Fall 2011 Good Living

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Good Living The Retirement Years

Exercise & Sleep • Dietician’s Advice for Keeping Healthy Avoiding Falls • Vitamin Safety • Workouts for Your Brain A SUPPLEMENT TO

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tab l e of c ontents Worried about vitamin safety?........................3

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Early Parkinson’s diagnosis...............................5

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Dietician’s advice for keeping healthy..........7

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Medicare enrollment on earlier schedule.....9

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Exercise & sleep, keys to good health.........10

and happenings in Skagit County.

Avoiding falls....................................................12 Workouts for your brain..................................13 Meet your Mr. or Mrs. Right............................14

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Worried about vitamin safety?

Experts offer advice

By MARILYNN MARCHIONE AP Chief Medical Writer Two studies this week raised gnawing worries about the safety of vitamin supplements and a host of questions. Should anyone be taking them? Which ones are most risky? And if you do take them, how can you pick the safest ones?

Vitamins have long had a “health halo.� Many people think

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they’re good for you and at worst might simply be unnecessary. The industry calls them an insurance policy against bad eating.

But our foods are increasingly pumped full of them already. Even junk foods and drinks often are fortified with nutrients to give them a healthier profile, so the risk is rising that we’re getting too much. Add a supplement and you may exceed the upper limit.

“We’re finding out they’re not as harmless as the industry might have us believe,” said David Schardt, a nutritionist at the consumer group Center for Science in the Public Interest.

This week, a study of nearly 40,000 older women found a slightly higher risk of death among those taking dietary supplements, including multivitamins, folic acid, iron and copper. It was just an observational study, though, not a rigorous test.

Another study found that men taking high doses of vitamin E — 400 units a day — for five years had a slightly increased risk of prostate cancer.

As many as one-third of Americans take vitamins and nearly half of people 50 and older take multivitamins, surveys suggest. Americans spent $9.6 billion on vitamins last year, up from $7.2 billion in 2005, according to the Nutrition Business Journal.

Multivitamins top the list, at nearly $5 billion in sales.

Yet there is no clear evidence that multivitamins lower the risk of cancer, heart disease or any other chronic health problems. No government agency recommends them “regardless of the quality of a person’s diet,” says a fact sheet from the federal Office of Dietary Supplements. And vitamins aren’t required to undergo the strict testing required of U.S.-approved prescription medicines.

Some fads, such as the antioxidant craze over vitamins A and E and beta-carotene, backfired when studies found more health risk, not less.

And studies that find more disease in people with too little of a certain vitamin can be misleading: Correcting a deficiency so you have the right daily amount is different from supplementing beyond recommended levels.

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The best way to get vitamins is to eat foods that naturally contain them, said Jody Engel, a nutritionist with Office of Dietary Supplements. “Foods provide more than just vitamins and minerals, such as fiber and other ingredients that may have positive health effects.”

Schardt adds: “It’s virtually impossible to overdose on the nutrients in food.”

Some folks may need more of certain nutrients and should talk with their doctors about supplements: • Postmenopausal women regarding calcium and vitamin D to protect bones.

• Women planning on pregnancy regarding folate, or folic acid, to prevent birth defects.

• People over age 50 and vegans who may need vitamin B12. “As we get older, a number of us no longer produce enough acid in the stomach to extract the B12 in food,” Schardt explained.

• Pregnant women, who may need extra iron.

• Breastfed infants and possibly other infants concerning vitamin D. Vitamin D is a nutrient many of us may need to supplement. Last fall, the Institute of Medicine, a panel of scientists who advise the government, raised the recommended amount but also warned against overdoing it. People ages 1 to 70 should get 600 international units a day, older folks 800 units.

If you do need a supplement, beware: Quality varies. Consumerlab. com, a company that tests supplements and publishes ratings for subscribers, has found a high rate of problems in the 3,000 products it has tested since 1999.

“One out of 4 either doesn’t contain what it claims or has some other problems such as contamination or the pills won’t break apart properly,” said company president Dr. Tod Cooperman.

For example, one gummy bear calcium product had 250 percent of the amount of vitamin D claimed on the label. Another liquid product made with rose hips had just over half the amount of vitamin C listed.

