How White Is Your Tongue?

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It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small

❝So its normal to develop a white sort of coating on the tongue, right? It develops when I eat, and is able to (somewhat) easily be brushed off❞

If (and only if) there is no soreness and the coverage of the whiteness is not extreme, then, yes, that is normal and fine.

Your mouth has a microbiome, and it’s supposed to have one (helps keep the conditions in your mouth correct, so that food is broken down and/but your gums and teeth aren’t).

Read more: The oral microbiome: Role of key organisms and complex networks in oral health and disease

The whiteness you often see on a healthy tongue is, for the most part, bacteria and dead cells—harmless.

Cleaning the whiteness off with your brush is fine. You can also scrape off with floss is similar if you prefer. Or a tongue-scraper! Those can be especially good for people for whom brushing the tongue is an unpleasant sensation. Or you can just leave it, if it doesn’t bother you.

By the way, that microbiome is a reason it can be good to go easy on the mouthwash. Moderate use of mouthwash is usually fine, but you don’t want to wipe out your microbiome then have it taken over by unpleasantries that the mouthwash didn’t kill (unpleasantries like C. albicans).

There are other mouthwash-related considerations too:

Toothpastes and mouthwashes: which kinds help, and which kinds harm?

If you start to get soreness, that probably means the papillae (little villi-like things) are inflamed. If there is soreness, and/or the whiteness is extreme, then it could be a fungal infection (usually C. albicans, also called Thrush), in which case, antifungal medications will be needed, which you can probably get over the counter from your pharmacist.

Do not try to self-treat with antibiotics.

Antibiotics will make a fungal infection worse (indeed, antibiotic usage is often the reason for getting fungal growth in the first place) by wiping out the bacteria that normally keep it in check.

Other risk factors include a sugary diet, smoking, and medications that have “dry mouth” as a side effect.

Read more: Can oral thrush be prevented?

If you have any symptoms more exciting than the above, then definitely see a doctor.

Take care!

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  • How gender-affirming care improves trans mental health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In recent years, a growing number of states have passed laws restricting or banning gender-affirming care for transgender people, particularly minors. As conversations about gender-affirming care increase, so do false narratives about it, with some opponents falsely suggesting that it’s harmful to mental health.

    Despite widespread attacks against gender-affirming care, research clearly shows that it improves mental health outcomes for transgender people.

    Read on to learn more about what gender-affirming care is, how it benefits mental well-being, and how you can access it.

    What is gender-affirming care?

    Gender-affirming care describes a range of medical interventions that help align people’s bodies with their gender identities. While anyone can seek gender-affirming care in the form of laser hair removal, breast augmentation, erectile dysfunction medication, or hormone therapy, among other treatments, most conversations about gender-affirming care center around transgender people, whose gender identity or gender expression does not conform to their sex assigned at birth.

    Gender-affirming care for trans people varies based on age. For example, some trans adults seek hormone replacement therapy (HRT) or gender-affirming surgeries that help their bodies match their internal sense of gender.

    Trans kids entering adolescence might be prescribed puberty blockers, which temporarily delay the production of hormones that initiate puberty, to give them more time to figure out their gender identities before deciding on next steps. This is the same medication given to cisgender kids—whose gender identities match the sex they were assigned at birth—experiencing early puberty.

    What is gender dysphoria?

    Gender dysphoria describes a feeling of unease that some trans people experience when their perceived gender doesn’t match their gender identity. This can lead to a range of mental health conditions that affect their quality of life

    Some trans people may manage gender dysphoria by wearing gender-affirming clothing, opting for a gender-affirming hairstyle, or asking others to refer to them by a name and pronouns that authentically represent them. Others may need gender-affirming care to feel at home in their bodies.

    Trans people who desire gender-affirming care and have not been able to access it experience psychological distress, including depression, anxiety, self-harm, and suicidal ideation. The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People found that roughly half of trans youth “seriously considered attempting suicide in the past year.”

    A grid shows 10 drawings of people in black and white. Seven of the people are highlighted in purple squares. Text on the image reads,

    How does gender-affirming care improve mental health?

