Certain ankle positions, by influencing posture and the tilt of the pelvis when standing, can facilitate pelvic floor muscle activity. The technique may be a useful add-on to pelvic floor training exercises intended to help women with stress urinary incontinence.

Dr. Gwo-Jaw Wang and colleagues from Kaohsiung Medical University School of Medicine, Taiwan, studied 39 women (average age 59 years) with clinically diagnosed stress urinary incontinence. The participants engaged in testing the changes in pelvic floor muscle activity during various pelvic tilt angles created by standing with the feet horizontal, flexed up, or flexed down.

The women stood in these positions with the help of an adjustable tilt platform that set the ankles at the appropriate angle. The researchers used an intravaginal probe to measure pelvic muscle activity.

Pelvic floor muscle contraction was greatest when the ankles were flexed upward, and least when they were flexed downward, the investigators report in the journal Urology.

Overall, they observe that an upright standing position with the ankles flexed up facilitated the forward tilt of the pelvis, "which in turn increased effective pelvic floor muscle activity to its greatest point."

Also, they point out that "there is a connecting relationship among pelvic floor muscle activity, abdominal muscle strength, and pelvic tilt tendency, which is worthy of additional investigation."

Reuters Health - headlines

The hard sell began Saturday as dozens of private insurers tried to sign up some 42 million older and disabled people for the government's new Medicare prescription drug benefit.

The program, which starts in January, is designed to reduce the out-of-pocket cost of medications. Overall, the government will spend an estimated $724 billion on the drug benefit over the coming decade.

Some questions and answers about the benefit:

Q: How will the program work?

A: People must enroll in a plan offered by a private provider that contracts with the federal government. The insurer will issue a card that beneficiaries will take to the pharmacy along with their doctor's prescription. The pharmacist will use the card to determine the type of coverage the customer has; that dictates out-of-pocket costs.

Q. What will it cost to participate?.....Yahoo! Health News:MORE

"A looming explosion in the U.S. population of elderly and frail citizens threatens to force a crisis in long-term care in the United States, a White House advisory group reported Thursday.

The number of aging Americans is set to double by 2050, spurring demand for healthcare and nursing-home capacity for millions more people, the President's Council on Bioethics said in its report, "Taking Care: Ethical Caregiving in Our Aging Society." The trend also could cause huge cultural shifts, as tens of millions more working-age people become caregivers for elderly parents, the report said.

In one alarming statistic, the number of people in the United States with dementia caused by Alzheimer's disease is expected to triple -- to 12 million by 2050. Yet the nation -- and its leaders -- scarcely has begun to consider the far-reaching implications of the aging of the U.S. population, the report cautioned.

"We are on the threshold and may have already crossed the threshold of a large crisis of long term care," Dr. Leon Kass, the council's chairman, said at a news briefing. "The first thing we wanted to do be sure is understood is that this is serious and this is real."

The report warned that the number of health workers qualified to deliver long-term care is dropping, even as the number of elderly persons rises. The lack of qualified workers threatens to lead to "warehousing" of the elderly in nursing homes too poorly equipped to care for them ethically.

The report also directly opposed the use of assisted suicide and euthanasia, warning that shortages in qualified caregivers could push doctors and nurses to "abandon" elderly patients out of convenience.

"This is going to be an increasing temptation, and we have to guard against it," Kass told reporters.

At the same time, the report said doctors should be discouraged from delivering medical care intended to prolong life at all costs, when the care is unduly burdensome to patients. The issue gained the national spotlight last March during the debate over Terri Schiavo, the young woman who was presumed to have lived in a persistent vegetative state for many years, until a court ordered her to be denied food and water. She died March 31, 13 days after her feeding tube was removed.

That episode caused widespread interest in advanced directives, which many experts said at the time would have made Schiavo's wishes for her care known and would have spared her and her family the drawn-out court battles that occurred.

The council's report criticized the use of advanced directives, however, as "limited and flawed" in their ability to predict what kinds of care elderly patients actually would need at the end of life. Such documents often do little to instruct family members and doctors about patients' wishes, the report said. Instead, the council promoted the use of "proxy directives," which appoint a trusted family member or other person to make decisions on behalf of incapacitated patients.

Gail Gibson Hunt, president and chief executive officer of the National Alliance for Caregiving, criticized the report for not adequately addressing the demographic shift's impact on family members. Millions of adults with frail parents could be forced to quit work and provide healthcare with little training, she said.

Few federal programs provide family caregivers with compensation for lost wages or lowered pensions, and those that do constitute "just a drop in the bucket," she said."MedlinePlus:

Applied NeuroSolutions, Inc. (OTC BB:APNS - News; www.appliedneurosolutions.com), a biotechnology company dedicated to developing products to diagnose and treat Alzheimer's disease ("AD"), said its Alzheimer's disease test was featured earlier this month on Chicago's WGN-TV news (http://wgntv.trb.com/news/local/eveningnews/wgntv-090705medicalwatch, 0,6713777.story?coll=wgntv-evening-news-2)(Due to the length of this URL, it may be necessary to copy and paste this hyperlink into your Internet browser's URL address field. You may also need to remove an extra space in the URL if one exists.) and in the trade publication Medical Device Daily.During the segment on WGN-TV News at Nine, medical reporter Dina Bair discussed how the test works, using cerebrospinal fluid to detect an abnormal protein that is found in people who have AD. The segment noted that a simple and accurate AD test would be significant because it would help differentiate AD from other dementias, enabling patients to start receiving treatments earlier. Such a test would also assist in the development of new medications and be helpful in testing the effectiveness of various therapies, according to the report.

