June 2014
3
TIPS
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50
Body&More
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A Special Suppliment to
JOURNAL GAZETTE & TIMES-COURIER
Stand Up for Yourself Is sitting all day really as bad for your health as smoking?
+
5 Best Exercises for Fitness Novices
Self-Care Tips for Caregivers
hello,
Dolly!
Singer, actress, living legend: The inimitable Dolly Parton continues to live her dreams, on and off the stage
Brain-Boosters!: 3 Tips to Get Smart Exercise Supplement Caution
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BODY & MORE 50+
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How to Use Electronic Health Records, f you signed up to access your electronic personal health records through your health care provider you have a lot of information about your health status. However, even if you know your triglyceride or blood glucose numbers you can’t manage your health on your own, according to Dr. Grant M. Greenberg. “You may see what’s going on but not how to apply it,” says Dr. Greenberg. Instead, you can use the information to have a conversation, electronically or in person, with your physician. For example, if your records show that your LDL cholesterol is higher than in the past you can ask your physician whether you should be concerned. By having your personal health information you’re more likely to take care of your health, Dr. Greenberg says.
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Move It, Don’t Lose It “Cognitive ability peaks in the late 20s, early 30s and starts to decline from there. It’s fairly normal to remember less in your 40s and 50s.” — Jeffrey Toth, Ph.D.
Shedding Weight Feeling Great When Sarah Bush Lincoln initiated its weight loss program, Eric Boerngen decided to give it a try. The program uses the HMR (Health Management Resources) method, the nation’s leading provider of weight management treatment services to hospitals. The 12-week program uses nutritionally complete weight-loss shakes and entrées in place of store bought food, making it easy to follow and decision-free. Losing an average of five pounds a week, Eric lost a total of 60 pounds during the 12-week period. “I’ve had unbelievable success with the program and I feel great,” he said. “It was easier than I thought it would be. If you just follow the plan it works.” “Seeing the weight come off each week was very motivational to me. The results are what keep you going,” he said. “The diet is just as much about education, a lifestyle change and eating well, as it is about losing weight.” Today Eric had lost a total of 90 pounds.
t’s not uncommon for your memory to decline as you age and the process could start relatively early.
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“Cognitive ability peaks in the late 20s, early 30s and starts to decline from there. It’s fairly normal to remember less in your 40s and 50s,” says Jeffrey Toth, Ph.D. But brisk exercise that improves your blood flow – such as walking 30 minutes a day at a fast pace, biking or swimming – may be good for your cognitive health. Physical exercise may make your brain more flexible and adaptable, which in turn could make cognitive training more effective, according to Toth, who is studying the effect of combining aerobic and cognitive brain exercise.
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Step Into Change espite the abundance of supervised programs and gizmos to encourage movement, health experts are still asking what it takes to get you moving. It’s probably more than your good intentions. “It’s very challenging to rely on will power to change,” says Jeremy Adam Steeves. He’s encouraging people to increase the number of steps they take each day. “The average American is getting just over 5,000 steps a day. The goal is 10,000 steps,”
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Steeves says. In one experiment he divided 58 sedentary, overweight adults into two groups. During the six-month trial, one group walked for 30 minutes a day; the second group stepped in place during the commercials in a 90-minute stretch of television viewing daily. Both groups increased their daily steps while decreasing their body fat and their waist to and hip circumference over the length of the experiment. The TV-stepping group broke up their sitting time, which also is important, ac-
cording to Steeves. For Marc Hamilton, the answer is to encourage more everyday movement. “If it looks like exercise and requires equipment you’ll perform it like exercise. You’ll do it for 30 minutes, check it off the list, then park yourself in front of the TV,” says Hamilton. People can “retool the habits of their day,” according to his research. “There are practical, feasible things you can do without exerting yourself. You’ll feel better, have a greater sense of energy and be more productive, ” Hamilton says. Make it a practice to get up
JUNE 2014 — 3 from your desk to talk to colleagues across the room or pick up around the house every day. “You can experience healthful results based on how much
time you spend moving, not just how much you exert yourself,” he says.
