Archive for the ‘seniors’ Category
Thursday, July 8th, 2010
806,000 hip and knee implants were performed in the US in 2007 – that’s double the amount done a decade earlier. However, a 2007 study demonstrates that 7% of Medicare patients who underwent a hip replacement required another replacement hip within seven and a half years. That number, small as it sounds, translates into thousands of patients who eventually need a “do over”. A joint surgery involves risk, pain, convalescence, rehab and medical expenses; no one wants to go through that more than once if necessary.
A National Joint Replacement Registry helps reduce the rate of failed procedures by keeping a database of information that keys in surgeons to problematic implants, and provides insight as to how to avoid mess ups. According to Dr. Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn, “Every country that has developed a registry has been able to reduce failure rates significantly.” Sweden is one case in point.
The newly formed American Joint Replacement Registry is still in its nascent stage and has started collecting data. Its goal is to improve the quality, outcomes, and cost-effectiveness of total joint replacement (TJR) surgeries through the achievement of four objectives:
1. Establish an infrastructure and a uniform system for the collecting device information and monitoring outcomes of TJR throughout the U.S.;
2. Identify patients who may need follow-up evaluation thereby increasing patient safety;
3. Create real-time survivorship curve in order to detect poorly performing implants;
4. Establish a uniform system that can be used to define the epidemiology of TJR for outcomes research to improve the quality and outcomes of patient care.
Until we have access to solid facts from the U.S. Registry, there are some proactive steps you can take if you are in the market for a new joint.
– Go with a highly experienced surgeon in a busy hospital; don’t look for the best deal. Ask for recommendations. A 2004 study published in The Journal of Bone and Joint Surgery found that patients receiving knee replacements from doctors who performed more than 50 of the procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.
A similar trend was documented with hospital volume. Patients at hospitals that performed more than 200 knee replacements a year fared better than patients at hospitals that performed 25 or fewer.
– A joint replacement is not for everyone. Some arthritic problems are better served with medication, and surgery may be too risky for those who have uncontrolled high blood pressure or another serious chronic condition.
– Research the joint implant that your surgeon recommends. Find out how well it has performed in others and if there are known complications. Some implants are somewhat controversial and may cause tissue and bone damage; newer doesn’t necessarily mean better. If the hospital has its own registry, ask to review the data.
– Educate yourself as to what the surgery entails. The American Academy of Orthopaedic Surgeon’s patient information Web site, orthoinfo.org is very helpful.
– Prepare your recovery in advance. Arrange for the necessary support upon your return home, and make sure you have all the help you need. It is crucial not to overexert yourself during your initial healing period.
Tags: aging, hip replacement, research, seniors, surgery
Posted in aging, fitness, health, knee & hip, prevention, rehab, research, seniors | No Comments »
Monday, May 17th, 2010
As we work with administrators to help navigate the world of Long Term Care it is hard not to be hyper-aware of our own mortality and the eventuality that we, too, are likely to reach a point where we will need some level of assistance in getting through the tasks of day-to-day living. This awareness, combined with our mission to be a resource for those who serve the aging, means that our antennae are up for any news related to maintaining our bodies and minds well into our twilight years!
A New York Times review of the new book The Secret Life of the Grown-Up Brain caught my eye a week or so ago, and the author, Barbara Straunch, had some interesting insights to share relative to what middle-aged brains are actually good at, and how to keep our brains functioning well into the future.
- Our brains are still growing and developing far into adulthood. Although we do have some compromises in short term memory (Where are my keys anyway? And what is your name?), the middle-aged brain is actually better in many ways than at any other point in our lives.
- Logic, creativity and social skills are all at a high point during those middle years. Although you might not remember the name of the person to whom you are speaking, you will be an excellent judge of his character.
- We do not, as previously thought, actually lose brain cells as we age.
- Exercise and diet recommendations that benefit your heart are also likely to benefit the health of your brain. Exercise in particular can actually help strengthen and grow your brain. So get out there and start moving!
- Although there are benefits to making your brain work hard, crossword puzzles and learning a foreign language hold no particular magic powers in terms of maintaining the health of your brain. Partaking in vigorous debates on subjects of interest can be just as helpful, so unless you just love the Sunday Times crossword puzzle, you can stop doing it!
- Meeting and engaging with people is healthy for your brain, and your mood!
It is so refreshing to hear that middle age is not necessarily the beginning of a slow slide into senility. Staying engaged and active in life, both in terms of intellectual pursuits and social involvement, seems to be key to keeping your gray matter from graying.
