Our Friday Song of the Week – Margaretaville
HHS Launches Brain Health Initiative (Video)
Smokers 45 Percent More Likely to Develop Dementia (Video)
Preventing Depression from Age-related Vision Loss
Depression is a common risk for people who have lost their vision from age-related macular degeneration (AMD), but a new study shows that a type of rehabilitation therapy can cut this risk in half. The study was funded by the National Eye Institute (NEI), part of the National Institutes of Health.
Activities that used to be fun and fulfilling may begin to seem burdensome or even impossible. With loss of the ability to drive and navigate unfamiliar places, it becomes easier to stay at home than to see friends or meet new people. All of this can take a toll on mental health, and past studies have found that as many as one-third of people with bilateral AMD develop clinical depression.
Barry Rovner, M.D., a professor of psychiatry and neurology at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia led the study.
“Behavior activation involves helping people to focus on activities they enjoy, to recognize that loss of those activities can lead to depression, and to re-engage in those activities,” said Robin Casten, Ph.D., a co-author and an associate professor of psychiatry and human behavior at Jefferson. Helping people maintain an active social life is an important part of the approach, she said.
They studied 188 participants, 84 years of age on average, 70 percent women, of which 50 percent lived alone. Each participant had mild depressive symptoms and was at risk for developing clinical depression.
During the trial, the participants had two visits with an optometrist, during which they were prescribed low-vision devices such as handheld magnifiers. After those initial visits, the participants were randomly split into two groups.
One group received behavior activation from an occupational therapist specially trained in the approach. The occupational therapist worked with participants to guide them on using the low-vision devices, to make changes around the home (such as using brighter lights and high-contrast tape), to increase their social activities, and to help them set personal goals and break these down into manageable steps.
The second group of participants served as a control group. They talked about their difficulties to a therapist, but did not receive behavior activation or low-vision occupational therapy.
By four months, 12 participants in the control group and seven participants in the behavior activation group had withdrawn from the trial or passed away. Of the remaining 169 participants, 18 (23.4 percent) in the control group and 11 (12.6 percent) in the behavior activation group developed clinical depression.
Behavior activation had the most benefit for participants with the worst vision, reducing the risk of depression by about 60 percent compared to controls.
“Stronger links between primary eye care and mental health care workers would be needed to make behavior activation more widely available for AMD patients,” Dr. Rovner said.
Our Friday Song of the Week – Satisfaction
Adults with extreme obesity have increased risks of dying at a young age from cancer and many other causes including heart disease, stroke, diabetes, and kidney and liver diseases, according to results of an analysis of data pooled from 20 large studies of people from three countries. The study, led by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, found that people with class III (or extreme) obesity had a dramatic reduction in life expectancy compared with people of normal weight.
“While once a relatively uncommon condition, the prevalence of class III, or extreme, obesity is on the rise. In the United States, for example, six percent of adults are now classified as extremely obese, which, for a person of average height, is more than 100 pounds over the recommended range for normal weight,” said Cari Kitahara, Ph.D., Division of Cancer Epidemiology and Genetics, NCI, and lead author of the study.
In the study, researchers classified participants according to their body mass index (BMI). BMI classifications are:
- Normal weight: 18.5-24.9
- Overweight: 25.0- 29.9
- Class I obesity: 30.0-34.9
- Class II obesity: 35.0-39.9
- Class III obesity: 40.0 or higher
The 20 studies that were analyzed included adults from the United States, Sweden and Australia. After excluding individuals who had ever smoked or had a history of certain diseases, the researchers evaluated the risk of premature death overall and the risk of premature death from specific causes in more than 9,500 individuals who were class III obese and 304,000 others who were classified as normal weight.
The researchers found that the risk of dying overall and from most major health causes rose continuously with increasing BMI within the class III obesity group. Deaths in the class III obesity group were mostly due to heart disease, cancer and diabetes. Years of life lost ranged from 6.5 years for participants with a BMI of 40-44.9 to 13.7 years for a BMI of 55-59.9.
Guns and the Elderly – Five Questions to Ask
Elderly Americans are the most likely to own a gun. Those aged 65 and older now have the highest rate of gun ownership in America and that presents both medical and legal problems for physicians and caregivers according to Dr. Ellen Pinholt writing in the Journal of the American Geriatrics Society.
Federal law prohibits mentally incompetent persons from possessing a gun; however, this only applies to a formal finding by a court and not necessarily to a physician’s diagnosis of dementia. Dr Pinholt suggests ‘5 L’s’, questions about gun ownership, which should be asked as routinely as questions about driving.
- If there is a gun present is it Locked?
- Is it Loaded?
- Are Little children present?
- Does the gun owner feel Low?
- Is the gun owner Learned?
Elderly people also have a high prevalence of depression and suicide. Dementia can add additional layers of risk. Geriatric professionals and home health providers have a unique and increasingly important role to play, but there are no national guidelines to aid providers in assessing gun safety.
Our Friday Song of the Week – Pink Cadillac