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Can a daily multivitamin improve your memory?

<p><a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, <em><a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em><a href="https://theconversation.com/au/topics/research-check-25155">Research Checks</a> interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.</em></p> <hr /> <p>Don’t we all want to do what we can to reduce the impact of age-related decline on our memory?</p> <p>A new study suggests a daily multivitamin and mineral supplement is a simple and inexpensive way to help older adults slow the decline in some aspects of memory function.</p> <p>The <a href="https://ajcn.nutrition.org/article/S0002-9165(23)48904-6/fulltext">new study</a>, which comes from a <a href="https://www.clinicaltrials.gov/ct2/show/NCT02422745?term=NCT02422745&amp;draw=2&amp;rank=1">long-running clinical trial</a>, shows there may be a small benefit of taking a daily multivitamin and mineral supplement for one type of cognitive task (immediate word recall) among well-functioning elderly white people. At least in the short term.</p> <p>But that doesn’t mean we should all rush out and buy multivitamins. The results of the study don’t apply to the whole population, or to all types of memory function. Nor does the study show long-term benefits.</p> <h2>How was the study conducted?</h2> <p>The overarching COSMOS study is a well-designed double-blind randomised control trial. This means participants were randomly allocated to receive the intervention (a daily multivitamin and mineral supplement) or a placebo (dummy tablet), but neither the participants nor the researchers knew which one they were taking.</p> <p>This type of study is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654877/">gold standard</a> and allows researchers to compare various outcomes.</p> <p>Participants (3,562) were older than 64 for women, and 59 for men, with no history of heart attack, invasive cancer, stroke or serious illness. They couldn’t use multivitamins or minerals (or <a href="https://www.pnas.org/doi/10.1073/pnas.2216932120">cocoa extract</a> which they also tested) during the trial.</p> <p>Participants completed a <a href="https://www.clinicaltrials.gov/ct2/show/NCT04582617?term=NCT04582617&amp;draw=2&amp;rank=1">battery of online cognitive tests</a> at the start of the study (known as baseline), then yearly for three years, of which only three were reported in this paper:</p> <ul> <li> <p>ModRey, measuring immediate recall. Participants were shown “a list of 20 words, one at a time, for three seconds each,” and then had to type the list from memory</p> </li> <li> <p>ModBent, measuring object recognition. Participants were given 20 prompts with a shape and then had to select the correct match from a pair of similar prompts. After this, they were prompted with 40 shapes in turn, and had to indicate whether each was included in the original 20 or not</p> </li> <li> <p>Flanker, measuring “executive control”. Participants had to select a coloured block that corresponded to an arrow in a matrix of arrows, which could have the same (or different) colour to the surrounding arrows, and the same (or different) direction as the prompt block.</p> </li> </ul> <h2>What did the researchers find?</h2> <p>Of all the tests the researchers performed, only immediate recall (ModRey) at one year showed a significant effect, meaning the result is unlikely to just be a result of chance.</p> <p>At two and three years, the effect was no longer significant (meaning it could be down to chance).</p> <p>However they added an “overall estimate” by averaging the results from all three years to arrive at another significant effect.</p> <p>All the effect sizes reported are very small. The largest effect is for the participants’ immediate recall at one year, which was 0.07 – a value that is <a href="https://academic.oup.com/jpepsy/article/34/9/917/939415">generally considered very small without justification</a>.</p> <p>Also of note is that both the multivitamin and placebo groups had higher immediate word recall scores at one year (compared to baseline), although the multivitamin group’s increase was significantly larger.</p> <p><a href="https://www.pnas.org/doi/epdf/10.1073/pnas.2216932120">In the researchers’ prior study</a>, the increase in word recall scores was described as a “typical learning (practice) effect”. This means they attributed the higher scores at one year to familiarisation with the test.</p> <p>For some reason, this “learning effect” was not discussed in the current paper, where the treatment group showed a significantly larger increase compared to those who were given the placebo.</p> <h2>What are the limitations of the study?</h2> <p>The team used a suitable statistical analysis. However, it did not adjust for demographic characteristics such as age, gender, race, and level of education.</p> <p>The authors detail their study’s major limitation well: it is not very generalisable, as it used “mostly white participants” who had to be very computer literate, and, one could argue, would be quite well-functioning cognitively.</p> <figure class="align-center "><figcaption></figcaption>Another unmentioned limitation is the advanced age of their sample, meaning long-term results for younger people can’t be assessed.</figure> <p>Additionally, the baseline diet score for their sample was abysmal. The researchers say participants’ diet scores “were consistent with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1899558">averages from the US population</a>” but the cited study noted “the overall dietary quality… [was] poor.”</p> <p>And they didn’t measure changes in diet over the three years, which could impact the results.</p> <h2>How should we interpret the results?</h2> <p>The poor dietary quality of the sample raises the question: can a better diet be the simple fix, rather than multivitamin and mineral supplements?</p> <p>Even for the effect they observed, which micronutrient from the supplement was the contributing factor?</p> <p>The researchers speculate about vitamins B12 and D. But you can find research on cognitive function for any arbitrarily chosen <a href="https://www.centrum.com/content/dam/cf-consumer-healthcare/bp-wellness-centrum/en_US/pdf/lbl-00000775-web-ready-centrum-silver-adults-tablets-(versio.pdf">ingredient</a>, including <a href="https://scholar.google.com/scholar?hl=en&amp;as_sdt=0%2C5&amp;q=selenium+cognitive+function">selenium</a>, which can be <a href="https://www.sciencedirect.com/science/article/pii/S0048969720378608">toxic at high levels</a>.</p> <h2>So should I take a multivitamin?</h2> <p><a href="https://newsinhealth.nih.gov/2013/08/should-you-take-dietary-supplements">Health authorities advise</a> daily multivitamin use isn’t necessary, as you can get all the nutrients you need by eating a wide variety of healthy foods. However, supplementation may be appropriate to meet any specific nutrient gaps an individual has.</p> <p>Using a good quality multivitamin at the recommended dose shouldn’t do any harm, but at best, this study shows well-functioning elderly white people might show some additional benefit in one type of cognitive task from using a multivitamin supplement.</p> <p>The case for most of the rest of the population, and the long-term benefit for younger people, can’t be made.</p> <hr /> <h2>Blind peer review</h2> <p><strong>Clare Collins writes:</strong></p> <p>I agree with the reviewer’s assessment, which is a comprehensive critique of the study. The key result was a small effect size from taking a daily multivitamin and mineral (or “multinutrient”) supplement on memory recall at one year (but not later time points) and is equivalent to a training effect where you get better at taking a test the more times you do it.</p> <p>It’s also worth noting the study authors received support and funding from commercial companies to undertake the study.</p> <p>While the study authors state they don’t believe background diet quality impacted the results, they didn’t comprehensively assess this. They used a brief <a href="https://pubmed.ncbi.nlm.nih.gov/22513989/">diet quality assessment score</a> only at baseline. Participants may have changed their eating habits during the study, which could then impact the results.</p> <p>Given all participants reported low diet quality scores, an important question is whether giving participants the knowledge, skills and resources to eat more healthily would have a bigger impact on cognition than taking supplements. <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/208114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em>Image credit: Shutterstock</em></p> <p><em><a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, Senior Research Fellow, Biostatistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>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/can-a-daily-multivitamin-improve-your-memory-208114">original article</a>.</em></p>

