Posts Tagged ‘Aging’

Centenarian Filipina Reveals Secrets to Longevity

Thursday, July 29th, 2010

Excerpt from Marjorie Gorospe, loQal.ph

115-year-old I-Apayao native Rufina Daluyon reflects the healthy lifestyle of the I-Apayao tribe and despite her age, the centenarian shows no signs of serious illness.

Apo Rufina can still talk and can still walk but she only speaks Ilocano. She shares her stories to willing listeners through her great granddaughter Susan.

1. Lifelong Physical Activity
The I-Apayao tribe is related to Isneg tribe and both tribes are known as good farmers.

2. Diet – mostly vegetables
Susan says being a member of the I-Apayao tribe, Apo Rufina is very fond of vegetables.

3. Good Genes
Apo Rufina’s husband lived for 126 years. Apo Rufina has three children, but only one among the three is still alive at a still remarkable age of 90.

4. Spirituality and Gratitude

5. Discipline
“Napakahigpit nya (Rufina) lalo pagdating sa pag-uwi ng maaga sa bahay at tamang pagkain. (She is very strict, particularly on curfews and eating the right food),” says Susan in jest.

Centenarian Northern Philippines

Centenarian Northern Philippines

“Minsan tinatanong na rin nya kung bakit di pa sya namamatay at mukha daw nalimutan na siya ni Lord sunduin. (She often wonders why she’s still alive and that the Lord probably has forgotten about her),” says Susan who often visits her great grandmother and gives her a shower.

For her part, Susan says she is thankful for the life that God has granted Apo Rufina.

But Susan admits that things are getting harder for Apo Rufina. Susan says all they can do is to give her the love that she deserves while she is still alive.

Folic Acid Does Not Prevent Memory Decline

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

Lifestyle Diseases (Sakit sa Puso) A Poem by JD

Thursday, July 1st, 2010

Lifestyle Diseases (Sakit sa Puso)

Sinulat ni JD Agapito

Sa dami ng sakit sa ating lipunan

Sakit ng katawan ay kayang pigilan

Lalo na’t sa puso ang pag-uusapan.

Disiplina ang siyang tanging kailangan

Bakit ko nasabi ang huli kong linya?

Dahil ang sakit ay tayo ang may gawa.

Alam na masamang kumain ng taba.

Hanap nitong dila’y karneng mamantika.

Kung may pera nama’y panay rin ang punta

Sa mga food chains na prito ang siyang tinda.

Sa order na chicken, balat ang inuuna.

Mataas na kolesterol siyang ‘di iniinda.

Bukod pa nga rito’y ang hindi paggalaw.

Panay ang pag-upo’t di man lang sumayaw.

Kahit na minsan lang sa buong isang araw.

Maglakad lakad ng taba ay matunaw.

Maging sa inumi’y di displinado.

Kung uminom ng softdrinks sadyang bigay todo.

Dapat ay minsan lang sa buong ‘sang linggo.

Mas maraming tubig ang dapat sa iyo.

Kaya’t mas marami ang may hypertension.

Dahil sa kinai’y mayr’ong alta presyon.

Dagdagan pa natin ng lahat ng tensyon.

Dala na rin mismo ng mga sitwasyon.

Kaya kung ikaw ay hindi magbabago.

Lalo pa kung ika’y naninigarilyo.

Tiyak ang buhay mo ay mamimiligro.

Sakit sa puso ang tatapos sa iyo.

Dito sa aking tula ‘y may hihilingin.

Pwede bang pagkain ay sadyang isipin

Para makontrol ang taba maging asin.

Mga simpleng bagay ‘wag ng problemahin.

Kaya’t sana ay hindi pa mahuli.

Itong aking payong hangad ay mabuti.

Upang maiwasan itong maatake.

At di na mangyari itong pagsisisi.

Dahil may dalanging kasama ang tula.

Itaas sa Diyos ang nais na sadya.

Sa kanyang patnubay lahat magagawa.

Kung buhay ay maayos, siya’y matutuwa.

Contributed by COMADD NIH Member
Prof JD
June 28, 2010 5:00

Medical Profession Needs to Prepare for the Rapidly Growing Elderly Population

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

Coping With Dementia: Violence and Aggression

Sunday, May 16th, 2010

Tips from the Alzheimer’s Disease International website:

Violence and aggression

“Violence and aggression are caused by the illness.”

