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Geographic inequality shown to affect hip fracture recovery

Older adults living in economically disadvantaged neighbourhoods spend significantly fewer days at home in the year following a fall-related hip fracture than those in more affluent areas, according to an extensive national study published in JAMA Network Open. The findings highlight how recovery after a significant injury is shaped not only by medical care, but also by the social and physical conditions of the places where people live.

The researchers analysed Medicare data from more than 52,000 older adults who experienced a hip fracture. After accounting for individual factors such as age and chronic illness, they found that people living in the most economically disadvantaged neighbourhoods spent an average of 23 fewer days at home in the year after their injury compared with those in the least disadvantaged areas. Instead, they spent more time in skilled nursing facilities or long-term care settings, suggesting slower or more complicated recoveries.

The study’s senior author, Jason R. Falvey, Associate Professor of Physical Therapy and Rehabilitation Science at the University of Maryland School of Medicine, emphasised that neighbourhood context is often overlooked in hip fracture research. He noted that older adults in highly disadvantaged areas face multiple barriers to recovery, including limited access to rehabilitation services, fewer supports for caregivers, and environmental challenges such as damaged pavements that restrict safe mobility. Together, these factors make it harder for individuals to regain independence after injury.

To assess neighbourhood disadvantage, the researchers used the Area Deprivation Index, a national measure that incorporates income, education, employment, and housing quality. Participants living in the most deprived neighbourhoods were more likely to belong to racial or ethnic minority groups and to be dually eligible for Medicare and Medicaid—these overlapping forms of disadvantage point to broader structural inequalities that extend well beyond the hospital setting.

The findings matter because hip fractures are life-changing events and a leading cause of disability and loss of independence in older adults. “Days at home” is a patient-centred measure that captures quality of recovery, reflecting independence, well-being, and the ability to age in place. The study shows that even when medical factors are similar, place-based disadvantage reduces the likelihood of spending time at home after surgery, underscoring the role of environment in shaping outcomes.

The researchers argue that improving recovery after hip fracture will require action beyond clinical care alone. For clinicians, this means considering neighbourhood and social factors when planning discharge and rehabilitation. For health systems and policymakers, it points to the need for investment in community-based supports, transportation, caregiver resources, home health services, and safer neighbourhood infrastructure. Future research will focus on developing care models that address these barriers and help more older adults recover and remain at home, regardless of where they live.

More information: Alyssa M. Baginski et al, Neighborhood Deprivation and Days Spent at Home After Fall-Related Hip Fracture, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.49118

Journal information: JAMA Network Open Provided by University of Maryland School of Medicine

An AI-Driven Review of a Century of Ageing Research Reveals Trends and Gaps

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A research article published in Volume 17, Issue 11 of Aging-US on 25 November 2025 presents a large-scale, AI-based analysis of how ageing research has evolved over the past century. Titled “A natural language processing–driven map of the aging research landscape, the paper adopts a meta-research perspective, using computational tools to examine not a single biological problem, but the structure, priorities, and blind spots of ageing science as a whole. It aims to provide a clear, data-driven overview of where the field has come from and where it may need to go next.

The study was led by Jose Perez-Maletzki, affiliated with Universidad Europea de Valencia and Universitat de València, in collaboration with Jorge Sanz-Ros from Stanford University School of Medicine. Together, the authors used artificial intelligence to analyse global ageing research output, seeking to identify long-term trends, shifts in emphasis, and areas that remain underexplored. Their approach reflects a growing recognition that understanding the organisation of scientific knowledge is itself essential for accelerating progress.

To conduct the analysis, the team examined more than 460,000 scientific abstracts published between 1925 and 2023. This massive dataset allowed them to capture nearly a century of research across basic biology, clinical medicine, and population health. By focusing on abstracts, the authors were able to include a broad range of disciplines and journals, producing a more comprehensive and less selective overview than is typically possible with traditional narrative reviews.

Using natural language processing and machine-learning techniques, the researchers grouped publications into thematic clusters and tracked how interest in each topic changed over time. Their methodology combined Latent Dirichlet Allocation, term frequency–inverse document frequency analysis, dimensionality reduction, and clustering to generate a structured thematic map of ageing research. This enabled them to visualise both dominant research areas and weaker connections between topics, revealing patterns that are difficult to detect through manual review alone.

