Jan Willem Elte, The Netherlands Physical exercise is often recommended to older persons but it is not always easy to motivate them. A recent randomized clinical trial (in JAMA) investigated whether older persons who talked with peers about their exercise program (interpersonal strategy) were able to increase and sustain physical activity levels better than those who focused on self-motivation by setting fitness goals (intrapersonal strategy). Low physical activity among older adults is linked with disability, increased weight, difficulty in managing chronic conditions, increased falls and related injuries. Exercise may help. Yet fewer than 16 % of older adults meet the recommended guidelines (150 minutes of moderate aerobic activity and two muscle-strenghtening sessions per week). More than 300 participants aged 70 years and older who did not meet physical activity guidelines were given a wearable fitness tracker and an exercise program and randomly divided in four groups: One using intrapersonal behavior change strategies Another using interpersonal strategies A group combining both intra- and interpersonal strategies A control group that received neither intervention For eight weeks, all participants exercised in meetups and discussed their progress in their groups, afterwards they were left on their own devices and monitored for the remainder of […]

Recently the AHA (American Heart Association) reported a study on the Life’s Essential 8 (LE 8) and its association with both life expectancy and health span free of chronic diseases such as cardiovascular disease (cvd), cancer, diabetes and dementia. Ths study was performed in the UK and included more than 135,000 adults with a mean age of 55. The study was published in JAMA Internal Medicine (Wang et al. JAMA Intern Med. 2023;183(4):340-349. doi:10.1001/jamainternmed.2023.0015) and summarized in Medscape. The AHA Essential Life’s Essential 8 score includes: Not smoking; Regular physical activity; Healthy weight; Healthy diet; Healthy sleep (defined as an average of 7-9 hours nightly); Blood pressure in a healthy range; Blood glucose in a healthy range; and LDL (bad) cholesterol in a healthy range. In a large cohort study of 135199 adults from the UK Biobank researchers investigated the association of cardiovascular (cv) health levels (as estimated by  the AHA Essential Life’s Essential 8 score) with life expectancy free of major disease. The study population was divided into three groups: those with low, moderate and high LE 8 scores, indicating low, moderate and high cv health. The average life expectancy free of chronic disease was estimated (at age 50) to […]

Polypharmacy and deprescribing Polypharmacy is an increasing problem in a population, which gets older, is more obese and affected with more diabetes and subsequently cardiovascular problems (see earlier news item). In this short report polypharmacy is the excessive or unnessary use of medications. The polypill is one solution, predescribing is another one. Polypharmacy has several possible consequences: Adverse drug effects such as nausea, confusion, bleeding Drug-drug interactions , when a medication changes the effect of other medications taken together Medication nonadherence Deceased mobility and falls Increased health care use, including visits to a clinic, an emergency department or hospitalization Higher costs both out-of-pocket and for the community How can the risk of polypharmacy be decreased: Bring an up-to-date list of prescriptions and over-the-counter medications or take all medication bottles to each medical appointment and also report if you take dietary supplements, they may interact. Talk with a doctor or pharmacist before starting any over-the-counter medications or dietary supplements to be taken on a regular basis. When a new medication is recommended, ask the doctor or pharmacist how long you should expect to take it. Talk with a doctor or pharmacist if you are taking a medication longer than planned, to […]

Daniel Sereni, France 1. What is the cause of acute Low Back Pain (Backache)? Ninety percent of adults experience at least one episode of backache during their life. In most cases the lumbar pain is acute and resolves in less than one or two days. It may be provoked by an effort or an unusual and brisk movement; but it can also appear suddenly without evident reason. Pain can be intense with a sensation of burning aggravated by bending or walking. Acute Lumbar Pain is not the consequence of any anomaly of the vertebrae or of the vertebral disk. Pain is triggered by a sudden strain in the muscles and ligaments around the intervertebral disk. As the disk is richly innervated this situation results in an acute pain. 2. Is it necessary to visit a doctor? To have x-rays? Low back Pain may be very painful, but it does not mean that it is dangerous. In an adult in general good health the backache will resolve in a few hours or days. There is no need to visit a doctor; x -rays will not show anything relevant and should not be performed.  Yet there are some situations when a call to […]

Jan Willem Elte, The Netherlands For many years we know that patients may continue to have complaints long after an acute infection (mostly viral) has vanished. New research now sheds light on some of the problems associated with the post viral syndrome. Until now no good explanation for these lasting complaints has been found and also no cure. Well-known viral infection diseases such as influenza, Q-fever, Epstein-Barr virus and mononucleosis infectiosa (M.Pfeiffer) have resulted in long-lasting periods of complaints, described as post-viral disease. Nowadays these complaints have been taken together and called myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). ME/MFS is a complex, chronic condition influenced by multiple factors and it received its name because despite extensive research no definitive cause or tools with which to diagnose it are available. The condition results in debilitating symptoms with extreme fatigue, unfreshing sleep, difficulty in recovering from exertion, cognitive dysfunction and immune system abnormalities. It may last for years with little or no improvement. Moreover, these complaints are quite frequent and are non-specific. Infections may just be one of the causes and indeed after certain infections some persons experience durable symptoms.  Since the start of the Covid-19 pandemic, infection with SARS-CoV-2 […]