The article in the trade publication Medical Device Daily focused on Applied NeuroSolutions' recent submission of its pre-IDE application with the FDA, studies that reflect the effectiveness of the test and the vast market potential for such a product.MORE- Yahoo!
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The findings provide scientific backing for previous studies suggesting that higher intake of fruit and vegetables may lower the risk of developing the disease.
Due to present the research at the British Pharmaceutical Conference in Manchester, the scientists from King's College London have found that compounds in each of these fruit and vegetables inhibit acetylcholinesterase, the enzyme responsible for the breakdown of the neurotransmitter acetylcholine.

This is also the target of common Alzheimers drugs and although it has been previously suggested that some vegetables might have this activity too, no detailed investigation has ever been carried out, claim the UK team.

Of each of the fruit and vegetables studied, broccoli was found to have the most potent activity and in further tests, the researchers showed that glucosinolates, a group of compounds found throughout the cabbage family, were likely to be responsible for this action.

Professor Peter Houghton, from King's College London, noted that this is "the first report that glucosinolates have acetylcholinesterase inhibitory properties".

They have previously been studied for their anti-cancer activity.

He cautioned that it has not yet been proven that eating broccoli would have a beneficial effect on Alzheimer's disease.{CLICK FOR MORE}nutraingredients.com

Research from the University of California at Los Angeles shows that early-onset dementia is often due to potentially preventable causes rather than from Alzheimer's disease.

Lead investigator Dr. Aaron M. McMurtray of UCLA presented his team's findings Monday during the 130th annual meeting of the American Neurological Association, which is underway in San Diego, California.

The study consisted of 1683 patients who were being evaluated at UCLA for declines in memory or cognition during the 4-year period between 2001 and 2004. Of these, 948 patients, or 56%, met the diagnostic criteria for dementia.

The researchers divided patients into two age groups: those younger than 65 years of age and those 65 or older. Dr. McMurtray announced that patients with early-onset dementia were more likely to have a history of alcohol abuse, head trauma, HIV infection or frontotemporal lobar degeneration as the cause of their dementia. Conversely, older dementia patients more often had Alzheimer's disease as the cause of their decline in cognitive function.

"Early onset dementia, with onset in those younger than 65, is a potentially devastating problem," Dr. McMurtray told Reuters Health. "These patients are often actively involved in holding jobs, providing for families and caring for children when the disease strikes."

"Patients with early-onset dementia are more likely to be misdiagnosed, having dementias other than Alzheimer's disease, or have a potentially treatable or preventable etiology," Dr. McMurtray noted.

"Current work in mild cognitive impairment as a prelude to Alzheimer's disease further highlights the importance of early diagnosis of dementing illnesses, and this is especially important at a young age. Public health measures need to address common preventable causes of dementia in this age group, including traumatic brain injury, alcohol and drug abuse and HIV infection."
www.medscape.com

A fatty acid found in corn, sunflower, and safflower oils may help prevent Alzheimer's disease in some people, researchers report.

The researchers studied two groups of people: Those with a known inherited risk factor for Alzheimer's disease, the ApoE e4 gene, and those who did not have the gene.

In people who did not have the gene, eating a diet rich in linoleic acids reduced the risk of developing Alzheimer's disease by about 50%. But in those who carried the disease-causing gene, linoleic acids appeared to raise the risk of developing the mind-robbing disease even further, says researcher Sara M. Debanne, PhD, professor of epidemiology and biostatistics at Case Western Reserve University School of Medicine in Cleveland. This was updated information presented at the American Neurological Association's 130th Annual Meeting this week.

Debanne says she suspects the fatty acids' cholesterol-lowering properties account for their protective effect in some people. Several studies have shown that the cholesterol-lowering statin drugs appear to ward off the disease.

Aaron McMurtray, MD, a neurobehavior fellow in the department of neurology at the University of California, Los Angeles, says the research "gives people good reason to be tested for their ApoE e4 gene status."

For people who do not test positive, "eating a diet rich in fatty acids is an easy, practical thing you can do on your own to change your risk,"Fatty Acids May Ward Off Alzheimer's Disease

Some older people who are unintentionally losing weight may be in the early stages of Alzheimer's disease, U.S. researchers reported Tuesday.

A study of 918 older, healthy nuns, priests and monks showed that those who lost about one unit of body mass index a year -- a little more than five pounds or so -- had a 35 per cent greater risk of developing Alzheimer's than those who didn't lose weight. And, those whose weight stayed the same had a 20 per cent greater risk, compared with people who gained a pound or so per year.

The findings held true even after considering factors such as chronic health problems, age, gender and education.

Writing in the journal Neurology, Dr. Aron Buchman and colleagues at Rush University Medical Center in Chicago said they used information from an ongoing study of Catholic volunteers who undergo extensive health exams and keep careful diaries.

"These findings suggest that subtle, unexplained body mass and weight loss in an older person may be an early sign of AD [Alzheimer's disease] and can precede the development of obvious memory problems," said Dr. David Bennett, who directs the Rush Alzheimer's Disease Center.

"The most likely explanation is that there is something about these individuals or about this disease that affects BMI before the clinical syndrome becomes apparent -- that loss of BMI reflects the disease process itself."

Doctors can look at a patient's weight when trying to figure out their risk of dementia, the researchers said.

"There are actually very few predictors of Alzheimer's disease," Bennett said. "This study makes us think about the spectrum of clinical signs of AD beyond changes in memory and behavior and motor skills. Changes in BMI are easy to measure in a doctor's office without an expensive scan."
CBC News