Seniors Health chat

Came across this news report the other day, about sporting injuries in middle age and beyond. Thought others might also find it interesting.

https://www.nlm.nih.gov/medlineplus/news/fullstory_154418.html

More Older Americans Falling Prey to Bike Injuries
Riders over 45 a big part of jump in hospital admissions for more severe accidents, report finds

Is your heart older than you?

https://www.nlm.nih.gov/medlineplus/news/fullstory_154410.html

Some research into Parkinson's, and memory.

I remember we discussed some Parkinson's related matters in the early posts of Over The Hill Gang.

https://www.nlm.nih.gov/medlineplus/news/fullstory_154485.html

And this is encouraging general health news for those of us concerned with increasing frailty and loss of independence. The outlook is better than we think! ( I don't have the reference, but I did read a research article last week that demonstrated the predicted dementia tide is actually slowing, from the swamping tsunami predicted in a few years. Still big, but not as big)

https://www.nlm.nih.gov/medlineplus/news/fullstory_154486.html

I have to admit, after watching my mother's decline over two years or so (longer, but it was not extremely noticeable until we decided it was time to move her to assisted living) I am terrified of dementia. I would rather be dead than live with the confusion and fear she experienced. Yes, I really would.

There is some marvellous research showing practical resources and strategies to be available within the next year or so, following new multi-disciplinary thinking. It's really quite exciting! If you like, we can start a thread specifically on brain matters, and that might also include some post-stroke and post-brain injury info.

One of the most exciting pieces of information I heard the last 4weeks was that between 40 and 75% of cognitive issues in older Australians can be attributed to poorly prescribed and administered medications, compounded by years of renewed prescriptions. Because the senior years are also when we see an increase in chronic conditions, and living with more than one condition, and often at least one of these is an inflammatory condition (not always well-managed), cognition tends to be affected by infections and related inflammation or circulatory issues. Now those links are better understood and more easily managed, so prevention is more easily handled.

If you take several medications and dietary supplements, it's a good idea to have a Home Medicine Review with a visiting pharmacist, to check for interactions, dose ages and to monitor your storage conditions.

That's not a bad idea, the thread about brain issues. And I'm awfully glad to hear there are advances in progress that will help our generation.

I am still trying to find a doctor in CT that is in my general area, knows his/her stuff about my health issues, and is worth seeing. Very discouraging. But when I do find a doctor, we are going to have a lot to talk about.

That reminds me, Peggy: at our Network Breakfast last week, the local manager of the Australian Hearing office said they've come up with a new way to test for Auditory Processing Disorder. It's mainly perceived as a children's disorder (because it's picked up in schools by observant teachers) and relatively easily treated on de other things are ruled out. Adults can develop it too, as brain functions get confused or overwhelmed, particularly following injury or illness. Hearing aids won't help.

Their test, which doesn't just rely on pitch and volume of sound, but also looks at brain waves? Brain patterns? Something... Is a world-first.

Peggy, I have to get to bed... I'll start that thread tomorrow. Meantime, I've read about a small dementia study that may interest you, on how the beta-amyloid tangles start forming.

https://www.nlm.nih.gov/medlineplus/news/fullstory_154215.html

Wow! Turns out that, after all, carrots are good for your eyes!!

Warning: potential woo-research ahead

https://www.nlm.nih.gov/medlineplus/news/fullstory_155057.html certainly leaves room for lots more research.

As we keep saying, tell us something we don't know!

https://www.nlm.nih.gov/medlineplus/news/fullstory_154932.html

Excellent news for people concerned about balance issues! This report backs up what I've been hearing here, that over the past couple of decades we've taught (and learnt) the risk factors of falls and fractures so well that seniors falls profiles have changed.

All things being equal, it's now more likely that reason you're more vulnerable to a balance/fall issue today than yesterday is whether or not you're immune system is fighting an infection.

https://www.nlm.nih.gov/medlineplus/news/fullstory_155077.html

Several small mechanisms come into play, affecting your centre of gravity, spatial awareness and peripheral sensitivity/twitch responses.

joanne said:
Peggy, I have to get to bed... I'll start that thread tomorrow. Meantime, I've read about a small dementia study that may interest you, on how the beta-amyloid tangles start forming.
https://www.nlm.nih.gov/medlineplus/news/fullstory_154215.html

This is one of my favorite TED talks which correlates beta-amyloid with sleep. https://www.youtube.com/watch?v=MJK-dMlATmM

This one is really great too about the relationship between insulin resistance and Alzheimers. https://www.youtube.com/watch?v=7cVWh7P5QZM

Yes, it's seen in some circles as a very big contributor ("diabetes type 3"), but there's more evidence for tau buildup (and less, now, for the beta amyloid plaques) in the very early barely diagnosable stages of what becomes Alzheimer's and related dementias. Remember, not all dementia is Alzheimers and not cognition problems are dementia.

What appears to be confusing the researchers is contribution that chronic inflammatory disease makes, and what is actually occurring with this process. (Is it autoimmune? Much of what happens with psoriasis, gout, allergies, Crohns, arthritis, etc seems to support this. Is it 'merely' lifestyle and insulin resistance? As indicated by hyper/hypo glycemia, gout, some cancers etc. What about the contribution of inflammation to high blood pressure, fluctuating heart beats and lung function? Certain asthmas and cardiac conditions suggest controlling inflammation controls the condition but what causes the inflammation apart from infection?)