EAT IT UP
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ACTIVE AGE rowing older doesn’t mean becoming less active. According to the 2013 Tracking the Fitness Movement report from the Sports and Fitness Industry Association, 45 percent of baby boomers visit a gym two or more times a week, and 21 percent of people older than 55 say they exercise at home. Here are the five most popular fitness activities among the 50plus crowd: 1. WALKING FOR FITNESS – 47.8% 2. TREADMILL – 15.7% 3. HAND WEIGHTS – 14.4% 4. STRETCHING 12.8% 5. BOWLING – 11.6%
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4 — JUNE 2014
BODY & MORE 50+
‘I’m Still Dreaming
Big!’
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Living legend Dolly Parton, 68, is still living her very active, successful dream By Lisa Iannucci CTW Features wo weeks out of every year, Dolly Parton tunes out the world. She says it’s her time to concentrate on songwriting. “I head up into the mountains to my lake house and let the words flow,” says the legendary singer. This time the words flowed right into “Blue Smoke” – her newest album that she describes as celebrating the colors of her career. “On this CD I think there are all of the colors of my life in all the areas of music that you’ve allowed me to dabble in through the years,” says Par-
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Putting a concert together is a long process for Parton and her team. “We start about a year and a half before we hit the road,” she says. “We got to decide if you really want to do the tour, what we want the show to be and then get with the promoters, sell it and see what time of year is good for a tour. Then we work for weeks and weeks getting the show ready. I just think, “Oh God, just let me get on the tour so I can rest.” At 68, touring must be the only time that Parton, in a sense, cuts back. She is a successful musical artist, contributor of songs to major motion pictures such as “Nine to Five,”
“We have some crew members who have health problems and some who are vegetarians. We have a great chef that provides really good food, in addition to junk food if we want it.” ton, who has sold a staggering 100 million records worldwide. “You will hear my old world mountain voice on songs like ‘Banks of The Ohio’ and ‘If I Had Wings,’ my tender side on songs like ‘Miss You – Miss Me’ and ‘Unlikely Angel.’ My country/bluegrass side of songs, like ‘Home,’ ‘Blue Smoke’ and ‘Don’t Think Twice’ and my funny tongue-in-cheek side on ‘Lover du Jour.’” Parton’s career has spanned nearly five decades, but instead of slowing down and enjoying her successes, she’s gearing up for the start of yet another international tour.
“Steel Magnolias,” “Straight Talk” and “Joyful Noise.” She has received two Oscar nominations – one for writing the title tune to “Nine to Five” and the other for “Travelin’ Thru” from the film “Transamerica.” She’s achieved 25 certified gold, platinum and multi-platinum awards and has had 25 songs reach No. 1 on the Billboard Country charts, a record for a female artist, has 41 career Top 10 country albums, a record for any artist, and she has 110 career charted singles over the past 40 years. When she’s on the road, Parton makes sure to take care of
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herself and her crew. “When we travel, we have our own caterer that is with us all the time,” she says. “We have some crew members who have health problems and some who are vegetarians. We have a great chef that provides really good food, in addition to junk food if we want it.” During the tour, she makes it a point to rest her most important instrument, her voice. “I don’t have anything to do after the show, so I make sure I rest my voice,” says Parton. “I read, write and don’t do interviews during the day. I have to rest my body and voice. We’re all pretty health conscious. We’re all older, worked together for a long time and just know what we need to do.” Parton says that she’s excited about her new album, but then again, she’s excited when any one of her albums comes out. “The songs are my children, and I joke that I hope they support me when I’m old,” she says. “I always think the album I’ve just done is the best one yet. I get a chance to work with the same musicians on my road show and we get excited together knowing we can enjoy them together.”
