Health & Chiro Articles

A story by John Dorschner of Knight Ridder News Service and published in the January 30, 2005 issue of the Miami Herald reported on the huge increase of insurance companies covering, what they termed, “Alternative Medicine”. The story reports that this activity is now a $30 billion industry.

Some insurance programs, such as Vista Healthplan, based in Hollywood, Fla., has even announced a discount program for its members of up to 30 percent to encourage usage of some 30 alternative programs. Steve Russell, a Vista vice president commented on a new program where seniors enrolled in Vista can get a $25 voucher to try alternative care. He noted, “Most of them don’t know about these things. Basically, we’re encouraging them to step over the line.” He continued, “To increase their mobility, their flexibility, to get out and try new things.”

Santiago Leon, a Miami health insurance broker who has studied the field extensively stated, “Complementary medicine is going mainstream quickly. Part of the impulse is therapeutic. Part of it is economic.”

John Dorschner, author of the article noted that chiropractic care may not even be considered alternative anymore. He stated “Chiropractic, once considered alternative, is now considered mainstream, or nearly so. A chiropractor’s adjustment of a back, or a few minutes of massage therapy, when effective, costs a fraction of what back surgery does. Eighty-seven percent of firms offering health insurance now have benefits for chiropractic, according to the Kaiser Family Foundation.”

The above headline comes from the February 17, 2004 Associated Press, and offers seniors hope for a vital life. Researchers at the University of Illinois reported that improving fitness can boost the thinking ability of aging adults. The study published in the online edition of Proceedings of the National Academy of Sciences, showed that adults ages 58 to 78 who began a fitness program, even as simple as brisk walking, saw improvements in how their brains functioned.

In the study 41 adults began an exercise program that gradually increased over three months to a 45-minute walk three times a week. Their brain activity was measured by magnetic resonance imaging. After three months the adults in the exercise program showed increased brain activity and had an 11 percent improvement on tests that measured their decision-making while performing a variety of tasks.

A control group of similar age and health that only did stretching and toning exercises, but not the cardiovascular walking program, had lower brain activity than the other group and only showed a 2 percent improvement in performance. Arthur F. Kramer of the Beckman Institute for Advanced Science and Technology at Illinois explained, “The kinds of tasks that we explored are similar to those encountered in real world situations such as driving a vehicle or any endeavor that requires a person to pay attention despite distractions,”

A research study published in the July 12, 2006 issue of the Journal of the American Medical Association (JAMA), shows that daily activity can have a positive impact on life expectancy in older adults. It was previously known that exercise had a positive effect on life expectancy. This study also shows that those who are active in their daily routine, even non-exercise activities, are also getting positive benefits.

This study, conducted by Todd M. Manini, Ph.D., and his colleagues of the National Institute on Aging, in Bethesda, Md., was designed to determine the association of what the researchers called “free-living activity energy expenditure” and death rates. The study looked at a group of 302 high-functioning, community-dwelling seniors ranging in age from 70 to 82.

In this study the researchers measured energy expenditure over a two week period using sophisticated processes of tracking certain isotopes of hydrogen and oxygen as eliminated from the body as carbon dioxide. This process then determined the amount of energy expenditure and therefore the activity of the individual. The 302 participants were followed on average for just over 6 years. Over this period of time 55 participants (18.2 percent) died. The researchers then compared the activity levels of all participants to see if there was a correlation between death rates and activity levels.

The results showed that after adjusting for other factors, higher levels of activity energy expenditure and physical activity were indeed associated with a lower risk of death. When the researchers categorized activity levels of the participants into three groups they found that risk of death was only 12.1 percent in the group with the highest level of activity energy expenditure. The group in the middle third, relative to activity level, had a 17.6 percent risk of death. However, the group in the bottom third level of activity had a 24.7 percent risk of death. Statistically, this meant that those with the highest level of activity had a 69 percent better chance of survival than those with the lowest activity.

The authors of this study commented, “Our study suggests that any activity energy expenditure in older adults can help lower mortality risks.” They continued, “Efforts to increase or maintain free-living activity energy expenditure will likely improve the health of older adults.” In the study they concluded, “Objectively measured free-living activity energy expenditure was strongly associated with lower risk of mortality in healthy older adults. Simply expending energy through any activity may influence survival in older adults.”

