Archive for the ‘research’ 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
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Thursday, June 17th, 2010
The Philippines needs to prepare for the burgeoning population of older persons. The population 60 years and above has grown at a very rapid rate, increasing from 3.2 million in 1990 to 4.6 million in 2000. By the year 2030, ten percent of our population will be composed of senior citizens. The National Institutes of Health (NIH) study “Status of Geriatric Education in Philippine Medical Schools” presented during the NIH Forum 17 June 2010, looked at how Geriatrics (the study of health and disease in old age) is taught in Philippine Medical Schools and the perception of graduating medical students on how well they can take care of old patients after receiving their MD diplomas.
The study revealed that most medical schools do have Geriatrics as part of a required course and 61% enjoy institutional support for developing said course. However, although 70% of the graduating medical students believe they are prepared to take care of the elderly in outpatient clinics and hospitals, only 61% of their teachers think they possess the necessary KAP (knowledge, attitude and practice) for such a job!
Some of the contributors to the lack in KAP of fresh graduates include the crowded medical course schedule and the lack of a curricular map of subjects that teach them how to take care of the elderly. Medical students learn the basics during the first three years of med school (classroom) but may not possess the skills in the final clinical years called internship (hospital exposure). The lack of clinical teachers and researchers were also identified as obstacles to the development of a good Geriatric program.
This study also contains recommendations as to how the situation can be rectified; how we can mold our future doctors into providing excellent and compassionate healthcare for the elderly. We can begin by increasing the number of doctors that are trained and dedicated to teaching, and by establishing a well mapped curriculum in Geriatrics. We also need to support researches that lead to improvement of the health and quality of life of the aging Filipino. The Association of Philippine Medical Colleges, DOH, DSWD, NIH and CHED can help lead this change.
About the NIH and Aging Study Group:
The National Institutes of Health (NIH) was created on January 26, 1996 by the UP Board of Regents as an institutional home of a network of various research and extension units specializing in health and socio-biomedical concerns. This thrust is consistent with the country’s vision of “Health for All”.
Currently, the NIH has various research institutes and active study groups that continue to develop and produce outputs that serve as vital guideposts in shaping national programs and policies. The Aging Study Group and the Committee on Aging and Degenerative Diseases (COMADD) has contributed greatly to current clinical and educational programs and policies on Aging. The vision of COMADD is “The Filipino elderly enjoying a healthy body, mind and spirit, being treated with dignity, and valued as a productive member of society, in a dynamic process unique to himself, and beginning a life of unlimited possibilities”.
Principal Investigator:
Shelley F. de la Vega, MD., MSc
Chair, Aging Study Group
Institute of Health Policy and Development Studies
UP Manila-NIH
Co-Investigators:
Jose Alvin Mojica, M.D., MHPEd
Chair, Department of Rehabilitation Medicine
Philippine General Hospital
Josephine Agapito, PhD
College of Arts and Sciences
UP Manila
Click here to view related post in Manila Bulletin Online
Tags: Aging, education, filipinos, Geriatric, geriatrics, Gerontology, philippines, policy, research
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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
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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
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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
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Sunday, March 7th, 2010
Mercedes Concepcion, PhD
Dr. Concepcion was elected Academician by the National Academy of Science and Technology (NAST), and was proclaimed National Scientist in January 2010. She obtained her B.Sc. degree in chemistry from UP in 1951 before pursuing Biostatistics at the School of Hygiene and Tropical Medicine of the University of Sydney from 1953 to 1954 under the Colombo Plan fellowship. She obtained her PhD from the University of Chicago in 1963.
Dr. Concepcion was crucial in the establishment of the UP Population Institute (UPPI) in 1964, which was funded by the Ford Foundation. The UPPI was instrumental in the enactment of the Population Act of 1971.
In the last Annual Scientific Meeting of the NAST “Active Aging towards Quality Life” held July 8 and 9, 2009 at the Manila Hotel, she served as Steering Committee member and co-Chair of sessions on the sociological and demographic aspects of Aging. She played an important role in drafting the Resolution on Active Aging by the NAST.
