The Washington Post - 03.03.2020

E4 eZ ee THE WASHINGTON POST.TUESDAy, MARCH 3 , 2020

BY TEO ARMUS

Only George Hood’s forearms and toes were touching the platform as he h eld the r est of his b ody in midair: an exercise, known as planking, for his core but also for his arms and legs. Powered by the mix of heavy metal songs blaring over the speakers, the 62-year-old f rom Na- perville, Ill., didn’t look at the clock or even at t he t ime displayed on the phone in between his hands to control the music. He drank only periodic sips of water, and he didn’t eat much at all. Instead, he planked and planked and planked. Eight hours, 15 minutes and 15 seconds later, when he finally unclenched his thighs and stretched his arms out, Hood had broken the Guinness world r ecord for t he abdominal plank. The record-breaking feat, which Guinness officially an- nounced recently, caps nearly a decade of planking for the former Marine and Drug Enforcement Administration officer, who trained for hours each d ay t o raise awareness about mental health issues. “A lot of peers in my age group

... they use it as an excuse. ‘Oh, I’m
too old,’ ” he told The Washington
Post l ast week. “Well, I ’m c hanging
all that. I’m in the b est shape of my
life, and that’s how everybody
should f eel.”
The previous record for men’s
planking was set by Mao Weidong
of China, w ho in 2016 held a plank
for 8 hours, 1 minute and 1 second.
Canadian Dana Glowacka holds
the current record for women, at
4 hours, 19 minutes, 55 seconds.
Hood said he can’t remember
how he learned about the plank a
decade ago, back when the exer-
cise was unheard of in the U.S.
fitness world. But when he did, he
got hooked fast, and by early 2011,
at age 53, he was testing out the
move for five minutes at a time at
his gym in Illinois.
“It was a static exercise. There
was no movement involved. I
could put music in my ears at the
gym and lay on the floor and
plank,” h e said. “So I s aid to myself,
‘I think I can do this, I’ll t ry i t,’ and
I did.”
As a former Marine and super-
visory special agent with the D EA,
he had long been used to working
out to fit the part for his occupa-
tions. But planking provided a
kind of mental peace of mind that
weightlifting and other gym exer-
cises never c ould.
“When I plank, I don’t have to
sit in traffic. I don’t have to buy
gas. I don’t h ave to sit and l isten to
anyone... c omplain about how
tired they are,” he said. “I just
plank and that gives me all the
satisfaction I need.”
In fact, he said, planking has
allowed him to work through per-

sonal issues. While talking mid- plank, either to himself or to oth- ers, he often gets ensconced in his emotions, which both distract him and fuel him to hold the pose longer. Part of his goal in setting the Guinness record was raising awareness for mental health issues, particularly among military and l aw e nforcement o fficers. As h e planked for h ours, Hood’s intense poses became a full-time job. He was invited to Asia for international planking competi- tions in the mid-2010s and held a multihour plank aboard the USS Midway in honor of Veterans Day. Soon, an elevated platform for planking became the centerpiece of his home. “Do I have a social life?” h e said. “No, not one to really speak of, because all I do is train.” In 2014, China’s Mao had far surpassed a record Hood set in 2011, g oing 1 hour and 20 minutes. Two years later, Mao beat the American at a n event where Hood had surpassed his own record. There was always another record to beat, or another record beating that record that would be coming up in the queue of claims to the Guinness title. But Hood was s tarting to realize the t oll his p lanking a ddiction had taken on h im, a nd he w as ready to call it quits. Except he wanted to leave his planking career with a Guinness world record. As part of his 18-month prepa- ration, Hood stuck t o a strict train- ing regimen that took up about seven hours every day: 700 push- ups, 2,000 crunches, 500 toe squats, 500 band curls, 30 minutes of cardio and four to five hours of planking, broken up into three sets or less. Meals were in- terspersed in between, so that Hood wasn’t done with his last plank of the week until 10 p.m. on Sundays. The morning of the Feb. 15 chal- lenge required an even stricter routine: Hood woke up four hours before the planking, downed half a cup of oatmeal, an egg and lots of water, before purging his body of any food so that he could hold the pose without needing to go to the bathroom for more than eight hours. Then came the rock music: Van Halen and Te d Nugent, “Highway Star” by Deep Purple and Rammstein’s “Du Hast,” a ll played at earsplitting decibels in the gym to motivate him to hold the pose for longer than most people sleep at n ight. Once the world record was his, he took a short break and celebrat- ed with 75 consecutive push-ups. He told The Post that one of his next two goals is to break the world record for push-ups. His other goal? Make i t to age 100.

