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These 12 things can reduce your dementia risk – but many Australians don’t know them all

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Dementia is a <a href="https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/jan-may-2022">leading</a> cause of death in Australia. Although dementia mainly affects older people, it is an avoidable part of ageing. In fact, we all have the power to reduce our risk of developing dementia, no matter your age. Research shows your risk of developing dementia could be <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduced by up to 40%</a> (and even higher if you live in a <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30074-9/fulltext">low or middle-income country</a>) by addressing lifestyle factors such as healthy diet, exercise and alcohol consumption. But the first step to reducing population-wide dementia risk is to understand how well people understand the risk factors and the barriers they may face to making lifestyle changes. Our new <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">paper</a>, published this week in the <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">Journal of Ageing and Longevity</a>, found most older people are aware that dementia is a modifiable condition and that they have the power to change their dementia risk. We also found the key barrier to making brain healthy lifestyle choices was a lack of knowledge, which suggests a public awareness campaign is urgently needed. <h2>What we did</h2> We began by <a href="https://www.mdpi.com/2673-9259/2/4/21/htm">reviewing</a> the published research to identify 12 factors shown to reduce dementia risk. We surveyed 834 older Australians about their awareness of the 12 factors, which were: <ol> <li>having a mentally active lifestyle</li> <li>doing physical activity</li> <li>having a healthy diet</li> <li>having strong mental health</li> <li>not smoking</li> <li>not consuming alcohol</li> <li>controlling high blood pressure</li> <li>maintaining a healthy weight</li> <li>managing high cholesterol</li> <li>preventing heart disease</li> <li>not having kidney disease</li> <li>not having diabetes</li> </ol> <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">The Lancet</a> subsequently published its own list of factors that help reduce dementia risk, which covered much the same territory (but included a few others, such as reducing air pollution, treating hearing impairment and being socially engaged). Of course, there is no way to cut your dementia risk to zero. Some people do all the “right” things and still get dementia. But there is <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">good evidence</a> managing lifestyle factors help make it less likely you will get dementia over your lifetime. Our study shows many older Australians are quite aware, with over 75% able to correctly identify more than four of the factors in our list of 12. However, few were able to name the less well-known risk factors, such as preventing heart disease and health conditions like kidney disease. The good news is that close to half of the sample correctly identified more than six of the 12 protective factors, with mentally active lifestyle, physical activity and healthy diet in the top three spots. <h2>Two key issues</h2> Two things stood out as strongly linked with the ability to identify factors influencing dementia risk. Education was key. People who received more than 12 years of formal schooling were more likely to agree that dementia was a modifiable condition. We are first exposed to health management in our school years and thus more likely to form healthier habits. Age was the other key factor. Younger respondents (less than 75 years old) were able to accurately identify more protective factors compared to older respondents. This is why health promotion initiatives and public education efforts about dementia are vital (such as Dementia Awareness Month and <a href="https://www.memorywalk.com.au/">Memory, Walk and Jog initiatives</a>). <h2>How can these findings be used in practice?</h2> Our findings suggest we need to target education across the different age groups, from children to older Australians. This could involve a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/ajag.13049">whole system approach</a>, from programs targeted at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858574/#:%7E:text=Family%20Coaching%20has%20specific%20goals,to%20problem%20solve%20challenging%20situations.">families</a>, to educational sessions for school-aged children, to involving GPs in awareness promotion. We also need to tackle barriers that hinder dementia risk reduction. This means doing activities that motivate you, finding programs that suit your needs and schedule, and are accessible. <h2>What does this mean for you?</h2> Reducing your dementia risk means recognising change starts with you. We are all familiar with the everyday challenges that stop us from starting an exercise program or sticking to a meal plan. There are simple and easy changes we can begin with. Our team has developed a program that can help. We are offering limited <a href="https://www.brainbootcamp.com.au/">free brain health boxes</a>, which include information resources and physical items such as a pedometer. These boxes aim to help rural Australians aged 55 years and over to adopt lifestyle changes that support healthy brain ageing. If you’re interested in signing up, visit our <a href="https://www.brainbootcamp.com.au">website</a>. Now is the time to think about your brain health. Let’s start now.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/191504/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joyce-siette-1377445">Joyce Siette</a>, Research Theme Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/laura-dodds-1378067">Laura Dodds</a>, PhD Candidate, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/these-12-things-can-reduce-your-dementia-risk-but-many-australians-dont-know-them-all-191504">original article</a>. </div>

Mind

We tend to underestimate our future expenses – here’s one way to prevent that

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> <h2>The big idea</h2> When asked to estimate how much money they would spend in the future, people underpredicted the total amount by more than C$400 per month. However, when prompted to think about unexpected spending in addition to typical expenses, people made much more accurate predictions. These are the main findings of a series of <a href="https://doi.org/10.1177%2F00222437211068025">studies and experiments that we conducted</a> and which have just been published in the <a href="https://journals.sagepub.com/home/mrj">Journal of Marketing Research</a>. In our first study, we began by asking 187 members of a Canadian credit union to predict their weekly spending for the next five weeks. Then, at the end of each week, we asked them how much they actually spent. For the first four weeks, people underpredicted their weekly spending by about $100 per week or $400 for the month. In the study’s fifth and final week, we ran an experiment to see if we could improve people’s prediction accuracy. Specifically, we randomly assigned participants to one of two groups. In group one, participants estimated their spending for the next week just as they had done in previous weeks. These folks once again significantly underpredicted their spending. In group two, participants were asked to think of three reasons why their spending for the next week might be different than usual before making their estimate. This led them to make higher and much more accurate predictions – coming within just $7 of what they actually spent. Importantly, participants in each group spent roughly the same amount of money that week, on average. The only difference between the two groups was whether they accurately predicted that amount. <iframe id="WlDv3" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/WlDv3/3/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Next, we conducted nine experiments to better understand why people underpredict their spending and whether being prompted to think of unusual expenses helps improve accuracy. In all, over 5,800 people participated in these experiments, including a representative sample of U.S. residents. These experiments revealed two important insights. First, people primarily base their spending predictions on typical expenses like groceries, gasoline and rent. They usually fail to account for irregular – though still common – expenses like car repairs, last-minute concert tickets or one-off health care bills. This is what leads to underprediction. Second, prompting people to think of irregular expenses in addition to typical expenses helps them to make more accurate spending predictions. In our studies, people did not factor in atypical expenses unless we asked them to do so. <h2>Why it matters</h2> Helping people improve the accuracy of their spending predictions could help them improve their financial well-being. Underpredicting expenses can be costly. For example, 12 million Americans <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">borrow a total of more than $7 billion</a> in payday loans each year because they can’t meet their monthly expenses. These loans typically have extremely high interest rates – <a href="https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2022/how-well-does-your-state-protect-payday-loan-borrowers">more than 250% in some states</a>. Payday loans also come due in full so quickly that around three in four borrowers <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">end up borrowing again</a> to pay off the original loan. If consumers could better anticipate how much money they will spend in the future, it might help motivate them to spend less and save more in the present. In fact, one of our studies shows that our suggested prediction strategy <a href="https://doi.org/10.1177/0022243721106802">not only boosted spending estimates</a>, it also increased intentions to save. <h2>What’s next</h2> Members of our research team are currently investigating if, when and why underpredicting one’s expenses may be beneficial. For example, if a person sets an optimistically low budget and actively tracks their spending against it, does that help them reduce their spending? We are also investigating whether people who work in the gig economy show a corresponding tendency to mispredict their future income.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/189100/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, Assistant Professor of Marketing & Behavioral Science, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, Lecturer in Banking and Finance, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-tend-to-underestimate-our-future-expenses-heres-one-way-to-prevent-that-189100">original article</a>. </div>

Money & Banking

Walking can prevent low back pain, a new study shows

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly <a href="https://pubmed.ncbi.nlm.nih.gov/31208917/">70% of people</a> who recover from an episode of low back pain will experience a new episode in the following year. The recurrent nature of low back pain is a major contributor to the <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">enormous burden</a> low back pain places on individuals and the health-care system. In our new study, published today in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00755-4/fulltext">The Lancet</a>, we found that a program combining walking and education can effectively reduce the recurrence of low back pain. <h2>The WalkBack trial</h2> We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control). Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences. The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls. The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program. Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred. People in the control group received no preventative treatment or education. This reflects what <a href="https://www.sciencedirect.com/science/article/abs/pii/S2468781222001308?via%3Dihub">typically occurs</a> after people recover from an episode of low back pain and are discharged from care. <h2>What the results showed</h2> We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services. The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%. Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group. Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group. This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings. Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians. <h2>Walking has multiple benefits</h2> We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all <a href="https://www.sciencedirect.com/science/article/pii/S0140673618304896?via%3Dihub">previous studies</a> have focused on treating episodes of pain, not preventing future back pain. A limited number of <a href="https://pubmed.ncbi.nlm.nih.gov/26752509/">small studies</a> have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals. On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care. Walking also delivers many other <a href="https://www.vichealth.vic.gov.au/sites/default/files/VH_Benefits-of-Walking-Summary2020.pdf">health benefits</a>, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases. While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants <a href="https://pubmed.ncbi.nlm.nih.gov/37271689/">reported</a> that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently. <h2>Why is walking helpful for low back pain?</h2> We don’t know exactly why walking is effective for preventing back pain, but <a href="https://www.e-jer.org/journal/view.php?number=2013600295">possible reasons</a> could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which <a href="https://my.clevelandclinic.org/health/body/23040-endorphins">block pain signals</a> between your body and brain – essentially turning down the dial on pain. It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, <a href="https://pubmed.ncbi.nlm.nih.gov/34783263/">no studies</a> have investigated this. Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tash-pocovi-1293184">Tash Pocovi</a>, Postdoctoral research fellow, Department of Health Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, Institute for Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>; <a href="https://theconversation.com/profiles/petra-graham-892602">Petra Graham</a>, Associate Professor, School of Mathematical and Physical Sciences, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/simon-french-713564">Simon French</a>, Professor of Musculoskeletal Disorders, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/walking-can-prevent-low-back-pain-a-new-study-shows-231682">original article</a>. </div>

