### Comprehensive Report on Tai Chi and Fall Prevention for Aging Adults

#### Introduction
Falls are a significant health risk for older adults, often leading to serious injuries, loss of independence, and even death.

With one in four seniors over the age of 65 falling each year, and one in five of those falls causing serious injuries such as broken bones or head injuries, it is crucial to explore effective methods for fall prevention.

Tai Chi, a traditional Chinese martial art, has been increasingly recommended for improving balance and coordination in older adults.

This report examines the scientific evidence behind Tai Chi as a method to reduce falls and improve physical stability.

#### The Problem: Falls in Older Adults
Falls are a leading cause of injury-related morbidity and mortality among older adults.

According to Dr.

Boris Goralnik, a geriatric specialist, falls can result in a range of negative outcomes, including:
- **Fall-related injuries**: Fractures, hematomas, and skin lacerations.

### Comprehensive Report on Tai Chi and Fall Prevention for Aging Adults

#### Introduction
Falls are a significant health risk for older adults, often leading to serious injuries, loss of independence, and even death.

Title:

Content: Healthy aging comes with challenges. For a variety of reasons, as each year passes, the likelihood of falling increases.

According to Dr. Boris Goralnik, a geriatric specialist at UPMC in North Central Pa, a fall is defined as an unexpected event in which a person comes to rest on the ground, floor, or a lower level.

“Falls result in fall-related injuries, progression of gait impairments, loss of independence, depression,” Goralnik said. “It is a leading cause of injury-related morbidity and mortality among older adults.”

By preventing falls, providers try to prevent related injuries such as fractures, hematomas, and skin lacerations. From practice and literature, said Goralnik, the most important risk factor of falls is a previous history of falls.

According to Janine Fee, MS, MPT, a physical therapist who is certified in vestibular rehabilitation at Evangelical Community Hospital, physical balance, which is important to avoid falling, can be complicated.

“I like to use the analogy of a baseball field,’’ Fee said. “Every player on the field is important and if a player is not working, then your team — your balance — is going to be impacted.”

Fee said many systems have a direct impact on balance. Eyes, ears, sense of touch — especially with our feet, muscle strength, flexibility, and posture are a few. And, the brain can have a major impact on our ability to avoid falling.

Fee said any weakening of one or more of these areas will significantly increase the risk of falling.

According to the Centers for Disease Control website, one out of four seniors over the age of 65 will fall each year. One out of five of those falls will cause serious injuries such as broken bones or head injuries.

“This can then lead to serious consequences that may significantly impact a person’s overall quality of life,” said Fee. “Even if the fall didn’t cause harm, it is likely that the person now develops a fear of falling.”

Many factorsIn many cases, Goralnik said, falls and fall-related injuries lead to substantial deficiency in activities of daily living and the need for supportive care for older adults. He agreed with Fee that a fear of falling leads to things like not participating in activities that require balance, causing weaknesses and furthering the risk of repeated falls. Paying attention to the body and being more aware of areas contributing to balance is a big step in preventing falls.

Age alone should not be blamed as a factor regarding balance, said Fee.

“I strongly believe that if you stay active, you can minimize the effects that aging has on all of these players,” Fee said.

Diseases and underlying medical conditions like Parkinson’s disease, Multiple Sclerosis, neuropathy, strokes, vision problems, and pain can impact a person’s balance. Other factors such as medications, fear of falling, and environmental factors.

It is very important for older patients to discuss with their providers any changes in the gait, possible new onset gait unsteadiness, or if they start to experience new musculoskeletal pain, Goralnik advised.

“Some of the medications may increase the risk of falls,” said Goralnik. “It is very important for people to have a complete list of all current medications when they visit their medical providers.”

Having detailed information, he said, about existing and potential risk factors may help reduce the risk of future falls.

Fee added that testing can be completed to assess balance and what kind of treatment or therapy might be available to assist with balance. Fee said a fall risk assessment is a good first step to preventing falls.

“You can talk to your doctor or health care provider to refer you to a physical therapist to evaluate your risk for falling,” said Fee.

She said a physical therapist will measure/evaluate strength, flexibility, analyzation of posture and feet, how you walk and perform specific balance measures to determine your areas of weakness. The therapist may also ask about fall history and possible home hazards like uneven pavement, rugs, steps, clutter or pets.

“Then a physical therapist can design a specialized treatment program to help you reduce your risk of falls,” Fee said. “Other recommendations to improve overall balance is getting involved in a local gym where you can perform strength and balance exercises like Tai Chi or yoga.”

Temporary conditionsIn addition to medical conditions such as strokes, brain injuries, etc., other temporary conditions also have effects on an individual’s balance.

Fee, a physical therapist who specializes in inner ear disorders, said the most common inner ear problem is a condition known as Benign Paroxysmal Positional Vertigo (BPPV). Classic symptoms include brief episodes of spinning or imbalance that occur when lying down, rolling over in bed, or looking up.

“BPPV can significantly increase a person’s risk for falling especially if they have other balance risk factors. This problem is easily identified by the physical therapist that is trained in detecting inner ear problems,” she added.

Fee said a physical therapist with specialized training can provide the most appropriate intervention to reduce or resolve these symptoms in as little as one to three sessions.

Fee said physical therapists can often identify risk factors and provide specific recommendations to improve balance.

“Physical therapists are like coaches, but you have to do the work. In order for your balance to improve, you have to challenge the team!”

Goralnik added, that in many cases, falls and fall-related injuries lead to substantial deficiency with activities of daily living and the need for supportive care for older adults.

The economic burdens from falls are substantial and likely to increase with the growth of the older population, according to Goralnik.

Fall-related health care costs include hospital bills, fees for professional service, and costs of prescription medications, home health services, long-term care facilities, and durable medical equipment.

“Always inform your doctor about recent falls and fall-related injuries,” concluded Gorainik.

It is very important for seniors to discuss any changes of the gait, possible new onset gait unsteadiness, or if they started to experience new musculoskeletal pain with their doctor.

