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Do You Qualify for “Extra Help” With Your Prescription Drug Plan Costs?

Medications play an important role in senior health. They are beneficial in controlling many of the diseases and conditions that older adults experience, such as arthritis, diabetes, high blood pressure, osteoporosis, heart disease and more. But many seniors fail to take their medications correctly, or at all. The reason may be that the high cost of prescription drugs means they must choose between their medications and food or other necessities.

Seniors on Medicare who have a limited income should know that they may be able to save money on their medications. They may be unaware that they could qualify for the Social Security Extra Help program, which could save them up to $4000 each year on the cost of drugs.

Here is information from Social Security about the Extra Help benefit:

Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income also may be able to get Extra Help to pay for the costs related to a Medicare prescription drug plan. This might include:

  • Monthly premiums
  • Annual deductibles
  • Prescription co-payments

To qualify for Extra Help, you must meet three requirements:

  • You must reside in one of the 50 states or the District of Columbia
  • Your resources must be limited to $13,300 for an individual or $26,580 for a married couple living together. Resources include such things as bank accounts, stock and bonds. Social Security does not count your home, car and any life insurance policy as resources.
  • Your annual income must be limited to $17,235 for an individual or $23,265 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where your income may be higher are if you or your spouse:
  • Support other family members who live with you
  • Have earnings from work
  • Live in Alaska or Hawaii

How To Apply

It is easy to apply for Extra Help. Just complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). Here’s how:

  • You can apply online at www.socialsecurity.gov/extrahelp . The online application is secure and easy to use.
  • Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application
  • Apply to your local Social Security office

After you apply, Social Security will review your application and send you a letter to let you know if you qualify for Extra Help. Once you qualify, you can choose a Medicare prescription drug plan. If you do not choose a plan, the Centers for Medicare & Medicaid Services (CMS) will do it for you. The sooner you join a plan, the sooner you begin receiving benefits.

For more information, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Source: U.S. Social Security Administration, edited by AgeWise, 2013

Why Do We Get Our Flu Shot in the Fall?

Cooler weather, falling leaves, children in their back-to-school finery … these are all things we associate with autumn. Healthcare personnel also think of fall as the time for patients to be vaccinated for the annual seasonal flu.

Have you ever wondered why flu season in the U.S. peaks during the fall and winter months? Scientists have asked the same question. Is it because children return to school and “share” the virus? Is it because people are cooped up in closer proximity to one another during the colder winter months? Or perhaps the lower levels of light affect our immune systems? Researchers from Virginia Tech recently studied the relationship between flu outbreaks and humidity. They found that the virus thrives very well in low humidity—making our dry, heated homes the perfect condition for the flu to spread. (On the other hand, the virus also survives in very high humidity, which may be why flu season peaks during the rainy season in tropical climates.)

No matter what the reason for the timing of flu season, it’s wise to be vaccinated at the recommended time. Seniors are at highest risk of complications from the flu, and 90 percent of flu-related deaths occur in people older than 65. Talk to your healthcare provider about the flu vaccine you should receive. You can also visit www.flu.gov to learn more about the risks of the flu in older adults, the importance of annual vaccination, and available vaccine options.

Copyright © AgeWise, 2013

Ten Things You May Not Know About Hospice

November is National Hospice/Palliative Care Month. Here is some information about hospice care from the National Hospice and Palliative Care Organization.

Most Americans have heard about hospice care. They know that hospices care for people at the end of life. Most people know a family or friend who was helped by hospice when faced with the serious illness and death of a loved one. But there’s so much more to know.

For example, did you know that hospice provides what the majority of Americans say they want at the end of life? Excellent pain management, comfort, and support for the patient and family caregivers.

Ten more things you should know about hospice:

  1. Hospice is not a place but a special kind of care.
  2. A hospice care team is made up of doctors, nurses, social workers, counselors, spiritual care providers, trained volunteers and other skilled professionals who provide high-quality, compassionate care.
  3. Hospice care is available to people of all ages with any kind of life-limiting illness, including cancer, advanced Alzheimer’s disease, heart disease, lung disease, kidney disease, HIV/AIDS and other life-limiting illnesses.
  4. Hospice care is fully covered by Medicare, Medicaid, and most private insurance plans and HMOs.
  5. Hospice provides all medications and medical equipment needed to keep a person safe and comfortable.
  6. There’s no limit to the amount of hospice care a person can receive; it’s available as long as a doctor believes a patient is eligible.
  7. Most care is provided at home but hospice is also available in nursing homes, assisted living and long term care facilities and hospice inpatient units.
  8. Hospice care can include complementary therapies, such as music and art, to bring additional comfort to patients and families.
  9. Hospice programs offer grief support to the families they care for as well as to others in the community who are grieving.
  10. More than 1.5 million people receive care every year.

