Monthly Archives: March 2026

USC research shows early Alzheimer’s brain markers vary across diverse populations

A team of researchers from the USC Mark and Mary Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine of USC has identified meaningful differences in how early brain changes linked to Alzheimer’s disease appear across racial and ethnic groups. The findings highlight the importance of using more inclusive approaches when studying and diagnosing Alzheimer’s, particularly as current knowledge has largely been based on more limited populations. The study has been published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

The research drew on a large and diverse group of older adults who did not have dementia. It found that Black and Hispanic participants showed higher levels of tau, a protein associated with Alzheimer’s disease, in key areas of the brain involved in memory. Notably, these higher tau levels were observed even before the buildup of amyloid plaques, which are typically considered an early sign of Alzheimer’s. This suggests that the sequence or pattern of brain changes may differ across populations.

At the same time, the study found that the link between these brain changes and memory performance was not the same for all groups. While higher levels of tau were generally associated with poorer memory, the role of amyloid in strengthening this relationship varied. In particular, amyloid appeared to intensify the connection between tau and memory decline in non-Hispanic white and Hispanic participants, but not in Black participants. This indicates that common Alzheimer’s biomarkers may not fully explain cognitive changes in every population.

The data came from the Health and Aging Brain Study–Health Disparities (HABS-HD), one of the largest and most diverse brain imaging studies of ageing in the United States. Researchers used advanced PET scans to detect abnormal protein buildup in the brain years before symptoms appear. They analysed brain scans and memory test results from more than 1,500 participants who were either cognitively healthy or experiencing mild cognitive impairment.

The findings also suggest that factors beyond amyloid and tau may play a larger role in cognitive changes for some groups. These may include vascular health, other medical conditions, long-term exposure to stress, and broader social influences. In addition, researchers noted that some differences in tau levels might be linked to technical limitations in imaging methods, as certain scans can produce signals that are not directly related to tau. This reinforces the need to validate diagnostic tools across diverse populations.

Overall, the study points to the possibility that Alzheimer’s disease may develop through different biological pathways in different groups. This has important implications for how the disease is detected, monitored, and treated. Future research will continue to follow participants over time to better understand how biological, genetic, and social factors interact to shape cognitive ageing across communities, to improve care and prevention for all populations.

More information: Koral V. Wheeler et al, The relationships between ethnoracial identity, Aβ positivity, APOEε4, and medial temporal lobe tau PET, Alzheimer’s & Dementia. DOI: 10.1002/alz.71226

Journal information: Alzheimer’s & Dementia Provided by Keck School of Medicine of USC

Researchers find gut health supplement may help relieve arthritis pain

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A new study has found that a prebiotic fibre supplement can reduce pain, enhance grip strength, and lower pain sensitivity in people living with knee osteoarthritis (OA), while also achieving markedly better adherence than a digital physiotherapy programme. The findings come from the INSPIRE clinical trial, led by researchers at the University of Nottingham, and point to a simple, diet-based approach that may complement or, in some cases, outperform existing non-pharmacological interventions.

The trial demonstrated that a daily supplement of inulin—a naturally occurring dietary fibre found in foods such as chicory root and Jerusalem artichokes—significantly reduced pain levels among participants with OA. Published in the journal Nutrients, the results suggest that targeting gut health may offer a promising and accessible strategy for managing a condition that affects hundreds of millions of people globally, particularly older adults.

Knee osteoarthritis remains a leading cause of chronic pain and disability, with current treatment options often centred on pain medications or structured exercise programmes. However, medications can carry risks of side effects, and exercise regimens are frequently difficult for patients to maintain over time. In this context, a dietary supplement that is easy to incorporate into daily routines may provide a practical and sustainable alternative or complement to existing therapies.

According to lead author Dr Afroditi Kouraki, the findings highlight the potential of small dietary changes to deliver meaningful clinical benefits. Adding a fibre supplement to everyday meals, such as breakfast or yoghurt, could reduce pain and improve physical function without requiring substantial lifestyle disruption. This ease of integration may explain the notably low dropout rate observed among participants assigned to the inulin group.

