Reducing Risk of Dementia in old age

Source: Reducing Risk of Dementia in old age

Reducing Risk of Dementia in old age

Reducing Risk of Dementia in old age

There is no cure for dementia (i.e. Alzheimer’s disease), but there are ways to reduce the risk of developing it. Dementia is more common in older people. Alzheimer’s disease is the most common type of dementia and it effects 5 million people in the United States. The onset begins with memory loss, language problem and difficulty with logical thinking. There is no curative treatment but individuals may be able to lower the chance of developing it. There are three main areas of focus in the prevention of dementia: lifestyle habits, medical conditions and mental/social well-being.

Lifestyle Habits: Physical activity, regular exercise is a key factor for brain health. Walking briskly is a good choice. Healthy eating, diet of fish, nuts, olive oil and vegetables (Mediterranean diet) lowers dementia risk. Sleep hygiene, a good night’s sleep helps the brain repair itself. DO NOT SMOKE, tobacco damages brain cells and blood vessels.

Medical Conditions: Treat heart problems, heart attacks and heart failure are associated with dementia. Control blood pressure and blood sugar, diabetes and hypertension effect brain cell function, protect your dead, head trauma and concussion increase dementia risk. Test hearing, hearing loss is associated with dementia.

Mental & Social Wellbeing: Stay curious, interested and willing to learn new things. Being an active learner helps the brain engage in memory and processing. Stay socially active, cultural programs and support groups have positive effect on the brain. Demetria is believed to have multiple causes and develops over decades. Prevention should start as early in life as possible. If you have concerns speak to your healthcare provider.

Ref:Alzheimer’s Association, CDC, National Institute on aging

Written By: Dr. David Stahura, Primary Care Physician at AbsoluteCARE Medical Center and Pharmacy

Updates on Two Common Medical problems: Back Pain and Insomnia

UPDATES ON TWO COMMON MEDICAL PROBLEMS: BACK PAIN AND INSOMNIA

Source: Updates on Two Common Medical problems: Back Pain and Insomnia

Updates on Two Common Medical problems: Back Pain and Insomnia

Back Pain and Insomnia

Low Back Pain:

The American college of physicians that alternative therapies should be the first line in the treatment of back pain and not drugs such as Opioids. Their literature review shows that chronic pain can be eased with exercise, multidisciplinary rehabilitation, acupuncture and mindful stress reduction. Similar results have been achieved with tai chi, yoga, biofeedback, spinal manipulation and cognitive behavioral therapy.

If this treatment fail reasonable trail period non-steroidal anti-inflammatory drugs (NSAID’s) should be the first choice. Opioids should only be used when all the above treatments have failed and the benefits of the narcotic medication outweigh the risk.

Acute and sub-acute back pain was shown to improve over time regardless of the treatment. Thus, recommendation for treatment should be hot packs, acupuncture and massage with NSAID’s if needed. If you have back pain, get an evaluation by your healthcare provider to determine what approach to therapy is right for you.

Insomnia:

The American Academy of sleep medicine recently released guidelines for the treatment of chronic insomnia in adults. They have recommended Cognitive Behavioral Therapy for Insomnia (CBT-I) as a first line treatment. It has been proven to be very effective for long-term control and is an available treatment at AbsoluteCARE Medical Center. The guidelines did not find significant difference in the use of medication in the overall treatment but did have recommendations in treatment of different situations. In the case of sleep onset insomnia, the following medications are recommended: Lunesta, Sonata, Ambien, Halcion, Restoril and Rozerem, all use in the lowest effective dose for shortest time along with CBT-I.

In the treatment of sleep maintenance insomnia, the recommendations were: Belsomra, Ambien, Restoril

The following medications were NOT recommended: Trazodone, Melatonin, Tryptophan and Valerian. The guideline stress that CBT-I is critical to successful treatment of insomnia.

Talk to your healthcare provider if this problem affects your lifestyle.

Written By: Dr. David Stahura, Primary Care Physician at AbsoluteCARE Medical Center and Pharmacy

Lipid Disorders: Screening & Treatment

Lipid Disorders: Screening & treatment

The US Preventive Service Task Force has updated recommendations for screening and treatment for Lipid disorders in adults.

What is a Lipid Disorder?

Lipid disorders refer to abnormal levels of fat in the bloodstream. Cholesterol is divided into Low Density Lipid (LDL or bad cholesterol) and High Density Lipid (HDL or good cholesterol). High Cholesterol usually means a high LDL. Triglycerides are another form of fat in the blood, high level of Triglycerides is usually associated with high LDL and HDL.

Lipid Disorders increase the risk of arthrosclerosis or cardiovascular disease (CVD). When arthrosclerosis occurs in the heart or brain it increases the risk of heart attack or stroke. Lowering cholesterol with lifestyle modification and/or medication reduce the risk of dying from CVD.

