Exploring Comprehensive Support Services for Residents

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Guest Post:

In today’s increasingly complex world, the need for comprehensive support services for

residents has never been more critical. Whether in care homes, communities, or urban

environments, residents require a network of resources that not only meets their basic needs

but also promotes their well-being and enhances their quality of life. This blog explores the

various aspects of comprehensive support services available to residents, highlighting their

importance, components, and benefits.

The Importance of Comprehensive Support Services

Comprehensive support services play a vital role in ensuring that residents lead fulfilling

lives. As society ages and the population grows, the demand for these services has

intensified. The objective is to create an environment where residents feel secure,

supported, and empowered. These services encompass various aspects, including

healthcare, emotional support, social interaction, and community engagement. Care home

services in Bournemouth provide vital support to residents, ensuring they have access to

healthcare, social activities, and emotional well-being tailored to their individual needs.

Key Components of Support Services

Comprehensive support services can be divided into several key components, each

addressing different facets of residents’ lives.

1. Healthcare Services

Access to healthcare is paramount for residents, particularly for older people and those with

chronic conditions. Comprehensive support services include regular medical check-ups,

access to specialists, and emergency care. Additionally, preventive services such as

vaccinations and health screenings are crucial in promoting overall health and well-being.

2. Emotional and Psychological Support

Mental health is an often overlooked aspect of comprehensive support services. Residents

benefit from counseling and psychological support to navigate life’s challenges, cope with

loss, or manage anxiety and depression. Support groups and peer-led initiatives can also

foster a sense of community, allowing residents to share experiences and build connections.

3. Social Activities and Community Engagement

Social isolation can significantly impact residents’ mental and emotional health.

Comprehensive support services should include opportunities for social interaction through

organized events, recreational activities, and community groups. These activities not only

promote socialization but also help residents develop a sense of belonging and purpose.

4. Transportation and Mobility Assistance

For many residents, mobility can be a barrier to accessing essential services and engaging

with the community. Support services should provide transportation solutions, such as

shuttle services or volunteer drivers, to help residents attend medical appointments, social

events, and other activities. Additionally, mobility aids and home modifications can enhance

residents’ independence.

5. Nutritional Support

Proper nutrition is fundamental to maintaining health, particularly for seniors. Comprehensive

support services should include meal planning, nutritional counseling, and access to healthy

meal options. Community kitchens and food delivery services can ensure that residents

receive balanced and nutritious meals tailored to their dietary needs.

The Benefits of Comprehensive Support Services

The implementation of comprehensive support services yields numerous benefits for

residents and the community as a whole. These services enhance the quality of life by

promoting health, fostering social connections, and providing a safety net for individuals

facing challenges. Moreover, they empower residents to take an active role in their well-

being, encouraging independence and self-management.

By addressing the diverse needs of residents, comprehensive support services create a

more inclusive and supportive environment. This not only benefits individual residents but

also strengthens the community, fostering a culture of care and compassion.

Conclusion

In conclusion, exploring comprehensive support services for residents reveals their essential

role in promoting health, well-being, and social engagement. By focusing on key

components such as healthcare, emotional support, social activities, transportation, and

nutrition, communities can create a robust support network that enhances residents’ quality

of life. As we move forward, prioritizing these services will be crucial in building healthier,

happier, and more connected communities.

How to Break Down Long-Term Care Planning Effectively

Guest post by Nicole Rubin

How to Break Down Long-Term Care Planning Effectively
Having a plan for long-term care is not just smart — for most adults, it is an absolute necessity. Paying for long-term care takes many people by surprise, but it really shouldn’t since most people will require long-term care in their lifetime. So, to make sure you aren’t caught unprepared, MindSpa offers the following guidance.

Be Aware of How Much Insurance Will Help
When you think about insurance, you should know that Medicare is not going to help with long-term care costs. The most you will get is some coverage for direct healthcare expenses, but that’s only a sliver of most long-term care needs. If you decide to plan ahead, you could look into long-term care coverage that can offset costs, or you can look at Medicare Advantage or supplemental plans that can give you more coverage for healthcare, prescriptions, and other related expenses.  

Contribute More to Retirement Investments
Boosting your retirement contributions can also be helpful if you want to start to save for potential long-term care costs. It’s never too soon to draft a retirement plan. But a plan is only as good as your discipline to stick to it. With a reasonable budget and appropriate savings, you can have a practical plan to meet all your needs.

Keep Your Long-Term Factors in Mind
It’s a bit tricky to estimate your need for care. While you can’t predict the future, Genworth suggests looking at factors that can play a role in requiring long-term care. Ask yourself some important questions when thinking about your risks: is there a history of Alzheimer’s in the family? This condition is typically passed down through the maternal side of families, so if a maternal grandparent required care, you may need the same kind of care in the future.

Plan for Assisted Living
Exploring local assisted living and nursing home facilities involves conducting research on various options that align with your needs. This entails examining reviews, evaluating their locations, and learning about the amenities they offer. After gathering this information, you can formulate a plan to visit different communities. Once your research is complete, you can arrange tours of the facilities that seem like potential matches for your requirements.

 Take Steps to Take Care of Your Health
Watch what you eat and maintain a healthy weight, but also commit to a regular fitness plan. DailyCaring points out that exercise is especially critical in maintaining muscle tone and flexibility needed to prevent falls. You can also think about making changes to your home to make it safer for you to age in place. Basic features, such as grab bars in the bathroom and non-slip rugs, can be vital in fall prevention at home.

Assisted Care
You know you’ll probably need some type of care as you get older. It may be as simple as hiring a home health care assistant, or you may need to create a plan to eventually move to assisted living. The big question is, how will you pay for that care? The good news is there are quite a few ways to cover long-term care expenses. If you have a home or property, you can easily sell your house when you are older and have more equity to get the cash you need.

Reverse Mortgages
If you plan to age in place, a reverse mortgage could be a great option as well. With a reverse mortgage, you or your spouse can remain in the home while receiving payments from your chosen lender to help offset any unexpected costs. When the homeowner passes away, the house is sold for profit by the lender. There are a lot of pros and cons to a reverse mortgage, so practice due diligence if you plan to pursue this option.

 Paying for long-term care doesn’t have to put you in a stressful situation. Take proactive steps now, such as planning to sell your home once you have sufficient equity, starting a business to boost your retirement income, and taking better care of your health. Just be sure to plan ahead for your need for care and lay out a solid financial strategy for covering any costs of long-term care. When the time comes, you will be thankful you did!

Strong link between ADHD and car crashes in older adult drivers

October 4, 2023

Science Daily/Columbia University's Mailman School of Public Health

In a study on the prevalence of attention-deficit/hyperactivity disorder (ADHD) and its association with crash risk among older adult drivers, researchers at Columbia University Mailman School of Public Health found that older adult drivers with ADHD are at a significantly elevated crash risk compared with their counterparts without ADHD. Outcomes included hard- braking events, and self-reported traffic ticket events, and vehicular crashes. Until now research on ADHD and driving safety was largely limited to children and young adults, and few studies assessed the association of ADHD with crash risk among older adults. The results are published online in JAMA Network Open.

Older adult drivers were more than twice as likely as their counterparts without ADHD to report being involved in traffic ticket events (22 versus 10 per million miles driven), and vehicular crashes (27 versus 13.5 per million miles driven).

