by James Hubbard, M.D., M.P.H.

The older we get, the more we start to worry about dementia. … What was I saying?  Oh, yeah, dementia, a decline in our memory, thinking, figuring things out.  Declining cognition.  Alzheimer’s is a type of dementia.

Actually, it is nothing to laugh about. The increasing elderly population makes certain it will become a big and bigger public health hazard.  Our ignorance of how to prevent or treat it, or even knowing the causes for certain, makes it fair game for people to want to try anything they’ve heard might help.

Ginkgo biloba falls into that category of hope.

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by James Hubbard, M.D., M.P.H.

Former first lady Nancy Reagan fell and fractured her pelvis.  She is 87, recuperating at home and expected to recover in about eight weeks.  She had fallen a few months ago, also.  Unfortunately, falls resulting in fractures are all too common at ages 65 and older.  The risk of another fall after the first one is high.  Fractures are devastating, especially of the hip.  The brittle bones of osteoporosis play a role. (Experts debate whether most falls cause the fracture or vice versa.)

Dr. Mary E. Tinetti has studied falls in the elderly for a long time.  In her latest findings, published in the July 17, 2008, New England Journal of Medicine, she notes that previous studies have revealed that in people over 65, falls caused 10 percent of emergency room visits and 6 percent of hospitalizations. They were also a major cause of nursing home placement.

Do you know if you or an elderly family member is at risk? Several factors increase it.

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by James Hubbard, M.D., M.P.H.

A piece of rare, good news for Alzheimer patients. A recent study showed that the drug, Dimebon, significantly stabilized the decline of the major debilitation problems of Alzheimer’s, including memory, cognition (awareness, processing information), activities of daily living (grooming, hygiene, dressing and feeding oneself) and behavior. In fact, some patients actually improved. Published in the July 19, Lancet, a prestigious British medical journal, the patients were studied for 1 year, with half taking placebo (no active ingredients) and the others taking the active drug.

Then, last month at an Alzheimer’s conference, the investigators reported that they had extended the study for 6 months for those who chose to continue.

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by James Hubbard, M.D., M.P.H

Life expectancy in the U.S. is at a record high according to a new report by the CDC. Death rates reported in 2006 were down in flu, pneumonia, aids, infants, heart disease, strokes, diabetes, hypertension, accidents.

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By James Hubbard, M.D., M.P.H.

Retirement before age 65 increases your risks of heart disease and stroke. Researchers posted a study in the March 1, 2008 issue of the American Journal of Epidemiology after studying 16,827 Greek men and women for 7.7 to 12.5 years. Retirement age ranged from less than 45 to over 65. For every 5 extra years of working the total deaths were ten percent less than the retired at that age.

They took into account variables such as weight, activity, smoking, alcohol and gender. At enrollment they excluded people with chronic diseases such diabetes, stroke, cancer and heart disease. Most of the increased deaths seen in the early retirees were from heart diseases and strokes.

The cause of the increased mortality is unknown. I have often speculated about people who seem to be healthy and work into older ages, then when they finally retire tend to die soon afterwards. I have wondered whether it was just their age, or if they had lost a major reason for living. This study seems to lean toward the latter.

But that does not mean that there are a lot happy, early retirees who live long lives. Perhaps it has something to do with having a purpose to live, for instance, family, friends, hobbies or volunteering.

by James Hubbard, M.D., M.P.H.

The Advisory Commitee on Immunization Practices (ACIP) now recommends the Shingles vaccine for all adults over 60 even if you have had a case of shingles in the past.

Download the below for more information about the vaccine
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-shingles.pdf

Shingles occurs much more commonly in people over 50, and becomes more frequent with increased age. At seventy the risk is about 1 percent per year (10 out of 100 will have shingles in their seventies). It is a painful disease. The rash is localized, lasts for a few weeks, and is painful. In about 1 in 5, the pain lingers several weeks after the rash goes away. Sometimes it lingers longer. If the rash occurs on the face, it can cause eye complications. Rarely there are even more serious, life threatening complications. (more…)

by James Hubbard, M.D., M.P.H.

Some studies have actually shown an increase in the incidence of heart attacks (MI’s) during the Christmas holidays. Others have shown that the risk of death from these MI’s is higher also (possibly due to shorter medial staffing during the holidays). So the obvious reaction should be to try your best to decrease your risk of an MI.

The Vanderbilt physicians offer valuable advice toward this end. However, I think they left out a key factor, which is stress. There are so many things going on with the gift giving, parties, traveling, family reunions, etc. Good stress can affect you as much as bad, and it is additive. So plan ahead a little to limit it. (more…)

by James Hubbard, M.D., M.P.H.

The American College of Sports Medicine and the American Heart Association have published 2007 exercise recommendations for older adults in the August, 28, 2007, issue of Circulation.

Their definition of older adults is:

• people over 65
• people aged 50 to 64 with chronic conditions (such as high blood pressure or other treated or untreated ongoing issues) or functional limitations (something that “impairs the ability to engage in physical activity”). (more…)