Strength training for persons older than 60 years

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People lose 30% of their muscle strength between the ages of 50 and 70 years. However, maintaining muscle strength in old age is enormously important in order to maintain mobility and to be able to lead an independent life and manage everyday tasks independently. In the current issue of Deutsches Ärzteblatt International, Frank Mayer and colleagues from the University of Potsdam conclude that progressive strength (resistance) training counteracts muscular atrophy in old age (Dtsch Arztebl Int 2011; 108(21): 359-64).

The authors investigated the extent of the effects that can be achieved by strength (resistance) training in elderly persons and which intensities of exercise are useful and possible in persons older than 60 years. They found that regular strength (resistance) training increased muscle strength, reduced muscular atrophy, and that tendons and bones adapt too. These successes in turn had a preventive effect in terms of avoiding falls and injuries. Greater intensities of training yielded greater effects than moderate and low intensities. In order to increase muscle mass, an intensity of 60-85% of the one-repetition-maximum is required. In order to increase rapidly available muscle force, higher intensities (>85%) are required. The optimum amount of exercise for healthy elderly persons is 3 to 4 training units per week.

In the coming decades, the importance of maintaining the ability to work and to make a living will increase, as will the need for independence in everyday life and leisure activities. The increase in the retirement age to 67 years from 2012 means that one in three adults of working age will be older than 50 by 2020, and by 2050, the proportion of people older than 60 in Germany's population will rise to an estimated 40%. Currently, the proportion of elderly persons who practice strength (resistance) training is about 10-15%.

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Managing Seizures with Supplements Effectively: Importance of Vitamins and Minerals in Epilepsy

As per one of the theory attempting to explain the cause of seizures, epileptic attacks are attributed to the damage of fatty membranes that surround the nerve cells. Preliminary research studies have shown that Vitamin E, with its strong antioxidant properties, prevents the damage of the fatty membrane and thereby prevents the occurrence of seizures. Though there is no concrete proof of how supplements benefits of supplements in management of seizures and epilepsy, their role in managing epileptic attacks is undisputed.

Seizures are associated
with abnormal impulses
in the brain

How Supplements to help manage Epilepsy: Role of Supplements in managing Seizures

It should be noted that supplements can’t cure the condition and anticonvulsant drugs are mandatory for the treatment of epilepsy. Under no circumstances should supplements be considered as substitute to prescription drugs. However supplements do contribute positively in management of seizures,

• Nutritional deficiencies are identified as one of the leading cause of epileptic seizures. Supplements help in correction of these nutritional deficiencies and prevent recurrence of seizures
• At times supplements contribute effectively in aiding anti-convulsant drugs by enhancing their efficacy.
• Prolonged use of anticonvulsant drugs is associated with unpleasant side-effects, which can also be effectively managed by supplements. 

Supplements for Epilepsy: Important Vitamins and Minerals to Manage Seizures

• Vitamin B complex, especially Vitamin B6 and Folic Acid play a crucial role in management of epileptic attacks. Vitamin B6 is involved in the production of neurotransmitters (i.e. chemicals meant to send message from one neuron to another). However, since most of the B complex vitamins work in conjunction, it is best to take a Vitamin B complex supplement. Ideally 400 mcg of Folic Acid and 150 mcg of Vitamin B12 is ideal
• Calcium and Magnesium deficiencies also have been associated with epileptic seizures. Ideally consume 250 mg about twice a day. However there are certain precautions for magnesium supplements.
• Glutamine and Taurine are two amino acids whose deficiency is associated with seizures. Glutamine helps stabilize the blood sugar levels while Taurine regulates electrical impulses in the brain which may result in a tranquilizing and calming effect



Supplements enhance
the effectiveness of
Anti Convulsant drugs

• Regular intake of 5000 IU of Vitamin E is presumed to improve the nerve sheath, which in turn is reported to improve electrical transmission of impulses and helps in preventing seizures.