One of the most common sentiments shared by families who have been helped by hospice care is, “We wish we had known about hospice sooner.”

To find out if hospice might be right for you or your family, or to learn more, visit Caring Connections at www.caringinfo.org or call the HelpLine at 1-800-658-8898.

Source: National Hospice and Palliative Care Organization (www.nhpco.org)

Is Depression a Risk Factor for Alzheimer’s Disease?

November is National Alzheimer’s Disease Awareness Month.

Depression is one of the most common conditions affecting older adults. According to the University of Pittsburgh School of Medicine, an estimated 15 percent of people older than 65 are dealing with depression, which affects the whole person: mind, body and emotions. Symptoms include a persistent feeling of sadness, lack of energy, changes in normal eating and sleeping, memory disturbances and impaired concentration, loss of interest in usual activities, and trouble keeping up with normal activities at home and work.

If you compare these symptoms to those of Alzheimer’s disease and related conditions, you will notice some striking similarities. Many of the symptoms of depression are known to mimic dementia, so closely that families and even healthcare providers may at first mistakenly suspect that a person with depression has Alzheimer’s disease. Ruling out depression is an important first step in diagnosing dementia.

Further complicating things, depression itself may be one early sign of dementia. But if depression is a symptom of Alzheimer’s disease, could it also be a risk factor? For years, researchers have speculated that people with depression are more likely to later develop dementia. What is the connection? How could a history of depression make it more likely that a person will suffer cognitive losses later in life?

The American Academy of Neurology states that depression may nearly double a person’s risk of developing dementia. Researcher Jane Saczynzki, Ph.D., from the University of Massachusetts Medical School says, “While it’s unclear if depression causes dementia, there are a number of ways depression might impact the risk of dementia. Inflammation of the brain tissue that occurs when a person is depressed might impact the risk of dementia. Certain proteins found in the brain that increase with depression may also increase the risk of developing dementia.” Researchers from the University of Edinburgh also looked at brain shrinkage caused by high levels of certain stress hormones.

It is also possible that a particular factor—perhaps not yet known—underlies both depression and dementia. Research is underway to determine the precise nature of the connection between the two conditions.

Treating depression supports brain health

One thing researchers agree upon: Depression makes it much less likely that we will follow a healthy lifestyle that protects our memory health. It saps our will and motivation and our desire to be active. Says Saczynski, “Several lifestyle factors related to long-term depression, such as diet and the amount of exercise and social time a person engages in, could also affect whether they develop dementia.”

This is yet another reason to seek professional help if you or a loved one is showing signs of depression. Depression can become disabling if not properly treated. All too often, people are resistant to the idea that they might have a true depression, feeling that somehow they will “just snap out of it.” But depression is an illness that results from a chemical imbalance in the brain, and it can respond successfully to treatment.

The first step in reversing depression is to have it diagnosed by a physician or other qualified professional. After a thorough exam, the healthcare provider will first try to identify the cause of the depression, which might stem from:

  • Distressing life events such as the death of a spouse, financial worries or illness
  • Chronic pain
  • Nutritional deficiencies such as lack of vitamin B-12 or folic acid, or poor nutrition in general
  • Underlying medical conditions such as low thyroid or other hormone changes, diabetes, heart disease or Parkinson’s disease
  • Side effects of specific medications, overmedication, or effects of polypharmacy—taking many drugs which might have a negative interaction.

Treatment for depression may include…

Lifestyle changes—Patients are advised to focus on better nutrition, spending more time with others, increasing physical activity, making more time for enjoyable activities, managing other health conditions, and confronting and dealing with negative thoughts.

Counseling—It’s not always possible for a person with depression to work through troubling thoughts on their own. Talking with a mental health professional may help identify the stressors that have led to depression, aid in developing strategies to lessen those stressors, and change negative thoughts as patients learn to take better care of themselves.

Medication—Antidepressant medications work by helping the brain make its normal chemicals again. These medications can help with sleep, improve energy and reduce anxiety and negative thoughts. There are several classes of these drugs; it is important to work closely with the healthcare provider during the process of finding the best medication for each patient. This may take several months.

