Exercise, Not Vitamin D, Recommended to Prevent Falls

Exercise, Not Vitamin D, Recommended to Prevent Falls

WEDNESDAY, Sept. 27, 2017 (HealthDay News) — Falls and fractures are a major cause of disability in old age. An influential U.S. medical task force is recommending exercise and, in some cases, medical evaluation to help seniors stay on their feet.

But the new draft recommendations from the U.S. Preventive Services Task Force (USPSTF) say there isn’t enough evidence at this time to either endorse or advise against taking vitamin D or calcium supplements to prevent broken bones.

And based on current evidence, the panel recommends against taking vitamin D solely to prevent falls.

For Americans 65 and older, falls are the leading cause of injuries and injury-related deaths, according to the U.S. Centers for Disease Control and Prevention. On average, one older person falls every second in the United States, the CDC says.

“Fortunately, there are things we can do to help prevent falls,” said Dr. Alexander Krist, a task force member.

However, “we found that it is unclear whether vitamin D and calcium can help prevent fractures at higher doses,” said Krist, an associate professor of family medicine and population health at Virginia Commonwealth University. “They do not prevent fractures at lower doses.”

More research is needed to evaluate the potential benefit of high-dose calcium and vitamin D supplementation for fracture prevention after menopause, the task force noted.

“We hope that you talk to your primary care provider about exercise to prevent falls if you have any concerns about falling, as well as vitamin D or calcium supplementation if you have any questions about your personal risk of fractures,” Krist added.

The USPSTF, an independent panel of experts, provides guidance to physicians about how to prevent medical problems.

The proposed guidelines are intended to help prevent falls and fractures in generally healthy adults aged 65 and older who live at home and don’t have medical problems such as osteoporosis, vitamin D deficiency, Parkinson’s disease or dementia.

After reviewing the available studies, “we found that exercise had a moderate benefit in preventing falls in older adults at increased risk for falls,” Krist said.

The task force didn’t suggest any particular type of exercise. Still, “supervised exercise that improves balance, the way someone walks, and helps with completing common tasks are helpful,” Krist said.

“These can be done in group or individual classes and either at home or in the community. Patients should talk with their clinician about what exercise programs are best for them,” he added.

The task force also recommends that health care providers “selectively check older adults’ risks for falls, and then offer tailored interventions that address those specific risks.”

However, one expert doubts that such risk assessments will become common.

“Medical offices are businesses. Anything that adds time to the office visit, without adding revenue, is unlikely to be added to the majority of visits,” said Dr. Chris Sciamanna, a professor of medicine and public health sciences at Penn State College of Medicine. He wasn’t involved in writing the draft recommendations.

Sciamanna suggested that seniors test themselves: “If you can’t stand on either leg for 10 seconds without grabbing onto something, you’re at risk and should talk to your doctor,” he said.

But, he added, “the reality is that there’s little for doctors to do other than to refer you to an exercise program or, in some cases, reduce the dose of a medicine that may be hurting your balance, like a blood pressure medicine.”

In a perfect world, Sciamanna said, he would have his patients enroll in a strength and balance program three times each week, and also “get aerobic exercise, preferably something that would be fun and build their agility.”

Although the task force recommends against taking vitamin D to prevent falls, there’s no recommendation regarding whether seniors should take vitamin D for general health.

As for other ideas, the task force said there’s not enough evidence to show the value of single strategies like managing medications or making the home environment safer.

The task force released its draft recommendations Sept. 26 and is accepting comments about them on their website until Oct. 23.

More information

For more about preventing falls, see theĀ U.S. National Institutes of Health.

SOURCES: Alexander Krist, M.D., MPH, associate professor of family medicine and population health, Virginia Commonwealth University, Richmond, Va.; Chris Sciamanna, M.D., MPH, professor, medicine and public health sciences and vice chair, research, department of medicine, Penn State College of Medicine, Hershey, Pa.; U.S. Preventive Services Task Force, draft recommendations, Sept. 26, 2017

Certain Jobs Linked to Raised Risk of Rheumatoid Arthritis

Certain Jobs Linked to Raised Risk of Rheumatoid Arthritis

Rheumatoid arthritis, a painful disease in which a person’s immune system attacks the joints, appears to be more common among people in certain types of jobs, researchers suggest.

The findings “indicate that work-related factors, such as airborne harmful exposures, may contribute to disease development,” study author Anna Ilar said. She is a doctoral student in epidemiology at the Karolinska Institute in Stockholm.

The study looked at more than 3,500 people in Sweden with rheumatoid arthritis, and nearly 5,600 people without the disease.

Among men, those in manufacturing jobs had a higher risk of rheumatoid arthritis than those in the professional, administrative and technical sectors, the findings showed. The risk was twice as high for electrical and electronics workers, and three times higher for bricklayers and concrete workers.

Among women, assistant nurses and attendants had a slightly higher risk, but women in manufacturing jobs did not. The researchers suspect that’s because fewer women than men work in manufacturing.

More study is needed to zero in on the exposures that may be involved, Ilar noted. Potential culprits include silica, asbestos, organic solvents and engine exhaust.

The report was published online Aug. 10 in the journalĀ Arthritis Care & Research.

“It is important that findings on preventable risk factors are spread to employees, employers, and decision-makers in order to prevent disease by reducing or eliminating known risk factors,” Ilar said in a journal news release.

The researchers said they accounted for lifestyle factors associated with rheumatoid arthritis, such as body fat, smoking, alcohol use and education level. However, while the study found an association between certain occupations and rheumatoid arthritis risk, it didn’t prove a cause-and-effect relationship.

Take the Back Pain Out of Backpacks

Take the Back Pain Out of Backpacks

Backpacks can mean backaches for schoolchildren, but an orthopedic surgeon has advice for parents and kids about how to keep soreness at bay.

“Parents should inspect their child’s backpack from time to time,” said Dr. Joshua Hyman of New York-Presbyterian Morgan Stanley Children’s Hospital in New York City.

Kids “often carry much more than they should, with extra shoes, toys, electronic devices and other unnecessary items,” he explained in a hospital news release.

Hyman suggests that before sending kids off to school, parents should follow these backpack safety tips:

  • Be a weight-watcher. According to Hyman, backpacks shouldn’t weigh more than 15 percent of a kid’s body weight. That’s the equivalent of 7 pounds for a 50-pound child.
  • Lighten the load. If you feel that your child is weighed down by too many textbooks, talk to the teacher about whether any can be left at school. If not, a backpack on wheels may be an option.
  • Two straps are better than one. Encourage your child to wear the straps over both shoulders — not over one shoulder — so the weight of the bag is distributed evenly.
  • Size matters. Get a correctly sized backpack that’s not wider or longer than your child’s torso, and make sure it doesn’t hang more than 4 inches below your kid’s waist. A low-hanging backpack could force your child to lean forward while walking.
  • The more padding the better. Look for a backpack with straps that are wide and padded to prevent them from digging into the child’s shoulders. Also, look for one with a padded back. This can reduce the risk that your child will be hurt by sharp objects inside the backpack.
  • Watch for signs of trouble. Be on the lookout for pain, posture changes, tingling or red marks due to backpack use. If your child’s pain is persistent, talk to your pediatrician.