• Screening is done by blood test.
• Treatment is most often involves using “statin” medications. Other medications are also available but the USPSTF only addressed “statin” drugs.
• The USPSTF recommendation refers to all adults over age 40, regardless of risk factors. The additional risk factor beyond increase cholesterol are diabetes mellitus, hypertension and tobacco use.
• The benefits of “statin” use is to lessen the risk of CVD. The side effect of “statin”, are very small but it is a lifelong medication if needed.

Current Recommendations:

Screening is indicated for all adults 40 to 75 years old. Treatment is indicated for everyone with a cardiovascular risk ratio greater than10% and anyone with CV risk ratio greater than 7.5% and multiple risk.

Discuss your situation with your health provider, they can calculate your CV risk ratio and recommend the most effective plan for your situation.

Written By: Dr. David Stahura, Primary Care Physician at AbsoluteCARE Medical Center and Pharmacy

AbsoluteCARE Nutrition Department’s Recipe of the Month –June 2016

Tomato Cucumber Avocado Salad

Makes: 6 Servings

INGREDIENTS (Key: T = Tablespoon, t = teaspoon, oz = ounce)

1 red bell pepper

1.5 cups cherry tomatoes, quartered

1 cucumber

1 ripe avocado

1 T red wine vinegar

¼ cup olive oil

Juice of 1 lemon

Salt and pepper to taste

2 T fresh cilantro, chopped

DIRECTIONS

1. Peel the cucumber and remove the seeds.
2. Chop cucumber, bell pepper, cherry tomatoes, and avocado.
3. Pour all chopped ingredients into a bowl.
4. Whisk together oil, vinegar, lemon juice, salt, pepper, and cilantro. Pour into bowl with vegetables and toss to coat.

 

NUTRITION INFORMATION (for each serving)

Calories: 156

Fat:  14 grams

Saturated fat:  1 grams

Total Carbohydrates:  7.5 grams

Fiber:  4 grams

Sodium:  103.5 milligrams

Protein:  2 grams

 

Source:

“Healthy Tomato Cucumber Avocado Salad” Available at: http://peasandcrayons.com/2016/02/healthy-tomato-cucumber-avocado-salad-recipe.html. Accessed May 3, 2016.

 

AbsoluteCARE Nutrition Department’s Recipe of the Month –May 2016

Pan-Grilled Corn with Chipotle-Lime Butter

Makes: 4 Servings (Serving Size: 1 ear of corn)

INGREDIENTS (Key: T = Tablespoon, t = teaspoon, oz = ounce)

Cooking spray

4 ears shucked corn

1 T butter

½ t chipotle chile powder

½ t grated lime rind

¼ t black pepper

1/8 t salt

DIRECTIONS

1. Heat a large grill pan over medium-high heat. Coat pan with cooking spray. Add corn to pan; cook 8 minutes, turning frequently.
2. Place butter in a small microwave-safe bowl. Microwave on HIGH for 30 seconds or until butter melts. Stir in chile powder, lime rine, pepper, and salt. Brush butter mixture over corn.

NUTRITION INFORMATION (for each serving)

Calories: 103

Fat:  3.9 grams

Saturated fat:  2 grams

Polyunsaturated fat:  0.6 grams

Monounsaturated fat: 1.1 grams

Cholesterol:  8 milligrams

Total Carbohydrates: 17.3 grams

Fiber:  2.5 grams

Sodium:  115 milligrams

Protein:  3 grams

 

Source:

“Pan-Grilled Corn with Chipotle-Lime Butter” Cooking Light Super Simple Cooking. Page 83.

AbsoluteCARE Nutrition Department’s Recipe of the Month –April 2016

Makes: 6 Servings

INGREDIENTS

2 medium green bell peppers, cored and seeded, julienned
1 medium orange, zest removed, peeled and sectioned
1 head Boston lettuce, washed and torn into pieces
2 cups fresh baby spinach
½ small red onion, cut into thin rings
2 tablespoons olive oil
2 tablespoons balsamic vinegar
2 teaspoons Mrs. Dash® Table Blend
zest from orange (above)

DIRECTIONS

Prepare peppers and zest orange before peeling and sectioning.

Toss lettuce and spinach together, divide between 6 plates.

Arrange pepper slices, orange sections and onion rings on top of the lettuce.

Prepare dressing just before serving. Make dressing by combining olive oil, balsamic vinegar, Mrs. Dash® Table Blend and orange zest. Drizzle salad with dressing and serve.

 

Source:

Fruits and Veggies More Matters. URL: http://www.fruitsandveggiesmorematters.org/?page_id=35&iRID=392. Date accessed March 20, 2011. However, fruitsandveggiesmorematters.org credits the recipe as: courtesy of Mrs. Dash.

