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[ { "from": "human", "value": "What causes Dry Mouth?" }, { "from": "gpt", "value": "Dry mouth can cause several problems, including difficulty tasting, chewing, swallowing, and speaking. Swallowing may be especially difficult for those with too little saliva. For example, people with dry mouth may be unable to swallow dry food at all unless they also drink fluids with food. They also need to take small bites of food and be very aware of chewing and swallowing so they don't choke. Dry mouth may also increase the chance of developing dental decay as well as oral fungal infections such as thrush, which causes painful white patches in the mouth." } ]

[ { "from": "human", "value": "What are the symptoms of Dry Mouth?" }, { "from": "gpt", "value": "Dry mouth can be uncomfortable. Some people notice a sticky, dry feeling in the mouth. Others notice a burning feeling or difficulty while eating. The throat may feel dry, too, and swallowing without extra fluids can often be difficult. Also, people with dry mouth may develop mouth sores, cracked lips, and a dry, rough tongue." } ]

[ { "from": "human", "value": "What causes Dry Mouth?" }, { "from": "gpt", "value": "Yes. More than 400 medicines, including some over-the-counter medications, can cause the salivary glands to make less saliva, or to change the composition of the saliva so that it can't perform the functions it should. As an example, medicines for urinary incontinence, allergies, high blood pressure, and depression often cause dry mouth." } ]

[ { "from": "human", "value": "What are the treatments for Dry Mouth?" }, { "from": "gpt", "value": "Certain cancer treatments can affect the salivary glands. Head and neck radiation therapy can cause the glands to produce little or no saliva. Chemotherapy may cause the salivary glands to produce thicker saliva, which makes the mouth feel dry and sticky." } ]

[ { "from": "human", "value": "What causes Dry Mouth?" }, { "from": "gpt", "value": "Some diseases affect the salivary glands. Sjgren's syndrome and diabetes can cause dry mouth. Injury to the head or neck can damage the nerves that tell salivary glands to make saliva." } ]

[ { "from": "human", "value": "What is (are) Dry Mouth?" }, { "from": "gpt", "value": "Sjgren's Syndrome Clinic National Institute of Dental and Craniofacial Research Building 10, Room 1N113 10 Center Drive MSC 1190 Bethesda, MD 20892-1190 301-435-8528 http://www.nidcr.nih.gov/Research/NIDCRLaboratories/ MolecularPhysiology/SjogrensSyndrome/default.htm" } ]

[ { "from": "human", "value": "What is (are) Dry Mouth?" }, { "from": "gpt", "value": "For information about the clinical trial on this topic, visit: http://www.clinicaltrials.gov/ct/show/NCT00372320?order=1. If you would like to read an interview with Dr. Bruce Baum, the study's principal investigator, click on: http://www.nidcr.nih.gov/Research/ ResearchResults/InterviewsOHR/TIS032007.htm." } ]

[ { "from": "human", "value": "What are the treatments for Dry Mouth?" }, { "from": "gpt", "value": "Dry mouth treatment will depend on what is causing the problem. If you think you have dry mouth, see your dentist or physician. He or she can help to determine what is causing your dry mouth. If your dry mouth is caused by medicine, your physician might change your medicine or adjust the dosage. If your salivary glands are not working right, but can still produce some saliva, your dentist or physician might give you a special medicine that helps the glands work better. He or she might suggest that you use artificial saliva to keep your mouth wet. (Watch the video to learn how dry mouth is treated. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)" } ]

[ { "from": "human", "value": "What is (are) Dry Mouth?" }, { "from": "gpt", "value": "You should avoid sticky and sugary foods. If you do eat them, brush immediately afterwards. Also, be aware that spicy and salty foods can cause pain in a dry mouth. You should also avoid drinks with caffeine and alcohol. They can dry out the mouth." } ]

[ { "from": "human", "value": "What is (are) Dry Mouth?" }, { "from": "gpt", "value": "National Institute of Dental and Craniofacial Research 1 NOHIC Way Bethesda, MD 20892-3500 (301) 402-7364 http://www.nidcr.nih.gov" } ]

[ { "from": "human", "value": "What is (are) Osteoporosis?" }, { "from": "gpt", "value": "A Bone Disease Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but any bone can be affected. You can't \"catch\" osteoporosis or give it to someone else. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. Although osteoporosis can strike at any age, it is most common among older people, especially older women. How Bone Loss Occurs Bone is living tissue. Throughout our lives, the body breaks down old bone and replaces it with new bone. But as people age, more bone is broken down than is replaced. The inside of a bone normally looks like a honeycomb, but when a person has osteoporosis, the spaces inside this honeycomb become larger, reflecting the loss of bone density and strength. (The word \"osteoporosis\" means \"porous bone.\") The outside of long bones -- called the cortex -- also thins, further weakening the bone. Sometime around the age of 30, bone mass stops increasing, and the goal for bone health is to keep as much bone as possible for as long as you can. In most women, the rate of bone loss increases for several years after menopause, then slows down again, but continues. In men, the bone loss occurs more slowly. But by age 65 or 70, most men and women are losing bone at the same rate. Weak Bones Can Lead to Fractures Osteoporosis is often called \"silent\" because bone loss occurs without symptoms. People may not know that they have osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a trip to the hospital, surgery, and possibly a long-term disabling condition. Broken bones in your spine are painful and very slow to heal. People with weak bones in their spine gradually lose height and their posture becomes hunched over. Over time a bent spine can make it hard to walk or even sit up. Broken hips are a very serious problem as we age. They greatly increase the risk of death, especially during the year after they break. People who break a hip might not recover for months or even years. Because they often cannot care for themselves, they are more likely to have to live in a nursing home. Prevention and Treatment The good news is that osteoporosis can often be prevented and treated. Healthy lifestyle choices such as proper diet, exercise, and treatment medications can help prevent further bone loss and reduce the risk of fractures." } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "Risk Factors You Can't Change Some risk factors for osteoporosis cannot be changed. These include - Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis.\n- Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis.\n- Ethnicity. Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with other ethnic groups. African-American and Hispanic women are also at risk, but less so.\n- Family History. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.\n- History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another. Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis. Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis. Ethnicity. Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with other ethnic groups. African-American and Hispanic women are also at risk, but less so. Family History. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too. History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another. Risk Factors You Can Change There are other risk factors for osteoporosis that can be changed. \n-Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D -- either from your diet, supplements, or sunlight -- can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health.\n- Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise.\n- Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies. Learn more about smoking and bone health. Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D -- either from your diet, supplements, or sunlight -- can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health. Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise. Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies. Learn more about smoking and bone health.\n- Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones.\n- Low body weight. Women who are thin -- and small-boned -- are at greater risk for osteoporosis. Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones. Low body weight. Women who are thin -- and small-boned -- are at greater risk for osteoporosis. Use this checklist to find out if you are at risk for weak bones. Many of these risk factors, both ones you can change and ones you cannot change, affect peak bone mass, which is when your bones achieve maximum strength and density. Because high peak bone density can reduce osteoporosis risk later in life, it makes sense to pay more attention to those factors that affect peak bone mass. Learn more about peak bone mass." } ]

[ { "from": "human", "value": "What are the symptoms of Osteoporosis?" }, { "from": "gpt", "value": "Fractures -- A Possible Warning Sign Osteoporosis does not have any symptoms until a fracture occurs. Women and men with osteoporosis most often break bones in the hip, spine, and wrist. But any fracture in an older person could be a warning sign that the bone is weaker than optimal. Some people may be unaware that they have already experienced one or more spine fractures. Height loss of one inch or more may be the first sign that someone has experienced spine fractures due to osteoporosis. Multiple spine fractures can cause a curved spine, stooped posture, back pain, and back fatigue. Women and men who have had a fracture are at high risk of experiencing another one. A fracture over the age of 50 or several fractures before that age may be a warning sign that a person has already developed osteoporosis. People over the age of 50 who have experienced a fracture should talk to their doctor about getting evaluated for osteoporosis. Risk Factors for Fractures The more likely you are to fall, the higher your risk for a fracture. And more severe falls increase your risk for fractures. Factors that increase your risk of falling and of fracturing a bone include - decreased muscle strength\n- poor balance\n-impaired eyesight\n- impaired mental abilities\n- certain medications, such as tranquilizers and muscle relaxants\n- hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks. decreased muscle strength poor balance impaired eyesight impaired mental abilities certain medications, such as tranquilizers and muscle relaxants hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks. The angle at which you fall also affects your risk of fracture. Hip Fractures Although low bone mass (or low bone density) plays an important role in determining a person's risk of osteoporosis, it is only one of many risk factors for fractures. Various aspects of bone geometry, such as tallness, hip structure, and thighbone (femur) length, can also affect your chances of breaking a bone if you fall. Increasing age, too much weight loss, a history of fractures since age 50, having an existing spine fracture, and having a mother who fractured her hip all increase the risk of hip fracture regardless of a person's bone density. People with more risk factors have a higher chance of suffering a hip fracture." } ]

[ { "from": "human", "value": "How to diagnose Osteoporosis?" }, { "from": "gpt", "value": "Who Should Be Tested? The United States Preventive Service Task Force recommends that women aged 65 and older be screened (tested) for osteoporosis, as well as women aged 60 and older who are at increased risk for an osteoporosis-related fracture. However, the decision of whether or not to have a bone density test is best made between a patient and his or her physician. Medicare will usually cover the cost of a bone density test, and a follow up test every 2 years, for female beneficiaries. It also will cover screening and follow up of any male Medicare recipients who have significant risk factors for osteoporosis. When To Talk With a Doctor Consider talking to your doctor about being evaluated for osteoporosis if - you are a man or woman over age 50 or a postmenopausal woman and you break a bone\n- you are a woman age 65 or older\n- you are a woman younger than 65 and at high risk for fractures\n- you have lost height, developed a stooped or hunched posture, or experienced sudden back pain with no apparent cause\n- you have been taking glucocorticoid medications such as prednisone, cortisone, or dexamethasone for 2 months or longer or are taking other medications known to cause bone loss\n- you have a chronic illness or are taking a medication that is known to cause bone loss\n- you have anorexia nervosa or a history of this eating disorder.\n- you are a premenopausal woman, not pregnant, and your menstrual periods have stopped, are irregular, or never started when you reached puberty. you are a man or woman over age 50 or a postmenopausal woman and you break a bone you are a woman age 65 or older you are a woman younger than 65 and at high risk for fractures you have lost height, developed a stooped or hunched posture, or experienced sudden back pain with no apparent cause you have been taking glucocorticoid medications such as prednisone, cortisone, or dexamethasone for 2 months or longer or are taking other medications known to cause bone loss you have a chronic illness or are taking a medication that is known to cause bone loss you have anorexia nervosa or a history of this eating disorder. you are a premenopausal woman, not pregnant, and your menstrual periods have stopped, are irregular, or never started when you reached puberty. Diagnosing Osteoporosis Diagnosing osteoporosis involves several steps, starting with a physical exam and a careful medical history, blood and urine tests, and possibly a bone mineral density assessment. When recording information about your medical history, your doctor will ask questions to find out whether you have risk factors for osteoporosis and fractures. The doctor may ask about \n-any fractures you have had\n-your lifestyle (including diet, exercise habits, and whether you smoke)\n- current or past health problems\n- medications that could contribute to low bone mass and increased fracture risk\n- your family history of osteoporosis and other diseases\n- for women, your menstrual history. any fractures you have had your lifestyle (including diet, exercise habits, and whether you smoke) current or past health problems medications that could contribute to low bone mass and increased fracture risk your family history of osteoporosis and other diseases for women, your menstrual history. The doctor will also do a physical exam that should include checking for loss of height and changes in posture and may include checking your balance and gait (the way you walk). Bone Density Tests The test used to diagnose osteoporosis is called a bone density test. This test is a measure of how strong -- or dense -- your bones are and can help your doctor predict your risk for having a fracture. Bone density tests are painless, safe, and require no preparation on your part. Bone density tests compare your bone density to the bones of an average healthy young adult. The test result, known as a T-score, tells you how strong your bones are, whether you have osteoporosis or osteopenia (low bone mass that is not low enough to be diagnosed as osteoporosis), and your risk for having a fracture. Some bone density tests measure the strength of the hip, spine, and/or wrist, which are the bones that break most often in people with osteoporosis. Other tests measure bone in the heel or hand. Although no bone density test is 100 percent accurate, it is the single most important diagnostic test to predict whether a person will have a fracture in the future. The most widely recognized bone density test is a central DXA (dual-energy x-ray absorptiometry) scan of the hip and spine. This test shows if you have normal bone density, low bone mass, or osteoporosis. It is also used to monitor bone density changes as a person ages or in response to treatment." } ]

[ { "from": "human", "value": "What are the treatments for Osteoporosis?" }, { "from": "gpt", "value": "Who Treats Osteoporosis? Although there is no cure for osteoporosis, it can be treated. If your doctor does not specialize in osteoporosis, he or she can refer you to a specialist. There is not one type of doctor who cares for people with osteoporosis. Many family doctors have been learning about osteoporosis and can treat people who have it. Endocrinologists, rheumatologists, geriatricians, and internists are just a few of the specialists who can provide care to people with osteoporosis. Here is how to find an appropriate health care professional to treat osteoporosis. The Goal of Treatment The goal of treatment is to prevent fractures. A balanced diet rich in calcium, adequate vitamin D, a regular exercise program, and fall prevention are all important for maintaining bone health. Medications Several medications are approved by the Food and Drug Administration for the treatment of osteoporosis. Since all medications have side effects, it is important to talk to your doctor about which medication is right for you. Bisphosphonates. Several bisphosphonates are approved for the prevention or treatment of osteoporosis. These medications reduce the activity of cells that cause bone loss. - Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly. Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly. - A few people have muscle, bone, or joint pain while using these medicines. A few people have muscle, bone, or joint pain while using these medicines. \n-Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, deterioration of the jawbone or an unusual type of broken bone in the femur (thigh bone) has occurred in people taking bisphosphonates. Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, deterioration of the jawbone or an unusual type of broken bone in the femur (thigh bone) has occurred in people taking bisphosphonates. - The Food and Drug Administration recommends that health care professionals consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than 5 years. The Food and Drug Administration recommends that health care professionals consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than 5 years. Parathyroid hormone. A form of human parathyroid hormone (PTH) is approved for postmenopausal women and men with osteoporosis who are at high risk for having a fracture. Use of the drug for more than 2 years is not recommended. RANK ligand (RANKL) inhibitor. A RANK ligand (RANKL) inhibitor is approved for postmenopausal women with osteoporosis who are at high risk for fracture Estrogen agonists/antagonists. An estrogen agonist/ antagonist (also called a selective estrogen receptor modulator or SERM) is approved for the prevention and treatment of osteoporosis in postmenopausal women. SERMs are not estrogens, but they have estrogen-like effects on some tissues and estrogen-blocking effects on other tissues. Calcitonin. Calcitonin is approved for the treatment of osteoporosis in women who are at least 5 years beyond menopause. Calcitonin is a hormone involved in calcium regulation and bone metabolism. Estrogen and Hormone Therapy. Estrogen is approved for the treatment of menopausal symptoms and osteoporosis in women after menopause. - Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first. Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Osteoporosis?" }, { "from": "gpt", "value": "Scientists are pursuing a wide range of basic and clinical studies on osteoporosis. Significant advances in preventing and treating osteoporosis continue to be made. Such advances are the direct result of research focused on \n-determining the causes and consequences of bone loss at the cellular and tissue levels\n- assessing risk factors\n- developing new strategies to maintain and even enhance bone density and reduce fracture risk\n- exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. determining the causes and consequences of bone loss at the cellular and tissue levels assessing risk factors developing new strategies to maintain and even enhance bone density and reduce fracture risk exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass. Get more information about ongoing research on osteoporosis from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) at NIH." } ]

