Is Brain Volume reduced with diabetes?

Type 2 diabetes is associated with a number of other health complications, but a new study  appearing  in the online edition of Radiology, and reported by HealthDay, suggests that people with type 2 diabetes may lose more brain volume than is expected as they age.

Although common wisdom is that the shrinkage of blood vessels is usually associated brain-related health conditions such as strokes or dementia, but with Type 2 diabetes as a factor, the actual cause may be related to how the brain handles excess sugar.

It appears that there may be two ways diabetes affects the brain, damage to blood vessels and brain-cell degeneration.  Nearly 26 million people in the United States have diabetes, according to the American Diabetes Association. In Type 2 diabetes, the body often doesn't use insulin efficiently, leading to an excess of both insulin and blood sugar.

The brain shrinkage seen in this study may be linked with how sugar is used by the brain. The study determined that the longer a patient had Type 2 diabetes, the more brain volume loss occurred, particularly in the gray matter. Gray matter includes areas of the brain involved in muscle control, seeing and hearing, memory, emotions, speech, decision-making and self-control.

The study would suggest that clients closely monitor blood sugar levels and follow their physician’s orders on diabetes control.  Home care aides can assist in ensuring compliance and assessing blood sugar levels to help reduce the potential harm to the brain.
Communication with family and medical personnel is vital in sugar levels and medication compliance. 

Richard Ueberfluss, PT

www.assistinghands.com/naperville 

Are Polypharmacy and medication compliance related?

According to Reuters Health, which reported on a study by from Northwestern University Feinberg School of Medicine in Chicago published in “Patient Education and Counseling,” miscommunication between healthcare providers and patient concerns over drug interactions lead to many seniors having an unnecessarily complicated medication regimen.

The report suggests that the more complicated the drug routine, the more likely doses and medications will be overlooked. For example, if a patient is prescribed three medicines that are each supposed to be taken twice per day, it’s likely they can be taken together each time.

The study’s team found that 85 of the participants – just over 42 percent - were following a medicine regimen that could be simplified. Of these, 53 participants, or more than one quarter, could cut the number of times they took their medicines by once per day; and 32 participants, or 16 percent, could reduce that number by at least two times each day.

“The team also identified the most common reasons for an overly complicated medication routine. One was patients’ concerns about interactions between food and medicines, and between different medicines. Another was misunderstanding medication instructions given to the participants by healthcare providers like pharmacists or physicians.”

Study authors recommend that patients should check with their doctor before changing the way they take their medicines, but the results of the study show the importance of a discussion between patients and providers about the logistics of taking necessary medicines.

A good way to start is for caregivers to spend the day with a loved one and review their drug regimen.  If a patient is taking too many medications, or the regimen seems too complicated, a discussion should take place with a physician or pharmacist.

Our home health aides can play a role in medication management and help ensure compliance. Richard Ueberfluss, PTwww.assistinghands.com/naperville

Caregivers should be alert to link between depression and arthritis

While arthritis is associated with a deteriorating physical condition, a new study suggests that it also can affect an arthritis patient’s psychological condition. 

Arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia, and gout. Symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

An estimated 50 million U.S. adults (about 1 of 5) report having doctor-diagnosed arthritis. As the U.S. population ages, the number of adults with arthritis is expected to increase sharply to 67 million by 2030.  Not surprising is that arthritis is more common among adults aged 65 years or older, although all age groups, including children, can suffer from the condition..

According to a new study conducted by the Department of Exercise Science in the University of South Carolina and reported in the on-line dailyRx News, there is a link between an arthritis sufferer’s physical abilities and their perceived level of disability and mood.  Altogether, 401 adults with arthritis, most of whom were women, participated in the study. The participants were asked to rate their depressive symptoms on a scale from zero to three based on a 10-item questionnaire called the Center for Epidemiological Studies Depression Scale.

The researchers found that patients who perceived their disability to be more limiting were more likely to be depressed than patients who thought their arthritis did not limit their quality of life.  The study also suggested that when arthritis patients had trouble performing certain exercises, it tended to impact their mood.

