Softly Softly: The stats and facts of Long Covid

As part of a short series of articles on Long Covid, we take a look at the latest stats and facts and the results from FHT’s 2021 Long Covid survey

Most people affected by coronavirus (COVID-19) have mild to moderate symptoms and recover relatively quickly. However, some people experience ongoing symptoms that can last for four weeks or longer. These symptoms, often referred to as ‘long COVID’ can be highly variable and wide-ranging and are not limited to people who were seriously ill or hospitalized with coronavirus.

What is long COVID?

Interestingly, there is no universally agreed definition of the term ‘long COVID’.

‘Acute COVID-19’ is a term used by health professionals to typically describe the initial signs and symptoms that last up to four weeks. (‘Acute’ refers to the first signs of infection, rather than the severity of the illness.) If symptoms continue after four weeks, then the following two terms are typically used, both of which may also be referred to by the health authorities, researchers and media as ‘long COVID’:

Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from four weeks up to 12 weeks.

Post-COVID-19 syndrome: signs and symptoms which develop during or after an infection that is consistent with COVID-19, continue for more than 12 weeks and are not explained by another diagnosis. (NICE, RCGP and SIGN, 2020)

Common symptoms of long COVID

The most commonly reported symptoms include:

Respiratory symptoms

• Breathlessness

• Cough

Cardiovascular symptoms (heart and circulation)

• Chest tightness

• Chest pain

• Palpitations

General symptoms

• Fatigue

• Fever

• Pain

Neurological symptoms

• Cognitive impairment (‘brain fog’, loss of concentration, or memory issues)

• Headache

• Sleep disturbance

• Peripheral neuropathy symptoms (pins and needles, and numbness)

• Dizziness

• Delirium (in older people)

• Mobility impairment

• Visual disturbance

Gastrointestinal symptoms

• Abdominal pain

• Nausea

• Diarrhoea

• Weight loss and reduced appetite

Musculoskeletal symptoms

• Joint pain

• Muscle pain

Psychological/psychiatric symptoms

• Symptoms of depression

• Symptoms of anxiety

• Symptoms of post-traumatic stress disorder

Ear, nose and throat symptoms

• Tinnitus (ringing in the ears)

• Earache

• Sore throat

• Dizziness

• Loss of taste, smell or both

Dermatological symptoms

• Skin rashes

• Hair loss

(NICE, RCGP and SIGN, 2020)

According to a recent statistical bulletin published by the Office of National Statistics (ONS, 2021), as of 2 October 2021, an estimated 1.2 million people living in private households in the UK were experiencing self-reported long COVID (symptoms persisting for more than four weeks after the first suspected COVID-19 infection, that were not explained by something else). The bulletin also highlighted that:

  • Fatigue was the most common symptom reported as part of individuals’ experience of long COVID (55% of those with self-reported long COVID), followed by shortness of breath (39%), loss of smell (33%) and difficulty concentrating (30%).
  • More than two-thirds (65%) of those with self-reported long COVID said that their symptoms adversely affected their day-to-day activities, with 19% reporting that their ability to undertake their day-to-day activities had been ‘limited a lot’.
  • As a proportion of the UK population, prevalence of self-reported long COVID remained greatest in people aged 35 to 69 years; females; people living in more deprived areas; those working in health or social care; and those with another activity-limiting health condition or disability. (ONS, 2021),

As therapists, it is important to note that anyone who thinks they may have symptoms of long COVID are strongly advised to speak to their GP, who may suggest different tests to find out more about their symptoms and to rule out other underlying causes. (NHS England and NHS Improvement, 2021; NHS, 2021).

While it is difficult to say how long a person’s long COVID symptoms will last, current evidence suggests that in most cases, symptoms will improve over time (NHS infom, 2021).

Members’ experiences of long COVID

In October 2021, we launched a short survey to gain some insight into our members’ personal and professional experiences of long COVID. For the purposes of the survey, we defined long COVID as ‘signs and symptoms that develop during or following an infection consistent with COVID-19, which continue for more than 12 weeks and are not explained by an alternative diagnosis’ (NHS England and NHS Improvement, 2021; NHS 2021).

