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Mature Focus: May 1

Arthritis underestimated

A new analysis shows that the number of Americans suffering from arthritis may be far greater than previously thought.

May is National Arthritis Awareness Month, which calls attention to the massive impacts – both personal and economic – of this common inflammatory condition.

By current conservative estimates, about 54 million American adults have physician-diagnosed arthritis. It is the leading cause of disability among people of working age [18-64 years], and its painful effects are most serious and life-limiting among seniors.

But new information suggests that the prevalence of arthritis in the United States has been greatly underestimated – especially among younger people.

Researchers from the Boston University School of Medicine recently conducted an analysis of the National Health Interview Survey that found arthritis symptoms actually affected 29.9% of men and 31.2% of women under age 65. Among those 65 and older, they found arthritis impacts among 55.8% of men and 68.7% of women.

When those statistics are used as a representative sample of the entire U.S. population, arthritis more likely affects 91.2 million U.S. adults, including 61.1 million under 65 – a prevalence estimate which is 68% higher than previously reported.

Current national statistics on arthritis rely on a single survey question, asking whether participants remember ever being told by a health professional that they have arthritis, without using information on patients’ joint symptoms also included in the survey. Using this information, the Boston University team developed a method for arthritis surveillance based on diagnosed arthritis as well as patient reports of chronic joint symptoms lasting longer than three months.

“Our findings are important because of underestimated, yet enormous, economic and public health impacts of arthritis, including healthcare costs and costs from loss of productivity and disability,” said Dr. S. Reza Jafarzadeh, who helped to develop the new estimates. “Studies have also reported a rising rate of surgeries such as total knee replacement that outpaced obesity rates in recent years, especially among younger adults affected by arthritis.”

Dangerous yoga poses

Doing certain yoga poses could be risky for seniors with osteoporosis or osteopenia.

Practicing certain yoga poses could pose a risk to seniors with osteoporosis or osteopenia, new Mayo Clinic research has found.

Yoga has long been hailed for its benefits for older people in terms of improving flexibility, strength and balance. Past studies also have suggested that practicing yoga could have a protective effect against osteoporosis, although their findings are somewhat inconclusive.

However, for those who already have the condition – estimated at about 25% of women and 5% of men over 65 in the U.S. – certain poses may lead to further soft tissue and bone injuries.

“Multiple reports have described injuries resulting from yoga, ranging from mild muscle strains to bony fractures,” the Mayo Clinic researchers wrote in their report. “For osteoporotic and osteopenic patients in particular, the reports of bony injuries raise concerns that warrant further investigation.”

The research team analyzed the health records of older people who sought treatment at the Mayo Clinic between 2006 and 2018, due to pain that they thought had been caused by yoga participation. All had experienced pain in their backs, necks, shoulders, hips or knees.

These patients specified 12 yoga poses as having either caused them pain or worsened existing pain. They included common poses such as Downward-Facing Dog, Bridge Pose, and the Supported Headstand.

Using health records, medical exams and imaging results, the researchers categorized the injuries sustained as bone injuries, soft tissue injuries, or joint injuries. They found that specific yoga poses had led to 29 types of bone injuries, which included disk degeneration, vertebrae slippage, and compression fractures, likely due to poses that compounded the pressure on disks and vertebrae.

The researchers said they do not discourage people with osteopenia or osteoporosis from practicing yoga; rather, they should modify certain poses to reduce their risk of injury.

“As people age, they can benefit by getting a review of their old exercise regimens to prevent unwanted consequences,” said senior author Dr. Mehrsheed Sinaki. “Yoga has many benefits…“but if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition.”

Pet positives

Pets contribute greatly to the well-being of older adults, according to a recent national survey.

Pets offer unconditional love, comfort and companionship that are especially important to the well-being of older Americans, according to a new national poll.

The University of Michigan National Poll on Healthy Aging, conducted in late 2018, asked a national sample of older adults about their reasons for having – or not having – pets, and the benefits and challenges of pet ownership.

More than half of those surveyed [55%] reported having a pet, mainly dogs [68% of pet owners]. The vast majority said their pets help them enjoy life, make them feel loved, reduce stress, provide a sense of purpose and help them stick to a daily routine.  Most respondents also reported that their pets help them connect with other people, help them be physically active, and help them cope with physical and emotional symptoms, including taking their minds off pain related to health problems.

Poll director Dr. Preeti Malani said the results point to a need for physicians and other health care providers to ask older adults specific questions about the role of pets in their lives.

“More activity, through dog walking or other aspects of pet care, is almost always a good thing for older adults. But the risk of falls is real for many, and 6% of those in our poll said they had fallen or injured themselves due to a pet,” she said. “At the same time, given the importance of pets to many people, the loss of a pet can deal a very real psychological blow that providers, family and friends should be attuned to.”