 more at washingtonpost.com/ nation

62-year-old vet planks

for over 8 hours, breaks

Guinness world record

Josef HolIc PHotogrAPHy

George Hood holds a plank, an exercise where only the forearms and toes touch the platform and the rest of the body is held in midair. “I’m in the best shape of my life,” the 62-year-old said.

Scientists have spotted in
rocks from northern China what
may be the oldest fossils of a
green plant ever found, tiny
seaweed that carpeted areas of
the seafloor about 1 billion years
ago and were part of a primordi-
al revolution among life on
Earth.
Last week, researchers said
the plant, called Proterocladus
antiquus, was about the size of a
rice grain and boasted numerous
thin branches, thriving in shal-
low water while attached to the
seafloor with a rootlike struc-
ture.
It may seem small, but Prot-
erocladus — a form of green
algae — was one of the largest
organisms of its time, sharing
the seas mainly with bacteria
and other microbes.
It engaged in photosynthesis,
transforming energy from sun-

light into chemical energy and producing oxygen. “Proterocladus antiquus is a close relative of the ancestor of all green plants alive today,” said Qing Tang, a Virginia Te ch post- doctoral researcher in paleobiol- ogy who detected the fossils in rock dug u p in Liaoning province near the city of Dalian and lead author of the study published in the journal Nature Ecology & Evolution. Earth’s biosphere depends heavily on plants for food and oxygen. The first land plants, thought to be descendants of green seaweeds, appeared about 450 million years ago. There was an evolutionary shift on Earth perhaps 2 billion years ago from simple bacteria- like cells to the first members of a group called eukaryotes that spans fungi, plants and animals.

The first plants were single- celled organisms. The transition to multicellular plants such as Proterocladus was a pivotal de- velopment that paved the way for the riot of plants that have inhabited the world, from ferns to sequoias to the Venus’ flytrap. Proterocladus is 200 million years older than the previous earliest-known green seaweed. One of its modern relatives is a type of edible seaweed called sea lettuce. Proterocladus represents the oldest unambiguous green plant fossil. Fossils of possible older single-celled green plants are still a matter of debate. Plants were not the first to practice photosynthesis. They had an ancestor that apparently acquired the photosynthesis cel- lular apparatus from a type of bacteria called cyanobacteria.

This ancestor of all green plants gave rise to two major branches; one of them includes some aquatic plants and all land plants while the other — the group to which Proterocladus belongs — is made up exclusively of aquatic plants. “Proterocladus antiquus is the sister of the evolutionary great, great grandmother of all green plants alive today,” Virginia Te ch paleobiologist and study co-author Shuhai Xiao said. — Reuters

Discovery in China may be the oldest fossil of a g reen plant, researchers say

toP: VIrgInIA tecH/reuters; rIgHt: DIngHuA yAng/reuters

TOP: A green seaweed fossil from China dating back 1 billion years as seen through a microscope. The fossil is about the size of a rice grain. The plant engaged in photosynthesis, transforming energy from sunlight into chemical energy and producing oxygen. RIGHT: A digital recreation of the plant, called Proterocladus antiquus, during prehistoric times.

