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Certain kinds of video games — like Nintendo’s Wii Sports — may help overweight seniors become more physically active and burn calories, new research suggests.

Although not an improvement on real-life gaming and sports activity, the study team found that movement-oriented video games offer a good alternative for those older individuals for whom real sports participation is a remote option.

“Few studies have investigated the use of active video games in aging populations or individuals with disabilities,” Elizabeth Orsega-Smith, associate professor of health, nutrition and exercise sciences at the University of Delaware, said in a news release.

“Given that 40 percent of older-adult females and 30 [percent] of males ages 70 and above do not participate in any significant physical activity, this population faces growing health challenges,” she said. “For otherwise sedentary people, games like the Wii offer an enjoyable way to become more active and more healthy.”

Orsega-Smith and her colleagues were scheduled to report their findings Friday in Baltimore at the annual meeting of the American College of Sports Medicine.

To assess the exercise potential of different Wii games, the authors outfitted 24 overweight to obese men and women with wrist-worn accelerometers to measure the number of calories burned while playing games for a half hour. All were between 66 and 78 years old.

The research team found that those who played an individual bowling version of Wii burned between 20 and 176 calories during the exercise. Team bowling was less beneficial, consuming 18 to 89 calories, baseball 22 to 144, and tennis 17 to 72.

“Wii playing,” concluded Orsega-Smith, “may be a vehicle for physical activity participation, especially for those older adults who do not have access to a fitness facility or who may have physical limitations to their mobility.”

SOURCE: American College of Sports Medicine, news release.

The dirtier the air, the more likely people are to suffer sudden cardiac arrest, new research from Australia shows.

Particulate matter — tiny specks of soot, dust, and other pollutants in the air that can be breathed deep into the lungs — has been “consistently” linked to increases in deaths from heart disease and clogged arteries, Dr. Martine Dennekamp of Monash University in Melbourne and her colleagues note.

But studies looking at whether air pollution specifically ups the risk of heart attack or cardiac arrest have had mixed results.

Airborne particles are harmful to people with existing health problems, the researchers add, but they could also trigger heart attack or even sudden death in people with no apparent symptoms of cardiovascular disease.

To investigate, Dennekamp and her team looked at 8,434 cases of sudden cardiac arrest among people 35 and older that occurred in metropolitan Melbourne between 2003 and 2006.

After a rise in concentration of the tiniest airborne particles (particles less than 2.5 microns across, known as PM2.5), the likelihood of cardiac arrest rose, and stayed higher than average for two days. For every 4.26 micrograms per cubic meter increase in PM2.5 concentrations, the risk of cardiac arrest was 4 percent higher than average for the next 48 hours.

An individual’s risk of suffering sudden cardiac arrest is quite low; the American Heart Association estimates that there’s about one cardiac arrest per 2,000 people every year in North America. And the study does not prove that pollution causes more cardiac arrests, as the researchers did not find out whether participants in the study also smoked or had other risk factors for heart disease.

Carbon monoxide levels also were associated with increases in cardiac arrest risk, although the effect wasn’t as strong as it was for PM2.5. None of several other pollutants the researchers measured, including larger airborne particles, affected risk. The effect was strongest for people 65 to 74 years old, and weakest for those 75 and older.

Australia currently has an “advisory standard” limiting PM2.5 concentrations to 25 micrograms per cubic meter or less, the researchers note.

Given that an increase of less than 5 micrograms per cubic meter was tied to significant health effects, they add, “the present study suggests an increase in the risk of cardiac effects at concentrations below the current air quality standards in Australia.”

SOURCE: http://journals.lww.com/epidem/Abstract/publishahead/Outdoor_Air_Pollution_as_a_Trigger_for.99685.aspx Epidemiology.

Today, CDC announced that the 2009 National Youth Risk Behavior Survey (YRBS) (www.cdc.gov/yrbss) found that 1 in 5 high school students in the United States have ever taken a prescription drug, such as OxyContin, Percocet, Vicodin, Adderall, Ritalin, or Xanax, without a doctor’s prescription. This is the first year the survey assessed prescription drug abuse among high school students. The 2009 YRBS shows that many high school students engage in risk behaviors that are harmful to their overall health and increase their risk of disease and injury.

Both the new YRBS data and CDC’s Injury Center’s recently released issue brief, “Unintentional Drug Poisoning in the United States” highlight a serious public health problem with nonmedical use of prescription drugs. The issue brief points out that drug overdose rates have risen steadily in the United States since 1999, with most of the increase due to prescription drugs.

Data from the Drug Abuse Warning Network (DAWN), operated by the Substance Abuse and Mental Health Services Administration (SAMHSA), estimate that in 2008 people 12-20 years old accounted for an estimated 141,417 (14.5 percent) of the 971,914 emergency department visits for nonmedical use of pharmaceuticals. These numbers do not include suicide attempts.

