Category Archives: Successful Aging & Elder Care

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Q & A: How to Manage COPD

Q.  Hi, Dr. Ben. I was recently diagnosed with moderate COPD.  I “knew” I have had it for a few years, but I didn’t want to admit it.  What exercises do you recommend that I perform to keep my lungs functioning at their best capacity?  I know I need to keep active, keep a healthy lifestyle, and keep going!  I gave up smoking last week when I was diagnosed.  I am not on oxygen at this time.  Inhalers are being used to manage my COPD at this time.  I hope this will help others from being stubborn, choose to give up the smokes, and “get real” because this can happen to any of us!  Thanks, Ben!  -Linda

A.  Thanks for your question, Linda! I am sorry to hear about your recent diagnosis of COPD.  It sounds like you are already making some appropriate and much needed lifestyle changes to help to manage the disease.

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease (meaning it worsens over time).  COPD is currently the third leading cause of death in the United States.  It is typically diagnosed in middle aged or older adults.  Cigarette smoking is the leading cause of COPD.  Most cases of COPD are associated with those that have smoked, used to smoke or who were around heavy amounts of smoke.  Other potential causes include: exposure to chemicals that irritate the lungs (such as air pollution, chemical fumes from paint or other industrial causes); exposure to high levels of dust and dirt; and genetic factors.

Chronic Obstructive Pulmonary Disease

Symptoms of COPD:

  • Coughing (typically producing large amounts of mucus).
  • Wheezing.
  • Shortness of breath (SOB).
  • Tightness in the chest.

With COPD, there is less air flow in and out of the lungs.  This can occur for one or several of the following reasons:

  • The airways and air sacs (alveoli) lose their elasticity.
  • Walls between the air sacs are damaged and/or destroyed.
  • Ways of the air sacks become thick and/or inflamed.
  • There is excessive mucus production in the air sacks causing them to clog.

COPD is most commonly associated with two conditions, either emphysema or chronic bronchitis.  In the case of emphysema, the walls of the air sacs are damaged and/or destroyed which leads to less air sacks (alveoli) to assist in gas exchange during breathing.  In the case of chronic bronchitis, the lining of the airways is chronically irritated and inflamed.  This leads to a thickening and excessive mucus production, which blocks the airways and causes difficulty with breathing.  Generally individuals with COPD tend to have both emphysema and chronic bronchitis.

Those with COPD are especially prone to other illnesses, such as colds, flu, and pneumonia, and they are in a high risk category.  Although controversial in western medicine, I am convinced that proper supplementation of key nutrients can assist your immune system in fighting many common illnesses.

Strategies for managing COPD:

Medication.

Your physician will likely prescribe medications to help you to manage COPD.  These will typically include anti-inflammatory medications and bronchial dilator medications.  Be sure to always follow your physician’s advice when utilizing prescription medication.

Stop smoking.

This may sound obvious, but smoking cessation is critical to managing COPD.  Smoking was likely a major contributing factor to developing COPD.  It will be very difficult to manage the disease long term if you do not stop smoking.  If a person continues to smoke, lung function and prognosis for disease management will decline at a much faster rate than average.  Many programs are available that can help you to quit smoking.  Please speak with your physician to learn more about resources in your area.

Daily activity.

Daily activity is important for everyone, but especially for those with COPD.  A sedentary lifestyle will only worsen your symptoms.  Depending on the severity of your COPD, your ability to perform certain activities will vary.  For more information, please refer to How to Jumpstart a Sedentary Lifestyle and Why You Should Walk, Not Run.

As your disease progresses, it will become increasingly difficult to remain active. Activity modification will be part of your management strategy, but continue to do what you can. It is critical to keep regular activity as part of your disease management strategy.

Exercise.

It is critically important that you engage in specific, purposeful exercise.  A thorough exercise program should include components of each of the following:

  1. Weight Training
  2. Cardiovascular Exercise
  3. High Intensity Training

Each exercise program should be specifically designed for the individual.  These three forms of exercise have significant research in improving physical function (including muscular, cardiovascular, and pulmonary function).  It is extremely important that your exercise program is properly dosed and prescribed just for you.  As your disease progresses, your dosing and exercise prescription will also change.  To adequately mange the condition, you must implement a thorough exercise program.

You will likely need assistance in designing a program specifically for your needs.  First, please speak with your physician.  Then seek a qualified physical therapist that specializes in cardiovascular disorders.  The American Physical Therapy Association offers a wonderful resource to help find a physical therapist in your area. In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to seek your physician’s opinion as well). Another option is to seek a local cardiac and pulmonary rehabilitation program in your area. These are usually associated with your local hospital.

As your disease progresses, it will become increasingly difficult to exercise, but continue to do what you can. The intensity and duration may change and you will need additional rest. It is critical to maintain some form of exercise as part of your disease management strategy. This is an exercise is medicine approach.

Rib and thoracic mobility.

Addressing rib and thoracic mobility is one way to make quick improvements in a person’s ability to breathe and generally improve endurance and lung function. Unfortunately, this is underutilized in most COPD sufferers.

Since COPD affects the lungs, restrictions in the musculature and the skeletal system that encase the lungs will only worsen a person’s breathing difficulties. The key is to help your body move as efficiently as possible. In order to achieve this, the ribs and thoracic spine along with the associated musculature must be free to move. Any restrictions in this area will only make it more difficult to breathe.

When you sign up to receive my blog posts via e-mail, you will automatically gain access to my FREE resource, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain. These exercises address the most common rib and thoracic restrictions, so that you can maximize your rib and thoracic mobility in order to breathe easier. Detailed photos and exercise instructions will help you to get started.  I recommend that you combine these with a daily deep breathing program.

Deep breathing.

