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Speaker 1: It's a seven yel tune weekend breakfast witness all you

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Speaker 1: need to know about staying.

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Speaker 2: Fit all right.

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Speaker 3: Time to get this party underway, And as always on

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Speaker 3: a Saturday, we kick off the show with fitness discussion,

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Speaker 3: and this morning we're talking about the importance of balance,

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Speaker 3: making sure you are balanced, you have strength, core strength

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Speaker 3: in particular because of the risk of falling that you

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Speaker 3: can develop as you grow older. If you don't have

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Speaker 3: the right kind of balance or your strength is off,

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Speaker 3: you do increase your risk of falling later on, which

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Speaker 3: is not ideal. And the idea of balancing yourself we're

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Speaker 3: ensuring you have balance is not a thing you should

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Speaker 3: only be thinking about once you're nearing retirement, once you

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Speaker 3: stop working. It is the kind of thing you can

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Speaker 3: start working on when you are younger. And so this

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Speaker 3: morning we're joined on the line by specialist geriatrician doctor

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Speaker 3: Tessanine Bucks, who joins us for our conversation.

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Speaker 2: Of course, we'd like to hear from you on No.

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Speaker 3: Double one, eight, three or seven to send us your

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Speaker 3: semesters on through one seven oh two, Doctor Bucks.

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Speaker 2: A great pleasure having you on the show.

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Speaker 1: Good morning, good morning, Thank you for having me.

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Speaker 3: So often when we hear about balance, we kind of

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Speaker 3: take it for granted, especially when we're younger, because it's

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Speaker 3: the kind of thing you just you have it. You're

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Speaker 3: able to prevent yourself from falling, your unlikely to fall

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Speaker 3: because of a loss of balance, you generally have a

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Speaker 3: bit more strength in your body, and so it's the

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Speaker 3: kind of thing we often think, Oh, I'm just gonna

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Speaker 3: have this forever, I'll always have decent balance.

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Speaker 2: But that doesn't seem to be the case.

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Speaker 1: No, it's not.

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Speaker 3: So talk to us what happens to our balance and

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Speaker 3: our strength as we get older.

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Speaker 1: So an important part of it is something called sarcopenia,

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Speaker 1: which is an important component of frailty that we see

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Speaker 1: in a lot of older people. And sycopenia is the

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Speaker 1: progressive and generalized gletal muscle muss that happens over time,

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Speaker 1: and it actually begins in the fourth decades of life,

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Speaker 1: and it's estimated at about eight percent a decade, So

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Speaker 1: by the time you reach eighty, you've got like fifty

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Speaker 1: percent muscle rock. So that's one of the key components,

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Speaker 1: is that the muscles that we use for balance and stabilization,

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Speaker 1: if we don't maintain them are actually lost.

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Speaker 3: And so these muscles that are important for balance and stabilization,

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Speaker 3: what exactly do we use them for? Because again, when

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Speaker 3: we think of balance, we think of the use of

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Speaker 3: our balance when we do certain things. When you're riding

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Speaker 3: a bike, when you're playing sports, maybe you're playing with

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Speaker 3: the kids, maybe when you're dancing. Those are places where

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Speaker 3: we often think, oh, okay, yeah, here I am using

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Speaker 3: my balance. But what are the other times where our

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Speaker 3: our balance and our strength are constantly being used, even

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Speaker 3: when we don't realize we're doing so.

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Speaker 1: Yeah, So even just to stay upright, So to stay upright,

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Speaker 1: you know, in the correct position, with the correct position

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Speaker 1: of your shoulders and knees, that is what we use

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Speaker 1: our muscles for. They help us also in the way

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Speaker 1: we walk, so for example, our stride length and our

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Speaker 1: arms wings that also is dependent on our muscles. You

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Speaker 1: know that. The other thing, obviously, is that as we age,

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Speaker 1: we do have some stiffening of the connective tissue, which

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Speaker 1: leads to decreased range of joint motion, which is something

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Speaker 1: that also impacts balance and fall length. Yeah. But and

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Speaker 1: an important part of how we use our writing reflects

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Speaker 1: is also also comes from our muscles and our joints

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Speaker 1: and our strength. But it's not just the muscle last

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Speaker 1: there are a few things that happened as we age,

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Speaker 1: you know that sort of contribute to what we saw

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Speaker 1: the physiology.

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Speaker 3: Yeah, so talk to us about those things that you

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Speaker 3: know do contribute to the physiology of falling.

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Speaker 1: So aside from the muscle mass and the connective tissues stiffening,

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Speaker 1: which we've mentioned, so, there are neurological changes, so the

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Speaker 1: changes in the nervous systems. So we have an increased

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Speaker 1: reaction time. We don't react as quickly, and this is

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Speaker 1: due to slowing of nerve conduction. With age. We have

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Speaker 1: decreased writing reflexes, we have decreased appropriate reception. There's a

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Speaker 1: lot of visual changes that also happen as we age.

