Monthly Archives: May 2024

The intertwining of breast cancer treatment, specifically chemotherapy, could potentially accelerate the physical deterioration in elderly individuals

A study led by UCLA suggests that older adults aged 65 or older with high-risk breast cancer who undergo chemotherapy are more prone to experiencing a significant decline in physical function. This research, published in a special issue of the Journal of Cancer Survivorship, reveals that over 30% of older women diagnosed with early-stage breast cancer and treated with chemotherapy encountered a notable reduction in their ability to perform daily activities such as walking or climbing stairs, compared to those who did not undergo chemotherapy and women of the same age without cancer.

This study stands as the first of its kind to contrast the functional decline in elderly individuals with early-stage breast cancer undergoing chemotherapy against breast cancer patients who did not receive chemotherapy, as well as age-matched women without cancer. Dr Mina Sedrak, the study’s first author and an associate professor of medicine at the David Geffen School of Medicine at UCLA, highlights the importance of this comparison in understanding whether such decline signifies an acceleration of the ageing process itself.

Breast cancer, particularly in older women, often leads to accelerated ageing and a decline in physical abilities. This phenomenon, termed accelerated ageing, can significantly impact individuals’ quality of life, independence, and even lifespan. Given the projected increase in the number of older breast cancer survivors — expected to surpass 6 million by 2040 — comprehending the mechanisms of accelerated ageing and devising strategies to mitigate it becomes paramount.

To delve deeper into the repercussions of breast cancer treatment on ageing-related declines in physical function, the researchers conducted a multicenter prospective study. They compared changes in physical function over time in women aged over 65, involving 444 women with early-stage breast cancer receiving chemotherapy, 98 receiving non-chemotherapy treatments, and 100 women without cancer of similar age.

Participants underwent two assessments: completing questionnaires on demographics and health status and a geriatric assessment. For breast cancer patients, additional data on cancer-specific and treatment-related characteristics were obtained from medical records. The second assessment, including another round of the geriatric evaluation, occurred within 30 days of completing chemotherapy for the chemotherapy group or at matched time points for the other two groups.

The analysis revealed that 30% of elderly adults receiving chemotherapy for breast cancer experienced a significant decline in physical function, compared to 8% among those who did not receive chemotherapy and 5% among those without cancer. Among those experiencing a notable decline, climbing stairs was the activity most adversely affected (75.7%), followed by walking one mile (73.0%) and engaging in moderate activity (68.6%).

These findings suggest that the combination of high-risk breast cancer and chemotherapy contributes to an accelerated decline in physical function among older adults with early-stage breast cancer. Dr. Sedrak emphasizes the impact of cancer and its treatment on physical function in older women, underscoring the importance of preserving physical function throughout the cancer journey.

The research team now aims to elucidate the biological mechanisms underlying the interplay between cancer treatment and fundamental ageing processes. Specifically, they are investigating cellular senescence and identifying mechanisms that could be targeted by drugs to potentially reverse these processes, offering hope for improving the quality of life for elderly breast cancer patients.

More information: Mina S. Sedrak et al, Functional decline in older breast cancer survivors treated with and without chemotherapy and non-cancer controls: results from the Hurria Older PatiEnts (HOPE) prospective study, Journal of Cancer Survivorship. DOI: 10.1007/s11764-024-01594-3

Journal information: Journal of Cancer Survivorship Provided by University of California, Los Angeles

Is difficulty swallowing and allergies in children and young adults due to eosinophilic esophagitis?

Eosinophilic esophagitis is characterized by inflammation of the oesophagal lining, leading to possible injury and throat narrowing. This condition can affect individuals of any age but is predominantly seen in children between 5 to 14 years and adults from 20 to 45 years. It occurs 3 to 4 times more frequently in males than females. There has been a noticeable increase in the incidence of this condition, particularly in North America and Europe. However, whether this is due to heightened awareness or an actual rise in the prevalence within the community remains to be seen.

The most common manifestations of eosinophilic esophagitis in adolescents and adults are difficulty swallowing and food lodged in the oesophagus. In contrast, children are more likely to experience symptoms such as abdominal pain, heartburn or reflux, a decreased appetite, chronic cough, vomiting, or failure to thrive. Remarkably, around 75% of patients with this condition have at least one atopic (allergic) condition, including food or environmental allergies, asthma, or eczema.

The diagnostic process typically involves taking the patient’s medical history and conducting 4 to 6 biopsies of the oesophagal tissue from at least two different areas during a gastroscopy or endoscopy. Management strategies, commonly called the “3 Ds” — diet, drugs, and oesophagal dilation — are implemented to mitigate long-term complications.

Distinguishing between eosinophilic esophagitis and eating disorders in adults is crucial as they can present similarly. Drs. Milli Gupta and Michelle Grinman from the Cumming School of Medicine at the University of Calgary highlight the importance of a detailed dietary history to understand the types of foods a patient avoids and the reasons behind such avoidance. For instance, individuals with eosinophilic esophagitis might steer clear of meat and bread due to previous choking incidents. In contrast, those with eating disorders might avoid these foods due to their caloric content.