Learning a variety of breathing techniques will also be a critical component in managing COPD. Deep breathing allows the body to uptake more oxygen. It also helps to reduce stress and anxiety. The mechanical act of breathing more deeply helps your ribs and thoracic spine to remain mobile. It also helps to train all of the muscles associated with breathing–from the diaphragm and intercostal muscles to the lesser known accessory breathing muscles (sternocleidomastoid, the scalenes, serratus anterior, pectoralis major and minor, trapezius, latissimus dorsi, erector spinae, iliocostalis lumborum, quadratus lumborum, serratus posterior superior and inferior, levatores costarum, transversus thoracis, and the subclavius).

Incentive Spirometer

When performed properly, deep breathing can help you to maintain your lung capacity. An incentive spirometer should be used regularly as part of maintaining proper lung capacity and function. It can also decrease your risk of pneumonia, which is always a concern for those with COPD.

Learning multiple methods of breathing will be important as you progress in your disease management. Each method is used for a different situation. Along with deep breathing exercises, diaphragmatic and pursed lip breathing techniques will also be beneficial.

Adequate sleep.

Poor sleep is linked to the following cardiovascular risk factors:  high blood pressure; atherosclerosis; heart failure; heart attack; stroke; diabetes; and obesity.  These all have negative effects on COPD management.

Be sure to get as much sleep as you need (typically 7-9 hours at night).  Short naps are also an excellent way to get more sleep.  I recommend that you read Michael Hyatt’s 6 Strategies to Sleep Soundly, Wake Rested, and Accomplish More.

Acupuncture is also a proven method to help people sleep better and more soundly.  It can be used to treat insomnia as well.

Reduce your stress.

Stress is a normal part of life.  Poorly managed stress or excessive stress can lead to emotional, psychological, and physical problems, such as cardiovascular disease and high blood pressure.  High stress leads to more anxiety which can affect breathing patterns.  Individuals with COPD will already struggle at times with breathing, which will worsen as the disease progresses.  High stress will only make this worse.  Regular exercise, massage, yoga, acupuncture, and Tai Chi have all been proven to reduce stress.

Maintain a healthy weight.

Additional weight makes it more difficult to move around. It also creates additional pressure in the rib cage–making breathing more difficult. The heavier you are, the more difficult it will be to exercise which is a critical component of COPD management. Obesity is associated with diabetes, high blood pressure, and coronary artery disease.  These all increase your risk of developing heart disease and have a negative effect on health and COPD management.  Studies have shown that excess body weight (not including all of the other associated medical conditions) can also lead to heart failure.  Even if you are healthy otherwise, being overweight still places you at a greater risk of developing cardiovascular and pulmonary related diseases.

Stay hydrated.

Drink more water.  The older you are, the easier it is to become dehydrated.  Proper hydration is critical to keeping lung tissue healthy. The human body is primarily made of water, which is critical for all body functions. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Water intake supports proper brain, lung, muscle, and hormone function as well as lubrication of the joints and skin appearance.

Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names that you can’t spell or pronounce. Drinking more water not only prevents dehydration, but it also aids in preventing urinary tract infections (UTI).

Living with and managing COPD will be a different journey for everyone.  When managed correctly, individuals with COPD can live a long time.  Although there isn’t presently a cure for COPD, treatment options continue to improve every year.  The important part is to start addressing the disease early through medication management and lifestyle changes including:  smoking cessation; healthy eating and proper hydration; stress management; breathing techniques; and optimizing your exercise and activity levels in order to maintain proper rib and thoracic mobility.

Thanks for your question, Linda!  For additional information on the topic of COPD, please visit the following:  http://www.nhlbi.nih.gov/health/health-topics/topics/copd/ and http://copd.about.com/od/copdbasics/a/copdlifeexpectancy.htm.

Do you or a loved one suffer from COPD?  Please share your experience with us.  Together we can all grow and learn how to best manage this disease.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.

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Astronauts Resistance Train and So Should You

Space travel has long been in the hearts and minds of men and women.  The Martian, a bestselling book and recent movie starring Matt Damon, depicts a manned mission to Mars.  (Personally, this is something I hope to see in my lifetime!)  Damon stars as an astronaut who is mistakenly presumed dead and left behind on Mars, and who then fights to survive.  Among the many potential hazards of space travel, one not so well known issue is osteopenia and/or osteoporosis.  The lack of gravity and weight bearing activity causes demineralization and weakness in the bones.  This significantly increases one’s risk of a bone fracture.

In space, bone loss starts within a few days and escalates between 2-5 months.  On earth, it tends to be a more gradual loss.  Bone density tends to peak in a person’s mid-twenties and worsens as a person ages.  Statics conclude that in individuals over 50, one in two women and one in eight men will have an osteoporosis related fracture within their lifetime.

For NASA, learning the causes of space induced osteoporosis and prevention methods is critical to long term space travel and any potential manned mission to Mars.  The treatment for osteoporosis is quite straight forward on earth and taking steps to prevent osteoporosis is critical.  The sooner, the better!  Regardless of age or severity of the condition, it’s never too late to start.

Osteopenia and osteoporosis can occur for many different reasons, but the most common reasons include:

  • Gender. Females are more likely to experience bone loss.
  • Certain ethnic groups. White Anglo-Saxons are more likely to develop these conditions.
  • Smoking.
  • Prior family history.
  • Alcoholism.
  • Medication side effects.
  • Lack of proper nutrition, including vitamin deficits such as low Vitamin D3 levels.
  • Hormonal dysregulation.
  • Lack of weight bearing exercise.
  • Being bed bound. Studies conclude that completely immobilized bones can lose up to 15% of mineral density within three months.
  • Lack of resistance exercise.
  • Certain genetic disorders.
  • Space travel. The lack of gravity and weight bearing activity causes demineralization and weakness in the bones.

