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There are several factors that predispose us to have altered posture as we age and each will be considered. But before mentioning each factor, it is important to know that our bones, muscles, and joints are all part of the musculoskeletal system that defines our posture. The backbone or vertebral column is made up of the bones (called vertebra), joint-like spaces called intervertebral discs, and muscles. Age has a pronounced effect on all three and over time the back tends to curve forward resulting in an increasingly stooped posture.

Osteopenia and osteoporosis are medical terms that mean loss of bone density — little to more, respectively. There is loss of calcium in the bones and this produces the loss of density. This begins in women at menopause and in men around age 65. There can be a slight reduction of the size of less dense bones in the spine that could contribute to posture.

The major factor that contributes to spinal curvature is the change in the intervertebral discs. Between each vertebra, there is a gelatin-like cartilage that separates the vertebra. With age, these discs harden and lose flexibility with the inevitable result of compressed total length of the spine and a forward tilt called kyphosis. These aging changes together are called senile kyphosis and are considered a normal part of aging.

Muscle mass also changes with age with a process called sarcopenia. Muscles shrink and may be replace by fat and/or fibrous tissue either of which weakens the muscle. The loss of muscle strength with age contributes to the curvature of the spine.

Another factor that influences statue is the change from a lean body to one with more fat. This process begins at age 30 in both genders. The fat tends to be concentrated at the waist. Men tend to gain weight until about age 55 and women 65. The redistribution of weight contributes to the changes in the spine.

Some of the pathologic processes that can occur with the normal aging are fractures of the bones and arthritis that make the bones and discs more rigid, curved and painful.

As with most age-related changes, there are things that we can do to prevent or delay the changes. The list below shows factors that we choose and which can improve our posture. Most of the factors are self-explanatory and well known to readers of this column. Exercise is by far the most important factor in maintaining a younger posture because it improves the bone and muscle functions that are essential in maintaining musculoskeletal health. The last item, paying attention to erect posture and not slumping, is easier said than done. One must be mindful of proper carriage.

Factors Affecting Postural Changes With Age:

• Exercise — the more one regularly exercises the more posture
  can improve.
• Diet — balanced diet with vegetables, fruit, no red meat leads
  to health.
• Calcium and vitamin D improve bone density.
• Limit alcohol use.
• Do not smoke.
• Behavioral changes of purposefully maintaining erect posture.

As with so many things in healthy aging, there are constant and immutable changes that occur simply because they are a normal part of the aging process. Erect posture is one of the things that is lost with age, but there are a number of things we can do to delay or minimize the changes in posture as our bones, joints, and muscles are altered by age.

Osteoporosis is known as a “silent” disease with no obvious signs or symptoms. Often the first sign of the disease is a potentially debilitating fracture. Osteoporosis is characterized by structural deterioration of bone tissue which causes bones to become porous and fragile.

Currently, about 10 million Americans have been diagnosed with osteoporosis. Of this number, 80 percent are women. Estimates suggest that about half of all women older than 50 will break a bone due to osteoporosis. It is estimated that another 34 million Americans have osteopenia or weak bones which places them at a greater risk for osteoporosis.

Risk factors of osteoporosis include gender, race and age. Being female, of Caucasian or Asian descent and older in age all increase the risk of osteoporosis. Family history of osteoporosis and/or personal history of broken bones also play a role. Those that have lower levels of hormones such as estrogen or testosterone or low vitamin D and calcium intake are also at risk. Long-term use of tobacco, alcohol and some medications can also place individuals at a greater risk for osteoporosis.

Three factors essential for keeping your bones healthy throughout your life are: 1) adequate amounts of calcium, 2) adequate amounts of vitamin D, and 3) regular weight-bearing exercise.

Physical Therapists can instruct on how to maintain proper alignment throughout all mobility including walking and stair management. Physical therapy staff can also provide strengthening programs to assist in the prevention of injuries as well as education on fall prevention,

Occupational Therapists can teach safe and adaptive techniques during self-care tasks such as dressing, bathing and bed mobility to prevent injuries. Occupational therapy staff can also provide adaptive equipment to make daily activities easier and allow for energy conservation.

Please join us July 17th at 1:30 pm in the PAC for our Smart Moves presentation on Osteoporosis.

One out of three older adults (those aged 65 or older) falls each year, but less than half talk to their healthcare providers about it. If you have a fall or incident, you want to report it to your healthcare provider because it may be an indication of larger problems or issues. Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn, increases their actual risk of falling.