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The elderly can not fall to the National Health Agency to take 5 steps to reduce the risk
2024 / 3 / 15 12: 39
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(Central News Agency reporter Chen Jiling, Taipei 15) Taiwan is expected to officially enter the ultra-senior society next year.
The survey found that every 6 elderly people in the past 1 year has fallen, the elderly fall may be accompanied by disability, the National Health Administration of the Ministry of Health and Welfare today put forward anti-fall 5 steps, of which the devil felt shoes incarnate anti-fall sharp device.
According to the statistics of the Ministry of the Interior, as of January 113, Taiwan's elderly population over 65 years of age has exceeded 4.31 million people, accounting for 18.4% of the total population, and has reached the aging society.
The National Development Council estimates that Taiwan will enter a super-elderly society next year (the elderly population accounts for more than 20%).
The National Health Administration today reminded through a press release that falling prevention for the elderly will become an important issue, and elderly people who fall seriously may cause long-term bedridden or even death; elderly people who have fallen may also increase their family care and financial burden.
The National Health Interview Survey in 106 years found that about one in six people over the age of 65 had fallen in the past year.
The National Health Administration said that with age, the elderly cause physical, mental or mobility decline, in fact, people usually master five steps, can reduce the incidence of falls.
First of all, you can start from wearing the hands, the first step is "suitable to wear", it is recommended that the elderly should wear fit clothes, trousers are not too long, choose non-slip, have sufficient fixed, such as the choice of shoes without shoelaces, with buttons, devil's felt, etc., these small changes can greatly reduce the risk of elderly falling.
The change of the home environment is also very important, the second step is to "build a safe home", the public should pay special attention to the environmental lighting, the floor to stay dry, while to avoid uneven ground, the aisle piled debris, these may cause the potential crisis of falling must be adjusted.
The third and fourth steps are "adequate nutrition" and "regular exercise", usually pay attention to the intake of sufficient calories and protein, if necessary, consult a dietitian; in addition, regular exercise, exercise muscle strength, improve the elderly 's daily independent activity function, improve self-defense when falling.
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If the above steps are implemented, do not forget the fifth step, "drug safety", consult with doctors and pharmacists and other professionals to help evaluate the drug, avoid drug interactions, decreased attention, dizziness and muscle weakness, etc., to increase the risk of falls.
In addition, the county and city health department is promoting the "six forces for the elderly" to assess the elderly "cognitive, mobility, nutrition, vision, hearing and depression" functional indicators, and early detection of signs of functional decline in the elderly.
If the elderly have any one of the abnormal assessment results, they will arrange intervention services or further refer the elderly to suitable medical institutions to prevent and delay functional decline.
(Editor: Guan Zhongwei) 1130315
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Content: "Tumbler" anti-fall exercises home to play across space
Post Date: June 17, 2024
[Ming Pao News] In Hong Kong, for every 100 elderly people living in the community, an average of about 20 people fall one or more times a year. Each fall, about 75% will suffer various types of injuries, of which about 7% are more serious, including head injuries, wrist or hip fractures, resulting in reduced mobility.
Some elderly people who have fallen have restricted their social activities because they are worried about falling again, resulting in a deterioration in their quality of life and a reduction in their healthy life expectancy.
Therefore, it is especially important to assess your risk of falling and learn how to reduce it.
According to data released by the United Nations, the life expectancy of Hong Kong is 86 years, which is among the highest in the world.
According to the data of the Census and Statistics Department of Hong Kong, the elderly population aged 65 or above accounts for about 20% of the total social population, with the number of people reaching 1.45 million. The data also predicts that the proportion of the elderly population will climb to 36% in 2046.
Thanks to the increasing advances in modern medical technology, a large group of elderly people can rely on various advanced technologies to help them maintain a healthy old age with limited social resources.
Among them, fall prevention is one of the health management issues closely related to the lives of the elderly.
3-step screening to assess fall risk
According to the World Falls Guidelines, the risk of falls in the elderly can be initially screened through the following three questions:
1.
Have you fallen in the last 12 months?
2. Do you feel unstable when walking or standing?
3.
Are you worried that you will fall?
If the elderly answer "yes" to any of the above questions, it means that they are at a certain risk of falling and should be further assessed.
Initial screening shows that elderly people who are at risk of falling may undergo a “walking speed test ” or a“ standing up and walking test ” to further identify the risk of falling.
The Walking Speed Test calculates the daily walking speed of an elderly person by measuring the time it takes to walk 4 meters.
The "sit up and walk test" requires the elderly to sit in a chair first, then stand up and walk forward for 3 meters and then return to the chair to sit down, and calculate the completion time of the whole process.
If the walking speed is greater than or equal to 0.8 meters per second, or if the time to complete the walk is less than 15 seconds, the risk of falling is considered "low".
Conversely, it indicates that the risk of falling is “medium ” and requires“ tailor-made ” fall prevention training.
A more detailed fall risk assessment is required to identify other fall risk factors, such as cognitive ability, vision, environmental factors, etc., if one of the following criteria is met, indicating that the risk of falling is “high. ”
• Has been injured as a result of a fall
• Lie on the ground after falling and “can ’ t get up ”
Fell more than twice in a year.
• Diagnosed with senility
• Sudden fainting and loss of consciousness
Step training to save yourself when you fall
Once you know your risk of falling, how can you reduce your risk and prevent falls?
Exercise training has been shown to be one of the most effective measures to reduce the risk of falls.
The main sports training content includes: balance training, strength training and walking training (see "fall training").
In addition, in recent years, studies have shown that different types of step training can effectively improve the agility and reaction speed at the moment of falling, and train the elderly to step quickly and save themselves at the moment of falling.
This type of training is thought to have a significant fall prevention effect in a shorter period of time.
The Department of Rehabilitation Sciences of The Hong Kong Polytechnic University (PolyU) is focusing on the development of compound treadmill training to enhance the effectiveness of anti-fall exercise.
Text: Lam Man Hin (Assistant Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University)
Editor: Liang Xiaoling
Art: Hsieh Wai-ho
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Related Words: Physiotherapy Elderly Fall Prevention Healthy Fall Elderly Fall Exercise Prescription Daily Ming Pao - Health
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The elderly are prone to fall on the road, which may be due to insufficient muscle mass, that is, sarcopenia.
According to Ranus, the manager of St James ’ Settlement Wing Ka Nok Health Centre, elderly people with myasthenia suffer from poor walking, balance, coordination and overall physical fitness, or their quality of life is reduced.
If you want to improve sarcopenia, in addition to supplementing protein in your diet, you can also do a few actions at home to prevent it.
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National Health Agency: 1 out of every 6 seniors has fallen
During the past year, returning home and family, spend a few days together to find out whether grandpa and grandma are more inconvenient to move, and their health is getting worse and worse.
According to the World Health Organization (WHO), about 646,000 people worldwide die from falls every year, so it is important to prevent falls and injuries in older people.
According to statistics from the National Health Administration of the Ministry of Health and Welfare of Taiwan, one in six elderly people has a fall accident within a year. It is recommended that elderly people can strengthen muscle endurance and avoid falling accidents through five exercises at home.
Falls are also one of the main causes of accidents and deaths among the elderly, affecting not only the long-term physical, mental, social functions and quality of life, but also increasing national health care expenditures.