    For trans adults, gender-affirming care can alleviate gender dysphoria, which has been shown to improve both short-term and long-term mental health. A 2018 study found that trans adults who do not undergo HRT are four times more likely to experience depression than those who do, although not all trans people desire HRT.

    Extensive research has shown that gender-affirming care also alleviates gender dysphoria and improves mental health outcomes in trans kids, teens, and young adults. A 2022 study found that access to HRT and puberty blockers lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the risk of self-harm and suicidal thoughts by 73 percent.

    Both the Endocrine Society—which aims to advance hormone research—and the American Academy of Pediatrics recommend that trans kids and teens have access to developmentally appropriate gender-affirming care.

    How can I access gender-affirming care?

    If you’re a trans adult seeking gender-affirming care or a guardian of a trans kid or teen who’s seeking gender-affirming care, talk to your health care provider about your options. You can find a trans-affirming provider by searching the World Professional Association for Transgender Health directory or visiting your local LGBTQ+ health center or Planned Parenthood.

    Some gender-affirming care may not be covered by insurance. Learn how to make the most of your coverage from the National Center for Transgender Equality. Find insurance plans available through the Marketplace that cover gender-affirming care in some states through Out2Enroll.

    Some states restrict or ban gender-affirming care. Learn about the laws in your state by visiting the Trans Legislation Tracker.

    Where can trans people and their families find mental health support?

    In addition to working with a trans-affirming therapist, trans people and their families can find mental health support through these free services:

    • PFLAG offers resources for families and friends of LGBTQ+ people. Find a PFLAG chapter near you.
    • The Trevor Project’s hotline has trained counselors who help LGBTQ+ youth in crisis. Call the TrevorLifeline 1-866-488-7386 or text START to 678-678.
    • The Trans Lifeline was created by and for the trans community to support trans people in crisis. You can reach the Trans Lifeline hotline at 1-877-565-8860.

    For more information, talk to your health care provider.

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • The Dopamine Precursor And More

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What Is This Supplement “NALT”?

    N-Acetyl L-Tyrosine (NALT) is a form of tyrosine, an amino acid that the body uses to build other things. What other things, you ask?

    Well, like most amino acids, it can be used to make proteins. But most importantly and excitingly, the body uses it to make a collection of neurotransmitters—including dopamine and norepinephrine!

    • Dopamine you’ll probably remember as “the reward chemical” or perhaps “the motivation molecule”
    • Norepinephrine, also called noradrenaline, is what powers us up when we need a burst of energy.

    Both of these things tend to get depleted under stressful conditions, and sometimes the body can need a bit of help replenishing them.

    What does the science say?

    This is Research Review Monday, after all, so let’s review some research! We’re going to dive into what we think is a very illustrative study:

    A 2015 team of researchers wanted to know whether tyrosine (in the form of NALT) could be used as a cognitive enhancer to give a boost in adverse situations (times of stress, for example).

    They noted:

    ❝The potential of using tyrosine supplementation to treat clinical disorders seems limited and its benefits are likely determined by the presence and extent of impaired neurotransmitter function and synthesis.❞

    More on this later, but first, the positive that they also found:

    ❝In contrast, tyrosine does seem to effectively enhance cognitive performance, particularly in short-term stressful and/or cognitively demanding situations. We conclude that tyrosine is an effective enhancer of cognition, but only when neurotransmitter function is intact and dopamine and/or norepinephrine is temporarily depleted❞

    That “but only”, is actually good too, by the way!

    You do not want too much dopamine (that could cause addiction and/or psychosis) or too much norepinephrine (that could cause hypertension and/or heart attacks). You want just the right amount!

    So it’s good that NALT says “hey, if you need some more, it’s here, if not, no worries, I’m not going to overload you with this”.

    Read the study: Effect of tyrosine supplementation on clinical and healthy populations under stress or cognitive demands

    About that limitation…

    Remember they said that it seemed unlikely to help in treating clinical disorders with impaired neurotransmitter function and/or synthesis?

    Imagine that you employ a chef in a restaurant, and they can’t keep up with the demand, and consequently some of the diners aren’t getting fed. Can you fix this by supplying the chef with more ingredients?

    Well, yes, if and only if the problem is “the chef wasn’t given enough ingredients”. If the problem is that the oven (or the chef’s wrist) is broken, more ingredients aren’t going to help at all—something different is needed in those cases.

