Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there. Did your doctor somehow miss the recovery protocol that Pedro Bach-y-Rita used to recover fully back in 1958 with only a partial brain?

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label frailty. Show all posts
Showing posts with label frailty. Show all posts

Sunday, October 25, 2026

6 things you’ve been told about healthy aging that aren’t actually true, according to doctors

 I'll easily get to 100, vast social connections, Mom at 97 still living alone at home. I'll make sure I'm never frail.

6 things you’ve been told about healthy aging that aren’t actually true, according to doctors

Key Takeaways

  • Aging doesn’t have to mean less sleep, less strength, or fewer friends. Older adults still need seven to nine hours of sleep, strength training can slow muscle decline, and building social activities into your routine can help protect against loneliness.
  • There’s no magic food or pill for longevity. No single superfood determines how well you age, and supplements are best used selectively when there’s a specific need, ideally after talking with your doctor.
  • Experts say prioritizing sleep, eating a varied diet, and moving your body regularly has the greatest impact.

Contrary to popular belief, living a longer, healthier life doesn’t require an elaborate wellness routine or giving up life’s everyday pleasures and little indulgences. Here, experts debunk common aging myths, plus practical ways to support your health as you get older.

Myth: Older Adults Can Get by on Less Sleep  

“Don’t assume that because you’re getting older, you’ll have problems with sleeping,” says Tracy Lippard, MD, geriatrician at Kaiser Permanente in Colorado, noting that the misconception may stem from changes in sleep patterns as we age, partly due to declining melatonin levels. “It takes us longer to fall asleep, sleep is more fragmented, and our sleeping schedule usually shifts to earlier bedtimes and earlier mornings.”

But older adults still need seven to nine hours of sleep each night. “It’s essential for memory consolidation and clearing away toxins that can harm the brain,” Dr. Lippard says. “Getting enough sleep also reduces the chances of developing depression and anxiety.” Adequate sleep may even help lower the risk of diabetes, hypertension, obesity, and heart problems, she adds.

If you’re having sleep troubles, Dr. Lippard suggests talking with your doctor, as this might be caused by medications, or conditions such as sleep apnea or restless legs syndrome.

 Related video
: If you can still do these 7 things after 60, your body is aging better than most (Dr. Borja Bandera)

Myth: Getting Older Means Getting Weaker 

“Muscle mass and strength tend to peak in our 30s and gradually decline from there, but that trajectory isn’t set in stone,” says Robert ‘Neal’ Mills, MD, MBA, chief medical officer at EHE Health. “How active you are, what you eat, your overall health, and other individual factors can all influence how much muscle you maintain as you age.”

Getting enough protein is particularly important for maintaining muscle as you get older, and while you can’t control every factor that affects muscle health, you can take steps to help preserve your strength through everyday lifestyle choices.

“Prioritize strength training,” Dr. Mills says. Bodyweight movements and exercises using free weights, such as squats, shoulder presses, and bicep curls, can all help build and maintain strength. “Staying active can substantially slow age-related declines in strength and function, and resistance training is one of the most effective tools we have for maintaining muscle as we age,” Dr. Mills says. “Start where you are and start small. The goal is to challenge your muscles consistently and build from there, at a level that’s appropriate for your health and ability.”

Myth: Inflammation Is the Enemy of Healthy Aging 

“Inflammation has developed a bad reputation in the wellness world, but it’s one of the body’s essential defense and repair mechanisms,” says Jill Villa, physician associate and founder of Goldhaus Wellness. “When you cut your finger, develop an infection, or strain a muscle, your immune system activates an inflammatory response to protect the affected area, fight pathogens, clear damaged tissue and begin the healing process.” 

Unlike acute inflammation, chronic, low-grade inflammation can linger without obvious symptoms. “You may not necessarily feel anything, but that ongoing inflammatory activity can contribute to long-term health problems,” Villa says. “Things like chronic stress, poor sleep, smoking, excess visceral fat, and metabolic dysfunction can all play a role.” Over time, persistent inflammation has been associated with health conditions such as cardiovascular disease and type 2 diabetes.

Villa says the goal isn’t to eliminate inflammation, but to support a healthy response, and she recommends moving your body regularly and prioritizing sleep. “It doesn’t have to be complicated. Walk more, incorporate strength training, and try not to spend hours at a time sitting,” she says. “Sleep is really when the body gets the opportunity to repair and recover, so consistency matters.”

