New Guidelines for Health

keep moving

The Office of Disease Prevention and Health Promotion has updated the physical activity guidelines for all Americans.

Main takeaways include:

  • Adults of all ages should move more and sit less
  • Any moderate to vigorous activity counts (and there are some ideas and planners available – see below)
  • Adults should aim for at least 150 minutes per week of moderate to vigorous exercise
  • All adults should do some kind of strength training at least 2 days per week
  • Any amount of exercise has immediate benefits, including less anxiety, lower blood pressure, better sleep and better insulin response
  • New research shows even more long term benefits for those who exercise, including reducing the risk of 8 types of cancer (bladder, breast, colon, endometrium, esophagus, kidney, stomach, and lung).
  • Exercise also reduces the risk of dementia (including Alzheimer’s disease), all-cause mortality, heart disease, stroke, high blood pressure, type 2 diabetes, and depression; and improves bone health, physical function, and quality of life.
  • For older adults, physical activity also lowers the risk of falls and injuries from falls.
  • New research also highlights that exercise helps manage chronic conditions: reduces pain from osteoarthrits, slow progression for hypertension and type 2 diabetes, manage symptoms of Parkinsons, dementia, anxiety and depression.

Lots of activities can be counted as exercise, including shoveling snow and playing with children or pets. There are also so many exercises to choose from, to help ward off boredom and increase the chance to socialize with others.

Give yourself the gift of better health this holiday season, and well into the future. You can check out the health.gov planner by clicking on the link below.

Move Your Way link: Want to get more physical activity? Build a weekly plan

Why Fall Prevention?

Fall Prevention

What’s the big deal about falling? Everyone falls from time to time, right? But how many people do you know who’ve fallen, had to move into care, and even died as a result? Every 13 seconds an adult over 65 is admitted to the ER after injuring themselves in a fall.

The costs of a bad fall are not just in medical expenses. It’s the loss of independence, which often leads to isolation and depression, that worries many older adults. As a result, some become cautious and give up doing what they love, hoping to stay safe.

Unfortunately, this has the opposite effect.

The single most important way of preventing a fall is to keep active.

A key difference between a stumble and full-on fall is how fast your brain and muscles can react to catch you. That only comes with continued use, and even, with specialised balance training.

Those who take up an exercise class and stick with it report a host of additional benefits: making friends, feeling more energetic and interested in life, happiness at still being able to line dance, or travel at age 89 and beyond.

There are many resources out there to help manage all kinds of balance problems. Your doctor and pharmacist are a good place to start to check your medications. Physical therapy and Tai Chi are especially well documented for improving balance.

We’re living longer, let’s make sure we enjoy those extra years.

Tell me more about balance

 

There is more information from the Center for Disease Control on the cost of falls, and some sensible steps everyone can take to avoid them.

September 22 is  Falls Prevention Awareness Day, the 10th anniversary of the initiative set up by the National Council on Aging. #FPAD18

Title image courtesy of National Senior Games Association

5 Easy Balance Hacks You Can Do in Secret

balanced chick

How good is your balance today? It’s hard to measure without professional help, but you can still take action. Here are 5 simple balance exercises you can do without the need to put on your active wear or make a fuss.

As with any exercise, don’t attempt if you don’t feel confident, and check with your doctor first if you have any doubts.

  1. Brush your teeth. It takes 2 minutes, and you’re standing in front of a counter or sink that you can use for support. Use this wasted time to practise standing on one leg. Hold onto the counter and raise one leg off the floor. Hold for up to one minute. If you have to put your foot down to feel secure, that’s ok, just rebalance and then raise it again until the minute is up. Then repeat with the other leg.
  2. In the grocery check out line: stop checking Facebook on your phone, stand close to the shopping cart, using the handle for support if necessary. You can do the one legged balance again, or this time rise up onto your toes slowly and then lower back down again. No one else will notice (unless they’ve read this blog too).
  3. Waiting to meet someone? Don’t take that comfy chair, choose to stand instead. Put your feet hip width apart and stand tall, distributing your weight evenly on both feet. How still can you stand before you need to move?
  4. Waiting for coffee to brew? Or water to boil? Or the microwave? Try a tandem stance. You may want to hold onto the counter to start with. Put the heel of one foot directly in front of the toes of the other (as if you’re walking on an narrow beam). Look straight ahead and hold for one minute. Repeat with the other foot in front.
  5. Watching TV? In the commercial break, stand up and sit back down again 10 times. If you’re bingewatching on Netflix, you can do this at the start or end of each episode.

What do you think? Have you tried these or other balance exercises? Which ones are hard for you, which ones do you like? And can you feel a difference in your balance afterwards?

