Sunday, October 4, 2009

Seniors Need Pneumonia, Seasonal Flu Shots; CDC Finds Pneumonia Bacteria in H1N1 Fatalities

CDC Advisory Committee recommends single dose of PPSV23 (23–valent pneumococcal polysaccharide vaccine) for all senior citizensOct. 1, 2009 - Senior citizens may have relaxed about the H1N1 flu shot, convinced it seems more likely to attack younger people, but they do have vaccinations they should worry about. They should not only be getting their vaccination for the seasonal flu but need to get their pneumonia vaccination, too, according to an alert from the Centers for Disease Control and Prevention. Many people who have died from H1H1 this year were also infected with pneumonia bacteria, warns the CDC.
These co-infections with a common bacteria (Streptococcus pneumoniae, or pneumococcus) likely contributed to their death, according to a report published in the CDC Morbidity and Mortality Weekly Report. Pneumonia is an inflammation of one or both lungs, usually caused by infection from a bacterium or virus.CDC is reminding people of the importance of being vaccinated against this common bacterium and advising them to talk with their doctor.CDC’s Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PPSV23 (the 23–valent pneumococcal polysaccharide vaccine) for all people 65 years and older and for persons 2 to 64 years of age with certain high-risk conditions. People in these groups are at increased risk of pneumococcal disease as well as serious complications from influenza. A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS or malignancy. All people who have existing indications for PPSV23 should continue to be vaccinated according to current ACIP recommendations during the outbreak of novel influenza A(H1N1). Emphasis should be placed on vaccinating people aged less than 65 years who have established high-risk conditions because PPSV23 coverage among this group is low and because people in this group appear to be overrepresented among severe cases of novel influenza A (H1N1) infection, based on currently available data. >> Recommended adult immunization schedule - United States, 2009 >> PPSV23 guidance for H1N1 “Our influenza season is off to a fast start and unfortunately there will be more cases of bacterial infections in people suffering from influenza,” said CDC Epidemiologist Dr. Matthew Moore. “It′s really important for people, especially those at high risk for the serious complications from influenza, to check with their provider when they get their influenza vaccine about being vaccinated against pneumococcus.” The CDC report included an analysis of specimens taken from 77 fatal cases of 2009 H1N1. Bacterial co-infections, including some caused by Streptococcus pneumonia, were noted in about a third of those cases. The CDC does not have senior citizens on a high priority for the H!N! vaccination, due to an apparent immunity found in seniors. For more detail see story linked in sidebar above on left.

Thursday, October 1, 2009

Make A Difference Day

USA WEEKEND Magazine's Make A Difference Day is a celebration of neighbors helping neighbors. Now in its 19th year, USA WEEKEND, HandsOn Network and Newman's Own, in concert with AARP and other groups, expect to rally millions of volunteers on Saturday, October 24, 2009. If you don't currently volunteer, Make A Difference Day offers a great way to start.

Everyone - young and old, individuals and groups - can carry out a volunteer project. Ideas for volunteering can be found at AARP’s Create The Good or the Make A Difference Day Idea Generator.

And this year, AARP Create The Good will provide two $5,000 charitable awards for volunteer projects that help older people stay in their homes. Ten Make A Difference Day efforts will also receive Newman's Own charitable awards of $10,000 for a range of volunteer efforts. The awards go to individuals or organizations, but the money itself will go to a charity suggested by the award winner - another way to help spread good work.

You can enter to win an award by submitting your entry describing your project on www.makeadifferenceday.com by November 16th, 2009.

Help an older person, organize your block to clean a local park, donate toys to a shelter, or help in another way. Be sure to read USA WEEKEND over the next few weeks for the latest information on Make A Difference Day and AARP's award.

Thursday, September 24, 2009

Chair Exercises for Seniors

The Importance of Exercise

Senior exercise is an important part of the health and wellness of seniors. It helps increase your metabolism, energy levels and alertness. Research shows that those suffering from chronic illnesses benefit from exercise, even if it is while sitting in a chair.

What are Chair Exercises for Seniors

Chair exercises can increase your strength, balance and vitality all while sitting down. They create movement, stretching, and help increase your heart rate. Each exercise involves a series of slow movements.

This form of exercising, also known as chair aerobics, is perfect for a senior who has trouble standing on his own or has difficulty balancing. Doctors recommend you exercise at least 30 minutes a day.

Benefits of Chair Exercises

There are numerous benefits of practicing chair exercises for seniors, including:

  • Improved vitality and range of motion
  • Pain relief
  • Cognitive improvement
  • Increased circulation
  • Increased muscle strength
  • Lead to healthy aging

Another benefit to exercise classes is the social interaction, which helps participants remain independent longer.

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What to Wear

There is no need to dress up or buy special clothing when getting ready to pull up a chair. Loose fitting clothing and comfortable shoes are all you need. If you plan to also exercise standing up, make sure your shoes have a good arch support, and a cushioned elevated heel to absorb shock.

Types of Chair Excercises for Seniors

Your chair exercise classes will provide a variety of stretching and toning. Begin slow. If you feel tired, stop and take a break. You will build stamina and strength the more you do it.

Stretching

Many of your excercises will involve stretching your arms, fingers, legs and torso. They are as simple as lifting your arms about your head, pushing your legs out, and raising your arms and leaning backwards. Stretching is an important step to take before beginning any exercise.

Exercise Examples

You need to exercise your arms and legs to tone your muscles and keep them strong. Some easy chair excercises for seniors include:

  • Boxing or punching (without fully extending or snapping the elbow)
  • Arm circles
  • Foot bounces (put your feet flat on the floor and lift your heal in time to the music, do one foot at a time, both or alternate)
  • Leg kicks (extend your leg and kick out)
  • Leg crosses (scoot down on your chair so you can fully extend your legs, Cross them, and uncross them in the air)

You want to work your lower body as much as possible. Many chair excercises for seniors involve popular warm-ups sitting down.

  • Seated Jumping Jacks involves sitting up tall and placing your feet spread apart on the ground with all your weight. Then lift them up, cross them in the air, and place them on the floor crossed. Lift again, uncross and put down. Repeat this exercise 20 times.
  • Work your full body by pushing out your legs and arms at the same time and straigtening them.

Another variation of chair excercises involves standing up and using the chair for balance or as a tool. Leg squats or knee bands are a great example of standing up and using the chair for balance.

Chair Yoga

Chair excercises as a form of fitness is growing in popularity and branching out. Chair Yoga replaces a yoga mat with a chair. The workout involves modified yoga excercises and sometimes uses two chairs for stretching. The chair is used both as a tool and as a safety measure.

Friday, September 18, 2009

Reduce Your Diabetes Risk

By Sheryl Kraft, November & December 2008

Millions of Americans have dangerously high blood sugar—and most don’t know it. Here are steps you can take to stay healthy

For years Steve Segerman’s doctor had warned him to lose weight. But the New Jersey insurance sales representative had other priorities. Faced with mounting career pressures, Segerman, a self-confessed emotional eater, turned to fattening comfort foods such as chips and cookies.

Then, at 53, Segerman was diagnosed with elevated blood sugar, the mark of a little-known but surprisingly common condition called prediabetes. Still, he let the weight stay on. “I didn’t see any obvious health issues related to my weight gain, even though they were right in front of me,” he says.

But six months later, blurry vision and fatigue sent Segerman back to the doctor’s office, where another blood test revealed his condition had progressed to full-blown type 2 diabetes. That’s not unusual: people with prediabetes are as much as 15 times more likely to develop type 2 diabetes than are people who have normal glucose levels. And that means they’re 15 times more likely to suffer the heart and kidney disease, eye problems, and other complications that diabetes can cause.

If Segerman had taken steps earlier to lose weight and exercise, he might have avoided getting diabetes. But it still wasn’t too late to turn things around. He changed his diet, shedding more than 20 pounds, and began exercising regularly. At least three days each week, he walked, either on a treadmill or on local roads. His symptoms abated, his blood sugar levels moved closer to normal, and his diabetes was brought under control. Says Segerman, “It’s amazing that doing so little can do so much.”

About 57 million Americans have prediabetes—and most don’t know they have it. While everybody’s blood sugar goes up after eating, those with prediabetes have blood sugar levels that go up considerably higher than normal and often remain so long after eating. That’s a concern, because the physical damage of elevated blood sugar begins well before the condition reaches the level at which diabetes is diagnosed. This is why doctors are focusing more and more on discovering high blood sugar early—and on controlling blood sugar to keep it in the normal range. “The earlier you treat it, the lower the rate of complications,” says Om P. Ganda, M.D., associate professor of medicine at Harvard Medical School and senior physician at Boston’s Joslin Diabetes Center.

Educate Yourself

If you are new to a diagnosis of prediabetes or diabetes, these books can help you understand your condition and stay as healthy as possible.

Beating Diabetes by David M. Nathan, M.D., and Linda Delehanty (McGraw-Hill, 2006). The authors helped design the Diabetes Prevention Program study, which proved that diet and exercise can stave off diabetes in people who have impaired glucose tolerance. This guide offers what you need to do to prevent or manage the disease.

