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Wednesday, March 11, 2015

Exercise May Boost Mobility in Old Age

Exercise May Boost Mobility in Old Age — www.m.webmd.com — Readability

Exercise May Boost Mobility in Old Age
WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, March 11, 2015 (HealthDay News) -- Staying physically active as you age may ward off brain damage that can limit mobility, a small study says.

Small areas of brain damage called white matter hyperintensities are seen in MRI scans of many older patients, according to scientists from Rush University Medical Center in Chicago. Higher levels of this damage have been linked to difficulty walking and other mobility problems, the researchers said.

"Preserving motor function is just as important as preserving mental function to maintain independence and quality of life in older age," said lead researcher Debra Fleischman, a professor in the departments of neurological sciences and behavioral sciences.

"Our results suggest that daily physical activity may be able to protect motor function from age-related injury to the brain," she added.

The study, published March 11 online in the journal Neurology, involved 167 patients, average age 80.

For the study, Fleischman's team had participants wear movement monitors on their wrists for up to 11 days. These devices measured exercise and non-exercise activity. Participants also took 11 tests of movement ability, and researchers used MRI scans to assess the level of white matter hyperintensities in the brain.

The researchers found that those seniors who exercised the most, even if they had high levels of brain damage, maintained their scores on the movement tests. However, for those who exercised less, brain damage was associated with lower scores on the movement tests.

The findings held after the researchers adjusted for other factors that might influence exercise, such as weight, depression, and conditions that affect blood circulation.

Dr. Sam Gandy, professor and associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City, called this an "extremely important" study.

"Virtually everything about Alzheimer's and other dementia appears to be mitigated by physical exercise," he said. "I think that this study serves to make that case even more compelling."

The bottom line, Fleischman said, is to do some kind of safe and enjoyable movement daily to protect motor function from brain injury that may occur as you get older.

The message she said she gives patients is: "You do not have to be marathon runners."

Fleischman cautioned that this study does not prove that physical activity directly preserves movement ability, it only shows an association between the two.

Although there are good treatments for conditions that impair movement, such as Parkinson's disease and arthritis, age-related movement problems are common and often left untreated, she said.

"Until we have a more complete understanding of the biological mechanisms underlying chronic late-life motor impairment, and have developed effective drug treatments to lessen the effects of brain injury on motor function, efforts to encourage an active lifestyle in older adults will be a critical element in meeting this public health challenge," Fleischman said.

Tuesday, March 10, 2015

Circadian Surprise: How Our Body Clocks Help Shape Our Waistlines

Just yesterday I wrote about the importance of sleep on our overall health and specifically on its influence on our weight. How timely then that this segment appeared on NPR this morning. I hope you enjoy and find it helpful. 


I'm very excited about the Apple Watch. I can see endless possibilities for its applicability towards moving health forward. 

As a busy clinician, being able to quickly and discreetly glance at my wrist for a notification (phone call, text or email) from a patient, other physician or my office staff without have to pull my entire phone out of my pocket will enable me to spend more time focused on the patient in front of me and less time looking at my phone. 

As a health and fitness tool, I see the watch being able to help my patients move more and eat better. Already there are applications designed to track general daily activity, specific exercise tracking, and even app's to help with cooking and food intake tracking. 

In combination with the newly announced Reseach Kit platform, medical researchers will be able to use data from the Apple Watch and the iPhone in new and imaginative ways. 

However, I believe this is just the tip of the iceberg. Just as none of us could have envisioned the iPhone to become ubiquitous in our society (2 year olds and 90 years old use them just as easily) so too will devices like the Apple Watch become a part of us. Given a platform like the Watch, the real breakthroughs will come from the engineers at Apple continuing to push the device forward and from the app developers imagining new and innovative ways to use the device. 

Monday, March 9, 2015

The Importance of Sleep

On the way home from a trip to Rhode Island, my wife and I listened to an amazing TED talk by Russell Foster titled "Why do we sleep."

I am aware of the link between sleep deprivation and obesity. I am aware of the link between sleep in teenagers testing scores and employees productivity and creativity. 

I spend a lot of time talking to my patients about sleep but in the past, the conversation mostly focuses mostly focuses on their risk of sleep apnea, If they do no have sleep apnea, I typically have let sleep issues fall by the way side. 

Now, it is clear to me that sleep needs to be discussed along with not smoking, maintaining a healthy weight, heart healthy eating, low consumption of alcohol and lots of exercise as the keys towards leading a healthy and long life. Specifically, for all those patients that are trying to lose weight, ensuring that they get at least 7-9 hours of sleep a night will help combat the hormonal disregulation for which sleep deprivation leads to  increased appetite (specifically for carbs), increased adipose (fat) deposition around the waist, increased inflammation, increased irritability and leads to lack of energy zapping the oomph for physical activity.