Alternative Medicine for the Elderly Springer-Verlag Berlin Heidelberg GmbH P. CHERNIACK· N. CHERNIACK (EDS.) Alternative Medicine for the Elderly , Springer Library of Congress Cataloging-in-Publication Data Alternative medicine for the elderly 1 Paul Cherniack, Neil Cherniack (eds.). p.;cm. ISBN 978-3-642-07913-9 ISBN 978-3-662-05185-6 (eBook) DOI 10.1007/978-3-662-05185-6 1. Alternative medicine. 2. Aged - Diseases - Alternative treatment. 1. Cherniack, Paul, 1959-II. Cherniack, Neil S. [DNLM: 1. Complementary Therapies - methods - Aged. WB 890 A46558 2003] R733.A469 2003 615.5'47-dc21 2003041540 ISBN 978-3-642-07913-9 This work is subject to copyright. AII rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broad casting, reproduction on microfilm or in any other way, in storage in data banks. Duplications of this publication or parts thereof is permitted only under the provision of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag Berlin Heidelberg GmbH. Violations are liable for prosecution under the German Copyright Law. http://www.springer.de/medizin © Springer-Verlag Berlin Heidelberg 2003 Originally published by Springer-Verlag Berlin Heidelberg New York in 2003 Softcover reprint of the hardcover 1s t edition 2003 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protec tive laws and regulations and therefore free for general use. Product liability: The publisher cannot guarantee the accuracy of any informat ion about dosage and application thereof contained in this book. In every individual case the user must check such informa tion by consulting the relevant literature. Cover Design: design & production, Heidelberg Typesetting: Hilger VerlagsService SPIN 10878049 3109 - 5432 10 Printed on acid free paper Foreword The explosion of information about complementary and alternative medicine (CAM) has demanded the attention of health professionals and responsible consumers, in cluding the elderly. Increasingly, medical schools are providing education about CAM. This book brings together for academicians and interested mainstream practitio ners much of the current information on CAM and its role in the health of the elderly. The individual chapters are thoroughly researched and quite readable, even for patients and the lay public concerned with the state of the evidence and art supporting CAM's role in prevention and management of illness and well-being. This book provides edu cators with much necessary information needed to prepare coursework and learning activities. Although definitive data are lacking regarding efficacy and even safety of CAM methodologies, many chapters in this book summarize the existing evidence in a us able way. The topics analyzed range from well-accepted therapies, such as vitamin E for dementia and zinc tablets for the common cold, to far less conventional therapies such as transcendental meditation. The conclusions are often surprising, but well-presented and defended. Even the most highly controversial areas, such as the use of acupuncture to treat low back pain and osteoarthritis of the knee, are thoroughly and fairly re viewed. Finally, the chapters address some of the political issues that challenge CAM. These issues include who should be allowed to practice a CAM discipline whose efficacy is not based on the scientific method, and some of the state-to-state variations in prac tice standards and licensure. Clearly, more research on CAM is needed. This book provides the information needed to guide both future investigational efforts and the attitudes that health care practitioners, grounded in conventional science but aware of its limitations, and older individuals, attracted by the promise of preservation of function and greater control over their own care, ought to have toward CAM as new evidence becomes available in the decades ahead. Spring 2003 Bernard A. Roos, MD, Director Division of Gerontology and Geriatric Medicine University of Miami School of Medicine Miami, Florida Table of Contents A Epidemiology 1 Patterns and Predictors of CAM Use Among Older Adults .................. 3 J.A.AsTiN Introduction .................................................... 3 Patterns of CAM Use ............................................. 3 Predictors of CAM Use ........................................... 5 Summary and Conclusions ........................................ 7 2 Why Do the Elderly Use Complementary and Alternative Medicine? ......... 9 A. FURNHAM Introduction .................................................... 9 What is CAM? ................................................... 10 CAM in the Elderly Patient ........................................ 13 Why Do People Choose CAM? ..................................... 15 The Consultation ................................................ 20 3 The Use of Alternative Medicine by the Elderly and the Doctor-Patient Relationship .................................. 27 E.P. CHERNIACK Introduction .................................................... 27 Characteristics of the Elderly Outpatient ........ . . . . . . . . . . . . . . . . . . .. 27 Physicians' Attitudes Towards CAM ................................ 