The underlying mechanism appears to involve the gut microbiome, the complex community of microorganisms in the digestive system that plays a crucial role in overall health, including pain perception. Inulin acts as a prebiotic, nourishing beneficial gut bacteria and promoting the production of short-chain fatty acids such as butyrate. These compounds are known to influence inflammation and pain signalling pathways. Participants who took inulin also showed increased levels of glucagon-like peptide-1 (GLP-1), a hormone associated with both pain regulation and muscle function, with higher levels linked to improved grip strength.

The six-week randomised controlled trial included 117 adults with knee OA and compared four groups: inulin alone, physiotherapy-supported exercise alone, a combination of both, and a placebo. While both inulin and physiotherapy reduced knee pain, only inulin improved grip strength and pain sensitivity—key indicators of how the nervous system processes pain. Importantly, adherence differed substantially, with just 3.6% of participants in the inulin group dropping out compared to 21% in the physiotherapy group. These findings underscore the potential of gut-targeted interventions as a safe, well-tolerated, and scalable approach to improving quality of life for people with osteoarthritis, while also opening new avenues for research into the broader gut–muscle–pain connection.

More information: Afroditi Kouraki et al, Effect of Prebiotic Supplementation With and Without Physiotherapy on Pain and Pain Sensitivity in People with Knee Osteoarthritis, Nutrients. DOI: 10.3390/nu18050714

Journal information: Nutrients Provided by University of Nottingham

Outages Drive Rise in Emergency Hospital Visits Among Elderly Populations

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Adults aged 65 and older experience higher rates of emergency hospitalisations for cardiovascular and respiratory conditions during and following power outages, according to a new study led by Heather McBrien of the Columbia Mailman School of Public Health and colleagues. The research, published on 12 March in the open-access journal PLOS Medicine, highlights a growing but under-recognised public health concern affecting older populations.

Across the United States, power outages have become more frequent and longer in duration, largely driven by severe weather linked to climate change and the strain on ageing electrical infrastructure. Earlier research conducted in New York State suggested that outages may contribute to increased hospitalisations among older adults, particularly for heart and lung conditions. These risks are often tied to the loss of essential services such as air conditioning, heating, communication devices, and electrically powered medical equipment, including oxygen support systems. However, until recently, national-level evidence on this issue had been limited.

To address this gap, the researchers conducted a nationwide analysis using data from 2018. They identified power outages across the country and examined healthcare records from approximately 23 million Medicare beneficiaries. By analysing daily rates of emergency hospital admissions, the study was able to estimate the broader health impacts of outages on older adults at a national scale.

The findings revealed that power outages lasting more than eight hours were associated with noticeable increases in hospitalisations for both cardiovascular and respiratory diseases. Respiratory-related admissions were most likely to occur on the same day as the outage, reflecting immediate vulnerabilities such as loss of temperature control or respiratory support. In contrast, cardiovascular-related hospitalisations were more likely to peak on the day following an outage, suggesting delayed physiological stress or complications. Overall, the researchers estimated that 4,246 additional hospitalisations among adults aged 65 and over in 2018 could be attributed to power outages.

The study underscores the importance of strengthening electrical grid reliability as a critical public health intervention. Improving infrastructure resilience could help reduce preventable health risks, particularly for vulnerable populations. In addition, targeted measures—such as ensuring access to backup batteries for medical devices and mobile phones, or providing generators to maintain heating and cooling systems—may offer practical ways to mitigate harm during outages.

The authors emphasise that their findings demonstrate a clear link between power outages and increased hospitalisation risks among older adults. They note that the magnitude of risk rises with the proportion of the population affected by an outage. As climate change continues to intensify extreme weather events and place further strain on ageing energy systems, the need for preventative strategies becomes more urgent. Future research examining individual-level data may provide deeper insights into risk patterns and help inform more precise interventions to safeguard health.

More information: Heather McBrien et al, The association between power outages and cardiovascular and respiratory hospitalizations among US Medicare beneficiaries in 2018: A case-crossover study, PLOS Medicine. DOI: 10.1371/journal.pmed.1004923

Journal information: PLOS Medicine Provided by PLOS

Physical Function and Its Importance in Heart Failure Survival Prediction

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Monitoring and treating heart failure (HF) remains difficult at any age, especially among older adults. Doctors often rely on prediction models to estimate a patient’s chances of survival. Well-known tools such as the AHEAD and BIOSTAT compact models use clinical factors like irregular heart rhythm, anaemia, age, diabetes, kidney function, and ejection fraction. However, research has shown that these models, which were mainly developed using European and North American populations, tend to underestimate risk in older East Asian patients. This raises an important question about whether including additional factors could improve survival predictions.