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What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</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>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p>If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months).</p> <p>There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles.</p> <p>We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>.</p> <p>But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again.</p> <h2>People are often given the wrong advice</h2> <p>People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis.</p> <p>But these findings are very common in people <em>without</em> low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain.</p> <p>Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain.</p> <p>In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress.</p> <p>It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves.</p> <h2>So how should low back pain be treated?</h2> <p>A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety.</p> <p>Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language.</p> <p>They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities.</p> <p>An example of this type of care is cognitive functional therapy.</p> <h2>What is cognitive functional therapy?</h2> <p><a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out.</p> <p>The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it.</p> <p>It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>.</p> <p>Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required.</p> <h2>What’s the evidence for this type of therapy?</h2> <p>Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments.</p> <p>We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”.</p> <p>We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care.</p> <p>The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>.</p> <p>People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group.</p> <p>The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work.</p> <h2>What does this mean for you?</h2> <p>This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success.</p> <p><a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up.</p> <p>The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <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/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</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>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>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-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.</em></p>

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3 ways your brain changes with ageing

<p dir="ltr">Your entire body changes when you age, including your brain, which is responsible for everything. Regardless of your physical or neurological health, there is such a thing as “cognitive ageing.” It happens to the best of us!</p> <p dir="ltr">So, what are these changes? </p> <p dir="ltr" role="presentation"><strong>1. Processing speed</strong></p> <p dir="ltr">This refers to how quickly the brain can process information and provide a response. Processing speed affects almost every function in the brain, and it’s measured by how quickly you can manage a mental task. </p> <p dir="ltr">How it changes with ageing: </p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">It decreases over time.</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">The decrease starts in early adulthood, so by the time you reach your 70s and 80s, your processing speed is significantly down compared to the speed you once had in your 20s. </p> </li> </ul> <p dir="ltr"><strong>2. Memory</strong></p> <p dir="ltr">Memory is complex, and there’s different kinds of memory, but these are the functions that you’ll notice changes in as you age:</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Working memory, the ability to hold information and manipulate it mentally, declines </p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Episodic memory, the ability to remember personally experienced events at a certain plane or time, declines </p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Prospective memory, the ability to remember to do things in the future, declines</p> </li> </ul> <p dir="ltr"><strong>3. Attention</strong></p> <p dir="ltr">The ability to concentrate and focus on something specific so that information can be mentally processed changes. </p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Selective attention, the ability to focus on something specific despite distractions or irrelevant stimuli, declines</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Divided attention, also known as “multi-tasking”, declines</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Sustained attention, the ability to remain concentrated on one task for an extended period of time, declines</p> </li> </ul> <p dir="ltr"><strong>Can anything be done?</strong></p> <p dir="ltr">Unfortunately, there is no way to combat cognitive ageing, but there are things you can do to keep your brain healthy, which in turn will help keep you sharp.</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Adequate sleep</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Proper nutrition</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Stimulate your brain with crosswords, sudoku or brain training apps </p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Speak to people every day</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Read more</p> </li> </ul> <p dir="ltr">The longer you wait to help keep your brain healthy, the harder it becomes for your brain to remember things. </p> <p dir="ltr"><em>Image credit: Shutterstock</em></p>

