Earning the Brains & Balance Past 60 Certificate Part 4: Making Connctions: Challenging the Older Brain

This is part 4 of the 4 parts covering the Exercise Etc seminar I attended on Saturday, October 18, 2014

Part 1 Forever Young: Secrets of the Older Mind      

Part 2: Balance, Stability & Fall Prevention

Part 3 Balance, Mobility & Function

Articles like this are why I train older clients the way I do.

 
New York times article: A tiny stumble- a-life-upended. 

The first topic Guy covered in this session was Understanding Cognition:

What other things besides mental stimulation and exercise effect cognition?

     *  Nutrition
     *  Hydration
     *  Medication
     *  Alcohol
     *  Companionship
     *  Depression

Just like mental stimulation and exercise we have control over most of these things. Depression can be a whole other issue. It can be effected by everything else on this list.

According to the Centers of Disease Control the following statistics cover Cognitive Disorders:

        INCIDENCE:                                                      CAUSES:
   *  Alzheimer's                                                         *  Alzheimer's
      -  Over the age 65:    13%                                        -  Family History
      -  Over the age 85:    45%                                        -  Lack of mental stimulation

  *  Vascular Dementia                                                *  Vascular Dementia
      -  Over the age 71:      5%                                          -  Poor Blood Flow
      -  Over the age 90:    38%                                          -  Stroke

  *  Depression                                                             * Depression
      -  Community based:  1%                                         - Isolation
      -  Nursing home:       15%                                        -  Hopelessness
         

Consider what stands out about these statistics:

     - As seniors age the chances of developing Alzheimer's increases 346% in twenty years and   
       Vascular Dementia increases 760% in 19 years.

     - Being part of a socially active community instead of a nursing home decreases your chances of 
       developing depression from 15% to 1%.  It pays to have friends when you get older.

 What are the leading causes of being 
admitted to a Nursing Home?

     -    Neurological
           *  Dementia

     -    Cardiovascular
           * Congestive Heart Failure
           
     -    Musculoskeletal
          *  Osteoporosis
          *  Osteoarthritis

According to the Wall Street Journal, February, 2014, the medical cost of treating dementia exceed the cost of Heart Disease and Cancer combined.

What role does the Medical Community play in Intervention? 

       *  The Primary Care Physician must be an active participant in the effort to maintain cognition.  

       *  Every individual (or their caregivers) should request a medication review with the following questions:
            
           -  Are they all necessary?
           -  Can Dosages be reduced?
           -  What are there interactions of the drugs being taken?
           -  Are there vitamin/mineral deficiencies?

10 Drugs that May Impair a Persons Memory 

AARP: May 2013                  

   
          *  Stain Drugs                                                              *  Anti-Anxiety Meds
          *  Blood Pressure Meds                                               *  Parkinsons Drugs
          *  Anti-Depressants                                                      * Incontinence Meds
          *  Anti-Seizure Meds                                                   *  Sleeping Aids
          *  Narcotic Pain Relievers                                            * Antihistamines

According to the Centers for Disease Control (2012) 
the average American 65 year-old is on 4 prescription meds. 

The average 85 year-old is on 14. 

 

What role does Hydration play in 

keeping your cognitive functions?    

   -  Dehydration can mimic the symptoms of dementia. If you become too dehydrated your blood 
      pressure can become so low that not enough blood and oxygen gets to your brain

Some excellent sources of vitamins

What Vitamin Deficiencies are 

Associated with Impaired Brain Function?

    -  B - 12 and Folate 

I wonder what effect Spirulina and Cholrella might have on retaining memory?

What Supplements play a role in 

keeping Cognitive Functions.

      *  Lactulose
          -  This laxative also removes ammonia which is considered a Neurotoxin from the body.

      *  Lysine - ask you Dr. about it
          - Some research suggest the it slows the progression of Alzheimer's, some research suggest it
            accelerates the progression.

      * CoQ10 - ask your Dr. about it.
         -  Research is interesting yet inconclusive regarding it's effect of cognition.

I added:
 
      *  Coconut Oil
        - It is an excellent source of Medium Chain Fatty Acids which might help feed the brain.

       *  Vitamin D
           -  Dr. Mercola article talking about the role of Vitamin D levels and Dementia

 
Alcohol, Ammonia and Cognition 

      *   Ammonia is a known neurotoxin that shows down processing speed and affects language,
           memory, problem solving and reasoning abilities. 