One key finding was a clear historical shift in focus. Early ageing research was primarily centred on fundamental cellular processes and animal models, whereas more recent decades show a strong move towards clinical and disease-oriented studies. In particular, research on Alzheimer’s disease, dementia, and geriatric healthcare has grown rapidly. While this reflects the realities of ageing populations, the analysis also indicates a widening gap between basic biological research and clinical application.

The study shows that basic and clinical ageing research often develops in parallel, with limited integration. Clinical studies tend to focus on care, neurodegeneration, and age-related disease, while basic science emphasises mechanisms such as mitochondrial dysfunction, telomere shortening, oxidative stress, and cellular senescence. Emerging areas like autophagy, RNA biology, and nutrient sensing are expanding quickly but remain weakly connected to clinical research. The authors argue that these gaps represent missed opportunities and potential directions for future interdisciplinary work.

Overall, this AI-driven analysis provides a powerful tool for reflecting on how ageing research is organised and prioritised. By identifying both strong connections and neglected links, the study offers guidance for shaping more integrated and translational research strategies. As global populations continue to age, such a comprehensive and critical overview may help ensure that future research is not only productive but also better aligned with real-world health outcomes.

More information: Jose Perez-Maletzki et al, A natural language processing–driven map of the aging research landscape, Aging-US. DOI: 10.18632/aging.206340

Journal information: Aging-US Provided by Impact Journals LLC

As neuron death increases with ageing, a natural human protein treatment shows potential to halt Alzheimer’s-related brain cell loss

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Scientists at the University of Colorado Anschutz have found that changes in brain neurons, including gradual cell loss, may begin much earlier in life than previously thought. Their research also suggests that a drug already approved for other medical uses could potentially be repurposed to slow this damage, offering fresh hope for people living with Alzheimer’s disease and other cognitive disorders. The findings highlight a possible new direction in tackling neurodegeneration, an area where effective treatments remain limited.

The study, published in Cell Reports Medicine, builds on earlier clinical work involving sargramostim, also known as Leukine. According to senior author Professor Huntington Potter, director of the University of Colorado Alzheimer’s and Cognition Center, the drug showed encouraging effects in its first clinical trial. Over a relatively short period, sargramostim reduced a blood-based marker of neuron death in people with Alzheimer’s disease and improved performance on one established cognitive test. These findings are notable because they link biological evidence of reduced neuronal damage with measurable cognitive benefit.

Sargramostim is a synthetic version of GM-CSF, a natural human protein that stimulates the immune system. It has been used safely for around 30 years, particularly in cancer care, to promote the production of immune cells. In early neurological studies, the drug improved blood biomarkers associated with brain pathology. While these biomarker improvements were only maintained during active treatment, gains in one measure of memory persisted beyond the treatment period, suggesting longer-lasting effects on brain function.

In the new cross-sectional study, researchers examined blood samples from individuals across a wide age range. They focused on proteins released when neurons are damaged or die, including UCH-L1 and neurofilament light chain (NfL). Levels of both proteins were low in early life but increased exponentially with age, reaching much higher concentrations in later adulthood. While modest increases earlier in life likely reflect normal ageing, higher levels in older age were associated with poorer outcomes, pointing to accelerated neuronal damage as a contributor to cognitive decline and Alzheimer’s disease.

The team also measured glial fibrillary acidic protein (GFAP), a marker of brain inflammation believed to play a central role in cognitive deterioration. GFAP levels rose significantly from around age 40, supporting the idea that neuroinflammation intensifies in midlife and may drive later neuronal loss. Interestingly, age-related levels of GFAP and UCH-L1 were higher in women than in men, although the reasons for this difference remain unclear.

Results from the clinical trial were particularly striking. People with Alzheimer’s disease who received sargramostim showed a roughly 40 per cent reduction in blood levels of UCH-L1, comparable to levels typically seen much earlier in life. They also performed better on the Mini-Mental State Examination than those receiving a placebo. Although UCH-L1 levels returned to pre-treatment values after the drug was stopped, the cognitive improvement persisted, raising essential questions about how the treatment works and how long its benefits might last.