The authors advocate for a collaborative approach in decision-making between the physician and the patient to lessen the impact of the disease and its treatment on the patient’s quality of life. They recommend a comprehensive treatment plan that may include dietary adjustments and medications tailored to the severity of the disease and the risk of future complications. Oesophageal dilation might be necessary for patients at high risk of food impaction, and consultations with a gastroenterologist and dietitian are advised to customize care.

More information: Milli Gupta et al, Diagnosis and management of eosinophilic esophagitis, Canadian Medical Association Journal. DOI: 10.1503/cmaj.230378

Journal information: Canadian Medical Association Journal Provided by Canadian Medical Association Journal

Grandmothers: The Answer to Adolescent Angst?

Recent research conducted jointly by Finland’s University of Turku and Edith Cowan University (ECU) sheds light on the profound impact of maternal grandmother investment on grandchildren who have endured multiple adverse early life experiences (AELEs). This study underscores how maternal grandmothers’ support and involvement can significantly mitigate emotional and behavioural challenges in affected children.

The findings underscore a crucial correlation: children facing cumulative AELEs are more susceptible to emotional and behavioural issues during adolescence. However, the research also highlights the pivotal role of supportive caregiving in shielding children from the adverse effects of early adversity.

Senior Lecturer at ECU, Dr David Coall, emphasises the significance of maternal grandmother investment in alleviating adolescent dysfunction stemming from early stressors. While no investment can entirely erase the effects of AELEs, the study reveals that maternal grandmother investment can notably diminish the negative impact on children’s emotional and behavioural well-being.

Interestingly, the research suggests that investments from other grandparents do not yield the same level of buffering effect. This disparity underscores maternal grandmothers’ unique and significant role in mitigating the consequences of early life stressors on grandchildren.

The study’s findings advocate for a deeper exploration into the long-term health and well-being outcomes of grandchildren, particularly in relation to the buffering effect of maternal grandmother investment. This nuanced understanding could potentially inform targeted interventions to foster resilience in children exposed to adverse early life experiences.

Dr Coall underscores the evolving nature of grandparental involvement, challenging the perception that such investments are relics of the past. With increasing life expectancy and shifting family dynamics, grandparents today have more opportunities to forge meaningful connections with fewer grandchildren, thereby enabling greater investment in each child’s well-being.

Moreover, societal shifts, such as higher divorce rates and increased single-parent households, underscore the growing importance of grandparental support in contemporary family structures. This trend is further amplified by the rise of working mothers, creating a heightened demand for intergenerational support and caregiving.

Despite geographical distances, modern technology enables grandchildren to maintain close relationships with grandparents, transcending physical barriers. Despite the challenges posed by events like the COVID-19 pandemic, virtual connections have proven invaluable in sustaining familial bonds and facilitating grandparental investment in children’s lives.

In essence, this research underscores the pivotal role of maternal grandmothers in buffering the adverse effects of early life stressors on grandchildren. By nurturing supportive relationships and providing emotional and practical support, grandmothers emerge as potent agents of resilience in navigating the complexities of adolescent development.

More information: Samuli Helle et al, Investment by maternal grandmother buffers children against the impacts of adverse early life experiences, Scientific Reports. DOI: 10.1038/s41598-024-56760-5

Journal information: Scientific Reports Provided by Edith Cowan University

A study on calorie restriction unveils intricacies in the relationship between diet and the ageing process

Researchers at Penn State may have uncovered another layer of complexity in the mystery surrounding how diet influences the ageing process. A recent study, spearheaded by researchers from the Penn State College of Health and Human Development, delved into the impact of caloric restriction on telomeres – the protective caps at the ends of chromosomes composed of genetic bases.

Published in Aging Cell, the study analysed data from a two-year investigation into human caloric restriction. The findings revealed that individuals who restricted their calorie intake experienced varying rates of telomere loss compared to the control group, despite both groups ending the study with telomeres of approximately equal length. Previous research has indicated that restricting calories by 20% to 60% can contribute to extended lifespans in various animal models.

Throughout a human lifespan, each time cells replicate, some telomeres are lost as chromosomes are copied into new cells. This continual loss shortens the overall length of telomeres. Eventually, the protective cap provided by telomeres is depleted, leaving genetic information vulnerable to damage, which can hinder cellular function and reproduction. Longer telomeres indicate a younger functional age for a cell, highlighting that individuals of the same chronological age may possess different biological ages based on telomere length.

Factors such as typical ageing, stress, illness, genetics, and diet can influence the frequency of cell replication and the extent to which telomeres retain their length. Idan Shalev, associate professor of biobehavioral health at Penn State, led the team analysing genetic samples from the CALERIE study – the first randomised clinical trial of human calorie restriction. They aimed to ascertain the impact of caloric restriction on telomere length, offering insight into how this dietary intervention may decelerate ageing.

Waylon Hastings, lead author of the study and a 2020 Penn State doctoral graduate in biobehavioral health, emphasised the multifaceted mechanisms through which caloric restriction potentially extends the human lifespan. One primary mechanism involves cellular metabolism; reduced energy consumption within cells during caloric restriction leads to fewer waste products, mitigating oxidative stress and preserving cellular integrity.