A

l eading group of medi-
cal experts has de-
clined to endorse cog-
nitive screening for
older adults, fueling a
debate that has simmered for
years.
The U.S. Preventive Services
Ta sk Force said it could neither
recommend nor oppose cognitive
screening, citing insufficient sci-
entific evidence of the practice’s
benefits and harms and calling
for more studies.
The task force’s work informs
policies set by Medicare and pri-
vate insurers. Its recommenda-
tions, an accompanying scientific
statement and two editorials
were published last week in the
Journal of the American Medical
Association.
The task force’s position comes
as concern mounts over a rising
tide of older adults with Alzheim-
er’s disease and other dementias
and as treatments remain elusive.
Nearly 6 million Americans have
Alzheimer’s disease; that popula-
tion is expected to swell to nearly
14 million by 2050.
Because seniors are at higher
risk of cognitive impairment, pro-
ponents say screening — testing
people without any symptoms —
is an important strategy to identi-
fy p eople with unrecognized diffi-
culties and can potentially lead to
better care.
“This can start a discussion
with your doctor: ‘You know,
you’re having problems with your
cognition, let’s follow this up,’ ”
said Stephen Rao of Cleveland
Clinic’s L ou Ruvo Center for Brain
Health.
Opponents say the benefits of
screening are unproven and the
potential for harm is worrisome.
“Getting a positive result can
make someone wary about their
cognition and memory for the
rest of their life,” said Benjamin
Bensadon, an associate professor
of geriatric medicine at the Uni-
versity of Florida College of Medi-
cine.
The task force’s stance is con-
troversial, given how poorly the
health-care system serves seniors
with memory and thinking prob-
lems. Physicians routinely over-
look cognitive impairment and
dementia in older patients, failing
to recognize these conditions at
least 50 percent of the time, ac-
cording to several studies.
When the Alzheimer’s Associa-
tion surveyed 1,954 seniors in
December 2018, 82 percent said
they thought it was important to
have their thinking or memory
checked. But only 16 percent said
physicians regularly checked
their cognition.
Medicare policies appear to af-
firm the value of screening. Since
2011, Medicare has required that
physicians assess a patient’s cog-
nition during an annual wellness
visit. But only 19 percent of se-
niors took advantage of this vol-
untary benefit in 2016, the most
recent year for which data is avail-
able.
Ronald Petersen, co-author of
an editorial accompanying the
recommendations, cautioned
that they shouldn’t discourage
physicians from evaluating older
patients’ memory and thinking.
“There is increased awareness,
both on the part of patients and
physicians, of the importance of
cognitive impairment,” said Pe-
tersen, director of the Mayo Clin-
ic’s Alzheimer’s Disease Research
Center. “It would be a mistake if
physicians didn’t pay more atten-
tion to cognition and consider
screening on a case-by-case basis.”
Similarly, seniors shouldn’t
avoid addressing worrisome
symptoms.
“If someone has concerns or a
family member has concerns
about their memory or cognitive
abilities, they should certainly
discuss that with their clinician,”
said Douglas Owens, chair of the
task force and a professor at S tan-
ford University School of Medi-

cine. In more than a dozen inter- views, experts teased out com- plexities surrounding this topic. Here is what they told me: Screening basics. Cognitive screening involves administering short tests (usually five minutes or less) to people without any symptoms of cognitive decline. It’s an effort to bring to light problems with thinking and memory that otherwise might es- cape attention. Depending on the test, people may be asked to recall words, draw a clock face, name the date, spell a word backward, relate a recent news event or sort items into different categories, among other tasks. Common tests include the Mini-Cog, the Memory Impairment Screen, the General Practitioner Assessment of Cog- nition and the Mini-Mental Sta- tus Examination.

The task force’s evaluation fo- cuses on “universal screening”: whether all adults 65 and older without symptoms should be given tests to assess their cognition. It found a lack of high-quality scientific evidence that this practice would improve older adults’ quality of life, ensure that they get better care or positively affect other outcomes such as caregiv- ers’ efficacy and well-being. A disappointing study. High hopes had rested on a study by researchers at I ndiana University, published in December. In that trial, 1,723 older adults were screened for cognitive impairment, while 1,693 were not. A year later, seniors in the screening group were not more depressed or anxious — important evidence of the lack of harm from the assessment. But the study failed to find evidence that people screened had a better health-related quality of life or lower rates of hospitalizations or emergency department visits. Two-thirds of seniors who tested positive for cognitive impairment in the study declined to undergo further evaluation. That’s consistent with findings from other studies, and it testifies to “how many people are terrified of dementia,” said Timothy Hold- en, an assistant professor at Washington University School of Medicine in St. Louis. “What seems clear is that screening in and of itself doesn’t

