Healthy Aging: The Top Healthy Aging: The Top 3 Killers 3 Killers

Lecture notes 8/1Lecture notes 8/1

Healthy AgingHealthy Aging

What are the top 3 What are the top 3 killers?killers?• Heart Disease-Top killer, and 2nd Heart Disease-Top killer, and 2nd

cause of disability. Several million cause of disability. Several million deaths/yr.in USdeaths/yr.in US

• Cancer-2nd leading cause of death Cancer-2nd leading cause of death w/ 2 million deaths/yr. in US, 5 w/ 2 million deaths/yr. in US, 5 million new diagnoses/yr.million new diagnoses/yr.

• Stroke- 3rd leading cause of death Stroke- 3rd leading cause of death w/ >150,000 deaths and many w/ >150,000 deaths and many more disabledmore disabled

Heart Disease-Heart Disease-Assessing the Risks Assessing the Risks

• Some risk factorsSome risk factors– high blood pressurehigh blood pressure– smokingsmoking– sedentarysedentary– family history of heart diseasefamily history of heart disease– overweightoverweight– high saturated fat diethigh saturated fat diet– STRESS! STRESS!

Heart Disease-Heart Disease-Patient presentationPatient presentation• Chest pain or dizziness with exertionChest pain or dizziness with exertion

• Pain in arm, jaw, neck, shoulder, ribsPain in arm, jaw, neck, shoulder, ribs

• Heart Failure-Fatigue, pallor, Heart Failure-Fatigue, pallor, dyspnea, pitting edema (right-venous dyspnea, pitting edema (right-venous edema Vs. left-lung edema)edema Vs. left-lung edema)

• Coronary Ischemia- Syncope, Coronary Ischemia- Syncope, confusion, dyspnea, chest painconfusion, dyspnea, chest pain

• What about women and heart What about women and heart disease?disease?

Heart: HPPHeart: HPP

• Increase water consumptionIncrease water consumption

• Decrease fat (increasing Decrease fat (increasing fruits/veggies)fruits/veggies)

• Higher fiber diet (wheat bran/oats)Higher fiber diet (wheat bran/oats)

• Physical ActivityPhysical Activity!!!!!!

• Weight reductionWeight reduction

• Stop smokingStop smoking!!

• Stress management/reductionStress management/reduction

Other health promotion Other health promotion thoughts...thoughts...• Supplementation-Vit. A, E, C, BSupplementation-Vit. A, E, C, B

• Use less salt, eat less fatUse less salt, eat less fat

• Limit alcohol useLimit alcohol use

• Mediterranean Diet-higher in fiber, Mediterranean Diet-higher in fiber, fruits, veg, fish, omega 3 fatty acids, fruits, veg, fish, omega 3 fatty acids, lower in fat and red meatlower in fat and red meat

• Biofeedback, yoga, breathing Biofeedback, yoga, breathing exercises, or other natural stress exercises, or other natural stress management strategiesmanagement strategies

Cancer - SkinCancer - Skin

• Skin-most common CA (1 in 3 will Skin-most common CA (1 in 3 will get skin cancer) Over 1 million get skin cancer) Over 1 million new cases/year and 10,000 new cases/year and 10,000 deaths/yeardeaths/year

• 100% curable, if detected early100% curable, if detected early

• Prevention- Wear sun screen and Prevention- Wear sun screen and a hat, limit sun exposurea hat, limit sun exposure

• Early detection: A, B, C, D!Early detection: A, B, C, D!

Early Detection Is The Early Detection Is The Key!Key!• A=Asymmetry of lesionsA=Asymmetry of lesions

• B=Border’s irregularityB=Border’s irregularity

• C=Color variationC=Color variation

• D=Diameter >6mm or growth of sm. D=Diameter >6mm or growth of sm. LesionLesion– Give the patient a look, measure, draw Give the patient a look, measure, draw

pictures, take notes, re-assess regularlypictures, take notes, re-assess regularly– you may be the only one to LOOK at the you may be the only one to LOOK at the

patient’s back and neck over several patient’s back and neck over several yearsyears

Cancer- LungCancer- Lung

• LeadingLeading cause of cancer death cause of cancer death

• 25% of metastases to spine are 25% of metastases to spine are from lungfrom lung

• PreventionPrevention– Stop smoking!Stop smoking!– Wear masks if the job demandsWear masks if the job demands– Avoid radon exposureAvoid radon exposure

Cancer: Prostate and Cancer: Prostate and BreastBreast• 2nd leading2nd leading cause of cancer death cause of cancer death

• 60% of spinal metast. from prostate60% of spinal metast. from prostate

• PreventionPrevention– Lower fat intake/alcohol intakeLower fat intake/alcohol intake– Saw palmetto, Stinging nettlesSaw palmetto, Stinging nettles– Regular health screeningsRegular health screenings

•Annual DRE and PSA males > 50 (0ver 40 ?)Annual DRE and PSA males > 50 (0ver 40 ?)

•Monthly breast exams and bi-yearly Monthly breast exams and bi-yearly mammograms (females > 45 or > 40 w/ risks)mammograms (females > 45 or > 40 w/ risks)

Cancer: ColonCancer: Colon• Strikes 1 in 17 people (US)Strikes 1 in 17 people (US)

• 55,000 deaths/year in the US55,000 deaths/year in the US

• Risks: Fam. History, high fat, low Risks: Fam. History, high fat, low fiber diet, chronic constipationfiber diet, chronic constipation

• Preventable-(yrly screen: fecal o. Preventable-(yrly screen: fecal o. blood)blood)– High fiber diet (30 grams/day), add CA++ High fiber diet (30 grams/day), add CA++ – Lower fat in dietLower fat in diet– Water!Water!

StrokeStroke

• 3rd leading cause of death3rd leading cause of death

• 150,000 deaths/yr in US150,000 deaths/yr in US

• Risk factorsRisk factors– High BPHigh BP– Prevent/reduce atherosclerosisPrevent/reduce atherosclerosis– OverweightOverweight– StressStress– Sedentary Sedentary

Stroke-Stroke-Patient PresentationPatient Presentation• Unusual visual disturbancesUnusual visual disturbances

• unusual speech disturbancesunusual speech disturbances

• unusual weakness or sensations in unusual weakness or sensations in extremitiesextremities

• dizzinessdizziness

• syncopesyncope

• HEADACHES-focal, progressive HEADACHES-focal, progressive worsening of neurological lossworsening of neurological loss

Stroke PreventionStroke Prevention

• Quit smokingQuit smoking

• Increase physical activity!!Increase physical activity!!

• Lower BP, cholesterol, weight Lower BP, cholesterol, weight (monitor)(monitor)

• Diet-Diet-– Increase fish, fruits, veggies, grains in Increase fish, fruits, veggies, grains in

dietdiet– Increase vitamin C, B, K+, CA++, Mg+Increase vitamin C, B, K+, CA++, Mg+– Decrease meat based proteins and fatDecrease meat based proteins and fat