Diabetes for Dummies, third edition, by Alan L. Rubin, M.D. (For Dummies, 2008). Like all the “Dummies” books, this one is written for the person who knows next to nothing. It clearly lays out the basics for dealing with diabetes, including information on preventing it if you have prediabetes.

Living With Diabetes by Rosemarie Perrin and Seth Braunstein, M.D., editor (AARP Books/Sterling, 2007). An AARP Guide to enjoying your life while taking the best possible care of yourself, it has solid information about management, monitoring, and medications.
—Holly Zimmerman

So are you at risk for prediabetes? If you’re an average American over 45, you probably are, especially if you answer yes to any of the following questions:

Are you overweight? The more fatty tissue you have, the more resistant your cells become to insulin, a hormone that helps your body metabolize sugar and get it out of your bloodstream. And body shape is a significant factor: you’re at higher risk if you’re apple-shaped—storing fat around the middle—rather than pear-shaped.

Are you inactive? It’s not just that people who are sedentary are likely to be overweight. Exercise actually helps your body use insulin and process glucose. In fact, a lack of exercise impedes this process.

Are you genetically predisposed? If you have a parent or a sibling who has type 2 diabetes, this increases your risk for developing prediabetes. In addition, the condition is more common among certain ethnic groups: African Americans, Latinos, American Indians, and Asian Americans.

Are you numerically predisposed? Your risk of prediabetes rises if you have high blood pressure, low “good” HDL (high-density lipoprotein) cholesterol (35 milligrams per deciliter or less), or high triglycerides—fats—in the blood (250 mg/dL or more).

If you’re at risk, it’s important to be screened before you experience symptoms of prediabetes. If you’ve already developed symptoms—such as excessive thirst, frequent urination, and slow healing of sores—it’s even more important to be tested. “If we just wait for people to come in with symptoms, the body’s machinery is so messed up that it’s hard to do a good job with treating the illness,” explains John Buse, M.D., Ph.D., president, medicine and science, of the American Diabetes Association and professor at the University of North Carolina School of Medicine.

The standard screening test—a fasting plasma glucose test—measures blood sugar first thing in the morning, before breakfast. A more sensitive test, the oral glucose tolerance test, measures blood sugar both after fasting and two hours after consuming a glucose-rich drink. The manufacturer of a third—and simpler—test for diabetes and prediabetes is expected to seek FDA approval within the next six months: the VeraLight Scout system would use ultraviolet light to detect markers of diabetes and prediabetes in a patient’s skin, with no need for fasting or having blood drawn.

If you’ve had a screening test and your blood sugar was normal, guidelines suggest that you should have it checked again in three years. If your blood sugar was elevated, your doctor will probably recommend lifestyle changes. A typical recommendation would be to reduce your weight by 5 to 7 percent and to add physical activity: 150 minutes of moderate aerobic activity, such as walking, biking, or swimming, plus two or three weight-training workouts per week. What’s more, your physician might prescribe an oral diabetes drug to help your body process glucose more efficiently.

Want proof that being proactive will pay off? The Diabetes Prevention Program, a large study carried out by the National Institutes of Health, showed that lifestyle changes and medication can dramatically reduce the progression of prediabetes to type 2 diabetes. And, interestingly, lifestyle changes worked even better at preventing the disease than medication did; people 60 and older who made lifestyle changes reduced their risk by 71 percent.

So if you are at risk of prediabetes or if you already have it, heed the lessons of Steve Segerman’s case. No matter how busy you are, it’s worth making the time to take care of your health. This is one instance where—with discipline and with luck—you really can turn back the clock.

Sheryl Kraft is a health and fitness writer based in Wilton, Connecticut.

Tuesday, September 15, 2009

My Personal Medication Record

By: AARP Outreach & Service | Source: AARP.org

Get a Copy

How to get your copy of "Prescription Drug Label Made Easy":
Download a PDF
• Call 1-888-OUR- AARP (1-888-687-2277) to request a copy. Request stock number D18547.

The best way to track your medications and help your doctor and pharmacist have the most updated information is to create a Personal Medication Record. This form, available in both English and Spanish, allows you to list all the medicines you take, including over-the-counter drugs and herbal supplements, the doses, and how you take them.

While your doctor may have a list of his own, you may be seeing more than one doctor. So, it is very important for you to reduce medication risks and bring your updated personal record to all of your appointments and even provide a copy to the pharmacies you use.

Follow these tips:

Make copies of your personal medication record

• Give one to your doctor, one to your pharmacist, and one to a loved one.

• Carry one with you and keep a copy at home.

Keep your personal medication record updated

• Make a note if you are taking new medications or stopping medications.

• Record any drug allergies, side effects, or sensitivities you have

How to get a personal medication record:

• Download a MS Word document to complete electronically.

• Download and print a PDF in English to complete by hand.

• Download and print a PDF in Spanish to complete by hand.

• Order a printed copy.

• Call 1-888-OUR-AARP (1-888-687-2277) to request a copy:

• Personal Medication Record (English): Request stock number D18358

• Personal Medication Record (Spanish): Request stock number D18396

How to fill out record

Prescription drug labels are confusing to read. Our guide, "Prescription Drug Label Made Easy," explains the information and can help you fill out a personal medication record. In addition, AARP's article, Over-the-Counter Drug Fact Labels, explains how to read over-the-counter drug labels. When completing the Personal Medication Record, it's important to list any over-the-counter medication you are currently taking on this form.

Thursday, September 10, 2009

Health Discovery: New Drops May One Day Reverse Glaucoma

By: Susan Q. Stranahan | Source: AARP Bulletin Today | September 8, 2009

STUDY FINDINGS
• A new type of eye drop appears to halt some sight loss in patients with glaucoma.
• Because the treatment is still experimental, it will take at least six years before it might be available.


Italian researchers have developed an eye drop that may one day be able to restore the vision of people who have lost part of their vision to glaucoma.

In people with glaucoma, the second leading cause of blindness worldwide, increased pressure in the eye damages the optic nerve. About 4 million Americans have glaucoma—but half don’t know it because there are often no symptoms until vision begins to dim. By the time glaucoma is diagnosed, optic nerve pressure can be controlled, but the damage to eyesight can’t be reversed.

In the study, researchers in Rome gave laboratory rats with glaucoma eye drops containing a molecule with proteins that signal cells to survive, differentiate or grow. When the rats’ eyesight improved, the researchers gave the drops to three patients with advanced glaucoma, each of whom had significant vision loss. Two patients showed improved vision, and the third had his vision stabilized, according to a study published in August in the Proceedings of the National Academy of Sciences.

The new drops hold out the possibility of restoring vision, says Alessandro Lambiase, M.D., assistant professor of ophthalmology at the University of Rome Campus Bio-Medico, and lead author of the study. The significance of the study, he says, is that it is the first to demonstrate visual improvement in patients with advanced optic nerve damage.

Large clinical trials will be required to confirm these early findings, and even if studies continue to show the drops help glaucoma patients, it could still be at least six years before they are available commercially.

David Wright, chief executive officer of the International Glaucoma Association, cautions that the findings are just “the first step.” But if the early results are confirmed, he says, the use of this molecule in eye drops “will become the treatment of choice almost certainly, and it would revolutionize the treatment of glaucoma.”

Monday, September 7, 2009

Guide to Quick-Cook 20 Vegetables



By EatingWell, EatingWell.com

If you want more fiber, nutrients and antioxidants in your diet—eat more vegetables! We know it’s tough to expand your vegetable vocabulary when you don’t know how to cook unfamiliar varieties, so we’ve compiled this cooking guide for 20 of our favorite vegetables: artichokes, asparagus, beets, broccoli, brussels sprouts, carrots, cauliflower, corn, eggplant, fennel, green beans, leeks, peas, spinach, acorn squash, squash delicata, summer squash, sweet potatoes, turnips.

Find grocery shopping tips, quick and easy preparation techniques and cooking methods to bring out the flavor of each vegetable.

Start with 1 pound untrimmed raw vegetables.

1. Artichokes, baby

Look for: Tight, small heads without browning or bruising.

Prep: Snip off tough outer leaves; cut off top quarter and trim off woody stem.

Braise: Heat 2 teaspoons extra-virgin olive oil in a large skillet; add baby artichokes and cook for 1 minute, stirring constantly. Add 1 cup each white wine (or dry vermouth) and water and 1 teaspoon dried thyme (or rosemary or tarragon). Bring to a simmer; cover, reduce heat and cook until tender, about 15 minutes.

Grill: Halve artichokes, scoop out the choke if necessary, then toss with 1 tablespoon extra-virgin olive oil and 1⁄2 teaspoon kosher salt. Preheat grill. Place the artichokes over direct, medium-high heat and cook, turning once or twice, until tender, about 8 minutes.

Microwave: Place artichokes in a large glass pie pan or baking dish, add 1⁄2 cup white wine (or dry vermouth), 1⁄2 teaspoon salt and 1 teaspoon dried thyme. Cover tightly and microwave on High until tender, about 8 minutes.

Steam: Place artichokes in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and steam until tender, about 15 minutes.

