Author Archives: support

Wearable ‘thimble’ with accelerometer and vibrator could help prevent falls in older adults

Researchers in Japan have crafted and trialled a pioneering wearable device designed to be worn on the fingertips, employing the principle of ‘light touch’ to bolster balance awareness. This innovation promises a marked decrease in fall occurrences among the elderly population. The research outcomes were disclosed in the Scientific Reports journal.

As individuals age, their equilibrium may deteriorate, leading to enhanced postural instability and a heightened likelihood of falls and associated injuries. This issue is particularly pressing in advanced nations where the elderly demographic constitutes a significant and growing segment of society. Thus, addressing the challenges posed by postural instability has become increasingly crucial.

While traditional support tools like canes and walkers are beneficial, their effectiveness can be compromised in certain situations, such as navigating stairs or getting in and out of vehicles, potentially aggravating balance issues and escalating injury risks.

Recent scientific endeavours have concentrated on exploring the ‘light touch’ phenomenon to counteract these balance difficulties in older adults. This effect demonstrates that even minimal contact with a tactile reference point, like a curtain or a sheet of paper, using just the fingertips can significantly curtail body sway despite these objects providing no substantial physical support.

A team from Yokohama National University (YNU) and the Prefectural University of Hiroshima aimed to replicate this tactile cue through a ‘virtual light touch’ (VLT) system, effectively simulating a virtual tactile reference. The system’s preliminary iteration employed a compact device, reminiscent of a thimble, placed over the fingertip to provide a subtle vibrotactile signal at the onset of swaying. Initial evaluations employing a 3D motion capture system revealed the system’s efficacy, mirroring the stabilizing effect of actual physical contact.

Recognizing the impracticality of using elaborate motion capture technology for everyday applications, the researchers refined the VLT system by integrating an accelerometer—a device common in modern smartphones—to detect movement. This modified system, coupled with the vibrotactile thimble, was tested on 150 volunteers from the sixties to the nineties, demonstrating a significant reduction in postural sway akin to physical touch.

This advanced VLT system, leveraging an accelerometer and vibrotactile feedback, presents a feasible and effective solution for enhancing balance in daily activities, offering the potential for widespread adoption among older adults. Nonetheless, the research team aims to refine the device further by reducing its size and improving its sway reduction capabilities, intending to deepen the understanding of the light touch effect’s underlying mechanisms in supporting human balance.

More information: Keisuke Shima et al, A wearable light-touch contact device for human balance support, Scientific Reports. DOI: 10.1038/s41598-021-85687-4

Journal information: Scientific Reports Provided by Yokohama National University

How music may safeguard against cognitive deterioration

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Normal ageing is linked with a gradual cognitive decline. However, can we exercise our brains to slow down this inevitable process? A collaborative effort by researchers from the University of Geneva (UNIGE), HES-SO Geneva, and EPFL has unearthed that engaging in and listening to music can positively affect cognitive decline in healthy older adults by encouraging the growth of grey matter. To substantiate their findings, the team monitored over a hundred retirees without experience with musical practice. These individuals participated in piano lessons and music appreciation courses over six months. The outcomes of this research, published in NeuroImage: Reports, shed new light on approaches to support healthy ageing.

The brain is a dynamic organ that continually reshapes itself throughout our lives, adapting its morphology and connections based on environmental stimuli and experiences, such as learning new skills or recovering from a stroke. Yet, our brain’s plasticity or ability to change diminishes as we age. Concurrently, the brain experiences a loss of grey matter, the critical region where neurons reside, a process known as brain atrophy. That leads to a gradual decline in cognitive abilities, with working memory—one of the most crucial cognitive functions—being significantly affected. Working memory involves temporarily holding and manipulating information to achieve specific tasks, such as jotting down a phone number or translating a sentence from another language.

The study, spearheaded by UNIGE, HES-SO Geneva, and EPFL, demonstrated that musical engagement, through either playing or listening, could stave off the decline of working memory. These activities enhanced brain plasticity and were associated with an increased volume of grey matter. Improvements were also observed in working memory. This research involved 132 healthy retirees aged 62 and 78 who had not engaged in music lessons for over six months.

The study distinguished between practising music and listening to music. Damien Marie, the lead author of the study and a research associate at the CIBM Center for Biomedical Imaging, Faculty of Medicine, and the Interfaculty Center for Affective Sciences (CISA) at UNIGE, as well as at the Geneva School of Health Sciences, emphasized the selection of participants who had no prior musical training to avoid any pre-existing brain plasticity related to music learning that could skew the results.

Participants were divided into two groups, one receiving piano instruction and the other engaging in active listening, which involved recognizing instruments and analyzing musical properties across various genres. Both groups were assigned homework for half an hour daily.