Resilience: The Enduring Philosophy of Thriving Older Adults

As the US population continues to grow, so does the aging population. The number of Americans aged 65 and older is projected to double from 46 million to more than 98 million by 20601. Staying healthy, active and productive are admirable goals for our nation’s older adults. However, society’s traditional view of “old age” has not always kept up with the reality of being old in America. Many older adults and others in society buy into the old myths of fragility, feebleness, forgetfulness, and senility2. Therefore, many are treated by healthcare providers as such and may and/or have been pigeonholed to those stereotypes. Physical therapists are in one of the best roles to dramatically change this practice and improve the aging populations health status and function. The goal in this article is to help the physical therapist incorporate the concept of resilience into the rehab process.

Resilience: The Game Changer

Resilience is described as the ability to achieve, retain, or regain a level of physical or emotional health after illness or loss3. There are multiple interventions as listed below that physical therapists can perform in clinic to help their older adult clients learn resiliency skills. Additionally, older adults can achieve greater outcomes in physical therapy as a result of learning these skills. This provides another avenue in which a physical therapist can be more effective.

Physical therapists can provide a quick written guide (pamphlet in their waiting room or as a parting gift provided at their first appointment) to their older adult population on local community and/or outreach groups that are specific to certain conditions or just for general social interaction. There a multitude of different national organizations in the government and NGO’s involved in improving the nation’s older adults.
For example: National Coalition on Aging created an Aging Mastery Program with reading materials and access to classes that are led by expert speakers who help participants gain the skills and tools they need to manage their health, remain economically secure, and contribute actively in society.

Education is key with the older population.

It is necessary to take time (even a whole PT session) to go over concept points on resilience and use client centered language that makes the client feel heard. Furthermore, it might be helpful to ask the client to bring in important family members that either help in their care or are essential to their social identity.
Physical therapy clinics can and sometimes do provide info-seminars. These seminars can bring together older adults with similar and/or different conditions in order to promote camaraderie and dissemination of knowledge.
Open floor clinics are sometimes a great setting for older adults to come in and use their session as a way to socialize with others with similar changes to their lifestyle. Many times this gives that older adult a glimpse into the future success they will incur with continuing their PT program.

It is not a form of defeat for a physical therapist to refer individuals who display symptoms of severe depression and or other mental health disorders to an appropriate mental health professional

Physical therapists who are owners of a brick and mortar clinic can provide fun and interesting group classes that target at risk older adults (dance, yoga, stretching, etc). Making it more of a recreational activity can boost self esteem and create a meaningful experience.

During the session focused activities to enhance happiness, with the conclusion that doing so can improve resilience. This can be done by creating positive goals (written in clinic or in a daily journal) related to previous activities that have made the client optimistic about the future or happy in the present.

Other effective interventions may emphasize the strengths of older adults, including the ability to establish and maintain social connections, willingness to help others, and desire to engage in the community. For example having a retired family law practitioner who just underwent a knee replacement to help get back to standing for hours on end in order to provide pro bono work for at risk youth3.

In conclusion:

Clinicians must educate older adults about topic of resilience and the importance of physical activity in any form. It empowers older adults to play a more informed, active role in their own health. Clinicians can correct misconceptions that illness and disabilities are caused by activity or necessitate inactivity.

References:

http://www.apa.org/pi/aging/resources/guides/older.aspx
http://transgenerational.org/aging/myths-of-aging.htm
MacLeod S et al. (2016). The impact of resilience among older adults. Geriatric Nursing, 37, 4, 266-72.

5 Things Worth Being Thankful For and Why it’ll Keep You Younger

Each November, teachers around the country prompt kids to think about what they’re thankful for. But how many of us do this in adulthood? And why only once a year? Is it merely a social habit, or is there actually a benefit to it that goes beyond the obvious good manners?

A number of studies have drawn a positive link between people who regularly practise gratitude and good mental health. They have a sense of perspective about their problems, don’t ‘sweat the small stuff’ and report that they generally feel happy, or contented.

Furthermore, in her recent book, Dr Elizabeth Blackburn (who was awarded a Nobel Prize for her work on telomeres), explains that people who take time to be present in the moment, and direct positive thoughts towards themselves and their lives, are more likely to be healthy for longer, and less likely to suffer from the diseases of aging – diabetes, heart disease, cancers.

“The ability to focus on… your present experience, turns out to be very good for the cells of your body” – Elizabeth Blackburn

According to Blackburn’s research, everything from the food we put in our bodies to the thoughts we think, have an effect – positive and negative – on the health of individual cells. The telomeres inside our cells, which control when and how they grow or die, are easily affected by what we do.

