Why people with Parkinson's may sustain falls?
Freezing: Freezing is a phenomenon when a person with Parkinson's, suddenly stops or freezes while he is walking. He may find that his feet are is stuck to the ground and he is unable to move them. This may last, at times, for a few minutes also. Freezing is due to muscular rigidity and slowness of muscular movements.
It is worse when the effects of medication are fading and next dose is yet to be consumed. Freezing can make a person unsteady and increases chances of fall.
Posture: The people with Parkinson's tend to stoop forwards and walk with smaller steps. It has been likened to a person bending forwards and walking as if to catch his own centre of gravity. This is due to muscular rigidity and slowness of movements, two of the cardinal signs of the disease. This also increases chances of falls.
Blood Pressure fluctuations: The Autonomic Nervous system, which is not under our conscious control, is in control of all the body functions such as Blood pressure, heart rate, respiration, sweating, temperature regulation. This system may get affected early in Parkinson's and this can produce a sudden drop in BP when a person suddenly gets up from lying down position or changes posture. This can lead to dizziness and imbalance.
Side effects of medication: some of the drugs that the people with Parkinson's receive can cause abnormal movements. Some drugs can cause dizziness leading to imbalance and fall.
Should a diabetic do muscle-strengthening exercises on a regular basis?
Now a days we see elderly people going to gym. Diabetic people are always advised to do physical activity regularly. Many doctors advice their diabetic patients to do weight training or muscle-strengthening exercises. Many doctors say only brisk walking is enough. What should a diabetic do? Today we shall see if a diabetic really needs to do muscle-strengthening exercises or not. I am Dr Prasad Honap, a consulting physician and you are watching let’s talk about wellness.
As we age, there is a loss of muscle mass, almost one or two percent per year till age of 70 and more afterwards. This lost muscle is replaced by fibrous tissue or fat, both very slow in burning calories than muscles. For a diabetic person this means poor sugar control.
That is why it is important for a diabetic to maintain muscle mass as long as possible. The only way to do this is to perform muscle-strengthening exercises and eat proper high protein diet.
We have been told the for a diabetic only exercise that is needed is brisk walking. Nothing is far from the truth.
Walking briskly, cycling, swimming are all excellent exercises that one can not avoid and walking is the easiest. But the exercise regimen that a diabetic person must follow should consist of a few minutes of warm up, then aerobic activity such as brisk walking or treadmill, this should also include muscle-strengthening exercises involving different muscle groups at least twice a week. Excecise should end with proper stretching and cooling down, both activities are very important to avoid injury and soreness.
Though it is better to go to gym, you can do these exercises at home with handheld weights, resistance bands or even using your own body weight you can to push-ups, Surya namaskar, squats etc
What are the benefits of muscle-strengthening exercises?
1. Loss of muscle mass is postponed and minimized
2. Weight loss
3. Improves bone health
4. Improves maintenance of balance, proper posture, prevent falls as well as postural back problems
5. Improves insulin sensitivity and helps proper utilization of glucose
6. Improves the muscle tone and maintains a higher muscle tone for many hours after the exercise. A muscle with a higher tone burns more calories per minute than a muscle which is flaccid or has low tone. So these muscles continue to burn more calories long after the exercise has finished
7. Lowers the risk of IHD and CVD
A diabetic person should perform physical activity at least 150 minutes a week. Muscle-strengthening exercises involving different muscle groups should be done at least twice a week. muscle-strengthening exercises should be started moderately and should be incremental as you become familiar with them.
It will always help you to go to gym as you can learn the correct technique, correct form and proper stretching necessary for a particular muscle group. This all will avoid injury.
Lastly one thing that a diabetic person be careful about is fall in blood sugar called hypoglycemia.
Hypoglycemia can be experienced if
1. Exercise is done on empty stomach
2. If you do abnormally heavy exercise when you are not accustomed to it
3. If you have skipped a meal
4. If you are doing exercise for a very long time
5. If you are taking Insulin or drugs which increase insulin production.
If your blood sugar falls to dangerously low levels you may
1. Start sweating profusely
2. May feel hunger pangs
3. Suddenly feel very weak
4. May feel confused or disoriented.
In an event of hypoglycemia, you must act ASAP
Always carry a pack of Glucose D powder or tablets. Consume one or two tablespoons of powder or 3-4 tablets. Once you have done this then you can have a fruit juice or a bar of chocolate. If you continue to experience signs of hypoglycemia it is better to contact your doctor.