After six months, both interventions were found to have beneficial effects, including increased grey matter in four brain regions involved in advanced cognitive functions, such as areas of the cerebellum linked to working memory. Participants saw a 6% improvement in performance, directly correlated with cerebellar plasticity. Factors such as sleep quality, lesson attendance, and daily practice also positively influenced performance improvement.

However, differences between the groups were noted. For pianists, the volume of grey matter in the right primary auditory cortex, crucial for sound processing, remained stable, whereas it decreased in the active listening group. Despite observing a general pattern of brain atrophy across all participants, Damien Marie noted that musical interventions did not rejuvenate the brain but helped prevent ageing in specific regions.

These findings highlight that engaging in and listening to music can foster brain plasticity and cognitive reserve. The authors advocate for these enjoyable and accessible interventions to be prioritized in policies for healthy ageing. The research team plans to explore the potential benefits of these interventions for individuals with mild cognitive impairment, a transitional stage between normal ageing and dementia.

More information: Damien Marie et al, Music interventions in 132 healthy older adults enhance cerebellar grey matter and auditory working memory, despite general brain atrophy, NeuroImage. DOI: 10.1016/j.ynirp.2023.100166

Journal information: NeuroImage Provided by Université de Genève

Self-monitoring enhances the physical activity levels of older adults requiring care

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Monitoring one’s physical activity through using accelerometers and receiving feedback has proven to be an effective strategy for enhancing the physical activity levels among elderly individuals who require ongoing support. This groundbreaking revelation comes from a study conducted by Kobe University, marking the first time evidence has been provided to show that simple, safe methods can significantly improve physical activity in this group. Such improvements are anticipated to be crucial in preventing severe illnesses and reducing the financial burden associated with long-term care.

The importance of increasing physical movement, specifically taking more steps and reducing sedentary time, is well-documented for its positive effects on preventing numerous noncommunicable diseases, including heart disease, diabetes, and stroke, especially among the elderly who rely on long-term care. This demographic is known to be less active, taking fewer steps, and spending more time seated compared to their healthier counterparts, thus facing a higher risk of illness that can degrade their quality of life and exert pressure on healthcare resources. Despite existing knowledge that self-monitoring can boost physical activity among older adults, its effectiveness has not been previously confirmed for those at greater risk.

Kobe University health scientists Kazuhiro Izawa and Masahiro Kitamura addressed the gap through a study involving 52 participants from a daycare centre in Japan. The research compared the effects of self-monitoring physical activity. Participants were educated about the benefits of increased activity and instructed to use accelerometers to log their movement. Those in the intervention group also kept daily activity records and received weekly feedback and advice.

Published in European Geriatric Medicine, the findings revealed that the intervention group exhibited more physical activity, including taking more steps, spending less time sitting, and engaging in more light physical activities. This study is particularly novel for including metrics on sedentary behaviour alongside traditional step counts, offering insights into how reducing sitting time can complement efforts to increase overall activity levels.

However, the study’s five-week duration was noted as a limitation for observing long-term health benefits, suggesting the need for future research with larger participant groups and extended follow-ups to understand and thoroughly verify the long-term effectiveness of such interventions.

This research underscores the feasibility and effectiveness of simple interventions to improve physical activity among older adults needing care. It lays a foundation for future studies to enhance care prevention strategies through self-monitoring techniques. With further investigation, these methods can be refined and expanded to support better the health and well-being of older adults requiring assistance.

More information: Masahiro Kitamura et al, Effects of self-monitoring using an accelerometer on physical activity of older people with long-term care insurance in Japan: a randomized controlled trial, European Geriatric Medicine. DOI: 10.1007/s41999-024-00935-w

Journal information: European Geriatric Medicine Provided by Kobe University

The Mediterranean diet is a simple option to boost IVF success among numerous nutritional strategies

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Adjunctive treatments aiming to assist infertile women in achieving pregnancy through IVF, particularly for those who have had unsuccessful attempts in the past, have become increasingly commonplace in both the preparatory and active phases of treatment cycles. A recent in-depth review of the effectiveness of various dietary supplements and nutritional regimes thought to enhance IVF outcomes has highlighted the Mediterranean diet as a singularly clear and evidence-backed option for improving success rates, in stark contrast to the outcomes associated with a Western diet.

The investigation into nine popular nutritional supplements revealed a landscape of variable and often questionable quality evidence. This analysis, conducted by Professor Roger Hart from the University of Western Australia and City Fertility in Perth, Australia, has been published in the peer-reviewed journal Reproductive Biomedicine Online.

