Latest news with #geriatrician
Yahoo
29-07-2025
- Health
- Yahoo
This Is The Reason Drinking Alcohol Makes You Feel Worse As You Get Older
'Drink in moderation' is advice we hear often, but as most people can attest to after a booze-filled holiday season, it isn't easy to stick to. When we can stick to moderate drinking, however, we usually feel pretty good about ourselves. According to the 2020-2025 Dietary Guidelines for Americans, moderate drinking is defined as no more than two drinks per day for men, and no more than one drink per day for women. That means if we have a glass of wine after work every day, we're not doing much harm to our bodies and brains, right? That depends. Dr. Elizabeth Landsverk, a geriatrician and dementia expert, tells HuffPost that the way alcohol impacts the body will vary based on your age. If your 2024 goals include plans to drink in moderation, here's what she wants you to know. How 1-2 Alcoholic Drinks Per Day Impact The Body In Your 20s, 30s And 40s Related: Related: Your 20s, Landsverk says, are a resilient time for the body — which is probably why hangovers aren't nearly as bad during that decade. 'The liver and brain have the most resilience during that time,' she said. 'The frontal lobes (reasoning, and judgment) are not quite developed. One is more likely to be open to drinking more or taking more risks, and this can set habits that will cause problems down the line.' You probably won't notice a huge difference as you head into your 30s as long as you're drinking moderately, but it's important to keep your overall health in mind. 'Ask yourself: How is your health otherwise? Obesity, which is epidemic in America, increases the risk of non-alcoholic fatty liver,' Landsverk said. 'Alcohol increases the risk of liver disease and scarring (cirrhosis). As a geriatrician, I would say a glass or two a week is fine. Some doctors say one drink a day is fine, but it is also neurotoxic and that can catch up with you.' In your 40s, more health risks begin to pop up, Landsverk explains. 'Obesity, diabetes, hypertension and high cholesterol all increase the risk for heart attacks, strokes and small stroke dementia,' she said. If you're living with any of these conditions, even a small amount of alcohol can further increase your risk of events like heart attacks or strokes, so keep that in mind. How 1-2 Alcoholic Drinks Impact The Body In Your 50s And 60s Once you hit your 50s, Landsverk says, even moderate drinking can wreak havoc on the body. 'Alcohol, besides the vascular damage and dementia risks, increases the risk of breast cancer, esophageal cancer and liver cancer (after disease),' she said. Because cancer risk drastically increases as we age, adding any amount of alcohol into the mix will only further increase that risk. 'Plus, as we age, good sleep is more elusive,' Landsverk added. 'Substances like caffeine, cigarettes and alcohol all hinder sleep' In your 60s, you'll likely begin to feel the effects of moderate drinking on your body. 'I can speak from experience: This is the age when tolerance may decrease dramatically,' Landsverk said. 'I am healthy. I can ski or swim a mile, but a glass of wine makes me feel ill and slow the next day.' This, she says, is because older people are more likely to lose the enzyme to metabolize alcohol (alcohol dehydrogenase). 'At this point, I can tolerate about one glass a week,' Landsverk noted. 'If I had it daily, I would feel sick with just one glass a day. Older people have less reserve in the brain, liver and kidneys. The damage to the brain from even one glass a day is worse [when you're over 60].' Landsverk suggests that you think of alcoholic beverages like candy bars. 'They're nice with some meals, but they can increase your weight and blood sugar, and over decades adds to cancer risk and chronic illnesses that can lead to poor health.' If you want to stay as healthy as possible and feel your best as you age, do you have to give up alcohol completely? No, Landsverk emphasizes, and it's important to remember to remember that other factors influence the impact alcohol has on your health and well-being, such as if you're living with a disease like obesity or hypertension. If you're older and in generally good health, you shouldn't worry too much about the occasional alcoholic beverage. That's certainly the case for Landsverk. 'I have decided that a glass of wine with a nice meal is worth it,' she said. 'But not every night.' This article originally appeared on HuffPost. Also in Goodful: Also in Goodful: Also in Goodful:
Medscape
10-06-2025
- Health
- Medscape
As Cannabis Users Age, Health Risks Appear To Grow