For example, the researchers found that patients who did not perform as well as others on the chair stand test (which measures lower body strength) and involves counting how many times in a 30-second period a person could sit down in a chair and stand back up using only their legs, they were more likely to exhibit depressive symptoms.

According to the researchers, the conclusions of this study could be used to change how doctors treat arthritis by addressing coping skills along with physical symptoms.

A previous study showed that a significant number of people with arthritis also had depression, a mental health condition characterized by a persistent low mood.

It is possible that the limited physical ability that comes with arthritis could make an arthritis patient more likely to have depression.

This measure may be a particularly strong indicator of mental health status, perhaps because lower body strength is most essential to completing activities of daily living and maintaining independence.

But the strongest association was between perceived disability and depressive symptoms. Participants who felt as though they could not accomplish their daily activities without help were more likely to be depressed, even if they had an average score on the physical tests.

Like many chronic conditions, depression and arthritis are a cycle, so when physical health worsens, it can bring on the onset of depression.

For people with arthritis, physical therapy and pain relief may result in incomplete treatment if the patient's mental health is not addressed, according to the study.

The message for caregivers is that by taking steps to help arthritis sufferers lead a more active lifestyle, their physical and mental state can improve.  Our home care aides, working with your healthcare team, can make recommendations to begin and sustain the process.  

Richard E Ueberfluss, PT

www.assistinghands.com/hinsdale 

Are care requirements higher for women stroke survivors?

A recent story in HealthDay News, quoting from a new study published in the journal Neurology, found that women who survive a stroke tend to have a poorer quality of life than male stroke survivors do.

After studying women stroke survivors for three months, “women were more likely than men to have mobility problems, pain and discomfort, as well as anxiety and depression. At one year, women still had poorer overall quality of life than men, but the difference was not as large as at three months, the investigators found.”

The lead researchers suggest that quality-of-life issues will need more scrutiny from caregivers and the healthcare medical team, including better interventions and gender-specific screening tools, to improve these patients' lives.   

The study may indicate that women stroke survivors require greater supervision by caregivers and home health aides. 

Richard Ueberfluss, PT
www.assistinghands.com/naperville

Are Seniors Safe during the Summer Temperatures

Summer temperatures can pose a danger to older adults. Working or playing in the sun, spending time in an unventilated home, or sitting in a closed vehicle can result in uncomfortable and even dangerous temperatures.
As we grow older, our bodies are less efficient at regulating temperature. Especially at risk are people with health problems such as cardiovascular disease, kidney or lung problems, unhealthy body weight, or those who take certain medications that interrupt the body's ability to protect itself by perspiring. Other risk factors include: age-related changes to the skin, including inefficient sweat glands; being substantially overweight or underweight; and dehydration.
Here are some tips for staying safe and comfortable during periods of higher heat:

• Drink plenty of fluids, even if you don't feel thirsty. On hot days, the body loses moisture more rapidly, so keep hydrated with water or fruit juice. Avoid caffeine and alcohol, which cause the body to lose more fluid. (If you are on a fluid-restricted diet, speak to your healthcare provider during periods of heat.)
• Keep your home comfortable by letting in cool air during the early morning and evening hours. Create cross-ventilation by opening windows on two sides of the building. Use fans to circulate cooler air. Close curtains and blinds during the warmest hours.
• Take a break at an air conditioned location during the hottest part of the day. Go to the mall, a movie, the library.
• Dress for the weather. Wear short-sleeve, loose-fitting garments. Natural fibers and light colors are cooler than synthetic materials and dark colors. And don't forget your sun hat!
• Exercise and work outside only during the cooler hours of the day, and pace your activities.
• Wear sunblock when you are outdoors. Sunburn reduces the body's ability to regulate heat.