Depression Screenings

Depression is a type of behavioral health problem that often goes unrecognized and untreated.  Depression is a major cause of disability among adults in the United States.  It affects individuals and as a result, their families.  Screening can lead to early diagnosis and treatment.

Screening refers to medical professionals asking about symptoms of depression, even when patients do not mention them.  Depression symptoms include feeling sad, hopelessness, fatigue, loss of interest in activities, and inability to concentrate.  It is common for depression to occur without physical symptoms.  Because of that it is difficult for health care professionals to be able to diagnose unless asked directly.

SCREENING METHODS

Several questionnaires are used to screen for depression.  The most commonly used in the primary care setting are patient Health Questionnaire (PHQ) and the Becks Depression Inventory.  These consist of between 2 to 9 questions and require only a few minutes to complete.

WHO SHOULD BE SCREENED

The US Preventive Health task Force currently recommends depression screening for all adults older than 18 years of age, including pregnant women and new mothers as well as elderly adults.  Extensive research has shown that there is significant patient benefit to diagnosis and treatment of depression.

TREATING DEPRESSION

There are many effective ways to treat depression including counseling, cognitive behavior therapy, medication and a combination of these approaches.  Your provider and the behavioral health team at AbsoluteCARE are equipped to address and treat this issue. Call 404.231.4431 to schedule an appointment.

Advocating for HIV

This post is a personal account of HIV Advocacy Day at the Capitol written by Jennifer Caruso, RN BSN at AbsoluteCARE.

My experience at the capitol building lobbying for the HIV/AIDS population in the state of Georgia was really exciting. Along with Georgia Equality and the Georgia AIDS Coalition, the number of people coming together for a common cause was really incredible. I felt empowered, I felt part of bigger picture, and I felt like maybe, just maybe, something one of us would/could say, might actually influence our state legislators. Dr. Quintin Robinson, Medical Assistant Ben Walker, and LMSW Kim Koett were in attendance as well.

On the agenda that Georgia Equality provided us were issues relating to the criminalization of HIV, increase of MSM youths acquiring HIV in the metro area, HIV care in the rural settings of GA, HIV positive women and reproductive issues and the LGBTQ communities and the prevalence of HIV. Georgia Equality and Ga. AIDS Coalition did a great job in organizing and directing us in how to speak with our legislators. Initially it seems like everything is completely disorganized, where to get in line, little slips of white/yellow papers, middle school children running into the legislative hall actually hunting down your requested reps; however, it was actually a very smooth process. I was surprisingly impressed. We each had about 2-5 minutes of talking time with our selected representatives. I had an opportunity to meet Senator Marty Harbin from my district in Fayette County. He was kind and open to hearing what I had to say. I expressed the desire for there to be adequate prevention and education, especially focusing on every person knowing their status. I explained to Senator Harbin that I am a Registered Nurse and that I previously worked in a rural area where funding was low and thus, this formulates an obstacle to care for positive patients living in the rural areas of Georgia. We discussed the differences in care in relation to small, rural towns, such as the one he currently lives in, and the major metro cities access to care: ie: transportation. Dr. Robinson was able to speak with House Representative Marie Metze, from Fulton County. He voiced his concerns regarding the non-existent expansion of Medicaid, and the increased number of HIV cases among young black males in metro Atlanta. House Representative Metze (as was Senator Harbin) very open to listening to the concerns of their constituents’.

I truly wish that everyone could have the opportunity and be able to make the time to develop relationships with their district and state legislators.  Yesterday was just a beginning in the forging of these relationships. Even if one does not have the ability to go and spend the day at the capital, a letter conveying your concerns is always acceptable. If you do not have a computer, fret not! There is always the local library in your county, OR, one can resort to the gone but not forgotten handwritten note. Sometimes I think this more effective. It adds a personal touch and who doesn’t love to get something in the mail? If we want HIV/AIDS to decrease in the state of GA, if we want access to care for all HIV positive patients, then we are responsible for letting our voice be heard. Today was an exceptional lesson in this for me. I do not know if my enthusiasm and my passion for the HIV communities of Georgia will make a difference in Senator Harbin’s voting, or House Rep Metze’s voting, but at least I took a stand. One cannot kvetch about the sad state of affairs, if one is not willing to at least do their part. I am grateful that I was able to stand among colleagues and at least do my small part. I leave you with one of my favorite quotes, and hopefully my actions yesterday, as well as the actions of Ga Equality and the GA AIDS Coalition will help illuminate the needs of HIV/AIDS action here in the state of GA.

There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance-that principle is contempt prior to investigation. Herbert Spencer.