2. Asparagus

Look for: Sturdy spears with tight heads; the cut ends should not look desiccated or woody. Fresh asparagus should snap when bent.

Prep: Trim off stem ends; shave down any woody bits with a vegetable peeler.

Braise: Place a large skillet over high heat. Add asparagus, 1⁄2 cup water and a slice of lemon. Cover, bring to a simmer, and cook until tender, about 5 minutes.

Grill: Preheat grill; lightly oil rack. Place asparagus over direct, medium heat; cook until browned, turning occasionally, about 6 minutes.

Microwave: Place asparagus on a glass platter or pie pan; add 1⁄4 cup water, drizzle with 1 teaspoon extra-virgin olive oil, and cover tightly. Microwave on High until tender, about 3 minutes.

Roast: Preheat oven to 500°F. Spread asparagus on a baking sheet or in a pan large enough to hold it in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until wilted and browned, about 10 minutes.

3. Beets

Look for: Small beets with firm, dark ruby or bright orange skins.

Prep: Peel.

Microwave: Cut beets into 1⁄4-inch-thick rings; place in a large glass baking dish or pie pan. Add 1⁄4 cup water, cover tightly and microwave on High for 10 minutes. Let stand, covered, for 5 minutes before serving.

Roast: Preheat oven to 500°F. Cut beets into 1 1⁄2-inch chunks. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until tender, about 30 minutes.

Sauté: Heat 1 tablespoon extra-virgin olive oil in a large skillet over medium heat. Grate beets into the pan using the large-hole side of a box grater. Add

1 minced garlic clove. Cook, stirring constantly, for 1 minute. Add 1⁄3 cup water and bring to a simmer. Cover, reduce heat to low and cook until tender, about 8 minutes.

Steam: Cut beets into quarters. Place in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and steam until tender, about 15 minutes.

4. Broccoli

Look for: Sturdy, dark-green spears with tight buds, no yellowing and a high floret-to-stem ratio.

Prep: Cut off florets; cut stalks in half lengthwise and then into 1-inch-thick half-moons.

Microwave: Place stems and florets in a large glass baking dish. Cover tightly and microwave on High until tender, about 4 minutes.

Roast: Preheat oven to 500°F. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 1 tablespoon extra-virgin olive oil. Roast, turning once halfway through cooking, until tender and browned in places, about 10 minutes.

Steam: Place stems in a steamer basket over 2 inches of water (with 1 tablespoon lemon juice added to it) in a large pot set over high heat. Cover and steam for 2 minutes. Add florets; cover and continue steaming until tender, about 5 minutes more.

5. Brussels Sprouts

Look for: Tight, firm, small deep-green heads without yellowed leaves or insect holes. The sprouts should preferably still be on the stalk.

Prep: Peel off outer leaves; trim stem.

Braise: Place sprouts and 1 cup dry white wine in a large skillet over medium-high heat. Cover and braise until tender, about 7 minutes. Remove sprouts with a slotted spoon; increase heat to high, add 1 teaspoon butter and reduce liquid to a glaze. Pour over sprouts.

Microwave: Place sprouts in a large glass baking dish. Add 1⁄4 cup broth (or water), cover tightly and microwave on High until tender, about 6 minutes.

Roast: Preheat oven to 500°F. Cut sprouts in half. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 1 tablespoon extra-virgin olive oil. Roast, turning once halfway through cooking, until browned and tender, about 20 minutes.

Steam: Place sprouts in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and steam until tender, 6 to 8 minutes.

6. Carrots

Look for: Orange, firm spears without any gray, white or desiccated residue on the skin. The greens should preferably still be attached.

Prep: Peel; cut off greens.

Microwave: Cut carrots into 1⁄8-inch-thick rounds. Place in a large glass baking dish or pie pan. Add 1⁄4 cup broth (or white wine). Cover tightly and microwave on High until tender, about 3 minutes.

Roast: Preheat oven to 500°F. Cut carrots in half lengthwise then slice into 1 1⁄2-inch-long pieces. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until beginning to brown, about 15 minutes.

Sauté: Cut carrots into 1⁄8-inch-thick rounds. Melt 1 tablespoon butter in a large skillet over medium-low heat. Add carrots; stir and cook until tender, about 4 minutes. Add 1 teaspoon sugar; stir until glazed.

Steam: Cut carrots into 1⁄8-inch thick rounds. Place in a steamer basket over 1 inch of water in a large pot set over high heat. Cover and steam for 4 minutes.

7. Cauliflower

Look for: Tight white or purple heads without brown or yellow spots; the green leaves at the stem should still be attached firmly to the head, not limp or withered.

Prep: Cut into 1-inch-wide florets; discard core and thick stems.

Braise: Place florets in a large skillet with 1⁄2 cup dry white wine and 1⁄2 teaspoon caraway seeds. Bring to a simmer, reduce heat, cover and cook until tender, about 4 minutes.

Microwave: Place florets in a large glass baking dish. Add 1⁄4 cup dry white wine (or dry vermouth). Cover tightly and microwave on High until tender, about 4 minutes.

Roast: Preheat oven to 500°F. Spread florets on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 1 tablespoon extra-virgin olive oil. Roast, turning once halfway through cooking, until tender and beginning to brown, about 15 minutes.

Steam: Place florets in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and steam for 5 minutes.

8. Corn

Look for: Pale to dark green husks with moist silks; each ear should feel heavy to the hand, the cob filling the husk well.

Grill: Pull back the husks without removing them; pull out the silks. Replace the husks; soak the ears in water for 20 minutes. Preheat grill. Place corn (in husks) over high heat and grill, turning occasionally, until lightly browned, about 5 minutes. Remove husks before serving.

Microwave: Husk corn and cut ears in thirds; place in a large glass baking dish or microwave-safe container. Cover tightly and microwave on High until tender, about 4 minutes.

Sauté: Remove kernels from cobs. Melt 2 teaspoons butter in a large skillet over medium heat. Add corn kernels; cook, stirring constantly, until tender, about 3 minutes. Stir in 1⁄2 teaspoon white-wine vinegar before serving.

Steam: Husk corn, then break or cut ears in half to fit in a steamer basket. Set over 2 inches of water in a large pot over high heat. Cover and steam until tender, about 4 minutes.

9. Eggplant

Look for: Smooth, glossy skins without wrinkles or spongy spots; each eggplant should feel heavy for its size.

Prep: Slice into 1⁄2-inch-thick rounds (peeling is optional).

Braise: Cut eggplant slices into cubes. Mix with an 8-ounce jar of salsa. Pour into a pan and place over medium heat. Cover and cook, stirring often, until thick, about 15 minutes.

Grill: Preheat grill. Brush eggplant slices lightly with extra-virgin olive oil. Place over medium-high heat and grill, turning once, until browned, about 8 minutes.

Roast: Preheat oven to 500°F. Brush both sides of eggplant slices with 2 teaspoons extra-virgin olive oil and arrange on a baking sheet or pan large enough to hold them in a single layer. Roast, turning once halfway through cooking, until tender, about 15 minutes.

Sauté: Cut eggplant slices into cubes; mix with 2 teaspoons salt. Let stand for 5 minutes, then blot dry with paper towels. Heat 2 teaspoons extra-virgin olive oil in a large skillet over medium heat. Add the eggplant; cook until tender, stirring often, about 4 minutes.

10. Fennel

Look for: Small, white, unbruised bulbs with brilliant green stalks and feathery fronds.

Prep: Cut off the stalks and fronds where they meet the bulb, remove any damaged outer layers, cut 1⁄4 inch off the bottom and remove the core.

Braise: Slice bulb into 1-inch pieces. Heat 1 tablespoon extra-virgin olive oil in a large skillet over medium heat. Add fennel and 2 teaspoons dried rosemary, crushed. Cook 1 minute, stirring constantly. Add 1⁄2 cup dry white wine (or dry vermouth). Cover, reduce heat and cook until tender, about 15 minutes.

Roast: Preheat oven to 500°F. Slice bulb into 1⁄4-inch pieces. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until tender and beginning to brown, 18 to 20 minutes.

Steam: Slice bulb into 1-inch pieces. Place in a steamer basket over 2 inches of water (with 1 teaspoon mustard seeds and bay leaves added to it) in a large pot set over high heat. Cover and steam until tender, about 15 minutes.

11. Green Beans

Look for: Small, thin, firm beans.

Prep: Snip off stem ends.

Microwave: Place beans in a large glass baking dish. Add 1⁄4 cup broth (or water). Cover and microwave on High for 4 minutes.

Roast: Preheat oven to 500°F. Spread beans on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 1 tablespoon extra-virgin olive oil. Roast, turning once halfway through cooking, until tender and beginning to brown, about 10 minutes.

Sauté: Heat 2 teaspoons walnut oil in a large skillet. Add beans; cook, stirring constantly, for 2 minutes.

Steam: Place beans in a steamer basket over 1 inch of water in a large pot set over high heat. Cover and steam for 5 minutes.

12. Leeks

Look for: Long, thin stalks that do not bend and are not bruised; the outer layers should not be wrinkly or dried out.