Here is her list of the things that make them happy and healthy:

  • Positive attitude: viewing problems as challenges that we’ll enjoy tackling can reduce stress response from unhealthy to healthy
  • Meditation, mindfulness and breathing exercises also reduce production of cortisol, the stress hormone, and can even help lengthen telomeres
  • Exercise, especially cardiovascular exercise, is great for telomeres
  • Eat fresh, whole foods. Avoid processed and high sugar items
  • Socialize. When we feel connected and safe with other people, whether family or friends, our cells know about it. This makes a difference, regardless of income or abilities.

So although Thanksgiving only comes once a year, make some time in your day to sit quietly and think about the good things in your life right now. It will keep you present, and it can also help strengthen good habits, like taking regular exercise and enjoying delicious food that’s good for your cells.

Why Memory Training Is More Important Than You Think

Train your brain

Ever walk into a room and forget what you came in for? Lose your keys? Your glasses? And at what point do you stop laughing it off and start worrying that these are the early warning signs of dementia?

Scientists in Italy  recently researched a link between age-related cognitive decline and general inflammation in otherwise healthy adults. Age-related inflammation typically shows itself in conditions like thickened arteries, arthritis and diabetes, and increases at a similar time to a decrease in memory and reasoning.

The study took 32 adults over 60 and treated them to 1 hour of Memory Training twice a week for 6 months, while another group of 28 older adults received no intervention. At the start and end of the study the participants took a number of cognitive tests, as well as giving a blood sample so that the scientists could establish levels of Cortisol (the stress hormone) and other inflammatory markers.

While memory training, or Brain Training, as it is sometimes called, has become a popular in commercial products, the research behind it has often been called into question. Just because you train your mind to recall a list of names, and makes you better at name recall, doesn’t necessarily mean that your brain is ‘fitter’ all over.

But, interestingly, the 2017 study discovered that the adults who received training in specific memory tasks, namely:

  • shopping list recall
  • remembering the locations of monuments on a map in an unfamiliar city
  • names and photographs of faces
  • remembering a short story and re-writing it from memory

not only performed better in recall tests, but also showed lower inflammatory markers and lower Cortisol in the 6 month follow-up test. The mechanism for this relationship is not fully understood, but it seems that by practising these tasks, not only did the participants’ brains improve in memory tests, but their level of inflammation (and therefore risk of diabetes, thickened arteries and arthritis) declined over the same period.

Perhaps there is more to Memory Training than simply finding your keys where you expected them to be.

5 Ways You’re Hurting Your Balance and How to Fix It

I’m not talking about your bank balance, but your physical, stay-upright-don’t-fall balance.

Think you don’t have a problem? You may be right, yet the vast majority of balance problems go unnoticed until someone actually falls and injures themselves. And whether you’re 35 or 75, recovering from a fall is whole lot harder than not falling over in the first place.

But with a little self knowledge, you can assess some of your possible weaknesses, and take action without needing to become a statistic (every 20 seconds someone over 65 has to visit the ER because they’ve injured themselves in a fall).

  1. You sit down all day. The human body is brilliant at adaptation. The most common reason people in retirement fall over is because they’ve spent the last 40 years sitting down and their muscles have adapted to doing that very well, and lost their earlier ease for movement. Fortunately, this change can be reversed by challenging the body again: exercise that targets strength, flexibility and balance will send different signals to your brain and muscles and they will start to respond. Start slowly, and seek help. A class like Tai Chi, which also incorporates breathing exercises, has been shown to be particularly good for improving  balance.
  2. You’ve started new medication. Or changed the dosage. Many medicines affect your balance, either over the short term while your body adjusts, or longer term because of interractions with other drugs (including over the counter medicines) you may be taking. Always take professional advice from your doctor or pharmacist. Talk to them about how all your medications make you feel and they can help make sure they’re not increasing your risk of falling.
  3. Your eyesight is poor. Our eyes play an enormously important role in keeping us balanced, and not only by warning us of holes we may drop into or obstacles we may trip over. Our brains compare input from other senses with the information coming in through our eyes to tell if we’re leaning, standing upright, moving, or stationary. That moment of confusion many people experience when stepping off a moving treadmill is a good example of this. As eyesight can deteriorate over time, it is worth checking in with an optometrist yearly to ensure your eyes are working at their best.
  4. You suffer from hearing loss. This can be a problem on two levels. One, you may not become aware of a hazard until too late, resulting in sudden movement and possible loss of balance. Secondly, with loss of hearing, many people withdraw from their surroundings, tuning out some of the other senses as well. This can make you additionally vulnerable. Sometimes being aware of this tendency can be enough to make a conscious effort to stay alert. In other cases, it can be worth seeing a doctor about hearing aides.
  5. You’re depressed or anxious about falling. Both depression and anxiety can lead people to disengage from those around them, physically and emotionally. Often people avoid going out and doing things they used to enjoy because they’re worried about falling . But studies have shown that such behaviour actually increases the risk of having a fall. The best protection is to stay active and engaged in your life, in order to maintain an alert brain, and strong, flexible muscles.