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Speaker 1: Our visual accurity decreases, our ability to perceive depths decreases,

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Speaker 1: we have decreased contrast sensitivity in our eyes. What also

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Speaker 1: happens is as we age, we become more prone to

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Speaker 1: a drop in blood pressure, and also the specific reflex

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Speaker 1: that's responsib to increase our heart rates with a drop

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Speaker 1: in blood pressure, like that sort of fails, and that's

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Speaker 1: something that contributes to falling. As well as well as

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Speaker 1: when you're older, you're also prone to dehydration.

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Speaker 3: And so doctor you mentioned that this issue of you know,

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Speaker 3: this loss of balance and strength is actually thing that

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Speaker 3: happens quite early in life, and then it starts happening

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Speaker 3: in our forties. And so if it is that the

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Speaker 3: forties are kind of where we're starting the strop, what

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Speaker 3: are the things we could be doing or should be

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Speaker 3: doing as early as our forties, Is it even as

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Speaker 3: early as our thirties to ensure that by the time

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Speaker 3: we are in our sixties, seventies, eighties.

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Speaker 2: Will reduce our risk of falling.

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Speaker 3: I don't know if you can diminish it entirely, get

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Speaker 3: rid of it altogether, but I imagine there are ways to

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Speaker 3: reduce that risk. And what should we be doing early

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Speaker 3: on thirty late thirties, forties around that time?

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Speaker 1: Yeah, so yeah, So sycopenia it begins in the fourth decade,

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Speaker 1: so that's already in your socies, so that that is

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Speaker 1: really when it starts. Especially if you try to start

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Speaker 1: when you are already eighty, it's very difficult, you know,

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Speaker 1: to to regain muscle rebold, muscle mass. So it definitely

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Speaker 1: is something that you should start in your younger years,

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Speaker 1: and things you should focus on would be things like

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Speaker 1: strength training, so particularly resistance training, and focus on progressive

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Speaker 1: overload of the muscles to keep them present and also

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Speaker 1: to build on them. And then other exercises which are

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Speaker 1: grateful balance are things like yoga, things like i chi.

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Speaker 1: Those kinds of things work or help specifically for for balance,

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Speaker 1: which is great. And then also another important thing is

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Speaker 1: if you are starting and you're older, is ideally you

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Speaker 1: should you should not be, you know, beginning starting to

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Speaker 1: exercise on your own. You should ideally be doing this

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Speaker 1: under the guidance of something like a physio therapist or

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Speaker 1: a bio biokineticist, you know, because if you've already fallen, yeah,

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Speaker 1: you're at risk of another four and so you shouldn't

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Speaker 1: be attempting these things sort of unsupervised.

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Speaker 3: If you will, doctor tell us about is there a

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Speaker 3: difference in the I guess the progression and the loss

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Speaker 3: of balance and loss of muscle mass in women, because

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Speaker 3: women often start seeing the thinning or the weakening of

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Speaker 3: their bones as a result of something like osteoporosis. Is

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Speaker 3: there a difference in the ways in which women lose

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Speaker 3: their balance and Austrians training in the way that we've

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Speaker 3: discussed so far, that like it starts happening late thirties forties,

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Speaker 3: you start seeing it. Is it different for women just

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Speaker 3: in terms of scale and how how quickly it happens?

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Speaker 2: Does it happen earlier? What do we know?

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Speaker 1: So obviously gender and aging are risk practice for syclopedia,

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Speaker 1: not to say that that specifically happens more in women,

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Speaker 1: but in terms of asterioporocess, what does happen more in women?

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Speaker 1: You know is that rapid bone lash, especially post menopausally.

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Speaker 1: So that is something important and that's something that contributes

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Speaker 1: to making falls in older women so dangerous because of

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Speaker 1: the rest of ostereoporosis.

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Speaker 3: And so in the instance, doctor with you said, you know,

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Speaker 3: someone needs to be very very careful if they've already

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Speaker 3: experienced a form, and that's why, for instance, they shouldn't

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Speaker 3: be exercising alone, they should exercise with someone else. Can

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Speaker 3: you even once you've had a fall, can you then

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Speaker 3: correct your balance and your strength after that indent of

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Speaker 3: having fallen from a lack of you know, strength training,

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Speaker 3: you know core strength balance, Can you still fix it

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Speaker 3: once there's.

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Speaker 2: Been a fall?

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Speaker 1: Yeah, there is definitely the opportunity, you know, to make

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Speaker 1: an impact and to have some recovery, certainly with regards

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Speaker 1: to if you begin some form of exercise, particularly strength exercise,

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Speaker 1: as well as things like tachi and yoga which help

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Speaker 1: you with your balance, but also if you look at

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Speaker 1: certain other things which also contribute to falling in people

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Speaker 1: who are older, there's certain things like medication, whether or

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Speaker 1: not they use alcohol and if they use it to

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Speaker 1: access if they have any problems with their eyes, for example,

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Speaker 1: they may actually need cataract surgery and that's something that's

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Speaker 1: contributing to their faults. You also look at their environment.

