Regular Walking Prevents Memory Loss and Delays Alzheimer’s Disease

Sunset in Calgary, Alberta. (Dr. Noorali Bharwani)
Sunset in Calgary, Alberta. (Dr. Noorali Bharwani)

There are many health benefits to regular walking. It helps your heart, lungs, joints and muscles. It may even regulate your bowel movements. You can add one more benefit to that list. According to a recent Australian study, regular walking is the best defense against age-related memory loss.

The researchers at the University of Melbourne followed 387 women for two decades. They found that participants who did some form of movement every day were less likely to suffer memory loss in their 60s and 70s, compared to their sedentary peers.

The article, published in the American Journal of Geriatric Psychiatry, shows that little physical effort like walking can go a long way in improving cognition in old age. Dementia is one condition that affects older individuals and affects their cognition.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Memory loss is an example. Alzheimer’s is the most common type of dementia. It accounts for 60 to 80 percent of cases.

The Australian researchers set out to find risk factors for dementia that could be changed. The study participants were between the ages of 45 and 55 when the study began in 1992. The researchers tested their cognitive abilities at the outset to get a baseline measure.

In the study, regular physical activity had the most protective effect on short-term memory. But aerobic exercise – the kind that makes you breathe heavily – proved less important than frequency of movement. If a person walked more then the benefit was greater.

Researchers concluded that physical activity has a direct relationship with cognition, over and above any influence on weight and cholesterol. The idea is to move more and move often. If you have difficulty walking then take up swimming or other activity that will keep you moving.

A study published in 2014 says if you take your brain for a brisk walk three times a week then it delays dementia. Studies on men and women aged 60 to 80 found that taking a short walk three times a week increased the size of brain regions linked to planning and memory over the course of a year.

The results suggest that brain and cognitive function of the older adults remain plastic and highly malleable. We used to think that as you get older there is inevitable decline in your brain function. That is not true. Don’t give up on your brain.

Reports indicate there is a desperate need for any approach that could slow the rising epidemic of dementia. An estimated 44.4 million people now have dementia worldwide, and that number is expected to reach 75.6 million in 2030, according to figures from Alzheimer’s Disease International.

If you are able to walk then keep walking. If not then do some other physical activity that will keep your brain busy. Move more, move often.

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Smart Sunscreen Strategy Needed to Prevent Skin Cancer

Sunset in Hawaii. (Dr. Noorali Bharwani)
Sunset in Hawaii. (Dr. Noorali Bharwani)

There are three types of skin cancers. Basal cell cancer (BCC) and Squamous cell cancer (SCC) are not lethal but can leave you with scars and deformities on your face and other parts of the body. Then there is melanoma. If not detected early and treated melanoma can be lethal.

When exposed to sunrays, some people burn easily and others slowly. Those who burn easily have a higher risk of skin cancer than others. But everybody is at some risk of getting skin cancer. So be smart and prevent skin cancer. Here are some guidelines.

Minimize sun exposure. Avoid the sun or stay in the shade when the sun is the strongest (10 a.m. to 4 p.m.), and dress right for the occasion. Wear a hat and clothing that’s made from tightly woven fabric.

Use appropriate sunscreen. The American Academy of Dermatology (AAD) guidelines recommend people use sunscreens with three important qualities:

  1. Use broad-spectrum sunscreen to protect against ultraviolet A rays and B rays. Ultraviolet A rays make up 95 percent of the UV spectrum and are most associated with wrinkling. Ultraviolet B rays, cause sunburn and are stronger at midday and in the summer. Both types of rays can cause skin cancer.
  2. Use water resistant sunscreen – no sunscreen is “water proof” but water resistant means you can go up to 80 minutes in the water before you need to reapply.
  3. Use sunscreen with SPF of at least 30.

To understand what sunscreens people actually use compared to what they need to prevent burning, the researchers looked at the most popular sunscreens on Amazon – the top one per cent, or 65 products.

The researchers found 40 percent – 26 of 65 – of the products did not meet AAD requirements. Most products that failed to meet the standards, 72 percent, did so because they were not water resistant.

A Consumer Reports study (May 2016) found only the following five met the AAD criteria:

  1. Hawaiian Tropic Sunscreen Silk Hydration SPF 30
  2. Neutrogena Age Shield Face Lotion Sunscreen SPF 110
  3. EltaMD UV Physical SPF 41
  4. Neutrogena Ultra Sheer Dry – Touch Sunscreen SPF 55
  5. Neutrogena Sunscreen Ultra Sheer Stick SPF 7

Make sure you use enough sunscreen. Apply sunscreen 15 to 30 minutes before you go outside. For lotions, a good rule of thumb is a teaspoon per body part or area.

For sprays, apply as much as can be rubbed in, then repeat. Regardless of which kind you use, reapply every two hours and after swimming or sweating. Use spray sunscreens carefully. Sprays are flammable; so let it dry before going near an open flame.

Consumer Reports article concludes by saying, “Tests over the past four years indicate that choosing a chemical sunscreen with an SPF of 40 or higher will give you a better chance of getting at least an SPF 30. Using any sunscreen is better than using none, but it’s just one part of a smart sun protection strategy.”

Take care and enjoy the summer.

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Use and Abuse of Prescription Painkillers – Dentists, Drugs and Dependence

Happy Canada Day. (Dr. Noorali Bharwani)
Happy Canada Day. (Dr. Noorali Bharwani)

NBC News called it “The Deadly Triangle: Dentists, Drugs and Dependence.”