“You don’t have to pay a lot. Price is not necessarily linked to quality,” he said. “The quality doesn’t really relate

November 2011 | Fall GOOD LIVING: The Retirement Years

to where you’re buying it. I know many people are surprised by that or don’t want to believe it, but that is the case. We find good and bad products in every venue.”

Mark Blumenthal, executive director of the American Botanical Council, suggests looking for “seals of approval” or certifications of quality from groups that spot-test supplements such as the USP, or United States Pharmacopeia; NSF International and NPA, the Natural Products Association.

Experts offered this advice: • Keep it simple. The more ingredients there are in a supplement combo, the more chance that one of them will not be the right amount, Cooperman said.

• Consider a supplement combo tailored to your gender and age, the Office of Dietary Supplements suggests.

Multivitamins often contain little iron, and ones for seniors give more calcium and vitamin D than products aimed at younger adults.

• Take vitamin D with dinner. A study found significantly more absorption of that nutrient when it was consumed at the largest meal, which tends to have more fat, than at breakfast, Cooperman said.

• Watch out for vitamin K — it promotes clotting and can interfere with common heart medicines and blood thinners such as warfarin, sold as Coumadin and other brands.

• Current and former smokers are advised to avoid multivitamins with lots of beta-carotene or vitamin A; two studies have tied them to increased risk of lung cancer.

• For cancer patients, “vitamins C and E might reduce the effectiveness of certain types of chemotherapy,” Engel said.

• People having surgery should know that some vitamins can affect bleeding and response to anesthesia.

With any supplement — ask your doctor.

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By IRENE MAHER St. Petersburg Times

Early Parkinson’s diagnosis aided by new technology

To diagnose Parkinson’s disease, physicians for decades have had to rely largely on a keen eye and experience.

Now the pairing of a new drug and a high-tech nuclear brain scan is offering long-awaited help in recognizing the progressive movement disorder, which has neither a specific diagnostic test nor a cure.

Researchers hope that by finding Parkinson’s earlier, it may be possible someday to halt the disease’s progress.

The telltale signs of Parkinson’s — among them trembling of the head, hands, legs or face, rigid posture, lack of facial expression — can range from severe to very subtle, especially at the early stages. Adding to the difficulty, other neurological conditions can be mistaken for Parkinson’s, but require different treatments. Some prescription medications have side effects that can cause Parkinson’s-like symptoms,

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further complicating a diagnosis.

Research has shown that about 10 percent of patients suspected of having Parkinson’s do not have it.

That figure may be 15 or even 25 percent in practices that don’t specialize in the condition, said Dr. Robert Hauser, director of the University of South Florida’s Health’s Parkinson’s Disease and Movement Disorders Center.

End result: The proper diagnosis and treatment can be delayed for years. The delay is frustrating at best, and dangerous at worst.

The Food and Drug Administration in January approved a procedure called DaTscan from GE Healthcare, and it’s

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becoming more widely available. Available in Europe for the past decade, the procedure uses an injected drug,

two fat commas in the brain,” Hauser said of the brain area where dopamine is concentrated. “But because you lose dopamine neurons from the back forward ... one of those commas looks more like a period.”

Early diagnosis is important because there’s evidence that at least one Parkinson’s medication, Azilect, may both reduce symptoms and slow the disease’s progression.

“Normally when you have (obvious) symptoms, you have already lost 80 to 90 percent of cells that produce dopamine in the brain. You want to diagnose (the disease) at 30 percent” and treat patients earlier, said Saleem Khamisani, a neurologist at St. Anthony’s Hospital in St. Petersburg, Fla. He specializes in Parkinson’s and recently started offering the test.

In the summer of 2010, Tampa reading teacher Vicky Greer noticed she was extremely fatigued, had trouble walking and was developing a slight tremor in her right hand. Her family doctor dismissed the notion of Parkinson’s. When her symptoms worsened, she sought out Hauser.

By the time Greer had a DaTscan at Tampa General Hospital in December as part of a clinical trial, her dopamine level was 60 percent depleted.

“He looked at me and watched me walk and said he was about 98 percent sure that it was Parkinson’s,” Greer recalled about Hauser.

The scan confirmed the diagnosis.

“It was hard,” said Greer.”I’m an active, young 59-year-old. It has really impacted my lifestyle.”

