Phys­i­cal ex­er­cise sharp­ens the older mind as well as the body

The Weekend Australian - Travel - - Health - Com­piled by Dr Chris­tine White

EX­ER­CISE may be just as good for the mind as it is for the body. A new study in the Cochrane Li­brary has found that aer­o­bic ex­er­cise not only im­proves car­dio­vas­cu­lar fit­ness but can also in­crease think­ing speed and con­cen­tra­tion in older peo­ple. Re­searchers com­bined the re­sults of 11 stud­ies ex­am­in­ing the ef­fects of phys­i­cal ex­er­cise in healthy peo­ple over 55. In each study par­tic­i­pants were ran­domly di­vided into two groups: one com­pleted an aer­o­bic ex­er­cise pro­gram three times a week for be­tween eight and 26 weeks, and the con­trol group par­tic­i­pated in an­other type of pro­gram (strength/bal­ance train­ing or so­cial ac­tiv­i­ties) or no pro­gram. In all the stud­ies, par­tic­i­pants in the aer­o­bic group per­formed bet­ter on at least one test of brain func­tion com­pared to the con­trol group. The great­est im­prove­ments were seen in man­ual dex­ter­ity, lis­ten­ing skills and me­mory. Cochrane Data­base Syst Rev 2008; doi:10.1002/14651858.CD005381.pub2 (Angevaren M, et al) OLDER men tak­ing drugs known as ‘‘ loop di­uret­ics’’ for high blood pres­sure and heart fail­ure may be at risk of bone loss and frac­tures, ac­cord­ing to new re­search in the ArchivesofIn­ter­nalMedicine . Th­ese drugs in­crease the amount of cal­cium ex­creted in urine, which could even­tu­ally dam­age bones. The study in­volved 3269 men aged 65 and older. At an ini­tial ex­am­i­na­tion, they were sur­veyed about their use of med­i­ca­tions and their hip bone den­sity was mea­sured. An av­er­age of 4.6 years later, the men were sur­veyed again and re­peat bone den­sity mea­sure­ments were taken. A to­tal of 84 men used loop di­uret­ics con­tin­u­ously dur­ing the study, 181 used them in­ter­mit­tently and 3004 did not use them at all. Com­pared to the rate of hip bone loss in non-users, the rate of loss in in­ter­mit­tent users was two-fold higher and in con­tin­u­ous users was 2.5-fold higher. Doc­tors should take loop di­uretic use into ac­count, say the au­thors, when de­ter­min­ing an older man’s risk of bone loss and frac­tures. ArchIn­ternMed 2008;168:735-740 (Lim LS, et al) CON­STANT cough­ing can keep kids and par­ents awake all night, but new Aus­tralian re­search in the Cochrane Li­brary shows that anti-his­tamines are not the an­swer for cough­ing chil­dren. If an adult has a chronic cough, an anti-his­tamine such as ce­t­i­rizine (Zyrtec) will of­ten do the trick. Led by Anne Chang from the Royal Chil­dren’s Hospi­tal in Bris­bane, re­searchers com­bined the re­sults of five stud­ies in­volv­ing 955 chil­dren aged six months to 17 years. In con­trast to adults, they found that the pos­si­ble side ef­fects of an­ti­his­tamines in chil­dren far out­weighed any ben­e­fits. One study showed an im­prove­ment in cough symp­toms with anti-his­tamine treat­ment, but only when the cough was caused by pollen al­lergy. Given that the side ef­fects of anti-his­tamines in chil­dren can in­clude stom­ach up­set, breath­ing dif­fi­cul­ties and heart prob­lems, say the au­thors, chil­dren’s coughs may be bet­ter treated by a doc­tor with a ‘‘ cau­tious, wait-see-and-re­view’’ approach. Cochrane Data­base Syst Rev 2008; doi:10.1002/14651858.CD005604.pub3 (Chang AB, et al) HIGH blood lev­els of a com­pound called urate may be as­so­ci­ated with a slower pro­gres­sion of Parkin­son’s dis­ease, con­cludes a study in the ArchivesofNeu­rol­ogy this week. Urate is a pow­er­ful an­tiox­i­dant, which could pro­tect against the loss of brain cells that oc­curs in Parkin­son’s dis­ease. Re­searchers stud­ied 804 pa­tients with early symp­toms of the dis­ease, mea­sur­ing their blood urate lev­els and as­sess­ing their dis­ease symp­toms ev­ery few months for two years. Over­all, 493 pa­tients (61 per cent) had se­vere symp­toms re­quir­ing treat­ment by the end of the study. Pa­tients with the high­est lev­els of urate (6.7 mil­ligrams per deciliter or higher) were half as likely to re­quire treat­ment as those with the low­est lev­els (less than 4.3 mil­ligrams per deciliter). Tar­get­ing urate lev­els may be a promis­ing approach for fu­ture Parkin­son’s treat­ments, say the au­thors. ArchNeu­rol 2008;doi:10.1001/ arch­neur.2008.65.6.nct70003 (Sch­warzschild MA, et al) SYMP­TOMS of Alzheimer’s dis­ease, in­clud­ing re­duced brain func­tion and be­havioural prob­lems, could be treated us­ing an ex­tract from Chi­nese club moss called Hu­perzine A. The club moss has been used in Chi­nese medicine for cen­turies to treat in­flam­ma­tion and fever. In the latest is­sue of the Cochrane Li­brary, re­searchers ex­am­ined six small tri­als of the moss ex­tract in­volv­ing a to­tal of 454 Alzheimer’s pa­tients. Each of the tri­als com­pared the ef­fects of Hu­perzine A with those of an in­ac­tive placebo. Both six weeks and 12 weeks of treat­ment with Hu­perzine A were found to sig­nif­i­cantly im­prove over­all brain func­tion and be­hav­iour in Alzheimer’s pa­tients. Only mild side ef­fects were re­ported, and there was no dif­fer­ence in side ef­fects be­tween the ex­tract and placebo. Much larger tri­als are now needed, say the au­thors, to prove the ef­fec­tive­ness of Hu­perzine A in the treat­ment of Alzheimer’s and other forms of de­men­tia. Cochrane Data­base Syst Rev 2008; doi:10.1002/14651858.CD005592.pub2 (Li J, et al) Want to know more? Items are ref­er­enced where pos­si­ble. A ref­er­ence such as ‘‘ 2007;35:18-25’’ means the source ar­ti­cle was pub­lished on pages 18-25 in vol­ume num­ber 35 of the pub­li­ca­tion, in 2007. A doi num­ber or web­site ad­dress is used for re­search pub­lished on a jour­nal’s web­site.

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