Category: Ageing

Categories : Ageing Diet and NutritionTags :

Quality of Carbohydrates Matters for Healthy Ageing

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Photo by Mariana Kurnyk

Intakes of dietary fibre as well as high-quality and total carbohydrates in midlife were favourably linked to healthy aging and other positive health outcomes in older women, according to a new study appearing in the journal JAMA Network Open.

“We’ve all heard that different carbohydrates can affect health differently, whether for weight, energy, or blood sugar levels. But rather than just look at the immediate effects of these macronutrients, we wanted to understand what they might mean for good health 30 years later,” said Andres Ardisson Korat, a scientist at Tufts University and lead author of the study. “Our findings suggest that carbohydrate quality may be an important factor in healthy aging.”

Researchers from Tufts University and Harvard T.H. Chan School of Public Health analysed data from Nurses’ Health Study questionnaires collected every four years between 1984 and 2016. They examined the midlife diets and eventual health outcomes of more than 47 000 women who were between the ages of 70 and 93 in 2016.  Intakes of total carbohydrates, refined carbohydrates, high-quality (unrefined) carbohydrates, carbohydrates from whole grains, fruits, vegetables, and legumes, dietary fibre, and the dietary glycaemic index and glycaemic load were derived from the validated food-frequency questionnaires. The researchers defined healthy aging as the absence of 11 major chronic diseases, lack of cognitive and physical function impairments, and having good mental health, as self-reported in the Nurses’ Health Study questionnaires. In the new study, 3706 participants met the healthy aging definition.

The analysis showed intakes of total carbohydrates, high-quality carbohydrates from whole grains, fruits, vegetables, and legumes, and total dietary fibre in midlife were linked to 6 to 37% greater likelihood of healthy aging and several areas of positive mental and physical health. In the other direction, intakes of refined carbohydrates (carbohydrates from added sugars, refined grains, and potatoes) and starchy vegetables were associated with 13% lower odds of healthy aging.

“Our results are consistent with other evidence linking consumption of fruits and vegetables, whole grains, and legumes with lower risks of chronic diseases, and now we see the association with physical and cognitive function outcomes,” said senior author Qi Sun, associate professor in the departments of nutrition and epidemiology at Harvard Chan School.

The authors note as a limitation that the study population was composed mostly of white health professionals; future research will be necessary to replicate these findings in more diverse cohorts. 

Ardisson Korat also noted that additional work is needed to understand the potential mechanisms linking dietary fiber and high-quality carbohydrates to healthy aging.

“Studies are starting to find an association between food choices in midlife and quality of life in later years. The more we can understand about healthy aging, the more science can help people live healthier for longer,” added Ardisson Korat.

Source: Tufts University

Categories : Ageing NeurologyTags :

Analysis of Pulse Rate can Predict Faster Cognitive Decline in Older Adults

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Healthy hearts are adaptable, and heartbeats exhibit complex variation as they adjust to tiny changes in the body and environment. Mass General Brigham researchers have applied a new way to measure the complexity of pulse rates, using data collected through wearable pulse oximetry devices. The new method, published in the Journal of the American Heart Association, provides a more detailed peek into heart health than traditional measures, uncovering a link between reduced complexity and future cognitive decline.

“Heart rate complexity is a hallmark of healthy physiology,” said senior author Peng Li, PhD, of the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital (MGH) and the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital (BWH). “Our hearts must balance between spontaneity and adaptability, incorporating internal needs and external stressors.”

The study used data from 503 participants (average age 82, 76% women) in the Rush Memory and Aging Project. The researchers analysed overnight pulse rate measurements – collected by a fingertip pulse oximetry device known as the Itamar WatchPAT 300 device – and comprehensive measures of cognitive functions, collected around the same time as the pulse rate measurement and at least one annual follow-up visit up to 4.5 years later.

The team found that people with greater complexity in their heartbeats at baseline tend to experience slower cognitive decline over time. They determined that the conventional measures of heart rate variability did not predict this effect, indicating their measure was more sensitive in capturing heart functions predictive of cognitive decline.