Tags: Excellence, filipinos, Leadership, NAST, philippines, senior citizens, wisdom
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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
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Sunday, July 20th, 2008
The Baseline Survey for the National Objectives of Health (BSNOH) research done by the UP Manila NIH and DOH revealed that of the 2,690 older persons surveyed, only 0.3 percent ever had a Geriatric Health Screen. The number of elderly who had screening for geriatric syndromes such as urinary incontinence, memory and affective illnesses was less than 5 percent. The BSNOH Survey also revealed that fewer that 10 percent had their height and weight determined, and only 15 percent had a hearing evaluation. Sixty one percent indicated that lack of money was the major reason for delaying medical consultation, and ninety two percent were without any form of pension.
Philhealth (PHIC) is trying to address this gap by creating responsive benefits that will address the rising prevalence of chronic diseases. These include a hypertension package, out-patient drug benefits, home peritoneal dialysis. PHIC plans to invest in long-term care bundle payments for post hospital care, integration of acute care and some coverage into one delivery system. In the open forum that followed, issues raised included the difficulty in Philhealth reimbursement of all members of the multi-disciplinary healthcare team, and the lack of coverage for nursing home and home care.
Tags: Filipino, Leadership, philippines, policy, research, senior citizens
Posted in Doctor, Nurses, Physician, education, geriatrics, healthcare services, philippines, physical therapy, policy, public health, research | No Comments »
Sunday, July 20th, 2008
Brief History of the Committee on Aging and Degenerative Diseases
The University of the Philippines Manila is the country’s leading institution for health research and development. The creation of the National Institutes of Health was approved by the Board of Regents at its 1094th meeting on 26 January 1996, and with it, the Gerontology and Disabilities Programs Cluster, through the Committee on Aging and Degenerative Diseases. The committee is composed of various physicians, academicians, and allied medical professionals within the UP-PGH system.
The COMADD is currently comprised of volunteer consultants from various Clinical and Basic Sciences Departments of the UP-PGH system:
1. Philippine General Hospital – Clinical Departments are involved through their representatives, including: Internal Medicine, Family Medicine, Surgery, Orthopedics, Rehabilitation, Neurology, Psychiatry and Nutrition.
2. UP College of Nursing – membership representation
3. UP Manila College of Arts and Sciences – membership representation thru the Department of Behavioral Sciences (Anthropology)
4. College of Allied Medical Professionals
5. College of Pharmacy
6. College of Dentistry
Mission-Vision: Institute for Aging and Degenerative Diseases
Vision
The Filipino elderly enjoying a healthy body, mind and spirit, being treated with dignity, and valued as a productive member of society, in a dynamic process unique to himself, and beginning a life of unlimited possibilities.
Mission
The institute shall create with the aging Filipino, unlimited possibilities for their value added life through scientific research, training and education, and specialized services.
Clinical Programs
The Committee on Aging and Degenerative Diseases through it multidisciplinary membership is involved in the development and management of various clinical programs within the UP-PGH system, including:
Outpatient geriatric evaluation and wellness clinic
Inpatient geriatric medical consultation
Memory clinic
Stroke unit
Rehabilitation unit (physical, occupational and speech therapy)
Menopause clinic
Specialized services such as Spine/Osteoporosis care; Rheumatology clinic
Policy Development
The Committee and its members have been directly involved as technical advisers in the development of
The Philippine Plan of Action for Older Persons, DSWD
The Health Program for Older Persons, DOH
Baseline Surveys for the National Objectives of Health, DOH, NIH
Periodic Health Examination Guideline, PHILCLEN, DOH
Alzheimer’s Disease Association of the Philippines Recommendations on Diagnosis, Prevention and Management
Education
The Committee has undertaken 9 successful Post-graduate courses in Geriatric Medicine for physicians, nurses, and allied medical professions since 1997
Research
The Committee and its members are involved in funding and development of essential national health researches including those that resulted in the Policy and Recommendation documents above.
Tags: education, Excellence, filipinos, Geriatric, geriatrics, Gerontology, Interdisciplinary, Leadership, Nurses, Organization, philippines, policy, research
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