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Mature Focus: Aug. 9

By: Lisa Russell


Knowing the signs of heat-related illness – and the risk factors for it – is especially important for older adults during the hot and humid summer months.

News & Notes

Dangerous dog days of summer

With August temperatures typically rising into the triple digits in St. Louis, it’s important to know the signs and symptoms of heat-related illnesses, which can hit older adults and people with chronic medical conditions particularly hard. The National Institute on Aging [NIA], part of the National Institutes of Health, offers information to help seniors recognize and deal with the potential dangers of hot summer weather.

Heat illness, also called hyperthermia, is caused by a failure of the body’s heat-regulating mechanisms, and the risk for it increases with high temperatures, underlying general health problems and individual lifestyle factors. Heat stress, fatigue, sudden dizziness after exercising in hot weather, heat-related muscle cramps and heat exhaustion are all forms of hyperthermia.

Heatstroke is the most dangerous, potentially life-threatening heat illness. It occurs when a person’s body is overwhelmed by heat and becomes unable to regulate temperature. Signs of heatstroke include a significant increase in body temperature [generally above 104 degrees], pounding and rapid pulse, lack of sweating, flushed skin, feeling faint or dizzy, and changes in mental state such as confusion or combativeness. Emergency medical attention is critical for a person with heatstroke symptoms, especially an older adult.

The NIA cites a number of factors that can increase one’s risk for all types of hyperthermia, including:

  • Dehydration
  • Alcohol use
  • Taking medications such as diuretics, sedatives, tranquilizers, and certain heart and blood pressure drugs, which cause decreased sweating
  • High blood pressure or other health conditions that require special diets, such as salt-restricted diets [however, salt pills should not be used to treat a heat illness without consulting a doctor]
  • Use of multiple medications
  • Age-related circulatory problems
  • Existing heart, lung or kidney disease, or any other illness that causes fever or weakness
  • Being significantly overweight or underweight

On hot and humid days, especially when an air pollution alert also is in effect, older adults who have chronic medical conditions should stay indoors or in air-conditioned places whenever possible. If a heat-related illness is suspected, get the person into the shade or inside where it’s cool and help them to lie down. Call 911 if the person shows symptoms of heatstroke. If he or she can swallow safely, offer fluids without alcohol or caffeine. If possible, apply a cold, wet cloth to areas like the wrists, neck and armpits to cool the person down. Encourage the person to take a cool shower or sponge bath if it can be done safely.

Length of exposure to estradiol, the most common type of estrogen, may contribute to whether a woman develops depression during or after menopause, a new study shows.

Estradiol and the blues

Many past studies have linked fluctuating hormones with depression in women. An estimated 15 percent of women who give birth each year struggle with postpartum depression, and millions more deal with significant depression just before, during or after their transition into menopause. However, there’s been no definitive answer found to the question of why some women feel extremely “blue” during these times of hormonal change, while others breeze through with few or no problems.

A recent study published online in Menopause, the journal of The North American Menopause Society [NAMS], may provide some clues. The study includes data obtained from more than 1,300 regularly menstruating, premenopausal women who were between the ages of 42 and 52 when they entered the study.

The research focused primarily on the effects of estradiol, which is the predominant estrogen hormone present during women’s reproductive years. One of estradiol’s key functions is to modulate the synthesis, availability and metabolism of serotonin, a neurotransmitter in the brain that plays a critical role in depression. While all women experience fluctuations of estradiol during the menopause transition, the amount of lifetime exposure to estradiol varies widely from woman to woman.

Most significantly, the study found that longer periods of estradiol exposure, from the start of menstruation until the onset of menopause, was related to a reduced risk of depression during the menopause transition, and for up to 10 years afterward. Longer duration of birth control use also was associated with a decreased risk of depression; however, the number of pregnancies or whether the women breastfed their children had no effect on depression risk. In addition, the study found a higher risk for depression in women with earlier onset of menopause, fewer menstrual cycles over the lifespan and more frequent hot flashes.

“Women are more vulnerable to depressive symptoms during and after the menopause transition because of fluctuating hormone changes,” said NAMS Executive Director Dr. JoAnn Pinkerton. “Women and their providers need to recognize symptoms of depression, such as mood changes, loss of pleasure, changes in weight or sleep, fatigue, feeling worthless, being unable to make decisions or feeling persistently sad, and take appropriate action.”