yield benefits unless it’s a ccompa- nied by appropriate diagnostic follow-up and care,” said Nicole Fowler, associate director of the Center for Aging Research at I ndiana University’s Regenstrief Insti- tute. Selective screening. “Selective screening” for cognitive impairment is an alternative to universal screening and has gained sup- port. In a statement published in the fall, the American Academy of Neurology recommended that all patients 65 and older seen by neurologists get yearly cognitive health assessments. Also, the American Diabetes Association recommends that all adults with diabetes 65 and older be screened for cognitive impairment at an initial visit and annually thereaf- ter “as appropriate.” And the American College of Surgeons now recommends screening older adults for cognitive impairment before surgery. Why test select groups? Many patients with diabetes or neuro- logical conditions have overlap- ping cognitive symptoms and “it’s important to know if a patient is having trouble remembering what the doctor said,” said Nor- man Foster, chair of the work group that developed the neurology statement and a professor of neurology at the University of Utah. Physicians may need to alter treatment regimens for older adults with cognitive impairment or work more closely with family members. “If someone needs to manage their own care, it’s i mpor- tant to know if they can do that reliably,” Foster said. With surgery, older patients who have preexisting cognitive impairments are at higher risk of developing delirium, an acute, sudden-onset brain disorder. Identifying these patients can alert medical staff to this risk, which can be prevented or miti- gated with appropriate medical attention. Also, people who learn they have early-stage cognitive i mpair- ment can be connected with com- munity resources and take steps to plan for their future, medically and financially. The hope is that, one day, medical treatments will be able to halt or slow the progres- sion of dementia. But current treatments don’t f ulfill that prom- ise. Steps after screening. Screen- ing shouldn’t be confused with diagnosis: All these short tests can do is signal potential problems. If results indicate reason for concern, a physician should ask knowledgeable family members or friends what’s going on with an older patient. “A re they depressed? Having problems taking care of themselves? Asking the same question repeatedly?” said

David Reuben, chief of geriatrics at UCLA’s David Geffen School of Medicine and director of UCLA’s Alzheimer’s and Dementia Care program. A comprehensive history and physical examination should then be undertaken to rule out potential reversible causes of cognitive difficulties, implicated in about 10 percent of cases. These include sleep apnea, depression, hearing or vision loss, vitamin B12 or folic acid deficiencies, alcohol abuse and side effects from anticholin- ergic drugs or other medications, among other conditions. Once other causes are ruled out, neuropsychological tests can help establish a diagnosis. “If I detect mild cognitive impairment, the first thing I’ll do is tell a patient I don’t have any drugs for that but I can help you compensate for deficits,” Reuben said. The good news, he said: A substantial number of patients with mild cognitive impairment — a bout 50 percent — d on’t d evel- op dementia within five years of being diagnosed. The bottom line. “ If you’re con- cerned about your memory or thinking, ask your physician for an assessment,” said David Knop- man, a neurologist at the Mayo Clinic. If that test indicates reason for concern, make sure you get appropriate follow-up. That’s easier said than done if you want to see a dementia spe- cialist, said Soo Borson, a professor emerita of psychiatry at the University of Washington. “Every- one I know who’s doing clinical dementia care says they have wait lists of four to six months,” she said. With shortages of geriatric psy- chiatrists, geriatricians, neurop- sychologists and neurologists, there aren’t enough specialists to handle demands that would arise if universal screening for cognitive impairment were implement- ed, Borson said. If you’re a family member of an older adult who’s r esisting getting tested, “reach out privately to your primary care physician and express your concerns,” said Holden of Washington University. “A nd let your doctor know if the person isn’t seeing these changes or is resistant to talk about it.” This happens frequently because people with cognitive impairments are often unaware of their problems. “But there are ways that we, as physicians, can work around that,” Holden said. “If a physician handles the situa- tion with sensitivity and takes things one step at a time, you can build trust and that can make things much easier.”

this column is produced by Kaiser Health news, a nonprofit news service covering health-care policy and politics. It is not affiliated with Kaiser Permanente.

Cognitive screening still stirs debates

DIgItAlVIsIon Vectors/getty ImAges

The task force said it

could neither

recommend nor oppose

cognitive screening,

citing insufficient

scientific evidence.

Searing nocturnal pain... wapo.st/medicalmysteries

S04

61 1x1

The Washington Post - 03.03.2020

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