The researchers evaluated telomere length in 175 study participants at the onset of the CALERIE study, after one year, and upon its conclusion after 24 months of caloric restriction. Approximately two-thirds of the participants adhered to caloric restriction, with the remaining third being the control group.

During the study, telomere loss exhibited changing trajectories. In the initial year, participants undergoing caloric restriction experienced rapid telomere loss alongside weight reduction compared to the control group. Subsequently, telomere loss slowed down during the second year as participants on caloric restriction stabilised their weight after one year. By the study’s end, both groups exhibited similar telomere lengths.

Shalev highlighted the unexpected findings, noting that while they hypothesised slower telomere loss among those on caloric restriction, the initial rapid loss followed by a slower rate was observed instead.

The results prompted numerous questions, including the potential impact of an additional year of data collection. Study participants are scheduled for a 10-year follow-up, which Shalev anticipates will provide further insights.

Despite the nuanced results, there remains promise regarding the potential health benefits of caloric restriction in humans. Previous analyses of CALERIE data have indicated potential reductions in harmful cholesterol levels and blood pressure due to caloric restriction. Although the two-year timeline did not reveal evident telomere-related benefits, further investigations may unveil them.

The research team, led by Shalev, comprised three of his trainees: Hastings, current graduate student Qiaofeng Ye, and former postdoctoral scholar Sarah Wolf. Hastings expressed gratitude for the opportunity to lead the study, acknowledging its pivotal role in shaping his career trajectory. As he prepares to embark on his role as an assistant professor in the Department of Nutrition at Texas A&M University, Hastings credits this project for providing invaluable experience in nutrition research under Shalev’s guidance.

More information: Waylon J. Hastings et al, Effect of long-term caloric restriction on telomere length in healthy adults: CALERIE™ 2 trial analysis, Aging Cell. DOI: 10.1111/acel.14149

Journal information: Aging Cell Provided by Penn State

Studies on atopic dermatitis lack patient images

Sam Polesie, an associate professor at the Sahlgrenska Academy, University of Gothenburg, and a dermatologist at Sahlgrenska University Hospital, has led a significant study on visualising patient conditions in scientific research.

Polesie emphasises a crucial shift in patient care, highlighting the increased empowerment of patients in their healthcare decisions. This participatory approach necessitates healthcare professionals to make treatment decisions with their patients. However, Polesie observes that scientific literature has not fully embraced these changes. He advocates for including more patient images in scientific publications to facilitate communication, asserting that the intricate figures currently used can be daunting for patients to comprehend, particularly when describing the severity of conditions or the potential effects of treatments. This shift could significantly empower patients in their healthcare journey.

The study, which also involved Danish researchers, revealed concerning statistics about the representation of patients in scientific journals, particularly those with psoriasis and atopic dermatitis. Despite reviewing 60 studies encompassing nearly 18,000 patients, only 16 images from six patients were used across these publications, equating to a mere 0.3 per thousand of the depicted patients.

Atopic dermatitis, a familiar yet variably severe chronic inflammatory skin disease, affects about 25% of children and 10% of adults. It can cause dry, itchy skin patches and severely impact a person’s quality of life in more severe cases. Polesie explains that the appearance of eczema varies significantly across different skin tones. In lighter-skinned individuals, eczema may appear red, while in those with melanin-rich skin, it tends to show up darker, often perceived as purple or greyish. This variability makes the need for diverse patient images in educational materials even more critical.

According to Polesie, there’s an urgent need to expand the visual resources available in medical education. He proposes that having a comprehensive set of images illustrating various types of atopic dermatitis across different patient groups and their responses to treatments would significantly enhance the training of healthcare professionals and medical students and also aid in educating patients themselves. This aligns with international recommendations and guidelines emphasising patient education’s importance in managing atopic dermatitis. This could open up new opportunities for healthcare professionals and medical students to enhance their understanding and skills in dermatology.

Moreover, more images are needed to improve patient education and care and hinder the advancement of artificial intelligence in dermatology. Machine learning algorithms necessitate extensive datasets of images to be effectively trained. With more comprehensive image collections, these AI systems could revolutionise dermatology, assisting dermatologists in identifying the most effective treatment options tailored to individual patients shortly. This presents an exciting prospect for the future of dermatological care.

Polesie’s findings, published in the Journal of Dermatological Treatment, underscore a significant gap in integrating visual aids in scientific documentation and education concerning dermatological conditions. If addressed, this gap could enhance patient understanding, participation, and the effectiveness of treatment regimens.

More information: Sam Polesie et al, A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy, Journal of Dermatological Treatment. DOI: 10.1080/09546634.2024.2338280

Journal information: Journal of Dermatological Treatment Provided by University of Gothenbur

New tool developed for investigating the mechanisms of cancer, autoimmunity, and neurodegeneration through screening

The team has pioneered an innovative screening tool, scSNV-seq, that delves into the intricate relationship between genetic alterations and gene activity, potentially shedding light on the origins of various diseases, from cancer to cardiovascular conditions. This state-of-the-art tool revolutionises the field by enabling the simultaneous investigation of numerous DNA mutations previously identified in genetic studies within a single experiment. Its versatility and effectiveness pave the way for developing sophisticated diagnostic methods and treatments.