Myth: Getting Older Means Losing Your Social Circle 

“Loneliness is very common,” Dr. Lippard says, pointing to a 2023 national poll in the United States that found 37% of adults aged 50 to 80 reported feeling lonely. “As people get older, their social circle may get smaller for lots of reasons, such as retirement [or] the death of a spouse or friends.”

Loneliness can also increase the risk of depression, anxiety, and cognitive impairment, Dr. Lippard says. “However, older adults may have a few treasured relationships that they safeguard, and this can protect them from being lonely.”

Dr. Lippard recommends making socializing part of your routine. “Maybe it’s coffee once a week with the same friend or two, a regular yoga class, or a Saturday morning volunteer shift at the animal shelter,” she says. “It makes it easier to nourish relationships when social activities are built into the fabric of your life.”

Myth: You Need Superfoods to Live Longer 

Superfoods like blueberries, salmon, and turmeric have all earned a reputation for their health benefits, but as Villa explains, “No single food is going to determine how well you age.” Instead, their benefits occur within the context of an overall healthy lifestyle. 

Eating the same handful of ingredients every day can mean missing out on important nutrients, Villa says. “Different foods provide different vitamins, minerals, fibers, and polyphenols, all of which contribute to overall health.”

Rather than focusing on individual superfoods, Villa recommends building balanced meals around whole, minimally processed foods while still making room for the things you enjoy. “Start with a lean, high-quality protein source, add plenty of vegetables or lower-glycemic fruits, incorporate healthy fats like avocado, olive oil, and nuts, and choose carbohydrates that are high-fiber like beans, lentils, quinoa, oats, and sweet potatoes,” she says. “A healthy diet is one that supports your health and that you can realistically maintain for years.”

Myth: You Need Supplements to Live Longer 

“One of the biggest misconceptions is that taking more supplements automatically means better health,” Dr. Mills says. “Supplements can be useful when there’s a specific need, but they aren’t a substitute for healthy eating.”

Though older adults may be more likely to fall short on nutrients such as calcium and vitamin D, individual needs vary. “Food should do most of the heavy lifting, with supplements used selectively when there’s a reason for them,” he says, suggesting a varied diet rich in fruits and vegetables, whole grains, healthy fats, and quality protein sources. 

Before adding supplements to your routine, talk with your physician about your diet, health history, medications, and whether any testing might be appropriate.

The Bottom Line

When it comes to living a longer, healthier life, Villa says the most effective approach often comes down to getting the basics right: prioritizing sleep, eating well, and moving your body regularly. “You don’t have to do everything perfectly or follow an elaborate wellness routine,” she says. “It’s what you do consistently, day after day and year after year, that ultimately has the greatest impact on how well you age.”

Read the original article on Real Simple

Researchers spent 16 weeks studying adults with an average age of 79. Here’s the surprisingly hopeful takeaway

 

Did your competent? doctor get you recovered enough to do this fast walking?

NO? So, PURE INCOMPETENCE THEN!

My doctor knew nothing about recovery and did nothing. Which is why my gait is still screwed up; 15 degree leftward angle of left foot, no push-off, no free swinging lower leg, hyperextension of left knee. Can't do fast walking until these are fixed or I'll destroy my left knee.

This will never occur in your hospital, too worried about you falling. 

Just bought a 4 level condo, 7 steps to each level. Absolutely do not believe in removing steps in living quarters. Don't do steps at home, won't be able to travel to step laden places like Machu Pichu or restrooms anywhere in Europe!

Researchers spent 16 weeks studying adults with an average age of 79. Here’s the surprisingly hopeful takeaway

 Key takeaways
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  • Faster Walking Benefits: Older adults who walked briskly during supervised sessions were more likely to reduce frailty, with ~70% improving versus 46% in casual walkers.
  • Frailty Measurement: Researchers assessed grip strength, fatigue, appetite, mobility, and activity to track improvements from frail → pre-frail/non-frail.
  • Lifelong Practice Matters: Skills and habits—like languages, hobbies, or running—decline without regular use, emphasizing the need to challenge yourself appropriately.anguage, but without the chance to practice it, it kind of goes away.

If you rest, you rust.

When we stop using muscles—metaphorical muscles or physical ones—we tend to lose the ability to use them. A few examples:

Since I’m talking about personal habits and skills, I’ll add one of mine. I used to run marathons, a full 20 years ago. But I had one kind of stupid injury during a light run the week after I ran one of them.

