Tai Chi Can Reduce Osteoarthritis Pain in the Elderly

From Geriatric Pharmacy Intern, Wendy Fisher, PharmD (c)
Nova Southeastern University College of Pharmacy

Tai Chi (pronounced “tie chee”) is an old Chinese practice of martial arts designed to exercise the mind and body. It combines mental concentration with slow, rhythmic movements to challenge the body and focus the mind. Tai Chi helps to stimulate mental relaxation and improves balance, strength and flexibility. Almost anyone can do Tai Chi, even people with conditions that may exclude them from other forms of exercise.
Knee Osteoarthritis (OA) is a common form of arthritis that causes deterioration of joint cartilage. This results in pain, limitations of function and reduced quality of life. The elderly population is at the greatest risk for developing this type of arthritis.
According to researchers, patients over the age of 65 with knee osteoarthritis who engage in Tai Chi exercise improve physical function and experience less pain. "Tai Chi is a mind-body approach that appears to be an applicable treatment for older adults with knee OA," said Dr. Chenchen Wang, M.D., M.Sc. of Tufts University School of Medicine. Researchers have observed an improvement in physical function, depression, health status and a decrease in pain in knee osteoarthritis patients after doing Tai Chi for 12 weeks.
The current exercise recommendations for OA are identical to the physical components of Tai Chi. This seems like a feasible therapy to help ease the horrible pain from OA and it is fun and relaxing. I actually did Tai Chi in China and it felt amazing. J As always, please speak with your Doctor before starting any new exercise programs.

Other Cognitive Abilities Declining in Alzheimer's Disease

From Geriatric Pharmacy Intern, Phuong Pham, PharmD(c)
University of Florida College of Pharmacy

Researchers have been trying to identify the signs and symptoms that can lead to the diagnosis of Alzheimer's disease as early as possible. Alzheimer's disease has been commonly linked to a loss of episodic memory, in which a person fails to remember a past event that has occurred in his or her life. However, according to a study done, they found that other cognitive abilities, besides memory, may start to decline years before the diagnosis of Alzheimer is made. The study had enrolled 444 individuals without dementia between 1979 and 2006. These individuals had a clinical evaluation and a psychometric assessment done, including four cognitive factors: global cognition, verbal memory, visuospatial skill, and working memory. Visuospatial skill means the ability to process and interpret the relationship between objects and their location in space. After an average follow-up of 5.9 years, they found that 134 individuals had developed dementia and 44 with dementia died with a confirmed diagnosis of Alzheimer’s disease. When the researchers graphed the data from the psychometric assessments, they found that there was a sudden and steeper decline in the slope of the visuospatial skills three years before patients with dementia were diagnosed. The global cognition graph showed a steep decline two years before clinical diagnosis of dementia, while verbal and working memory did not show until one year before. The authors concluded, "Some of the earliest signs of preclinical disease may occur on tests of visuospatial and speeded psychomotor skills. Furthermore, the greatest rate of preclinical decline may occur on executive and attention tasks. These findings suggest that research into early detection of cognitive disorders using only episodic memory tasks, such as word lists or paragraph recall, may not be sensitive to either all of the earliest manifestations of disease or the most rapidly changing domain."

Top 10 exercises for weight control

1. Walking
2. Crunches/sit-ups
3. Jogging
4. biking
5. Swimming
6. Resistance training
7. Dancing
8. Aerobic exercise
9. Yoga
10. Hiking
    

My first 5K road race in two years

Sunday morning, the day after Halloween, I awoke at 4am to drive up to Boca Raton for the Citibank 5K- in conjunction with the PBA Half-Marathon. since the start time was 6:30 am, I needed to be up early. As you know, Sunday began Eastern Standard Time, so I set my alarm an hour early, just in case the clock wasn't smart enough to change on it's own. My wife's alarm clock changed last week- it's a little older and has the old dates built in.

So, what about the race? I arrived in Boca on time. But I was so worried about being there at the right time, I forgot to wear my watch. More about that in a bit.

It's great to run a road race. On most days, I run in my neighborhood, and many days in the dark, before sunrise. I only pass by a few people on my route- doing my best to avoid cranky dogs! But at a road race, there are hundreds of people all out there to run the same route with you. It's encouraging to see all these people. There are even children that run with their parents!

