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Tired? Weak? You’re Not ‘Just Getting Old’; Something is Wrong

When Dr. Christopher Callahan examines older patients, he often hears a similar refrain.

“I’m tired, doctor. It’s hard to get up and about. I’ve been feeling kind of down, but I know I’m getting old and I just have to live with it.”

This fatalistic stance relies on widely-held but mistaken assumptions about what constitutes “normal aging.”

In fact, fatigue, weakness and depression, among several other common concerns, aren’t to-be-expected consequences of growing older, said Callahan, director of the Center for Aging Research at Indiana University’s School of Medicine.

Instead, they’re a signal that something is wrong and a medical evaluation is in order.

“People have a perception, promulgated by our culture, that aging equals decline,” said Dr. Jeanne Wei, a geriatrician who directs the Donald W. Reynolds Institute on Aging at the University of Arkansas for Medical Sciences.

“That’s just wrong,” Wei said. Many older adults remain in good health for a long time and “we’re lucky to live in an age when many remedies are available.”

Of course, peoples’ bodies do change as they get on in years. But this is a gradual process. If you suddenly find your thinking is cloudy and your memory unreliable, if you’re overcome by dizziness and your balance is out of whack, if you find yourself tossing and turning at night and running urgently to the bathroom, don’t chalk it up to normal aging.

Go see your physician. The earlier you identify and deal with these problems, the better. Here are four common concerns that should spark attention — only a partial list of issues that can arise:

Fatigue. You have no energy. You’re tired all the time.

Don’t underestimate the impact: Chronically weary older adults are at risk of losing their independence and becoming socially isolated.

Nearly one-third of adults age 51 and older experience fatigue, according to a 2010 study in the Journal of the American Geriatrics Society. (Other estimates are lower.) There are plenty of potential culprits. Medications for blood pressure, sleep problems, pain and gastrointestinal reflux can induce fatigue, as can infections, conditions such as arthritis, an underactive thyroid, poor nutrition and alcohol use.

All can be addressed, doctors say. Perhaps most important is ensuring that older adults remain physically active and don’t become sedentary.

“If someone comes into my office walking at a snail’s pace and tells me ‘I’m old; I’m just slowing down,’ I’m like no, that isn’t right,” said Dr. Lee Ann Lindquist, a professor of geriatrics at Northwestern University’s Feinberg School of Medicine in Chicago.
“You need to start moving around more, get physical therapy or occupational therapy and push yourself to do just a little bit more every day.”

Woman with photo of elderly woman's eyes on hers'

Woman with photo of elderly woman’s eyes on hers’

 

Appetite loss. You don’t feel like eating and you’ve been losing weight.

This puts you at risk of developing nutritional deficiencies and frailty and raises the prospect of an earlier-than-expected death. Between 15 and 30 percent of older adults are believed to have what’s known as the “anorexia of aging.”

Physical changes associated with aging — notably a reduced sense of vision, taste and smell, which make food attractive — can contribute. So can other conditions: decreased saliva production (a medication-induced problem that affects about one-third of older adults); constipation (affecting up to 40 percent of seniors); depression; social isolation (people don’t like to eat alone); dental problems; illnesses and infections; and medications (which can cause nausea or reduced taste and smell).

If you had a pretty good appetite before and that changed, pay attention, said Dr. Lucy Guerra, director of general internal medicine at the University of South Florida.

Treating dental problems and other conditions, adding spices to food, adjusting medications and sharing meals with others can all make a difference.

Depression. You’re sad, apathetic and irritable for weeks or months at a time.

Depression in later life has profound consequences, compounding the effects of chronic illnesses such as heart disease, leading to disability, affecting cognition and, in extreme cases, resulting in suicide.

A half century ago, it was believed “melancholia” was common in later life and that seniors naturally withdrew from the world as they understood their days were limited, Callahan explained. Now, it’s known this isn’t so. Researchers have shown that older adults tend to be happier than other age groups: only 15 percent have major depression or minor variants.

Late-life depression is typically associated with a serious illness such as diabetes, cancer, arthritis or stroke; deteriorating hearing or vision; and life changes such as retirement or the loss of a spouse. While grief is normal, sadness that doesn’t go away and that’s accompanied by apathy, withdrawal from social activities, disturbed sleep and self-neglect is not, Callahan said.

With treatments such as cognitive behavioral therapy and anti-depressants, 50 to 80 percent of seniors can expect to recover.

Weakness. You can’t rise easily from a chair, screw the top off a jar, or lift a can from the pantry shelf.

You may have sarcopenia – a notable loss of muscle mass and strength that affects about 10 percent of adults over the age of 60. If untreated, sarcopenia will affect your balance, mobility and stamina and raise the risk of falling, becoming frail and losing independence.

Age-related muscle atrophy, which begins when people reach their 40s and accelerates when they’re in their 70s, is part of the problem. Muscle strength declines even more rapidly — slipping about 15 percent per decade, starting at around age 50.

The solution: exercise, including resistance and strength training exercises and good nutrition, including getting adequate amounts of protein. Other causes of weakness can include inflammation, hormonal changes, infections and problems with the nervous system.

Watch for sudden changes. “If you’re not as strong as you were yesterday, that’s not right,” Wei said. Also, watch for weakness only on one side, especially if it’s accompanied by speech or vision changes.

