Posted by: yoga librarian | September 1, 2019

Falls Prevention Awareness Day (FPAD) 2019

The annual Falls Prevention Awareness Day (FPAD) — September 23, 2019 — raises awareness about how to prevent fall-related injuries among older adults. National, state, and local partners collaborate to educate others about the impact of falls, share fall prevention strategies, and advocate for the expansion of evidence-based community fall prevention programs. National and state efforts are published in NCOA’s annual FPAD Impact Report. If you would like to learn more about fall prevention efforts in your state, please contact your State Falls Prevention Coalition lead.

Visit the National Council on Aging website for more resources to engage in FPAD!

NCOA

Fact Sheet: Osteoporosis, Falls and Broken Bones

Take action to prevent osteoporosis, falls, and broken bones. Download and share this one-page handout on the link between fall-related injuries and osteoporosis. Created by the NCOA Falls Free® Coalition and the National Association of Chronic Disease Directors.

Download the Fact Sheet: Osteoporosis, Falls and Broken Bones.

Posted by: yoga librarian | August 22, 2019

Osteoporosis drugs linked to reduced risk of premature death

A large cohort study has revealed a common osteoporosis drug significantly decreases premature mortality risk, likely related to a reduction in bone loss.

Date: August 12, 2019
Source: Garvan Institute of Medical Research

Two studies led by the Garvan Institute of Medical Research have revealed that nitrogen-bisphosphonates, drugs commonly prescribed for osteoporosis, reduced the risk of premature mortality by 34% in a cohort of over 6,000 individuals. This reduction in early mortality risk was significantly associated with a reduction in bone loss compared with no treatment.

The findings present new advice of the significant benefits of taking approved osteoporosis medicine for those at risk of osteoporosis, and their health care professional.

After the age of 50, 40% of women and 25% of men will sustain an osteoporotic fragility fracture in their life, an injury that puts them at risk of further fractures. However, currently fewer than 30% of women and 20% of men with fragility fractures are taking approved treatments for osteoporosis.

“It’s a common misconception that osteoporosis affects only women, and many people choose to not take recommended treatments,” says Professor Jacqueline Center, who heads the Clinical Studies and Epidemiology laboratory at the Garvan Institute and is an Endocrinologist at St Vincent’s Hospital, who led the studies. “But osteoporotic fractures are not benign. Osteoporosis medication not only decreases the risk of further fractures — but it appears that this same medication also decreases mortality rates over the subsequent 15 years.”

Reduction in mortality risk

Osteoporosis affects around 200 million people worldwide, and is a progressive disease in which bones become more porous and fragile, often without symptoms until the first fracture occurs.

A Garvan-led team of international researchers analysed data from a cohort of 6,120 participants aged over 50, who took part in the observational Canadian Multicentre Osteoporosis Study.

The analysis showed that individuals treated with nitrogen-bisphosphonates (alendronate or risedronate) had a 34% reduction in mortality risk over the subsequent 15 years, compared to non-treated individuals. The study was published in the April issue of the journal Osteoporosis International(1).

In a second follow-up study, published in the Journal of Bone and Mineral Research, the team analysed data from a cohort of 1,735 women, from the same study. The analysis revealed that 39% of the reduction in premature mortality risk was mediated through a reduction in the rate of bone loss.

The researchers also directly compared the nitrogen-bisphosphonates (alendronate or risedronate) with a weaker, non-nitrogen bisphosphonate and found a similar reduction in mortality risk benefit with the nitrogen-bisphosphonates.

The study provides additional evidence that nitrogen-bisphosphonate treatment can provide significant benefits for those with osteoporosis and is the first to examine potential mechanisms.

“For many individuals with osteoporosis, bone health isn’t front-of-mind,” says first author of both studies, Garvan’s Dr Dana Bliuc, Research Officer in the Clinical Studies and Epidemiology laboratory. “We hope our study results will encourage people with osteoporosis or at risk of a fracture to seek treatment — and commit to taking it.”


Story Source:

Materials provided by Garvan Institute of Medical Research.