From the University of Buffalo comes an article that raises questions and concerns about the amount of medications taken by senior citizens. Dr. Wayne K. Anderson, Dean of the School of Pharmacy and Pharmaceutical Sciences states, “Different physicians use different drugs to treat different conditions, and some of these drugs interact, in some cases exacerbating the side effects of other drugs that are being taken for other conditions.”

Anderson estimates that senior citizens in the United States age 65 and older take an average of six to eight prescription drugs daily. His response is, “That is probably too many. Proper pharmaceutical therapy management probably could cut in half the number of drugs most senior citizens now are taking so the amount of money they are spending is reduced and the quality of their lives is much improved.”

Anderson also notes that a person taking eight drugs can expect at least one drug interaction that will have a negative effect on his health. Additionally he noted that the American Association of Consultant Pharmacists suggest that 25 percent of admissions to nursing homes result from failed drug regimens, noncompliance by patients, drug interactions, inappropriate medications being prescribed for certain conditions and the lack of good therapeutic monitoring.

Dr. Andersons answer to this problem is “proper pharmaceutical therapy management.” From a chiropractic perspective the answer seems obvious. Healthier seniors will just naturally need less medications. Chiropractic has always focused on removing interference to the functions of the nervous system and therefore allowing people to function better. Millions of senior citizens already know this approach makes sense and works for them.

Several articles appeared in a number of publications over the past month questioning the effectiveness of the flu vaccine for the elderly. One such article in the October 25, 2008 Daily Press from Richmond, Virginia noted that the flu vaccine may not give the benefits that were previously advertised.

The article reports that Lone Simonsen, a researcher from George Washington University believes the skepticism concerning the vaccinations is long overdue. She commented, “If I could have it my way, we would start by going back and looking at the basic premise for flu vaccination of seniors.” In the article Simonsen, a former epidemiologist for the National Institute of Allergy and Infectious Diseases, noted that the flu vaccination rate among U.S. seniors has risen over the past 25 years up to 65 percent in 2007. However, over that same period of time, hospitalizations and deaths caused by flu or pneumonia have declined only marginally in the 65-and-over population.

The article references a study published in the August 2, 2008 scientific Journal, Lancet. In that study researchers looked at the cases of 3,519 patients older than 65 who had been admitted to the hospital with pneumonia either just prior to, or during the 2000-2002 flu season. The results of that study showed that those who had been immunized against flu were no less likely to develop pneumonia requiring hospitalization than those who had not been vaccinated.

A second study published in the June 2008 issue of the American Journal of Respiratory and Critical Care Medicine also reached the same conclusion. The author of that study reported that deaths due to flu in their study showed that 8% had been vaccinated while 15% had not. However, he noted that this difference was not due to the vaccination but rather to what he called the “healthy user effect”. This was described in the article as, “Seniors who get vaccinated against flu tend to be younger, healthier, more active and better able to take care of themselves.”

The conclusion of the study in the Lancet stated, “The effect of influenza vaccination on the risk of pneumonia in elderly people during influenza seasons might be less than previously estimated.” Likewise the conclusion of the study published in the American Journal of Respiratory and Critical Care Medicine stated, “Previous observational studies may have overestimated mortality benefits of influenza vaccination.”

From the Australian scientific journal, Chiropractic & Osteopathy, comes a report dated September 6, 2007 that chronicles how elderly adults in the United States utilize chiropractic care. The study interviewed over four thousand seniors over 70 years of age, and then correlated those interviews to Medicare records. The results of the study were then extrapolated to give a picture of the overall population.

The research, headed by Dr. Fredric D Wolinsky, and Dr. Gary E Rosenthal of the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP) at the Iowa City VA Medical Center reported that on an annual basis about 4.6% of seniors 70 or older see a chiropractor. These seniors are more likely to be in pain and have a means of self transportation to get to the chiropractor’s office.

The report also noted that predominantly, there were unexplainable racial discrepancies noting that, “African Americans and Hispanics are simply much less likely to visit chiropractors than Whites in the United States”. Researchers also reported that those who used chiropractic were much more likely to have arthritis and/or drink alcohol.

