds a strikingly strong link between exercise and weight — arguably stronger than the link to diet.

The American College of Sports Medicine offers this summary:

The study found that moderate-to-vigorous physical activity was significantly associated with two measures of weight status – body mass index and waist circumference.
For both men and women and in all age groups, higher levels of moderate-to-vigorous physical activity were associated with lower BMI and smaller waist circumference.
The associations of diet quality with weight status were much less consistent; higher diet quality was associated with lower weight variables in only a few gender and age groups.

Which groups? From the paper’s abstract: “Diet quality was inversely associated with the weight status variables only in men age 30–39, 40–49 (BMI only), and 50–59 and women age 50–59.”

And of course, if you’re in one of those cohorts now, you won’t be forever. More from the summary:

“The study also found that, as age increased, physical activity declined, diet improved, and BMI and waist circumference increased.”

In other words, even as we get more virtuous in our diets, we tend to exercise less and gain weight. Continue reading

Why To Exercise Today: Avoid Brain Shrinkage As You Age

MilitaryHealth/flickr

MilitaryHealth/flickr

Middle-age adults take note: the exercise you shirk today may lead to shrunken brain tissue in a couple of decades.

This, according to research presented at the American Heart Association Epidemiology/Lifestyle meeting in Baltimore this week.

After reviewing exercise data taken from more than 1,200 adults who were around 40 years old — a subset of the Framingham Heart Study — researchers found that twenty years later when these same individuals underwent MRI scans, those with “lower fitness levels in midlife also had lower brain tissue levels in later life,” said Nicole L. Spartano, Ph.D., lead author and a postdoctoral fellow at the Boston University School of Medicine.

Though the findings are preliminary, Spartano says it looks like there’s a link between lower fitness levels and faster brain aging. Since the MRI’s in this study were done on people about 58 years old, the researchers didn’t expect to see high rates of dementia, but they did detect “the beginning of shrinkage,” Spartano said. “We look at the brain MRI as an early warning sign for deterioration. This may give us some idea of decreased cognition a decade or so later.”

Specifically, the researchers evaluated fitness based on how the heart changes in the early stages of exercise. Continue reading

Study: For Sleep Problems In Older Age, Try Mindful Meditation

(Fairy Heart/flickr)

(Fairy Heart/flickr)

Insomnia is insidious, infuriating and often debilitating.

For anyone who has suffered with eyes-wide-open at 4 a.m. it’s not terribly surprising that more and more Americans (particularly older people and women) are being prescribed serious drugs to help them sleep.

But these medications, known as benzodiazepines, have been linked to numerous health problems, ranging from an increased risk of dementia, to car crashes and falls. And once you’re on them, it’s hard to stop, as I can attest from personal experience. While debate continues over the safety and effectiveness of these medications, a small study suggests that an alternative approach may offer some relief.

Research published online by JAMA Internal Medicine found that a practice of mindful meditation — basically just focusing on breathing and remaining in the present moment while observing your thoughts easily drift by — may help certain people with sleep problems. “Mindfulness meditation practices resulted in improved sleep quality for older adults with moderate sleep disturbance…” the report concludes.

The study, by researchers at the University of Southern California in Los Angeles, reflects a growing body of evidence showing that the practice of “mindful meditation” can be used as a low-cost, non-drug intervention that can, in certain cases, reduce stress and help with other physical and mental health woes.

Here’s more from the JAMA release:

Sleep disturbances are a medical and public health concern for our nation’s aging population. An estimated 50 percent of individuals 55 years and older have some sort of sleep problem. Moderate sleep disturbances in older adults are associated with higher levels of fatigue, disturbed mood, such as depressive symptoms, and a reduced quality of life… Continue reading

Delirious: Study Finds Simple, Humane Fixes For Aged, Disoriented Patients

(Xavi Talleda/Flickr)

(Xavi Talleda/Flickr)

By Alison Bruzek
Guest Contributor

The patient was an older man, living at a nursing facility. He’d originally been admitted to the hospital for surgery to treat a urinary tract infection. But now, lying in his bed at the hospital after the operation, he was convinced that two people were standing outside his room and planning to blow it up.

“We could tell this person was delirious,” says Dr. Eyal Kimchi, a neurologist at Massachusetts General Hospital

Delirium is a complicated syndrome, most common among the hospitalized elderly where it’s estimated 29 to 64 percent of patients have it. However, it’s underreported and researchers estimate as many as two-thirds of cases go undiagnosed.

While usually temporary, it leaves people feeling severely confused. Their brains switch rapidly between mental states, increasing their risk of falling and later brain problems like dementia.