Heat-Related Illness
Hyperthermia is the name for a variety of heat-related illnesses that can include:

• Heat cramps (a painful tightening of the muscles of the abdomen, arms or legs)
• Heat edema (swelling of the ankles and feet)
• Heat syncope (a sudden dizziness and rapid pulse that usually occurs when someone is exercising in the heat)

If ignored, these conditions can progress to a dangerous condition called heat stroke. The symptoms of heatstroke are:

o    Fainting
o    Body temperature over 104
o    Confusion, staggering
o    Dry, flushed skin with no sweating
o    Strong, rapid pulse
o    Headache
o    Unconsciousness

A person with heat stroke should be seen by a physician immediately!
The National Institute on Aging provides five tips on what to do if you suspect someone is suffering from a heat-related illness:

1. Get the person out of the sun and into an air-conditioned or other cool place.
2. Offer fluids such as water, fruit and vegetable juices, but avoid alcohol and caffeine.
3. Encourage the individual to shower, bathe or sponge off with cool water.
4. Apply a cold, wet cloth to the wrists and/or neck, places where arterial blood passes close to the surface and the cold cloths can help cool the blood.
5. Urge the person to lie down and rest, preferably in a cool place.

Richard Ueberfluss, PT Owner of www.assistinghands.com/naperville.com

Consider a caregiver to check in with seniors at least three times a week.

Are Falls a normal part of the Aging Process?

New research out of Washington University in St. Louis, Missouri, and reported by CNN, points to falls as being more common among individuals with the earliest signs of Alzheimer’s. Researchers found that silent biological changes in the brain may take place a decade or more before the outward symptoms begin to manifest.

An estimated 5.4 million Americans are currently living with Alzheimer’s disease. It’s the sixth-leading cause of death in the United States, the only one of the top ten causes of death that can’t be prevented, cured, or slowed.

“Alzheimer’s not only impacts the lives of those with the disease, but adds great stress to caretaker families. Monitoring seniors at home susceptible to falling, especially those with Alzheimer’s, requires treatment and even home aides that are trained in both fall prevention and Alzheimer’s care,” said Ueberfluss, a Naperville physical therapist.

The Centers for Disease Control and Prevention estimates that in 2000, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion. The financial toll for older adult falls is expected to increase as the population ages, and may reach $54.9 billion by 2020 (adjusted to 2007 dollars).

The lead researcher pointed out that Alzheimer’s is a multi-system disease. “People who do have instability in their gait probably have a predisposition to cognitive impairment and Alzheimer’s disease in the future.”

The bottom line: A fall by an older adult who is usually steady on his feet may signal a need for diagnostic evaluation, whether or not it signals the onset of Alzheimer’s. Other conditions that lead to falls include blood pressure, medicines, general weakness and a recent hospital stay.
www.assistinghands-naperville.com

Is Family Caregiver Burnout avoidable?

Visit any family caregiver website and you will find an abundance of statistics proving that family caregivers are not alone, that caregiving is difficult, and that if caregivers follow their general suggestions, “Make time for yourself,” you will be OK.

Family caregivers average 21 hours per week providing care to needful loved ones and as time passes, additional hours are required to meet increasing demands. The average length of time a family caregiver provides care for a loved one is 4.6 years. According to studies by the National Alliance for Caregiving and AARP, 70% of working caregivers suffer work-related difficulties due to their caregiving roles. Among working caregivers caring for a family member or friend, 69% report having to rearrange their work schedule, decrease their hours or take an unpaid leave in order to meet their caregiving responsibilities. Also, 5% turn down a promotion, 4% choose early retirement and 6% give up working entirely. In another study by the MetLife Mature Market Institute, a key finding reports that for those who left the workforce early, the cost impact for the average male or female caregiver over the age of 50 who cares for a parent is $303,880 in lost wages, pension, and Social Security benefits.
What is the cost of burnout, and who fills in when the family caregiver needs help themselves?