A research team from Juntendo University in Japan has worked to address this issue by developing a more accurate model for predicting long-term survival after heart failure. Professor Tetsuya Takahashi, Assistant Professor Kanji Yamada, and Associate Professor Nobuyuki Kagiyama led the study. They used machine learning methods to identify which patient characteristics are most important for predicting outcomes. Their findings were published in February 2026 in The Lancet Regional Health – Western Pacific.

One of the key limitations of existing models is that they mainly focus on heart-related and biological measurements. According to Dr Yamada, this approach often overlooks other important factors such as physical function, frailty, and nutritional status. These factors are especially important in older adults because they strongly influence recovery and survival. Unlike age or other fixed characteristics, physical function and nutrition can potentially be improved through rehabilitation and supportive care, making them valuable targets for treatment.

To build a better model, the researchers used data from the J-Proof HF registry, which tracks elderly heart failure patients across 96 hospitals in Japan. They analysed data from 9,700 patients who were treated between December 2020 and March 2022 and later discharged from the hospital. Using this data, they trained a machine learning algorithm called XGBoost to predict the risk of death within one year after treatment. They then created a simpler version of the model using the 20 most important variables identified by the algorithm.

Interestingly, seven of these top 20 variables were related to physical function and other non-cardiac factors. Measures such as the Barthel Index (BI) and Short Physical Performance Battery (SPPB) were especially important. These are performance-based tests that assess a patient’s ability to carry out daily activities and physical tasks. Compared to more subjective assessments, these tests provide more consistent and reliable results and better reflect a patient’s true functional ability.

Both versions of the model performed well in predicting one-year mortality, but the simplified Top-20 model was particularly effective at classifying patients into different risk levels. It also outperformed traditional models like AHEAD and BIOSTAT compact. Because it was developed using data from Japanese patients, it may be better suited for assessing risk in older individuals with heart failure in Japan and similar populations.

This new model could help healthcare professionals move away from a one-size-fits-all approach to treating heart failure. Instead, doctors could use it to identify patients who need closer monitoring or more personalised care after leaving the hospital. It could also help make better use of medical resources. Importantly, the strong role of physical function in the model highlights the value of rehabilitation and maintaining physical ability both before and after hospitalisation.

The researchers emphasise that physical function at discharge is just as important as traditional heart-related risk factors in predicting survival. Their findings support the idea that routine care for older heart failure patients should include broader assessments that consider overall physical and functional health. While the team is optimistic about the model’s potential, they note that further testing in different populations is needed. They are also working on developing a practical tool that clinicians can use to estimate a patient’s risk more easily.

More information: Kanji Yamada et al, Machine learning prediction of 1-year mortality in older patients with heart failure: a nationwide, multicenter, prospective cohort study, The Lancet Regional Health – Western Pacific. DOI: 10.1016/j.lanwpc.2026.101808

Journal information: The Lancet Regional Health – Western Pacific Provided by Juntendo University Research Promotion Center

New Perspective Positions Buildings as Critical to Health Determinants

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As populations continue to age, growing attention is being directed towards the institutional environments where many older adults live, including nursing homes and long-term care facilities. These settings play a significant role in shaping residents’ health and overall quality of life. Increasing evidence shows that the built environment can influence both the physical and cognitive wellbeing of older individuals in complex ways.
Design elements within these spaces can have meaningful consequences. Factors such as layout, lighting, materials and spatial organisation may affect risks related to falls, infection transmission, preventable hospital admissions and even cognitive disorientation. In this way, architecture does not simply provide shelter, but actively shapes health outcomes for ageing populations.

Despite this growing body of research, its application in real-world building projects remains inconsistent. Much of the existing evidence is not systematically integrated into the planning or renovation of long-term care environments. In response, a multidisciplinary team from Boston University Chobanian & Avedisian School of Medicine has introduced a new framework aimed at bridging this gap.

