Charts: Omicron Variants Spread Rapidly in South Africa

COVID cases exploded last week

No Omicron Variant in the last 2 weeks on Nov 1, 2021

25% Cases are caused by Omicron Variant in the last 2 weeks of Nov 15, 2021

88% Omicron cases on Nov 29, 2021

Source : Our World in Data

Afternoon Tea Set of Flame in Hong Kong

Menu

Cedar Plank Smoked Salmon with Guacamole on Greenhouse Cucumber

Quesadillas with Shrimp, Arugula, Semi Dries Tomato

Crabless Cake with Figs Marmalade

Spinach Quiche

Deep-fried Mozzarella Stick

Caramel Crème Brulee

Chestnut Tartlet

New York Cheese Cake

Macaron

Osmanthus, Apple & Pear Tea


The price is HK$368 (plus 10%) for 2 persons.

Study: ‘Mild Cognitive Impairment’ in Older Age Often Disappears

Enlarge image . . . . .

Cara Murez wrote . . . . . . . . .

A diagnosis of mild cognitive impairment (MCI) might worry an older adult, who could see it as a stepping stone to dementia. But a new study suggests one does not necessarily lead to the other.

In fact, nearly half of seniors tracked in the study — all of who had been diagnosed with issues in memory and thinking and received an MCI diagnosis — no longer had the condition a few years later.

The study was conducted to help better understand what factors might be important to a person’s risk for dementia.

“We wanted to gain more knowledge about the earliest stages of dementia, as a potential time window for dementia prevention or intervention strategies,” said study lead author Jennifer Manly, a professor of neuropsychology at Columbia University in New York City.

She said the study was conducted among a diverse group of Americans. “Most prior MCI studies are conducted among only non-Hispanic white older adults who seek help from a doctor who specializes in memory disorders,” Manly explained.

The findings highlight that people who have MCI are a varied group, she said. They won’t all develop dementia in the short term, which suggests that MCI status should be viewed as a “higher risk classification,” and not as an early stage of dementia, Manly said.

Interestingly, the predictors of MCI are not necessarily the same factors that predict progression of MCI to dementia, she added.

For the study, the researchers followed just over 2,900 study participants, average age mid-70s, for about six years.

During the research period, 752 participants were diagnosed with MCI. Those diagnoses happened when the participants reported problems with memory or thinking and a test showed cognitive impairment. They were still able to maintain daily activities and had problems with fewer than three activities, such as shopping or handling medications, according to the study.

Of those with MCI, 480 did follow-up assessments. Two years later, 13% of those with MCI had dementia. Another 30% still had MCI but had not developed dementia. About 10% had declines in mental functioning, but still did not meet the criteria for MCI or dementia.

But nearly half — 48% — of those who had previously been diagnosed with MCI were “cognitively normal” on a follow-up visit an average of 2.4 years later. They may have met one or two of the three criteria for MCI initially.

Among the modifiable risks that predicted a lower risk of developing MCI, researchers found that having more years of education and taking part in more leisure activities like reading, visiting a friend or going for a walk could make a difference. So, too, could a higher income.

Specifically, those who had more education or participated in more leisure activities were 5% less likely to develop MCI.

Predictors that increased the risk of someone with MCI developing dementia included the use of antidepressants, having symptoms of depression, having the particular gene that increases Alzheimer’s risk and having MCI that affects several aspects of thinking skills, including memory, language and spatial skills.

About 18% of those who used antidepressants developed dementia, compared to 7% who continued to have MCI and 6% of those who no longer met the criteria for MCI, the findings showed.

Manly noted that the results did not mean that these risk factors cause dementia, but that they showed an association. These findings could help define future public health initiatives, Manly said, especially when risk factors can be modified.

The findings were published online Dec. 1 in the journal Neurology. Study limitations included that the follow-up time was relatively short.

While mild cognitive impairment has often been thought of as a precursor to dementia and Alzheimer’s disease, MCI is really a mixed group with cases that will diverge along different paths, said Dr. Zaldy Tan, director of the Memory and Aging Program for Cedars-Sinai in Los Angeles. Tan was not involved in the study.

“I think it just confirms that people with mild cognitive impairment are a heterogeneous group, that some people are in fact on the Alzheimer’s disease or dementia path, and some people are having mild cognitive impairment because of other things that are potentially reversible like depression, poor sleep, for example having obstructive sleep apnea,” Tan said. “Some of these things can interfere with memory, and someone can have a subjective complaint of a memory problem but may not necessarily have the pathology for dementia.”

Evidence suggests that a healthy lifestyle, including regular physical activity, good sleep, controlling heart risk factors, reducing stress and remaining cognitively and socially engaged are all beneficial for overall brain health, Tan said, but that does not mean they will prevent someone with MCI from developing dementia.