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Man accused of stealing $16,000 from wedding functions

<p dir="ltr">A man has been accused of allegedly gatecrashing eight weddings and stealing a total of $16,000 and other gifts. </p> <p dir="ltr">The 24-year-old Melbourne man pretended to be a wedding guest at eight events from between April 2 and May 22.</p> <p dir="ltr">He allegedly stole $16,000 cash, jewellery and gift cards from at least three of the events.</p> <p dir="ltr">Bride Kellee Pace said she felt violated when she found out that the man had allegedly stolen some of her and her husband’s gifts and even wrote in their guest book.</p> <p dir="ltr">"It was the best wedding he'd apparently ever attended and he was feeling awesome and lucky on the night, three quarters of our wishing well was missing," she told Nine News.</p> <p dir="ltr">"We definitely felt really violated, we were mingling with people and he was downstairs drinking in the bar and we had no idea he was even there."</p> <p dir="ltr">The wedding industry shared his photo around before he was spotted at a Macedonian wedding by wedding planner Jasmine Arapovic.</p> <p dir="ltr">"My dad then put him in a bit of a headlock to make sure he didn't try and escape before I could have a chat with the venue manager to get them to put him in a room."</p> <p dir="ltr">Police arrested the man and he was slapped with 27 charges, including aggravated burglary, burglary, theft and going equipped to steal.</p> <p dir="ltr">Police will allege they found jewellery and gift cards when they searched a property on Tuesday.</p> <p dir="ltr">He has been granted bail and will appear before Melbourne Magistrates' Court on October 18.</p> <p dir="ltr"><em>Images: Nine News</em></p>

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Vitamin C deficiency linked to cognitive impairment

<p dir="ltr">A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain.</p> <p dir="ltr">Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult.</p> <p dir="ltr">The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre.</p> <p dir="ltr">From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy.</p> <p dir="ltr">“Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>.</p> <p dir="ltr">The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment.</p> <p dir="ltr">They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions.</p> <p dir="ltr">“It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said.</p> <p dir="ltr">“Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.”</p> <p dir="ltr">With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment.</p> <p dir="ltr">The study was published in the journal <em><a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a></em>.</p> <p><span id="docs-internal-guid-2ab5757b-7fff-e419-e985-eb63d06eb2d3"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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Air pollution may impair cognitive function