There are many different causes that can contribute to a fall. There are muscular, external, and internal factors. Muscular factors that could contribute to a fall are, the muscles of the legs have become too weak or the muscles of the core aren’t strong enough for balance. Your trunk is the foundation for your posture, balance, and coordinated movement. External factors that can contribute to a fall could be any tripping hazards, distractions, or inadequate support tools such as, canes, walkers, wheelchairs, grab bars, and/or shoes. Internal factors that could contribute to a fall are your vestibular system (inner ear), blood sugar, blood pressure, dehydration, and vision.

There are many ways to prevent falls from happening. Exercise regularly, it is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. You want to ask your doctor/pharmacist to review your medications. They can identify what medicines may cause side effects such as dizziness or drowsiness. Making your home safer can reduce and tripping hazards. Be sure to add grab bars wherever needed, improve the lighting in your home, repair or remove lose carpets, and you want to be sure to rearrange any furniture and electrical cords that may be in walking paths. Lastly, you want to always take care of yourself and live a healthy lifestyle. You want to have regular vision and hearing checkups, get adequate amounts of vitamin D and calcium, exercise regularly and eat a healthy, well-balanced diet. Preventing falls can help you live a more independent life. If you can prevent a fall you are less likely to have an injury that can prevent you from carrying on your daily activities, such as bathing, cooking, shopping, or just going for a walk.

Knowing the signs of a stroke is the first step in stroke prevention. A stroke is sometimes called a “brain attack”, it occurs when blood flow to an area of the brain is cut off. The brain cells become deprived of the oxygen and glucose needed to survive which causes them to die.

There are two types of strokes, ischemic and hemorrhagic. Ischemic stroke is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can form in the brain’s blood vessels, in blood vessels leading to the brain, or even in blood vessels elsewhere in the body and then travel to the brain. These clots block blood flow to the brain’s cells. Ischemic stroke can also occur when too much plaque clogs the brain’s blood vessels. Hemorrhagic strokes occur when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain tissue, causing damage to brain cells. The most common causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall.

There are several common symptoms of a stroke that if they are experienced by anyone, 911 needs to be called. The symptoms are weakness or numbness of the face, arm, or leg on one side of the body, loss of vision or dimming in one or both eyes, loss of speech, difficulty speaking, or understanding what others are saying, sudden severe headache with no known cause, and loss of balance or unstable walking, usually combined with another symptom. Immediate treatment can save one’s life or increase chances of full recovery.

Up to 50% of all strokes are preventable. Many risk factors can be controlled before they cause problems. The controllable risk factors consist of high blood pressure, atrial fibrillation, uncontrolled diabetes, high cholesterol, smoking, excessive alcohol intake, obesity, carotid or coronary artery disease. The uncontrollable risk factors are age- anyone 65 or older, gender- men have more strokes, but women have deadlier strokes, race- African-Americans are at increased risk, and family history of stroke.

Your doctor can evaluate your risk for stroke and help you control your risk factors. Sometimes, people experience warning signs before a stroke occurs. These warning signs are called transient ischemic attacks (TIA or mini-stroke) and they are short, brief episodes of the stroke symptoms. Some people have no symptoms warning them prior to a stroke or symptoms are so mild they are not noticeable. Regular check-ups are important in catching problems before they become serious. Remember to report any symptoms or risk factors to your doctor.

Is your sleep different than it used to be when you were younger? It happens to a lot of people. Nearly half of men and women over the age of 65 say they have at least one sleep problem. With age, many people get insomnia or have other sleep disorders. It’s true that as we get older, our sleep patterns change. In general, older people sleep less, wake up and go back to sleep more often, and spend less time in deep sleep or dreaming than younger people. But at any age, you still need quality rest to be healthy.

Some common reasons that cause sleep problems with age include poor sleep habits. When one does not keep a schedule for going to bed and waking up, it can affect your body’s internal clock and make it even harder to get good sleep. At any age, drinking alcohol before bedtime, napping too much, or staying in bed when you are not sleeping can make it difficult to get good sleep. Worry, stress, or grief, which all comes with aging and its life changes, can all alter your sleep patterns. Sleep disorders can be a reason for one’s sleeping problems. Insomnia and disrupted sleep in elderly people are a common side effect caused by many chronic medical conditions such as arthritis, congestive heart failure, and depression. Respiratory disorders, such as sleep apnea, which cause multiple arousals during the night, also become more common as people age. Unfortunately, sleep problems in older adults often go undiagnosed and untreated simply because many people believe sleep problems are a normal part of aging or that nothing can be done to help them sleep better. Thankfully, treating any underlying medical disorders can dramatically improve sleep.