From time to time, the person may become angry, aggressive or violent. It is not a personal attack on you, but a part of their illness. There are many reasons why a person with dementia may feel angry. They may not like being helped with things they used to do on their own, or may simply be frustrated due to an inability to do things.
Angry Skull
These short-term changes happen for a variety of reasons such as the person’s sense of loss of social control and judgment, loss of the ability to express negative feelings safely, and loss of the ability to understand the actions and abilities of others. It is therefore worth finding and avoiding the causes of unwanted certain reactions.

If the person feels angry, aggressive or violent, keep calm and try not to show fear or alarm. Give them more space and try to draw their attention to a calming activity.

This is one of the most difficult things to cope with for a caregiver, and if violence occurs often, you will need to seek help. Talk to someone for support, and speak with your doctor about help with managing the person.

Coping with Dementia: Alcohol and Cigarette Smoking

Sunday, May 16th, 2010

Modified from Alzheimer’s International UK:

Alcohol and cigarettes

“Supervise drinking and smoking to make sure accidents don’t happen.”

There is no problem for a person with dementia drinking alcohol in moderation if their medication allows. However the person may forget they have just had a drink and so have another one. This cycle can lead to repetition with the person becoming drunk or unmanageable.

1. Do not buy or store alcohol at home.
- reduce the number of bottles of alcohol available in the drinks cabinet
- empty or dilute some of them.
2. Distract the person with another activity, so that they do not think about drinking.
3. Provide water, juice, light soda, and other healthy cool drinks.

Tobacco Smoking Elderly

Cigarettes introduce a greater danger because of the risk of fire and damage to health.
1. Do not buy or store cigarettes at home.
2. Always supervise the person when smoking
- but remember the dangers of second-hand and third hand smoke!!!
3. Discourage smoking altogether and enroll in a smoking cessation program
4. Make sure that the clothes they wear and the furniture in the house are fire-resistant.
5. Install a smoke alarm, which can alert you to any danger.

Preventing Alzheimer’s Part 2: The NIH Consensus 2010

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.

Tai chi PGH Geriatric Clinic

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

Preventing Alzheimer’s Part 1: The NIH Consensus 2010

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

Driving and Dementia

Monday, April 19th, 2010

The American Academy of Neurology has released a guideline on Driving among Patients with Dementia.

Concerned about the Driving Ability and Driving Safety of a patient, parent, friend or loved one?

Ask yourself the following questions.

QUESTIONNAIRE for FAMILY OR CAREGIVER :
1. How many times has the patient been stopped or ticketed for a traffic violation in the last three years? (0, 1, 2, 3, 4 or more)
2. How many accidents has the patient been in, or caused, within the last three years? (0, 1, 2, 3, 4 or more)
3. In how many accidents was the patient at fault in the last three years? (0, 1, 2, 3, 4 or more)
Use this scale to answer the following questions:
1 strongly disagree;2 disagree; 3 no opinion; 4 agree; 5 strongly agree.
1. I have concerns about the patient’s ability to drive safely.
2. Others have concerns about his/her ability to drive safely.
3. The patient has limited the amount of driving that he/she does.
4. He/she avoids driving at night.
5. He/she avoids driving in the rain.
6. He/she avoids driving in busy traffic.
7. The patient will drive faster than the speed limit if the patient thinks he/she won’t be caught.
8. The patient will run a red light if the patient thinks that he/she won’t be caught.
9. The patient will drive after drinking more alcohol than the patient
should.
10. When he/she gets angry with other drivers, the patient will honk the horn, gesture, or drive up too closely to them.

cartoon from telspatch.co.uk

cartoon from telspatch.co.uk


If you have numerous YES responses:
1. Seek help from the patient’s healthcare provider for an assessment of Dementia (neurologist, geriatrician).
2. Make sure the patient gets a vision and hearing check.
3. Review medications and drugs (including alcohol and sleeping pills) that may increase the risk of driving accidents.

Source: American Academy of Neurology Guidelines 2010
Published in: Neurology 74 April 20, 2010

How to Make Wise Health Choices

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.