Senior Health News E-Update, October, 2010

AAA Warman Home Care’s E-Update is intended to bring to you timely and useful articles and information at the click of the mouse. It is sent monthly in an effort to keep you apprised of what is happening across the healthcare continuum of care effecting hospital, hospice and rehabilitation social workers and case managers, as well as Assisted Living, Independent Living and Skilled Nursing facility executives. Warman understands that time is limited and has undertaken to share with you important industry information without your having to search for it.

IN THIS UPDATE:

Walking May Preserve Brain Size and Memory in Later Life
Regular Rehabilitation Leads to Rheumatic Disease Relief
10 Tips for Breast Cancer Patients During Treatment
Study Finds Watermelon Lowers Blood Pressure
Spread the Word, Not the Flu Germs

1. Walking May Preserve Brain Size and Memory in Later Life

Walking improves brain size and memory in elderly

A new US study found that walking six to nine miles a week may preserve brain size and consequently stop memory deteriorating in later life.

The study was published online on 13 October in Neurology, the medical journal of the American Academy of Neurology.

The lead and corresponding author was Dr Kirk I. Erickson, from the University of Pittsburgh in Pennsylvania; other authors were also from the University of Pittsburgh, the University of Nevada in Las Vegas, and the University of California, Los Angeles.

Erickson told the press that our brains shrink in late adulthood, and this can lead to memory problems.

Researchers have promoted the theory that physical activity helps to preserve grey matter volume in late adulthood, which in turns protects memory function, but there have not been enough studies following a sizeable group of elderly people for a good number of years to back this with evidence.

Grey matter comprises mostly the cell bodies of neurons, as opposed to the axons or fibres that link them together and transmit signals.

Erickson said he and his colleagues hope their results will now prompt some "well-designed trials of physical exercise in older adults as a promising approach for preventing dementia and Alzheimer's disease".

For their study, the team looked at data on 299 adults of average age 78 years who took part in the Cardiovascular Health Cognition Study, where researchers had taken measures of grey matter volume as well as physical activity and cognitive impairment.

Physical activity was assessed at the start of the study (baseline), in terms of number of blocks walked per week. None of the participants had dementia at baseline.

The participants underwent high-resolution MRI brain scans to assess white matter volume and other brain health characteristics 9 years after baseline, and they underwent cognitive impairment tests, to assess memory and thinking skills and signs of dementia, 13 years after baseline.

The results showed that:

At baseline, walking amounts ranged from 0 to 300 blocks, with an average of 56.
At the 9-year point, participants who had reported walking at least 72 blocks a week (about 6 to 9 miles) at the start of the study, had more grey matter volume than those who walked less (they had "greater volumes of frontal, occipital, entorhinal, and hippocampal regions").
Walking more than 72 blocks did not appear to increase grey matter further.
At the 13-year point, 116 (40 per cent) of the participants had developed cognitive impairment or dementia.
The participants who had walked the most appeared to have halved the risk of developing memory problems.

The researchers concluded that:

"Greater amounts of walking are associated with greater grey matter volume, which is in turn associated with a reduced risk of cognitive impairment."

Erickson said:

"If regular exercise in midlife could improve brain health and improve thinking and memory in later life, it would be one more reason to make regular exercise in people of all ages a public health imperative."

It is interesting that the researchers did not measure grey matter volume at baseline: presumably this measure was not available to them in the Cardiovascular Health Cognition Study data set.

So strictly speaking, they have not assessed whether walking helped to preserve each person's brain volume, only that people who walked the most tended to have larger grey matter volumes than those who walked less.

There is no proof of cause and effect here (this was a longitudinal study and not a controlled trial), only the suggestion of a strong link, and the reasonable, but still arguable, assumption that it is walking that preserved brain volume rather than having more brain volume encouraged people to do more walking.

The reasonableness of assuming it is the former is bolstered by the numerous studies that show our brains shrink as we age.

Funds from the National Institute on Aging in the US helped pay for the research.

Source: Neurology, October 14, 2010

2. Regular Rehabilitation Leads to Rheumatic Disease Relief

The American College of Rheumatology is celebrating National Physical Therapy Month by encouraging people with arthritis and other rheumatic diseases to discover the benefits of rehabilitation with a physical therapist.

For the 46 million Americans 300,000 of which are children who suffer from arthritis and other rheumatic diseases, symptoms can cause pain and challenges in day-to-day living. When this happens, people often seek the help of a rheumatologist and rheumatology health care professionals including physical therapists whose primary roles are to assist patients in preventing disability and achieving optimal function and pain relief.