You want to make sure you are getting enough sleep. Everyone is different when it comes to the amount of sleep you need to feel well rested, but if you have noticed that your lack of sleep affects you during the day, tell your doctor. There are steps you can take to get better rest. Many are simple tweaks to your daily routine, like setting a regular bedtime, being more active, and taking steps to ease your mind before you hit the hay.

Do you often feel like you are tired or just don’t have the energy to do something you would like to? You are not alone. Many people report experiencing this issue, especially as they age, or with changes in the weather. The good news is, there are some things that can be done to increase your energy levels.

There are many potential causes of low energy levels. Some possible causes include hormone changes, medications, fitness levels, depression, Vitamin B 12 deficiency, and diet. Speak with your doctor about what the cause might be and discuss how you would like to treat it. One of the best treatment options to combat low energy is exercise. Exercise helps your body use calories efficiently, builds muscle mass, increases the amount of energy your body has available and has many other health benefits. In addition, exercise releases endorphins that naturally make you feel better. Exercise can also help to better regulate blood sugar spikes, which can impact things like diabetes and reduce your risk of pre-diabetes. Simple exercises, such as walking, lifting weights, yoga, and water aerobics are all great ways to get started. If needed, please feel free to contact Mary Hand in the Oasis here at Kirby Pines for additional information for the water aerobics classes and other group classes that the wellness programs here at Kirby Pines offer. There are also group exercise classes held regularly in the PAC. Please be sure to check out the calendar of events like these here in this edition of the Pinecone.

If you feel your lack of energy is causing you to be unbalanced or if you feel it prevents you from doing your daily tasks safely, therapy is another great option for you. Therapists can help you work toward more normal levels of energy while making sure you are safe and progressing toward your goals.

Don’t let low energy levels hold you back. Take control of your health today and let’s begin to get you the energy you need to live the life you want to live!

Please join us March 20th at 1:30 pm in the PAC for our Smart Moves presentation on this topic.

How many times in your life have you stopped, looked at the life choices you were making and thought, “I need to do better.” Maybe you thought you should change your diet, exercise more, stop smoking or be more careful about blood pressure or cholesterol.

Research shows those who can reach cardiovascular wellness goals by age 50 can expect to live another 40 years free from heart disease and stroke. What are those wellness goals? Let’s take a look at Life’s Simple Seven, developed by the American Heart Association.

Managing Blood Pressure.

Hypertension, or high blood pressure, is the single most significant risk factor for heart disease. It’s sometimes called “the silent killer” because it has no symptoms. One in three American adults has high blood pressure, yet about 21% don’t even know they have it. Of those with high blood pressure, 69% are receiving treatment, but only 45% have their blood pressure controlled.

Get Active.

The evidence is clear: people who exercise have better health than those who do not. A recent American Heart Association survey shows that fewer than two out of every ten Americans get the recommended 150 minutes or more of moderate physical activity each week.

Eat Better.

Eating for good health means choosing lots of fruits and vegetables, whole-grain carbohydrates, and fat-free or low-fat dairy products. You might have to train yourself to avoid foods and drinks with high sodium or added sugar. Another perhaps surprising part of healthy eating is to regularly include fish rich in Omega-3’s. It’s great for your heart and your brain.

Control Cholesterol.

Everyone has cholesterol. It’s the waxy substance in your bloodstream and cells. Some cholesterol is important for good health, but too much cholesterol in your blood puts you at major risk for heart disease and stroke. When too much LDL (or bad) cholesterol circulates in the blood, it can slowly build up inside the walls of your arteries that feed your heart and brain. Cholesterol particles combine with other substances in your blood to form plaque. This can narrow the arteries and make them less flexible, putting you at major risk for heart disease and stroke.

Lose Weight.

If you’re overweight, don’t waste your energy feeling guilty or bad about it. Instead, do something positive. BMI is the key. BMI is a height-to-weight comparison that helps you identify the healthy weight target for your height. If your BMI is higher than 25, you need to bring that number down. Losing weight means changing the balance of calories in to calories out.

Reduce Blood Sugar.

Your digestion turns all carbohydrates into sugar or glucose which is then carried throughout your bloodstream to give you energy. Complex carbohydrates like whole-wheat breads and grains, and fruits and vegetables take longer to digest, helping to keep your energy supply steady. But simple sugars, like sweets, donuts, and white bread are very quickly converted into glucose, which can cause your body to call for extra surges of a hormone, insulin, to help regulate the energy supply. If your blood sugar is high, as often happens when you maintain a diet with too many simple carbohydrates, there will be a growth of plaque in your arteries. Diabetes is treatable but very dangerous and can often lead to heart disease and stroke. Even if you don’t have diabetes, you need to know your blood sugar level. Be sure to get a blood sugar level test after fasting at least every three years, because controlling glucose is an important part of stopping heart disease before it starts.