[ { "from": "human", "value": "What is (are) Osteoporosis?" }, { "from": "gpt", "value": "Osteoporosis is a disease that thins and weakens the bones to the point that they break easily. Women and men with osteoporosis most often break bones in the hip, spine, and wrist, but osteoporosis can be the cause of bone fractures anywhere." } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "Some risk factors for osteoporosis cannot be changed. These include - Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis.\n- Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis.\n- Ethnicity. Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with other ethnic groups. African-American and Hispanic women are also at risk, but less so.\n- Family History. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.\n- History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another. Gender. Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis. Age. Because bones become thinner with age, the older you are, the greater your risk of osteoporosis. Ethnicity. Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with other ethnic groups. African-American and Hispanic women are also at risk, but less so. Family History. Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too. History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another." } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "Here are risk factors for osteoporosis that you can control. \n-Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D -- either from your diet, supplements, or sunlight -- can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health.\n- Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise.\n- Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies. Learn more about smoking and bone health.\n- Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones.\n- Low body weight. Women who are thin -- and small-boned -- are at greater risk for osteoporosis. Poor diet. Getting too little calcium over your lifetime can increase your risk for osteoporosis. Not getting enough vitamin D -- either from your diet, supplements, or sunlight -- can also increase your risk for osteoporosis. Vitamin D is important because it helps the body absorb calcium. An overall diet adequate in protein and other vitamins and minerals is also essential for bone health. Physical inactivity. Not exercising and being inactive or staying in bed for long periods can increase your risk of developing osteoporosis. Like muscles, bones become stronger with exercise. Smoking. Cigarette smokers may absorb less calcium from their diets. In addition, women who smoke have lower levels of estrogen in their bodies. Learn more about smoking and bone health. Medications. Some commonly used medicines can cause loss of bone mass. These include a type of steroid called glucocorticoids, which are used to control diseases such as arthritis and asthma; some antiseizure drugs; some medicines that treat endometriosis; and some cancer drugs. Using too much thyroid hormone for an underactive thyroid can also be a problem. Talk to your doctor about the medications you are taking and what you can do to protect your bones. Low body weight. Women who are thin -- and small-boned -- are at greater risk for osteoporosis." } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "If you have any of these red flags, you could be at high risk for weak bones. Talk to your doctor, nurse, pharmacist, or other health care professional. Do any of these apply to you? -Im older than 65.\n-Ive broken a bone after age 50.\n-My close relative has osteoporosis or has broken a bone.\n-My health is fair or poor.\n-I smoke.\n-I am underweight for my height.\n-I started menopause before age 45.\n-Ive never gotten enough calcium.\n-I have more than two drinks of alcohol several times a week.\n-I have poor vision, even with glasses.\n-I sometimes fall.\n-Im not active.\n-I have one of these medical conditions:- Hyperthyroidism- Chronic lung disease- Cancer- Inflammatory bowel disease- Chronic hepatic or renal disease- Hyperparathyroidism- Vitamin D deficiency- Cushings disease- Multiple sclerosis- Rheumatoid arthritis____ Im older than 65.Ive broken a bone after age 50.My close relative has osteoporosis or has broken a bone.My health is fair or poor.I smoke.I am underweight for my height.I started menopause before age 45.Ive never gotten enough calcium.I have more than two drinks of alcohol several times a week.I have poor vision, even with glasses.I sometimes fall.Im not active.I have one of these medical conditions:- Hyperthyroidism\n- Chronic lung disease\n- Cancer\n- Inflammatory bowel disease\n- Chronic hepatic or renal disease\n- Hyperparathyroidism\n- Vitamin D deficiency\n- Cushings disease\n- Multiple sclerosis\n- Rheumatoid arthritis- Hyperthyroidism\n- Chronic lung disease\n- Cancer\n- Inflammatory bowel disease\n- Chronic hepatic or renal disease\n- Hyperparathyroidism\n- Vitamin D deficiency\n- Cushings disease\n- Multiple sclerosis\n- Rheumatoid arthritis Hyperthyroidism Chronic lung disease Cancer Inflammatory bowel disease Chronic hepatic or renal disease Hyperparathyroidism Vitamin D deficiency Cushings disease Multiple sclerosis Rheumatoid arthritis -I take one of these medicines:- Oral glucocorticoids (steroids)- Cancer treatments (radiation, chemotherapy)- Thyroid medicine- Antiepileptic medications- Gonadal hormone suppression- Immunosuppressive agents____ I take one of these medicines:- Oral glucocorticoids (steroids)- Cancer treatments (radiation, chemotherapy)\n- Thyroid medicine\n- Antiepileptic medications\n- Gonadal hormone suppression\n- Immunosuppressive agents\n- Oral glucocorticoids (steroids)\n- Cancer treatments (radiation, chemotherapy)\n- Thyroid medicine\n- Antiepileptic medications\n- Gonadal hormone suppression\n- Immunosuppressive agents Oral glucocorticoids (steroids) Cancer treatments (radiation, chemotherapy) Thyroid medicine Antiepileptic medications Gonadal hormone suppression Immunosuppressive agents" } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "Women have smaller bones, and they lose bone more rapidly than men because of hormone changes that occur after menopause. Therefore, women are at higher risk for osteoporosis." } ]

[ { "from": "human", "value": "How to prevent Osteoporosis?" }, { "from": "gpt", "value": "Preventing falls is a special concern for men and women with osteoporosis. Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton. In addition to the environmental factors listed below, falls can also be caused by impaired vision or balance, chronic diseases that affect mental or physical functioning, and certain medications, such as sedatives and antidepressants. It is also important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait, and that they discuss these changes with their health care provider. Here are some tips to help eliminate the environmental factors that lead to falls. Outdoors: - Use a cane or walker for added stability.\n- Wear rubber-soled shoes for traction.\n- Walk on grass when sidewalks are slippery.\n- In winter, carry salt or kitty litter to sprinkle on slippery sidewalks.\n- Be careful on highly polished floors that become slick and dangerous when wet.\n- Use plastic or carpet runners when possible. Use a cane or walker for added stability. Wear rubber-soled shoes for traction. Walk on grass when sidewalks are slippery. In winter, carry salt or kitty litter to sprinkle on slippery sidewalks. Be careful on highly polished floors that become slick and dangerous when wet. Use plastic or carpet runners when possible. Indoors: \n-Keep rooms free of clutter, especially on floors.\n- Keep floor surfaces smooth but not slippery.\n- Wear supportive, low-heeled shoes even at home.\n- Avoid walking in socks, stockings, or slippers.\n- Be sure carpets and area rugs have skid-proof backing or are tacked to the floor.\n- Be sure stairwells are well lit and that stairs have handrails on both sides.\n- Install grab bars on bathroom walls near tub, shower, and toilet.\n- Use a rubber bath mat in shower or tub.\n- Keep a flashlight with fresh batteries beside your bed.\n- If using a step stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps.\n- Add ceiling fixtures to rooms lit by lamps.\n- Consider purchasing a cordless phone so that you dont have to rush to answer the phone when it rings, or so that you can call for help if you do fall. Keep rooms free of clutter, especially on floors. Keep floor surfaces smooth but not slippery. Wear supportive, low-heeled shoes even at home. Avoid walking in socks, stockings, or slippers. Be sure carpets and area rugs have skid-proof backing or are tacked to the floor. Be sure stairwells are well lit and that stairs have handrails on both sides. Install grab bars on bathroom walls near tub, shower, and toilet. Use a rubber bath mat in shower or tub. Keep a flashlight with fresh batteries beside your bed. If using a step stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps. Add ceiling fixtures to rooms lit by lamps. Consider purchasing a cordless phone so that you dont have to rush to answer the phone when it rings, or so that you can call for help if you do fall. Learn more about devices that can help prevent falls in older adults." } ]

[ { "from": "human", "value": "Who is at risk for Osteoporosis??" }, { "from": "gpt", "value": "The more likely you are to fall, the higher your risk for a fracture. And more severe falls increase your risk for fractures. Factors that increase your risk of falling and of fracturing a bone include - decreased muscle strength\n- poor balance\n-impaired eyesight\n- impaired mental abilities\n- certain medications, such as tranquilizers and muscle relaxants\n- hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks. decreased muscle strength poor balance impaired eyesight impaired mental abilities certain medications, such as tranquilizers and muscle relaxants hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks." } ]

[ { "from": "human", "value": "What is (are) Osteoporosis?" }, { "from": "gpt", "value": "If you have osteoporosis, ask your doctor which activities are safe for you. If you have low bone mass, experts recommend that you protect your spine by avoiding exercises or activities that flex, bend, or twist it. Furthermore, you should avoid high-impact exercise to lower the risk of breaking a bone. You also might want to consult with an exercise specialist to learn the proper progression of activity, how to stretch and strengthen muscles safely, and how to correct poor posture habits. An exercise specialist should have a degree in exercise physiology, physical education, physical therapy, or a similar specialty. Be sure to ask if he or she is familiar with the special needs of people with osteoporosis. If you have health problemssuch as heart trouble, high blood pressure, diabetes, or obesityor if you aren't used to energetic activity, check with your doctor before you begin a regular exercise program." } ]

[ { "from": "human", "value": "What are the symptoms of Osteoporosis?" }, { "from": "gpt", "value": "Osteoporosis does not have any symptoms until a fracture occurs. Some people may be unaware that they have already experienced one or more spine fractures. Height loss of one inch or more may be the first sign that someone has experienced spinal fractures due to osteoporosis. People who have experienced a fracture are at high risk of having another one. A fracture over the age of 50 or several fractures before that age may be a warning sign that a person has already developed osteoporosis. Any fracture in an older person should be followed up for suspicion of osteoporosis." } ]

[ { "from": "human", "value": "What is (are) Osteoporosis?" }, { "from": "gpt", "value": "Consider talking to your doctor about being evaluated for osteoporosis if - you are a man or woman over age 50 or a postmenopausal woman and you break a bone\n- you are a woman age 65 or older\n- you are a woman younger than 65 and at high risk for fractures\n- you have lost height, developed a stooped or hunched posture, or experienced sudden back pain with no apparent cause\n- you have been taking glucocorticoid medications such as prednisone, cortisone, or dexamethasone for 2 months or longer or are taking other medications known to cause bone loss\n- you have a chronic illness or are taking a medication that is known to cause bone loss\n- you have anorexia nervosa or a history of this eating disorder.\n- you are a premenopausal woman, not pregnant, and your menstrual periods have stopped, are irregular, or never started when you reached puberty. you are a man or woman over age 50 or a postmenopausal woman and you break a bone you are a woman age 65 or older you are a woman younger than 65 and at high risk for fractures you have lost height, developed a stooped or hunched posture, or experienced sudden back pain with no apparent cause you have been taking glucocorticoid medications such as prednisone, cortisone, or dexamethasone for 2 months or longer or are taking other medications known to cause bone loss you have a chronic illness or are taking a medication that is known to cause bone loss you have anorexia nervosa or a history of this eating disorder. you are a premenopausal woman, not pregnant, and your menstrual periods have stopped, are irregular, or never started when you reached puberty. Here is how to find an appropriate health care professional to treat osteoporosis." } ]

[ { "from": "human", "value": "How to diagnose Osteoporosis?" }, { "from": "gpt", "value": "Diagnosing osteoporosis involves several steps, starting with a physical exam and a careful medical history, blood and urine tests, and possibly a bone mineral density assessment. When recording information about your medical history, your doctor will ask questions to find out whether you have risk factors for osteoporosis and fractures. The doctor may ask about \n-any fractures you have had\n-your lifestyle (including diet, exercise habits, and whether you smoke)\n- current or past health problems\n- medications that could contribute to low bone mass and increased fracture risk\n- your family history of osteoporosis and other diseases\n- for women, your menstrual history. any fractures you have had your lifestyle (including diet, exercise habits, and whether you smoke) current or past health problems medications that could contribute to low bone mass and increased fracture risk your family history of osteoporosis and other diseases for women, your menstrual history." } ]

[ { "from": "human", "value": "What are the treatments for Osteoporosis?" }, { "from": "gpt", "value": "A comprehensive osteoporosis treatment program includes a focus on proper nutrition, exercise, and safety issues to prevent falls that may result in fractures. In addition, your doctor may prescribe a medication to slow or stop bone loss, increase bone density, and reduce fracture risk. Nutrition. The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. All of these nutrients are needed in balanced proportion. In particular, calcium and vitamin D are needed for strong bones and for your heart, muscles, and nerves to function properly. Exercise. Exercise is an important component of an osteoporosis prevention and treatment program. Exercise not only improves your bone health, but it increases muscle strength, coordination, and balance, and leads to better overall health. Although exercise is good for someone with osteoporosis, it should not put any sudden or excessive strain on your bones. As extra insurance against fractures, your doctor can recommend specific exercises to strengthen and support your back. Therapeutic medications. Several medications are available for the prevention and/or treatment of osteoporosis, including: bisphosphonates; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMS); calcitonin; parathyroid hormone; estrogen therapy; hormone therapy; and a recently approved RANK ligand (RANKL) inhibitor. (Watch the video to learn how exercise helped a 70-year-old woman with osteoporosis. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)" } ]

[ { "from": "human", "value": "What are the treatments for Osteoporosis?" }, { "from": "gpt", "value": "Several medications are approved by the Food and Drug Administration for the treatment of osteoporosis. Since all medications have side effects, it is important to talk to your doctor about which medication is right for you. Bisphosphonates. Several bisphosphonates are approved for the prevention or treatment of osteoporosis. These medications reduce the activity of cells that cause bone loss. - Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly. Side effects of taking oral bisphosphonates may include nausea, heartburn, and stomach pain, including serious digestive problems if they are not taken properly. - A few people have muscle, bone, or joint pain while using these medicines. A few people have muscle, bone, or joint pain while using these medicines. \n-Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, deterioration of the jawbone or an unusual type of broken bone in the femur (thigh bone) has occurred in people taking bisphosphonates. Side effects of intravenous bisphosphonates may include flu-like symptoms such as fever, pain in muscles or joints, and headaches. These symptoms usually stop after a few days. In rare cases, deterioration of the jawbone or an unusual type of broken bone in the femur (thigh bone) has occurred in people taking bisphosphonates. - The Food and Drug Administration recommends that health care professionals consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than 5 years. The Food and Drug Administration recommends that health care professionals consider periodic reevaluation of the need for continued bisphosphonate therapy, particularly for patients who have been on bisphosphonates for longer than 5 years. Parathyroid hormone. A form of human parathyroid hormone (PTH) is approved for postmenopausal women and men with osteoporosis who are at high risk for having a fracture. Use of the drug for more than 2 years is not recommended. RANK ligand (RANKL) inhibitor. A RANK ligand (RANKL) inhibitor is approved for postmenopausal women with osteoporosis who are at high risk for fracture Estrogen agonists/antagonists. An estrogen agonist/ antagonist (also called a selective estrogen receptor modulator or SERM) is approved for the prevention and treatment of osteoporosis in postmenopausal women. SERMs are not estrogens, but they have estrogen-like effects on some tissues and estrogen-blocking effects on other tissues. Calcitonin. Calcitonin is approved for the treatment of osteoporosis in women who are at least 5 years beyond menopause. Calcitonin is a hormone involved in calcium regulation and bone metabolism. Estrogen and hormone therapy. Estrogen is approved for the treatment of menopausal symptoms and osteoporosis in women after menopause. - Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first. Because of recent evidence that breast cancer, strokes, blood clots, and heart attacks may be increased in some women who take estrogen, the Food and Drug Administration recommends that women take the lowest effective dose for the shortest period possible. Estrogen should only be considered for women at significant risk for osteoporosis, and nonestrogen medications should be carefully considered first." } ]