The authors caution that these findings are still preliminary. Blood markers of neuronal damage change naturally with age, and more research is needed to determine whether sargramostim can slow normal age-related cognitive decline or requires continuous use to maintain its effects. A larger, longer clinical trial in people with mild-to-moderate Alzheimer’s disease is currently underway. Until regulatory review is complete, the drug should not be used outside its approved indications.

More information: Stefan H. Sillau et al, Blood measure of neuronal death is exponentially higher with age, especially in females, and halted in Alzheimer’s disease by GM-CSF treatment, Cell Reports Medicine. DOI: 10.1016/j.xcrm.2025.102525

Journal information: Cell Reports Medicine Provided by University of Colorado Anschutz

How a brain care score can predict stroke risk across racial groups, study finds

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A new study led by researchers at Mass General Brigham has found that the Brain Care Score (BCS) is a strong predictor of stroke risk across racial groups in the United States. The findings, published in Neurology, the medical journal of the American Academy of Neurology, suggest that this composite measure of brain health may be especially valuable for addressing long-standing disparities in stroke risk. In particular, the results indicate that improvements in the Brain Care Score could yield meaningful benefits for stroke prevention among Black adults.

Black adults in the United States face a two- to threefold higher risk of stroke compared with white adults, a disparity that has persisted despite decades of research and public health efforts. Senior author Sanjula Dhillon Singh, a principal investigator in the Brain Care Labs within the Mass General Brigham Department of Neurology, explained that the Brain Care Score offers a practical way to understand better and address this gap. By focusing on modifiable behaviours, the score provides a framework for identifying concrete actions that can lower stroke risk, rather than treating such disparities as inevitable or purely genetic.

The Brain Care Score was initially developed at the McCance Center for Brain Health as a holistic tool that brings together multiple dimensions of brain health into a single metric. It incorporates physical, lifestyle, and social-emotional factors, including blood pressure and blood sugar control, nutrition, alcohol intake, physical activity, stress levels, and social relationships. Scores range from 0 to 21, with higher values reflecting healthier behaviours and a lower risk of age-related brain diseases such as stroke, dementia, and depression.

To assess the predictive value of the BCS, the researchers analysed data from 10,861 participants in the federally funded Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. This large national cohort included Black and white adults aged 45 and older who had no history of stroke at baseline and complete data for all components of the Brain Care Score. Participants were followed for a median of 15.9 years, allowing the researchers to examine long-term stroke outcomes in relation to baseline brain health.

Over the follow-up period, higher Brain Care Scores were consistently associated with lower stroke risk in both racial groups. A five-point increase in the BCS was linked to a 53 per cent reduction in stroke risk among Black participants and a 25 per cent reduction among white participants, even after adjusting for demographic and socioeconomic factors. These findings suggest that while the Brain Care Score is predictive across groups, its potential benefits may be particularly pronounced for those at higher baseline risk.

The study was observational and cannot establish causality, but the results reinforce the importance of addressing behavioural and social determinants of health in efforts to reduce stroke disparities. As Jonathan Rosand, Director of the Brain Care Labs at Mass General Brigham and Founder of the Global Brain Care Coalition, noted, confirming the predictive power of the Brain Care Score in diverse populations is a critical step towards ensuring that everyone has the opportunity to protect and improve their brain health.

More information: Evy M. Reinders et al, Association of Modifiable Risk Factors Measured With the Brain Care Score and Incident Stroke in the REGARDS Cohort, Neurology. DOI: 10.1212/WNL.0000000000214488

Journal information: Neurology Provided by Mass General Brigham

A genetic blind spot: how ‘junk’ DNA might hold Alzheimer’s clues

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When most people think about DNA, they tend to picture genes that determine physical traits, influence behaviour, and keep the body’s cells and organs functioning properly. This familiar image is useful, but it captures only a small slice of what our genetic material actually does. The reality is that genes themselves make up only a minor fraction of the human genome.

In fact, only about 2% of our DNA encodes the roughly 20,000 genes that code for proteins. The remaining 98% belongs to the non-coding genome, long dismissed as “junk” DNA. Scientists now know that much of this DNA is anything but useless, as it contains regulatory elements that act like switches, controlling when genes are activated and how strongly they are expressed.

