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New study reveals extreme weather's impact on seniors' attendance at doctor appointments

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New study reveals extreme weather's impact on seniors' attendance at doctor appointments

Whether it’s the dog days of summer or a cold snap in the dead of winter, extreme temperatures tend to bring people’s activities to a halt — including doctors’ appointments. 

Seniors in particular are more likely to skip their scheduled medical visits if it’s too hot or too cold, according to a study from the American Journal of Preventative Medicine.

On days that are 90 degrees or hotter, for every 1 degree increase in temperature, the rate of missed appointments rises by 0.64%, as reported by researchers at the Drexel University College of Medicine in Philadelphia, Pennsylvania.

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The rate of missed appointments is even higher on cold days, going up by 0.72% for every 1-degree decrease below 39 degrees.

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“The key finding is that people are less likely to keep their doctors’ appointments when it is extremely hot or extremely cold,” said senior author Nathalie S. May, M.D., a professor at Drexel University College of Medicine, in a statement to Fox News Digital.

Seniors are more likely to skip their scheduled medical visits if it’s too hot or too cold outside, according to a new study from the American Journal of Preventative Medicine. (iStock)

In the study, the researchers analyzed more than one million appointments involving 91,560 adult patients from Jan. 2009 through Dec. 2019.

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The appointments were all made at 13 university outpatient clinics in Philadelphia, according to a university press release.

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The appointment data was compared to temperature and precipitation records from the National Oceanic and Atmospheric Administration (NOAA).

Based on the findings, the researchers are calling for telemedicine to become a permanent covered mode of health care delivery. (iStock)

Lakelyn Eichenberger, PhD, a gerontologist and caregiver advocate at Home Instead, an Honor Company in Omaha, Nebraska, said she was not surprised by the study findings.

“For many older adults, going to a doctor’s appointment takes considerable effort, especially for those with mobility issues, chronic conditions, complex medical needs or cognitive impairment,” Eichenberger, who was not involved in the research, told Fox News Digital via email.

“When you add extreme or inclement weather, it presents even more challenges. For some, it might seem easier to skip the appointment altogether to avoid the risks that extreme conditions could pose.”

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Shana Johnson, a physician in Scottsdale, Arizona, who teaches at the University of Arizona College of Medicine in Phoenix, also commented on the findings.

“Individuals with heart and lung conditions, including heart failure, asthma and chronic obstructive pulmonary disease, have a hard time tolerating extreme heat,” said Johnson, who was also not involved in the study.

“The heat may exacerbate their symptoms, making breathing as well as dizziness and falls more likely.”

“For many older adults, going to a doctor’s appointment takes considerable effort.”

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In her own practice, Johnson has seen many patients who had disabilities or difficulty walking.

“Transportation to the visit and walking safely were greatly affected by the weather,” she said.

“Cold temperatures, which often come with heavy rain or snow, make surfaces slippery, increasing the risk of falls and injuries.”

If the weather is poor, cancellations and no-shows tend to increase, she noted. 

4 ways to prevent skipped appointments

“It is critical that we have alternative methods for the delivery of primary care during various scenarios,” Adrienne Willard, M.D., associate professor of medicine at the Drexel University College of Medicine, told Fox News Digital.  

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Experts recommend scheduling appointments during times when the weather is typically more favorable. (iStock)

Experts offered the following tips to ensure that seniors make it to essential appointments despite challenging weather conditions.

1. Plan ahead to ensure safety

Schedule appointments during times when the weather is typically more favorable, Eichenberger suggested. 

“For example, avoid early morning appointments in winter when sidewalks might be icy, and avoid mid-afternoon appointments during the hottest part of the day,” she advised. 

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“Monitor weather forecasts and reschedule appointments if extreme weather is expected — it’s better to err on the side of caution.” 

Allow plenty of time to get ready and travel safely to your destination, Eichenberger said. 

“Be prepared for weather-related delays or breakdowns during travel by carrying water to stay hydrated and snacks to avoid hunger and lightheadedness,” an expert advised. (iStock)

“Dress in layers during cold weather and wear appropriate footwear to prevent slips and falls,” she said. 

“In hot weather, opt for light, breathable clothing and use sun protection, such as hats and sunscreen.”

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2. Consider telehealth appointments when possible

Based on the findings, the researchers are calling for telemedicine to become a permanent, covered mode of health care delivery — as it was during the COVID pandemic.