Body

Independent you: preventing, and recovering from, elder abuse

From implementing safeguards to stop it from beginning to taking back control if it does, there is a lot of power in your hands to avoid elder abuse. Previously, we explored the warning signs of elder abuse and how <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">it is possible to be a victim without even realising it</a>. And with more wealth owned by people over 60 now than ever before, the potential for abuse only continues to grow. So, how can you prevent elder abuse happening to you? And if you are already experiencing it, what can you do to regain control over your finances, independence and wellbeing? Prevention better than cure The best way to avoid the impacts of elder abuse is to protect yourself against it beginning in the first place. Awareness is the first step, so having <a href="https://www.oversixty.com.au/finance/retirement-income/are-you-a-victim-of-elder-abuse-without-even-realising-it">read this article and knowing the warning signs</a>, you’re already ahead of the game! Other preventative actions include: <ul> <li>Maintaining contact: social interactions are important not just for warding off loneliness but providing access to other points of view and avenues for support. </li> <li>External advisers: engage your own advisers – don’t simply employ who someone tells you to. They should be an impartial, qualified set of eyes to monitor things for you and point out anything that doesn’t seem right. This includes a financial advisor, lawyer, accountant, doctor and so on. A support person attending appointments with you may give you extra assurance.</li> <li>Power of attorney/guardianship: nominate multiple people, so that no one individual has all the say. It can be useful to include someone who is not a relative for impartiality, such as a trusted friend or your lawyer. </li> <li>Superannuation beneficiaries: super is separate from your will, but beneficiary nominations can only be spouse, child, dependent or interdependent otherwise it will go to you Will. In your Will you can direct to other people or charities. Some beneficiaries lapse, so will need to be renewed.</li> <li>Wills: review your will to ensure it reflects YOUR wishes, not someone else’s. People can jostle over not only their own inheritance but may try to influence you to leave others out. </li> <li>Documenting everything: keep a written record, especially where money is concerned – such as acting as Bank of Mum and Dad for adult kids to purchase property. Outline how much is given, what if any interest/repayments are expected and when, and what happens if their relationship subsequently breaks down.</li> <li>Encouraging independence: people who have come to expect handouts can become abusive if those handouts stop or requests for more are denied. Support and encourage others, especially your kids, to be financially independent and self-sufficient.</li> </ul> Taking back control Sadly, prevention is no longer an option for an <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/population-groups/older-people?xd_co_f=YjAzZDU4YTUtYzA5YS00YTNkLWJkNDQtNjdiZTM5ZmY5ZjQx#abuse">estimated 598,000 Australians</a> already experiencing elder abuse. However, it is still possible to break the cycle. Don’t be embarrassed or stick your head in the sand hoping things will improve. You have done nothing wrong. You are entitled to enjoy your retirement years. To take back control over your affairs, your wellbeing and your independence: <ul> <li>Ensure your physical safety first and foremost.</li> <li>Seek medical attention for your physical and mental health (the latter is crucial for making good decisions around the other points on this list).</li> <li>Get support from another relative, close friend, neighbour, or other trusted person. Don’t be alone.</li> <li>Secure a roof over your head. Having a stable place to live gives you the security and focus to tackle other concerns.</li> <li>Freeze access to your money – bank accounts, credit cards etc. This will stop (further) unauthorised withdrawals or purchases being charged to you.</li> <li>Seek professional advice. Your financial adviser, tax accountant and lawyer will be able to guide you through protecting your home, money, guardianship and estate planning matters.</li> <li>Make informed changes. Don’t do anything rashly – make necessary changes once you have sought independent advice and considered your options. This may involve making changes to your power of attorney, will, superannuation, bank accounts, even your phone number in extreme cases.</li> <li>Consider counselling. Your abuser may not realise the severity of their actions. An independent counsellor may be able to help them see this and change their ways, and ultimately salvage your relationship.</li> </ul> If you or someone you know is experiencing elder abuse, seek help straight away. Speak to a trusted relative or friend. Seek independent legal and financial advice about your affairs. Or call the government’s free elder abuse line on 1800 353 374. And if your life is in danger, call triple zero (000) immediately. Helen Baker is a licensed Australian financial adviser and author of On Your Own Two Feet: The Essential Guide to Financial Independence for all Women. Helen is among the 1% of financial planners who hold a master’s degree in the field. Proceeds from book sales are donated to charities supporting disadvantaged women and children. Find out more at <a href="http://www.onyourowntwofeet.com.au/">www.onyourowntwofeet.com.au</a> Disclaimer: The information in this article is of a general nature only and does not constitute personal financial or product advice. Any opinions or views expressed are those of the authors and do not represent those of people, institutions or organisations the owner may be associated with in a professional or personal capacity unless explicitly stated. Helen Baker is an authorised representative of BPW Partners Pty Ltd AFSL 548754. Image credits: Getty Images

Caring

Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?

<a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.” “My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video. No further details have been released about the Princess of Wales’ treatment. But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment. <h2>It’s not the same as preventing cancer</h2> To <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">prevent cancer developing</a>, lifestyle changes such as diet, exercise and sun protection are <a href="https://www.cancer.org.au/about-us/how-we-help/prevention">recommended</a>. Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at <a href="https://www.mayoclinic.org/diseases-conditions/breast-cancer/in-depth/breast-cancer/art-20045353">high risk of breast cancer</a>. Aspirin <a href="https://www.cancer.gov/about-cancer/causes-prevention/research/aspirin-cancer-risk">can also be used</a> for those at high risk of bowel and other cancers. <h2>How can chemotherapy be used as preventive therapy?</h2> In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning. If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer. If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate <a href="https://www.healthline.com/health/cancer/metastatic-cancer">around the body</a> . The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer <a href="https://www.verywellhealth.com/adjuvant-therapy-5198903">coming back</a>. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later. With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back. If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer. <h2>How effective is preventive therapy?</h2> The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy. Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564362/">first chemotherapy tested</a> improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%. Preventive chemotherapy is usually given for three to six months. <h2>How does chemotherapy work?</h2> Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations. Chemotherapy is not selective for cancer cells. It kills any dividing cells. But cancers consist of a higher proportion of dividing cells than the normal body cells. A <a href="https://www.canceraustralia.gov.au/cancer-types/breast-cancer/treatment/chemotherapy/how-does-chemotherapy-work#:%7E:text=Chemotherapy%20works%20by%20killing%20cells%20that%20are%20rapidly,cells%20can%20repair%20the%20damage%20and%20can%20recover.">greater proportion of the cancer is killed</a> with each course of chemotherapy. Normal cells can recover between courses, which are usually given three to four weeks apart. <h2>What are the side effects?</h2> The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells. The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection. Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance. Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet. There are also generalised symptoms such as <a href="https://www.cancervic.org.au/cancer-information/treatments/treatments-types/chemotherapy/side_effects_of_chemotherapy.html">fatigue</a>. Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226461/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-olver-1047">Ian Olver</a>, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/kate-middleton-is-having-preventive-chemotherapy-for-cancer-what-does-this-mean-226461">original article</a>.

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What happens to teeth as you age? And how can you extend the life of your smile?

<a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> A healthy smile <a href="https://pubmed.ncbi.nlm.nih.gov/37314011/">helps us</a> live long, well and happy lives. But just <a href="https://pubmed.ncbi.nlm.nih.gov/37436910/">like our bodies</a>, our teeth succumb to age-related changes. So what happens to teeth as you age? And what can you do to ensure your smile lasts the distance? <h2>First, what are teeth made of?</h2> The tooth crown is covered by a hard enamel coat that surrounds softer, brown dentine, which protects a centrally located pulp. Enamel is a complex weave of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584618/">brittle</a>, honeycomb-clustered strands that interact with light to make teeth appear opalescent (a pearly, milky iridescence). <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1601-1546.2012.00269.x">Dentine under enamel</a> forms most of the tooth crown and root, and is made of collagen, mineral, water and proteins. Collagen strands are <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">woven</a> to stretch and spring back, to <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib12">prevent teeth</a> from cracking and breaking when we grind and chew. The pulp has blood vessels and nerves that communicate with the rest of your body. Enmeshed in the dentine mineral and collagen are small, <a href="https://pubmed.ncbi.nlm.nih.gov/8809302/">interconnected tubules</a> formed by specialised cells called <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847799940960">odontoblasts</a> that settle around the pulp, once our teeth completely form. Each tooth contains a <a href="https://pubmed.ncbi.nlm.nih.gov/23803461/">finite number of odontoblasts</a>, unlike the constantly replenished special bone cells that renew. <h2>How do our teeth change as we age?</h2> Unable to renew, our teeth <a href="https://www.sciencedirect.com/science/article/pii/S0003996922002102?via%3Dihub#bib19">become brittle</a>, and prone to fracture as dentine loses its spring. This is <a href="https://www.sciencedirect.com/science/article/pii/S0002817714613532?casa_token=1K9Y6CJXmsAAAAAA:t6y_b_Iy02AWpUGaiz4H8Fk0Kdfx6z1ypHiGOEjFqFNlU1jvSRCVjfYOyysgIErJvgCzh33c2hfX">more common</a> in teeth with existing crack lines, large fillings or root canal treatments. With time, the outer surface of enamel <a href="https://www.sciencedirect.com/science/article/abs/pii/S0022391305004348?casa_token=xXfdecXrLaoAAAAA:YE_0swAFtT3RyCUeJmPwciixQ0hwL-foLyC2RGtnlyUSJ9O-pPLQz0B8XNd4Gq1AMtCN2BgnCrqo">thins</a> to reveal the relatively opaque dentine that darkens as we age. The dentine darkens because the collagen weave <a href="https://www.sciencedirect.com/science/article/abs/pii/S1047847722000697">stiffens and shrinks</a>, and the fluid in the tubules <a href="https://www.sciencedirect.com/science/article/pii/S2590152422000010?via%3Dihub">fills with mineral</a>. The odontoblasts continue to form dentine inside the tooth to reduce the translucent pulp space. The increase in dentine makes our teeth appear <a href="https://www.sciencedirect.com/science/article/abs/pii/S0003996913003294">opaque</a> and insulates from hot and cold sensations. This is why <a href="https://www.sciencedirect.com/science/article/pii/S0300571215000494?casa_token=iiLtoxOZOYQAAAAA:RfaGR7lrq9dgWuO_nh6hLETzVUiIWdu-mB-Ev019vZH5t6meVyAHs3YpZzcu9FNrDBYQL6OExu6j">X-rays</a> are useful to detect cavities we may not feel. Food and drink particles fill micro-gaps and age-related fine crack lines that run up and down enamel to <a href="https://www.researchgate.net/profile/Yash-Kapadia/publication/322509199_Tooth_staining_A_review_of_etiology_and_treatment_modalities/links/5b4cd922a6fdcc8dae245b7d/Tooth-staining-A-review-of-etiology-and-treatment-modalities.pdf">discolour and stain</a>. These stains are easily managed by <a href="https://www.sciencedirect.com/science/article/pii/S2772559622000207">tooth whitening</a>. How else can you extend the life of your teeth and brighten your smile? Here are seven tips to avoid dental decline: <h2>1. Avoid unnecessary forces</h2> Avoid <a href="https://www.nature.com/articles/sj.bdj.2012.722">using</a> your teeth to hold things such as working tools or to open packaging. Take measures to avoid forces such as <a href="https://www.sciencedirect.com/science/article/pii/S1882761622000059">grinding or clenching</a> by wearing a night guard. If you have <a href="https://www.sciencedirect.com/science/article/pii/S0109564122002421">large fillings</a> or <a href="https://www.sciencedirect.com/science/article/pii/S0109564122001579?casa_token=kQPjGNgU2iQAAAAA:ytMnT5MLV8aRehNyyWD7qC7FXSBE5xpPCxnzZ2ryKsuyJePq1jHisue1udtN0Cs6NDYJ37xYHy_5">root canal-treated</a> teeth, speak to your dentist about <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/aej.12002?casa_token=RwMhhwmgjwwAAAAA%3AGCWVA9vjFX68S2DdKbCFl4jwTAjMeqVDoT3GtXTSjA7SMEc3ksktOMCUSz9ArikD4XhBM5v08nGCvmVF0g">specific filling materials or crowns</a> that can protect your teeth from cracking or breaking. <h2>2. Share the load</h2> If you are missing molars or premolars, distribute chewing forces evenly to prevent overloading your remaining teeth. Replace missing teeth with <a href="https://www.sciencedirect.com/science/article/pii/S010956411100858X?casa_token=4vrj3ssj0PEAAAAA:UODaFxNDCKmQ_lQs1faL6lh0xIeIfSFrRQBq-s0KF1ZvUJd6ytbXX37TVaiHLRzJPJaSDF_2aVmL">bridges</a>, <a href="https://aap.onlinelibrary.wiley.com/doi/full/10.1902/jop.2008.080188?casa_token=uA0r7imcRbUAAAAA%3AeXGszI5-Dcu4oKi33FCrRRviiAj0uyoP7V5wApIRQD1-1Zu-rkLAcoLhKMAJYVnC9tEnxj33UdNJIndEBA">implants</a> or well-fitted <a href="https://www.mdpi.com/1660-4601/18/13/6776">dentures</a> to support your bite. Get your dentures <a href="https://www.sciencedirect.com/science/article/pii/S0022391320301554">checked regularly</a> to ensure they fit and support adequately, and replace them at least every ten years. <h2>3. Preserve your enamel</h2> Reduce <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12330?casa_token=W2Ib34A77-QAAAAA%3AnLZtwwqZuueyHf1CMX0K9MERSW_Pvc3w0KlpArFT1KNusuopjEUcWmGd8pDUA7fQcj6DMkcS-JnXISFV1w">further enamel and dentine loss</a> by selecting soft-bristled <a href="https://www.tandfonline.com/doi/full/10.1080/00016350802195041?casa_token=E-ErdP543QUAAAAA%3A0Wz5AWwQxntBIc3UndFX_5nVbAYoPDx-PX1tg7Umxjr_QepX3CSIFVXYcrrxWV9iTx99Afk8c_zff-o">tooth brushes and non-abrasive toothpastes</a>. Certain whitening toothpastes can be abrasive, which can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8874033/">roughen and wear</a> the tooth surfaces. If you are unsure, stick with toothpastes that are labelled “sensitive”. Reduce your exposure to <a href="https://www.nature.com/articles/sj.bdj.2012.722">acid</a> in food (think lemons or apple cider vinegar) or illness (reflux or vomiting) where possible to maintain enamel and prevent erosion. <h2>4. Enhance your saliva</h2> <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jtxs.12356?casa_token=1moXbwnrDQIAAAAA%3AHz3Im9lmR3h75TmG8FSUQH-8_0UGnQ9TNkgaPL79LlrCmwC3kzZZJaAB2mSZHf4X7PX5y3GKaVoY5cm5JA">Saliva</a> protects against acid attacks, flushes our teeth, and has antibacterial properties to reduce erosion and decay (holes forming). Saliva is also important to help us chew, swallow and speak. But our saliva quality and quantity reduces because of age-related changes to our salivary glands as well as certain medications prescribed to <a href="https://pubmed.ncbi.nlm.nih.gov/19392837/">manage chronic illnesses</a> such as depression and high blood pressure. Speak to your doctor about other medication options to improve your saliva or manage reflux disease to prevent erosion. <h2>5. Treat gum disease</h2> Aesthetically, <a href="https://pubmed.ncbi.nlm.nih.gov/37358230/">treating gum disease (periodontitis)</a> reduces gum shrinkage (recession) that typically exposes the relatively darker tooth roots that are more <a href="https://journals.sagepub.com/doi/abs/10.1177/00220345231166294">prone to developing holes</a>. <h2>6. Manage and prevent senescence</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36908187/">Cellular senescence</a> is the process that changes DNA in our cells to reduce our ability to withstand physical, chemical or biological damage. Cellular senescence enhances new cancer formation, the spread of existing cancers and the onset of chronic illnesses such as Alzheimer’s disease, diabetes, osteoporosis and heart disease. You can prevent cell damage by managing lifestyle factors such as smoking, uncontrolled diabetes and chronic infections such as gum disease. <h2>7. Adapt and ask for help</h2> <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jan.15769?casa_token=SC-LouFQThsAAAAA%3A4jcvLRuJ56dGEm7ttvMad65hvUoZ7V5nvILg5sLFVZo8jxyQGR6YFeTcfM8sByTbdVrCWR1O5ytI3Z_crA">Ageing</a> can affect our cognition, hand dexterity and eyesight to prevent us from cleaning our teeth and gums as effectively as we once could. If this describes you, talk to your dental care team. They can help clean your teeth, and <a href="https://www.magonlinelibrary.com/doi/full/10.12968/bjon.2020.29.9.520?casa_token=_rol0NXx9c8AAAAA%3Aq8zgxiMSASwF1MRQZnZzfzmttn2x7FfGwsiIv71C_s_PTTmGD9JOIbqqtLNXa0oF9ogOjOCZwwpwB94">recommend products and tools</a> to fit your situation and abilities.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215786/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/arosha-weerakoon-792707">Arosha Weerakoon</a>, Senior Lecturer, School of Dentistry, The University of Queensland and General Dentist., <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-to-teeth-as-you-age-and-how-can-you-extend-the-life-of-your-smile-215786">original article</a>.