"Our findings suggest that effective interventions to improve the diagnosis and clinical management of ADHD among older adults are warranted to promote safe mobility and healthy aging," observed Yuxin Liu, MPH, Columbia Mailman School of Public Health, and first author.

ADHD is a chronic neurodevelopmental condition with symptoms such as inattentiveness, impulsivity, and hyperactivity. Although ADHD is commonly considered a childhood disorder, it can persist into adulthood and affect daily life performances of older adults. In the U.S., the reported prevalence of ADHD is 9% to 13% in children younger than 17 years and 8% in adults 18 to 44 years of age. The reported prevalence of ADHD in adults has increased in recent years due to improved diagnosis. In general, the prevalence of ADHD decreases with advancing age.

Study participants were active drivers aged 65 to 79 years of age enrolled during 2015 and 2017 in the Longitudinal Research on Aging Drivers (LongROAD) project who were followed for up to 44 months through in-vehicle data recording devices and annual assessments. The data analysis was performed between July 2022 and August 2023.

Of the 2832 drivers studied, 75 (2.6 %) had ADHD. The prevalence of ADHD was 7.2% among older adults with anxiety or depression. With adjustment for demographic characteristics and comorbidities, ADHD was associated with a 7% increased risk of hard-braking events, a 102% increased risk of self-reported traffic ticket events, and a 74% increased risk of self-reported vehicular crashes.

The researchers collected data from primary care clinics and residential communities in five U.S. sites in Ann Arbor, Michigan; Baltimore, Maryland; Cooperstown, New York; Denver, Colorado; and San Diego, California between July 2015 and March 2019. Participants were active drivers aged 65 to 79 years enrolled in the LongROAD project who were followed through in-vehicle data recording devices and annual assessments.

"Our study makes two notable contributions to research on healthy and safe aging, "said Guohua Li, M.D., DrPH, professor of epidemiology at Columbia Mailman School of Public Health, and senior author. "The research fills a gap in epidemiologic data on ADHD among older adults and provides compelling evidence that older adult drivers with ADHD have a much higher crash risk than their counterparts without ADHD."

Dr. Li and colleagues launched the LongROAD Project in 2014 to understand and meet the safe mobility needs of older adult drivers.A 2016 study by Li and colleagues in theJournal of the American Geriatrics Societyshowed that health worsens when older adults stop driving. Early this year, the research team reported in a study published in Artificial Intelligence in Medicine that driving data captured by in-vehicle recording devices are valid and reliable digital markers for predicting mild cognitive impairment and dementia.

"There are 48 million older adult drivers in the United States. As population aging continues, this number is expected to reach 63 million in 2030. Data from the landmark LongROAD project will enable us to examine the role of medical, behavioral, environmental, and technological factors in driving safety during the process of aging." said Li, who is also professor of anesthesiology at Columbia Vagelos College of Physicians and Surgeons, and founding director of the Columbia Center for Injury Science and Prevention.

https://www.sciencedaily.com/releases/2023/10/231004132403.htm

Life satisfaction may not enhance cognitive functioning among some older adults

Feeling satisfied in life is generally thought to be a boost to physical and mental health, but a new study suggests that life satisfaction provides little benefit to older adults who also experience health or socioeconomic challenges.

September 29, 2023

Science Daily/Boston University School of Public Health

Numerous studies have shown that leading a fulfilling and satisfying life may improve cognitive function by encouraging health-protective behaviors such as physical activity and reduced stress. Many of these studies assess this relationship from a population level, rather than among individuals.

But a closer look within the general population suggests that life satisfaction may not have a positive effect on all people, according to a new study led by Boston University School of Public Health researchers.

Published in the journal SSM -- Mental Health, the study examined psychological well-being among older individuals in the United States and United Kingdom. High life satisfaction was associated with increased cognitive functioning among most individuals, but it was less beneficial for people of low socioeconomic status, in poor health, or experiencing adverse psychological conditions.

The study is the first to examine the effects of psychological well-being on cognitive functioning among older adults. It is important to note that the researchers observed no association of average cognitive effects from psychological well-being at a population level, so without this more granular analysis, the potentially adverse effects of life satisfaction would have been overlooked.

"It was impressive to observe how a relationship with no associations on population average showed underlying differences based on sociodemographic factors, physical health, and psychosocial elements," says study lead author Toshiaki Komura, a master of public health student at BUSPH.

This new insight emphasizes the importance of considering heterogeneities in public health research to understand who benefits from life satisfaction and who does not.

"Our results indicate that the health benefit of experiencing high life satisfaction may be smaller among socially marginalized groups, so further research is needed to ensure potential interventions have equitable health impacts," says study senior author Dr.Koichiro Shiba, assistant professor of epidemiology at BUSPH.

For the study, the team used a novel machine-learning method to analyze nationally representative survey data on life satisfaction and cognitive functioning among more than 15,000 adults ages 50 and older in the US and UK, for four-year periods between 2010 and 2016.

The health-promoting effect of life satisfaction in older adults was only evident among participants with higher SES, fewer pre-existing health problems, and better psychological functioning, which was about half of the survey participants.

The researchers surmise that the physical, mental, or socioeconomic challenges that low-SES individuals or adults in poorer health experience may have outweighed any possible cognitive benefits from life satisfaction. For example, life satisfaction could boost cognitive functioning by promoting physical activity, but exercise is not achievable if an individual is not in basic good health or does not have access to resources to exercise, such as residential green space or a gym.

This counterintuitive finding of the adverse effects of life satisfaction may also be explained by a concept called"response shift," which involves changing internal standards, values and the conceptualization of quality of life.

"Response shift is the adjustment of one's internal view of their quality of life when facing challenging circumstances in which their health status is severely deteriorated," Komura explains. "In such situations, their standard of quality of life may shift to maintain a favorable psychological environment."

According to this theory, individuals with disadvantaged socioeconomic, health, and psychosocial conditions might have reported life satisfaction that had been "adjusted" to their circumstances. "Our findings suggest such adjusted subjective feelings might have limited health-promoting effects on cognitive functioning," he says.

https://www.sciencedaily.com/releases/2023/09/230929131440.htm

At which age we are at our happiest?

September 19, 2023

Science Daily/Ruhr-University Bochum

At what age are people at their happiest? This seemingly simple question has been studied extensively over the past decades, but a definitive answer has long been elusive. A research team has now shed light on the question in a comprehensive meta-analytic review. The findings show that the respondents' life satisfaction decreased between the ages of 9 and 16, then increased slightly until the age of 70, and then decreased once again until the age of 96.

An evaluation of over 400 samples shows how subjective well-being develops over the course of a lifespan.

More than 460,000 participants

In their study, the researchers examined trends in subjective well-being over the lifespan based on 443 samples from longitudinal studies with a total of 460,902 participants. "We focused on changes in three central components of subjective well-being," explains Professor Susanne Bücker, who initially worked on the study in Bochum and has since moved to Cologne: "Life satisfaction, positive emotional states and negative emotional states."

The findings show that the life satisfaction decreased between the ages of 9 and 16, then increased slightly until the age of 70, and then decreased once again until the age of 96. Positive emotional states showed a general decline from age 9 to age 94, while negative emotional states fluctuated slightly between ages 9 and 22, then declined until age 60 and then increased once again. The authors identified greater median changes in positive and negative emotional states than in life satisfaction.

