Tag: Geriatrics

Eating Green Leafy Vegetables May Prevent Memory Decline

A new study out of Rush University Medical Center found that eating just one serving a day of green, leafy vegetables may be linked to a slower rate of brain aging. 

The study found that people who ate at least one serving of green, leafy vegetables a day had a slower rate of decline on memory tests and thinking skills than people who rarely or never ate those vegetables. Green leafy vegetables include kale, broccoli, mustard greens, collards and spinach.

The cognitive difference between the groups who did and didn’t eat those vegetables regularly was about 11 years, according to study authors.

The study involved 960 people with an average age of 81 who did not have dementia and were followed for an average of 4.7 years. Participants completed a questionnaire about eating habits and had thinking and memory skills tested yearly.

The study was published today in the online issue of the medical journal of the American Academy of Neurology.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.

Less Than an Hour of Activity a Week Might Prevent Age-Related Disability

A new study has found that sedentary older adults who add less than an hour of moderate physical activity per week can improve overall physical functioning.

Researchers analyzed data from more than 1600 men and women ages 70-89 over an average of 2.6 years. All had problems moving normally at the beginning of the study and most reported fewer than 20 minutes of physical activity a week.

Over 24 months, researchers found that participants who engaged in at least 48 minutes of physical activity a week (or around 7 minutes a day) saw the greatest benefit. 48 minutes or more of physical activity a week was also associated with preventing major loss of mobility.

Researchers say the study is encouraging and suggests that even small increases in physical activity in older adults can prevent muscle loss, lower disability risks and help sustain independence into old age.

Potential acknowledged limitations of the study are that some participants monitored activity using a wearable “device” while some self-reported

The work is part of the Lifestyle Interventions and Independence for Elders (LIFE) study and was published last month in the online journal Public Library of Science Journal.  

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.

Why Another of West Virginia's Geriatricians is Leaving the State

Last year we ran a story about the shortage of geriatricians in West Virginia. In it, we featured Todd Goldberg, the only full-time geriatrician in Charleston and head of the West Virginia University geriatrics fellowship program.

Since that story ran, WVU decided to end their fellowship program after it failed to attract applicant for a fourth year in a row. Now, Goldberg has decided to leave West Virginia citing a personal reason – the need to care for his own aging parents in Pennsylvania. Health reporter Kara Lofton recently sat down with Goldberg at Edgewood Retirement Community in Charleston to talk about his decision to leave and what one fewer geriatrician in an aging state means for the future of elder-care in West Virginia. 

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation, Charleston Area Medical Center and WVU Medicine.

Mental Health in the Elderly and the W.V.a Geriatric Psychiatrist Shortage

Herb Myers is one of the only geriatric psychiatrists currently working in West Virginia’s nursing homes. He is also an old friend of health reporter Kara Lofton. Lofton sat down with Meyers a few weeks ago to discuss the state of geriatric psychiatry in West Virginia and what will happen when Meyers retires next year.

LOFTON: You have worked in geriatrics for a number of years in West Virginia. Psychiatry is not something you usually associate with a nursing a nursing home. Why is that important to have geriatric psychiatry in a nursing home?

MYERS: Nursing homes are becoming the institutions where elderly mentally ill end up residing many times so they need good management. There’s a lot of restriction on use of psychotropic in nursing homes…

LOFTON: Can you explain for people not familiar with that term what is a psychotropic?

MYERS: A psychotropic is a medication that is primarily is used for mental illness and behavioral problems. It’s a medication that primarily targets the mind or the brain.

LOFTON: So when I talked to you the other day on the phone you said you were the only geriatric psychiatrist that you knew of working in nursing homes in the state of West Virginia. And you are slotted to retire next year, so what will happen to your patient population when you are no longer in practice?

MYERS: We don’t know at this point. It’s not real hopeful that we’ll be able to find someone to replace me. We are looking at other options. One coming down the road is tele-psychiatry, that’s being developed in West Virginia, but I don’t know that it’s being developed in the psychiatry field at this point. Another group of professionals that are developing are nurse practitioners who specialize in geriatrics and particularly geriatric mental health.

LOFTON: And so when you are working in these nursing homes you said this is where elderly patients with mental illness usually end up. Are you seeing an increase in that population in nursing homes over the last couple of years?