Garvan Institute of Medical Research. “Osteoporosis drugs linked to reduced risk of premature death.” ScienceDaily. ScienceDaily, 12 August 2019. <www.sciencedaily.com/releases/2019/08/190812155456.htm>.


Journal Reference:

  1. Dana Bliuc, Thach Tran, Tineke Geel, Jonathan D Adachi, Claudie Berger, Joop den Bergh, John A Eisman, Piet Geusens, David Goltzman, David A Hanley, Robert Josse, Stephanie Kaiser, Christopher S Kovacs, Lisa Langsetmo, Jerilynn C Prior, Tuan V Nguyen, Jacqueline R Center. Reduced Bone Loss Is Associated With Reduced Mortality Risk in Subjects Exposed to Nitrogen Bisphosphonates: A Mediation Analysis. Journal of Bone and Mineral Research, 2019; DOI: 10.1002/jbmr.3816

Republished from Kaiser Health News
Byline:

Listen to the story.

Modern medicine often views the mind and body on separate tracks, both in terms of treatment and health insurance reimbursement. But patients with psychological disorders can have a hard time managing their physical health.

So some Medicaid programs, which provide health coverage for people with low incomes, have tried to coordinate patients’ physical and mental health care.

The goal is to save state and federal governments money while improving the health of patients like John Poynter of Clarksville, Tenn.

Poynter has more health problems than he can recall. “Memory is one of them,” he said, with a laugh that punctuates the end of nearly every sentence.

He is recovering from his second hip replacement, related to his dwarfism. Poynter gets around with the help of a walker, which is covered in keychains from places he has been. He also has diabetes and struggles to manage his blood sugar.

But most of his challenges, he said, revolve around one thing: alcoholism.

“I stayed so drunk, I didn’t know what health was,” Poynter said, with his trademark chuckle.

Nevertheless, he often used Tennessee’s health system back when he was drinking heavily. Whether because of a car wreck or a glucose spike, he regularly visited hospital emergency rooms, where every bit of health care is more expensive.

The Case For Coordination Of Mind-Body Care

Tennessee’s Medicaid program, known as TennCare, has more than 100,000 patients in circumstances similar to Poynter’s. They’ve had a psychiatric inpatient or stabilization episode, along with an official mental health diagnosis — depression or bipolar disorder, maybe, or, as in Poynter’s case, alcohol addiction.

Their mental or behavioral health condition might be manageable with medication and/or counseling, but without that treatment, their psychological condition is holding back their physical health — or vice versa.

“They’re high-use patients. They’re not necessarily high-need patients,” said Dr. Roger Kathol, a psychiatrist and internist with Cartesian Solutions outside Minneapolis. He consults with hospitals and health plans working to integrate mental and physical care.

As studies have shown, these dual-track patients end up consuming way more care than they would otherwise need.

“So, essentially, they don’t get better either behaviorally or medically,” Kathol said, “because their untreated behavioral health illness continues to prevent them from following through on the medical recommendations.”

For example, a patient’s high blood pressure will never be controlled if an active addiction keeps them from taking hypertension medication.

Coordinating mental and physical health care presents business challenges because, typically, two different entities pay the bills, even within Medicaid programs. That’s why TennCare started offering incentives to reward teamwork.

Paying For Performance

TennCare’s interdisciplinary program, known as Tennessee Health Link, was launched in December 2016. The first year, the agency paid nearly $7 million in bonuses to mental health providers who guide patients in care related to their physical health.

TennCare has a five-star metric to gauge a care coordinator’s performance, measuring each patient’s inpatient hospital and psychiatric admissions as well as visits to emergency rooms. Providers are eligible for up to 25% of what’s calculated as the savings to the Medicaid program.

Studies show this sort of coordination and teamwork could end up saving TennCare hundreds of dollars per year, per patient. And a 2018 study from consulting firm Milliman found most of the savings are on the medical side — not from trimming mental health treatment.

In experiments around the U.S. among varied patient populations, savings from care coordination at times have been elusive. A TennCare spokesperson said it’s too early to tell whether its program is either improving health or saving money. As a start, though, TennCare reports these dual-track patients are visiting the ER less often.