<div class="copy"> <p>A joint China-US research team has found that exposure to even short-term air pollution may impair cognitive function.</p> <p>Air pollution is a growing cause of sickness and death globally, with a <a href="https://cosmosmagazine.com/climate/air-pollution-pandemic-warning/" target="_blank" rel="noreferrer noopener">recent study</a> estimating that it caused an extra 8.8 million premature deaths in 2015, surpassing the 7.2 million caused by tobacco smoking. It has well-established effects on the lungs and the heart – it has been linked with spikes in <a href="http://jaha.ahajournals.org/content/5/5/e002742" target="_blank" rel="noreferrer noopener">heart attacks, strokes</a> and <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180522" target="_blank" rel="noreferrer noopener">asthma</a>, and is a carcinogen known to cause lung cancer.</p> <p>Increasingly, research is also associating air pollution with other health impacts including <a href="https://cosmosmagazine.com/biology/kidney-disease-linked-to-air-pollution/" target="_blank" rel="noreferrer noopener">kidney disease</a>, <a href="https://cosmosmagazine.com/climate/could-air-pollution-contribute-to-psychiatric-illness/" target="_blank" rel="noreferrer noopener">psychiatric illness</a> and <a href="https://cosmosmagazine.com/biology/air-pollution-link-to-alzheimer-s-mooted/" target="_blank" rel="noreferrer noopener">Alzheimer’s</a>.</p> <p><strong>What causes air pollution?</strong></p> <ul> <li>Air pollution is the release of pollutants into the air that have detrimental effects on human or planetary health.</li> <li>It can have natural sources, such as desert dust or bushfire smoke, but is increasingly created by humans, primarily from burning fossil fuels.</li> <li>There are two main types: smog occurs when emissions from burning fossil fuels react with sunlight, while soot is made up of tiny particles made up of smoke, soil, dust, allergens or chemicals. Anything that combusts fossil fuels can cause this, including vehicle exhaust, power plants, incinerators and more.</li> </ul> <p>Now, in a new study <a href="https://doi.org/10.1038/s43587-021-00060-4" target="_blank" rel="noreferrer noopener">published</a> in the journal <em>Nature Ageing</em>, researchers have linked poor air quality with decreased brain health.</p> <p>The team studied a sample of 954 Caucasian males (with an average age of 70) from the Boston area in the US, who were participants in the Veterans Affairs Normative Aging Study. Their cognitive function was measured by a series of assessments to test their attention, learning and memory, as well as an screening to help detect early signs of dementia.</p> <p>This was compared to the average levels of fine particulate matter (PM2.5, smaller than 2.5 micrometres in size) in the area, both on the day of each test and in the 28 days prior. The team found the participants tended to score lower when levels of PM2.5 were higher in the month before the tests – even when levels were still below what is considered as “hazardous”.</p> <p>“The findings were quite startling,” write cognitive health researchers Joanne Ryan and Alice J. Owen, in an <a href="https://dx.doi.org/10.1038/s43587-021-00062-2" target="_blank" rel="noreferrer noopener">accompanying article</a>. “Even relatively small increases in the levels of PM2.5 in the 3–4 weeks prior to testing were associated with consistently worse cognitive performance.”</p> <p>Ryan and Owen, both from Monash University in Australia and both not involved in the study, point out that Boston “has by no means the worst air quality in the USA or the world, and yet significant detrimental effects of air pollution on cognitive function were observed”.</p> <p>While a decline in brain function in older adults is common, it can be exacerbated – and accelerated – by environmental factors. Evidence is <a href="https://doi.org/10.3233/jad-180631" target="_blank" rel="noreferrer noopener">mounting</a> that air pollution could be a risk factor for dementia and could, over the long term, be <a href="https://dx.doi.org/10.1016%2Fj.neuro.2016.06.004" target="_blank" rel="noreferrer noopener">associated</a> with cognitive declines.</p> <p>“The results of the current study are especially important because they provide some of the first evidence that even relatively low-level, short-term increases in PM2.5 are detrimental for thinking and memory, as well as global cognition in older adults,” Ryan and Owen write.</p> <p>The results may point to a general trend in the larger population, given that air pollution <a href="https://www.unicef.org/environment/files/Danger_in_the_Air.pdf" target="_blank" rel="noreferrer noopener">affects brain development</a> in kids, and women seem to be <a href="https://doi.org/10.1289/ehp.0900994" target="_blank" rel="noreferrer noopener">more strongly affected</a> than men.</p> <p>Interestingly, the researchers also found that the participants who were prescribed NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin) were less adversely affected. This may be because the health impacts of air pollution tend to involve activating the body’s inflammatory response. But caution is warranted; there may be many other differences between participants who do and don’t use NSAIDs.</p> <p>This study also had a relatively small sample size and focused on a certain geographical area, so further research is needed to solidify the link between air pollution and cognitive function.</p> <p>However, Ryan and Owen emphasise the importance of the results.</p> <p>“The implications for public health, and consequent health, societal and economic costs of air pollution, are immense,” they write. “This should be a further wake-up call about the urgent need for action.</p> <p>“It has been estimated that 90% of the world’s population breathe polluted air. Breathing clean air is fundamental to our health but represents a global challenge and one of substantial inequity, disproportionally affecting the most vulnerable.”</p> <p><em>Image credits: Getty Images</em></p> <p><em><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=149918&amp;title=Air+pollution+may+impair+cognitive+function" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/air-pollution-may-impair-cognitive-function/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Lauren Fuge. </em></p> </div>

Mind

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4 signs your loved one could have high-functioning depression

<p><strong>1. They decline social invitations</strong></p> <p><span style="font-weight: 400;">High-functioning depression looks a lot like chronic low-level depression and can last around five years in adults or one to two years in children and teens, according to the Harvard School of Public Health. And while it may not leave a person devastated and hopeless, high-functioning depression can seriously dent your quality of life, dampening your enthusiasm for work, school, family and even social activities. A change in social activities can be one of the earliest warning signs.</span></p> <p><span style="font-weight: 400;">“People with high-functioning depression still go to work and interact with people, but outside of work, they may stop hanging out with friends, and make excuses like ‘work’s been really stressful,’” says psychiatrist Dr Jason Stamper. “They will be somewhat isolative, and this often translates into distance in relationships.”</span></p> <p><span style="font-weight: 400;">Learn </span><a href="https://www.readersdigest.com.au/healthsmart/tips/12-simple-ways-to-make-friends-as-an-adult"><span style="font-weight: 400;">these simple ways to make friends as an adult</span></a><span style="font-weight: 400;">.</span></p> <p><strong>2. They have other health issues</strong></p> <p><span style="font-weight: 400;">This is a two-way street. On one hand, underlying medical conditions can prompt depression. “Co-occurring medical conditions, like diabetes or cancer, cause stress and strain that can lead to depression,” says professor psychiatry Dr Michelle Riba. On the other hand, depression can lower immunity, making you more vulnerable to getting sick.</span></p> <p><strong>3. They’re sleeping differently</strong></p> <p><span style="font-weight: 400;">Whether you can’t nod off as easily, you’re snoozing more than usual, or you’re tossing and turning, sleep problems can warn of possible depression – and it can make your symptoms dramatically worse. “Good sleep is key to good mental health,” says Dr Carol Landau, a clinical professor of psychiatry at Brown University.</span></p> <p><span style="font-weight: 400;">Here are </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/thyroid/9-silent-signs-thyroid-problem-you-may-be-ignoring"><span style="font-weight: 400;">the medical reasons you’re tired all the time</span></a><span style="font-weight: 400;">.</span></p> <p><strong>4. They’re worried or anxious</strong></p> <p><span style="font-weight: 400;">We’re so quick to equate depression with sadness that we tend to overlook another strongly-linked emotion: anxiety. It’s important to also note that anxiety isn’t limited to fear; it can manifest itself in multiple ways, according to Dr Stamper. You might experience mental restlessness, confusion and that feeling of having a “pit in your stomach.”</span></p> <p><span style="font-weight: 400;">Try sharing these </span><a href="https://www.readersdigest.com.au/thought-provokinginspirational/14-magic-phrases-to-instantly-calm-your-anxiety"><span style="font-weight: 400;">14 magic phrases to instantly calm anxiety</span></a><span style="font-weight: 400;">.</span></p> <p><em><span style="font-weight: 400;">Written by Brook Bolen. This article first appeared in <a href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/signs-your-loved-one-could-have-high-functioning-depression">Reader’s Digest</a>. Find more of what you love from the world’s best-loved magazine, <a href="https://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA93V">here’s our best subscription offer</a>.</span></em></p>