If someone does have concerns about their memory, it’s important they let their primary care doctor know, Tan said.

“The primary physician will be the best judge of whether they need further evaluation through memory testing or neuroimaging or neuro-psychological testing,” Tan said.

Source: healthDay

Brodetto

Ingredients

2-pound mixture of fish fillets or steaks, such as monkfish, cod, haddock, halibut or bake
2-pound mixture of conger eel, red or gray mullet, snapper or small whitefish
1 onion, halved
1 celery stalk, coarsely chopped
8 ounces squid
8 ounces fresh mussels
1-1/2 pounds ripe tomatoes
4 tablespoons olive oil
1 large onion, thinly sliced
3 garlic cloves, crushed
1 teaspoon saffron strands
2/3 cup dry white wine
6 tablespoons chopped fresh parsley
salt and ground black pepper
croutons, to serve

Method

  1. Remove any skin and bones from the fish fillets or steaks, cut the fish into large pieces and reserve. Place the bones in a pan with all the remaining fish.
  2. Add the halved onion and the celery and just cover with water. Bring almost to a boil, then reduce the heat and simmer gently for about 30 minutes. Lift out the fish and remove the flesh from the bones. Reserve the stock.
  3. To prepare the squid, twist the head and tentacles away from the body. Cut the head from the tentacles. Discard the body contents and peel away the mottled skin. Wash the tentacles and bodies and dry on paper towels.
  4. Scrub the mussels, discarding any that are damaged or open ones that do not close when tapped.
  5. Plunge the tomatoes into boiling water for 30 seconds, then refresh in cold water. Peel away the skins and chop coarsely.
  6. Heat the oil in a large saucepan or sauté pan. Add the sliced onion and the garlic and fry gently for 3 minutes. Add the squid and the uncooked white fish, which you reserved earlier, and fry quickly on all sides. Drain.
  7. Add 2 cups strained reserved fish stock, the saffron and tomatoes to the pan. Pour in the wine. Bring to a boil, then reduce the heat and simmer for about 5 minutes.
  8. Add the mussels, cover, and cook for 3-4 minutes until the mussels have opened. Discard any that remain closed.
  9. Season the sauce with salt and pepper and put all the fish in the pan. Cook gently for 5 minutes. Scatter with the parsley and serve with the croutons.

Makes 4 to 5 servings.

Source: Healthy Mediterranean Cookbook


Today’s Comic

Major Life Events Influence Level of Physical Activity, May Negatively Impact Heart Health

Starting a new school or a new job, having a baby or entering retirement are major life events that significantly affect a person’s physical activity level, which may lead to poorer heart health. Individuals and health care professionals need to be proactive in addressing this issue, according to guidance from a new American Heart Association Scientific Statement published today in the Association’s flagship journal Circulation. A scientific statement is an expert analysis of current research and may inform future guidelines.

The statement, entitled “Supporting Physical Activity in Patients and Populations During Life Events and Transitions,” focuses on the need to better understand how life changes affect physical activity levels and what can be done to help people maintain good heart health throughout life transitions. The statement writing group members note that because sedentary behavior is an emerging cardiovascular disease risk factor, it’s important to recognize how physical activity levels may impact health during major life events and transitions. The statement also provides guidance for health care professionals to identify, address and promote regular physical activity to patients experiencing significant changes in their lives. Options for community-level interventions to promote physical activity are also explored.

“Certain life events and transitions may mark the beginning and end of different phases of a person’s life, and these life changes may lead to periods of less physical activity and more sedentary lifestyle behaviors. Physical activity is an important heart-healthy behavior and too much sitting and inactivity is not good for you,” said the writing group Chair Abbi D. Lane-Cordova, Ph.D., FAHA, an assistant professor in exercise science at the Arnold School of Public Health at the University of South Carolina in Columbia South Carolina. “This is a particularly important topic right now because, in addition to life’s other major events, the COVID-19 pandemic is another disruption of everyone’s daily routines and activity levels.”

The American Heart Association recommends most adults participate in at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Children and adolescents 6-17 years old should get at least 60 minutes of moderate-to vigorous-intensity physical activity every day.

According to the U.S. Centers for Disease Control and Prevention’s Office of Disease Prevention and Health Promotion “Healthy People 2020” initiative, only 1 in 5 teens (20%) and about 1 in 4 adults (24%) in the U.S. routinely achieved the recommended levels of physical activity in recent years. While these rates are low across the board, data suggest these numbers could change significantly during a major life event or transition. The writing group examined data on 17 different life events or transitions, and found evidence of decreased activity levels during nine events:

Beginning a new school (elementary, middle, high school or college) – each distinct life events;

  • a first job or career change;
  • a marriage or civil union;
  • pregnancy;
  • parenting;
  • retirement; or
  • moving into a long-term care facility.