Professor Hart pointed out the widespread but poorly documented use of nutritional supplements in IVF treatment, noting that these supplements are typically self-administered by patients who purchase them online or over-the-counter, making reliable data on their use scarce. Despite the lack of solid usage data, the enthusiastic discussions on IVF forums online suggest a high level of public interest and widespread consumption.

Among the supplements reviewed, which included dehydroepiandrosterone (DHEA), melatonin, co-enzyme Q10 (CoQ10), and others, certain ones like DHEA and CoQ10 showed some promise in studies, offering benefits over standard treatments in cases of poor response to previous IVF attempts. Melatonin also showed potential benefits, though its optimal patient group and dosage remain unclear.

In contrast, the backing for the Mediterranean diet as a beneficial approach during IVF is robust, supported by numerous well-conducted randomised clinical trials. These trials have demonstrated positive effects on embryo development and pregnancy outcomes, even from interventions as brief as six weeks. The diet’s beneficial characteristics include a high intake of fruits, vegetables, whole grains, legumes, nuts, fish, and mainly monounsaturated or polyunsaturated fats, with minimal consumption of highly processed foods. It is rich in B vitamins, antioxidants, omega-3 polyunsaturated fatty acids, and fibre while low in saturated fat, sugar, and sodium. Omega-3 fatty acids, in particular, have been extensively studied in IVF contexts due to their general health and reproductive benefits, with evidence suggesting potential improvements in clinical outcomes and embryo quality.

However, when it comes to antioxidants, despite being widely used in combination supplements, the evidence from a significant review encompassing 63 studies on antioxidants in reproduction was of low quality. It failed to demonstrate any clear benefits for live birth rates.

From this comprehensive body of evidence, Professor Hart recommends a straightforward nutritional strategy for enhancing IVF success: adopting a Mediterranean diet. For women who have previously responded poorly to ovarian stimulation, pre-treatment with COQ-10 and DHEA could be beneficial, and omega-3 fatty acid supplementation may improve specific clinical and embryological outcomes. Additionally, he stresses the importance of adequate folate supplementation for all women trying to conceive and advises consulting with a healthcare provider to ensure optimal general health for conception.

More information: Hart RJ et al, Nutritional supplements and IVF: an evidence based approach, Reproductive BioMedicine Online. DOI: 10.1016/j.rbmo.2023.103770

Journal information: Reproductive BioMedicine Online

Facilitating mealtime engagement for older adults with dementia at home: Difficulties and approaches for caregivers

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For many individuals with dementia and their caregivers facilitating home living, navigating mealtime can prove to be a complex task rather than a simple daily routine.

The domestic setting introduces a series of obstacles for the person with dementia and the caregivers involved. These challenges range from confusion and functional impairments associated with dementia to the insufficient support available to friends and family members unexpectedly assuming caregiving responsibilities.

A pioneering study conducted by a team at Ohio State University has established the foundational steps towards developing a future intervention aimed at aiding caregivers in creating a secure and feasible mealtime schedule for dementia patients living at home.

The research highlights the numerous hurdles to patient participation in mealtime activities and draws on interviews with various healthcare professionals to outline methods for improving the dining experience. Recommendations include minimizing distractions, decluttering the eating area, utilizing visual aids, and drawing on resources from community nutrition programs like Meals-on-Wheels.

Lisa Juckett, the study’s lead author and an assistant professor of occupational therapy at The Ohio State University School of Health and Rehabilitation Sciences, emphasizes the importance of simplification in the mealtime environment. According to Juckett, the complexity of eating for individuals with dementia stems from multiple factors beyond mere forgetfulness, underlining the intricate nature of ensuring proper nutrition.

The research, recently published in The Gerontologist Journal, underscores the prevalence of dementia within the United States, with over 80% of those affected living at home. Many of these individuals face difficulty eating or preparing meals independently.

Juckett points out the growing older adult population and the anticipated increase in Alzheimer’s and related dementias, highlighting the strain this will place on the healthcare system and the increased responsibility on unpaid caregivers who desire to keep their loved ones at home.

The study acknowledges the efforts of organizations in offering training and support for home-based dementia care yet recognizes the potential for caregivers to feel too overwhelmed to engage with these resources. By interviewing 20 professionals from various disciplines involved in community-based dementia care, the study identifies key challenges to mealtime participation and recommends practical strategies to address them. These include reducing sensory distractions, decluttering living spaces, providing clear instructions, and optimizing the eating environment to suit the needs of individuals with dementia.

Additionally, the importance of community-based programs like Meals-on-Wheels is highlighted, not only for their direct benefit to those with dementia but also in offering caregivers much-needed support and relief.

The next phase of Juckett’s research involves gathering insights from caregivers and individuals with dementia to refine the intervention strategies further, with the ultimate goal of developing and testing an effective mealtime intervention for home settings.