Mind

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Sufferers of high-functioning depression could have these four symptoms

<p><strong>1. They may be relying more on vices of choice</strong></p> <p><span style="font-weight: 400;">That might mean drinking more alcohol than usual, taking drugs, eating more ice cream, or playing more video games – whatever behaviour serves as an emotional crutch. “If you’re feeling sad or lonely or otherwise ‘off,’ you may drink more wine more often to cover it up,” Dr Landau says. “This kind of self-medicating is especially troubling because substance abuse adds an extra layer of care that you need.” In addition to being addictive, drugs and alcohol especially can exacerbate symptoms of depression, anxiety and sleep problems, further hindering people’s abilities to cope.</span></p> <p><span style="font-weight: 400;">Watch out for </span><a href="https://www.readersdigest.com.au/culture/8-silent-signs-stress-is-making-you-sick"><span style="font-weight: 400;">these 8 signs stress is making you sick</span></a><span style="font-weight: 400;">.</span></p> <p><strong>2. They’re a successful, Type A personality</strong></p> <p><span style="font-weight: 400;">Affluent, educated people are, surprisingly, more likely to have high-functioning depression.” The paradox of high-functioning depression is that these are very often people who are educated and have important jobs,” Dr Stamper says. “They have the benefit of education and status, yet often their careers can be huge stressors.” Dr Landau says she works mostly with women whose lives and list of personal accomplishments is long and impressive. “In some ways, you’re better off as a low-functioning person,” she says, “because high-functioning people often don’t allow themselves to have all the necessary support.”</span></p> <p><span style="font-weight: 400;">Consider suggesting </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/10-habits-people-who-never-get-stressed"><span style="font-weight: 400;">these 10 habits of people who never get stressed.</span></a><span style="font-weight: 400;">.</span></p> <p><strong>3. They’re pretty grouchy</strong></p> <p><span style="font-weight: 400;">Irritability is another common symptom of high-functioning depression, and it’s especially problematic for women, according to Dr Landeau. “People are more likely to see an irritable woman as a ‘bitch,’ rather than showing concern, like, ‘Hey, you don’t seem the same lately. Are you okay?” she says. Because women are conditioned at an early age to be less assertive and to suppress “troublesome” emotions like anger, more subtle symptoms like irritability can be missed. Consider that some one in four women have been, or will be, depressed at least once in their lives, according to Landau, and irritability may be the chief sign.</span></p> <p><span style="font-weight: 400;">These </span><a href="https://www.readersdigest.com.au/healthsmart/conditions/mental-health/16-science-backed-ways-to-overcome-depression-naturally/"><span style="font-weight: 400;">science-backed ways to overcome depression naturally</span></a><span style="font-weight: 400;"> are worth sharing.</span></p> <p><strong>4. There is a family history</strong></p> <p><span style="font-weight: 400;">Experts agree that knowing your family’s history is essential for predicting and diagnosing depression. Studies show that the more relatives you have who have been diagnosed with mood disorders or drug or alcohol dependence, the more likely it is that you will too. “Knowing your genetics and family history can be enormously helpful,” says Dr Riba. Life changes and stress can trigger your biological predisposition to depression, so knowing your history can help you not only predict, but shape, your future.</span></p> <p><em><span style="font-weight: 400;">Written by Brook Bolen. This article first appeared in </span><a href="https://www.readersdigest.co.nz/healthsmart/conditions/mental-health/signs-your-loved-one-could-have-high-functioning-depression"><span style="font-weight: 400;">Reader’s Digest</span></a><span style="font-weight: 400;">. Find more of what you love from the world’s best-loved magazine, </span><a href="https://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA93V"><span style="font-weight: 400;">here’s our best subscription offer</span></a><span style="font-weight: 400;">.</span></em></p>

Mind

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7 silent signs of high-functioning anxiety

