Cycling CME

A unique CME learning experience for Physicians, PA-C's, and other Medical Providers who love to bike

Active CME:  Combining Continuing Medical Education (CME) and Bicycle Touring for the Healthcare Provider

Filtering by Tag: aging

Successful Aging - How Does It Happen?

Mark Twain said, “Age is an issue of mind over matter. If you don’t mind, it doesn’t matter”. However, as someone who follows the research on successful aging, there is clear interest in remaining healthy as time goes by. As an example, there were two articles related to aging at the end of 2017, which grabbed my attention.  The first, a study by Morris et al, reviewed diet and cognitive decline.  In a study of almost 1000 people, they found a significant slowing of cognitive decline in those who ate just one serving of green leafy vegetables a day.  The benefit was the equivalent of being 11 years younger in age! The authors felt the consumption of a diet rich in several bioactives and nutrients may help slow the decline in cognition with age. This study supports several other larger studies that have related the consumption of green leafy vegetables and the slowing of cognitive decline.  Even though these studies support my opinion on diet and aging, dietary studies are challenging with possible confounding biases. 

The second article was an editorial on the prevention of dementia by Eric Larsen, M.D.  Dr. Larsen has been directly involved in several committees, including the Lancet Commission, that have looked at the evidence for prevention of late-life dementia.  His conclusion was there is no definite “Magic Bullet” for preventing cognitive decline at the evidence level needed for the US Preventative Task Force.  The lack of evidence is a reflection of the challenge of research regarding aging.  Dementia is a chronic disease that begins decades before symptoms begin.  Trials, to understanding which interventions would be the most helpful, would be decades long with multiple barriers, including cost and ethical dilemmas.

What should we recommend in regards to the question of preventing dementia? The Lancet Commission concluded, the best chance to prevent dementia is a “life course” approach, which is an important focus of our conferences at Cycling CME.  This focus includes the basics of regular physical activity and healthy nutrition.  In addition, preventing or controlling diabetes, not smoking, maintaining a healthy weight, and continuing to engage your mind.

So be active today, eat your greens, and engage your mind.

Cycling CME


Larson, EB. Prevention of Late-Life Dementia: No Magic Bullet. JAMA, 2017.

Morris, MC, et al. Nutrients and Bioactives in Green Leafy Vegetables and Cognitive Decline. JAMA, 2017.


Resistance Training For All Ages!

Resistance Training for All Ages!


Anecdotally while taking care of patients with musculoskeletal problems, it seemed clear to me that strength training or activities that improved your strength, such as one’s occupation or hobbies, were important to overall health.  From the 82 year-old cyclist who continued to go to the gym daily to the 85 year-old who tended a garden that fed many beyond herself, clearly adding resistance training is important to these “successful agers”.  We know that the ability to develop strength, power, and muscular endurance is an essential part of the performance of athletes.  However, over the last two decades, there is more emphasis on the importance of resistance training for health promotion and both treatment and prevention of chronic disease in the general public.  In addition, there is evidence for benefit in improving functional capacity, independence, fall prevention, psychological well-being and overall quality of life. 

The standard teaching is that there is a reduction in muscle strength/size as we age, starting in the third decade.  This change in muscle mass, or sarcopenia, contributes to multiple changes which have an impact on our public health system.  Clearly, sarcopenia contributes to difficulties with activities of daily living and exercise tolerance.  There is also a very important relationship to our muscle mass and the development of osteopenia or osteoporosis.   Sarcopenia reduces the daily level of physical activity and energy expenditure, reducing our metabolic rate, which contributes to weight gain and obesity.  Undoubtedly, the loss of muscle mass has significant impact on our well-being and the aging process.

However, the loss of muscle mass/strength clearly can be attenuated and probably more than we thought even two decades ago.  Multiple studies have illustrated strength and functional gains in older subjects, including into their 80’s.  Interestingly, these improvements have included muscle strength, functional motion, and even muscle hypertrophy.  In addition, strength training helps preserve bone mass, decreases impact on joints, and has a very positive metabolic benefit.

Yes, the aging process is inevitable, but there is strong evidence that we can both markedly attenuate the process of sarcopenia and continue to draw benefit from strength training at any age.  Therefore, we should encourage a component of strength training into the fitness plan of our patients as well as ourselves.  So whether you are in the gym hitting the weights or bands or working in your garden, keep it up.

Cycling CME