Though the patient’s mind was muddled, the idea of an explosion hadn’t appeared to him out of the blue — he was at the hospital around the time of the Boston Marathon bombing. What had likely happened, says Kimchi, is the patient had begun misattributing the news reports he saw playing on the television to actual life.

And even though that patient fully recovered, some of those delirious thoughts remained. “Ultimately this person said, ‘I know I’m better, I know I was confused, but I also know they were trying to blow up the place,’ ” says Kimchi.

People with delirium can often run the gamut of states, from hyperactive and aggressive to withdrawn and nearly comatose. The causes are not well understood but it’s a combination of a person’s predisposition to delirium as well as an event that sets it off, says Kimchi. These could be “surgery, infections, other sorts of brain injuries like trauma,” he says. “It’s still very hard to predict on an individual basis.”

While there’s not a lot of research on the predictors of delirium, there are ways to prevent it, according to a study released this week in the Journal of the American Medical Association Internal Medicine.

Prevention may be as simple as reminders and attentive care, says, Dr. Tammy Hshieh, a researcher of aging and geriatrics at Brigham and Women’s Hospital and author of the JAMA study. She suggests preventative measures like reorienting patients to where they are, keeping them hydrated and healthy, and ensuring they have hearing aids or glasses or other physical assistance is an effective method to stop delirium. Continue reading

Out, Proud And Old: LGBT Seniors More Likely To Age Alone

(W.E. Jackson/Compfight)

(W.E. Jackson/Compfight)

By Jessica Alpert

Margueritte Wilkins was, as she likes to say, “born, bred, and buttered” in Manhattan’s Sugar Hill neigborhood, a northern section of Harlem.  Wilkins remembers that she came out to her family when she was in kindergarten: “My brother called me an early bloomer.”

Her family didn’t really know how to respond to her homosexuality and so they just “played it by ear.”  As she found support in friendships throughout middle and high school, her relationship with family deteriorated. Now, at age 66, Wilkins has no contact with her family.  “They think something is wrong with me,” she sighs.

Recent analyses suggest that there are at least 1.5 million lesbian, gay, bisexual, and transgender (LGBT) Americans over the age of 60.  These numbers are based on an estimate from UCLA’s Williams Institute on Sexual Orientation and the Law which has calculated that approximately 3.8 percent of Americans identify as LGBT.

LGBT elders deal with significant economic and health disparities as compared with heterosexual seniors. According to a 2011 national health study co-authored by the Center for American Progress and Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE), more than half of LGBT respondents have been told by a doctor that they have depression; 39 percent have seriously contemplated suicide; and 53 percent feel isolated from others. Social isolation remains a major issue as LGBT seniors are 3-4 times less likely to have children, twice as likely to live alone, and twice as likely to be single.

According to a 2010 MetLife Study  of Boomers from the MetLife Mature Market Institute, about 42% of the LGBT population identified their relationship status as single, far higher than the 27% of the general population. Like Margueritte Wilkins, many LGBT seniors may also be estranged from their biological families.

“This generation came of age when homosexuality was considered criminal, a form of mental illness, or a security risk,” says Brian De Vries, a professor of gerontology at San Francisco State University. “They don’t have the safety net available to them that heterosexuals have.”

Continue reading

Elderly Man (Me) Found In Snow With Punctured Lung But Still, At 79, I Ski

Author Ralph Gilbert, who suffered a punctured lung in a ski accident, and his son, Keith, his rescuer (Courtesy)

Author Ralph Gilbert, who suffered a punctured lung in a ski accident, and his son, Keith, his rescuer (Courtesy)

By Ralph M. Gilbert
Guest Contributor

Traumatic pneumothorax: the presence of air or gas in the pleural cavity, which impairs ventilation and oxygenation, caused by a severe trauma to the chest or lung wall. Symptoms are often severe, and can contribute to fatal complications such as cardiac arrest, respiratory failure, and shock.

Every time I tried to lift my head the sky began to spin. Then I felt the nausea. I knew that I had to get up out of the snow but after a few attempts, I just lay back, exhausted. Suddenly, a spray of powder was kicked onto my face as a young ski patrolwoman executed a hurried skid stop. She bent down and put her cold face next to mine:

“Sir,” she said looking into my unfocused eyes. “Are you all right? Do you know where you are, sir? Where are you, sir?”

“Huh?”

I realized that she wasn’t asking a particularly hard question, but I just couldn’t come up with an answer.

“I don’t know,” I replied.

She helped me to my feet.I looked around and saw the other skiers.

“I’m skiing…right?”

She radioed for help. The next thing I knew, I was being leaned back into a toboggan. Fighting the nausea and afraid that I would have to throw up, I asked to be tipped over momentarily before they restrained me to the sled for my ride down.

I regained consciousness in a strange hospital ER.

A young woman was standing over me. She asked: “Do you really think, sir, that a man of your age should be skiing alone in the glades?”