While there’s a strong financial case for coordination, it could also save lives. Studies show patients who have both a chronic physical condition and a mental illness tend to die young.

“They’re not dying from behavioral health problems,” noted Mandi Ryan, director of health care innovation at Centerstone, a multistate mental health provider. “They’re dying from a lack of preventive care on the medical side. So that’s where we really started to focus on how can we look at this whole person.”

But refocusing, she said, has required changing the way physicians practice medicine, and changing what’s expected of case managers, turning them into wellness coaches.

“We don’t really get taught about hypertension and hyperlipidemia,” said Valerie Klein, a care coordinator who studied psychology in school and is now an integrated care manager at Centerstone’s office in Clarksville, Tenn.

“But when we look at the big picture,” Klein said, “we realize that if we’re helping them improve their physical health, even if it’s just making sure they got to their appointments, then we’re helping them improve their emotional health as well.”

Klein now helps keep Poynter on track with his treatment. Her name appears regularly on a wall calendar where he writes down his appointments.

Poynter calls Klein his “backbone.” She helped schedule his recent hip surgery and knows the list of medications he takes better than he does.

Klein acknowledges it’s a concept that now seems like an obvious improvement over the way behavioral health patients have been handled in the past.

“I don’t know why we didn’t ever realize that looking at the whole person made a difference,” she said.


This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser Health News.

Posted by: yoga librarian | August 3, 2019

Recent research on vitamin K and fractures

An August 2019 article in Osteoporosis International looks at “Effect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials.”

Their conclusion:

“For post-menopausal or osteoporotic patients, there is no evidence that vitamin K affects bone mineral density or vertebral fractures; it may reduce clinical fractures; however, the evidence is insufficient to confirm this. There are too few trials to draw conclusions for other patient groups.”

Read the research summary: Osteoporosis International, , Volume 30, Issue 8, pp 1543–1559

 

 

Posted by: yoga librarian | July 23, 2019

Tai Chi for Fall Prevention

For the NPR Logo file, please download the NPR Logo zip.

Last week an NPR story included information on tai chi as a fall prevention exercise. I was intrigued because I have recently started teaching Tai Chi for Arthritis and Fall Prevention developed the Tai Chi for Health Institute.

Here are the relevant parts of the story and a link to the full story.

What are some of the interventions you’ve used that can help seniors?

You can do so many things. First of all, I tell everybody you’ve got to do some balance training. Tai chi is probably the best exercise to prevent falls, but whatever works for you. And, interestingly, just walking does not reduce your risk for falling. So a lot of doctors will say, “Just get out and walk 20 minutes every day, and that’ll keep you safe. That’ll help you stay healthy.” Walking is great for your heart; it’s great for your brain; it’s great for lots of it. But in order to really reduce your risk for falls, you’ve got to do something specific to balance.

What makes tai chi a good exercise to prevent falls? And why isn’t walking a good alternative?

Walking is kind of just keeping you in one plane moving forward, and it’s not doing any kind of postural training. What tai chi does is it gives you an increased area of postural stability, [which is] kind of your being able to remain upright in space. When you do tai chi, you do stepping moves to the front, to the side; you move your arms out, you reach, you bend. And basically that increases the size of your postural stability so that you can catch yourself and not have the fall. You can be a little bit off kilter and right yourself.

Listen to the full story: https://www.npr.org/sections/health-shots/2019/07/14/741310765/simple-ways-to-prevent-falls-in-older-adults

Posted by: yoga librarian | June 23, 2019

Does Hyperkyphosis Carry Similar Risks as Osteoporosis?

Yoga for Posture Improvement: Hyperkyphosis Carries Similar Risks as Osteoporosis, Research Finds

By: Eva Norlyk Smith, Ph.D., C-IAYT (Read the full article at YogaUOnline.com.)

drawing showing the spine in forward head posture and hyperkyphosis
If you’re over 40, or spend a lot of time hunched over your cell phone or computer, chances are that your posture is starting to look increasingly like the person in the image above.