Managing Epilepsy Effectively: Do’s and Don’ts for Seizures

There are certain things that need to be understood, especially while handling a person with seizures or epileptic attacks,

·      Don’t try to restrain a person having a seizure. This increases the risk of you either hurting yourself or the person.

·      Don’t try to insert a gag in the mouth of the person to prevent him from biting his tongue. You are actually putting the person at a greater risk of choking.

·      Cushion the persons fall and ensure that he/she doesn’t fall on a hard or a sharp object

·      After the seizure is over, turn the individual on to his/her side to prevent gagging or choking

A person who has had a previous episode of a seizure should refrain from the consumption of alcohol, as alcohol tends to interfere with the action of anticonvulsant drugs.                                    

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Bursitis a common cause of painful hips, knees, heels and elbows

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Most conditions can be managed with simple, nonsurgical techniques

As warm weather arrives and the great outdoors beckons, more and more men and women will be taking to the trails, the beaches, or their yards and gardens, embarking on physical activities that may result in sore, aching, swollen joints. While it may be tempting to ignore these aches and pains or treat them with a little over-the-counter liniment, a wiser choice is to visit a physician who can determine if the symptoms are due to bursitis, inflammation of the fluid-filled bursae, or sacs, that surround and cushion the joints.

Bursitis occurs when the bursae become irritated or infected, often causing pain on movement. When infection is involved, medical intervention is necessary to fight the underlying infection and prevent it from spreading; when infection is not involved, prompt medical attention can prevent the condition from becoming worse over time.
Four of the most common types of bursitis, affecting the hips (trochanteric bursitis), knees (prepatellar bursitis), elbows (olecranon bursitis) and heels (retrocalcaneal bursitis), are examined in a new review article published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

"Bursitis is a common cause of musculoskeletal pain and often prompts orthopaedic consultation," said study author Daniel Aaron, MD, a clinical instructor in the department of orthopaedics at Brown University in Providence, R.I. "One of the challenges facing clinicians is to differentiate bursitis from conditions with similar symptoms, including arthritis, tendinitis, fracture, tendon or ligament injury and tumor. Additionally, bursitis arises from infectious and noninfectious causes, and distinguishing between the two can be challenging.

"A thorough history and physical examination is required for accurate diagnosis, and in some cases, medical tests also may be used to help the clinician identify bursitis and determine whether or not infection is involved," he added.

Trauma or infection is usually the root cause of all four types of bursitis, Dr. Aaron said.

"Hip and heel bursitis usually result from 'overuse' syndromes involving underlying structures related to the tendons," he noted. "Elbow and knee bursitis can be traumatic, due to either chronic low-level trauma or acute trauma, or infectious. Other inflammatory conditions can lead to bursitis as well."

Typical symptoms of bursitis include:

• pain with or without joint movement;
• swelling of the area surrounding the joint;
• redness of the skin near the joint;
• warmth of the area near the joint; or
• pain or tenderness when the bursa is touched.

Dr. Aaron noted not all types of bursitis will involve the same kinds of symptoms. For instance:

• Hip bursitis may involve pain on the side of the hip, often radiating to the thigh. The hip area may be painful to the touch. Although range of motion of the hip may appear normal during the physical exam, the symptoms of trochanteric bursitis may be exacerbated by lying on your side, walking (especially uphill), climbing stairs and standing up from a seated position.

• Knee bursitis may be due to specific predisposing factors, including a history of trauma to the area, such as repetitive or prolonged kneeling, immune system disorders, alcoholism, chronic obstructive pulmonary disease (COPD), kidney failure, prior use of local corticosteroid medication and previous inflammation of the bursa. Pain with movement is uncommon, except when the joint is significantly flexed.

• Elbow bursitis typically involves a history of minor or repetitive local trauma. Although swelling is often involved in patients with olecranon bursitis, usually this swollen area is only tender when infection is involved.