Positive trend over a wide period of life

"Overall, the study indicated a positive trend over a wide period of life, if we look at life satisfaction and negative emotional states," as Susanne Bücker sums up the results. The researchers attribute the slight decline in life satisfaction between the ages of 9 and 16 to, for example, changes to the body and to the social life that take place during puberty. Satisfaction rises again from young adulthood onwards. Positive feelings tend to decrease from childhood to late adulthood. In very late adulthood, all components of subjective well-being tended to worsen rather than improve. "This could be related to the fact that in very old people, physical performance decreases, health often deteriorates, and social contacts diminish; not least because their peers pass away," speculates the researcher.

The study highlights the need to consider and promote subjective well-being with its various components across the lifespan, as the authors of the study conclude. Their findings could provide significant guidance for the development of intervention programmes, especially those aimed at maintaining or improving subjective well-being late in life.

https://www.sciencedaily.com/releases/2023/09/230919155016.htm

Older adults with digestive diseases experience higher rates of loneliness, depression

September 12, 2023

Science Daily/Michigan Medicine - University of Michigan

A team of gastroenterologists and hepatologists examine psychosocial factors in older Americans with gastrointestinal conditions.

While life expectancy rates for older Americans are rising, nearly 40% of adults report living with a digestive disease of some kind.

"Many people don't realize that these conditions are very common in ambulatory care," said Michigan Medicine gastroenterologist Shirley Ann Cohen-Mekelburg, M.D., who specializes in conditions like inflammatory bowel disease, Crohn's disease and ulcerative colitis.

"Ultimately, this creates an excess in health care spending in the United States. Not only are these conditions debilitating for the millions of people living with them, but they're also very expensive to treat."

Cohen-Mekelburg says that in recent years, there has been a greater emphasis among providers in detecting why so many Americans are developing digestive diseases.

However, she notes that current approaches often fail to consider how things like psychosocial factors contribute to these conditions.

"As physicians, it's important for us to pay attention to psychosocial factors involved in the lives of our patients, but they often go overlooked," she said.

"These factors have the potential to significantly impact gastrointestinal health, and they also play a crucial role in the overall wellbeing of our patients."

This notion inspired Cohen-Mekelburg and a team of fellow gastroenterologists and hepatologists to examine the rates of loneliness, depression and social isolation in older adults both with and without digestive diseases.

Their findings were recently published in Clinical Gastroenterology and Hepatology.

Cohen-Mekelburg notes that the team also "wanted to quantify these numbers with self-reported rates of poor health."

"Our research involved analyzing data from 2008 to 2016 from the University of Michigan Health and Retirement Study.

This is a longitudinal panel study that involves a representative sample of approximately 20,000 individuals in the U.S. who are 50 years and older, as well as their spouses," she said.

"It's important to note that loneliness refers to the subjective distressed feeling of being alone or lacking companionship. The correlation between loneliness and depression is well established."

However, Cohen-Mekelburg adds that social isolation refers to the "objective physical separation from other people, which is independent of psychological well-being."

"Therefore, there are people who live in isolation but are well-adapted, not lonely and report high psychological wellbeing. But on the other hand, there are also people who are socially connected, yet suffer from low psychological wellbeing and loneliness. This, despite having a strong social network."

Out of a pool of 7,110 participants, the team identified 56% of individuals with a digestive disease and 44% without one.

"Overall, 60.4% and 55.6% of respondents with and without digestive diseases reported loneliness, while 12.7% and 7.5% reported severe depression, and 8.9% and 8.7% reported social isolation, respectively," said Cohen-Mekelburg.

"We found that individuals with a digestive disease were more likely to report 'poor-or-fair' health when compared to those without one. And among patients with a digestive disease, loneliness, as well as moderate to severe depression, were associated with greater odds of self-reporting 'poor-or-fair' health."

Cohen-Mekelburg says that she hopes these findings eventually empower gastroenterologists to "screen patients for depression and loneliness," in addition to their physical symptoms. "By doing this, providers can better establish care pathways for mental health treatment for their patients, which is hugely important," she said.

"Our research shows that gastroenterologists are in a unique position to help their patients achieve good overall health. If you're a clinician who also happens to treat older adults, even better. Being aware of the link between loneliness, depressive symptoms and digestive diseases can really benefit your patients from a holistic perspective."

https://www.sciencedaily.com/releases/2023/09/230912165720.htm

Large amounts of sedentary time linked with higher risk of dementia in older adults

September 12, 2023

Science Daily/University of Southern California

Researchers have used machine learning to explore the links between sedentary behavior and dementia, finding that the total time spent sedentary matters for brain aging.

Adults aged 60 and older who spend more time engaging in sedentary behaviors like sitting while watching TV or driving may be at increased risk of developing dementia, according to a new study by USC and University of Arizona researchers.

Their study showed the risk of dementia significantly increases among adults who spend over 10 hours a day engaging in sedentary behaviors like sitting -- a notable finding considering the average American is sedentary for about 9.5 hours each day.

The study, published on Tuesday, September 12 in JAMA, also revealed the way sedentary behavior is accumulated over the course of the day didn't matter as much as the total time spent sedentary each day. Whether spent in extended periods spanning several hours or spread out intermittently throughout the day, total sedentary behavior had a similar association with dementia according to study author David Raichlen.

"Many of us are familiar with the common advice to break up long periods of sitting by getting up every 30 minutes or so to stand or walk around. We wanted to see if those types of patterns are associated with dementia risk. We found that once you take into account the total time spent sedentary, the length of individual sedentary periods didn't really matter," said Raichlen, professor of biological sciences and anthropology at the USC Dornsife College of Letters, Arts and Sciences.

Researchers used data from the U.K. Biobank, a large-scale biomedical database of participants across the United Kingdom, to investigate possible links between sedentary behavior and dementia risk.

As part of a U.K. Biobank sub-study, over 100,000 adults agreed to wear accelerometers, wrist-worn devices for measuring movement, for 24 hours per day for one week. The researchers focused on a sample of approximately 50,000 adults from this sub-study over the age of 60 who did not have a diagnosis of dementia at the start of the study.

The researchers then applied a machine-learning algorithm to analyze the large dataset of accelerometer readings and classify behaviors based on different intensities of physical activity. The algorithm was able to discern between different types of activity such as sedentary behavior versus sleeping. The accelerometer data, combined with advanced computing techniques, provided researchers with an objective measure of the time spent engaging in different types of sedentary behaviors.

After an average of six years of follow-up, the researchers used inpatient hospital records and death registry data to determine dementia diagnosis. They found 414 cases positive for dementia.

Then, the team adjusted their statistical analysis for certain demographics (e.g., age, sex, education level, race/ethnicity, chronic conditions, genetics) and lifestyle characteristics (physical activity, diet, smoking and alcohol use, self-reported mental health) that could affect brain health.

Total time spent sedentary each day drives dementia risk

While high amounts of sedentary behavior were linked with increased risk of dementia, the researchers found that there were certain amounts of sedentary behavior that were not associated with dementia.

"We were surprised to find that the risk of dementia begins to rapidly increase after 10 hours spent sedentary each day, regardless of how the sedentary time was accumulated. This suggests that it is the total time spent sedentary that drove the relationship between sedentary behavior and dementia risk, but importantly lower levels of sedentary behavior, up to around 10 hours, were not associated with increased risk," said study author Gene Alexander, professor of psychology and psychiatry at the Evelyn F. McKnight Brain Institute at the University of Arizona and Arizona Alzheimer's Disease Research Center.

"This should provide some reassurance to those of us with office jobs that involve prolonged periods of sitting, as long we limit our total daily time spent sedentary," said Raichlen.