The researchers plan to investigate whether pulse rate complexity can predict development of dementia, which would make it useful for identifying people at an early stage who might benefit from therapeutic interventions.

“The findings underscore the usefulness of our approach as a noninvasive measure for how flexible the heart is in responding to nervous system cues,” said lead author Chenlu Gao, PhD, also in the Department of Anesthesia, Critical Care and Pain Medicine at MGH. “It is suitable for future studies aimed at understanding the interplay between heart health and cognitive aging.”

Source: Mass General Brigham

Categories : AgeingTags :

Assessing Pain and Anxiety of Nursing Home Residents Unable to Speak

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As many as half of nursing home residents are cognitively impaired and may be unable to communicate symptoms such as pain or anxiety to the staff and clinicians caring for them. Therefore, information needed for the evaluation of symptoms and subsequent treatment decisions typically does not reliably exist in nursing home electronic health records (EHRs).

A new paper published in the International Journal of Geriatric Psychiatry reports on the novel adaptation of a commonly used symptom assessment instrument to more comprehensively acquire this difficult-to-obtain data with the ultimate goal of enabling knowledge-based expansion of palliative care services in nursing homes to address residents’ symptoms.

In the paper, part of the large, multi-state, multi-facility Utilizing Palliative Leaders in Facilities to Transform care for people with Alzheimer’s Disease (UPLIFT-AD) study researchers, including Regenstrief Institute, the Indiana University School of Medicine and the University of Maryland School of Social Work faculty, describe how they revamped and subsequently validated a symptom assessment tool used worldwide. The UPLIFT-AD researchers modified the instrument, originally designed for reporting by family members of individuals with dementia following their death, to enable reporting on the symptoms of current residents living with moderate to severe dementia by nursing home staff as well as family.

Led by Kathleen T. Unroe, MD, MHA, and John G. Cagle, PhD, the UPLIFT-AD team reports in the peer-reviewed paper that the tool they enhanced reliably addressed physical and emotional distress as well as well-being and symptoms that are precursors to end of life. This validation was critical as the researchers develop guidance for expansion of symptom recognition and management in any nursing home. Employing instruments used in other studies helps researchers to directly compare findings.

Dr. Unroe, Dr. Cagle and colleagues, including Wanzhu Tu, PhD, of the Regenstrief Institute and the IU School of Medicine, are in the late stages of the UPLIFT-AD clinical trial to enhance quality of care individuals with dementia by building capacity for palliative care within nursing homes.

“People receive care in nursing homes because they have significant needs – support for activities of daily living – as well as for complex, serious and multiple chronic conditions. But measuring symptoms of residents, especially those who are cognitively impaired, to address these needs is challenging,” said paper senior author Dr. Unroe, a Regenstrief Institute research scientist and an IU School of Medicine professor of medicine. “In my two decades of working as a clinician in nursing homes as well as a researcher, I have seen that often the information on symptoms that we want isn’t available consistently in the data that’s already collected or it isn’t collected at the frequency that we need to measure the impact of programs and approaches. And the gold standard for knowing if someone has a symptom, for example, if someone has pain or anxiety, to ask that person directly to assess the symptom, isn’t always possible for cognitively impaired residents. That’s why we took steps to validate a commonly used instrument in a wider population – individuals currently living with cognitive impairment – and added additional needed data points.

“While hospice care is typically available, there is widespread recognition that broader palliative care is needed in nursing homes. But there is no roadmap for how to provide it well. We hope that when we have our final results in 2026, UPLIFT-AD will prove to be a replicable model for implementing this much needed type of care.”

Source: Regenstrief Institute

Categories : Ageing ExerciseTags :

Twin Study Offers New Insights into Whether Exercise Extends life

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In a decades-long study following twins, researchers from the University of Jyväskylä, Finland, investigated the links between long-term leisure-time physical activity and mortality. They also sought to determine whether physical activity can mitigate the increased risk of mortality due to genetic predisposition to diseases. Moreover, they examined the relationship between physical activity and later biological aging. 

