Learning to Laugh

Learning to laugh with a group is often easier, you can benefit from laughing by yourself for 15 minutes a day.

Here's the laughter exercise:

1. Give 3 big, noisy sighs as you inhale through your nose and exhale through your mouth.
2. Stretch gently. Bring your shoulders to your ears; then lower gently. Rotate feet and elbows; turn your head from side to side—gently.
3. Take a few deep abdominal breaths and release slowly.
4. Holding your hands under your belly, make a laughing "ho-ho-ho." Make sure the sound comes from your core (you'll feel it in your hands when you're doing it right). Repeat 3 groups of 3, several times.
5. Change the sound to "ha-ha-ha" and repeat as above.
6. Change the sound to "hee-hee-hee" and repeat as above.
7. Put all 3 sounds together—"ho-ho-ho, ha-ha-ha, hee-hee-hee"—and repeat for 3 rounds, continuing until you develop a rhythm.
8. After the final round, break into your own natural laughter. Continue for a few minutes. If it becomes difficult, stop and go back to step #3 and start the laughing cycle again.

The exercise may feel contrived at first, but your normal laugh will come.

"We have gotten ourselves so overscheduled and overwhelmed that we forget to be like children. We forget to give ourselves permission to be happy, to smile,".

"This is one tool to put in your toolbox to make your life more rewarding and make you feel better."

Mental Activity May Keep Older Brains Healthy

Simple mental activity such as reading, writing, playing games and doing puzzles may protect brain health in old age, according to a new study being presented at a meeting in the US this weekend.

The study, presented at the 98th scientific assembly and annual meeting of the Radiological Society of North America (RSNA) in Chicago, is the work of Konstantinos Arfanakis and colleagues, from Rush University Medical Center and Illinois Institute of Technology.

"Reading the newspaper, writing letters, visiting a library, attending a play or playing games, such as chess or checkers, are all simple activities that can contribute to a healthier brain," says Arfanakis, an associate professor in the Department of Diagnostic Radiology and Nuclear Medicine at Rush University Medical Center, in a press statement.

White Matter

Previous studies have suggested keeping mentally active in old age also appears to keep the mind sharp, but few have looked at the effect on physical brain health, such as the structural integrity of white matter.

White matter comprises the axons or nerve fibers, the "electrical wiring" that transmits information around the brain.

Diffusion Anisotropy

For their study, Arfanakis and colleagues used a type of MRI scan called DTI, short for diffusion tensor imaging, which measures diffusion anisotropy, or how well water molecules travel in different directions in the brain. ("Anisotropy" literally means having different properties in different directions).

In white matter, water molecules move more easily in directions that are parallel to the "electrical wires" or axons, and less easily in directions that are perpendicular to them, because their path is impeded by axon or nerve fiber structures, such as their membranes and myelin protective sheath.

DTI takes a measure of this difference in water travelling or diffusion rates: the bigger the difference, the more diffusion there is in one direction compared to the other, explains Arfanakis.

Thus healthy brains have bigger diffusion anisotropy values than brains where the structures have deteriorated, such as through aging, injury or disease.

"Lower diffusion anisotropy values are consistent with aging," says Arfanakis.

The Study

The study involved 152 people of average age 81 years who were taking part in the Rush Memory and Aging Project, a large study examining risk factors for Alzheimer's disease.

Detailed clinical evaluations had established that none of the participants had dementia or mild cognitive impairment.

The researchers invited the participants to indicate how often in the past year they had engaged in mental activities such as reading newspapers and magazines, writing letters, and playing board games and cards. They had to indicate the frequency on a scale of 1 to 5.

During the 12 months following their clinical evaluation, the participants also underwent MRI brain scans that allowed the researchers to produce diffusion anisotropy maps.

The Results

The results showed a significant link between the frequency of mental activity and diffusion anisotropy values: more mental activity was linked to higher values.

"Keeping the brain occupied late in life has positive outcomes," says Arfanakis, after explaining what they found:

"Several areas throughout the brain, including regions quite important to cognition, showed higher microstructural integrity with more frequent cognitive activity in late life."

Arfanakis says diffusion anisotropy values start falling at around age 30. 

"Higher diffusion anisotropy in elderly patients who engage in frequent cognitive activity suggests that these people have brain properties similar to those of younger individuals," he adds.

Knee Replacements Are All The Rage With The Medicare Set

Spend a little time where seniors hang out and there's a good chance you'll hear about somebody getting a new knee — maybe two.
Some figures pulled from Medicare data analyzed in the latest JAMA, the Journal of the American Medical Association, help explain why.
There are about 600,000 knee replacements a year now, at a cost of around $15,000 a piece. All told, the tab for all that orthopedic work is about $9 billion a year, the JAMA study says.

What's going on with the Medicare set?
First off, there are a lot more older people with worn-out knees these days. In 1991, the knee-replacement researchers point out, there were about 30 million people with traditional Medicare coverage. By 2010, the figure was 39 million.
But the artificial knees have gotten better, and the procedures to implant them have improved too. So the annual rate of implants has gone way up, doubling, in fact, to 62 per 10,000 Medicare beneficiaries in 2010 from 31 per 10,000 in 1991.
There are some other changes worth noting. The time people spend in the hospital after the knee-replacement surgery has dropped a lot — from about 8 days to 3 1/2. And there's been an uptick in return admissions to the hospital for infections — 3 percent lately versus 1.4 percent two decades ago.