According to the results of the 2017 National Health Interview Survey, the proportion of people over the age of 65 who reported falling in the past year was 15.5%, and the proportion of people who fell and were hospitalized was 8.4%.
The National Health Administration recommends that anyone who has a grandpa, grandma or an elderly person over the age of 65 can perform five simple home exercises to train body softness, balance and muscle strength.
Body Softness Training
1. Shoulder rotation: Shoulder forward or backward rotation, each repeated 10 times.
2. Ankle movement: Place your feet flat on the floor, lift your toes up, rest for 10 seconds and then put them down. Repeat 10 times.
Balanced training
1. Stand on the floor, hand on the back of the chair, feet, heel wheel lift, repeat 10 times
Muscle Training
1. Sitting on the chair to lift the feet straight, each movement for 10 seconds, repeat 10 times.
2. Seated step: sit on the chair to do the step action, repeat 10 times.
The National Health Administration reminds that according to statistics, an average of 1 in 6 elders have fallen in the past year, and 1 in 12 elders have experienced a fall and seek medical attention.
It is recommended that the elderly can move at home every day to maintain a good habit of simple training, not afraid of years to bring vitality.
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Content: Can you stand on one leg?
This ability may be related to longevity.
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DUBAI, United Arab Emirates (CNN) -- The inability to stand on one leg for 10 seconds later in life may be linked to double the risk of death from any cause over the next decade, a new study shows.
The research, published Tuesday in the British Journal of Sports Medicine, suggested that a simple balance test may be useful in routine physical tests for middle-aged and older people.
The research pointed out that while aging leads to a deterioration in fitness, muscle strength and flexibility, balance remains well maintained until the age of 50, when it begins to decline relatively quickly.
Previous research has linked the inability to stand on one leg to an increased risk of falls and cognitive decline.
The study involved 1,702 people, aged 51 to 75, living in Brazil, who were asked to stand on one leg without support during the initial screening.
Participants were given three attempts to test their balance on either foot.
The ability to balance on one leg is important for older adults for many reasons, and it also reflects broader fitness and health levels, said study author Dr. Claudio Gil Araujo at the CLINIMEX Exercise Medicine Clinic in Rio de Janeiro, Brazil.
Araujo explained that there is an urgent need to stand on one leg, for example, when getting out of the car, when going up or down the stairs, and so on.
Not having this ability or being afraid to do so may be associated with loss of independence, inability to exercise, and other things.
Poor balance and longevity
The average age of the study participants was 61 years, and a third of them were men.
About 1 in 5 people failed the balance test on one leg for 10 seconds at the initial screening.
The researchers followed the study participants after the initial examination for seven years, during which 123 of them died, or about 7%.
The mortality rate among participants who failed the test, 17.5%, was significantly higher than among participants who managed to pass the 10-second balance test, 4.5%.
The study found that for those unable to complete the balance test, there was an 84% higher risk of death from any cause, and this link remained even when other factors — including age, gender, body mass index, pre-existing conditions, or health risks such as coronary artery disease, high blood pressure, obesity, high cholesterol, and diabetes — were all taken into account.
However, the researchers were unable to include other variables in their analysis such as the recent history of falls, the pattern of physical activity, exercise, diet, smoking, and drug use that may interfere with balance.
The research was based on observation, and did not reveal cause and effect.
The study did not investigate any possible biological mechanisms that might explain the link between poor balance and longevity.
Dr Navid Starr, a professor of metabolic medicine at the University of Glasgow ’ s Institute of Cardiovascular and Medical Sciences, said the research was interesting, but not definitive.
Starr, who was not involved in the study, added that "because standing on one leg requires good balance, associated with brain function, good muscle strength and good blood flow, it is likely to integrate the muscle, blood vessel and brain systems, so it is a global test for the risk of future death."
Improved balance
Overall, participants who failed the test had poor health, and included a higher percentage of people with obesity and / or heart disease, high blood pressure, and unhealthy blood fats, according to the study.
The study was conducted between 2009 and 2020, and was part of a broader research project that began in 1994.
The inability to complete the balance test increased with age, more or less doubling during subsequent 5-year periods of the age range between 51 and 55 years and beyond.
More than half (54%) of the 71-75 year olds were unable to complete the test, compared to 5% in the lower age group who were unable to pass it.
There were no clear trends in mortality, or differences in cause of death, between those who were able to complete the test and those who were unable to do it.
Araujo explained that balance could be significantly improved through specific training, which he was working on with patients participating in a medically supervised exercise program.
However, he said he did not have data yet to assess whether improved balance affects longevity.
And if you want to test your ability to balance on one leg for 10 seconds, Araujo advised that it ’ s best to stand near a wall, table, or anyone else for support.
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Silver-haired people at home exercise strong 4 moves simple
2024 / 06 / 16 05: 30
▲ Figure 1: Marching up your feet. (Photo courtesy of Chen Ruixin)
by Chen Jui-hsin
Aging is a continuous and irreversible process, but exercise can improve the muscle endurance and balance of the elderly, prevent the decline of physical function, reduce physical pain, and improve the quality of mental health life and the independence of daily life functions.
Improve Elder Muscle Endurance and Balance
There are many types of exercise. Aerobic exercise can improve cardiovascular health and enhance physical endurance, such as walking, jogging, cycling, swimming, etc.; muscle strength training can increase muscle mass and bone density, and improve muscle weakness through moderate training.
We can choose activities that are of interest, or find partners who exercise together to urge each other, give each other emotional support, and integrate exercise into daily life, for example: walk more instead of riding a car, climb stairs instead of taking an elevator, gradually adjust the intensity of exercise to avoid sports injuries.
When exercising, choose comfortable and thin clothing and shoes and socks, replenish the appropriate amount of water and food, and do 5-10 minutes of warm-up and stretching to reduce the chance of injury.
If you are engaged in outdoor sports, pay attention to the temperature, the surrounding environment safety, whether the road is flat; remember to keep your breath smooth, do not hold your breath, observe your physical condition, and properly rest, if you are dizzy, poor breathing, cold sweat, etc., you should immediately stop, and seek medical advice as soon as possible, and regular exercise is the long-term solution.
4 Simple Exercises You Can Do at Home
● Raise your feet: In the sitting position, the thighs are raised in turn, and the hands are naturally swinging. When the feet are raised, do not bend over the back; if you want to increase the difficulty, you can do it in the standing position (Figure 1).
● Tiptoe: can be performed in the sitting position first; to increase difficulty, in the standing position, both hands hold the chair tiptoe (Figure 2), or after one foot is raised, the other foot tiptoe.
▲ Figure 2: Tiptoe. (Photo courtesy of Chen Ruixin)
● Cat and Cow: kneel on four feet, first bend the spine completely and arch into a beautiful arc (Figure 3); then straighten the spine completely, and look forward to increase spinal activity.
▲ Figure 3: Cat and Cow Style. (Photo courtesy of Chen Ruixin)
● Sitting posture: the spine extends upwards, the waist remains in the center position, hand draw a semicircle to the opposite side when inhaling, feel the lateral abdomen slightly tight, then maintain the breath back to the starting position after 10 seconds (Fig. 4).
▲ Figure 4: Side Stretch. (Photo courtesy of Chen Ruixin)
Warm up and exercise regularly.
The above shared actions can be adjusted according to their ability to adjust the difficulty, if there is a problem to seek professional assistance, do not force, and pay attention to the safety of exercise.
(The author is a physiotherapist at Changhua Christian Hospital)
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With one in four seniors over the age of 65 falling each year, and one in five of those falls causing serious injuries such as broken bones or head injuries, it is crucial to explore effective methods for fall prevention.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

