Category: Ageing

Categories : Ageing HIVTags :

Older Adults are Getting Infected with HIV, but Prevention Focuses on Young People

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Prevention and treatment campaigns are not adequately targeting the particular needs of the 50+ years age group.

Photo by Sergey Mikheev on Unsplash

Indeed, between 2000 and 2016, the number of adults aged 50 years and older living with HIV in sub-Saharan Africa doubled. At present, their HIV prevalence is exceeding that of younger adults.

By 2040, one-quarter of people living with HIV in Africa will be aged 50 years and older; tailored awareness and treatment campaigns are pressing.

Dr Luicer Olubayo, a researcher at the Sydney Brenner Institute for Molecular Bioscience (SBIMB) at Wits University and the first author of a study published in The Lancet Healthy Longevity journal, which investigated HIV in older people in Kenya and South Africa, noted that perceptions on who acquires HIV are limited. “We often think of HIV as a disease of younger people. It doesn’t help that intervention campaigns are mainly targeted at the youth.”

Moreover, older adults are less likely to believe that they can get HIV. This misconception is pervasive and has consequences for reaching global targets to achieve UNAIDS’ 95-95-95 targets by 2030 (95% of people living with HIV know their status, 95% of people who know their status are on treatment, and 95% have a suppressed viral load).

“While HIV prevalence among individuals over 50 years of age is similar to or even exceeds that of younger adults, HIV surveys focus on younger individuals, leaving considerable gaps in understanding HIV prevalence, incidence and treatment outcomes in older populations,” says Associate Professor F. Xavier Gómez-Olivé, at the MRC/Wits-Agincourt Research Unit.

Stigma remains a barrier to treatment

The uptake of HIV testing among older adults is poor, which delays diagnosis and limits access to care. This is, indeed, one of the signifiers of the pervasiveness of stigma surrounding the disease.

“We know that there is significant social stigma related to HIV infection. This is why understanding HIV-related stigma in older adults remains crucial as a way to inform interventions to support older people’s mental health and overall well-being,” says Olubayo.

Interventions could focus on repeated testing, the use of pre-exposure prophylaxis (PrEP), and campaigns to increase awareness and reduce infections among the elderly.  

“HIV can be managed alongside other chronic conditions, too, since HIV is managed as a long-term illness,” says Gómez-Olivé.

Non-communicable diseases, such as hypertension, diabetes, and obesity, have dramatically increased in sub-Saharan Africa, particularly among older people. HIV treatment and intervention can be included in the healthcare ecosystem of long-term illnesses.

Apart from stigma, a complex interplay of factors shapes HIV risk

The study shows that age, education, gender, and where people live all affect their risk of HIV. Even though more people now have access to HIV treatment, older adults—especially in rural areas—still face significant challenges in preventing HIV, such as low education levels and gender inequality.

Widowed women had the highest HIV rate (30.8%). This may be due to losing a partner to HIV, stigma, and a greater risk of unsafe behaviours like transactional sex and limited power to negotiate condom use. People without formal education and those with low income also had higher rates of HIV infection.

The benefit of longitudinal data to make decisions

 An important added value of this study is the provision of longitudinal insights into the HIV epidemic among older adults in sub-Saharan Africa. “Our study is beneficial in that older populations are under-represented, and not much is known about them over time. What changes are occurring? We have to answer these kinds of questions. With longitudinal data, we can look at the effectiveness of antiretroviral therapy coverage in older people,” says Gómez-Olivé.

The study used data collected in urban Kenya and in urban and rural sites across South Africa during two data collection waves: 2013-2016 and 2019-2022.  

Throughout a decade of research, the team has been gaining a deeper understanding of this ageing HIV epidemic. Numerous important insights about HIV in older populations have been achieved, and research gaps are being covered.

Data for the study were drawn from the Africa Wits-INDEPTH Partnership for Genomic Research (AWI-Gen) from adults aged 40 years and older. AWI-Gen is a multicentre, longitudinal cohort study conducted at six research centres in four sub-Saharan African countries (South Africa, Kenya, Burkina Faso, and Ghana) to investigate various health determinants.

Source: University of the Witwatersrand

Categories : Ageing Environmental EffectsTags :

Intense Heat Changes Biology and Can Accelerate Ageing

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Photo by Amanda María on Unsplash
By Rongbin Xu

Heat takes it out of you. After a long, hot day, we feel tired and grumpy.