Researchers from UNSW Sydney have recently identified important DNA switches that regulate astrocytes, specialised brain cells that support neurons and help maintain normal brain function. Astrocytes are increasingly recognised as playing a key role in Alzheimer’s disease, making them an essential target for understanding how genetic regulation contributes to neurodegeneration.

In a study published in Nature Neuroscience, scientists from UNSW’s School of Biotechnology and Biomolecular Sciences examined nearly 1,000 potential switches, known as enhancers, in human astrocytes grown in the laboratory. Enhancers are challenging to study because they can be located far from the genes they regulate, sometimes hundreds of thousands of DNA base pairs apart. To overcome this challenge, the team combined CRISPR interference, which allows sections of DNA to be switched off without cutting them, with single-cell RNA sequencing to measure changes in gene expression.

This approach enabled the researchers to test the function of almost 1,000 enhancers simultaneously. By turning off each candidate enhancer and observing whether gene activity changed, they identified around 150 that functioned as genuine switches. Strikingly, many of these enhancers controlled genes already linked to Alzheimer’s disease, sharply narrowing the regions of the genome that scientists need to examine when searching for genetic risk factors.

Although the findings do not immediately translate into treatments, they provide a crucial foundation for future work. The results offer a detailed map of gene regulation in astrocytes, helping researchers interpret genetic changes found outside of genes themselves. The dataset can also be used to train artificial intelligence tools to predict enhancer function, potentially accelerating future research. In the longer term, the cell-type specificity of enhancers raises the possibility of precisely controlling gene activity in astrocytes, opening new directions for understanding and eventually treating Alzheimer’s disease.

More information: Nicole F. O. Green et al, CRISPRi screening in cultured human astrocytes uncovers distal enhancers controlling genes dysregulated in Alzheimer’s disease, Nature Neuroscience. DOI: 10.1038/s41593-025-02154-3

Journal information: Nature Neuroscience Provided by University of New South Wales

Living with food and financial insecurity may age the heart faster than recognised clinical risk factors

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A new analytical study exploring how social determinants of health influence cardiac ageing has identified financial strain and food insecurity as the most potent contributors to accelerated biological ageing of the heart and a heightened risk of death. The research demonstrates that these social pressures exert a more substantial effect than many traditional clinical risk factors, highlighting the intricate ways in which social and economic conditions shape cardiovascular outcomes. Published in Mayo Clinic Proceedings, the findings highlight the need for prevention strategies that go beyond purely biomedical models of care.

The study emerges at a time of profound demographic change. In the United States, the population aged 65 and over is projected to almost double by 2050, reaching approximately 82 million people, or nearly a quarter of the total population. As life expectancy rises, healthcare priorities have increasingly shifted towards promoting healthy ageing and preserving quality of life in later years. This transition has fuelled interest in identifying more meaningful measures of biological ageing, rather than relying solely on chronological age, to predict disease risk and guide interventions better.

According to lead investigator Dr Amir Lerman of the Mayo Clinic’s Department of Cardiovascular Medicine, the research was driven by growing evidence that conventional cardiovascular risk factors do not account equally for disease burden across patients. He notes that social influences on health are often overlooked in clinical settings, mainly because they are not routinely assessed or discussed. These unrecognised factors, he suggests, may play a significant role in accelerating biological ageing and could represent opportunities for intervention if correctly identified.

The cross-sectional analysis included data from more than 280,000 adults who received care at the Mayo Clinic between 2018 and 2023. Researchers evaluated social determinants of health using a comprehensive questionnaire covering nine domains: stress, physical activity, social connections, housing instability, financial strain, food insecurity, transport needs, nutrition, and education. Cardiac age was estimated using an artificial intelligence–enabled electrocardiogram. At the same time, advanced statistical modelling was employed to examine how social factors, traditional risk factors, and comorbidities interact to influence the gap between cardiac and chronological age.

