Bone Health In Older Adults (Credit-Canva)
Strengthening your bones is not something that can happen overnight, it takes years for your body to build strong bones and even then, it is natural for them to lose their dexterity. All you can do is keep your body healthy to make sure it is prepared for any unexpected situations. For years, many older adults have been told to take vitamin D and calcium supplements to keep their bones strong and prevent falls. However, a new report from U.S. Preventive Services Task Force (USPSTF) is changing that advice. This report suggests that for most older people, these supplements don't actually prevent falls or broken bones. This might be surprising news, we must understand why falls happen more often as we age, what vitamin D and calcium do in the body, and most importantly, what you can do to stay safe and prevent fractures.
According to the report, vitamin D supplements don't seem to help prevent falls or broken bones for most people over 60. They also found that these supplements, especially with calcium, might increase the risk of kidney stones. This report doesn't mean people with weak bones (osteoporosis), low vitamin D, or who take vitamin D for other health reasons shouldn't take it. It just means that for most healthy older people, these supplements don't prevent falls and fractures.
There are many reasons why older people are more prone to breaking their bones. Our bones are strongest when we're in our 20s and 30s, and they get weaker as we age so naturally, they can break easily. It can also be harder to move around as we get older, sometimes because of problems like arthritis this can affect how we walk and make us less steady.
There are also different issues like neuropathy, which is a nerve problem that can also make it harder to feel your feet and keep your balance. Eyesight is also a culprit as it can cause you to feel dizzy and fall. Some medicines can also make people feel unsteady, and older people often take more medicines than younger people. Low vitamin D itself can also increase the risk of falls, so keeping vitamin D levels up is still important.
USPSTF recommends a few better ways to protect your bone health and prevent broken bones and falls.
Regular walks strengthen your muscles and bones, which helps you stay steady on your feet. It is as simple as practice makes perfect so the more you walk, the better it is. Walking also improves your balance, making you less likely to fall.
Strength training, like lifting weights or using resistance bands, makes your bones stronger and helps prevent fractures if you do fall. It is like a safety cushion, but you must be careful while doing so because it can lead to injuries if done too much.
Activities like tai chi, Pilates, and yoga can improve your balance and coordination, making you more stable and less prone to falls. These can also help you improve your muscle flexibility and strength that in turn helps your body be stronger.
If you have osteoporosis, talk to your doctor about medications that can help strengthen your bones and lower your risk of fractures. Many medications can also have unsavory side effects like weakened joints, losing muscle strength, etc.
A proper diet goes a long way when it comes to your entire body health. So to keep up with your body’s nutrition and muscle health, eat more protein along with a balanced meal that includes loads of fiber, healthy fats and carbs.
Having poor eyesight can be difficult, not only does it make life difficult without glasses, but it also increases the possibilities of getting into minor accidents like bumping into people and missing objects placed in front of us.
Getting enough sleep is also important because when you are not sleeping, you get disoriented and can ignore even obvious things like the last stair in the staircase. Make sure you get enough sleep to keep you fresh and focused.
There are many things that can cause you to have accidents, even in your home. To avoid such falls, make sure there are no lose ends like crooked floor panels, rugs that are sticking out or protruding furniture that can hurt your knees
Credit: AI
After surgery, radiotherapy could significantly decrease the chances of an atypical meningioma returning, according to a new international phase 3 trial published in The Lancet.
The findings come from the ROAM/EORTC-1308 trial, the first randomised controlled trial to directly test whether patients with a completely removed atypical meningioma benefit from receiving radiotherapy or whether regular scans and observation are enough.
The results could help settle a treatment question that has remained uncertain for years.
Meningiomas are the most common brain tumours in adults. They develop from the meninges, the protective membranes surrounding the brain, and spinal cord.
An atypical meningioma is classified as a WHO grade 2 tumour. Unlike grade 1 meningiomas, that generally grow slowly, grade 2 tumours are more likely to grow again after surgery.
Even when surgeons manage to remove the entire visible tumour, microscopic tumour cells may remain, sparking a risk of recurrence.
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The ROAM/EORTC-1308 trial enrolled 157 patients whose atypical meningiomas had been completely removed surgically. They were randomly assigned to either:
After a median follow-up of about five years, the difference in recurrence was significant. 14% of patients in the radiotherapy group experienced a recurrence, compared to 30% in the observation group. In other words, the risk of recurrence was reduced by nearly half with postoperative radiotherapy.
Additionally, at five years, about 80% of patients receiving radiotherapy remained free of recurrence, compared to about 64% of those who were monitored without immediate radiotherapy.
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Until now, doctors have had to weigh two approaches after complete surgical removal of an atypical meningioma.
One option is to give radiotherapy immediately, hoping to destroy microscopic tumour cells that surgery may have missed. The other is to monitor the patient with regular brain scans and use radiotherapy if the tumour returns.
