HUB's LIST of medical fun facts

“You know you’re getting old when you stoop to tie your shoelaces and wonder what else you could do while you’re down there.” George Burns

“Walk Like An Egyptian” . . . or Joe Biden
A column in the Boston Globe caught my attention because it described how I walk.  “Joe used to mock-jog onto the stage for political events . . .when he was 70. Now he moves with a stiff and cautious gait at 81”. His slow, smaller-stepped pace has generated questions about the rest of his nervous system (brain). His well publicized missteps on stairs have added grist to the conspiracy theory mill. The explanation for his current walk and moments of imbalance is all in his old legs, not his old brain. According to Dr. Kevin O,Conner, the President’s Physician, Joe’s spinal arthritis is causing some peripheral neuropathy in his feet. Peripheral neuropathy affects nerves outside the brain and outside the spinal cord, and is common in old people. At least half of cases have no identifiable cause (idiopathic). As the nerves age, the sense of position of the feet decreases, so that you become more cautious walking, particularly on uneven ground like lawns or when touring the Texas border. A cane can help with balance and add a bit of position sense that gives a clue as to “what the ground is like”. Whenever Joe is filmed walking on uneven ground he is concentrating straight ahead at full attention, just like I do.

Is It 150 hours a Week or 10,000 steps a day?
A bunch of health and wellness organizations agree with the U.S. government that a minimum of 150 minutes a week of moderate physical activity can lower your risk for chronic disease and heart attacks. Who says? The usual suspects of scientific experts who combed the literature for evidence of the health benefits of exercise. Dr. George Malik of Harvard admits that a goal of 150 minutes a week might look large for those over 60, so he suggests breaking it up into five 30 minute sessions on different days. It was music to my ears when he also said that yard work and household shores can count. But he lost me with the suggestion of joining a pickleball group. What about that magical number of 10,000 steps a day? You may have noticed that the step goal has been reduced to 7,000 based on a number of well done studies. It turns out that the 10,000 number came from the stylish Japanese number 10,000 that was the logo of the company making the fit bit. No data at all.

Is Testosterone Supplement Good or Bad for Men?
A  study of over 5,000 men from age 45 – 80 years old with low testosterone blood levels (under 300 – normal level is 350-750) showed that over the three-year study period the supplement did NOT improve erectile dysfunction, did NOT increase bone mass, did NOT significantly increase libido, and, even more importantly, did NOT increase the risk for prostate cancer, heart attack, or stroke. The only “bad” effect was a surprising, slight increase in bone fractures in the men receiving the supplement. The editorialists speculated that the supplement “might have led to behavior changes” that resulted in more fractures, but no particular kind or site of fracture gave a clue.

When Do Older Adults Fall?
          The short answer is during the first 3 minutes after they stand up. When older people stand up after some time sitting or lying down their blood pressure tends to drop, a process called orthostatic hypotension. This study of 700 people over 70 years of age and  living at home with normal blood pressure showed that 32% of them dropped their blood pressure in the first 3 minutes of standing up. Another 16% dropped their blood pressure during the second 3 minutes. During the 9 month follow-up 491 people had 425 falls. Many patients were taking hypertension medicine, or had diabetes, or were “pre-frail”.  One way to decrease the chance of that drop (both blood pressure and physical) is to flex and extend your feet energetically and bunch up your calf muscles before you stand up after sitting or lying down for some time. That returns the blood pooled in your legs up into the rest of you, including your brain.