Archive for the ‘medical’ Category
Sunday, July 18th, 2010
The addition of folic acid to the list of vitamins and supplements for the prevention of memory decline is addressed in this meta-analysis. Wald et al conducted a meta-analysis of 9 randomized controlled trials on folic acid, with or without vitamin B and its effect on memory, speed of information processing, language and executive function (decision making). The median duration per study is 6 months and the median age of participants is 75 years.
The results showed no effect of folic acid in the prevention of cognitive decline (memory, speed of information processing, language and decision making) among individuals without preexisting dementia.
The pooled standardized mean difference
in cognitive function test scores was 0.01 (95% CI,
-0.08 to 0.10) after a median treatment of 6 months; an
increase of 1% of a standard deviation of a cognitive
function test score, with confidence intervals excluding
an improvement or a deterioration greater than 10% of 1
standard deviation.
Studies of longer duration are needed in order to address the role of folic acid in the prevention of cognitive decline.
Source: The American Journal of Medicine (2010) 123, 522-527
Tags: Aging, brain, dementia, elderly, Prevention, senior citizens, Syndrome
Posted in complimentary and alternative therapy, drug therapy, geriatrics, psychiatry, psychology, research | No Comments »
Saturday, July 10th, 2010
The newly signed Expanded Senior Citizens Act 0f 2010, RA 9994 includes discounts for vitamins, minerals, diapers, and essential medical supplies. This includes Calcium for osteoporosis, Iron tablets for anemia, and B complex for patients with neuropathy.
However, the DOH and FDA have clarified that discounted drug and medicine purchases, now extend to vitamins and minerals specifically prescribed by doctors for senior citizens for purposes of prevention, treatment, or diagnosis of a disease or illness. This excludes those classified as “food supplements with no approved therapeutic claim”.
This law also mandates that DOH is to provide free pneumoccocal and influenza vaccines to indigent senior citizens.
Moreover, the 20% discount also extends to the purchase of essential medical supplies, accessories or equipment like eyeglasses, dentures, hearing aids, walkers or wheelchairs, and even to geriatric diapers.
Wheelchair
Tags: elderly, filipinos, geriatrics, House of Representatives, philippines, policy, senior citizens, well-being
Posted in Uncategorized, complimentary and alternative therapy, drug therapy, healthcare services, medical, philippines, policy, public health | No Comments »
Saturday, July 10th, 2010
The Implementing Rules and Regulations (IRR) of Republic Act 9994 (Expanded Senior Citizens Act of 2010) went into effect on July 6 granting the full 20 percent discount – privileges to senior citizens.
Secretary Soliman emphasized that senior citizens who have queries and complaints may call the DSWD hotlines 951-7120 and cellphone number 0999-314-7425 or visit the National Coordinating and Monitoring Board (NCMB) website at http://ncmb.dswd.gov.ph and email at ncmb@dswd.gov.ph
“We also plan to set-up Help Desks at the DSWD Central Office and in all DSWD Regional Offices for senior citizens without access to phone lines and the internet,” Secretary Soliman added.
Secretary Soliman appealed to senior citizens to refrain from abusing the privileges under RA 9994. “The law is the government’s way of acknowledging and giving praise to senior citizens who contributed to nation building, and is designed for the sole enjoyment of the senior citizens, so please do not abuse these privileges,” Secretary Soliman stated.
DSWD Sec Dinky Soliman
Tags: DSWD, elderly, filipinos, Governance, philippines, policy, senior citizens, well-being
Posted in complimentary and alternative therapy, geriatrics, healthcare services, medical, philippines, policy, public health | No Comments »
Monday, June 7th, 2010
Source: Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza
Downloaded from www.nejm.org on May 6, 2010
Risk Factors for Complications of or Severe Illness with 2009 H1N1 Virus Infection.
Risk Factor Examples and Comments
1. Age <5 yr Increased risk especially for children <2 yr of age; highest hospitalization rates among children <1 yr
2. Pregnancy Risk of hospitalization increased by a factor of 4 to 7, as compared with agematched nonpregnant women, with highest risk in third trimester
3. Chronic cardiovascular condition Congestive heart failure or atherosclerotic disease; hypertension not shown to be an independent risk factor
4. Chronic lung disorder Asthma or COPD, cystic fibrosis
5. Metabolic disorder Diabetes
6. Neurologic condition Neuromuscular, neurocognitive, or seizure disorder
7. Immunosuppression Associated with HIV infection, organ transplantation, receipt of chemotherapy
or corticosteroids, or malnutrition
8. Morbid obesity – but not yet proved to be an independent risk factor for complications requiring hospitalization or ICU admission and possibly for death
9. Hemoglobinopathy Sickle cell anemia
10. Chronic renal disease Renal dialysis or transplantation
11. Chronic hepatic disease Cirrhosis
12. Long history of smoking Suggested but not yet proved to be an independent risk factor
13. Long-term aspirin therapy in children Risk of Reye’s syndrome; drugs containing salicylates should be avoided in children with influenza
14. Age ≥65 yr Highest case fatality rate but lowest rate of infection
* COPD denotes chronic obstructive pulmonary disease, HIV human immunodeficiency virus, and ICU intensive care unit.