This effort, supported by the National Institute on Aging’s IMPACT Collaboratory, signifies a significant step towards acknowledging and addressing the complexities of caregiving, particularly around mealtime routines, aiming to reduce the burden on caregivers and enhance the quality of life for individuals living with dementia at home.

The study’s co-authors include notable academics from Ohio State, the University of Wisconsin-Madison, and Brown University, showcasing a collaborative approach to tackling the challenges faced by those affected by dementia and their caregivers.

More information: Lisa A Juckett et al, Supporting mealtime participation among people living with dementia at home: Challenges and strategies for caregivers, The Gerontologist. DOI: 10.1093/geront/gnad167

Journal information: The Gerontologist Provided by Ohio State University

Routine physical activity can decelerate the progression of bone density loss

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A recent investigation highlights the potential benefits of incorporating medium-to-high-intensity impact activities into daily routines to mitigate the effects of ageing on bone density. This study revealed that individuals over 70 who engaged in activities with the intensity of brisk walking or gentle jumping as part of a year-long exercise regimen exhibited a more robust preservation of bone density. Conducted by the University of Jyväskylä in Finland, the research focused on men and women aged 70 to 85 who were previously inactive. While a decrease in bone mineral density at the femoral neck was observed, the overall structural integrity of the bone was either maintained or slightly enhanced for participants who engaged in moderate to high-intensity physical activities compared to those who were less active or whose activities were of lower intensity.

Postdoctoral Researcher Tiina Savikangas emphasized the importance of even short activity durations for skeletal health, noting the study’s attention to the impact forces generated by different activities. It was found that impacts akin to brisk walking were particularly effective in maintaining bone mineral density. The research underscores a common challenge: physical activity levels and bone health tend to decline as individuals age. However, the study suggests that strength training and activities that generate impact, e.g. running and jumping, can counteract bone density loss associated with ageing.

A novel aspect of this research was its examination of everyday physical activities in addition to structured exercise, pointing towards the value of integrating more impactful activities into daily life. Postdoctoral Researcher Tuuli Suominen offered practical advice on increasing high-intensity activities in daily routines, such as taking brisk walks, climbing stairs, and performing heel drops as a non-jumping alternative to create beneficial impacts.

The study highlights the femoral neck’s vulnerability to fractures, especially from falls. It underscores the importance of maintaining bone mineral density and preventing falls to avoid hip fractures. Savikangas and Suominen advocate for increasing daily physical activity in older adults who do not regularly exercise to preserve bone health and prevent fractures by enhancing functional capacity and muscle strength. Improved muscle strength and functional ability reduce the risk of falls and promote more effective bone loading.

This investigation is a segment of the PASSWORD study, executed by the Faculty of Sport and Health Sciences and the Gerontology Research Centre at the University of Jyväskylä, Finland, between 2017 and 2020. It involved 299 less active individuals aged 70 to 85 from Jyväskylä, engaging them in progressive training for muscle strength, endurance, balance, and flexibility. Half the participants received computer-based training to improve information processing skills alongside their physical exercise regimen. Activity levels were quantified with accelerometers, and bone density and structural attributes at the femoral neck were assessed using dual-energy X-ray absorptiometry before and after the year-long exercise program.

More information: T. Savikangas et al, Changes in femoral neck bone mineral density and structural strength during a 12-month multicomponent exercise intervention among older adults – Does accelerometer-measured physical activity matter? Bone. DOI: 10.1016/j.bone.2023.116951

Journal information: Bone Provided by University of Jyväskylä (Jyväskylän yliopisto)

Higher dementia diagnosis rates linked to benzodiazepine use in anxious older adults

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Research conducted at the Saint Louis University School of Medicine has unveiled significant findings regarding old adults, anxiety, dementia, and the role of benzodiazepines. The study, entitled “Anxiety Disorders, Benzodiazepine Prescription and Incident Dementia,” published in the Journal of the American Geriatrics Society, reveals a nuanced relationship between these elements. Patients aged 65 and older diagnosed with anxiety were found to have a notably higher likelihood of developing dementia. Moreover, exposure to benzodiazepines was linked to a 28% elevation in dementia risk. However, for those receiving benzodiazepines for an anxiety disorder, no significant correlation with dementia was observed, suggesting a complex interplay between anxiety management and dementia risk.

Jay A. Brieler, M.D., an associate professor of family and community medicine at SLU, spearheaded the research as the primary author, with Jeffrey Scherrer, PhD, a professor in the same department and a member of the AHEAD Institute, serving as the senior author. Their investigation aimed to discern the contributions of anxiety and benzodiazepine use to dementia risk amidst concerns over benzodiazepine-related dementia implications. The study’s conclusions indicate that both anxiety and benzodiazepine use independently are associated with increased dementia risk. Yet, when benzodiazepines are prescribed for anxiety disorders, this risk does not significantly change.

