Healthy aging and longevity Archive

Q. I have pelvic organ prolapse and work out at the gym almost every day. Are there any forms of exercise that will make my situation worse?

A. Pelvic organ prolapse results from weakened muscles and ligaments of the pelvic floor, which allow your bladder or uterus to drop and press against the walls of the vagina. You didn't say what type of exercise you do at the gym, but there are a few you should avoid—lifting heavy weights, especially over shoulder height; high-impact aerobic activities involving jumping or hopping; and sit-ups. You should check with a trainer at the gym to see how you can modify strength training, core exercises, and aerobics to reduce stress on your pelvic floor.

Q. The article in your December 2014 issue about women's waistlines expanding the past few years intrigued me, because I have experienced an increase, and I have not gained weight. My theory is that the styles of the past few years—pants riding low on the hips, no belts at the waist, and loose shirts—may have caused my waist to increase from 24 to 25½ inches. I am 59 years old, so it also could be aging in general, but I still think the belted styles kept women smaller. Am I right?

A. There is no evidence that the physical effect of wearing a belt influences waist circumference. At best, wearing a belt is one way to keep tabs on your waistline. While having to loosen their belt a notch may drive some women to re-examine their diet and exercise routines, it doesn't sound as if you need to do that. I think your alternative explanation that aging is responsible is more likely to be true.

As we reported in March, sleep apnea and other sleep breathing problems are associated with the development of dementia. Now a study published online April 15, 2015, by Neurology finds that sleep breathing problems are associated with an earlier onset of the decline in thinking skills.

Researchers analyzed the medical histories of about 2,500 people ages 55 to 90 and found that people with sleep breathing problems were diagnosed with mild cognitive impairment (a decline in thinking skills) an average of 10 years earlier than people who didn't have those problems. The encouraging news: people who treated their sleep breathing problems with a continuous positive airway pressure (CPAP) machine were diagnosed with mild cognitive impairment about 10 years later than people whose problems were not treated. The study doesn't prove a cause-and-effect relationship, but it does offer hope. "CPAP improves the quality of sleep in people with sleep-disordered breathing. Healthy sleep is an important time for our brains to accomplish critical 'housekeeping' tasks. One of these tasks is clearing beta-amyloid, one of the main proteins associated with Alzheimer's disease," says Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School.

Don't be misled by well-intentioned advice. Some processed foods offer nutritional value and convenience.

Nutrition gurus often urge us to spurn processed foods in favor of whole ones. But not all processed foods are necessarily bad. "Most food needs to go through some sort of processing for it to even be edible and digestible," says Stacey Nelson, a registered dietitian and manager of clinical nutrition at Harvard-affiliated Massachusetts General Hospital. "The minute you cook something, you are processing it."

An ingrown toenail is one of the most common sources of foot pain. Although it's usually just a nuisance, it can be a serious problem for anyone with diabetes or circulatory difficulties.

An ingrown toenail develops when the side of the nail digs into the skin. This can lead to pain, irritation, swelling, and redness. The big toe is most often affected, although no toe is immune. The problem usually develops because the nails have not been trimmed properly. Overly tight shoes may also be a factor. Some people have an inherited tendency to develop the problem.

When shopping for shoes, you want to have more than fashion in mind — you'll also want to consider function and keeping your feet in good shape. These 10 tips can help you choose the right shoes:

1. Take a tracing of your foot with you. Place any shoe you think you might buy on top of the tracing. If the shoe is narrower or shorter than the tracing, don't even try it on.
2. Shop for shoes during the afternoon — your foot naturally expands with use during the day.
3. Wear the same type of socks to the store that you intend to wear with the shoes.
4. Have a salesperson measure both of your feet — and get measured every time you buy new shoes. Feet change with age, often growing larger and wider. If one foot is larger than the other, buy a size that fits the larger foot.
5. Stand in the shoes. Press gently on the top of the shoe to make sure you have about a half-inch of space between your longest toe and the end of the shoe. This provides enough room for your foot to press forward as you walk. Wiggle your toes to make sure there's enough room.
6. Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don't rationalize that the shoes just need to be "broken in." Find shoes that fit from the start.
7. Trust your own comfort level rather than a shoe's size or description. Sizes vary between manufacturers. And no matter how comfortable an advertisement claims those shoes are, you're the real judge.
8. Pay attention to width as well as length. If the ball of your foot feels compressed in a particular shoe, ask if it comes in a wider size. Buying shoes that are a half-size bigger — but not any wider — won't necessarily solve the problem.
9. Feel the inside of the shoes to see if they have any tags, seams, or other material that might irritate your foot.
10.  Examine the soles. Are they sturdy enough to provide protection from sharp objects? Do they provide any cushioning? Take note of how they feel as you walk around the shoe store. Try to walk on hard surfaces as well as carpet to see how the shoe feels on both.

For more advice on keeping your feet pain-free, buy Healthy Feet, a Special Health Report from Harvard Medical School.

Many people with insomnia turn to sleeping pills, which often have unwanted side effects. Few of them know about an equally effective therapy that targets the root cause of insomnia without medications. Called cognitive behavioral therapy for insomnia, or CBT-i, this short-term talk therapy teaches people to change the unproductive thinking patterns and habits that get in the way of a good night’s sleep. While this therapy can’t “cure” insomnia, it does provide tools to better manage it. In a review article in this week’s Annals of Internal Medicine, researchers found that people treated with CBT-i fell asleep almost 20 minutes faster and spent 30 fewer minutes awake during the night compared with people who didn’t undergo CBT-i. These improvements are as good as, or better than, those seen in people who take prescription sleep medications such as zolpidem (Ambien) and eszopiclone (Lunesta). And unlike medications, the effects of CBT-i last even after the therapy ends.

Being a caregiver for an ailing parent, spouse, child, or other loved one can feel like a lonely undertaking. It needn't, even if you don't have family nearby to pitch in. Help for caregivers is available from various organizations. Once you learn what's available, it may be easier to chart a less-demanding course toward meeting the needs of your spouse, relative, or friend.

Here are some types of services and professionals you might want to investigate.

Regular physical activity helps keep your heart, lungs, and muscles in shape and can stave off the effects of aging. In much the same way, exercising your brain can help keep your mind sharp and your memory intact. Here are two ways to activate your brain.

Keep busy and engaged

The MacArthur Foundation Study on Successful Aging, a long-term study of aging in America, found that education level was the strongest predictor of mental capacity as people aged. The more education, the more likely an individual was to maintain his or her memory and thinking skills. Other research has shown that people who held jobs that involved complex work, such as speaking to, instructing, or negotiating with others, had a lower risk of memory loss (dementia) than people whose jobs were less intellectually demanding.

Substantial research proves the Mediterranean and DASH eating plans offer important health benefits for men.