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Taking more than 5 pills a day? ‘Deprescribing’ can prevent harm – especially for older people

<a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> People are living longer and with more <a href="https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-functioning/health-disability-status">chronic health conditions</a> – including heart disease, diabetes, arthritis and dementia – than ever before. As societies continue to grow older, one pressing concern is the use of multiple medications, a phenomenon known as <a href="https://www.who.int/docs/default-source/patient-safety/who-uhc-sds-2019-11-eng.pdf">polypharmacy</a>. About <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50244">1 million older Australians</a> experience polypharmacy and this group is increasing. They may wake up in the morning and pop a pill for their heart, then another one or two to control blood pressure, a couple more if they have diabetes, a vitamin pill and maybe one for joint pain. Polypharmacy is usually <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.1_polypharmacy_75_years_and_over.pdf">defined</a> as taking five or more different medications daily. In aged care homes, <a href="https://doi.org/10.1016/j.archger.2022.104849">90% of residents</a> take at least five regular medications every single day. That can put their health at risk with increased costs for them and the health system. <h2>Adding up over time</h2> As people age, the effects of medications can change. Some medications, which were once beneficial, might start to do more harm than good or might not be needed anymore. About <a href="https://www.psa.org.au/wp-content/uploads/2020/02/Medicine-Safety-Aged-Care-WEB-RES1.pdf">half of older Australians</a> are taking a medication where the likely harms outweigh the potential benefits. While polypharmacy is sometimes necessary and helpful in managing multiple health conditions, it can lead to unintended consequences. <a href="https://www.nps.org.au/living-with-multiple-medicines/costs">Prescription costs</a> can quickly add up. Taking multiple medications can be difficult to manage particularly when there are specific instructions to crush them or take them with food, or when extra monitoring is needed. There is also a risk of <a href="https://www.nps.org.au/consumers/understanding-drug-interactions">drug interactions</a>. Medications bought “over the counter” without a prescription, such as vitamins, herbal medications or pain relievers, can also cause <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja11.10698">problems</a>. Some people might take an over-the-counter medication each day due to previous advice, but they might not need it anymore. Just like prescription medications, over-the-counter medications add to the overall burden and cost of polypharmacy as well as drug interactions and side effects. Unfortunately, the more medications you take, the more likely you are to have <a href="https://www.nps.org.au/consumers/managing-your-medicines#risks-of-taking-multiple-medicines">problems with your medications</a>, a reduced quality of life and increased risk of falls, hospitalisation and death. Each year, <a href="https://www.psa.org.au/wp-content/uploads/2019/01/PSA-Medicine-Safety-Report.pdf">250,000 Australians</a> are admitted to hospital due to medication-related harms, many of which are preventable. For example, use of multiple medications like sleeping pills, strong pain relievers and some blood pressure medications can cause drowsiness and dizziness, potentially resulting in a <a href="https://betterhealthwhileaging.net/preventing-falls-10-types-of-medications-to-review/">fall</a> and broken bones. <h2>Prescribing and deprescribing are both important</h2> Ensuring safe and effective use of medications involves both prescribing, and <a href="https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/silver-book/part-a/deprescribing">deprescribing</a> them. <a href="https://www.australiandeprescribingnetwork.com.au/474-2/">Deprescribing</a> is a process of stopping (or reducing the dose of) medications that are no longer required, or for which the risk of harm outweighs the benefits for the person taking them. The process involves reviewing all the medications a person takes with a health-care professional to identify medications that should be stopped. Think of deprescribing as spring cleaning your medicine cabinet. Just like how you tidy up your house and get rid of objects that are causing clutter without being useful, deprescribing tidies up your medication list to keep only the ones truly required. <h2>But care is needed</h2> The process of deprescribing requires close monitoring and, for many medications, slow reductions in dose (tapering). This helps the body adjust gradually and can prevent sudden, unpleasant changes. Deprescribing is often done on a trial basis and medication can be restarted if symptoms come back. Alternatively, a safer medication, or non-drug treatment may be started in its place. Studies show deprescribing is a safe process when managed by a health-care professional, both for people living at <a href="https://link.springer.com/article/10.1007/s11606-020-06089-2">home</a> and those in <a href="https://doi.org/10.1016/j.jamda.2018.10.026">residential aged care</a>. You should always talk with your care team before stopping any medications. Deprescribing needs to be a team effort involving the person, their health-care team and possibly family or other carers. Shared decision-making throughout the process empowers the person taking medications to have a say in their health care. The team can work together to clarify treatment goals and decide which medications are still serving the person well and which can be safely discontinued. If you or a loved one take multiple medications you might be eligible for a free visit from a pharmacist (<a href="https://www.nps.org.au/assets/NPS/pdf/NPSMW2390_Anticholinergics_HMR_Factsheet.pdf">a Home Medicines Review</a>) to help you get the best out of your medications. <h2>What’s next?</h2> Health care has traditionally focused on prescribing medications, with little focus on when to stop them. Deprescribing is not happening as often as it should. <a href="https://www.australiandeprescribingnetwork.com.au/">Researchers</a> are working hard to develop tools, resources and service models to support deprescribing in the community. Health-care professionals may think older adults are not open to deprescribing, but about <a href="https://academic.oup.com/biomedgerontology/article/77/5/1020/6352400">eight out of ten people</a> are willing to stop one or more of their medications. That said, of course some people may have concerns. If you have been taking a medication for a long time, you might wonder why you should stop or whether your health could get worse if you do. These are important questions to ask a doctor or pharmacist. We need more <a href="https://shpa.org.au/news-advocacy/MedsAware">public awareness</a> about polypharmacy and deprescribing to turn the tide of increasing medication use and related harms. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-reeve-1461339">Emily Reeve</a>, Senior Research Fellow in the Centre for Medicine Use and Safety , <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>; <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/janet-sluggett-146318">Janet Sluggett</a>, Enterprise Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/kate-ohara-1462183">Kate O'Hara</a>, PhD student, Clinical Pharmacology and Toxicology, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-more-than-5-pills-a-day-deprescribing-can-prevent-harm-especially-for-older-people-211424">original article</a>.