Some negative aspects of senior pet ownership did emerge in the poll results as well. More than half of pet owners said that having a pet made it difficult to travel or enjoy activities outside the home.

One in six pet owners also said that they put their pet’s needs ahead of their own health concerns, a figure that was closer to one in four among those with health issues.

“For people living on a fixed income, expenses related to health care for pets, and especially pets that have chronic health issues, can be a struggle. Older adults can also develop health problems or disabilities that make pet care difficult,” Malani said.

Robot caregivers?

Researchers at Purdue University are working toward the development of “soft robots” using 3D printing technology. These robots could potentially be used in the future to help fill caregiving needs created by an exploding population of elderly people worldwide – a population expected to more than double by 2050.

Already, robotic assistants in some healthcare facilities are programmed to ask questions a nurse would ask and can monitor patients for falls. Robot trials are also underway in residential settings.

For instance, a robot created and currently being tested by Washington State University scientists to help elderly people with dementia can navigate through rooms and around obstacles to find residents, provide video instructions on how to do simple tasks and can even lead them to their medication or a snack in the kitchen.

However, the external hard structure of these robots prevents them from safe physical contact with people. This limits their capabilities to monitoring and social interaction only.

The Purdue researchers are using recent advances in material science to develop a new design method that shows promise in the fabrication of soft-bodied robots using a 3D printer. These robots, called architected soft machines [ASMs] move like humans, using miniaturized motors that pull from nylon lines attached to their limbs instead of muscles. Their bodies can also change shape when needed.

“ASMs can perform complex motions such as gripping or crawling with ease, and this work constitutes a step forward toward the development of autonomous and lightweight soft robots,” said Ramses Martinez, an assistant professor of industrial and biomedical engineering at Purdue. “The capability of ASMs to change their body configuration and gait to adapt to a wide variety of environments has the potential to not only improve caregiving but also disaster-response robotics.”

The Purdue researchers have patented their ASM technology, and are currently seeking partners to help them bring this technology to a wider market.

On the calendar

An AARP Smart Driver Course is offered on Friday, May 3 from 9 a.m.-1 p.m. at the Adult and Community Education Center, 2400 Zumbehl Road in St. Charles. This program will help tune up your driving skills, update your knowledge of the rules of the road, learn about normal age-related physical changes and ways to adjust for these changes. The cost is $15 for AARP members and $20 for non-members. Register by calling (636) 443-4043.

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St. Louis Oasis offers an Acute Bleeding Control course on Thursday, May 9 from 6:30-7:30 at Katherine Linneman Branch Library, 2323 Elm St. in St. Charles. When a bleeding incident occurs, bystanders trained in acute bleeding control [ABC] are uniquely positioned to save lives through the use of tourniquets and hemostatic dressings. This free course, presented in partnership with Barnes-Jewish St. Peters and Progress West hospitals, focuses on safe ways to stop bleeding for those who are taking blood thinners. To register, call (636) 928-9355.

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Barnes-Jewish St. Peters Hospital offers a “Freezing Gait” Boot Camp for people with Parkinson disease on Mondays, June 2 through July 7, from 10 a.m.-noon at Barnes Jewish St. Peters Hospital, 6 Jungermann Circle in St. Peters, in Suite 117 of the Healthwise Center. Freezing is a temporary, involuntary inability to move caused by Parkinson’s; boot camp participants will learn and practice strategies for overcoming a freezing episode, from expert physical and occupational therapists. Spouses or caregivers are also encouraged to attend. The sessions are free, but space is limited; early registration is recommended by visiting bjcstcharlescounty.org/Events [please register the patient only].

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The Alzheimer’s Association St. Louis Chapter presents 10 Warning Signs of Alzheimer’s on Wednesday, June 5 from 9:30-11 a.m. at Kathryn Linnemann Branch Library, 2323 Elm St. in St. Charles, in Meeting Room A. Learn about typical age-related changes, common warning signs of Alzheimer’s how to approach someone about memory concerns, early detection, the benefits of a diagnosis and the diagnostic process, along with Alzeimer’s Association Resources. This free program is presented in partnership with Barnes-Jewish St. Peters and Progress West Hospitals. To register, call (636) 928-9355 or visit bjcstcharlescounty.org/Events.

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BJC of St. Charles County, St. Louis Oasis and American Bone Health co-sponsor a Bone Health Series: Basics of Osteoporosis class on Wednesdays, June 5 through June 26, from 1:30-3 p.m. at Spencer Road Branch Library, 427 Spencer Road in St. Peters, in Multipurpose Room 112. Participants in this free four-part class series will learn the facts about osteoporosis including FRAX and T-Scores, the difference between osteoporosis, osteopenia and low bone density, and what medications are available for treatment. To register, call (636) 928-9355.

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