Goodbye stilettos and slippers

Alexandra Hospital gerontologist Lydia Au treated some 30 MDS members to a very interesting talk last Saturday. She is an expert on falls amongst the elderly and gave us some good news and bad.

We learned, for example, that 1 out of 4 over 65-year-olds who have fallen and broken a hip, do not survive the first year after the fall. They generally die of infections. Women are more likely to break a hip, but they are also more likely to survive the experience! Therefore Dr Au recommends keeping up our calcium and Vitamin D levels to help retard osteoporosis.

Some factors that predispose to falls are intrinsic and not much can be done about them – the ageing process, for example, means that our balance, eyesight, hearing, blood circulation, etc. is not what it used to be. But many factors are extrinsic, and therefore controllable.

Paying attention to slippery floors, poor lighting, clutter, loose carpets is particularly important for those who have experience a fall. Because their chances of a second fall are greatly higher.

So what to look out for? Some factors are medical, like paying attention to the side-effects of drugs, monitoring blood pressure and glucose levels, avoiding rapid movements which might affect balance, and making sure that one wears the right type of shoes – avoid high heels, loose-fitting shoes, and especially open-heeled slippers.

Simple awareness, we learned, can help reduce the changes of a nasty fall. And those of us with MD – or any form of poor vision – are especially vulnerable.

MDS Talk - Low Vision and Falls

Speaker: Dr Lydia Au
Date: Nov 28, 2009 (Sat)
Time: 2 - 4pm

Venue: Seminar Room, Alexandra Hospital

With low vision as a result of macular degeneration, sufferers are more likely to have some difficulties navigating around previously-familiar spaces like homes and offices. While the occasional trips may just be a nuisance, serious falls, especially among the elderly, would be severe. In some instances, it could even be life threatening.

Alexandra Hospital's geriatrician Dr Lydia Au is an expert on falls among the elderly and has studied the problem that low vision people has with movements. She spoke during last year's AMD Awareness Week, and has now kindly agreed to share her work and expertise with MDS members.

Tips will also be shared on how to make little changes in your homes to make sure that it is as friendly to low-vision people as possible.

* All talks are free for MDS members. Non-members can sign up as members at the door for an annual fee of just $10.

** Space is limited, so please reserve your seats soon. Please register by calling Anne at 6238-7387 or e-mail Sharon at

Egg yolks to combat AMD

Regular egg yolk consumption may reduce the risk of dry, age-related macular degeneration by raising macular pigment concentrations, according to a report in the November issue of the American Journal of Clinical Nutrition.

The study subjects were all older adults who were taking statins, and their low-density-lipoprotein cholesterol levels were unaffected even when they ate as many as four yolks per day.

"Two eggs per day is probably all that is needed to maximize blood levels of lutein and zeaxanthin as well as macular pigment optic density (MPOD) status," senior author Dr. Robert J. Nicolosi from the University of Massachusetts in Lowell told Reuters Health by email.

The 5-month study had 4 phases. As Dr. Nicolosi and his coauthors explain, a 4-week baseline phase was followed by a 5-week 2 yolks/day phase, then a 4-week washout phase, and finally a 5-week 4 yolks/day phase.

In the 52 participants (mean age, 69 years), serum lutein increased by an average of 16% after the 2-yolk phase and 24% after the 4-yolk phase compared to baseline, and serum zeaxanthin increased from baseline by 36% and 82% after the 2- and 4-yolk phases, respectively.

Macular pigment optic density increased significantly after both regimens (more so after the 4-yolk phase), but only among individuals with low baseline density values.

Serum HDL-cholesterol increased during both phases of the study, the researchers note, but there were no significant changes from baseline in total cholesterol, low-density-lipoprotein cholesterol, or triglyceride levels.

"We are presently evaluating the effect of consuming 12 eggs/week for 1 year on the progression of dry age-related macular degeneration" in subjects with early- to mid-stage disease, the investigators write.

"Although this was only a 5-week study and the 1-year data are not ready for comment, it would seem to me that physicians could consider that those patients on statins, who have early stage age-related macular degeneration, could be prescribed 2 egg yolks per day," Dr. Nicolosi said.

He added, "Our evidence and those of others indicate that increases in blood levels of lutein and zeaxanthin and MPOD correlate well with risk for age-related macular degeneration. So the egg yolk appears to enhance the bioavailability of nutrients that have been shown to reduce the risk of age-related macular degeneration, and at 2 egg yolks per day for individuals on statins, does not raise LDL and significantly raises HDL."