Posts Tagged ‘Prevention’

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

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

Tips to Reduce Clutter and Hoarding

Sunday, March 28th, 2010

Hoarding

Some people will hoard or save numerous items, including dirty clothes, food, and papers. Losing a meaningful role in life, work, friends, family, and a good memory can have an impact on a person’s need to hoard and or to “keep things safe”. Hoarding in this population is oftentimes triggered by the fear of being robbed.

When working with persons who have dementia, it is essential that you keep their safety in mind. Order, routine and simplicity are most helpful. A house or room that is relatively uncluttered is the ideal environment.

Ten Tips to Consider

1. Let go of ideal notions of cleanliness. Your patient may value items that appear to you as worthless. Parting with their belongings (even used paper cups) can cause severe emotional distress.

2. Ask your patient if they can donate or sell their belongings to charity.

3. Focus on fall prevention. Create pathways free of debris, loose cords or slippery rugs. Some frail patients hold onto furniture or other items while moving through the room; preserve their “props” until other assistive devices (canes, walkers) can be introduced.

4. Focus on fire prevention. Red flags include newspapers stored on top of or inside a hazardous area.

5. Be creative and negotiate. Consider photographing belongings, as this may help the patient part with things and preserve memories.

6. Begin by reorganizing a small corner of a room, a single table, or just a section of the table.

7. Have a friend or relative present during a major cleanout, preferably one who already has a supportive relationship with the patient. Clean-outs can be overwhelming to people with severe hoarding behavior. Have a back-up plan in case emergency psychiatric services are needed.

8. Discuss how to safeguard valuables in the cleaning process. Have a written contract. Agree on what to do with valuables that turn up, such as money, jewelry, or collectibles.

9. Consider relocating an individual to a new room if the clutter is the result of physical or mental frailty. A new environment can provide a fresh start and enable the patient to receive needed services sooner.

10. Plan for on-going maintenance and supervision to maintain a decluttered environment.

Adapted From: Weill Medical College of Cornell University

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.

Protect Seniors from Heat Stress

Tuesday, March 9th, 2010

Heat exhaustion is a form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids.

Warning signs vary but may include the following:

* Heavy sweating
* Paleness
* Muscle Cramps
* Tiredness
* Weakness
* Dizziness
* Headache
* Nausea or vomiting
* Fainting
* Skin: may be cool and moist
* Pulse rate: fast and weak
* Breathing: fast and shallow

To protect yourself from heat stress and heat stroke, follow these tips:

# Drink cool, nonalcoholic beverages. (If your doctor generally limits the amount of fluid you drink or has you on water pills ex. furosemide or hydrochlorothiazide, ask him how much you should drink when the weather is hot. Also, avoid extremely cold liquids because they can cause cramps.)
# Rest.
# Take a cool shower, bath, or sponge bath.
# If possible, seek an air-conditioned environment. (If you don’t have air conditioning, consider visiting an air-conditioned shopping mall or public building to cool off.)
# Wear lightweight clothing.
# If possible, remain indoors in the heat of the day.
# Do not engage in strenuous activities.

seniors swim
If you are living with or taking care of an older person

* Visit older adults at risk at least twice a day and watch them for signs of heat exhaustion or heat stroke.

* Encourage them to increase their fluid intake by drinking cool, nonalcoholic beverages regardless of their activity level.

Warning: If their doctor generally limits the amount of fluid they drink or they are on water pills, they will need to ask their doctor how much they should drink while the weather is hot.

* Take them to air-conditioned locations if they have transportation problems.

If You Don’t Have Air Conditioning:

• Take a cool shower, bath or sponge bath.
• Create cross-ventilation by opening windows on two sides of your house.
• Keep windows open at night.
• Keep curtains, shades or blinds drawn during the hottest part of the day.
• Cover windows when they are in direct sunlight.
• Electric fans may help, but when the temperature reaches the high 90s, fans won’t prevent heat-related illness.
• Go somewhere that’s air-conditioned like the shopping mall, the movies, the library, a senior center or a friend’s house. If you don’t have a car or no longer drive, ask a friend or relative to drive you. If necessary, take a taxi. Don’t stand outside waiting for a bus.

More heat stroke and heat stress information from the CDC link: Centers for Disease Control and Prevention USA

Pandemic Flu H1N1 Vaccination 2010

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.