The scSNV-seq method is not just a theoretical concept but a practical tool that empowers scientists to quickly evaluate the effects of numerous genetic alterations in cells that have not been previously screened. This approach provides a holistic perspective by linking these changes directly to cellular functions, enabling researchers to identify specific mutations that contribute to diseases. This practical application is crucial for developing targeted therapies.

A recent study published in Genome Biology highlights the application of scSNV-seq by researchers at the Wellcome Sanger Institute and their collaborators at Open Targets and EMBL’s European Bioinformatics Institute (EMBL-EBI). In this study, scSNV-seq was applied to the blood cancer gene JAK1, where it precisely determined the impacts of mutations, unveiling a previously unknown “halfway house” phenotype that fluctuates between different states, a discovery not achievable with earlier methodologies.

scSNV-seq is designed for versatility across various cell types, including challenging primary cells like T cells and stem-cell-derived neurons. It accommodates different editing techniques, such as base and prime editing. When applied on a large scale, this technique has the potential to revolutionise our understanding of the genetic alterations that drive cancer and aid in decoding genetic risks for complex diseases like Alzheimer’s, arthritis, and diabetes.

Despite the exponential growth in the identification of genetic variants linked to diseases, thanks to advancements in human genetics and the increased affordability of DNA sequencing technologies, the tools available for interpreting these variants often need to be improved, sometimes relying on laborious manual processes. Additionally, when introducing specific mutations using advanced gene-editing tools, current screening methods struggle to differentiate between cells where the editing was unsuccessful and those where it introduced benign changes without affecting cellular behaviour.

To tackle these challenges, researchers developed scSNV-seq, a technique that directly correlates the genetic makeup of a cell with its gene activity. The effectiveness of scSNV-seq was demonstrated through experiments on the JAK1 gene, associated with inflammation and cancer, to observe the effects of specific DNA modifications on cell behaviour. This technique categorised genetic alterations into three groups: benign, loss of function, and altered function, and revealed mutations that resulted in an intermediate phenotype cycling between states—insights unattainable with previous methods.

Dr Sarah Cooper, the first author of the study from the Wellcome Sanger Institute, emphasised the significance of scSNV-seq in the current genetic landscape, where the rate of variant discovery surpasses our capacity to interpret their impacts. She noted that scSNV-seq is already being used to explore how genetic variants associated with Alzheimer’s and Parkinson’s diseases affect brain cells.

Dr Andrew Bassett, the senior author of the study, also from the Wellcome Sanger Institute, highlighted that their technique uniquely connects mutation effects to cellular behaviours, uncovering downstream impacts previously invisible with older technologies. He remarked that this method accelerates the identification of causal genetic mutations, enhancing diagnostics and deepening our understanding of molecular disease mechanisms, ultimately paving the way for more targeted and effective treatments.

More information: Sarah E. Cooper et al, scSNV-seq: high-throughput phenotyping of single nucleotide variants by coupled single-cell genotyping and transcriptomics, Genome Biology. DOI: 10.1186/s13059-024-03169-y

Journal information: Genome Biology Provided by Wellcome Sanger Institute

Adult fish face challenges in recovering within marine protected areas

In the vast expanse of the ocean, age holds profound significance in safeguarding marine life. A robust cohort of adult organisms is imperative for perpetuating generations in the underwater realm. However, despite the noble intentions behind their establishment, many marine protected areas (MPAs) need to fulfil their fundamental purpose: revitalising struggling fish populations. In a groundbreaking study unveiled on April 4 in Global Change Biology, researchers embarked on a pioneering quest to scrutinise the age composition of reef-dwelling fish within marine sanctuaries. Their findings were stark: across the board, the populations of adult fish within these havens either stagnated or dwindled.

Steve Canty, a marine ecologist affiliated with the Smithsonian Environmental Research Center and one of the study’s principal investigators, underscored the pivotal role of adult fish in marine ecosystems. He elucidated, “Adult fish play a pivotal role in multiple facets. They constitute the primary catch in commercial fisheries, thereby sustaining the livelihoods and nutritional needs of coastal communities. Moreover, it is the adults that foster reproduction and replenish fish stocks, wherein size assumes paramount importance. Larger and older female fish yield greater quantities of superior-quality eggs, thus emerging as linchpins in the restoration of fish populations.”

This revelation assumes heightened significance against the backdrop of the global race to achieve the “30 by 30” target, which aims to conserve 30% of the Earth’s oceans by 2030. Envisioned during the United Nations Biodiversity Conference in December 2022, this ambitious objective holds profound implications. However, its realisation hinges on the judicious selection of sites conducive to the flourishing of marine life while concurrently accommodating the needs of coastal communities.

The study, conducted in the realm of the Mesoamerican Reef, sheds light on this problem. Extending over 600 miles along the coasts of southern Mexico, Belize, Guatemala, and Honduras, the Mesoamerican Reef stands as the longest reef in the Western Hemisphere. Renowned as a biodiversity hotspot, this region harbours over 500 fish species and 60 varieties of corals and hosts one of the most extensive congregations of whale sharks on the planet. Moreover, the marine resources of this ecosystem underpin the sustenance and food security of over a million individuals.