The report showed that over the 4 year study about 30% of those seniors who did have chiropractic visits continued to see a chiropractor over at least three of the four years studied. Researchers concluded that these seniors made chiropractic a regular part of their healthcare regime. Conversely, about 48 percent of those who visited a chiropractor did not have any visits in more than one of the four years in the study. They also found that, “among those who had seen a chiropractor, the volume of chiropractic visits was lower for those who lived alone, had lower incomes, and poorer cognitive abilities, while it was greater for the overweight and those with lower body limitations.”

The above is the title of a study published on February 21, 2012 in the journal, “Chiropractic & Manual Therapies”. The article reviews information and statistics about the usage and role of chiropractic care for the aging population.

The review starts off by noting that the demographics of the population in the US is aging. By the year 2030 it is expected that one in every five Americans will be age 65 or older. The authors of the study also report that 14% of patients who go to chiropractors are age 65 or more. These seniors mainly go to chiropractors for complaints of musculoskeletal aches and pains with back pain being the most common ailment that brings these seniors to a chiropractor.

The authors report that based on previous studies, 14.6% of seniors have gone to a chiropractor between the years of 1993 and 2007. On an annual basis, they report that between 4.1% 5.4% of seniors seek chiropractic services each year.

The study notes that chiropractors offer a variety of services to seniors with chiropractic adjustments, called SMT (spinal manipulative therapy) by the authors, being the most common service, and nutritional advice and exercise recommendations being common.

The authors report that chiropractic adjustments vary and there are many different techniques used by chiropractors in their offices. They also note that most techniques used for seniors have been modified for the age of the patients and their specific spinal conditions.

The authors also noted that other studies showed chiropractic helping elderly people with a range of other health issues including: COPD, constipation, depression (associated with back pain), Parkinson’s disease, multiple sclerosis, pneumonia, spinal stenosis, urinary incontinence, and osteoarthritic pain and dysfunction.

The study also reported that chiropractic care was safer than expected for older adults with two studies showing a small number of adverse events and none of them being serious. In their discussion the authors stressed the importance of chiropractic for seniors when they said, “As the population continues to age there will be a greater need for the chiropractic profession to meet the needs of the older adult.”

A study published on December 21, 2010 in the journal Chiropractic & Osteopathy reviewed how senior citizens utilize chiropractic care. The study was based on data obtained from a survey and Medicare claims from the years 1993 to 2007.

During the time of the study it was shown that 14.6 percent of seniors had used chiropractic at some time. However, many of those only used care in one of the years in the study. This meant that on average 4.8% of seniors used chiropractic in any given year.

The study noted that previous research showed that the population in general utilized chiropractic at a higher rate than did seniors in this study. The general population was reported to go to chiropractors at a rate of between 6.8% and 16% annually depending on the location and time of the study.

The study reported that the average senior who went to the chiropractor averaged 19.5 visits in a year. Other facts of usage also showed that the percentage of seniors going to chiropractors was higher in rural areas. The study also showed that chiropractic patients had greater mobility and function with simple tasks such as light lifting, climbing stairs and walking several blocks. Overall the study showed that the senior chiropractic patients had less difficulty with daily activities.

One interesting finding of the study was that those patients who went to the chiropractor more than 12 visits seemed to utilize chiropractic care at a much higher rate than the rest of the senior population who was seeing chiropractors. This shows that those who incorporate chiropractic as a part of their regular healthcare continue chiropractic even after their Medicare benefits have been exhausted.

The general population is going to chiropractors in record numbers. Seniors, the fastest segment of the population is no exception. According to a recent August 24th 1999 article in USA Today, more than 80% of seniors age 65 or greater are aware of what the article termed alternative medicine. This awareness has lead to a fairly fast growing utilization of these services. The breakdown for usage of chiropractic and other non-medical health care is as follows:

Chiropractic lead the way with a utilization of 32%, second was massage therapy at 16%, followed by acupuncture 9%, homeopathy at 4%, naturopathy 3% and Chinese medicine 3%.

A recent study published in Topics in Clinical Chiropractic of a randomized clinical trial showed data that found chiropractic geriatric patients were “less likely to have been hospitalized, less likely to have used a nursing home, more likely to report a better health status, more likely to exercise vigorously, and more likely to be mobile in the community.”