But sustained periods of heat do more than that – they age us faster. Cumulative heat stress changes our epigenetics – how our cells turn on or off gene switches in response to environmental pressure.

Now, new research from the United States explores the pressing question of how extreme heat affects humans. The findings are concerning. The more days of intense heat a participant endured, the faster they aged. Longer periods of extreme heat accelerated ageing in older people by more than two years.

As the climate heats up, humans will be exposed to more and more heat – and our bodies will respond to these stresses by ageing faster. These findings are especially pertinent to Australia, where heatwaves are expected to become more frequent and intense in a warmer world.

How, exactly, does heat age us?

Ageing is natural. But the rate of ageing varies from human to human. As we go through life, our bodies are affected by stresses and shocks. For instance, if we don’t get enough sleep over a long period, we will age faster.

While heat can directly sicken or kill us, it also has a long tail. Sustained heat stresses our bodies and make them less efficient at doing the many jobs needed to stay alive. This is what we mean when we say it accelerates biological ageing. This deterioration is likely to precede the later development of diseases and disabilities.

What does that look like on a genetic level? You might think your genes don’t change over your life, and this is mostly true (apart from random mutations).

But what does change is how your genes are expressed. That is, while your DNA stays the same, your cells can switch some of its thousands of genes off or on in response to stresses. At any one time, only a fraction of the genes in any cell are turned on – meaning they’re busy making proteins.

This is known as epigenetics. The most common and best-understood pathway here is called DNA methylation (DNAm). Methylation here refers to a chemical our cells can use to block a DNA sequence from activating and producing proteins with various functions.

Cellular changes in DNAm can lead to proteins being produced more or less, which in turn can flow on to affect physiological functions and our health status. This can be both bad or good.

Heat stress can alter the pattern of which genes are turned off or on, which in turn can affect our rate of ageing.

Severe heat stress can be remembered in cells, leading them to change their DNAm patterns over time. In laboratory testing, the effect is pronounced in fish, chickens, guinea pigs, and mice.

To date, much research on how heat affects epigenetics has focused on animals and plants. Here, the evidence is clear – even a single episode of extreme heat has been shown to have a long-lasting effect on mice.

But only a couple of studies have been carried out involving humans, and they have been limited. This is the gap this new research is intended to help fill.

Sustained heat changes how our cells express genes – accelerating ageing. Photo: aleks333/Shutterstock

What did the study find?

The study by researchers at the University of Southern California involved almost 3700 people, with an average age of 68 years.

Heat affects older people more than younger people. Our ability to control our body temperature drops as we age, and we are less resilient to outside stresses and shocks. We also know periods of extreme heat trigger a wave of illness and death, especially among older people.

The study set out to better-understand what happens to human bodies at a biological level when they’re exposed to intense heat over the short, medium, and longer term.

To do this, the researchers took blood samples and measured epigenetic changes at thousands of sites across the genome, which were used to calculate three clocks measuring biological age, named PcPhenoAge, PCGrimAge, and DunedinPACE.

Ageing is natural, but the speed at which we age can change. Photo: Bricolage/Shutterstock

Then, they looked at the levels of heat each participant would have been exposed to in their geographic areas over the preceding six years, which was 2010-16. They used the US heat index to assess heat, from caution (days up to 32°C), extreme caution (32–39°C), and danger (39–51°C). They used regression modelling to see how much faster people were ageing over the normal rate of ageing.

The effect of heat was clear in the three biological clocks. Longer-term exposure to intense heat increased biological age by 2.48 years over the six-year period of the study, according to PCPhenoAge; 1.09 years, according to PCGrimAge; and 0.05 years, according to DunedinPACE.

Over the period of the study, the effect was up to 2.48 years faster than normal ageing, where one calendar year equals one biological year of ageing. That is, rather than their bodies ageing the equivalent of six years over a six-year period, heat could have aged their bodies up to 8.48 years.

Importantly, the biological clocks differ quite substantially, and we don’t yet know why. The authors suggest the PCPhenoAge clock may capture a broader spectrum of biological ageing, covering both short-term and longer-term heat stress, while the other two may be more sensitive to long-term heat exposure.

The way these researchers have conducted their study gives us confidence in their findings – the study sample was large and representative, and the use of the heat index rather than air temperature is an improvement over previous studies.

