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Keeping Minds of Seniors Sharp: Some Answers Emerge

As a member of the Atari Generation, I remember my parents telling me to limit my time playing video games. Well guess what? Now I can tell them that if they want to improve their ability to fight cognitive decline, they should increase their time playing video games – at least when it comes to the games from www.Lumosity.com. A well-designed study published in PLoS One found cognitive benefits for seniors. No, this is not a paid advertisement. None of the funding for the study came from Lumosity. The study was funded by the government of Spain.

David Sheon

David Sheon

Let’s back up a bit. America is aging. As the massive number of baby boomers reach their twilight years, we’re well served to think through the implications of a couple of statistics mentioned on the recent 60 Minutes story, Living to 90 and Beyond. The fascinating story finds compelling evidence that as we age, drinking a glass of any alcohol a day, consuming coffee, and gaining weight (but not to the point of obesity) all increase the chances of living past 90.

The story also mentions that by about 2050, the number of Americans over age 90 is projected to quadruple. It also reports that the risk of developing dementia doubles every 5 years starting at the age of 65.

Although more research needs to be done before we can say that games for your brain delay dementia, we can say that Lumosity improves the ability of seniors to stay attentive and alert thanks to the Spanish-funded study by Julia Mayas et al.

Recently, research on aging has begun to examine cognitive “plasticity” in seniors and its capacity to counteract cognitive decline. The aim of the Spanish-funded study was to investigate whether older adults could benefit from brain training with video games, with additional distractions, like randomly generated noises created by the researchers, to assess distraction and alertness.

For example, participants were presented with a sequence of numbers on the screen that they labelled as “odd” or “even” while ignoring irrelevant sounds such as drilling, rain, or hammering, just before being shown the number. In most trials the sound was consistent, while in a small proportion of the trials, interspersed at random, the standard sound was replaced by a random sound not presented earlier in the task. Other studies have shown that random sounds seemed to startle and take study volunteers off task, if only for a second or two.

The researchers hypothesized that if video game training improves auditory attentional functions as it does visual attention or executive functions, then older adults in the study who used Lumosity for training would show reduced distraction and maintain their level of alertness or prevent its decline.

Forty healthy adult volunteers aged 57 to 77 years were randomly assigned to either the experimental or the control group. The study was completed by 15 of the 20 participants of the experimental group and 12 of the 20 members of the control group. All participants had normal hearing and normal or corrected-to-normal vision. In addition to the random noise task, all participants completed a battery of cognitive tests to be sure that participants in both groups had similar capabilities.

Each participant assigned to use the computer video games had 20 sessions of game training. They practiced 10 video games selected from Lumosity’s commercially available package. The games practiced were specifically designed to train a variety of mental abilities, including speed of processing and mental rotation, working memory, concentration, and mental calculation.

Points were awarded to participants based on their performance and on the time taken to complete the games. To make sure the data wasn’t biased, participants were not allowed to play any other video game during the study. None of the participants reported any previous experience with video games. The control group did not receive video games training but participated in three group meetings during this time in which they socialized with each other but didn’t try the games.

All participants were measured for the ability to cope with distractions and stay alert before and after the study. On both accounts, those who used the video games improved compared to those who did not do the video games.

The ability to ignore irrelevant sounds improved after video game training by about 12 milliseconds, while those in the control group saw no improvement.

Similar pre- and post-training comparisons showed a 26 millisecond increase of alertness in the experimental group with no significant difference in the control.

One thing that makes this study stand out is its ability to transfer findings from the computer games to real-world improvements.

According to the study authors, “practicing video games of this type may offer some protective factor against the effects of aging and may potentially be recommended to older individuals, alongside other interventions found to improve mental functions. These include, for example, a long-term physically active lifestyle (improving executive control and speed of processing), aerobic exercise (improving cognition by increasing the volume of grey and white matter in frontal and temporal sites), or social networking and innovative solutions to connect people in a multimodal way with family members, friends and caretakers.”