We all know that poor posture isn’t flattering. However, in reality, posture affects our health and well-being in numerous ways. And one particular posture problem has significant impact on our long-term health and wellbeing, and medical science is just starting to catch on to this fact.

Here is one of the posture problems you rarely hear about, but which is well worth paying attention to:

We are talking about forward head posture and it’s more advanced relative, hyperkyphosis. You may have heard of the new concept of ‘text neck’– which is essentially forward head posture, where our head is forward of the center.  In its more advanced stages, forward head posture may develop into hyperkyphosis.

And, hyperkyphosis, as we shall see, is the precursor of pretty much any age-related condition you don’t want to have.

Read the full article at YogaUOnline.com.

Posted by: yoga librarian | June 17, 2019

Why Your Perception Of ‘Old’ Changes As You Age

Why Your Perception Of ‘Old’ Changes As You Age

Aging

(KHN Illustration/Getty Images)

My perception of old age is inextricably linked to my grandmother. When I was a kid, I thought this 65-year-old, white-haired woman whose entire body wobbled when she walked was very old. Now that I’m 66, my personal perception — or perhaps, misperception — of old age has changed. I suspect I’ve got lots of company.

Many of us are convinced that while everyone else is aging, that person we see in the mirror every morning is magically aging at a somehow slower pace. The age confusion can start early. A 2018 Michigan State University online survey of respondents ages 10 to 89 revealed that most think middle age begins at 30 — and that old age begins at, OMG, 50.

Another study, from the University of Zurich, published in 2011, determined that older adults often try to avoid the negative stereotypes of their age group by distancing themselves from their age group. Yet another study, from Columbia University, in 2018 found considerable evidence that when confronted with negative age stereotypes, older adults tend to distance and dissociate themselves from this negative stereotype.

Call it what you will, but this gray-haired group of boomers and beyond — myself included — is having a hard time accepting the realities of aging. Yes, we are mortal, but we’re not quite believing it. The great irony, say experts on aging, is that this flirtation with a slightly different reality from our aging peers may, in fact, be a healthy thing.

“Baby boomers are redefining what aging is and what old age looks like,” said Jennifer Ailshire, assistant professor at the Leonard Davis School of Gerontology at the University of Southern California. William Chopik, assistant professor of psychology and principal investigator of the Michigan State study, knows this better than most of us.

“People — particularly older people — usually say they feel younger than they are,” said Chopik. “People who report feeling younger actually tend to live longer and healthier lives — and they don’t tend to have as much of a pattern of decline.”

In most cases, people say they feel about 20% younger than they really are, according to the Michigan State study of more than 500,000 people. This keeps ramping up as folks age, he said. Beginning at age 50, he said, many say they feel about 10 years younger.

The fact we’re generally living longer than we used to also plays a role, experts say. “As our life spans get longer, so does our view of old age,” said Chopik. “How we view ourselves changes constantly as we age.”

For me, it’s been more like a sentence to self-motivate. At age 66, when I look in the mirror, I may not see a 46-year-old staring back at me — but, perhaps, someone closer to 56. Maybe it’s because I’m so lousy at sitting still. I’m out walking my dog at 6:15 a.m., lifting weights in the gym by 7:30 a.m. and swimming laps in the pool before 9 a.m. five days a week. Welcome to my nonstop world that seems to somehow keep old age partially in check.

While it might not sound like your world, consider Theresa Paulus — the mother-in-law of USC’s Ailshire — who seems to be constantly in motion, too.

The 63-year-old Tempe, Ariz., resident’s morning bicycle workout, alone, makes my daily workout schedule look lame. She’s typically up by 5 a.m. and quickly out on her Trek bike for the next hour — or more — on a 10-mile-long excursion. If the weather is lousy, she’ll instead find her way to the spinning class at the local gym before heading to the weight room.

“I honestly feel like I’m in my 40s,” said the full-time nursing home caregiver, who three years ago, at age 60, got her degree in health service management from Arizona State University. “I haven’t slowed down one bit from the exercise routine I did at 40.”