The framework, known as Bioethics Peer Review for Long-Term Care Design (BPR-LTC), is designed to guide the evaluation of architectural plans for long-term care facilities. Its central goal is to ensure that evidence-based design principles are thoughtfully incorporated into the creation of spaces intended for older adults, aligning physical environments with their specific needs.

BPR-LTC brings together several distinct approaches, including evidence-based design research, clinical ethics consultation methods for addressing complex value-driven decisions, and geriatric care frameworks that prioritise the vulnerabilities and requirements of older individuals. While each of these components has contributed independently to long-term care, they have rarely been coordinated during the early stages of architectural design.

Unlike traditional design methodologies or performance metrics, BPR-LTC functions as an ethics-informed, deliberative process that structures how evidence and values are considered in decision-making. By introducing a more systematic and research-driven approach, the framework aims to improve the design of long-term care environments, ultimately enhancing the health and wellbeing of those who live and work within them.

More information: Diana Anderson et al, Bioethics Peer Review: A Structured Evaluation Framework for Long-Term Care Environments, Journal of the American Medical Directors Association. DOI: 10.1016/j.jamda.2025.106088

Journal information: Journal of the American Medical Directors Association Provided by Boston University School of Medicine

Science Reveals Why Full Doesn’t Mean Finished When It Comes to Food

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Research carried out at the University of East Anglia (UEA) offers a compelling explanation for a familiar experience: reaching for a snack even after feeling full. Many people assume that eating behaviour is governed purely by hunger, yet this study suggests something far more complex is at play. In modern environments filled with constant food advertising, tempting displays, and easy access to treats, the brain appears to remain highly responsive to food cues regardless of physical fullness. This may help explain why maintaining a healthy weight can feel so challenging for so many individuals.

The research indicates that the human brain continues to react strongly to appealing food stimuli even after the body’s energy needs have been met. In other words, while the stomach may signal satisfaction, the brain does not necessarily follow suit. This disconnect highlights how appetite is influenced not only by biological hunger but also by learned responses and environmental triggers. The findings suggest that overeating is not simply a matter of poor self-control, but rather a natural outcome of how the brain processes reward in a food-rich world.

Lead researcher Dr Thomas Sambrook, from UEA’s School of Psychology, emphasised that rising obesity rates should not be reduced to issues of willpower alone. Instead, he explained that modern surroundings, filled with enticing food cues, can override the body’s internal appetite regulation systems. The team aimed to explore how the brain behaves when a person is already full, and whether it reduces its response to food. Their findings revealed that even after eating enough to feel satisfied, the brain continues to react to appealing food in much the same way as it would when hungry.

To investigate this, researchers monitored 76 volunteers using electroencephalogram (EEG) brain scans while they took part in a reward-based learning task involving foods such as sweets, chocolate, crisps, and popcorn. During the experiment, participants were given one of these foods to eat until they felt they could not consume any more. By all behavioural and self-reported measures, participants were genuinely full. They expressed reduced desire for the food and demonstrated less interest in obtaining it during the task.

Despite this clear sense of fullness, the brain activity told a different story. Electrical signals in regions associated with reward continued to respond strongly when participants were shown images of the same foods they had just eaten. This suggests that the brain does not easily adjust its perception of how rewarding food appears, even when the body no longer needs it. The persistence of these responses indicates that visual or environmental food cues can still trigger a desire to eat, independent of actual hunger.

The study also points to the role of habit in shaping these reactions. Over time, repeated associations between certain foods and pleasure may create automatic patterns in the brain. These responses can operate outside conscious awareness, meaning a person might believe they are eating out of hunger when they are actually responding to ingrained cues. Notably, the research found no connection between an individual’s self-control and their brain’s resistance to reducing food reward signals. This suggests that even highly disciplined individuals can struggle, as their neural wiring continues to promote eating. In this light, resisting an extra treat is not merely a test of willpower, but a challenge rooted in the brain’s fundamental design.

More information: Thomas Sambrook et al, Devaluation insensitivity of event related potentials associated with food cues, Appetite. DOI: 10.1016/j.appet.2025.108390

Journal information: Appetite Provided by University of East Anglia

Women Can Experience Heart Attacks Even With Less Plaque Than Men

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Women may have less artery-clogging plaque than men, yet this does not necessarily shield them from heart disease, according to new research published in Circulation: Cardiovascular Imaging, a journal of the American Heart Association. The findings challenge a long-held assumption that lower plaque levels automatically translate into lower cardiovascular risk. Instead, the study suggests that women can face comparable dangers even when the buildup within their arteries appears less severe.