Prep: Trim off the thick green leaves, leaving only the pale green and white parts; pull off damaged outer layers, leaving the root end intact. Split in half lengthwise. Under cold running water, fan out inner layers to rinse out grit and sand.

Braise: Place leeks in a large skillet with 1⁄2 cup vegetable (or chicken broth), 1 sprig fresh rosemary (or 6 juniper berries and 6 black peppercorns). Bring to a simmer over high heat. Cover, reduce heat and cook until tender, about 12 minutes. Serve warm or cold with a vinaigrette dressing.

Grill: Preheat grill. Brush leeks with 1 tablespoon extra-virgin olive oil. Place over direct, medium heat and grill, turning occasionally, until lightly browned, about 8 minutes.

Roast: Preheat oven to 500°F. Trim off root ends of leeks, slice in half crosswise and then into 1⁄4-inch-thick slices lengthwise. Spread on a baking sheet or pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, stirring once halfway through cooking, until browned and tender, 10 to 15 minutes.

Sauté: Thinly slice leeks into half-moons. Heat 1 tablespoon butter in a large skillet over medium heat. Add leeks; cook, stirring often, until softened and very aromatic, about 5 minutes.

13. Peas

Look for: If fresh, look for firm, vibrant green pods without blotches and with the stem end still attached.

Prep: If fresh, zip open the hull, using the stem end as a tab. If frozen, do not defrost before using.

Microwave: Place peas in a glass baking dish or microwave-safe bowl; add 2 tablespoons broth (or unsweetened apple juice). Cover tightly and microwave on High for 2 minutes.

Sauté: Heat 2 teaspoons butter in a large skillet over medium heat. Add peas; cook, stirring often, until bright green, about 3 minutes.

Steam: Place peas in a steamer basket over 1 inch of water in a large pot set over high heat. Cover and steam for 2 minutes.

14. Potatoes, red-skinned or yellow-fleshed

Look for: Small potatoes with firm skins that are not loose, papery or bruised.

Prep: Scrub off any dirt (peeling is optional; the skin is fiber-rich and the nutrients are clustered about 1⁄2 inch below the skin).

Braise: Cut potatoes into 1⁄2-inch pieces. Place in a large skillet with 1⁄2 cup each vegetable broth and nonfat milk and 1 teaspoon butter. Bring to a simmer, cover, reduce heat and cook until tender and most of the liquid has been absorbed, about 20 minutes.

Roast: Preheat oven to 500°F. Halve potatoes then cut into 1⁄2-inch wedges. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, stirring once halfway through cooking, until crispy and browned on the outside and tender on the inside, 20 to 25 minutes.

Sauté: Peel potatoes (if desired), then shred using the large-hole side of a box grater. Heat 1 tablespoon canola oil in a large skillet over medium heat. Add potatoes; reduce heat. Cook, pressing down with the back of a wooden spoon, for 6 minutes. Flip the cake over and continue cooking until browned, about 5 minutes more.

Steam: Place potatoes in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and steam until tender when pierced with a fork, about 10 minutes.

15. Spinach & Swiss Chard

Look for: Supple, deeply colored leaves without mushy spots.

Prep: Rinse thoroughly to remove sand; remove thick stems and shred leaves into 2-inch chunks. Rinse leaves again but do not dry.

Braise: Heat 2 teaspoons walnut oil (or canola oil) in a large skillet over medium heat. Add spinach or chard and toss until wilted. Add 1⁄2 cup dry white wine or dry vermouth. Cover, reduce heat and cook until wilted, about 5 minutes. Uncover and cook until liquid is reduced to a glaze. Sprinkle 2 teaspoons balsamic vinegar (or rice vinegar) over the greens.

16. Squash, Acorn

Look for: Green, orange or white varietals with firm, smooth skins and no spongy spots.

Prep: Cut in quarters and scoop out the seeds.

Braise: Place squash in a pot with 2 cups unsweetened apple juice. Set over medium-high heat and bring to a simmer. Cover, reduce heat and cook until tender when pierced with a fork, about 20 minutes.

Microwave: Place squash in a large glass baking dish; add 1⁄2 cup water. Cover and microwave on High for 15 minutes; let stand, covered, for 10 minutes.

17. Squash, Delicata

Look for: Small, firm squash with bright yellow or orange skins that have green veins branching like lightning through them.

Microwave: Place squash in a large glass baking dish or microwave-safe bowl with 1⁄4 cup broth (or water). Cover tightly and microwave on High for 10 minutes.

Prep: Cut squash in half lengthwise, scoop out the seeds and slice into thin half-moons (peeling is optional).

Sauté: Melt 2 teaspoons butter in a large skillet over medium heat. Add squash slices; cook, stirring frequently, until tender, about 10 minutes. Stir in a pinch of grated nutmeg before serving.

Steam: Place squash slices in a steamer basket over 1 inch of water in a large pot set over high heat. Cover and cook until tender, about 6 minutes.

18. Squash, Summer & Zucchini

Look for: No breaks, gashes or soft spots; smaller squash (under 8 inches) are sweeter and have fewer seeds; do not peel, but scrub off any dirt.

Prep: Cut off stem ends.

Grill: Cut squash lengthwise into 1⁄4-inch strips. Preheat grill; brush strips lightly with 1 tablespoon extra-virgin olive oil. Place over direct, medium heat; grill, turning once, until marked and lightly browned, 3 to 4 minutes.

Roast: Preheat oven to 500°F. Cut squash lengthwise into 1⁄4-inch-thick slices. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until tender, about 10 minutes.

Sauté: Cut squash into 1⁄4-inch-thick rings. Heat 1 tablespoon extra-virgin olive oil in a large skillet over medium heat. Add 1 minced garlic clove and squash; cook, stirring frequently, until tender, about 7 minutes.

Steam: Cut squash into 1⁄2-inch-thick rings. Place in a steamer basket with a small onion, thinly sliced. Place over 1 inch of water in a large pot set over high heat. Cook until tender, about 5 minutes.

19. Sweet Potatoes

Look for: Taut if papery skins with tapered ends.

Prep: Scrub.

Braise: Peel sweet potatoes and cut into 1-inch pieces. Place in a large skillet with 1 cup vegetable broth, 1 teaspoon honey and 1⁄2 teaspoon dried thyme. Bring to a simmer over high heat; reduce heat, cover and cook until almost tender, about 15 minutes. Uncover, increase heat and cook until the liquid is reduced to a glaze, about 2 minutes.

Microwaving: Place 2 to 3 medium sweet potatoes in a large glass baking dish; pierce with a knife. Microwave on High until soft, 8 to 12 minutes. Let stand for 5 minutes.

Roast: Preheat oven to 500°F. Halve sweet potatoes, then slice into 1⁄2-inch wedges. Spread on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until browned and tender, 20 to 25 minutes.

Steam: Peel sweet potatoes and cut into 1-inch pieces. Place in a steamer basket over 2 inches of water in a pot set over high heat. Cover and steam until tender, about 20 minutes.

20. Turnips

Look for: Smaller turnips with firm, white skins; they should feel heavy to the hand. The greens should preferably still be attached.

Prep: Cut off the root end and the greens; peel, then cut into thin slices.

Grill: Steam turnip slices (see below) for 5 minutes; meanwhile, preheat grill. Place slices over direct, medium-high heat and grill, turning once, until lightly browned and tender, about 8 minutes.

Roast: Preheat oven to 500°F. Spread turnip slices on a baking sheet or in a pan large enough to hold them in a single layer. Coat with 2 teaspoons extra-virgin olive oil. Roast, turning once halfway through cooking, until tender, about 15 minutes.

Sauté: Cut turnip slices into matchsticks. Heat 1 teaspoon each butter and extra-virgin olive oil in a large skillet over medium heat; add slices and cook, stirring frequently, until tender, about 12 minutes.

Steam: Place turnip slices in a steamer basket over 2 inches of water in a large pot set over high heat. Cover and cook until tender when pierced with a fork, about 12 minutes.


Thursday, September 3, 2009

Hope Plays Role in Stroke Risk

By Todd Neale, Staff Writer, MedPage Today
Published: August 31, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

A feeling of hopelessness about the future appears to be associated with subclinical carotid atherosclerosis in apparently healthy, middle-age women, a cross-sectional study showed.

Those with greater degrees of hopelessness had higher mean (P=0.0139) and maximum (P=0.0297) carotid intimal-medial thickening compared with women who were more optimistic about their prospects in life, according to Susan Everson-Rose, PhD, MPH, of the University of Minnesota in Minneapolis, and colleagues.

This thickening is an early marker of atherosclerosis and stroke risk, they wrote online in Stroke: Journal of the American Heart Association.

Previous studies have linked depression and depressive symptoms -- including hopelessness -- to cardiovascular disease morbidity and mortality in men, but none has made the connection in women, the researchers said.

"This is the first study to suggest that hopelessness may be related to subclinical cardiovascular disease in women without clinical symptoms of heart disease and who are generally healthy," Everson-Rose said.

Her team looked at data from the Chicago and Pittsburgh sites of the Study of Women's Health Across the Nation (SWAN) Heart Study.