Physical therapists are licensed health care professionals trained extensively on anatomy and the musculoskeletal system. Coupled with visiting a rheumatologist, physical therapy can help patients improve or restore mobility and can often serve as a first line of defense before medication or surgical intervention is needed. "When used as a part of an overall rheumatology care plan, physical therapy can effectively relieve inflammation and joint pain," says Carol A. Oatis, PhD, a physical therapist and member of the ACR's health professional division, the Association of Rheumatology Health Professionals. "Rheumatic diseases are often complex, and physical therapists work in concert with other rheumatology health professionals to create a plan that allows patients to successfully manage life with a rheumatic disease."

When working with a physical therapist, patients can expect assistance in several areas, including:

Developing and managing an individualized plan of care that includes personal improvement goals and self‐management skills
Using therapeutic exercises to relieve discomfort and improve performance by strengthening muscles
Modifying activities that are painful or harmful
Adapting home and work environments to better suit individual needs

"Physical therapy is a successful tool that heumatologists use to treat patients with arthritis," explains Linda Ehrlich-Jones, PhD, RN and president of the ARHP. "We are taking advantage of this month to promote the power of rehabilitation and the treatments that encourage a healthy way of living."

In more than 43 states, patients have direct access to a physical therapist. In the remaining states, patients may be referred by health care providers for consultation and treatment. If you are being treated for arthritis or another rheumatic disease, speak with your rheumatologist about the positive role physical therapy can play in your overall wellness.

Source: American College of Rheumatology, October 5, 2010

3. 10 Tips for Breast Cancer Patients During Treatment

Throughout October, National Breast Cancer Awareness Month, experts from Fred Hutchinson Cancer Research Center and its clinical care partner, the Seattle Cancer Care Alliance, are offering a series of weekly research-based tip sheets regarding a variety of topics related to breast cancer, including breast cancer prevention, screening and early detection, treatment, and survivorship. The series will conclude Friday, Oct. 22.

Today's tip sheet, the third of four in the series, is "10 Tips for Breast Cancer Patients During Treatment" provided by Julie Gralow, M.D., director of Breast Medical Oncology at the Seattle Cancer Care Alliance and co-author of "Breast Fitness" (St. Martin's Press).

10 Tips For Breast Cancer Patients During Treatment

Get specifics on your diagnosis and treatment. In order to maximize your time with your providers, bring your questions with you in writing to your appointments. Ask for copies of your test results and keep a notebook of all these results. Keep a list of questions that arise between visits so you don't forget, and take notes of the answers. Above all, make informed decisions; learn as much as you can about your diagnosis and treatment.

Spend time choosing your doctor. Breast cancer specialists who work at dedicated cancer centers offer specific expertise as well as access to the latest treatments that are part of clinical studies. Such centers can provide other specialty services, usually under one roof, such as physical therapy, nutrition and social work.

Get the support you need for talking about your diagnosis. Breaking the news to your friends and family that you've been diagnosed with breast cancer can be just as difficult as first hearing the news yourself from your doctor. You may feel concerned about upsetting your family and friends or worried about how they will react. Even after you have shared the news, at times you may find it difficult to communicate openly. Sometimes it's uncomfortable to ask for help, answer questions about how you're doing, or tell well-meaning relatives and friends that you need some time and space for yourself. If available at your hospital, request to meet with a social worker to discuss any emotional support or resource referrals you might need. A local support group for women with breast cancer may also help considerably. Ask your hospital or clinic to help you identify appropriate resources in your area.

Seek help in navigating financial issues, if necessary. Your hospital or clinic should have a social worker, patient navigator or financial services department to help you manage financial issues and deal with private insurance companies, Medicare and Medicaid. If you have concerns, request an appointment.

Talk to your doctor about coping with menopause symptoms. Breast cancer patients who have undergone chemotherapy, ovary removal, or who have had to discontinue hormone replacement therapy upon diagnosis may experience symptoms of menopause. Talk to your doctor about how to safely minimize menopausal symptoms.

Get good nutrition. Your cancer treatment may influence your ability to taste and smell, and it may alter your digestion. Foods that you normally enjoy may not taste good during treatment while, paradoxically, foods that normally don't appeal to you might taste better. You may prefer and tolerate more cooked versus raw vegetables, so a vegetable stew or soup may be more appealing than a salad. You may have more energy and less nausea if you eat smaller amounts of foods more frequently rather than eating three big meals per day. Try not to gain weight by overindulging and blowing your calorie budget. Help fight your cancer by eating more vegetables, fruits, whole grains, nuts, seeds and legumes such as black beans and lentils. Choose a rainbow of colorful whole foods (like deep greens of spinach, deep blues of blueberries, white for onions, and so on) to ensure that you get a variety of anti-cancer nutrients. Alcohol is usually not preferred or recommended during treatment, but if you do drink, limit your intake to no more than three drinks per week. Recent studies have shown an association between alcohol and increased risk of breast cancer.