To Protect a Million Hearts

A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. “This wide-ranging collaboration among communities, health systems, government agencies, and private-sector partners will rely on individuals like you and me to meet that goal.

The initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive actions dubbed the ABCS:

• taking daily low-dose Aspirin, if prescribed. Only half of Americans who should be taking aspirin are doing it.
• managing Blood pressure and Cholesterol levels. Both of these silent conditions contribute to heart attack and stroke.
• quitting Smoking. Help is available for anyone who wants to quit.

In addition to reviewing the most current targets for blood pressure, cholesterol, and smoking cessation—and strategies for hitting them—we added D (for Diet) and E (for Exercise) to the Million Hearts alphabet. Because eating healthfully and staying physically active are important contributors to preventing cardiovascular disease.

Treating Neck Pain

Do your neck and shoulders ache? Not long ago, you would have been told to rest, maybe use a neck brace, and wait until the pain had ebbed away. Doctors have changed their song about the best treatment for neck and shoulder pain. They now recommend movement instead of rest.

As described in Neck and Shoulder Pain, a newly updated Special Health Report from Harvard Health Publications, there is mounting scientific evidence for the role of stretching and muscle strengthening in treating people with neck and shoulder pain. After a whiplash injury, for example, people heal sooner and are less likely to develop chronic pain if they start gentle exercise as soon as possible. For those with long-term pain (called chronic pain), results from controlled studies show that exercise provides some relief.

One review of the research found that exercise programs to stretch and strengthen either the neck alone or the neck plus the shoulders and the trunk improve pain in the short and long term compared with standard treatment with pain relief medication. Other studies support strengthening, stretching, and general physical activity. But exactly how much exercise to do, what types are best, and how often it should be done have yet to be determined. That uncertainty might explain why, despite the evidence favoring the role of exercise in relieving neck and shoulder pain, fewer than half of people who see a health professional for these problems are prescribed exercise as part of their treatment plan.

Taking steps

If you’re interested in using exercise to help relieve neck or shoulder pain, make sure to see your doctor for evaluation. Ask if you can get help from a physical therapist or other professional who can create an individualized exercise program based on your pain severity, limitation of movement, and current strength. The program should have clearly stated goals and include stretching and strengthening exercises, as well as exercises to improve how you use your neck muscles.

Ideally, if you are working with a therapist, he or she will guide you through appropriate exercises, motivating you to work hard enough to see results but not so hard as to cause further injury. At some point, you will be given exercises to do at home. Before you exercise independently, make sure you understand which exercises to do and how to do them safely. Ask for written instructions and illustrations if you are still unsure.

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How Anti-Aging Costmetics Work

 A team of investigators from UC Davis and Peking University have discovered a mechanism that may explain how alpha hydroxyl acids (AHAs) -- the key ingredient in cosmetic chemical peels and wrinkle-reducing creams - work to enhance skin appearance. An understanding of the underlying process may lead to better cosmetic formulations as well as have medical applications. 

The findings were published in the Journal of Biological Chemistry in an article entitled "Intracellular proton-mediated activation of TRPV3 channels accounts for exfoliation effect of alpha hydroxyl acids on keratinocytes." 

AHAs are a group of weak acids typically derived from natural sources such as sugar cane, sour milk, apples and citrus that are well known in the cosmetics industry for their ability to enhance the appearance and texture of skin. Before this research, little was known about how AHAs actually caused skin to flake off and expose fresh, underlying skin. 

The cellular pathway the research team studied focuses on an ion channel -- known as transient receptor potential vanilloid 3 (TRPV3) -- located in the cell membrane of keratinocytes, the predominant cell type in the outer layer of skin. The channel is known from other studies to play an important role in normal skin physiology and temperature sensitivity. 

In a series of experiments that involved recording electrical currents across cultured cells exposed to AHAs, the investigators developed a model that describes how glycolic acid (the smallest and most biologically available AHA) enters into keratinocytes and generates free protons, creating acidic conditions within the cell. The low pH strongly activates the TRPV3 ion channel, opening it and allowing calcium ions to flow into the cell. Because more protons also enter through the open TRPV3 channel, the process feeds on itself. The resulting calcium ion overload in the cell leads to its death and skin exfoliation. 

"Our experiments are the first to show that the TRPV3 ion channel is likely to be the target of the most effective skin enhancer in the cosmetics industry," said Jie Zheng, professor of physiology and membrane biology at UC Davis and one of the principal investigators of the study. "Although AHAs have been used for years, no one until now understood their likely mechanism of action." 

Besides being found in skin cells, TRPV3 also is found in cells in many areas of the nervous system and is sensitive to temperature as well as acidity. The authors speculate that the channel may have a variety of important physiological functions, including pain control. 

Lead author Xu Cao, who conducted the study with UC Davis scientists as a visiting student from Peking University Health Science Center, focuses on TRPV3 channel research. With a team of researchers in China, he recently contributed to the discovery that a mutation in TRPV3 leads to Olmsted syndrome, a rare congenital disorder characterized by severe itching and horny skin development over the palms of the hands and soles of the feet. While in the UC Davis Department of Physiology and Membrane Biology, Cao discovered that AHAs also utilize the TRPV3 channel. 

"Calcium channels are becoming increasingly recognized as having vital functions in skin physiology," said Cao. "TRPV3 has the potential to become an important target not only for the cosmetics industry but for analgesia and treating skin disease."