Treatment Strategies for Osteopenia and Osteoporosis:

Start Early 

As we age, our bones will normally start losing some bone density and flexibility.  (They become more rigid.)  It’s important to work on optimizing bone density early in life.  Bone density is best developed under 30 years of age.

There are also studies that indicate pregnancy may also help to improve bone density.  This assumes a healthy diet with adequate calcium levels is consumed during the pregnancy and while breastfeeding. 

Weight Training

Weight training is like living on a planet with increased gravity.  Weight training (particularly barbell training) loads the skeleton progressively over time, which can decrease bone loss and increase bone mineral density.  It also positively affects hormones, such as human growth hormone (HGH) and testosterone, needed to improve bone density and muscle strength.  Barbell training is the most effective method due to the progressive load on the skeletal system, and the muscle pull being exerted on the bone, which also stimulates bone formation.

ManDumbbellWeightTraining

Resistance training (other than through barbell training) can also be beneficial.  Since space is an anti-gravity environment, it’s impossible to load the skeleton via weight training.  Astronauts can resistance train by utilizing strong elastic bands and cords.  This allows variations of pushing or pulling exercises that exert a force on the muscle, which stimulates muscle and bone development as well as optimizes vital hormone function.  Depending on the type of exercise, the resistance bands can mimic skeletal loading and gravity.

The key to maintaining and improving bone density is always axial skeletal loading and the associated pull of muscles against the bone during activity (particularly, strenuous activity).  Examples of such exercises include squats, lunges, and dead lifts.

Weight Bearing Activities

This refers to any activity, such as walking, jogging, hiking, climbing stairs, and dancing performed against gravity.  Biking and swimming are examples of exercises that are not weight bearing and therefore, they are not as beneficial for bone development.  In space, nothing is considered a weight bearing activity because of the lack of gravity.  Any attempt of weight bearing activity will need an outside resistive force to accomplish the task until science can actually create an artificial gravity environment.

Vitamin D3

Vitamin D3 is critical to the absorption of calcium, through the intestinal wall, which is important for bone health.  Although calcium is a critical component of bone health, I cannot recommend extra supplementation because of the potential cardiac risks to over supplementation.  A healthy varied diet will typically supply adequate calcium levels (assuming that adequate Vitamin D3 levels are present for absorption and that you are avoiding drinking soda).  Vitamin D3 is also a critical nutrient in maintaining a healthy immune system.

Increase Your Intake of Vitamin K1 and K2

Research indicates that Vitamin K can help to reduce bone loss by helping the body regulate osteoclast function with in the bone.  An osteoclast is a type of bone cell that breaks down bone tissue. These very important cells are integral in maintaining proper bone density and insuring an appropriate amount of calcium in the blood stream.  Without adequate calcium, many critical cell functions can be affected, including heart function.  Both Vitamin K1 and K2 have been proven to reduce the risk of fractures, including hip and vertebral.

Vitamin K, found in green leafy vegetables, has anti-coagulation benefits.  If you take blood thinning medications, your physician will need to know how much you consume on a regular basis.

Avoid Soda

Excessive soda intake (particularly diet soda) has been linked to poor bone density.  The exact cause isn’t entirely clear.  Many theorize that the acidic nature of the soda along with the chemicals and additives cause increased osteoclast activity in the bones.  This releases more calcium into the blood stream in order to help fight the negative effects of soda consumption.  It is clear that too much soda is bad for your health and bones.

Magnesium

Magnesium is a critical component of bone health and health in general.  Magnesium helps the body to regulate calcium levels.  This has a positive effect on bone health and also has been proven to reduce the risk of kidney stones.  I also use magnesium as a sleep and recovery aid.  I consume it at night to help me sleep.  Magnesium can also reduce muscle soreness, cramps, and/or spasms.  You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates.

Most people are deficient in the amount of magnesium they consume on a regular basis.  I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose in 100 mg intervals as needed.  I would caution you that taking too much magnesium can lead to diarrhea.  Mag Glycinate in its oral form is the most highly absorbable.  Although not quite as absorbable, Thorne Research Magnesium Citrate is also a fantastic product.

Stop Smoking

If you smoke, please stop. It not only affects your bone density, but it has negative effects on every other body system. It also increases your risk of cancer and heart disease.

Eat Healthy

Do not eat anything that comes in a package.  A diet with proper vitamins and minerals is not only imperative to preventing osteoporosis, but it is the key to preventing most disease and illness.  Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil).  Any animal fat should be from organic and grass fed animals.  Your body tissue needs nutrients to be able to perform at a high level.

Avoid processed food as much as possible.  Limit sugary food and add more protein and healthy fat in your diet.  Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system.  Adequate protein intake is necessary to support muscle health and development.  A healthy diet equates to healthy bones.

In space, astronauts must eat a healthy diet and get plenty of exercise to prevent disuse osteoporosis.  Similar steps can be taken to prevent osteoporosis on earth.  Maintain a balanced diet rich in calcium, Vitamin D3, Vitamin K, and magnesium.  In order to prevent or alleviate osteoporosis and osteopenia, implement weight bearing exercise and resistance training; a lifestyle free of smoking and alcohol; and regular bone density screenings.  It’s never too late to implement these strategies as you maintain a healthy lifestyle.  For additional information, please refer to Q & A: How to Self-Treat Osteopenia and Q & A: Which Type of Imaging to Use.

