Caregiving Archive

You can strengthen your abs without feeling like you're tackling a daunting workout.

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For some people, crunches and other abdominal muscle workouts are the last thing they'd want to do — so they don't. "Part of the perception is that it's difficult. We tend to want to avoid doing things that require effort, especially as we get older, when that's harder for us," says Lorna Brown, a physical therapist who specializes in geriatrics at Harvard-affiliated Spaulding Rehabilitation Hospital.

But skipping abdominal strengtheners can have a big effect on your mobility and independence — and not for the better.

News briefs

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Past studies have suggested that drinking coffee is associated with many health benefits, such as added longevity, lower blood pressure, less weight gain with aging, and a reduced risk of many diseases, including type 2 diabetes, liver disease, cardiovascular disease, several degenerative neurological diseases (like Parkinson's disease), and cancer. Now a massive review of more than 200 large studies, published Nov. 22, 2017, in The BMJ, backs up many of those links. The largest health benefits were associated with drinking three to four cups of coffee per day: drinking more than four cups per day did not bring additional benefits. It's not all good news, however; the study found that women who drank coffee had greater risks for fracture and pregnancy complications. But over all, the researchers say, coffee drinking appears to be safe. They caution that the findings are all based on observational studies, not randomized controlled trials — the gold standard of research.

News briefs

Driving becomes challenging when you get older. Age-related health changes can make it hard to see at night, grip a steering wheel, or step on the brake at a moment's notice. Simple car tools, such as steering wheel covers that make the wheel easier to grip, can help. But research released in December 2017 from the AAA Foundation for Traffic Safety suggests that most older drivers aren't taking advantage of such tools. Between 2015 and 2017, researchers asked about 3,000 older adults (ages 65 to 79) about their use of adaptive vehicle tools. About 9% of respondents said they had at least one such tool. Researchers also asked older drivers if their vehicles had factory-installed safety features, such as technology that alerts you to danger when you are about to change lanes. Fifty-seven percent said they had at least one of these technologies, but only 43% of that group reported using them.

Even if your vehicle isn't equipped with high-tech safety features, adaptive vehicle tools can make driving safer, say researchers. If you're having trouble seeing over the dash, a seat cushion will give you a little height. There are also gadgets to bring pedals closer to you, put dashboard buttons on the steering wheel, and provide support for aching backs or arms. An occupational therapist can help determine which tools might help you, where to get them, and how to have them installed by a trained technician.

Research we're watching

Mental stress can cause arteries throughout the body to constrict. In people with heart disease, this effect can reduce blood supply to the heart muscle, a phenomenon known as mental stress–induced ischemia. New research suggests that this problem may affect women differently from men.

For the study, 678 adults (average age 63) delivered a speech while researchers measured their blood pressure and heart rate, took imaging pictures of their hearts, and measured the constriction of tiny arteries in their fingers. In women, mental stress–induced ischemia mostly resulted from constriction of tiny arteries. The resulting greater resistance requires the heart to use more force in pumping blood. In contrast, the ischemia seen in men was mostly due to a rise in blood pressure and heart rate. The findings are yet another reminder for people to find ways to avoid and manage mental stress. But they also hint that women's hearts may be more vulnerable to this problem. The study was published online Dec. 21, 2017, by the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

Men may be less able to perform daily activities as they age, but there are ways to reverse these changes.

Most men would prefer to maintain strength and robustness as they age. There are many ways to maintain a high level of health and energy through the years, but disease, surgery, and Father Time sometimes gang up and make men feel as if their best years are behind them.

Still, you don't have to take frailty lying down. "It's never too late to treat frailty and recoup what you may have lost," says Dr. Marian T. Hannan, co-director of the Musculoskeletal Research Center at the Institute for Aging Research at Harvard-affiliated Hebrew SeniorLife.

On call

Q. I have read that vitamin K supplements can help prevent heart disease. Should I take them?

A. Vitamin K — which is found in high levels in green leafy vegetables like spinach, kale, and romaine lettuce — plays a role in helping the body make blood clotting proteins. Although some observational studies have suggested a heart benefit from diets high in vitamin K, studies of supplements have not shown a protective effect.

In the journals

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Cardio is often regarded as the exercise of choice for weight loss, but older adults can benefit from adding weight lifting too, as it helps preserve muscle mass more than aerobic workouts.

A study published online Oct. 30, 2017, by the journal Obesity divided 249 overweight or obese adults in their 60s into three groups. One followed a restrictive diet of 1,200 to 1,800 daily calories. Another followed the diet and also did weight-machine workouts (four 45-minute sessions per week, targeting the major muscle groups). The third group followed the diet plus a cardio program of walking (45 minutes, four days a week, at a moderate-intensity level).

In the journals

Older adults who develop hearing loss are more likely to experience greater cognitive decline and develop dementia than their counterparts without hearing problems, according to a meta-analysis published online Dec. 7, 2017, by JAMA Otolaryngology — Head and Neck Surgery. Researchers examined data from 36 studies including more than 20,000 people who underwent both cognitive evaluations and hearing tests. Those with age-related hearing loss were more likely to have cognitive impairment or a diagnosis of dementia.

The study found a small but statistically meaningful association between hearing loss and a variety of specific cognitive abilities, including executive function, memory, processing speed, and visuospatial ability (how you recognize shapes and sizes and estimate the distance between two objects). The association between hearing loss and weaker cognitive skills was still strong even after accounting for risk factors like high blood pressure and smoking.

If you are noticing problems in yourself or a loved one, here's where to turn for help and support.

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You're talking with a friend about a movie you saw recently, but can't remember the actor's name. Last week you found yourself upstairs, but couldn't remember what you came up to look for. Your keys are always missing. You worry: are these normal memory lapses or early signs of Alzheimer's disease or another form of dementia?

"Because there has been so much attention paid lately to the aging baby boomer population, I think Alzheimer's disease is getting a lot of attention, which is leading a lot of people to believe they may have the condition," says Dr. Suzanne Salamon, associate chief of the gerontology division at Beth Israel Deaconess Medical Center and assistant professor of medicine at Harvard Medical School.

Ask the doctors

Q. I feel like I'm tired all the time. Is this just a normal part of aging?

A. The short answer to your question is, no. Getting older may mean you have less endurance than you used to and you may feel tired sometimes, just like anyone else, but if you are experiencing long-lasting daily fatigue, there could be an underlying medical cause.