We would like to say thank you to the 345 members and other therapists who took part in the survey, the key findings of which are outlined below.

About our survey respondents

Of those who completed or partially completed the survey:

  • 88% identify as female, 10% as male and 2% as non-binary/prefer not to say
  • 89% are self-employed (other statuses included students, employees, volunteers and employers)
  • 83% live in England, 5% in Wales, 5% in Scotland, 5% in Northern Ireland, 2% Republic of Ireland or Overseas.

The majority of those who responded are experienced therapists, with 43% practising for 16 or more years, 20% practising between 11 to 15 years and a further 16% practising between six and 10 years.

Seventeen per cent (60) have personally been affected by long COVID, with the most common self-reported symptom being fatigue/tiredness (affecting 78%), followed by a change in sense of taste or smell (60%), problems with memory and concentration or ‘brain fog’ (52%), headaches (52%), shortness of breath (50%), join pain (48%) and muscular/ soft tissue aches and pains (43%).

FHT members’ experience of clients with long COVID

Based on the survey results, 147 respondents (43%) reported that they have supported clients with long COVID, while 107 (31%) reported that they have not supported clients with long COVID. This leaves 91 respondents (26%) who either chose not to comment or dropped out of the survey by this stage.

Of those respondents who indicated they have supported clients with long COVID and who went on to complete further questions in the survey:

  • 90% reported that their clients had spoken to their doctor about their long COVID symptoms;
  • 38% indicated their clients were receiving conventional care (eg. from their doctor) alongside therapeutic support, 30% indicated their clients were not receiving conventional care alongside therapeutic support, and 32% indicated their clients were a mixture of the two.
  • 49% of respondents said their clients had commented that they’d tried conventional care but felt it didn’t improve their symptoms, 40% of clients commented they had struggled to access support from their GP/ the NHS, 38% felt therapeutic intervention would be more appropriate, and 10% didn’t like to put pressure on the NHS system.

In terms of how respondents supported their clients with symptoms of long COVID, 84% reported doing this ‘in person’, 13% over the phone, 13% via a video communication platform, 8% via email, 8% using distance healing/reiki and 4% via post, for example, sending clients aromasticks or other therapeutic products.

The most commonly used treatments to help support clients manage or improve their long COVID symptoms were reflexology (52%), Swedish or body massage (30%), aromatherapy (28%), reiki (22%), remedial massage (19%), sports massage (17%), healing (24%), Indian head massage (24%), myofascial release (12%) and mindfulness (4%).

Clients’ self-reported symptoms and improvements

Below is a table outlining a) some common symptoms associated with long COVID, as worded in the FHT survey b) what signs and symptoms clients reported they were experiencing and c) which symptoms clients felt their therapy treatments had improved:

A Symptom of long COVIDB Percentage of clients experiencing the symptomC Percentage of clients who felt treatment improved the symptom
Extreme tiredness (fatigue)92%75%
Depression or low mood68%56%
Stress or anxiety68%60%
Muscular/ soft tissue aches & pains66%55%
Difficulty sleeping/ insomnia65%56%
Problems with memory/ concentration (‘brain fog’)63%33%
Shortness of breath56%30%
Joint pain52%39%
Headaches48%36%
Change to sense of smell or taste (anosmia)42%12%
Dizziness36%16%
Chest pain or tightness32%21%
Heart palpitations26%12%
Pins and needles25%15%
Cough22%8%
Tinnitus, earaches20%12%
Feeling sick, diarrhoea, stomach upsets19%10%
Loss of appetite/ weight loss16%5%
Rashes/ dry skin / skin problems11%6%

Adverse or unusual responses to treatment

When asked, ‘Did any of your clients with long COVID experience any contra-actions or unusual responses to your treatments?’, 88% or respondents reported ‘no’ and 12% reported ‘yes’. Where further information was provided, the responses included: the client feeling more tired or symptoms worsening for a day or two after treatment but then much improved after; a change in colour in the urine; feeling slightly sick or faint; the feet jerking or twitching when treated; and heightened emotional release (for example, crying). One respondent commented that, ‘My client had recurrences of purpling on the toe after a couple of treatments (has had probably ten treatments now, weekly). But after discussion with doctors at a hospital appointment for overall long COVID symptoms, they concluded that it was highly unlikely to be related to the massage treatment’.