Delving deeper, the researchers scrutinised the biomass of adult versus juvenile fish across 139 reef sites, comprising 111 protected and 28 unprotected areas. Within the Mesoamerican Reef, protected sites are categorised into three tiers: “fully protected areas,” where fishing activities are entirely prohibited; “highly protected areas,” permitting limited activities such as subsistence and catch-and-release sport fishing; and “general use zones,” where commercial fishing is often permitted albeit subject to restrictions on specific methods or equipment. Alarmingly, only a meagre 24% of the marine protected areas under scrutiny qualified as either fully or highly protected.

Melanie McField, co-author and director of the Healthy Reefs Initiative, lamented the intrinsic challenges associated with curtailing fishing activities. She remarked, “Prohibiting fishing in any marine domain poses a formidable challenge, seemingly conflicting with inherent human instincts. Nonetheless, the comprehensive protection and stringent enforcement of these areas represent the most efficacious strategy for nurturing larger fish populations capable of stimulating stock recoveries and augmenting overall fish yields beyond the confines of fully protected zones.”

Drawing upon data furnished by the Healthy Reefs Initiative, the research team meticulously analysed fish biomass trends spanning 12 years, from 2006 to 2018. Their findings painted a disturbing picture: despite their avowed objective of replenishing fish stocks, merely 8% of the surveyed sites witnessed significant upsurges in adult biomass. Conversely, the majority of sites exhibited no discernible alteration, with 28 sites reporting declines. A common thread among the declinatory sites was the prevalence of heavy coastal development in proximity, coupled with elevated sea surface temperatures. Notably, these sites predominantly fell within general use zones, characterised by lax enforcement and susceptibility to unabated exploitation.

Abel Valdivia, a marine conservation scientist affiliated with the World Wildlife Fund and co-author of the study, underscored the pernicious ramifications of minimal protection within weakly enforced MPAs. He elucidated, “Contrary to conventional wisdom, scant protection within feeble MPAs proves more deleterious than the absence of protection altogether. It engenders continued and concentrated exploitation sans efficacious oversight. Unlike open-access zones, where fishing pressure may be dispersed, inadequately protected areas succumb to unchecked coastal development, escalating sea temperatures, and deficient enforcement, thereby precipitating declines in adult biomass.”

However, amidst the bleak panorama, a glimmer of hope emanates from the 11 sites where adult fish populations experienced resurgences. Commonalities among these sites include their location within fully protected areas boasting robust enforcement measures, limited occurrences of sea surface temperature anomalies, and adjacency to regions characterised by a diminished human footprint.

This panoramic vista of the Mesoamerican Reef proffers invaluable insights into the global pursuit of the “30 by 30” conservation agenda. The cornerstone of MPA efficacy lies in the implementation of stringent enforcement mechanisms and prudent management practices bolstered by robust community engagement. Furthermore, the imperative of selecting sites cognisant of climate change emerges as a linchpin in this conservation endeavour. While certain oceanic domains may inevitably succumb to the ravages of warming waters, identifying sites capable of serving as climate refuges for both adult and juvenile life stages assumes paramount importance.

Justin Nowakowski, another lead author and ecologist affiliated with the Smithsonian Environmental Research Center, underscored the disparate responses exhibited by adult and juvenile fish to management interventions and environmental perturbations. He postulated, “Adult and juvenile fish evince disparate sensitivities to stressors such as climate change, thereby undermining the local efficacy of MPAs. The crux of the matter lies in identifying optimal sites for new MPAs to maximise positive outcomes for regional fisheries. This necessitates a nuanced understanding of the distinct requirements of adult and juvenile life stages, failing which, we risk overlooking the holistic picture.”

The study furnishes a clarion call to action, urging policymakers and stakeholders to recalibrate existing conservation paradigms. By prioritising robust enforcement, community participation, and climate-resilient site selection, the aspirations encapsulated within the “30 by 30” agenda may yet metamorphose into tangible realities, fostering the rejuvenation of our planet’s marine ecosystems.

More information: Steven W. J. Canty et al, Interplay of management and environmental drivers shifts size structure of reef fish communities, Global Change Biology. DOI: 10.1111/gcb.17257

Journal information: Global Change Biology Provided by Smithsonian

Stressful experiences during middle age may be a risk factor for developing Alzheimer’s disease in later years

The study’s findings, which suggest a potential link between stressful experiences in midlife or during childhood and a higher risk of developing Alzheimer’s disease and neuroinflammation, are significant. Published in the Annals of Neurology by the Barcelona Institute for Global Health (ISGlobal), this research, supported by the “la Caixa” Foundation and in collaboration with the Barcelonaβeta Brain Research Center (BBRC), a Pasqual Maragall Foundation research centre, provides valuable insights into the complex relationship between stress and brain health.

Stressful Life Events refer to situations where objective external threats prompt behavioural and psychological responses, such as the death of a loved one, unemployment, or illness. There is growing evidence that stress could be associated with an increased risk of dementia and cognitive decline.