This retrospective cohort study meticulously analyzed electronic health records from 72,496 patients spanning 2014 to 2021, utilizing data from the Saint Louis University-SSM Healthcare System’s Virtual Data Warehouse (VDW). This resource, developed by the Advanced HEAlth Data (AHEAD) Research Institute at Saint Louis University, encompasses a vast array of clinical encounters and has been instrumental in facilitating research that would otherwise be challenging due to the logistical and financial constraints of longitudinal studies.

The findings underscore the complexity of treating late-life anxiety, particularly with benzodiazepines, which have been the subject of debate due to their association with cognitive impairment, falls, and fractures in the short term. The study highlights the critical need for careful consideration in the prescription of benzodiazepines to older adults, given their potential implications for dementia risk. Anxiety in older adults, associated with a spectrum of adverse health outcomes such as cardiovascular disease, depression, and chronic disease burden, presents a significant public health challenge, particularly as the population ages.

The study’s insights are particularly timely, given the projected increase in Alzheimer’s and related dementia diagnoses, which is expected to double by 2060. These findings advocate for a nuanced approach to managing anxiety in older adults, emphasizing the importance of further research to explore alternative anxiety treatments and their impacts on dementia risk. The authors call for additional studies to ascertain whether the association with incident dementia varies with the use of other anxiety medications, underscoring the ongoing quest for optimal strategies to mitigate dementia risk while effectively managing anxiety in the ageing population.

This research not only contributes to our understanding of the interrelations between anxiety, benzodiazepine use, and dementia risk but also exemplifies the value of leveraging real-world clinical data to address complex health questions. The support of the Saint Louis University Research Institute and the collaboration among a diverse team of researchers underscore the collective effort to improve the care and outcomes of older adults facing the dual challenges of anxiety and the risk of dementia.

More information: Jay A. Brieler et al, Anxiety disorders, benzodiazepine prescription, and incident dementia, Journal of the American Geriatrics Society. DOI: 10.1111/jgs.18515

Journal information: Journal of the American Geriatrics Society Provided by Saint Louis University

Scientists chart the progression of the measles virus through the human brain

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Researchers from the Mayo Clinic have meticulously traced the mutation and proliferation patterns of the measles virus in the brain of an individual who died from a rare and fatal brain condition. This disease is an uncommon complication arising from measles infection, and its occurrence might increase as measles becomes more prevalent among unvaccinated populations, according to the researchers.

Leveraging advanced genetic sequencing technologies, the Mayo Clinic team recreated the process by which a variety of viral genomes took hold within a human brain. These genomes underwent specific mutations facilitating the virus’s expansion from the frontal cortex to other areas.

Roberto Cattaneo, Ph.D., a leading virologist at Mayo Clinic and co-author of the study published in PLOS Pathogens, emphasized the significance of their findings. He stated that their research offers critical insights into how the viral RNA mutates and disseminates within a major human organ—specifically, the brain. These insights are pivotal for understanding the persistence and adaptation of other viruses within the human brain, potentially leading to disease. Furthermore, this knowledge could aid in the development of potent antiviral medications.

Measles is known for its high contagion levels. It initially infects the upper respiratory system and utilizes the trachea as a launch pad, spreading through droplets emitted during coughs or sneezes by infected individuals.

Dr. Cattaneo has been at the forefront of research on the systemic spread of the measles virus. His fascination with measles began approximately 40 years ago, particularly with subacute sclerosing panencephalitis (SSPE), a lethal brain disease that emerges in roughly 1 out of every 10,000 measles cases. SSPE manifests years after the initial measles infection, leading to severe neurological symptoms such as memory loss, seizures, and paralysis. Dr. Cattaneo dedicated many years to studying SSPE until the disease became rare, thanks to widespread measles vaccination.

However, the resurgence of measles, driven by vaccine scepticism and missed vaccinations, especially during the COVID-19 pandemic, has led to a significant rise in measles cases and deaths globally. The decline in vaccination rates has resulted in an estimated 18% increase in measles cases and a 43% surge in measles-related deaths in 2021 compared to the previous year, as the Centers for Disease Control and Prevention (CDC) reported.

The research team, including Dr. Cattaneo and Iris Yousaf, a Ph.D. candidate at the Mayo Clinic Graduate School of Biomedical Sciences, utilized a unique opportunity to study SSPE through a collaboration with the CDC. They analyzed brain samples from an individual who contracted measles in childhood and later succumbed to SSPE. By conducting genetic sequencing on various brain regions, they pieced together how the measles virus evolved and increased within the brain.

