Have you ever wondered whether it's worth your while to encourage an older person to start exercising? In 2014, the top-notch journal JAMA published the results of a fantastic research project: a study in which 1635 sedentary older adults (aged 70-89) were assigned to get either a structured exercise program, or a program of "successful aging" health education. The researchers called it the Lifestyle Interventions and Independence for Elders (LIFE) study. (You can read the full study here.) During the LIFE study, the two groups were followed for a little over 2.5 years. And by the end of the study, guess which group of volunteers was more likely to still walk a quarter of a mile (without a walker)? That's right. When it came to avoiding "major mobility disability" which the researchers defined as becoming unable to walk 400 meters or more a structured exercise program was better than a program of healthy aging education. Specifically, the researchers found that 30% of the exercisers experienced a period of major disability, compared to 35.5% of the seniors enrolled in the healthy aging education program. This is a very encouraging finding! That said, it's also a bit sobering to realize that even with exercise, almost 1 in 3 older adults experienced a period of limited mobility, of which half lasted 6 months or more. In this post, I'll share some more details on this study, because the results provide a wonderful wealth of information that can be helpful to older adults, family caregivers, and even geriatricians such as myself. Want to know how often the exercisers experienced "adverse events"? (Hint: often!) Wondering just what the structured exercise program involved? (Hint: more than walking!) Let's dig into the details! At the end of this post, I'll share my list of key take-home points for older adults and family caregivers. Who were the study volunteers? Whenever you read about a research study, it's important to understand how the study volunteers compare to the older adults in *your* life. One of... According to the above context, choose the correct option to answer the following question. Question: The author probably believes what? Options: A. Family caregivers cannot help old people. B. not enough information C. Health education programs are pointless. D. Structured exercise programs help old people avoid major disabilities.
D

(Question)
And once again, high blood pressure is making headlines in the news: the American Heart Association and the American College of Cardiology (AHA/ACC) have just released new guidelines about hypertension. Since this development is likely to cause confusion and concern for many, I'm writing this post to help you understand the debate and what this might mean for you and your family. By the way, if you've read any of my other blood pressure articles on this site, let me reassure you: I am not changing my clinical practice or what I recommend to others, based on the new AHA/ACC guidelines. The core principles of better blood pressure management for older adults remain the same: * Take care in how you and your doctors measure blood pressure (more on that here), * Start by aiming to get blood pressure less than 150/90 mm Hg, as recommended by these expert guidelines issued in 2017 and in 2014, * And then learn more about what are the likely benefits versus risks of aiming for more intensive BP control. Perhaps the most important thing to understand is this: treatment of high blood pressure in older adults offers "diminishing returns" as we treat BP to get lower and lower. Scientific evidence indicates that the greatest health benefit, when it comes to reducing the risk of strokes and heart attacks, is in getting systolic blood pressure from high (i.e. 160-180) down to moderate (140-150). From there, the famous SPRINT study, published in 2015, did show a further reduction in cardiovascular risk, when participants were treated to a lower systolic BP, such as a target of 120. However, this was in a carefully selected group of participants, it required taking three blood pressure medications on average, and the reduction in risk was small. As I note in my article explaining SPRINT Senior, in participants aged 75 or older, pushing to that lower goal was associated with an estimated 1-in-27 chance of avoiding a cardiovascular event. (The benefit was even smaller in adults aged 50-75.) According to the above context, choose the correct option to answer the following question. Question: Why was this post written? Options: A. To dispute the SPRINT study. B. To understand the debate about the new AHA guidelines. C. not enough information D. To manage people's blood pressure.
(Answer)
B

September 2006, and deep in the bowels of the Adam Street private members' club in London a very special group of people is crammed into a private room, supping imported Spanish beer from a free bar. The value - on paper at least - of the companies owned by those squeezed into this tiny, boiling space would dwarf the debt of a small African nation. Among those present are some of the key players in Europe's Internet industry. The content creators, the entrepreneurs, the inventors, the investors; these are the new media moguls. And tonight they're in their element. I'm hiding at the back of the room getting slowly drunk with the event's organiser, an entrepreneur who helped raise a ridiculous sum of money for a business networking site that had projected revenues of precisely zero. His mantra, he tells me, is 'revenue is the enemy'. It's not clear what that means, but I have to admit it sounds great. A microphone is being passed around and we're watching and listening as a succession of young - mostly under forty - men - they're mostly men - rattle off their CVs and their future plans. 'He,' whispers my drinking buddy, pointing the neck of his beer bottle at a short, well-groomed man wearing a yellow checked jacket and bright red trousers, 'was in the FT yesterday. Apparently BT are going to buy the company he co-founded for half a billion dollars.' 'Fuck,' I half-whisper back. One habit you soon pick up, hanging out with dot com entrepreneurs, is swearing. 'That's a terrible fit. It's like Friends Reunited* all over again. What the hell are BT going to do with them?' 'Nothing.' 'Nothing?' 'No, the story's bullshit. Totally made up. And they fucking printed it. ' 'Fuck.' 'Of course they printed it. They called the investors to check it out, but they refused to comment. So they ran it as a "rumour". And why not? It wouldn't exactly be the most outrageous deal of the year, would it?' He has a point. According to the above context, choose the correct option to answer the following question. Question: When did the narrator got drunk? Options: A. I did not drink at the party B. After party started. C. not enough information D. Before party started
B