The study included 22 750 Finnish twins born before 1958 whose leisure-time physical activity was assessed in 1975, 1981 and 1990. Mortality follow-up continued until the end of 2020.

Moderate activity yields maximum longevity benefits

Four distinct sub-groups were identified from the data, which was based on leisure-time physical activity over the 15-year follow-up: sedentary, moderately active, active and highly active groups. When the differences in mortality between the groups were examined at the 30-year follow-up, it was found that the greatest benefit – a 7% lower risk of mortality – was achieved between the sedentary and moderately active groups. A higher level of physical activity brought no additional benefit. 

When mortality was examined separately in the short and long term, a clear association was found in the short-term: the higher the level of physical activity, the lower the mortality risk. In the long term, however, those who were highly active did not differ from those who were sedentary in terms of mortality.

“An underlying pre-disease state can limit physical activity and ultimately lead to death, not the lack of exercise itself.”

“This can bias the association between physical activity and mortality in the short term”,  says Associate Professor Elina Sillanpää from the Faculty of Sports and Health Sciences. 

Meeting physical activity guidelines does not guarantee a lower mortality risk

The researchers also investigated whether following the World Health Organization’s physical activity guidelines affects mortality and genetic disease risk. The guidelines suggest 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous activity weekly. The study found that meeting these guidelines did not lower mortality risk or alter genetic disease risk. Even for twins who met the recommended levels of PA over a 15-year period, no statistically significant difference in mortality rates was found compared to their less active twin pair.

“The widely observed favorable association between physical activity and mortality are based on observational studies that are prone to bias from different sources.” 

“In our studies, we aimed to account for various sources of biases, and combined with the long follow-up period, we could not confirm that adhering to physical activity guidelines mitigates genetic cardiovascular disease risk or causally reduces mortality”, says postdoctoral researcher Laura Joensuu from the Faculty of Sports and Health Sciences.  

Link between physical activity and biological aging is U-shaped

For the subsample of twins, biological aging was determined from blood samples using epigenetic clocks. Epigenetic clocks allow a person’s biological aging rate to be estimated based on methyl groups that regulate gene expression and are linked to aging process. 

“We found that the association between leisure-time physical activity and biological aging was U-shaped: Biological aging was accelerated in those who exercised the least and the most,” says Sillanpää.

Other lifestyles, such as smoking and alcohol consumption, largely explained the favourable associations of physical activity with biological aging. 

Genetic data were available for 4897 twins. The genetic susceptibility of twins to coronary artery disease, as well as systolic and diastolic blood pressure was assessed using new polygenic risk scores, which sum the genome-wide susceptibility to morbidity. In addition, all-cause and cardiovascular mortality was followed in 180 identical twin pairs. The biological aging rate of 1153 twins was assessed from a blood sample.

Source: University of Jyväskylä

Categories : AgeingTags :

Lifestyle and Environmental Factors Affect Health and Ageing More than Genes

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A new study led by researchers from Oxford Population Health has shown that a range of environmental factors, including lifestyle (smoking and physical activity) and living conditions, have a greater impact on health and premature death than our genes.

The researchers used data from nearly half a million UK Biobank participants to assess the influence of 164 environmental factors and genetic risk scores for 22 major diseases on ageing, age-related diseases, and premature death. The study is published in Nature Medicine.

Key findings:

  • environmental factors explained 17% of the variation in risk of death, compared to less than 2% explained by genetic predisposition (as we understand it at present);
  • of the 25 independent environmental factors identified, smoking, socioeconomic status, physical activity, and living conditions had the most impact on mortality and biological ageing;
  • smoking was associated with 21 diseases; socioeconomic factors such as household income, home ownership, and employment status, were associated with 19 diseases; and physical activity was associated with 17 diseases;
  • 23 of the factors identified are modifiable;
  • early life exposures, including body weight at 10 years and maternal smoking around birth, were shown to influence ageing and risk of premature death 30-80 years later;
  • environmental exposures had a greater effect on diseases of the lung, heart and liver, while genetic risk dominated for dementias and breast cancer.