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Fans of all ages love Parton’s music, too. “People are always going to have the same thoughts and heartaches and we all have our true feelings, whether it’s our faith in God or family or love for our children,” she says. “I’ve done things with the little ones and was the aunt on ‘Hannah Montana’ so the younger ones know me now, too.” Reflecting back on her extensive career, Parton says that she’s proud of what she’s accomplished. “I’m so fortunate
that I was able to see my dreams come true when I think about so many others who were more talented than I am and who didn’t see their dreams come true,” she says. “It’s like that Kris Kristofferson song, ‘Why Me Lord?’ But I’m still dreaming big.” © CTW Features
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Caregiver Strong How to Help Those Who Help Others More than 65 million Americans are providing care to a family member, but knowing how to care for the caregiver is of equal importance to knowing how to care for the loved one By Yuliya Nemykina CTW Features hen Deborah Shouse’s mother was diagnosed with Alzheimer’s disease, she asked her father if she could help. “I wanted to stay connected with her on this journey,” Shouse says. She would eventually use her diaries and notes to write two books about caregiving and raise more than $80,000 for Alzheimer’s research. According the National Caregiving Alliance, in 2009 more than 65 million people in the U.S. cared for elderly, disabled or chronically ill members of their families. On average, this caretaking takes around 20 hours a week – the same time allotment as a parttime job. (Keep in mind the average caregiver already is working a job.) Stress, exhaustion and the physical demands of caregiving can harm the caretakers as much as their charges. Leah Eskenazi, director of operations for the Family Caregiver Alliance in San Francisco, says people often want to stay at home because they feel more comfortable surrounded by familiar things and people. But the caregivers also may benefit from the closer relationship. “You can be there to help somebody who, maybe, was there for you when you were growing up,” Eskenazi says. “You can supervise what’s going on, and make sure they have the best care.” Shouse acted as her mother’s assistant caretaker, supervisor and, once her mother began to lose communication skills, an interpreter. She says one of her favorite moments came from the psychological connection. “One of my favorite memories was when my mom could no longer carry on a conversation, but she was able to laugh. She looked into my eyes and it reminded me that even when she
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couldn’t talk or she could even say my name, the essence of her was still there,” she says. However, you may want to reconsider caregiving if the relationship between you and a hypothetical care receiver is sour, or if you have a chronic health condition of your own. Eskenazi especially emphasizes the dangers of caregiving alone. If there is no one else who is willing to help, it might not be a realistic plan for you, she says. Even caring for a favorite relative may prove difficult. Eskenazi says a caregiver may have to supervise midnight bathroom trips, lose the time they usually use to cook their own food, or forget to set up their own doctor’s appointments. “Often, we wind up with two patients,” Eskenazi says. “And, it’s always ‘I’m the caregiver. How did I wind up in the hospital?’” A caretaker’s friends and family members can lighten some of that burden, but those people need to realize that caregivers often are too overwhelmed to think of calling for help or to identify what they might need help with at any given moment, says Janice Schuster, senior writer at the Center for Eldercare and Advanced Illness at Altarum Institute in Ann Arbor, Mich. “The least helpful thing you can do is say ‘Give me a call if you need something,’” Schuster says. “The best thing to do is call and say ‘I’m in the area. Would you like me to pick something up? Would you like me to come by and help with dinner?’ Saying ‘I’m thinking of you’ is nice but not very helpful.” Having a willing listener may not be a bad idea. Denise Brown, founder of CareGiving.com, an online community to connect caregivers, also says the emotional rollercoaster can be the biggest surprise to new caregivers. “You feel guilty, you
