Accurately measure anxiety levels among seniors

New tool can efficiently and accurately measure anxiety levels among seniors!

March 19th, 2010

-Dr. Kathy Johnson, PhD, CMC

The department of psychiatry at Rhode Island Hospital has created a new questionnaire and measurement scale to evaluate anxiety in senior citizens. Anxiety is a condition that is becoming more common as an individual gets older. In order to determine the condition of a medical  disorder, it is necessary to evaluate outcomes. Standardized scales are always recommended as a tool to treat psychiatric disorders.

Some symptoms of Anxiety fall into four general categories:

* Tense muscles, which leads to shaking, trembling, muscle restlessness, and easy tiring
* Increased nervous system activity which leads to shortness of breath, rapid heart reate, sweating, dry mouth, dizziness, nausea, diarrhea, flushes or chills, frequent urination, or difficult swallowing
* Paranoia, feeling irritable
* Changes in normal behavior to avoid stressful situations such as avoiding meetings which leads to excessive hand washing for example

This new scale can be easily incorporated into routine clinical practice when treating for anxiety. Mark Zimmerman, MD director of outpatient psychiatry at Rhode Island Hospital and his colleagues created this new scale called CUXOS (Clinically Useful Anxiety Outcome Scale test”. 1000 outpatients completed the test in less than 1.5 minutes and each CUXOS could be scored in less than 15 seconds. This test has also been found to be a good valuation of symptom change. As Zimmerman says, “If the optimal delivery of mental health treatment ultimately depends on examining outcome, then precise, reliable, valid, informative, and user-friendly measurement is critical to evaluating the quality and efficiency of care in clinical practice.” This new scale is a valid test to measure anxiety in patients.

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Super Snacks for Seniors

When it comes to healthy snacks, the age of the baby carrot is over. Sure, raw carrots are great for you, but so are plenty of other delicious foods. These ten delicious snacks are also “superfoods” – not only are they not bad for you, they have health-boosting properties to boot. Whether you crave something sweet, something salty, something crunchy, or something creamy, there is a superfoods snack for you. Note the serving sizes mentioned and enjoy all snacks in moderation for a healthy, varied diet.

1. Almonds have been shown to lower cholesterol and help maintain a healthy weight. About a ¼ cup of almonds is a beneficial serving. Enjoy them plain or roasted, whole or slivered. Almond butter – just a tablespoon or two – is a healthy treat, too. Try some on a whole grain cracker and a cup of green tea for a late afternoon energy boost.

2. Blueberries are as full of cancer- and disease-fighting antioxidants as any food around, so much so that they have been even shown to restore antioxidant levels. Also, like cranberries, they can help prevent urinary tract infections. Note that wild blueberries tend to have even more antioxidants than cultivated ones. Fresh berries are delicious all on their own or with a bit of Greek yogurt (see #5). Frozen berries can be used in smoothies or put on top of low-fat frozen yogurt. Use about ½ cup fresh or frozen berries as a serving.

3. Broccoli eaten either raw or lightly steamed contains tons of soluble fiber and antioxidants, as well as folic acid, calcium, ion, and potassium. Broccoli has even been shown to have the power to reduce diabetic damage. Don’t throw away the stalk/stem! Cut off the thick, fibrous darker green peel to reveal the tender, pale green vegetable underneath – it has the crunch of celery and a mild broccoli flavor. Try broccoli florets or peeled stems with a little drizzle of soy sauce or a simple dip made from fat-free Greek yogurt (again see #5) – stir in minced garlic and herbs, lemon zest and minced rosemary, or a sprinkle of cumin and cayenne to taste. About ½ cup of florets or peeled stem is a serving.

4. Cherries, tart ones in particular, have similarly insanely high antioxidant levels as blueberries, putting them in the position to fight memory loss, heart disease, and diabetes. They’ve also been shown to help reduce inflammation, helping alleviate arthritic and gout pain. Fresh, frozen, or dried (unsweetened) tart cherries make a great snack on their own or combined with other nuts (almonds, walnuts, pumpkins seeds) and fruits (blueberries, raisins). Count ½ cup fresh cherries or ¼ cup dried cherries as a serving.

5. Greek yogurt is thick and creamy in a way regular yogurt can only dream of. It’s high in calcium, of course, and contains good levels of probiotics, which aid healthy digestion. But did you know low-fat and fat-free versions contain twice as much protein as regular yogurt? The texture of Greek yogurt makes it a great snack – especially when topped with dried fruits like blueberries, tart cherries, or raisins – as well as a good substitute for fatty sour cream. Include in it your three servings (1/2 cup each) of low-fat dairy a day.

6. Pumpkin seeds give you protein, zinc, magnesium, and selenium, a potent combination that can fight heart disease and depression. Selenium, a trace mineral, is essential for proper thyroid function. Look for roasted pumpkin seeds, often sold as “pepitas,” that are unsalted and flavor-free. As with all nuts and seeds, a serving is about ¼ cup.

7. Raisins, like all dried fruits, contain a lot of natural sugars, but the fiber and iron in raisins, along with high levels of vitamin C, put them squarely in the super snacks category. Plus, the phytochemicals in raisins have been shown to fight the bacteria that cause tooth decay and gum disease. Keep servings to about ¼ cup and buy only unsweetened raisins.

8. Soy beans (edamame) are a great source of protein as well as cancer-fighting flavonoids. Steamed or boiled fresh or frozen soy beans can be eaten like fresh sweet peas or in-shell peanuts – and, in fact, they taste a bit like a cross between the two –  where part of the fun is getting the nugget out of the shell. Enjoy ½ cup shelled soybeans or 1 cup in-the-pod soy beans as a tasty, healthful snack.