Which strategies can you implement in order to prevent and self-treat osteopenia and/or osteoporosis?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Longevity through Physical Therapy

LongevityShowPodcast

http://hartmanmedia.com/ls43/

The Longevity and Biohacking Show

November 12, 2015

Increasing your lifespan without increasing your health span is basically a self-torturing program.  If you don’t have quality of life in your later years, why would you want them?  Our guest, Ben Shatto, tells us about physical therapy and how it can be used as a preventative medicine to ward off many of the prominent illnesses attributed to aging.  Humans were designed to move much more than our current lifestyles afford us.  Get up and move!  Listen to the show

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3 Strategies to Start Right Now to Improve Health Span

You have likely heard about the life span revolution in the media. Many feel we are on the cusp of significantly advancing the length a person can live.  When in fact, the actual average number of years a person is expected to live has been stable or slightly decreasing.  This is entirely due to poor nutrition, lack of physical activity, and environmental factors.  Although the promise of a long life is appealing, one must ask an important question: Is a long life really what you want if there is no quality? Increasing the number of years that you live is not as important as increasing the way you can live those added years.  Spending an extra 5 or 25 years alive, but ill, is a curse not a blessing.

Today’s pharmaceutical giants, who fund much of this research, don’t want you to feel well during this time. Their intentions are likely not altruistic.  Imagine a longer lived population that is chronically ill.  Sounds like a lucrative opportunity, doesn’t it?

Now the good news! There are very simple and scientifically proven techniques that will allow you to improve your health span AND life span.  Health span refers to the period of time during one’s life that you are generally healthy and free from disease.

Physical factors that address health span include strength, balance, flexibility, and endurance. All of these factors affect your mobility during your life.  These same factors all contribute to your body’s physical resiliency.  Maintaining your mobility is critical for all body functions and is fundamental in avoiding chronic illness.

Elderly couple walking through the park hand in hand

3 Strategies to Start Right Now to Improve Health Span:

Weight Training

Weight training (in particular, barbell training) is a critical component in physical resiliency. Lifting appropriately heavy weights is applicable for almost everyone regardless of age and/or present health status. Weight training has positive benefits on: muscle strength; bone density; cardiovascular performance; neurologic performance and adaptability; mental and cognitive function; and proper hormonal regulation.

Barbell training is the most effective method due the progressive load on the skeletal system and the muscle pull which is exerted on the bone. It fights off frailty! It increases your body’s margin for error when illness or injury occurs. With proper guidance and the right exercise prescription/dosage, nearly everyone can improve in strength and benefit from weight training. To quote Mark Rippetoe, “Stronger people are harder to kill than weak people and more useful in general.”

Resistance training (other than through barbell training) can also be beneficial. An example of resistance training would be any type of pushing or pulling exercise that exerts a force on the muscle, which causes it to work harder than it would normally.  The key to all training is that the system must be properly overloaded to produce the desired effect.  Too little and you will not receive a positive benefit.  Too much and you risk injury.  This overload principle must guide all exercise routines if there is to be actual success and benefit from the program.  Although any properly dosed/prescribed form of resistive exercise would be beneficial, the most effective exercises either activate large muscle groups and/or load the skeletal system.  Examples include squats, lunges, and dead lifts.

High Intensity Training (HIT)

High Intensity Training (HIT) or High Intensity Interval Training (HIIT) involves performing short bursts (ranging from 30-60 seconds at a time) of activity followed by a 1-2 minute recovery. The 30-60 seconds should be at a high intensity, meaning that your rate of perceived exertion (RPE) is high and you’re breathing heavy.

The research involving HIT is ever evolving. Thus far, it appears that HIT may provide superior health benefits when compared to almost any other type of exercise. It has significant positive effects on hormone regulation, particularly Human Growth Hormone (HGH). It regulates insulin sensitivity and increases cardiovascular function (VO2 Max). It not only boosts metabolism, but it leads to greater fat loss than traditional forms of exercise.

There is ongoing research on its effects on all forms of chronic disease and illness, including Alzheimer’s disease, dementia, and cardiovascular disease. Preliminary evidence shows that HIT (when performed correctly) leads to superior benefits in much shorter bouts of exercise.

Walking after Meals

Diabetes and metabolic syndrome are major contributors to cardiovascular disease and most neurologic disorders, such as dementia. Heart disease remains the number one killer in men and women today. Regulation of blood sugar and insulin levels is such a critical aspect of being healthy in today’s sedentary, high fructose corn syrup filled lifestyle. Proper blood sugar and insulin regulation should be a primary concern of anyone desiring to live a long healthy life.

Walking after meals has been shown to stabilize blood sugar levels. It’s also an excellent way to boost metabolism and connect with friends and family.  Frequent walking is the most important physical activity a person can engage in.

Although there are many aspects (mental, social, financial, physical, spiritual, and emotional) to address in order to optimize your health span, it is clear that strength training, high intensity training (HIT), and walking after meals is critical in maximizing your health span and aging well.

What are some practical actions that you can take today to improve your health span? Please leave your comments below.

I would encourage you to sign up to receive each week’s blog post sent directly to your e-mail–making it even easier and more convenient! Advice will be related to physical therapy related topics; physical fitness and performance; health and nutrition; injury prevention and rehabilitation; and successful aging and elder care. I will provide useful and practical types of “how to” information, including methods to safely self-treat and manage common physical therapy related conditions. In addition, you will receive priority when submitting questions to be featured in an upcoming blog post by e-mailing contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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My Top 3 Posts on How to Age Well

We are in the midst of a giant generational shift. During this shift, the Baby Boomers are rapidly approaching elder status. At the present pace, over 8,000 baby boomers are turning 65 every day! We have turned to science to find the fountain of youth to help us all live longer (without much success so far).  However, health span is just as important as life span. How you spend your years is just as (if not more) important than your actual age. One of the most critical components to aging well and improving health span is physical activity.

Health care costs in the United States continue to outpace almost any other sector for inflation. Unfortunately, this increase in cost has not shown any actual positive change in health status.  It is imperative that we all take a leadership role in our own health care by continuing to be proactive.