Adapting treatments for clients with long COVID

In the survey, we asked members if they adapted their treatments when supporting clients with long COVID. Sixty said that they had made adaptations, including:

  • A change of position – treating clients in a seated or supine position rather than prone, to assist their breathing and make them feel generally more comfortable.
  • More gentle treatments, including lighter techniques, reducing pressure, avoiding sensitive areas.
  • Reducing the length of treatments, going at a slower pace and even taking short breaks.
  • Additional pillows and bolsters to support the client and enhance comfort.
  • A number of respondents mentioned using reflexology instead of other treatments, perhaps to avoid physically working/applying pressure to larger areas of the body.
  • More communication than usual was also key – from regularly ‘checking in’ with clients, to spending much longer listening, as clients needed to talk more.
  • Other adaptations including selecting products to use during the treatment or in the treatment area, such as essential oils, to assist breathing and promote relaxation.

Self-care techniques for clients

A total of 115 respondents reported that they had provided their clients with self-care techniques to help them manage or improve their long COVID symptoms. Of these, 17 provided the techniques instead of hands-on treatments, while the other 98 provided techniques to be used alongside (in between) treatments. The most popular self-care techniques shared with clients were:

  • Meditation/ mindfulness/ visualization/ relaxation techniques (51 respondents)
  • Gentle, graded exercises and stretches, including yoga and tai chi practices (43)
  • Breath work/ breathing exercises (40)
  • General guidance and advice around diet and nutrition (31)
  • Essential oil preparations, including aromasticks (28)
  • Working different reflex (reflexology) points (18)
  • Self-massage/ trigger point work (13)
  • Walking/ being outdoors/ fresh air (10)
  • Advice on staying hydrated (10)
  • Asking clients to rest when needed/ to listen to their body (9)
  • Journaling and bench marking progress in writing (5)
  • Therapy-specific self-care techniques, eg. manual lymphatic draining, emotional freedom technique (5)
  • Bach/ flower remedies (4)
  • Salt products, including bath salts and salt pipes (4)

Other self-care techniques provided or suggested included listening to relaxing music, the application of hot and cold products, hypnotherapy techniques and Chinese medicine.

Fifty-two percent of respondents indicated that the self-care techniques helped to improve their clients’ symptoms, 32% indicated these helped some clients but not all, and 16% indicated self-care techniques did not help their clients.

Supporting clients with long COVID

The results of FHT’s survey suggest that certain therapies and self-care techniques may be of benefit to clients experiencing symptoms of long COVID. This is very encouraging, particularly when we consider that many of these symptoms  – including fatigue, stress and anxiety, and muscular aches and pains – can be difficult to treat effectively with conventional medicine (sometimes referred to as ‘effectiveness gaps’). It is also important to bear in mind that, where appropriate, supporting clients with mild to moderate COVID-19 symptoms with complementary and other therapies could also help to take pressure off the NHS, which needs to prioritise clients with acute illnesses. 

However, it is important to note that these survey results do not constitute robust ‘evidence’ and although many long COVID symptoms are typical of what is seen in day-to-day therapy practice, the medical and scientific communities still have much to learn about long COVID, the full impact of the virus on long-term health, and the successful management of long COVID symptoms. This is an ever-evolving situation, with new data and new variants of the virus are regularly coming to the fore.