      *  Risk factors for Elevated Ammonia Levels:

          -  Alcohol use: Guy stated that they (I wish I knew who) consider drinking 2 servings of
              alcohol per day as Heavy Drinking.  This equates to 2 cans or bottles of beer or 8 ounces 
              of wine.  

          -  Smoking
          -  Aging Livers and Kidneys.

          -  Use of Barbiturates, Diuretics, and Narcotics, especially when combined with Alcohol.

 

 Sugar Intake and Cognition:

       *  1 tsp of sugar = 4 grams
       *  Seniors with the highest sugar consumption are almost twice as likely to develop cognitive
           impairment. - Mayo Clinic, 2014
       *  Although the brain runs on sugar, too much sugar increases insulin resistance, which deprives
           the brain of glucose.

Sodium and Cognition:

     *   Salt RDA = 2400 mg per day
     *  Avoid foods high in sodium because they can:
         - Cause dehydration which affects cognition  
     *  Seniors with the highest salt intake also are more likely to suffer cognitive impairment. -

         University of Toronto, 2014

IMO, we should not compare processed Table Salt with Unprocessed Sea Salt. 

Although I don't drink coffee, I love chocolate. I wonder what effect chocolate consumption has on memory?

Caffeine and Cognition:

     *  A 2014 study found that older women who consumed around 370mg of caffeine per day
         (around 2 cups) had maintained a higher cognitive level than women who did not.
     *  Caffeine from Tea or Soft Drinks DID NOT have the same effect.

How to Train the Brain:

      -  Lumosity.com (most of us have seen their commercials on TV.
      -  Crossword Puzzles, Sudoku, Jigsaw Puzzles. etc.
      -  Reading, Conversations which make you think and remember details.
      -  Scrabble, Bridge and other Card Games which require strategy.
      -  Brain Teasers, Riddles
      -  Painting a Picture, Writing a Poem.
      -  Making a list
      -  Writing in a Blog (I added this one)

100, 97, 94, 91........

Integrating Brains & Balance Drills:

Multitasking Drills

       *  Walk Forwards, Laterally or Backwards while:
           -  Counting Backwards from 100: by 2's, 3's, 5's 7's or any other numbers
           -  Answer questions such as State Capitals, Birds, Types of Pets, etc. Think of any type of list.

       *  Tracking Drills.
           - Step Side to Side while pretending to draw various shape using your hand, switch hands, etc.

This concludes my Blog Post on the 

Brains & Balance Past 60 Seminar. I hope you enjoyed reading them and learned some things as I did by I attending it.

          

How do you physically prepare for retirement? Part 5: How I begin working on my client’s dynamic and static balance.

In case you missed the first 4 posts:

Part 1 Posture 

Part 2 Posture

Part 3 Posture

Part 4 Mobility 

What you will find is we will use some of the same exercises for improving posture, mobility and strength. The difference is how the exercises are performed. 

In part 1 of my posture series the main focus was on posture while also working on the mobility and stability of the head and neck at the same time.

In part 2 we focused on posture while also working on the mobility and stability of the shoulders and thoracic spine at the same time.

In part 3 we focused on posture while also working on the mobility and stability of the Lumbar/Pelvic/Hip Complex at the same time.

In part 4 we began developing dynamic mobility in the hips and legs. 

Why do I begin with posture and mobility before strength? I want my clients to maximize the gains, while minimizing the risks they will make from the complex movements I use to make them stronger. The results will be much better if they can stabilize what I want stable and move with control what I want mobile.

WHEN WORKING ON ANY OF THESE EXERCISES, NEVER FORCE YOUR BODY INTO A POSITION. The focus should always be on how you are controlling the muscles and joints and the movements they are making. The pace of each movement should be slow. Perform from 5 to 10 reps of each. The goal is to get the muscles turned on as opposed to tiring them out. If you feel fatigue in the muscle when you are done, you have done too many.

What exercises you perform are important. How you perform them is more important.

Before attempting any of the following exercises, be sure to get the approval of your Physician. Especially if you have ever had ANY JOINT OR BACK PAIN or INJURY.  If you aren’t sure how to perform any of these exercises, have someone show you that knows how to teach you.

After my clients have learned their posture and mobility exercises I teach them more advanced balance and stability exercises.

____________________________________________________________

Balance Exercises:

____________________________________________________________

The Teeter Totter: Shifting weight form one leg to the other.

                            Weight shifting onto left leg                                                        

This is one of the easiest balance exercises to teach. It adds to the stability of the pelvis while also working on torso stability.