Grim as the news was, Greer said it was a relief to have an explanation for her symptoms: “It was better to know what was going on, to have a diagnosis.”

“Normally when you have (obvious) symptoms, you have already lost 80 to 90 percent of cells that produce dopamine in the brain. You want to diagnose (the disease) at 30 percent” and treat patients earlier.

- Saleem Khamisani Ioflupane I 123, and a type of brain imaging known as single photon emission computed tomography (SPECT) to look for dopamine, a brain chemical that Parkinson’s patients lack. As the disease progresses, dopamine levels decline. The scan checks that.

“A normal image looks like you have

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Dietician’s Advice For Keeping Healthy

Eat fish twice a week.

By AARON BURKHALTER Staff Writer Nutritionists and dietitians know the food we eat matters, but everyone is a little different. Especially as we age, our dietary and nutritional needs shift and change.

Still there are some common things anyone can do and questions they can ask their doctor to keep healthy. Here are a few tips provided by Skagit Valley Hospital Dietitian Supervisor Gina Dowe, United General Hospital Chief Clinical Dietitian Barbara Sutton and United General Dietitian Madeline Neff.

• Eat fish twice a week for those important omega 3 fats. Nut butters also provide a good source of omega 3 fats.

• Eat orange and green vegetables.

These nutrient dense products provide important vitamins and minerals like Vitamin A and iron.

• Do not eat red meat more than twice a week.

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• Buy fresh or frozen vegetables, not canned vegetables that often contain more salt.

• Yogurt is great for digestion.

• Seniors often need more fiber.

• Drink six glasses of water every day.

Managing a healthy diet can take a little work, but Sutton said it’s well worth it. Here are a few tips to plan for healthy eating: • Create a weekly meal menu to ensure that all the elements of a good diet are included. Health stores like the Skagit Food Coop often provide helpful information on what types of foods people should eat given their various conditions.

• Hospitals often provide screenings to determine if you are deficient on an important vitamin or mineral.

• Talk to a dietitian or a physician for help.

Eat orange & green vegetables.

So many vitamins, but which ones to take?

Malls and shopping centers are filled with diet and supplement shops. Local dietitians recommend that people talk with their physician before starting a new supplement. But there are a few helpful things to consider.

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Do not eat red meat more than twice a week.

Yogurt is great for digestion.

Seniors often need more fiber.

• Some seniors have deficiencies in vitamins D and B. • An A-Z vitamin pill like Centrum Silver can provide most of what seniors will need in a vitamin supplement.

• Supplements are often not regulated by the Food and Drug Administration, so the dosage may not be completely accurate.

• Some stores will push a supplement or brand that provides the best profit, not the best health outcomes.

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One common problem seniors can run into is managing their medication. Someone who sees a doctor and multiple specialists may have several medications to consider. Here are a few tips for managing medicine.

• Bring all your medicine to your physician, whether prescribed by a specialist or otherwise, so they can review the drug interactions.

• Some foods can inhibit or alter how medicine works. When picking up a prescription, make sure to ask if there are any special instructions regarding when and how to take the medication.

• When visiting any doctor, make sure they understand every medicine you’re currently taking, prescription and nonprescription.

Aaron Burkhalter can be reached at 360-416-2141 or aburkhalter@skagitpublishing.com. Follow him on Twitter at www.twitter.com/schools_svh.

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Medicare enrollment on earlier schedule this year

By David Sell The Philadelphia Inquirer

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Medicare enrollment began Oct. 15 — earlier than past years — and will run until Dec. 7.

The federal taxpayer-funded insurance program that provides medical care to those 65 and older (or disabled) still has four parts — A through D. The “2012 Medicare & You” handbook, produced by the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid, or CMS, was to be mailed to the homes of people in Medicare. It is online at: http://www.medicare.gov/ publications/pubs/pdf/10050.pdf.

Medicare part A covers inpatient care in hospitals, skilled nursing facilities, hospice, and some home health care. Part B covers doctors’ services, outpatient care and other home health services.

Part C, otherwise known as Medicare Advantage Plans, are offered by private insurance companies approved

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by Medicare. Such plans include Part A and B coverage. For a price, those plans usually offer extra coverage such as vision, hearing or dental. Most of those plans include Part D, which is the prescription drug plan.

