Associations of Long-Term Tea Consumption with Depressive and Anxiety Symptoms in Community-Living Elderly: Findings from the Diet and Healthy Aging Study.

OBJECTIVE: To examine the association between long-term tea consumption and depressive and anxiety symptoms in community-living elderly. DESIGN: Community based cross-sectional study. SETTING: The Diet and Healthy Aging Study (DaHA), a prospective cohort study in Singapore. PARTICIPANTS: 614 elderly aged 60 years and above, who were free of dementia and cognitive impairment. MEASUREMENTS: Information on tea consumption was obtained through interviewer-administered questionnaire. Long-term tea drinking was defined as regular consumption for at least 15 years. Depressive and anxiety symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15) and the 20-item Geriatric Anxiety Inventory (GAI), respectively. A generalized structural equation model (gSEM) was applied to ascertain the association between long-term tea consumption and depressive and anxiety symptoms. RESULTS: About 59% of the subjects had consumed tea for over 15 years. Long term tea consumption was significantly associated with a reduced odds of having depressive and anxiety symptoms, after adjusting for demographics (i.e., age, gender, education and ethnicity), comorbid conditions (i.e., heart disease, diabetes, stroke, hypertension and hyperlipidaemia) and long-term coffee consumption. CONCLUSION: There was evidence suggesting that long-term tea consumption was associated with reduced depressive and anxiety symptoms among community-living elderly. This suggests that it is worthwhile to further investigate the role of tea's bioactive compounds in promoting mental health in aging.

A follow-up study on the effects of a milk supplement on bone mineral density of postmenopausal Chinese women in Malaysia.

BACKGROUND: A previous study on a randomized controlled trial in 173 postmenopausal Chinese women in Kuala Lumpur showed that milk supplementation was effective to reduce bone loss at the total body, lumbar spine, femoral neck and total hip compared to the control group on a usual diet (Chee et al. 2003). OBJECTIVE: The objective was to determine whether the results were sustained after the conclusion of the study. DESIGN: A follow-up study, 18 months after a randomized controlled trial of milk supplementation was concluded. A total of 139 participants were followed up 21 months after the study ended. Bone mineral density (BMD) was measured at the total body, lumbar spine, femoral neck and total hip by dual energy X-ray absorptiometry, and anthropometric measurements as well as changes in dietary habits were measured. RESULTS: At the follow-up, the milk supplement group did not show significant bone loss from baseline at most sites (mean differences +/- SE) (total body 0.42 +/- 0.25%, femoral neck 0.44 +/- 0.58%, total hip -0.06 +/- 0.46%), unlike the control group (total body -1.07 +/- 0.28% p < 0.005, femoral neck -1.49 +/- 0.56% p < 0.05, total hip -0.89 +/- 0.57% p < 0.05). However, both the milk and control groups showed bone loss from baseline at the lumbar spine (milk -2.01%, control -3.29%, p superior 0.05). The calcium intake of the milk group remained significantly higher than the control group (milk 710 mg/day, control 466 mg/day, p < 0.005) despite discontinuation of the milk supplement. CONCLUSIONS: The results showed that some of the beneficial effects of a milk supplement were still evident at follow-up and it was possible to motivate subjects to adopt a positive change in dietary calcium intake after intervention.

Patients' expectation and experience of visual sensations during phacoemulsification under topical anaesthesia.

PURPOSE: To describe what patients expect to see and the visual sensations they actually experience during phacoemulsification under topical anaesthesia. We also sought to determine if patients find their intraoperative visual experience frightening and the factors associated with this. MATERIALS AND METHODS: Ninety-eight patients who underwent phacoemulsification and intraocular lens implantation under topical anaesthesia were interviewed preoperatively on what they expected to see with their operated eye during surgery and again postoperatively on what they actually saw. No patient received counselling about possible intraoperative visual sensations. A logistic (multivariate) regression model was used for statistical analysis. RESULTS: Preoperatively, 36 patients (36.7%) expected at least light perception, 38 (38.8%) expected no light perception, and 24 (24.5%) were unsure what to expect. Some patients also expected a variety of different visual sensations. Postoperatively, all patients (100%) reported seeing light intraoperatively and many experienced various other visual sensations. Nineteen patients (19.4%) found their visual experience frightening. The following factors were statistically associated with a frightening visual experience: preoperative anxiety, previous cataract surgery in the fellow eye, experiencing an intraoperative increase in clarity, not seeing movement intraoperatively, and not knowing what to expect. CONCLUSIONS: The majority of patients in this study either expected that they would see nothing at all during the surgery or were unsure of what to expect. All patients subsequently saw at least some light, and many perceived various other visual sensations that were frightening to nearly one in five patients. Preoperative counselling should inform about possible intraoperative visual experience.