• Heel bursitis often involves pain surrounding the Achilles tendon and heel areas, which are often tender when squeezed. This type of bursitis is typically associated with overuse and is especially common in runners, especially those who regularly train on inclines.

All types of bursitis often can be successfully managed non-surgically, and possible treatments include:

• use of ice packs or compressive dressings;
• activity modification that may reduce stress or irritation;
• administration of nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics;
• corticosteroid injections (knee and elbow);
• stretching exercises; and/or
• change of footwear (heel).

Surgery may be required in patients whose symptoms remain following these treatments and in certain situations when infection is involved.
Dr. Aaron said in most cases, the best way to prevent bursitis is to vary physical activity, avoiding repetitive activities that may increase stress and trauma on the joints. Padding surrounding the knee or elbow joints may help prevent repetitive trauma which could lead to bursitis in those areas. Finally, losing extra weight which may be causing stress on joints, particularly of the hips and knees, is also recommended.

"By recognizing the presence of bursitis and determining whether or not infection is involved, clinicians can identify the best mode of treatment which will resolve symptoms and help the patient regain mobility," Dr. Aaron said.

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Active social, spiritual and physical life helps prevent health decline in seniors

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Study shows small day-to-day changes can result in measurable improvements in quality of life

Small, healthy lifestyle changes and involvement in meaningful activities—going beyond just diet and exercise—are critical to healthy aging, according to a new USC study.

Guided by lifestyle advisors, seniors participating in the study made small, sustainable changes in their routines (such as visiting a museum with a friend once a week) that led to measurable gains in quality of life, including lower rates of depression and better reported satisfaction with life.

The study validates the current trend in public health strategies to focus on preventing illness and disability, as opposed to treating issues once they have already begun to negatively impact health, according to lead investigator Florence Clark.

"What is critical is that, as we age, we continue to be engaged in life through a sustainable mix of productive, social, physical and spiritual activities. This goal of prevention and wellness is really a key to health care reform, and results in cost savings to society," said Clark, professor and associate dean of the Division of Occupational Science and Occupational Therapy at the Herman Ostrow School of Dentistry of USC, and president of the American Occupational Therapy Association.

"The emphasis now is prevention," she said. "There are non-pharmacologic interventions that work."

The Well Elderly 2 trial was performed between 2004 and 2009, with the write-up appearing in the June 2 issue of the Journal of Epidemiology and Community Health.

During six-month periods, licensed occupational therapists assisted more than 200 individuals aged 60 and older to develop sustainably healthy lifestyles and see if they improved the participants' overall quality of life.

"The key to the individualized plans was to make them sustainable," Clark said.

For example, some people like going to the gym to stay physically healthy, but others find the thought of slaving away in a room indoors for three times a week utterly abhorrent—so much so that, no matter what good intentions they have, they will not wind up going. For such individuals, a more effective and longer-lasting strategy to improve physical health may be to instead walk for an hour around their neighborhood in the evenings.

The occupational therapists also provided guidance for using public transportation, getting the participants off of the couch and out into the world.

"You're able to go to a museum, you're able to go to a park… it can open up a whole world of opportunities," Clark said. In one instance, the therapists helped a woman who had taken a nasty fall while boarding a bus to work up enough confidence to ride again. Eventually, she was able to take the bus to go do volunteer work—a fulfilling pastime that she had sorely missed, Clark said.

"Being engaged in a social life has a positive effect on health," she said, "but the public is not sufficiently aware of how key this is to successful aging."

The older adult participants were described as "well" because they were living in the community, not in a skilled nursing facility or other institutional setting.

To determine the results of the trial, quality of life was measured using a variety of indicators, including physical health, mental health, social well-being and life satisfaction. The program participants were compared to a control group that did not receive the intervention.

Though the two groups started out roughly equivalent, the intervention group showed significant improvement in lessening bodily pain and depression while improving vitality, social function, mental health and overall life satisfaction.

