Smoking Linked to Frailty in Seniors

Smoking Linked to Frailty in Seniors

Seniors who smoke may be more likely to become frail, a new British study suggests.

Researchers tracked more than 2,500 people 60 and older in England and found that current smoking boosted that risk by about 60 percent. The scientists determined that the participants were frail if they had at least three of five conditions: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity.

Frail people are at higher risk of problems such as falls, broken bones and hospitalization. Researchers have also linked frailty to poor quality of life and dementia.

Interestingly, the researchers found that former smokers didn’t face a higher risk of frailty, and it didn’t matter if they’d quit within the past 10 years or earlier. In fact, their risks of frailty were about the same as those who had never smoked.

The research team also found evidence that chronic obstructive pulmonary disease (COPD), a respiratory condition that is typically brought on by years of smoking, boosts the risk of frailty.

But the study did not prove that smoking caused frailty risk to rise, just that there was an association.

The study was published recently in the journal Age & Ageing.

“Our study showed that current smoking is a risk factor of developing frailty. Additional analyses revealed that COPD seems a main factor on the causal pathway from smoking towards frailty,” study author Dr. Gotaro Kojima said in a journal news release. “But those who quit smoking did not carry over the risk of frailty.”

Kojima is geriatrics specialist from University College London.

More information

For details about how to quit smoking, visit the smokefree.gov.

SOURCE: Oxford University Press, press release, Aug. 17, 2017

Ditch the Throw Rugs, Seniors!

Ditch the Throw Rugs, Seniors!

Icy winter weather may lead to fewer hip fractures than many believe.

Most fall-related hip fractures among elderly people in a New England study occurred in warm months and indoors — with throw rugs a common culprit.

“Given the results of this study, it appears that efforts to decrease fall risk among the elderly living in cold climates should not be preferentially aimed at preventing outdoor fractures in winter,” said study author Dr. Jason Guercio.

Instead, preventive efforts should focus on conditions present year-round, and especially on indoor risk, said Guercio. He’s with North American Partners in Anesthesiology at the Hospital of Central Connecticut in New Britain, Conn.

The researchers analyzed details about hip fractures suffered by 544 patients treated at the Hospital of Central Connecticut between 2013 and 2016.

More than 55 percent of the hip fractures occurred during warm months, with the highest rates in May, September and October (around 10 percent each). In addition, the investigators found that more than three-quarters of the hip fractures occurred indoors.

Moreover, 60 percent of outdoor fractures occurred from May through October, not in the depths of winter.

The most common cause of both indoor and outdoor hip fracture? Tripping over an obstacle. Indoors, throw rugs were the most common obstacle cited.

Falling out of bed was the second leading cause of indoor hip fractures.

Outdoors, the other leading causes of hip fractures were being struck by a vehicle or falling from a vehicle, followed by accidents on stairs.

The study was scheduled for presentation Monday at the annual meeting of the American Society of Anesthesiologists, in Boston.

“Falls are one of the most common health concerns facing the elderly today. And this population is the fastest growing segment of the U.S.,” Guercio said in a meeting news release.

“Falls leading to fracture can result in disability and even death. Understanding the risk factors for fractures can help to focus efforts on decreasing them, and guide resources and appropriate interventions to prevent them,” Guercio said.

“It is counterintuitive that the risk for hip fracture would be higher in warm months, as ice and snow would appear to be significant fall risks,” he added.

Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. Centers for Disease Control and Prevention has more on hip fractures among older adults.

SOURCE: Anesthesiology annual meeting, news release, Oct. 23, 2017

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 the 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