The study builds on their previous research, which used self-reported health data to investigate how certain types of sedentary behavior, like sitting and watching TV, affect dementia risk more than others.

"Our latest study is part of our larger effort to understand how sedentary behavior affects brain health from multiple perspectives. In this case, wearable accelerometers provide an objective view of how much time people dedicate to sedentary behavior that complements our past analyses," said Raichlen.

More research is needed to establish causality and whether physical activity can mitigate the risk of developing dementia, the authors said.

https://www.sciencedaily.com/releases/2023/09/230912113525.htm

Hobbies linked to lower depression levels among older people

September 11, 2023

Science Daily/University College London

A new study aimed to see if the benefits of hobbies were consistent in different national settings, and looked at data from 93,263 people aged 65 or over who had enrolled in five existing longitudinal studies in England, Japan, United States, China and 12 European countries.

Having a hobby is linked to fewer depressive symptoms and higher levels of happiness, self-reported health and life satisfaction among people aged 65 and over, and this holds true across 16 countries on three continents, according to a new study led by UCL (University College London) researchers.

The study, published in the journal Nature Medicine, aimed to see if the benefits of hobbies were consistent in different national settings, and looked at data from 93,263 people aged 65 or over who had enrolled in five existing longitudinal studies in England, Japan, United States, China and 12 European countries.

Analysing data from participants spanning four to eight years, the researchers found that having a hobby was also linked to subsequent decreases in depressive symptoms and increases in happiness and life satisfaction, suggesting there might be a causal effect, although as an observational study it could not prove causality.

These results remained after adjusting for other factors such as partnership status, employment and household income.

The study found the benefits of having a hobby were relatively universal, with only small differences between countries.

Lead author Dr Karen Mak (UCL Institute of Epidemiology & Health Care) said: "Our study shows the potential of hobbies to protect older people from age-related decline in mental health and wellbeing. This potential is consistent across many countries and cultural settings.

"Of the four outcomes, life satisfaction was most strongly linked to hobby engagement. Hobbies may contribute to life satisfaction in our later years through many mechanisms, including feeling in control of our minds and bodies, finding a purpose in life, and feeling competent in tackling daily issues.

"Theoretical work suggests the relationship between hobbies and wellbeing may cut both ways -- that people with better mental health may be more likely to take up a hobby, and persisting with a hobby may help us to retain improved life satisfaction.

"Our research also supports policymakers in promoting access to hobbies among older people as a way to enhance their wellbeing and health."

Hobbies, defined as activities people engage in during their leisure time for pleasure, might range from volunteering or being part of a club to reading, gardening, playing games, and arts and crafts.

The researchers found the proportion of people who said they had a hobby varied considerably between countries, with 51% of study participants in Spain reporting having a hobby, compared to 96% in Denmark, 95.8% in Sweden and 94.4% in Switzerland.

China had the lowest level of hobby engagement, at 37.6%, but researchers cautioned that study respondents in China were asked only about social hobbies, not hobbies in general.

In countries with better life expectancy and national happiness levels, more people reported having a hobby, and also the link between wellbeing and having a hobby was stronger in those countries.

The five longitudinal studies were: the English Longitudinal Study of Ageing (ELSA), the Japan Gerontological Evaluation Study (JAGES), US Health and Retirement Study (HRS), Survey of Health, Ageing and Retirement in Europe (SHARE), and China Health and Retirement Longitudinal Study (CHARLS). In ELSA, JAGES, and HRS, participants were asked about hobbies and the word was not defined; in SHARE and CHARLS, participants were asked if they engaged in a specific list of hobbies.

https://www.sciencedaily.com/releases/2023/09/230911141131.htm

Caution: Living alone puts people with cognitive decline at risk

Patients forget appointments, mix up medications and have no one to contact in an emergency.

August 18, 2023

Science Daily/University of California - San Francisco

An estimated 1 in 4 older Americans with dementia or mild cognitive impairment lives alone and is at risk of practices like unsafe driving, wandering outside the home, mixing up medications and failing to attend medical appointments.

In a study publishing in JAMA Network Open on Aug. 18, 2023, researchers led by UC San Francisco concluded that the United States health system is poorly equipped to serve patients living solo with cognitive decline, a group whose numbers are predicted to swell as the population ages.

For these patients, living alone is a social determinant of health with an impact as profound as poverty, racism and low education, said first author Elena Portacolone, PhD, MBA, MPH, of the UCSF Institute for Health and Aging and the Philip R. Lee Institute for Health Policy Studies.

In this qualitative study, researchers interviewed 76 health care providers, including physicians, nurses, social workers, case workers, home care aides and others. Participants worked in memory clinics, home care services and social services and other places in California, Michigan and Texas

The providers raised concerns about patients missing medical appointments, failing to respond to follow-up phone calls from the doctor's office and forgetting why appointments were made, leaving them vulnerable to falling off the radar. "We don't necessarily have the staff to really try to reach out to them," said a physician in one interview.

Discharging a patient is like 'sending a kid out to play on freeway'

Some patients could not assist their doctor with missing information on their chart, leaving the providers uncertain about the pace of their patient's decline. Many had no names listed as emergency contacts, "not a family member, not even a friend to rely on in case of a crisis," according to a case manager.

These patients were at risk for untreated medical conditions, self-neglect, malnutrition and falls, according to the providers. A house service coordinator also noted that calls to Adult Protective Services were sometimes dismissed until a patient's situation became very serious.

One consequence of the shaky infrastructure supporting these patients was that they were not identified until they were sent to a hospital following a crisis, like a fall or reaction to medication mismanagement. Some were discharged without a support system in place. In one case, a patient was sent home with a taxi voucher, a situation that a psychiatrist likened to "sending a kid out to play on the freeway."

These findings are an indictment of our health care system, which fails to provide subsidized home care aides for all but the lowest-income patients, said Portacolone.

"In the United States, an estimated 79% of people with cognitive decline have an income that is not low enough to make them eligible for Medicaid subsidized home care aides in long-term care," she said, adding that the threshold for a person living alone in California is $20,121 per year.

While Medicare is available to adults over 65, subsidized aides are generally only provided after acute episodes, like hospitalizations, for fixed hours and for limited durations, she said.

"Most patients need to pay out-of-pocket and since cognitive impairment can last for decades, it is unsustainable for most people. Aides that are available via Medicaid are very poorly paid and usually receive limited training in caring for older adults with cognitive impairment," she added.

Subsidized home care aides plentiful in Europe, Japan, Canada

In contrast, subsidized home care aides are generally available to a significantly larger percentage of their counterparts living in parts of Europe, Japan and Canada, said Portacolone, citing a 2021 review of 13 countries, of which she was the senior author.

The study's findings illustrate substantial deficiencies in how our health system provides for people with dementia, said senior author Kenneth E. Covinsky, MD, MPH, of the UCSF Division of Geriatrics. "In an era when Medicare is going to spend millions of dollars for newly approved drugs with very marginal benefits, we need to remember that Medicare and other payers refuse to pay far less money to provide necessary supports for vulnerable people with dementia."

The researchers advocate for a system in which robust supports are made available by funding from an expanded Medicare and Medicaid. This will become increasingly critical, said Portacolone, "because effective treatments to reverse the course of cognitive impairment are unavailable, childlessness and divorce are common, and older adults are projected to live longer and often alone."

https://www.sciencedaily.com/releases/2023/08/230818135219.htm

How immunity contributes to aging and neurodegeneration

August 2, 2023

Science Daily/Ecole Polytechnique Fédérale de Lausanne

Researchers have found that a specific immune signaling pathway drives ageing-related inflammation and neurodegeneration. The work can help us understand the mechanisms behind ageing-associated impairment and disease.

