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Posts for: February, 2017

By Dr. Doug Williams
February 15, 2017
Category: Frailty
Tags: Healthy Aging   frailty   body systems  
Over the last few months, we have been working our way through the topic of Frailty, which is really a study of how the body unwinds over a life time. Most of the material we have been drawing from has come from an article published in "The American Geriatrics Society."

While some choose to look at topics like Frailty and the unwinding of our bodies over time as a bad thing, this article and our blog series took the approach that we are "Fearfully and Wonderfully Made" and understanding how we function in youth and as we age can help us live as full and complete a life as possible!

The lens that we used to look at this topic consisted of four, separate yet interrelated, segments:
  1. Inflammatory System
  2. Endocrine  System
  3. Musculoskeletal System
  4. Nervous System

The first thing we looked at was Inflammation. We saw that researchers looked at these main markers in inflammation:

  • Cytokine IL-6
  • C-Reactive Protein
  • Total number of monocytes

These were blood markers that increased with age and disease, and were related to the following disease states and functional issues:

  • Death (that is a big one)
  • Bone mineral loss
  • Muscle loss
  • Anemia
  • Insulin resistance (Adult Diabetes)

We also looked at how we could influence these various states of decline and dysfunction, primarily by how and what we ate. There are two links that can help with addressing this issue:

  1. Andrew Wiel Article
  2. Blog Summary from our Healthy Eating Series

Next, we looked at the Endocrine System.  The main markers researchers look at in the Endocrine System are

  • IGF-1
  • DHEA-S

These two markers primarily give insight into the sex hormones: Testosterone and Estrogen. These markers ebb and flow over a life time, but tend to trend down as we age, causing the following functional loss:

  • Decreased strength
  • Decreased endurance
  • Weight loss (due to loss of muscle tone)
  • Decreased walking speed
  • Decreased physical activity
  • Increased inflammation
  • Cognitive issues (dementia)

When looking for ways to positively influence these factors, we found several factors to pursue:

  1. Resistance training
  2. Weight loss/management
  3. Decreasing high glycemic index foods
  4. Increasing sleep
  5. Eating a high protein low carbohydrate snack before bed

Two links that were helpful were:

  1. Article in the Journal of Gerontology (Technical)
  2. Article in Life Extension Magazine (Reader Friendly)

After the Endocrine System, we looked at one of my favorite: the Musculoskeletal System! The main marker for this system is muscle mass or muscle to non-muscle tissue ratio.

We primarily focused on the glute muscle because it is such a big player in much of human locomotion. Decline in the musculoskeletal system results in the following disease and functional states:

  • Diabetes
  • Fall risk
  • Declining bone health
  • Independence

We referenced two helpful links:

  1. The Sit to Rise Test (explained the relationship between core strength and life expectancy)
  2. Getting Your Butt Off the Ground (blog series on how to improve the Sit to Rise Test!)

Finally, we looked at the Nervous System. We saw that the nervous system really brought everything together, which is why it is often called the Master System. The markers that were used in the original article are:

  • Gait (how stable and smoothly you walk)
  • Balance
  • Strength

We added a bonus one that has been making it's way into the literature lately:

  • Cognition (how well your brain works)

When the nervous system starts to fail, you see the following issues:

  • Falls
  • Loss of independence
  • Problems with coordination
  • Cognitive issues (mental slowness, dementia and, possibly, Alzheimer's's disease)

We linked to several articles:

  1. The Nurses Study on Walking (showed a dose-based relationship to exercise brain function)
  2. An Article in JAMA (relative to exercise and brain health - dementia and Alzhiemer's)
  3. Our previous blog series on Getting Out Of A Chair (practical place to start for glute strength)


What's Left?

As I write this article, I am 52 years old. I am sure that some of you reading are much younger than me and some older. One thing we all have in common is we are all headed to one last door in life to open.. death! We all are going to have to step through it, at some point. I have a lot to say about what I believe to be on the other side for me (the waiting arms of Jesus, who made the supreme sacrifice for me!), but that is not what this blog series has been about! This series has been about how things are going to unfold as you get to that last door. Personally, I would like to be able to walk right up to it at the end under my own power. While that may not be possible, I am going to do all that I can to operate as fully and completely as I can in the framework I have been given. I hope some of the material we have covered helps you to do the same.

In Health,

Doug Williams, D.C.
Care Chiropractic 
Lafayette, Indiana


By Dr. Doug Williams
February 08, 2017
Category: Frailty
Tags: exercise   frailty   nervous system  
 
The Nervous System Lies at the Hub of Frailty

We have been working through a series on Frailty, essentially what happens to our bodies as we age. This material is important for several reasons, not the least of which is, because it is going to affect all of us, if we live long enough, and knowing what is coming can be comforting on some level.