I am hopeful that by maintaining an active life filled with fulfilling relationships, creative pursuits and lively conversation, I can remain one less consumer of Long Term Care services in New York!
Tags: aging, brain, diet, exercise, health, research, seniors
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Saturday, May 1st, 2010
I am admittedly not the trendiest girl around. I don’t have designer shoes or a luxury car or get my hair blown out. Actually, where I live getting your hair blown out means you drove with a window open, but I don’t do that much either. The NYC crowd would have a field day with how un-cool I am with my suburban clothes and addiction to Dunkin’ Donuts iced coffee. I am about as mainstream as they come, and for this I am generally unapologetic. It’s who I am and I’m OK with that.
Although un-hip, I am quite interested in doing things to keep myself and my family healthy. I try mightily to get my children to willingly eat vegetables. I don’t cook red meat. I choose fresh ingredients rather than food-in-a-box whenever possible. I am embarking on an experiment to be a vegetarian, and I recently gave up caffeine for a month. I am willing to try new things – within reason.
There was a recent article in the New York Times about the popularity of a fermented tea drink called kombucha. Apparently this tea can do all kinds of magical things like re-growing hair, calming digestive issues and curing hangovers. Those who drink it claim that it is quite delish. Sounds good, right? I’m in! I could be the first one in the suburbs to partake of this delightful elixir! How do I get it?
This is where things get a little hairy for me. Because kombucha is made by immersing a disk of bacteria into brewed tea and letting it sit, unrefrigerated, for up to two weeks.
A disk of bacteria.
In your tea.
On purpose.
I am so not down with that.
I understand the benefits of probiotics. I eat yogurt (from the refrigerator, thank you very much). But, I have to admit that I wouldn’t even drink the plain tea if it sat out for two weeks – and the introduction of the bacteria disk into the equation does nothing to improve the situation for me.
I suppose the nature of kombucha is essentially similar to beer. Fermented substances in a drink are not that uncommon. And yet, I can’t quite get my head around voluntarily introducing bacteria into a completely acceptable drink like tea. I guess I don’t brew my own beer either, although I do enjoy drinking it.
There are packaged versions of kombucha available, including one made by Red Bull. I am slightly more comfortable with the manufactured versions, mostly because I work under the assumption that beverage manufacturers are as terrified of being sued as I am of dying of kombucha poisoning.
I am a big sucker for slick marketing and putting anything, even something utterly disgusting, in a pretty bottle and giving it a fun name goes a long way to drawing my interest. If I actually went out and purchased a Carpe Diem Kombucha, it would be an ultimate marking success for them.
Ooooo…pretty bottle….fancy name…who cares what’s in it? I must have it!
I want to be cool and brave enough to jump on this bandwagon and give kombucha a try. But the reality is that it’s probably beyond my capabilities to be that cool and brave. And the Dunkin’ Donuts coffee is working just fine for me, thanks!
Tags: diet, health, research
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Saturday, December 26th, 2009
With the number of U.S. seniors with Alzheimer’s skyrocketing, much research is underway to determine how to stave off this mental deterioration, keeping people physically and mentally sound as they age.
A recent report in the December Journals of Gerontology: Medical Sciences found that older women who volunteered for Experience Corps – tutoring elementary school children, had increased brain activity in regions important to cognitive function after a period of six months.
What was exciting about these results, is that it shows a direct correlation between community-based programs and improved cognitive functions. Until now, much study has been done on the brain-boosting power of cognitive, physical and social leisure activities, but little was known about the effectiveness of community-based service.
“This finding is best captured by a personal observation from one of the volunteers, who stated that ‘it [Experience Corps] removed the cobwebs from my brain.” wrote Michelle C. Carlson, of Johns Hopkins Bloomberg School of Public Health.
The seventeen women enrolled in this study were low-income African-Americans with little education, aged 65 and older, and deemed high-risk for cognitive declines, based on a mental state evaluation. Eight of the women actually participated in the tutoring program in Baltimore elementary schools, while the other nine served as the control.
Via functional magnetic resonance imaging, researchers assessed neural activity in the brain prior to the volunteering experience, and again after six months. Based on the fMRI assessment, the women who actively participated in Experience Corps saw improvements in mental function compared with those in the control group.
There you have it, doing your civic duty and assisting others is highly rewarding to all participants. These meaningful activities seem to be more enriching than highly stimulating activities performed alone
Tags: Alzheimer's, cognitive function, December Journals of Gerontology: Medical Sciences, functional magnetic resonance imaging, Johns Hopkins Bloomberg School of Public Health, mental function, Michelle C. Carlson, research
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Wednesday, September 30th, 2009
Yup, there’s actually such a title. A recent Wall Street Journal article highlighted the growth of a new genre – upscale, more palatable cuisine now offered in healthcare facilities.