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Speaker 1: Are their environmental hazards, you know, things like lots of cords,

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Speaker 1: loose piles, whose carpets that's contributing to falling, And then

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Speaker 1: you would just look at that. You know, are there

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Speaker 1: inflammation of joints while they're developing joint deformity as a

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Speaker 1: result of arthritis for example, Do they have some underlying

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Speaker 1: neurological condition that's causing them to stake or impairing their movements.

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Speaker 1: Do they have problems with their feet? Are they wearing

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Speaker 1: inappropriate shoes? So those are all things that you could

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Speaker 1: look at and that you could try and improve upon

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Speaker 1: in order to decrease your risk of falling. There's obviously

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Speaker 1: these multiple things that contributes, and then we try to

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Speaker 1: chip away at what we can, correct what we can,

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Speaker 1: but obviously we will never reduce to a forest to zero,

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Speaker 1: but we try to improve where we can.

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Speaker 3: Yeah, and so you know, with this idea of kind

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Speaker 3: of looking ahead, especially if you're younger right now and

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Speaker 3: you're thinking about, well, I want to be able to

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Speaker 3: still move my body, do things exercise, take care of myself,

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Speaker 3: eat on my own, be able to path myself, and

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Speaker 3: you're thinking about this issue of falling and this loss

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Speaker 3: of balance. What age exactly would you say we should

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Speaker 3: start doing this? And when you said the fourth decade

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Speaker 3: is generally where we start seeing that kind of decline,

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Speaker 3: what age should you start doing the exercises, the movements,

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Speaker 3: the yoga, the strength training that will start hopefully setting

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Speaker 3: up for better health in your older years.

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Speaker 1: Yes, so, I mean obviously, because the startupenia starts in

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Speaker 1: the fourth decade with ex per sense of sort of

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Speaker 1: my full last for years, that would be the ideal

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Speaker 1: time to start. But there's also there's no wrong time.

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Speaker 1: It's not ever too late. There are always deaths that

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Speaker 1: you can take and you know some things that you

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Speaker 1: can do that will improve your forsk and improve your outcomes.

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Speaker 1: So I think the important message is that ideally you

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Speaker 1: should start younger, but even if you are older, that

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Speaker 1: doesn't mean, you know, you should give up or not

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Speaker 1: bother there are still opportunities for you to make an improvement.

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Speaker 3: And so when would be then if you are someone

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Speaker 3: that is older concerned about their balance and strength, would

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Speaker 3: that be a good time to see someone who, for instance,

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Speaker 3: is like you as a specialist, as a specialist geriatrician,

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Speaker 3: Would that be the right time to come and see

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Speaker 3: you if I am a little bit concerned about my

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Speaker 3: strength and my balance.

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Speaker 1: So you know, it kind of depends. Are you just

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Speaker 1: someone who's otherwise well and just concerned that you're losing

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Speaker 1: strength or balance, or are they sort of other worrying

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Speaker 1: signs like maybe you have started to have a bit

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Speaker 1: of a tremor or a stace, Maybe you are having problems,

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Speaker 1: you know, sort of what's dizziness when you're standing, Maybe

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Speaker 1: you are having problems sort of even initiating your game

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Speaker 1: and things like that. Then that would be definitely the

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Speaker 1: time to consider seeing a neurologist or a Jerry Addissian,

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Speaker 1: just you know, to get a proper history taken and

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Speaker 1: a proper examination and assessment. Actually, you know, if there

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Speaker 1: could be something underlying that's contributing to this, but if

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Speaker 1: you ask someone who's otherwise well, I think a good

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Speaker 1: starting point would be to see your physio therapist or

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Speaker 1: your biofineticist for an assessment and depending on their findings

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Speaker 1: as well, they can then rushly you appropriately.

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Speaker 2: That's up.

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Speaker 3: I appreciate your time this morning. Thank you so much

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Speaker 3: for joining us on the show.

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Speaker 1: Thanks so much for having me books. Travis Gas there

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Speaker 1: you too.

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Speaker 2: That is doctor testinin As.

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Speaker 3: She is a specialist geriattrician joining us for fitness conversation

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Speaker 3: this morning. Coming up in our Health Conversation, were joined

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Speaker 3: by doctor from Deliati. He's our resident GP and we're

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Speaker 3: going to be talking about World Hearing Day for twenty

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Speaker 3: twenty six that's coming up on the third of March,

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Speaker 3: and this year's focus is on children, specifically hearing care

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Speaker 3: for all children. So we'll speak to doctor Datti about that.

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Speaker 3: But first, lots of sports to look ahead to, including

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Speaker 3: a sway to Darby today, so let's check in us,

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Speaker 3: your laters. I witnessed a new sport with Kulis Nema

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Speaker 3: Rimela