Falling is a major – and sometimes life-and-death – risk for the elderly. A quarter of those who fall and fracture their hip, even if it is repaired, may die within the first year of the accident. But Tel Aviv Sourasky Medical Center University and European researchers have found that training using virtual reality can prevent falls among older people in 40 percent of cases.
About a third of elderly people living in the community and 60% to 80% of those with moderate cognitive impairment, dementia or Parkinson’s disease, fall at least once a year. The cost of treating them is high – between 1%; and 2% of all health costs in the Western world.
Dr. Anat Mirelman, the lead author and deputy head of the center for walking and mobility research in the hospital’s neurology department, said that poor balance and weakened muscles were thought to be responsible for causing falls. But in recent years, “we have shown that vital cognitive factors are essential for safe walking. One has to be able to react to obstacles, cope properly with the environment and be able to walk and perform other tasks, such as speaking to someone or on the phone,” she explained.
“We developed a unique system that makes it possible to improve cognitive skills while on a treadmill and learn how to function routinely using virtual reality,” she said, calling their results a “breakthrough.”
Prof. Nir Giladi, head of Sourasky’s neurology department, said that the intervention, combining physical and cognitive aspects of walking, reduces falls in the elderly who suffer from neurological disorders such as Parkinson’s and loss of memory. Falls can result in brain hemorrhages, fractures, loss of independence, disability and even death.”
Researchers, who published their findings in the prestigious journal The Lancet, asked 302 adults between the ages of 60 to 90 who had already fallen at least once to exercise on a treadmill three times a week over a period of six weeks. Half of them were randomly chosen to use virtual reality systems as they exercised. The participants were at five medical centers, not only in Israel but also in Belgium, Italy, Holland and Britain.
Wearing virtual reality goggles that showed their own feet going through an obstacle course, they had to react immediately so as not to fall. It demanded great concentration while walking.
The number of falls during a six-month period was registered.
While the number of falls by the two groups was similar before the study, those who used virtual reality over six months fell an average of only six times compared to 11.9 falls by those who used only the treadmill. The technique was especially effective among Parkinson patients.
CORN FIBER CAN BUILD BONE
Supplementing women’s diets in adolescence and post menopause with soluble corn fiber can help build and retain calcium in bone, according to research from Purdue University in Indiana.
“We are looking deeper in the gut to build healthy bone in girls and help older women retain strong bones during an age when they are susceptible to fractures,” said Prof.
Connie Weaver, head of nutrition science at Purdue.
“Soluble corn fiber, a prebiotic, helps the body better utilize calcium during both adolescence and post-menopause.
The gut microbiome is the new frontier in health.”
The menopause findings are published in the American Journal of Clinical Nutrition and the adolescent findings in the Journal of Nutrition.
A prebiotic fiber passes through the gut for the microbes in the lower gut to digest. Here is where Weaver found that soluble corn fiber is broken down into short chain fatty acids to aid in bone health.
In the post-menopausal study, calcium retention was measured in 14 women by using an isotope to measure the excretion of 41Ca to measure bone loss. The women consumed 0 grams, 10 grams or 20 grams of this nondigestible carbohydrate each day for 50 days. Bone calcium retention was improved by 4.8 percent and 7 percent for those who consumed 10 grams and 20 grams, respectively.
These amounts of soluble corn fiber can be made in supplement form.
“If projected out for a year, this would equal and counter the average rate of bone loss in a post-menopausal woman,” said Weaver, an expert in mineral bioavailability, calcium metabolism, botanicals and bone health.
Thirty-one girls either consumed 0 grams, 10 grams or 20 grams of soluble corn fiber carbohydrate each day for three weeks while maintaining their regular diets. Both 10 grams and 20 grams led to improved calcium absorption by 12 percent for female adolescents, which would build 1.8% more skeleton a year.
In both studies, gastrointestinal symptoms were minimal and the same for the control groups, as well as in those who consumed soluble corn fiber.
“Most studies looking at benefits from soluble corn fiber are trying to solve digestion problems, and we are the first to determine that this relationship of feeding certain kind of fiber can alter the gut microbiome in ways that can enhance health,” Weaver said.
“We found this prebiotic can help healthy people use minerals better to support bone health. The finding doesn’t mean we should diminish our recommendation to drink milk and follow a well-balanced diet. This is a strategy to better utilize your minerals for those not consuming the whole recommendation of dairy,” Weaver said.
“Calcium alone suppresses bone loss, but it doesn’t enhance bone formation. These fibers enhance bone formation, so they are doing something more than enhancing calcium absorption.”
HYBRID HEART CARE
Jerusalem’s Shaare Zedek Medical Center has integrated open-heart surgery and angioplasty (catheterization). A new cath room recently opened there that enables heart surgeons and interventional cardiologists, who usually work separately, to cooperate. Prof. Dan Bitran, head of the cardiothoracic surgery department, treated a 60-year-old man suffering from narrowing of a coronary artery and a defective major valve in the heart together with Dr. Yaron Almagor, head of the intercentional cardiology unit.
The patient was “not suited” to open-heart surgery and was in danger, said Almagor.
“With our new room whose construction was just completed, we could offer him something original in Israel that has been carried out abroad only in a few cases.” The hybrid procedure involved a doing a bypass on a beating heart and implanting an artificial valve via the aorta. The patient quickly recovered and was discharged in good condition.
The hybrid facility is the first of its kind in Israel and planned specially for the complex procedures. It has devices with low radiation and advance imaging, with a large number of video screens transmitting a lot of data in real time and a movable bed using a gyroscope so procedures can be performed with great exactitude, the cardiologists said.
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