Why lupus patients use alternative medicine.

It is unclear whether patients use alternative medicine because of psychological distress associated with their disease or philosophical congruence with this form of treatment. Therefore, we have studied why patients with systemic lupus erythematosus (SLE) employ alternative medicine. We interviewed 192 consecutive Chinese SLE outpatients in a tertiary-care rheumatology centre. We recorded their demographic data, usage of traditional Chinese medication, the predominant form of alternative medicine in this group, and the Rheumatology Attitudes Index score. We distinguished two types of alternative medicine users: those who use it with intent to treat SLE (disease-specific users; 73 users, 38.0%) and those who use it for cultural and other reasons (general-health users; 55 users, 28.6%). Users regarded their disease as mild compared to nonusers. Disease-specific users were distinguished from nonusers by having Chinese as a first language (odds ratio, 2.14-8.83), greater learned helplessness (odds ratio, 1.02-1.29), and an earlier age of diagnosis (odds ratio, 0.92-0.98 for older age). In conclusion, the majority of our lupus patients have used alternative medicine. The motivations of general-health and disease-specific users are different. The patients' first language and perceived helplessness influenced the disease-specific users, while general-health users were subject to neither of these.

Kinematic and electromyographic analysis of the push movement in tai chi.

BACKGROUND: Tai chi is a form of exercise derived from the martial art folk traditions of China. The force used in tai chi includes different principles of mechanical advantage. No studies on the kinematic features of tai chi exercise have been published. OBJECTIVE: To analyse the kinematics and electromyographic characteristics of tai chi. METHODS: An experienced tai chi master was asked to perform a sequence of basic movements: ward off, roll back, press, and push. The movements were videotaped and digitised using a motion analysis system. Electromyographic activities of the lumbar erector spinae, rectus femoris, medial hamstrings, and medial head of gastrocnemius were recorded by surface electrodes. The push movement data were analysed. RESULTS: The medial hamstrings and medial head of gastrocnemius muscle groups maintained low activity, with higher electromyographic values in the lumbar erector spinae and substantially higher ones in the rectus femoris during the push movement. Both concentric and eccentric contractions occurred in muscles of the lower limbs, with eccentric contraction occurring mainly in the anti-gravity muscles such as the rectus femoris and the medial head of gastrocnemius. The forward and backward shifts in centre of gravity (CG) were mainly accomplished by increasing and decreasing respectively the joint angles of the bilateral lower limbs rather than by adopting a forward or backward postural lean. The path of the CG in the anteroposterior and mediolateral component was unique, and the sway or deviation from the path was small. The master maintained an upright posture and maintained a low CG (hips, knees, and ankles bent) while travelling slowly and steadily from one position to another. CONCLUSION: The eccentric muscle contraction of the lower limbs in the push movement of tai chi may help to strengthen the muscles.

The effect of milk supplementation on bone mineral density in postmenopausal Chinese women in Malaysia.

Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55-65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control -1.04%, milk -0.13%; P<0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (-0.90%) when compared to the milk (-0.13%) supplemented group at 24 months (P<0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control -1.21%, milk 0.51%) (P<0.01) and total hip (control -2.17%, milk -0.50%) (P<0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P<0.01) from 69.1 +/- 16.1 nmol/l at baseline to 86.4 +/- 22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects.

A preliminary evaluation of a disease management programme for patients with diabetes mellitus and hypertension in a primary healthcare setting.

INTRODUCTION: The Comprehensive Chronic Care Programme (CCCP) is an intensified programme designed to provide comprehensive care for the management of diabetes mellitus, hypertension and hyperlipidaemia at a primary healthcare setting. A formative study was done to evaluate the effectiveness of the CCCP compared to the normal polyclinic management of diabetes mellitus. MATERIALS AND METHODS: Control of diabetes (HbA1c) and hypertension (blood pressure) in 63 diabetic patients of a pilot CCCP was compared with 100 diabetic patients not on the programme (non-CCCP) after a 6-month follow-up. Paired t-tests were conducted for differences in mean HbA1c values between baseline and after 6 months. The H-rank test was applied to check for significant differences in change categories of hypertension control between CCCP and non-CCCP cases. RESULTS: In the CCCP group, there was a two-point decrease in HbA1c after 6 months and 65.1% of the patients showed improvement. The proportion of patients achieving optimal diabetic control increased from 9.5% to 36.5%. Conversely, there was deterioration in the non-CCCP group with decrease in the proportion of patients achieving optimal diabetic control from 31% to 21%. Of the hypertensive patients in the CCCP group, 54.5% showed an improvement in blood pressure (BP) control while 44% of the non-CCCP group showed improvement at 6 months. CONCLUSIONS: CCCP, a comprehensive chronic disease management programme, is effective for good diabetic control of patients with diabetes mellitus.