Saturday, 9 April 2011

stages of high BP and reduction goals

Thursday, 7 April 2011

Things to do to prevent falls in the elderly.

Things to do to prevent falls

1. Have your hearing checked regularly.

2. make sure your home is well lit, inside and outside.

3. use cane or walker if your care provider has so advised.

4. if you are on medicines, take them as recommended by doctor

5. if your medicine causes you to have lightheadedness or dizziness, discuss this with your doctor

6. over the counter medications like allergy pills, water pills etc can cause you to be dizzy.

7. if you are overweight, talk to you provider about weight control.

8. eat nutritious food.

9. take Vitamin D (has been shown to reduce falls --> see here

10. exercise daily to keep your muscles toned.

11. have your vision checked regularly.

Changes you can make around the house to reduce falls

1. use non slip floors, remove and mats, rugs or carpets that tend to slip

2. carpet or stair treds should be tacked down firmly

3. replace worn out areas of flooring or carpets

4. use good lighting and have switches at both ends of room or hallways

5. use a small night light, so you dont have to get up at night

dont have loose electric cords on floors

arrange clutter around the house and streamline furniture

8. watch for small pets (cats or dogs)
who could get in the way and make you trip

9. install grab bars in bathroom, shower and toilet.

Friday, 1 April 2011

Vitamin D prevents falls!

This week in the clinic we talked about falls in the elderly. One thing that came up during the discussion was a surprising topic that vitamin D can actually reduce the incidence of falls in the elderly.

Why are falls important in elderly? As many as a third of elderly (more than 65) people fall. Everyone knows at least one elderly person who fell and there on began a series of complications that were serious and lethal. There are many reasons why we can fall when we get older. Bad eyesight, poor co-ordination, muscle weakness, hearing problems and even medications can cause you to lose balance and fall.

A large meta-analysis published in 2010 January in the Cochrane database of systematic reviews1 looked at the effectiveness of vitamin D in preventing falls in the elderly. Based on the combined results of 7 trials (close to twenty five thousand patients), it was found that individuals who were taking about 700 units of vitamin D daily reduced falling by 22% compared with patients receiving calcium or dummy pill.  Effect was independent of calcium supplementation, type of vitamin D, duration of treatment or sex of the person.

What is vitamin D? This micronutrient is an important vitamin which has role to play in multiple systems. We all know that it is important for bone health.  What is not commonly known is that it is important for for muscle strength. The authors of this study and several other studies indicate that vitamin D improves the strength and tone of the muscles and bone, leading to fewer incidences of falls in elderly.
The new reference intakes for vitamin D are:
·         1–70 years of age: 600 IU/day (200 IU is 5 μg equivalent)
·         71+ years of age: 800 IU/day

Some good foods to obtain vitamin D naturally in food are2:

IUs per serving*
Percent DV**
Cod liver oil, 1 tablespoon
Salmon (sockeye), cooked, 3 ounces
Mackerel, cooked, 3 ounces
Tuna fish, canned in water, drained, 3 ounces
Milk, nonfat, reduced fat, and whole, vitamin D-fortified, 1 cup
Orange juice fortified with vitamin D, 1 cup (check product labels, as amount of added vitamin D varies)
Yogurt, fortified with 20% of the DV for vitamin D, 6 ounces (more heavily fortified yogurts provide more of the DV)
Margarine, fortified, 1 tablespoon
Liver, beef, cooked, 3.5 ounces
Sardines, canned in oil, drained, 2 sardines
Egg, 1 large (vitamin D is found in yolk)
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 0.75-1 cup (more heavily fortified cereals might provide more of the DV)
Cheese, Swiss, 1 ounce

And if you don’t meet your daily requirement by food, you can always take a vitamin D pill!

1.     Cameron ID, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD005465.
2.     Office of dietary supplements, National Institutes of health.