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Be Alert of These Health Issues – Prevention is the Cure!

I wish I could tell you that after turning 50, there are health issues associated with age I plan to be mindful of and address proactively. Unfortunately, that ship has sailed for me well more than a decade ago. So, I share this medical information, not only as a health professional but also as an experienced senior.

Entering the fifth decade is not all dome and gloom. Often, this decade is associated with an established family, gratifying career, good health and acquired self-confidence…realizing that life does not have to be perfect to be wonderful! 

However, research tells us that as the body ages, even small changes at the cellular level can be manifested into big changes and problems over time. Nine of ten older adults have some type of chronic disease and eight of ten have more than one. But the good news is that, with a modicum of effort, most of these illnesses can be controlled or prevented, including regular doctor visits, health screening and testing, and lifestyle changes.

Obesity

While it is normal to experience some weight gain is expected with age. However, uncontrolled, the average person will gain 1-2 pounds per year, leading to 11 pounds per decade, according to the National Institutes of Health. Consequently, almost 45% of Americans between 40 to 60 are obese. Obesity is associated with at least 20 chronic illnesses such as high blood pressure, heart disease, diabetes, cancer, and arthritis.

SCREEN: Body Mass Index (BMI)       

TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery

High Blood Pressure

With age, the flexibility of blood vessels loses elasticity and, unchecked, two out of three adults over 60 have high blood pressure. While genetics is a factor, there are a few things that you can control such as diet (salt, calories), exercise, weight, stress, and smoking.

SCREEN: Blood Pressure Test, Lab Tests, Electrocardiogram (ECG/EKG)       

TREATMENT: Diet, Exercise, Lifestyle, Medications

Heart Disease

Plaque buildup in the arteries of the heart begins in childhood and advances rapidly with age. 6-7 percent of US adults between the ages of 40 and 60. 20% of men and almost 10% of women between the ages of 60 and 80 have heart disease.

SCREEN: Blood Pressure, Cholesterol testing, Blood Sugar Testing, Imaging (ECG/MRI)

TREATMENT: Diet, Exercise, Lifestyle, Medications, Surgery

Diabetes

10 % of Americans have diabetes and the percent only increases with age. Diabetes is associated with many serious chronic illnesses such as heart disease, blindness, kidney disease and others.

SCREEN: Blood Test for blood sugar levels such as A1C, fasting plasma glucose test and random plasma glucose test

TREATMENT: Diet, Exercise, Lifestyle, Medications

Osteoarthritis

In many cases osteoarthritis (wear and tear of joints) is often associated with age. However, lifestyle, joint injuries, inactivity, obesity and diabetes play a significant role.

SCREEN: Physical Exam, Functional Scores, Xrays, MRI, CT, US

TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (NSAID’s, Steroids, Viscosupplementation), Bracing, Surgery

Osteoporosis

Loss of bone density and strength is associated with age and certain metabolic conditions such as early menopause, thyroid disease, prolonged use of blood thinners and steroids. However, a diet rich in vitamin D, regular weight bearing exercises such as walking, jogging, dancing etc can go a long way.

SCREEN: Fracture Risk Assessment Tool (FRAX), Dual-Energy X-Ray Absorptiometry (DEXA) TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications (Oral and Injection)

Balance/Falls

Losing balance with age is a common problem due to changes in the vestibular system (balance system in the brain), loss of muscle strength and joint flexibility, and compromised vision and hearing. This can often lead to falls, head injuries and fractures.

SCREEN: Timed Up and Go (TUG) Test, Morse Fall Scale

TREATMENT: Physical Therapy – Falls Prevention Program/Balance Training , Diet, Exercise, Lifestyle, Environmental Modification, Vision/Hearing Testing

Hearing Loss/Vision Loss

Almost 10% of adults between the ages of 55 and 65 have some form of vision and/or hearing loss. This can lead to many problems such as balance and falls as well as isolation and depression.

SCREEN: Regular Hearing Tests/Vision Testing          

TREATMENT: Corrective Devices

Bladder Issues

Both men and women suffer from bladder problems with age... especially frequency and control. It can impact lifestyles in many ways. Often adults fail to hydrate properly, especially when traveling, to control urgency. This can lead to other health problems.

SCREEN: Urine Analysis, PSA, Imaging, CT Urogram, Urine Cystoscopy, Ultrasound,           

TREATMENT: Diet, Exercise, Lifestyle, Avoid Caffeine and heavy lifting, Medications, Surgery

Cancer

As the body ages, so too do the cells that make it up. Often these cells change into cancer different parts of the body. Skin, colon, breast, prostate, lung, throat, etc. Today, however, much progress has been made for early detection and treatment.

SCREEN: Physical Exam (Skin Exams), Lab Tests (blood work, PSA), Imaging (CT, Mammography, MRI), Genetic Testing, Pap Smears, HPV Tests, Colonoscopies/Stool Tests, Multi-Cancer Early Detection (MCED)           

TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, Medications, Chemotherapy, Radiation, Immunotherapy and Targeted Therapy Surgery specific to the cancer type.

Dementia/Depression/Loneliness

Age related mental health issues are vastly unreported and diagnosed. Medical problems can contribute to mental health such as high blood sugar levels and some infections. Overall, lifestyle, environmental factors and family structure and support are particularly important.