Body

Daily aspirin doesn’t prevent strokes in older, healthy people after all

<a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The daily use of <a href="https://www.nps.org.au/australian-prescriber/articles/drugs-in-secondary-stroke-prevention">low dose aspirin</a> has been a mainstay of preventing strokes for decades. While there has always been a risk of bleeding associated with aspirin use, the benefits were thought to outweigh the risk. Now <a href="https://dx.doi.org/10.1001/jamanetworkopen.2023.25803">new research</a> led by Monash University has shown daily, low-dose aspirin doesn’t prevent strokes in relatively healthy people aged over 70. And it increases their risk of bleeding on the brain after falls or other injuries. But if you’re taking aspirin, it doesn’t mean you should abruptly stop. It may still have a role to play in treating people at high risk of stroke. Or, after talking to your doctor, there might be better options available. <h2>Why has aspirin been used to prevent strokes?</h2> Aspirin is an anti-platelet medicine, which is commonly known as a blood-thinner. <a href="https://www.lifeblood.com.au/blood/learn-about-blood/platelets">Platelets</a> are the component of blood primarily responsible for its clotting action. They are what stop you from continuously bleeding any time you have a cut or scrape on your skin. A <a href="https://strokefoundation.org.au/about-stroke/learn/what-is-a-stroke">stroke</a> is when oxygen can’t get into the brain because of a burst or blocked blood vessel. A blockage can occur when platelets in the bloodstream form a clot and it gets stuck in the artery. Because aspirin acts on platelets, it can help prevent the clots that can lead to a stroke. But because aspirin acts on platelets, it can also increase the risk of <a href="https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/daily-aspirin-therapy/art-20046797#:%7E:text=While%20daily%20aspirin%20can%20help,of%20developing%20a%20stomach%20ulcer.">unwanted bleeding</a>, usually in the stomach. It can also increase your risk of bleeding more when you have another injury, like hitting your head. Aspirin isn’t just used for the prevention of strokes. It is also the first aid treatment for someone undergoing a <a href="https://www.nps.org.au/australian-prescriber/articles/acute-myocardial-infarction-early-treatment">heart attack</a>. <h2>Findings of the Monash trial</h2> New <a href="https://dx.doi.org/10.1001/jamanetworkopen.2023.25803">research from Australia and the United States</a> reports results from the Aspirin in Reducing Events in the Elderly (ASPREE) trial. The researchers examined the protective use of daily low-dose aspirin (100 mg) in nearly 2,000 people who were aged 70 years and older and had no history of heart disease or stroke and whose blood pressure and cholesterol were well managed. When compared with placebo, aspirin didn’t reduce or increase the risk of stroke. Of the participants who took the aspirin, 195 or 4.6% had a stroke. Of those who took the placebo, 203 people or 4.7% had a stroke. But it did statistically increase the rate of non-stroke bleeding in the participants’ brains, for example when they injured their head. Those on aspirin showed a rate of bleeding in the brain of 1.1% (108 participants) compared with 0.8% (79 people) for those on placebo. This is a relatively, low but serious, risk. These findings are not entirely new. <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1800722?query=featured_home">Research</a> published five years ago based on the same ASPREE trial showed a similar result: a higher rate of bleeding among those taking low-dose aspirin compared with placebo. However as the study authors note, aspirin continues to be widely used for the prevention of stroke. <h2>What are the study’s limitations?</h2> The researchers examined aspirin in mostly people of white European heritage. So we don’t know whether the results are translatable to people with different ethnic backgrounds. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594139/">Genetics and ethnicity</a> can significantly impact the efficacy and safety of some drugs. The clinical trial only included people who were not significantly at risk of a stroke, and had no history of heart disease. Younger age groups were not studied either, so we cannot make any conclusions about their use of low dose aspirin to prevent stroke. It’s also possible the potential benefits and risks are different for those who have underlying heart problems or who have previously had a stroke and are therefore at higher risk of another stroke. <h2>I’m taking aspirin, what should I do?</h2> If you’re taking daily low-dose aspirin and are concerned by the results of the study, it’s important you don’t just stop taking your medicine. Speak to your doctor or pharmacist. For people who are at high risk of having a stroke, or have previously had one, low-dose aspirin may remain their treatment of choice despite the slight bleeding risk. If you’re at high risk of bleeding, for example because of falls and other accidents due to advanced age, frailty, or another underlying condition, your doctor may be able to reduce the amount of aspirin you take by adding in <a href="https://www.nps.org.au/australian-prescriber/articles/dipyridamole">dipyridamole</a> or prescribing a different medicine completely, such as <a href="https://www.nps.org.au/australian-prescriber/articles/clopidogrel">clopidogrel</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210388/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/daily-aspirin-doesnt-prevent-strokes-in-older-healthy-people-after-all-210388">original article</a>.

Body

How to prevent travel-related deep vein thrombosis

No matter your transportation of choice, sitting motionless for long periods of time puts people at increased risk of deep vein thrombosis (DVT). DVT refers to blood clots that form deep in your veins, usually in the calf or leg, and results in the sensation of a swollen, painful limb. If you’ve been susceptible to DVT in your past travels, there are a few simple things to do to combat the problem. <ul> <li>Stand up and walk around at least every hour to keep blood flowing</li> <li>Exercise your calf muscles by standing on tip-toes a few times</li> <li>If you can’t walk around, exercise legs by stretching them, flexing feet and curling or pressing toes frequently</li> <li>Drink lots of fluids, especially water, to prevent dehydration</li> <li>Reduce alcohol and coffee consumption, which contributes to dehydration</li> <li>Avoid crossing your legs when seated or at least for long periods of time</li> <li>Wear compression stockings that put on gentle pressure on leg muscles.</li> <li>Don’t wear regular socks that are right or have tight elastic bands at top</li> <li>Skip the aspirin; there’s no evidence that it’s effective as a preventative measure</li> </ul> Image credits: Getty Images

Travel Tips

13 things neurologists do to help prevent Alzheimer’s disease

Understand Alzheimer's disease Alzheimer’s disease is the leading cause of dementia. But all dementia is not Alzheimer’s, says Dr David Knopman, a neurologist at the Mayo Clinic in Minnesota. Dementia is a general term used to describe a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. Alzheimer’s is a physical disease that targets the brain, causing problems with memory, thinking and behaviour. It is also age-related (symptoms usually start at age 65) and progressive, as symptoms usually worsen over time. Research shows that plaques and tangles two proteins that build up and block connections between nerve cells and eventually kill nerve cells in the brain, cause Alzheimer’s symptoms. Get enough sleep When you toss and turn all night, levels of brain-damaging proteins in the cerebrospinal fluid can rise: A 2017 study in Brain suggests that those with chronic sleep problems during middle age may increase their risk of Alzheimer’s later in life. “You have to commit to the importance of sleep,” says neurologist Dr Gayatri Devi. “I prioritise sleep as one of the most important activities I do – I will leave a party early in order to get a good night’s sleep.” Stay socially active Say yes to those social invitations! A 2019 study published in PLOS Medicine found that social activity with friends in your 60s could lower your risk of dementia by 12%. “There is something intrinsically valuable about social engagement,” says Dr Knopman. “It makes sense that those who are more engaged, especially socially, will think more positively and have a better outlook on life.” Keep learning People with advanced degrees have a lower risk of Alzheimer’s, according to 2017 research published in the BMJ. Education seems to build a ‘cognitive reserve’, which enables the brain to better resist neurological damage. “Higher education has a powerful effect,” says Dr Knopman. It’s never too late, check out the continuing education courses offered online or near you. Learn a second language Speaking more than one language can protect against Alzheimer’s disease and other types of dementia, according to 2017 research published in Clinical Interventions in Aging. While no one is sure why a second language helps so much, Dr Knopman theorises that the effort to communicate bilingually is like a workout for the brain, helping preserve grey matter and neurons. Do it yourself Challenging your brain in new ways can enhance memory as you age. Dr Devi has her own take on this: “If there is a problem with the phone or the plumbing, I will try to fix it,” she says. “If I try to figure out how to fix this on my own, it is good for my brain.” Right now she’s designing and building a window seat. “It is a way to keep different parts of my brain thriving.” Stay active Exercise is crucial to your wellness and your brain. Research published in Cureus in 2020, found that people who exercise regularly can slow cognitive decline. According to the Alzheimer’s Society, the combined results of 11 studies indicate that regular exercise can reduce the risk of developing dementia by about 30%; it drops the risk of Alzheimer’s by 45%. “When you are physically active, you burn more calories and you’re less likely to be obese,” explains Dr Knopman. “You’ll have better cardiovascular health because you are pushing your heart rate.” Take care of your heart “What is good for the heart is good for the brain,” says Dr Devi. Conditions such as high blood pressure, diabetes and high cholesterol, which increase the risk of cardiovascular disease, may also increase the risk of developing Alzheimer’s, and a 2017 study in JAMA found that middle-aged people with risk factors for heart attacks and stroke are also more likely to develop changes in the brain that can lead to the disease. “Anything that keeps the heart healthy is directly related to brain health,” Dr Devi says. It also reduces the risk of stroke, which can cause its own kind of dementia – vascular dementia. Lower your stress levels Persistent stress can take a toll on the brain, and 2018 research published in Neurobiology of Stress indicates that chronic stress can accelerate Alzheimer’s disease. When you’re stressed, your body releases cortisol, a hormone linked to memory trouble. In addition, experts have found that stress can lead to conditions such as depression and anxiety, which also increases the risk for dementia, according to research in Current Opinion in Psychiatry. “Eliminating stress helps reduce the amount of cortisol and optimises glucose utilisation, which your brain needs for food,” says Dr Devi. Try the MIND diet A combination of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, the MIND diet is designed specifically for brain health. (MIND is short for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay.) The diet is pretty pleasant: you eat at least three servings of whole grains a day, two portions of vegetables (one of which must be a leafy green), snack on nuts, eat lean proteins like chicken and fish, berries, and have a glass of wine a day. According to research in Alzheimer’s & Dementia, those who adhered to the diet rigorously were able to lower their risk of cognitive decline later in life. You can’t trust all diets, warns Dr Knopman, but he likes this approach: “I tell my patients that if you follow a reasonable diet with lots of fresh fruits and vegetable that balances different food groups, and avoid obesity, you will be okay.” Get your snoring checked out Another way to wreck your sleep without realising it is with sleep apnea. According to the US National Institutes of Health, sleep apnoea occurs when a person’s upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow. Many factors – from obesity to large tonsils to neuromuscular disorders – can cause sleep apnoea. Sleep apnoea not only prevents restful sleep, but untreated it can increase the risk of developing certain health conditions. “If left untreated, sleep apnoea has significant cardiovascular consequences and consequences of mental function,” says Dr Knopman. Protect your head According to the Alzheimer’s Association, there is a strong link between serious head trauma and developing Alzheimer’s later in life, especially if the injury involves loss of consciousness. A 2017 review of research in PLOS One suggests head injuries that require medical attention may increase the risk of dementia and Alzheimer’s disease. Wear a helmet while cycling, make your home fall-proof, and always use a seat belt to help protect your noggin. Drink a cup of tea Green tea has loads of health benefits – including some for your brain. A 2019 systematic review in Nutrients found that green tea might reduce the risk of dementia. And research in the Journal of the American Chemical Society found that it’s a compound in the beverage that can disrupt the formation of toxic plaques that contribute to Alzheimer’s disease. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/conditions/13-things-neurologists-do-to-help-prevent-alzheimers-disease?pages=1" target="_blank" rel="noopener">Reader's Digest</a>.