Many older adults avoid seeking help for depression. They may have a generational attitude of self-sufficiency and keeping one’s problems to oneself. To help overcome that preconception, seniors should be encouraged to understand that treating depression is no different than treating any other illness. Professional help can let them get their lives back on track. And now we know it may very well also protect their brains!

Better treatment of depression and understanding of the connection between depression and dementia is not only important for senior patients; it is vital for our nation’s healthcare system as well. According to University of Pittsburgh School of Medicine professor Meryl Butters, Ph.D., “An understanding of how late-life depression increases the risk of dementia could lead to better prediction and prevention mechanisms. Early diagnosis and prevention of depression could have a major dual public health impact as they could also potentially prevent or delay cognitive decline and dementia in older adults.”

Copyright © AgeWise, 2013

Avoiding the Complications of Diabetes

November is National Diabetes Month.  This year’s theme is”Diabetes is a Family Affair,” reflecting the fact that this disease affects entire families, not just the person with diabetes. While people of every age can develop diabetes, it becomes more common as we grow older. Almost 26 million Americans today have diabetes—almost 8 percent of our population.

Diabetes develops when a person’s level of blood glucose, or blood sugar, is too high. This occurs when the pancreas cannot manufacture enough insulin, a hormone that helps glucose get into your cells to provide energy—or when the cells in the muscles, liver, and fat do not use insulin properly. As a result, the amount of glucose in the blood increases while the cells are starved of energy.

The complications from the disease can be severe. They include serious problems such as heart disease, eye and kidney damage, high blood pressure, and nerve damage that could result in amputation.

While this is a very sobering list of complications, patients themselves have the power to reduce the potential for complications, and to successfully manage the disease. Self-care practices such as healthy eating, being active, monitoring blood glucose levels and not smoking can make a big difference.

So, let’s review some diabetes complications, along with some positive actions that can help patients and loved ones minimize damage and improve outcome:

Nerve Damage

Nerve damage (called diabetic neuropathy) can appear as numbness, tingling, pain, perspiration problems and bladder problems. It is caused by high blood sugar. You can help control your blood sugar through eating the diet your healthcare provider suggests, as well as with exercise, taking medications correctly and frequent blood glucose level testing.

Increased Risk of Infection

For people with diabetes, high levels of blood sugar foster the growth of bacterial and fungal infections, especially common in the skin and urinary tract. You can decrease the risk of infection by keeping skin clean and dry, bathing regularly, drinking plenty of water, and reporting to the doctor if a cut doesn’t heal quickly.

Impaired Vision

While many people develop glaucoma and cataracts, people with diabetes develop them more often and at an earlier age. Over time, high blood sugar can injure the blood vessels of the eye, including the retina, lens and optic nerve. Regular eye examinations should be part of your diabetes management program, because early intervention for eye problems will help prevent more serious problems later. Remember—damage to the eyesight may not be apparent at first, so have an annual exam even if your vision isn’t bothering you.

Foot Problems

While anyone can have foot problems, people with diabetes are especially prone to corns, blisters, calluses, dry, cracked skin. Serious infection is much more common because the nerve damage described above can reduce feeling in the feet. It is important to pay attention to your feet, inspecting them regularly so problems won’t worsen. Keep feet clean and dry, and talk to your healthcare provider about the best type of shoes and socks to select.

Heart or Kidney Disease

Diabetes also makes it more likely that a person will suffer from cardiac or renal disease. A healthy lifestyle and commitment to managing those conditions is very important. This includes getting the right amount and type of exercise, complying with medication instructions, quitting smoking if you do, and regular monitoring of blood sugar.

For More Information

The National Diabetes Education Program [link to: http://ndep.nih.gov/index.aspx] partners with other organizations to sponsor National Diabetes Month [link to: http://ndep.nih.gov/partners-community-organization/national-diabetes-month/2013.aspx] and offers a wealth of information for people with diabetes and their families.

Copyright © AgeWise, 2013

October 29 is World Stroke Day

This year’s slogan is “Because I care….” The World Stroke Association says that this theme reminds us that caring about ourselves, our families and our friends is the key to preventing strokes and helping those who experience a stroke.

Stroke is among the five leading causes of death for people of all races and ethnicities in the United States. A stroke occurs when a clot blocks the blood supply to part of the brain or when a blood vessel in or around the brain bursts. In either case, parts of the brain become damaged or die. Stroke can affect your senses, speech, behavior, thoughts, memory, and emotions. One side of your body may become paralyzed or weak.

The good news is that there are things you can do to help prevent the devastating effects of stroke.