The research was conducted with a rigorous approach, aiming to determine whether the accumulation of stressful life events throughout an individual’s life could influence the development of pathologies related to Alzheimer’s in older age. To ensure comprehensive results, the research team engaged 1,290 volunteers from the ALFA cohort in Barcelona, also supported by the “la Caixa” Foundation. All participants were cognitively unimpaired at the study’s start but had a direct family history of Alzheimer’s disease.

The participants underwent interviews to evaluate their number of Stressful Life Events. They also underwent lumbar punctures and magnetic resonance imaging (MRI) to assess various biomarkers associated with Alzheimer’s disease.

The study highlighted midlife as a particularly vulnerable period. Statistical analysis showed that the accumulation of stressful events during this phase was linked to higher levels of β-amyloid (Aβ) protein, a critical factor in the development of Alzheimer’s disease. Eleni Palpatzis, an ISGlobal researcher and the first author of the study, noted that midlife might represent a susceptible period where psychological stress could have a lasting impact on brain health.

Additionally, the research indicated that higher levels of stressful experiences in childhood were associated with an increased risk of neuroinflammation in later life. Inflammation is a crucial molecular response in neurodegenerative diseases, and these findings align with emerging evidence that links childhood trauma to increased inflammation in adulthood.

The study also explored sex differences and the impact of stressors. It found that the accumulation of stressful life events was associated with higher levels of β-amyloid (Aβ) protein only in men. In women, however, more stressful experiences over life were linked to lower volumes of grey matter, suggesting that stress might have sex-specific effects on the brain.

Eider Arenaza-Urquijo, an ISGlobal researcher and the study’s last author, commented that the mechanisms through which life stressors affect brain health appear to differ between men and women, with amyloid protein accumulation observed in men and brain atrophy in women.

The study also highlighted that individuals with a psychiatric history might be more susceptible to the effects of stressful life events. This group showed higher levels of Aβ and tau proteins, neuroinflammation, and lower grey matter volume, potentially due to impaired stress-coping abilities making them more vulnerable.

The study’s findings, which support the notion that stress could significantly impact the development of Alzheimer’s disease, have potential implications for our understanding and management of this condition. The research provides preliminary insights into the mechanisms behind this effect, but further research is necessary to replicate and validate these initial findings, underscoring the importance of ongoing research in this field.

More information: Eleni Palpatzis et al, Lifetime Stressful Events Associated with Alzheimer’s Pathologies, Neuroinflammation and Brain Structure in a Risk Enriched Cohort, Annals of Neurology. DOI: 10.1002/ana.26881

Journal information: Annals of Neurology Provided by Barcelona Institute for Global Health (ISGLOBAL)

Utilising health records to anticipate patients’ susceptibility to falling

Using health records to forecast patients’ risk of falling within the next 12 months is feasible through a newly devised calculator based on NHS data. Known as eFalls, this falls prediction model utilises readily available primary care electronic health record data, marking a pioneering initiative globally. Developed and validated by researchers from the University of Leeds, the University of Birmingham, and a collaborative team supported by funding from the National Institute for Health and Care Research (NIHR), eFalls aims to pinpoint individuals at risk of hospitalisation or emergency department visits following a fall in the upcoming year. This proactive identification enables the provision of interventions to mitigate the occurrence of falls.

Detailed in a research paper published in Age and Ageing, the study underscores the significance of addressing falls among individuals aged 65 and above, given their potential impact on personal independence. The multifactorial nature of fall risks includes factors such as mobility or balance-affecting conditions, medications, and home hazards, with a history of falls being a prominent risk indicator. Moreover, the prevalence of falls is expected to escalate with the global ageing demographic.

The implications of these findings are substantial for proactive fall risk identification. By leveraging existing primary care data, eFalls streamlines the process, reducing the necessity for exhaustive clinical fall assessments and saving valuable time for healthcare professionals. Upon identification of individuals at risk, referral to specialist fall prevention services becomes feasible, facilitating assessment and treatment to avert future falls.

According to estimates from the National Institute for Health and Care Excellence (NICE), a significant proportion of falls result in severe injuries such as major lacerations, traumatic brain injuries, or fractures, alongside other complications such as distress, pain, and loss of independence. Andrew Clegg, Principal Investigator and Professor of Geriatric Medicine at the University of Leeds, emphasises the global significance of falls as a health concern, highlighting the proactive nature of eFalls in mitigating risks and reducing the burden on healthcare systems.

Lead author Lucinda Archer, Assistant Professor in Biostatistics at the University of Birmingham, underscores the potential of the eFalls calculator to predict fall risks based on existing GP records. Promising accuracy has been demonstrated through extensive testing across large datasets. Employing eFalls to target individuals needing specialist assessment holds promise for enhancing fall prevention services in the UK.

Health Minister Andrew Stephenson lauds innovations like eFalls for their potential to prevent falls, alleviate pain, and reduce resource strain on the NHS. As part of ongoing efforts to ensure timely and appropriate care, Stephenson underscores the importance of solutions like eFalls in addressing a widespread issue.

The research team embarked on a rigorous process to develop a robust method for proactively identifying individuals for fall prevention interventions, addressing the current scarcity of such systems. They drew from a vast dataset encompassing over 750,000 healthcare records to refine and validate the eFalls tool. This extensive testing demonstrated its potential in integrating with primary care electronic patient record systems in the UK, paving the way for its future implementation.