Mind

COVID nasal sprays may one day prevent and treat infection

We have vaccines to boost our immune response to SARS-CoV-2, the virus that causes COVID. We have medicines you can take at home (and in hospital) to treat COVID. Now researchers are trialling something new. They want to develop drugs that stop the virus getting into the body in the first place. That includes nasal sprays that stop the virus attaching to cells in the nose. Other researchers are looking at the potential for nasal sprays to stop the virus replicating in the nose, or to make the nose a hostile place to enter the body. Here’s where the science is up to and what we can expect next. <h2>How could we block the virus?</h2> “Viral blockade”, as the name suggests, is a simple premise based on blocking SARS-CoV-2. In other words, if something gets in its way, the virus cannot attach to a cell and it can’t infect you. As SARS-CoV-2 is a respiratory virus, it makes sense to deliver this type of medicine where the virus mainly enters the body – via the nose, in a nasal spray. There are various groups around the world working on this concept. Some research is still being conducted in the lab. Some agents have progressed to preliminary human trials. None are yet available for widespread use. Heparin Heparin is a common medicine that’s been used for decades to thin the blood. Studies in mice show that when heparin is delivered via the nose, <a href="https://link.springer.com/article/10.1007/s11095-022-03191-4" target="_blank" rel="noopener">it’s safe</a> and <a href="https://journals.asm.org/doi/10.1128/JVI.01987-20" target="_blank" rel="noopener">effective</a> in preventing the virus binding to nose cells. Researchers believe heparin binds to the virus itself and stops the virus attaching to the cells it’s trying to infect. A <a href="https://clinicaltrials.gov/ct2/show/NCT05204550" target="_blank" rel="noopener">clinical trial</a> is being <a href="https://www.premier.vic.gov.au/covid-nasal-spray-treatment-clinical-trials-begin" target="_blank" rel="noopener">conducted in Victoria</a> in collaboration between multiple Melbourne-based research centres and the University of Oxford. Covixyl-V Covixyl-V (ethyl lauroyl arginine hydrochloride) is another nasal spray <a href="https://assets.researchsquare.com/files/rs-911449/v1/0577f1f1-56f8-476f-97f6-d27d332ea9ca.pdf?c=1643375660" target="_blank" rel="noopener">under development</a>. It aims to prevent COVID by blocking or modifying the cell surface to prevent the virus from infecting. This compound has been explored for use in various viral infections, and <a href="https://assets.researchsquare.com/files/rs-911449/v1/0577f1f1-56f8-476f-97f6-d27d332ea9ca.pdf?c=1643375660" target="_blank" rel="noopener">early studies</a> in cells and small animals has shown it can prevent attachment of SARS-CoV-2 and reduce the overall viral load. Iota-carrageenan This molecule, which is extracted from seaweed, acts by blocking virus entry into <a href="https://www.frontiersin.org/articles/10.3389/fviro.2021.746824/full" target="_blank" rel="noopener">airway cells</a>. One study of about 400 health-care workers suggests a nasal spray may reduce the incidence of COVID <a href="https://www.dovepress.com/efficacy-of-a-nasal-spray-containing-iota-carrageenan-in-the-postexpos-peer-reviewed-fulltext-article-IJGM" target="_blank" rel="noopener">by up to 80%</a>. IGM-6268 This is <a href="https://www.nature.com/articles/s41586-021-03673-2" target="_blank" rel="noopener">an engineered antibody</a> that binds to SARS-CoV-2, <a href="https://www.sciencedaily.com/releases/2021/06/210603171306.htm" target="_blank" rel="noopener">blocking</a> the virus from attaching to cells in the nose. A nasal and oral (mouth) spray are in a clinical trial <a href="https://clinicaltrials.gov/ct2/show/NCT05184218?term=IGM-6268&draw=2&rank=2" target="_blank" rel="noopener">to assess safety</a>. Cold atmospheric plasma This is a gas that contains charged particles. At cold temperatures, it can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165322" target="_blank" rel="noopener">alter the surface</a> of a cell. A <a href="https://www.thno.org/v12p2811.htm" target="_blank" rel="noopener">lab-based study</a> shows the gas changes expression of receptors on the skin that would normally allow the virus to attach. This results in less SARS-CoV-2 attachment and infection. Scientists now think this technology could be adapted to a nasal spray to prevent SARS-CoV-2 infection. <h2>How could we stop the virus replicating?</h2> Another tactic is to develop nasal sprays that stop the virus replicating in the nose. Researchers are designing genetic fragments that bind to the viral RNA. These fragments – known as “<a href="https://www.nature.com/articles/s41467-022-32216-0" target="_blank" rel="noopener">locked nucleic acid antisense oligonucleotides</a>” (or LNA ASOs for short) – put a proverbial spanner in the works and stop the virus from replicating. A spray of these genetic fragments delivered into the nose <a href="https://www.nature.com/articles/s41467-022-32216-0" target="_blank" rel="noopener">reduced virus replication in the nose</a> and prevented disease in small animals. <h2>How could we change the nose?</h2> A third strategy is to change the nose environment to make it less hospitable for the virus. That could be by using a nasal spray to change moisture levels (with saline), alter the pH (making the nose more acidic or alkaline), or adding a virus-killing agent (iodine). Saline can reduce the amount of <a href="https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2768627" target="_blank" rel="noopener">SARS-CoV-2 in the nose</a> by simply washing away the virus. One study has even found that saline nasal irrigation <a href="https://journals.sagepub.com/doi/10.1177/01455613221123737" target="_blank" rel="noopener">can lessen COVID disease</a> severity. But we would need further research into saline sprays. An Australian-led study has found that an iodine-based nasal spray <a href="https://www.theajo.com/article/view/4466/html" target="_blank" rel="noopener">reduced the viral load</a> in the nose. Further <a href="https://www.uwa.edu.au/news/Article/2022/February/Study-finds-nasal-spray-could-aid-battle-against-COVID" target="_blank" rel="noopener">clinical trials</a> are planned. <a href="https://www.sciencedirect.com/science/article/pii/S1386653222001809#!" target="_blank" rel="noopener">One study</a> used a test spray – containing ingredients including eucalyptus and clove oils, potassium chloride and glycerol. The aim was to kill the virus and change the acidity of the nose to prevent the virus attaching. This novel formulation has been tested in the lab and in a <a href="https://www.sciencedirect.com/science/article/pii/S1386653222001809#!" target="_blank" rel="noopener">clinical trial</a> showing it to be safe and to reduce infection rate from about 34% to 13% when compared to placebo controls. <h2>Barriers ahead</h2> Despite promising data so far on nasal sprays for COVID, one of the <a href="https://www.nature.com/articles/d41586-022-03341-z" target="_blank" rel="noopener">major barriers</a> is keeping the sprays in the nose. To overcome this, most sprays need multiple applications a day, sometimes every few hours. So based on what we know so far, nasal sprays will not singlehandedly beat COVID. But if they are shown to be safe and effective in clinical trials, and receive regulatory approval, they might be another tool to help prevent it. This article originally appeared on <a href="https://theconversation.com/covid-nasal-sprays-may-one-day-prevent-and-treat-infection-heres-where-the-science-is-up-to-193840" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

Sounds great: Scientists are manipulating dreams to prevent nightmares

It’s estimated that at any given time, around 4% of adults suffer <a href="https://cosmosmagazine.com/health/one-side-of-your-brain-might-be-giving-you-nightmares/" target="_blank" rel="noreferrer noopener">chronic nightmares</a> but researchers in Switzerland have a new approach which will be music to the ears of night-terror-sufferers. Basing their study on the relationship between the types of <a href="https://cosmosmagazine.com/science/biology/nightmares-and-night-terrors-in-kids-when-do-they-stop-being-normal/" target="_blank" rel="noreferrer noopener">emotions experienced in dreams</a> and our emotional well-being, researchers have investigated how to help people by manipulating emotions in their dreams. Traditional methods to help chronic nightmare patients involves ‘imagery rehearsal therapy’, during which they are coached to rehearse the dream scenario during the day and redirect it towards a more positive ending. A <a href="https://link.springer.com/article/10.1007/s11818-021-00320-w" target="_blank" rel="noreferrer noopener">2021 study</a> of 28 participants showed 3 in 5 patients benefitted from this approach, however, it doesn’t work for everyone. <div class="newsletter-box"> <div id="wpcf7-f6-p220659-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/health/sounds-great-preventing-nightmares/#wpcf7-f6-p220659-o1" method="post" novalidate="novalidate" data-status="init"> <input class="wpcf7-form-control wpcf7-text referer-page" name="referer-page" type="hidden" value="https://cosmosmagazine.com/health/" data-value="https://cosmosmagazine.com/health/" aria-invalid="false" /> </form> </div> </div> In a <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(22)01477-4" target="_blank" rel="noreferrer noopener">study from Geneva University</a>, over a two-week period, researchers asked a group of 18 patients to create an association between the positively redirected version of their dream and a sound during an imagination exercise. The patients then wore wireless headbands during night which would play the specific sound during the REM (Rapid Eye Movement) stage of sleep – when <a href="https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515" target="_blank" rel="noreferrer noopener">nightmares typically occur</a>. When compared to 18 patients who undertook only the image rehearsal therapy, those who received the combined rehearsal and sound therapy had fewer nightmares. This trend continued even after three months post-intervention, with those receiving combination therapy also reporting experiencing more positive emotions such as ‘joy’ in their dreams. “We were positively surprised by how well the participants respected and tolerated the study procedures, for example performing imagery rehearsal therapy every day and wearing the sleep headband during the night,” says Lampros Perogamvros, senior author of the study and a psychiatrist at the Sleep Laboratory of the Geneva University Hospitals and the University of Geneva. “We observed a fast decrease of nightmares, together with dreams becoming emotionally more positive. For us, researchers and clinicians, these findings are very promising both for the study of emotional processing during sleep and for the development of new therapies.”  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=220659&title=Sounds+great%3A+Scientists+are+manipulating+dreams+to+prevent+nightmares" width="1" height="1" />  <div id="contributors"> <a href="https://cosmosmagazine.com/health/sounds-great-preventing-nightmares/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Clare Kenyon. Image: Getty Images </div>

Mind

Could the Senate inquiry into missing and murdered Indigenous women and children prevent future deaths?