As we age, our bodies undergo various changes that can impact our overall health and make us more susceptible to diseases. One common factor in the ageing process is low-grade inflammation, which contributes to age-related decline and impairment. However, the precise pathways responsible for this inflammation and their impact on natural ageing have remained elusive until now.

A new study led by Andrea Ablasser at EPFL now shows that a molecular signaling pathway called cGAS/STING, plays a critical role in driving chronic inflammation and functional decline during aging. By blocking the STING protein, the researchers were able to suppress inflammatory responses in senescent cells and tissues, leading to improvements in tissue function.

cGAS/STING is a molecular signaling pathway that detects the presence of DNA in cells. It involves two proteins, cyclic GMP-AMP synthase (cGAS) and Stimulator of Interferon Genes (STING). When activated, cGAS/STING triggers an immune response to defend against viral and bacterial infections.

Previous work by Ablasser and her colleagues has linked cGAS/STING to a number of biological processes, including cellular senescence, a hallmark of aging. Based on this, the researchers investigated whether it might underlie maladapted immune responses during ageing.

The research found that activating the STING protein triggers specific patterns of gene activity in microglia, the brain's first-line-of-defense immune cells. These gene-activation patterns matched those arising in microglia in distinct neurodegenerative conditions, such as Alzheimer`s disease and ageing.

"In search for a mechanism that would engage the cGAS-STING pathway in ageing, we considered aberrant mitochondrial DNA species," says Ablasser. "Mitochondria, the organelles that are responsible for energy production are well-known for disturbed functioning in ageing and disease. Indeed, in microglia from old, but not young mice, DNA from mitochondria accumulated in the cell cytoplasm, suggesting a possible mechanism by which the cGAS-STING pathway contributes to inflammation in the ageing brain."

The researchers studied the effects of blocking the STING protein in aged mice. As expected by its central role in driving inflammation, inhibiting STING alleviated markers of inflammation both in the periphery and in the brain. More importantly, animals receiving STING inhibitors displayed significant enhancements in spatial and associative memory. STING blockade also affected physical function with improved muscle strength and endurance.

The study advances our understanding of ageing-related inflammation and also offers potential strategies for slowing cognitive deterioration in age-associated neurodegenerative conditions. The precise elucidation of the neuroimmune crosstalk governing microglial-dependent neurotoxicity also holds promise for the future study of neurodegenerative diseases.

https://www.sciencedaily.com/releases/2023/08/230802132023.htm

Minds & eyes: Study shows dementia more common in older adults with vision issues

Even when wearing their glasses or contacts, those who scored worse on vision tests were also more likely to have concerning scores on cognitive tests

August 1, 2023

Science Daily/Michigan Medicine - University of Michigan

Losing the ability to see clearly, and losing the ability to think or remember clearly, are two of the most dreaded, and preventable, health issues associated with getting older.

Now, a new study lends further weight to the idea that vision problems and dementia are linked.

In a sample of nearly 3,000 older adults who took vision tests and cognitive tests during home visits, the risk of dementia was much higher among those with eyesight problems -- including those who weren't able to see well even when they were wearing their usual eyeglasses or contact lenses.

The research was published recently in JAMA Ophthalmology by a team from the Kellogg Eye Center at Michigan Medicine, the University of Michigan's academic medical center.

Based on data from a nationally representative study of older adults conducted in 2021 through the U-M Institute for Social Research, it adds to a growing pile of studies that have suggested a link between vision and dementia.

All of the older adults in the study were over the age of 71, with an average age of 77. They had their up-close and distance vision, and their ability to see letters that didn't contrast strongly with their background, tested by a visiting team member using a digital tablet. They also took tests of memory and thinking ability, and provided health information including any existing diagnosis of Alzheimer's disease or another form of dementia.

Just over 12% of the whole group had dementia. But that percentage was higher -- nearly 22% -- among those who had impaired vision for seeing up close.

In addition, one-third (33%) of those with moderate or severe distance vision impairment, including those who were blind, had signs of dementia. So did 26% of those who had trouble seeing letters that didn't contrast strongly against a background.

Even among those with a mild distance vision issue, 19% had dementia.

After the researchers adjusted for other differences in health status and personal characteristics, people with moderate to severe distance vision issues were 72% more likely than those with no vision issues to have dementia.

The gaps were smaller, but still large, for other types of vision impairment -- except mild problems with distance vision, where there was no statistical difference.

Those who had more than one kind of vision impairment were also 35% more likely to have dementia than those with normal vision.

The new study builds on previous studies that had similar findings but relied on self-reported vision abilities rather than objective testing, or that were not representative of the U.S. population.

It also builds on previous work about cataract surgery that showed lower rates of dementia over time in adults who had had their distance vision restored by having surgery.

The authors, led by ophthalmologists Olivia Killeen, M.D., M.S. and Joshua Ehrlich, M.D., M.P.H., write, "Prioritizing vision health may be key to optimizing both sight and overall health and well-being. Randomized trials are warranted to determine whether optimizing vision is a viable strategy to slow cognitive decline and reduce dementia risk."

But in the meantime, in an accompanying editorial, Sheila West, Ph.D., of the Wilmer Eye Institute at Johns Hopkins Medicine, wrote that the new study adds to accumulating evidence about the link between vision and cognitive issues.

"Equitable access to vision care services that prevent, reverse, or at least stave off progression of loss of sight is a worthy goal regardless of the potential impact on dementia and may be especially critical for those experiencing cognitive decline," she wrote.

The study is based on data from the National Health and Aging Trends Study, which is based at the U-M Institute for Social Research and the Johns Hopkins University Bloomberg School of Public Health.

Last year, Ehrlich and colleagues published a paper in JAMA Neurology that used another ISR-based survey of older adults -- the Health and Retirement Study -- to estimate the percentage of Americans with dementia whose condition is likely related to their vision loss. They calculated that 1.8 percent of all cases are vision-related, equating to more than 100,000 of the 6 million Americans with dementia. This study suggested that vision impairment should be considered alongside other more commonly recognized modifiable dementia risk factors. That study was funded by the U-M Center to Accelerate Population Research in Alzheimer's (CAPRA) through funding from the National Institute on Aging.

Killeen recently completed the National Clinician Scholars Program at the U-M Institute for Healthcare Policy and Innovation and is now at Duke University. Ehrlich is an assistant professor of Ophthalmology and Visual Sciences at Michigan Medicine and a research assistant professor at ISR, where he is a co-investigator of NHATS, as well as a member of IHPI.

https://www.sciencedaily.com/releases/2023/08/230801172009.htm

Half the population to have a mental health disorder by 75

July 31, 2023

Science Daily/University of Queensland

Scientists analyzed data from more than 150,000 adults across 29 countries between 2001 and 2022 with results demonstrating the high prevalence of mental health disorders, with 50 per cent of the population developing at least one disorder by the age of 75.

A global study co-led by researchers from The University of Queensland and Harvard Medical School has found one in two people will develop a mental health disorder in their lifetime.