The typical hospital fare such as jello, soggy sandwiches and tasteless chow that we’re all familiar with, seems to be a thing of the past. Think Machaca Steak with Sauce and Curried Banana Pierogi. Hospitals are now competing with the likes of five-star hotels and restaurants by installing sushi stations, organic salad bars and pizza ovens.
The National Society for Healthcare Foodservice Management recently launched an annual cooking competition. “We want to show the world that health-care food is so much different. It can be creative. It can dazzle,” said Betty Perez, a society board member and a hospital food administrator in New Jersey. “We have chefs that can compete with the best of them.”
However, hospital chefs must play by different rules than their glitzy restaurant counterparts. Their creative offerings must be in tune with doctors orders, as well as nutritionists and cost-sensitive food administrators.
600 calories, 20 grams of fat, and 1,000 milligrams of sodium were the max for each contest dish and the production cost per dish could not exceed $5.
So pass the Green Apple-Jicama Slaw and enjoy your stay.
Tags: Betty Perez, calories, chef, cooking competition, cuisine, fat, food administrator, healthcare facilities, hospital, hotels, National Society for Healthcare Foodservice Management, nutritionist, organic salad bars, pizza ovens, restaurants, sodium, sushi stations, Wall Street Journal
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Sunday, September 20th, 2009
It starts with neglecting one’s hygiene, nutrition and medications, and can lead to death within the year. According to data compiled by the Chicago Health and Aging Project (CHAP), an older person’s risk of dying within the year increases six-fold when he or she starts to ignore his or her physical and medical needs.
The CHAP study took place from 1993-2005 in three Chicago neighborhoods and the 9,318 participants were ages 65 or older. Among that population there were 1,544 reported cases of self-neglect (mean age of 73.2 years old) and in the average follow-up within almost a year, there were 927 deaths (47.8%) in that group.
Elder abuse of any kind also generated a greater mortality rate, with a 61.6% death rate within an average of 2.7 years.
By the self neglect cases, the increased mortality rate wasn’t affected by whether or not the senior’s cognitive or physical functions were impaired. However by confirmed abuse cases there was a significant difference – increased mortality was not associated with elder abuse of high functioning seniors, demonstrating that this group was more likely to recognize abuse and seek help.
Tags: CHAP, cognitive, elder abuse, hygiene, medications, mortality, nutrition, physical, self neglect, seniors
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Thursday, September 17th, 2009
As the Baby Boomer generation ages, there is a swelling populaton of people suffering from osteoarthritis. Arthritis pain seems to go hand in hand with insomnia, with joint pain keeping awake 60% of those with osteoarthritis
A new study, reported in the Aug. 15 issue of Journal of Clinical Sleep Medicine, finds that cognitive therapy has a beneficial effect on osteoarthritis patients and insomniacs – assisting them in their quest for a good night’s sleep.
Cognitive behavior therapy for insomnia or CBT-I,was given by an experienced clinical psychologist who taught participants cognitive restructuring techniques that helped change unrealistic beliefs and irrational fears regarding sleep or lack of it.
Handwritten sleep logs kept by participants documented their sleep patterns, and pain level was graded by the Short-Form McGill Pain Questionnaire (MPQ) and the Body Pain Subscale (SF-PAIN) question from the Medical Outcomes Study Short Form-36 Pain.
Results showed that after CBT-I treatement, patients were falling asleep faster than before, and remained sleeping approximately 37 minutes longer. CBT-I seems to be an effective tool for treatment of osteoarthritis in conjunction with other pain management techniques, and may also work well with other chronic pain conditions.
Tags: Aging Osteoarthritis, Arthritis pain, Baby Boomers, CBT, Cognitive Therapy, Insomnia, Joint pain, Pain Management, Psychology, research, seniors, Sleep, Stiff joints
Posted in Arthritis, Baby Boomers, aging, health, lifestyle, medicine, osteoporosis, prevention, rehab, research, seniors | No Comments »
Monday, August 17th, 2009
At the recent Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease, an eye opening study demonstrated that spouses who care for a mate suffering from dementia were more likely to develop the same condition, with husband caregivers at a much greater risk than wife caregivers.
Wives who cared for husbands with dementia were nearly four times more likely to develop dementia than wives of men who didn’t have dementia, while husband caregivers in the same circumstances were almost 12 times more likely to develop the disease.
So what exactly is it that causes the risk of developing Alzheimer’s to skyrocket? You can’t catch it, can you? Researchers think the root cause is the stress that comes along with these caregiving situations.