In the U.S., about five million people each year have wisdom teeth removed. Many of them are prescribed Percocet, a commonly used painkiller for post-surgery discomfort. But most patients are never warned that Percocet has the potential to make patients dependent on the drug. It is very addictive.

Percocet is an opioid, a class of drugs that chemically follows the same nerve pathways as heroin, eliciting a sense of euphoria. Examples of weak opioids are – codeine and dihydrocodeine. Examples of strong opioids are – tramadol, buprenorphine, methadone, diamorphine, fentanyl, hydromorphone, morphine, oxycodone, and pethidine.

Recently, a Harvard research team reported in the Journal of the American Medical Association (JAMA) that dentists are among the leading prescribers of opioid analgesics, particularly for surgical tooth extractions. The most revealing aspect of the study was that the highest number of these opioid painkiller prescriptions were for teenagers, aged 14 to 17 years old, closely followed by young adults 18 to 24 years, says the NBC News.

Opioid abuse has sky rocketed.

Some patients and certain conditions do need strong painkillers. When used properly, prescription drugs can help. But, there are many dangerous and unpredictable side effects associated with abusing prescription drugs including addiction, overdose and death, say Government of Canada website on prescription drug abuse.

Besides opioids (used to treat pain) there are other prescription medications, which can be addictive. For example benzodiazepines (used to treat anxiety and sleep disorders), and stimulants (used to treat attention deficit disorder).

When an individual intentionally takes prescription drug for recreational purposes to get high or change mood then it is called drug abuse.

Prescription drug abuse is a growing public health and safety problem in Canada, particularly among youth. In the 2012 Canadian Alcohol and Drug Use Monitoring Survey, approximately 410,000 Canadians reported abusing prescription drugs like opioid pain relievers.

The abuse of prescription drugs has harmful effects on teens’ health. They are especially vulnerable because their bodies and minds are still developing. It can damage a teen for life.

Psychoactive drugs change brain function and results in alterations in perception, mood, or consciousness. These drugs are the third most commonly abused substances, after alcohol and marijuana, among Canadian youth. Last year, over 80,000 Canadian teenagers used prescription drugs to get high, even though it can be very dangerous.

In Alberta, since 1986, the College of Physicians and Surgeons (CPSA) started the Triplicate Prescription Program (TPP) – considered an important tool in reducing the misuse and abuse of prescription medications. TPP collects prescribing and dispensing data for listed drugs. When the data meet certain criteria, physicians and others involved in the care of the patient are alerted, provided with information and directed to resources to support them in providing safe care.

So the TPP program has been in force for 30 years. Has this put a dent in the use and abuse of narcotics and other drugs amongst vulnerable population of Alberta? I hope so but I don’t have the numbers.

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Risk of Suicide After Head Injury is High

"To jump or not to jump?" (Dr. Noorali Bharwani)
"To jump or not to jump?" (Dr. Noorali Bharwani)

Some years ago a car hit my cousin while he was crossing a street on pedestrian crossing. A driver ignored a clear sign to stop for pedestrians. Probably the driver was distracted by something he shouldn’t have been doing. My cousin had concussion and was in a hospital unconscious for several days. He recovered and went home. But he was never the same. Some years later he committed suicide.

In Medicine Hat, I think 13th Avenue is quite unsafe. It is one of the busiest streets with several businesses and seniors residencies all cramped together. Businesses like gas station, Co-op, car wash, banks, doctor’s office, dental office, golf course, Alberta Motor Association – just to name a few – are all busy with traffic going in and out of their parking lots. I think 13th Avenue is very unsafe.

If a vehicle hits you then the chances of sustaining head injury and broken bones is very high if you are lucky enough to survive. Studies have shown head injuries have been associated with subsequent suicide among military personnel.

A study from Ontario (CMAJ April 19, 2016) looked at the long-term risk of suicide after a weekend or weekday concussion. They identified 235,110 patients with a concussion. Their mean age was 41 years, 52 per cent were men, and most (86 per cent) lived in an urban location. A total of 667 subsequent suicides occurred over a median follow-up of 9.3 years, equivalent to 31 deaths per 100,000 patients annually or three times the population norm.

Weekend concussions were associated with a one-third further increased risk of suicide compared with weekday concussions. The paper concluded that adults with a diagnosis of concussion had an increased long-term risk of suicide, particularly after concussions on weekends.

The authors of the article suggest greater attention to the long-term care of patients after a concussion in the community might save lives because deaths from suicide can be prevented. More important and better option would be to prevent injuries to the head completely.

Last year, a movie, Concussion, a biographical sports drama thriller was released in the U.S. It is a true story based on the exposé “Game Brain” by Jeanne Marie Laskas, published in 2009 by GQ magazine. It is a true story.

Set in 2002, the film stars Will Smith as Dr. Bennet Omalu, a forensic pathologist of Nigerian origin with the Allegheny County, Pennsylvania Coroner’s Office. Omalu fights against efforts by the National Football League to suppress his research on chronic traumatic encephalopathy (CTE). A kind of brain degeneration suffered by professional football players from repeated injuries to the head.

Head injuries can be prevented. For example, heavy alcohol consumption contributes to one-third of motor vehicle collisions. Medical warnings by physicians to patients who are potentially unfit to drive are effective for preventing serious collisions. Let us make our roads safe, vehicles safe, sports safe. Let us prevent head injury, disability and death.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!