Professor Cornelia van Duijn, St Cross Professor of Epidemiology at Oxford Population Health and senior author of the paper, said, “Our research demonstrates the profound health impact of exposures that can be changed either by individuals or through policies to improve socioeconomic conditions, reduce smoking, or promote physical activity.

“While genes play a key role in brain conditions and some cancers, our findings highlight opportunities to mitigate the risks of chronic diseases of the lung, heart and liver which are leading causes of disability and death globally. The early life exposures are particularly important as they show that environmental factors accelerate ageing early in life but leave ample opportunity to prevent long-lasting diseases and early death.”

The authors used a unique measure of ageing (a new ‘ageing clock’) to monitor how rapidly people are ageing using blood protein levels. This enabled them to link environmental exposures that predict early mortality with biological ageing. This measure was previously shown to detect age-related changes, not only in the UK Biobank but also in two other large cohort studies from China and Finland.

Dr Austin Argentieri, lead author of the study at Oxford Population Health and Research Fellow at Massachusetts General Hospital, said “Our exposome approach allowed us to quantify the relative contributions of the environment and genetics to ageing, providing the most comprehensive overview to date of the environmental and lifestyle factors driving ageing and premature death. These findings underscore the potential benefits of focusing interventions on our environments, socioeconomic contexts, and behaviours for the prevention of many age-related diseases and premature death.”

Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, added ‘Your income, postcode and background shouldn’t determine your chances of living a long and healthy life. But this pioneering study reinforces that this is the reality for far too many people.

“We have long known that risk factors such as smoking impact our heart and circulatory health, but this new research emphasises just how great the opportunity is to influence our chances of developing health problems, including cardiovascular disease, and dying prematurely. We urgently need bold action from Government to target the surmountable barriers to good health that too many people in the UK are facing.”

The research shows that whilst many of the individual exposures identified played a small part in premature death, the combined effect of these multiple exposures together over the life course (referred to as the exposome) explained a large proportion of premature mortality variation. The insights from this study pave the way for integrated strategies to improve the health of ageing populations by identifying key combinations of environmental factors that shape risk of premature death and many common age-related diseases simultaneously.

Professor van Duijn said, “Studies on environmental health have tended to focus on individual exposures based on a specific hypothesis. While this approach has seen many successes, the method has not always yielded reproducible and reliable findings. Instead, we have followed a ‘hypothesis free’ exposome approach and studied all available exposures to find the major drivers of disease and death.

“We have made a big leap forward in understanding how to provide accurate evidence on the causes and consequences of age-related diseases by combining novel computational methods with clinical and epidemiological knowledge to explore the interplay between multiple exposures. In an ever-changing environment, it is critical that we combine these techniques with novel advances in smart technology to monitor lifestyle and environment, as well as with biological data, to understand the impact of the environment over time. There are a lot of questions still to be answered related to diet, lifestyle, and exposure to new pathogens (such as bird flu and COVID-19) and chemicals (think of pesticides and plastics), and the impact of environmental and genetic factors in different populations.”

The paper. ‘Integrating the environmental and genetic architectures of aging and mortality‘. can be ready in Nature Medicine.

Source: University of Oxford

Categories : Ageing Environmental EffectsTags :

Extreme Heat may Speed up Aging in Older Adults

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Photo by Ketut Subiyanto

A new USC Leonard Davis School of Gerontology study suggests greater exposure to extreme heat may accelerate biological aging in older adults, raising new concerns about how climate change and heat waves could affect long-term health and aging at the molecular level.

People in neighbourhoods that experience more days of high heat show greater biological aging on average than residents of cooler regions, said Jennifer Ailshire, senior author of the study, which appears in Science Advances. Ailshire is professor of gerontology and sociology at the USC Leonard Davis School.