Tai Chi, a traditional Chinese martial art, has been increasingly recommended for improving balance and coordination in older adults.

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How to Reverse the Ageing of Your Brain
Consider additional strategies to improve your brain health, such as getting eight hours of sleep each night, reducing inflammation in the body, and optimizing vitamin D levels.
According to the AARP survey, 93% of Americans believe that maintaining brain health is very or extremely important.
Contrary to popular belief, forgetfulness and memory lapses are not an inevitable part of aging, you can keep your wits and mental abilities at any age.
Joseph Mercola: Reverse the aging of the brain
The good news is that your brain is a dynamic organ, constantly adapting and changing, for better or for worse.
Many of your daily activities, such as lack of sleep, can seriously affect your memory the next day.
On the other hand, a healthy lifestyle supports brain health and even stimulates the growth of new neurons in a process known as neurogenesis or neuroplasticity.
For example, research has shown that how your body responds to stress can be a factor in brain aging, including an increased risk of dementia and Alzheimer ’ s disease.
Exercise is a lifestyle choice that affects your stress response and is often valued for physical changes.
However, there is ample evidence that strength training is just as important for brain and nervous system health as it is for muscle strength.
A new study demonstrates that older adults can improve cognitive function through changes in eating habits and exercise.
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Small changes bring great benefits to cognitive function
In just six months, Duke University researchers found cognitive improvements in the adults involved in their study.
Dr. James Blumenthal, a clinical psychologist at Duke University, led the research published in Neurology.
He believes this was the first study to look at the separate and combined effects of diet and exercise on cognitive decline in those who are more vulnerable to developing dementia in old age.
The study involved 160 adult patients with a prior history of high blood pressure or other cardiovascular risks who had never exercised and had cognitive problems in executive functioning.
Those who were diagnosed with dementia were excluded.
The median age was 65 and two thirds of the participants were women.
At the beginning of the study, the participants' average cognitive skills were the same as those of 93 years old - an average of 28 years older than their actual age.
The volunteers were divided into four groups.
The former participated in a structured aerobic exercise program for the first three months, and in the following three months they were given exercises to do at home.
The second group was asked to follow a low-sodium DASH diet and was taught this program.
The third group was asked to exercise and change their diet at the same time.
A fourth group served as a control group and received a 30-minute training session over the phone on how to improve brain health, but they were asked not to change their training program or eating habits.
Results showed a decrease in brain age by nine years
Before starting the study, each participant underwent a set of cognitive tests, a treadmill stress test, and a nutrient intake analysis.
In addition, blood sugar and lipids were noted.
At the end of the study, the researchers found that those who followed the DASH diet without exercise had no significant improvement in their thinking skills.
The group that only trained had a greater improvement in executive functioning than the group that did not train.
But in the group that changed diet and exercised, the age of the brain decreased by nine years, bringing the average age of the brain to 84 years.
The executive function of the control group decreased by six months, which was expected as they were not subjected to intervention, and this was the total duration of the study.
Leg strength improves the health of the nervous system
Participants in the study were asked to walk for 35 minutes continuously or to cycle regularly just three times a week.
This study confirms other recent findings published in Frontiers in Neuroscience, showing that neurological health depends on both signals from the large leg muscles and signals from the brain to the muscles.
In other words, it is a double-edged sword, and both are equally important.
According to a press release, the discovery “significantly changes the medicine of the brain and nervous system, giving doctors new insights into why patients with motor neuron disease, multiple sclerosis, spinal muscle atrophy and other neurological ailments often rapidly deteriorate mental activity when their movement becomes restricted. ”
Researchers have found that the ability to exercise with weight is important not only for muscle mass and atrophy, but also for the chemistry of your body.
Neurosignaling was affected in such a way that the nervous system and brain began to deteriorate in an animal study only after 28 days.
Two genes also had adverse effects, one of which plays an important role in mitochondrial health and function.
Well-functioning mitochondria are crucial for optimal health.
This can be the cause of almost all chronic diseases, including neurodegeneration, since your brain requires more energy than any other organ, about 20 percent of the energy produced in your body.
In his book, Sitting Kills, Motion Heals, Dr. Joan Vernikos, former director of NASA ’ s Life Sciences Division, describes how weight retention versus gravity is an essential component for optimal functioning of the human body and brain.
Another key factor is how exercise affects the brain ’ s neurotrophic factor (BDNF) present in both your brain and muscles.
Exercise stimulates the production of a protein called FNDC5, which in turn triggers the work of BDNF, which preserves existing brain cells, activating them to convert into new neurons and promoting actual brain growth.
In the neuromuscular system, BDNF protects the neuromotor, a critical element in muscles that protects them from degradation.
Neuromotor degradation is part of the process that explains age-related muscle atrophy.
A list of studies demonstrating the connection between your muscles and the brain can be found in my previous article, “For optimal brain and nervous system health, you need to train your leg muscles. ”
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Reduce sitting time to protect your cognitive and physical health
Lower body exercises are important for maintaining cognitive abilities as you age.
Although researchers have demonstrated that walking three times a week can improve cognitive performance in as little as six months, other studies have shown that the damage caused by sitting all day cannot be compensated by exercise just once a day.
Long periods of time spent sitting can be fatal.
The data showed that those who moved more were generally healthier.
Constant exercise speeds up metabolism, reduces the risk of developing diabetes and certain types of cancer, and helps maintain a healthy weight.
Increasing the duration of inactivity with age can also reduce the ability to remain mobile.
One study found that those who were most active and sat less than six hours a day experienced the least mobility restrictions due to age compared to those who were least active and exercised less than three hours a week.
The researchers concluded that "reduced sitting time combined with increased physical activity may be necessary to maintain mobility in older age."
Another study, conducted by the University of California San Diego School of Medicine (UCSD), followed a group of women and found that those who sat for 10 or more hours a day experienced telomere shortening equal to eight years of aging.
In other words, excessive sitting accelerated the process of physical aging by eight years.
Lead author of the study Aladdin Shadyab, PhD, UCSD School of Medicine, said in a press release: "Our study showed that cells age faster with sedentary lifestyles.
Chronological age does not always correspond to biological age.
Cyclic ketogenic eating plan and intermittent fasting support brain health
In the presented study, participants used the DASH diet, which reduces the amount of processed foods and increases the consumption of whole foods.
However, the nutrition plan does not take into account the undeniable changes in health caused by the ketogenic diet.
One of the most striking studies of carbohydrates and brain health found that high-carb diets increased the risk of dementia by 89 percent, and high-fat diets reduced it by 44 percent.
A ketogenic diet with lots of healthy fats and low in net carbs (total carbs minus fiber) causes your body to burn fat as its primary fuel instead of sugar.
The result is ketones that not only burn efficiently, but are also an excellent fuel for your brain.
Ketones also generate less reactive oxygen species (ROS) and the harmful effects of free radicals.
Recent articles have also demonstrated the benefits of dietary ketosis for brain health.
In the first, the researchers found that the ketogenic diet improved nerve and vascular function, in part due to improvements in the gut microbiome.
In the second article, the authors concluded that the ketogenic diet proved to be a real “fountain of youth ” in animal studies, significantly improving the functioning of nerves, blood vessels and metabolism compared to animals that consumed an unrestricted diet.
Poor functioning of nerves and blood vessels is associated with loss of ability to speak, remember, and focus, and decreased cerebral blood flow increases the risk of depression, anxiety, and dementia.
The authors of a study analyzing the effects of the ketogenic diet on vegetative-vascular function in an animal model wrote: "Collectively, the KD [ketogenic diet] may protect against a variety of neurological disorders, possibly by restoring vegetative-vascular function and maintaining a healthy gut microbiome."
Consider These Strategies to Support Cognitive Health
Eating a ketogenic diet helps protect your brain from free radical damage and supplies cells with the preferred fuel.
You may also consider incorporating additional foods and strategies to maintain your cognitive health.
My previous article, “What foods stimulate the brain best? ” lists foods that you can easily incorporate into your daily eating plan.
Below are additional strategies you can consider:
Vitamin D is a steroid hormone that affects almost every cell in your body, so maintaining a healthy level of 60 to 80 ng / ml is important not only for bones, but also for heart and brain health, optimal immune system performance, and overall disease prevention.
In fact, there is an important link between vitamin D deficiency and insulin resistance, metabolic syndrome, and diabetes, both type 1 (insulin-dependent diabetes) and type 2, and both affect brain health.
Sleep – During deep sleep, your brain activates the glyphatic system, allowing you to flush out toxins and accumulated waste, including beta-amyloid proteins, which are a hallmark of Alzheimer ’ s disease.
Subscribe to our VIBER channel!
Reducing inflammation – Chronic inflammation and obesity can negatively affect the functioning of your brain.
For a list of foods that reduce inflammation and how it relates to brain volume, read my previous article, “Foods that prevent inflammation also improve your brain function. ”
Some of these foods are garlic, blueberries, walnuts and spinach.
Ashwagandha – Improving memory is one of the traditional uses, especially in the form of roots.
A 2017 study published in the Journal of Dietary Supplements found positive results using ashwagandha root extract to improve memory and cognitive function in 50 people with mild cognitive impairment.
Bacopa monnieri (Bacopa monnieri) is a popular herb in Ayurvedic medicine used in India for more than three centuries.
It is commonly known as a nootropic herb that can repair damaged neurons and improve brain function.
Nootropics are thought to have the ability to “unlock ” the brain when it comes to creativity and cognitive drive.
Curcumin – A double-blind, placebo-controlled study involved 40 adults aged 50 to 90 years with mild memory impairment but no dementia.
Those who took curcumin reported significant improvements in memory and concentration, and no improvements were observed in the control group.
published by econet
Author Joseph Mercola
P.S. And remember, just by changing your consumption - we are changing the world together!
© econet
Source: https: / / econet.ua /
* Ekonet.ru articles are intended for informational and educational purposes only and do not replace professional medical advice, diagnosis or treatment.
Always consult your doctor for any questions you may have about your health.
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Man does not live by what he eats, but by what he digests.
This is true for the mind and for the body.
Benjamin Franklin
Something interesting