The writing group also assessed the effects of major life changes on various subgroups within the U.S. population to identify people most in need of support during life transitions. People most at risk for significantly lower physical activity during life changes include:

  • individuals with lower levels of education;
  • those who lived alone during the initial COVID-19 venue closings;
  • those who lacked safe access to outdoor space for exercise and physical activity; and
  • women during pregnancy and parenthood.

The “socioecological model,” which encompasses individual, social, environmental and policy contributors, was the framework used to examine numerous factors that affected levels of physical activity.

The analysis found that general factors affecting physical activity levels among youth (<18 years of age) at the individual level include:

  • gender;
  • age;
  • motor coordination;
  • time outside;
  • physical activity preferences
  • body image;
  • perceived barriers;
  • involvement in school sports; and
  • physical education.

At the interpersonal level, youth were influenced by their weight and physical activity levels, and by their parents’ education level. Environmental influencers for youth included neighborhood crime rates, perception of safety, walkability, proximity and access to school programs and recreational facilities. COVID-19–related restrictions and stay-at-home orders have also been related to changes in physical activity in youth and Lane-Cordova noted more data in this area will be important to consider.

The analysis of physical activity levels for adults (18+ year old) found individual influencers included:

  • the perceived health benefits of exercise;
  • history of and intention to exercise;
  • self-efficacy/confidence to achieve goals;
  • enjoyment; and
  • lower stress levels.

Social and cultural norms affected adults both negatively and positively, while environmental influencers included proximity and access to recreation facilities and greenspaces, transportation, neighborhood walkability and convenience.

Research specific to factors affecting physical activity during life transitions is less robust, so the statement suggests future efforts to identify socioecological factors that may help support routine exercise. Examples of these factors include safer streets for pedestrians and cyclists, rails-to-trails programs and park upgrades. The writing group proposes public health policies to implement these infrastructure changes would help ensure support for physical activity during major life events.

The statement also suggests practical strategies for health care professionals to support routine physical activity levels during major life events and transitions. Health care professionals can assess physical activity by asking a few questions as part of the collection of vital signs during a routine health visit. A brief screening tool of questions for individual patient responses may be a low-cost option in a clinical setting to assess physical activity levels and support needed. For daily patient use, the writing group suggests simple, commercially available wearable technology such as pedometers or accelerometers to monitor physical activity levels and changes. Simple metrics like adding 1,000 steps per day to increase daily physical activity levels may result in improved health benefits.

“It’s important to maintain or improve physical activity when major life events happen, which is often a time when exercise is most needed,” Lane-Cordova said. “There are so many ways people can do this. They could plan family activities that involve exercise, use free videos or websites to exercise at home or take standing breaks while at work. The most important things are to be aware of the positive health and cardiovascular impact of physical activity and make the effort to get moving.”

The statement suggests health care professionals have a big role to play when it comes to opening the conversation about physical activity levels with their patients. The writing group recommends health care professionals focus on compassion and understanding. Given that primary care physicians may lack the necessary time and resources for follow-up support, clinicians may look at expanding the roles of other members of the clinical care team, including nurses, medical assistants and health or lifestyle coaches.

The statement also mentions behavioral counseling as another means to provide support for physical activity during major life transitions or events. There are numerous mental and physical health benefits of starting and maintaining regular physical activity during major life events and transitions. Urging regular physical activity along with offering compassion and empathy supports physical and mental health during challenging times.

The statement writing group notes that health care professionals can be an important source of encouragement. Referring to past accomplishments may increase a patient’s confidence in their ability to incorporate regular physical activity into their daily routine. Motivational interviewing may be better received during life transitions and events than a more traditional educational approach during life transitions and events. And a variety of health care professionals, such as medical assistants and health or lifestyle coaches, can help provide physical activity counseling.

The writing group said it is crucial “to look beyond the health care setting and engage organizations, communities, workplaces, faith-based communities and assisted living facilities to promote physical activity.” The statement provides a list of resources for individuals and health care professionals, many of which are free and online.
Future areas of research should include improved surveillance efforts to assess physical activity, sedentary behavior and the corresponding overall health and wellness, particularly among at-risk and underserved populations, according to the writing group. More information is also needed to effectively characterize the impact of life events and transitions on sedentary behavior, especially given the growing body of evidence that too much sitting is associated with worse health outcomes. Finally, the statement highlights the need to develop and test interventions that specifically target life events and transitions linked to declines in physical activity levels.

Source: American Heart Association