I hated that question. I found it particularly humiliating. As an intrepid, former U.S. Army trooper, I didn’t want to be talked to that way, especially by a woman who asked me the same questions my wife often asked.

Tests indicated a concussion. Upon release, I was told to buy a new helmet (each helmet can absorb only one crash), and not to ski for a week. I took only one day off, which I thought was plenty. I then purchased a new helmet and two days later I was back up on my skis again.

My next accident a few years later was to be worse, much worse.

Age denial? Not So Much

Before I tell you that story, I’d like to note that I’m not in total age denial. Now 79, I spend less and less of my après-ski time trading embellished ski stories with my buddies in smoky bars. These days, when we go on our annual ski trip, I can be found at night alone in my little room, carefully applying ice packs and winding compression bandages around my ill-treated joints.

I reject the idea, however, that I am suffering from any age-related diminution of muscle tone, balance or endurance. My ski dreams are still intact even if my body is not. I do realize that I should avoid the super steep double black diamond trails that I once traversed. But I just can’t resist.

Why? By story’s end, I’ll try to explain.

Male Bonding

Each year, twelve of us, former army buddies at Fort Bliss, Texas go on a ski trip together. We had trained as Nike Missile crewmen back in 1958 during the Cold War. Our job was to join with others to protect the City of New York.Stationed in a darkened radar van, we were to monitor our radar screens for Russian bombers. Our Nike Missiles were buried in concrete shafts near us. Our vantage point was Spring Valley, New York, which otherwise is known for kosher chickens and Hassids. If we saw any Russians in the air we were to electronically challenge them, then shoot them down. Continue reading

Why To Exercise (Outdoors) Today: Tranquility For Aging Ladies

(frodrig/Flickr)

(frodrig/Flickr)

It’s cold, it’s dark, it’s uninviting out there. So, all the more reason to drag yourself outside and do something.

In yet another study on how exercise can combat the bad physical and mental effects of aging, new research suggests that women who can get out the door, fight the elements and exercise might find some nifty benefits. Those benefits include alleviating depression and increasing adherence to an exercise program.

The small study, published in the journal Menopause, asserts it’s the outside air that really helps (as opposed to the stuffy gym or the treadmill in your basement, though I’ve found that when you’re desperate, those work too):

“Between baseline and week 12, depression symptoms decreased and physical activity level increased only for the outdoor group…” write the authors, led by Isabelle Dionne of the University Institute of Geriatrics of Sherbrooke in Quebec.

From the Reuters report:

Outdoor workouts left women in a better mood and kept them exercising longer than counterparts who exercised indoors, according to a small study from Canada.

Results of the three-month trial involving women in their 50s and 60s suggest that outdoor exercise programs should be promoted to help older women keep active, the researchers conclude…Only about 13 percent of Canadian women older than 59 years and less than 9 percent of older American adults get at least 150 minutes of physical activity each week… Continue reading

Foggy Days, Sleepless Nights: When Alzheimer’s Care Goes Nocturnal

(Ronel Reyes/Flickr via Compfight)

(Ronel Reyes/Flickr via Compfight)

By Jessica Alpert

Marion Tripp was what you might call a quintessential “Yankee.” From impeccable pie crusts to crackshot deer hunting, she regularly impressed people with her wide range of skills. When her daughter and son-in-law started an organic farm in rural Maine, she’d bundle up in a snowmobile suit and sell their rutabagas at the local farmer’s market. I never knew Marion but her grandson — my husband — loves to remember her this way.

Not the way she was at the end.

Alzheimer’s ravaged Marion’s brain and left her confused, “mean,” paranoid, and violent. The last three years of her life, she had round-the-clock care since she rarely slept more than a few hours at a time. Her nocturnal habits were not unique. Indeed, in the world of Alzheimer’s, this tendency toward nighttime wakefulness is known as “sundowning.”

“Several things go awry with Alzheimer’s that affect the person’s brain chemistry and changes their circadian rhythm,” says Dr. Paul Raia, vice president of clinical services for the Massachusetts/New Hampshire chapter of the Alzheimer’s Association. He says there are various reasons for this nocturnal shift including lack of melatonin, diminished access to natural light and less rapid eye movement or REM sleep.

But it’s not just about being unable to sleep for long stretches of time. Like Marion Tripp, many Alzheimer’s patients are often agitated, angry, even violent. “During that period [of REM sleep], you are ridding the toxins from your brain and you’re stabilizing memory and you’re dreaming and essentially you are paralyzed with your body in a relaxing mode,” says Raia. “[The patients] may take a series of small naps throughout the day and when they wake up, they may not be fully awake. They can’t navigate well or negotiate well in their environment.” Continue reading