In fact, she may have upped it a bit. Not the distance, mind you, but every day she tries to challenge herself a bit. “Each time I ask myself, can I get there and back just a little bit faster?” she said. She may be passing it along to the next generation, too, as she has taught her two granddaughters how to ride bikes.

Paulus’ ability to rebound from injuries is legendary among friends and family. On a recent walking tour of Ireland’s Cliffs of Moher, she twisted her ankle but continued days of walking — only to discover when she got home that she’d broken her foot. Back in 1969, while training on her bike, she was hit by a car — but escaped without so much as one broken bone. And after a moped accident in 2010, she crushed her leg and was advised by her doctor that she’d always walk with a limp — and a cane. She proved the doctor wrong and was soon racing bikes again.

Her daughter-in-law, USC’s Ailshire, isn’t surprised by any of this. After all, she said, some baby boomers’ bodies can perform as if they are between two and 15 years younger than their actual age.

Paola Sebastiani, 55, is living proof. She barely qualifies as a baby boomer, but when asked how old she feels, the professor of biostatistics at Boston University said she doesn’t even feel 40.

Perhaps that’s because she walks 2 miles (in Birkenstock sandals, no less) to and from work every weekday. Or maybe it’s because she’s adamant about eating no red meat and tries to eat avocado daily. Or perhaps it’s her who-gives-a-flip attitude. “My mom would have never worn jeans at my age — but I wear them all the time,” she said. Her point: Folks with a positive attitude toward aging often age more slowly.

Which brings us back to my dear grandmother. The most familiar smell from her kitchen was that of the fried chicken crackling on the front burner every Friday evening. I can’t remember even once seeing her exercise. Action, in her world, was a game of cards. And, as was all too common in her day, she thought her smoking habit helped her to relax.

Is it any wonder she was old at 65?

So, at 66, I’ve given up on most fried foods. I’ve never smoked. I don’t sit around much playing cards or watching TV. And all the time I spent walking our dog, lifting weights and swimming laps this morning I view as an invisible shield that protects me from looking into the mirror and seeing an old man staring back.

Instead, I still see me.


https://khn.org/news/why-your-perception-of-old-changes-as-you-age/

Posted by: yoga librarian | May 22, 2019

Tai Chi : sweeping the senior community in Maine

Maine has one of the oldest populations in the country.

Find out more about why tai chi is so popular among seniors in Maine.

TaiChi SMAA

Posted by: yoga librarian | April 4, 2019

Recommended Reading: Medical Yoga Therapy

I just bought Terry Roth Schaff’s new book, Medical Yoga Therapy A Practical Guide for the Yoga & Medical Community (2018) and I’ve already found modifications I can use in next week’s classes.

Based on extensive clinical experience with patients, Terry trains yoga and medical professionals to use yoga to treat such widespread ailments as osteoporosis, arthritis, herniated discs and stenosis.

Medical Yoga Therapy

I was already a big fan of Terry’s previous book, Yoga for a Healthy Spine (2012), which has been the foundation for several classes I’ve taught over the last six years.

Terry’s work has been featured in the medical journal, Topics On Geriatric Rehabilitation and in Yoga Therapy Today. Her recent book is receiving high praise from leading doctors at teaching hospitals.

Posted by: yoga librarian | April 3, 2019

Anyone Can Learn Tai Chi

Tai Chi for Health with Dr Paul Lam

Dr Paul Lam, Director of the Tai Chi for Health Institute and family physician, shares his tai chi journey in “Anyone Can Learn Tai Chi”.

In this 20-minute documentary, you’ll learn:

  • Why Dr Lam had arthritis as early as 13 years old, and why he considers it as one of the biggest blessings of his life.
  • How he started learning tai chi.
  • Why it became his lifelong mission, spending more than 40 years to date, to find the secret of tai chi.
  • How his team brings health benefits and enjoyment in weeks rather than years. Dr Lam explains the secrets of tai chi and how they correlate with medical science.
  • Who can learn tai chi, the incredible benefits of tai chi, and about the Tai Chi for Health Institute.

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