Biological age is a measure of how well the body functions at the molecular, cellular, and system levels, as opposed to chronological age based on one’s birthdate; having a biological age greater than one’s chronological age is associated with higher risk for disease and mortality. While exposure to extreme heat has itself long been associated with negative health outcomes, including increased risk of death, heat’s link to biological aging has been unclear.

Measuring epigenetic changes

Ailshire and her coauthor Eunyoung Choi, USC Leonard Davis PhD in Gerontology alumna and postdoctoral scholar, examined how biological age changed in more than 3600 Health and Retirement Study (HRS) participants aged 56 and older from throughout the U.S. Blood samples taken at various time points during the six-year study period were analysed for epigenetic changes, or changes in the way individual genes are turned “off” or “on” by a process called DNA methylation.

The researchers used mathematical tools called epigenetic clocks to analyse methylation patterns and estimate biological ages at each time point. They then compared participants’ changes in biological age to their location’s heat index history and number of heat days reported by the National Weather Service from 2010 to 2016.

The National Weather Service Heat Index Chart categorises heat index values into three levels based on the potential risk of adverse health effects. The “Caution” level includes heat index values ranging from 80°F (27°C) to 90°F (32°C), the “Extreme Caution” level includes values between 90°F (32°C) and 103°F (34°C), and the “Danger” level includes values between 103°F (34°C) and 124°F (51°C). Days in all three levels were included as heat days in the study.

The analysis revealed a significant correlation between neighbourhoods with more days of extreme heat and individuals experiencing greater increases in biological age, Choi said. This correlation persisted even after controlling for socioeconomic and other demographic differences, as well as lifestyle factors such as physical activity, alcohol consumption and smoking, she added.

“Participants living in areas where heat days, as defined as Extreme Caution or higher levels (32°C), occur half the year, such as Phoenix, Arizona, experienced up to 14 months of additional biological aging compared to those living in areas with fewer than 10 heat days per year,” she said. “Even after controlling for several factors, we found this association. Just because you live in an area with more heat days, you’re aging faster biologically.”

All three epigenetic clocks employed in the study – PCPhenoAge, PCGrimAge, and DunedinPACE – revealed this association when analysing epigenetic aging over a 1- to 6-year period. PCPhenoAge also showed the association after short (7 days) and medium (30-60 days) periods of time, indicating that heat-related epigenetic changes could happen relatively quickly, and some of them may accumulate over time.

Climate implications for communities

Older adults are particularly vulnerable to the effects of high heat, Ailshire said. She noted that the study used heat index, rather than just air temperature, to take relative humidity into account as they analyzed results.

“It’s really about the combination of heat and humidity, particularly for older adults, because older adults don’t sweat the same way. We start to lose our ability to have the skin-cooling effect that comes from that evaporation of sweat,” she explained. “If you’re in a high humidity place, you don’t get as much of that cooling effect. You have to look at your area’s temperature and your humidity to really understand what your risk might be.”

The next steps for the researchers will be to determine what other factors might make someone more vulnerable to heat-related biological aging and how it might connect to clinical outcomes. In the meantime, the study results could also prompt policymakers, architects, and others to keep heat mitigation and age-friendly features in mind as they update cities’ infrastructure, from placing sidewalks and building bus stops with shade in mind to planting more trees and increasing urban green space, Ailshire said.

“If everywhere is getting warmer and the population is aging, and these people are vulnerable, then we need to get really a lot smarter about these mitigation strategies,” she said.

Source: University of Southern California

Categories : Ageing ExerciseTags :

Brown Fat Could Help Maintain Exercise Capacity in Aging

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Rutgers Health researchers have made discoveries about brown fat that may open a new path to helping people stay physically fit as they age. A team from Rutgers New Jersey Medical School found that mice lacking a specific gene developed an unusually potent form of brown fat tissue that expanded lifespan and increased exercise capacity by roughly 30%. The team is working on a drug that could mimic these effects in humans.