Because I care…

I’ll learn the signs of stroke

The five most common signs and symptoms of a stroke are:

  • Sudden numbness or weakness of the face, arm, or leg.
  • Sudden confusion or trouble speaking or understanding others.
  • Sudden trouble seeing in one or both eyes.
  • Sudden dizziness, trouble walking, or loss of balance or coordination.
  • Sudden severe headache with no known cause.

Each year, about 795,000 people in the United States have a stroke. The risk of having a stroke varies among racial and ethnic groups. Compared to whites, African Americans are nearly twice as likely to have a first stroke. Hispanic Americans’ risk falls between the two.

Although stroke risk increases with age, strokes can—and do—occur at any age. Nearly one quarter of strokes occur in people under the age of 65. Learning about stroke can help you act in time to save a co-worker, friend, or relative.
I’ll find out what to do when a stroke occurs

Signs of a stroke come on suddenly. If your symptoms go away after a few minutes, you may have had a “mini-stroke,” also called a transient ischemic attack (TIA). TIAs do not cause permanent damage but can be a warning sign of a full stroke to come—you should still get help immediately.

If you or someone else experiences one or more signs or symptoms of stroke, call 9-1-1 immediately. Every minute counts! Patients who arrive at the emergency room within 3 hours of their first symptoms tend to be healthier 3 months after a stroke than those whose care was delayed.

I’ll help prevent strokes

Some risk factors for stroke—heredity, age, gender, and ethnicity—you cannot change. But whether you have these risk factors or not, you can reduce your risk by making healthy choices. You can make sure that you, your family, and your friends know to—

  • Eat a healthy diet that’s rich in fruits and vegetables and low in saturated fat, trans fat, sodium, and cholesterol.
  • Be physically active to help maintain a healthy weight.
  • Avoid (or stop) smoking, and limit alcohol use.

Some medical conditions can raise your stroke risk. If you have high cholesterol, high blood pressure, diabetes, prior stroke or TIA, atrial fibrillation or other heart diseases, you can lower your risk for stroke by having your cholesterol checked, monitoring your blood pressure, managing your diabetes, and taking your medicine as instructed by your doctor.

Family members and friends are the most important source of support to the stroke survivor during recovery and rehabilitation. According to the American Stroke Association www.strokeassociation.org), there are many things that family caregivers and the stroke survivor can do to speed recovery.

I will join community efforts against stroke

The U.S. Department of Health and Human Services launched the Million Hearts initiative (http://millionhearts.hhs.gov) to prevent 1 million heart attacks and strokes by 2017. You can share your commitment to heart disease and stroke prevention by taking the Million Hearts™ pledge on the Million Hearts website.

World Stroke Day brings together advocacy groups, patient survivor support networks, volunteer stroke societies, public health authorities, health care professionals, and community members for a collaborative approach to comprehensive stroke education, advocacy, prevention, treatment, and long-term care and support for stroke survivors.

On World Stroke Day, make the commitment to prevent strokes and to help those who are recovering from a stroke… because you care.

Source: Centers for Disease Control and Prevention (CDC)

Five Ways to Save Money on Your Medications

Managing medications can be difficult when the cost of your drugs is high. If you’re having trouble paying for your prescriptions, here are 5 ways you might be able to save money.

1. Talk to your doctor—and your plan.

When you’re prescribed a new medication, check to see whether it’s on your plan’s formulary (approved drug list) and how much your copayment is. If your drug plan doesn’t cover your prescription, or if your copayments are very high, ask your doctor for help.

Physicians will know whether there are comparable, less expensive drugs (e.g., generics) that may be available to you. Some may even be able to provide free samples of medications while you seek other coverage options. Doctors also can request an exception to ask your plan to cover the medication, or to pay at a lower tier.

2. See if you qualify for Extra Help.

The Medicare Part D program has a subsidy called Extra Help that assists people with limited income and resources with paying for their drugs. If you get Extra Help, you’ll save money on your drug plan premium, deductible, and at the pharmacy—with prescriptions costing between $1.15 and $6.60.

Learn more about who qualifies for Extra Help and apply online today. [link to: https://www.benefitscheckup.org/cf/extrahelp.cfm]

3. Check with your state.

About half of the states have State Pharmaceutical Assistance Programs (SPAPs) to help people with limited incomes pay for their prescriptions. Many SPAPs work with Medicare Part D, “wrapping around” coverage, meaning they help pay for certain costs that Part D does not cover.

