One Critical Mistake That Costs Seniors Their Mobility
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Will Harlow, the over-50s specialist physio, advises what to do instead:
Nose over toes
Often considered the most important test of mobility in later life (or in general, but later life is when it tends to decline) is the ability to get up off the floor without using your arms.
Many seniors, meanwhile, struggle to get out of a chair without using their arms.
Now, sitting in chairs in the first place is not good for the health, but that’s another matter and beyond the scope of today’s article.
If, perchance, you struggle to get up from a chair (especially if it’s low/deep, like many armchairs are) without using your hands, then here’s the way to do it:
- While practicing, cross your arms in front of you, so that you cannot use them.
- Shuffle yourself towards the front of the chair. No, don’t use your arms for this either, do a little butt-walk instead, to get you to the front edge of the chair.
- Lean forwards to position your nose over your toes (hence the mnemonic: “nose over toes”; memorize that!), as this will put your center of gravity where it needs to be.
- Now, push with your feet to rise up and forwards; slowly is better than quickly (quickly may be easier, but slowly will improve your strength and balance).
For more on all of this plus a visual demonstration, enjoy:
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For women with antenatal depression, micronutrients might help them and their babies – new study
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Getty Images Julia J Rucklidge, University of Canterbury; Elena Moltchanova, University of Canterbury; Roger Mulder, University of Otago, and Siobhan A Campbell, University of Canterbury
Antenatal depression affects 15% to 21% of pregnant women worldwide. It can influence birth outcomes and children’s development, as well as increase the risk of post-natal depression.
Current treatments like therapy can be inaccessible and antidepressants can carry risks for developing infants.
Over the past two decades, research has highlighted that poor nutrition is a contributing risk factor to mental health challenges. Most pregnant women in New Zealand aren’t adhering to nutritional guidelines, according to a longitudinal study. Only 3% met the recommendations for all food groups.
Another cohort study carried out in Brazil shows that ultra-processed foods (UPF) accounted for at least 30% of daily dietary energy during pregnancy, displacing healthier options.
UPFs are chemically manufactured and contain additives to improve shelf life, as well as added sugar and salt. Importantly, they are low in essential micronutrients (vitamins and minerals).
The consumption of these foods is concerning because a nutrient-poor diet during pregnancy has been linked to poorer mental health outcomes in children. This includes depression, anxiety, hyperactivity, and inattention.
Increasing nutrients in maternal diets and reducing consumption of UPFs could improve the mental health of the mother and the next generation. Good nutrition can have lifelong benefits for the offspring.
However, there are multiple factors that mean diet change alone may not in itself be sufficient to address mental health challenges. Supplementing with additional nutrients may also be important to address nutritional needs during pregnancy.
Micronutrients as treatment for depression
Our earlier research suggests micronutrient supplements for depression have benefits outside pregnancy.
But until now there have been no published randomised controlled trials specifically designed to assess the efficacy and safety of broad-spectrum micronutrients on antenatal depression and overall functioning.
The NUTRIMUM trial, which ran between 2017 and 2022, recruited 88 women in their second trimester of pregnancy who reported moderate depressive symptoms. They were randomly allocated to receive either 12 capsules (four pills, three times a day) of a broad-spectrum micronutrient supplement or an active placebo containing iodine and riboflavin for a 12-week period.
Micronutrient doses were generally between the recommended dietary allowance and the tolerable upper level.
Based on clinician ratings, micronutrients significantly improved overall psychological functioning compared to the placebo. The findings took into account all noted changes based on self-assessment and clinician observations. This includes sleep, mood regulation, coping, anxiety and side effects.
Adding micronutrients to the diet of pregnant women with antenatal depression significantly improved their overall psychological functioning. Getty Images Both groups reported similar reductions in symptoms of depression. More than three quarters of participants were in remission at the end of the trial. But 69% of participants in the micronutrient group rated themselves as “much” or “very much” improved, compared to 39% in the placebo group.
Participants taking the micronutrients also experienced significantly greater improvements in sleep and overall day-to-day functioning, compared to participants taking the placebo. There were no group differences on measures of stress, anxiety and quality of life.
Importantly, there were no group differences in reported side effects, and reports of suicidal thoughts dropped over the course of the study for both groups. Blood tests confirmed increased vitamin levels (vitamin C, D, B12) and fewer deficiencies in the micronutrient group.
Micronutrients were particularly helpful for women with chronic mental health challenges and those who had taken psychiatric medications in the past. Those with milder symptoms improved with or without the micronutrients, suggesting general care and monitoring might suffice for some women.