Private plans must follow Medicare rules, but they can set other policies on out-of-pocket costs or referrals, for example.

Information on plans is on the Medicare website, www.medicare.gov/find-aplan, or by calling 1-800-MEDICARE, and 1-800-633-4227.

Medicare officials want to encourage better health outcomes at lower cost, so insurers will get bonuses to gain or keep top marks in its 5-star rating system. CMS says people with Medicare can switch to an available 5-star plan at any time. Medicare will give $3 billion to $4 billion in bonuses in 2013 to 5-star insurers while cuts in funding occur elsewhere in the system.

November 2011 | Fall GOOD LIVING: The Retirement Years

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Exercise & Sleep Keys to good health

By TAHLIA honea Staff Writer Exercise and sleep go hand in hand with healthy aging.

“Seniors want to avoid having people care for them and the biggest bullet for health is physical activity,” said Liz McNett Crowl, coordinator of Healthy Communities and a certified health and fitness professional.

Healthy Communities is a joint effort between Skagit Valley Hospital and the Skagit County Public Health Department to increase seniors’ access to healthy nutrition and physical activity to decrease chronic disease and obesity.

It is no secret that exercise prevents disease and helps manage chronic conditions. Exercise also helps prevent falls and helps maintain muscle strength and endurance that keeps seniors out and about, enjoying life.

However, exercising can get challenging with aging. McNett Crowl gave some tips on how to incorporate exercise into everyday life in a fun way: • The surgeon general recommends 30 minutes of exercise a day; it can be broken up into smaller chunks of time.

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November 2011 | Fall GOOD LIVING: The Retirement Years

• Join a class like yoga or tai chi.

“The social piece is very important. I recommend that seniors check out other places seniors go to exercise that have a social element,” McNett Crowl said. “There are a lot of really good options in Skagit County for older adults at all fitness levels.”

• Go dancing.

• Start a group that goes for walks or hikes.

• Find a routine or activity that is constantly enjoyable.

All of these things will add to the quality of life, McNett Crowl said. The dangers of not getting exercise can lead not only to serious illness, but also potentially embarrassing moments like not being able to get on and off the toilet.

Getting exercise is self-preservation, McNett Crowl added. It will help you get better sleep and “could even be better for your sex life,” she said.

Adequate rest is vital

Speaking of sleep, a good night’s sleep is especially important with aging.

During the deep REM (Rapid Eye Movement) stage of sleep, hormones shift, giving people a rested, energetic

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feeling the next day, said Angela Clements, a physicians assistant at Skagit Regional Clinics in the Sleep Medicine Department.

Not getting proper sleep — seven to eight hours per night — directly correlates to a increase in risk of high blood pressure, obesity and diabetes, possibly leading to a heart attack or stroke.

Clements’ tips on how to get a good night sleep: • Establish regular times for waking up and going to bed. This helps maintain a circadian rhythm, in which the body establishes sleeping and eating patterns.

• Avoid a sedentary lifestyle.

• Avoid heavy meals two to three hours before going to bed.

• Don’t drink coffee too late in the day — the caffeine can stay in your system up to five hours, and may affect sleep for even longer.

• Avoid nicotine and alcohol.

• Avoid naps during the day.

“Those naps during the day can make it difficult to get to sleep or get into those deeper stages of sleep,” Clements said. Combining naps and caffeine can lead to a vicious cycle, leading to many hours or nights of missed sleep.

• Eat a high-protein, low-carbohydrate diet.

For more information about exercise opportunities for seniors in Skagit County visit www.beactiveskagit.org.

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Avoiding Falls

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By TAHLIA honea Staff Writer Falls can be life-changing for seniors, which is why preventing them is so important.

Seventy percent of accidental deaths in people over 75 years old nationally are caused by falls, according to Alice Collingwood, organizer of the Skagit Aging Coalition.

Forty percent of nursing home admissions are attributable to falls at home and 25 percent of seniors who suffer hip fractures die within one year, Collingwood said.

Collingwood gave some tips for aging safely and preventing falls within the home and in general.

“A lot of it is common sense, but we just forget,” she said.

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• Have grab bars by the shower and toilet.

• Keep clutter out of the walkways.