Looking ahead, the researchers aim to integrate the eFalls prediction model into UK primary care systems, collaborating with policymakers to explore its potential contributions to health policy. By harnessing the power of predictive analytics, eFalls represents a significant step towards enhancing preventive healthcare interventions and mitigating the burden of falls among older populations.

More information: Lucinda Archer et al, Development and external validation of the eFalls tool: a multivariable prediction model for the risk of ED attendance or hospitalisation with a fall or fracture in older adults, Age and Ageing. DOI: 10.1093/ageing/afae057

Journal information: Age and Ageing Provided by University of Leeds

Rural pharmacists play a crucial role in home-based palliative care

According to new findings, pharmacists are increasingly acknowledged for their essential contributions to supporting patients receiving home-based palliative care in rural areas. This research indicates that these professionals empower patients to remain at home and deliver considerable comfort and reassurance to patients, their caregivers, and their families.

The research, conducted by the University of South Australia with the support of the Pharmaceutical Society of Australia, demonstrates that pharmacists specializing in home palliative care significantly improve medication management, enhance communication between patients and their healthcare teams, and reduce the need for general practitioner visits.

The study focuses on the real-world influence of home palliative care pharmacists in rural South Australia. It evaluates the efficacy of this care model through the lens of healthcare professionals.

Globally, approximately 56.8 million people, including 25.7 million in their final year of life, require palliative care. However, only about 14% of those in need receive these services. As the population ages, the demand for palliative care is rising worldwide.

Tash Downing, the lead researcher and pharmacist, points out that although pharmacists are not traditionally seen as part of home palliative care teams, they hold an invaluable position.

“Many patients in palliative care express a preference for being at home, where they feel most comfortable and close to their loved ones. Nevertheless, home-based care presents numerous challenges, particularly in managing medications,” explains Downing.

Effective medication management can alleviate symptoms and enhance quality of life, but it often burdens patients, caregivers, and other medical professionals.

“Our findings suggest that incorporating a pharmacist into the rural palliative care team can mitigate workforce shortages in these areas and elevate the standard of available care for rural patients,” Downing adds.

Crucially, having a local pharmacist allows patients to make more informed choices about their care. They benefit from trusted, regional coordination of prescriptions and medications, reduced need for travel to appointments, and lower levels of distress.

Health professionals participating in the study also noted that the presence of a home palliative care pharmacist improved communication with the treating team, lightened the workload for other health professionals, and lessened the care disparity between rural and urban patients.

The pilot program, launched by the Pharmaceutical Society of Australia and funded by the South Australian Department for Health and Wellbeing, facilitated a pharmacist to deliver home-based care services in regional South Australia. This study assessed the care model by exploring the experiences of healthcare professionals who had worked with the palliative care patients involved in this initiative.

Dr. Gemma Skaczkowski, a co-researcher from the Department of Rural Health at the University of South Australia, remarks that this rural model of palliative care has been exceedingly effective in the areas participating in the pilot.

“By delineating the benefits and challenges of the pharmacist’s role as perceived by other healthcare professionals, we aim to draw more attention to the necessity of such a care model in rural settings and, ultimately, to enhance the palliative experience for patients, irrespective of their location,” says Dr Skaczkowski.

She emphasizes that further efforts are needed to explore sustainable funding for this model and to determine the best practices for broader implementation.

More information: Natasha J. Downing et al, A qualitative exploration of the role of a palliative care pharmacist providing home-based care in the rural setting, from the perspective of health care professionals, Australian Journal of Rural Health. DOI: 10.1111/ajr.13115

Journal information: Australian Journal of Rural Health Provided by University of South Australia

A study has evaluated the potential risk of mutations arising from the lingering radiation following the Fukushima nuclear disaster

Ionising radiation from nuclear disasters has known detrimental effects on the natural environment. The 2011 Fukushima Dai-ichi Nuclear Power Plant meltdown stands as a stark testament to such catastrophic events in recent history. Even now, a decade after the incident, concerns persist regarding the enduring impact of radiation. Particularly elusive are the ramifications of residual low-dose radiation on living organisms at the genetic level.

The primary brunt of such disasters typically falls upon the flora inhabiting contaminated regions, as they lack mobility. Yet, paradoxically, this immobility renders them ideal subjects for scrutinising the effects of ionising radiation on living organisms. Notably, coniferous species like the Japanese red pine and fir exhibited anomalous branching patterns post-Fukushima. Nevertheless, whether such aberrations signify genetic alterations induced by the prevailing low-dose-rate radiation remains uncertain.

In response to this uncertainty, a team of researchers from Japan devised a novel and cost-effective method to assess the mutation risks engendered by low-dose-rate radiation (ranging from 0.08 to 6.86 μGy h-1) in two commonly cultivated tree species of Japan thriving in the contaminated territory. Using a unique bioinformatics pipeline, they examined de novo mutations (DNMs), i.e., genetic changes or mutations absent in previous generations, within the germline of the gymnosperm Japanese cedar and the angiosperm flowering cherry. The study, led by Dr. Saneyoshi Ueno from the Forestry and Forest Products Research Institute, was a collaboration with Dr. Shingo Kaneko of Fukushima University. Dr Kaneko explained the motivation behind their work, stating, “Residents of the affected areas are anxious and seek reassurance in their daily lives. We aimed to dispel any misinformation surrounding the biological repercussions of the nuclear plant disaster.”