Benjamin Han, a geriatrician and addiction medicine specialist at the University of California-San Diego, tells his students a cautionary tale about a 76-year-old patient who, like many older people, struggled with insomnia. 'She had problems falling asleep, and she'd wake up in the middle of the night,' he said. 'So her daughter brought her some sleep gummies' — edible cannabis candies. 'She tried a gummy after dinner and waited half an hour,' Han said. Feeling no effects, she took another gummy, then one more — a total of four over several hours. Han advises patients who are trying cannabis to 'start low; go slow,' beginning with products that contain just 1 or 2.5 milligrams of tetrahydrocannabinol, or THC, the psychoactive ingredient that many cannabis products contain. Each of the four gummies this patient took, however, contained 10 milligrams. The woman started experiencing intense anxiety and heart palpitations. A young person might have shrugged off such symptoms, but this patient had high blood pressure and atrial fibrillation, a heart arrhythmia. Frightened, she went to an emergency room. Lab tests and a cardiac work-up determined the woman wasn't having a heart attack, and the staff sent her home. Her only lingering symptom was embarrassment, Han said. But what if she'd grown dizzy or lightheaded and was hurt in a fall? He said he has had patients injured in falls or while driving after using cannabis. What if the cannabis had interacted with the prescription drugs she took? 'As a geriatrician, it gives me pause,' Han said. 'Our brains are more sensitive to psychoactive substances as we age.' Thirty-nine states and the District of Columbia now allow cannabis use for medical reasons, and in 24 of those states, as well as the district, recreational use is also legal. As older adults' use climbs, 'the benefits are still unclear,' Han said. 'But we're seeing more evidence of potential harms.' A wave of recent research points to reasons for concern for older users, with cannabis-related emergency room visits and hospitalizations rising, and a Canadian study finding an association between such acute care and subsequent dementia. Older people are more apt than younger ones to try cannabis for therapeutic reasons: to relieve chronic pain, insomnia, or mental health issues, though evidence of its effectiveness in addressing those conditions remains thin, experts said. In an analysis of national survey data published June 2 in the medical journal JAMA , Han and his colleagues reported that 'current' cannabis use (defined as use within the previous month) had jumped among adults aged 65 or older to 7% of respondents in 2023, from 4.8% in 2021. In 2005, he pointed out, fewer than 1% of older adults reported using cannabis in the previous year. What's driving the increase? Experts cite the steady march of state legalization — use by older people is highest in those states — while surveys show that the perceived risk of cannabis use has declined. One national survey found that a growing proportion of American adults — 44% in 2021 — erroneously thought it safer to smoke cannabis daily than cigarettes. The authors of the study, in JAMA Network Open , noted that 'these views do not reflect the existing science on cannabis and tobacco smoke.' The cannabis industry also markets its products to older adults. The Trulieve chain gives a 10% discount, both in stores and online, to those it calls 'wisdom' customers, 55 or older. Rise Dispensaries ran a yearlong cannabis education and empowerment program for two senior centers in Paterson, New Jersey, including field trips to its dispensary. The industry has many satisfied older customers. Liz Logan, 67, a freelance writer in Bronxville, New York, had grappled with sleep problems and anxiety for years, but the conditions grew particularly debilitating 2 years ago, as her husband was dying of Parkinson's disease. 'I'd frequently be awake until 5 or 6 in the morning,' she said. 'It makes you crazy.' Looking online for edible cannabis products, Logan found that gummies containing cannabidiol, known as CBD, alone didn't help, but those with 10 milligrams of THC did the trick without noticeable side effects. 'I don't worry about sleep anymore,' she said. 'I've solved a lifelong problem.' But studies in the United States and Canada, which legalized nonmedical cannabis use for adults nationally in 2018, show climbing rates of cannabis-related health care use among older people, both in outpatient settings and in hospitals. In California, for instance, cannabis-related emergency room visits by those 65 or older rose, to 395 per 100,000 visits in 2019 from about 21 in 2005. In Ontario, acute care (meaning emergency visits or hospital admissions) resulting from cannabis use increased fivefold in middle-aged adults from 2008 to 2021, and more than 26 times among those 65 and up. 'It's not reflective of everyone who's using cannabis,' cautioned Daniel Myran, an investigator at the Bruyère Health Research Institute in Ottawa and lead author of the Ontario study. 'It's capturing people with more severe patterns.' But since other studies have shown increased cardiac risk among some cannabis users with heart disease or diabetes, 'there's a number of warning signals,' he said. For example, a disturbing proportion of older veterans who currently use cannabis screen positive for cannabis use disorder, a recent JAMA Network Open study found. As with other substance use disorders, such patients 'can tolerate high amounts,' said the lead author, Vira Pravosud, a cannabis researcher at the Northern California Institute for Research and Education. 