When it comes to supporting clients with symptoms of long COVID, there are no black and white answers. As with any condition, every client’s experience is unique. Some people may experience severe or debilitating symptoms that impact their daily lives and quality of life, others may have more mild and ‘irritating’ symptoms. Some will see their symptoms wax and wane, overlap and change over time, others will wake up one morning and notice their symptoms have gone. Some may have pre-existing health conditions as well as long COVID symptoms. Others will be receiving ongoing medical care and assessment. And some may think they have long COVID symptoms, when in fact there is another underlying cause (which is why anyone who thinks they have symptoms of long COVID should be encouraged to see their doctor).

What is key is that any therapist looking to support a client with symptoms of long COVID follows the principles of best practice including:

  • First, do no harm. If in doubt, or you simply feel uncomfortable about treating someone, do not treat them.
  • If you have any cause for concern about a client’s symptoms, refer them on to their GP or another healthcare professional.
  • If a client is receiving medical care for their long COVID symptoms, ask them to speak to their GP/ health care provider about having treatment before going ahead.
  • Carry out a full and detailed consultation, before every treatment, to help you determine if there are any red flags or health changes that may make treatment inappropriate. The information they provide you will also help you to adapt your treatments accordingly.
  • If, after a full assessment, you and your client are comfortable to go ahead with a treatment:
    • A common phrase used by many therapists is ‘less is more’. Start very gently and take a graded approach (eg. provide shorter treatments with less pressure or exercises than usual to see how your client responds).
    • Adapt your treatments to suit their current needs at that given point in time and to ensure their comfort.
    • Monitor your clients closely throughout the treatment and contact them in the days immediately after for feedback about how they are feeling. Do not go ahead with any further treatments if they raise anything that concerns you and where necessary, advise them to see their GP.
    • Be prepared to spend a little extra time listening to clients with long COVID and validating their symptoms and concerns.   
    • Keep detailed records about their treatments and treatment outcomes.

Remember you can always offer self-care advice or non-hands-on treatments and support to clients who you are concerned about physically treating or who are particularly sensitive to touch.

by Karen Young

Long Covid Research

We take a look at two pilot studies looking into complementary therapy approaches to support clients with symptoms of long Covid

The Anosmia, Acupressure, Aromastick and Aromapot Project

By project leads, Dr Peter Mackereth, Paula Maycock and Ann Carter

Before COVID 19 emerged, anosmia (the inability to detect odours) was a relatively unknown term outside of medicine; however, olfactory disorders are not new health concerns. Nasal polyps, enlarged turbinates*, as well as degenerative disorders such as multiple sclerosis, Parkinson’s disease and Alzheimer’s can result in difficulties to detect odours. Patients who have had laryngectomies or tracheotomies may also experience hyposmia (decreased ability to detect odours) due to a reduced or absent nasal airflow. Head trauma and local disease, such as cancer (and some cancer treatments), can be linked with long-term disorders of taste and smell.

For several years, our project team has worked in cancer care with patients experiencing symptoms such as anosmia and xerostomia (dry mouth) – often referred to as ‘difficult to treat’ concerns. To help ease these distressing side-effects of treatment, with some success, we have used various therapies such as acupuncture/acupressure, massage, essential oils and reflexology, often in combination.

The challenge is that most of these symptoms require a series of treatment combinations and ongoing advice and self-care. What we do know is that these challenging symptoms can affect quality of life, in particular depressing a cancer patient’s mood and reducing their appetite (Bernhardson et al, 2009).

Long COVID patients can ill afford the detrimental effects of anosmia, which is often experienced alongside fatigue, breathlessness, muscle and joint pain and insomnia. As therapists, we know that interventions that combine touch techniques with aromatherapy can have benefits on wellbeing. From our review of the literature, we have found that even odour-evoked memories can alter mood and be useful for helping with psychological and physical health concerns (Carter et al, 2019). For someone who has altered ability to smell, even using regular recall of an aroma could be potentially of benefit.

Importantly, there are many factors that can increase and decrease nasal resistance. Both smoking and alcohol increase nasal resistance, as does infective rhinitis – all can compromise the ability to detect odours. Research studies have shown that marked sensation of increased airflow was demonstrated when substances such as camphor, eucalyptus, L-menthol, vanilla, or lignocaine were applied to the nasal mucosa (Chaaban & Corey, 2011).