However, each state runs its program differently, so it’s best to check what the rules are in your area. See if your state has an SPAP. [link to: http://www.mymedicarematters.org/PrescriptionDrugs/CurrentCoverage/spap_contact.php]

4. Find help from drug manufacturers.

Patient Assistance Programs, or PAPs, are programs offered by drug companies to help people pay for their drugs. Through these programs, many drug manufacturers offer the drugs they make for free, or at a discount. Some PAPs are for people who don’t have insurance, while a few help people with Medicare Part D who don’t qualify for Extra Help.

The National Council on Aging’s (NCOA) BenefitsCheckUp® screening tool [link to: https://www.benefitscheckup.org] can help you see whether you can get help from a PAP—or any of the other programs mentioned on this page.

5. Don’t forget Open Enrollment!

Every year from Oct. 15 to Dec. 7, people with Medicare can switch their prescription drug plans for the following year. If you’re having trouble with your drug costs, it’s a good idea to compare plans to see if there’s a more affordable option.

You can go online at any time to compare plans using the Medicare Plan Finder, or you can get personalized help from your State Health Insurance Assistance Program (SHIP). Every state has a SHIP that offers free, objective, and personalized information to people with Medicare.

You also can ask your SHIP whether you qualify for a Special Enrollment Period to switch plans. Find your SHIP here. [link to: https://shipnpr.shiptalk.org]

Source: The National Council on Aging (www.ncoa.org) is a nonprofit service and advocacy organization whose mission is to improve the lives of millions of older adults, especially those who are vulnerable and disadvantaged. NCOA is a national voice for older Americans and the community organizations that serve them, and works with thousands of organizations across the country to help seniors find jobs and benefits, improve their health, live independently, and remain active in their communities.

 

People with Medicare and the Health Insurance Marketplace: Frequently Asked Questions

You have probably heard that a key part of the new healthcare law, the new Health Insurance Marketplace, will begin on October 1. Seniors on Medicare have expressed confusion about how they are impacted by this new law and what they should do. Here is a brief overview:

Q: How will the Health Insurance Marketplace that starts in 2014 affect my Medicare coverage?

The Health Insurance Marketplace is designed to help people who don’t have any health insurance. You have health insurance through Medicare. The Marketplace won’t have any effect on your Medicare coverage.

Your Medicare benefits aren’t changing. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now, and you won’t have to make any changes.

The Marketplace provides new health insurance options for many Americans. If you have family and friends who don’t have health insurance, tell them to visit HealthCare.gov to learn more about their options.

Q: Do I need to do anything with Marketplace plans during Medicare Open Enrollment (October 15 – December 7, 2013)?

Medicare’s Open Enrollment isn’t part of the new Health Insurance Marketplace. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan.

Medicare Open Enrollment (October 15 – December 7, 2013) is the time when all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage and benefits that will take effect next year. If you want to change your coverage for next year, this is the time to do it. If you’re satisfied that your current coverage will continue to meet your needs for next year, you don’t need to do anything. For more information on Medicare Open Enrollment, visit Medicare.gov or call 1-800-MEDICARE.

Note: The Health Insurance Marketplace Open Enrollment period (October 1, 2013 to March 31, 2014) overlaps with the Medicare Open Enrollment period (October 15 – December 7, 2013). Therefore, people with Medicare who are looking to make Medicare coverage changes should make sure that they are reviewing Medicare plans and not Marketplace options.

Q: What should I do if I’m contacted about signing up for a health plan?

  • The Medicare open enrollment period is a time when there’s a higher risk for fraudulent activities.
  • It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan.
  • DO NOT share your Medicare number or other personal information with anyone who knocks on your door or contacts you uninvited to sell you a health plan.

Senior Medicare Patrol programs are teaching people with Medicare how to detect and report fraud, and protect themselves from fraudulent activity and identity theft. To learn more about health care fraud and ways to protect against it, visit StopMedicareFraud.gov or the Senior Medicare Patrol (SMP) program in your area (locate your SMP at SMPresource.org).

Source: United States Department of Health and Human Services.

 

Will Medicare Pay for Long-Term Care?

“Long-term care” means the health and support services that we may need as we age or have a disability. Long-term care may include care provided in a person’s home, such as home health care, in-home companion care and assistance with household tasks. Long-term care may also be provided in a residential facility, such as a nursing home, assisted living or adult family home.

Many people believe that Medicare will cover the cost of nursing home care or home care. But it is important to know that Medicare and most private health insurance cover only limited, medically necessary care. Medicare does not cover personal care—assistance with bathing, dressing, supervision for patients with Alzheimer’s disease and so forth.