'They continue using even if it interferes with their social or work or family obligations' and may experience withdrawal if they stop. Among 4,500 older veterans (with an average age of 73) seeking care at Department of Veterans Affairs health facilities, researchers found that more than 10% had reported cannabis use within the previous 30 days. Of those, 36% fit the criteria for mild, moderate, or severe cannabis use disorder, as established in the Diagnostic and Statistical Manual of Mental Disorders. VA patients differ from the general population, Pravosud noted. They are much more likely to report substance misuse and have 'higher rates of chronic diseases and disabilities, and mental health conditions like PTSD' that could lead to self-medication, she said. Current VA policies don't require clinicians to ask patients about cannabis use. Pravosud thinks that they should. Moreover, 'there's increasing evidence of a potential effect on memory and cognition,' said Myran, citing his team's study of Ontario patients with cannabis-related conditions going to emergency departments or being admitted to hospitals. Compared with others of the same age and sex who were seeking care for other reasons, research shows these patients (ages 45 to 105) had 1.5 times the risk of a dementia diagnosis within 5 years, and 3.9 times the risk of that for the general population. Even after adjusting for chronic health conditions and sociodemographic factors, those seeking acute care resulting from cannabis use had a 23% higher dementia risk than patients with noncannabis-related ailments, and a 72% higher risk than the general population. None of these studies were randomized clinical trials, the researchers pointed out; they were observational and could not ascertain causality. Some cannabis research doesn't specify whether users are smoking, vaping, ingesting or rubbing topical cannabis on aching joints; other studies lack relevant demographic information. 'It's very frustrating that we're not able to provide more individual guidance on safer modes of consumption, and on amounts of use that seem lower-risk,' Myran said. 'It just highlights that the rapid expansion of regular cannabis use in North America is outpacing our knowledge.' Still, given the health vulnerabilities of older people, and the far greater potency of current cannabis products compared with the weed of their youth, he and other researchers urge caution. 'If you view cannabis as a medicine, you should be open to the idea that there are groups who probably shouldn't use it and that there are potential adverse effects from it,' he said. 'Because that is true of all medicines.'
CBC
28-05-2025
- General
- CBC
$24M research project looks to improve care Indigenous people with dementia
When Elizabeth Edgar-Webkamigad's mother first showed signs of dementia, it was a long and difficult process to get a diagnosis. "It was right smack in the middle of COVID," said Edgar-Webkamigad, who lives in Sault Ste. Marie, Ont. Because her mom started to show signs of dementia in the middle of a global pandemic, it took time just to get an appointment with a family doctor. But to get a brain health assessment, Edgar-Webkamigad's mother had to be referred to a geriatrician. "It took almost a year to get that actually happening," she said. Even after her mother's diagnosis, her care didn't always recognize her culture and the trauma she experienced attending the Spanish Indian Residential School for Girls. A doctor told Edgar-Webkamigad her mom was lashing out when a personal support worker tried to bathe her. "I can tell you in most of my life, I saw my mom bathe maybe a handful of times," she said. That was because her mother had traumatic experiences in residential school, and later a tuberculosis hospital (although she was never diagnosed with the disease) while bathing. "For her, bathing time was not a sacred time," Edgar-Webkamigad said. "It was a time where violence was introduced. It was a time where body shaming happened. It was a time where abuse happened." Because of those experiences she had sponge baths for most of her life. Edgar-Webkamigad said the health care system should do better at recognizing Indigenous traditions and medicines. She mentioned that in her part of northeastern Ontario, for example, there's a plant-based medicine that has a calming effect and has been used for generations to help people with dementia. Creating care 'bundles' Now Edgar-Webkamigad is sharing her family's experiences with a $24-million research project that spans seven universities across Canada along with several Indigenous organizations, such as the Maamwesying North Shore Community Health Services and the Métis Nation of Alberta. The Indigenous Brain Health Assessment Bundle Project has received funding from the New Frontiers in Research Fund to create bundles, which are region-specific resources for health care providers to provide culturally appropriate care for people who are showing signs of dementia. Sharlene Webkamigad, Edgar-Webkamigad's niece, is a researcher at Laurentian University who is involved in the project. She's been meeting with people like her aunt to hear their stories and help find better ways for the health system to care for their loved ones. "I've been hearing about the importance of healthcare professionals having knowledge of those more culturally specific ways of approaching somebody who has dementia, including the care for them within long term care facilities," Webkamigad said. The research project will span six years.