In the last 12 months, our team has embarked on a pilot project with volunteers. The process seeks to evaluate the combination of twice daily aroma trainings, using three separate pots, each with a pad infused with a different single essential oil. Prior to the inhalations from each of the three aromapots, the volunteers are asked to carry out a tapping routine of specific acupressure points which link to olfaction and gustatory function. During the day, our participants supplement this routine with using an aromastick with the same combination of essential oils used in the three pots. Participants are advised to hold the aromastick 2 to 6cms away from the nostrils, then use a gentle breathing technique, which we call ‘3 Breaths to Calm’. This involves breathing in through the nose and then out through the mouth (Carter & Mackereth, 2019). Usually, this activity can be done before a coffee or tea break and before lunch, so approximately three times a day, linked to consumption of food and drink.

Using questionnaires, we are collecting data at the start of an individual’s personal project and after five weeks of adhering to the routine. Our initial pilot work with six participants revealed improvements in anosmia after three to four weeks of using the protocol. We are also intending to gather qualitative data via interviews with volunteers about the experience of living with anosmia and using our aromatherapy and acupuncture protocol. Our purpose in using the protocol is to stimulate the participants’ parasympathetic response to the triggers of selected aromas, combined with gentle acupressure, so promoting olfactory and gustatory function. Currently we have four students, all aromatherapists, from our recent online ‘Therapeutic Uses of Aromasticks and Aromapots’ course assisting with the project.

We hope to present our work in 2022, once the data has been collected from a larger sample.

*Turbinates are several thin bony elongated ridges forming the upper chambers of the nasal cavities – these increase the surface area allowing for rapid warming and humidification of inhaled air.

Dr Peter Mackereth was the clinical lead of the complementary therapy and wellbeing service at The Christie for more than 15 years. He is currently an honorary researcher and lecturer at The Christie and a volunteer therapist at St Ann’s Hospice. Paula Maycock is a senior complementary therapist at The Christie, Manchester. Ann Carter has worked as a complementary therapist and teacher since 1989 in hospices and the acute sector.

Bowen therapy study

By project lead, Jo Wortley

In February 2021, I joined forces with Dianne Bradshaw* to launch a quantitative observational study that would look at whether Bowen therapy might prove a helpful intervention in improving the symptoms and wellbeing of people affected by long COVID.

The initial aim was to recruit 60 to 70 qualified Bowen practitioners, who would provide a series of six weekly Bowen sessions to self-elected clients (participants) who had been experiencing symptoms of long COVID for six months or more and were eligible to take part in the study. Measure Yourself Medical Outcome Profile (MYMOP) questionnaires were to be completed by each participant, with all of the Bowen practitioners taking part receiving online training to help them understand the aims and objectives of the study and how to use the MYMOP questionnaires appropriately, in order for the data to be valid.

As with many complementary therapy interventions, in a ‘real world’ situation, Bowen sessions are adapted to meet the needs and presenting symptoms of the individual client, which may change from one session to the next. For this reason, the Bowen practitioners taking part were not required to follow a ‘standardized’ treatment, however they were asked to only use moves learned during their core Bowen training (modules 1 to 5).

At the time of writing (December 2021), I am pleased to report that 30 practitioners managed to complete a series of six treatments with at least one study participant, producing a total of 26 valid sets of data. While I am yet to fully collate and compare the data, the initial results look very promising, with the majority of participants seeing an improvement in one or both symptoms that they were seeking help with, as identified in their MYMOP questionnaires. When comparing data taken from Weeks 1 and Weeks 7 only:

  • 14 out of 15 participants reported an improvement in their fatigue;
  • 12 out of 14 participants reported an improvement in their mobility (walking, jogging or running);
  • 20 out of 22 participants reported an improvement in their general wellbeing 

While these results look very positive, we do need to understand what happens to people who have no intervention over a 7-week period, to establish whether this is ‘normal’ recovery.

It was also very pleasing to see that the vast majority (22 out of 24) also highly recommended Bowen, rating it between 8 and 10 out of 10.