Aboriginal and Torres Strait Islander readers are advised this article contains names of deceased people and mentions domestic violence and murder. <hr /> <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Legal_and_Constitutional_Affairs/FirstNationswomenchildren/Public_Hearings" target="_blank" rel="noopener">Public hearings</a> have officially commenced into the Senate Committee <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Legal_and_Constitutional_Affairs/Missingmurderedwomen" target="_blank" rel="noopener">Inquiry</a> into Missing and Murdered Indigenous Women and Children. The inquiry has <a href="https://www.aapnews.com.au/news/indigenous-legal-service-funds-fall-short" target="_blank" rel="noopener">found</a> “Murder rates for Indigenous women are eight times higher than for their non-Indigenous counterparts”. This came as no surprise to many of us who have worked in this field for a long time. In fact, these numbers are likely to be higher when they include manslaughter rates. The rate at which women are murdered in Australia over time (<a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Legal_and_Constitutional_Affairs/FirstNationswomenchildren/Public_Hearings" target="_blank" rel="noopener">2005-06 to 2019-20</a>) have been declining. But according to the <a href="https://www.aic.gov.au/sites/default/files/2022-03/sr39_homicide_in_australia_2019-20.pdf" target="_blank" rel="noopener">Homocide Report Australia 2019 -20</a>, report, this sadly is not the case for Indigenous women. When women are murdered in Australia, there is understandable <a href="https://www.bbc.com/news/world-australia-44491670" target="_blank" rel="noopener">outrage</a>, displays of <a href="https://www.abc.net.au/news/2020-03-09/hannah-clarke-children-funeral-service/12024138" target="_blank" rel="noopener">grief</a> and moments of reflection in our parliament. However, there is often silence in the media and in public discussion about the violence Indigenous women experience, as Indigenous studies Professor Bronwyn Carlson has <a href="https://theconversation.com/no-public-outrage-no-vigils-australias-silence-at-violence-against-indigenous-women-158875" target="_blank" rel="noopener">discussed</a>. This inquiry has the potential to provide voice to the Indigenous women and children we have lost and continue to lose to violence, as well as ending the silence that follows. <h2>What is this senate inquiry?</h2> In November 2021, First Nations Greens senators Dorinda Cox and Lidia Thorpe called for a Senate inquiry into the high rates of missing and murdered Indigenous women and children in Australia. Through measures including hearing testimony from survivors of violence and examining police responses, this will be an opportunity to investigate what can be changed to better address violence against Indigenous women and children in Australia. Available data tell us Indigenous women represent up to <a href="https://www.abc.net.au/news/2019-12-09/linda-burney-wants-senate-inquiry-into-missing-indigenous-women/11773992" target="_blank" rel="noopener">10%</a> of unsolved missing persons cases in Australia, many of whom are presumed dead. Indigenous women are also <a href="https://www.aihw.gov.au/reports/australias-welfare/indigenous-community-safety" target="_blank" rel="noopener">30 times</a> more likely to be hospitalised for assault-related injuries. As part of its public hearings, the inquiry is examining these damning statistics. However, the inquiry is also delving deeper, <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Legal_and_Constitutional_Affairs/FirstNationswomenchildren/Public_Hearings" target="_blank" rel="noopener">asking more</a> about the women’s stories, with the intention to go beyond statistics and hear how people are affected by their experiences with family violence. <h2>Police and domestic violence services are not helping</h2> My research has found violence against Indigenous women is significantly <a href="https://www.telethonkids.org.au/globalassets/media/documents/aboriginal-health/working-together-second-edition/wt-part-5-chapt-23-final.pdf" target="_blank" rel="noopener">under-reported</a> and perpetrators regularly go unpunished. This is not to say Indigenous women are not crying out for support: they are and have been. However, they are often confronted with a dilemma of who is safe to turn to, and what the consequences of reporting might be. For First Nations women, there are significant risks to consider when reporting violence to police or seeking assistance from domestic violence services. These risks include their children being <a href="https://theconversation.com/another-stolen-generation-looms-unless-indigenous-women-fleeing-violence-can-find-safe-housing-123526" target="_blank" rel="noopener">taken from them</a> by child protection services, the women themselves being arrested for unrelated criminal matters, and the risk of being misidentified as the perpetrator. Criminology and law researcher <a href="https://academic.oup.com/bjc/advance-article/doi/10.1093/bjc/azab103/6430028" target="_blank" rel="noopener">Emma Buxton-Namisnyk’s</a> study of domestic violence policing of First Nations women in Australia found “there were very few examples of police interventions that did not produce some identifiable harm”. Buxton-Namisnyk found this harm was through police inaction and non-enforcement of domestic violence laws. Some instances involved police action resulting in “eroding victim’s agency” through criminalising victims and increasing police surveillance over their families. In June 2022, Acting Coroner Elisabeth Armitage handed down <a href="https://www.abc.net.au/news/2022-06-10/coronial-inquest-roberta-findings-darwin-local-court/101141340" target="_blank" rel="noopener">damning findings</a> against the Northern Territory Police in the death of Roberta, an Aboriginal woman from the Katherine region. Armitage said the police “did nothing to help her”. In fact, the fatal assault was the seventh time Roberta’s partner had abused her in less than two weeks. It was five days after Roberta had been told by police to “<a href="https://justice.nt.gov.au/__data/assets/pdf_file/0012/1113600/D01052019-Roberta-Curry.pdf" target="_blank" rel="noopener">stop calling us</a>”. Armitage summed up this case as one in which police failed to follow any of their procedures concerning domestic violence complaints. She also found their manner towards Roberta was rude and dismissive. These actions and failures were not confined to the actions of police. The triple-zero call operator incorrectly classified Roberta’s calls for help, and the parole officer tasked with supervising Roberta’s partner was oblivious to his breaches of parole conditions. The breakdown in communication across these services and the lack of support available to Roberta created the conditions that led to her death. This case also speaks to a broader issue of bystanders who fail to act on our women’s cries for help. The Northern Territory is a unique jurisdiction in that it is <a href="https://nt.gov.au/law/crime/domestic-family-and-sexual-violence/report-domestic-family-and-sexual-violence" target="_blank" rel="noopener">mandatory</a> for all adults to <a href="https://legislation.nt.gov.au/en/LegislationPortal/~/link.aspx?_id=2AB69753FCA64C5281F9E2ED1FF089E7&_z=z" target="_blank" rel="noopener">report domestic violence</a> “when the life or safety of another person is under serious or imminent threat” or be liable for a fine up to $20,000. Despite this, Armitage explained there were witnesses to the violence Roberta endured, who did not report. To my knowledge, no one has been held accountable for failing to report. <h2>There are stories behind the numbers</h2> During this Senate inquiry, politicians need to consider the stories behind the statistics, such as Roberta’s. It is these stories that demonstrate the need for domestic and family violence death reviews in all of our states and territories. They provide the opportunity to understand the victim’s story and how it is affected by services and systems currently in place. But it’s also critical Indigenous people are included in the process of reviews and the analysis of what keeps going wrong with services that are meant to save lives. In addition to this, there needs to be an extensive review of cases over time to understand trends in missing and murdered Indigenous women and children. We need to find out whether systemic problems or issues in practice are responsible for failing these women. As the United Nations’ violence against Indigenous women and girls <a href="https://documents-dds-ny.un.org/doc/UNDOC/GEN/G22/323/90/PDF/G2232390.pdf?OpenElement" target="_blank" rel="noopener">report</a> states, Indigenous women already have to navigate violence in the form of racial discrimination and system inequities. Our calls for help need to be met with a culturally safe person who can hear our stories and respond with care and respect to help us navigate our way to safety. This article originally appeared on <a href="https://theconversation.com/could-the-senate-inquiry-into-missing-and-murdered-indigenous-women-and-children-prevent-future-deaths-192020" target="_blank" rel="noopener">The Conversation</a>. Image: Getty

Legal

Your dog can get dementia - here’s how to prevent it

Just like us, dogs can experience cognitive decline as they age. They can also risk developing a neurodegenerative condition called Canine Cognitive Dysfunction (CCD), a condition similar to Alzhheimer’s Disease. Like Alzheimer’s, symptoms dogs with CCD can experience include a loss of spatial awareness, memory deficiencies, disrupted sleep, and altered social interactions. Both CCD and Alzheimer’s also share symptoms found in the brain itself, including <a href="https://oversixty.com.au/health/mind/alzheimer-s-marker-found-in-the-brain" target="_blank" rel="noopener">the buildup of fragments of a protein called beta-amyloid</a> in between nerve cells. According to a new study published in the journal <a href="https://doi.org/10.1038/s41598-022-15837-9" target="_blank" rel="noopener">Scientific Reports</a>, the risk of developing CCD increases by 68 percent each year after dogs turn 10. The team studied a whopping 15,019 dogs that took part in a longitudinal study called the Dog Ageing Project. Between 2019 and 2020, the owners of participating pets completed two surveys about the health status and physical activity of their dogs. They also completed the Canine Social and Learned Behaviour survey, which tested for symptoms of CCD such as dogs failing to recognise familiar people. But, they also found that older pooches that were very active had a much smaller risk of developing the condition in comparison to less active dogs of the same breed and health - with the more sedentary dogs having a 6.47 times higher risk of having CCD. They stress that their study doesn’t show that a lack of physical activity causes CCD, and are calling for more research to determine whether CCD is caused by less physical activity or if the inactivity is caused by CCD. Because of the similarities between CCD and Alzheimer’s disease, the team argue that means that researching CCD could have implications for our understanding and treatment of Alzheimer’s, and vice versa. For example, the association between physical activity and lower risks of CCD come after numerous studies showing this relationship in rodents <a href="https://oversixty.com.au/health/mind/the-surprising-reason-exercise-improves-symptoms-of-alzheimer-s" target="_blank" rel="noopener">and in humans</a>. “These observations may reflect a variety of biologic mechanisms, including a reduction of pro-inflammatory cytokines in the brain that otherwise contribute to neural damage and death, and an increase in neural plasticity,” they write of the studies with rodents and people, adding that these mechanisms might also explain the link between physical activity and CCD risk. “Given increasing evidence of the parallels between canine and human cognitive disease, accurate CCD diagnosis in dogs may provide researchers with more suitable animal models in which to study ageing in human populations.” Image: Getty Images

Family & Pets

Having ‘good’ posture doesn’t prevent back pain, and ‘bad’ posture doesn’t cause it