Many caregivers wait until a crisis hits with mom or dad or themselves and are forced into making quick decisions that may be uninformed. Many of the phone calls trusted advisors receive asking for help are after an injury, fall, hospital or skilled rehabilitation stay. The good news is that caregivers can do more than just survive family caregiving. The better news is that this can be the most gratifying time for loved one and the most fulfilling time for caregivers. Family caregivers would be better suited to create a plan that allows time management for self, family, and loved one: a plan that also considers career goals, outside interests and additional help. Consider consulting a geriatric care manager, a social worker or other resources like Caregiver Harbor which caters to caring for caregivers themselves. Frequently, licensed home care agencies can assist with hands on care, housekeeping or transportation and allow important respite and time management opportunities for busy caregivers. Thanks to Frank Blood at www.caregiverharbor.com


www.assistinghands-naperville.com

Is Pain "Just Part of Growing Older?"

Physical therapy is just one of the many pain control
options offered by specialists today.

Although older adults are more likely to experience pain, it is not a "symptom" of aging, and it should not be accepted as inevitable. Unfortunately, pain has often been undertreated in older adults, but pain relief is an essential part of good healthcare.
Untreated pain can cause a significant decline in the well-being and quality of life of older adults, resulting in fatigue, depression, anxiety, withdrawal from social life, and reduced ability to perform the activities of daily living.
Understanding pain
Pain is a complex mechanism. It is a signal to the brain that something threatens the well-being of the body. The process is usually quick and simple: we touch a hot stove...the pain message rushes to our brain...our brain tells our arm to pull our hand away as rapidly as possible...and we do! We could not survive without this alert system.
In addition to the physical response to pain, the latest research is showing a complex mechanism of brain, spinal cord and hormonal reactions that can modify or augment pain.
Acute pain is limited in duration, and is the result of a specific injury or short-term illness (such as a burn, surgery, appendicitis or an ear infection). Chronic pain is ongoing—sometimes for years—and can be the result of an incurable condition (such as arthritis, migraine headaches, neck or back pain, irritable bowel syndrome or diabetic neuropathy). Sometimes chronic pain is caused by damage to the nerves themselves
and is worsened by the brain, hormones, stress and other factors.

Special concerns of older adults
Certain painful conditions are more common as we grow older. These include arthritis, osteoporosis, fractures, angina, shingles, and circulatory problems. An older adult may suffer from a combination of conditions, each condition having its own pain control challenge.
However, while older adults are more likely to experience pain, they are the least likely to ask for or receive relief. They might believe that they are "just getting older" or "don't want to be a bother." They may avoid pain medication, fearing addiction or a reduction in function.
People who have Alzheimer's disease or other dementia may be unable to clearly communicate when they are experiencing pain. Caregivers should learn to interpret certain signals, such as slower movements, decreased function, irritability or other behavior changes.
One of the best things patients can do to reduce arthritis pain is exercise.
Stiff joints need to be moved, obviously movement can hurt a bit at first, go slow and consult a specialist.
Pain management: know when to seek help
Never assume that nothing can be done. Since each case is different, it is important to work with the healthcare provider to determine the most effective treatment or combination of treatments. Here are some of the many options:
Medication
Today, modern pain control specialists have a wide array of medications to offer patients. The main classes of pain-relieving drugs are:

• Morphine, codeine and related opioid drugs, used to manage moderate to severe pain
• Over-the-counter pain medications, including aspirin, ibuprofen and acetaminophen
• Antidepressants, used to treat some types of nerve pain
• Muscle relaxants, for use when pain results from muscle spasms
• Corticosteroids, which lessen painful inflammation
• Topical medications, applied to the skin for burns, arthritis, oral sores, blisters and other conditions