Previous studies have shown that the availability of telemedicine reduces the chances of missed appointments by 13%, they noted.

“If the opportunity to choose an [insurance] plan that provides coverage for telemedicine presents itself, it may be a preferred option,” Willard told Fox News Digital.

      

Johnson agreed that telemedicine is the “most practical and immediate solution,” particularly for individuals with chronic conditions who are well-known to their providers.

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“Telemedicine increases access to care providers and extends the reach of specialists to rural areas,” she said. “Telemedicine across state lines would extend that reach further.”

3. Find reliable transportation

For patients who still drive, ensure the car is serviced regularly to avoid car trouble, Eichenberger recommended. 

If the patient no longer drives, it’s important to arrange for reliable transportation options. 

“Telemedicine increases access to care providers and extends the reach of specialists to rural areas,” a doctor said. (iStock)

“This could include asking family members or friends for help — or using home care services, ride-sharing services or senior transportation programs.”

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For those using public transportation, Eichenberger stressed the need to seek shelter while waiting for the bus to avoid being out in the weather.

4. Have the essentials on hand

“Be prepared for weather-related delays or breakdowns during travel by carrying water to stay hydrated and snacks to avoid hunger and lightheadedness,” Eichenberger said. 

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If traveling by car, she recommends keeping an emergency kit with essentials such as water, snacks, blankets and a first-aid kit — as well as any necessary medications that need to be taken throughout the day.

Potential limitations

The researchers acknowledged some limitations of the study — particularly that it relies on limited data sets.

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“We acknowledge that the data collected on maximum daily temperatures from one central location may not capture urban heat island effects throughout the city,” Drexel College of Medicine clinical associate professor Janet H. Fitzpatrick, M.D., one of the lead authors of the study, told Fox News Digital via email. 

“It is critical that we have alternative methods for the delivery of primary care during various scenarios.”

“In addition, patients with multiple medical problems impacted the ability to explore how individual diseases affect the associations between extreme weather and missed appointments.”

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Other research has pointed to additional factors — such as the day of the week, previous no-shows and the use of automated reminders — as impacting the rate of attendance, according to a university press release.

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The researchers recommend considering the availability of transportation in future studies assessing missed appointments.

Health

Brain Health Challenge: Try a Brain Teaser

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Brain Health Challenge: Try a Brain Teaser

Welcome back! For Day 4 of the challenge, let’s do a short and fun activity based around a concept called cognitive reserve.

Decades of research show that people who have more years of education, more cognitively demanding jobs or more mentally stimulating hobbies all tend to have a reduced risk of cognitive impairment as they get older.

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Experts think this is partly thanks to cognitive reserve: Basically, the more brain power you’ve built up over the years, the more you can stand to lose before you experience impairment. Researchers still don’t agree on how to measure cognitive reserve, but one theory is that better connections between different brain regions corresponds with more cognitive reserve.

To build up these connections, you need to stimulate your brain, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. To do that, try an activity that is “challenging enough that it requires some effort but not so challenging that you don’t want to do it anymore,” he said.

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Speaking a second language has been shown to be good for cognition, as has playing a musical instrument, visiting a museum and doing handicrafts like knitting or quilting. Reading is considered a mentally stimulating hobby, and experts say you’ll get an even bigger benefit if you join a book club to make it social. Listen to a podcast to learn something new, or, better yet, attend a lecture in person at a local college or community center, said Dr. Zaldy Tan, the director of the Memory and Healthy Aging Program at Cedars-Sinai. That adds a social component, plus the extra challenge of having to navigate your way there, he said.

A few studies have found that playing board games like chess can be good for your brain; the same goes for doing crossword puzzles. It’s possible that other types of puzzles, like those you find in brain teaser books or from New York Times Games, can also offer a cognitive benefit.

But there’s a catch: To get the best brain workout, the activity should not only be challenging but also new. If you do “Wordle every day, it’s like well, then you’re very, very good at Wordle, and the Wordle part of your brain has grown to be fantastic,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School. “But the rest of your mind might still need work.”

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So play a game you’re not used to playing, Dr. Selwa said. “The novelty seems to be what’s driving brain remodeling and growth.”

Today, we want you to push yourself out of your cognitive comfort zone. Check out an online lecture or visit a museum with your challenge partner. Or try your hand at a new game, below. Share what novel thing you did today in the comments, and I’ll see you tomorrow for Day 5.