So I guess that like when my parents told me to put down the joystick and play outside, I get to remind them to do the same. Just don’t be quick to dismiss video games as part of the equation to a healthier mind in our senior years.

Do you use Lumosity or any other brain training program? Have you noticed it helping you? We’d love to hear about it.

A Shot of Courage for Those Who Fear Needles

This is the first of a two-part series on what’s working to prevent and address needle fear.

Most people don’t enjoy shots.

But for those with needle phobia, the fear of shots can be so severe that they actively avoid medical procedures involving injections, and in extreme cases avoid medical care more generally.

Jamie Elizabeth Rosen

Jamie Elizabeth Rosen

Needle phobia can arise from genetic and environmental factors, including experiencing pain during encounters with needles or seeing others uncomfortable or distressed by needles. Studies show that approximately two out of three children and one in four adults are afraid of needles, and 10 percent of adults have an outright needle phobia, characterized by avoidance behavior and physiological responses, such as increased heart rate or fainting.

The miracle of modern medicine has enabled us to protect ourselves from a range of dangerous or life-threatening diseases. In one recent study, seven to eight percent of adults and children reported avoiding potentially life-saving immunizations as a result of needle fear. Given the growth of vaccine-preventable outbreaks throughout the world (check out this interactive map), this is not only a concern for individual health but also for public health.

Preventing and Addressing Needle Fear

Fortunately, a growing cadre of empathetic health professionals is taking the prevention of needle pain, which can trigger needle fear, to the next level.

“In order to combat pain, vascular access professionals across the country are looking at creative ways to address patient pain and patients’ perception of pain,” said nursing leader and vascular access expert Lorelle Wuerz, MSN, BS, BA, RN, VA-BC. “Offering the patient options before you do any procedure is important.”

Wuerz said that she uses a variety of interventions to combat needle fear and pain in patients, including:

  • Ensuring patients know what to expect;
  • Deep breathing;
  • Guided imagery;
  • Distraction techniques;
  • Topical agents;
  • Warm compresses;
  • Involvement of child life professionals;
  • Pain control devices, such as Buzzy®;
  • Aromatherapy (“Anecdotally, this is something patients find soothing and calming during an uneasy time,” Wuerz said.).

Needle pain prevention extends beyond traditional health care settings. For instance, after discovering that 23 percent of Americans who skipped flu vaccination did so to avoid needles, Target Pharmacy began offering micro-needle flu vaccines. The needles are 90% smaller than those that have traditionally been used and reportedly result in less muscle ache and pain immediately following injection.

“Treating needle pain reduces pain and distress and improves satisfaction with medical care,” wrote pain researcher Anna Taddio in a chapter on needle procedures in the Oxford Textbook of Paediatric Pain. “Other potential benefits include a reduction in the development of needle fear and subsequent health care avoidance behaviour.” 

The 4 Ps of Needle Pain Management

In the Oxford Textbook chapter, Taddio outlined the four domains of interventions that can reduce needle pain for patients, known as the 4 Ps: procedural, pharmacological, psychological, and physical.

Procedural interventions involve bypassing needles altogether through the use of needle-free immunization or non-invasive sampling devices. Pharmacological interventions include local anesthetics, which have been shown to be effective and safe for reducing pain from common needle procedures, and sweet solutions for infants up to 12 months, which have been shown to reduce needle pain behaviors. Psychological interventions include coaching people to cope and providing distractions. Physical interventions – such as upright body positioning, tactile stimulation, and use of cooling agents or ice – can also reduce the perception of needle pain.

Empowering Ourselves

Many people will celebrate the day when shots are replaced with futuristic technology, such as a robotic pill or one of many other innovations currently in development.

In the meantime, what can patients do to help themselves? “A patient should never not speak up,” Wuerz said. “It’s okay to have all of the information before you make a choice.”