While it’s involved a lot of time and effort, it’s exciting to be leading the way with this study and once it has been published, I will of course ensure that FHT members are made aware of the key outcomes. Although this study obviously focuses on Bowen therapy, it is important that as a community of professional therapists, we all share as much information and best practice as we can, to ensure the long-term safety of our clients and to also demonstrate the potential role that therapies may have in helping to support clients with long COVID, where appropriate.

* Dianne, an experienced Bowen and McTimoney practitioner who worked on both humans and animals, sadly passed away several months after the study was launched. 

Jo Wortley is a Director and Senior Tutor at the College of Bowen Studies, which offers an FHT accredited practitioner qualification in the Bowen Technique, alongside a range of Bowen masterclasses. thebowentechnique.com

Population health – a new approach for better wellbeing

Health is not just defined by the absence of illness. It’s also about our physical, mental and emotional wellbeing.

Access to traditional health services are of course important, but there are lots of other factors that affect our health and wellbeing. These include access to green spaces, social activities, education and employment opportunities, healthy food, and good housing and transport services. To prevent ill health and improve wellbeing within our local communities, all of these aspects need to be considered, which is sometimes referred to as a ‘population health’ approach.

The King’s Fund has produced a short animation that illustrates what a population health approach looks like. You can also find out more by reading their report, A vision for population health: towards a healthier future or by attending their free ‘virtual’ conference, The big population health conversation. Better still, FHT members who attend The King’s Fund virtual conference and complete a 500 word reflective practice form (downloadable from http://www.fht.org.uk/cpd) can gain 5 CPD points.

Complementary therapy gaining popularity in England

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The article below was first published in International Therapist issue 129 (Summer 2019)

Complementary therapy use in England has grown by 4% between 2005 and 2015, according to a national survey (sharp et al, 2018).

Ipsos MORI asked 4,862 adults in England about their complementary therapy use over the past 12 months, with 766 saying they had seen a practitioner during that time. This means 16% of respondents had treatments in 2015, up from 12% in 2005.

Those interviewed visited practitioners for therapies including massage, acupuncture, yoga, reflexology and mindfulness. They most commonly sought treatments to help with musculoskeletal conditions (68%), particularly back pain (38%). The second most popular reason was support with a mental health condition (12%), including for stress, anxiety or depression (7%) and sleep problems, tiredness or fatigue (4%). Around 11% had therapies to support general wellbeing and prevent ill health.

However, because therapies are predominantly self-funded, access is unequal, with wealthier people far more likely to get the support they need compared with people on a low income. More than two-thirds (67%) of complementary therapy users either pay for their treatments or have them paid for by friends and family, while 17% are referred by their GP and 4% by another health professional. Those who were referred by a GP or healthcare professional usually had treatments funded by the NHS and were more often than not unemployed, with lower socioeconomic status. Almost 40% felt that increased NHS funding and GP referrals and/or endorsement would increase their complementary therapy use.

Those in the south of England were almost twice as likely to have treatments as people living in the Midlands or the north of England. This could again relate to wealth, as the average person living in the south is more likely to have the disposable income to pay for treatments than those further north.

Just over one-fifth of respondents (22%) claimed they would not be willing to pay for a therapy treatment.

Read more about the survey at fht.org.uk/IT-129-research-Sharp

Not yet an FHT member?

Join today and enjoy more articles like this in our online reading room and quarterly membership magazine, International Therapist. As a member, you can access lots of other benefits, too, such as tailor-made insurance policies and a listing on our Accredited Register of complementary therapists, independently approved by the Professional Standards Authority for Health and Social Care (eligibility criteria apply). Click here to learn more about the benefits of being an FHT member

 

Set aside some time for yourself this September

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As a therapist, you may spend countless hours supporting the health and wellbeing of clients, but do you set aside enough time to look after yourself?

We all need to look after our own mental and physical wellbeing to avoid problems like stress, anxiety, burnout and overuse injuries.