Professor John McGrath from UQ's Queensland Brain Institute, Professor Ronald Kessler from Harvard Medical School, and their colleagues from 27 other countries, analysed data from more than 150,000 adults across 29 countries between 2001 and 2022, taken from the largest ever coordinated series of face-to-face interviews -- the World Health Organisation's World Mental Health Survey initiative.

Lead author Professor McGrath said the results demonstrate the high prevalence of mental health disorders, with 50 per cent of the population developing at least one disorder by the age of 75.

"The most common were mood disorders such as major depression or anxiety," Professor McGrath said.

"We also found the risk of certain mental disorders differed by sex."

The 3 most common mental health disorders among women:

• Depression

• Specific phobia (a disabling anxiety that interferes with daily life)

• Post-traumatic stress (PTSD)

The 3 most common mental health disorders among men:

• Alcohol abuse

• Depression

• Specific phobia

The research also found mental health disorders typically first emerge in childhood, adolescence or young adulthood.

"The peak age of first onset was at 15 years old, with a median age of onset of 19 for men and 20 for women," Professor McGrath said.

"This lends weight to the need to invest in basic neuroscience to understand why these disorders develop."

Professor Kessler said investment was also needed in mental health services with a particular focus on young people.

"Services need to be able to detect and treat common mental disorders promptly, and be optimised to suit patients in these critical parts of their lives," Professor Kessler said.

"By understanding the age at which these disorders commonly arise, we can tailor public health interventions and allocate resources to ensure that appropriate and timely support is available to individuals at risk."

The researchers said the outcomes provide valuable insights into the frequency and timing of mental disorder onset based on many different populations.

The study is published in The Lancet Psychiatry.

https://www.sciencedaily.com/releases/2023/07/230731110734.htm

Scientists may have discovered mechanism behind cognitive decline in aging

July 25, 2023

Science Daily/University of Colorado Anschutz Medical Campus

Scientists at the University of Colorado Anschutz Medical Campus have discovered what they believe to be the central mechanism behind cognitive decline associated with normal aging.

"The mechanism involves the mis-regulation of a brain protein known as CaMKII which is crucial for memory and learning," said the study's co-senior author Ulli Bayer, PhD, professor of pharmacology at the University of Colorado School of Medicine. "This study directly suggests specific pharmacological treatment strategies."

The study was published today in the journal Science Signaling.

Researchers using mouse models found that altering the CaMKII brain protein caused similar cognitive effects as those that happen through normal aging.

Bayer said that aging in mice and humans both decrease a process known as S-nitrosylation, the modification of a specific brain proteins including CaMKII.

"The current study now shows a decrease in this modification of CaMKII is sufficient to cause impairments in synaptic plasticity and in memory that are similar in aging," Bayer said.

Normal aging reduces the amount of nitric oxide in the body. That in turn reduces nitrosylation which reduces memory and learning ability, the study said.

Bayer said the new research opens the way toward developing drugs and other therapeutic interventions that could normalize the nitrosylation of the protein. He said that holds out the possibility of treating or staving off normal cognitive decline for an unknown period of time.

He pointed out that this would only work in normal age-related cognitive decline, not the decline seen in Alzheimer's disease and dementia.

"We know this protein can be targeted," Bayer said. "And we think it could be done pharmacologically. That is the next logical step."

https://www.sciencedaily.com/releases/2023/07/230725171914.htm

Volunteering in late life may protect the brain against cognitive decline and dementia

July 20, 2023

Science Daily/University of California - Davis Health

Volunteering in late life is associated with better cognitive function -- specifically, better executive function and episodic memory. Those are the findings of a new study from UC Davis Health presented today (July 20) at the Alzheimer's Association International Conference 2023 in Amsterdam.

"We hope these new data encourage individuals of all ages and backgrounds to engage in local volunteering -- not only to benefit their communities, but potentially their own cognitive and brain health," said Donna McCullough, Alzheimer's Association chief mission and field operations officer.

Volunteer activities -- such as supporting educational, religious, health-related or other charitable organizations -- allow older adults to be more physically active, increase social interaction and provide cognitive stimulation that may protect the brain. However, there has been a lack of information on the relationship between volunteering and cognitive function, especially in large, diverse populations.

Yi Lor, an epidemiology doctoral student at UC Davis, and Rachel Whitmer, the study's principal investigator, examined volunteering habits among an ethnic and racially diverse population of 2,476 older adults. The participants are in the Kaiser Healthy Aging and Diverse Life Experiences Study (KHANDLE) and the Study of Healthy Aging in African Americans (STAR).

The study group had an average age of 74 and contained 48% Black, 20% white, 17% Asian and 14% Latino participants. A total of 1,167 (43%) of the participants reported volunteering in the past year.

The researchers found that volunteering was associated with better baseline scores on tests of executive function and verbal episodic memory. This was true even after adjusting for age, sex, education, income, practice effects and interview mode (phone versus in-person).

Those who volunteered several times per week had the highest levels of executive function.

"Volunteering may be important for better cognition in late life and could serve as a simple intervention in all older adults to protect against risk for Alzheimer's disease and associated dementias," Lor said. "Our next steps are to examine whether volunteering is protective against cognitive impairment, and how physical and mental health may impact this relationship."

Volunteering was also associated with a trend toward less cognitive decline over the follow-up time of 1.2 years, but this association did not reach statistical significance.

"You're not in control of your family history or age -- you can't turn back the clock. But you are in control of how you spend your day and life," Whitmer said. "Volunteering is about keeping your brain active. It's also about socializing, which keeps you engaged and happy, and potentially lowers stress."

https://www.sciencedaily.com/releases/2023/07/230720124958.htm

Social isolation linked to lower brain volume

July 12, 2023

Science Daily/American Academy of Neurology

Older people who have little social contact with others may be more likely to have loss of overall brain volume, and in areas of the brain affected by dementia, than people with more frequent social contact, according to a study published in the July 12, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study does not prove that social isolation causes brain shrinkage; it only shows an association.

"Social isolation is a growing problem for older adults," said study author Toshiharu Ninomiya, MD, PhD, of Kyushu University in Fukuoka, Japan. "These results suggest that providing support for people to help them start and maintain their connections to others may be beneficial for preventing brain atrophy and the development of dementia."

The study involved 8,896 people with an average age of 73 who did not have dementia. They had MRI brain scans and health exams. To determine social contact, people were asked one question: How often are you in contact with relatives or friends who do not live with you (e.g., meeting or talking on the phone)? The choices for answering were every day, several times a week, several times a month and seldom.

The people with the lowest amount of social contact had overall brain volume that was significantly lower than those with the most social contact. The total brain volume, or the sum of white and grey matter, as a percentage of the total intracranial volume, or the volume within the cranium, including the brain, meninges, and cerebrospinal fluid, was 67.3% in the lowest contact group compared to 67.8% in the highest contact group. They also had lower volumes in areas of the brain such as the hippocampus and amygdala that play a role in memory and are affected by dementia.

The researchers took into account other factors that could affect brain volume, such as age, diabetes, smoking and exercise.

The socially isolated people also had more small areas of damage in the brain, called white matter lesions, than the people with frequent social contact. The percentage of intracranial volume made up of white matter lesions was 0.30 for the socially isolated group, compared to 0.26 for the most socially connected group.

The researchers found that symptoms of depression partly explained the relationship between social isolation and brain volumes. However, symptoms of depression accounted for only 15% to 29% of the association.

"While this study is a snapshot in time and does not determine that social isolation causes brain atrophy, some studies have shown that exposing older people to socially stimulating groups stopped or even reversed declines in brain volume and improved thinking and memory skills, so it's possible that interventions to improve people's social isolation could prevent brain volume loss and the dementia that often follows," Ninomiya said.