 

Protein power

While many seniors may think protein supplement drinks are just for bodybuilders, new Canadian research shows that older adults may benefit significantly from using them as well – whether or not the supplements are combined with exercise.

A natural part of aging involves the gradual deterioration of muscle mass and strength. This deterioration, called sarcopenia, can increase the risk for falls, metabolic disorders and the need for help with everyday tasks, which eventually may require a move to assisted living.

“Older people who do little to prevent the progression of sarcopenia drift toward a state where they find activities of daily living, like rising from a chair or ascending stairs, very difficult or maybe impossible,” said Stuart Phillips, a professor in the Department of Kinesiology at McMaster University, where the study was conducted.

The researchers recruited two groups of men aged 70 and older, and combined a number of nutritional ingredients that have been shown to fight sarcopenia – including whey protein, creatine, vitamin D, calcium and fish oil – into a ready-to-drink nutritional supplement.

One group took the supplement for six weeks while the other took a placebo; both groups did no additional regular exercise. After the initial six-week period, all study participants continued to take either the supplement or placebo while also completing a 12-week progressive exercise training program, which consisted of twice-weekly resistance and high-intensity interval training.

In terms of strength and lean body mass, both before and after the exercise program, the results were “more impressive than we expected,” according to one researcher. Most notably, the men who took the supplement showed significant improvements in deteriorating muscle health and overall strength even before they started the exercise program. After the first six weeks, those taking the supplement gained an average of 700 grams [about a pound and a half] of lean body mass – the same amount of muscle these men normally would have lost in a year. When combined, the men showed even greater strength gains – especially compared to those who also exercised, but took the placebo.

The study, conducted within the McMaster Institute for Research on Aging, was published in PLoS One.

 

Stronger bones – in a minute 

Older women who think they don’t have enough time to exercise – or who don’t have the stamina for long workouts – may want to take note of a new study that suggests even a single minute of intense exercise can have a significant positive impact on women’s bone health.

Scientists from the University of Exeter and the University of Leicester in the U.K. recently found that women who did “brief bursts” of high-intensity, weight-bearing exercise for an average of 60 to 120 seconds per day had 4-percent stronger bones than those who exercised for less than a minute. To reach that conclusion, the researchers examined data from more than 2,500 women, and compared their activity levels, measured by wrist-worn monitors, with bone health assessed through an ultrasound scan of their heel bones. The exercise intensity level studied was equivalent to a medium-paced run for pre-menopausal women, or a slow jog for post-menopausal women.

“We don’t yet know whether it’s better to accumulate this small amount of exercise in bits throughout each day or all at once, [or] whether a slightly longer bout of exercise on one or two days per week is just as good as 1-2 minutes a day. But there’s a clear link between this kind of high-intensity, weight-bearing exercise and better bone health in women,” said lead author Dr. Victoria Stiles, of the University of Exeter.

“Because this is a cross-sectional study, which assesses data taken from a subset of the population at a particular point in time, we can’t be sure whether the high-intensity physical activity led to better bone health, or whether those with better bone health do more of this exercise. However, it seems likely that just 1-2 minutes of running a day is good for bone health,” she added.

 

On the calendar

Conquer Your Knee Pain, a free seminar offering information about non-surgical and surgical options for knee pain and chronic stiffness, is offered from 6-7 p.m. on Wednesday, Aug. 16 at Des Peres Hospital, 2315 Dougherty Ferry Road in St. Louis, in the MyNewSelf Education Room. The session is conducted by an orthopedic physician. To register, visit www.despereshospital.com or call (855) 290-9355.

• • •

Knee Replacement: Is It Right for Me?, a discussion with an orthopedic physician about minimally invasive knee replacement surgery and other treatment options for knee arthritis, is offered from 6-7 p.m. on Wednesday, Aug. 23 at St. Luke’s Hospital, 222 S. Woods Mill Road in Chesterfield, in the third floor conference room. Attendance is free. Register online at www.stlukes-stl.com; call (314) 542-4848 for more information.

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