Action for Happiness has given us a gentle reminder with its September Self-Care action calendar, with a simple suggested task each day to keep us all on the right track.

The movement publishes monthly calendars, offering daily suggested tasks on the theme of the respective month. ‘Self-Care September’ follows other recent calendars, including ‘Altruistic August’, ‘Jump Back July’, ‘Joyful June’, ‘Meaningful May’ and ‘Active April’.

Suggestions for this month include the following:

  • Talk to yourself like you would to someone you love
  • Stop the glorification of ‘busy’, it’s good to take a break
  • Notice the things you do well today, however small
  • Get active outside and give your mind and body a natural boost
  • Accept your mistakes as a way of helping you make progress

Download the calendar

Complementary therapies are beneficial to people with advanced cancer

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The article below was first published in International Therapist issue 129 (Summer 2019)

Aromatherapy, reflexology and massage can all benefit clients with advanced cancer, according to a review published in Palliative Medicine.

Searching medical databases, a team of researchers found five qualitative studies evaluating the therapeutic needs of people in palliative care with advanced cancer, which provide evidence of the benefits of therapies.

They examined three ‘analytical themes’: the patient experience during the therapy (enhanced wellbeing and escapism), beyond the complementary therapy session (lasting benefits and overall evaluation), and the delivery of complementary therapy in palliative care (value of therapist and delivery of the complementary therapy).

The results showed that people with advanced cancer experienced benefits from aromatherapy, reflexology and massage, including enhanced wellbeing, respite and escapism from their disease.

Access the review abstract at fht.org.uk/IT-129-cancer-therapies

Not yet an FHT member?

Join today and enjoy more articles like this in our online reading room and quarterly membership magazine, International Therapist. As a member, you can access lots of other benefits, too, such as tailor-made insurance policies and a listing on our Accredited Register of complementary therapists, independently approved by the Professional Standards Authority for Health and Social Care (eligibility criteria apply). Click here to learn more about the benefits of being an FHT member

Apathy is the forgotten symptom of dementia

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Apathy is the most common neuropsychiatric symptom of dementia, with a bigger impact on function than memory loss – yet it is under-researched and often forgotten in care.

A new study has found that apathy is present in nearly half of all people with dementia, with researchers finding it is often distinct from depression.

Although common, apathy is often ignored as it is less disruptive in settings such as care homes than symptoms like aggression.

Defined by a loss of interest and emotions, it is extremely distressing for families and it is linked with more severe dementia and worse clinical symptoms.

Now, research led by the University of Exeter and presented at the Alzheimer’s Association International Conference in LA has analysed 4,320 people with Alzheimer’s disease from 20 cohort studies, to look at the prevalence of apathy over time.

At the start of the study, 45% presented with apathy, and 20% had persistent apathy over time. Researchers found that a proportion had apathy without depression, which suggests that the symptom might have its own unique clinical and biological profile when compared to apathy with depression and depression only.

Dr Miguel de Silva Vasconcelos, of the University of Exeter and King’s College London, said: ‘Apathy is an under-researched and often ignored symptom of dementia. It can be overlooked because people with apathy seem less disruptive and less engaging, but it has a huge impact on the quality of life of people living with dementia, and their families. Where people withdraw from activities, it can accelerate cognitive decline and we know that there are higher mortality rates in people with apathy. It’s now time this symptom was recognised and prioritised in research and understanding.’

Professor Clive Ballard, of the University of Exeter Medical School, said: ‘Apathy is the forgotten symptom of dementia, yet it can have devastating consequences. Our research shows just how common apathy is in people with dementia, and we now need to understand it better so we can find effective new treatments. Our WHELD study to improve care home staff training through personalised care and social interaction included an exercise programme that improved apathy, so we know we can make a difference. This is a real opportunity for interventions that could significantly benefit thousands of people with dementia.’

Source

Rye is healthy, thanks to an interplay of microbes

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Eating rye comes with a variety of health benefits. A new study from the University of Eastern Finland now shows that both lactic acid bacteria and gut bacteria contribute to the health benefits of rye. Published in Microbiome, the study used a metabolomics approach to analyse metabolites found in food and the human body.