Don’t Smoke.

Even if you’ve smoked for years, your body can start the repair process as soon as you stop. If you’re ready to start your plan for smoke-free health, it’s a good idea to talk with your healthcare provider. Medication can be helpful for some people during the kick-the-habit phase and research shows combining medical and behavioral therapies can increase success rates.

Remember, Life’s Simple Seven work together to help you build a better and stronger life, so by investing in improving in one area, like your blood sugar levels, you are likely to improve your weight and nutrition, too. However, without a plan, you’ll be at an increased risk of heart disease, stroke and other illnesses and disabilities. You may see an increased need for surgeries and other medical treatments, and you’ll almost certainly face a diminished quality of life.

Please join us February 20th at 1:30 pm in the PAC for our Smart Moves presentation on this topic.

Eye examinations are an important part of health maintenance for everyone. Adults should have their eyes tested to keep their prescriptions current and to check for early signs of eye disease. Doctors check your eyes for signs of eye diseases, assess how your eyes work together, and evaluate your eyes as an indicator of overall health.

There are some symptoms that are considered “normal” when aging. Those would include dry eyes, cataracts, loss of peripheral vision, as well as spots and floaters. 75% of those over 65 experience dry eyes due to the lessened production of tears. Cataracts are also frequent among older adults. Cataracts can cause blurry, hazy vision that worsens over time. Also, oversensitivity to light are signs that an opaque spot on the lens of the eye may be growing and obscuring vision.

Serious eye conditions that are seen with aging are glaucoma, macular degeneration, and diabetic retinopathy. Glaucoma refers to diseases that cause optic nerve damage, some of which are related to an increase in intraocular pressure, which cause progressive vision loss. Symptoms are very few until diminished vision is noticed. Conventional treatments can be pretty drastic but research is showing that vigorous exercise may reduce the intraocular pressure associated with glaucoma. Macular degeneration is the leading cause of blindness among Americans over the age of 65. Dry macular degeneration causes gradual central vision loss and results from aging and thinning of tissues in the macula or deposit of pigment. Wet macular degeneration arises from the body’s attempt to make up for lack of nutrients by building extra blood vessels beneath the retina, but the new blood vessels leak fluid which causes permanent damage to the retinal cells. Studies are showing that AMD is a nutritional and lifestyle responsive eye disease. Diabetic retinopathy is vision-threatening damage to the retina caused by diabetes. Blindness is largely preventable if the patient and doctor work together for proper use of medications, blood sugar testing, and proper diet and lifestyle.

Here are some of the easy steps to keep your eyes healthy. Having a healthy lifestyle, you want to have a healthy diet and exercise regularly. There are certain nutrients and vitamins that help ward off age-related vision problems. Your eyes need good blood circulation and oxygen intake, and both are stimulated by regular exercise. You want to be sure to wear sunglasses to help protect your eyes from the sun’s UV rays. Too much UV exposure can boost your chances of cataracts and macular degeneration. Keep these simple steps in mind to help protect your sight and see your best.

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Please join us January 16th at 1:30 pm in the PAC for our Smart Moves presentation on Eye Health.

What usually happens in the winter? We have shorter days with less sunshine, cooler temperatures, more germs spreading, slicker surfaces and more holidays with food. All of these side effects of winter can affect our health. So how can we stay healthy during the winter season?

According to Centers for Disease Control and Prevention, older individuals live more independently, have fewer health costs, and remain healthy if they engage in preventative services and practice healthy behaviors. Five preventative services and/or healthy behaviors include:

1. Soak Up The Sunshine

To help avoid the winter blues, soak up 10-15 minutes of sunshine a day. Winter has limited daylight, so try to sit next to a window to get sunlight when it is available. Though it might be too cold to go outside, it is still important to get some sunshine. The sun is a great source of vitamin D which helps decrease inflammation, depression, and illness while promoting bone growth. The sun also helps to enhance your mood by increasing your serotonin levels. Serotonin is
known to positively affect your mood and behavior.