Yahoo
18-05-2025
- Health
- Yahoo
Boomers have a drug problem, but not the kind you might think
Baby boomers – that's anyone born in the U.S. between 1946 and 1964 – are 20% of the population, more than 70 million Americans. Decades ago, many in that generation experimented with drugs that were both recreational and illegal. Although boomers may not be using those same drugs today, many are taking medications, often several of them. And even if those drugs are legal, there are still risks of interactions and side effects. The taking of multiple medications is called polypharmacy, typically four or more at the same time. That includes prescriptions from doctors, over-the-counter medicines, supplements and herbs. Sometimes, polypharmacy can be dangerous. I am a geriatrician, one of only 7,500 in the U.S. That's not nearly enough to accommodate the surging number of elderly boomers who will need medical care over the next two to three decades – or help in dealing with the potential problems of multiple drug use. We geriatricians know that polypharmacy isn't always bad; multiple medications may be necessary. If you've had a heart attack, you might be on four medications or more – beta-blockers, ACE inhibitors, statins and aspirin, for instance. And that's appropriate. But about half of older adults take at least one medication that's not necessary or no longer needed. Doctors need to periodically reevaluate to make sure each medication is still right for the patient and still the correct dose. During treatment, the patient's weight may fluctuate, either up or down. Even if it stays the same, body composition might change; that occurs as people age. As a result, one may react differently to a drug. That can happen even with a medication a person has been on for years. Polypharmacy often means higher health care costs and more drug interactions. Patients are more likely to miss medications or stop taking them altogether. Sometimes, physical activity diminshes; falls, cognitive impairment, malnourishment and urinary incontinence increase; there may be less ability to do daily tasks. Those on five or more medications have a much higher incidence of having an ADE – an adverse drug event – compared to those using fewer meds. Making matters worse, the symptoms of polypharmacy are sometimes masked and taken as signs of aging. Studies have suggested solutions, with better coordination among care providers being one. Making the pharmacist an integral part of routine care is another. The increasing use of electronic patient records helps. So do smartphone apps, sometimes an easier way for patients and providers to connect. But so far, there's no magic pill, and as researchers and clinicians investigate improvements, much of the burden remains on patients and their families. There are steps you can take to stay safe, however. Regularly clean out the medicine cabinet and get rid of expired medicines or those you're no longer taking. Either throw them away or ask your doctor or pharmacist about the best way to dispose of them. When seeing the doctor, bring in the meds you take and review each one in detail. Make certain you need to continue taking them all and verify the right dose. You can also check the PIMs list, also known as the Beer's List. Published by the American Geriatric Society, it's an index of medications potentially harmful to the elderly. Some are linked to increased risks of side effects, and not a few are sold over-the-counter without prescription. That includes medicines containing antihistamines like diphenhydramine, or Benadryl. In the elderly population, Benadryl carries an increased risk of dizziness, confusion and urinary retention. Medicines that are part of the NSAID family (nonsteroidal anti-inflammatory drugs) are also on the list. In some elderly patients, they can cause high blood pressure or kidney failure. Commonly used medicines in the NSAID family are those containing ibuprofen or naproxen. Just because a medicine is on the Beer's List doesn't mean your doctor was wrong to prescribe it, or that you should stop using it. Instead, use the medication with caution and discuss with your doctor to make sure you need it. Determine with your doctor the lowest useful dose, monitor for side effects, and speak up if you have any. As a geriatrician, I see patients in an outpatient setting, either as their primary care provider or as a specialist consultant. We review medications at every visit: the list, the dose and how often the patient is taking it. A true and accurate medication list is the critical first step in geriatric care. This is especially important during care transitions, such as when a patient is coming out of the hospital or nursing home. Particularly at that time, we find out if the patient is using the medication as prescribed, or taking it more frequently or less or not at all. Which leads to my final piece of advice: If you've strayed with your meds, one way or another, know that we doctors don't judge or punish patients. Just tell us the truth. That's all we want to hear. Then we can move forward together to find the best regimen for you. This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Laurie Archbald-Pannone, University of Virginia Read more: To tackle gendered violence, we also need to look at drugs, trauma and mental health Do we really need to burp babies? Here's what the research says What are heart rate zones, and how can you incorporate them into your exercise routine? Laurie Archbald-Pannone is affiliated with American Geriatrics Society.