Rye sourdough used for the baking of rye bread is rich in lactic acid bacteria. In addition to fermenting the dough, these bacteria also modify bioactive compounds found in rye. They produce branched-chain amino acids and amino acid-containing small peptides, which are known to have an impact on insulin metabolism, among other things.

Many of the compounds found in rye are processed by gut bacteria before getting absorbed into the body. The study found that gut microbes and microbes found in sourdough produce compounds that are partially the same. However, gut microbes also produce derivatives of trimethylglycine, also known as betaine, contained in rye. An earlier study by the research group has shown that at least one of these derivatives reduces the need for oxygen in heart muscle cells, which may protect the heart from ischemia or possibly even enhance its performance. The findings can explain some of the health benefits of rye, including better blood sugar levels and a lower risk of cardiovascular diseases.

The study used metabolomics as the primary method to carry out an extensive analysis of metabolites found in food and the human body. The effects of gut microbes were studied in mice and in an in vitro gastrointestinal model, mimicking the function of the human gut. Using these two models, the researchers were able to eliminate naturally occurring differences in the gut microbiome between different individuals, making it easier to detect metabolites actually originating from rye.

Rye can be traced back to what is now known as present-day eastern Turkey, from where it has spread to many cuisines across the world. In Finland, for example, rye has been consumed for thousands of years, and it was recently selected as the country’s national food.

Although the health benefits of rye are long known, the underlying mechanisms are still poorly understood. For instance, the so-called Rye Factor refers to the lower insulin response caused by rye than, for example, wheat bread. Eating rye makes blood sugar levels fall slower, which leads to beneficial effects on the health – for a reason that remains unknown.

A significant factor contributing to the health benefits of rye are its bioactive compounds, or phytochemicals, which serve as antioxidants. In addition, gut microbes seem to play an important role in turning these compounds into a format that can be easily absorbed by the body, making it possible for them to have a greater effect.

“The major role played by gut microbes in human health has become more and more evident over the past decades, and this is why gut microbes should be taken very good care of. It’s a good idea to avoid unnecessary antibiotics and feed gut microbes with optimal food – such as rye,” Researcher Ville Koistinen from the University of Eastern Finland notes.

Source

Action for happiness hopes we have an altruistic August

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Action for Happiness hopes to spread selfless goodwill next month, with its ‘Altruistic August’ action calendar.

The movement publishes monthly calendars, offering daily affirmations on the theme of the respective month. ‘Altruistic August’ follows other recent calendars, including ‘Jump Back July’, ‘Joyful June’, ‘Meaningful May’ and ‘Active April’.

Suggestions for this month include the following:

  • Decide to be kind to others (and yourself) all this month.
  • Offer your seat, give way, or hold the door open for others.
  • Take a friend on a spontaneous adventure.
  • Try to bring a smile to as many people as possible today.
  • Sign up to be an organ donor or give blood.

Download the calendar

College of Medicine announces dates for this year’s food conference

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Food on Prescription 2019 is the latest in a series of food conferences, run by the College of Medicine, that have become a leading UK event on food, lifestyle and medicine for all healthcare professionals, who want to create a healthier future for patients, communities and the nation.

Held on Thursday October 24 at the Royal Society of Medicine, the conference will focus on:

  1. The latest insight on the biome and the relationship of food to our major lifestyle conditions
  2. Supporting healthy eating throughout our communities and nation
  3. Transforming the clinician and patient relationship including the 10 min consultation
  4. Creating a stronger coalition of stakeholders to reverse the current situation whereby those who most need healthy food are the least likely to be able to either access it or want it.

The Conference will include presenters who represent some of the leading experts and leaders in food, lifestyle and medicine as well as senior politicians from the largest political parties.  As in previous years, it is a conference that will ‘walk the talk’ including a healthy lunch and positive interaction with the audience but with a sharp focus on bringing about effective change at every level.

Vist the College of Medicine website for more information and to book tickets