“Our Nation faces many public health threats that deserve our immediate attention. Among them, there is the pressing reality of drug overdoses. Teens and others have a false assumption that prescription drugs are a safer ‘high’,” said Grant Baldwin, PhD, MPH, Director of CDC’s Injury Center Division of Unintentional Injury Prevention. “These data and that from other sources show us that prescription drug misuse is a significant problem in both adolescents and adults.”

The CDC recommendations in the issue brief are based on promising interventions and expert opinion to help health care providers, state and federal agencies, as well as private insurance providers and pharmacy benefit managers, to better understand the impact and cost of unintentional poisoning. CDC continues to respond to this problem through surveillance activities, epidemiologic research, and evaluation of interventions with the greatest promise of creating a public health impact.

People with atrial fibrillation, a form of abnormal heart rhythm, are more likely than others to develop dementia, including Alzheimer’s disease, a new study finds.

The presence of atrial fibrillation also predicted higher death rates in dementia patients, especially among younger patients in the group studied, meaning under the age of 70.

“This leaves us with the finding that atrial fibrillation, independent of everything else, is a risk factor [for dementia],” said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. “This is adding one more brick in the road toward understanding that cardiovascular disease is a major risk factor for dementia.”

“Alzheimer’s disease, in particular, is one where we don’t quite understand the risk factors and what causes it, so studies [like this] that try to investigate the causative effect will help us understand that and ultimately design therapies and approaches to prevent or minimize disease,” added Dr. Jared Bunch, lead author of a study appearing in the April edition of the HeartRhythm Journal and a cardiologist/ electrophysiologist with Intermountain Medical Center in Murray, Utah.

This study, however, was not specifically set up to establish a direct cause-and-effect relationship.

The authors looked at 37,025 patients without atrial fibrillation or dementia, aged 60 to 90, over a five-year period.

Individuals who developed atrial fibrillation had a higher risk of all types of dementia, even when other risk factors were taken into account. Alzheimer’s disease is by far the most common form of dementia.

More surprising was that those in the younger group — under age 70 — who had atrial fibrillation had the highest risk of developing dementia, even though dementia is normally associated with aging. People in this group were also at a 38 percent higher risk of dying.

Among the 764 patients who developed both conditions, diagnosis of atrial fibrillation usually happened first, followed by a diagnosis of dementia. Sometimes the diagnoses occurred simultaneously, the researchers noted.

The authors hypothesized that both atrial fibrillation and dementia may arise from the same risk factors, such as hypertension. Another possibility is that atrial fibrillation increases inflammation, and dementia has been shown to be higher in people with signs of systemic inflammation. Investigating whether treatment of hypertension and/or inflammation in AF patients might help curb the risk of dementia is an area of future study, the researchers added.

“From a public health perspective, the best thing we can do to decrease the coming epidemic of Alzheimer’s disease is to do a much better, more aggressive job of helping people with heart disease,” Kennedy said. “That means diet and exercise, of course — everyone knows that. We need to look at obstacles that people encounter beyond their own behavior, obstacles we put up environmentally in the workplace, in the school, that keep people from having better diet and exercise. A heart-healthy diet and lifestyle are really the best means we have available to prevent dementia.”

About 2.2 million Americans have atrial fibrillation, while an estimated 5.5 million suffer from Alzheimer’s.

SOURCES: Jared Bunch, M.D., cardiologist and electrophysiologist, Intermountain Medical Center, Murray, Utah; Gary Kennedy, M.D., director, geriatric psychiatry, Montefiore Medical Center, New York City; 2010 Heart Rhythm Journal

If an artificial heart valve derived from a cow or pig fails to work properly, researchers say implanting a mechanical valve inside the artificial valve could be an option for high-risk patients.

“Once expanded and opened, the new valve opens and functions similarly to the patient’s own valve. The advantage is that failing surgical valves can be replaced without the need for open-heart surgery,” study lead author Dr. John G. Webb, medical director of Interventional Cardiology and Interventional Research at St. Paul’s Hospital in Vancouver, Canada, explained in an Ameruican Heart Association news release.

Webb and colleagues report on 24 high-risk patients who underwent surgery that transplanted a new artificial valve into the existing artificial one. The valves were inserted through a catheter — either via a tiny incision between the ribs, or through a leg blood vessel — and expanded with the help of balloons that pushed the old valves away.

The strategy isn’t appropriate in all cases. Still, “patients may recover more rapidly, and the concerns about major surgery are reduced,” Webb said.

The researchers report that the traditional treatment — a new open-heart operation — is very risky.

The study was reported in the journal Circulation.