Heart disease remains the leading cause of illness and death both in the United States and globally. Data from the American Heart Association’s 2026 Heart Disease and Stroke Statistics highlight the scale of the issue, affecting millions of people each year. Previous research has consistently shown that women tend to have a lower prevalence of arterial plaque than men, which has often been interpreted as a protective factor. However, the new study indicates that this difference may not provide the level of protection once believed.

To better understand how plaque levels relate to heart risk, researchers analysed health data from more than 4,200 adults, with women making up over half of the participants. All individuals had stable chest pain but no prior diagnosis of coronary artery disease. Participants were randomly assigned to undergo coronary computed tomography angiography, an imaging technique that uses X-rays to examine the heart and blood vessels. They were then monitored for approximately two years to track outcomes such as heart attacks, hospitalisations, or death.

The study revealed clear differences in plaque presence between men and women. About 55% of women had plaque in their coronary arteries compared to 75% of men. In addition, women had significantly lower volumes of plaque overall, with a median measurement of 78 mm³ versus 156 mm³ in men. Despite these differences, the likelihood of serious outcomes remained similar. Rates of death, non-fatal heart attack, or hospital admission for chest pain were 2.3% in women and 3.4% in men, indicating that lower plaque levels did not correspond to markedly lower risk.

Researchers also found that women began to face increased cardiovascular risk at lower plaque thresholds than men. For total plaque burden, women’s risk started to rise at around 20%, whereas men’s risk increased at approximately 28%. As plaque levels grew, the associated risk escalated more sharply in women. One possible explanation is that women typically have smaller coronary arteries, meaning even modest plaque accumulation can have a greater impact on blood flow and overall heart health.

Experts say the findings highlight important biological differences in how cardiovascular disease develops and affects men and women. These differences can influence everything from risk factors and symptoms to treatment outcomes. The study underscores the need for more tailored approaches to assessing and managing heart disease in women, as traditional definitions of “high risk” may underestimate their vulnerability. With cardiovascular disease accounting for 433,254 deaths among females of all ages—nearly half of all cardiovascular-related deaths—the research adds to growing evidence that improved awareness and targeted care are essential for reducing its impact.

More information: Jan Brendel et al, Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial, Circulation Cardiovascular Imaging. DOI: 10.1161/CIRCIMAGING.125.019011

Journal information: Circulation Cardiovascular Imaging Provided by American Heart Association

Clinical pilot study shows potential of low-dose lithium in slowing verbal memory loss

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Lithium, a treatment long used for bipolar disorder, may offer neuroprotective effects that extend beyond mood stabilisation. An exploratory clinical trial conducted by the University of Pittsburgh suggests that low-dose oral lithium could help slow the decline of verbal memory—the ability to remember and recall words and sentences—in older adults with mild cognitive impairment. The potential benefit appeared most pronounced among individuals with evidence of amyloid beta, a key biomarker associated with Alzheimer’s disease.

The study, published in JAMA Neurology on 2 March, was designed to address an important early-stage question: whether lithium shows enough promise to justify a larger clinical trial focused on slowing cognitive decline linked to Alzheimer’s disease. While lithium has been studied for decades in psychiatric contexts, its possible role in neurodegeneration remains an area of active investigation.

The research was led by Dr Ariel Gildengers, a professor of psychiatry at the University of Pittsburgh and a geriatric psychiatrist at UPMC. His previous work found that older adults with bipolar disorder who used lithium over long periods tended to show signs of better brain integrity. These earlier findings provided the scientific basis for testing whether lithium’s apparent protective effects on the brain might also apply beyond mood disorders.

To explore this question, the research team designed a two-year clinical trial involving adults aged 60 and above who had mild cognitive impairment. Participants were randomly assigned to receive either a low dose of lithium or a placebo. Over the course of the study, which concluded in August 2024, participants underwent annual evaluations that included detailed cognitive assessments, high-resolution brain imaging, and analysis of biological markers associated with Alzheimer’s disease.