    So it is with, for example, many cases of depression.

    See for example: Tyrosine for depression: a double-blind trial

    About blood pressure…

    You may be wondering, “if NALT is a precursor of norepinephrine, a vasoconstrictor, will this increase my blood pressure adversely?”

    Well, check with your doctor as your own situation may vary, but under normal circumstances, no. The effect of NALT is adaptogenic, meaning that it can help keep its relevant neurotransmitters at healthy levels—not too low or high.

    See what we mean, for example in this study where it actually helped keep blood pressure down while improving cognitive performance under stress:

    Effect of tyrosine on cognitive function and blood pressure under stress

    Bottom line:

    For most people, NALT is a safe and helpful way to help keep healthy levels of dopamine and norepinephrine during times of stress, giving cognitive benefits along the way.

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  • Cacao vs Carob – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing cacao to carob, we picked the cacao.

    Why?

    It’s close, and may depend a little on your priorities!

    In terms of macros, the cacao has more protein and fat, while the carob has more carbohydrates, mostly sugar. Since people will not generally eat this by the spoonful, and will instead either make drinks or cook with it, we can’t speak for the glycemic index or general health impact of the sugars. As for the fats, on the one hand the cacao does contain saturated fat; on the other, this merely means that different saturated fat will usually be added to the carob if making something with it. Still, slight win for the carob on the fat front. Protein, of course, is entirely in cacao’s favor.

    In the category of vitamins and minerals, they’re about equal on vitamins, while cacao wins easily on the mineral front, boasting more copper, iron, magnesium, manganese, and phosphorus.

    While both have a generous antioxidant content, this one’s another win for cacao, with about 3x the active polyphenols and flavonoids.

    In short: both are good, consumed in moderation and before adding unhealthy extra ingredients—but we say cacao comes out the winner.

    If you’re looking specifically for the above-depicted products, by the way, here they are:

    Cacao powder | Carob powder

    Want to learn more?

    You might like to read:

    Enjoy!

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  • Accidental falls in the older adult population: What academic research shows

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Accidental falls are among the leading causes of injury and death among adults 65 years and older worldwide. As the aging population grows, researchers expect to see an increase in the number of fall injuries and related health spending.

    Falls aren’t unique to older adults. Nealy 684,000 people die from falls each year globally. Another 37.3 million people each year require medical attention after a fall, according to the World Health Organization. But adults 65 and older account for the greatest number of falls.

    In the United States, more than 1 in 4 older adults fall each year, according to the National Institute on Aging. One in 10 report a fall injury. And the risk of falling increases with age.

    In 2022, health care spending for nonfatal falls among older adults was $80 billion, according to a 2024 study published in the journal Injury Prevention.

    Meanwhile, the fall death rate in this population increased by 41% between 2012 and 2021, according to the latest CDC data.

    “Unfortunately, fall-related deaths are increasing and we’re not sure why that is,” says Dr. Jennifer L. Vincenzo, an associate professor at the University of Arkansas for Medical Sciences in the department of physical therapy and the Center for Implementation Research. “So, we’re trying to work more on prevention.”

    Vincenzo advises journalists to write about how accidental falls can be prevented. Remind your audiences that accidental falls are not an inevitable consequence of aging, and that while we do decline in many areas with age, there are things we can do to minimize the risk of falls, she says. And expand your coverage beyond the national Falls Prevention Awareness Week, which is always during the first week of fall — Sept. 23 to 27 this year.

    Below, we explore falls among older people from different angles, including injury costs, prevention strategies and various disparities. We have paired each angle with data and research studies to inform your reporting.

    Falls in older adults

    In 2020, 14 million older adults in the U.S. reported falling during the previous year. In 2021, more than 38,700 older adults died due to unintentional falls, according to the CDC.

    A fall could be immediately fatal for an older adult, but many times it’s the complications from a fall that lead to death.

    The majority of hip fractures in older adults are caused by falls, Vincenzo says, and “it could be that people aren’t able to recover [from the injury], losing function, maybe getting pneumonia because they’re not moving around, or getting pressure injuries,” she says.