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Popular intermittent fasting diets may not deliver the health benefits many expect

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Popular intermittent fasting diets may not deliver the health benefits many expect

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Time-restricted eating has gained popularity in recent years, but a recent study suggests that intermittent fasting — while effective for weight loss — might not live up to the hype in terms of wider benefits.

The small German study found that participants who were placed on two different time-restricted eating schedules lost weight, but experienced no improvement in blood glucose, blood pressure, cholesterol or other key cardiometabolic markers.

The participants included 31 overweight or obese women. One group ate between 8 a.m. and 4 p.m. and the other group ate between 1 p.m. and 9 p.m. for a two-week period, while maintaining their typical caloric intake, according to a press release.

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The findings, which were published in the journal Science Translational Medicine, suggest that the widely touted cardiometabolic benefits of intermittent fasting may be a result of eating fewer calories rather than meal timing, the researchers say.

The participants also showed a shift in their circadian rhythms (sleep/wake cycles) when they were placed on the time-restricted eating schedules, but the associated health impacts are not known.

A recent study suggests that intermittent fasting — while effective for weight loss — might not live up to the hype in terms of wider benefits. (iStock)

The study did have some limitations. Some researchers have cast doubt on the significance of the study due to its small size.

“It is severely underpowered to detect any difference, considering how gentle the intervention is,” Dr. Dr. Jason Fung, a Canadian physician, author and researcher, told Fox News Digital. He also noted that the participants were fasting for 16 hours a day instead of the normal 12 to 14 hours.

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Lauren Harris-Pincus, a registered dietitian nutritionist in New Jersey, agreed that the findings could be due to the fact that there was no intentional caloric restriction, and reiterated that the sample size is “quite small.” 

“As a registered dietitian, I only recommend time-restricted eating when it is carefully planned and shifted earlier within the day,” Harris-Pincus, who was not involved in the study, told Fox News Digital.

One group in the study ate between 8 a.m. and 4 p.m. and the other group ate between 1 p.m. and 9 p.m. for a two-week period, while maintaining their typical caloric intake. (iStock)

“Only one in 10 Americans consumes the recommended number of fruits and veggies, and 93% miss the mark on fiber goals. Restricting an eating window necessitates more careful meal planning to ensure adequate intake of macro- and micronutrients.”

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The expert also cautioned that skipping breakfast to enable a later eating window may result in lower intake of the “nutrients of concern” in the American diet, including calcium, potassium, fiber and vitamin D. 

Looking ahead, the researchers said more studies are needed to explore the effects of time-restricted eating over longer time periods. It also remains to be seen how the combination of caloric restriction and time-restricted eating may affect outcomes. Future research could also explore how different populations may respond.

“I only recommend time-restricted eating when it is carefully planned and shifted earlier within the day.”

Dr. Daryl Gioffre, a gut health specialist and celebrity nutritionist in New York, noted that the study didn’t account for critical factors like chronic stress, sleep quality, medications, hormone status and baseline metabolic health.

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“All of these can significantly blunt fat loss and cardiometabolic improvements,” Gioffre, who also was not involved in the research, told Fox News Digital.

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“Cortisol, the body’s primary stress hormone, is naturally highest in the morning, which overlaps with one of the fasting windows studied,” he went on. “If stress is elevated, cortisol alone can block fat burning, disrupt blood sugar regulation, and mask cardiovascular improvements, regardless of calorie intake or eating window.”

Growing research shows intermittent fasting — when done correctly and sustained over time — can improve insulin regulation, reduce inflammation, support fat loss and contribute to better cardiovascular health, an expert said. (iStock)

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Gioffre did agree, however, that growing research shows intermittent fasting — when done correctly and sustained over time — can improve insulin regulation, reduce inflammation, support fat loss and contribute to better cardiovascular health.

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“These are outcomes that simply cannot be captured in a short, stress-blind study like this,” he added.

Fox News Digital reached out to the researchers for comment.

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Brain Health Challenge: Workouts to Strengthen Your Brain

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Brain Health Challenge: Workouts to Strengthen Your Brain

Today, you’re going to do perhaps the single best thing for your brain.

When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.

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“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.

Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.

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Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.

Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.

All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.

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The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.

The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.

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Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.

Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.

If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”

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For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.

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