It's all complicated, isn't it?

I've been convinced for years that a lot of my health issues are auto-immune related. No proof, of course.

I was reading something very early this morning that seemed to indicate that more and more, a lot of our later-life or persistent conditions seems to come back to chronic inflammation that began with childhood infections we thought we had dealt with but had lingered. A bit like how we now know shingles comes from chicken pox virus.

Ah well.

I'm off in a couple of hours to get those odd spots checked: places that don't see the sun, suddenly developing 'freckles'. Sigh.

(Oh, and did I mention we finally have a partial answer to the female-troubles??? Chronic persistent endometriosis! Hah!)

What are those spots all over my body? They all seem to have appeared in a few months.

Oh well, if you were here, I'd suggest you visit "Call me Philip" (barely 40s, tall, dark, fit, good looking, great smile, you really don't mind the thought of probably having to disrobe...)....

Turns out I have what he tactfully suggested was 'merely' ageing skin, not quite doing the age spots thing but the stage before when the capillaries burst. Sigh. However the spot is a mole to keep an eye on. First sign of bother, he'll be happy to respond. Oh, happy sigh! Our so-far-unstuffed Medicare system means I got to see him within 2 days (most of the practice is booked up for around 8 or 10 months), and for $35 after the rebates come back tomorrow. ($225 full fee).

Trouble sleeping? Maybe we expect too much.

Turns out there's good evidence not to expect 8 hours of deep slumber, most nights, and there never has been.

http://www.theguardian.com/science/2015/oct/15/modern-life-is-rubbish-sleep-is-just-the-same-as-ever-say-scientists there were earlier reports of this research, going back to April, I think.

http://www.bbc.com/news/magazine-16964783 how to deal with segmented sleep, and some historical background info.

joanne said, a while back: "between 40 and 75% of cognitive issues in older Australians can be
attributed to poorly prescribed and administered medications, compounded by years of renewed prescriptions."

Based on family experiences, I would guess this problem is also common in the US. Patient goes to various doctors for various ailments, docs don't coordinate care, even a single doc may say Well, let's try this med, and not remember to say *and stop taking* this other med. With my MIL, when her meds were thoroughly reviewed and reduced, it was like she was waking from a stupor. BIG improvement.

joanne also mentioned, not for the first time: "If you take several medications and dietary supplements, it's a good idea to have a Home Medicine Review with a visiting pharmacist, to check for interactions, dosages and to monitor your storage conditions."

afaik, this terrific service is not available in the US, though a visiting nurse might look around, or a hospice care provider, but even then, it's not a pharmacist. A person could take meds, or list of meds, to a pharmacy for review, though that wouldn't cover storage conditions, nor assure that there weren't additional Rx's/supplements/OTCs around the house.

And thanks, joanne!! for the piece(s) on segmented sleep, and your many other informative & sympathetic posts over the years.

I remember snooping around online and discovered that indeed you do have a medicines review service but you have to know to ask for it. I can't remember enough, right now, how I found the info or how you need to initiate - it might require clever conversations with a pharmacist you trust, who can tell you.

I slo remember some threads where other wrote about their parents need the help of pharmaco-gerontology specialists. Astute geriatricians would know who these are.

Ok! You need to talk to your preferred pharmacist (not the staff, the actual pharmacist) about to arrange Medications Therapy Management plan including a visit at home to be sure everything OTC is included, storage is checked and old meds removed.

http://www.pharmacist.com/mtg

There appears to be a lot of professional discussion around how these are put in place, etc. But NJ has been trying to bring these plans to every medical practice and every patient who asks for several years, and apparently your federal health policy people agree. But doctors assume people don't need it because they present well, pharmacists can't do it unless asked, hospitals get involved too late... How silly.

Thanks for checking into that, joanne!

Related to that, the NIH Health News page just published this neat little item.

A study on prescription writing, and overdosing.

Note the part that highlights the doctors who wrote the most scripts for narcotic painkillers are also writing lots of scripts for sedatives/tranquilizers for the very same patients. Not only contraindicated, it's potentially very harmful. (NJ wasn't included in the study)

https://www.nlm.nih.gov/medlineplus/news/fullstory_155169.html

A Swiss study on the effects of collaborative health reassessments for adults 65 years and older:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001889

For me, it's kind of exciting to see confirmation of the anecdotal and small-study evidence we've seen in the field.

If you're reviewing scripts and medications, please keep the following in mind:

https://www.nlm.nih.gov/medlineplus/news/fullstory_155269.html

However, please also note that there are valid, non-mental health and dementia uses for anti-psychotics! Often we find chronic pain will respond to it better than to more conventional analgesia (anti-psychotics work on different neurotransmitters and neural pathways), for example. Part of the reason to get permission to talk with the docs.

Who knows what about sundowning in folks with dementia?

Why are you asking? what do you want to know?

Dementias are being discussed in the Brain Thread