Seniors should be aware that medications can affect us differently as we grow older. Decreased digestive and kidney function may cause substances to be excreted more slowly, which may allow a toxic dose to build up. Some side effects, such as gastrointestinal irritation, dizziness and constipation, become more common in older adults.
In addition, many seniors take medications for multiple conditions, increasing the possibility of adverse drug interactions. It is important that a person's pharmacist and all healthcare providers are aware of all medications being taken, both prescription and over-the-counter.
Physical treatments
Medication is not the only option for pain relief. Physical therapists and pain specialists offer a variety of treatments, such as massage; immobilization with cast or slings; heat and cold; electrical current devices; therapeutic exercise; and alternative therapies, such as acupuncture. Surgery on the nerves may also be indicated for extreme pain.
Pain isn't "all in our head"
The way we think about pain makes a difference, however. Stress and anxiety magnify the perception of pain, which in turn increases stress and anxiety. To break that cycle—and to gain power over pain through thinking of it in a different way—some of the following techniques may be helpful:

• Education about the nature of one's pain, what causes it, and what can be done about it
• Relaxation techniques, such as yoga, breathing exercises, meditation or stress management classes
• Biofeedback instruments, which help the patient learn the "relaxation response"
• Distraction techniques to help the brain transcend pain messages

Pain threatens the quality of life of older adults, but a multidisciplinary approach that includes physical, emotional and spiritual care can help break the "pain cycle" and let older adults feel more in control of their condition.
Guess what else helps with pain?  Movement and exercise?
Are our clients afraid to move or exercise because of pain.
A Physical Therapist is a great place to start to begin a program safely.
Richard Ueberfluss, PT
www.assistinghands.com/naperville

Is bed rest injuring patients after discharge

Bed Rest serves as a time honored treatment for both injury and illness, and is prescribed more often around flu season. A normal muscle, at complete rest, in absence of illness, loses up to 15% of its strength each week.1 During bed rest, the first muscles to become atrophied are the trunk and lower extremity muscles involved in gait and upright posture.2 Illness itself can also cause atrophy of the skeletal muscles, over and above the strength losses caused by rest. Your elderly patients prove particularly vulnerable to the negative sequel of rest. Among a test sample of healthy subjects age 67 and older, 10 days of bed rest resulted in more lean tissue loss than 28 days of bed rest caused in younger test subjects.3 For patients over the age of 70, bed rest is associated with a major, new disability in one-third of prolonged cases.4 Among elderly patients, when the negative effects of bed rest are not addressed assertively, injury or prolonged difficulties become more likely.
Research has found that during periods of bed rest at home elderly patients tend to spend more time than needed resting in bed or sitting.4 This stems largely from a lack of confidence and fear of self-injury inspired by the sudden loss of strength and fitness. After the injury has healed, many elderly patients still experience considerable risks associated with their period of rest. Rate of recovery from disuse weakness is slower than the rate of loss. With intensive exercise, patients take 2.5 times longer than the period of rest to regain lost strength.5 The fact of the matter is that most elderly patients do not engage in intensive exercise after periods of bed rest and are more likely to quietly decrease their daily activities and self-care. Fall injuries, medication errors, and other problems become more likely during the months following bed rest. www.assistinghands-naperville.com
References
1. Dittmer D, Teasell R. Complications of immobilization and bed rest – Part 1: musculoskeletal and cardiovascular complications. Can Fam Physician. 1993; 39: 1428-1437.
2. Halar E, Bell K. Rehabilitation’s relationship to inactivity. In: Kottke F, Lehmann J, editors. Krusen’s handbook of physical medicine and rehabilitation. 4th ed. Philadelphia: WB Saunders Co, 1990: 1113-39.
3. Kortebein P, Ferrando A, Lombeida J, et al. Effect of 10 days of bed rest on skeletal muscle in healthy older adults. JAMA. 2007; 297 (16): 1772-1774.
4. Brown C, Redden D, Flood K, et al. The underrecognized epidemic of low mobility during hospitalization of older adults. Journal of the American Geriatrics Society. 2009; 57 (9): 1660-65.
5. Muller E. Influence of training and inactivity on muscle strength. Arch Phys Med Rehabil. 1970; 51: 449-62.