A central concept in the study is the “cardiac age gap, which reflects the difference between a person’s biological heart age and their actual age. A larger gap indicates an older biological heart and a greater likelihood of future cardiovascular disease. The findings demonstrate that the combined influence of social determinants was the most significant driver of this gap, surpassing traditional clinical factors. Among all social variables assessed, financial strain and food insecurity consistently showed the strongest association with accelerated cardiac ageing, both in the overall population and when analysed by sex. Several social factors, including housing instability and physical inactivity, were also found to predict mortality risk at levels comparable to, or exceeding, established medical risks.

The authors acknowledge limitations, noting that the AI-based ECG tool was validated within a single healthcare system and that most participants identified as non-Hispanic White, which may limit generalisability to other populations. Nevertheless, the study underscores the importance of integrating social context into cardiovascular care. Dr Lerman concludes that recognising and addressing key social determinants can enable more targeted prevention efforts and support genuinely patient-centred care, ultimately improving heart health by confronting the broader conditions that contribute to disease.

More information: Nazanin Rajai et al, Interplay of Social Determinants of Health and Traditional Risk Factors in Predicting Cardiac Aging, Mayo Clinic Proceedings. DOI: 10.1016/j.mayocp.2025.01.024

Journal information: Mayo Clinic Proceedings Provided by Elsevier

New Video Dataset Supports the Evolution of AI-Enabled Health Care

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Researchers at the University of Pennsylvania have introduced Observer, a first-of-its-kind multimodal medical dataset designed to capture anonymised, real-time interactions between patients and clinicians. Comparable in atmosphere to medical dramas that depict the intensity of life in clinical settings, Observer offers a genuine view inside primary care consultations. Unlike fictional portrayals, however, the recorded encounters are real, securely anonymised, and created specifically to support research and responsible AI development.

Historically, health care research has relied on information left behind after a clinical visit, such as clinician notes, laboratory values, and vital signs. While valuable, these records omit much of what actually shapes a medical encounter. Elements like body language, tone of voice, eye contact, room layout, and the presence of computers or digital tools are rarely documented, yet they strongly influence communication, trust, and outcomes. Observer addresses this gap by combining video, audio, transcripts, and clinical data, allowing researchers to examine what happens during care rather than inferring it after the fact.

Kevin B. Johnson, the project’s lead investigator, explains that much of medical care has remained invisible to researchers. By using technology that automatically anonymises recordings and ensures compliance with US privacy regulations, Observer enables observation of care as it unfolds. This evidence, he argues, is not only essential for improving clinical practice but also critical for developing AI systems that support care in ethical and meaningful ways.

The dataset is already being used. Pilot grants have been awarded to research teams exploring new questions using Observer, with the longer-term aim of expanding it into a national resource. Johnson describes this as a “flywheel” effect: as more researchers contribute insights and recordings, the dataset grows, enabling increasingly ambitious investigations into how care is delivered and experienced.

Clinical data have long been central to improving health care. Large datasets of medical records have underpinned decades of research and, more recently, have played a key role in training AI models to identify patterns linking diagnoses, treatments, and outcomes. Yet, as Johnson notes, understanding the whole experience of care requires data that captures what happens in the room. With Observer, researchers can now study questions such as how humour affects visits, how often clinicians engage with screens instead of patients, and how patients respond to explanations of diagnoses.

Protecting patient privacy has been a central challenge. To make Observer possible, the research team developed MedVidDeID, an automated system that de-identifies video and audio recordings. The tool removes identifying text, alters voices, and detects and blurs faces and other visual identifiers, with human reviewers providing final quality checks. This approach has dramatically reduced the time and effort required to prepare recordings for research use safely.

With initial data collection complete and early studies underway, the team plans to expand Observer and open access to qualified researchers through an application process. The goal is systemic change. As Johnson emphasises, improving care and building meaningful clinical AI depend on understanding the clinical encounter itself. When researchers can observe hundreds or thousands of real visits, genuine transformation becomes possible.

More information: Kevin B. Johnson et al, Observer: creation of a novel multimodal dataset for outpatient care research, Journal of the American Medical Informatics Association. DOI: 10.1093/jamia/ocaf182

Journal information: Journal of the American Medical Informatics Association Provided by University of Pennsylvania School of Engineering and Applied Science

Safety Concerns: Blood Flow Restriction Cuffs and Falls in Older Adults

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New research from Murdoch University’s School of Allied Health, conducted in collaboration with the Health Futures Institute, has found that wearing blood flow restriction cuffs can alter the way older adults walk, potentially increasing unsteadiness during exercise. The findings highlight essential safety considerations as this form of training becomes increasingly widespread among ageing populations seeking to improve strength and mobility through low-load exercise.