The client stands with their feet about as far apart as the can. They shift their weight to one foot while their entire body shifts towards that foot. They then change directions.

They focus on how their weight is shifting from foot to foot and side to side while they control how the body is moving.  ______________________________________________________________

Forwards/Backwards Weight Shift:

 

                              Forward Shifting                                                     

This one begins with the client in a staggered stance like a split squat with the legs straight.  They shift their weight onto the front foot and then reverse the weight shift onto the rear foot. After 5 - 10 reps they repeat this with the position of the feet reversed (while facing in the opposite direction if holding onto a counter top.) The focus here is on how their muscles react when each foot lands on the ground. 

I might begin with the client holding onto a counter top with the hand on the rear foots side, if they aren't ready to perform this without using their hands.

They focus on how their weight is shifting from foot to foot and forwards to backwards while they control how the body is moving.  

  Single Leg Hip Hinge with rear foot on ground                   

Once the clients balance is good enough I advance them to a one legged version of the Hip Hinge. First they might have to have the rear foot on the ground. 

                       Look Ma NO HANDS!                           

The goal is to develop enough strength and confidence to do this without holding on to anything and having the rear foot off the ground. Think about how much the torso is moving compared to how stationary it is with the beginning version.  

More advance versions can be added that involve reaching at various directions with one or both hands.

 ______________________________________________________________

Clock Steps:

Imagine standing in the middle of a big one of these.

 

Once I feel that the client has mastered the Teeter Totter and Forward and Backward Weight Shift I might advance them to Clock Steps. They begin standing with their feet next to each other. Imagine standing in the middle of a clock. They then begin stepping in various directions with one foot landing on different spots like 12 noon or 6 pm or any other part of the clock. Once they have done from 6 – 15 steps leading with one foot they repeat the process with the other foot. They might begin with a set pattern such as. 12 – 3  - 6. 

I make sure they focus on leading with the hips instead of the shoulders. This increases the amount of stability in the torso.

Beginners start with small steps and very little bend in their knees. As they advance the size of the steps gets larger and the bend in the knees gets greater until the steps look like lunges at various angles. To increase the difficulty, I might have them increase the speed of the steps.

For variety I might call out random spots. This takes more concentration. Any variety you can think of can be used.

The focus here is also on how their muscles react when a foot lands on the ground.

 ______________________________________________________________

Leaning Tower: This one I learned while working at Banes West.

Another great balance exercise i use sometimes is one I call the Leaning Tower. I have the client stand straight. I stand behind them with my hands on their near their pelvis. I gently push their pelvis in various directions until they have to react while trying to keep their torso/hips and pelvis from moving.

The focus is on how they react to my pushing them. I start by telling the client which direction I am going to be pushing. (forwards, backwards, sideways or at various angles) As they advance I don't tell them which direction I am pushing so that it is more challenging. To make it even more challenging I have them react while they have their eyes closed. 

Another way I might increase the challenge is to push the client far enough that they lose their balance and have to react to regain it. I make sure I have control of their pelvis/hips so there is no chance of them falling. Their reaction really increases how much improvement they get in the level of balance from this exercise. 

_________________________________________________________________

Cross Over Lunge to Speed Skaters:

Crossover Lunge

This is another exercise that only my more advanced clients are ready to use.

The focus is on controlling the hips while maintaining a upright torso. They alternate which foot is in the forward position. As they advance the amount of bend in the knees can increase. The body doesn't move much from side to side. 

Even fewer of my clients advance to the next level. 

Speed Skaters:

These are a lot like crossover lunges with more lateral movement. The goal is to hop with greater side to side distance. You can pause with each step or quickly jump with each step. One challenges stability more and one challenges mobility more. There tends to be more forward flexion from the hips. 

______________________________________________________________

Stationary Heel to Toe: Forwards and Backwards, Sideways: This is one exercise most of my clients can do.

The client begins standing in a partial squat position.  They keep one knee, hip and ankle as stable as they can while moving the other leg forwards until the heel touches and then backwards until the toes touch. This is repeated 5 - 15 times and then they perform this with the other side held stable. I then have them stabilize the first side again while moving the other leg sideways. This is also repeated 5 -15 times and then they perform this with the other side held stable. This exercise can do wonders for the clients level of balance since it increases their ability to control how well they can keep their lower bodies stable.

___________________________________________________________________

I hope you have enjoyed this post while 

learning a few things about how to 

increase your dynamic and static balance.

My next post will cover how I begin 

increasing my clients level of strength by 

advancing what they have been taught.