Managing chronic conditions Archive

The shift from this condition to dementia is not necessarily inevitable.

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Will I get dementia? That common question takes on urgency if you have mild cognitive impairment (MCI), a slight but noticeable change in memory and thinking skills. But the progression from MCI to dementia is not automatic. In fact, MCI is not always permanent. "It depends on the underlying cause," says Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital.

What are the causes of MCI?

MCI is not dementia (see "What is dementia?"), but it's not normal thinking, either. It often stems from disease or treatments for disease, including

Weight loss can be challenging, but there are some strategies for success.

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If you're struggling to lose weight, you probably feel like the odds are stacked against you. You're not necessarily wrong.

"There is so much great-tasting food, and it's abundant and in your face all the time. To me it's kind of a miracle that people aren't even heavier than they are," says Dr. Meir Stampfer, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. In addition to an abundance of food, most people today also have a far more sedentary lifestyle than past generations. "Even active people who exercise a lot aren't expending the calories their ancestors did," says Dr. Stampfer.

On call

Q. I have just recovered from the flu. How soon can I resume exercise again and can I go straight back to my previous routine?

A. The recommendations about when to return to exercise after respiratory infections, such as the flu, colds, or bronchitis, are vague. One major reason is that each person's response to illness is so variable. But here is my general advice.

Falls can lead to pneumonia, brain injuries, or muscle breakdown. Learn the risks so you can avoid them.

It's easy to see why falls are a top cause of injury and death among older adults. Crashing to the ground with force obviously can break a bone, or worse. But are you familiar with that "worse" part? Learn about fall risks now, so you can do as much as possible to avoid injuries in the future and maintain your mobility and independence.

Fractures

In older adults, about 90% of broken bones (fractures) happen because of a fall. Breaks commonly occur in the ribs, spine, wrist, arm, ankle, or hip.

Ask the doctor

Q. What are mRNA vaccines, and could they prevent other diseases besides infections?

A. The very first vaccines approved in the United States to prevent COVID-19 are a new type: mRNA vaccines. The way any type of vaccine works is to train a person's immune system to recognize and attack a target, like a virus, when it enters the body. A vaccine does that by "showing" the immune system either a harmless (dead or weakened) virus or a critical piece of the virus' protein coat. With the COVID-19 virus, that critical piece is called the spike protein.

Here's what to ask when email and phone calls are the main way to help loved ones in a long-term care facility.

Managing a loved one's care in a nursing home or an assisted living facility has always been challenging. And it's harder now that visitation is extremely limited to protect residents from COVID-19. So how can you check on your loved ones, make sure they're being cared for properly, and let them know you're there for them?

Direct communication

If your loved one is able to communicate well, a daily phone or video call is crucial. But remember that when you ask basic questions — "How are you feeling?" "Are you eating and drinking enough?" "Are you getting enough sleep?" — you may not get an honest answer. "They may just tell you what you want to hear," says Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center.

How much weight, how many reps and sets, and how often? Here's what new guidelines suggest.

Old-fashioned resistance training — lifting heavy weights multiple times — is the best way for men to slow and even reverse age-related muscle loss, known as sarcopenia. It can also increase your strength, protect against falls, and help you live a more independent life.

Resistance training (also known as strength training) consists of doing upper- and lower-body exercises using free weights (like dumbbells, kettlebells, or barbells), weight machines, resistance bands, or just your own body weight.

Exercise and recreational balls can play an important role in recovery and pain reduction.

A golf ball to ease foot pain? A kids' playground ball to recover from a knee injury? The combinations may sound foreign, but they're familiar approaches in the world of physical therapy. Here's how these tools of the trade (and the toy box) can help you.

A playground ball

This is the kind of inexpensive rubber or plastic ball (less than $10) you'll find at a grocery or big-box store. It's about the size of a soccer ball, but lighter. "We commonly use that type of ball for knee rehabilitation. We'll have someone do mini squats against the wall with the ball between the knees. Squeezing the ball strengthens the quadriceps muscles," explains Clare Safran-Norton, clinical supervisor of rehabilitation ­services at Harvard-affiliated Brigham and Women's Hospital.