All 559 women included in the study were free from clinical cardiovascular disease.

Hopelessness was measured using a two-item questionnaire assessing expectations about the future and the ability to reach one's personal goals.

Intimal-medial thickening was measured using ultrasound.

Each 1-point increase in the hopelessness score was associated with a 0.0061-mm greater mean (P=0.0217) and 0.0074-mm greater maximum (P=0.0409) intimal-medial thickness.

The association remained significant after adjusting for demographic variables, depression, and cardiovascular risk factors.

Women who felt the most hopeless had an average intimal-medial thickness that was 0.066 mm greater than the rest (P=0.0008), which could be clinically significant, the researchers said.

"Such small incremental differences in intimal-medial thickness are associated with increased cardiovascular risk as well as incident cardiovascular disease and stroke," they said.

Although the mechanism underlying the association remains unclear, animal studies have shown that hopelessness -- demonstrated by exposure to learned helplessness and uncontrollable stressors -- causes autonomic, inflammatory, and neuroendocrine changes that can result in atherogenesis.

However, they said, the mechanism likely operates along multiple pathways, which need to be explored in future studies.

The authors acknowledged that the study was limited by its cross-sectional nature and said it is unclear whether hopelessness is associated with the progression of atherosclerosis.

In addition, they said, it is unknown whether the findings would apply to women who had poorer cardiovascular profiles or who were more socioeconomically disadvantaged.

Primary source: Stroke: Journal of the American Heart Association
Source reference:

Monday, August 31, 2009

The Elderly: Finding a Good Geriatric Care Manager

Such professionals can be a tremendous help if you're trying to take care of ailing parents but live far away

By Lauren Young

Click here to find out more!

On a Tuesday night in late July, Jon Meyers, 42, got the call every child with an elderly parent dreads. His 84-year-old mother, Ruth, who suffers from dementia, had fallen in her kitchen and was heading to a New Jersey hospital by ambulance. But instead of agonizing over not being able to get there quickly—it's four hours from his home in Washington, D.C., to Point Pleasant, N.J.—Meyers took comfort in the fact that Stephen Mielach, a geriatric care manager, was following the ambulance, ready to take control.

Before 2007, Meyers had never heard of geriatric care managers (also called geriatric case managers). But then his mother developed problems that required hospitalization, and Meyers couldn't keep taking days off from his job as an art director at the Cato Institute, a Washington think tank. On the recommendation of his mother's physician, Meyers, an only child, hired Mielach. He accompanies Meyer's mother on doctor visits, looks after her dog on occasion, and even helped with the paperwork for a reverse mortgage so that she could stay in her home.

The role of a geriatric care manager goes well beyond that of a home health aide. The primary job of home health aides is to administer medication and provide companionship. By contrast, care managers oversee many things busy or far-flung family members might not be able to stay on top of: vetting nursing homes and assisted living facilities, overseeing home health aides, providing guidance about applying for federal, state, and other benefits. They may also tend to more day-to-day tasks, like making sure that rugs in a parent's home don't slip and that refrigerators are stocked.

An estimated 7 million people care for adult relatives from a distance, according to the National Alliance for Caregiving. On top of the logistical benefits of hiring a care manager, preliminary research indicates that elderly patients who have a geriatric care manager get more thorough care than patients who do not. Evercare by UnitedHealthcare (UNH), which hooks up patients with care managers, conducted the research in conjunction with Santa Monica (Calif.) think tank Rand Corp.

GOOD CHEMISTRY

What kind of expertise do geriatric case managers bring to the table? They often have some background in nursing or social work. Linda Fodrini-Johnson, president-elect of the National Association of Professional Geriatric Care Managers, estimates that 35% of the group's 2,000 members have nursing degrees and 50% have social work or counseling backgrounds. The other 15% have experience in fields such as physical therapy or occupational therapy, or have advanced degrees in gerontology and related fields.

When choosing a care manager, find one with experience dealing with issues similar to those of your relative. If a parent has a complicated medical history, consider hiring someone with a nursing background to coordinate care among doctors, who often don't talk with each other, says Julie Davis, managing editor of Parentgiving.com, a caregiving Web site. And make sure there is good chemistry with your family.

The network of caregivers in most communities is fairly small, and many people say the best referrals come from their parent's doctor, local hospital, or nursing home. Jan Rosenbaum, 53, a molecular pharmacologist working in the life sciences group at CincyTech in Cincinnati, which invests in technology startups, got a recommendation from a psychologist working at her dad's independent living facility in Orange County, Calif. "We were concerned—and rightly so—that the facility would not be paying careful attention to the details of his case and that as his memory worsened, he might not be properly understanding or communicating everything the doctors were saying," she says.

Rosenbaum's advice is to include the elderly parent in the selection process—after all, he or she is the one who will have the most direct contact with the professional caregiver. " The relationship will only work once a high level of trust is established between the two of them," says Rosenbaum.

It's also a good idea to ask potential care managers if they receive financial incentives from nursing homes or other providers for directing clients there. "Make sure you are dealing with a care manager who is most concerned with recommending the appropriate care for your parent vs. someone who might have a special financial relationship with a facility," says Paul Hogan, co-author of Stages of Senior Care (McGraw-Hill), to be published this November.

Caregivers kick off the process with an assessment. This includes a review of the medical history, and, if your parent is living at home, an evaluation of the setup, looking at stairs, lighting, and other issues. Care managers may even take a peek at the checkbook to find out if bills are being paid on time (some people give care managers power of attorney and the right to make medical decisions, but that's unusual).

Hiring one of these professionals isn't cheap. Initial assessments, which last a few hours, range from $200 to $850, depending where you live. Hourly rates can range from $80 to $200. While most payments are out-of-pocket, check your parent's long-term care insurance policy to see if it covers the expense, and check your employer's elder-care benefits.

In the end, finding someone to help you take care of an elderly relative can benefit your health as well as theirs. Suzanne and Peter Cooper of Upper Saddle River, N.J., are raising their five-year-old son while living with her 84-year-old mother, Irma, who has Alzheimer's disease. Suzanne, 49, says her own mental and physical state has improved dramatically since she hired Nancy Bortinger, the director of geriatric services at Vantage Health System in Dumont, N.J.

Bortinger plowed through a list of 20 local day-care facilities to get Suzanne's mother out of the house for stimulation and socialization. Now Bortinger is helping Suzanne place Irma in a respite care center for a week while the family takes a much needed vacation. Suzanne equates the role of a geriatric care manager with a global positioning system for your car. "Even if you have maps in the glove compartment, the GPS gets you right to the place you need to get to," she says.

To see a geriatric care manager discuss her role in assisting families with caregiving, go to www.businessweek.com/go/09/care

Thursday, August 27, 2009

The ‘quicker and sicker’ exit strategy

By Deborah G. Schuss July 30, 2009

WHEN MY cellphone rang, I expected the emergency-room doctor with an update on my father’s condition. Diagnosed with pneumonia and an apparent infection, my dad was in a holding area while waiting for a hospital bed to clear.

“I need your plan for discharge,’’ announced a hospital official whose name I had to extract.

So went my introduction to the case manager, a hospital fixture and healthcare’s equivalent of the meter maid. Pat’s no-nonsense demeanor as she proceeded with her revenue-focused mission of orchestrating my father’s departure even before his formal admission is emblematic of what’s often missing these days for patients’ families: a genuine sense of caring to accompany the care.

It wasn’t so long ago that a hospital social worker would meet with family caregivers a day or two before our loved one was discharged; patient advocacy was the dominant theme, as this person sorted out post-hospital challenges and weaved a plan to cushion patients while propping up their caregivers.

Now, hospitalizations beyond a day or two are rare, and there is an army of Pats lined up at the command post to bounce patients from their hospital beds quicker and sicker: One day they are on oxygen and IV drips, the next day the ambulance driver is depositing them at their doorstep. The lucky ones have relatives or friends to step in as caregivers and tend to their health needs.

In a recent study, the New York-based Commonwealth Fund reported that about one-third of US patients hospitalized with heart failure in 2006 didn’t even receive written discharge instructions. And that is only one component of discharge planning.

Dena Salzberg, a Massachusetts patient advocate and care coordinator, has “gone head to head’’ with hospital case managers after receiving frantic calls from families who hire her to intervene. “They’re saying, ‘I’m so scared. They’re kicking my mother out of the hospital,’ ’’ says Salzberg, a nurse who runs Care Management Consultants. “People are leaving hospitals with a lot more complex needs.’’

So who are these uber-efficient hospital case managers? They are nurses, social workers, or even an embedded care manager of your insurance company, all operating against a backdrop of managed-care and Medicare mandates on length of stay. Their goal is simple: swift exit.

The results? Sometimes the discharge plan is unworkable. The case manager assigned to my father the day he was expected to go home apparently never bothered to find out he was incapable of walking up the steps to his house.

Other times, families or their hired guns - like patient-advocate Salzberg - are doing battle with case managers over post-hospital placement driven by moving patients out rather than forward.