[ { "from": "human", "value": "What is (are) Osteoporosis?" }, { "from": "gpt", "value": "Millions of Americans are able to lead healthy, productive lives while living with osteoporosis. If you have been feeling symptoms of depressionsuch as loss of appetite, hopelessness, feeling useless and helpless, or having thoughts of suicidefor more than 2 weeks, consult a doctor, social worker, or therapist. Medications and counseling are available to fight depression. Learn more about the emotional impact of osteoporosis. Learn more about older adults and depression. " } ]

[ { "from": "human", "value": "What is (are) Kidney Disease?" }, { "from": "gpt", "value": "What the Kidneys Do You have two kidneys. They are bean-shaped and about the size of a fist. They are located in the middle of your back, on the left and right of your spine, just below your rib cage. The kidneys filter your blood, removing wastes and extra water to make urine. They also help control blood pressure and make hormones that your body needs to stay healthy. When the kidneys are damaged, wastes can build up in the body. Kidney Function and Aging Kidney function may be reduced with aging. As the kidneys age, the number of filtering units in the kidney may decrease, the overall amount of kidney tissue may decrease, and the blood vessels that supply the kidney may harden, causing the kidneys to filter blood more slowly. If your kidneys begin to filter less well as you age, you may be more likely to have complications from certain medicines. There may be an unsafe buildup of medicines that are removed from your blood by your kidneys. Also, your kidneys may be more sensitive to certain medicines. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) and some antibiotics may harm your kidneys in some situations. The next time you pick up a prescription or buy an over-the-counter medicine or supplement, ask your pharmacist how the product may affect your kidneys and interact with your other medicines. Learn more about how the kidneys work. How Kidney Disease Occurs Kidney disease means the kidneys are damaged and can no longer remove wastes and extra water from the blood as they should. Kidney disease is most often caused by diabetes or high blood pressure. According to the Centers for Disease Control and Prevention, more than 20 million Americans may have kidney disease. Many more are at risk. The main risk factors for developing kidney disease are - diabetes\n- high blood pressure\n- cardiovascular (heart and blood vessel) disease\n- a family history of kidney failure. diabetes high blood pressure cardiovascular (heart and blood vessel) disease a family history of kidney failure. Each kidney contains about one million tiny filtering units made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. This is called chronic kidney disease. As more and more filtering units are damaged, the kidneys eventually are unable to maintain health. Early kidney disease usually has no symptoms, which means you will not feel different. Blood and urine tests are the only way to check for kidney damage or measure kidney function. If you have diabetes, high blood pressure, heart disease, or a family history of kidney failure, you should be tested for kidney disease. Kidney Failure Kidney disease can get worse over time, and may lead to kidney failure. Kidney failure means very advanced kidney damage with less than 15% normal function. End-stage renal disease (ESRD) is kidney failure treated by dialysis or kidney transplant. If the kidneys fail, treatment options such as dialysis or a kidney transplant can help replace kidney function. Some patients choose not to treat kidney failure with dialysis or a transplant. If your kidneys fail, talk with your health care provider about choosing a treatment that is right for you. " } ]

[ { "from": "human", "value": "How to prevent Kidney Disease?" }, { "from": "gpt", "value": "Risk Factors Diabetes and high blood pressure are the two leading causes of kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease -- without you feeling it. Other risk factors for kidney disease include: - cardiovascular (heart) disease\n- family history -- if you have a mother, father, sister, or brother who has had kidney failure, then you are at increased risk. cardiovascular (heart) disease family history -- if you have a mother, father, sister, or brother who has had kidney failure, then you are at increased risk. Additionally, African Americans, Hispanics, and Native Americans are at high risk for developing kidney failure. This is in part due to high rates of diabetes and high blood pressure in these communities. If you have ANY of these risk factors, talk to your health care provider about getting tested for kidney disease. If you have kidney disease, you may not feel any different. It is very important to get tested if you are at risk. Prevention If you are at risk for kidney disease, the most important steps you can take to keep your kidneys healthy are to - get your blood and urine checked for kidney disease.\n- manage your diabetes, high blood pressure, and heart disease. get your blood and urine checked for kidney disease. manage your diabetes, high blood pressure, and heart disease. Manage your diabetes and high blood pressure, and keep your kidneys healthy by \n-eating healthy foods: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat dairy foods\n- cutting back on salt\n- limiting your alcohol intake\n- being more physically active\n- losing weight if you are overweight\n- taking your medicines the way your provider tells you to\n- keeping your cholesterol levels in the target range\n- taking steps to quit, if you smoke\n- seeing your doctor regularly. eating healthy foods: fresh fruits, fresh or frozen vegetables, whole grains, and low-fat dairy foods cutting back on salt limiting your alcohol intake being more physically active losing weight if you are overweight taking your medicines the way your provider tells you to keeping your cholesterol levels in the target range taking steps to quit, if you smoke seeing your doctor regularly. By following these steps and keeping risk factors under control -- especially your blood pressure -- you may be able to delay or even prevent kidney failure. Talk to your health care provider to find out the steps that are right for you. Learn about preventing high blood pressure. Learn about preventing type 2 diabetes." } ]

[ { "from": "human", "value": "What are the symptoms of Kidney Disease?" }, { "from": "gpt", "value": "Kidney Disease Kidney disease is often called a \"silent\" disease, because most people have no symptoms with early kidney disease. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms! If you are at risk for kidney disease, talk to your health care provider about getting tested. (Watch the video to learn more about the symptoms of kidney disease. To enlarge the videos on this page, click the brackets in the lower right-hand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Symptoms of Kidney Failure Kidney failure means that damaged kidneys are filtering less than 15% of the amount of blood filtered by healthy kidneys. If kidney disease progresses to kidney failure, a number of symptoms may occur. Some people experience fatigue, some lose their appetite, and some have leg cramps. These problems are caused by waste products that build up in the blood, a condition known as uremia. Healthy kidneys remove waste products from the blood. When the kidneys stop working, uremia occurs. The kidneys also make hormones and balance the minerals in the blood. When the kidneys stop working, most people develop conditions that affect the blood, bones, nerves, and skin. These problems may include itching, sleep problems, restless legs, weak bones, joint problems, and depression. How Kidney Disease Is Diagnosed Blood and urine tests are the only way to check for kidney damage or measure kidney function. It is important for you to get checked for kidney disease if you have the key risk factors, which are - diabetes\n- high blood pressure\n- heart disease\n- a family history of kidney failure. diabetes high blood pressure heart disease a family history of kidney failure. If you are at risk, ask about your kidneys at your next medical appointment. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. If you have diabetes, high blood pressure, heart disease, or a family history of kidney failure, you should get a blood and urine test to check your kidneys. Talk to your provider about how often you should be tested. (Watch the video to learn more about tests for kidney disease.) Blood Test The blood test checks your GFR. GFR stands for glomerular (glow-MAIR-you-lure) filtration rate. GFR is a measure of how much blood your kidneys filter each minute. This shows how well your kidneys are working. GFR is reported as a number. \n-A GFR of 60 or higher is in the normal range.\n- A GFR below 60 may mean you have kidney disease. However, because GFR decreases as people age, other information may be needed to determine if you actually have kidney disease.\n- A GFR of 15 or lower may mean kidney failure. A GFR of 60 or higher is in the normal range. A GFR below 60 may mean you have kidney disease. However, because GFR decreases as people age, other information may be needed to determine if you actually have kidney disease. A GFR of 15 or lower may mean kidney failure. You can't raise your GFR, but you can try to keep it from going lower. Ask your healthcare provider what you can do to keep your kidneys healthy. Learn more about the GFR test. Urine Test The urine test looks for albumin (al-BYOO-min), a type of protein, in your urine. A healthy kidney does not let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. This test has several different names. You could be told that you are being screened for \"proteinuria\" or \"albuminuria\" or \"microalbuminuria.\" Or you could be told that your \"urine albumin-to-creatinine ratio\" (UACR) is being measured. If you have albumin or protein in your urine, it could mean you have kidney disease. \n-A urine albumin result below 30 is normal.\n- A urine albumin result above 30 is not normal and may mean kidney disease. A urine albumin result below 30 is normal. A urine albumin result above 30 is not normal and may mean kidney disease. Learn more about the urine albumin test. Your healthcare provider might do additional tests to be sure." } ]

[ { "from": "human", "value": "What are the treatments for Kidney Disease?" }, { "from": "gpt", "value": "Different Treatments for Different Stages There are several types of treatments related to kidney disease. Some are used in earlier stages of kidney disease to protect your kidneys. These medications and lifestyle changes help you maintain kidney function and delay kidney failure. Other treatments, such as dialysis and transplantation, are used to treat kidney failure. These methods help replace kidney function if your own kidneys have stopped working. Treatments for Early Kidney Disease Treatments for early kidney disease include both diet and lifestyle changes and medications. - Making heart-healthy food choices and exercising regularly to maintain a healthy weight can help prevent the diseases that cause further kidney damage.\n- If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys.\n- Choose and prepare foods with less salt and sodium. Aim for less than 2,300 milligrams of sodium each day.\n- Eat the right amount of protein. Although it is important to eat enough protein to stay healthy, excess protein makes your kidneys work harder. Eating less protein may help delay progression to kidney failure. Talk to your dietitian or other health care provider about what is the right amount of protein for you.\n- If you have been diagnosed with kidney disease, ask your doctor about seeing a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease. You can find a dietitian near you through the Academy of Nutrition and Dietetics directory.\n- If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse. Making heart-healthy food choices and exercising regularly to maintain a healthy weight can help prevent the diseases that cause further kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys. Choose and prepare foods with less salt and sodium. Aim for less than 2,300 milligrams of sodium each day. Eat the right amount of protein. Although it is important to eat enough protein to stay healthy, excess protein makes your kidneys work harder. Eating less protein may help delay progression to kidney failure. Talk to your dietitian or other health care provider about what is the right amount of protein for you. If you have been diagnosed with kidney disease, ask your doctor about seeing a dietitian. A dietitian can teach you how to choose foods that are easier on your kidneys. You will also learn about the nutrients that matter for kidney disease. You can find a dietitian near you through the Academy of Nutrition and Dietetics directory. If you smoke, take steps to quit. Cigarette smoking can make kidney damage worse. Medicines Medicines can also help protect the kidneys. People with kidney disease often take medicines to lower blood pressure, control blood glucose, and lower blood cholesterol. Two types of blood pressure medicines -- angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) -- may protect the kidneys and delay kidney failure. These medicines may even protect kidney function in people who don't have high blood pressure. The most important step you can take to treat kidney disease is to control your blood pressure. Many people need two or more medicines to keep their blood pressure at a healthy level. For most people, the blood pressure target is less than 140/90 mm Hg. An ACE inhibitor, ARB, or diuretic (water pill) may help control blood pressure. Your healthcare provider will work with you to choose the right medicines for you. Be Safe With Your Medicines Some older adults with kidney disease may take medicines for other diseases as well. If you have kidney disease, you need to be careful about all the medicines you take. Your kidneys do not filter as well as they did in the past. This can cause an unsafe buildup of medicines in your blood. Some medicines can also harm your kidneys. As kidney disease progresses, your doctor may need to change the dose (or amount) of all medicines that affect the kidney or are removed by the kidney. You may need to take some medicines in smaller amounts or less often. You may also need to stop taking a medicine or switch to a different one. Effects of NSAID Drugs Non-steroidal anti-inflammatory drugs (NSAIDs) can harm your kidneys, especially if you have kidney disease, diabetes, and high blood pressure. NSAIDs include common over-the-counter and prescription medicines for headaches, pain, fever, or colds. Ibuprofen and naproxen are NSAIDs, but NSAIDs are sold under many different brand names. If you have kidney disease, do not use NSAIDs. Ask your pharmacist or health care provider if the medicines you take are safe to use. You also can look for NSAIDs on Drug Facts labels." } ]

