Physical And Mental Exercise Lower Chances For Developing Delirium After Surgery


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After having surgery, many older adults develop delirium, the medical term for sudden and severe confusion. In fact, between 10 and 67 percent of older adults experience delirium after surgery for non-heart-related issues, while 5 to 61 percent experience delirium after orthopedic surgery (surgery dealing with the bones and muscles).

Delirium can lead to problems with thinking and decision-making. It can also make it difficult to be mobile and perform daily functions and can increase the risk for illness and death. Because adults over age 65 undergo more than 18 million surgeries each year, delirium can have a huge impact personally, as well as for families and our communities.

Healthcare providers can use several tools to reduce the chances older adults will develop delirium. Providers can meet with a geriatrician before surgery, review prescribed medications, and make sure glasses and hearing aids are made available after surgery (since difficulty seeing or hearing can contribute to confusion). However, preventing delirium prior to surgery may be the best way to help older adults avoid it.

A team of researchers from Albert Einstein College of Medicine designed a study to see whether older adults who are physically active before having surgery had less delirium after surgery. The research team had previously found that people who enjoy activities such as reading, doing puzzles, or playing games experienced lower rates of delirium. The team published new findings on physical activity in the Journal of the American Geriatrics Society.

The researchers noted that several studies have shown that exercise and physical activity may reduce the risks of developing dementia (another medical condition affecting mental health, usually marked by memory problems, personality changes, and poor thinking ability). What’s more, earlier studies have shown that regular exercise can lower the risk of developing delirium by 28 percent.

The participants in this study were adults over 60 years old who were undergoing elective orthopedic surgery. Most participants were around 70 years old. None had delirium, dementia, or severe hearing or vision problems.

The researchers asked participants the question “In the last month, how many days in a week did you participate in exercise or sport?” The researchers noted the type of physical activities the participants did, as well as whether and how often they read newspapers or books, knitted, played cards, board games, or computer games, used e-mail, sang, wrote, did crossword puzzles, played bingo, or participated in group meetings.

The participants said their physical exercise included walking, taking part in physical therapy, lifting weights, cycling, stretching, engaging in competitive sports, and dancing. The most commonly reported activity was walking. Though most participants were only active one day a week, nearly 26 percent were active five to six days a week and 31 percent were active five to seven days a week.

Of the 132 participants, 41 (31 percent) developed postoperative delirium.

The researchers reported that participants who were physically active six to seven days a week had a 73 percent lower chance of experiencing postoperative delirium (delirium that develops after surgery). They also reported that being mentally active was a strong factor in reducing chances of developing postoperative delirium. Participants who regularly read newspapers or books, knitted, played games, used e-mail, sang, wrote, worked crossword puzzles, played bingo, or participated in group meetings had an 81 percent lower chance of developing postoperative delirium.

“While our study was preliminary in nature, we found that modest regular physical activity, as well as performing stimulating mental activities, were associated with lower rates of delirium after surgery,” said the researchers. The researchers also found that physical and cognitive activities seemed to offer benefits independent of each other. This suggests that people with activity-limiting injuries or conditions can still benefit from being mentally active, and people with mild cognitive impairment can still benefit from being physically active. The researchers noted that more research is needed to learn about the role of exercise and cognitive training in reducing delirium after surgery.

Source: HealthinAging


Read also:

Delirium Toolkit . . . . .

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As Americans Get Heavier, Obesity-linked Cancers May Strike Earlier

Linda Carroll wrote . . . . . . . . .

Increasing numbers of middle-aged Americans appear to be developing cancers that can be associated with obesity, new data suggest.

And the increase in these cancers among 50- to 64-year-olds parallels the rising rates of obesity, researchers say.

In their analysis of more than six million cancer cases, researchers found that obesity-associated cancers appeared to be shifting to younger people, including those under 50, according to the report published in JAMA Network Open.

“Obesity creates a state of constant low-grade inflammation, as well as multiple growth stimulating factors, all of which can accelerate the development of cancer,” explained the study’s lead author, Siran Koroukian, an associate professor in the department of population and quantitative Health Sciences at the Case Western Reserve University School of Medicine and director of the Population Cancer Analytics Shared Resource at Case Comprehensive Cancer Center, both in Cleveland, Ohio.

It’s possible that people can impact their cancer risk by watching their weight, Koroukian said in an email. “There is some evidence that weight loss (among those who are obese) can prevent the development of cancer,” she added. “The most important strategy is maintaining a normal weight.”

To take a closer look at the impact of obesity on cancer risk, Koroukian and her colleagues turned to data from the Surveillance, Epidemiology and End Results 18 (SEER18) database, focusing on cancer cases diagnosed from 2000 through 2016. The database is nationally representative and covers geographically diverse regions of the country.

The researchers looked for trends in the percentage of cases diagnosed in three age groups: 20-49, 50-64 and 65 and older.

