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  • New Guidelines Emphasize Physical Activity in Cancer Prevention

    Adopting a physically active lifestyle can help achieve and maintain a healthful weight and affect the levels of some hormones that contribute to cancer formation, say new guidelines recently issued by the American Cancer Society (ASC).  

    ASC's guidelines are revised approximately every 5 years by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy. They reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but they recognize that choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, the experts present recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk.

    Specific to physical activity, ASC says, "Although the optimal intensity, duration, and frequency of physical activity needed to reduce cancer risk are unknown, approaching and exceeding 300 minutes of moderate intensity activity per week or 150 minutes of vigorous activity per week is likely to provide additional protection against cancer." For people who are inactive or just beginning an exercise program, "engaging in activity levels below the recommended minimum can still be beneficial." Furthermore, because children who are engaged in physical activity are more likely to remain active as adults, and because physical activity plays a critical role in weight maintenance, children and adolescents should be physically active at moderate to vigorous intensities for at least 1 hour per day, with vigorous activity occurring at least 3 days per week. 

    In addition to adopting a physically active lifestyle, the guidance calls for people to eat a healthful diet, with an emphasis on fruits and vegetables, and limit alcohol consumption.

    The guidelines are published in the January/February issue of CA: A Cancer Journal for Clinicians.

    SSRIs Linked With Increased Falls Risk in Nursing Home Residents

    Nursing home residents with dementia who use average doses of selective serotonin reuptake inhibitors (SSRIs) are 3 times more likely to have an injurious fall than similar people who don't use these drugs, according to the British Pharmacological Society.

    SSRIs are generally considered the treatment of choice for nursing home residents with dementia and who have depression. The risk of falling increases as people take higher doses.

    Researchers recorded the daily drug use and daily falls in 248 nursing home residents with dementia from January 2006 until January 2008. Data about the residents' day-by day drug use came from a prescription database, and information on falls and subsequent injuries came from a standardized incident report system. In total, they collected a dataset of 85,074 person-days.

    The mean age of the participants was 82 years. The prescription records showed that antidepressants had been used on 13,729 (16.1%) days, with SSRIs being used on 11,105 of these days.

    The incident reports showed that 152 of the 248 residents (61.5%) sustained 683 falls, corresponding to a fall incidence of 2.9 falls per person-year. Thirty-eight residents had a single fall; 114 fell more frequently. Of the 220 falls recorded, 10 resulted in hip fractures, 11 in other fractures, and 198 in injuries such as grazes, open wounds, sprains, bruises, and swellings. One person died after falling.

    The risk of having an injurious fall increased threefold for residents taking SSRIs, from an absolute daily risk of 0.09% for a female aged 80 not taking an SSRI, to 0.28% for a female aged 80 taking 1 defined daily dose of SSRIs. Similar increases in absolute daily risk were found for both men and women, for different ages.

    Check out APTA's Balance and Falls Web page for patient care and consumer resources, in addition to CEU courses related to falls and balance.