They found that the virus’s genome began mutating in detrimental ways upon entering the brain, creating a diverse population of viral genomes. Two specific genomes possessed characteristics that significantly enhanced the virus’s ability to spread from the frontal cortex, effectively colonizing the entire brain.

The research team plans to explore further how particular mutations facilitate the virus’s spread in the brain. These investigations will involve studies on brain cell cultures and brain-like organoids. The aim is to uncover potential antiviral treatments to prevent virus proliferation within the brain. Despite the challenges in treating advanced stages of diseases like SSPE, vaccination against measles remains the most effective prevention strategy.

More information: Iris Yousaf et al, Brain tropism acquisition: the spatial dynamics and evolution of a measles virus collective infectious unit that drove lethal subacute sclerosing panencephalitis, PLoS Pathogens. DOI: 10.1371/journal.ppat.1011817

Journal information: PLoS Pathogens Provided by Mayo Clinic

What is the typical age and level of disability among older adults transitioning into long-term care?

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Kenneth Lam, MD, MAS, a geriatrician with extensive experience advising families about when and how their older relatives should transition into nursing homes or assisted living facilities, emphasizes the complexity of such decisions. Lam, an assistant professor of geriatric medicine at the University of Colorado School of Medicine, has spent years in clinical practice developing an intuition for the most suitable care settings for older adults based on their individual needs. However, transitioning into a research role, he became acutely aware of the lack of data guiding these critical life decisions. This realization led him to pursue research aimed at filling this gap.

In his study published on November 6 in JAMA Internal Medicine, titled “The Natural History of Disability and Caregiving Before and After Long-Term Care Entry,” Lam sought to understand the typical ages at which individuals enter care facilities and their levels of disability before doing so. Utilizing the National Health and Aging Trends Study, which annually tracks older adults’ capabilities and the extent of assistance they require, Lam explored the independence levels of these individuals before they transition to a care facility and the type and amount of help they receive.

Lam’s research revealed that the average age of individuals entering care facilities is 84, often after experiencing several months of severe disability and increasing levels of care, usually provided by unpaid family members. Specifically, he found that those moving into nursing homes typically already face severe disabilities and receive around 27 hours of care weekly for at least a month before their move. In contrast, those transitioning to assisted living facilities are less likely to be severely disabled but still receive an average of 18 hours of care weekly.

The study highlights the significant amount of care and the challenges of severe disability that families manage at home for extended periods before the transition to nursing homes occurs. Lam notes that the situation is somewhat different for those moving into assisted living facilities, reflecting the socio-demographic advantages of this group. Interestingly, Lam discovered that within one to two years, the level of severe disability among those in assisted living facilities approaches that of nursing home residents, raising questions about the long-term viability of assisted living as a permanent solution.

Lam points out that the decision to move into a nursing home often comes late in the disability trajectory. This phenomenon raises questions about the underlying reasons, such as stigma or financial constraints. The study offers a glimpse into the critical moment when individuals and society confront the need to make significant care decisions, often dictated by affordability and the desire to maintain independence as long as possible.

Following this quantitative study, Lam is conducting qualitative research to gain deeper insights into the experiences of those who have recently moved into long-term care facilities, including their social lives and the impact of dementia on such decisions. This approach aims to provide a more comprehensive understanding of the factors influencing the decision to transition into long-term care and to offer advice to others facing similar choices.

Lam hopes his research will serve as a foundation for clinicians, patients, and families to discuss and navigate the complex decisions surrounding long-term care for older adults. By establishing an average age of entry into such facilities, the study offers a basis for discussions about the timing of this transition, inviting further exploration into whether the timing of entry significantly impacts outcomes. Lam’s work underscores the importance of a nuanced approach to these decisions, recognizing the individuality of each situation and the need for ongoing discussion and research in this area.

More information: Kenneth Lam et al, The Natural History of Disability and Caregiving Before and After Long-Term Care Entry, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2023.5427

Journal information: JAMA Internal Medicine Provided by University of Colorado Anschutz Medical Campus

Studies reveal that active social involvement enhances the ageing process optimally for older adults

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A comprehensive study observed over 7,000 Canadians, who were middle-aged and older, for about three years to explore if a higher level of social engagement was linked to more successful ageing later in life. The findings revealed that individuals who engaged in volunteer activities and recreational pursuits were more likely to sustain outstanding health over the three years of the study and were less prone to physical, cognitive, mental, or emotional issues.

The criteria for successful ageing, as defined by the researchers, included the absence of any severe physical, cognitive, mental, or emotional conditions that could hinder daily activities, along with a high degree of self-reported happiness, robust physical health, and mental well-being. The study initially included only those participants who were already ageing successfully. The objective was to determine if social engagement contributed to their chances of continuing to enjoy excellent health.