9. Walnuts bring protein, fiber, vitamins, minerals and precious omega-3s to the party. They’ve been shown to lower cholesterol, improve brain function, regulate sleep patterns, and fight cancer and heart disease. If you find walnuts a bit too bitter to enjoy them fully, use this trick: blanch walnut halves in boiling water for 30 seconds to remove some of the bitterness, drain them, and then toast them on a baking sheet in a 375-degree oven for 10 to 15 minutes to bring back their crunch. As with all nuts, limit your serving size to about ¼ cup.

10. Dark chocolate – saving the best for last. Dark chocolate has tons of antioxidants, magnesium, manganese, copper, zinc, and phosphorous. Look for chocolate that contains over 70% cocoa to get the full benefit of chocolate’s antioxidant powers and limit your intake to about an ounce a day.

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How to Improve Seniors Sleep Patterns

Naps and medication are two of the most frequently cited ways seniors and their caregivers try to solve their sleep problems. Either (or both) may be appropriate, but each carries its own ability to disrupt sleep further. Each must be used carefully and purposefully, and in conjunction with healthy sleep habits (a.k.a. “sleep hygiene”) as outlined below.

Naps can be either the cause or the cure, depending on how and when they happen. For seniors who struggle to stay alert all day, a short nap may be the bridge they need to get them from a convenient waking time to a reasonable bedtime. Good, healthy, restorative naps are short – just 15 to 30 minutes – since longer naps can lead to drowiness and an inability to fall asleep at bedtime, relatively early in the afternoon so they don’t conflict with bedtime, and physically comfortable in a quiet and dimly lit place.

Many seniors turn to the ever-growing numbers of sleep aids – both prescription and over-the-counter – that are available. One of the potential problems with this route is that sleep aids can interact negatively with a range of medications the senior may already be taking and/or they can cause drowsiness that itself leads to accidents and falls. Worse, many sleep aids can cause confusion and disorientation even in younger, healthier people. For seniors with any level of dementia, this potential side effect must be closely monitored and avoided since it can lead to night fears, heightened anxiety, and even worse: sleep problems.

For seniors having trouble getting to sleep and staying asleep long enough to feel rested and refreshed in the morning, these “sleep hygiene” tips and habits are the first steps to take:

Gradually eliminate caffeine from your diet, or at least limit caffeine intake to one caffeinated beverage in the morning. Avoid all caffeine after lunch.

  1. Eat a big meal at lunchtime, and have a lighter dinner.
  2. Avoid alcohol, or at least limit alcohol consumption to one drink, preferably with a meal and not right before bedtime.
  3. Do some sort of physical activity every day, preferably outside where you can get direct daylight. Exercise early in the day since physical exertion too close to bedtime can be stimulating.
  4. Establish and maintain a set bedtime and waking time. If you choose to take a nap (see guidelines above), do so at a regular, set time.
  5. Establish a pre-bedtime calming routine. This may include a warm bath, reading, or listening to restful music.
  6. Avoid television right before bed.
  7. Write down or simply state aloud any fears, worries, or concerns that are on your mind as part of your bedtime routine – giving voice to such concerns can help reduce their ability to negatively impact sleep.
  8. Use your bed (and preferably the whole bedroom) only for sleeping, do not read or watch television in bed.

If you don’t fall asleep after 15 – 20 minutes, get out of bed and do something quiet and calm, read or listen to restful music or a book on tape. Serious or long-term sleep disorders should always, of course, be brought to the attention of a health care provider.

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Magnesium help maintain cognitive function

Did you know that even while living in an industrialized country with east access to healthy food and nutritional supplements, magnesium deficiency is very common?
According to a new study done by Tel Aviv University suggest that magnesium, which is a key nutrient for the functioning of the memory, may be critical for neurons of children and healthy brain cells in aging adults.

Their research began at MIT and evolved to become a multi-center experiment.  It focused on a new magnesium supplement called magnesium-L-theronate, which effectively crosses the blood-brain barrier to inhibit calcium fluz in brain neurons.  The new study found that the synthetic magnesium compound works fro both young and aging animals to enhance memory or prevent its impairment.  The research has significant implications for the use of over-the-counter magnesium supplements

The study was conducted over a five year period with two groups of rates that ate normal diets containing a healthy amount of magnesium from natural sources.  The first group was given a supplement of MgT and the second control group had only its regular diet.  Through behavioral tests the first group of rats demonstrated an improvement in cognitive functioning and had an increase of synapses in the brain- connective nerve endings that carry memories in the form of electrical impulses from one part of the brain to the other.

“We are really pleased with the positive results of our studies,” says Dr. Slutsky. “But on the negative side, we’ve also been able to show that today’s over-the-counter magnesium supplements don’t really work. They do not get into the brain.”

Though the effects were not immediate, the researchers of the study were able to assesses that the new compound show improved permeability of the blood-brain barrier.  After only two week of oral administration of the compound in mice, magnesium levels in the cerebral-spinal fluid increased.

“Magnesium is the fourth most abundant mineral in the body, but today half of all people in industrialized countries are living with magnesium deficiencies that may generally impair human health, including cognitive functioning.”

The new compound is not commercially available currently, but Dr. Slutsky advises people to get their magnesium the old-fashioned way, which is by eating lots of green leaved, broccoli, almonds, cashews and fruits.  The effects will not appear overnight, she cautions, but with persistent change in diet over a long period of time, memory should improve and the effects of dementia and other cognitive impairment diseases related to aging may be considerably delayed.

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