Can Monitoring Type 2 Diabetes Diminish More Serious Diseases

Type 2 diabetes is associated with a number of other health complications, but a new study  appearing  in the online edition of Radiology, and reported by HealthDay, suggests that people with type 2 diabetes may lose more brain volume than is expected as they age.

Although common wisdom is that the shrinkage of blood vessels is usually associated brain-related health conditions such as strokes or dementia, but with Type 2 diabetes as a factor, the actual cause may be related to how the brain handles excess sugar.

It appears that there may be two ways diabetes affects the brain, damage to blood vessels and brain-cell degeneration.  Nearly 26 million people in the United States have diabetes, according to the American Diabetes Association. In Type 2 diabetes, the body often doesn't use insulin efficiently, leading to an excess of both insulin and blood sugar.

The brain shrinkage seen in this study may be linked with how sugar is used by the brain. The study determined that the longer a patient had Type 2 diabetes, the more brain volume loss occurred, particularly in the gray matter. Gray matter includes areas of the brain involved in muscle control, seeing and hearing, memory, emotions, speech, decision-making and self-control.

The study would suggest that caregivers closely monitor blood sugar levels and ensure that seniors are following their physician’s orders on diabetes control.  Home aides can assist in ensuring compliance and assessing blood sugar levels to help reduce the potential harm to the brain.  
Richard Ueberfluss, PT
www.assistinghands.com/naperville

Alzheimer's takes greater toll on women

Alzheimer's takes a disproportionate toll on women, according to a report released from the Alzheimer's Association. The report, as noted in USA Today, found that women are far more likely to develop the fatal disease than men: one in six women over 65 will get it during their lifetime, compared with one in 11 men.

And, not surprisingly, women are more likely to be caregivers for someone with Alzheimer's, and to pay a bigger personal and professional price for that care than men do.

The association also noted that as many as half the people with Alzheimer's don't know they have it.

 The report notes that  “the toll of Alzheimer's is gigantic and climbing fast. Feared primarily for its attacks on memory, Alzheimer's is nearly as lethal as America's biggest killers, heart disease and cancer, new estimates suggest.”

Nearly $1 of every $5 spent by Medicare goes to someone living with Alzheimer's or another form of dementia, and nationwide we'll spend about $214 billion this year on the disease, according to the Alzheimer's Association.

More than twice as many women provide Alzheimer's care than men, the care they provide is sustained and time-consuming, and substantially more women than men have to cut back on work hours, give up jobs and/or lose benefits to provide that care, the study shows. Obviously, caring for a loved one who is slowly losing their memory and heading toward death takes an emotional toll as well.

If you are struggling with Alzheimer’s care, ask Assisting Hands about our in-home care. Our homes aids get special training in Alzheimer’s care. 

Richard Ueberfluss, PT

www.assistinghands.com/hinsdale  

Are Arthritis and Depression linked?

While arthritis is associated with a deteriorating physical condition, a new study suggests that it also can affect an arthritis patient’s psychological condition. 

Arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia, and gout. Symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.

An estimated 50 million U.S. adults (about 1 of 5) report having doctor-diagnosed arthritis. As the U.S. population ages, the number of adults with arthritis is expected to increase sharply to 67 million by 2030.  Not surprising is that arthritis is more common among adults aged 65 years or older, although all age groups, including children, can suffer from the condition..

According to a new study conducted by the Department of Exercise Science in the University of South Carolina and reported in the on-line dailyRx News, there is a link between an arthritis sufferer’s physical abilities and their perceived level of disability and mood.  Altogether, 401 adults with arthritis, most of whom were women, participated in the study. The participants were asked to rate their depressive symptoms on a scale from zero to three based on a 10-item questionnaire called the Center for Epidemiological Studies Depression Scale.

The researchers found that patients who perceived their disability to be more limiting were more likely to be depressed than patients who thought their arthritis did not limit their quality of life.  The study also suggested that when arthritis patients had trouble performing certain exercises, it tended to impact their mood.