[ { "from": "human", "value": "What are the treatments for Kidney Disease?" }, { "from": "gpt", "value": "Kidney disease can get worse over time, and may lead to kidney failure. Kidney failure means advanced kidney damage with less than 15% normal function. Most people with kidney failure have symptoms from the build up of waste products and extra water in their body. End-stage renal disease (ESRD) is kidney failure treated by dialysis or kidney transplant. If kidney disease progresses to kidney failure, the goal of treatment changes. Since the kidneys no longer work well enough to maintain health, it is necessary to choose a treatment in order to maintain health. There are two main options for this: dialysis and transplantation. Some patients choose not to treat kidney failure with dialysis or a transplant. Instead, they receive supportive care to treat their symptoms. Before you and your health care team decide on a treatment plan, it is important that you understand how each treatment option is likely to affect how long you will live or how good you will feel. If your kidney disease is progressing, talk with your health care provider about choosing a treatment that is right for you. (Watch the video to learn more about dialysis decisions. To enlarge the videos on this page, click the brackets in the lower right-hand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) Two Kinds of Dialysis Dialysis is a treatment that takes waste products and extra fluid out of your body. In hemodialysis, your blood passes through a filter outside of your body and the clean blood is returned to your body. In hemodialysis, blood is run through a filter outside of your body and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week, but it can also be done at home. Each session usually lasts between three and four hours. Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through small blood vessels in this lining. This fluid with the waste products is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep. Hemodialysis and peritoneal dialysis do not cure kidney failure. They are treatments that help replace the function of the kidneys and may help you feel better and live longer. But, for some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help. If You Are on Dialysis Although patients with kidney failure are now living longer than ever, over the years, kidney disease can cause problems such as \n-depression\n- heart disease\n- bone disease\n- arthritis\n- nerve damage\n- malnutrition. depression heart disease bone disease arthritis nerve damage malnutrition. To stay as healthy as possible for as long as possible while on dialysis, - follow your dietitian's advice,\n- take your medicines, and\n- follow healthy lifestyle and diet habits to keep a healthy weight and control blood pressure, blood sugar, and cholesterol. follow your dietitian's advice, take your medicines, and follow healthy lifestyle and diet habits to keep a healthy weight and control blood pressure, blood sugar, and cholesterol. Dialysis can be a special challenge for older adults, especially those who have other diseases or conditions. For example, for hemodialysis, a person must be able to leave home, travel to the dialysis facility, and sit for 4 hours during treatment. Peritoneal dialysis can be done at home, but someone needs to help. Often, older adults need help with some or all of these activities. They and their families need to think about these issues as they choose treatment options and living facilities. Learn more about dialysis. Eating, Diet, and Nutrition on Dialysis For people who are on dialysis or approaching total kidney failure, adequate nutrition is important for maintaining energy, strength, healthy sleep patterns, bone health, heart health, and good mental health. The diet should be based on the type of treatment the person is getting. \n-People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus.\n- In contrast, people on peritoneal dialysisa type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the bodymay be able to eat more potassium-rich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis.\n- Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat protein-rich foods such as meat, fish, and eggs. People on hemodialysis must watch how much fluid they drink and avoid eating foods with too much sodium, potassium, and phosphorus. In contrast, people on peritoneal dialysisa type of dialysis that uses the lining of the abdomen, or belly, to filter the blood inside the bodymay be able to eat more potassium-rich foods because peritoneal dialysis removes potassium from the body more efficiently than hemodialysis. Both hemodialysis and peritoneal dialysis can remove proteins from the body, so anyone on either form of dialysis should eat protein-rich foods such as meat, fish, and eggs. All dialysis centers have a renal dietitian, who helps people with kidney failure make healthy food choices. People who are on dialysis should talk with their clinics renal dietitian. The renal dietitian can help make a meal plan that will help their treatment work well. Kidney Transplantation Some people with kidney failure -- including older adults -- may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work the failed kidneys used to do. The donated kidney can come from someone you dont know who has recently died, or from a living person -- usually a family member. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend. Due to the shortage of kidneys, patients on the waiting list for a deceased donor kidney may wait many years. (Watch the video to learn more about kidney transplantation.) Kidney transplantation is a treatment for kidney failure -- not a cure. You will need to see your healthcare provider regularly. And you will need to take medicines for as long as you have your transplant. These medicines suppress your immune system so it doesn't reject the transplanted kidney. Eating, Diet, and Nutrition After a Transplant After a transplant, it is still important to make healthy food choices. It is still important to eat foods with less salt. This may help you keep a healthy blood pressure. You should also choose foods that are healthy for your heart, like fresh fruits, fresh or frozen vegetables, whole grains, and low-fat dairy foods. If you were on dialysis before the transplant, you may find that your diet after transplant is much easier to follow. You can drink more fluids and eat many of the fruits and vegetables you had to eat less of while on dialysis. You may even need to gain a little weight, but be careful not to gain weight too quickly. All transplant clinics have a renal dietitian, who helps people with kidney failure make healthy food choices. People who have had a transplant should talk with their clinics renal dietitian. The renal dietitian can help make a meal plan that will help keep the new kidney healthy. Learn more about kidney transplantation. Choosing Not to Treat With Dialysis or Transplant You may choose not to treat kidney failure with dialysis or a transplant. Instead, you may choose to focus on treating its complications. If you choose this path, you will still get care from your health care team. Your care may include - medicines to protect remaining kidney function for as long as possible\n- medicines to treat symptoms of kidney failure (such as nausea, anemia, and poor appetite)\n- advice on diet and lifestyle choices, and\n- care to ease symptoms, provide relief from physical and emotional pain, and enhance quality of life. medicines to protect remaining kidney function for as long as possible medicines to treat symptoms of kidney failure (such as nausea, anemia, and poor appetite) advice on diet and lifestyle choices, and care to ease symptoms, provide relief from physical and emotional pain, and enhance quality of life. You have the right to choose not to start dialysis or undergo transplant surgery. You may choose not to treat with dialysis or transplant if you feel that the burdens would outweigh the benefits. Or, you may make this choice if you feel these treatments would lower your quality of life. Only you know what it is like for you to live with kidney failure. Treatment with no dialysis or transplant may be a choice for you if - you and your doctor feel dialysis or transplant will not improve your health. For some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help.\n- you feel youve accomplished what you wanted in life.\n- family and friends support your decision. you and your doctor feel dialysis or transplant will not improve your health. For some people who have many health problems and are age 75 or older, studies show that treatment with dialysis may not help. you feel youve accomplished what you wanted in life. family and friends support your decision. Choosing the Right Treatment Not all treatments are right for all people. Talk to your doctor and other health professionals -- including nurses, dietitians, and diabetes educators -- to figure out the best treatment plan for you. The right choice for you depends upon your medical condition, lifestyle, and personal likes and dislikes. Each treatment option may have a different effect on \n-how long you live\n- your overall health\n- what and how much you can do\n- how well you can get around\n- how you feel emotionally\n- how well you can think, learn, and remember\n- your sex life. how long you live your overall health what and how much you can do how well you can get around how you feel emotionally how well you can think, learn, and remember your sex life." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Kidney Disease?" }, { "from": "gpt", "value": "Many areas of Research Researchers are working at every stage of kidney disease to improve diagnosis and treatment, including \n-trying to find a better way to identify who is at greatest risk for rapidly progressing kidney disease\n-trying to find more effective medications to treat kidney disease and its risk factors, and\n-improving dialysis and the results of kidney transplantation. trying to find a better way to identify who is at greatest risk for rapidly progressing kidney disease trying to find more effective medications to treat kidney disease and its risk factors, and improving dialysis and the results of kidney transplantation. Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease. Interaction With Other Diseases Another focus is on the interaction between kidney disease, diabetes, and cardiovascular (heart) disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention. Disease Progression NIDDK is sponsoring a major study -- the Chronic Renal Insufficiency Cohort (CRIC) study -- to learn more about how kidney disease progresses. CRIC is following 6,000 adults with mild to moderate kidney disease. About half have diabetes. It is believed that some CRIC study participants' kidney function will decline more rapidly than others', and that some will develop cardiovascular disease while others won't. The goal of the study is to identify the factors linked to rapid decline of kidney function and the development of cardiovascular disease. The data and specimens collected from study participants will be available to other researchers who are studying kidney disease and cardiovascular disease. The CRIC study will allow future investigation into the role of genetic, environmental, behavioral, nutritional, and other factors in kidney disease. Learn more about the CRIC Study. Improving Transplants In the area of transplantation, researchers are working to develop new drugs that help the body accept donated organs. The goal is to help transplanted kidneys survive longer and work better. NIDDK scientists are also developing new techniques to improve the body's tolerance for foreign tissue even before the donated kidney is transplanted. This could help reduce or eliminate the need for drugs that suppress the immune system, which could reduce transplantation costs and complications. In the future, scientists may even develop an artificial kidney for implantation." } ]

[ { "from": "human", "value": "What is (are) Kidney Disease?" }, { "from": "gpt", "value": "Kidney disease -- also known as chronic kidney disease (CKD) -- occurs when kidneys can no longer remove wastes and extra water from the blood or perform other functions as they should. According to the Centers for Disease Control and Prevention, more than 20 million Americans may have kidney disease. Many more are at risk. " } ]

[ { "from": "human", "value": "What causes Kidney Disease?" }, { "from": "gpt", "value": "Kidney disease is most often caused by diabetes or high blood pressure. Each kidney contains about one million tiny filters made up of blood vessels. These filters are called glomeruli. Diabetes and high blood pressure damage these blood vessels, so the kidneys are not able to filter the blood as well as they used to. Usually this damage happens slowly, over many years. As more and more filters are damaged, the kidneys eventually stop working." } ]

[ { "from": "human", "value": "Who is at risk for Kidney Disease??" }, { "from": "gpt", "value": "Diabetes and high blood pressure are the two leading risk factors for kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease -- without you feeling it. There are several other risk factors for kidney disease. Cardiovascular (heart) disease is a risk factor. So is family history: if you have a mother, father, sister, or brother who has had kidney disease, then you are at increased risk. African Americans, Hispanics, and Native Americans tend to have a greater risk for kidney failure. This is mostly due to higher rates of diabetes and high blood pressure in these communities, although there may be other reasons. " } ]

[ { "from": "human", "value": "What are the symptoms of Kidney Disease?" }, { "from": "gpt", "value": "Kidney disease is often called a \"silent\" disease, because most people have no symptoms in early kidney disease. In fact, you might feel just fine until your kidneys have almost stopped working. Do NOT wait for symptoms! Blood and urine tests are the only way to check for kidney damage or measure kidney function. " } ]

[ { "from": "human", "value": "What is (are) Kidney Disease?" }, { "from": "gpt", "value": "When you visit your doctor, here are questions to ask about your kidneys. - What is my GFR?\n- What is my urine albumin result?\n- What is my blood pressure?\n- What is my blood glucose (for people with diabetes)? What is my GFR? What is my urine albumin result? What is my blood pressure? What is my blood glucose (for people with diabetes)?" } ]

[ { "from": "human", "value": "What are the treatments for Kidney Disease?" }, { "from": "gpt", "value": "Treatments for early kidney disease include both diet and lifestyle changes and medications. Diet and lifestyle changes, such as eating heart healthy foods and exercising regularly to maintain a healthy weight, can help prevent the diseases that cause kidney damage. If you already have diabetes and/or high blood pressure, keeping these conditions under control can keep them from causing further damage to your kidneys. " } ]

[ { "from": "human", "value": "What are the treatments for Kidney Disease?" }, { "from": "gpt", "value": "During your next health care visit, talk to your provider about your test results and how to manage your kidney disease. Below is a list of questions you may want to ask. Add any questions you think are missing, and mark those that are most important to you. Bring your list with you. About your tests\n- Did you check my kidney health with blood and urine tests?\n-What was my GFR? What does that mean?\n- Has my GFR changed since last time?\n- What is my urine albumin level? What does that mean?\n- Has my urine albumin changed since the last time it was checked?\n- Is my kidney disease getting worse?\n- Is my blood pressure where it needs to be?\n- Will I need dialysis?\n- When should I talk to my family about dialysis or a kidney transplant? Did you check my kidney health with blood and urine tests? What was my GFR? What does that mean? Has my GFR changed since last time? What is my urine albumin level? What does that mean? Has my urine albumin changed since the last time it was checked? Is my kidney disease getting worse? Is my blood pressure where it needs to be? Will I need dialysis? When should I talk to my family about dialysis or a kidney transplant? (Watch the video to learn more about dialysis decisions. To enlarge the videos on this page, click the brackets in the lower right-hand corner of the video screen. To reduce the videos, press the Escape (Esc) button on your keyboard.) About treatment and self-care - What can I do to keep my disease from getting worse?\n- Do any of my medicines or doses need to be changed?\n- Do I need to change what I eat? Am I eating the right amount of protein, salt (sodium), potassium, and phosphorus?\n- Will you refer me to a dietitian for diet counseling?\n- When will I need to see a nephrologist (kidney specialist)?\n- What do I need to do to protect my veins? What can I do to keep my disease from getting worse? Do any of my medicines or doses need to be changed? Do I need to change what I eat? Am I eating the right amount of protein, salt (sodium), potassium, and phosphorus? Will you refer me to a dietitian for diet counseling? When will I need to see a nephrologist (kidney specialist)? What do I need to do to protect my veins? (Watch the video to learn more about lifestyle and diet changes to make with kidney disease.) About complications - What other health problems may I face because of my kidney disease?\n- Should I be looking for any symptoms? If so, what are they? What other health problems may I face because of my kidney disease? Should I be looking for any symptoms? If so, what are they? If you're told that you need renal replacement therapy (dialysis or a transplant) - How do I decide which treatment is right for me?\n- How do I prepare for dialysis?\n- What is an AV fistula?\n- How soon do I begin preparing?\n- How can my family help me? How do I decide which treatment is right for me? How do I prepare for dialysis? What is an AV fistula? How soon do I begin preparing? How can my family help me?" } ]

[ { "from": "human", "value": "What is (are) Kidney Disease?" }, { "from": "gpt", "value": "When your kidneys fail, they are no longer able to filter blood and remove waste from your body well enough to maintain health. Kidney failure causes harmful waste and excess fluid to build up in your body. Your blood pressure may rise, and your hands and feet may swell. Since the kidneys are not working well, the goal is to find treatments that can replace kidney function in order to maintain health. There are two main options for this: dialysis and transplantation." } ]

[ { "from": "human", "value": "What are the treatments for Kidney Disease?" }, { "from": "gpt", "value": "Dialysis is a treatment to filter wastes and water from your blood. There are two major forms of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, blood is run through a filter outside of your body and the clean blood is returned to the body. Hemodialysis is usually done at a dialysis center three times a week, but it can also be done at home. Each session usually lasts between three and four hours. Peritoneal dialysis is another way to remove wastes from your blood. This kind of dialysis uses the lining of your abdominal cavity (the space in your body that holds organs like the stomach, intestines, and liver) to filter your blood. It works by putting a special fluid into your abdomen that absorbs waste products in your blood as it passes through small blood vessels in this lining. This fluid is then drained away. A key benefit of peritoneal dialysis is that it can be done at home, while you sleep. Get more information about dialysis." } ]