And still other times, a patient is boomeranged back to the same hospital within days of an express-lane discharge. Eighteen percent of chronically ill people hospitalized in the United States were readmitted or went to an emergency room as a result of complications after a discharge, according to the Commonwealth Fund.

And as families race to their bedsides, or work the office phones to craft a care plan, the ripple effects are felt elsewhere in the economy: American businesses lose up to $33.6 billion a year because of employees’ caregiving responsibilities for someone age 18 or older, according to a 2006 study conducted by the MetLife Mature Market Institute and the National Alliance for Caregiving.

Of course, there are some outstanding, compassionate case managers. Let’s make sure they are not part of a dying breed. As the ailing US healthcare system once again lies on the national examination table, some elixirs go back to basics: more resources directed toward exceptionally coordinated continuity of care - as much a patient lifeline as the heart surgery she received in the operating room.

A high-quality and efficient care-delivery system also recognizes the public value of family caregivers in this process. With insurance cutbacks that narrowed reimbursable services, we are required to dispense post-hospital medical care previously unthinkable for anyone except a healthcare professional; by flushing feeding tubes and dressing amputees’ wounds, we help our loved ones remain at home and away from more costly alternatives. It’s all the more reason for gold-standard care coordination.

Discharge planning should not require paying an advocate to wage war, further dividing the rich from the poor in healthcare. And families should be part of a collaborative effort, not treated as though we are double-parked in a tow zone.

Sunday, August 23, 2009

The Coffee Brew-haha Most studies find drinking coffee brings health benefits, but old myths persist

By: Sid Kirchheimer | Source: AARP Bulletin Today | May 22, 2009


So far this year, the findings are enough to perk up coffee drinkers beyond what they get with their morning jolt.

In just the last five months, studies have found that coffee may protect against dementia, stroke and skin cancer.

This follows previous research—among some 20,000 studies to date exploring the health impact of America’s most popular beverage—that suggests regular coffee consumption may reduce the risk of Parkinson’s, type 2 diabetes, several types of cancer, suicide and some mood disorders, gallstones, liver cirrhosis and even cavities.

Coffee has long been known as an effective emergency treatment for an asthma attack and a go-to headache remedy, and, more recently, as an aid to help alcoholics quit drinking. It may even extend a person’s lifespan, researchers say. It’s the second most studied substance after cigarettes, and the studies keep percolating along.

In January, Finnish researchers reported in the Journal of Alzheimer’s Disease that after tracking 1,400 adults for 20 years and controlling for their other lifestyle and dietary habits, those drinking three to five cups per day were two-thirds less likely to develop dementia than non-imbibers.

In February came two studies—one by Harvard University School of Public Health and Spanish researchers tracking 83,000 middle-aged women since 1980, and the other by University of California, Los Angeles and University of Southern California scientists analyzing data on 9,400 adults older than 40—that showed a lower risk of stroke among coffee drinkers, with rates decreasing with the more cups consumed each day. Then there was also research in the Journal of Investigative Dermatology suggesting that consuming caffeine may protect against skin cancer by disrupting a protein that causes sun-damaged skin cells to self-destruct.

March was quiet on the java front, but with April came two more findings: Researchers at Roswell Park Cancer Institute in Buffalo, N.Y., reported that among 1,100 women studied for 16 years, those who regularly drank coffee or tea had a lower risk of endometrial cancer compared with nondrinkers. The more coffee the women consumed, the lower the disease rates. And in the International Journal of Sport Nutrition and Exercise Metabolism, scientists from the University of Iceland and the University of Illinois-Urbana found that drinking coffee seems to help relieve the pain of exercise.

Coffee shakes bad reputation

There seems to be a new coffee study published in medical journals every few weeks, for several reasons. It’s readily available, inexpensive and popular. Some 400 billion cups are consumed every year worldwide. It’s not fattening, with zero calories when served black or with artificial sweeteners. And, researchers say, it may just be one of the healthiest substances you can get.

But it wasn’t always regarded that way. Even today, some folks (typically, those not doing the research) still avoid this virtuous vice—believing coffee causes ailments ranging from bone loss and heart problems to stomach and pancreatic cancer and “the shakes.”

“When I was in medical school, we were taught that coffee was bad,” says Peter R. Martin, M.D., director of Vanderbilt University’s Institute for Coffee Studies. “But that was because early studies in the 1960s and 1970s were not well done, not taking into effect other lifestyle factors, such as that people who drank coffee also tended to smoke. And they developed health problems.” (Researchers have now realized that in those early studies, coffee-drinking smokers tended to under-report how much they smoked.)

Today, however, epidemiological studies are done more carefully, tracking various factors affecting health and illness in large groups for many years or decades. Most, say leading researchers, reach the same conclusion: For those not prone to its effect on sleep problems (decaf solves that) or indigestion, and not worried that it can slightly raise “bad” cholesterol, coffee is healthy and may even help prevent many age-related conditions.

“Coffee is most famous for being the best source of caffeine—there’s three times as much in a cup of coffee compared to an equal amount of cola—and despite its bad reputation, caffeine has some health benefits. But coffee is a very complex substance with as many as 2,000 different chemical components, including many powerful antioxidants and phytochemicals,” notes James Coughlin, a food and chemical toxicologist who has studied coffee’s health effects for more than three decades and has personally conducted or analyzed data from some 10,000 studies.

What’s more, roasting coffee beans causes a chemical reaction that makes some of these disease-fighting antioxidants even more powerful, adds Coughlin, past president of the Association for Science and Information on Coffee, a Paris-based organization of scientists who conduct coffee-related research and are funded in part by the coffee industry. This may explain why, measure for measure, coffee has been documented as the richest source of antioxidants in the American diet.

Beyond caffeine, benefits of the bean

On its own, caffeine reacts with certain brain receptors—one explanation why studies have shown it protects against Alzheimer’s and Parkinson’s, boosts mood and lowers suicide risk, and reduces pain. But an additional brain-boosting benefit comes from coffee’s abundance of chlorogenic acids, a family of antioxidants that also protect the brain and other body systems, adds Martin. “Chlorogenic acids improve the capacity of the body to metabolize sugar and glucose, which is perhaps the reason why it may be protective against type 2 diabetes and liver disease.”

In one notable study that analyzed data on 126,000 people over a period of 18 years, Harvard researchers found that, all else being equal, those drinking one to three cups of caffeinated coffee each day were slightly less likely than nondrinkers to develop type 2 diabetes. But among those drinking six or more cups daily, men’s risk was slashed by 54 percent and women’s by 30 percent compared with nondrinkers. Since then, other studies have found that regularly drinking decaf also lowers the risk of diabetes.

“Whether you drink regular or decaf coffee, you’re getting chlorogenic acids,” notes Frank Hu, M.D., professor of nutrition and epidemiology at Harvard’s School of Public Health, who led that January 2004 diabetes study published in Annals of Internal Medicine and participated in the recent February report indicating a lower risk of stroke among coffee drinkers. “These substances have a powerful, positive effect on cardiovascular health and in preventing gallstones, which, similarly to diabetes, is related to insulin resistance.”

Antioxidants in coffee may also play a role in reducing the risk of certain cancers. “There really seems to be a strong, consistent protective effect against liver and endometrial cancer, with the benefit coming with at least two cups per day,” says Lenore Arab, a researcher at UCLA’s David Geffen School of Medicine who analyzed more than 500 previous coffee studies for a study soon to be published in Nutrition & Cancer. “There is increasing evidence that coffee is protective against colorectal cancer.” Her research indicates that coffee has little impact—positive or negative—on cancers of the breast, pancreas, kidney, ovaries, prostate or stomach. And in one of the first studies of its kind, a recent study from Japan finds lower rates of oral cancers among coffee drinkers.

However, more than six cups a day is linked with a higher risk of bladder cancer in men, but not women, adds Arab. And higher rates of leukemia occur in people whose mothers drank more than two cups a day during pregnancy.

What about bone loss leading to osteoporosis, a common concern from drinking coffee? “There is very little risk in drinking up to four cups per day,” Coughlin says.

Even many patients with heart arrhythmias—long told to avoid coffee—can drink it with their doctor’s approval. In fact, mounting evidence suggests that coffee may be heart-healthy. A study last year that tracked nearly 128,000 adults for 18 year or longer indicated that, all else considered, coffee drinkers have a longer lifespan than nondrinkers. Why might that java habit help people live longer? Coffee is rich in magnesium—important for heart health—and its bounty of antioxidants helps reduce inflammation and protect the inner lining of blood vessels, says lead researcher Esther Lopez-Garcia of the Universidad Autónoma de Madrid in Spain.

The bottom line: “For most people in their 50s, 60s or older,” says Harvard’s Hu, “there is no reason to worry about coffee. Just don’t add too much sugar or cream.”



Thursday, August 20, 2009

Stillwater Senior Center presents 'Baubles, Bangles & Bobbers'

The Stillwater Senior Center will host its sixth annual fundraiser, Baubles, Bangles & Bobbers, from 9 a.m. to 4 p.m. Thursday, Aug. 20.

People will have the chance to rummage through and purchase jewelry and homemade desserts from the bake sale at 2300 W. Orleans St. in Stillwater.