Stay tuned for Part II of the series, in which Dr. Amy Baxter, MD – pain researcher, CEO of MMJ Labs, and inventor of Buzzy® Drug Free Pain Relief – will outline how you can protect yourself and your family from needle pain. Dr. Baxter will appear on ABC’s Shark Tank Friday, February 28 at 9:00 pm EST.

How do you respond to needles? What works for you? Have you had a good experience with a health care professional? Post your experiences to the comments section.

Should clinicians replace medication with an ancient spiritual practice?

Researchers from Johns Hopkins University sifted through over 18,000 studies on a potential treatment for pain, anxiety and depression, narrowing their meta-analysis to 47 scientifically rigorous clinical trials. The results, published in the journal JAMA Internal Medicine, revealed what many have experienced over thousands of years: while it’s not a cure-all, this treatment can help alleviate pain, anxiety and depression. The treatment? Meditation.

David Sheon

David Sheon

Meditation began as an ancient spiritual practice but is now also utilized outside of traditional settings to promote health and well-being. The study findings incorporate the effects of mindfulness meditation on over 3,500 participants who were selected to take part in either a meditation regimen or a different therapy, such as exercise. Overall, researchers found that the effect of meditation on participants was moderate and on par with that of prescription medications.

While this is a promising result on the benefits of meditation, the researchers identified a number of limitations. The study did not find any evidence of meditation affecting other health concerns such as positive mood, attention, substance use, eating habits, sleep and weight. Also, meditation did not provide any long-term therapy as compared to medication. “The benefits did attenuate over time — with the effectiveness of meditation decreasing by half, three to six months after the training classes ended,” said study leader Dr. Madhav Goyal, an assistant professor of medicine at Hopkins. “We don’t know why this occurred, but it could have been that they were practicing meditation less often.”

Still, Dr. Goyal said he is encouraged by the study’s results, specifically because of the short training periods for the participants. There may be greater potential for individuals with more instruction or experience in meditation. “Compared to other skills that we train in, the amount of training received by the participants in the trials was relatively brief,” he said. “Yet, we are seeing a small but consistent benefit for symptoms of anxiety, depression and pain. So you wonder whether we might see larger effects with more training, practice and skill.”

While the new study suggests that in some cases, meditation may be used in addition to or in lieu of prescription drugs to treat pain, anxiety and depression, it is important for patients to consult their doctors before altering any course of treatment.

At RealWorldHealthCare.org, we have been interested in meditation’s potentially positive impact on health. Last April, we posted about a recent study in which meditation halved the risk of death, heart attack and stroke in African American men.

Meditation may have economic benefits as well. According to a July 2013 Huffington Post blog, Aetna’s employee health care costs went down by 7 percent in 2012 after the company implemented a wellness program, which CEO Mark Bertolini attributes to reducing stress through meditation and yoga. In recognition of its positive health impact, some insurance companies provide benefits for meditation instruction. For example, CareFirst’s Options Discount Program offers up to 30% off fees for participating meditation instructors. In 2010, Americans spent more than $11 billion on antidepressants, according to the American Psychological Association.

The National Center for Complementary and Alternative Medicine of the NIH offers an introduction to meditation, its uses and guidance for those who wish to practice meditating. The National Meditation Specialist Certification Board, an organization that seeks to promote meditation as a specialized field in health care, keeps a directory of meditation specialists, and there are many other such directories available online or through participating insurance providers.

In a Psychology Today article guiding those interested in mindfulness meditation, Dr. Karen Kissel Wegela emphasizes that sick or healthy, meditation can help people cope. “The sitting practice of mindfulness meditation gives us exactly this opportunity to become more present with ourselves just as we are,” she says. “This, in turn, shows us glimpses of our inherent wisdom and teaches us how to stop perpetuating the unnecessary suffering that results from trying to escape the discomfort, and even pain, we inevitably experience as a consequence of simply being alive.”

Have you ever meditated? Have you or someone you know ever meditated to treat depression, pain or anxiety? Did you find it effective?

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