† Morbid obesity is defined as a body-mass index (the weight in kilograms divided by the square of the height in meters)
of 40 or more.
Tags: elderly, Geriatric, pandemic, research, swine flu
Posted in geriatrics, medical, public health, research | No Comments »
Tuesday, May 4th, 2010
Part 2: Cognitive Engagement and Physical Activity
1. Cognitive Engagement.
Cognitive Training – modest benefits on cognitive functioning and a small but statistically significant effect on reducing the extent of age-related decline in cognitive function at a 5-year follow-up. Very small but statistically significant benefit on instrumental activities of daily living—for example, managing finances, managing medications, keeping house, and, in a subgroup analysis, benefit on driving performance in the elderly.
However, these results from a single trial must be replicated to confirm the benefits of cognitive engagement on preventing
cognitive decline over a longer time period and in study subjects with varying levels of baseline cognitive abilities before a firm recommendation can be made.
2. Physical Activity. Increased physical activity, including walking, may help maintain or improve cognitive function in normal adults.
Although encouraging, these data should be viewed as preliminary. Work is ongoing to further investigate the benefits of
physical activity.
Factors associated with decreased risk of Alzheimer’s disease and cognitive decline were cognitive engagement (as indicated by literacy and social enrichment), physical activities in later life, and a diet low in saturated fat and high in vegetable intake. Light to moderate alcohol intake
is reported to be associated with reduced risk of Alzheimer’s disease, but results are inconsistent for cognitive decline
Source: NIH State-of-the-Science Conference:
Preventing Alzheimer’s Disease and Cognitive Decline
April 26–28, 2010
Tags: Aging, brain, dementia, elderly, healthy, middle-aged, minds, Prevention, research, senior citizens, Syndrome, wisdom
Posted in Guideline, complimentary and alternative therapy, geriatrics, lifestyle, psychiatry, psychology, research | No Comments »
Tuesday, May 4th, 2010
Part 1: Supplements and Medicines for Alzheimer’s Prevention
Available scientific evidence is inadequate to conclude that any known preventive strategies are effective. This conclusion is based on a review of published literature of randomized, controlled trials (RCTs), the most rigorous, highest quality evidence.
Summary of Detailed Interventions:
1. Vitamins, Nutrients, and Dietary Supplements.
Vitamin E – no evidence that this factor altered the onset of the Alzheimer’s disease.
Gingko biloba – A recent, large long-term RCT showed no reduction in the incidence of Alzheimer’s disease, leading to the conclusion that there is not sufficient evidence to support the efficacy of gingko biloba.
2. Medications
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) – this class of drugs is not effective in preventing Alzheimer’s disease.
Anti-hypertensive medications – negative with insufficient evidence for protection against Alzheimer’s disease.
NSAIDs—rofecoxib, naproxen, and celecoxib—suggest an increased incidence of Alzheimer’s disease with treatment.
Conjugated equine estrogen, one combined with methyl progesterone – suggest an increased incidence of dementia (including Alzheimer’s disease) with treatment.
Together, these trials suggest that no known medication can be said to reliably delay the onset of Alzheimer’s disease.
Source: NIH State-of-the-Science Conference:
Preventing Alzheimer’s Disease and Cognitive Decline
April 26–28, 2010
Tags: Aging, anticholinergics, brain, dementia, elderly, geriatrics, minds, Prevention, senior citizens, Syndrome, wisdom
Posted in geriatrics, medical, psychiatry, psychology, research | No Comments »
Saturday, March 13th, 2010
Ask yourself these questions before following a health advise from a friend:
1. Is this person giving advise a friend or a salesperson?
2. Will I suffer from harm if I do not follow his/her health advise?
3. What kind of product or procedure is this person recommending?
4. What are the benefits?
a. what are the effects on my body/mind and are these the effects I desire?
b. how soon can the benefits be felt?
c. how long will the effects last?
d. how many in 10 who follow the advise will feel the benefit? how many in 100?
e. how many in 10 people tested represent my age group?
Watch out for testimonials or personal anecdotes! One person in ten may have benefited but you need to ask: “How many took the product? What happened to the nine others who took the product?”
5. Are there side effects or harmful outcomes?
how many in 10 persons will feel worse? how many in 100?
7. Will the cost/money/time I spend be worth the benefit?
8. Do I have enough information to make a wise health choice?
a. ask about scientific randomized trials or systematic reviews on the product or procedure in which all relevant studies are identified and those of adequate quality selected. Results from selected studies are usually pooled (using meta-analysis) to give the
best single estimate of effect.
b. ask for help from a trusted physician but avoid doctor shopping.
c. search trusted internet sites and peer reviewed medical journals.