    In addition, “sometimes people restrict their movement and activities after a fall, which they think is protective, but leads to further functional declines and increases in fall risk,” she adds.

    Factors that can cause a fall include:

    • Poor eyesight, reflexes and hearing. “If you cannot hear as well, anytime you’re doing something in your environment and there’s a noise, it will be really hard for you to focus on hearing what that noise is and what it means and also moving at the same time,” Vincenzo says.
    • Loss of strength, balance, and mobility with age, which can lessen one’s ability to prevent a fall when slipping or tripping.
    • Fear of falling, which usually indicates decreased balance.
    • Conditions such as diabetes, heart disease, or problems with nerves or feet that can affect balance.
    • Conditions like incontinence that cause rushed movement to the bathroom.
    • Cognitive impairment or certain types of dementia.
    • Unsafe footwear such as backless shoes or high heels.
    • Medications or medication interactions that can cause dizziness or confusion.
    • Safety hazards in the home or outdoors, such as poor lighting, steps and slippery surfaces.

    Related Research

    Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021
    Ramakrishna Kakara, Gwen Bergen, Elizabeth Burns and Mark Stevens. Morbidity and Mortality Weekly Report, September 2023.

    Summary: Researchers analyzed data from the 2020 Behavioral Risk Factor Surveillance System — a landline and mobile phone survey conducted each year in all 50 U.S. states and the District of Columbia — and data from the 2021 National Vital Statistics System to identify patterns of injury and death due to falls in the U.S. by sex and state for adults 65 years and older. Among the findings:

    • The percentage of women who reported falling was 28.9%, compared with 26.1% of men.
    • Death rates from falls were higher among white and American Indian or Alaska Native older adults than among older adults from other racial and ethnic groups.
    • In 2020, the percentage of older adults who reported falling during the past year ranged from 19.9% in Illinois to 38.0% in Alaska. The national estimate for 18 states was 27.6%.
    • In 2021, the unintentional fall-related death rate among older adults ranged from 30.7 per 100,000 older adults in Alabama to 176.5 in Wisconsin. The national estimate for 26 states was 78.

    “Although common, falls among older adults are preventable,” the authors write. “Health care providers can talk with patients about their fall risk and how falls can be prevented.”

    Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012-2018
    Briana Moreland, Ramakrishna Kakara and Ankita Henry. Morbidity and Mortality Weekly Report, July 2020.

    Summary: Researchers compared data from the 2018 Behavioral Risk Factor Surveillance System. Among the findings:

    • The percentage of older adults reporting a fall increased from 2012 to 2016, then slightly decreased from 2016 to 2018.
    • Even with this decrease in 2018, older adults reported 35.6 million falls. Among those falls, 8.4 million resulted in an injury that limited regular activities for at least one day or resulted in a medical visit.

    “Despite no significant changes in the rate of fall-related injuries from 2012 to 2018, the number of fall-related injuries and health care costs can be expected to increase as the proportion of older adults in the United States grows,” the authors write.

    Understanding Modifiable and Unmodifiable Older Adult Fall Risk Factors to Create Effective Prevention Strategies
    Gwen Bergen, et al. American Journal of Lifestyle Medicine, October 2019.

    Summary: Researchers used data from the 2016 U.S. Behavioral Risk Factor Surveillance System to better understand the association between falls and fall injuries in older adults and factors such as health, state and demographic characteristics. Among the findings:

    • Depression had the strongest association with falls and fall injuries. About 40% of older adults who reported depression also reported at least one fall; 15% reported at least one fall injury.
    • Falls and depression have several factors in common, including cognitive impairment, slow walking speed, poor balance, slow reaction time, weakness, low energy and low levels of activity.
    • Other factors associated with an increased risk of falling include diabetes, vision problems and arthritis.

    “The multiple characteristics associated with falls suggest that a comprehensive approach to reducing fall risk, which includes screening and assessing older adult patients to determine their unique, modifiable risk factors and then prescribing tailored care plans that include evidence-based interventions, is needed,” the authors write.

    Health care use and cost

    In addition to being the leading cause of injury, falls are the leading cause of hospitalization in older adults. Each year, about 3 million older adults visit the emergency department due to falls. More than 1 million get hospitalized.

