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People who lead overall healthy lives - exercising, eating right, and not smoking - are at significantly lower risk for age-related macular degeneration (AMD), new study findings show. Exercise and diet each reduced the risk, but both combined, along with a lack of smoking, caused a "particularly profound lowering" of the risk - by more than 70%, study author Dr Julie Mares of the University of Wisconsin in Madison told Reuters Health. "We don't need to be passive victims of these ravages of old age," Dr Mares said. "Relatively small things could make a difference in whether or not we develop AMD in our lifetime." Healthy habits work together Because healthy habits tend to work together in achieving certain health goals, Dr Mares and her colleagues reviewed information about diet, exercise, and smoking from 1,313 women between the ages of 55 and 74, collected during the 1990s. Women were revisited on average six years later, at which point they received an eye exam to check for AMD. As the research team reported in Archives of Ophthalmology, 202 women had AMD, mostly early-stage. Among the women who ate the healthiest (based on the modified 2005 Healthy Eating Index), 11% had an early form of AMD, compared to 19% of women with the worst diets, factoring in their intake of fruit, vegetables, whole grains, fat and sugar, among other elements. The statistics About one in 10 women in the highest quintile of exercise developed AMD, versus one in five of those who barely got any exercise. When the researchers combined the influence of diet, exercise and no smoking, the risk of AMD decreased even further, even though smoking alone was not related to AMD. Since previous research has linked specific dietary elements to AMD, the researchers looked at the associations of specific antioxidants with AMD risk. Women with higher levels of these antioxidants had lower risks of AMD, but not as low as women who ate well overall, Dr Mares noted. "The findings for overall healthy diets are much stronger than for single nutrients," she said. And when it comes to exercise, even 10 hours per week of light exercise - including housework, gardening, or walking - or 8 hours of moderate exercise per week was associated with a lower risk of AMD, Dr Mares said. The study doesn't prove that a healthy lifestyle causes the decrease in AMD, but there are many reasons why it might, Dr Mares said. Diet and exercise lower blood pressure, which can protect the eyes from degeneration. Diet and exercise also reduce free radicals and are associated with lower levels of inflammation - effects that could directly protect against AMD or help enhance the accumulation of pigments at the back of the eye, which absorb potentially damaging light. Equal results in men and women Even though the study only included women, Dr Mares said she suspects there will be a similar trend in men. "There's no reason I can think of to expect different results in men or women. However, these findings need to be confirmed in separate samples that include men." "Decades of studies - basic science, retrospective and prospective clinical trials - have all established that AMD is, in part, a nutrition-responsive disease," Dr Stuart Richer of the Captain James Lovell Federal Health Care Facility told Reuters Health in an e-mail. "Our current approach is to detect AMD at the end of the disease process and then utilise injected designer pharmaceuticals," Dr Richer said. This has helped people with advanced AMD, but there are many more people with earlier forms who have vision problems and also need help, he said. (Reuters Health/ December 2010)

Many older adults lose the ability to advocate for themselves, and when this occurs it is important to find a trustworthy person or entity to advocate for them. The best advocates for older adults are usually close family members or concerned friends. However, if no family or friends are available to monitor the best interests of an elderly person, there are organizations that advocate for older adults. Legal Services Advocacy services can assist you or your loved one legal help. Professional advocate services for the elderly often provide their clients with direct legal services in a wide variety of areas of law affecting seniors. Some of these areas include: Advance care planning Consumer protection Consent and capacity Elder abuse Health care Home care Long-term care homes Retirement homes Pensions and income

Vitamin D supplementation and exercise may help prevent older men and women from falling, suggests a new review of 54 studies by the U.S. Preventative Services Task Force (USPSTF). Falls are the leading cause of death, disability and loss of independence for people 65 years and older. About one in every three adults in this age group who are not institutionalized will fall in a given year. More than $20 billion in annual health care costs may be associated with those events. "The number of falls among older adults is increasing significantly every year, and it's not because the percentage who fall is increasing. Rather, it's because the number of older adults is growing and will continue to grow," lead researcher Dr. Yvonne Michael of Drexel University in Philadelphia, told Reuters Health. "Understanding how to prevent falls is crucial," added Michael, who started the review while at Kaiser Permanente Center for Health Research, in Portland, Oregon. Michael and her colleagues set out to determine what interventions might be useful for primary care physicians to prescribe to their older patients. They identified 54 relevant studies, which included a total of more than 26,000 participants. Getting exercise and taking vitamin D supplements appeared to offer the most potent prevention among the interventions investigated, which also included vision correction and modifying the home environment, report the researchers in Annals of Internal Medicine. . Exercise, on average, cut the seniors' risk of falls by 13 percent. Specific interventions ranged from programs that improve balance, strength and flexibility to weight training, general physical activity such as walking or aerobics. Vitamin D supplementation, with or without calcium, reduced the risk of falling by an average of 17 percent. Half of the trials used daily doses above 800 international units(IU). A previous review had found vitamin D to be ineffective in preventing falls. However, Michael pointed out, one of the large studies included in that analysis was determined not to be of high enough quality to be incorporated into the new review. In its place, the researchers included four other studies they deemed more appropriate. "We need to do more study," Michael said. "But, on the basis of this review, I think there is fairly stable evidence that physicians can successfully reduce the percent of (those who fall) through vitamin D supplementation." The researchers acknowledge some limitations to their review, including the issues inherent in any effort to combine results from multiple studies, such as a lack of consistency in terminology, interventions and measurements. The current findings will serve as the basis for recommendations from the USPSTF, an independent panel of experts in prevention and evidence-based medicine. A draft, expected soon, will be available for public comment before becoming finalized. In an accompanying article in the same issue of the Annals, researchers addressed the unique challenges in formulating any prevention-related recommendations for older adults. "As we age, prevention is no longer a 'one size fits all' endeavor," lead author Dr. Rosanne Leipzig of the Mount Sinai School of Medicine, in New York City, told Reuters Health in an e-mail. Older men and women are often burdened by an array of complicating conditions and other issues. "We can't point to just one thing that is the cause of a fall in an older adult. A number of factors can come together to lead to a fall," added Michael. "Still, there are still some things that physicians are able to recommend or prescribe to their patients." "Hopefully this will make it easier for physicians to make treatment plans that include exercise and vitamin D, and will be covered by insurance," she said.