However, the findings don’t account for whether the participants had airconditioning in their homes or spent much time outside.

We need to know more

Perhaps surprisingly, there’s been little research done to date on what heat does to human epigenetics.

In 2020, we conducted a systemic review of the science of how environment affects human epigenetics. We found only seven studies, with most focused on the effect of cold rather than heat.

Now we have this new research that sheds light on the extent to which heat ages us.

As we face a warmer future, our epigenetics will change in response. There’s still a lot of work to do to see how we can adapt to these changes – or if we even can, in some parts of the world.
The Conversation
This article originally appeared on The Conversation, and was co-authored with Shuai Li, University of Melbourne.

This article was first published on Monash Lens. Read the original article

Categories : Ageing CancerTags :

Y Chromosome Loss in Immune Cells Creates Opportunity for Cancers

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Scanning electron micrograph of a T cell lymphocyte. Credit: NIH / NIAID

A study initiated by a University of Arizona Comprehensive Cancer Center physician-scientist has for the first time defined how loss of the Y chromosome in male immune cells negatively affects immune system function. The findings, published in Nature, may explain why loss of Y is associated with lower cancer survival rates.

In males, each cell in the body usually contains one X and one Y chromosome. “Loss of Y” is a common, nonhereditary genetic change in men in which an immune cell in the blood loses its Y chromosome. It is often associated with aging. Loss of Y has been linked to increased mortality from carcinomas for many years, though no one knew why.

This study is the first to identify and define the relationship between loss of Y in white blood cells, immune cells and tumours, providing insights as to why men with loss of Y have increased cancer risks and poorer outcomes.

“These findings represent a big step forward in our understanding of why men with loss of Y in their blood cells have a higher mortality from cancer. It turns out it’s because these cells make the immune system infiltrating the cancer less effective,” said Dan Theodorescu, MD, PhD, director of the Cancer Center and a professor in the College of Medicine – Tucson. 

“We hope this provides a solid lead and framework for the nascent Y chromosome field to pursue so we can collectively better understand all the possible biological implications of this finding and how to use them to develop more effective approaches in prevention, treatment resulting in higher survival rates for patients.”

The research team discovered that loss of the Y chromosome – previously identified in malignant epithelial cells by the Theodorescu lab – also occurred in nearby noncancerous tissues, including connective tissue and immune cells.

Most notably, the team found that this chromosomal loss in helper and cytotoxic T cells, which are responsible for attacking cancer cells, was associated with a reduced ability to kill those cancerous cells. The findings suggest a mechanism by which tumours may evade immune detection and suppression.

Finally, the research team found that loss of Y in epithelial cells, combined with loss of Y in T cells, resulted in more aggressive cancers and lower survival rates in patients.

“The study has potential implications for current immunotherapies, including CAR T therapy,” Theodorescu said. “Further research is clearly needed but perhaps immunotherapies using cells from a patient’s immune system could be screened for loss of Y before being used in treatment.”

Source: University of Arizona

Categories : Ageing Diet and NutritionTags :

Consuming a Variety of Flavonoids Extends Life, New Study Suggests

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Photo by Annemarie Grudën on Unsplash

New research has found that those who consume a diverse range of foods rich in flavonoids, such as tea, berries, dark chocolate, and apples, could lower their risk of developing serious health conditions and have the potential to live longer.

The study was led by a team of researchers from Queen’s University Belfast, Edith Cowan University Perth (ECU), and the Medical University of Vienna and Universitat Wien.

The findings reveal that increasing the diversity of flavonoids within your diet could help prevent the development of health conditions such as type 2 diabetes, cardiovascular disease (CVD), cancer and neurological disease.

Flavonoids are found in plant foods like tea, blueberries, strawberries, oranges, apples, grapes, and even red wine and dark chocolate.

The study in Nature Food followed over 120 000 participants aged 40–70 for over a decade. It is the first study of its kind to suggest that there is a benefit to consuming a wide range of flavonoids beyond that of simply consuming a high quantity.

ECU Research Fellow, first author and co-lead of the study Dr Benjamin Parmenter, made the initial discovery that a flavonoid-diverse diet is good for health.

“Flavonoid intakes of around 500mg a day was associated with a 16% lower risk of all-cause mortality, as well as a ~10% lower risk of CVD, type 2 diabetes, and respiratory disease. That’s roughly the amount of flavonoids that you would consume in two cups of tea.”