The uncertainty existed as strong randomised evidence showing whether immediate radiotherapy actually reduced recurrence had been lacking. The trial helps cement that evidence.
The researchers say that treatment decisions still need to be made jointly by doctors and patients, taking into account possible side effects and the long-term consequences of radiation treatment. Serious radiation-related complications were uncommon in the trial.
The study also did not establish whether the recurrence benefit extends beyond five years. This means that longer follow-up will be needed to gather more evidence. According to the researchers, the findings are expected to shape national and international treatment guidelines.
The options may extend for patients who have undergone complete removal of a WHO grade 2 atypical meningioma. Rather than contemplating “Should we simply watch and wait?”, they can consider moving to a more evidence-based discussion about whether postoperative radiotherapy should be offered upfront.
Credit: iStock
Heart care has been revolutionized in recent decades. New imaging tools, less invasive procedures, implantable devices and digital instruments are allowing doctors to find problems earlier and with more detail. This means that treatment options tend to be more personalized and recovery time can be shortened.
A big part of this shift comes from new tech in heart testing. Doctors can see how big the heart is, what shape it is and how it moves using cardiac CT, MRI and echo. These tests can give specific information on the functioning of the heart. AI is also being looked at for tasks like reading ECG results, analysing heart scans, and tracking patients over time. The American Heart Association says AI may have uses across heart care. At the same time, many tools still need more proof in real clinical settings before they are widely used.
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Tech is also changing how some heart issues are handled. In the past, some cases needed full open surgery. Now, for certain patients, doctors may use catheter-based or minimally invasive methods instead. Take TAVR as an example. In that approach, a new aortic valve is placed using a catheter. It is positioned inside the older, damaged valve. For the right group of patients, this can avoid open surgery.
Device design is moving forward too. Newer cardiac devices are adding options for people with rhythm problems and other heart conditions. Leadless pacemakers are one example. These devices are meant to support heart rhythm in an effective way while reducing some drawbacks seen with older device types.
Remote monitoring and wearable tools are growing fast. Some devices can track things like heart rate all day. That can reveal issues that someone might not notice on their own. Still, these tools should sit alongside routine checkups. They should not be used to diagnose yourself.
At the end of the day, the goal is not to swap out a cardiologist for a machine. Tech should help doctors gather clearer data. It can also support more accurate procedures. It may even spot disease earlier than before. What treatment makes sense varies from person to person. Doctors weigh age, past health, how bad the condition is, the test results, and the overall level of risk. As new heart devices keep coming, doctors will need solid proof and good judgment about who should use them. That is how new ideas lead to real gains in heart care.
Credit: iStock
She came to the hospital because of a cough that would not go away. The cough was eventually found to be nothing serious. But her CT scan revealed something unexpected — a 12 mm nodule in the outer part of her right lung.
She had never smoked. She felt completely well.
Yet that tiny shadow raised a big question: was it an old tuberculosis scar, a harmless growth, or an early lung cancer?
A CT scan can show us that a nodule is there. It cannot always tell us what it is.
This is an increasingly familiar situation. As CT scans have become more widely used, particularly after the COVID-19 pandemic, doctors are finding small lung nodules in people being scanned for entirely different reasons. Most turn out to be benign. Some, however, need closer assessment.
India has another challenge. Tuberculosis and its scars are common, and a lung shadow can sometimes be attributed to TB without tissue confirmation. While treating tuberculosis promptly is important, assuming that every suspicious nodule is TB can occasionally delay the diagnosis of something else, including cancer.
The answer, when appropriate, is to obtain a tissue sample.
Traditionally, a small nodule deep in the lung could be difficult to reach. A needle biopsy through the chest can be effective but carries a risk of a collapsed lung. Conventional bronchoscopy is excellent for the larger airways but becomes more challenging as the target gets smaller and farther towards the edge of the lung. Surgery may sometimes be necessary.
Navigation bronchoscopy uses the patient's CT scan to create a three-dimensional map of the airways and guide a thin catheter towards the nodule. Cone Beam CT adds real-time three-dimensional imaging during the procedure, allowing the doctor to check where the instruments are in relation to the lesion before taking the biopsy.
In simple terms, navigation helps us find the way; Cone Beam CT helps us confirm we are there.
The tissue can then be examined immediately where appropriate, helping determine whether the sample is adequate and whether additional material is needed for advanced testing.
Importantly, not every nodule needs a biopsy. Many are best managed through carefully planned follow-up scans. The decision depends on the nodule's size and appearance, previous scans, and the patient's overall risk.
For patients, the message is reassuring: a lung nodule does not mean cancer. But it should not be ignored either.
Keep previous scans. Ask what the likely possibilities are. Understand why your doctor recommends surveillance or biopsy — and make sure the follow-up happens.
Today, advanced bronchoscopy is helping doctors turn a worrying shadow into something much more useful: an answer.
(By Dr Shyam Krishnan, Intervention Pulmonologist, CMRI)
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