[ { "from": "human", "value": "What is (are) Kidney Disease?" }, { "from": "gpt", "value": "Instead of dialysis, some people with kidney failure -- including older adults -- may be able to receive a kidney transplant. This involves having a healthy kidney from another person surgically placed into your body. The new, donated kidney does the work that your two failed kidneys used to do. The donated kidney can come from an anonymous donor who has recently died, or from a living person -- usually a relative. But you might also be able to receive a kidney from an unrelated donor, including your spouse or a friend. Kidney transplantation is a treatment for kidney failure -- not a cure. You will need to see your healthcare provider regularly. And you will need to take medications for as long as you have your transplant to suppress your immune system so it doesn't reject the transplanted kidney." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Kidney Disease?" }, { "from": "gpt", "value": "There are many researchers who are working on kidney disease. They are looking for ways to improve diagnosis, make treatments more effective, and make dialysis and transplantation work better. Several areas of research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) hold great potential. Emphasis is being placed on research related to prevention and early intervention in kidney disease. Another focus is on the interaction between diabetes, kidney disease, and cardiovascular disease. Advances in treatments for diabetes and high blood pressure may help reduce the damage these conditions do to the kidneys in the first place. Research into how to predict who will develop kidney disease may improve prevention." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Alzheimers disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It begins slowly and gets worse over time. Currently, it has no cure. A Common Cause of Dementia Alzheimers disease is the most common cause of dementia among older people. Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a persons daily life and activities. Dementia ranges in severity from the mild stage, when it is just beginning to affect a persons functioning, to the severe stage, when the person must depend completely on others for basic care. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer's disease. Alzheimers is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people Risk Increases With Age In most people with Alzheimers, symptoms first appear in their mid-60s, and the risk of developing the disease increases with age. While younger people -- in their 30s, 40s, and 50s -- may get Alzheimer's disease, it is much less common. It is important to note that Alzheimer's disease is not a normal part of aging. The course of Alzheimers diseasewhich symptoms appear and how quickly changes occurvaries from person to person. The time from diagnosis to death varies, too. It can be as little as 3 or 4 years if the person is over 80 years old when diagnosed or as long as 10 years or more if the person is younger. Memory Problems: One of the First Signs Memory problems are typically one of the first signs of Alzheimers disease, though initial symptoms may vary from person to person. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease. People with Alzheimers have trouble doing everyday things like driving a car, cooking a meal, or paying bills. They may ask the same questions over and over, get lost easily, lose things or put them in odd places, and find even simple things confusing. Some people become worried, angry, or violent. Other Reasons for Memory Issues Not all people with memory problems have Alzheimers disease. Mild forgetfulness can be a normal part of aging. Some people may notice that it takes longer to learn new things, remember certain words, or find their glasses. Thats different from a serious memory problem, which makes it hard to do everyday things. Sometimes memory problems are related to health issues that are treatable. For example, medication side effects, vitamin B12 deficiency, head injuries, or liver or kidney disorders can lead to memory loss or possibly dementia. Emotional problems, such as stress, anxiety, or depression, can also make a person more forgetful and may be mistaken for dementia. Read more about causes of memory loss and how to keep your memory sharp. Mild Cognitive Impairment Some older people with memory or other thinking problems have a condition called mild cognitive impairment, or MCI. MCI can be an early sign of Alzheimers, but not everyone with MCI will develop Alzheimers disease. People with MCI have more memory problems than other people their age, but they can still take care of themselves and do their normal activities. Signs of MCI may include - losing things often\n- forgetting to go to events and appointments\n- having more trouble coming up with words than other people the same age. losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age. If you or someone in your family thinks your forgetfulness is getting in the way of your normal routine, its time to see your doctor. Seeing the doctor when you first start having memory problems can help you find out whats causing your forgetfulness. Learn more about mild cognitive impairment (MCI). What Happens to the Brain in Alzheimers? Alzheimer's disease is named after Dr. Alois Alzheimer, a German doctor. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). Plaques and tangles in the brain are two of the main features of Alzheimer's disease. Another is the loss of connections between nerve cells (neurons) in the brain. Neurons send messages between different parts of the brain, and from the brain to muscles and organs in the body. It seems likely that damage to the brain starts 10 years or more before memory or other thinking problems become obvious. During the earliest stage of Alzheimers, people are free of symptoms, but harmful changes are taking place in the brain. The damage at first appears to take place in cells of the hippocampus, the part of the brain essential in forming memories. Abnormal protein deposits form plaques and tangles in the brain. Once-healthy nerve cells stop functioning, lose connections with each other, and die. As more nerve cells die, other parts of the brain begin to shrink. By the final stage of Alzheimers, damage is widespread, and brain tissue has shrunk significantly. Get more details about Alzheimers disease." } ]

[ { "from": "human", "value": "What causes Alzheimer's Disease?" }, { "from": "gpt", "value": "There are two types of Alzheimers diseaseearly-onset and late-onset. Early-onset Alzheimers is a rare form of the disease that occurs in people age 30 to 60. It occurs in less than 5 percent of all people with Alzheimers. Almost all people with Alzheimers disease have late-onset Alzheimer's, which usually develops after age 60. Causes Not Fully Understood Scientists do not yet fully understand what causes Alzheimer's disease in most people. In early-onset Alzheimers, a genetic mutation is usually the cause. Late-onset Alzheimers arises from a complex series of brain changes that occur over decades. The causes probably include a mix of genetic, environmental, and lifestyle factors. These factors affect each person differently. Research shows that Alzheimers disease causes changes in the brain years and even decades before the first symptoms appear, so even people who seem free of the disease today may be at risk. Scientists are developing sophisticated tests to help identify who is most likely to develop symptoms of Alzheimers. Ultimately, they hope to prevent or delay dementia in these high-risk individuals. Risk Factors Some risk factors for Alzheimers, like age and genetics, cannot be controlled. Other factors that may play a role in the development of the diseasesuch as how much a person exercises or socializescan be changed. Lifestyle factors, such as diet and physical exercise, and long-term health conditions, like high blood pressure and diabetes, might also play a role in the risk of developing Alzheimers disease. For more information, see the chapter entitled Prevention. Older AgeThe Biggest Risk Factor Increasing age is the most important known risk factor for Alzheimer's disease. The number of people with the disease doubles every 5 years beyond age 65. Nearly half of people age 85 and older may have Alzheimers. These facts are significant because the number of older adults is growing. Genetics Genetics appears to play a part in both early- and late-onset Alzheimers disease. In early-onset Alzheimers, most cases are caused by specific genetic mutations permanent changes in genes that can be passed on from a parent to a child. This results in early-onset familial Alzheimers disease, or FAD. Most people with Alzheimers disease have late-onset Alzheimer's, in which symptoms appear in a persons mid-60s. No obvious family pattern is seen in most of these cases, but certain genetic factors appear to increase a persons risk. Many studies have linked the apolipoprotein E gene to late-onset Alzheimers. One form of this gene, APOE 4, increases a persons risk of getting the disease. But many people who get Alzheimers do not have the APOE 4 gene, and some people with the gene never get Alzheimers. Scientists have identified a number of other genes in addition to APOE 4 that may increase a persons risk for late-onset Alzheimers. Knowing about these genes can help researchers more effectively test possible treatments and prevention strategies in people who are at risk of developing Alzheimers -- ideally, before symptoms appear. Learn more about the genetics of Alzheimers disease." } ]

[ { "from": "human", "value": "What are the symptoms of Alzheimer's Disease?" }, { "from": "gpt", "value": "Alzheimer's disease varies from person to person so not everyone will have the same symptoms. Also, the disease progresses faster in some people than in others. In general, though, Alzheimers takes many years to develop and becomes increasingly severe over time. Memory Problems -- A Common Early Sign Memory problems are typically one of the first signs of Alzheimers disease. However, not all memory problems are caused by Alzheimers. If you or someone in your family thinks your forgetfulness is getting in the way of your normal routine, its time to see your doctor. He or she can find out whats causing these problems. A person in the early (mild) stage of Alzheimers disease may - find it hard to remember things\n- ask the same questions over and over\n- get lost in familiar places\n- lose things or put them in odd places\n- have trouble handling money and paying bills\n- take longer than normal to finish daily tasks\n- have some mood and personality changes. find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks have some mood and personality changes. Other thinking problems besides memory loss may be the first sign of Alzheimers disease. A person may have - trouble finding the right words\n- vision and spatial issues\n- impaired reasoning or judgment. trouble finding the right words vision and spatial issues impaired reasoning or judgment. See a chart that compares signs of Alzheimers disease with signs of normal aging. Later Signs of Alzheimers As Alzheimers disease progresses to the moderate stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. Other symptoms at this stage may include - difficulty learning new things and coping with new situations\n- trouble carrying out tasks that involve multiple steps, like getting dressed\n- impulsive behavior\n- forgetting the names of common things\n- hallucinations, delusions, or paranoia\n- wandering away from home. difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. Symptoms of Severe Alzheimers As Alzheimers disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they are incontinentthey cannot control their bladder and/or bowels. Eventually, they need total care. Benefits of Early Diagnosis An early, accurate diagnosis of Alzheimer's disease helps people and their families plan for the future. It gives them time to discuss care options, find support, and make legal and financial arrangements while the person with Alzheimers can still take part in making decisions. Also, even though no medicine or other treatment can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms. How Alzheimers Is Diagnosed The only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, an examination of the brain done after a person dies. Doctors can only make a diagnosis of \"possible\" or probable Alzheimers disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors who can diagnose Alzheimers include geriatricians, geriatric psychiatrists, and neurologists. A geriatrician specializes in the treatment of older adults. A geriatric psychiatrist specializes in mental problems in older adults. A neurologist specializes in brain and nervous system disorders. To diagnose Alzheimers disease, doctors may - ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality\n- conduct tests to measure memory, problem solving, attention, counting, and language skills\n- carry out standard medical tests, such as blood and urine tests\n- perform brain scans to look for anything in the brain that does not look normal. ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal. Test results can help doctors know if there are other possible causes of the person's symptoms. For example, thyroid problems, drug reactions, depression, brain tumors, head injury, and blood-vessel disease in the brain can cause symptoms similar to those of Alzheimer's. Many of these other conditions can be treated successfully. New Diagnostic Methods Being Studied Researchers are exploring new ways to help doctors diagnose Alzheimers disease earlier and more accurately. Some studies focus on changes in a persons memory, language, and other mental functions. Others look at changes in blood, spinal fluid, and brain-scan results that may detect Alzheimers years before symptoms appear. Watch a video that explains changes in diagnostic guidelines for Alzheimers." } ]

[ { "from": "human", "value": "How to prevent Alzheimer's Disease?" }, { "from": "gpt", "value": "Currently, no medicines or other treatments are known to prevent Alzheimers disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some long-term health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers. Exercise and Physical Activity Studies show that exercise and other types of physical activity are good for our hearts, waistlines, and ability to carry out everyday activities. Research suggests that exercise may also play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning. See suggestions for ways older adults can start or continue to exercise. Diet and Dietary Supplements A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. A diet that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugar can reduce the risk of heart disease and diabetes. Researchers are looking at whether a healthy diet also can help prevent Alzheimers. One study reported that people who ate a Mediterranean diet had a 28 percent lower risk of developing MCI (mild cognitive impairment) and a 48 percent lower risk of progressing from MCI to Alzheimers disease. (MCI often, but not always, leads to Alzheimers dementia.) A Mediterranean diet includes vegetables, legumes, fruits, cereals, fish, olive oil, and low amounts of saturated fats, dairy products, meat, and poultry. For more about healthy eating as you age , see Eating Well As You Get Older. Other research has looked at the effect on brain health of several different vitamins and dietary supplements. One area of research focuses on antioxidants, natural substances that appear to fight damage caused by molecules called free radicals. Other studies are looking at resveratrol, a compound found in red grapes and red wine, as well as vitamins and other substances found in food. Chronic Diseases Age-related diseases and conditionssuch as vascular disease, high blood pressure, heart disease, and diabetesmay increase the risk of Alzheimers. Many studies are looking at whether this risk can be reduced by preventing or controlling these diseases and conditions. For example, one clinical trial is looking at how lowering blood pressure to or below current recommended levels may affect cognitive decline and the development of MCI and Alzheimers disease. Participants are older adults with high systolic (upper number) blood pressure who have a history of heart disease or stroke, or are at risk for those conditions. Diabetes is another disease that has been linked to Alzheimers. Past research suggests that abnormal insulin production contributes to Alzheimers-related brain changes. (Insulin is the hormone involved in diabetes.) Diabetes treatments have been tested in people with Alzheimers, but the results have not been conclusive. Keeping the Brain Active Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. One clinical trial is testing the impact of formal cognitive training, with and without physical exercise, in people with MCI to see if it can prevent or delay Alzheimers disease. Other trials are underway in healthy older adults to see if exercise and/or cognitive training (for example, a demanding video game) can delay or prevent age-related cognitive decline. Find out about things you can do that may keep your brain healthy." } ]

[ { "from": "human", "value": "What are the treatments for Alzheimer's Disease?" }, { "from": "gpt", "value": "Medications Can Treat Symptoms There is no known cure for Alzheimer's disease, but there are medicines that can treat symptoms of the disease. Most Alzheimers medicines work best for people in the mild or moderate stages of the disease. For example, they can keep memory loss from getting worse for a time. Other medicines may help behavioral symptoms, such as trouble sleeping or feeling worried or depressed. All of these medicines may have side effects and may not work for everyone. A person with Alzheimer's should be under a doctor's care. He or she may see a primary care doctor or a specialist, such as a neurologist, geriatric psychiatrist, or geriatrician. The doctor can treat the person's physical and behavioral problems, answer questions, and refer the patient and caregiver to other sources of help. Medications for Alzheimers Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild to moderate Alzheimers, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimers, although it also has limited effects. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, and loss of appetite. You should report any unusual symptoms to a doctor right away. It is important to follow a doctor's instructions when taking any medication. Scientists are testing many new drugs and other treatments to see if they can help slow, delay, or prevent Alzheimers disease. Learn how Alzheimers medications work, how to take them, and where to find more information. Managing Behavioral Symptoms Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. Treating these symptoms often makes people with Alzheimers disease more comfortable and makes their care easier for caregivers. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution. Memory Aids Memory aids may help some people who have mild Alzheimers disease with day-to-day living. A calendar, list of daily plans, notes about simple safety measures, and written directions describing how to use common household items can be useful. Help for Caregivers Caring for a person with Alzheimers can have high physical, emotional, and financial costs. The demands of day-to-day care, changing family roles, and difficult decisions about placement in a care facility can be difficult. Sometimes, taking care of the person with Alzheimers makes caregivers feel good because they are providing love and comfort. At other times, it can be overwhelming. Changes in the person can be hard to understand and cope with. Here are some ways for caregivers of people with Alzheimers to get help. - Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break.\n- Join a caregivers support group.\n- Use home health care, adult day care, and respite services. Ask family and friends to help out in specific ways, like making a meal or visiting the person while they take a break. Join a caregivers support group. Use home health care, adult day care, and respite services. For more information about caring for someone with Alzheimers disease, see Alzheimer's Caregiving." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Alzheimer's Disease?" }, { "from": "gpt", "value": "Research supported by the National Institutes of Health (NIH) and other organizations has expanded knowledge of brain function in healthy older people, identified ways that may lessen age-related cognitive decline, and deepened our understanding of Alzheimers. Many scientists and physicians are working together to untangle the genetic, biological, and environmental factors that might cause Alzheimers disease. This effort is bringing us closer to better managing and, ultimately, better treating and preventing this devastating disease. Types of Research Different types of researchbasic, translational, and clinical researchare conducted to better understand Alzheimers and find ways to treat, delay, or prevent the disease. - Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses.\n- Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease.\n- Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective. Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or other intervention in people to see if it is safe and effective. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research. Basic Research Basic research seeks to identify the cellular, molecular, and genetic processes that lead to Alzheimers disease. Basic research has focused on two of the main signs of Alzheimers disease in the brain: plaques and tangles. Plaques are made of a protein called beta-amyloid and form abnormal clumps outside nerve cells in the brain. Tangles are made from a protein called tau and form twisted bundles of fibers within nerve cells in the brain. Scientists are studying how plaques and tangles damage nerve cells in the brain. They can see beta-amyloid plaques and tau tangles by making images of the brains of living people. Such imaging has led to clinical trials that are looking at ways to remove beta-amyloid from the human brain or halt its production before more brain damage occurs. Scientists are also exploring the very earliest brain changes in the disease process. Findings will help them better understand the causes of Alzheimers. As they learn more, they are likely to come up with better targets for further research. Over time, this might lead to more effective therapies to delay or prevent the disease. Genetics is another important area of basic research. Discovering more about the role of genes that increase or decrease the risk of developing Alzheimers will help researchers answers questions such as What makes the disease process begin? and Why do some people with memory and other thinking problems develop Alzheimers disease while others do not? Genetics research helps scientists learn how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. This research also helps identify people who are at high risk for developing Alzheimers and can participate in clinical research on new prevention and treatment approaches. Translational Research Translational research allows new knowledge from basic research to be applied to a clinical research setting. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in test-tube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat or prevent the symptoms of Alzheimers disease and mild cognitive impairment. Clinical Research Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test medicines, therapies, medical devices, or other interventions in people to see if they are safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. NIH, drug companies, and other research organizations are conducting many clinical trials to test possible new treatments that may - improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment\n- relieve the behavior problems of Alzheimers, such as aggression and agitation\n- delay the progression from mild cognitive impairment (MCI) to Alzheimers\n- prevent Alzheimers disease. improve memory, thinking, and reasoning skills in people with Alzheimers or mild cognitive impairment relieve the behavior problems of Alzheimers, such as aggression and agitation delay the progression from mild cognitive impairment (MCI) to Alzheimers prevent Alzheimers disease. A wide variety of interventions are being tested in clinical trials. They include experimental drugs as well as non-drug approaches." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Alzheimer's Disease?" }, { "from": "gpt", "value": "All types of people are needed to volunteer for Alzheimers research. People with Alzheimer's disease or MCI, those with a family history of Alzheimers, and healthy people with no memory problems and no family history of Alzheimers may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging and in Alzheimers. Results of these trials are used to improve prevention and treatment methods. The Alzheimers Disease Education and Referral (ADEAR) Centers clinical trials finder makes it easy for people to find out about studies that are sponsored by the federal government and private companies, universities, and other organizations. It includes studies testing new ways to detect, treat, delay, and prevent Alzheimers disease, other dementias, and MCI. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinical-trials. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the ADEAR Center at 1-800-438-4380 or adear@nia.nih.gov. Also, visit its website at www.nia.nih.gov/alzheimers/volunteer." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Alzheimers disease is a brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It begins slowly and gets worse over time. Currently, it has no cure. Alzheimers disease is the most common cause of dementia in older people. Get more details about Alzheimer's disease." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Dementia is a loss of thinking, remembering, and reasoning skills that interferes with a persons daily life and activities. Alzheimers disease is the most common cause of dementia among older people. Dementia ranges in severity from the mild stage, when it is just beginning to affect a persons functioning, to the severe stage, when the person must depend completely on others for care." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Mild cognitive impairment, or MCI, is a condition that can be an early sign of Alzheimers diseasebut not everyone with MCI will develop Alzheimers. People with MCI can still take care of themselves and do their normal activities. Signs of MCI may include - losing things often\n- forgetting to go to events and appointments\n- having more trouble coming up with words than other people the same age. losing things often forgetting to go to events and appointments having more trouble coming up with words than other people the same age." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Memory problems are typically one of the first signs of Alzheimers disease, though different people may have different initial symptoms. A decline in other aspects of thinking, such as finding the right words, vision/spatial issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimers disease." } ]