How doesTai Chi help prevent falls for older people?

It improves the balance of older people.

What are some of the benefits of practicing Tai Chi regularly?

What benefits does Tai Chi haves for healthy aging?

It helps to improve factors linked to a longer life like balance, mobility, and stability.

What did studies show about Tai Chi's health benefit?

It limits the danger of falls among the elderly.

It improves the balance of older people.

What do orthopedic specialists say about the benefits of learning Tai Chi?

Excercises like the horse stance in Tai Chi that can help prevent falls.

What study was included in trials combining excercise with a cognitive compoent?

Cognitively enhanced tai chi in older adults at risk for dementia.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

How doesTai Chi help prevent falls for older people?

It improves the balance of older people.

What are some of the benefits of practicing Tai Chi regularly?

What benefits does Tai Chi haves for healthy aging?

It helps to improve factors linked to a longer life like balance, mobility, and stability.

What did studies show about Tai Chi's health benefit?

It limits the danger of falls among the elderly.

It improves the balance of older people.

What do orthopedic specialists say about the benefits of learning Tai Chi?

Excercises like the horse stance in Tai Chi that can help prevent falls.

What study was included in trials combining excercise with a cognitive compoent?

Cognitively enhanced tai chi in older adults at risk for dementia.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

This report examines the scientific evidence behind Tai Chi as a method to reduce falls and improve physical stability.

Title:

Content: Heart Failure With Preserved EF: New Insights, Respect for Exercise?

Kathleen Doheny

May 16, 2023

LONG BEACH, California ― Supervised exercise has enormous potential to improve the outcomes for people with heart failure with preserved ejection fraction (HFpEF). That was one message at a session on heart failure in older patients at the American Geriatrics Society (AGS) 2023 Annual Scientific Meeting.

HFpEF accounts for about half of all cases of heart failure and affects an estimated 10% of Americans older than 75 years. In a scientific statement issued in March 2023 by the American Heart Association and the American College of Cardiology, experts said supervised exercise training, unlike most drugs, has produced consistent improvement in exercise capacity for those with HFpEF.

Speakers also discussed the latest information on risks, diagnosis, pharmacologic management, and inequities in access to care.

Supervised Exercise

The case for physical rehabilitation, or supervised exercise training, to help patients with HFpEF is strong, said Amy M. Pastva, PT, MA, PhD, professor of orthopedics, medicine, population health, and cell biology at Duke University School of Medicine, in Durham, North Carolina. Pastva cited the scientific statement, published studies, and an ongoing multicenter study funded by the National Institute on Aging.

Dr Amy Pastva

"When we look at trials of exercise-based interventions in chronic HFpEF, we have consistently demonstrated these large, significant, clinically meaningful improvements in symptoms, exercise capacity, and, usually, quality of life," she said.

These may be attributed to the pleiotropic effects of such training, she said, and may affect the full range of abnormalities that contribute to exercise intolerance. These peripheral effects can drive changes in exercise capacity. "What we don't know yet in these trials is whether it affects clinical events," she said. "But exercise capacity or cardiorespiratory fitness is an independent, clinically meaningful patient outcome."

Pastva highlighted some of the trials cited in the scientific statement that show positive results. However, she said, gaps remain, and information about how much exercise is ideal, among other questions, is needed. "We know about the short term, but not as much about the long term," she said.

Another interesting area of research, Pastva said, is the effect of combining interventions, such as weight loss, with supervised exercise. She cited a recently published study that focused on the effect of adding resistance training to caloric restriction and exercise training for HFpEF patients with obesity. The researchers found large improvement in VO2peak and quality of life with restriction and training; adding resistance training increased leg strength and muscle quality without additional effects on either measure.

"The addition of resistance training to the caloric restriction was well tolerated," she said. Physical rehabilitation that begins during the hospital stay and continues for 3 months after also could help frail, older patients who are hospitalized for acute decompensated heart failure with HFpEF, Pastva said, citing her research and that of other groups.

These ideas led to the REHAB-HFpEF trial, which began earlier this year. The trial is expected to be completed by 2025. The study aims to follow up to 880 older men and women with HFpEF who have been hospitalized for heart failure. The participants will be randomly assigned before discharge either to undergo physical rehabilitation three times per week for 12 weeks or to receive conventional care. The primary outcome is hospitalization and death at 6 months.

Other speakers updated epidemiology, diagnosis, pharmacology, and inequities.

Epidemiology and Diagnosis of HFpEF

HFpEF was initially believed to be a milder form of heart failure, but that is no longer thought to be the case, according to Michael W. Rich, MD, a professor of medicine at Washington University School of Medicine in St. Louis.

HFpEF is defined as heart failure with an ejection fraction of 50% or more. Women are twice as likely as men to have the condition; the incidence in Blacks is higher than in Whites, as is the rate of increase. From 2008–2018, the increase in hospitalizations rose 2.6-fold.

Signs and symptoms of this form of heart failure include dyspnea on exertion, exercise intolerance, rales, and elevated jugular venous pressure, he said.

"Diagnosis of HFpEF can also be done using the so-called H2F-PEF Score, which includes weight, high blood pressure, atrial fibrillation, pulmonary hypertension, older age, and elevated filling pressure," Rich said. "It's been shown in those with unexplained dyspnea, an H2F-PEF score of 6 points or higher is highly diagnostic of HFpEF."

Regarding the biomarker B-type natriuretic peptide, Rich said the diagnostic threshold for NT-pro-BNP is ≥450 pg/mL for those yougner than 50 years, ≥900 pg/mL for those aged 50–75 years, and 1800 ≥450 pg/mL for those aged 75 years and older. If the result is <300 pg/mL, acute heart failure is unlikely at any age, he said.