31 Patients' Attitudes Towards CAM ........ . . . . . . . . . . . . . . . . . . . . . . . . . .. 35 4 Alternative Medicines and the Elderly ................................. 47 J.e. McELNAY AND e.M. HUGHES Definitions and Remit of the Chapter ............................... 47 Utilization Trends of Alternative Medicines by the Elderly. . . . . . . . . . . .. 47 Adverse Effects Associated with Alternative Medicines ................ 50 How Can the Elderly Patient Achieve Benefit from Alternative Medicine? 56 The Role of Conventional Health Care Professionals in Promoting the Safe and Effective Use of Alternative Medicines ...... 58 Conclusions ..................................................... 59 VIII Table of Contents 5 Ethical Issues Associated with CAM Use Among the Elderly . . . . . . . . . . . . . . . .. 63 P. KOMESAROFF Ethical Issues in Relation to Individuals ............................. 63 Ethical Issues in Relation to Society ................................ 68 Conclusion: The Need for a New Paradigm .......................... 70 6 Future Trends in Use - Focus on Transcendental Meditation as a Traditional System of Natural Medicine ............................ 73 R.H. SCHNEIDER, J.W. SALERNO AND S.1. NIDICH, WITH A PREFACE BY E.P. CHERNIACK Preface ......................................................... 73 Focus on Transcendental Meditation as a Traditional System of Natural Medicine .............................................. 75 Maharishi Vedic Medicine - Introduction and Theory ................ 77 Conclusion ...................................................... 84 B Types of Cam Used 7 Alternative Therapy: Vitamin Use in the Elderly . . . . . . . . . . . . . . . . . . . . . . . . .. 91 J.E. THURMAN, A.D. MOORADIAN Antioxidant Vitamins .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 92 Vitamin B Complex .............................................. 96 Other Vitamins .................................................. 101 Conclusions ..................................................... 103 8 Herbal Therapy and the Elderly ...................................... 111 B.A. BAUER Introduction .................................................... 111 Dementia ....................................................... 114 Depression ...................................................... 115 Anxiety ......................................................... 117 Post-Menopausal Symptoms ....................................... 118 Benign Prostate Hypertrophy ...................................... 121 Circulatory Problems: Claudication ................................ 122 Circulatory Problems: Venous Insufficiency ......................... 123 Energy Enhancers ................................................ 124 Osteoarthritis ................................................... 125 Discussing Herbs with Patients .................................... 127 Information Sources .............................................. 128 Table of Contents IX 9 The Use of Green Tea by the Elderly 133 F. AFAQ, V.M. ADHAMI, H. MUKHTAR Introduction .................................................... 133 Tea and Its Constituents .......................................... 134 Tea and Its Biochemical Properties ................................. 136 Tea, Disease Control and Prevention ................................ 137 Conclusions ................. " .................................. 141 10 Chiropractic Spinal Manipulation for the Elderly? ........................ 145 E.ERNST Introduction .................................................... 145 Definitions ...................................................... 145 Effectiveness .................................................... 146 Safety .......................................................... 149 Conclusion ...................................................... 151 11 Unconventional Western Medicine .................................... 153 R. MCCARNEY, P. FISHER Introduction .................................................... 153 Homeopathy .................................................... 153 Naturopathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 157 Anthroposophical Medicine ....................................... 160 Alexander Technique ............................................. 161 Aromatherapy ................................................... 163 Autogenic Training ............................................... 165 Hypnotherapy ................................................... 167 Massage ........................................................ 168 Conclusion ...................................................... 170 12 The Use of Traditional Japanese and Chinese Medicine for the Elderly . . . . . . .. 173 K. MIYAMOTO, WITH A PREFACE BY E.P. CHERNIACK Preface ......................................................... 173 Traditional Japanese and Chinese Medicine for the Elderly ............ 177 TCM and TJM ................................................... 177 13 Acupuncture in the Context ofTraditional Chinese Medicine ............... 195 N.S. CHERNIACK, E.P CHERNIACK Traditional Chinese Medicine ...................................... 