Back to my watch. When I train, I wear my watch and my iPod. I know how I'm doing by how my split times are at 1/2-mile, 1 mile, 2 miles, etc. Sunday I didn't have either with me. I pace myself with some folks that ran slower than my normal pace, but I didn't know it until I heard my 3 mile time. That's when I sprinted to the finish. Since Sunday, I've sliced over 2 minutes off my best time. It pays to keep track of your progress. Something I always stress in my Health & Wellness Coaching

My next race will be the Turkey Trot 5K at Tropical Park in Miami. I can bet I'll wear my watch!

Why should I care about dietary fiber?

My coaching clients often ask me this question during sessions. "'Cause it keeps ya regular," your grandpa may have told you. There are many more reasons to get enough fiber in your diet, but I'll get into that in a minute. First, let's talk about what dietary fiber is and how it works.

So, what is dietary fiber?

Dietary fiber is all the plant material your body cannot absorb or digest. Also known as bulk fiber or roughage, fiber passes through your body, basically unchanged. Although counted as a carbohydrate, it does not really contribute to your calorie count, since the intake equals the output.

There's SOLUBLE fiber and there's INSOLUBLE fiber.

• Soluble fiber becomes a gel-like substance in water. Foods higher in soluble fiber include peas, apples, citrus fruits, oatmeal, beans, carrots, oats and psyllium.
• Insoluble fiber, as the name implies, is not soluble and includes wheat bran, nuts, whole-wheat flour and several vegetables.

So, what's the difference?

• Soluble fiber helps lower cholesterol and control blood sugar levels
• Insoluble fiber helps keep bowel function, well, functioning optimally. It also helps with watery or loose stools by absorbing water.

In general, dietary fiber is also an excellent part of any weight loss strategy. In fact, Weight Watchers considers fiber in the calculation of all food point values in their Momentum program. Foods high in fiber are "filling," allowing you to feel fuller longer and less likely to snack on foods high in sugar, fat or salt.

How much do you need?

The latest recommendations for women are 25 grams per day if 50 or younger and 21 grams per day for women over 50. For men, it's 38 grams if under 50 and 30 grams if over 50. Sadly, few Americans even come close and may explain why two-thirds of the population is overweight or obese.

One final word of caution: When increasing the amount of fiber in your diet, do it gradually. Too big of a change may cause flatulence and abdominal discomfort, which may lead to giving up prematurely on a fiber-rich diet. Start low, go slow, but GO!

SMART Goals in Health & Wellness

All of us have set goals for ourselves at some point. Those who are most successful at achieving their goals utilize SMART goals. The acronym "SMART" is broken down this way:

• S is for SPECIFIC. If you have a certain amount of pounds to lose- name it. Instead of saying "I want to lose weight," a specific goal is a goal of losing 10 lbs., etc.
• M is for MEASURABLE. If your goal is weight loss, use a scale to measure your progress. A fitness goal might be running 1 mile in under 10 minutes.
  
• A is for ATTAINABLE. Is running a 4-minute mile possible for you?
  
• R is for REALISTIC. Be realistic about the goals you set. Getting down to your high school weight after having 3 children may not be realistic. Set a goal that you can not only attain, but is in reason for you. You know yourself best.
  
• T is for TIME-BOUND. Give your goal a deadline. A dream is merely a goal without a deadline. Spending 45 minutes working out 4-5 times a week is timely.

Finally, I recommend stating your written goals a certain way, which gives them even greater power. Notice I said "written." State your SMART goal in the 1st person, present tense and in the affirmative. For example: "I exercise 45 minutes per day, 4 times per week." Write the goals so it stretches you a little but doesn't snap you. Stating your goals in this manner gives them much greater power- so much that your brain takes them as commands!

Let me know how this works for you.

Avoiding Emotional Eating

Wow! What a week it's been. Four screws in three different tires of our two family cars, including one flat. A fender-bender with my wife's car (not her fault!) Medicare-Medicaid re-certification inspection at one of the nursing homes I consult. Company last weekend. A two year old with endless energy and curiosity.

All of this can lead a man (or woman) to hit the Checker's Drive Thru pretty hard. And I've done that countless times in the past. The short-term satisfaction of a creamy shake, greasy fries and mouth-watering burger soon lead to indigestion, a little (or a lot) guilt and added pounds.

Being more mindful of my feelings and emotions helps me to nearly eliminate these fast food runs and stay aligned with my health, wellness and fitness goals. One of my best strategies is to always carry portable, healthy snacks- sort of like a survival kit. Having these treats available at arms-reach buys me enough time to think twice about the consequences of making a very poor food choice. Try it on for yourself!