Obesity-associated cancers considered by the researchers included myeloma, female breast cancer and cancers of the colon and rectum, gallbladder, esophagus, stomach, liver, pancreas, uterus, kidney and thyroid.

Among the more than 6 million cases, 43.6% were obesity-associated cancers.

When the researchers analyzed their data, they found a greater increase in the odds for an obesity-associated cancer compared to non-obesity associated cancers in the 50- to 64-year age group, but a decrease for older individuals.

While it looks like the growing rates of obesity are driving up obesity-associated cancers, this study can’t prove that, said Dr. Daniel Labow, chair of surgical oncology at the Mount Sinai Health System.

A major limitation of the study, he pointed out, is that the SEER database does not include information on body mass index, so it’s impossible to know whether these cancers are actually occurring in obese individuals.

“There are so many other factors that could be affecting trends and movements in cancer incidence,” Labow said. For example, the trend could be explained by the kinds of foods people are eating, he added.

“A high animal fat diet and lots of processed foods certainly could be contributing,” Labow said. Nevertheless, “obesity is not good for many different things so we should be working on decreasing it and it would be nice if we also saw a downstream trend of reduction of cancers,” he added.

Dr. Jian-Min Yuan agrees that there could be many factors that changed over time besides obesity. “A person who was a teen in the late 70s to early 80s, might have experienced a lifestyle change,” Yuan said. “Maybe they were more stressed. Maybe they ate a lot more meat and consumed less fiber. They could have consumed more alcohol. Their sleeping patterns might have changed in that era because of a much faster modern lifestyle.”

Source: Reuters


Today’s Comic

Chowbotics is Sending Sally the Salad Making Robot Off to Colleges

Chris Albrecht wrote . . . . . . . . .

Chowbotics is packing up Sally the salad making robot and sending it off to college. Well, many colleges actually, as the food robotics startup is set to announce next week a bigger push into the higher education market.

Chowbotics told us that this school year, students at multiple colleges and universities in the U.S. will be able to buy salads and breakfast bowls from Sally the robot. Those schools include: Case Western Reserve University in Cleveland, OH; College of the Holy Cross in Worcester, MA; the University of Guelph in Ontario, Canada; Elmira College in Elmira, NY; the University of Memphis in Memphis, TN; and Wichita State University in Wichita, KS. These schools join Marshall University in Huntington, WV, which installed Sally in 2018.

Students can order from thousands of different custom and pre-made meals Sally can make from the 22 ingredients it stores. Sally will work with campus meal plans and accept credit cards for payment, but unlike the school cafeteria or on-campus restaurants, Sally can fit in the corner of a dorm lobby and feed people 24 hours a day.

Sally is part of two big trends we at The Spoon see accelerating. First it’s emblematic of the golden age of vending machines that we are entering. Advances in robotics and other technologies means that automated vending machines are no longer relegated to sodas and Snickers bars. Machines like Sally and Yo-Kai Express can whip up complex, high-end meals in just minutes and around the clock in high-traffic locations like colleges, hospitals and airports.

But Sally is also part of a bigger wave of robots heading off to college. In addition to the stationary Sally, delivery robots from Starship and Kiwi are rolling around more campuses delivering restaurant made meals to the student masses.

The bottom line is that eating at college is not only vastly different from when I went to school (long ago) — but pretty soon, it will also be a lot different from how people ate at college last year.

Source: The Spoon

Grilled Pork Skewers with Couscous

Ingredients

1 teaspoon Dijon mustard
1 teaspoon honey
juice of 1 lemon
1 tablespoon fresh thyme (about 4 sprigs), plus more for garnish
salt and freshly ground pepper
2-1/2 tablespoons olive oil, plus more to brush on grill
2 cloves garlic, peeled and finely chopped
1-1/4 pounds pork tenderloin, trimmed and cut into 1-inch cubes
1/2 medium red onion, cut into 1/4-inch dice
1/2 each small zucchini and yellow squash, cut into 1/4-inch dice
1 each red and yellow peppers, seeded and cut into 1/4-inch dice
1 cup dry couscous
1 cup boiling water

Method

  1. Mix first 4 ingredients, salt, pepper, 1 tablespoon oil, and half the garlic in a large bowl. Add pork and cover; let stand for at least 1/2 hour.
  2. Heat remaining oil in a saucepan over medium-low heat. Add remaining garlic and the onion. Cook until translucent, about 4 minutes.
  3. Add vegetables, raise heat, and cook until just soft, about 5 minutes more.
  4. Add couscous and water. Sir well. Turn off heat, cover, and let sit for 5 minutes. Season with salt and pepper.
  5. Heat grill and brush with oil.
  6. Thread pork on skewers and season with salt and pepper.
  7. Grill on each side until done. Serve over the couscous.

Makes 4 servings.

Source: What to Have for Dinner

Afternoon Tea at Hotel Chinzanso Tokyo, Japan

The price is 4,000 yen + tax for each person.