    In 2021, falls led to more than 38,000 deaths in adults 65 and older, according to the CDC.

    The annual financial medical toll of falls among adults 65 years and older is expected to be more than $101 billion by 2030, according to the National Council on Aging, an organization advocating for older Americans.

    Related research

    Healthcare Spending for Non-Fatal Falls Among Older Adults, USA
    Yara K. Haddad, et al. Injury Prevention, July 2024.

    Summary: In 2015, health care spending related to falls among older adults was roughly $50 billion. This study aims to update the estimate, using the 2017, 2019 and 2021 Medicare Current Beneficiary Survey, the most comprehensive and complete survey available on the Medicare population. Among the findings:

    • In 2020, health care spending for non-fatal falls among older adults was $80 billion.
    • Medicare paid $53.3 billion of the $80 billion, followed by $23.2 billion paid by private insurance or patients and $3.5 billion by Medicaid.

    “The burden of falls on healthcare systems and healthcare spending will continue to rise if the risk of falls among the aging population is not properly addressed,” the authors write. “Many older adult falls can be prevented by addressing modifiable fall risk factors, including health and functional characteristics.”

    Cost of Emergency Department and Inpatient Visits for Fall Injuries in Older Adults Lisa Reider, et al. Injury, February 2024.

    Summary: The researchers analyzed data from the 2016-2018 National Inpatient Sample and National Emergency Department Sample, which are large, publicly available patient databases in the U.S. that include all insurance payers such as Medicare and private insurance. Among the findings:

    • During 2016-2018, more than 920,000 older adults were admitted to the hospital and 2.3 million visited the emergency department due to falls. The combined annual cost was $19.2 billion.
    • More than half of hospital admissions were due to bone fractures. About 14% of these admissions were due to multiple fractures and cost $2.5 billion.

    “The $20 billion in annual acute treatment costs attributed to fall injury indicate an urgent need to implement evidence-based fall prevention interventions and underscores the importance of newly launched [emergency department]-based fall prevention efforts and investments in geriatric emergency departments,” the authors write.

    Hip Fracture-Related Emergency Department Visits, Hospitalizations and Deaths by Mechanism of Injury Among Adults Aged 65 and Older, United States 2019
    Briana L. Moreland, Jaswinder K. Legha, Karen E. Thomas and Elizabeth R. Burns. Journal of Aging and Health, June 2024.

    Summary: The researchers calculated hip fracture-related U.S. emergency department visits, hospitalizations and deaths among older adults, using data from the Healthcare Cost and Utilization Project and the National Vital Statistics System. Among the findings:

    • In 2019, there were 318,797 emergency department visits, 290,130 hospitalizations and 7,731 deaths related to hip fractures among older adults.
    • Nearly 88% of emergency department visits and hospitalizations and 83% of deaths related to hip fractures were caused by falls.
    • These rates were highest among those living in rural areas and among adults 85 and older. More specifically, among adults 85 and older, the rate of hip fracture-related emergency department visits was nine times higher than among adults between 65 and 74 years old.

    “Falls are common among older adults, but many are preventable,” the authors write. “Primary care providers can prevent falls among their older patients by screening for fall risk annually or after a fall, assessing modifiable risk factors such as strength and balance issues, and offering evidence-based interventions to reduce older adults’ risk of falls.”

    Fall prevention

    Several factors, including exercising, managing medication, checking vision and making homes safer can help prevent falls among older adults.

    “Exercise is one of the best interventions we know of to prevent falls,” Vincenzo says. But “walking in and of itself will not help people to prevent falls and may even increase their risk of falling if they are at high risk of falls.”

    The National Council on Aging also has a list of evidence-based fall prevention programs, including activities and exercises that are shown to be effective.

    The National Institute on Aging has a room-by-room guide on preventing falls at home. Some examples include installing grab bars near toilets and on the inside and outside of the tub and shower, sitting down while preparing food to prevent fatigue, and keeping electrical cords near walls and away from walking paths.

    There are also national and international initiatives to help prevent falls.