 

September is National Fall Prevention Month, and there are events going on all around the country to help raise awareness and put people back on their feet. Falling is not a natural part of aging. But you might have to do something about it to make sure it doesn’t happen to you.

4 Things You Didn’t Know About Allergy Dangers

The blossoms are beautiful this time of year. Trees, shrubs, the grassy parks alive with wildflowers. Everything comes alive, people start planning summer fun. But, this beauty extracts quite a price from a number of people, in the form of seasonal allergies, like hayfever.

  1. over 17 million adults suffer from hayfever in the US
  2. 4 million work days are lost to hayfever each year
  3. Allergies can increase your risk of falling
  4. Risk of bad side effects to allergy medication increases with patient age

 

While an allergy doesn’t affect your balance directly, it impacts some of the systems that contribute to good balance. When suffering from symptoms, many people experience poor sleep, and feel tired and unable to focus during the day.

Having a stuffy nose or blocked sinuses also makes some feel removed from the world around them. Both these symptoms make people less alert to trip hazards and slower to respond when they do notice. Perhaps when tired you start to shuffle your feet, rather than walk normally. Itchy, streaming eyes can affect vision quality.

While some medications can help with the symptoms above, they come with their own problems, especially first generation antihistamines, which can cause drowsiness, and even an inability to think clearly. These effects can be magnified in older adults because aging means there are fewer receptors in the brain, and increased blood-brain permeability.

So what can you do? Unfortunately, there is no magic solution to removing allergy symptoms, but there are things you can do to prevent a fall.

  1. Pay attention, consciously, when you move around. Be aware that your body might need more time to react, and plan accordingly
  2. Before taking any medication, check with your doctor to make sure it won’t react with anything else you take, and if a non-drowsy version is right for you
  3. Perhaps schedule in some daytime rest – meditation, reading, or napping, to make up for loss of sleep at night
  4. Drink plenty of fluids
  5. Don’t stop exercising: if the climate outdoors makes you miserable, try changing your routine for a bit. Go swimming, or take a class inside.

 

What is your favourite way to beat allergies? We’d love to hear from you.

‘Senior’ is a Dirty Word

Try this experiment: ask a random group of people the following question:

If you had to identify the kind of person you are, using only 3 words, what would those words be?

I’m willing to predict that the vast majority of the answers concern their job, spare time interest, such as a sport, and perhaps a characteristic, like ‘kind’ or ‘energetic’. Some will mention religious affiliation, perhaps ethnic group or gender, some, that they are a parent. A very tiny minority will mention their age-group.

When I conducted this research myself, the only ones to fall into this latter group were people not yet 25 years old. I found that the older people were, the less they identified themselves by their age, or their relationship to family (many grandparents whom I know adore their grandchildren, did not choose ‘grandparent’ as one of their defining terms – or even ‘parent’). 

And yet, companies and government agencies talk to and about ‘Seniors’ and ‘Baby-Boomers’ as if they are an homogenous group with the same aspirations, fears and experiences. I may be a 40-something mother of 2, but if I came across someone marketing a product to me in those terms, I’d be pretty sure to run a hundred miles in the opposite direction because those are not the things by which I choose to define myself.

So if you want me to choose your product, you’d better pay attention to that. And when companies talk to 30 and 40 year olds, most of them realize this and refine the pitch. Why then, do we expect people to lay down their individuality at the doorstep of a particular decade?

We recently participated in National Falls Prevention and Awareness Week (#FPAD15), lead by the National Council on Aging, and other agencies. Here in Houston, there have been a few well-attended events connecting users of community centers with advice on exercise programs and home safety. But the response from the press and a number of ‘senior’ living establishments has been somewhat underwhelming.

I wonder how much of that is because the help is being broadcast on the wrong channels? Perhaps if we used more positive language we might gain more interest, and therefore be able to help more people. We should be using labels like #ageDisgracefully or #DontLeaveitTotheKids for the adventurous set, #golfersDoitStanding (change the sport as appropriate), #brainsloveoxygen for culture vultures, and so on.

People of all ages hate being told where they are weak. It’s time to celebrate how we are strong, and how to stay that way.