Do your homework! Click any of these links for medical information on western and complementary medicine Medline Plus , the Cochrane Review of Complementary Medicine and Pubmed and the US Food and Drug Administration
Watch out for quacks and snake-oil salesmen!
You may be dealing with a quack if:
1. The information only includes stories of patients who benefit from the product.
2. You cannot obtain information on the number of people who do not improve after taking the product/procedure.
3. The advertiser is quiet about those who experience harmful side effects.
Reference: Irwig et al. Smart Health Choices. Allen and Unwin 1999.
Tags: Aging, education, elderly, healthy, Prevention, research, well-being, wisdom
Posted in Words from the Wise, complimentary and alternative therapy, drug therapy, education, healthcare services, lifestyle, research | No Comments »
Saturday, February 20th, 2010
The flu pandemic is not over.
The 2009 AH1N1 influenza virus continues to be the dominant influenza virus in circulation in the world. Based on historical data, pandemics are characterized by several successive waves, potentially more impactful (e.g. 1968 pandemic). Compared with seasonal flu, the proportion of severe / deadly cases in previously healthy and young subjects is substantially higher. Although fewer older persons were infected with the pandemic AH1N1 virus, paradoxically, infected older people will experience the highest rates of severe disease and death of any age group. Vaccination of older persons is therefore a priority.
Because it is the dominant circulating strain, the WHO recommends that the pandemic H1N1 strain should be incorporated into the seasonal flu vaccine for 2010. Keiji Fukuda, MD, MPH, special adviser to the WHO director-general on pandemic influenza, stressed that the recommendation does not indicate that the pandemic is over.
Although fewer older persons were infected with the pandemic AH1N1 virus, paradoxically, infected older people will experience the highest rates of severe disease and death of any age group. Vaccination of older persons is therefore a priority.
“The recommendation to put the pandemic virus in the upcoming vaccine really means that this has been a dominant virus, and it is expected that it will continue to be a very significant virus circulating around the world,” Fukuda said.
The WHO Recommendation for the Composition of the 2010 Southern Hemisphere (SH) Vaccine is:
— an A/California/7/2009 (H1N1)-like virus, the pandemic strain
— an A/Perth/16/2009 (H3N2)-like virus;
— a B/Brisbane/60/2008-like virus.
Tags: AH1N1, geriatrics, pandemic, Prevention, senior citizens, swine flu, well-being
Posted in drug therapy, emergency preparedness, healthcare services, public health | No Comments »
Sunday, February 14th, 2010
Authors: Martin M. Monti, Ph.D., Audrey Vanhaudenhuyse, M.Sc., Martin R. Coleman, Ph.D., et al published by the New England Journal of Medicine February 2010.
In this study, 5 out of the 54 comatose patients were able to modulate their brain activity using functional MRI testing.
One patient was able to answer YES or NO using the technique described.
While in the functional MRI scanner, all patients were asked to perform two imagery tasks. In the motor imagery task, they were instructed to imagine standing still on a tennis court and to swing an arm to “hit the ball” back and forth to an imagined instructor. In the spatial imagery task, participants were instructed to imagine navigating the streets of a familiar city or to imagine walking from room to room in their home and to visualize all that they would “see” if they were there.
This technology may be developed further to help comatose patients communicate their need for pain medication, manipulate their environment, express their feelings and choices, and improve their quality of life.
Tags: brain, research, well-being
Posted in Doctor, medical, research | No Comments »
Monday, February 1st, 2010
Excerpts from the American and British Geriatric Societies Clinical Practice Guideline 2010:
Prevention of Falls in Older Persons
Summary of Recommendations
SCREENING AND ASSESSMENT
1. All older individuals should be asked whether they have fallen (in the past year).
2. An older person who reports a fall should be asked about the
frequency and circumstances of the fall(s).
3. Older individuals should be asked if they experience difficulties with walking or balance.
4. Older persons who present for medical attention because of a fall, report recurrent falls in the past year, or report difficulties in walking or balance (with or without activity curtailment) should
have a multifactorial fall risk assessment.
Photo of the 4-step balance assessment demo at the Training of Trainors program, COMADD and Palo SHS:
The multifactorial fall risk assessment should include the following:
Focused History
1. History of falls: Detailed description of the circumstances of the fall(s), frequency, symptoms at time of fall,
injuries, other consequences
2. Medication review: All prescribed and over-the-counter medications with dosages
3. History of relevant risk factors: Acute or chronic medical problems, (e.g., osteoporosis, urinary incontinence, cardiovascular disease)
Physical Examinations
Functional Assessment
Environmental Assessment
Details are available at the AGS Website
Tags: geriatrics, guideline, practice guideline, Syndrome
Posted in emergency preparedness, environment, geriatrics, medical, physical therapy | No Comments »