Back pain is the leading cause of <a href="https://pubmed.ncbi.nlm.nih.gov/24665116/" target="_blank" rel="noopener">disability</a> worldwide. Most people experience an episode of back pain in their lifetime. It often emerges during <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/" target="_blank" rel="noopener">adolescence</a> and becomes more common in adults. For <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771685/" target="_blank" rel="noopener">25%</a> of people who develop back pain, it can become persistent, disabling and distressing. It can affect a person’s ability to participate in activities of <a href="https://pubmed.ncbi.nlm.nih.gov/31369481/" target="_blank" rel="noopener">daily living, physical activity and work</a>. Activities such as sitting, standing, bending and lifting frequently aggravate back pain. There is a common belief that “good” posture is important to protect the spine from damage, as well as prevent and treat back pain. Good posture is commonly defined as sitting “upright”, standing “tall and aligned”, and lifting with a squat technique and “straight back”. Conversely, “slump” sitting, “slouch” standing and lifting with a “round back” or stooped posture are frequently warned against. This view is widely held by people <a href="https://pubmed.ncbi.nlm.nih.gov/23806489/" target="_blank" rel="noopener">with and without back pain</a>, as well as clinicians in both <a href="https://pubmed.ncbi.nlm.nih.gov/30553985/" target="_blank" rel="noopener">occupational health and primary care</a> settings. Surprisingly, there is a lack of evidence for a strong relationship between “good” posture and back pain. Perceptions of “good” posture originate from a combination of social desirability and unfounded presumptions. Systematic reviews (studies looking at a number of studies in one area) have found <a href="https://pubmed.ncbi.nlm.nih.gov/20360197/" target="_blank" rel="noopener">ergonomic interventions</a> for workers, and advice for manual workers on the <a href="https://pubmed.ncbi.nlm.nih.gov/19734238/" target="_blank" rel="noopener">best posture for lifting</a>, have not reduced work-related back pain. <h2>Sitting and standing posture</h2> Our group has conducted several studies exploring the relationship between spine posture and back pain. We investigated whether “slump” sitting or “non-neutral” standing postures (overarching or slouching the back, for example), in a large population of adolescents, were <a href="https://pubmed.ncbi.nlm.nih.gov/21350031/%20https://pubmed.ncbi.nlm.nih.gov/18758367/" target="_blank" rel="noopener">associated with</a>, or <a href="https://pubmed.ncbi.nlm.nih.gov/28915771/" target="_blank" rel="noopener">predicted</a> future back pain. We found little support for this view. These findings are consistent with systematic reviews that have found no consistent differences in <a href="https://pubmed.ncbi.nlm.nih.gov/31451200/" target="_blank" rel="noopener">sitting</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/25012528/" target="_blank" rel="noopener">standing</a> posture between adult populations with and without back pain. People adopt a range of different spine postures, and no single posture <a href="https://pubmed.ncbi.nlm.nih.gov/31366294/" target="_blank" rel="noopener">protects a person from back pain</a>. People with both slumped and upright postures can experience <a href="https://pubmed.ncbi.nlm.nih.gov/16540876/" target="_blank" rel="noopener">back pain</a>. <h2>Lifting posture</h2> Globally accepted occupational health practices about “good” or safe back postures during lifting also lack evidence. Our systematic review found no evidence lifting with a <a href="https://pubmed.ncbi.nlm.nih.gov/31775556/" target="_blank" rel="noopener">round-back posture</a> is associated with or predictive of back pain. Our <a href="https://pubmed.ncbi.nlm.nih.gov/34288926/" target="_blank" rel="noopener">recent lab study</a> found people without back pain, employed in manual work for more than five years, were more likely to lift with a more stooped, round-back posture. In comparison, manual workers with back pain tended to adopt more of a squat lift with a <a href="https://pubmed.ncbi.nlm.nih.gov/34288926/" target="_blank" rel="noopener">straighter back</a>. In other words, people with back pain tend to <a href="https://pubmed.ncbi.nlm.nih.gov/31730537/" target="_blank" rel="noopener">follow “good” posture advice</a>, but people who don’t lift in the “good” way don’t have more back pain. In a small study, as people with disabling back pain recovered, they became <a href="https://pubmed.ncbi.nlm.nih.gov/32621351/" target="_blank" rel="noopener">less protective</a> and generally moved away from the “good” posture advice. <h2>If not posture – what else?</h2> There is no evidence for a single “good posture” to prevent or reduce back pain. People’s spines come in all shapes and sizes, so posture is highly individual. Movement is important for back health, so learning to <a href="https://pubmed.ncbi.nlm.nih.gov/31366294/" target="_blank" rel="noopener">vary and adopt different postures</a> that are comfortable is likely to be more helpful than rigidly adhering to a specific “good” posture. While back pain can be intense and distressing, for most people (90%) back pain is not associated with identifiable <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/" target="_blank" rel="noopener">tissue damage or pathology</a>. Back pain can be like a sprain related to awkward, sudden, heavy or unaccustomed loads on our <a href="https://pubmed.ncbi.nlm.nih.gov/25665074/" target="_blank" rel="noopener">back</a>, but can also occur like a bad headache where there is no injury. Importantly, people are more vulnerable to back pain when their health is compromised, such as if someone is: <ul> <li> feeling <a href="https://pubmed.ncbi.nlm.nih.gov/20393261/" target="_blank" rel="noopener">stressed</a> </li> <li> experiencing low mood </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/25665074/" target="_blank" rel="noopener">tired or fatigued</a> </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/16741460/" target="_blank" rel="noopener">sleeping poorly</a> </li> <li> being less active. </li> </ul> Back pain is more likely to persist if a person: <ul> <li> becomes overly <a href="https://pubmed.ncbi.nlm.nih.gov/12446259/" target="_blank" rel="noopener">worried and fearful</a> about their back pain </li> <li> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771685/" target="_blank" rel="noopener">overprotects their back</a> and avoids movement, physical activity, work and social engagement. </li> </ul> <h2>What can people do about back pain?</h2> In a small group (1-5%), <a href="https://pubmed.ncbi.nlm.nih.gov/27745712" target="_blank" rel="noopener">back pain</a> can be caused by pathology including a fracture, malignancy, infection or nerve compression (the latter is associated with leg pain, and a loss of muscle power and sensation). In these cases, seek medical care. For most people (90%), back pain is associated with sensitisation of the back structures, but not identifiable tissue damage. In this situation, too much focus on maintaining “good” posture can be a distraction from other factors known to be important for spine health. These include: <ul> <li> moving and relaxing your back </li> <li> engaging in regular physical activity of your preference </li> <li> building confidence and keeping fit and strong for usual daily tasks </li> <li> maintaining healthy sleep habits and body weight </li> <li> caring for your general <a href="https://pubmed.ncbi.nlm.nih.gov/31892534/" target="_blank" rel="noopener">physical and mental health</a>. </li> </ul> Sometimes this requires some support and coaching with a skilled clinician. So if you are sitting or standing, find comfortable, relaxed postures and vary them. If you are lifting, the <a href="https://pubmed.ncbi.nlm.nih.gov/34288926/" target="_blank" rel="noopener">current evidence</a> suggests it’s OK to lift naturally – even with a round back. But make sure you are fit and strong enough for the task, and care for your overall health. This article originally appeared on <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Body

The 15 minute hack to reduce bathroom mould

When it comes to mould, bathrooms are often the first place the pesky growth will show up. While we can’t do anything about the sheer volume of mould spores in the air, we can control the environment. Mould thrives in cold and damp areas, which make bathrooms the logical place it would show up first. Prevention is better than a cure, so when it comes to mould, taking preventative measures will set you up for success. According to John Liddell, the managing director at The Mould Doctor, reducing extra moisture is a must. “If a property is damp from condensation, building defects or inadequate ventilation, the humidity will be elevated,” says John. “When the humidity in a living space exceeds 55%, the conditions are ideal for mould." According to information on the Mould Doctor website, a significant cause of elevated humidity levels in a home is steam escaping from the bathroom. While running the exhaust while you are showering can help, it isn’t always enough. The key is to leave it on after you’ve finished and left the bathroom. The length of time you need to leave the exhaust on will vary, but around 15-20 minutes should be enough to eliminate that extra moisture. As well as this, using dehumidifiers and air conditioning units can help get rid of extra moisture, banishing the growth of mould in your home. Image credits: Getty Images

Home & Garden

I’m getting older, how can I prevent falls?

Falls are common. Each year <a href="https://www.who.int/publications/i/item/9789241563536">one in every three</a> people aged over 65 will fall. Around <a href="https://protect-au.mimecast.com/s/TmbBC6XQ4LfoyR3W3CpQkee?domain=cambridge.org">one in ten falls</a> lead to serious injury. Most of us have a friend or relative who has experienced an injury from a fall and know what a life-changing event it can be. The most common serious injuries are fractures and brain injuries. Falls can also result in a loss of confidence, which can lead to restriction of activity and a lower quality of life. Many older people never regain their pre-fall level of function and might even struggle to keep living by themselves. The consequences of falls cost Australia a staggering <a href="https://www.aihw.gov.au/reports/injury/falls-in-older-australians-2019-20-hospitalisation/contents/about">$4.3 billion</a> every year. The good news is <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/full">20-30% of falls</a> among older Australians can be prevented. Why do we fall in older age? Falls happen when there is a mismatch between our physical abilities and the immediate demands of the environment or activity being undertaken. Falls become more common as we get older because as we age, there is a natural decline in muscle strength, balance and vision, all of which are important for helping us stay upright. The risk of falls is increased by certain medical conditions (such as Parkinson’s disease, dementia and stroke) and certain medications (such as sleeping tablets). But this doesn’t mean falls are inevitable. Exercise makes the most difference <a href="https://bjsm.bmj.com/content/54/15/885">Exercise</a> that aims to improve balance and leg strength is the most effective in preventing falls. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/462685/original/file-20220512-15-imz9uz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Older people doing yoga" /></a><figcaption>Exercise for strength and balance should be done often. Shutterstock</figcaption></figure> This means exercise that is carried out while standing (not while seated), with the feet positioned close together or while standing on one leg (if safe to do so), while performing controlled movement of the upper body (leaning and reaching movements, for example). Balance training combined with strength training for the major muscle groups is most effective. These exercises need to be tailored to individual abilities. Middle-aged people with good physical function will benefit from harder exercises (such as functional training at a gym or boot camp incorporating squats and step-ups). <a href="https://www.safeexerciseathome.org.au/">Effective exercises</a> for people with impaired physical function or frailty will follow the same principles but should be modified for safety and effectiveness. These include everyday activities such as standing up from a seated position without using arms for support, walking up and down stairs, walking in one line, stepping over obstacles or balancing on one leg. For lasting impacts, it’s important this type of exercise is done often. The <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">World Health Organization</a> recommends incorporating these exercises two to three times a week as part of the 150-300 minutes a week of moderate activity recommended for improving health. Not everyone enjoys exercising, which means some people struggle to prioritise it. It’s very important to know nobody is ever “too old” to start exercising, and benefits are gained at any age. But don’t hold off to start exercising either – the earlier we start to build our strength and balance, the better off we will be in our older years. Starting small and building up the amount and intensity of activity, and choosing something enjoyable, are the best ways to start. If you can’t reach a high dose of exercise initially, any amount is better than nothing. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=420&fit=crop&dpr=1 600w, https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=420&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=420&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=528&fit=crop&dpr=1 754w, https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=528&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/462622/original/file-20220512-12-qljf6d.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=528&fit=crop&dpr=3 2262w" alt="Woman sitting in chair. Woman pushing herself up with her legs. Woman standing." /></a><figcaption>Simple sit-to-stand exercises can improve strength and balance. Shutterstock</figcaption></figure> If you like exercising in a group, consider finding a local program and invite a friend along for added support and social connection. Your <a href="https://www.activeandhealthy.nsw.gov.au/">state government</a> or local council should have their classes listed online. If you’re not sure where to start, the best thing to do is to seek professional help to select exercises that suit your abilities and health conditions. Talk to your GP, local <a href="https://choose.physio/find-a-physio">physio</a> or <a href="https://www.essa.org.au/find-aep/">exercise physiologist</a>. What else can we do to prevent falls? In addition to exercise to improve balance and strength, other actions that can reduce the risk of falls include talking to your doctor or pharmacist to review your medications, seeing a podiatrist if you have painful feet, and maximising the safety of your home environment by installing adequate lighting and grab rails, and ensuring walkways are free from clutter and liquid spills. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/462669/original/file-20220512-20-arf332.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Man with his GP" /></a><figcaption>If you have had a fall or are worried about mobility, talk to your GP. Shutterstock</figcaption></figure> Falls are not inevitable as we age. We need investment in strategies to help older Australians stay active and independent, and avoid falls. Despite knowing what works to avoid them, we have no national policy or strategy to implement and fund fall prevention programs. Doing so would not only help older Australians, but the budget bottom-line too.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/182043/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anne-tiedemann-409380" target="_blank" rel="noopener">Anne Tiedemann</a>, Professor of Physical Activity and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841" target="_blank" rel="noopener">University of Sydney</a>; <a href="https://theconversation.com/profiles/cathie-sherrington-561141" target="_blank" rel="noopener">Cathie Sherrington</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841" target="_blank" rel="noopener">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kim-delbaere-667" target="_blank" rel="noopener">Kim Delbaere</a>, Senior Principal Research Scientist, <a href="https://theconversation.com/institutions/neuroscience-research-australia-976" target="_blank" rel="noopener">Neuroscience Research Australia</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-getting-older-how-can-i-prevent-falls-182043" target="_blank" rel="noopener">original article</a>. Image: Getty Images

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How to deal with mould outbreaks this winter