The results indicated that those receiving lithium experienced a slower rate of decline in verbal memory, a cognitive function that is often affected early in Alzheimer’s disease. Although the findings were not definitive, they were considered encouraging, particularly in this domain. Brain imaging revealed that the hippocampus, a region essential for memory, decreased in size over time in both groups. However, exploratory analyses suggested that participants with amyloid beta showed potentially greater benefit from lithium, hinting at a biological effect that warrants further study. Importantly, the treatment was found to be safe and well-tolerated when carefully monitored.

One limitation of the study was that participants were selected based on clinical symptoms rather than confirmed amyloid status, as blood-based diagnostic tools were not widely available when the trial began. This may have reduced the ability to detect stronger effects. Future research aims to address this by using modern biomarker testing to enrol participants more precisely. Researchers are now seeking support for a larger trial that could determine whether lithium can meaningfully delay cognitive decline and neurodegeneration. While the current findings are preliminary, they suggest that further investigation is both feasible and justified.

More information: Ariel Gildengers et al, Low-Dose Lithium for Mild Cognitive Impairment A Pilot Randomized Clinical Trial, JAMA Neurology. DOI: 10.1001/jamaneurol.2026.0072

Journal information: JAMA Neurology Provided by University of Pittsburgh

Majority of Older Adults in England Regard Climate Change as a Serious Issue

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Six in ten older people in England consider climate change a serious risk. At the same time, only a small minority—around one in 17 (5.8%)—dismiss such concerns altogether, according to new research led by University College London (UCL). The findings challenge common assumptions that older generations are largely disengaged from environmental issues, instead revealing widespread recognition of climate-related threats among this population.

The study, published in The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, analysed survey responses from 6,572 individuals aged 50 and over across England. Participants were asked to indicate their level of agreement with a series of statements relating to climate change, allowing researchers to assess both awareness and attitudes towards environmental risks.

Based on these responses, the research team categorised participants into several distinct groups. Around 30% were classified as highly engaged with climate change, while a further 31% were considered engaged. Just over one fifth (22%) were uncertain or ambivalent, expressing mixed or unclear views. Smaller groups included those who were aware of the risks but felt fatalistic about the ability to address them (11%), and a minority who were dismissive (5.8%).

Age differences were also evident in how respondents viewed climate change. Individuals in their 50s were more likely to be highly engaged, whereas those in their 70s and beyond were more commonly found in the “risk-aware but fatalistic” category. These individuals recognised the seriousness of climate change but believed it was too late to take meaningful action, highlighting a sense of resignation among some older age groups.

The study further identified social and economic patterns linked to climate attitudes. Participants who were more financially secure, better educated, and socially active were significantly more likely to be engaged or highly engaged with climate risks. In contrast, those experiencing financial hardship or with lower levels of education were more likely to report uncertainty or ambivalence, suggesting that access to information and resources may shape environmental awareness.

Survey responses also revealed strong overall concern about climate impacts. A large majority (82%) agreed that people in the UK would be affected by climate change within the next 30 years, while 64% believed that continuing current trends could lead to a major environmental disaster. At the same time, nearly one-third of respondents felt that climate change was already beyond control. Researchers noted that older adults are not only vulnerable to climate-related events such as heatwaves and flooding, but also represent an influential group with high levels of political participation, meaning they have considerable potential to shape future climate action and policy.

More information: Giorgio Di Gessa et al, Attitudes toward Climate Change Risk Among Older People: New Evidence from the English Longitudinal Study of Ageing, The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences. DOI: 10.1093/geronb/gbag029

Journal information: The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences Provided by University College London

New study reveals staffing levels in care homes may help prevent harmful falls

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A new study has found that nursing homes with higher staffing levels tend to report fewer injurious falls among long-stay residents, highlighting the importance of adequate workforce support in long-term care settings. Conversely, facilities operating with insufficient staffing were associated with increased rates of falls, suggesting that staffing shortages may directly impact resident safety. These findings reinforce growing concerns about how workforce capacity influences the quality of care in nursing homes.

Falls remain one of the most common and serious safety issues affecting older adults in long-term care. They frequently lead to physical injury, reduced independence, and a decline in overall wellbeing, while also contributing to rising healthcare costs. Despite the significance of this issue, large-scale research exploring how staffing patterns affect fall-related injuries in nursing homes has been relatively limited until now.