    Stopping Elderly Accidents, Deaths and Injuries, or STEADI, is an initiative by the CDC’s Injury Center to help health care providers who treat older adults. It helps providers screen patients for fall risk, assess their fall risk factors and reduce their risk by using strategies that research has shown to be effective. STEADI’s guidelines are in line with the American and British Geriatric Societies’ Clinical Practice Guidelines for fall prevention.

    “We’re making some iterations right now to STEADI that will come out in the next couple of years based on the World Falls Guidelines, as well as based on clinical providers’ feedback on how to make [STEADI] more feasible,” Vincenzo says.

    The World Falls Guidelines is an international initiative to prevent falls in older adults. The guidelines are the result of the work of 14 international experts who came together in 2019 to consider whether new guidelines on fall prevention were needed. The task force then brought together 96 experts from 39 countries across five continents to create the guidelines.

    The CDC’s STEADI initiative has a screening questionnaire for consumers to check their risk of falls, as does the National Council on Aging.

    On the policy side, U.S. Rep. Carol Miller, R-W.V., and Melanie Stansbury, D-N.M., introduced the Stopping Addiction and Falls for the Elderly (SAFE) Act in March 2024. The bill would allow occupational and physical therapists to assess fall risks in older adults as part of the Medicare Annual Wellness Benefit. The bill was sent to the House Subcommittee on Health in the same month.

    Meanwhile, older adults’ attitudes toward falls and fall prevention are also pivotal. For many, coming to terms with being at risk of falls and making changes such as using a cane, installing railings at home or changing medications isn’t easy for all older adults, studies show.

    “Fall is a four-letter F-word in a way to older adults,” says Vincenzo, who started her career as a physical therapist. “It makes them feel ‘old.’ So, it’s a challenge on multiple fronts: U.S. health care infrastructure, clinical and community resources and facilitating health behavior change.”

    Related research

    Environmental Interventions for Preventing Falls in Older People Living in the Community
    Lindy Clemson, et al. Cochrane Database of Systematic Reviews, March 2023.

    Summary: This review includes 22 studies from 10 countries involving a total of 8,463 older adults who live in the community, which includes their own home, a retirement facility or an assisted living facility, but not a hospital or nursing home. Among the findings:

    • Removing fall hazards at home reduced the number of falls by 38% among older adults at a high risk of having a fall, including those who have had a fall in the past year, have been hospitalized or need support with daily activities. Examples of fall hazards at home include a stairway without railings, a slippery pathway or poor lighting.
    • It’s unclear whether checking prescriptions for eyeglasses, wearing special footwear or installing bed alarm systems reduces the rate of falls.
    • It’s also not clear whether educating older adults about fall risks reduces their fall risk.

    The Influence of Older Adults’ Beliefs and Attitudes on Adopting Fall Prevention Behaviors
    Judy A. Stevens, David A. Sleet and Laurence Z. Rubenstein. American Journal of Lifestyle Medicine. January 2017.

    Summary: Persuading older adults to adopt interventions that reduce their fall risk is challenging. Their attitudes and beliefs about falls play a large role in how well they accept and adopt fall prevention strategies, the authors write. Among the common attitudes and beliefs:

    • Many older adults believe that falls “just happen,” are a normal result of aging or are simply due to bad luck.
    • Many don’t acknowledge or recognize their fall risk.
    • For many, falls are considered to be relevant only for frail or very old people.
    • Many believe that their home environment or daily activities can be a risk for fall, but do not consider biological factors such as dizziness or muscle weakness.
    • For many, fall prevention simply consists of “being careful” or holding on to things when moving about the house.

    “To reduce falls, health care practitioners have to help patients understand and acknowledge their fall risk while emphasizing the positive benefits of fall prevention,” the authors write. “They should offer patients individualized fall prevention interventions as well as provide ongoing support to help patients adopt and maintain fall prevention strategies and behaviors to reduce their fall risk. Implementing prevention programs such as CDC’s STEADI can help providers discuss the importance of falls and fall prevention with their older patients.”

    Reframing Fall Prevention and Risk Management as a Chronic Condition Through the Lens of the Expanded Chronic Care Model: Will Integrating Clinical Care and Public Health Improve Outcomes?
    Jennifer L. Vincenzo, Gwen Bergen, Colleen M. Casey and Elizabeth Eckstrom. The Gerontologist, June 2024.