“Exercise capacity diminishes as you get older, and to have a technique that could enhance exercise performance would be very beneficial for healthful aging,” said Stephen Vatner, university professor and director of the Cardiovascular Research Institute in the medical school’s Department of Cell Biology and Molecular Medicine and senior author of the study in Aging Cell. “This mouse model performs exercise better than their normal littermates.”

Unlike white fat, which stores energy, brown fat burns calories and helps regulate body temperature. This study revealed brown fat also plays a crucial role in exercise capacity by improving blood flow to muscles during physical activity.

The genetically modified mice produced unusually high amounts of active brown fat and showed about 30% better exercise performance than normal mice, both in speed and time to exhaustion.

The discovery emerged from broader research into healthy aging. The modified mice, which lack a protein called RGS14, live about 20% longer than normal mice, with females living longer than males – similar to the pattern seen in humans. Even at advanced ages, they maintain a healthier appearance, avoiding the typical signs of aging, such as loss of hair and graying that appear in normal elderly mice. Their brown adipose tissue also protects them from obesity, glucose intolerance, cardiovascular disorders, cancer and Alzheimer’s disease, in addition to reduced exercise tolerance.

To test whether the brown fat – rather than some other result from the missing genes –accounted for the benefits, the researchers transplanted the brown fat to normal mice. They noted that the recipients gained similar benefits within days. Transplants using regular brown fat from normal mice, by contrast, took eight weeks to produce much milder improvements.

The discovery could eventually improve human lifespans – the total time when people enjoy good mental and physical health.

“With all the medical advances, aging and longevity have increased in humans, but unfortunately, healthful aging hasn’t,” Vatner said. “There are a lot of diseases associated with aging – obesity, diabetes, myocardial ischemia, heart failure, cancer – and what we have to do is find new drugs based on models of healthful aging.”

Rather than develop a treatment that addresses aging broadly, which poses regulatory challenges, Vatner said his team plans to test for specific benefits such as improved exercise capacity and metabolism. This approach builds on their previous success in developing a drug based on a different mouse healthful longevity model.

“We’re working with some people to develop this agent, and hopefully, in another year or so, we’ll have a drug that we can test,” Vatner said.

In the meantime, techniques such as deliberate cold exposure can increase brown fat naturally. Studies have found such efforts to produce short-term benefits that range from enhanced immune system function to improved metabolic health, but Vatner said none of the studies have run long enough to find any effect on healthful aging.

He added that most people would prefer to increase brown fat levels by taking pills rather than ice baths and is optimistic about translating the newest finding into an effective medication.

Source: Rutgers University

Categories : Ageing Obstetrics & GynaecologyTags :

Researchers Unravel Menopause Timing, Shedding Light on Ovarian Aging and Fertility

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Female reproductive system. Credit: Scientific Animations CC4.0 BY-SA

Menopause, driven by ovarian aging and the depletion of ovarian reserve, marks the end of a woman’s fertility, and while many aspects of these processes are well understood, the overall dynamics remain unclear. A new study from Rice University researchers, published in Biophysical Journal, introduces a novel approach to unravelling the complex patterns of ovarian aging using stochastic analysis, a mathematical approach that examines systems by evaluating all potential outcomes using random probability.

Led by Anatoly Kolomeisky, professor of chemistry and chemical and biomolecular engineering, the research team has developed a theoretical framework that quantitatively predicts menopause timing. By analysing how ovarian follicles transition through different stages, the researchers’ model explains why menopause occurs and sheds light on individual variability and cross-population differences. These insights could improve fertility planning, inform health care decisions related to hormonal therapies and enhance our understanding of age-related health risks associated with ovarian aging.

“By considering menopause as a sequential process involving random transitions of follicles, we can better understand individual variability and population-wide trends in menopause timing,” Kolomeisky said.

A new theoretical model unlocks the mystery of menopause

The research team hypothesised that ovarian aging follows a stochastic sequential process influenced by follicles transitioning through multiple developmental stages. Unlike previous studies focusing primarily on hormonal and genetic influences, this study employed explicit analytical calculations supported by extensive computer simulations.