196 Acupuncture .................................................... 197 x Table of Contents 14 Current Practice of Acupuncture - Use in Common Diseases of the Elderly .... 203 XIAO CHUN Yu, JIANG HONG YE, WEN HSIEN Wu The Meridians ................................................... 203 Acupoints ....................................................... 207 General Principles of Acupuncture ................................. 208 Needling Manipulations .......................................... 209 Application of Acupuncture in the Treatment of Diseases of the Elderly . 210 1S Tai Chi Use and the Elderly .......................................... 227 S.J. FARRELL General ......................................................... 227 Cardiopulmonary System ......................................... 228 Balance ......................................................... 230 Musculoskeletal System .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 231 Other Health Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 232 Summary ....................................................... 232 16 Ayurveda - The Ancient Scientific Medicine with Natural Healing ........... 235 1. RAMAKRISHNA KRISHNA, WITH A PREFACE BY E.P. CHERNIACK Preface ......................................................... 235 Ayurveda - The Ancient Scientific Medicine with Natural Healing ...... 236 Diagnosis and Treatment in Ayurveda .............................. 245 Conclusion ...................................................... 254 17 Herbal Folk Medicine ............................................... 257 E.P. CHERNIACK Stinging Nettles .................................................. 257 Willow Bark ..................................................... 258 Sassafras ........................................................ 258 Other Native American Medicines .................................. 258 European Folk Medicines ......................................... 259 African Folk Medicines ........................................... 259 18 Native American Elder Care .......................................... 265 L. MEHL-MADRONA Introduction .................................................... 265 Age Roles: Script Negotiation ...................................... 266 Culture and the Elderly ........................................... 267 Respect for the Aged and the Dead ................................. 268 Health in Native America ......................................... 268 Table of Contents XI Food and Health in Native America 270 Health, Hunter-Gatherers, and the Transition to Agriculture ........... 273 Native American Herbal Pharmacology ............................. 275 Mind-Body Therapies in Native America ............................ 278 Exercise in Native America ........................................ 278 Spiritual Therapies in Native America .............................. 279 Manipulative and Energy Therapies in Native America ............... 279 Agriculture and Health ........................................... 279 Oriental Medicine: Similarities to Native American Practice ........... 281 Place, Health, Modern Corporatization, and Aging .................... 281 Today's Situation .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 284 19 Looking After Our Elders: Healthcare and Well-being of the Elderly from the Perspective of Gwich'in and Other First Nations of Canada 287 R. WELSH, N.J. TURNER Introduction .................................................... 287 Food and Nutrition .............................................. 288 Shelter and Living Requirements ................................... 290 Self Sufficiency, Self Esteem and Respect ............................ 292 Medicine and Healing Needs ...................................... 293 Changes ........................................................ 295 20 Complementary and Alternative Medicine Use Among Latinos ............. 301 D. SALAS-LoPEZ, A. NATALE-PEREIRA Una de Gato (Cat's Claw) .......................................... 302 Menta (Mint) .................................................... 302 Rabo de Gato (Cat's tail) .......................................... 303 Rompepiedras (Stone busters) ..................................... 303 Cola de Caballo (Horse Tail) ....................................... 303 Diente de Leon (Lion's teeth) ...................................... 304 Rusco (Butcher's Broom) .......................................... 304 Gordolobo (Mullein) ............................................. 304 Yuca (Yucca) .................................................... 305 Verdolaga (Pursley) .............................................. 305 Trebol de Agua (Buckbean) ........................................ 305 Helecho macho (Male fern) ....................................... 305 Avena (Oatmeal plant) ............................................ 306 Cilantro (Coriander) ............................................. 306 Hierba centella (Cowslip) ......................................... 306 Migranela ....................................................... 307 Amapola ........................................................ 307