Evaluation should include a history and physical, labs (CBC, CMP, TFTs, UA, possibly lipids), a 12-lead ECG, and transthoracic echo with Doppler. Additional testing, decided on an individualized basis, may be needed. The differential diagnosis includes cardiac amyloid, hypertrophic cardiomyopathy, cardiac sarcoid, iron overload, tumors, esophageal enlargement, and other problems.

Rich advises physicians to refer for cardiac consultation when a patient is hospitalized more than twice in a year, when the patient's blood pressure is low (<90–100 mm Hg) or if the patient has diuretic resistance or cardiorenal syndrome.

Pharmacologic Management

Managing pharmacotherapy for HFpEF involves inherent tension between therapy benefits and the risks of polypharmacy, said Parag Goyal, MD, director of the HFpEF and Cardiac Amyloidosis Program and associate professor of medicine at Weill Cornell Medicine, in New York City.

Goyal provided several recommendations to balance that tension.

  • Decongestion should be effected with loop diuretics. Which is the best? Goyal cited a 2023 study that compared torsemide and furosemide. There was no difference in mortality at the 12-month follow-up, he said. "It probably doesn't make any difference which diuretic you use," but the medications help patients feel better and stay out of the hospital.

  • SGLT-2 inhibitors should be prescribed. "Multiple organs are involved in HFpEF, and that includes the heart, vasculature, and kidneys, and SGLT-2 inhibitors actually target each of these," he said.

  • Mineralocorticoid receptor agonists should be prescirbed. A post hoc analysis of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial found that in the Americas, but not in Russia, spironolactone reduced cardiovascular deaths and hospitalizations from heart failure.

  • Other medications to consider include angiotensin receptor/neprilysin inhibitors, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors. But caution should be exercised if the patient has low blood pressure, he said.

  • Consideration should be given to deprescribing beta blockers, which may not be helpful, Goyal said, citing recent research.

  • Use of statins should be considered. "The jury is still out," he said, but he also cited preliminary research from his group and others that found benefit.

Dr Parag Goyal

"The field is moving toward phenotype-based therapy," he said, which makes more individualized treatments possible.

Inequities

Heart failure affects everyone, said Khadijah Breathett, MD, an advanced heart failure and transplant cardiologist and associate professor of medicine at Indiana University, in Indianapolis. Ethnic and racial differences exist, she said.

Dr Khadijah Breathett

Datasets differ, and the changing definitions make assessing differences more complicated. Overall, she said, the highest prevalence of heart failure is among Black patients; the condition affects 3.6% of Black men and 3.3% of Black women, compared to 2.4% of White men and 1.4% of White women. Inequities are worsening.

Rates of hospitalizations for HFpEF are higher among Black patients, but mortality is higher among Whites, and men fare worse than women.

Breathett's research and that of others has found in a multiracial cohort that obesity and hypertension were strong risk factors for HFpEF, with obesity strongest for Black women.

Advice for clinicians? Pay heed to the 2022 ACC/AHA heart failure guidelines, she advised, which recommend addressing risk factors often found in the disparities.

"Support clinical trials so we can get better data," she added.

Rich and Pastva have disclosed no relevant financial relationships. Goyal has received research support from the National Institute on Aging and the American Heart Association. Breathett has received funding from the National Heart, Lung, and Blood Institute and HRSA Prime.

American Geriatrics Society (AGS) 2023 Annual Scientific Meeting: Presented May 5, 2023.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

processing....

How doesTai Chi help prevent falls for older people?

It improves the balance of older people.

What are some of the benefits of practicing Tai Chi regularly?

What benefits does Tai Chi haves for healthy aging?

It helps to improve factors linked to a longer life like balance, mobility, and stability.

What did studies show about Tai Chi's health benefit?

It limits the danger of falls among the elderly.

It improves the balance of older people.

What do orthopedic specialists say about the benefits of learning Tai Chi?

Excercises like the horse stance in Tai Chi that can help prevent falls.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

#### The Problem: Falls in Older Adults
Falls are a leading cause of injury-related morbidity and mortality among older adults.

According to Dr.

Title:

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08:07aClinical Review of ropeginterferon alfa-2b Suggests Amended Dosing Schedule May Support Improved Clinical Outcomes in Polycythemia Vera
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01/14PharmaEssentia Corporation Submits New Drug Registration of BESREMi for PV in Malaysia
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Clinical Review of ropeginterferon alfa-2b Suggests Amended Dosing Schedule May Support Improved Clinical Outcomes in Polycythemia Vera

02/02/2023 | 08:07am EST

Review of studies published in Frontiers in Oncology highlights dosing considerations that may help more patients achieve earlier complete hematological response

PharmaEssentia USA Corporation, a subsidiary of PharmaEssentia Corporation (TPEx:6446), a global biopharmaceutical innovator based in Taiwan leveraging deep expertise and proven scientific principles to deliver new biologics in hematology and oncology, today announced the publication of a review of clinical literature in the journal, Frontiers in Oncology. The research indicates that an amended dosing schedule, with higher initial dose and faster dose titration of ropeginterferon alfa-2b (marketed as BESREMi®), may correlate to earlier complete hematological response (CHR) in polycythemia vera (PV) in adults. The analysis titled, “An alternative dosing strategy for ropeginterferon alfa-2b may help improve outcomes in myeloproliferative neoplasms: An overview of previous and ongoing studies with perspectives on the future,” was co-authored by PharmaEssentia researchers.

“This publication delves into the critical connection between an accelerated dosing regimen for ropeginterferon alfa-2b and the key efficacy, safety and tolerability outcomes we aim to achieve for our patients,” said John Mascarenhas, M.D., Director of the Adult Leukemia Program and Leader of Clinical Investigation within the Myeloproliferative Disorders Program at Mount Sinai and study author. “The data from these clinical and investigational studies suggest that a higher starting dose and faster titration could be an appropriate approach to attain clinical outcomes earlier while minimizing the risk of thrombosis and hemorrhage in patients with PV.”

PV is the most common myeloproliferative neoplasm (MPN) and a long-term, potentially life-threatening disease with limited treatment options. Recent clinical investigations suggest the potential for rapid titration and higher starting doses to benefit those with PV.1

The publication highlights the findings from multiple studies supporting the efficacy, safety and tolerability of a 250-350-500 mcg titration dosing regimen of ropeginterferon alfa-2b:

  • A compassionate use program (CUP) study in Taiwan (n=14; hydroxyurea and/or anagrelide resistance or intolerance patients) resulted in a CHR rate of 73% at 52 weeks vs 51% observed in a study with a slower titration method. No new safety signals were detected.
  • Interim results from an ongoing, Phase 2, single-arm study in Chinese PV patients (n=49; resistant or intolerant to hydroxyurea) showed that amended dosing achieved a CHR rate of 52% at Week 24 compared to 43% at Week 52 observed in PROUD-PV. Treatment-related Grade >3 adverse events (AEs) were reported in five patients (10.2%).
  • Data from an investigator-initiated trial in Korea (n=45; hydroxyurea naïve or pre-treated PV patients) indicated higher hematologic and molecular responses at 6 months. Dose reductions were required in 4.4% of patients and the majority of AEs were Grade 1 or 2 with no treatment-related serious AEs reported.