The Physical Therapy Advisor will continue to the lead the way in providing useful and practical types of “how to” information, including methods to safely self-treat and manage common physical therapy related conditions. My desire is to help you address the aspects of optimizing your life while promoting well-being in order to manage pain, improve mobility, and to age well.Image courtesy of Pond5My Top 3 Posts on How to Age Well: 

  1. How to Age Successfully
  2. My Top 10 Anti-Aging Tips
  3. Why Walking is Critical for Your Health

The American Physical Therapy Association (APTA) has designated October as National Physical Therapy Month. This October, the content focuses on how physical therapy can help you to age well. You can also find local physical therapists (PTs) in your area as well as search for general advice on many physical therapy related conditions at MoveForward.

What does aging well mean to you? How can I help you in this endeavor?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

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Inactivity Kills

Physical inactivity is responsible for more than twice as many deaths as obesity. A recent study of both men and women over a 12 year period of time clearly determined that inactivity does indeed lead to an untimely death. Increasing your activity level to 20 minutes a day of brisk walking is enough to significantly reduce your risk of death. This was true in those who were obese and normal weight as indicated in the study.

Other recent research indicates that sitting for more than two hours at a time can significantly lessen your life span. Even if you regularly exercise, sitting for more than two hours a day will still lower your life span. Frequent movement throughout the entire day is critical for your health.

Senior couple in the gym

Research is clear on the topic of activity. We are designed to be mobile. Regular activity has been clearly shown to:

  • Reduce the risk of diabetes.
  • Reduce the risk of heart disease.
  • Prevent Alzheimer’s disease.
  • Improve bone density.
  • Increase and maintain muscle strength, which is strongly correlated to independence in your environment and reducing the risk of falling.
  • Improve and maintain balance, which is critical to reducing the risk of falling.
  • Maintain proper hormone levels.
  • Reduce stress.
  • Increase feelings of well-being.
  • Reduce pain levels.

This is not an exhaustive list of the benefits of regular activity. Exercise and regular activity are critical to maintaining a healthy lifestyle. Frequent activity and movement throughout the day is best. Choose a form of activity and exercise that you enjoy and keep it as part of a lifelong pursuit.

What is your favorite form of exercise? Please leave your comments below.

Looking for relevant senior related resources in your community? The Seniors Blue Book is full of relevant resources for seniors as well as helpful articles on successful aging and elder care.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

(This article first appeared in the Seniors Blue Book, October-December 2015, pages 106 and 107.)

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Q & A: How to Self-Treat Osteopenia

Q.  I had my annual visit with my physician, and she says that I have osteopenia. She recommended that I start taking calcium and maybe even another prescription to help. Isn’t there a better way to treat this without the use of drugs? -Mary

A.  Thank you, Mary, for this fantastic question! Osteopenia can be a very serious condition and is the precursor to osteoporosis. Osteopenia is defined as lower than normal bone density, but not to the severity of osteoporosis.

Osteopenia and osteoporosis significantly increase your risk of a bone fracture if you fall. When the condition is severe, the fracture can occur spontaneously from normal activities. Nearly 20% of all hip fractures in the elderly will result in death within the first year, and 50% of people will never regain their prior level of function after suffering from a hip fracture. Treating osteopenia and osteoporosis is a critical first step in reducing fractures and maintaining independence as a person ages.

Osteopenia can occur for many different reasons. Risk factors include:

  • Side effects of medications, such as chemotherapy or chronic corticosteroid use
  • Eating disorders
  • Radiation exposure
  • Gender – Females are more likely to experience bone loss.
  • Certain ethnic groups – White Anglo-Saxons are more likely to have thin bones.
  • Smoking
  • Prior family history
  • Alcoholism
  • Chronic soda consumption
  • Having a very thin build
  • Lack of physical activity

Osteopenia and osteoporosis are typically diagnosed via a bone density scan, which is recommended for woman over the age of 65. Depending on the risk factors for both men and women, your physician may order the scan at different times. For more information on a bone density scan, please refer to Q & A: Which Type of Imaging to Use?

Mary, you are correct. There are many options to help manage this condition other than prescription medications. I highly suggest that you speak with your physician about all available treatment options. The following recommendations are helpful in managing and treating osteopenia, but there may be more complicated internal issues affecting your body’s ability to improve bone density. Hormonal imbalances (such as low testosterone), menopause related hormone changes, and thyroid related issues (among others) may affect bone density. All possible hormone regulation issues should be screened for and addressed as you implement the following strategies.

Senior couple in the gym. How to Self-Treat Osteopenia.

How to Self-Treat Osteopenia:

1. Weight Training

Weight training (particularly barbell training) loads the skeleton progressively over time, which can decrease bone loss and increase bone mineral density. It also positively affects hormones, such as human growth hormone (HGH) and testosterone, needed to improve bone density and muscle strength. Barbell training is the most effective method due to the progressive load on the skeletal system, and the muscle pull being exerted on the bone, which also stimulates bone formation.

Weight training or resistance training (other than through barbell training) can also be beneficial. An example of weight or resistance training would be any type of pushing or pulling exercise that exerts a force on the muscle, which causes it to work harder than it would normally. Although any form of resistive exercise would be beneficial, the most effective exercises either activate large muscle groups and/or load the skeletal system. Examples include squats, lunges, and dead lifts.

2. Weight Bearing Activities

This refers to any activity, such as walking, jogging, and hiking, performed against gravity. Biking and swimming are examples of exercises that are not weight bearing and therefore, they aren’t as beneficial for bone development.

3. Vitamin D

Vitamin D is critical to the absorption of calcium, which is important for bone health. Although calcium is a critical component of bone health, I cannot recommend extra supplementation because of the potential cardiac risks to over supplementation. A healthy varied diet will typically supply adequate calcium levels (assuming that adequate vitamin D levels are present for absorption and that you are avoiding drinking soda).

4. Avoid Soda

Excessive soda intake (particularly diet soda) has been linked to poor bone density. The exact cause isn’t entirely clear. It’s debatable as to whether it’s a sign of an unhealthy lifestyle or that the additives, acids, and artificial sweeteners affect the bone density (but it’s likely both factors). What is clear is that too much soda is bad for your health and bad for your bones.