For the Japanese cedar sampling, the team initially gauged the levels of radioactive cesium (137Cs) in the cone-bearing branches. Subsequently, these cones were utilised for seed collection, germination, and DNA extraction from the remaining megagametophytes. Conversely, an artificial crossing experiment preceded seed collection and DNA extraction for the Japanese flowering cherry. Employing restriction site-associated DNA sequencing, the researchers juxtaposed the DNA sequences of the offspring with those of the parent. The DNMs were discerned utilising a bioinformatic pipeline devised by the researchers.

Significantly, the researchers discovered no DNMs in the Japanese flowering cherry samples. However, an average of 0.67 DNMs per megagametophyte sample emerged for the Japanese cedar within the “difficult-to-return” zone. Surprisingly, neither the concentration of 137Cs nor the ambient dose rate showed any discernible impact on the presence or absence of DNMs in Japanese cedar and flowering cherry. These findings suggest that the mutation rate in trees thriving in contaminated regions did not significantly increase due to ambient radiation. Dr Ueno emphasised, “Our findings also suggest that mutation rates vary among lineages and are primarily influenced by environmental factors.”

This study marks the inaugural use of DNM frequency to evaluate the aftermath of a nuclear catastrophe. As the proliferation of nuclear power plants heightens globally, so does the peril of nuclear accidents. Regarding the future implications of their research, Dr. Ueno commented, “The methodology advanced in our study can not only enhance our comprehension of the interplay between genetics and radiation but also expedite hereditary risk assessments following nuclear mishaps.”

More information: Saneyoshi Ueno et al, Rapid survey of de novo mutations in naturally growing tree species following the March 2011 disaster in Fukushima: The effect of low-dose-rate radiation, Environment International. DOI: 10.1016/j.envint.2023.107893

Journal information: Environment International Provided by Forestry and Forest Products Research Institute

Exploring the intricate connection between age, looks, and health: new insights on wrinkles and wisdom

The intricate interplay between physical appearance and mental and physical health as we age forms the crux of new research recently published in the journal Psychology and Aging.

Julie Ober Allen, an assistant professor of health promotion at the University of Oklahoma, spearheaded this research. It reveals that 59% of adults aged 50 to 80, in a nationally representative survey of Americans, believe they appear younger than their peers. These individuals reported more positive ageing experiences, such as being sought after for advice and possessing a strong sense of purpose. Conversely, those who felt they looked older than their contemporaries experienced more negative interactions. Allen’s research highlights that ageism—which encompasses stereotypes, prejudices, and discrimination based on age—can lead to chronic stress and have detrimental health effects.

Allen explains, “Ageism often presents itself through micro-aggressions.” For example, complimenting an older individual on looking suitable for their age or assuming they are inept with technology can trigger a stress response akin to a fight or flight reaction. To cope, some might turn to stress-eating sweets or smoking, which are behaviours linked to adverse health outcomes.

Allen’s team delved into how physical appearance is a surrogate for age. Individuals displaying characteristics typically associated with old age, like grey hair or wrinkles, are more likely to be stereotyped and face discrimination. According to Allen, this bias originates from the American cultural fixation on youth and specific beauty standards.

“We asked participants how much time and effort they devote to looking younger, which is a complex question as it can reinforce certain stereotypes,” Allen remarked. About 35% of participants admitted investing time and money to appear younger. Interestingly, these individuals reported positive and negative ageing experiences in society. Those who successfully appeared younger faced less discrimination, yet they might also have experienced increased anxiety and discomfort about their ageing appearance.

Allen emphasizes that ageism, unlike other forms of discrimination such as racism, sexism, or homophobia, is often disregarded and more socially tolerated. Her findings indicate that ageism affects both genders equally and that older adults from all racial and ethnic backgrounds across the US experience it.

“People often assume women are more affected by ageism, but the data doesn’t support this,” she stated. “Men and women might experience it differently, but both genders are impacted.”

Allen’s research conclusively shows that individuals who perceive themselves as looking younger enjoy more positive experiences and better mental and physical health outcomes. Moreover, those who appear more youthful experience less age-related discrimination. However, Allen suggests focusing solely on looking young might not be the best approach for ageing Americans.

“We should prioritize healthy behaviours, which also affect ageing and appearance. Engaging in regular exercise, maintaining a healthy weight, and abstaining from smoking can help you appear younger as you age. Thus, appearance is a beneficial secondary result,” she explained. “By adopting healthy behaviours, you not only enhance your health but also improve your quality of life and reduce functional limitations.”

More information: Allen, J. O., Moïse, V., Solway, E., Cheney, M. K., Larson, D. J., Malani, P. N., Singer, D., & Kullgren, J. T. How Old Do I Look? Aging Appearance and Experiences of Aging Among U.S. Adults Ages 50–80, Psychology and Aging. DOI: 10.1037/pag0000800

Journal information: Psychology and Aging Provided by The University of Oklahoma