Across the studies, ropeginterferon alfa-2b was generally well-tolerated. No thromboembolic complications have been reported with the accelerated titration regimen in PV. Rather, the review authors indicate that it is reasonable to believe that the accelerated dosing regimen may potentially minimize the risk of thrombosis and hemorrhage associated with an under-dosing during dose titrations.

“As more clinicians gain familiarity with BESREMi®, we want to support treatment goals by ensuring patients can effectively achieve and maintain their target clinical and molecular responses, as this may help reduce the risk of disease progression over time,” said Raymond Urbanski, M.D., Ph.D., Senior Vice President and U.S. Head of Clinical Development and Medical Affairs. “This latest research will help support more informed dialogue among physicians regarding their patients with PV.”

PharmaEssentia is interested in the attributes of the amended dosing approach with ropeginterferon alfa-2b that may extend into related MPNs with unmet needs such as essential thrombocythemia (ET) and pre-fibrotic primary myelofibrosis (pMF). Several planned or ongoing Phase 3 clinical trials will further evaluate this regimen of ropeginterferon alfa-2b in ET (SURPASS and EXCEED trials) and PV (ECLIPSE trial). Plans for a Phase 3 clinical trial in pMF are also underway.

Follow PharmaEssentia USA on Twitter and LinkedIn for news and updates.

About Polycythemia Vera (PV)

Polycythemia vera (PV) is a cancer originating from a disease-initiating stem cell in the bone marrow resulting in a chronic increase of red blood cells, white blood cells, and platelets. PV may result in cardiovascular complications such as thrombosis and embolism, and often transforms to secondary myelofibrosis or leukemia. While the molecular mechanism underlying PV is still subject of intense research, current results point to a set of acquired mutations, the most important being a mutant form of JAK2.2

About BESREMi® (ropeginterferon alfa-2b-njft)

BESREMi is an innovative monopegylated, long-acting interferon. With its unique pegylation technology, BESREMi has a long duration of activity in the body and is aimed to be administered once every two weeks (or every four weeks with hematological stability for at least one year), allowing flexible dosing that helps meet the individual needs of patients.

BESREMi has orphan drug designation for the treatment of polycythemia vera (PV) in adults in the United States. The product was approved by the European Medicines Agency (EMA) in 2019, in the United States in 2021, and has recently received approval in Taiwan and South Korea. The drug candidate was invented by PharmaEssentia and is manufactured in the company’s Taichung plant, which was cGMP certified by TFDA in 2017 and by EMA in January 2018. PharmaEssentia retains full global intellectual property rights for the product in all indications.

Indication

BESREMi is indicated for the treatment of adults with polycythemia vera.

Important Safety Information

WARNING: RISK OF SERIOUS DISORDERS

Interferon alfa products may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Therapy should be withdrawn in patients with persistently severe or worsening signs or symptoms of these conditions. In many, but not all cases, these disorders resolve after stopping therapy.

CONTRAINDICATIONS

  • Existence of, or history of severe psychiatric disorders, particularly severe depression, suicidal ideation, or suicide attempt
  • Hypersensitivity to interferons including interferon alfa-2b or any of the inactive ingredients of BESREMi.
  • Moderate (Child-Pugh B) or severe (Child-Pugh C) hepatic impairment
  • History or presence of active serious or untreated autoimmune disease
  • Immunosuppressed transplant recipients

WARNINGS AND PRECAUTIONS

  • Depression and Suicide: Life-threatening or fatal neuropsychiatric reactions have occurred in patients receiving interferon alfa-2b products, including BESREMi. These reactions may occur in patients with and without previous psychiatric illness.
    Other central nervous system effects, including suicidal ideation, attempted suicide, aggression, bipolar disorder, mania and confusion have been observed with other interferon alfa products
    Closely monitor patients for any symptoms of psychiatric disorders and consider psychiatric consultation and treatment if such symptoms emerge. If psychiatric symptoms worsen, it is recommended to discontinue BESREMi therapy.
  • Endocrine Toxicity: These toxicities may include worsening hypothyroidism and hyperthyroidism. Do not use BESREMi in patients with active serious or untreated endocrine disorders associated with autoimmune disease. Evaluate thyroid function in patients who develop symptoms suggestive of thyroid disease during BESREMi therapy. Discontinue BESREMi in patients who develop endocrine disorders that cannot be adequately managed during treatment with BESREMi.
  • Cardiovascular Toxicity: Toxicities may include cardiomyopathy, myocardial infarction, atrial fibrillation and coronary artery ischemia. Patients with a history of cardiovascular disorders should be closely monitored for cardiovascular toxicity during BESREMi therapy. Avoid use of BESREMi in patients with severe or unstable cardiovascular disease, (e.g., uncontrolled hypertension, congestive heart failure (≥ NYHA class 2), serious cardiac arrhythmia, significant coronary artery stenosis, unstable angina) or recent stroke or myocardial infarction.
  • Decreased Peripheral Blood Counts: These toxicities may include thrombocytopenia (increasing the risk of bleeding), anemia, and leukopenia (increasing the risk of infection). Monitor complete blood counts at baseline, during titration and every 3-6 months during the maintenance phase. Monitor patients for signs and symptoms of infection or bleeding.
  • Hypersensitivity Reactions: Toxicities may include serious, acute hypersensitivity reactions (e.g., urticaria, angioedema, bronchoconstriction, anaphylaxis). If such reactions occur, discontinue BESREMi and institute appropriate medical therapy immediately. Transient rashes may not necessitate interruption of treatment.
  • Pancreatitis: Pancreatitis has occurred in 2.2% of patients receiving BESREMi. Symptoms may include nausea, vomiting, upper abdominal pain, bloating, and fever. Patients may experience elevated lipase, amylase, white blood cell count, or altered renal/hepatic function. Interrupt BESREMi treatment in patients with possible pancreatitis and evaluate promptly. Consider discontinuation of BESREMi in patients with confirmed pancreatitis.
  • Colitis: Fatal and serious ulcerative or hemorrhagic/ischemic colitis have occurred in patients receiving interferon alfa products, some cases starting as early as 12 weeks after start of treatment. Symptoms may include abdominal pain, bloody diarrhea, and fever. Discontinue BESREMi in patients who develop these signs or symptoms. Colitis may resolve within 1 to 3 weeks of stopping treatment.
  • Pulmonary Toxicity: Pulmonary toxicity may manifest as dyspnea, pulmonary infiltrates, pneumonia, bronchiolitis obliterans, interstitial pneumonitis, pulmonary hypertension, and sarcoidosis. Some events have resulted in respiratory failure or death. Discontinue BESREMi in patients who develop pulmonary infiltrates or pulmonary function impairment.
  • Ophthalmologic Toxicity: These toxicities may include severe eye disorders such as retinopathy, retinal hemorrhage, retinal exudates, retinal detachment and retinal artery or vein occlusion which may result in blindness. During BESREMi therapy, 23% of patients were identified with an eye disorder. Eyes disorders ≥5% included cataract (6%) and dry eye (5%). Advise patients to have eye examinations before and during BESREMi therapy, specifically in those patients with a retinopathy-associated disease such as diabetes mellitus or hypertension. Evaluate eye symptoms promptly. Discontinue BESREMi in patients who develop new or worsening eye disorders.
  • Hyperlipidemia: Elevated triglycerides may result in pancreatitis. Monitor serum triglycerides before BESREMi treatment and intermittently during therapy and manage when elevated. Consider discontinuation of BESREMi in patients with persistently, markedly elevated triglycerides.
  • Hepatotoxicity: These toxicities may include increases in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT) and bilirubin. Liver enzyme elevations have also been reported in patients after long-term BESREMi therapy. Monitor liver enzymes and hepatic function at baseline and during BESREMi treatment. Discontinue BESREMi in patients who develop evidence of hepatic decompensation (characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or variceal hemorrhage) during treatment.
  • Renal Toxicity: Monitor serum creatinine at baseline and during therapy. Avoid use of BESREMi in patients with eGFR <30 mL/min. Discontinue BESREMi if severe renal impairment develops during treatment.
  • Dental and Periodontal Toxicity: These toxicities may include dental and periodontal disorders, which may lead to loss of teeth. In addition, dry mouth could have a damaging effect on teeth and mucous membranes of the mouth during long-term treatment with BESREMi. Patients should have good oral hygiene and regular dental examinations.
  • Dermatologic Toxicity: These toxicities have included skin rash, pruritus, alopecia, erythema, psoriasis, xeroderma, dermatitis acneiform, hyperkeratosis, and hyperhidrosis. Consider discontinuation of BESREMi if clinically significant dermatologic toxicity occurs.
  • Driving and Operating Machinery: BESREMi may impact the ability to drive and use machinery. Patients should not drive or use heavy machinery until they know how BESREMi affects their abilities. Patients who experience dizziness, somnolence or hallucination during BESREMi therapy should avoid driving or using machinery.
  • Embryo-Fetal Toxicity: Based on the mechanism of action, BESREMi can cause fetal harm when administered to a pregnant woman. Pregnancy testing is recommended in females of reproductive potential prior to treatment with BESREMi. Advise females of reproductive potential to use an effective method of contraception during treatment with BESREMi and for at least 8 weeks after the final dose.