Around 72% of participants involved in volunteer or recreational activities at the beginning of the study continued to age successfully after three years. In contrast, only two-thirds of those who did not participate in these activities managed to age as successfully by the study’s end. Considering various sociodemographic factors, the results suggested that those engaged in recreational and volunteer or charitable activities had a 15% and 17% higher likelihood of maintaining excellent health throughout the study.

Mabel Ho, the study’s lead author and a doctoral candidate at the University of Toronto’s Factor-Inwentash Faculty of Social Work and the Institute of Life Course and Aging, remarked that while the study’s observational nature limits definitive conclusions about causality, the link between social activity and successful ageing is intuitively logical. Social engagement plays a crucial role at any age in enhancing mood, reducing feelings of loneliness and isolation, and bolstering mental and overall health.

The concept of “social prescribing” is now being adopted by some healthcare professionals, who recommend social activities as a non-drug intervention that connects primary care with community services. This approach encourages older adults to partake in volunteering and recreational activities.

Esme Fuller-Thomson, the study’s senior author and a professor at the University of Toronto, highlighted the positive implications of the findings for older adults and their families, who often fear that a steep decline in health is unavoidable with age. She stressed the importance of collaborative efforts among older adults, their families, practitioners, policymakers, and researchers to foster an environment conducive to a fulfilling and healthy later life.

This study proposes a more inclusive definition of successful ageing than previous research by considering objective and subjective health measures. Unlike earlier studies that disqualified individuals with any chronic health conditions from being considered as “ageing successfully,” this research allows for the inclusion of those with chronic illnesses, provided they can still participate in daily activities and are not hindered by disabling chronic pain. This broader definition also considers the personal perceptions of older adults regarding their ageing process, physical and mental health, and emotional well-being, including happiness and life satisfaction, aspects often overlooked in past research.

Published in the International Journal of Environmental Research and Public Health, this study utilized longitudinal data from the Canadian Longitudinal Study on Aging (CLSA) covering the initial and first follow-up phases to investigate factors contributing to optimal ageing. The CLSA comprised 7,651 respondents aged 60 years or older in the second wave who were in optimal health during the first data collection wave. The sample was limited to those in excellent health at the outset, constituting only 45% of the participants.

More information: Ho, M., Pullenayegum, E., & Fuller-Thomson, E. (2022). Is Social Participation Associated with Successful Aging among Older Canadians? Findings from the Canadian Longitudinal Study on Aging (CLSA). International Journal of Environmental Research and Public Health, 20(12): 6058. https://doi.org/10.3390/ijerph20126058

Journal information: International Journal of Environmental Research and Public Health Provided by University of Toronto

Research uncovers the most compelling proof yet of the brain’s capacity to offset cognitive deterioration linked to ageing

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Researchers have uncovered the most compelling evidence to date that the human brain can adapt to counteract the effects of ageing on cognitive functions. This adaptation involves activating additional brain regions to support and sustain mental performance.

As individuals age, the brain undergoes a natural process of atrophy, characterized by the loss of nerve cells and connections. This process can result in diminished brain functionality. The variability in cognitive resilience among older adults and strategies for safeguarding against cognitive decline remains a subject of scientific inquiry.

The prevailing theory suggests that some individuals’ brains can effectively offset the loss of brain tissue by activating alternative brain regions to aid in task execution. Previous brain imaging studies have indeed observed such compensatory activations, but the impact of these activations on task performance and their contribution to task understanding were unclear.

A groundbreaking study published in the journal eLife, led by researchers from the University of Cambridge in partnership with the University of Sussex, demonstrates that this brain adaptation occurs and enhances task performance in older adults.

Dr Kamen Tsvetanov, spearheading the study at the University of Cambridge, highlights the investigation into the preservation of ‘fluid intelligence’—the capacity for abstract problem-solving—which tends to decline with age. The study aimed to understand why some individuals maintain higher levels of fluid intelligence by possibly engaging different brain regions to counteract detrimental brain changes.

The research utilized functional magnetic resonance imaging (fMRI) to study brain activity in 223 adults aged 19 to 87 from the Cambridge Centre for Ageing & Neuroscience (Cam-CAN). Participants solved puzzles of varying difficulty while undergoing fMRI, allowing the team to analyze changes in brain blood flow and activity patterns.

Findings indicated a general decline in problem-solving ability with age, with specific brain regions, including those involved in visual processing, remaining active. Further machine learning analysis identified two brain areas—the cuneus and a frontal cortex region—showing heightened activity in older individuals, correlating with improved task performance. Notably, the cuneus region’s activity was more closely linked to performance improvements in older participants, providing new insights beyond the multiple demand network’s role.