The study, titled “Falls in the Nursing Home: The Impact of Staffing Levels and Agency Staff Use on Injurious Falls,” was published in the Journal of the American Medical Directors Association. It examined data from more than 1.1 million Medicare beneficiaries across 11,183 nursing homes. Researchers focused on the relationship between total staffing hours, the use of temporary agency staff, and rates of injurious falls. A benchmark of 2.45 certified nursing assistant (CNA) hours per resident per day was used to define recommended staffing levels, with nearly 30% of facilities meeting this threshold and over 70% falling below it.

Findings showed that nursing homes meeting recommended CNA staffing levels, alongside increased hours for both CNAs and registered nurses, experienced significantly lower rates of injurious falls. In well-staffed facilities, each additional hour of registered nurse coverage was linked to nearly a 40% reduction in such incidents. This suggests that both the quantity and skill mix of staff play a crucial role in protecting residents from harm.

However, the study also revealed a more complex pattern in under-resourced facilities. Among nursing homes that did not meet recommended CNA staffing levels, increases in CNA hours were paradoxically associated with higher rates of injurious falls. This indicates that simply adding staffing hours without addressing broader systemic shortages or organisational challenges may not lead to improved outcomes and could even have unintended consequences.

Overall, the results underscore the nuanced relationship between staffing patterns and resident safety. Effective improvements depend not only on increasing staff numbers but also on ensuring adequate baseline resources and a balanced staffing structure. As co-author Sarah Berry, MD, MPH, noted, ensuring resident safety requires tailored staffing strategies. While meeting recommended CNA and RN levels can significantly reduce harmful falls, addressing wider staffing shortages and resource gaps remains essential for meaningful and sustained improvements in care quality.

More information: Jenna S. Khoja et al, Falls in the Nursing Home: The Impact of Staffing Levels and Agency Staff Use on Injurious Falls, Journal of the American Medical Directors Association. DOI: 10.1016/j.jamda.2025.106083

Journal information: Journal of the American Medical Directors Association Provided by Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research

Exercise and Nutritional Support May Help Reduce Care Dependency in Dementia

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A simple combination of daily physical exercise and protein-rich nutritional drinks may offer meaningful health benefits for people living with dementia. Researchers from Karolinska Institutet report that participants who followed this routine showed improvements in their physical capabilities. After three months, the researchers also observed indications that some individuals were able to manage more everyday tasks independently. The findings were published in the journal Alzheimer’s and Dementia, contributing to growing evidence that relatively straightforward lifestyle interventions can influence health and independence among older adults in care settings.

Older adults who live in residential care facilities frequently face several health challenges, including a higher risk of malnutrition, reduced muscle strength, and increasing frailty. These factors can significantly affect both overall wellbeing and daily functioning. Previous work from the OPEN study has already demonstrated that this programme can improve physical function and support better muscle mass and nutritional status among residents. The latest research builds on those earlier findings by examining whether the same programme also influences the amount of assistance individuals require in their daily routines.

The analysis included 102 residents from eight nursing homes located in the Stockholm region. Participants in the intervention group followed a structured routine for twelve weeks. This routine involved performing short standing exercises several times throughout the day while also consuming one or two protein-enriched nutritional drinks. These drinks were designed to help increase protein intake, which is often insufficient among older adults, particularly those living in care environments where appetite loss or illness can make adequate nutrition difficult to maintain.

Throughout the study period, researchers closely monitored the level of support participants required for routine daily activities. These included personal hygiene, getting dressed, and moving from one place to another within the care facility. Such tasks are commonly used as indicators of functional independence because they reflect how well individuals can manage essential aspects of daily life without assistance. By comparing the intervention group with a control group that did not follow the programme, the researchers aimed to determine whether improvements in physical strength and nutrition translated into practical changes in care needs.

When the research team analysed the results across all residents collectively, they did not observe a clear overall difference between the intervention and control groups. However, a more detailed analysis revealed an interesting pattern once the results were separated according to ward type. Among residents living in dementia units, those who had participated in the exercise and nutrition programme demonstrated improvements in their functional abilities. As a result, they required less time from staff for assistance compared with residents in the control group.