For example, the researchers found that patients who did not perform as well as others on the chair stand test (which measures lower body strength) and involves counting how many times in a 30-second period a person could sit down in a chair and stand back up using only their legs, they were more likely to exhibit depressive symptoms.

According to the researchers, the conclusions of this study could be used to change how doctors treat arthritis by addressing coping skills along with physical symptoms.

A previous study showed that a significant number of people with arthritis also had depression, a mental health condition characterized by a persistent low mood.

It is possible that the limited physical ability that comes with arthritis could make an arthritis patient more likely to have depression.

This measure may be a particularly strong indicator of mental health status, perhaps because lower body strength is most essential to completing activities of daily living and maintaining independence.

But the strongest association was between perceived disability and depressive symptoms. Participants who felt as though they could not accomplish their daily activities without help were more likely to be depressed, even if they had an average score on the physical tests.

Like many chronic conditions, depression and arthritis are a cycle, so when physical health worsens, it can bring on the onset of depression.

For people with arthritis, physical therapy and pain relief may result in incomplete treatment if the patient's mental health is not addressed, according to the study.

The message for caregivers is that by taking steps to help arthritis sufferers lead a more active lifestyle, their physical and mental state can improve.  Our home care aides, working with your healthcare team, can make recommendations to begin and sustain the process.   

Can More Activity Can Reduce Risk of Disability?

As a certified physical therapist, my staff and I understand the importance of staying active as we age, so our health aides encourage our clients to increase their activity during the day.  This becomes all the more important when you realize that adults 60 and over, spend an average of two-thirds of their waking time being sedentary -- roughly nine hours a day.

Now a new study in the Journal of Physical Activity and Health of more than 2,200 people, as reported by USA Today, found that every additional hour adults over age 60 spend sitting increases by 50% their risk of being disabled for activities of daily living such as bathing, dressing and walking.

The study suggests that health problems associated with sitting disease are mounting. Research has linked too much sitting to increased risk of heart failure, type 2 diabetes and death from cancer, heart disease and stroke. It may affect mood and creativity. One study showed that if most people spent fewer than three hours a day sitting, it would add two years to the average life expectancy in this country.

USA Today notes that the study participants wore accelerometers (motion sensors) during their waking hours for one week during the three-year survey period. This measured the time they spent being sedentary, doing light physical activity such as pushing a grocery cart, doing moderately vigorous physical activity such as brisk walking, or vigorous physical activity such as running.

Among the findings out Tuesday in the • 6.2% of participants met the government's physical activity guidelines, which advise adults to get at least 2½ hours of moderate-intensity physical activity each week, such as brisk walking, or 1¼ hours of a vigorous-intensity activity, such as jogging or swimming laps, or a combination of the two types.
We encourage caregivers to help their elder family members increase their level of activity and we can create an exercise regimen to accomplish this.  Our home aides also can assist in motivating seniors to stay more active.
www.assistinghands.com/Naperville
Richard Ueberfluss,PT

Falls among older adults leading to increase in spinal injuries

A story by United Press International (UPI) discovered that traumatic spinal cord injuries are on the rise in the United States and the leading cause no longer is motor vehicle crashes, but falls, researchers say. The story appeared in the   Journal of Neurotrauma.

UPI’s source was Dr. Shalini Selvarajah, a post-doctoral surgical research fellow at the Johns Hopkins University School of Medicine in Baltimore, who noted that the rates of these injuries -- whose symptoms range from temporary numbness to full-blown paralysis -- were rising fastest among older people, suggesting preventing falls could significantly curb spinal injuries.

According to UPI “Selvarajah and colleagues analyzed data from 43,137 adults treated in U.S. hospital emergency rooms for spinal cord injury from 2007 to 2009. While the incidence among those ages 18 to 64 ranged from 52.3 per million in 2007 to 49.9 per million in 2009, the incidence per million in those 65 and older increased from 79.4 in 2007 to 87.7 in 2009.