Take steps to prevent lymphedema. Lymphedema is a side effect of breast cancer treatment that involves swelling of the soft tissues of the arm, hand or chest wall. It isn't life threatening, but it needs to be treated to avoid getting worse. The swelling may be accompanied by numbness, discomfort and infection. There's no reliable way to assess your risk for lymphedema, but by taking proper precautions you can greatly reduce your chances of developing the condition. Ask your doctor about scheduling physical therapy if you notice symptoms, or consider seeing a physical therapist even before symptoms begin in order to minimize their chance of developing in the first place.

Get exercise. Gentle exercise during treatment, such as regular walks, can help with both the mental and physical effects of treatment. After treatment is completed, increasing your exercise gradually will help improve your fatigue and rebuild muscle tone. Getting your circulation going may also help with chemobrain, the mental fogginess noticed by some patients during and after chemotherapy, and it can certainly improve your mood and your outlook on life. Try yoga, tai chi, swimming or water aerobics. Be physically active for at least 30 minutes every day. If you are having difficulty exercising or aren't sure what to do, request a referral to a physical therapist from your medical provider.

Bone up on bone health. Keeping your bones healthy throughout your life is important; however, if you're a woman who's been diagnosed with breast cancer, bone health is especially important. Research shows that some breast cancer treatments can lead to bone loss. Plus, women are about twice as likely as men to develop osteoporosis after age 50. Talk to your health care team about specific recommendations for keeping bones healthy, taking calcium and vitamin D, and appropriate weight-bearing exercises to help keep bones strong.

Treatment and work. Some people are able to work throughout their cancer treatment. Yet for some, reducing one's work capacity or taking a break altogether may be necessary. If you take time off and then return to work shortly after your treatment ends, you may find that it helps you maintain your identity and even boosts your self-esteem, not to mention your income. You may want to talk with your employer about options such as flextime, job sharing or working from home. Options like these may help your mind and body ease back into the demands of your job. Try to be patient and take care of yourself as you go back to your "normal" life.

Source: Fred Hutchinson Cancer Research Center, October 18, 2010

4. Study Finds Watermelon Lowers Blood Pressure

No matter how you slice it, watermelon has a lot going for it sweet, low calorie, high fiber, nutrient rich and now, there's more. Evidence from a pilot study led by food scientists at The Florida State University suggests that watermelon can be an effective natural weapon against prehypertension, a precursor to cardiovascular disease.

It is the first investigation of its kind in humans. FSU Assistant Professor Arturo Figueroa and Professor Bahram H. Arjmandi found that when six grams of the amino acid L-citrulline/L-arginine from watermelon extract was administered daily for six weeks, there was improved arterial function and consequently lowered aortic blood pressure in all nine of their prehypertensive subjects (four men and five postmenopausal women, ages 51-57).

"We are the first to document improved aortic hemodynamics in prehypertensive but otherwise healthy middle-aged men and women receiving therapeutic doses of watermelon," Figueroa said. "These findings suggest that this 'functional food' has a vasodilatory effect, and one that may prevent prehypertension from progressing to full-blown hypertension, a major risk factor for heart attacks and strokes.

"Given the encouraging evidence generated by this preliminary study, we hope to continue the research and include a much larger group of participants in the next round," he said.

Why watermelon?

"Watermelon is the richest edible natural source of L-citrulline, which is closely related to L-arginine, the amino acid required for the formation of nitric oxide essential to the regulation of vascular tone and healthy blood pressure," Figueroa said.

Once in the body, the L-citrulline is converted into L-arginine. Simply consuming L-arginine as a dietary supplement isn't an option for many hypertensive adults, said Figueroa, because it can cause nausea, gastrointestinal tract discomfort, and diarrhea.

In contrast, watermelon is well tolerated. Participants in the Florida State pilot study reported no adverse effects. And, in addition to the vascular benefits of citrulline, watermelon provides abundant vitamin A, B6, C, fiber, potassium and lycopene, a powerful antioxidant. Watermelon may even help to reduce serum glucose levels, according to Arjmandi.

"Cardiovascular disease (CVD) continues to be the leading cause of death in the United States," Arjmandi said. "Generally, Americans have been more concerned about their blood cholesterol levels and dietary cholesterol intakes rather than their overall cardiovascular health risk factors leading to CVD, such as obesity and vascular dysfunction characterized by arterial stiffening and thickness issues that functional foods such as watermelon can help to mitigate.

"By functional foods," said Arjmandi, "we mean those foods scientifically shown to have health-promoting or disease-preventing properties, above and beyond the other intrinsically healthy nutrients they also supply."