<p><strong>What is high-functioning anxiety?</strong><br />When we talk about people with high-functioning anxiety, we are talking about people who, at least on the surface, seem successful at school, work, or home, explains clinical psychologist Dr Inna Khazan. On the inside, however, they are experiencing a near-constant state of anxiety. “People with high-functioning anxiety push themselves to get things done, with anxiety constantly holding a ‘stick’ over their heads,” she says. “Fear of what might happen if they don’t move forward keeps them moving forward. And because these people are often high-achieving, no one thinks that there is anything ‘wrong’ with them.”</p> <p><strong>You worry excessively</strong><br />It’s normal to ruminate over things and have brief periods of worry. But if this is the mental state you experience 15-plus days a month for six months or more, you have an anxiety disorder, says psychotherapist Annie Wright. Specifically, this could signal generalised anxiety disorder. Wright explains that such worries can run the gamut from your love life to your retirement savings. “And, often, the amount and intensity of the worry you have are likely disproportionate to the event itself. In other words, everything feels like a really big deal when perhaps it isn’t.”</p> <p><strong>You can’t control your anxiety (but nobody realises this)</strong><br />Even if you know all the calming tricks – deep breaths, magic phrases to clam yourself down, jotting down your thoughts – you still live with your worries on a daily basis. Despite your self-care practices, your anxiety may still get the better of you because you simply cannot control it, says Wright. And while you’re aware of these feelings, chances are, others might not be. “People who experience it do not look like what we expect a highly anxious person to look like – frozen, unable to make decisions, failing to get things done,” she says. “Also, people with high-functioning anxiety rarely allow themselves to ask for help or admit that there is anything wrong.”</p> <p><strong>Nothing is ever good enough</strong><br />People who have anxiety disorders often feel a constant pressure to perform at top-notch standards across all areas of life. But after a while, this can wear on you. Generally, a person who we might classify as having high-functioning anxiety is ambitious, perfectionistic, and set in their way of doing things,” says Khazan. Interestingly, she explains that anxiety is often about feeling unsafe. “These structured rituals and certain ways of doing things provide people with high-functioning anxiety with a sense of safety,” Khazan says. “They may become quite upset if they are knocked out of their routine because the lack of familiar structure feels overwhelmingly unsafe.”</p> <p><strong>Your anxiety is interfering with your daily life</strong><br />You may be aware that it’s becoming harder to feel secure and competent at work and in your relationships with partners, relatives, and friends, says Wright. In other words, you appear calm and in control on the surface, but it’s a different story on the inside. As Wright puts it, “inwardly, you’re living out a high-drama movie each day and it’s starting to wear on your quality of life.”</p> <p><strong>You can’t sleep</strong><br />It’s not uncommon to have trouble falling or staying asleep, or to have a restless sleep. “You may rely on a glass or two of wine or paracetamol to mask it temporarily, but basically, you have sleep issues,” warns Wright. In addition, because your nervous system is in overdrive, you may also have a heightened startle response. This means you may jump or startle easily, such as when ambulance sirens go off or a door slams shut. Neither paracetamol nor wine are long-term solutions and may even worsen your sleep issues. Some people find taking melatonin helps with their nighttime anxiety, but ultimately you should talk to a medical professional about solutions for the long haul.</p> <p><strong>You can’t concentrate</strong><br />Concentration issues go hand-in-hand with anxiety, says Wright. For example, it may be hard to focus at work or you may have to re-read a page of a book several times because your mind wandered. Instead of concentrating on what’s happening in front of you right now, you may find yourself worrying about the future. Or, you might feel as though your mind is blank.</p> <p><strong>You’re irritable and tense</strong><br />Living with anxiety means living with a low capacity for stressors, says Wright. In other words, you sweat the small stuff, your patience is thin, and you feel grumpy. But it’s not just your mind that’s tense; many people with anxiety disorders experience tightness, constricting, and general tension in their muscles. “If you’re emotionally and mentally wound up in knots, your body is likely holding onto the tension, leading to a general feeling of physical tightness,” explains Wright.</p> <p><strong>How to get help</strong><br />Make sure you do indeed take care of yourself. “People often think they are fine because they get praise and approval from others about their leadership or accomplishments,” explains marriage and family therapist. “But ignoring it can cause burnout and increase your risk of physical health issues, sleep problems, relationship problems, anger, irritability, depression.” Individual or group therapy, along with medication, can help treat anxiety. You’ll learn to replace worrisome thoughts and behaviours with more beneficial coping strategies. Therefore, you’ll start to feel comfortable about things that previously left you anxious, she explains.</p> <div class="share-buttons"> <div class="addthis_inline_share_toolbox" data-url="https://www.readersdigest.com.au/healthsmart/7-silent-signs-of-high-functioning-anxiety" data-title="7 silent signs of high-functioning anxiety | Reader's Digest Australia" data-description="Your anxiety may be affecting your life – and your general health – more than you realise. Here are the warning signs."> <div id="atstbx" class="at-resp-share-element at-style-responsive at-mobile addthis-smartlayers addthis-animated at4-show" aria-labelledby="at-2c7a604c-a5b4-4c9a-99ad-f2b49444aed8"><em>Written by Claire Gillespie. This article first appeared on <a href="https://www.readersdigest.co.nz/healthsmart/7-silent-signs-of-high-functioning-anxiety">Reader’s Digest.</a> For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.co.nz/subscribe"><span class="s1">here’s our best subscription offer</span></a>.</em></div> </div> </div>

Mind

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Could cochlear implants improve your cognitive function?