Please remember, hypoglycemia is a rare event but regular exercise if going to help you a long way and its benefits outweigh the occasional risk of hypoglycemia.
Sitting is new smoking!!
You must have observed health warnings on a packet of cigarettes saying cigarette smoking can kill you, similar warnings can also be seen on alcohol bottle. Eating fast food has also been blamed for all sorts of health problems such as high cholesterol diabetes obesity hypertension etcetera. But what would be your reaction if in future you see a warning sign saying “Sitting can be injurious to your health”?
Yes, you heard right, it’s sitting in a chair or a couch or reclining for long hours can lead to an early death. We spend most of our time sitting. It starts with sitting on a commode, then on dining chair for breakfast, then in a car driving to workplace. Once there we spend another 7 to 8 hours sitting on a chair at your desk or in a meeting room. Then driving back home, sitting in front of a TV, dinner and then bed time. Experts compere prolonged sitting with smoking and have concluded that sitting for 8 hours in a chair can be as harmful as smoking 20 cigarettes.
Let’s start with our evolution that is has been going on for millions of years and will continue in future also, of course, as long as we allow this planet to survive.
Our ancestors, 100000 years back were hunter-gatherers. They spent a lot of time in walking, sometimes for miles in a day. They also had to run, at times with very high speed to run away from danger or when chasing a prey. But they did spend a lot of time in daytime resting. The scientists have compered incidence of cardiac events in modern human beings with hunter-gatherers of Hadza tribe in Tanzania. Hazdas have a far lesser chance of getting cardiac events than modern humans have. The study shows that our ancestors spent same time, resting that we spend now, at times even more. But the chances of a hunter-gatherer getting a heart attack were much less than us getting heart attacks. https://www.youtube.com/watch?v=vaaiRy04Nro
So, what is the difference in the rest that they took 70000 years ago and the rest that we take today? For one, our time is spent in sitting on a chair, mostly slouching, and craning our necks forward. Our ancestors mostly knelt or squatted. In both these postures our back muscles as well as glutei and muscles of thigh and legs were active. But when we sit is a chair, these muscles are at rest and flaccid. Second, our ancestors were engaged in some other chores while sitting such as making tools, knitting, or gossiping. The study has found that squatting or kneeling involves a lot of muscular activity than in sitting in a chair or on a couch. This means when we squat or kneel, we burn a lot more calories than when we sit in chair and our muscles are actively involved in kneeling or squatting.
These days it has become almost normal, or it ought to become normal for younger persons to go to gym. Even people above age of 40, also go to gym for workout. Unfortunately it is found that the health benefit of working out regularly is completely negated by then sitting in a chair for long hours.
Let’s see how does sitting affects our body.
Low Back pain
Prolonged sitting puts a lot of pressure or strain on your lower back and spine. Added to this is the strain due to poor posture while we sit. We generally slouch and this causes postural malalignment. Sitting also involves deconditioning of the muscles. More muscle fatigue, weak core muscles, all this contributing to lower back problems.
Heart Disease
Sitting means lack of physical activity that means increased risk of cardiovascular disease. The more you sit, the more likely you are to have a heart attack. Sitting also contributes to weight gain and diabetes, and these two are major risk factors for cardiovascular disease. Remember, sitting is new smoking!!
Cancer
Sedentary lifestyle and sitting too much appear to contribute independently to cancer as do eating too much red meat and smoking.
Obesity
Just a hundred years ago, physical activity was part of our lives. We did not have phones, we did not have tap water, or bedrooms attached with bathrooms. So, we had to move constantly and that helped us to keep our weights in check. Now as we know, we just don’t move so the obesity is natural effect. Obesity will lead to hypertension, diabetes, and heart disease.
Vascular problems
Sitting on a chair can slow down the circulation in leg veins. After all, contractions of calf muscles are essential to push the blood upwards to the heart. That is why calf muscles are called hearts in the legs. When sitting, our calf muscles stop squeezing the blood up to the heart. This pooling of blood can lead to what is known as Deep Vein Thrombosis or DVT for short. Rarely a blood clot from the leg vein can get dislodged and travel to the lungs. If it sticks into one of the pulmonary arteries then one can get Acute pulmonary embolism, many times a cause of sudden death.
So, what do we do?
1. Make it a habit, to get up from your chair after every 1 hour and do some stretching or take a short stroll.
2. Use desk which allow you to work standing.
3. Every time you feel thirsty walk to the water cooler and drink a glass of water. Don’t keep water bottle on your desk.