The approach allowed researchers to model the gradual depletion of ovarian follicle reserves, providing a detailed quantitative framework that aligns with medical data from diverse populations.

“By applying stochastic analysis, we can move beyond broad observations and develop precise, predictive insights into menopause timing and variability,” Kolomeisky said.

Key findings uncover menopause timing

The researchers discovered a universal relationship between three critical factors: the initial follicle reserve, the rate of ovarian depletion and the threshold that triggers menopause. Their model also revealed that menopause occurs within a surprisingly narrow age range, a phenomenon that had not yet been fully explained.

“One of the most unexpected findings was the synchronisation of follicular transitions, which may regulate the timing of menopause,” Kolomeisky said. “This suggests that underlying biochemical processes ensure a relatively consistent age of menopause despite individual variations.”

Source: Rice University

Categories : AgeingTags :

Hormones may Hold Therapeutic Potential to Prevent Wrinkles and Greying

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Hormones may be leveraged to treat and prevent signs of aging such as wrinkles and hair greying, according to a new study published in the Endocrine Society journal Endocrine Reviews.

Until now, only a limited number of hormones, mainly topical retinoids (retinol and tretinoin) and oestrogen which is typically used to treat side effects of menopause, have been used in clinical practice as anti-skin aging compounds. This study reviews a new class of hormones and their anti-aging properties.

“Our paper highlights key hormone players that orchestrate pathways of skin aging such as degradation of connective tissue (leading to wrinkling), stem cell survival and loss of pigment (leading to hair greying),” said lead author Markus Böhm, MD, of the University of Münster in Germany. “Some of the hormones we studied have anti-aging properties and may be used in the future as agents to prevent skin aging.”

The skin is the largest organ and undergoes both intrinsic (chronological) and extrinsic aging which is caused by environmental factors such as sun exposure.

“Skin is not only a target for various hormones that control pathways of skin aging but itself is certainly the largest and richest site for hormone production besides classical endocrine glands,” Böhm said.

To better understand the connection between hormones and skin aging, the researchers studied the pivotal hormones controlling skin aging, including insulin-like growth factor 1, growth hormone, oestrogens, retinoids and melatonin. Melatonin is especially interesting as a potential anti-skin aging substance as it is a small molecule, inexpensive, well-tolerated and a direct and indirect antioxidant as well as a regulator of mitochondrial metabolism. Some of the studied hormones, moreover, have astonishing and unexpected biological effects on skin function and hair aging as highlighted by distinct genetic deficiency syndromes.

They also reviewed the emerging roles of additional endocrine players, including α-melanocyte-stimulating hormone (responsible for skin pigmentation), members of the hypothalamic-pituitary-thyroid axis, oxytocin, endocannabinoids (found in CBD products) and peroxisome proliferator-activated receptor modulators and found they have very promising effects, eg on UV-induced genotoxic stress crucially involved in the development of photoaging and pigment synthesis within skin and hair.

“Further research into these hormones may offer opportunities to develop new therapeutics for treating and preventing skin aging,” Böhm said.

Source: The Endocrine Society

Categories : AgeingTags :

Older Patients can Inadvertently be Put at Risk When Taken off Anticoagulants

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For patients with atrial fibrillation, the risk of stroke or heart attack from stopping anticoagulants usually outweighs the risk of bleeding, according to new findings from the University of Bath.

Clinicians often worry about the dangers of prescribing blood thinning medications to older patients, due to concerns about falls and major bleeding, however this new study suggests that for patients with the common heart condition atrial fibrillation (AF), the health risks of not taking these drugs are significantly higher than the risk of a life-threatening bleed.

AF is associated with a fivefold increase in the risk of stroke. It also increases the risk of heart attacks and death. Anticoagulants are highly effective in managing AF and preventing strokes and other complications.

Older people also tend to fall more frequently, with falls being a leading cause of injury among adults aged 65 and older. These can lead to serious injuries, such as hip fractures and head injuries.