The recent downpour of rain mixed with humid temperatures has led to nation-wide mould outbreaks in many homes. Toxic mould can take a toll on your health, and hijack hidden corners of your home without you even realising. In order to reproduce, mould produces tiny particles called spores that are carried in the air and may cause health problems if inhaled by people who are sensitive or allergic to them, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/mould.aspx">NSW Health advises</a>. Experts have shared how to spot mould in your home, as well as how to clean it and prevent it from coming back. What exactly is mould? <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/mould.aspx">Mould</a> is a type of fungi, an organism from the same group that includes yeast and mushrooms, which is present virtually everywhere both indoors and outdoors. When airborne mould spores land on damp spots indoors, they may begin to grow and spread. Mould thrives in moist areas that are not adequately ventilated, with rooms such as laundries, bathrooms most at risk, as well as walls and ceilings that don’t receive direct sunlight. Wet weather, increased humidity, and flood damage have seen households across the country battling recent mould outbreaks in their homes. How do I stop mould from growing in my house? Experts say that prevention is much more effective than mould removal, with the key being to keep your home dry and dust-free. Fix any structural damage Leaks in roofs, full gutters and leaky appliances are all things that will bring mould into your home. Fixing these issues as soon as they arise is vital, as you want to aim to keep the main structure of your home free of any spontaneous leaks. “If you do notice any leaks, get on top of that immediately because dried mould can still become easily airborne,” consultation microbiologist Dr Cameron Jones told <a href="https://7news.com.au/lifestyle/health-wellbeing/mould-is-coming-back-with-a-vengeance-heres-how-to-tackle-the-outbreak-c-6840176">7News</a>. “That’s how people can become quite ill from mould which has dried inside roof voids and dried on insulation - and then it enters into the home around the perimeters and downlights.” Ventilation is key Keeping your home well ventilated is your best bet when preventing the growth of mould. Jones says that for good ventilation in the home, you can try, “opening windows, and making sure that ceiling fans in wet areas like laundries and bathrooms are on and working.” “As soon as the weather is good, you should start opening your windows and get some ventilation through,” Institute for Infectious Diseases Professor Dee Carter told 7News. “Drying things out is really key or it’ll just come back.” Some air conditioners have a handy dry mode, while portable dehumidifiers also work to draw in extra moisture from the air. Cut condensation Use extractor fans in the kitchen while cooking, and in the bathroom and laundry while washing. Reducing the condensation in your home can also be as simple as popping a lid on your saucepan when boiling water, and opening windows when you’re creating steam within the house. If you see condensation building on walls and inner windows, wipe it up before it has the chance to encourage growth of mould. Getting rid of mould For a routine clean-up of mould, NSW Health suggests using mild detergent or vinegar. Bleach can be used on non-porous surfaces such as tiles and in bathrooms but is not recommended for materials like wood or drywall. Mould has roots that it sends deep into porous materials, so antibacterial agents work best to attack the roots as well as the surface of the fungi. If you see a spot of mould in one particular place, it’s always best to do a clean sweep of the entire room to see if it is hiding anywhere else. Move all your furniture away from the wall and check hidden crevices. There’s nothing worse than thinking your cleaning job is done and then finding a huge mouldy patch behind your lounge or bed frame. In order to stop your furniture being attacked by pesky mould, try to keep your furniture an inch or two out from the wall. This will stop the mould transferring from walls to surfaces such as fabric that are harder to clean. Can mould be killed permanently? Even if you successfully get rid of mould in one area, you’ll need to maintain the conditions of your home continuously to discourage regrowth. “Mould can grow wherever there is moisture source, the correct temperature, and something to grow on,” Jones said. “Cellular debris and the food and liquid waste” are also used as a food source by “the pathogens, which are normally around us all the time”, Jones said. If mould grows in a spot once, it can grow there again. Is mould harmful to humans? A 2018 inquiry by the University of Melbourne recommended that the Department of Health undertake further research into the potential health effects of mould exposure and its prevalence in the built environment. <a href="https://www.mouldlab.com.au/">MouldLab</a> defined biotoxins at the time as including “toxic chemicals found on spores, fine or ultrafine fragments of mould or fungus … that are able to be released into the air”. They stated that some people are “genetically susceptible” and may develop inflammation and chronic illness after coming into contact with these biotoxins. Reported <a href="https://www.healthline.com/health/black-mold-exposure#symptoms">symptoms of mould exposure</a> include coughing, wheezing, stuffiness, red or itchy eyes, skin rashes, and a sore throat. These symptoms can be more severe if you have an allergy to mould. Image credits: Getty Images

Home & Garden

Doing these 9 things can cut your risk of dementia by 35 per cent – here’s why

Is dementia actually preventable? Forgetfulness might seem like an unavoidable part of ageing, but you aren’t destined to dementia. In fact, there’s actually a lot you can do to prevent dementia. A Lancet Commissions report from 24 leading dementia researchers says 35 per cent of dementia comes from preventable causes. Follow these steps and you could ward off a condition affecting about 47 million people worldwide. Keep learning Adults who don’t have at least a secondary school degree are at higher risk for developing dementia, according to the report. This could be because more education usually means a higher socioeconomic status, but it could have to do with learning itself. “Cognitive resilience in later life is likely to be enhanced by building brain reserve earlier in life through education and other intellectual stimulation,” write the study authors. Check your hearing After age 55, hearing loss is associated with higher risk of dementia. It’s probably not a cause – older adults are already at generally higher risk for both dementia and hearing loss – but fixing hearing could make cognitive loss easier. For one thing, dementia might be even more stressful for people who can’t hear. Plus, people might disengage socially when they have a hard time hearing, which could speed up any cognitive decline, say the researchers. Hearing loss is sometimes associated with Alzheimer’s as well, though generally, the causes of the two diseases are different. Get your blood pressure down Without a healthy heart, it could be hard for your body to balance out the harmful free radicals in your body. In turn, that could cause oxidative stress and inflammation, which could damage your neurons. Manage your diabetes Having diabetes raises the risk of dementia, though researchers aren’t sure why. The theory is that when you can’t control your blood sugar, more goes to your brain. In turn, that can cause damage that leads to loss of cognitive function. Lose some weight Obesity raises your risk of dementia – possibly because it puts you at risk for high blood pressure and type 2 diabetes. By keeping to a healthy weight, you can cut your risk for all three. Go for a walk This isn’t just about keeping at a healthy weight; a workout itself could cut down your risk. Older adults who exercise are less likely to develop dementia than those who don’t work out. Quit smoking If lung cancer wasn’t enough to make you kick your cigarette addiction, maybe this will: smokers are at higher risk of dementia. Researchers think that a couple things could be at play. For one thing, smoking isn’t healthy for your heart, and cardiovascular problems are linked with dementia. For another, the chemicals in the smoke could be toxic to your brain. What you put in your body has a huge impact on how it performs, especially later in life. Schedule a mental health visit There’s a link between depression and dementia, but researchers aren’t sure which causes the other. Depression might be an early sign in people who already have dementia, but it could also be a separate risk factor. Because depression affects stress hormones, brain neurons and the hippocampus (the part of the brain that deals with emotions and memory), it could increase dementia risk. Some antidepressants decrease the production of amyloid, which are proteins that can build up into plaque. Set up a coffee date Social isolation is associated with dementia. Like depression, though, researchers aren’t sure which one comes first. Either way, spending time with loved ones is a fun way to keep your brain active and raise your spirits – both of which can protect against cognitive decline. Expanding your social circle is another habit that reduces your risk of dementia. Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/doing-these-9-things-can-cut-your-risk-of-dementia-by-35-per-cent-heres-why" target="_blank" rel="noopener">Reader's Digest</a>.

Mind

6 warning signs of kidney stones – and what you can do to prevent them

Who develops kidney stones? Professor of urology, Dr Christopher Coogan, says about 10 to 15 per cent of the population will develop kidney stones in their lifetimes, small hard mineral deposits formed in the kidney that can be painful to pass, with white men ages 40 to 60 the most likely to have kidney stones. Those who already have had a kidney stone have a 50 per cent chance of developing another within 10 years. But how do you know if what you have is a kidney stone opposed to stomach or back pain? Sudden and severe pain Adults are often diagnosed with kidney stones after a trip to the emergency room or visit to their primary physician because of sudden severe abdominal and/or back pain they’ve been experiencing. This sudden and severe pain in the stomach and/or one side of the back is one of the classic symptoms of kidney stones. “Pain associated with kidney stones often comes on suddenly and is sometimes described as excruciating as the pain associated with labour,” says Dr Douglas Propp. Severe pain from which you can find no relief helps differentiate pain associated with kidney stones from a stomach ache or back strain. Pain associated with kidney stones can sometimes be confused with a backache because pain associated with kidney stones can start higher up in the back. As the stone moves closer to the bladder, the location of the pain can move lower. An important difference though: the back pain that accompanies kidney stones is unlike the pain of typical back strains because it is not associated with any movement. “One can usually figure out which side the kidney stone is on because the pain will typically, although not always, be on one side of the stomach versus the other,” says Dr Coogan. Kidney stones can range in size; Dr Coogan notes the average size of a kidney stone is 5 millimetres. However, the size of the stone doesn’t necessarily affect how much pain someone is in. Even a very tiny kidney stone can cause a “whole lot of hurt,” says Dr Coogan. Kidney stones can be so painful that they awaken people from sleep and prevent them from finding a standing, sitting, or lying down position that provides relief. “The pain can come on at any time and is severe, typically preventing the individual from finding a comfortable position, says Dr Propp. Blood in the urine Another possible warning sign of kidney stones is finding blood in one’s urine. Dr Coogan says this occurs in the majority of patients who have kidney stones. Blood in the urine is an abnormal condition and you should get evaluated if you notice this symptom. Other warning signs While sudden and severe stomach and/or back pain and blood in the urine can be key indicators of kidney stones, Dr Propp and Dr Coogan noted other warning signs that patients should look for: <ul> <li>Nausea</li> <li>Vomiting</li> <li>Perspiring</li> <li>Turning very pale because of the pain</li> <li>Certain types of kidney stones can also cause infections, which can lead to fevers.</li> </ul> “When the kidney gets obstructed, it can lead to fever because there can be back up of urine and that can lead to an infection,” says Dr Coogan. How kidney stones are diagnosed and treated Kidney stones can be diagnosed through X-ray, ultrasound, or CAT scan and are typically found after a person visits the emergency room or makes an appointment with their primary care physician because of the pain they’ve been experiencing. Dr Propp says most patients pass their kidney stones, leading to significant relief of their symptoms. But some kidney stones require surgery to remove them. Doctors sometimes prescribe medication to either manage the pain associated with kidney stones or to help the stone pass. “The smaller the stone is the more likely it is to pass on its own, not requiring surgery,” says Dr Coogan. How to prevent kidney stones Dr Coogan says one way people can prevent kidney stones from developing is to drink enough water, as dehydration is considered one of the main causes. Water helps to dilute the substances in urine that lead to kidney stones. You should also watch your sodium intake. A high-sodium diet can increase the amount of calcium in your urine. When calcium combines with oxalate or phosphorus, it creates kidney stones. Keep your sodium intake to no more than 2300 milligrams (mg) a day; if you’ve had kidney stones in the past, reduce that amount to 1500 mg. Limiting your animal protein can also help. Too much animal protein, such as red meat, poultry, eggs, and seafood, increases the amount of uric acid in your body. Uric acid is another kidney stone culprit. Written by Colette Harris. This article first appeared in <a href="https://www.readersdigest.com.au/healthsmart/6-warning-signs-of-kidney-stones-and-what-you-can-do-to-prevent-them" target="_blank" rel="noopener">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.com.au/c/readersdigestemailsubscribe?utm_source=over60&utm_medium=articles&utm_campaign=RDSUB&keycode=WRA87V" target="_blank" rel="noopener">here’s our best subscription offer.</a>

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6 warning signs of kidney stones – and what you can do to prevent them

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