Since the study involved only older Japanese people, a limitation is that the findings may not be generalizable to people of other ethnicities and younger people.

https://www.sciencedaily.com/releases/2023/07/230712165229.htm

Lower levels of physical activity can protect against depression among older adults

Major new study shows even moderate daily activity can lower risk of depressive symptoms

July 11, 2023

Science Daily/University of Limerick

Brand new research from University of Limerick in Ireland has revealed that even moderate daily physical activity can reduce the risk of depression.

The new study, conducted by physical activity and mental health experts at University of Limerick and Trinity College Dublin, has shown that a physical activity dose equivalent to just 20 minutes a day (for five days a week) of moderate-intensity physical activity, like brisk walking, was linked with less risk of depressive symptoms and odds of major depression.

The study, funded by Ireland's Health Research Board, has just been published in the JAMA Network Open journal.

Depression is unfortunately increasingly common among older adults, and has significant risk factors for major chronic conditions, including cognitive decline, cardiovascular disease and chronic pain, and increased risk of death and suicide.

Depression causes over 5-10% of the burden of all diseases in Europe and the economic cost in the United States alone is estimated to be over $210.5 billion. Identifying potentially easy and low-cost health and lifestyle solutions that could reduce the risk of depression remains a top priority.

Recent research has shown moderate-to-vigorous physical activity (MVPA) was linked with benefits for depression.

"However," explained Dr Eamon Laird, lead author on the paper and a post-doctoral researcher in the Department of Physical Education and Sport Sciences at UL, "there is no agreement on how much physical activity is protective for depression overall, or how this may vary among adults with disease.

"For this work, we used 10 years of data from the Irish Longitudinal Study On Ageing which included information on depression, MVPA, and other key health-related variables such as disease, lifestyle factors and socio-economic status.

"We sought to identify the lowest dose of MVPA associated with protection against Major Depression and depressive symptoms and the extent to which this varied based on the presence of chronic disease," added Dr Laird.

Key findings from the study include:

• A physical activity dose equivalent to 20 minutes a day of MVPA (brisk walking) for five days per week was associated with a 16% lower rate of depressive symptoms and 43% lower odds of Major Depression

• A dose-response effect was found, such that more MVPA was associated with greater protection for Depression;

- Specifically, doses equivalent to ~30 minutes a day of MVPA were associated with 7% lower risk of depressive symptoms and 44% lower odds of Major Depression;

- Doses equivalent to ~60 minutes a day of MVPA were associated with: 16% lower risk of depressive symptoms and 41% lower odds of Major Depression;

- Doses equivalent to ~120 minutes a day of MVPA were associated with: 23% lower risk depressive symptoms and 49% lower odds of Major Depression

• These findings remained significant even after controlling for relevant health-related factors like biological sex, education, age, smoking and alcohol, obesity, antidepressant use and time.

• These findings were also materially the same for older adults with and without a chronic illness.

According to Dr Laird: "This study is very relevant given the high prevalence of depression in our increasing older adult population. Physical activity at lower doses than World Health Organization recommendations for overall health may offer protection against depressive symptoms and Major Depression -- at minimum, try to engage in 20 minutes a day of moderate-intensity activity at least five days per week, with more benefits seen at higher doses.

"Try and build it into a routine with hobbies or activities you enjoy and trying to do it with others as social interactions particularly with activity can also have mental health benefits. Remember that it is one component, and that nutrition and healthy lifestyle will also give additive benefits in addition to the physical activity."

Dr Matthew Herring, a Senior Lecturer and Investigator in the Physical Activity for Health Research Centre at UL and Principal Investigator of this HRB-funded research, added: "The current findings have significant implications in highlighting that significant antidepressant benefits appear to be associated with doses of physical activity that are lower than current World Health Organization recommendations for overall health, though greater doses were associated with stronger protection.

"We are clearly not advocating for lower physical activity among the older adult population, but findings suggest that the largest improvements in protection against depression among older adults may be made by engaging inactive older adults in physical activity even at doses below those recommended for overall health."

https://www.sciencedaily.com/releases/2023/07/230711133208.htm

Older adults who remain more active have a better quality of life

July 4, 2023

Science Daily/University of Cambridge

A reduction in the amount of time spent physically active when adults are over sixty years old is linked to lower quality of life, a Cambridge study of almost 1,500 adults has shown.

The same was also true for increases in the amount of sedentary time, such as watching TV or reading. The researchers say this highlights the need to encourage older adults to remain active.

Physical activity -- particularly when it is moderate-intensity and raises your heart rate -- is known to reduce the risk of a number of diseases, including heart disease, stroke, diabetes and cancer. The NHS recommends that adults do at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity a week. Older adults are also recommended to break up prolonged periods of being sedentary with light activity when physically possible, or at least with standing, as this has distinct health benefits for older people.

A team led by researchers at the University of Cambridge examined activity levels among 1,433 participants aged 60 and above using accelerometers. The participants had been recruited to the EPIC (European Prospective Investigation into Cancer)-Norfolk study.

Alongside this, the team also looked at health-related quality of life, a measure of health and wellbeing that includes pain, ability to care for yourself and anxiety/mood. Participants were given a score between 0 (worst quality of life) and 1 (best) based on their responses to a questionnaire. Lower quality of life scores are linked with an increased risk of hospitalisation, worse outcomes following hospitalisation, and early death.

Participants were followed up an average of just under six years later to look at changes in their behaviour and quality of life. The results of the study are published in Health and Quality of Life Outcomes.

On average, six years after their first assessment, both men and women were doing around 24 minutes less moderate-to-vigorous physical activity per day. At the same time, the total sedentary time increased by an average of around 33 minutes a day for men and around 38 minutes a day for women.

Those individuals who did more moderate-to-vigorous physical activity and spent less time sedentary at their first assessment had a higher quality of life later on. An hour a day spent more active was associated with a 0.02 higher quality of life score.

For every minute a day less of moderate-to-vigorous physical activity measured six years after the first assessment, quality of life scores dropped by 0.03. This means that an individual who spent 15 minutes a day less engaged in such activity would have seen their score drop by 0.45.

Increases in sedentary behaviours were also associated with poorer quality of life -- a drop in the score of 0.012 for everyone minute a day increase in total sedentary time six years after the first measurement. This means that an individual who spent 15 minutes a day more sitting down would have seen their score drop by 0.18.

To put the results into a clinical context, a 0.1 point improvement in quality of life scores has previously been associated with a 6.9% reduction in early death and a 4.2% reduction in risk of hospitalisation.

Dr Dharani Yerrakalva from the Department of Public Health and Primary Care at the University of Cambridge said: "Keeping yourself active and limiting -- and where you can, breaking up -- the amount of time you spend sitting down is really important whatever stage of life you're at. This seems to be particularly important in later life, when it can lead to potentially significant improvements to your quality of life and your physical and mental wellbeing."

Because the team measured physical activity and sedentary behaviour at different points of time, they say they can be reasonably confident that they have shown a causal link -- that is, that quality of life improves becausepeople remain more physically active, for example.

Dr Yerrakalva added: "There are several ways in which improvements in our physical behaviours might help maintain a better quality of life. For example, more physical activity reduces pain in common conditions such as osteoarthritis, and we know that being more physically active improves muscle strength which allows older adults to continue to care for themselves. Similarly, depression and anxiety are linked to quality of life, and can be improved by being more active and less sedentary."