The benefits of micronutrients were comparable to psychotherapy but with less contact. There are no randomised controlled trials of antidepressant medication to compare these results.
Retention in the study was good (81%) and compliance excellent (90%).
Beyond maternal mental health
We followed the infants of mothers enrolled in the NUTRIMUM trial (who were therefore exposed to micronutrients during pregnancy) for 12 months, alongside infants from the general population of Aotearoa New Zealand.
This second group of infants from the general population contained a smaller sub-group who were exposed to antidepressant medication for the treatment of antenatal depression.
We assessed the neuro-behavioural development of each infant within the first four weeks of life, and temperament up to one year after birth.
These observational follow-ups showed positive effects of micronutrients on the infants’ ability to regulate their behaviour. These results were on par with or better than typical pregnancies, and better than treatments with antidepressants.
Micronutrients during pregnancy improved the neurological and behavioural development of infants. Getty Images Infants exposed to micronutrients during pregnancy were significantly better at attending to external stimuli. They were also better able to block out external stimuli during sleep. They showed fewer signs of stress and had better muscle tone compared to infants not exposed to micronutrients.
They also displayed greater ability to interact with their environment. They were better at regulating their emotional state and had fewer abnormal muscle reflexes than infants exposed to antidepressant medication in pregnancy.
Reassuringly, micronutrients had no negative impact on infant temperament.
These findings highlight the potential of micronutrients as a safe and effective alternative to traditional medication treatments for antenatal depression.
The prenatal environment sets the foundation for a child’s future. Further investigation into the benefits of micronutrient supplementation would gives us more confidence in their use for other perinatal (from the start of pregnancy to a year after birth) mental health issues. This could provide future generations with a better start to life.
We would like to acknowledge the contribution of Dr Hayley Bradley to this research project.
Julia J Rucklidge, Professor of Psychology, University of Canterbury; Elena Moltchanova, Professor of Statistics, University of Canterbury; Roger Mulder, Professor of Psychiatry, University of Otago, and Siobhan A Campbell, Intern Psychologist, Researcher – Te Puna Toiora (Mental Health and Nutrition Research Lab), University of Canterbury
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Reversing Alzheimer’s – by Dr. Heather Sandison
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The title here is bold, isn’t it? But, if the studies so far are anything to go by, she is, indeed, reversing Alzheimer’s. By this we mean: her Alzheimer’s patients have enjoyed a measurable reversal of the symptoms of cognitive decline (this is not something that usually happens).
The science here is actually new, and/but references are given aplenty, including Dr. Sandison’s own research and others—there’s a bibliography of several hundred papers, which we love to see.
Dr. Sandison’s approach is of course multivector, but is far more lifestyle medicine than pills, with diet in particular playing a critical role. Indeed, it’s worth mentioning that she is a naturopathic doctor (not an MD), so that is her focus—though she’s had a lot of MDs looking in on her work too, as you may see in the book. She has found best results in a diet low in carbs, high in healthy fats—and it bears emphasizing, healthy ones. Many other factors are also built in, but this is a book review, not a book summary.
Nor does the book look at diet in isolation; other aspects of lifestyle are also taken into account, as well as various medical pathways, and how to draw up a personalized plan to deal with those.
The book is written with the general assumption that the reader is someone with increased Alzheimer’s risk wishing to reduce that risk, or the relative of someone with Alzheimer’s disease already. However, the information within is beneficial to all.
The style is on the hard end of pop-science; it’s written for the lay reader, but will (appropriately enough) require active engagement to read effectively.
Bottom line: if Alzheimer’s is something that affects or is likely to affect you (directly, or per a loved one), then this is a very good book to have read
Click here top check out Reversing Alzheimer’s, and learn how to do it!
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Managing Chronic Pain (Realistically!)
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Realistic chronic pain management
We’ve had a number of requests to do a main feature on managing chronic pain, so here it is!
A quick (but important) note before we begin:
Obviously, not all chronic pain is created equal. Furthermore, we know that you, dear reader with chronic pain, have been managing yours for however long you have, learning as you go. You also doubtlessly know your individual condition inside out.
We also know that people with chronic health conditions in general are constantly beset by well-meaning unsolicited advice from friends and family, asking if you’ve heard about [thing you heard about 20 years ago] that will surely change your life and cure you overnight.
It’s frustrating, and we’re going to try to avoid doing that here, while still offering the advice that was asked for. We ask you, therefore, to kindly overlook whatever you already knew, and if you already knew it all, well, we salute you and will not be surprised if that’s the case for at least some readers. Chronic pain’s a… Well, it’s a chronic pain.