<p>Cochlear implants could be associated with improved speech perception and cognitive function in adults with profound hearing loss who are 65 years or older. Here is a comprehensive break-down of the associated options.</p> <p><strong>What is a cochlear implant?</strong></p> <p>It is a small electronic hearing device that provides a sense of sound to profoundly deaf patients by electronically stimulating the hearing nerve and bypassing damaged parts of the inner ear. It has both internal and external parts. The complex technology essentially emulates the function of an ear to receive, process and transmit sound waves.</p> <p>The external part of a cochlear implant is placed just above the ear and involves a microphone and sound processor, which selects and arranges sound. While the transmitter converts the signals from the processor and converts them into electric impulses. The impulses are sent to the internal part of the implant, which is put in place surgically under general anaesthesia. This internal part involves a receiver and magnet under the skin behind the ear and a series of electrodes placed in the cochlear. The electrodes collect the impulses and send them to different regions of the auditory nerve.</p> <p>A cochlear implant for someone who is considered deaf is a useful representation of sound in the environment and helps them to understand speech. It bypasses the damaged portions of the ear and directly stimulates the auditory nerve. Although it takes some time to learn or relearn, hearing by a cochlear implant allows the user to recognise warning signals, understand environmental noises and even have conversations.</p> <p><strong>Who needs them?</strong></p> <p>Cochlear implants are useful for children or adults who are deaf or severely hard-of-hearing. Many children who are deaf at birth receive cochlear implants from 12 months of age. However, adults who lose hearing later in life also frequently use the devices. These individuals are then able to associate the provided signals with sounds they remember, negating the need to learn lip-reading or sign language.</p> <p>People over the age of 65 years are three times more likely to have hearing loss than younger adults. This is largely due to the damage we expose our ears to on a day-to-day basis. Loud or excessive noise damages the hair cells in the cochlear, which unfortunately don’t regrow. As well as gradual hearing loss, many people may also have incidents that cause them to suddenly lose their hearing, meaning they will also require the assistance of these devices.</p> <p><strong>Implantation</strong></p> <p>Use of a cochlear implant requires both a surgical procedure and significant therapy. Cochlear implantations are almost always safe, however, as with all surgical procedures there is always a small risk. Cochlear implants are quite costly, and the learning process is quite lengthy, however, the benefits are considered to be usually worthwhile.</p> <p><strong>Cochlear implant or hearing aid?</strong></p> <p>Hearing aids simply amplify sounds and can be easily fitted on the external part of the ear, requiring no surgical procedure. There are a variety of hearing aids available, which generally consist of a microphone, amplifier, miniature loudspeaker and battery. Hearing aids pick up and amplify surrounding sounds and help to make speech more intelligible. People with profound hearing loss or residual low frequency hearing will likely receive no benefit from hearing aids and will be considered for a cochlear implant.</p> <p><strong>Costs</strong></p> <p>Cochlear implants are an expensive piece of technology, possible adding up to around $40,000. Depending on your state Department of Health, funding is usually provided for a limited number of cochlear implants per year. Most private health fund cover the costs of the implant and hospital expenses and holders of Gold Veteran Affairs cards are usually fully covered.</p> <p>As well as financial costs, time costs must also be taken in to consideration. The assessment period usually takes three months, and then there is usually a few week’s wait for surgery. After surgery, the MAP (the programming for the cochlear implant) will need to be adjusted to the needs of its user.</p> <p><strong>Benefits</strong></p> <p>Several studies have shown benefits. One that adult cochlear implant patients allow a more marked improvement physically, psychologically and socially than hearing aid patients. This means that cochlear implants can bring as much benefit to those with profound hearing loss as hearing aids bring to those with less severe hearing loss. Another found that cochlear implants vastly improve the quality of life of deaf patients over 50. Cochlear implants are found to be a cost-effective solution in this age group, due to their increase in health and emotional-related quality of life. Increases in speech perception scores showed a strong correlation with magnitude of health utility gains.</p> <p>More recent research which was published online by JAMA Otolaryngology - Head and Neck Surgery. This research indicates that cochlear implantation is positively associated with improved cognitive function and speech perception in adults 65 years and older with profound hearing loss. Hearing impairment correlates strongly with cognitive decline, and in cases where hearing aids are not sufficient, cochlear implantation is seen to be highly beneficial for older patients.</p> <p>This study also showed that cochlear implants not only improve speech perception – in both quiet and noise – however, they can also improve quality of life and show less incidence of depression. More than 80% of the 94 patients in the study with impaired cognitive function improved their brain function scores one year after implantation.</p> <p><strong>Who to see</strong></p> <p>If you have suddenly or gradually become profoundly hard-of-hearing, it is important to seek professional medical advice immediately. Help is available and seeking advice early could increase your quality of life.</p> <p>Options are to either visit an otolaryngologist, a doctor specialising in the diagnosis of ear, nose and throat diseases; an audiologist, who has specialised training in identifying and measuring the type and degree of hearing loss and recommends option; or a hearing aid specialist, who conducts and evaluate basic tests and offers counselling. Because cochlear implantation is for more serious hearing loss, you will need to see a specialist and then be referred to receive surgical treatment.</p> <p><em>Written by Greta Mayr. Republished with permission of <a href="https://www.wyza.com.au/articles/health/could-cochlear-implants-could-improve-your-cognitive-function.aspx">Wyza.com.au.</a></em></p>