feel resentful, you feel guilty, you feel angry, you feel guilty. Sometimes, when a caregiver expresses that frustration, someone who doesn’t understand may say ‘Well, why don’t you just put them in a home?’ But that’s not what the caregiver is looking for.” And whether you’re the primary caregiver or just giving them a break, it’s important to do what you can to take care of yourself. Schuster says the first step might be recognizing that caretaking is a job, not just something you do as a good child or spouse. It’s also good to keep up favorite habits. Shouse carried a list of things she enjoyed doing for ideas during downtime. “They were simple things like ‘I like to read,’ ‘I like to go outside,’ ‘I like to eat chocolate,’” she says. “When I had a few free minutes, I’d pull it out.” Shouse says she concentrated on “staying in the present” instead of missing the way her mother used to be or what life would be like as the disease progressed. “I trained myself to think about what she was to me,” Shouse says. “Sometimes that could be holding her hand, or looking into her eyes, or leafing through a magazine together. These days, everything is in a rush, but I needed to slow down with mom. I walked slower when I came into her area. It helped me get into the present.” Eskenazi says communities can offer services like grocery deliveries, adult day care, respite care, support groups and information. Brown cites a CareGiving.com member from a small British island who told her about a local initiative in which postal workers check on chronically ill, disabled and elderly people to make sure they have everything they need. © CTW Features
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3 Bright Ideas for Boosting Memory
Staving off Alzheimer’s and other brain-related diseases isn’t always possible, but experts say an active, challenged mind is essential to mental health By Bev Bennett CTW Features hen you forget the name of a movie you recently saw or where you put your glasses, you may conclude you need to sharpen your memory, especially if you’re a mature adult. Look around and you’ll find a wide range of options for brain training, from crossword puzzles to specially designed products to research projects that need volunteers. Companies are spending a lot of money to create cognitive exercise programs, according to Michael Marsiske, Ph.D., associate professor in the department of clinical and health psychology at the University of Florida in Gainesville. In addition, health experts are dedicated to finding ways to reduce the risk of cognitive decline. Yet even though there are lots of strategies and theories, scientists aren’t at the point of being able to tell people “you should do this, this and this, “ says Marsiske, who has been a principal investigator on a long-term study of Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE). However, experts can make some suggestions for what you devote your time and energy to doing, based on current research.
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1. TRY SOMETHING NEW AND DIFFICULT Try something challenging and novel, says Jeffrey Toth. Ph.D., associate professor at the University of North Carolina-Wilmington. He recommends sustained cognitive activities that take you out of your comfort zone, such as learning a new lan-
JUNE 2014 — 7
guage or taking up a musical instrument. In fact, doing something you find difficult may be beneficial. “I actually think my non-enjoyment of video games may be helpful. I have to strain and pay attention because I’m not great at them,” says Marsiske. The reverse also may be true. If your skill becomes easy and habitual, it’s time to try something else, according to experts.
2. MAKE LEARNING A LIFELONG HABIT “Learn new things. Take on challenging tasks throughout life,” says Toth, a cognitive psychologist, who researches memory, attention and cognitive aging. Still you may wonder about the efficacy of particular braintraining games. A game based on recollection may be beneficial, according to Toth. “I think that’s the type of thing we should think more of,” says Toth, who created Art Dealer, a memory enhancement game.
training and training in speeding up the time they spent in mentally processing information. “ACTIVE challenged with something new and difficult; something that demanded something of people that wasn’t in their current repertoire,” says Marsiske.
“Learn new things.Take on challenging tasks throughout life.” — Jeffrey Toth, Ph.D. Although some people in ACTIVE worked alone, being in a group may offer an advantage, according to the Florida expert.