And, to be honest, I never really 100 percent recovered.

I had all of this in mind when I came across a recent study showing what happened when older adults with signs of frailty were encouraged to walk a little bit more briskly during supervised exercise sessions.

Short version: Those who walked faster were more likely to become less frail.

Writing in the journal PLOS One, researchers described an experiment involving residents of retirement communities around Chicago. They enrolled 165 people, with 105 ultimately included in the analysis. Their average age was about 79.

I spoke with the study’s lead author, Margaret Danilovich. She’s a physical therapist who conducted the research while an assistant professor at Northwestern University. (She is now director of clinical programs at Agilon Health.)

For years, she told me, there had been a tendency to treat frailty as something that only gets worse. And, to avoid asking too much of people who already have limited strength and endurance.

But her experience working with patients made her suspect that “maybe this hands-off approach was not actually helpful for older adults.”

So, the researchers randomly assigned retirement communities to one of two walking programs. Participants in both groups participated in individual, 45-minute sessions with trained research assistants, three times a week for 16 weeks.

One group walked at a casual pace. The other was encouraged to walk as fast as they safely could, aiming for roughly 70 percent of their maximum heart rate.

At the end of the experiment, about 70 percent of participants with follow-up frailty measurements in the faster-walking group improved by at least one frailty category.

That compared with about 46 percent in the casual-walking group.

Frailty here is something researchers actually measured, using grip strength and questions about fatigue, appetite, mobility, and physical activity. Improvement meant moving from frail to pre-frail or non-frail, or from pre-frail to non-frail.

Look, I find this research hopeful, but I also hope I’m a long way off from having to worry about something like frailty.

But it has me thinking about the things I want to stay proficient at, and whether I’m actually doing them often enough.

Or if maybe I could even turn back time, through sheer effort.

As Danilovich put it, we should be asking “What’s the appropriate challenge for people? And for people with frailty, it’s often a lot more than we think they’re capable of doing.”

I wouldn’t pretend that I’m going to start running marathons again just because I read a study.

Although …

Anyway, if there are things you want to remain able to do, you probably have to make room to keep doing them—and sometimes ask a little more of yourself while you’re at it.

As a wise man once said: “If you rest, you rust.”

This post originally appeared at inc.com.

Monday, October 5, 2026

Stroke Recovery’s Hidden Divide: Frailty Paths Predicted by Mind and Mood

 

Make damn sure your competent? doctor has EXACT PROTOCOLS that prevent frailty/sarcopenia/muscle loss post stroke! Doesn't have them; fire him/her and replace your incompetent board of directors!

Stroke Recovery’s Hidden Divide: Frailty Paths Predicted by Mind and Mood

When an older adult survives a stroke, the visible battle often ends at discharge. But a new longitudinal study from China suggests that the quieter war against frailty is only beginning, and that the trajectory it follows over the following year may be charted within the first days of hospitalization. Researchers tracking more than three hundred stroke survivors aged 60 and older found that frailty does not follow a single path after stroke. Instead, patients split into three distinct courses over twelve months, and the forces steering them toward the worst outcomes were strikingly non-physical: impaired cognition, damaged mood, heavy comorbidity burdens, and thin social support.

The study, conducted at the Department of Neurology of the First Affiliated Hospital of Nanjing Medical University, enrolled 314 consecutive older adults hospitalized for acute stroke between April and December 2024. Baseline assessments were completed within 48 hours of admission, capturing demographic and clinical characteristics, stroke severity measured on the National Institutes of Health Stroke Scale, comorbidity burden, perceived social support, and five domains of what geriatricians call intrinsic capacity. Frailty itself was scored using the Fried Frailty Phenotype, a five-criterion instrument assessing unintentional weight loss, exhaustion, low physical activity, slowness, and grip weakness. Follow-up assessments repeated the frailty measurement at three, six, and twelve months after discharge, and 293 participants—93.3 percent of the cohort—completed the full year of observation.

To make sense of the repeated measurements, the team turned to latent class growth modeling, a statistical technique that searches heterogeneous longitudinal data for hidden subgroups of people whose scores change in similar ways over time. Rather than averaging everyone’s frailty scores into a single trend line, the method asks whether the population actually contains several trend lines. Model selection relied on standard fit criteria, including the sample-size adjusted Bayesian Information Criterion and the adjusted Lo-Mendell-Rubin likelihood ratio test, which together determine how many trajectory classes the data genuinely support. The answer was three, and the differences between them were clinically dramatic.