5. Creatine

Creatine monohydrate is helpful for increasing skeletal muscle size, strength, and power production. Increased muscle strength means increased muscle pull on the bones, which causes them to grow stronger. It may also have the added benefit of a preventative effect for dementia and neurodegenerative diseases. I recommend taking 5 g per day, and I typically consume it in 6-8 week cycles.

6. Magnesium

Magnesium is a critical component of bone health and health in general. I also use magnesium as a sleep and recovery aid. I consume it at night to help me sleep. Magnesium can also reduce muscle soreness, cramps and/or spasms. You can take Mag Glycinate in pill form or by eating foods higher in magnesium such as spinach, artichokes, and dates.

Most people are deficient in the amount of magnesium they consume on a regular basis. I recommend beginning with a dose of 200 mg (before bedtime) and increasing the dose in 100 mg intervals as needed. I would caution you that taking too much magnesium can lead to diarrhea. Mag Glycinate in its oral form is the most highly absorbable. Although not as absorbable, Thorne Research Magnesium Citrate and magnesium oxide can also be beneficial.

7. Stop Smoking

If you smoke, please stop. It not only affects your bone density, but it has negative effects on every other body system. It also increases your risk of cancer and heart disease.

8. Eat Healthy

Do not eat anything that comes in a package. Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil). Any animal fat should be from organic and grass fed animals. Your body tissue needs nutrients to be able to perform at a high level.

Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development. A healthy diet equates to healthy bones.

9. Avoid Excessive Alcohol Consumption

A moderate amount of alcohol has been shown to have cardiovascular health benefits. Excessive amounts can lead to kidney and liver related issues as well as negatively affect bone density. The general recommendation is to consume no more than 1-2 servings of alcohol per day.

Mary, you should be able to affectively treat osteopenia without prescription medications by implementing these strategies, avoiding known risk factors when possible, and addressing any potential hormonal related issues. Thanks again for the question!

How has osteopenia or osteoporosis affected your life? Which strategies can you implement to improve your condition? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.

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7 Tips on How to Avoid a Heart Attack

Approximately 735,000 Americans have a heart attack every year. Heart disease is the #1 killer in western countries, including the United States, with over 17 million people dying every year due to heart disease worldwide. Most heart attacks are preventable and most risk factors for cardiovascular disease are preventable. Learn how to recognize the possible signs of a heart attack and how to avoid one with the following 7 tips.

Man with chest pain

The cardiovascular system consists of the heart and blood vessels. It is responsible for carrying nutrients and oxygen to the tissues and removing carbon dioxide and other waste out of the cells and tissues. Diseases of the cardiovascular system include the following (this is only a partial list):

  • Heart attack
  • Stroke – cerebral vascular accident (CVA)
  • Arteriosclerosis – hardening of the arteries
  • Coronary artery disease (CAD) – also known as heart disease
  • Heart valve diseases/disorders
  • Heart (cardiac) arrhythmias – abnormal rhythms of your heart rate or beat
  • Heart failure – also known as congestive heart failure (CHF)
  • Hypertension – high blood pressure
  • Peripheral vascular system (PVD) or peripheral artery disease (PAD)

Heart attacks are often associated with men, but cardiovascular disease is actually the leading cause of death in both genders. One out of every two men and one out of every three women will develop heart disease.

Although more men die of heart disease than women, females tend to be underdiagnosed. Once the condition is discovered, it’s often too late to intervene. Nearly 29% of female related death is cardiovascular in nature.

Possible Signs of a Heart Attack:

  • Pain in the left shoulder, pain in the jaw, neck or upper back
  • Dizziness, lightheadedness or fainting spells
  • Shortness of breath
  • Pressure or pain in the chest, typically the left side
  • Nausea and vomiting
  • Sudden sweating
  • Extreme fatigue

Symptoms of a heart attack can be very different among individuals and are typically more subtle in women. If you have any concerns, please seek medical advice immediately. Most importantly, be proactive! The best time to start is prior to an issue occurring.

7 Tips on How to Avoid a Heart Attack:

1. Manage Your Diabetes

If you are diabetic, you are at an increased risk of heart attack and cardiovascular disease. Newer research indicates that sugar and insulin resistance is more of a significant risk factor for cardiovascular disease than excessive saturated fat intake and/or salt. Reduce your carbohydrate (sugar) intake and manage your diabetes. The best and most effective method is through a proper diet and exercise program. For specific strategies on how to improve your health, please refer to 15 Strategies to Make 2015 Your Healthiest Year. 

2. Stop Smoking

Smoking is highly correlated to cardiovascular disease. If you smoke, please make every effort to cut back and then quit. Nearly 20% of all deaths from heart disease are directly related to cigarette smoking.

3. Manage Your High Blood Pressure

High blood pressure makes the heart and cardiovascular system work harder. Over time, this excessive pressure can lead to an enlarged heart (cardiomegaly) as well as damage to the blood vessels in the kidneys and brain. It increases the risk of a heart attack, stroke, and kidney disease. High blood pressure also increases your risk of developing dementia or Alzheimer’s disease.

Acupuncture is proven to be helpful in lowering blood pressure. By applying acupuncture needles at specific sites along the wrist, the forearm or leg, it stimulates the release of opioids, which decreases the heart’s activity and thus, its need for oxygen. In turn, this will lower your blood pressure.

Blood pressure can typically be managed through a healthy diet and regular exercise. For tips on how to get started, please refer to How to Jumpstart a Sedentary Lifestyle and 15 Strategies to Make 2015 Your Healthiest Year.

4. Maintain a Healthy Weight

Obesity is associated with diabetes, high blood pressure, and coronary artery disease. These all increase your risk of developing heart disease. Studies have shown that excess body weight (not including all of the other associated medical conditions) can also lead to heart failure. Even if you are healthy otherwise, being overweight still places you at a greater risk of developing cardiovascular related diseases.