Figueroa said oral L-citrulline supplementation might allow a reduced dosage of antihypertensive drugs necessary to control blood pressure.

"Even better, it may prevent the progression from prehypertension to hypertension in the first place," he said.

While watermelon or watermelon extract is the best natural source for L-citrulline, it is also available in the synthetic form in pills, which Figueroa used in a previous study of younger, male subjects. That investigation showed that four weeks of L-citrulline slowed or weakened the increase in aortic blood pressure in response to cold exposure. It was an important finding, said Figueroa, since there is a greater occurrence of myocardial infarction associated with hypertension during the cold winter months.

"Individuals with increased blood pressure and arterial stiffness especially those who are older and those with chronic diseases such as type 2 diabetes would benefit from L-citrulline in either the synthetic or natural (watermelon) form," Figueroa said. "The optimal dose appears to be four to six grams a day."

Approximately 60 percent of U.S. adults are prehypertensive or hypertensive. Prehypertension is characterized by systolic blood pressure readings of 120-139 millimeters of mercury (mm Hg) over diastolic pressure of 80-89 mm Hg. "Systolic" refers to the blood pressure when the heart is contracting. "Diastolic" reflects the blood pressure when the heart is in a period of relaxation and expansion.

Findings from Figueroa's latest pilot study at Florida State are described in the American Journal of Hypertension. A copy of the paper ("Effects of Watermelon Supplementation on Aortic Blood Pressure and Wave Reflection in Individuals With Prehypertension: A Pilot Study") can be accessed online.

The paper's lead author, Figueroa holds a medical degree, a doctoral degree in physiological sciences, and a master's degree in sports medicine. He has been a faculty member in the Florida State University Department of Nutrition, Food and Exercise Sciences since 2004. Figueroa's coauthor and colleague Arjmandi serves as chairman of the department, which is a part of Florida State's interdisciplinary College of Human Sciences. Arjmandi also is the author or coauthor of an extensive body of published research on the health benefits of prunes and other functional foods.

Coauthors of the Figueroa-Arjmandi paper in the American Journal of Hypertension are Marcos A. Sanchez-Gonzalez, a Florida State doctoral student in exercise physiology, and Penelope Perkins-Veazie, a horticulture professor at North Carolina State University.

Source: Florida State University, October 14, 2010

5. Spread the Word, Not the Flu Germs

You're having that dreaded feeling. Your muscles are aching, you've got a a fever and sore throat . Get ready: It is flu season again!

The flu is a respiratory virus that's contagious. In addition to the symptoms above, a, cough and headache, as well as diarrhea may indicate the virus is present.

The influenza virus may linger a few days or several weeks. However, in severe cases, it can be deadly. Those at high risk include the elderly, children, and people with some chronic health conditions. However, everyone is susceptible, which is why it's so important to thwart it if possible.

According to the Centers for Disease Control and Prevention,when people with the flu sneeze or cough, droplets can travel as far as six feet from the source. The flu virus may also be transferred to people if it's on a surface.

You don't have to take getting the flu lying down (unless absolutely necessary). That's why LifeBridge Health has two of the most important ways to prevent someone in your family from catching it.

"For most people, the best way to avoid the flu is by rolling up your sleeve and getting vaccinated every year," say Peter Andrews, P.A., director of employee health at LifeBridge Health. "Each season, different strains of the seasonal flu are targeted. You should always check with your own doctor to make sure you are physically able before receiving the shot or nasal spray."

This year's seasonal flu vaccine includes protection against the 2009 H1N1 virus, the H3N2 virus and an influenza B virus.

Andrews adds, "Just remember that it takes about two weeks after getting the vaccine before antibodies develop in the body to protect against the influenza virus."

You should try to get the flu shot as soon as you can. However, it can still be effective if you get it as late as May. The peak flu season is usually January or later, although cases of the virus can begin as early as this month.

The vaccine is not the only way to prevent the flu. Hand washing with soap and water is one of the most effective ways to stop the spread of the virus.

Using soap and water for between 15 and 20 seconds (the time it takes to sing "Happy Birthday") is easy and invaluable. However, an alcohol-based hand rub also works.

Source: LifeBridge Health, October 15, 2010

AAA Warman Home Care is a family-owned Residential Service Agency which has been providing in-home health care services to thousands of clients for the past twenty years. Warman specializes in providing the highest quality of private duty, non-medical care and companionship for the elderly, those recuperating after hospitalization / rehabilitation, the terminally ill, disabled, alone or at-risk. It is our goal to assist our clients in living the most independent, healthy and comfortable lives in the privacy of their own homes.

Warman can be reached at (888)-243-6602.

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