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... Why did elderly people have a decrease in the likelihood of suffering a major mobility disaster? - They used a structured exercise program. - They used a successful aging health education program. - not enough information - They used a family caregiver.
They used a structured exercise program.

When I first started out in the field, I was working at a private hospital in the locked psychiatric unit, and there was a call from one of the med floors requiring someone from our unit to assist with a problem of a young man who had bitten through his cotton restraints on his wrists. They were requesting he be restrained with leather ones. I had not done any restraining and was asked to assist a woman counselor to show me the ropes (no pun intended). When we arrived in the patients room, I was shocked to see a man in his early 20's flailing around spasmodically on the bed with his gums bleeding in between his teeth. The nurse informed us that the patient was dying of a liver disease and his body and brain had become toxic, causing delirium. The counselor instructed me to hold down his arms and she placed him in leather restraints which were fastened to the side of the bed. The most upsetting thing which to this day I can not remove from memory was this man literally snapping his jaws at me like a mad animal with traumatized bloody gums from biting so hard on the cloth restraints. There was nothing I, or anyone could do, except keep him restrained from hurting himself or others. It is the kind of witness to suffering I had never experienced before, and I felt almost relieved when the nurse quietly said, " He will die before morning. " I suppose what is so traumatic about witnessing such situations is the utter sense of helplessness. I was a trained therapist, and in this situation, I was unable to do anything, and was rendered powerless. I recall being plagued by this young man's face for some time when I tried to go to sleep at night. Bruce Kugler Why was the patient being restrained with leather restraints? - not enough information - because he was dying - because he had bitten through cotton ones - because his body and brain had become toxic
because he had bitten through cotton ones

A federal judge on Thursday rejected efforts by Texas to stop the resettlement of Syrian refugees within its borders. The ruling comes days after presumptive Republican presidential nominee Donald Trump called to block non-citizen Muslims from entering the U.S. following the Orlando nightclub massacre. Even before the attack, Americans were divided, mostly along party lines, on the issue of refugees from war-torn countries in the Middle East. A survey conducted in late May by the Brookings Institution found of those polled, just 38 percent of Republicans supported taking in refugees from Syria and the Middle East, compared with 77 percent of Democrats. But among Trump supporters, an overwhelming 77 percent said they oppose taking in refugees. So who are these people who cause such a divide among Americans, triggering feelings of dread and suspicion in some and feelings of empathy and hospitality in others? Millions have been forced to flee the bloody conflicts in Syria, Iraq, Libya and other Middle Eastern nations. In 1951 the United Nation's Refugee Convention defined a refugee as someone who "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable to, or owing to such fear, is unwilling to avail himself of the protection of that country." By the end of 2014, there were 19.5 million refugees worldwide, according to the United Nations, 14.4 million of whom were under the mandate of the United Nations Human Rights Council. This was an increase of 2.9 million from 2013. The remaining 5.1 million refugees were registered with the United Nations Relief and Works Agency. However, there are an estimated 59.5 million forcibly displaced persons around the world, according to United Nation's Global Trends report. This population not only includes refugees, but internally displaced persons, asylum-seekers and stateless people as well. President Barack Obama has set... What is probably true about Trump supporters? - they are open minded - not enough information - they accept all people - they do not like Muslims
they do not like Muslims

The city was gray but the buildings contrasted with dirt red. The morning settled my nerves a bit more and before long the train pulled into the station. Boston had a slower feel, much slower than New York. The air was cool and peppered with moisture. I knew I was close to the ocean. Vision blurry, I wobbled out of the train depot and thought about the fact that I had never really done anything crazy in my life. The colors meant something here. Green was the color of plants but it was also the color of money. Plants were good but money was bad. I didn't know what green meant. Blue and red were clear though. Blue was the color of ocean and sky, both good things. Red was the color of Mars and it was manly but mars meant aliens and aliens were bad so red was bad. This is how I navigated. I followed the colors. I was lost in a daze of exhaustion and moved my feet slowly. They were dead and raw with pain and blisters, and I shuffled out into the city. My eyes darted from color to color, sign to sign, connection to connection. I floated like a ghost and thought about crying. There were few people out so I found a relative ease in that but my mind still jumped around reckless. I needed to find Kim. I saw a silent pay phone with a dangling phonebook and headed towards it until I remembered that phone books don't normally list cell phones. Kim wasn't the type of girl to list herself in the phonebook either. I had no leads but I knew I could go to a library and maybe find out her number if she had listed it on Facebook, so I kept walking. Stopping at benches, I would rest until I could muster more energy. When did his feet get covered in blisters? - When he took his first step - not enough information - After walking for so long - Before he started walking
After walking for so long