    Summary: The authors recommend approaching fall prevention from the lens of chronic disease management programs because falls and fall risk are chronic issues for many older adults.

    “Policymakers, health systems, and community partners can consider aligning fall risk management with the [Expanded Chronic Care Model], as has been done for diabetes,” the authors write. “This can help translate high-quality research on the effectiveness of fall prevention interventions into daily practice for older adults to alter the trajectory of older adult falls and fall-related injuries.”

    Disparities

    Older adults face several barriers to reducing their fall risk. Accessing health care services and paying for services such as physical therapy is not feasible for everyone. Some may lack transportation resources to go to and from medical appointments. Social isolation can increase the risk of death from falls. In addition, physicians may not have the time to fit in a fall risk screening while treating older patients for other health concerns.

    Moreover, implementing fall risk screening, assessment and intervention in the current U.S. health care structure remains a challenge, Vincenzo says.

    Related research

    Mortality Due to Falls by County, Age Group, Race, and Ethnicity in the USA, 2000-19: A Systematic Analysis of Health Disparities
    Parkes Kendrick, et al. The Lancet Public Health, August 2024.

    Summary: Researchers analyzed death registration data from the U.S. National Vital Statistics System and population data from the U.S. National Center for Health Statistics to estimate annual fall-related mortality. The data spanned from 2000 to 2019 and includes all age groups. Among the findings:

    • The disparities between racial and ethnic populations varied widely by age group. Deaths from falls among younger adults were highest for the American Indian/Alaska Native population, while among older adults it was highest for the white population.
    • For older adults, deaths from falls were particularly high in the white population within clusters of counties across states including Florida, Minnesota and Wisconsin.
    • One factor that could contribute to higher death rates among white older adults is social isolation, the authors write. “Studies suggest that older Black and Latino adults are more likely to have close social support compared with older white adults, while AIAN and Asian individuals might be more likely to live in multigenerational households,” they write.

    “Among older adults, current prevention techniques might need to be restructured to reduce frailty by implementing early prevention and emphasizing particularly successful interventions. Improving social isolation and evaluating the effectiveness of prevention programs among minoritized populations are also key,” the authors write.

    Demographic Comparisons of Self-Reported Fall Risk Factors Among Older Adults Attending Outpatient Rehabilitation
    Mariana Wingood, et al. Clinical Interventions in Aging, February 2024.

    Summary: Researchers analyzed the electronic health record data of 108,751 older adults attending outpatient rehabilitation within a large U.S. health care system across seven states, between 2018 and 2022. Among the findings:

    • More than 44% of the older adults were at risk of falls; nearly 35% had a history of falls.
    • The most common risk factors for falls were diminished strength, gait and balance.
    • Compared to white older adults, Native American/Alaska Natives had the highest prevalence of fall history (43.8%) and Hispanics had the highest prevalence of falls with injury (56.1%).

    “Findings indicate that rehabilitation providers should perform screenings for these impairments, including incontinence and medication among females, loss of feeling in the feet among males, and all Stay Independent Questionnaire-related fall risk factors among Native American/Alaska Natives, Hispanics, and Blacks,” the authors write.

    Resources and articles

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Yoga Safety: Simple Guidelines

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I was wondering whether there were very simple, clear bullet points or instructions on things to be wary of in Yoga.❞

    That’s quite a large topic, and not one that lends itself well to being conveyed in bullet points, but first we’ll share the article you sent us when sending this question:

    Tips for Avoiding Yoga Injuries

    …and next we’ll recommend the YouTube channel @livinleggings, whose videos we feature here from time to time. She (Liv) has a lot of good videos on problems/mistakes/injuries to avoid.

    Here’s a great one to get you started:

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  • Mediterranean Diet Book Suggestions

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝What is Mediterranean diet which book to read?❞

    We did a special edition about the Mediterranean Diet! So that’s a great starting point.

    As to books, there are so many, and we review books about it from time to time, so keep an eye out for our daily “One-Minute Book Review” section. We do highly recommend “How Not To Die”, which is a science-heavy approach to diet-based longevity, and essentially describes the Mediterranean Diet, with some tweaks.

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