• Do not use throw rugs: “Throw rugs are a really serious problem,” she said.

• Wear good slippers, not flip-flops or anything the dog can step on or bite and make you trip.

• Make sure there are handrails on the stairways.

• Make sure your residence has good lighting.

• Take all medications to your pharmacist every year to make sure no medications are interacting in such a way to create side effects such as dizziness.

Collingwood calls the following items the “brown bag review.”

• Get your vision checked regularly.

• Exercise: even chair exercises can be beneficial if seniors find it difficult to stand.

It’s important for seniors to keep exercising, Collingwood said, even if they’ve had a previous mishap.

“When somebody falls, they become afraid that they will fall again, then they become immobile,” Collingwood said.

• Don’t be ashamed to use a cane or walker to be steady.

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Workouts for your brain

By TAHLIA honea Staff Writer Mandy Buck teaches neurobics to seniors at Creekside Retirement Community in Burlington.

Neurobics is a system of brain exercises using the five physical senses and emotions to enhance the brain’s performance; the exercises are designed to help the brain manufacture nutrients that strengthen, preserve and grow brain cells.

Buck gave several examples that can be incorporated into everyday life, helping to stimulate the brain.

“Your brain is just like any other muscle: Use it or lose it,” she said.

Try to include one or more of your senses in an everyday task: • Get dressed with your eyes closed.

• Wash your hair with your eyes closed.

• Share a meal using visual cues to communicate without talking.

Combine two senses • Listen to music and smell flowers.

• Listen to rain and tap your fingers.

Break routines • Take a new route to go to work.

• Eat with your opposite hand.

• Shop at a new grocery store.

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Meet your Mr. or Mrs. Right

By Wina Sturgeon Adventure Sports Weekly David Turner probably knows more about human nature than most people. That’s because he is the Program Manager for Salt Lake County’s Active Aging Program in Utah, and the manager of Salt Lake County’s 18 senior centers. Senior centers all across the country have become like social clubs, with great activities for those 55 and older.

Turner sees all kinds of behavior, because he said that human nature doesn’t change much with age.

As boomers get older, they are more likely to live alone. Many are lonely and want to connect with someone special for companionship or marriage. That’s where senior centers come in.

Turner has paid a lot of attention to seniors who are looking. He advises those who

November 2011 | Fall GOOD LIVING: The Retirement Years

want a significant other: “Go where they are. It’s that straightforward. The mistake is going out just for the purpose of finding someone. That comes across as a little desperate.”

He has a strong and blunt opinion for senior men who want to find someone: “I think old men ought to clean up. Often men who are single and older have let go of the basics of hygiene, laundry and self care. They stop getting a haircut because they don’t have anyone to remind them of it. One of the first things to take care of is appearance, the way they present themselves.

Those things should never be let down.”

Women who are looking for a man have to deal with their own major issue: There are 10 times as many senior women available as there are men. “Ten to one,” says Turner, who brings up another big issue: “Many older men have health problems, and women take on the caretaker role without realizing it’s happening,” he says. He also warns that one of the biggest mistakes a senior can make is “deciding that having someone is more important than their standards; sacrificing standards to overcome loneliness.”

While there are constant reminders not to give out personal information online, especially after beginning to correspond with

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someone a boomer has only met online, it’s just too easy for many boomers and seniors to trust a person who types convincing words. There are many international predators who specialize in preying on older people. Seniors who are lonely can become vulnerable. Federal agents are unfortunately too familiar with foreign chat room thugs who operate criminal scams, like the person who comes on strong and sends an attractive photo, but then suddenly needs emergency money for the rent or a car payment. If the victim sends even a small amount of money, the predator begins to manipulate them to send more and more, until they are drained dry.

Those looking for a friend or romantic attachment should meet them first in person in a neutral environment such as clubs or groups formed for a particular activity, like a book club, a biking group or a group that meets to go to movies; senior centers and volunteer organizations. Remember, whatever you’re looking for, whether it’s friendship or romance, others are looking as well. Seek and ye shall (often) find.

Wina Sturgeon is an active boomer based in Salt Lake City who mountain bikes, skates on both ice blades and wheels, lifts weights and runs to stay in shape. A version of this story formerly appeared in Media One’s Young At Heart.

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