The role of the cuneus, typically associated with focus and visual processing, suggests a compensatory mechanism for the age-related decline in visual memory, possibly through altered visual attention strategies.

Dr Ethan Knights from the Medical Research Council Cognition and Brain Sciences Unit at Cambridge expresses optimism that understanding this compensatory mechanism could lead to identifying factors that enable some older individuals to maintain cognitive functions better than others. This understanding could inform interventions to extend such benefits to a broader population.

Dr Alexa Morcom from the University of Sussex adds that these findings challenge the previous assumption that compensation relies solely on the multiple-demand network, indicating that preserved brain regions are also crucial in ageing.

Supported by several prestigious institutions, including the Medical Research Council and the Alzheimer’s Society, this research marks a significant advancement in understanding brain plasticity and cognitive ageing, opening avenues for enhancing cognitive health in later life.

More information: Ethan Knights et al, Neural Evidence of Functional Compensation for Fluid Intelligence Decline in Healthy Ageing, eLife. DOI: 10.7554/eLife.93327

Journal information: eLife Provided by University of Cambridge

Older adults with a history of stroke are at a heightened risk of experiencing depression induced by the pandemic

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A recent longitudinal study conducted by the University of Toronto has shed light on the significant mental health impact that the COVID-19 pandemic has had on older adults with a previous stroke history.

The research involved analyzing data from over 500 older adults with stroke histories sourced from the Canadian Longitudinal Study on Aging. This comprehensive dataset tracks the health of older Canadians. The findings revealed a pronounced increase in depression rates among this demographic throughout the pandemic.

Andie MacNeil, the study’s lead author and a research assistant at the University of Toronto’s Factor-Inwentash Faculty of Social Work, highlighted the heightened vulnerability of stroke survivors to adverse mental health conditions such as depression. The pandemic exacerbated these vulnerabilities due to widespread disruptions in care for stroke patients, significantly affecting their physical and psychological health.

The study distinguished between participants who had previously experienced depression and those who had not before the pandemic. It found that 1 in 7 older adults with a stroke history reported experiencing depression for the first time during the pandemic. Among those with a prior depression history, the rate was even more alarming, with half of these individuals facing a recurrence or continuous depression throughout the pandemic period.

Grace Li, a co-author of the study and a PhD candidate at the University of Victoria, emphasized the struggles faced by stroke survivors during lockdowns, including those previously in good mental health. The study underscores the importance of screening for depression in older adults with a stroke history, including those without a prior history of the condition.

The research also identified risk factors for both the initial onset and recurrence of depression. Functional impairment was a significant risk factor among those with a history of depression, doubling the risk during the pandemic.

Aneisha Taunque, another co-author and research assistant at the University of Toronto, pointed out the specific high risk of depression among older adults with both a stroke and depression history. She noted the crucial role of functional status in this dynamic, exacerbated by the pandemic’s impact on rehabilitation services.

Difficulty in accessing healthcare services emerged as a critical factor, increasing the risk of new-onset depression threefold. Ishnaa Gulati, a Master of Public Health Student and co-author, highlighted the additional stressors for stroke patients, including delays in medical appointments and treatments and the stress of navigating healthcare access challenges.

The study also found that feelings of loneliness at the pandemic’s start significantly increased the risk of developing depression, especially among those who strictly adhered to physical distancing to mitigate COVID-19 risks. Esme Fuller-Thomson, the senior author and a professor at the University of Toronto, emphasized the established link between loneliness and depression risk.

Interestingly, among participants without a depression history, being an immigrant was associated with a roughly threefold increase in the risk of developing depression, likely due to the disproportionate impact of COVID-19 on communities with high immigrant populations.

Family stressors, including separation from family and caregiving challenges, were also identified as risk factors for both new and recurrent depression. Margaret de Groh, a Scientific Manager at the Public Health Agency of Canada, noted the increased depression risk due to pandemic-related family separations and caregiving difficulties.

A sensitivity analysis comparing pre-pandemic data further confirmed the pandemic’s unique impact on depression rates among older adults with a stroke history, underscoring the increased vulnerability of this group during the COVID-19 crisis.

The study’s findings are crucial for healthcare professionals, highlighting key risk factors for depression among stroke survivors. Fuller-Thomson expressed hope that these insights would guide targeted screening and interventions to support the mental health of this particularly vulnerable population.

More information: Andie MacNeil et al, Depression during the COVID-19 pandemic among older adults with stroke history: Findings from the Canadian Longitudinal Study on Aging, International Journal of Geriatric Psychiatry. DOI: 10.1002/gps.6062

Journal information: International Journal of Geriatric Psychiatry Provided by University of Toronto