Updated on Jun 30, 2022 | Geriatrics, Health Tips, Neurology, Physical Therapy, Rehab Medicine
Phineas Gage was an American railroad construction foreman in the 1800s who is remembered for his survival of an accident in which a large iron rod was driven completely through his head, destroying much of his brain’s frontal lobe. After that, his personality and behavior were so profoundly affected that friends saw him as “no longer Gage.”
Types of Brain Injury
Gage had suffered a traumatic brain injury, or TBI—the same type of injury experienced lately by several well-known individuals, including Sen. Gabby Gifford and Junior Seau. While there are two types of brain injury—TBI and acquired brain injury—what we hear about in the media mostly involves TBI, an often-puzzling condition. The Brain Injury Association of America defines it as an alteration in brain function, or other evidence of brain pathology, caused by an external force. According to the Centers for Disease Control and Prevention, the causes of brain injury are falls (35.2%), motor vehicle crashes (17.3%), struck by/against events (16.5%), assault (10%) and unknown (21%).
There are many different types of TBI: diffuse axonal injury, concussion, contusion, coup-contracoup and penetrating injury, to name a few. Depending on the type of injury and its location on the brain, the outcome—including the behavior of the injured individual—varies. Brain injury can affect people of any age or gender.
Rehabilitation Takes a Team
Individuals who suffer brain injuries will begin acute rehabilitation as early as possible. In acute rehabilitation, a team of health professionals with experience and training in brain injury work with the patient to regain as many activities of daily living as possible. The team includes a physiatrist (doctor who specializes in physical medicine and rehabilitation), rehabilitation nurse, physical therapist, occupational therapist, speech therapist, social worker and nutritionist. Activities of daily living include dressing, eating, toileting, walking, speaking and more.
Prevention Tips
Preventing TBI has become a public health priority. The American Association of Neurological Surgeons offers the following guidelines:
* Buy and use helmets or protective head gear for such sports as baseball, cycling, skiing and more;
* Wear a seatbelt when you drive or ride in a car;
* Do not drink alcohol and drive;
* Do not dive in water less than 12 feet deep or in an above-ground pool;
* Remove hazards at home that can contribute to falls, like scatter rugs, electrical cords, etc.; and
* Maintain safety in the bathroom for the elderly.
Finally, if you or your loved one suffers a TBI, community support is available through your local hospital, Brain Injury Association of America and even in online communities.
References
Brain Injury Association of America (2012).
American Association of Neurological Surgeons (2012).
To find a great doctor who is right for you, please call the Physician Referral Service at 1 (866) 804-1007 Monday through Friday, 9 am to 5 pm.
Updated on Jun 30, 2022 | Diabetes, Geriatrics, Neurology
Diabetes is a disease that affects all ages. But as people get older it’s particularly difficult to deal with—especially because diabetics are more likely to develop dementia.
In an 11-year study of more than 1,000 people, 27% of those with diabetes developed dementia, compared to 20% of people with normal blood sugar levels. Diabetes and Alzheimer’s disease (an advanced form of dementia) are connected in ways that still aren’t completely understood. It’s thought that diabetes contributes to vascular disease, disrupting the flow of oxygen to the brain.
In the last 50 years, the number of people diagnosed has risen from 1.5 million to around 26 million, and it’s estimated that 60 million have prediabetes. So the prevalence of dementia could increase as the U.S. population ages. However, taking steps to control diabetes now may help reduce the risk of Alzheimer’s later. And that’s important because the treatment for dementia is very limited.
Reducing the risk of dementia is actually quite simple—it’s all about managing diabetes in the best possible way. Here are some steps that can help:
* Follow physician recommendations for monitoring blood glucose, cholesterol level and blood pressure.
* Eat healthy foods, including fruits and vegetables, lean meats, whole grains, and low-fat milk and cheese.
* Exercise at least 30 minutes most days of the week.
* Maintain a healthy weight. Losing weight can seriously reduce the negative effects of diabetes. Just 10 to 15 pounds can make a difference.
* Take a doctor-approved multivitamin to help fill nutrient gaps in the diet.
* Take medications on schedule. There are reminder alarms with a vibration feature for people who have trouble hearing. For people who have trouble opening small pill containers, there are larger, easy-to-open pill containers available. Some include magnifiers for reading medicine labels. And for people with vision problems, there are blood glucose meters that “talk.”
* Keep an updated list of medications and record important information about each one.
Diabetics can significantly reduce the risk of dementia by consistently managing their disease.
For more information and help on managing the disease and caring for elderly diabetics, visit www.friedmandiabetesinstitute.com.
Updated on Jun 30, 2022 | Geriatrics, Speech Pathology
Some forgetfulness, or a little memory loss, in people middle-aged and older, is actually normal and not a cause for concern. There are natural aging processes that explain minor lapses in memory, more popularly called “senior moments.”
As we age, our ability to divide our attention among two or more activities starts to diminish slightly—it may be harder to do “two things at once”! The holiday season is an especially busy and hectic time, full of many tasks that we feel we have to accomplish before the festivities begin. We may find it more efficient to do one thing at a time, from start to finish, as typical interruptions may lead us to forget momentarily what we were doing or saying.
After about 55 years of age, both our physical and mental responses naturally start to slow down. Humans have millions of impressions, recollections, words, dates and other items stored in our memory bank. Withdrawing information—such as remembering appointments, errands to run, people’s names and phone numbers—might take a little longer as we get older, so it’s always a good idea to mark a calendar and write things down. The more we have on our mind, the more we should use simple reminders such as “to-do” lists, wrist-watch or cell-phone alarms, and pill boxes sorted by day of week.
So, while the occasional forgetting where we placed our car keys or the pen we were just writing with is typical of normal aging, there are other memory changes that are not normal. Benign senescent forgetfulness is a disorder characterized by continual repetition of accounts of events, questions and requests; generally, the person’s short-term memory loss does not worsen or interfere with everyday life. Dementia is a far more serious and progressive decline in mental functions, including not remembering your name and address, how to dress yourself or balance your checkbook, and clearly requires an evaluation by a physician.
For more information on normal and abnormal behavior as we age, please visit http://www.merckmanuals.com/professional/geriatrics.html or the Beth Israel Senior Health web site at http://www.wehealny.org/services/bi_seniorhealth/index.html.
Updated on Jun 30, 2022 | Family Medicine, Geriatrics, Men's Health, Sexual Health, Urology
Guest blog post by Doron S. Stember, MD, Urologist at Beth Israel Medical Center.
A major medical study published several years ago showed that 50% of all men between the ages of 40 and 70 experience erectile dysfunction (ED) on at least some occasions. The first line of treatment is oral therapy (pills), including Viagra, Levitra and Cialis. For most men with ED, these pills provide a satisfactory solution. Some men, however, do not respond to pills, and for others, including those with certain heart conditions, the pills are unsafe. What are their options? (more…)