The National Clearinghouse for Long-Term Care Information now offers information to help consumers plan ahead for future needs, select the right level of care, and locate resources. Information includes:

Planning ahead for long-term care includes understanding the financial resources that can help.

 

Study Finds Tai Chi Benefits Parkinson’s Patients

Exercise is important for a healthy lifestyle but it is also a key part of therapy, rehabilitation and disease management. For Parkinson’s disease, exercise routines are often recommended to help maintain stability and the coordinated movements necessary for everyday living. A recent study funded by the NIH’s National Institute of Neurological Disorders and Stroke (NINDS), which was reported in the New England Journal of Medicine, evaluated three different forms of exercise – resistance training, stretching, and tai chi – and found that tai chi led to the greatest overall improvements in balance and stability for patients with mild to moderate Parkinson’s disease.

Parkinson’s disease is a movement disorder that is caused by the loss of brain cells which control coordinated and purposeful motions. This cell loss results in tremor, rigidity, slowed movement (known as bradykinesia) and impaired balance (postural instability). While some symptoms, such as tremor, at least benefit from drug therapy initially, the medications currently available to treat Parkinson’s are not as effective in restoring balance. This is a special concern for Parkinson’s patients because postural instability frequently leads to falls.

Several studies have demonstrated that resistance training, for instance with ankle weights or using weight-and-pulley machines, has a positive effect on balance and gait. As a result, doctors often suggest exercise or prescribe physical therapy to address problems with instability.

Fuzhong Li, Ph.D., research scientist at the Oregon Research Institute in Eugene, was part of a team of researchers who, in 2007, published a pilot study showing that tai chi was a safe exercise for individuals with mild to moderate Parkinson’s disease. “We had been using tai chi for balance training in healthy older adults,” Dr. Li commented, “and older adults and patients with Parkinson’s disease share some difficulties with falls.”

Tai chi is a balance-based exercise that originated in China as a martial art. While there are many different styles, all are characterized by slow, relaxed and flowing movements. In both the pilot study and the recent New England Journal of Medicine study, patients performed a tai chi routine designed to challenge patients’ stability and address the balance and stability-related symptoms of Parkinson’s. The routine included slow, intentional, controlled movements that maximized the swing time of arm and leg motions, and repeatedly incorporated gradual shifts of body weight from one side to another, varying the width of their base of support by standing with feet together or further apart.

With support from NINDS, Dr. Li and colleagues conducted a larger clinical trial to compare tai chi to resistance training and stretching. The study assigned a total of 195 patients with mild to moderate Parkinson’s disease to one of three exercise groups: tai chi, resistance training, or stretching. Patients attended class twice a week for 24 weeks. The investigators assessed balance and movement control by testing how far patients could lean and shift their center of gravity without losing balance, and how directly the patients could reach out to a target, with a minimum of extraneous movement.

After six months, the patients in the tai chi group showed the greatest amount of improvement in balance and stability. Furthermore, patients in the tai chi and resistance training groups had a significantly fewer falls over the six month period compared to participants in the stretching group. “There is a learning curve involved,” Dr. Li noted, adding that improvement is seen after four to five months of continued practice twice a week, and this trend is similar to what he had noted in his studies of older people.

Dr. Li described tai chi as similar to resistance training, the more commonly recommended physical therapy, in that it requires repetitive movement. Tai chi, however, not only involves shifting a person’s weight and center of gravity, but it is also practiced at a dramatically slow speed and greatly emphasizes intentional control of movement. “In tai chi we emphasize very slow and intentional movement,” Dr. Li commented. “That imposed a lot of challenge, especially to those in the tai chi group who were used to fast movement.”

Dr. Li also noted that tai chi is very safe and can be performed without equipment and in limited space.

Beth-Anne Sieber, Ph.D., a program officer at NINDS, said that falls are a dangerous side effect of Parkinson’s disease and commented on the significance of Dr. Li’s work. “The key observation in Dr. Li’s study is that a specifically designed sequence of tai chi movements improves postural stability and prevents falls for an extended period of time in persons with Parkinson’s disease. In addition, tai chi sequences can be tailored to improve balance in a spectrum of patients with mild to moderate symptoms.” Dr. Sieber also noted that this study is indicative of a growing interest in examining how physical activity may improve symptoms of Parkinson’s disease. Further research will provide additional information on ways in which physical activity can improve disease symptoms and quality of life for people with Parkinson’s disease.

Source: National Institute of Neurological Disorders and Stroke. For more information about Parkinson’s disease, visit www.ninds.nih.gov/PD.