Lesser, though still measurable, gains were made in general health and physical abilities.

At the end of the first phase of the trial, the control group was provided with the same treatment that had been given to the intervention group—and made identical progress.

The study findings replicate the outcomes of the influential Well Elderly 1 trial, but extend them to a more ethnically diverse population living in a wide range of community settings, demonstrating the lifestyle program's value for the general public.

The results of the Well Elderly 1 trial, conducted in 1997, were used by the London-and-Manchester-based National Institute for Health and Clinical Excellence (NICE) to develop recommendations for British public health policies.

"Although people are living longer, it is important that they also live better. This intervention results in improved quality of life and provides a vehicle for maintaining health as we age," Clark said.

The Well Elderly 2 trial demonstrated that, compared with other interventions, this lifestyle intervention was cost-effective. For every dollar spent, there was a significant enough gain in health outcomes to justify the expenditure, according to Clark.

"The American public needs to know about this," she said. "Making positive changes in how we live each day, and sustaining those changes over the long term, is critical for maintaining independence and healthy aging."

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Moderate to intense exercise may protect the brain

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Older people who regularly exercise at a moderate to intense level may be less likely to develop the small brain lesions, sometimes referred to as "silent strokes," that are the first sign of cerebrovascular disease, according to a new study published in the June 8, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology (AAN).

"These 'silent strokes' are more significant than the name implies, because they have been associated with an increased risk of falls and impaired mobility, memory problems and even dementia, as well as stroke," said study author Joshua Z. Willey, MD, MS, of Columbia University in New York and a member of the American Academy of Neurology. "Encouraging older people to take part in moderate to intense exercise may be an important strategy for keeping their brains healthy."

The study involved 1,238 people who had never had a stroke. Participants completed a questionnaire about how often and how intensely they exercised at the beginning of the study and then had MRI scans of their brains an average of six years later, when they were an average of 70 years old.

A total of 43 percent of the participants reported that they had no regular exercise; 36 percent engaged in regular light exercise, such as golf, walking, bowling or dancing; and 21 percent engaged in regular moderate to intense exercise, such as hiking, tennis, swimming, biking, jogging or racquetball.

The brain scans showed that 197 of the participants, or 16 percent, had small brain lesions, or infarcts, called silent strokes. People who engaged in moderate to intense exercise were 40 percent less likely to have the silent strokes than people who did no regular exercise. The results remained the same after the researchers took into account other vascular risk factors such as high blood pressure, high cholesterol and smoking. There was no difference between those who engaged in light exercise and those who did not exercise.

"Of course, light exercise has many other beneficial effects, and these results should not discourage people from doing light exercise," Willey said.

The study also showed that the benefit of moderate to intense exercise on brain health was not apparent for people with Medicaid or no health insurance. People who exercised regularly at a moderate to intense level who had Medicaid or no health insurance were no less likely to have silent infarcts than people who did no regular exercise. "It may be that the overall life difficulties for people with no insurance or on Medicaid lessens the protective effect of regular exercise," Willey said.

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Sucking up to the boss may keep you healthy

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Ingratiation used by politically savvy individuals neutralizes psychological distress

Savvy career minded individuals have known for some time that ingratiating oneself to the boss and others – perhaps more commonly known as 'sucking up'– can help move them up the corporate ladder more quickly. However, a recent study published in the Journal of Management Studies suggests that politically savvy professionals who use ingratiation as a career aid may also avoid the psychological distress that comes to others who are less cunning about their workplace behavior.

This new research shows that when politically savvy professionals use the coping skill of ingratiation, they may neutralize ostracism and other psychological distress that other less savvy individuals have to cope with in the workplace. Ostracized employees experience more job tension, emotional exhaustion and depressed mood at work.