Technology

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5 secrets to improving pelvic floor function

<p><em><strong>Dr Kate Gregorevic is a geriatrician with a research interest in health and lifestyle factors that are associated with healthy ageing and recovery from illness.</strong></em></p> <p>The vagina is both for fun and function. Childbirth (whether vaginal or caesarean) is an incredible achievement, but due to human babies having relatively oversized heads and the female pelvis being relatively narrow to allow us to walk upright, many women experience trauma to the pelvic floor. In addition the hormones of pregnancy and menopause can also increase the stress on the pelvic floor muscles and contribute to pelvic floor dysfunction, which can result in incontinence, constipation and <span style="text-decoration: underline;"><strong><a href="https://www.physio-pedia.com/Low_Back_Pain_and_Pelvic_Floor_Disorders" target="_blank">even back pain.</a></strong></span></p> <p>Some women, particularly those who have experienced vaginal birth, may have a vaginal prolapse. This occurs when the tissues of the vagina become weakened and some of the surrounding structures bulge into the vagina. This is extremely common, affecting up to forty per cent of all women who have had a vaginal birth. When I was a medical student, we were taught that after menopause, prolapse would invariably get worse, but now we know that with the right strategies, a prolapse may even improve. These are some simple lifestyle steps that can have a big impact on pelvic floor function:</p> <p><strong>1. Learn to do your pelvic floor exercises PROPERLY</strong></p> <p>The pelvic floor is a string of muscles that goes from your tailbone to your pubic bone, and so doing pelvic floor exercises involves <a href="http://stableandstrong.com.au/exactly-activate-pelvic-floor-correctly-caution-real-talk-ahead/" target="_blank"><strong><span style="text-decoration: underline;">drawing up the muscles around the rectum, vagina and urethra</span></strong></a>. The next step is to activate the deep core muscles in the abdomen. Over time, you can then build up to co-ordinating all muscles at the same time.</p> <p><strong>2. Once you’re doing your exercises properly, get upright</strong></p> <p>Many women do their pelvic floor exercises while they are sitting. This is a good way to start practicing, but the pelvic floor also needs to be active when you are upright doing day-to-day activities. This involves progressing to getting upright, and even to making sure your pelvic floor is engaged when you exercise. A good rule is that if you can’t engage your pelvic floor while doing an exercise, you need to take a break. An exercise physiologist or women’s health physiotherapist can be a great help in this stage.</p> <p><strong>3. Avoid constipation</strong></p> <p>Constipation is passing infrequent or difficult to pass stools. This can lead to straining on the toilet, which can actually worsen a prolapse. A diet high in fibre is key to improving constipation because it makes the faeces bulkier and softer, so easier to pass. Fibre is the indigestible part of plant-based foods, like fruit, vegetables and wholegrains. Not only is this good for protecting your pelvic floor, but diets high in fibre are actually linked to better overall health and a <span style="text-decoration: underline;"><strong><a href="http://www.oversixty.com.au/health/body/2017/01/why-a-healthy-gut-is-important-in-older-age/http:/www.oversixty.com.au/health/body/2017/01/why-a-healthy-gut-is-important-in-older-age/" target="_blank">more diverse gut microbiome</a></strong></span>.</p> <p><strong>4. Use the correct POOsition</strong></p> <p>The optimal position for defaecation is actually crouching, not sitting. When we sit upright, a loop of muscle naturally kinks our rectum, meaning that we have to strain more to poo. By placing a stool under your feet and leaning forward, you can get the optimal angle and avoid straining and the pressure on your pelvic floor.</p> <p><strong>5. Get professional help</strong></p> <p>It is worth seeking out a physiotherapist or exercise physiologist with a specialisation in women’s health.  It can feel embarrassing to discuss such personal issues with someone, but women who enter this profession are experts at their job and making their clients feel at ease. They can help you develop a personalised management plan to focus on your specific needs.</p> <p>Even with the right lifestyle measures, some women may still require surgery for a symptomatic prolapse or incontinence, but these lifestyle measures are still important to optimise outcomes. One of the most important lessons to come from the <a href="http://www.abc.net.au/news/2017-11-30/controversial-vaginal-mesh-implants-banned-for-pelvic-prolapse/9209940" target="_blank"><strong><span style="text-decoration: underline;">vaginal mesh scandal</span></strong></a> is to highlight how important it is to talk about these common and treatable conditions.</p> <p>Speaking about this with other women, many will have shared the experience of pelvic floor dysfunction. Poor pelvic floor function is not inevitable with age. Even decades post-partum, with the right exercises and lifestyle measures, continence and sexual function can improve significantly. Whether your goal is avoiding prolapse surgery or running with the grandchildren, taking these steps to optimise pelvic floor function can make a huge contribution to living your best life.</p> <p><em>For the latest research on ageing well, follow Kate on Instagram <span style="text-decoration: underline;"><strong><a href="https://www.instagram.com/drkate_gregorevic/" target="_blank">@drkate_gregorevic</a></strong></span>.</em></p>

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