All that said, let’s dive in…
How are you treating your body right now?
Are you hydrated; have you eaten; are you standing/sitting/lying in a position that at least should be comfortable for you in principle?
The first two things affect pain perception; the latter can throw a spanner in the works if something’s not quite right.
Move your body (gently!)
You know your abilities, so think about the range of motion that you have, especially in the parts of your body that hurt (if that’s “everywhere”, then, our sympathies, and we hope you find the same advice applies). Think about your specific muscles and joints as applicable, and what the range of motion is “supposed” to be for each. Exercise your range of motion as best you can (gently!) to the point of its limit(s) and/or pain.
- If you take it past that limit, there is a good chance you will make it worse. You don’t want that.
- If you don’t take it to the limit, there is a good chance your range of movement will deteriorate, and your “safe zone” (i.e., body positions that are relatively free from pain) will diminish. You definitely don’t want that, either.
Again, moderation is key. Yes, annoying as the suggestion may be, such things as yoga etc can help, if done carefully and gently. You know your limits; work with those, get rest between, and do what you can.
For most people this will at least help keep the pain from getting worse.
Hot & Cold
Both of these things could ease your pain… Or make it worse. There is an element of “try it and see”, but here’s a good general guide:
Here’s How to Choose Between Using Ice or Heat for Pain
Meditation… Or Distraction
Meditating really does help a lot of people. In the case of pain, it can be counterintuitively helpful to focus for a while on the sensation of the pain… But in a calm, detached fashion. Without judgement.
“Yes, I am experiencing pain. Yes, it feels like I’m being stabbed with hot knives. Yes, this is tortuous; wow, I feel miserable. This truly sucks.”
…it doesn’t sound like a good experience, does it? And it’s not, but paying it attention this way can paradoxically help ease things. Pain is, after all, a messenger. And in the case of chronic pain, it’s in some ways a broken messenger, but what a messenger most needs is to be heard.
The above approach a) is good b) may have a limit in how long you can sustain it at a time, though. So…
The opposite is a can be a good (again, short-term) approach too. Call a friend, watch your favorite movie, play a video game if that’s your thing. It won’t cure anything, but it can give you a little respite.
Massage
Unless you already know this makes your pain worse, this is a good thing to try. It doesn’t have to be a fancy spa; if the nature of your pain and condition permits, you can do self-massage. If you have a partner or close friend who can commit to helping, it can be very worth them learning to give a good massage. There are often local courses available, and failing that, there is also YouTube.
Here’s an example of a good video for myofascial release massage, which can ease a lot of common kinds of chronic pain:
Some quick final things to remember:
- If you find something helps, then it helps, do that.
- That goes for mobility aids and other disability aids too, even if it was designed for a different disability. If it helps, it helps. You’re not stealing anyone’s thunder (or resources) by using something that makes your life easier. We’re not in this life to suffer!
- There is no such thing as “this pain is not too much”. The correct amount of pain is zero. Maybe your body won’t let you reach zero, but more than that is “too much” already.
- You don’t have to be suffering off the scale to deserve relief from pain
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The Problem With Active Listening
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The problem with active listening
Listening is an important skill to keep well-trained at any age. It’s important in romantic relationships, parent-child relationships, friendships, and more.
First, for any unfamiliar or hazy-of-memory: active listening is the practice of listening, actively. The “active” side of this comes in several parts:
- Asking helpful questions
- Giving feedback to indicate that the answer has been understood
- Prompting further information-giving
This can look like:
- A: How did you feel when that happened?
- B: My heart was racing and I felt panicked, it really shocked me
- A: It really shocked you?
- B: Yes, because it was so unexpected; I’d never imagined something like this happening
- A: You’d never expect something like that
- B: No, I mean, I had no reason to
And… As a superficial listening technique, it’s not terrible, and it has its place
But unfortunately, if it’s one’s only listening technique, one will very quickly start sounding like a Furby—that children’s toy from the 90s that allegedly randomly parroted fragments of things that had been said to it. In fact this was a trick of programming, but that’s beyond the scope of this article.
The point is: the above technique, if used indiscriminately and/or too often, starts to feel like talking to a very basic simulacrum.
Which is the opposite of feeling like being listened to!
A better way to listen
Start off similarly, but better.
Ask open questions, or otherwise invite sharing of information.