Workplace ostracism—an adult form of bullying—is often described as an individual's belief that they are ignored or excluded by superiors or colleagues in the workplace. A 2005 survey of 262 full-time employees found that over a five-year period, 66% of respondents felt they were systematically ignored by colleagues, and 29% reported that other people intentionally left the area when they entered. Previous studies have shown that ostracism is an interpersonal stressor that can lead to psychological distress, and distress in the workplace is strongly linked to life distress, employee turnover, and poor physical health.

In the present study, researchers examined the relationship between workplace ostracism and employee psychological distress, with a focus on moderating effects of ingratiation and political skill. The research team surveyed employees from two oil and gas companies in China, with 215 employees providing responses. "Our data confirmed that workplace ostracism was positively related to psychological distress," explains Ho Kwong Kwan one of the study's authors. "We found that ingratiation neutralized the relationship between workplace ostracism and psychological distress when used by employees with a high level of political skill, but exacerbated the association when ingratiation was used by employees with low political savvy."

While the path to success and health may appear to come from sucking up, the authors of the study have a better suggestion. They say that organizations should create a culture that discourages workplace ostracism by provide training to managers and employees, which enhances self-esteem, encourages effective problem solving techniques, and promotes the development of political skills.

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SAFETY, CANCER-TARGETING ABILITY OF NUTRIENT IN BROCCOLI

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Sulforaphane, one of the primary phytochemicals in broccoli and other cruciferous vegetables that helps them prevent cancer, has been shown for the first time to selectively target and kill cancer cells while leaving normal prostate cells healthy and unaffected.

The findings, made by scientists in the Linus Pauling Institute at Oregon State University, are another important step forward for the potential use of sulforaphone in cancer prevention and treatment. Clinical prevention trials are already under way for its use in these areas, particularly prostate and breast cancer.

It appears that sulforaphane, which is found at fairly high levels in broccoli, cauliflower and other cruciferous vegetables, is an inhibitor of histone deacetylase, or HDAC enzymes. HDAC inhibition is one of the more promising fields of cancer treatment and is being targeted from both a pharmaceutical and dietary approach, scientists say.

“It’s important to demonstrate that sulforaphane is safe if we propose to use it in cancer prevention or therapies,” said Emily Ho, a principal investigator in the Linus Pauling Institute, lead author on the study and associate professor in the OSU Department of Nutrition and Exercise Sciences.

“Just because a phytochemical or nutrient is found in food doesn’t always mean its safe, and a lot can also depend on the form or levels consumed,” Ho said. “But this does appear to be a phytochemical that can selectively kill cancer cells, and that’s always what you look for in cancer therapies.”

The findings were published in Molecular Nutrition and Food Research, a professional journal. Research was supported by the National Cancer Institute, National Institute of Environmental Health Sciences and the OSU Agricultural Experiment Station.

The Linus Pauling Institute has conducted some of the leading studies on sulforaphane’s role as an HDAC inhibitor – one, but not all, of the mechanisms by which it may help prevent cancer. HDACs are a family of enzymes that, among other things, affect access to DNA and play a role in whether certain genes are expressed or not, such as tumor suppressor genes.

Some of the mechanisms that help prevent inappropriate cell growth – the hallmark of cancer – are circumvented in cancer cells. HDAC inhibitors can help “turn on” these silenced genes and restore normal cellular function.

Previous OSU studies done with mouse models showed that prostate tumor growth was slowed by a diet containing sulforaphane.

“It is well documented that sulforaphane can target cancer cells through multiple chemopreventive mechanisms,” the researchers wrote in their study. “Here we show for the first time that sulforaphane selectively targets benign hyperplasia cells and cancerous prostate cells while leaving the normal prostate cells unaffected.”

“These findings regarding the relative safety of sulforaphane to normal tissues have significant clinical relevance as the use of sulforaphane moves towards use in human clinical trials,” they said.

The results also suggest that consumption of sulforaphane-rich foods should be non-toxic, safe, simple and affordable.

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