5. Reduce Your Stress

Stress is a normal part of life. Poorly managed stress or excessive stress can lead to emotional, psychological, and physical problems, such as cardiovascular disease and high blood pressure. Regular exercise, massage, yoga, acupuncture, and Tai Chi have all been proven to reduce stress.

6. Improve Your Sleep Quality

Poor sleep is linked to most of the cardiovascular risk factors including: high blood pressure; atherosclerosis; heart failure; heart attacks; stroke; diabetes; and obesity.

Be sure to get as much sleep as you need (typically 7-9 hours at night). Short naps are also an excellent way to get more sleep. I recommend that you read Michael Hyatt’s 6 Strategies to Sleep Soundly, Wake Rested, and Accomplish More.

Acupuncture is also a proven method to help people sleep better and more soundly. It can be used to treat insomnia as well.

7. Sit Less

Sitting for more than two hours at a time is linked to an increased risk of dying from cardiovascular related deaths. Walking daily can reduce stress, improve circulation and hormone regulation as well as benefit your overall well-being. To find out more about starting a walking program, please refer to Why Walking is Critical for Your Health.

Implement these 7 tips to increase your health, avoid cardiovascular related illness, and help you to ultimately age successfully. Proper cardiovascular health will help you to avoid heart attacks and strokes. It will also help you to reduce your risk of other serious medical conditions, such as cancer and dementia.

What steps are you taking to avoid cardiovascular disease and to live healthfully? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice. No health care provider/patient relationship is formed. The use of information on this blog or materials linked from this blog is at your own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Do not disregard, or delay in obtaining, medical advice for any medical condition you may have. Please seek the assistance of your health care professionals for any such conditions.

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Out of Balance?

Poor balance and the fear of falling are primary reasons for declining mobility as a person ages.  Mobility is an important factor in the quality of life.  As balance worsens (increasing the risk of falling), it is more difficult to be mobile.  Unfortunately, falling is the number one cause of hip fracture.  Nearly 20% of all hip fractures in the elderly will result in death within the first year, and 50% of people will never regain their prior level of function.

Physical therapy is a very viable and helpful resource in improving balance and mobility in order to maintain your independence.  The key to helping someone improve balance is to understand why his/her balance is worsening in the first place.  Determining the best intervention to address balance-related issues can be difficult and is typically multifactorial.  Once the reason for the decline is determined, an effective treatment program can be designed by the physical therapist to address the issue.  The following different body systems affect balance:

  • Musculoskeletal System – A person needs to have adequate strength and bone structure for mobility and balance.
  • Somatosensory – This system consists of all of the touch and nerve receptors in the muscles, tendons, and joints. A common problem affecting the somatosensory system is neuropathy. One very common form of neuropathy is from diabetes. Having numb feet makes it very difficult to balance!
  • Eyesight – We rely heavily on our eyesight for mobility and to know where we are located in our environment. Eyesight can be affected by eye conditions such as glaucoma, cataracts or even if you wear poorly fitting eyewear. Your eyesight is not just about the acuity at which you see, but is also how the eyes move. Gaze stabilization is how well you can stabilize on a target in your field of vision.
  • Vestibular System – Our vestibular system is located in our inner ears. It provides us with information on head movement. It works to process information on the head’s position in your environment. The vestibular system is one of the more adaptable systems, and with practice, it can be improved.
  • Central Nervous System – The brain is responsible for coordinating all of the information gathered by the body’s other systems. Damage from trauma or conditions, such as Parkinson’s disease, or a stroke can also affect balance. Other factors such as medications and dehydration can also affect balance.

Fitness group doing tai chi in park on a sunny day

One of the best ways to maintain your balance as you age is to remain active and move more!  Balance is an integration of many body systems, so movement is an excellent way to work on all of the body systems!

If you desire specific advice, I highly recommend that you seek assistance from a qualified medical doctor or physical therapist that is well versed in balance related disorders.  The American Physical Therapy Association (APTA) offers a wonderful resource to help find a physical therapist in your area.  In most states, you can seek physical therapy advice without a medical doctor’s referral (although it may be a good idea to hear your physician’s opinion as well).

For additional information on the five different body systems which affect balance and how they work together to insure proper balance and mobility in our environment, please refer to How Do I Improve Balance? (Part I), How Do I Improve Balance? (Part II), and How to Improve Balance Using a Water Noodle.

How do you incorporate balance activities into your therapeutic exercise program? Please leave your comments below.

Don’t forget to subscribe to my e-mail list to receive each week’s blog post sent directly to your e-mail.  You will automatically gain access to my FREE resource, My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain.  Download the .pdf file, which is full of photos and exercise instructions, to get started!  Subscribe now by clicking on the subscribe button located on the upper right-hand sidebar.  (Or scroll down further if you’re on a mobile device.)  Thank you!

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com.  Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

(This article first appeared in the Seniors Blue Book, October 2014-March 2015, page 84.)

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Q & A: 10 Tips to Prevent Dementia

Q.  My mother had dementia, and I have heard that it can run in families. Is there anything I can do to prevent dementia?  – Judy

A.  Thank you, Judy, for the question. Dementia is a very popular topic lately, especially as cases of dementia continue to rise at a startling rate.  One aspect of the Physical Therapy Advisor web site is to provide “how to” advice on successful aging as well as how to manage your health and well-being.  Preventing dementia is definitely a critical component in successful aging and a healthy lifestyle.

Let’s first define exactly what dementia is, and then we will address the symptoms and risk factors.  Dementia is not actually a specific disease.  It’s a term used to describe a group of symptoms affecting a person’s memory or ability to perform activities of daily living (ADLs). There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking), and continence.