According to Anders Wimo, a researcher at the Department of Neurobiology, Care Sciences and Society at Karolinska Institutet, one possible explanation lies in the physical condition of residents within dementia wards. Some individuals in these units may retain enough physical capacity to respond positively to targeted exercise and nutritional support. When their strength and function improve, they may regain the ability to perform certain tasks independently, which can reduce their reliance on caregivers for everyday activities.

The researchers also note that earlier interviews conducted as part of related sub-studies suggest improved physical function may influence how much help a person needs in various situations. Nevertheless, they emphasise that the current findings should be interpreted cautiously because the analysis was conducted retrospectively as a secondary outcome. Further research is therefore needed, particularly studies designed specifically to measure care time as a primary outcome. Future work should also consider organisational factors, such as staffing levels and workplace routines, which may influence how improvements in residents’ abilities translate into actual changes in care provision.

More information: Anders Wimo et al, Impact of an exercise and nutrition program on caregiver time with residents in institutional care—A secondary analysis, Alzheimer’s & Dementia. DOI: 10.1002/alz.71198

Journal information: Alzheimer’s & Dementia Provided by Karolinska Institutet

Prenatal Lead Exposure Connected to Lower Cognitive Ability in Adulthood

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A study published on 18 February 2026 in Neurology suggests that exposure to lead before birth may be linked to reduced cognitive performance later in life. Researchers found that female participants who had higher levels of prenatal lead exposure tended to perform worse on tests that measured thinking and memory skills when they were around sixty years old. The authors of the study emphasised that their findings show an association rather than a direct cause-and-effect relationship. In other words, while prenatal lead exposure was related to lower test scores decades later, the research does not prove that lead exposure itself caused the decline in cognitive performance.

The research was led by Ruby C. Hickman, who conducted the study while working at the Harvard T.H. Chan School of Public Health. Hickman explained that lead exposure in the United States reached its highest levels during the 1960s, 1970s, and 1980s. Many people born during those decades are now entering middle age or older adulthood, a period when the long-term effects of early environmental exposures may become more noticeable. According to Hickman, examining how prenatal exposures influence cognitive health later in life is important for understanding the lasting impact of environmental hazards.

To estimate the participants’ early exposure to lead, researchers relied on an unusual and valuable source of biological evidence: baby teeth. Decades earlier, between 1958 and 1972, parents living in the St. Louis, Missouri area had donated their children’s baby teeth to a separate study that focused on radiation exposure. The teeth were carefully preserved, creating a unique historical record. Many years later, the research team worked to locate the individuals who had originally donated those teeth and invited them to participate in new testing designed to measure their cognitive abilities.

Baby teeth provide important information about environmental exposure because they absorb substances from the body as they form. As teeth develop, elements such as lead can become incorporated into their structure. By analysing the chemical composition of these teeth, scientists can estimate the level of lead that individuals were exposed to before birth and during early childhood. Using this approach allowed researchers to reconstruct prenatal exposure levels even though several decades had passed since the participants were born.

In total, the study included 715 participants who were successfully located and agreed to take part in the research. The average age of the participants was approximately sixty-two. Each participant completed a series of cognitive tests on their home computers or digital devices, allowing researchers to evaluate their thinking and memory skills. The baby teeth from these participants were also analysed for lead content. The median concentration of lead in the teeth was found to be 1.34 parts per million, providing a measure of the participants’ early exposure levels.

The results showed that among female participants, higher levels of prenatal lead exposure were associated with lower scores on cognitive tests later in life. Specifically, each increase of one part per million in lead concentration during the second trimester of pregnancy corresponded with test scores that were 0.16 standard deviations lower. In the researchers’ analysis, this difference was roughly equivalent to about three additional years of cognitive ageing. The researchers also noted that the study had limitations, including the fact that most participants were white and had relatively high educational and socioeconomic backgrounds during childhood, which means the findings may not apply equally to more diverse populations.

More information: Ruby C. Hickman et al, Prenatal and Early Postnatal Lead Exposure and Later Adulthood Cognitive Function in the St. Louis Baby Tooth–Later Life Health Study, Neurology. DOI: 10.1212/WNL.0000000000214616

Journal information: Neurology Provided by American Academy of Neurology