ADVERSE REACTIONS

The most common adverse reactions reported in > 40% of patients in the PEGINVERA study (n=51) were influenza-like illness, arthralgia, fatigue, pruritis, nasopharyngitis, and musculoskeletal pain. In the pooled safety population (n=178), the most common adverse reactions greater than 10%, were liver enzyme elevations (20%), leukopenia (20%), thrombocytopenia (19%), arthralgia (13%), fatigue (12%), myalgia (11%), and influenza-like illness (11%).

DRUG INTERACTIONS

Patients on BESREMi who are receiving concomitant drugs which are CYP450 substrates with a narrow therapeutic index should be monitored to inform the need for dosage modification for these concomitant drugs. Avoid use with myelosuppressive agents and monitor patients receiving the combination for effects of excessive myelosuppression. Avoid use with narcotics, hypnotics or sedatives and monitor patients receiving the combination for effects of excessive CNS toxicity.

USE IN SPECIFIC POPULATIONS

  • Pregnancy: Based on mechanism of action and the role of interferon alfa in pregnancy and fetal development, BESREMi may cause fetal harm and should be assumed to have abortifacient potential when administered to a pregnant woman. There are adverse effects on maternal and fetal outcomes associated with polycythemia vera in pregnancy. Advise pregnant women of the potential risk to a fetus.
  • Lactation: There are no data on the presence of BESREMi in human or animal milk, the effects on the breastfed child, or the effects on milk production. Because of the potential for serious adverse reactions in breastfed children from BESREMi, advise women not to breastfeed during treatment and for 8 weeks after the final dose.
  • Females of Reproductive Potential: BESREMi may cause embryo-fetal harm when administered to a pregnant woman. Pregnancy testing prior to BESREMi treatment is recommended for females of reproductive potential. Advise female patients of reproductive potential to use effective contraception during treatment with BESREMi and for at least 8 weeks after the final dose.
  • Pediatric Use: Safety and effectiveness in pediatric patients have not been established.
  • Geriatric Use: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other therapy.

Please see accompanying full Prescribing Information, including Boxed Warning.

About PharmaEssentia

PharmaEssentia (TPEx: 6446), headquartered in Taipei, Taiwan, is a global and rapidly growing biopharmaceutical innovator. Leveraging deep expertise and proven scientific principles, PharmaEssentia aims to deliver effective new biologics for challenging diseases in the areas of hematology and oncology, with one approved product and a diversifying pipeline. Founded in 2003 by a team of Taiwanese-American executives and renowned scientists from U.S. biotechnology and pharmaceutical companies, today PharmaEssentia is expanding its global presence with operations in the U.S., Japan, China, and Korea, along with a world-class biologics production facility in Taichung, Taiwan.

For more information about PharmaEssentia USA, visit the website, LinkedIn or Twitter.

Forward Looking Statement

This press release may contain forward looking statements, including statements regarding the clinical benefits to be derived from ropeginterferon alfa-2b, the commercial opportunity and competitive positioning, new indications or labeling for ropeginterferon alfa-2b, and any business prospects for ropeginterferon alfa-2b. For those statements, we claim the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995 and similar legislation and regulations under Taiwanese law. These forward-looking statements are based on management expectations and assumptions as of the date of this press release, and actual results may differ materially from those in these forward looking statements as a result of various factors. These factors include risks and uncertainties related to the initiation, timing, progress and results of our research and development programs, preclinical studies, clinical trials, and regulatory submissions. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof.

© 2023 PharmaEssentia Corporation. All rights reserved.

BESREMi and PharmaEssentia are registered trademarks of PharmaEssentia Corporation, and the PharmaEssentia logo is a trademark of PharmaEssentia Corporation.

1 Qin A, Urbanski R, et al. An Alternative Dosing Strategy for Ropeginterferon alfa-2b may Help Improve Outcomes in Myeloproliferative Neoplasms: An Overview of Previous and Ongoing studies with Perspectives on the Future. Front. Oncol. (2023) 13; doi:10.3389/fonc.2023.1109866.

2 Cerquozzi S, Tefferi A. Blast Transformation and Fibrotic Progression in Polycythemia Vera and Essential Thrombocythemia: A Literature Review of Incidence and Risk Factors. Blood Cancer J (2015) 5, e366; doi:10.1038/bcj.2015.95.

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Financials
Sales 2022 2 670 M 89,5 M 89,5 M
Net income 2022 -1 286 M -43,1 M -43,1 M
Net cash 2022 6 492 M 218 M 218 M
P/E ratio 2022 -109x
Yield 2022 -
Capitalization 148 B 4 976 M 4 976 M
EV / Sales 2022 53,1x
EV / Sales 2023 14,9x
Nbr of Employees 131
Free-Float 73,1%
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Kuo Chung Lin Chief Executive Officer
Hsueh Ling Chang Chief Financial & Accounting Officer
Ching Liu Chan Chairman & Deputy General Manager
Joe K. Tseng Director-Medical Research
Lih-Ling Lin Chief Scientific Officer
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Boris Goralnik, a geriatric specialist, falls can result in a range of negative outcomes, including:
- **Fall-related injuries**: Fractures, hematomas, and skin lacerations.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.

Why did the Chinese Center for Disease Control and Prevention advised elderly people to practice Tai Chi?

Because it can prevent falls that may result in fracture.