The largest group, comprising 67.24 percent of participants, followed a low-decreasing trajectory: they began with low frailty scores and improved further over the year, suggesting that for roughly two-thirds of older stroke survivors, recovery of physical resilience is the default course. A second group, 20.48 percent, was moderate-stable, entering the study with intermediate frailty and remaining there through all four assessments. The most concerning group, 12.29 percent of the sample, followed a high-increasing trajectory, starting with high frailty and growing progressively frailer across the twelve months after discharge. One in eight older stroke patients, in other words, does not merely fail to recover—they deteriorate steadily, and the study set out to identify who they are before the deterioration begins.

The answer came from multinomial logistic regression, which compared each trajectory group against the low-decreasing reference while adjusting for demographic and clinical covariates. Two findings stood out for their consistency across both unfavorable trajectories. Cognitive impairment, assessed with the Montreal Cognitive Assessment, roughly doubled the odds of belonging to the moderate-stable group (odds ratio 2.632, 95 percent confidence interval 1.263 to 5.488) and more than quadrupled the odds of landing in the high-increasing group (odds ratio 4.506, 95 percent confidence interval 1.846 to 11.002). Psychological impairment, screened with the 15-item Geriatric Depression Scale, showed a parallel pattern, tripling the odds of moderate-stable membership (odds ratio 3.671) and roughly tripling the odds of high-increasing membership (odds ratio 3.161). The mind, it appears, is not a bystander in physical recovery—it is a load-bearing pillar.

The high-increasing trajectory had its own additional risk architecture. Patients who had experienced moderate or severe strokes, rather than normal or mild ones, were far more likely to deteriorate; conversely, a normal or mild stroke reduced the odds of high-increasing membership by nearly three-quarters (odds ratio 0.271, 95 percent confidence interval 0.095 to 0.773). A high comorbidity burden, quantified with the age-adjusted Charlson Comorbidity Index, nearly quadrupled the odds of the worsening trajectory (odds ratio 3.801, 95 percent confidence interval 1.610 to 8.978). And social connection mattered: low or moderate perceived social support, measured with the Perceived Social Support Scale, more than tripled the odds of belonging to the high-increasing group (odds ratio 3.171, 95 percent confidence interval 1.310 to 7.672). Frailty after stroke, the data imply, is not simply a matter of damaged brain tissue—it is the product of neurological injury layered on chronic disease, eroded cognition, depressed mood, and isolation.

The concept binding these threads together is intrinsic capacity, a framework promoted by the World Health Organization through its Integrated Care for Older People initiative. Intrinsic capacity refers to the composite of all an individual’s physical and mental capacities—locomotion, cognition, psychological state, vitality or nutrition, and sensory function—and the study assessed all five domains at baseline using validated instruments including the Short Physical Performance Battery, the Mini Nutritional Assessment Short-Form, and the Montreal Cognitive Assessment. The WHO’s model treats aging not as a disease to be cured but as a dynamic balance between capacity and environment, and this study provides some of the most granular evidence yet that the framework has predictive teeth in a specific clinical population. Where capacity is compromised—particularly in the cognitive and psychological domains—the trajectory of frailty bends downward.

For geriatric nursing, the implications are concrete. The study’s authors argue that early multidomain assessment, performed within the first 48 hours of admission, can flag patients at risk of unfavorable frailty trajectories before they leave the hospital. A nurse armed with a cognitive screen, a depression scale, a comorbidity index, and a social support questionnaire can identify the roughly one in eight patients destined for progressive frailty and tailor post-discharge monitoring accordingly: closer follow-up intervals, cognitive rehabilitation referrals, psychological support, caregiver engagement, and structured social interventions. The alternative—waiting for frailty to declare itself in the community—may mean intervening a year too late, after slowness, exhaustion, and weight loss have already compounded.

The study’s design carries both strengths and limits worth noting. Its prospective longitudinal structure, near-complete follow-up, and use of a validated phenotype instrument lend credibility to the trajectory findings, and the statistical approach is well suited to the question of heterogeneous recovery. Yet the cohort was drawn from a single tertiary hospital in Nanjing, participants ranged only from 60 to 86 years with a mean age just under 69, and observational associations cannot prove that treating depression or bolstering social support would reroute a patient’s frailty course. Those questions demand intervention trials. Still, the core message is hard to dismiss: recovery from stroke in later life is a year-long process with predictable failure modes, and the earliest warning signs are written not in the legs but in the mind, the mood, and the web of people around the patient.