Dr Parmenter added, however, that those who consumed the widest diversity of flavonoids, had an even lower risk of these diseases, even when consuming the same total amount. For example, instead of just drinking tea, it’s better to eat a range of flavonoid-rich foods to make up your intake, because different flavonoids come from different foods.

“We have known for some time that higher intakes of dietary flavonoids, powerful bioactives naturally present in many foods and drinks, can reduce the risk of developing heart disease, type 2 diabetes, and neurological conditions like Parkinson’s,” study co-lead Professor Aedín Cassidy from the Co-Centre for Sustainable Food Systems and Institute for Global Food Security at Queen’s said.

“We also know from lab data and clinical studies that different flavonoids work in different ways, some improve blood pressure, others help with cholesterol levels and decrease inflammation. This study is significant as the results indicate that consuming a higher quantity and wider diversity has the potential to lead to a greater reduction in ill health than just a single source.”

Professor Tilman Kuhn from the Medical University of Vienna, Universitat Wien and Queen’s University Belfast was also a co-lead author, noted that the importance of diversity of flavonoid intake has never been investigated until now, making this study very significant as the findings align with popular claims that eating colourful foods are invaluable to maintain good health.

“Eating fruits and vegetables in a variety of colours, including those rich in flavonoids, means you’re more likely to get the vitamins and nutrients you need to sustain a healthier lifestyle,” he said.

The first-ever dietary guidelines for flavonoids were released recently recommending increasing the consumption of flavonoids to maintain health.

“Our study provides inaugural evidence that we may also need to advise increasing diversity of intake of these compounds for optimal benefits,” Dr Parmenter said.

“The results provide a clear public health message, suggesting that simple and achievable dietary swaps, such as drinking more tea and eating more berries and apples for example, can help increase the variety and intake of flavonoid-rich foods, and potentially improve health in the long-term,” Professor Cassidy added.

Source: Edith Cowan University

Categories : AgeingTags :

Could ‘Pausing’ Necrosis be the Final Frontier in Ageing and Medicine?

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Necrosis, unprogrammed cell death, spews a host of toxic molecules into the cellular environment. Credit: University College London

In a new study, published in Oncogene, a world-leading international team of scientists and clinicians explore the potential of necrosis to reshape our understanding and treatment of age-related conditions and even protect astronauts on longer journeys into space.

Challenging prevailing views, the paper brings together evidence from cancer biology, regenerative medicine, kidney disease, and space health to argue that necrosis is not merely an endpoint, but a key driver of aging that presents an opportunity for intervention.

Dr Keith Siew, an author of the study from UCL Centre for Kidney & Bladder Health, said: “Nobody really likes talking about death, even cell death, which is perhaps why the physiology of death is so poorly understood. And in a way necrosis is death. If enough cells die, then tissues die, then we die. The question is what would happen if we could pause or stop necrosis.”

Dr Carina Kern, lead author of the study and CEO of LinkGevity, a biotech company based at Cambridge’s Babraham Research Campus and part of the NASA Space-Health program, said: “Necrosis remains one of the last frontiers in medicine – a common thread across aging, disease, space biology, and scientific progress itself.”

Cells are the fundamental building blocks of life and can die in various ways. ‘Programmed’ forms of cell death are beneficial, carefully orchestrated processes that allow our tissues to replenish themselves and function well throughout life.

But ‘unprogrammed’ cell death, or necrosis, is an uncontrolled and catastrophic process that leads to tissue degeneration and biological decline.

At the centre of the necrotic process is calcium, a vital resource that effectively controls the cell by determining which functions are switched on or off. Calcium ions are normally maintained at a level that is 10 000 to 100 000 times higher outside the cell than inside.

When this finely tuned balance fails, calcium floods the cell like an electrical short circuit, pushing the cell into chaos. Unlike programmed death, where cells dismantle in an orderly manner, necrosis causes cells to rupture, spilling toxic molecules into surrounding tissues.

This sparks a chain reaction that causes widespread inflammation and affects tissue repair, creating a snowball effect that ultimately leads to frailty and the onset of chronic age-related conditions such as kidney disease, heart disease and Alzheimer’s.

Dr Siew added: “When cells die, it’s not always a peaceful process for the neighbours.”