Long-term symptom remission is common among patients after they’ve been hospitalized because of borderline personality disorder, says a new study.

The disorder is characterized by chronic unhappiness, frequent changes in mood, irrational thoughts, impulsivity and unstable interpersonal relationships.

The study included 290 patients who were evaluated every two years after their release from the hospital. After 10 years of follow-up, 86 percent of the patients had sustained remission of symptoms.

While achieving concurrent symptom remission and good psychosocial functioning seems difficult for many borderline personality disorder patients, this recovery is relatively stable once it’s attained, said Mary Zanarini and colleagues at McLean Hospital in Massachusetts.

The researchers suggested that treatment for borderline personality disorder should include a rehabilitative component that focuses on social and work skills.

“Improving interpersonal relationships and job performance is a large part of the goal for many patients and their families. A rehabilitation approach might also have the practical effect of reducing the percentage of patients who receive Social Security disability benefits, and, equally important, it could help alleviate some of their feelings of low self-worth,” Zanarini stated in a news release from the American Psychiatric Association.

The study was published online in the American Journal of Psychiatry.

High levels of vitamin D in the blood appear to be linked to lower risks of colorectal cancer, although it’s not clear if higher intake of the vitamin actually prevents the disease, researchers say.

Still, the findings are food for thought: Scientists found that those with the highest levels of vitamin D in their blood had as much as a 40 percent lower risk for developing colorectal cancer than those with the lowest levels.

The research, published online Jan. 21 in BMJ, is based on a study of more than 520,000 people from 10 countries in Western Europe. The study participants gave blood samples and filled out diet and lifestyle questionnaires between 1992 and 1998. They were then tracked for several more years to see what happened to them.

During the follow-up period, 1,248 were diagnosed with colorectal cancer. These participants were compared with a similar group of 1,248 people who were not diagnosed with the disease.

The researchers cautioned that it’s not clear if there are risks from consuming high levels of vitamin D, which is available in supplements. It’s also not known whether supplements are necessary if people reach certain levels through a healthy diet, exercise and moderate exposure to sunlight.

The study authors noted that current recommendations for preventing colorectal cancer include exercising, not smoking, reducing obesity and abdominal fat, and limiting consumption of alcohol and red and processed meats.

SOURCE: BMJ, news release

The use of braces to correct excessive curvature of the spine (scoliosis) in adolescents is a subject of ongoing debate and a new review of the medical literature does little to resolve the matter.

Although there is some evidence that adolescents with scoliosis may benefit from wearing hard or elastic braces to correct spinal curvature, research thus far has failed to prove definitively that bracing works, the investigators conclude.

The evidence for bracing is weak, as is the evidence of any long-term benefits of bracing, Dr. Stefano Negrini of the Italian Scientific Spine Institute of Milan, Italy, and colleagues report in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Negrini and his team searched the medical literature for studies comparing braces with no treatment, other treatment, surgery, and different types of braces. From a pool of 1,285 titles, the researchers read 128 full texts, and found only 2 that fit their criteria.

One study involved 286 girls; some wore a brace, some received electrical stimulation, and some received no treatment at all, for up to 4 years.

This study found evidence that bracing was more effective than observation (wait-and-see) or electrical stimulation. At three years, the success rates were 80 percent for bracing, 46 percent for observation and 39 percent for electrical stimulation. At four years, the success rates were 74 percent, 34 percent and 33 percent, respectively. However, over the long term, formerly braced patients reverted back to their pre-treatment curvatures.

The other study compared the efficacy of rigid versus elastic braces in 43 girls over 45 months. This study found evidence that rigid braces were more effective than elastic braces.

However, both studies, the researchers emphasize, constituted very “low quality evidence” in favor of using braces.

Despite the lack of strong evidence, Negrini told the Health Behavior News Service, that his clinic often prescribes braces in conjunction with exercises for patients with scoliosis.

“We are aware of the very good results it is possible to obtain with high-quality bracing and making sure there is good patient compliance with wearing the brace,” Negrini said.

Dr. John Dormans, chief of orthopedic surgery at the Children’s Hospital of Philadelphia and president of the Pediatric Orthopedic Society of North America, also favors bracing.

“If you polled the orthopedists who treat the vast majority of patients with adolescent idiopathic scoliosis, the overwhelming opinion would be that bracing is effective, that it does alter the natural history of the disease,” Dormans said.

But getting teenagers to wear the brace for an adequate number of hours each day is a big issue. “The efficacy of bracing depends on two main factors: efficacy of the brace itself and compliance,” Negrini wrote in an email to Reuters Health.

Questions about the effectiveness of bracing for adolescent scoliosis might soon be answered by more definitive research: a five-year, multimillion-dollar study funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases is currently under way.

SOURCE: The Cochrane Library, 2010.