[ { "from": "human", "value": "What is (are) Alzheimer's Disease?" }, { "from": "gpt", "value": "Alzheimer's disease has three stages: early (also called mild), middle (moderate), and late (severe). A person in the early stage of Alzheimers may - find it hard to remember things\n-ask the same questions over and over\n-get lost in familiar places\n-lose things or put them in odd places\n- have trouble handling money and paying bills\n- take longer than normal to finish daily tasks. find it hard to remember things ask the same questions over and over get lost in familiar places lose things or put them in odd places have trouble handling money and paying bills take longer than normal to finish daily tasks. As Alzheimers disease progresses to the middle stage, memory loss and confusion grow worse, and people may have problems recognizing family and friends. Other symptoms are this stage include \n-difficulty learning new things and coping with new situations\n- trouble carrying out tasks that involve multiple steps, like getting dressed\n-impulsive behavior\n- forgetting the names of common things\n- hallucinations, delusions, or paranoia\n- wandering away from home. difficulty learning new things and coping with new situations trouble carrying out tasks that involve multiple steps, like getting dressed impulsive behavior forgetting the names of common things hallucinations, delusions, or paranoia wandering away from home. As Alzheimers disease becomes more severe, people lose the ability to communicate. They may sleep more, lose weight, and have trouble swallowing. Often they are incontinentthey cannot control their bladder and/or bowels. Eventually, they need total care." } ]

[ { "from": "human", "value": "What causes Alzheimer's Disease?" }, { "from": "gpt", "value": "Scientists do not yet fully understand what causes Alzheimer's disease in most people. In early-onset Alzheimers, which occurs in people between the ages of 30 and 60, a genetic mutation is usually the cause. Late-onset Alzheimers, which usually develops after age 60, arises from a complex series of brain changes that occur over decades. The causes probably include a mix of genetic, environmental, and lifestyle factors. These factors affect each person differently. Learn more about the genetics of Alzheimers disease. Increasing age is the most important known risk factor for Alzheimer's disease. Lifestyle factors, such as diet and physical exercise, and long-term health conditions, like high blood pressure and diabetes, might also play a role in the risk of developing Alzheimers disease." } ]

[ { "from": "human", "value": "How to diagnose Alzheimer's Disease?" }, { "from": "gpt", "value": "The only definitive way to diagnose Alzheimer's disease is to find out whether plaques and tangles exist in brain tissue. To look at brain tissue, doctors perform a brain autopsy, an examination of the brain done after a person dies. Doctors can only make a diagnosis of \"possible\" or probable Alzheimers disease while a person is alive. Doctors with special training can diagnose Alzheimer's disease correctly up to 90 percent of the time. Doctors who can diagnose Alzheimers include geriatricians, geriatric psychiatrists, and neurologists. A geriatrician specializes in the treatment of older adults. A geriatric psychiatrist specializes in mental problems in older adults. A neurologist specializes in brain and nervous system disorders. To diagnose Alzheimer's disease, doctors may - ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality\n- conduct tests to measure memory, problem solving, attention, counting, and language skills\n- carry out standard medical tests, such as blood and urine tests\n- perform brain scans to look for anything in the brain that does not look normal. ask questions about overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality conduct tests to measure memory, problem solving, attention, counting, and language skills carry out standard medical tests, such as blood and urine tests perform brain scans to look for anything in the brain that does not look normal." } ]

[ { "from": "human", "value": "How to diagnose Alzheimer's Disease?" }, { "from": "gpt", "value": "An early, accurate diagnosis of Alzheimer's disease helps people and their families plan for the future. It gives them time to discuss care options, find support, and make legal and financial arrangements while the person with Alzheimers can still take part in making decisions. Also, even though no medicine or other treatment can stop or slow the disease, early diagnosis offers the best chance to treat the symptoms." } ]

[ { "from": "human", "value": "How to diagnose Alzheimer's Disease?" }, { "from": "gpt", "value": "The time from diagnosis of Alzheimers disease to death varies. It can be as little as 3 or 4 years if the person is over 80 years old when diagnosed or as long as 10 years or more if the person is younger." } ]

[ { "from": "human", "value": "What are the treatments for Alzheimer's Disease?" }, { "from": "gpt", "value": "Currently, no treatment can stop Alzheimer's disease. However, four medications are used to treat its symptoms. These medicines may help maintain thinking, memory, and speaking skills for a limited time. They work by regulating certain chemicals in the brain. Most of these medicines work best for people in the early or middle stages of the disease. For people with mild or moderate Alzheimer's, donepezil (Aricept), rivastigmine (Exelon), or galantamine (Razadyne) may help. Donepezil is also approved to treat symptoms of moderate to severe Alzheimer's. Another drug, memantine (Namenda), is used to treat symptoms of moderate to severe Alzheimer's, although it also has limited effects. All of these medicines have possible side effects. Learn how Alzheimers medications work, how to take them, and where to find more information. Certain medicines and other approaches can help control the behavioral symptoms of Alzheimer's disease. These symptoms include sleeplessness, agitation, wandering, anxiety, anger, and depression. See more about medications used to treat behavioral symptoms. Some medicines must be used with caution." } ]

[ { "from": "human", "value": "How to prevent Alzheimer's Disease?" }, { "from": "gpt", "value": "Currently, no medicines or treatments are known to prevent Alzheimer's disease, but scientists are studying many possibilities. These possibilities include lifestyle factors such as exercise and physical activity, a healthy diet, and mentally stimulating activities. In addition to lifestyle factors, scientists have found clues that some long-term health conditions, like heart disease, high blood pressure, and diabetes, are related to Alzheimer's disease. Its possible that controlling these conditions will reduce the risk of developing Alzheimers." } ]

[ { "from": "human", "value": "How to prevent Alzheimer's Disease?" }, { "from": "gpt", "value": "Research suggests that exercise may play a role in reducing risk for Alzheimers disease. Animal studies show that exercise increases both the number of small blood vessels that supply blood to the brain and the number of connections between nerve cells in older rats and mice. In addition, researchers have found that exercise raises the level of a nerve growth factor (a protein key to brain health) in an area of the brain that is important to memory and learning. Learn more about the benefits of exercise for older adults. For more on specific exercises geared to the needs of older adults, visit Go4Life, the exercise and physical activity campaign from the National Institute on Aging." } ]

[ { "from": "human", "value": "How to prevent Alzheimer's Disease?" }, { "from": "gpt", "value": "A number of studies suggest that eating certain foods may help keep the brain healthyand that others can be harmful. Researchers are looking at whether a healthy dietone that includes lots of fruits, vegetables, and whole grains and is low in fat and added sugarcan help prevent Alzheimers. For more information about healthy eating as you age, see Eating Well As You Get Older." } ]

[ { "from": "human", "value": "How to prevent Alzheimer's Disease?" }, { "from": "gpt", "value": "Keeping the mind sharpthrough social engagement or intellectual stimulationis associated with a lower risk of Alzheimers disease. Activities like working, volunteering, reading, going to lectures, and playing computer and other games are being studied to see if they might help prevent Alzheimers. But we do not know with certainty whether these activities can actually prevent Alzheimers. Find out about things you can do that may keep your brain healthy." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Alzheimer's Disease?" }, { "from": "gpt", "value": "Basic research helps scientists gain new knowledge about a disease process, including how and why it starts and progresses. In Alzheimers disease, basic research seeks to identify the cellular, molecular, and genetic processes that lead to the disease. For example, scientists are studying - the ways in which plaques and tangles damage nerve cells in the brain\n- the very earliest brain changes in the disease process\n- the role of Alzheimers risk-factor genes in the development of the disease\n- how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. the ways in which plaques and tangles damage nerve cells in the brain the very earliest brain changes in the disease process the role of Alzheimers risk-factor genes in the development of the disease how risk-factor genes interact with other genes and lifestyle or environmental factors to affect Alzheimers risk. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Alzheimer's Disease?" }, { "from": "gpt", "value": "Translational research grows out of basic research. It creates new medicines, devices, or behavioral interventions aimed at preventing, diagnosing, or treating a disease. An important goal of Alzheimers translational research is to increase the number and variety of potential new medicines and other interventions that are approved for testing in humans. Scientists also examine medicines approved to treat other diseases to see they might be effective in people with Alzheimers. The most promising interventions are tested in test-tube and animal studies to make sure they are safe and effective. Currently, a number of different substances are under development that may one day be used to treat the symptoms of Alzheimers disease or mild cognitive impairment. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Alzheimer's Disease?" }, { "from": "gpt", "value": "Clinical research is medical research involving people. It includes clinical studies, which observe and gather information about large groups of people. It also includes clinical trials, which test a medicine, therapy, medical device, or intervention in people to see if it is safe and effective. Clinical trials are the best way to find out whether a particular intervention actually slows, delays, or prevents Alzheimers disease. Trials may compare a potential new treatment with a standard treatment or placebo (mock treatment). Or, they may study whether a certain behavior or condition affects the progress of Alzheimers or the chances of developing it. See the latest Alzheimers Disease Progress Report to read about results of NIA-supported Alzheimers research." } ]

[ { "from": "human", "value": "What are the treatments for Alzheimer's Disease?" }, { "from": "gpt", "value": "People with Alzheimer's disease, those with mild cognitive impairment, those with a family history of Alzheimers, and healthy people with no memory problems who want to help scientists test new treatments may be able to take part in clinical trials. Participants in clinical trials help scientists learn about the brain in healthy aging as well as what happens in Alzheimers. Results of these trials are used to improve prevention and treatment methods. To find out more about Alzheimers clinical trials, talk to your health care provider or contact the Alzheimers Disease Education and Referral (ADEAR) Center at 1-800-438-4380. You can search for studies about a certain topic or in a certain geographic area by going to www.nia.nih.gov/alzheimers/clinical-trials." } ]

[ { "from": "human", "value": "What is (are) Rheumatoid Arthritis?" }, { "from": "gpt", "value": "An Inflammatory, Autoimmune Disease Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can cause mild to severe symptoms. Rheumatoid arthritis not only affects the joints, but may also attack tissue in the skin, lungs, eyes, and blood vessels. People with rheumatoid arthritis may feel sick, tired, and sometimes feverish. Rheumatoid arthritis is classified as an autoimmune disease. An autoimmune disease occurs when the immune system turns against parts of the body it is designed to protect. Rheumatoid arthritis generally occurs in a symmetrical pattern. This means that if one knee or hand is involved, the other one is, too. It can occur at any age, but usually begins during a person's most productive years. Affects More Women Than Men Rheumatoid arthritis occurs much more frequently in women than in men. About two to three times as many women as men have the disease. Learn more about how rheumatoid arthritis occurs. Effects Vary Rheumatoid arthritis affects people differently. Some people have mild or moderate forms of the disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Others have a severe form of the disease that is active most of the time, lasts for many years or a lifetime, and leads to serious joint damage and disability. Although rheumatoid arthritis is primarily a disease of the joints, its effects are not just physical. Many people with rheumatoid arthritis also experience issues related to - depression, anxiety\n- feelings of helplessness\n- low self-esteem. depression, anxiety feelings of helplessness low self-esteem. Rheumatoid arthritis can affect virtually every area of a persons life from work life to family life. It can also interfere with the joys and responsibilities of family life and may affect the decision to have children. Treatment Can Help Fortunately, current treatment strategies allow most people with the disease to lead active and productive lives. These strategies include pain-relieving drugs and medications that slow joint damage, a balance between rest and exercise, and patient education and support programs. In recent years, research has led to a new understanding of rheumatoid arthritis and has increased the likelihood that, in time, researchers will find even better ways to treat the disease." } ]

[ { "from": "human", "value": "What causes Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Actual Cause Is Unknown Scientists believe that rheumatoid arthritis may result from the interaction of many factors such as genetics, hormones, and the environment. Although rheumatoid arthritis sometimes runs in families, the actual cause of rheumatoid arthritis is still unknown. Research suggests that a person's genetic makeup is an important part of the picture, but not the whole story. Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. However, a specific agent or agents are not yet known. Not Contagious It is important to note that rheumatoid arthritis is not contagious. A person cannot catch it from someone else. Learn more about the causes of rheumatoid arthritis." } ]

[ { "from": "human", "value": "What are the symptoms of Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Swelling and Pain in the Joints Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Diagnostic Tests Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. \n-The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body\n- a test for white blood cell count and\n- a blood test for anemia. the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count and a blood test for anemia. Diagnosis Can Take Time Symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. The full range of symptoms develops over time, and only a few symptoms may be present in the early stages. Learn more about how rheumatoid arthritis is diagnosed." } ]