2. Get Your Flu Shot

The winter time brings dryer air and colder temperatures, thus creating an environment for germs to live longer. To prevent disease, get vaccinated. As we age, our immune systems become weaker and therefore we become more susceptible to become ill. People 65 and older are 90 percent of flu-related deaths and 60 percent of flu-related hospitalizations. Once vaccinated, it takes two weeks for our body to develop an immune response which means, ideally, we should get vaccinated in mid-October.

3. Healthy Eating Habits

What comes with the winter season? Many holidays with great food! While we eat, we should be mindful of the amount and types of food we are putting into our bodies. Remember these simple phrases:

“Out of sight, out of mind”
This philosophy teaches you to place your food on your plate and then walk away from the food. Many times individuals consume food just because it is right in front of them. However, if we adopt the “out of sight, out of mind” philosophy, we will remove ourselves from having easy access to food.

“Smaller plate, smaller portion”
Where you taught to clean your plate? Sometimes this can cause us to overeat even when our body tells us to stop. To help avoid overeating, use a smaller plate. The smaller the plate, the less food we will eat and if we have the “out of sight, out of mind” philosophy, we will not go back for several servings.

“Colorful plate, healthy weight”
What are the most colorful foods? Fruits and vegetables. According to the World Health Organization, insufficient consumption of fruit and vegetables have caused 1.7 million deaths worldwide. Eating colorful foods can prevent obesity as well as heart disease, diabetes, and cancer. Fruits and vegetables contain adequate amounts of vitamins and fiber.

4. Safety

What else can occur in the winter season? Slippery walking surfaces and occasional outings. Walking outdoors can be more difficult than walking inside our homes. There are sidewalk cracks, curbs, and changes in walking surfaces. Now place some wintery mix on those sidewalks and it can create even more safety hazards. To prevent slipping, always ensure you have someone with you and try walking flat-footed. We also have to be mindful of safety in our family and
friends homes during the holiday season.

Items to consider in homes other than your own:

• Are there throw rugs?
• Are there steps?
• Is there room to navigate with my walker, wheelchair, or cane?
• Do their chairs have arms to aid with standing?
• Is their toilet raised or have grab bars to aid with standing?

5. Physical Activity

Cooler temperatures are brought on by high air pressure which increases our blood pressure and can trigger thickness in the fluid around our joints causing joint pain. Cold weather also thickens our blood which can cause more heart complications. For this reason, it is important to stay active all year around. Exercise can help reduce blood pressure, arthritis pain, and heart disease.

If you feel ill and weak this winter season, therapy can help. Therapy can assist in developing a wellness plan that will help prevent loss of strength, range of motion, and falls so you can continue living an independent and active lifestyle. Let’s be preventative this winter season and not wait until something happens for us to take action.

Please join us December 19th at 1:30 pm in the PAC for our Smart Moves presentation on this topic.

Diabetes describes a group of metabolic diseases in which a person has high blood glucose (blood sugar). Glucose is vital to your health because it is an important source of energy for the cells that make up your muscles and tissues. Glucose is also your brain’s main source of fuel. Even though glucose plays a significant role in our health, having too much glucose can lead to serious health problems. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the cause may differ.

The different types of diabetes are type 1, type 2, and gestational diabetes. Type 1 diabetes is usually diagnosed in children and young adults. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. Type 2 diabetes is the most common form of diabetes and most often diagnosed in adults. If you have type 2 your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn’t able to keep up and can’t make enough insulin to keep your blood glucose at normal levels. Gestational diabetes appears for the first time during pregnancy. This can put one at risk for type 2 diabetes later in life.

The causes of type 1 and type 2 diabetes are thought to be a combination of genetic and environmental factors, but the exact cause is unknown. With this being said, there are some factors that may signal an increased risk. The risk factors for type 1 diabetes include family history, environmental factors, the presence of damaging immune cells, and dietary factors. The risk factors for type 2 diabetes include weight, inactivity, family history, race, age, high blood pressure, and abnormal cholesterol levels. Type 1 diabetes cannot be prevented but type 2 diabetes can by making healthy lifestyle choices. Eating healthier, getting more physical activity, and losing excess weight if you are overweight can help prevent type 2 diabetes.

Diabetes has long-term complications that develop gradually. The longer you have diabetes, and the less controlled your blood sugar is, will result in the higher risk of complications. Possible complications include cardiovascular disease, nerve damage, kidney damage, foot damage, skin conditions, hearing impairment, and Alzheimer’s disease. Diabetes is a serious disease so maintaining your blood sugar is very important. If you have diabetes, no matter what type, you want to commit to managing it.

Please join us November 21st at 1:30 pm in the PAC for our Smart Moves presentation on Diabetes.