Blood flow restriction (BFR) training has gained global popularity as a way to increase muscle strength using lighter physical loads. The technique involves placing inflatable cuffs around the arms or legs to restrict blood flow during movement or exercise partially. This approach allows individuals to achieve strength benefits without the heavier resistance often required in traditional training methods, which can be challenging for some older adults.

By limiting the flow of blood into and out of a limb, BFR creates a low-oxygen environment within the working muscles. This causes the muscles to fatigue more quickly and work harder, even at lower intensities. As a result, improvements in strength and muscle size can be achieved with less mechanical stress on joints, making the method appealing in rehabilitation and ageing-related exercise settings.

Associate Professor Brendan Scott from the Centre for Healthy Ageing explained that while restricting blood flow to the legs during walking has been shown to improve muscle strength and size, caution is required. He noted that although BFR can be a powerful tool for enhancing stability and functional ability in older adults, research shows that wearing cuffs. At the same time, walking alters gait patterns, suggesting that exercise should be conducted in a safe, controlled environment.

The study involved 10 healthy adults, with an average age of 73, who walked on a treadmill for 10 minutes at different speeds. Participants completed trials without cuffs, then with cuffs inflated to 40 and 60 per cent of the pressure required to restrict blood flow fully. A small motion sensor placed on the lower back was used to assess balance and stability during walking.

Results showed that balance worsened whenever the cuffs were inflated, regardless of walking speed, and higher pressures led to greater instability. Despite this, the researchers emphasised that BFR training may still offer long-term benefits if applied correctly. Professional supervision, low starting pressures, and a safe environment can help challenge balance during BFR walking, helping older adults adapt over time while minimising the risk of falls.

More information: Brook Galna et al, Bilateral blood flow restriction of the legs worsens acute walking balance of older adults – a full factorial randomised experiment, Gait & Posture. DOI: 10.1016/j.gaitpost.2025.110022

Journal information: Gait & Posture Provided by Murdoch University

Frailty and depression together may substantially increase dementia risk in later life

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Concurrent physical frailty and depression are likely to markedly increase the risk of dementia in older people, with the interaction between these two factors alone accounting for around 17% of overall dementia risk, according to findings from an extensive international study published in the open-access journal General Psychiatry. The researchers note that around 57 million people worldwide are currently living with dementia, a figure projected to triple by 2050, underscoring the urgency of identifying modifiable risk factors. While previous research has primarily examined physical frailty and depression separately, the authors highlight that the two conditions share overlapping physiological and pathological mechanisms, making their combined impact particularly important to understand.

To investigate this interaction, the study followed 220,947 participants with an average age of 64, of whom just over half were women, drawn from three major cohort studies: the UK Biobank, the English Longitudinal Study of Ageing, and the Health and Retirement Study. Physical frailty was measured using modified Fried frailty criteria, classifying individuals as frail if they met at least three indicators, including unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weak grip strength. Depression was identified through validated mental health questionnaires and, in some cases, linked hospital admission records. Across all three cohorts, frail participants tended to be older, more often female, heavier, living with more long-term health conditions, and had lower levels of educational attainment than those in good physical health.

Over an average follow-up period of nearly 13 years, 9,088 participants were diagnosed with dementia of any type. Analysis showed that frailty alone was associated with more than a 2.5-fold increase in dementia risk, while depression was linked to a 59% higher risk. Strikingly, individuals who were both physically frail and depressed were more than three times as likely to develop dementia as those in good physical and mental health. Beyond these individual effects, the researchers identified a significant interaction between frailty and depression, with approximately 17% of dementia risk attributable specifically to their combined presence.