[ { "from": "human", "value": "What are the treatments for Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Most Symptoms Are Treatable Doctors use a variety of approaches to treat rheumatoid arthritis. The goals of treatment are to help relieve pain, reduce swelling, slow down or help prevent joint damage, increase the ability to function, and improve the sense of well-being. Current treatment approaches include - lifestyle modification\n- medications\n- surgery\n- routine monitoring and ongoing care. lifestyle modification medications surgery routine monitoring and ongoing care. Balance Rest and Exercise People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can also help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the persons physical abilities, limitations, and changing needs. Learn more about the health benefits of exercise for older adults. More information about exercise and physical activity for older adults can be found at Go4Life, the exercise and physical activity campaign from the National Institute on Aging. Reduce Stress People with rheumatoid arthritis face emotional challenges as well as physical ones. The emotions they feel because of the diseasefear, anger, and frustrationcombined with any pain and physical limitations can increase their stress level. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn about relaxation techniques that may relieve tension. Eat a Healthful Diet Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. See Eating Well as You Get Older for more about healthy eating. Reduce Stress on Joints Some people find using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Splints are used mostly on wrists and hands, but also on ankles and feet. A doctor or a physical or occupational therapist can help a person choose a splint and make sure it fits properly. Other ways to reduce stress on joints include - self-help devices (for example, zipper pullers, long-handled shoe horns)\n-devices to help with getting on and off chairs, toilet seats, and beds\n-changes in the ways that a person carries out daily activities. self-help devices (for example, zipper pullers, long-handled shoe horns) devices to help with getting on and off chairs, toilet seats, and beds changes in the ways that a person carries out daily activities. Medications Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. \n-Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. - DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. DMARDS called biologic response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, anakinra, golimumab, adalimumab, rituximab, and abatacept. \n-Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biologic response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage. Surgery In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Surgery may also improve a person's ability to perform daily activities. Joint replacement and tendon reconstruction are two types of surgery available to patients with severe joint damage. Routine Monitoring and Ongoing Care Regular medical care is important to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. Monitoring typically includes regular visits to the doctor. It also may include blood, urine, and other laboratory tests and x rays. Monitor Osteoporosis Risk People with rheumatoid arthritis may want to discuss preventing osteoporosis with their doctors as part of their long-term, ongoing care. Osteoporosis is a condition in which bones become weakened and fragile. Having rheumatoid arthritis increases the risk of developing osteoporosis for both men and women, particularly if a person takes corticosteroids. Such patients may want to discuss with their doctors the potential benefits of calcium and vitamin D supplements or other treatments for osteoporosis. See What is Osteoporosis? to learn more about this disease." } ]

[ { "from": "human", "value": "what research (or clinical trials) is being done for Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Scientists are making rapid progress in understanding the complexities of rheumatoid arthritis. They are learning more about how and why it develops and why some people have more severe symptoms than others. Research efforts are focused on developing drugs that can reduce inflammation and slow or stop the disease with few side effects. Identifying Possible Triggers Some evidence shows that infectious agents, such as viruses and bacteria, may contribute to triggering rheumatoid arthritis in people with an inherited tendency to develop the disease. Investigators are trying to identify the infectious agents and understand how they work. This knowledge could lead to new therapies. Why More Women Than Men? Researchers are also exploring why so many more women than men develop rheumatoid arthritis. In the hope of finding clues, they are studying complex relationships between the hormonal, nervous, and immune systems in rheumatoid arthritis. For example, they are exploring whether and how the normal changes in the levels of steroid hormones such as estrogen and testosterone during a person's lifetime may be related to the development, improvement, or flares of the disease. Scientists are also examining why rheumatoid arthritis often improves during pregnancy. Learn more about current research on rheumatoid arthritis. Interested in Clinical Trials? The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at Clinical Trials.gov. To see a list of current clinical trials on rheumatoid arthritis, type \"rheumatoid arthritis\" into the search box." } ]

[ { "from": "human", "value": "What is (are) Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Rheumatoid arthritis is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It can cause mild to severe symptoms. People with rheumatoid arthritis may feel sick, tired, and sometimes feverish. Sometimes rheumatoid arthritis attacks tissue in the skin, lungs, eyes, and blood vessels. The disease generally occurs in a symmetrical pattern. If one knee or hand is involved, usually the other one is, too. It can occur at any age, but often begins between ages 40 and 60. About two to three times as many women as men have rheumatoid arthritis. Learn more about how rheumatoid arthritis occurs." } ]

[ { "from": "human", "value": "What causes Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Scientists believe that rheumatoid arthritis may result from the interaction of many factors such as genetics, hormones, and the environment. Although rheumatoid arthritis sometimes runs in families, the actual cause of rheumatoid arthritis is still unknown. Research suggests that a person's genetic makeup is an important part of the picture, but not the whole story. Some evidence shows that infectious agents, such as viruses and bacteria, may trigger rheumatoid arthritis in people with an inherited tendency to develop the disease. The exact agent or agents, however, are not yet known. It is important to note that rheumatoid arthritis is not contagious. A person cannot catch it from someone else. Learn more about the causes of rheumatoid arthritis." } ]

[ { "from": "human", "value": "What are the symptoms of Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. The pain of rheumatoid arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint." } ]

[ { "from": "human", "value": "How to diagnose Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse." } ]

[ { "from": "human", "value": "How to diagnose Rheumatoid Arthritis?" }, { "from": "gpt", "value": "There is no single, definitive test for rheumatoid arthritis. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis. However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. - The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body\n- a test for white blood cell count\n- a blood test for anemia. the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count a blood test for anemia. X-rays are often used to determine the degree of joint destruction. They are not useful in the early stages of rheumatoid arthritis before bone damage is evident, but they can be used later to monitor the progression of the disease. Learn more about how rheumatoid arthritis is diagnosed." } ]

[ { "from": "human", "value": "What are the treatments for Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Medication, exercise, and, in some cases, surgery are common treatments for this disease. Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. People with rheumatoid arthritis can also benefit from exercise, but they need to maintain a good balance between rest and exercise. They should get rest when the disease is active and get more exercise when it is not. In some cases, a doctor will recommend surgery to restore function or relieve pain in a damaged joint. Several types of surgery are available to patients with severe joint damage. Joint replacement and tendon reconstruction are examples." } ]

[ { "from": "human", "value": "What are the treatments for Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Most people who have rheumatoid arthritis take medications. Some drugs only provide relief for pain; others reduce inflammation. Still others, called disease-modifying anti-rheumatic drugs or DMARDs, can often slow the course of the disease. - DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine.\n- Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids.\n- DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra.\n- Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. DMARDs include methotrexate, leflunomide, sulfasalazine, and cyclosporine. Steroids, which are also called corticosteroids, are another type of drug used to reduce inflammation for people with rheumatoid arthritis. Cortisone, hydrocortisone, and prednisone are some commonly used steroids. DMARDs called biological response modifiers also can help reduce joint damage. These drugs include etanercept, infliximab, and anakinra. Another DMARD, tofacitinib, from a new class of drugs called jak kinase (JAK) inhibitors is also available. Early treatment with powerful drugs and drug combinations -- including biological response modifiers and DMARDs -- instead of single drugs may help prevent the disease from progressing and greatly reduce joint damage." } ]

[ { "from": "human", "value": "What is (are) Rheumatoid Arthritis?" }, { "from": "gpt", "value": "Rest. People with rheumatoid arthritis need a good balance between rest and exercise; they should rest more when the disease is active and exercise more when it is not. Rest helps to reduce active joint inflammation and pain and to fight fatigue. The length of time for rest will vary from person to person, but in general, shorter rest breaks every now and then are more helpful than long times spent in bed. Exercise. Exercise is important for maintaining healthy and strong muscles, preserving joint mobility, and maintaining flexibility. Exercise can help people sleep well, reduce pain, maintain a positive attitude, and manage weight. Exercise programs should take into account the persons physical abilities, limitations, and changing needs. For more information on exercise classes, you may want to contact the Arthritis Foundation at 1-800-283-7800. Learn more about the health benefits of exercise for older adults. More information about exercise and physical activity for older adults can be found at Go4Life, the exercise and and physical activity campaign from the National Institute on Aging. Diet. Special diets, vitamin supplements, and other alternative approaches have been suggested for treating rheumatoid arthritis. Although such approaches may not be harmful, scientific studies have not yet shown any benefits. An overall nutritious diet with the right amount of calories, protein, and calcium is important. Some people need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. See Eating Well as You Get Older to learn more about healthy eating. Joint Care. Some people find that using a splint for a short time around a painful joint reduces pain and swelling by supporting the joint and letting it rest. Assistive devices may help reduce stress and lessen pain in the joints. Examples include zipper pullers and aids to help with moving in and out of chairs and beds. Stress Reduction. Finding ways to reduce stress is important. Regular rest periods can help and so can relaxation, distraction, or visualization exercises. Exercise programs, participation in support groups, and good communication with the health care team are other ways to reduce stress. Learn about relaxation techniques that may relieve tension." } ]

[ { "from": "human", "value": "What is (are) Hearing Loss?" }, { "from": "gpt", "value": "Hearing loss is a common problem caused by noise, aging, disease, and heredity. Hearing is a complex sense involving both the ear's ability to detect sounds and the brain's ability to interpret those sounds, including the sounds of speech. Factors that determine how much hearing loss will negatively affect a persons quality of life include \n-the degree of the hearing loss\n-the pattern of hearing loss across different frequencies (pitches)\n-whether one or both ears is affected\n-the areas of the auditory system that are not working normallysuch as the middle ear, inner ear, neural pathways, or brain\n-the ability to recognize speech sounds\n- the history of exposures to loud noise and environmental or drug-related toxins that are harmful to hearing\n- age. the degree of the hearing loss the pattern of hearing loss across different frequencies (pitches) whether one or both ears is affected the areas of the auditory system that are not working normallysuch as the middle ear, inner ear, neural pathways, or brain the ability to recognize speech sounds the history of exposures to loud noise and environmental or drug-related toxins that are harmful to hearing age. A Common Problem in Older Adults Hearing loss is one of the most common conditions affecting older adults. Approximately 17 percent, or 36 million, of American adults report some degree of hearing loss. There is a strong relationship between age and reported hearing loss: 18 percent of American adults 45-64 years old, 30 percent of adults 65-74 years old, and 47 percent of adults 75 years old, or older, have a hearing impairment. Men are more likely to experience hearing loss than women. People with hearing loss may find it hard to have a conversation with friends and family. They may also have trouble understanding a doctor's advice, responding to warnings, and hearing doorbells and alarms. Types of Hearing Loss Hearing loss comes in many forms. It can range from a mild loss in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing. It can be hereditary or it can result from disease, trauma, certain medications, or long-term exposure to loud noises. There are two general categories of hearing loss. - Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is usually permanent.\n- Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax build-up, fluid, or a punctured eardrum. Medical treatment or surgery can usually restore conductive hearing loss. Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is usually permanent. Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax build-up, fluid, or a punctured eardrum. Medical treatment or surgery can usually restore conductive hearing loss. What is Presbycusis? One form of hearing loss, presbycusis, comes on gradually as a person ages. Presbycusis can occur because of changes in the inner ear, auditory nerve, middle ear, or outer ear. Some of its causes are aging, loud noise, heredity, head injury, infection, illness, certain prescription drugs, and circulation problems such as high blood pressure. Presbycusis commonly affects people over 50, many of whom are likely to lose some hearing each year. Having presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying. Tinnitus: A Common Symptom Tinnitus, also common in older people, is a ringing, roaring, clicking, hissing, or buzzing sound. It can come and go. It might be heard in one or both ears and be loud or soft. Tinnitus is a symptom, not a disease. It can accompany any type of hearing loss. It can be a side effect of medications. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also be the result of a number of health conditions. If you think you have tinnitus, see your primary care doctor. You may be referred to an otolaryngologist -- a surgeon who specializes in ear, nose, and throat diseases -- (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine the appropriate treatment. Hearing Loss Can Lead to Other Problems Some people may not want to admit they have trouble hearing. Older people who can't hear well may become depressed or may withdraw from others to avoid feeling frustrated or embarrassed about not understanding what is being said. Sometimes older people are mistakenly thought to be confused, unresponsive, or uncooperative just because they don't hear well. Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, you can get help. See your doctor. Hearing aids, special training, certain medicines, and surgery are some of the choices that can help people with hearing problems." } ]

[ { "from": "human", "value": "How to prevent Hearing Loss?" }, { "from": "gpt", "value": "Causes of Hearing Loss Hearing loss happens for many reasons. Some people lose their hearing slowly as they age. This condition is called presbycusis. Doctors do not know why presbycusis happens, but it seems to run in families. Another cause is the ear infection otitis media, which can lead to long-term hearing loss if it is not treated. Hearing loss can also result from taking certain medications. \"Ototoxic\" medications damage the inner ear, sometimes permanently. Some antibiotics are ototoxic. Even aspirin at some dosages can cause problems, but they are temporary. Check with your doctor if you notice a problem while taking a medication. Heredity can cause hearing loss, but not all inherited forms of hearing loss take place at birth. Some forms can show up later in life. In otosclerosis, which is thought to be a hereditary disease, an abnormal growth of bone prevents structures within the ear from working properly. A severe blow to the head also can cause hearing loss. Loud Noise Can Cause Hearing Loss One of the most common causes of hearing loss is loud noise. Loud noise can permanently damage the inner ear. Loud noise also contributes to tinnitus, which is a ringing, roaring, clicking, hissing, or buzzing sound in the ears. Approximately 15 percent (26 million) of Americans between the ages of 20 and 69 have high frequency hearing loss due to exposure to loud sounds or noise at work or in leisure activities. Avoiding Noise-Induced Hearing Loss Noise-induced hearing loss is 100 percent preventable. You can protect your hearing by avoiding noises at or above 85 decibels in loudness, which can damage your inner ear. These include gas lawnmowers, snowblowers, motorcycles, firecrackers, and loud music. Lower the volume on personal stereo systems and televisions. When you are involved in a loud activity, wear earplugs or other hearing protective devices. Be sure to protect children's ears too. Although awareness of noise levels is important, you should also be aware of how far away you are from loud noise and how long you are exposed to it. Avoid noises that are too loud (85 decibels and above). Reduce the sound if you can, or wear ear protection if you cannot. Potential damage from noise is caused by the loudness of the sound and the amount of time you are exposed to it. If you experience tinnitus or have trouble hearing after noise exposure, then you have been exposed to too much noise. Other Ways to Prevent Hearing Loss There are other ways to prevent hearing loss. - If earwax blockage is a problem for you, ask you doctor about treatments you can use at home such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax.\n- If you suspect that you may have a hole in your eardrum, you should consult a doctor before using such products. A hole in the eardrum can result in hearing loss and fluid discharge.\n- The ear infection otitis media is most common in children, but adults can get it, too. You can help prevent upper respiratory infections -- and a resulting ear infection -- by washing your hands frequently.\n- Ask your doctor about how to help prevent flu-related ear infections. If you still get an ear infection, see a doctor immediately before it becomes more serious.\n- If you take medications, ask your doctor if your medication is ototoxic, or potentially damaging to the ear. Ask if other medications can be used instead. If not, ask if the dosage can be safely reduced. Sometimes it cannot. However, your doctor should help you get the medication you need while trying to reduce unwanted side effects. If earwax blockage is a problem for you, ask you doctor about treatments you can use at home such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax. If you suspect that you may have a hole in your eardrum, you should consult a doctor before using such products. A hole in the eardrum can result in hearing loss and fluid discharge. The ear infection otitis media is most common in children, but adults can get it, too. You can help prevent upper respiratory infections -- and a resulting ear infection -- by washing your hands frequently. Ask your doctor about how to help prevent flu-related ear infections. If you still get an ear infection, see a doctor immediately before it becomes more serious. If you take medications, ask your doctor if your medication is ototoxic, or potentially damaging to the ear. Ask if other medications can be used instead. If not, ask if the dosage can be safely reduced. Sometimes it cannot. However, your doctor should help you get the medication you need while trying to reduce unwanted side effects." } ]