As populations age and stroke survival improves, the number of older adults living in the aftermath of stroke will only grow, and frailty will remain one of the strongest predictors of disability, institutionalization, and death in this group. What this study adds is a map—a way to see, within days of admission, which road a patient is likely to travel. Turning that map into better outcomes will require health systems to treat cognition, mood, and social connection not as soft extras but as core vital signs of post-stroke recovery, monitored and managed with the same urgency as blood pressure and mobility. The patients most at risk of a fading year are identifiable on day two. The task now is to act on what the data already show.

Subject of Research: Frailty trajectories and intrinsic capacity in older stroke survivors during the first year after hospital discharge

Article Title: Frailty trajectories from hospitalization to 12 months after discharge in older stroke survivors and their associations with intrinsic capacity: implications for geriatric nursing

Article References: Tang, X.-X., Tang, Q.-Y., Liu, L., Li, B.-B., Mei, J., & Yu, L. (2026). Frailty trajectories from hospitalization to 12 months after discharge in older stroke survivors and their associations with intrinsic capacity: implications for geriatric nursing. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08415-5

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08415-5

Thursday, October 1, 2026

A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial

 Did your competent? doctor get you recovered enough to do this fast walking?

NO? So, PURE INCOMPETENCE THEN!

My doctor knew nothing about recovery and did nothing. Which is why my gait is still screwed up; 15 degree leftward angle of left foot, no push-off, no free swinging lower leg, hyperextension of left knee. Can't do fast walking until these are fixed or I'll destroy my left knee.

This will never occur in your hospital, too worried about you falling. 

A high intensity vs. casual speed walking intervention to reverse frailty among older adults: a cluster randomized controlled trial


Margaret Danilovich, Daniel S. Rubin David E. Conroy, Laura Diaz, Ying Cheung, Lauren Balmert Bonner 
Published: September 30, 2026 https://doi.org/10.1371/journal.pone.0357605

Abstract

Interventions to reduce frailty and promote healthy aging are critical to improving quality of life and reducing disability in older adults. Walking is the most common form of exercise among older adults; however, the optimal walking intensity for prefrail and frail adults remains unclear. We conducted a cluster-randomized, assessor- and participant-blinded trial to determine whether high-intensity walking (HIW) improves frailty more than casual-speed walking (CSW). Fourteen retirement communities were randomized to either HIW or CSW using a modified minimal sufficient balance randomization scheme. We recruited 165 prefrail and frail adults aged ≥60 years, of whom 105 were included in the analytic cohort. Participants were able to ambulate at least 10 feet with moderate assistance or less. The HIW group targeted 70% of heart rate maximum (HRmax), while the CSW group walked at self-selected speeds below 60% HRmax. Supervised walking sessions were 45 minutes, three times per week, for 16 weeks. The primary outcome was improvement by at least one frailty category on the SHARE-FI (Survey of Health Among Retired Europeans – Frailty Index). Secondary outcomes included the Timed Up and Go, Short Physical Performance Battery, Berg Balance Scale, and 6-Minute Walk Test (6MWT), measured at baseline and 16 weeks. Participants had a mean (SD) age of 79.2 (8.0) years; 79% were female, and 75% were non-Hispanic White. Improvement in frailty category occurred in 32 of 46 (69.6%) HIW participants versus 26 of 56 (46.4%) CSW participants (OR = 2.91, 95% CI 1.19–7.13, p = 0.02). HIW participants showed greater gains in gait speed (mean difference = 0.08 m/s, 95% CI 0.03–0.13, p = 0.036) and 6MWT distance (mean difference = 48.99 m, 95% CI 21.1–76.9, p = 0.0088). Mean HRmax was 71% in HIW vs. 59% in CSW (p < 0.001). Median completed sessions were similar (HIW = 35; CSW = 36; p = 0.07). This cluster-randomized trial demonstrates that high-intensity walking can reverse frailty more effectively than casual-speed walking due to increased physiologic stimuli during more intensive activity. This study is registered at ClinicalTrials.gov ID NCT03654807 (https://clinicaltrials.gov/study/NCT03709251) Registered 10/12/2018.