"It's the best sale of the year for just about everyone, but it's particularly suited to the accessories-challenged and frugal," event organizers said in a release. "Baubles, Bangles & Bobbers features funky used jewelry and purses in almost endless variety, plus a bake sale to tempt the wise shopper who knows it's almost impossible to 'outgrow' a classy pair of earrings."

Also, new this year is a "men's room" offering fishing gear and memorabilia for men, who will finally have a feature of their own at this event.

As the Senior Center's biggest annual fundraiser, this sale raised $5,000 last year to support various programs, activities and speakers for area senior citizens, according to Senior Program Director Karla Bataglia. She added that a successful sale is more important than ever this year when donations to non-profits are down due to the poor economy.

Approximately 75 volunteers have been involved in preparations for the sale, and many will be on hand to assist shoppers as clerks and cashiers at the event.

Donated jewelry is sorted, evaluated and priced by volunteers, who include former local jeweler Jeff Sherburne and antiques dealer Sandra Bjorndahl. Local jewelry maker Lonnie Lovness donates the use of small, yellow boxes for shoppers.

Shoppers will find bracelets, necklaces, chains, earrings (screw, clip-on and pierced), pins, matching sets, rings, watches, children's, holiday, religious and vintage jewelry, all at bargain basement prices. Tables are replenished throughout the day of the sale "so shoppers can come anytime and be assured of finding a great buy," organizers said.

Community Thread (formerly Community Volunteer Service and Senior Centers) is a nonprofit human service agency that has been in existence since 1967.

Monday, August 17, 2009

A Way Found to Judge Driving Safety of Alzheimer's Patients

By Kristina Fiore, Staff Writer, MedPage Today
Published: February 11, 2009
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

IOWA CITY, Iowa, Feb. 11 -- The difficult judgment call on whether Alzheimer's patients are safe to drive can be helped by a battery of cognitive tests, researchers here said.
Action Points

* Explain to interested patients that tests of memory, visual, and motor abilities may predict which patients with Alzheimer's disease may make more safety errors while driving.

Patients who performed better on these tests made fewer errors during a supervised test drive, Jeffrey D. Dawson, M.D., of the University of Iowa, and colleagues reported in the Feb. 10 issue of Neurology.

"By measuring driver performance through off-road tests of memory, visual, and motor abilities, we may be able to develop a standardized assessment of a person's fitness to drive," Dr. Dawson said.

To determine whether performance on tests of cognition, visual perception, and motor function could predict the level of safety in licensed drivers with early Alzheimer's, the researchers conducted a controlled trial of 40 patients with mild disease and 115 patients without dementia.

All participants were tested on a battery of cognitive, visual, and motor tasks, from which the researchers calculated a composite measure of cognitive impairment (COGSTAT).

An experimental drive was conducted aboard ARGOS (Automobile for Research in Ergonomics and Safety), which has hidden instrumentation and sensors. Participants drove a supervised 35-mile test drive on roads within and surrounding Iowa City.

A certified safe driving instructor reviewed video tapes of each drive to assess the number and type of safety errors made by the drivers.

The researchers found that drivers with Alzheimer's disease committed an average of 42 safety errors per drive, compared with an average of 33.2 for controls.

Lane observance errors were significantly more common in the Alzheimer's group, but no other general category of errors was significantly more common in Alzheimer's patients.

"This suggests that patients with mild Alzheimer's have the ability to handle certain aspects of driving," the researchers said.

Some of the more serious errors in this class included straddling the center line and failing to proceed through the intersection even though the light had turned green.

Drivers with higher overall cognitive function as measured by COGSTAT tended to make fewer total safety errors, the researchers said.

Other tests that were significant predictors of safety errors among drivers with the disease included working memory, visual search and visual motor speed, visuo-constructional abilities, and motor function.

"Given that driving puts demands on diverse cognitive functions, it is unlikely that a test of any single cognitive ability will be an accurate predictor of driving safety," the researchers said.

The study may have been limited by a lack of investigation of other environmental factors, such as having family members in the vehicle and time of day, as well as a possible lack of generalizability because only seven of the 40 patients in the experimental group were women.

Still, the researchers concluded that for predicting safety errors within the Alzheimer's disease group, "off-road neuropsychological tests of cognition, vision, and motor abilities gave additional information above and beyond diagnosis alone. Hence, performance on these tests can be helpful when predicting whether a patient with Alzheimer's disease can safely drive a vehicle."

Thursday, August 13, 2009

Alzheimer's Linked to Cholesterol Level in Middle Age

By Crystal Phend, Senior Staff Writer, MedPage Today
Published: August 04, 2009

Action Points

* Explain to interested patients that cholesterol levels are an important marker of cardiovascular health and may likewise be linked to dementia risk.


* Note that the retrospective observational study suggested a temporal relationship but could not determine causality.

Even modestly elevated cholesterol in midlife portends greater Alzheimer's disease risk in old age, researchers found.

Above average cholesterol of 220 mg/dl or higher at age 40 to 45 raised the risk 31% to 58% for Alzheimer's diagnosis in the next three decades, compared with low cholesterol, Alina Solomon, MD, of the University of Kuopio, Finland, and colleagues reported in the August issue of Dementia & Geriatric Cognitive Disorders.

These results suggested a lower threshold for risk than some prior studies, the researchers noted.

Cholesterol over 250 mg/dl in middle age elevated Alzheimer's disease risk in the CAIDE study and Finnish cohort of the Seven Countries Study, although it has not been linked over a broader time course in other studies, including the Framingham study.

Rather than waiting to address dementia symptoms as they arise with age, the results support a shift toward earlier attention, the researchers wrote. That means "addressing risk factors as early as midlife, before the underlying disease(s) or the symptoms appear."

Effective management requires a cross-disciplinary approach to lifestyle changes, added co-author Rachel Whitmer, PhD, of Kaiser Permanente in Oakland, Calif.

The researchers analyzed the longitudinal electronic medical record databases of Kaiser Permanente of Northern California.

The cohort included members of the health maintenance organization who had completed detailed health evaluations as part of a "multiphasic" well-care initiative in the organization from 1964 through 1973, when they were ages 40 to 45.

Overall, 9,844 individuals remained members through at least 1994, after which dementia ascertainment started.

In the cohort, cholesterol levels of at least 240 mg/dl during their 40s -- considered high by Adult Treatment Panel (ATP) III guidelines -- were associated with 57% elevated Alzheimer's disease risk three decades later (HR 1.57, 95% CI 1.23 to 2.01).

Cholesterol levels considered borderline (200 to 239 mg/dl) showed a more modest trend for increased Alzheimer's risk compared with cholesterol under 200 mg/dl (HR 1.23, 95% CI 0.97 to 1.55).

Interestingly, the opposite was true for the second most common type of dementia.

Borderline-elevated cholesterol at age 40 to 45 significantly predicted elevated vascular dementia risk (HR 1.50, 95% CI 1.01 to 2.23), whereas frank hypercholesterolemia did not (HR 1.26, 95% CI 0.82 to 1.96).

Further refining the analysis by quartiles of cholesterol at midlife revealed a significant link for both above-average groups compared with the lowest quartile (cholesterol levels under 198 mg/dl).

Those in the top quartile (249-mg/dl-and-over) quartile were at 58% higher Alzheimer's risk (95% CI 1.22 to 2.06), while those in the quartile with 221-248 mg/dl cholesterol were at 31% elevated risk (95% CI 1.01 to 1.71).

The researchers noted that the vascular dementia findings were based on relatively few events and that the study did not include data on subtypes of cholesterol or use of lipid-lowering therapy.

However, because the initial cholesterol measurements were collected at a time in life when Alzheimer's disease and other forms of dementia would be unlikely, the results suggested a temporal association.

The mechanism for it may have been vascular since serum cholesterol is related to both cardiovascular and cerebrovascular conditions, which have been in turn been linked to Alzheimer's disease.

But the researchers noted that their findings were significant even after adjustment for major vascular factors and conditions.

Other possible pathways might be cholesterol turnover in the brain, which has been associated with neurodegenerative diseases, they said.

Cholesterol plays a key function in the brain and, while it does not cross the blood-brain barrier, stores of it in the serum and brain do interact.

The authors noted that "about 60 to 70% of the total serum cholesterol is typically represented by LDL cholesterol, the major atherogenic lipoprotein. However, the role of LDL as a risk factor for AD or VaD could not be investigated in this study because data on LDL levels in 1964 to 1973 was not available."

Monday, August 10, 2009

Thank Boomers for Buffing Up Brain Market

By Sonia Arrison

TechNewsWorld
11/02/07 8:30 AM PT

As members of the baby boomer generation attempt to retain good health into old age, they have spurred the development of technology designed to keep the mind sharp. While some so-called brain fitness regimens are more helpful than others, the development of the industry will lead to benefits for all age groups.


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This month America's first baby boomer, Kathleen Casey-Kirschling, signed up for the Social Security benefits she will start to collect in January. The new phase of life that she and her generation are entering is creating demand for new industries that affect everyone, one of which involves "brain fitness."