MYERS: Yes it has been increasing. Partly because – and this was true in Pennsylvania as well as West Virginia – the states are trying to get out of the state hospital business. That’s where people with mental illness used to end up if they couldn’t be easily managed in the community. The states are no longer dealing with those people – or trying not to- and closing down those facilities. 4:10. 4:30 And the nursing homes are often hesitant to take them because it increases the percentage of their residents who are on psychotropic or drugs for mental illness. And the higher their percentage, the worse it looks for them.

LOFTON: So that’s really interesting to me that there’s a penalization for having more people on psychotropic medications or folks that are mentally ill. I mean I wonder is it appropriate to put elderly mentally ill in a nursing home with folks that aren’t? I mean should we have a separate facility for them or is it better to kind of have this cross population of folks in what is essentially long-term care facilities?

MYERS: I think most of the time that it’s appropriate. People who are well controlled on their medications generally do well in a nursing home and in the general population. I was talking to a group today about this and emphasized that people with mental illness don’t belong on a dedicated dementia unit with people with dementia, they should be in the general population – unless there’s a safety issue. But by and large they do very well in a nursing home. In fact, I think they do better than they did in the community sometimes because they get their meds regularly, they have programs, they have good nutrition, they have good hygiene in the nursing home so – it’s not a bad place.

LOFTON: You talked a little bit earlier about the shift of states to move away from having severely mentally ill folks in state institutions like hospitals. Is there a benefit to moving them to nursing homes or is that just a shifting of the problem so to speak? I mean do the patients actually have better outcomes in nursing homes rather than a state hospitals.

MYERS: One of the problems you face is that the funding is such that the government – Medicaid generally pays for nursing home care, but they don’t pay for assisted living. Some of these people really could do well in assisted living, which is in a sense a lower level of care where you do more for yourself. Because I see some of these people in the nursing homes who can do a lot for themselves, but they just can’t survive alone in the community.

Well thank you Herb, for talking with me today, I appreciate it.

MYERS: You’re welcome.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

West Virginia Struggles with Shortage of Geriatric Physicians

At Edgewood Summit retirement community in Charleston, 93-year-old Mary Mullens is waxing eloquent about her geriatrician.

“Poor old doctor Goldberg…There’s only so much a person can do, and he sure got a lot to do and does it so well,” she said.

Todd Goldberg is one of just 36 geriatricians in West Virginia, according to the American Geriatrics Society. The state needs more than four times that many.

“With the growing elderly population across America and West Virginia, obviously we need healthcare providers,” said Goldberg.

According to Goldberg, West Virginia needs not only geriatricians (a physician specializing in adults ages 65 and older), but nurses, physical therapists, and psychologists who know how to handle this patient population.

“Experts feel that the current workforce is inadequately trained and inadequately prepared to deal with what’s been called the silver tsunami – a tidal wave of elderly people – increasing in the population in West Virginia, across America, and across the world really,” he said.

The deficit of properly trained physicians is expected to get worse. One in five Americans will be eligible for Medicare by 2030.

Few Young Doctors Are Becoming Geriatricians

Goldberg is also chair of geriatrics at West Virginia University-Charleston. It’s home to one of the state’s four geriatric fellowship programs for medical residents. Geriatric fellowships are required for any physician wanting to enter the field.

For the past three years, no students have entered the fellowship program at WVU-Charleston. In fact, for the past three years, no students have enrolled in any of the four geriatric fellowship programs in West Virginia.

“This is not just our local program or in West Virginia, this is a national problem,” said Goldberg.

According to the American Geriatrics Society, only 63 percent of the nation’s geriatric fellowship positions were filled in 2014. As Goldberg put it, why would a resident apply to a West Virginia School, when even the worst student could get into a program like Yale or Harvard?

Goldberg says some young doctors he works with want to go into geriatrics, but crushing student debt forces them into higher paying specialities.

This trend is troubling for West Virginia families.

“It’s kind of scary that they don’t have the care that really they need to help them through these times and help them prolong their life and give them a better life,” said Todd Plumley. His elderly mother has dementia and “a little bit of Alzheimer’s.” There are no geriatricians in Plumley’s hometown so he, or one of his siblings, drives their mother almost 45 minutes to Huntington to see a specialist. Plumley said the effort has helped stabilize his mother’s symptoms.

“Right now, if we didn’t have the knowledge and resource that we did have, I believe my mother would have progressed a lot further along quicker.”

Plumley is in his 50s. If trends persist, and the field of geriatrics continues to contract, in 20 years, should he need specialized care, driving even 45 minutes may not be an option.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

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