The authors suggest that lower levels of either frailty or depression may allow the health system to compensate for the cognitive burden imposed by the other condition. Still, once both exceed a certain threshold, this compensatory capacity may break down, resulting in a sharp rise in dementia risk. Although the study is observational and cannot establish causality, and definitions of frailty, depression, and dementia varied across cohorts, the findings remain clinically meaningful. The researchers conclude that because both physical frailty and depression are potentially modifiable, interventions targeting them together could play a significant role in reducing the future burden of dementia.

More information: Yihong Ding et al, Associations of physical frailty, depression and their interaction with incident all-cause dementia among older adults: evidence from three prospective cohorts, General Psychiatry. DOI: 10.1136/gpsych-2025-102172

Journal information: General Psychiatry Provided by BMJ Group

Long-term mortality outcomes of natural disasters in ageing populations

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Severe weather events can have enduring effects on the health and survival of older adults, particularly those who are already vulnerable, according to research published in the Journal of the American Geriatrics Society drawing on data from the aftermath of Hurricane Harvey.

Using Medicare claims records for almost 1.8 million fee-for-service beneficiaries aged 65 and over in Texas and Louisiana, the researchers examined mortality patterns following the hurricane. Their analysis showed that older adults who were exposed to areas of high rainfall during Hurricane Harvey faced a 3 per cent higher risk of death within one year of the event compared with their less-exposed counterparts. The increase in mortality was most pronounced among individuals with chronic conditions that require ongoing medical management, such as chronic kidney disease, Alzheimer’s disease and related dementias. In absolute terms, the most significant number of excess deaths occurred among people living with Alzheimer’s disease and related dementias, with an estimated 1,245 additional deaths in the year after the hurricane.

The study also revealed marked disparities across racial and ethnic groups. Black older adults experienced a 6 per cent higher mortality risk. In comparison, Hispanic and Latino older adults faced a 13 per cent increase relative to other populations, underscoring how disasters can disproportionately affect groups that already face structural disadvantages.

Commenting on the findings, corresponding author Sue Anne Bell, PhD, of the University of Michigan, emphasised that the consequences of disasters extend well beyond their immediate aftermath. She noted that such events not only disrupt services in the short term but also lay bare and intensify existing weaknesses in the healthcare system. For older adults who depend on regular, uninterrupted care, even brief interruptions can lead to serious, lasting health consequences.

More information: Sue Anne Bell et al, Variation in One-Year Mortality Following Severe Weather Exposure Among Older Americans by Chronic Health Condition and Sociodemographic Status, Journal of the American Geriatrics Society. DOI: 10.1111/jgs.70237

Journal information: Journal of the American Geriatrics Society Provided by Wiley

Night waking disrupts cognitive functioning regardless of how long one sleeps

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For many years, guidance around healthy sleep has centred on the number of hours spent asleep each night. However, emerging evidence suggests that for older adults, how well they sleep may be more critical for next-day thinking skills than how long they sleep. A recent study by researchers from Penn State and a medical college in the Bronx indicates that sleep quality can influence cognitive performance the following day, even when total sleep time remains unchanged.

The study, published in mid-December in the journal Sleep Health, showed that older adults who experienced more disrupted sleep processed information more slowly the next day. Rather than focusing on bedtime or total hours of sleep, the researchers assessed sleep quality by measuring how long participants remained awake after initially falling asleep. This period of wakefulness proved a stronger predictor of next-day cognitive speed than sleep duration alone.

One of the study’s authors explained that most people are familiar with the mental fog that follows a poor night’s sleep, but this research aimed to pinpoint which aspects of sleep matter most for daily cognitive functioning. The findings suggest that, at least in the short term, sleep continuity plays a key role for older adults. In other words, a night marked by frequent awakenings may impair cognition even if the overall number of hours slept appears adequate.

The researchers analysed data from 261 adults aged 70 or older who were taking part in a long-running study of ageing and cognitive health. Over 16 days, participants wore wrist-based devices that recorded their sleep patterns. During the same time, they completed brief cognitive tasks on a smartphone several times each day, including after waking and before bedtime. These tasks measured processing speed, visual working memory, and visuospatial abilities, resulting in more than 20,000 individual assessments.

On average, participants slept just over seven hours per night but spent more than an hour awake. When an individual experienced an additional half-hour of wakefulness compared with their usual pattern, their processing speed was noticeably slower the next day. Factors such as naps, bedtime, and total sleep duration did not show a meaningful association with cognitive performance. When comparing participants, those who consistently spent more time awake at night also performed worse on several cognitive tests, including measures of working memory.