People can be resistant to stock phrases like “How did that make you feel?”, but this can be got around by simply changing it up, e.g.:
- “What was your reaction?” ← oblique but often elicits the same information
- “I’m not sure how I’d feel about that, in your shoes” ← not even a question, but shows active attention much better than the “mmhmm” noises of traditional active listening, and again prompts the same information
Express understanding… But better
People have been told “I understand” a lot, and often it’s code for “Stop talking”. So, avoid “I understand”. Instead, try:
- “I can understand that”
- “Understandable”
- “That makes sense”
Ask clarifying questions… Better
Sometimes, a clarifying question doesn’t have to have its own point, beyond prompting more sharing, and sometimes, an “open question” can be truly wide open, meaning that vaguer is better, such as:
- “Oh?”
- “How so?” ← this is the heavy artillery that can open up a lot
Know when to STFU
Something that good therapists (and also military interrogators) know: when to STFU
If someone is talking, don’t interrupt them. If you do, they might not start again, or might skip what they were going to say.
Interruption says “I think you’ve said all that needs to be said there”, or else, if the interruption was to ask one of the above questions, it says “you’re not doing a good enough job of talking”, and neither of those sentiments encourage people to share, nor do they make someone feel listened-to!
Instead, just listen. Passive listening has its place too! When there’s a break, then you can go to one of the above questions/prompts/expressions of understanding, as appropriate.
Judge not, lest they feel judged
Reserve judgement until the conversation is over, at the earliest. If asked for your judgement of some aspect, be as reassuring as you can. People feel listened-to when they don’t feel judged.
If they feel judged, conversely, they can often feel you didn’t listen properly, or else you’d be in agreement with them. So instead, just sit on it for as long as you can.
Note: that goes for positive judgements too! Sit on it. Expressing a positive judgement too soon can seem that you were simply eager to please, and can suggest insincerity.
If this seems simple, that’s because it is. But, try it, and see the difference.
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Understanding Cellulitis: Skin And Soft Tissue Infections
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What’s the difference between a minor passing skin complaint, and a skin condition that’s indicative of something more serious? Dr. Thomas Watchman explains:
More than skin-deep
Cellulitis sounds benign enough, like having a little cellulite perhaps, but in fact it means an infection of the skin and—critically—the underlying soft tissues.
Normally, the skin acts as a barrier against infections, but this barrier can be breached by physical trauma (i.e. an injury that broke the skin), eczema, fungal nail infections, skin ulcers, and other similar things that disrupt the skin’s ability to protect us.
Things to watch out for: Dr. Watchman advises we keep an eye out for warm, reddened skin, swelling, and blisters. Specifically, a golden-yellow crust to these likely indicates a Staphylococcus aureus infection (hence the name).
There’s a scale of degrees of severity:
- Class 1: No systemic toxicity or comorbidities
- Class 2: Systemic toxicity or comorbidities present
- Class 3: Significant systemic toxicity or comorbidities with risk of significant deterioration
- Class 4: Sepsis or life-threatening infection
…with antibiotics being recommended in the latter two cases there, or in other cases for frail, young, old, or immunocompromised patients. Given the rather “scorched earth” results of antibiotics (they cause a lot of collateral iatrogenic damage), this can be taken as a sign of how seriously such infections should be taken.
For more about all this, including visual guides, enjoy:
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Want to learn more?
You might also like to read:
- Of Brains & Breakouts: The Brain-Skin Doctor
- Beyond Supplements: The Real Immune-Boosters!
- Antibiotics? You Might Want To Think Thrice
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The CBT Workbook for Mental Health – by Dr. Simon Rego & Sarah Fader
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We have often reviewed psychology books here with a note saying “and no, it’s not just a book of the standard CBT techniques that you probably already know”.
So today, this one’s for anyone who was ever thinking “but I don’t know the standard CBT techniques and I would like to know them!”.
The authors outline specific solutions to many common quantifiable problems, with simple exercises that are well-explained and easy to implement.
Cognitive Behavioral Therapy (CBT) is not a panacea, but for the things it can be used for, it’s very effective and is a very good “first thing to reach for” to see if it works, because its success rate for a lot of problems is very high.
What kinds of things is this book most likely to help with? A lot of common forms of stress, anxiety, self-esteem issues, cravings, shame, and relationship issues. Other things too, but we can’t list everything and that list already covers a lot of very high-incidence stuff.
Bottom line: if CBT isn’t something already in your toolbox, this book will help you add all its best tips and tricks.
Click here to check out The CBT Workbook for Mental Health, and get tooled up!
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