SCREEN: No Single Test – Combination of Tools including - Neurological and Cognitive Tests, Brain Scans (CT/MRI), Blood tests, Genetic Testing

TREATMENT: Diet, Exercise, Physical Therapy, Lifestyle, (avoid excessive toxins like alcohol and nicotine), Medications, Environmental Modifications.

SOURCES: WebMD, NIH, Mayo Clinic, Alzheimer’s Association, American Cancer Society, American Heart Association, American Diabetes Association

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Have Fun and Get in Shape in the Pool!

There is still plenty of summer remaining and its not too late to think of your pleasure puddle in different light…a health spa! It may very well be the exercise of choice for many people. Many have discovered the benefits of moving their limbs in the warm water of a home pool following knee or shoulder surgery. Also, long distance runners who often look for cross training methods without joint compression and arthritis sufferers who are often limited in exercise choices by joint pain from compressive forces when bearing weight, can enjoy the buoyancy effects of  water. These are good examples of the benefits or water exercise…aerobic and resistive exercise without joint compression.  

Pool Exercise and Arthritis

Most doctors recommend some form of exercise with arthritis. Pain and fatigue are the most limiting factors for the person with arthritis. Pool exercise may be the answer. With proper technique, adequate rest periods, appropriate resistance and repetitions, water exercise can be very effective.

Pool Exercise Benefits

The following are some of the benefits of water exercise:

Getting Started with Pool Exercise

  1. Start Slowly – Don’t Overdo it
    • 5-10 minutes and repetitions first time and add 2-3 minutes/repetitions each week
    • Long Term Goal: 20 – 40 minutes per session - 3-4 times per week           
  2. Submerge The Body Part
    • That you want to exercise into the water and move it slowly
  3. Complete The Range of Motion
    • Initially 5 times, then 10-15-20-30 times
  4. Assess
    • Determine if you have pain 3-4 hours after you exercise or into the next day. If so you overdid it and make adjustments next time by decreasing repetitions, speed, amount and intensity of exercise.
  5. Warm-Up
    • Make sure you warm up slowly before the exercise with slow and easy movements
  6. Advance Slowly
    • By adding webbed gloves, weighted boots, and buoyant barbells to Increase the resistance.
  7. Exercises – standing in shallow end of pool

Visit your doctor regularly and listen to your body.     

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Most would agree that this spring has a little cloudy, rainy and cool in NEPA. However, warm sunny days are soon to come. While protection from the sun is very important, too much time indoors playing computer games and watching television, can lead to potential problems from lack of exposure to the sun. One must use good judgment and have balance as the potential exists for Vitamin D deficiency due to lack of sun exposure. This problem may be true for individuals who use too much protection or spend most of their day indoors due to occupation or poor health. Therefore, it will be the purpose of this column to discuss the importance of Vitamin D for health and wellness.

Vitamin D, a fat soluble vitamin, is found in food and can be made by your body after exposure to ultraviolet (UV) rays from the sun. The liver and kidney help convert it to its active form. Therefore, vitamin D assists calcium absorption, which is essential for normal development and in forming and maintaining strong bones and teeth. Without it, bones can become thin, brittle and soft. The classic Vitamin D deficiency diseases are rickets in children and osteomalacia in adults. Rickets results in skeletal deformities. Osteomalacia is the softening of bones. Therefore, it is essential for normal bone health and may diminish or prevent the onset of osteoporosis in the elderly.

The requirement for Vitamin D is dependent on age, sex, degree of sun exposure and the amount of pigmentation in the skin. Since it can be produced by the body and retained for long periods of time by the body’s tissues, the precise daily requirement has been difficult to determine. Instead, an Adequate Intake (AI) level has been established. AI is a level of intake sufficient to maintain healthy blood levels of an active form of Vitamin D.

AIs are similar for males and females but increase with age:

Sources of Vitamin D:

Vitamin D Deficiency:

Vitamin D deficiency can occur when dietary intake is inadequate, when there is limited sunlight exposure, when the kidney cannot convert Vitamin D to its active form or when Vitamin D is inadequately absorbed from the gastrointestinal tract. Season, geographic location, time of day, cloud cover, air pollution, sunscreens, living indoors and living in cities where tall buildings block adequate sunlight from reaching the ground affect UV ray exposure. Therefore, individuals with limited sun exposure are at risk of this deficiency. Homebound individuals, people living in northern latitudes (e.g. New England, Alaska), individuals who cover their bodies for religious reasons and people whose occupations prevent exposure to sunlight may need to supplement in other forms.

Sunscreens with a sun protection factor of 8 or greater will block UV rays that produce Vitamin D. Older adults have a higher risk for this deficiency because the skin’s ability to convert Vitamin D to its active form decreases with age and the kidneys, which help convert Vitamin D to its active form, do not work as well when people age. Individuals with pancreatic enzyme deficiency, Chron’s disease, cystic fibrosis, sprue, liver disease, surgical removal of part or all of the stomach or small bowel disease may need extra intake because Vitamin D is a fat soluble and they have reduced ability to absorb dietary fat. Supplements are often recommended for exclusively breast-fed infants because human milk may not contain adequate Vitamin D. Consult with your pediatrician on this issue.

SOURCES: The National Institutes of Health; CDC

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!