Sleep disturbances are common in later life, and persistent problems have been linked to faster cognitive decline and a higher risk of dementia. The researchers emphasised that occasional poor sleep is not a cause for alarm, and that worrying about sleep can make matters worse. Instead, they advised focusing on long-term habits, such as maintaining a consistent bedtime, creating a calm sleep environment, and limiting screen use before bed. Where difficulties persist, non-drug approaches such as cognitive behavioural therapy may help improve sleep quality safely, potentially supporting healthier cognitive ageing over time.

More information: Orfeu Buxton et al, Within- and between-person associations of sleep characteristics with daily cognitive performance in a community-based sample of older adults, Sleep Health. DOI: 10.1016/j.sleh.2025.11.010

Journal information: Sleep Health Provided by Penn State

Ongoing Physical Activity Helps Prevent Metabolic Syndrome

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A recent Finnish study shows that adults who remain physically active throughout adulthood have a significantly lower prevalence of metabolic syndrome at age 61 than those whose leisure-time physical activity remains low. Notably, the findings also indicate that taking up physical activity later in life can still be beneficial. In particular, physical activity in early to late adulthood—especially muscle-strengthening exercise—may help reduce the health risks linked to earlier inactivity.

The study is part of a long-running longitudinal research project conducted at the University of Jyväskylä, Finland, which has followed the same participants for over 50 years. In this analysis, researchers examined leisure-time physical activity patterns among 159 participants at ages 27, 42, 50, and 61, alongside assessments of their cardiometabolic health at age 61. The primary outcome of interest was the presence of metabolic syndrome.

Metabolic syndrome refers to a cluster of cardiovascular risk factors that tend to occur together, including increased waist circumference, high blood pressure, impaired glucose metabolism, and unhealthy blood lipid levels. Having metabolic syndrome substantially raises the risk of cardiovascular disease and type 2 diabetes, making it an important indicator of long-term metabolic health.

Across the 34-year follow-up period, the researchers identified three distinct trajectories of leisure-time physical activity. One group was consistently active, exercising several times a week from early adulthood onwards. A second group became increasingly active over time, reaching activity levels similar to those of the consistently active group by midlife. The third group was consistently inactive, engaging in leisure-time physical activity no more than once a week throughout adulthood.

Apparent differences emerged when the prevalence of metabolic syndrome was compared between these groups. Individuals who were consistently inactive had nearly a fourfold risk of metabolic syndrome in early and late adulthood compared with those who were consistently active. Those who increased their activity over time had an intermediate risk, at roughly twice that of the consistently active group. However, these differences decreased after accounting for participants’ current engagement in various types of physical activity at age 61, suggesting that recent behaviour plays an important role.

Postdoctoral Researcher Tiina Savikangas notes that while long-term physical activity is strongly associated with better metabolic health in later life, the findings also highlight the value of being active in older age. Muscle-strengthening activities, in particular, appear to make a meaningful contribution to metabolic health, even among those who were less active earlier in adulthood.

Analysis of individual components of metabolic syndrome showed that long-term leisure-time physical activity was associated with a smaller waist circumference and a more favourable lipid profile. These associations also weakened after accounting for current physical activity. Participants who regularly engaged in muscle-strengthening exercise and active commuting had higher levels of beneficial HDL cholesterol, and those who performed strength training tended to have a smaller waist circumference than those who did not.

Overall, the findings reinforce the idea that physical activity supports metabolic health across the entire lifespan. While staying active from early adulthood offers clear advantages, the study also delivers an encouraging message: adopting or increasing physical activity later in life can still provide essential health benefits, and it is never too late to start.

More information: Tiina Savikangas et al, Leisure-Time Physical Activity Trajectories across Adulthood and Cardiometabolic Risk at the Beginning of Late Adulthood – A Prospective Cohort Study, Medicine & Science in Sports & Exercise. DOI: 10.1249/MSS.0000000000003883

Journal information: Medicine & Science in Sports & Exercise Provided by University of Jyväskylä – Jyväskylän yliopisto