Falls were the leading cause of traumatic spinal cord injury over the three-year study period at 41.5 percent, followed by motor vehicle crashes at 35.5 percent. Fall-related spinal cord injuries increased during the study period overall. Among the elderly, they increased from 23.6 percent to 30 percent of injuries.

The researchers said even when taking into account injury severity and other illnesses experienced by the patients, older adults with traumatic spinal cord injury were four times more likely to die in the emergency room from such an injury compared with younger adults. If they survive and are admitted, they are six times more likely to die during their hospital stay.

Recognizing the inherent dangers of home falls, all Assisting Hands home aides are trained in fall prevention. 
Richard Ueberfluss, PT
www.assistinghands.com/naperville 

Can more exercise prevent heart attacks?

Quoting from a study by the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, HealthDay News reports that being physically fit can help prevent heart attacks and increase survival in people with stable coronary artery disease.

This was true whether or not the patients underwent a procedure to open blocked heart arteries.

Researchers analyzed data from more than 9,800 adults with coronary artery disease who underwent a treadmill stress test. They were also followed for 11 years to see if they suffered a heart attack, had undergone a procedure to open blocked heart arteries or had died from any cause.

"In our study, the patients who were most fit had a 75 percent lower risk of dying from any cause compared to those who were least fit. This was true regardless of whether the patient had previous stenting or bypass surgery to open up any blocked arteries," study author Rupert Hung, a Hopkins medical student.

Although the study found an association between greater exercise capacity and reduced risk of complications from heart disease, it did not prove a cause-and-effect relationship. The findings highlight the importance of exercise and fitness for people with coronary artery disease, according to the researchers.

At Assisting Hands, our home aides, trained by two physical therapists, can help keep home-bound seniors with heart problems stay active to reduce a potential heart attack.   Ask us about our preventive health programs.    

Richard Ueberfluss, PT

www.assistinghands.com/naperville

Seniors Account for 9 out of the 10 Most Frequent, Fastest Growing Conditions in U.S. Hospitals

According to the Agency for Healthcare Research and Quality, which has analysed data from the Hospital Cost and Utilization project , senior health conditions accounted  for  9 out of the 10 most frequent, fastest growing conditions  leading to  hospitalization in 2011.  While seniors may not account for most of the conditions listed, they are common among this age group.

. According to AHRQ's Statistical Brief #162, the most frequent diagnoses in 2011 were:

1. Liveborn (newborn infant) —123 stays per 10,000 population

2. Pneumonia — 36 stays per 10,000 population

*3. Septicemia — 35 stays per 10,000 population

4. Congestive heart failure (nonhypertensive) — 31 stays per 10,000 population

*5. Osteoarthritis — 31 stays per 10,000 population

6. Mood disorders — 29 stays per 10,000 population.

7. Cardiac dysrhythmias — 26 stays per 10,000 population

8. Chronic obstructive pulmonary disease and bronchiectasis — 23 stays per 10,000 population

9. Complication of device, implant, or graft — 22 stays per 10,000 population

10. Spondylosis, intervertebral disc disorders and other back problems — 21 per 10,000 population.

Particularly alarming is the increase in some condition between1997 and 2011.

1. Acute and unspecified renal failure — 346 percent increase (from 4 to 16 stays per 10,000 population)

*3. Septicemia — 132 percent increase (from 15 to 35 stays per 10,000 population)

4. Pulmonary Heart Disease — 118 percent increase (from 3 to 6 stays per 10,000 population)

*5. Osteoarthritis — 102 percent increase (from 15 to 31 stays per 10,000 population)

6. Anemia — 100 percent increase (from 4 to 7 stays per 10,000 population)

7. Respiratory failure, insufficiency or arrest — 78 percent increase (from 7 to 13 stays per 10,000 population)

8. Skin and subcutaneous tissue infections — 73 percent increase (from 12 to 21 stays per 10,000 population)

For comparison, the average percentage change for all principle diagnoses between 1997 and 2011 was a 3 percent decrease.

By Richard Ueberfluss, Physical Therapist
www.assistinghands.com/hinsdale