However, more than that, I believe that understanding how we are "fearfully and wonderfully made" allows us to not only appreciate what we have been given in our bodies, but also inspires us to take the best care possible of them.

With that in mind, we have been going over what happens to us over time, but also how to positively impact it. The Nervous System literally and figuratively lies at the center of our life and, ultimately, death.

Components of the Nervous System
 
The Nervous System is structurally broken down into two parts:
  1. Central Nervous System, which is composed of the brain, spinal cord and nerve roots
  2. Peripheral Nervous System, which is composed of the nerves once they leave the spinal cord
The Nervous System is functionally composed of about a million different parts! Okay, maybe not a million, but way more than I am prepared to cover in this material.
 
The most useful model for the functional aspect of the Nervous System is to think of it as a great big feedback mechanism.

It is constantly seeking information through our senses on things like: gravity, position, resistance, stability, sound, smell, sight, temperature, feel, etc., and relaying this to the brain in order for the brain decide what it wants to do next.
 
 
Think of Your Nervous System Like a Submarine
 
Submarines are known for operating on sonar - essentially, making a sound, waiting for the sound wave to bounce off something and return back to the sender. The submarine then could make a decision on whether or not it wanted to go in this direction or that. This is often called pinging.

Pinging is what your nervous system is doing all day long, searching out information from the periphery, relaying it to the brain, deciding what, if anything, to do about what it has found out and then taking action.

Going up a flight of stairs? Your eyes gauge the height of the stairs, your foot tells you if the surface is smooth like wood or has resistance like carpet, your heart rate and blood pressure increase (via messages from the nervous system) as you ascend and relay information to the brain in order to make a decision if you need to stop and rest halfway up or not.

Most of this happens automatically without you thinking about it... until it doesn't! Then, you have a problem - you might slip, stumble and fall, or catch yourself.

The interesting thing is that failures in the feedback mechanism happen at both ends of the age spectrum - a 2-year old learning to negotiate the stairs has some of the same issues as an 82-year old might - and for the same reason: The Nervous System is Not Completely Plugged In!

Often times, our physical "Pinging and Processing" can parallel our cognitive (ability to think and reason) "Pinging and Processing." In other words, our brains can slow to match our bodies!

This presents some very interesting possibilities. For instance, if you train the body, will the brain follow suit?
 
 
Train the Body, Train the Brain!
 
An interesting study published in JAMA (Journal of the American Medical Association) in 2004 looked at over 18,000 women between the ages of 70-81 and their activity levels, specifically walking. The study found that, not only was there a 20% difference in cognitive function (brain activation), but that their cognitive function was related, in part, on a dose basis: the more active they were, the better off they were!

This is only one of many articles you can find on physical activity and the role it plays in keeping the brain healthy. Really, keeping the brain healthy is a reciprocal action, just like our sonar example from the submarine. The more information you can process, the more likely you are to get up and process it; rinse and repeat!

Another article published in JAMA in 2008 studied elderly individuals with memory issues but had not met the criteria for Alzheimer's. 138 people completed this study that split the group into two: half did what was considered an "educational and usual care program" and the other half did a "24 week at-home physical activity program." The "educational and usual care program" showed deterioration over the study time - they actually lost ground. In contrast, the "at-home physical activity group" not only didn't lose ground, but they showed improvement!

Components of accessing the nervous system for frailty include:
  • Gait: how well and how much you can walk
  • Balance: a measure of strength and coordination
  • Strength: a measure of how well you recruit your muscles to do a task; this can be a quantity and quality issue
Doesn't that sound a lot like exercise? It sure does to me! Once again, we find ourselves back at the basic premise that we were born to move and, when we stop moving, we stop living (maybe not all at once, but progressively, in both body and mind)!

Training movement has a lot of components, but at the heart of it is this concept:

GET UP AND DO SOMETHING... ANYTHING!
 
A good place to start would be our blog series on getting out of a chair. It has some simple step-by-step exercises for strengthening your glutes, the biggest muscles in your body.
 
Whew! Well, I hope you have gotten something out of our series on Frailty. Next week, we will wrap it up and pull everything together. The last portion of the theory on Frailty is called Integrative, I think you will like it!

Until then,
Get Up and Do Something!

Doug Williams, D.C.
Care Chiropractic
Lafayette, Indiana

PS: Don't forget to visit our new blog page at Doug Williams, DC - there is lots of great stuff to explore!