[ { "from": "human", "value": "What are the symptoms of Hearing Loss?" }, { "from": "gpt", "value": "Don't Ignore Hearing Problems Some people have a hearing problem without realizing it. Others might think they have a problem, but are too embarrassed to tell their doctor, friends, or family. You can help identify a possible hearing problem by asking yourself some key questions and, if necessary, having your hearing checked by a doctor. If a hearing loss is ignored or untreated, it can get worse. But a hearing loss that is identified early can be helped through treatment, such as hearing aids, certain medications, and surgery. Do You Have A Hearing Problem? Ask yourself the following questions. If you answer \"yes\" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked by a doctor. - Do I have a problem hearing on the telephone?\n- Do I have trouble hearing when there is noise in the background?\n- Is it hard for me to follow a conversation when two or more people talk at once?\n- Do I have to strain to understand a conversation?\n- Do many people I talk to seem to mumble or not speak clearly?\n- Do I misunderstand what others are saying and respond inappropriately?\n- Do I often ask people to repeat themselves?\n- Do I have trouble understanding women and children when they talk?\n- Do people complain that I turn the TV volume up too high?\n- Do I hear a ringing, roaring, clicking, buzzing, or hissing sound a lot?\n- Do some sounds seem too loud? Do I have a problem hearing on the telephone? Do I have trouble hearing when there is noise in the background? Is it hard for me to follow a conversation when two or more people talk at once? Do I have to strain to understand a conversation? Do many people I talk to seem to mumble or not speak clearly? Do I misunderstand what others are saying and respond inappropriately? Do I often ask people to repeat themselves? Do I have trouble understanding women and children when they talk? Do people complain that I turn the TV volume up too high? Do I hear a ringing, roaring, clicking, buzzing, or hissing sound a lot? Do some sounds seem too loud? Sudden sensorineural hearing loss, or sudden deafness, is a rapid loss of hearing. It can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. If you or someone you know experiences sudden sensorineural hearing loss, you should visit a doctor immediately. Who Should I See? The most important thing you can do if you think you have a hearing problem is to seek professional advice. There are several ways to do this. You may start with your primary care physician, an otolaryngologist, an audiologist, or a hearing aid specialist. Each has a different type of training and expertise. Each can be an important part of your hearing health care. An otolaryngologist\n-- a surgeon who specializes in ear, nose, and throat diseases -- will try to find out why you have a hearing loss and offer treatment options. He or she will ask you for your medical history, ask if other family members have hearing problems, perform a thorough exam, and prescribe any needed tests. An audiologist is a health professional who can identify and measure hearing loss. The audiologist will use a device called an audiometer to test your ability to hear sounds of different loudness and pitch (where the sound falls on the scale, from high to low). The tests that an audiologist performs are painless. Audiologists do not prescribe medications or perform surgery. If you need a hearing aid, some audiologists are licensed to help you choose the right one. A hearing aid specialist (or hearing aid dispenser) is a licensed professional that can check your hearing, fit a hearing aid, counsel and rehabilitate, evaluate treatment for tinnitus, and help with swim molds, ear molds, and noise protectors." } ]

[ { "from": "human", "value": "What are the treatments for Hearing Loss?" }, { "from": "gpt", "value": "Your doctor can recommend strategies to help reduce the effects of a hearing loss. Scientists are studying ways to develop new, more effective methods to treat and prevent hearing loss. Hearing Aids A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder so that a person with hearing loss can listen, communicate, and participate more fully in daily activities. A hearing aid can help people hear more in both quiet and noisy situations. However, only about one out of five people who would benefit from a hearing aid actually uses one. A hearing aid has three basic parts: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker. Types of Hearing Aids There are a number of different types of hearing aids to treat different kinds of hearing loss. Choosing one will depend on the kind of hearing loss you have, you lifestyle, and your own preferences. - Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic earmold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the earmold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic earmold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the earmold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. - Open-fit hearing aids fit completely behind the ear with only a narrow tube inserted into the ear canal. This lets the ear canal remain open. Open-fit hearing aids may be a good choice for people with a buildup of earwax since this type of aid is less likely to be damaged by earwax. Some people may prefer the open-fit hearing aid because they do not perceive their voice as sounding plugged up. Open-fit hearing aids fit completely behind the ear with only a narrow tube inserted into the ear canal. This lets the ear canal remain open. Open-fit hearing aids may be a good choice for people with a buildup of earwax since this type of aid is less likely to be damaged by earwax. Some people may prefer the open-fit hearing aid because they do not perceive their voice as sounding plugged up. - In-the-ear hearing aids fit completely inside the outer ear. The case holding the electronic components is made of hard plastic. Some in-the-ear hearing aids may also use a telecoil, which is a small magnetic coil that allows you to receive sound through the circuitry of the hearing aid, rather than through the microphone. You can use the telecoil when you use the telephone and when you are in public places that have installed induction loop systems, such as churches, schools, airports, and auditoriums. In-the-ear hearing aids fit completely inside the outer ear. The case holding the electronic components is made of hard plastic. Some in-the-ear hearing aids may also use a telecoil, which is a small magnetic coil that allows you to receive sound through the circuitry of the hearing aid, rather than through the microphone. You can use the telecoil when you use the telephone and when you are in public places that have installed induction loop systems, such as churches, schools, airports, and auditoriums. - Canal hearing aids fit into the ear canal and are available in two styles. The in-the-canal hearing aid is made to fit the size and shape of your ear canal. A completely-in-canal hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss. Because they are small, canal aids may be difficult for a person to adjust and remove. In addition, canal aids have less space available for batteries and additional devices, such as a telecoil. They usually are not recommended for people with severe to profound hearing loss because their reduced size limits their power and volume. Canal hearing aids fit into the ear canal and are available in two styles. The in-the-canal hearing aid is made to fit the size and shape of your ear canal. A completely-in-canal hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss. Because they are small, canal aids may be difficult for a person to adjust and remove. In addition, canal aids have less space available for batteries and additional devices, such as a telecoil. They usually are not recommended for people with severe to profound hearing loss because their reduced size limits their power and volume. An audiologist or hearing aid specialist can help you determine if a hearing aid, or even two hearing aids, is the right treatment for you. Wearing two hearing aids may help balance sounds, improve your understanding of words in noisy situations, and make it easier to locate the source of sounds. Cochlear Implants If your hearing loss is severe and of a certain type, your doctor may suggest that you talk to an otolaryngologista surgeon who specializes in ear, nose, and throat diseasesabout a cochlear implant. A cochlear implant is a small electronic device that the surgeon places under the skin and behind the ear. The device picks up sounds, changes them to electrical signals, and sends them past the non-working part of the inner ear and on to the brain. A cochlear implant does not restore or create normal hearing. Instead, it can help people who are deaf or who have a severe hearing loss be more aware of their surroundings and understand speech, sometimes well enough to use the telephone. Learning to interpret sounds from the implant takes time and practice. A speech-language pathologist and audiologist can help you with this part of the process. Assistive Listening Devices Assistive listening devices devices can help you hear in certain listening environments. These can include telephone and cell phone amplifying devices, smart phone or tablet \"apps,\" and closed circuit systems (induction coil loops) in places of worship, theaters, and auditoriums. TV listening systems help you listen to the television or the radio without being bothered by other noises around you. Some hearing aids can be plugged into televisions or stereos to help you hear better. New and Improved Treatments Under Study Researchers are studying the causes of hearing loss as well as new treatments. For example, they are studying ways to improve hearing aids so that wearers can hear certain sounds more clearly even when a person is surrounded by background noise. They are also studying how to improve cochlear implants to enhance a person's ability to understand sounds. And they are conducting a study on twins aged 50 and over to determine the extent to which age-related hearing loss runs in families." } ]

[ { "from": "human", "value": "How many people are affected by Hearing Loss?" }, { "from": "gpt", "value": "Approximately 17 percent, or 36 million, of American adults say that they have some degree of hearing loss. Hearing loss is a common condition in older adults. Roughly one-third of Americans 65 to 74 years of age and 47 percent of those 75 and older have hearing loss." } ]

[ { "from": "human", "value": "What is (are) Hearing Loss?" }, { "from": "gpt", "value": "Presbycusis is common in older adults. Presbycusis comes on gradually as a person ages and mostly affects people over 50. Doctors do not know why presbycusis happens, but it seems to run in families. Presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying. This type of hearing loss involves damage to the inner ear and is permanent. Tinnitus, also common in older people, is the ringing, roaring, clicking, hissing, or buzzing sound in the ears frequently caused by presbycusis, exposure to loud noise or certain medications. Tinnitus can accompany any type of hearing loss. It also can be a sign of other important health problems, too, such as allergies and problems in the heart and blood vessels. Tinnitus may come and go, or stop altogether." } ]

[ { "from": "human", "value": "What causes Hearing Loss?" }, { "from": "gpt", "value": "Hearing loss can result from taking certain medications. \"Ototoxic\" medications damage the inner ear, sometimes permanently. Check with your doctor if you notice a problem while taking a medication." } ]

[ { "from": "human", "value": "How to prevent Hearing Loss?" }, { "from": "gpt", "value": "Washing your hands frequently can help prevent upper respiratory infections, which can lead to an ear infection called otitis media. The ear infection otitis media can be a cause of long-term hearing loss. Also, ask your doctor about a yearly flu shot to help prevent flu-related ear infections. If you still get an ear infection, see a doctor immediately before it becomes more serious." } ]

[ { "from": "human", "value": "What are the treatments for Hearing Loss?" }, { "from": "gpt", "value": "Assistive Listening Devices Assistive listening devices devices can help you hear in certain listening environments. These can include telephone and cell phone amplifying devices, smart phone or tablet \"apps,\" and closed circuit systems (induction coil loops) in places of worship, theaters, and auditoriums. TV listening systems help you listen to the television or the radio without being bothered by other noises around you. Some hearing aids can be plugged into televisions or stereos to help you hear better. Cochlear Implant If your hearing loss is severe and of a certain type, your doctor may suggest that you talk to an otolaryngologist about a cochlear implant. An otolaryngologist is a surgeon who specializes in ear, nose, and throat diseases. A cochlear implant is a small electronic device that the surgeon places under the skin and behind the ear. The device picks up sounds, changes them to electrical signals, and sends them past the non-working part of the inner ear and on to the brain. Hearing through a cochlear implant sounds different from normal hearing, but it lets many people communicate orally in person and over the telephone, and perceive sounds in the environment." } ]

[ { "from": "human", "value": "How to prevent Hearing Loss?" }, { "from": "gpt", "value": "Researchers funded by the National Institutes of Health are studying the causes of hearing loss as well as new treatments. For example, they are studying ways to improve hearing aids so that you can hear certain sounds more clearly even when you are surrounded by background noise. They are also working to to improve cochlear implants and develop diagnostic methods to determine who would benefit from two versus one cochlear implant, especially in young children. Finding ways to improve access to accessible and affordable hearing health care, including screening and assessment, hearing aid selection and fitting, and rehabilitation of hearing loss, is also a goal of currently funded research." } ]

[ { "from": "human", "value": "What is (are) Low Vision?" }, { "from": "gpt", "value": "Everyday Tasks Are Challenging Low vision means that even with regular glasses, contact lenses, medicine, or surgery, people find everyday tasks difficult to do. Reading the mail, shopping, cooking, seeing the TV, and writing can seem challenging. Millions of Americans lose some of their vision every year. Irreversible vision loss is most common among people over age 65. Not a Normal Part of Aging Losing vision is not just part of getting older. Some normal changes occur as we get older. However, these changes usually don't lead to low vision." } ]

[ { "from": "human", "value": "What causes Low Vision?" }, { "from": "gpt", "value": "Eye Diseases and Health Conditions Most people develop low vision because of eye diseases and health conditions like macular degeneration, cataracts, glaucoma, and diabetes. Your eye care professional can tell the difference between normal changes in the aging eye and those caused by eye diseases. Injuries and Birth Defects A few people develop vision loss after eye injuries or from birth defects. Although vision that is lost usually cannot be restored, many people can make the most of the vision they have. How a Scene Looks to People With Normal and Low Vision Scene as viewed by a person with normal vision. Scene as viewed by a person with diabetic retinopathy. Scene as viewed by a person with age-related macular degeneration. Scene as viewed by a person with glaucoma. Scene as viewed by a person with cataracts." } ]

[ { "from": "human", "value": "What are the symptoms of Low Vision?" }, { "from": "gpt", "value": "There are many signs that can signal vision loss. For example, even with your regular glasses, do you have difficulty - recognizing faces of friends and relatives?\n- doing things that require you to see well up close, such as reading, cooking, sewing, fixing things around the house, or picking out and matching the color of your clothes?\n- doing things at work or home because lights seem dimmer than they used to?\n- reading street and bus signs or the names of stores? recognizing faces of friends and relatives? doing things that require you to see well up close, such as reading, cooking, sewing, fixing things around the house, or picking out and matching the color of your clothes? doing things at work or home because lights seem dimmer than they used to? reading street and bus signs or the names of stores? Early Diagnosis Is Important Vision changes like these could be early warning signs of eye disease. People over age 60 should have an eye exam through dilated pupils at least once a year. Usually, the earlier your problem is diagnosed, the better your chances of undergoing successful treatment and keeping your remaining vision. Regular dilated eye exams should be part of your routine health care. However, if you think your vision has recently changed, you should see your eye care professional as soon as possible." } ]

[ { "from": "human", "value": "What is (are) Low Vision?" }, { "from": "gpt", "value": "Low vision is a visual impairment, not correctable by standard glasses, contact lenses, medicine, or surgery, that interferes with a person's ability to perform everyday activities. " } ]

[ { "from": "human", "value": "What causes Low Vision?" }, { "from": "gpt", "value": "Low vision can result from a variety of diseases, disorders, and injuries that affect the eye. Many people with low vision have age-related macular degeneration, cataracts, glaucoma, or diabetic retinopathy. Age-related macular degeneration accounts for almost 45 percent of all cases of low vision." } ]