At least two brain functions, such as memory loss and impaired judgement, need to be affected for a person to be diagnosed with dementia.  A person may experience memory loss along with difficulty of performing ADL tasks, such as how to cook or drive.  Loss of memory only would not necessarily mean that a person has dementia.  Although there are many potential causes of dementia, Alzheimer’s disease is the most common form of dementia.  Other possible causes include:

  • Vascular dementia
  • Lewy Bodies dementia
  • Frontotemporal dementia
  • Parkinson’s dementia
  • Huntington’s dementia
  • Hydrocephalous
  • Dementia like symptoms caused by nutrient deficiencies or reactions to medications

Dementia is a serious health problem facing many industrialized nations including the United States.  Actual numbers of people diagnosed with dementia vary between 2 and 5 million people.  Even more troubling is that 5-8% of people over the age of 65 have some form of dementia and that number doubles every 5 years after the age 65.

Close Up Portrait of Worried Senior Couple

Symptoms of Dementia may include the following:

  • Memory loss
  • Difficulty communicating
  • Difficulty with complex tasks, such as driving or math
  • Difficulty with motor programming or coordination
  • Easily disoriented or getting lost easily
  • Personality changes
  • Difficulty with logic or reason
  • Loss of safety awareness or judgement
  • Paranoia
  • Agitation
  • Hallucinations

Dementia like symptoms should be evaluated by a medical physician and should be openly discussed with all parties involved.  Many forms of dementia are progressive.  Early diagnosis allows for proper planning and time to make crucial decisions.  Depending on the type of dementia, there may be medical options to slow down the progression.  In addition, some causes of dementia like symptoms are reversible if caught early.  Your physician can assist you in determining your specific diagnosis and prognosis.

Risk Factors for Dementia:

  • Age – Dementia can occur at any age, but the risk significantly increases after the age of 65. Dementia is not considered a normal aging process.
  • Family History – Genetics play a role. A family history of dementia and certain specific genetic mutations increase your risk.
  • Down syndrome – Down syndrome increases your risk of developing dementia.
  • Alcohol Abuse – Heavy drinking and alcohol abuse increases your risk. Mild to moderate alcohol consumption may help to prevent dementia (particularly when consumed in the form of red wine).
  • Microvascular diseases such as diabetes or atherosclerosis, which is the fatty build up in the arteries. Any disease process that has an inflammatory effect on the small blood vessels of the body increases your risk.
  • High Blood Pressure
  • Depression
  • Hearing Loss
  • Obesity
  • Smoking

Now that we have identified exactly what dementia is and many of the risk factors that increase your risk for developing dementia, let’s address Judy’s question regarding prevention.

10 Tips to Prevent Dementia:

  1. Eliminate known risk factors. This includes eliminating smoking and avoiding heavy alcohol consumption.
  2. Stay social. To experience purpose in your life, it’s key to maintain your social outlets and friendships. It also helps to decrease your risk of developing depression, which is a risk factor for dementia. Be active in your community by interacting with family, friends, church, civic organizations or volunteer projects.
  3. Maintain sharp mental health. Regardless of age, it’s important to remain engaged and mentally sharp through constant and varied mental stimulation. Read, play engaging games, and avoid excessive TV watching.
  4. Get hearing aids. Poor hearing is associated with an increased risk of dementia. When a person loses his/her hearing, he/she tends to disengage with the environment. He/she becomes less social, more depressed, and no longer participates in stimulating activities. Stay engaged by quickly addressing hearing loss.
  5. Exercise. Walk daily or take a yoga or Tai Chi class. Participate in a strength training and high intensity training (HIT) program. Exercise can help you to maintain a suitable weight by insuring your metabolism stays elevated and your hormone levels remain balanced. It also insures good blood flow to the smaller vessels in the brain and helps to regulate insulin levels, which prevents diabetes (a risk factor for dementia).
  6. Do not eat anything that comes in a package. Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil). Any animal fat should be from organic and grass fed animals. Your brain and body tissue need nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development.
  7. Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Water intake supports proper brain, muscle, and hormone function as well as lubrication of the joints and skin appearance. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names that you can’t spell or pronounce.
  8. Manage your weight. Obesity places additional strain on your cardiovascular system and increases your risk of diabetes—thus increasing your risk of stroke, heart disease, and dementia. When attempting to lose weight, aim for 1-2 pounds per week.
  9. Sleep more. While sleeping, your brain clears out metabolic waste, known as neurofibrillary tangles, which are associated with dementia. Your body must rest in order to grow and develop. Most people are not getting adequate sleep and rest. Sleep is critical to maintaining your growth hormone and testosterone production as well as stabilizing your metabolism.
  10. Supplements. There is some evidence that certain vitamins, minerals, and/or herbal supplements may help to reduce your risk of dementia. Folic acid, vitamin B12, vitamin D, magnesium, and fish oil are believed to preserve and improve brain health. Although results are less conclusive, vitamin E, ginkgo biloba, coenzyme Q10, and turmeric may also be beneficial in the prevention of or delay the onset of dementia like symptoms. Please consult with your healthcare practitioner to determine if these supplements are ideal for you.

Dementia is quickly becoming a major public health crisis.  The risk for developing dementia rapidly increases as baby boomers (and others in the western world) age.  Although the exact cause of the spike in dementia cases is unknown, it’s pertinent that we live a healthy lifestyle and avoid known risk factors.  To learn more about how to age successfully, please refer to My Top 10 Anti-Aging Tips.  For inspiration regarding the aging process, I also recommend reading Ken Dychtwald’s Age Power: How the 21st Century Will Be Ruled by the New Old.  Thank you, Judy, for this question!

Do you have a loved one or friend who is experiencing dementia?  Which tip will you implement in order to prevent dementia?  Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. Be sure to join our growing community on Facebook by liking The Physical Therapy Advisor!

Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.