“Some studies showed that small group training was more effective. You have peers who can model,” Marsiske says. © CTW Features
3. TRAIN THE BRAIN Formal training programs also may provide positive results. In Marsiske’s ACTIVE research study, older adult volunteers who were given mental training sessions reported cognitive improvements for 10 years. Volunteers selected for the training, designed to see whether cognitive training helps with everyday functions, underwent ten, 60- to 75minute sessions of memory, reasoning and speed-of-processing exercises. The volunteers received memory training, reasoning
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TOTAL EXCHANGE OF THE JOINT Today, baby boomers and seniors have a desire to stay active longer. As such, there has been a rise in total joint replacement procedures and along with it a more efficient, effective and safer surgery By Yuliya Nemykina CTW Features rack open a tabloid magazine or tune into any “Real Housewives” show and it would be easy to think of the U.S. as the land of plastic surgery, but there is another type of surgery on the rise: total joint replacement. According to the Centers for Disease Control and Prevention, U.S. surgeons replaced 1,051,000 hips and knees in 2010 alone. Some argue the surgery’s popularity a mathematical illusion as baby boomers come into their 50s and 60s, creating the largest and longest-lived senior population in recent memory. “There isn’t really an increase in the percentage of patients in need of total joint replacement,” says Dr. Brian Parsley, president of the Amer-
C
ican Association of Hip and Knee Surgeons. Others argue the demand in joint replacement has grown faster than the population, and the average age at the time of surgery has decreased. “Patients, especially younger patients, are unwilling to accept lifestyle accommodations and lead a more sedentary life when they know that, with surgery, they can lead a more active lifestyle,” Robb says. “Walking aids like canes and wheelchairs are not as accepted as they used to be. There have been changes in perception of physical disability and the way society judges people who use them.” Generational characteristics also may play a role, says Dr. Steven Kurtz, the vice president and principal at Exponents, a biotechnological consulting firm. Kurtz wrote a
seminal paper on the rise of total joint replacement, noting that baby boomers drive the joint replacements at a younger age, seeking to keep up their athletic lifestyles. “Sporty people get osteoarthritis more often,” he says. “There is always some counter-example going, ‘I’m 50 years old, and I’m running a marathon,’ but there isn’t a big percentage of 50-year-olds running marathons.” A 2012 Brigham and Women’s Hospital study published in The Journal of Joint and Bone Surgery supported the second hypothesis when it found the increase in arthoplasties between 1999 and 2008 had outpaced both the growth in the senior population and the rise in obesity. According to the American Academy of Orthopedic Surgeons, this surgery is the solu-
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tion to joint pain that medications no longer control. According to William Robb, the orthopedic director for Illinois Bone and Joint Surgery, partial joint surgery may be possible, but not in cases of osteoarthritis or inflammation. Kurtz also notes the procedure has become more efficient over time, allowing surgeons to replace more joints in a day, and the increasing number of people with fake joints might be good advertising for the procedure. “There are a number of people who have these devices implanted in them, and have had positive experiences,” he says. Although some wear and tear on the joints is natural, there are a few things you can do to preserve your knees and hips for as long as possible. Kurtz says high-impact activities like team sports and jogging tend to wear down the joints quicker because they’re more likely to injure the person compared to hiking or bicycling. Swimming and water sports may be especially effective, as it holds up your weight. “Your body is enclosed in water, and the force of it lightens the load on your joints,” he says. It’s also important to keep up general health. According to Parsley, obesity puts a severe strain on your knees, which carry about five times the strain of your total weight. His study showed that obese patients need joint replacement seven to 16 years earlier than non-obese patients. Diabetes and smoking also may cause issues by weakening the immune system, weakening the processes that allow your knees to rebound from injury and microscopic tears.
However, even artificial joints are not invulnerable to everyday wear and tear. Much like their bone-and-cartilage counterparts, they may dislocate, loosen or become infected. In fact, according to the American Academy of Orthopedic Surgeons, prosthetics last about a decade, and you might have to replace one even sooner if you don’t take care of it. Parsley says patients have to especially watch out for immune system damage from smoking and diabetes, and be even more careful with the artificial joint than with a natural one. “Your body has the ability to heal and recover when you have natural joints, but, when you have an artificial joint, you don’t have that healing ability,” Parsley says. “So, you have to do everything to keep it working for you.” Luckily, joint surgery is improving. Robb says surgeons have streamlined and improved the procedure to reduce the risk or infection and chances of further pain. The new implants also last longer. “We’re stretching what would’ve been a 10-year span into 20 or more years,” he says. According to Kurtz, today’s joints are created from metal, ceramics and plastic usually serve people quite well. “Artificial joints are very effective in returning people to their active lifestyles,” he says. © CTW Features
“Your body has the ability to heal and recover when you have natural joints, but, when you have an artificial joint, you don’t have that healing ability.” — Dr. Brian Parsley, president of the American Association of Hip and Knee Surgeons