Dr Kern explains: “Necrosis has been hiding in plain sight. As a final stage of cell death, it’s been largely overlooked. But mounting evidence shows it’s far more than an endpoint. It’s a central mechanism through which systemic degeneration not only arises but also spreads. That makes it a critical point of convergence across many diseases. If we can target necrosis, we could unlock entirely new ways to treat conditions ranging from kidney failure to cardiac disease, neurodegeneration, and even aging itself.”

Notably, it is in the kidneys that necrosis may have its most devastating and underappreciated impact. Necrosis induces kidney disease, which can lead to kidney failure requiring a transplant or dialysis. By age 75 nearly half of all individuals develop some degree of kidney disease as part of the natural aging process.

Dr Siew added: “With kidney disease, there’s no one underlying reason that the kidneys fail. It could be a lack of oxygen, inflammation, oxidative stress, a build-up of toxins, and so on. All of these stressors eventually lead to necrosis, which initiates a positive feedback loop that spirals out of control, leading to kidney failure. We can’t stop all of these stressors, but if you could intervene at the point of necrosis, you’d effectively achieve the same result.”

Another area where interrupting necrosis could have a big impact is spaceflight, where astronauts often experience accelerated ageing and kidney-related decline due to the effects of low gravity and exposure to cosmic radiation. A 2024 study involving Dr Siew demonstrated that the human kidney may be the ultimate bottleneck for long-duration space missions.

The authors say finding solutions to this accelerated aging and kidney disease may be the final frontier for human deep space exploration.

Dr Kern said: “In many age-related diseases – affecting diverse organs such as the lungs, kidneys, liver, brain, and cardiovascular system – relentless cascades of necrosis fuel the progression of disease. This is often alongside impaired healing that leads to fibrosis, inflammation and damaged cells. Each cascade triggers and amplifies the next.

“If we could prevent necrosis, even temporarily, we would be shutting down these destructive cycles at their source, enabling normal physiological processes and cell division to resume – and potentially even allowing for regeneration.”

Source: University College London

Categories : AgeingTags :

Can Engaging in Social Activities Prolong Life?

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Photo by Jusfilm on Unsplash

A study in the  Journal of the American Geriatrics Society indicates that social engagement may help older individuals live longer.

In the study of 2268 US individuals aged 60 years and older who completed the Psychosocial and Lifestyle Questionnaires and provided blood samples in 2016, there was a strong association between engaging in social activities and a low risk of 4-year mortality. High social engagement was associated with a 42% lower mortality risk than low engagement.

Specific activities, such as charity work, engaging with grandchildren, and participation in sports or social clubs, were particularly significant predictors of a reduced risk of dying.

Also, analyses indicated that decelerated biological aging and greater physical activity levels played key roles in facilitating the beneficial relationship between social engagement and lower mortality rates.

“Staying socially active is more than a lifestyle choice. It is closely linked to healthier aging and longevity,” said corresponding author Ashraf Abugroun, MBBS, MPH, of the University of California, San Francisco. “These results underscore how participating in community life contributes to better health in older adults.”

Source: Wiley

Categories : Ageing Metabolic DisordersTags :

Midlife Weight Loss Linked to Longer, Healthier Lives

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Photo by I Yunmai on Unsplash

Losing weight via lifestyle adjustments can deliver significant long-term health benefits, without the need for surgery or anti-obesity drugs. Alongside preventing diabetes, it can help ward off chronic conditions including arterial and pulmonary diseases as well as cancers.

A University of Helsinki study tracked 23 000 individuals from Finland and the UK, aged 30 to 50 at the outset, over a period of 12 to 35 years. Health benefits were found in overweight men and women who lost an average of 6.5% of their body weight in early middle age and maintained it throughout the 12–35-year follow-up period. Weight maintenance is crucial. 

“The benefits of lifestyle-based weight management are widely discussed even though studies have found it surprisingly difficult to demonstrate health benefits beyond the prevention of diabetes,” notes Professor Timo Strandberg.  

The study he led is now filling this gap. 

“I hope the findings will inspire people to see that lifestyle changes can lead to major health improvements and a longer life. This is particularly important today as more people are overweight than when the collection of our research data began 35 years ago.” 

The study also supports the view that, for optimal health, a lifelong body mass index (BMI) under 25 is ideal.   

The study was published in JAMA Network Open, the open-access journal of the American Medical Association.

Source: University of Helsinki

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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Photo by Matteo Vistocco on Unsplash

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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Photo by Pexels on Pixabay

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