Sleeping Pill Use by Older Adults Linked to Greater Need for Blood Pressure Medications

In a Geriatrics & Gerontology International study of 752 older adults with hypertension followed from 2008–2010 through 2012–2013, using sleeping pills on a regular basis was linked with use of an increasing number of blood pressure medications over time.

The association was observed regardless of sleep duration and quality, body mass index, diet, physical activity, and hypertension control.

Although additional research is needed to understand this link, the findings suggest that sleeping pill use may be an indicator of a future need for greater hypertension treatment and the need to investigate underlying sleep disorders or unhealthy lifestyles that may contribute to hypertension.

“Previous reports on associations of sleep characteristics with blood pressure and hypertension were focused on middle-aged adults; however these associations were absent or inconsistent among older adults,” said senior author Dr. José Banegas, of the Universidad Autónoma de Madrid, in Spain.

Source: Wiley


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Attention, Seniors: Drink More Water and Head Off Disease

Not drinking enough water is a common but under-recognized problem among American seniors that puts their health at risk, researchers say.

“So many health issues are related to inadequate hydration,” including urinary tract and respiratory infections, frequent falls and other problems, said study author Janet Mentes. She’s a professor of nursing at the University of California, Los Angeles (UCLA).

One problem in determining seniors’ hydration levels is a lack of a gold standard of assessment. In this study, the researchers investigated whether a method called salivary osmolality could be used to check hydration levels in older adults.

Salivary osmolality compares the ratio of water to certain chemicals that occur naturally in saliva. It can be measured using a simple, noninvasive device called an osmometer.

The study of 53 people, aged 65 or older, in Los Angeles found that, overall, seniors had higher osmolality (that is, greater dehydration) than younger adults. Seniors’ dehydration was higher in the morning than the afternoon, and it was a bigger problem for those with limited mobility, the findings showed.

Interviews with participants pointed to a major reason for higher osmolality in the morning: Many avoid drinking water so they won’t have to urinate during the night.

The study was recently published online in the journal SAGE Open Nursing.

“Many seniors are underhydrated for a period of time, and when they are exposed to a virus or bacteria they are more likely to develop an infection, such as urinary tract infections, pneumonia or other respiratory diseases,” Mentes said in a UCLA news release.

“And they will be treated for the infection, but the underlying underhydration will not be recognized,” she added. “Thus, an opportunity to educate the individual about adequate fluid intake is missed.”

Up to 40 percent of older people who live in the community may be chronically underhydrated, the researchers said.

Dehydration accounted for a 5 percent increase in preventable emergency department visits between 2008 and 2012, and adults older than 65 have the highest hospital admission rates for dehydration, according to the U.S. Agency for Healthcare Research and Quality.

Source: HealthDay


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For Older Adults, Sense of Control Tied To Feeling Younger

Matt Shipman wrote . . . . . . . . .

A recent study on the psychology of aging finds that older adults feel younger when they feel that they have more control over their daily lives, regardless of stress or health concerns. However, stress and health – not a sense of control – play a significant role in how old younger adults feel.

“We recently found that there are things older adults can do to improve their feelings of control in their everyday lives,” says Shevaun Neupert, a professor of psychology at North Carolina State University and co-author of a paper on the work. “Now this study highlights how those feelings of control influence perceptions of age. The more control older adults think they have, the younger they feel.”

For this study, researchers had 116 older adults (ages 60-90) and 107 younger adults (ages 18-36) fill out a daily survey for eight consecutive days. Study participants were asked questions aimed at assessing their daily stresses, physical health, sense of control over their daily lives, and how old they felt.

“Everyone’s sense of control fluctuates from day to day, or even over the course of a day – that’s normal,” Neupert says. “We found that when older adults felt more in control, they also felt younger. That was true even when accounting for stress and physical health.”

However, an individual’s sense of control had no bearing on self-perceptions of age for young adults. But stress and adverse changes in health did make young people feel older.

“This highlights the importance of having older adults retain some sense of autonomy,” Neupert says. “It’s not just a nice thing to do, it actually affects their well-being.”

The paper, “Feeling Young and in Control: Daily Control Beliefs are associated with Younger Subjective Ages,” is published in the Journal of Gerontology: Psychological Sciences.

Source: North Carolina State University


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Higher Fitness Level Can Determine Longer Lifespan After Age 70

Researchers have uncovered one more reason to get off the couch and start exercising, especially if you’re approaching your golden years. Among people over age 70, physical fitness was found to be a much better predictor of survival than the number of traditional cardiovascular risk factors in a study being presented at the American College of Cardiology’s 68th Annual Scientific Session.

While high blood pressure, high cholesterol, diabetes and smoking are closely linked with a person’s chance of developing heart disease, these factors are so common in older people that the total number of risk factors becomes almost meaningless for predicting future health, researchers said. The new study suggests doctors can get a better picture of older patients’ health by looking at how fit they are, rather than how many of these cardiovascular risk factors they have.

“We found fitness is an extremely strong risk predictor of survival in the older age group—that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit,” said Seamus P. Whelton, MD, MPH, assistant professor of medicine at Johns Hopkins School of Medicine and the study’s lead author. “This finding emphasizes the importance of being fit, even when you’re older.”