Ralph Nixon, MD, PhD, a psychiatrist and Alzheimer’s disease expert at NYU and vice chairman of the Medical & Scientific Advisory Council at the Alzheimer’s Association feels that “the amount of stress involved in caring for a spouse with dementia is tremendous,and stress is a known risk factor for dementia.”
Healthy diet and exercise are key factors of good brain health, and both of these areas tend to falter when one is stressed out. It is critical that caregivers look after themselves properly, making sure to rest, to visit a doctor regularly and to maintain social ties.
Since men tend to rely on their wives to serve as the impetus for seeing the doctor and keeping up with friends and family, they are more apt than women caregivers to let these things slide when their spouse is cognitively impaired – thereby increasing their risk of high cholesterol, blood pressure and other conditions that can lead to dementia.
Tags: Alzheimer's, Alzheimer's Association, blood pressure, caregiver, cholesterol, dementia, exercise, healthy diet, NYU, Ralph Nixon, risk factor, spouse, stress
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Sunday, November 30th, 2008
~ by Lydia Yolen
Relax actively. That’s the advice of researchers to the retired and the elderly. Not only is it beneficial for your heart, it’s beneficial for your mind.
This news is the conclusion of numerous studies concerning how exercise affects the brain. Exercise causes a chain of reactions that release chemicals into the bloodstream, while regular aerobic workouts build up the presence of these chemicals. The results are startling. Far from the usual shrinking that accompanies aging, the brain begins to grow.
Children have flourishing brains that branch out new neurons with an exuberant frequency. The adult brain begins trimming back unused neurons, and some also die on their own. Until these recent studies, scientists believed that these dead neurons could never regrow. Now they know differently.
In a study by Columbia University’s Scott Small and the Salk Institute’s Fred Gage, subjects asked to exercise regularly seemed to sprout new neurons; the more fit they became the more neurons they grew. The neurons appeared in the section of the brain dedicated to learning and memory, one of the first sections to age. “It’s not just a matter of slowing down the aging process,” explained Arthur Kramer, of the University of Illinois. “It’s a matter of reversing it.”
Exercise does more than just grow a bigger brain. A research group at the University of Washington found that people who exercise three or more times a week have a 30% lower risk of developing Alzheimer’s. Nor did the exercise have to be an intense aerobic workout. Lead researcher Dr. Eric Larson said that a 15-minute walk three times a week was enough to reduce the risk. A similar study found that five to six hours of vigorous physical activity each week led to a 40% decrease in risk of developing Parkinson’s Disease.
Scientists don’t know why this happens, and they haven’t yet zeroed in on the best exercises. But until they figure it out, one thing remains clear: being a couch potato is bad for the brain. So move!
Tags: brain, cognition, dementia, exercise, fitness, Middle age, neurons
Posted in Alzheimer's, aging, exercise, fitness, research, seniors | No Comments »
Monday, November 17th, 2008
by Jose Sonik
With aging, comes reduced hormone levels. Does reversing the hormone levels reverse aging?
Not exactly, but it might come close.
Human growth hormone is a hormone that predominantly increases height. While doing so, it also increases muscle mass and bone density. HGH is at its highest levels during childhood and puberty. As we mature, the levels decrease, beginning a sharp decline at around age 30. At around that time, bone density declines, muscle mass reduces, and physical disorders like diabetes increase.
Until now, some of the more desperate aging generation have taken HGH in the hope of reversing aging, but research has not corroborated their theory.
But now, something new is in the air. According to Natalie Angier of the NY Times: “In a clinical trial of 21 healthy men ranging in age from 61 to 81, researchers found that after six months of injections of a genetically engineered version of the natural body hormone, the men emerged with bodies that by many measures were almost 20 years younger than the ones they started with.”
Aging was measured only in the distribution of body weight. The men were found to have increased muscle mass and decreased fat. The scientists hypothesize that some bulk went to internal organs, which shrink with age, but aren’t sure. The men’s skin also increased in thickness and youth, and bone density increased.
Of course, the significance of this improvement is debatable. HGH is known to increase muscles mass and reduce fat, but without really increasing strength. And what’s the point of muscle without strength? Similarly, the change in appearance was not correlated to an increase in performance of organs or body.
And as with all drugs, there were the side effects. HGH can cause swelling in the face, arms, and legs; arthritis; diabetes; hardened arteries, high blood pressure, and heart failure; and abnormal growth of bones and organs, among others.
Tags: aging, bone density, HGH, hormone replacement, muscle mass, reverse aging
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