However, the new study, published in Heart, found that contrary to popular medical belief, stopping anticoagulants for patients aged 75 and over does not change the risk of major bleeds. These findings are important for clinicians to factor into their prescribing behaviour, according to the study’s authors.

“Prescribers need to consider the increased risk to patients of coming off anticoagulants, including stroke,” said Dr Anneka Mitchell, who conducted the research from the University of Bath and is a visiting researcher at the University’s Department of Life Sciences.

Rising cases

Cases of AF are rising in all age groups but particularly among people aged 85 years and over. In this age group, the number of people diagnosed with the condition doubled in men from 11.6% to 22.1% between 2000 and 2016, and increased in women from 9.6% to 16.5%. There is no data available to show trends from 2016.

Though there is a large body of evidence to support the use of blood thinners for older people with AF, the new study is believed to be the first to measure patient outcomes when anticoagulant medication is stopped.

Dr Mitchell’s study analysed data from the UK Clinical Practice Research Datalink (a research dataset that includes anonymised patient data from some UK general practices) between 2013 and 2017, focusing on patients aged 75 and older who were newly prescribed anticoagulants.

It found that the risks of stroke and death were three times higher during periods when patients were not receiving anticoagulation therapy. The risk of heart attacks was nearly double compared with periods when patients were treated with anticoagulants.

Warfarin versus direct oral anticoagulants

Dr Mitchell believes that as well as concern about falls, many clinicians base their decisions to withhold anticoagulants on the historic experience of patients taking the anticoagulant warfarin.

This medication – the only available option for treating AF until 2012 – is associated with a complex medication regimen, along with dietary restrictions and frequent blood-tests, making treatment difficult for many older patients.

Since 2013, however, a new family of drugs called direct oral anticoagulants (DOACs) have become the first line option for most patients. DOACs are as effective and safe as warfarin – sometimes more so – and are far more straightforward to take.

Dr Mitchell said: “For example, apixaban (a DOAC) has a lower risk of significant bleeding than warfarin, so for many older patients with AF, this would be an excellent medication.

“Our findings highlight the critical need for clinicians to carefully consider the risks of stopping anticoagulation therapy in older patients. Despite concerns about bleeding, this study suggests that discontinuing anticoagulation does not significantly affect the risk of major bleeding but does increase the risk of serious events such as stroke and death.”

She added: “Both the risks and benefits of medication must be discussed fully with patients before a medic stops prescribing anticoagulants, so that both doctor and patient are making a shared and informed decision. This study underscores the importance of evaluating the consequences of deprescribing anticoagulants, particularly in older adults who are at higher risk of adverse outcomes.”

Impacting the lives of older patients

Dr Anita McGrogan who led the research team from the Department of Life Sciences at Bath, said: “Older patients were poorly represented in clinical trials that evaluated the efficacy and safety of DOACs before these products were licensed, and those who were included were healthier than many people in the target group for prescribing. Because of this, the safety of these medications for people aged 75-plus was not evaluated, and many chose to avoid prescribing them for older people.

“This study has produced important results that will have an impact on patients in the future. It has filled the information gap by looking at anonymous data on 20 167 people aged over 75 years, collected by GPs. It clearly demonstrates the value of using big data to investigate important clinical questions, especially in vulnerable populations.”

Dr Tomas Welsh, an academic geriatrician at Royal United Hospitals Bath and research & medical director at ReMind, hopes the new research will provide both clinicians and patients with better evidence to inform their decisions regarding anticoagulants. He noted that, until now, clinicians advising patients to stop taking blood thinners were unable to quantify the increased risk of stroke.

“These data help patients and clinicians have a firmer grasp of the risks that they are being exposed to,” he said.

Dr Welsh also stressed that new-generation blood thinners were not always the right course of action for frail, older people.

“Suspending any medication or reducing the use of multiple medications in a frailer older patient is always a nuanced and individual discussion,” he said.

Source: University of Bath