Brain fitness is exactly what it sounds like -- a workout program for your mind beyond simple activities like crossword puzzles or sudoku. The brain buffing scene doesn't seem to feature a character like fitness legend Jack LaLanne just yet, but many companies, particularly in the tech sector, vie for the title. MindFit, Happy Neuron and Lumosity all offer programs designed to "pump up" brain power.

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More Than Fun and Games

Yet with so many anti-aging products flooding the market these days, some might question whether brain fitness is a true concept or just another snake-oil marketing Download Free eBook - The Edge of Success: 9 Building Blocks to Double Your Sales plan. While some programs on the market are more entertainment than science, like Nintendo's "Brain Age," scientific studies show that when properly targeted, computer programs can have a dramatic impact on brain health.

Short-term studies show that after four to six weeks of using structured brain workout programs like MindFit or Posit Science's Brain Fitness Program 2.0, users see marked improvement in areas like auditory processing or short-term memory, according to Alvaro Fernandez, CEO and cofounder of San Francisco-based SharpBrains. This could be helpful in the long term because results published in the Journal of the American Medical Association show that benefits from well-designed cognitive training programs can last for five years even after the training is finished.

Implications for Younger Set

All of this complements longitudinal studies conducted in individuals over 50 showing that mental stimulation and lifelong learning can reduce the risk of developing the nasty symptoms of Alzheimer's by 35 to 40 percent, even after controlling for physical exercise and nutrition. That's good news for the older generation, but are there any applications for those in the Gen X or Y category?

The answer is yes, and the range of applications confirms what 18th century philosopher Adam Smith said: When individuals follow their self-interest, benefits accrue to the entire community. That is true of boomers battling the effects of aging, but to keep employees of all ages sharp, some corporations are already using brain fitness programs. This area is expected to grow rapidly. SharpBrains's Fernandez, who spends his time analyzing the market, says that the 2007 market for brain fitness was US$225 million; $25 million of that being corporate. However, there are other fascinating applications as well.

The education market is worth about $50 million, and many schools across the country are helping children overcome reading problems using programs like those offered by Scientific Learning or Lexia. There are even basketball teams like the Memphis Tigers who use a computer-based cognitive training program, Intelligym, to get a leg up on the court. It will come as no surprise that the U.S. military is using brain fitness programs too.

The Future

One day, it may be routine practice to get a baseline assessment on brain fitness from one's doctor, a change that would bring the brain, an important part of the body, more fully into wellness planning. Indeed, in the future it will probably be shocking that today most doctors fail to conduct routine brain exams, especially since the technology for a rudimentary exam already exists.

It could be possible to use neuron-imaging technologies in order to tell a person what areas of their brain are most active, but such a test is expensive and not normally offered to the average consumer. Fernandez says that he could imagine brain imaging technology used in conjunction with cognitive training on a more widespread basis within 10 to 20 years. Hopefully, the technology will move quicker than that, and if it does, we can thank the boomers for what some see as their anti-aging crusade.

The next time someone complains about the baby boomers' obsession with youth, a good response would be to evoke Adam Smith. Remind them that self-interest in a free market creates enormous benefits for society, including new ways to keep our brains healthy.

Wednesday, August 5, 2009

Brain exercises used for vitality, memory 'Neurobics' aid in disease treatment, aging seniors' lives

By Stephanie Innes
ARIZONA DAILY STAR
Tucson, Arizona | Published: 08.02.2009

When 65-year-old Paul Person was diagnosed with Parkinson's disease this year, the first thing he did was contact a personal trainer — not for his body, but for his brain.
Though somewhat limited by a heart condition, Person has always been physically active, walking about two miles each day. He is also a regular golfer. But now his daily routine includes about an hour of "brain aerobics" — vocal cord exercises, exaggerated movements, word games and other mind-stimulating activity he can fit into his regular life, like moving money from one pocket to the other while he walks.
"Another one is reading some sentences at the same time that I bounce a tennis ball," Person said. "That's one I find difficult."
Person's personal brain fitness trainer is Tucson physical therapist and neuroscientist Becky Farley, who is part of a growing movement of health experts emphasizing mental fitness, or "neurobics," — a phrase popularized by late neurobiologist Lawrence Katz to describe mental exercises that do for the brain what aerobics does for the body.
But like physical fitness, brain fitness takes effort and discipline. Boredom and complacency are to be avoided.
While Farley mainly focuses on specific exercises for people who have diagnoses of Parkinson's, multiple sclerosis or Alzheimer's, she's hoping to expand the practice she's developing — Southwest NeuroGym — to include the general senior citizen population. Her biggest emphasis is on challenging people. If it's not difficult, then it's not effective, she said.
"If it doesn't feel hard, you are not working hard enough," Farley said.
Farley, who is working with the local Mid-Valley Athletic Club, is not the only local person advocating cognitive calisthenics. The Fairwinds Desert Point retirement community has a brain fitness area in its gym, and a 2-year-old business called MindWorks Studio focuses solely on mental fitness.
Nationally, there's a growing number of brain fitness companies with names like Happy Neuron Inc., CogniFit Ltd. and Vibrant Brains.
"A generation ago, exercise training revolutionized our notion of aging and physical decline. It is now accepted that most of the physical decline we experience as we age is unnatural, resulting from a lack of exercise," said Dr. Michael J. Maximov, an internist with Saguaro Physicians in Tucson who works closely with Tucson Medical Center's Senior Services.
"Now, a similar revolution is occurring in the realm of brain health. It may be that much of our mental decline is due to a lack of brain exercise and is not entirely a natural process."
At Fairwinds Desert Point in Oro Valley, residents are taking part in a national computer program through a company called Posit Science Corp. that requires a one-hour daily commitment, five days per week for eight weeks.
"It's like working out, so you need rest days," Fairwinds activities coordinator Elizabeth Sims. said.
The program has games and challenges with increasing levels of difficulty, including deciphering word sounds, recalling sequences of objects and reading comprehension.
The age of Sims' students has ranged from 74 to 104.
"The senior population starts to get very weary when they realize they are forgetting words. They become reclusive and don't want to engage. They don't want to look silly," Sims said. "But you can recover brain vitality."
Seventy-six-year-old Fairwinds resident Barbara Gilbert is the cognitive equivalent of a gym rat. She's completed two eight-week Posit Science courses and now feels comfortable using a computer. She's also hopeful she's sharpened her memory.
"I read a lot, and I play cards twice per week, but I wanted to test myself," she said. "I take care of myself, of all my affairs, and I would love to keep it that way."
Eighty-eight-year-old June McNichols and her 91-year-old husband, Bill, recently completed their first eight-week session.
"If it will do anything to help the memory at this stage in the game, it's well worth the time," June McNichols said.
Another Fairwinds resident, 79-year-old Barbara Saltzman, said the exercises improved her attention to small details and sharpened her driving.
Indeed, brain fitness is often touted as helping seniors maintain spatial and speed reaction times necessary for safe driving.
"You use it or lose it," Saltzman said.
The notion of a brain gym is increasingly appealing to a demographic of people who are already interested in being physically active, said L'Don Sawyer, manager of senior services at Tucson Medical Center.
Sawyer's department has been offering brain fitness for about two and a half years.
"The things being taught are oftentimes what we knew throughout life — we're just thinking about them differently," she said. "It's like the game 'categories' that kids play on car trips . . . You can be in a grocery store and think of naming U.S. states that begin with A."
Brain gym exercises often advocate multitasking. For example, Sawyer likes to say number problems aloud while hiking — like six times two minus three, and then spelling out the answer.
Farley stresses physical fitness as the starting point for better mental acuity. She cites studies that show children who exercise in the morning fare better on tests held sooner after the workout rather than later.
Doing nothing is a recipe for faster aging, she said.
"When you do nothing and are negative, it's all a domino effect," she said. "If you are active you will have an active mind, too."
Similarly, MindWorks Studio owner Deborah DuSold tells clients the first step toward brain fitness is a healthy body.
DuSold uses Posit Science computer programs, as well as a method of brain-wave biofeedback that monitors the brain's rhythms in conjunction with video games and music to improve cognitive skills.
"I've put my mother through the Posit Science programs — she's 87 and she recently beat out a 40-year-old," DuSold said. "We can maintain brain fitness into our 90s and 100s. And when you keep up the cognitive skills your mood goes through the roof. The same chemicals we use to learn and keep us sharp also keep us happy."
When he looks back, Paul Person believes he's probably had Parkinson's for the past year or two. Family pictures show his head drooping, and his smile not quite as big as it once was. His wife, Patty, said he shuffled when he walked. And he was dropping things, like cutlery.
But she's noticed a difference since her husband began doing Farley's exercises. A retired engineer, Person is methodical and disciplined. When he was on vacation in Hawaii for three weeks, he did his brain exercises every day, said Patty, who is 54. The couple also does tai chi and avoids television.
Now, Paul's smile is bigger, he stands up taller, his head droops less and he's not dropping things as often, his wife said.
"I see you going back to normal life more," Patty said to her husband last week as they sat at the kitchen table of their Tucson-area home.
"Some days I don't feel like I have Parkinson's at all," Paul said.