Doctors use cardiovascular risk factors to help guide decisions about preventive measures and medications. Previous studies have shown that quitting smoking and controlling blood pressure, cholesterol and diabetes can reduce heart disease risk. However, most studies of cardiovascular risk factors have focused on middle-aged people, leaving a knowledge gap regarding the importance of these risk factors in older people, Whelton said.

The team analyzed medical records from more than 6,500 people aged 70 years and older who underwent an exercise stress test at a Henry Ford Health Systems-affiliated medical center between 1991 and 2009. They assessed fitness based on patients’ performance during the exercise stress test, which required patients to exercise on a treadmill as hard as they could. They divided patients into three groups reflecting their fitness based on the number of METs (metabolic equivalents, a measure of exercise workload) they achieved during the test: most fit (10 or more METs), moderately fit (six to 9.9 METs) and least fit (six or fewer METs). For this study, the researchers grouped patients with zero, one, two, or three or more cardiovascular risk factors.

On average, participants were 75 years old when they underwent the stress test. Researchers tracked the patients for an average of just under 10 years, during which time 39 percent of them died. Over this period, the researchers found higher fitness was associated with significantly increased rates of survival. The most fit individuals were more than twice as likely to be alive 10 years later compared with the least fit individuals.

In contrast, a patient’s total number of cardiovascular risk factors was not associated with their risk of death and patients with zero risk factors had essentially the same likelihood of dying as those with three or more risk factors.

Whelton said the findings demonstrate that fitness level is an important indicator of an older patient’s health that doctors could benefit from considering more often. While an exercise stress test using a treadmill or stationary bicycle provides the most precise way to measure fitness, doctors can also get a general idea of a patient’s fitness level by asking about their exercise routine.

“Assessing fitness is a low-cost, low-risk and low-technology tool that is underutilized in clinical practice for risk stratification,” Whelton said.

The study did not account for any changes in fitness level that the participants may have experienced over time. However, previous studies have suggested that improving fitness can help improve heart health, even late in life.

“People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first,” Whelton said.

Source: American College of Cardiology


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Opinion: Canadian Food Guide Falls Short for Aging Seniors

Heather Keller wrote . . . . . . . . .

“What do you think of the new Canada’s Food Guide?” is a question I have been asked a lot since Health Canada launched new guidance on how the country should eat. The guide recommends a plant-focused diet, but not to the exclusion of animal products — an approach consistent with the Mediterranean diet that has been studied extensively and shown to promote good health.

The guide is well designed for the healthy among us. That’s good news. But what about those living with chronic illness or frailty? Canada’s Food Guide has traditionally been used to plan menus for hospitals and care residences, despite the fact that it was not intended for this purpose.

When someone is frail, they have poor function in many areas of their life and are vulnerable to bad health outcomes; even a minor stress can result in a crisis. The new food guide is not specific enough to meet the essential dietary needs of aging seniors living with chronic illness or frailty.

What’s the difference?

As we get older, we start to lose our muscle mass because of our sedentary lifestyles and also because of what we eat. Muscles allow us to get out of a chair, pick up our grandchildren, balance so we don’t fall. It is now recognized that older adults need more protein, and specifically quality protein, than other age groups to maintain their muscle and prevent frailty.

So what is enough?

Experts recommend one to 1½ grams per kilogram of body weight per day. So, someone who weighs 80 kg (around 175 lbs.) should have 80 to 120 g of protein per day. But what do I mean by “quality protein”? This is protein that contains the essential amino acids that our body cannot make; it needs to come from what we eat.

Animal products, such as meat, poultry, fish, eggs and milk products, provide all of these essential amino acids in the right amounts, but not all plants do (an exception is soy). So if you avoid animal products, this means eating a variety of plant sources every day to get the right mix of essential amino acids. This takes education, planning and often cooking your own food; this can be challenging for older adults at risk for frailty, such as those living alone.

For older adults, getting enough of those essential amino acids without blowing their calorie requirements is also a challenge. Most plant sources are not as efficient as animal sources for attaining requirements; we need to eat more lentils, beans and nuts to get the protein we need.

Take the humble egg, with six grams of protein and 70 calories; the same amount of protein from peanut butter will double your calories. A chicken breast with no skin (three ounces) has around 30 grams of protein in under 200 calories. To get the same amount of protein from soy would mean more calories.

Also, some key nutrients known to mitigate frailty (calcium, vitamin D, omega-3 fatty acids) are more often found naturally in animal products.

We know that menus in long-term care often miss the mark on almost half of necessary nutrients, in part because the 2007 Food Guide was used for planning. A dietitian is the best resource for guiding those who are sick in hospitals or frail in residences.

With malnutrition common in hospitalized patients, many of whom are older adults, this means we need to work toward a standard for health-care institutions that promotes recovery from illness and prevents more malnutrition and consequent frailty. The good news is that the Canadian Malnutrition Task Force with the Canadian Nutrition Society is working towards this goal.

As a Canadian Frailty Network investigator, I have been advocating for some time that dietary reference intakes, which provide specific recommendations by sex and age group for vitamins, minerals and protein, should be the starting point for hospital and residence menus to prevent deficiency and chronic diseases. So, do I like the new food guide? I do. I am, however, waiting for more information on how this guide can be adapted to vulnerable populations, including older adults living with frailty and those living in our health-care institutions.

Heather Keller is the Schlegel Research Chair in Nutrition and Aging and a professor in the department of kinesiology at the University of Waterloo. She is also a researcher with Canadian Frailty Network.

Source: Winnipeg Free Press