4. Some ingenious offices provide the facility of working while walking on a treadmill!!
How to keep Dementia at bay?
Indian population is aging. We are now living longer lives. With longer lives comes rising incidence of Dementia. So, it should not be surprising that
The estimated dementia prevalence for adults ages 60+ in India is 7.4%.
About 8.8 million Indians older than 60 years live with dementia.
Dementia is more prevalent among females than males and in rural than urban areas.
So, who are the people who have high risk of getting dementia? People, above age of 60, women, those who have high BP or Diabetes, smokers, people with low educational level and those who live in rural area have more chance of getting dementia.
Let’s see what is dementia. Dementia is an umbrella term used for many conditions that lead to progressive decline in cognitive function of brain, which results in memory loss, deterioration in skills such as language, problem solving, thinking, decision making etc. This ultimately impairs the ability to live daily life independently.
The difference between memory loss of elderly and that of a person with dementia is peculiar. When an old man complains that he has forgotten where he has kept his car keys, that is age related memory loss. But a person with dementia has lost his memory in such a way that even after looking at the car keys he can not make out what a key is and how to use it. A dementic person will demand that breakfast be served to him, completely forgetting that he had breakfast just 1.2 hour ago.
There are many causes of dementia. Alzheimer’s dementia, vascular dementia, Parkinson’s disease are some of the common causes of dementia. Generally, dementia is progressive and non-curable, but some dementia’s can be treated and are reversible.
What are the symptoms of dementia?
• Short term memory loss
• Difficulty in speaking, understanding, reading and writing
• Confusion, wandering away and getting lost
• Repeating same question gain and again
• Slowness in carrying out normal functions
• Hallucinations and delusions
• Lack of interest in the surroundings
• Movement problems and frequent falls
What can help to lessen the severity of dementia?
Physical activity
Doing regular physical activity is one of the best ways to reduce your risk of dementia. It’s good for your heart, circulation, weight and mental wellbeing.
There are two main types of physical activity – aerobic activity and strength-building activity. Each type will keep you fit in different ways. Doing a combination of these activities will help you to reduce your risk of dementia
Aerobic activity
Aerobic activity helps to keep your heart, lungs and blood circulation healthy – and this is good for brain health too.
Strength-building activity
Strength-building activity works your major muscles (legs, back, stomach, shoulders, arms). This helps you to do everyday tasks. This type of activity also helps you to control the level of sugars in your blood and reduce your risk of diabetes, which is a risk factor for dementia. Ideally you should do strength-building activities on at least two or more days each week.
Eat Healthy
• Include wholegrain starchy foods in most meals – for example, whole-wheat bread, rice and millets, pasta.
• Eat more fruits, vegetables, pulses (for example, beans, peas and lentils) and nuts and seeds.
• Eat less red meat – for example beef and lamb, and especially processed meats such as sausages and bacon.
• Eat fish regularly – particularly oily types like salmon and mackerel. However, try to limit eating battered or breaded fish which is high in unhealthy fat.
• Try to choose lower-fat dairy foods where possible.
• Use vegetable and plant oils for cooking and dressing – for example, olive oil and rapeseed oil. Try to avoid solid fats like butter, lard or ghee.
• Limit the amount of salt in your diet – try not to eat more than 6g (about a teaspoon) a day.
• Try to make sugary foods only occasional treats – such as pastries, sweets, biscuits, cakes and chocolate.
Don't smoke
If you smoke, you’re putting yourself at a much higher risk of developing dementia later in life.
Smoking does a lot of harm to the circulation of blood around the body, particularly the blood vessels in the brain, as well as the heart and lungs.
Drink less alcohol
Drinking too much alcohol increases your risk of developing dementia.
If you regularly drink alcohol, try to do so in moderation and within recommended limits. Drinking too much alcohol at one time exposes your brain to high levels of harmful chemicals. One should try to limit alcohol intake to 14 units of alcohol every week, spread over at least 3 days.
Stay mentally active
• Learn something, anything. Learn a new language, a new game, learn to play a musical instrument
• Join arts and crafts course, if you are so inclined
• Volunteering, for example volunteering with Alzheimer's Society
• Do ‘brainteasers’, such as puzzles, crosswords or quizzes
• Play Bridge, chess or similar brain games such as sudoku.
• Read books,
• Do creative writing or keeping a diary
Stay socially active
• Be active on social media
• Join groups of college mates, relatives and other friends and meet as many times as possible
• Exchange gossip
• Go for vacations or short trips
• Do social work