Taking steps to address weakness doesn’t mean you’ll have the same strength and endurance as when you were in your 20s or 30s. But it may mean doctors catch a serious or preventable problem early on and forestall further decline.

By Judith Graham, Kaiser        Health News       Fri December 16, 2016
 
source: www.cnn.com
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Skimping on Sleep May Activate The ‘Munchies’

BY KATHRYN DOYLE

(Reuters Health) – Getting too little sleep may activate the same chemical pathways in the brain that are involved in heightened attraction to and enjoyment of junk food associated with marijuana use – also known as “the munchies” – according to a small U.S. study.

Researchers found that a night of restricted sleep was followed by extended peaks, later in the day, in natural signaling chemicals that regulate hunger and pleasure. They think that may be one reason sleep deprivation is linked to weight gain.

“Our current study adds to that growing literature and suggests that along with changes in leptin and ghrelin, alterations in endocannabinoids – all changing in the direction to favor food intake – may be mechanisms by which sleep restriction promotes overeating,” said lead author Erin Hanlon, a research associate in endocrinology, diabetes and metabolism at the University of Chicago.

“And, on a larger scale, evidence from both laboratory and epidemiologic studies have consistently associated insufficient sleep or short sleep with increased risk of obesity,” Hanlon said.

munchies

The researchers studied 14 healthy young adults ranging in age from 18 to 30 years who got four nights of sufficient sleep, about eight and a half hours, then four nights of sleep restricted to 4.5 hours. The two sleep tests took place in a sleep lab and were separated by a month.

During waking hours, participants were housed in a private room and kept basically sedentary. They had three identical meals at 9 a.m., 2 p.m. and 7 p.m.

In each test, calorie intake was controlled for the first three days and on the fourth day participants were allowed to eat as much or as little as they liked from a buffet tailored to individual preferences. Meanwhile, researchers monitored participants’ calorie intake and analyzed blood samples.

Participants also answered questions about their hunger, appetite, energy level and mood during the 24-hour period of blood sampling, 25 minutes before each meal and one hour and 35 minutes afterward.

When sleep deprived, participants had higher levels of endocannabinoid 2-arachidonoylglycerol (2-AG), a chemical signal that makes foods, particularly junk foods, pleasurable. This blood chemical is usually low overnight and rises steadily during the day, peaking in the afternoon.

But in the sleep-deprived phase, 2-AG remained elevated late in the evening and participants reported higher hunger scores, according to the results in the journal Sleep.

“These are the first results showing that sleep restriction influences the endocannabinoid system in humans,” said Frank Scheer of the Medical Chronobiology Program at Brigham and Women’s Hospital in Boston who wrote a commentary alongside the new study. “This opens up a new insight into systems involved in energy balance and food reward,” he told Reuters Health by email.

“Previous studies had shown that experimental sleep loss causes an increase in ‘hunger hormone’ ghrelin and a decrease in ‘satiety hormone’ leptin,” Scheer said. “The increase in the peak in endocannabinoids following sleep restriction provides an additional mechanism that could help explain an increase in hunger.”

Adults should aim for seven to nine hours of sleep per night, he said.

“With decreasing amounts of sleep, the metabolic effects appear to become progressively stronger,” Scheer said.

SOURCE: bit.ly/1UzIW0G and bit.ly/1VRhaLB Sleep, online February 29, 2016.   Reuters


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Lose Weight Listening to Music

How what you hear affects your food intake.

By Dee Van Dyk

How music affects the body

Music, said English poet and playwright William Congreve, has charms to soothe the savage beast. But does music have the power to quash the dieter’s appetite?

Maybe. After all, consider how widely your moods and memories are associated with music. Joggers know that you can press yourself a little farther with the right tunes coaxing you on; soothing music in the doctor’s or dentist’s office can help calm frightened patients. Spiritual music can inspire.

According to Brooklyn doctor Edward Podolsky, fast music ratchets up your metabolism and muscular energy, accelerating your heartbeat and elevating your blood pressure. A slow beat does the exact opposite.

What effect does music have on appetite?

Taste is the most obvious sense associated with food, but it is by no means the only sense we engage to enjoy a good meal. In fact, all our senses come into focus when we eat. Think of the sizzle of a steak on the barbecue, or the contrasts of textures in a smooth crème brûlée topped by a crisp sugar crust. Imagine an attractively laid-out meal or the scent of your mother’s roast dinner. All of these scenarios describe food through a different sense, and all are capable of stimulating appetite.

A Johns Hopkins study found that music has the ability to influence the speed with which we eat. Slow music slows us down: test subjects listening to slow music downed three mouthfuls of food per minute, as compared to the five mouthfuls diners listening to a fast beat consumed.

Hoteliers and restaurateurs know that taste is only one aspect of a good meal. A recent British survey examined consumer responses over eighteen evenings. Diners were treated to classical music, pop music or no music during their meals. Results showed that people were willing to (and actually did) spend more money on the evenings they ate to the strains of classical music.

food music

What does this mean to the average dieter?

Be aware that sounds – and music, especially – can trigger eating habits you may or may not want. If playing Christmas carols sends you into a frenzied state of Christmas baking, you might want to time your music selection accordingly. Experiment with music while you eat. Do you eat less to the strains of Bach? Or does the beat of the latest boy band have you up and moving around instead of snacking in front of the fridge?

The bottom line

Pay attention to how your body reacts to the external stimuli it receives. Sight, sound, smell, touch and taste are all part of the equation.