American Geriatrics Society Helps You “Choose Wisely”

This week, the American Board of International Medicine (ABIM) Foundation published the latest of its ground-breaking Choosing Wisely® “five-things” lists, and I’m pleased to report that one of these new lists comes from the American Geriatrics Society. In case you’re not familiar with these important Choosing Wisely lists, here’s a little background:

Two years ago, the ABIM Foundation and Consumer Reports launched the Choosing Wisely campaign to encourage people to learn more about the tests and treatments their healthcare providers recommend, and to question and discuss these with their healthcare professionals under certain circumstances. There are two parts to the Choosing Wisely campaign. Numerous medical societies have gone through an in-depth review process to identify five tests or treatments for which there may not be enough medical research that shows safety or effectiveness. In some cases, the research may even show unwanted effects. At the same time, the Foundation and Consumer Reports have been encouraging people to check the lists to see if tests or treatments their healthcare providers have recommended are on them. If so, the campaign urges people to bring this up with their healthcare professionals and discuss it.

Some societies developed and published their Choosing Wisely lists last year. The AGS and others in a second group published theirs this week. And a new group of societies is now working on their lists. So, the Choosing Wisely campaign is growing, gaining momentum, and getting more and more attention from the public, from healthcare professionals, and from the media.

I encourage you to check the AGS’ list, which includes five treatments that may pose more risks than benefits in older people. Check to see if any medications or other treatments you’ve been prescribed are listed. This is particularly important for older adults. Why? Treatments that may be helpful for younger adults may not be safe or reliable in older people, because of physical changes that take place as we get older. For example, older people may respond differently to medications than younger adults.

In addition to reviewing the AGS list, you can also check the lists developed by other organizations at the Choosing Wisely website. Don’t worry if a test or treatment your healthcare provider has recommended is on one of the Choosing Wisely lists, and don’t stop a treatment if it’s on the list. Just because a test or treatment is listed doesn’t mean it’s unreliable or ineffective for you. Different people respond differently, and there is no “one-size-fits-all” when it comes to medical care.

But be sure to ask questions. Talk to your healthcare provider and sort it out. The Choosing Wisely campaign’s goal is to spark conversations about potentially unnecessary tests or treatments and to empower the public to ask questions of their healthcare providers.

To help you understand the items on the AGS’ Choosing Wisely list, the AGS Foundation for Health in Aging has developed “Ask the Expert” resources for each of our five items.

You can find additional, easily understandable background information about the AGS’ “five things.” Just visit the  “Choosing Wisely” section under Health A-Z. Complementing these resources, Consumer Reports has posted supplemental information on http://www.choosingwisely.org/. Enlightened reading!

Heart Healthy Reflections for Valentine’s Day

Valentine’s Day is a time of flowers, chocolate hearts, and celebrations of love and life.  For thousands of years, the heart has symbolized love and passion and has inspired great poetry, literature, art, and music. But maybe this year we should start a new tradition on Valentine’s Day: To check in with ourselves and those around us to look for signs of heart disease.

There are several types of heart disease, with coronary artery disease being the most common. It is estimated that more than 80 million Americans have at least one major risk factor for heart disease and stroke, such as high blood pressure, obesity, diabetes, and high cholesterol levels.

All told, some one million people a year will die of heart disease. Though one of the risk factors is advancing age, more than 150,000 heart disease and stroke deaths every year are among people younger than 65. With the rise in obesity and type 2 diabetes rates in children, we will likely see increased rates of heart disease and stroke occurring at earlier ages.

Heart disease is more common in men, particularly those with a strong family history, but it can strike anyone without warning at any time. Many people do not realize that, in addition to men, heart disease is the number one cause of death in women.

It is critical to recognize the symptoms of a possible heart attack and take immediate action. Don’t assume that it is indigestion or a muscle ache from overexertion. When in doubt, check it out.

Symptoms of a heart attack include:

  • Chest pain or discomfort such as a feeling of squeezing, fullness, or pressure
  • Pain in the upper arms (more common in men)
  • Pain in the back, jaw or stomach (more common in women)
  • Shortness of breath
  • Nausea/vomiting (more common in women)
  • Profuse sweating
  • Light-headedness
  • Unexplained anxiety (more common in women)

If you think that you are having a heart attack:

  • Do not wait
  • Call 911 – do not have a relative drive you to the hospital or worse, drive yourself
  • Immediately chew an uncoated adult aspirin or 3 baby aspirin (an aspirin must be chewed and not swallowed whole to offer heart protection benefits).

Remember: Time is critical in protecting your heart muscle.

Healthinaging.org has a wealth of information about the causes and symptoms of different types of heart disease. You will also find information about ways to prevent a heart attack through lifestyle choices such as not smoking, eating a heart healthy diet, and exercising.

A healthy heart is the best Valentine’s Day present we can give to ourselves and to those around us. I encourage you to celebrate this Valentine’s Day by doing something good for your heart!