The EPIC-Norfolk study is funded by the Medical Research Council and Cancer Research UK.

Five ways to keep yourself physically-active in older age

• A brisk daily walk -- ideally for around 20 minutes

• Gardening

• A bicycle ride

• Dancing

• Tennis

https://www.sciencedaily.com/releases/2023/07/230704110923.htm

Poor sense of smell linked to increased risk of depression in older adults

June 26, 2023

Science Daily/Johns Hopkins Medicine

In a study that followed more than 2,000 community-dwelling older adults over eight years, researchers at Johns Hopkins Medicine say they have significant new evidence of a link between decreased sense of smell and risk of developing late-life depression.

Their findings, published June 26 in Journal of Gerontology: Medical Sciences, do not demonstrate that loss of smell causes depression, but suggests that it may serve as a potent indicator of overall health and well-being.

"We've seen repeatedly that a poor sense of smell can be an early warning sign of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease, as well as a mortality risk. This study underscores its association with depressive symptoms," says Vidya Kamath, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "Additionally, this study explores factors that might influence the relationship between olfaction and depression, including poor cognition and inflammation."

The study used data gathered from 2,125 participants in a federal government study known as the Health, Aging and Body Composition Study (Health ABC). This cohort was composed of a group of healthy older adults ages 70-73 at the start of the eight-year study period in 1997-98. Participants showed no difficulties in walking 0.25 miles, climbing 10 steps or performing normal activities at the start of the study, and were assessed in person annually and by phone every six months. Tests included those for the ability to detect certain odors, depression and mobility assessments.

In 1999, when smell was first measured, 48% of participants displayed a normal sense of smell, 28% showed a decreased sense of smell, known as hyposmia, and 24% had a profound loss of the sense, known as anosmia. Participants with a better sense of smell tended to be younger than those reporting significant loss or hyposmia. Over follow-up, 25% of participants developed significant depressive symptoms. When analyzed further, researchers found that individuals with decreased or significant loss of smell had increased risk of developing significant depressive symptoms at longitudinal follow-up than those in the normal olfaction group. Participants with a better sense of smell tended to be younger than those reporting significant loss or hyposomia.

Researchers also identified three depressive symptom "trajectories" in the study group: stable low, stable moderate and stable high depressive symptoms. Poorer sense of smell was associated with an increased chance of a participant falling into the moderate or high depressive symptoms groups, meaning that the worse a person's sense of smell, the higher their depressive symptoms. These findings persisted after adjusting for age, income, lifestyle, health factors and use of antidepressant medication.

"Losing your sense of smell influences many aspects of our health and behavior, such as sensing spoiled food or noxious gas, and eating enjoyment. Now we can see that it may also be an important vulnerability indicator of something in your health gone awry," says Kamath. "Smell is an important way to engage with the world around us, and this study shows it may be a warning sign for late-life depression."

Humans' sense of smell is one of two chemical senses. It works through specialized sensory cells, called olfactory neurons, which are found in the nose. These neurons have one odor receptor; it picks up molecules released by substances around us, which are then relayed to the brain for interpretation. The higher the concentration of these smell molecules the stronger the smell, and different combinations of molecules result in different sensations.

Smell is processed in the brain's olfactory bulb, which is believed to interact closely with the amygdala, hippocampus and other brain structures that regulate and enable memory, decision-making and emotional responses.

The Johns Hopkins researchers say their study suggests that olfaction and depression may be linked through both biological (e.g., altered serotonin levels, brain volume changes) and behavioral (e.g., reduced social function and appetite) mechanisms.

The researchers plan to replicate their findings from this study in more groups of older adults, and examine changes to individuals' olfactory bulbs to determine if this system is in fact altered in those diagnosed with depression. They also plan to examine if smell can be used in intervention strategies to mitigate risk of late-life depression.

https://www.sciencedaily.com/releases/2023/06/230626164246.htm

Fighting loneliness by finding purpose

June 26, 2023

Science Daily/Washington University in St. Louis

A sense of purpose in life -- whether it's a high-minded quest to make a difference or a simple hobby with personal meaning -- can offer potent protection against loneliness, according to new research.

A new study co-authored by Patrick Hill, associate professor of psychological and brain sciences, offers an important message for our times: A sense of purpose in life -- whether it's a high-minded quest to make a difference or a simple hobby with personal meaning -- can offer potent protection against loneliness.

"Loneliness is known to be one of the biggest psychological predictors for health problems, cognitive decline, and early mortality," Hill said. "Studies show that it can be as harmful for health as smoking or having a poor diet."

The new study, based on surveys of more than 2,300 adults in Switzerland, found that feelings of loneliness were less common in people who reported a purposeful life, regardless of their age. It was co-authored by Mathias Allemand of the University of Zurich in Switzerland and Gabriel Olaru of Tilburg University in the Netherlands.

Respondents were asked to score their feelings on a lack of companionship, isolation from other people, and a sense of being "left out or passed over" during a four-week period. Participants also filled out the six-item Life Engagement Test, which asked them to rate statements such as "there is not enough purpose in my life" and "I value my activities a lot."

"A sense of purpose is this general perception that you have something leading and directing you from one day to the next," Hill said. "It can be something like gardening, supporting your family, or achieving success at work."

Many of the activities that can provide a sense of purpose -- joining a club, volunteering at a school, playing in a sports league -- involve interaction with others, which is one reason why a purpose-filled life tends to be less lonely. In the study, people who said they received or provided social support were especially likely to report feelings of purpose.

But Hill noted that there's more to fighting loneliness than simply being around others. "We've all had time in our lives when we've felt lonely even though we weren't actually alone." There's something about having a sense of purpose that seems to fight loneliness regardless of how many other people are involved, he said.

The study found a slight uptick in reports of loneliness for people in their 70s and beyond, an age when a sense of purpose can be especially important. "We're trying to dispel the myth from previous generations that this is simply a time for retiring and resting," Hill said. "There are no downsides to finding something meaningful later in life."

Still, it's important to keep in mind that a quest for purpose can be somewhat self-defeating if taken too seriously. "Feeling like you need to save the world can lead to existential dread and distress," Hill said. When it comes to purpose and meaning, even small things can matter. "It's OK if someone else thinks that your purpose is trivial, as long as it's meaningful to you."

https://www.sciencedaily.com/releases/2023/06/230626164203.htm

Lean body mass, age linked with alcohol elimination rates in women

June 26, 2023

Science Daily/University of Illinois at Urbana-Champaign, News Bureau

Research links women's lean body mass with how quickly they eliminate alcohol from their system. Women with obesity and those who are older eliminate alcohol from their bloodstreams faster than those of normal weight and those who are younger.

The rate at which women eliminate alcohol from their bloodstream is largely predicted by their lean body mass, although age plays a role, too, scientists found in a new study. Women with obesity -- and those who are older -- clear alcohol from their systems 52% faster than women of healthy weights and those who are younger, the study found.

Lean body mass is defined in the study -- published in the journal Alcohol Clinical and Experimental Research -- as one's total body weight minus fat.

"We believe the strong relationship we found between participants' lean body mass and their alcohol elimination rate is due to the association that exists between lean body mass and lean liver tissue -- the part of the liver responsible for metabolizing alcohol," said research group leader M. Yanina Pepino, a professor of food science and human nutrition at the University of Illinois Urbana-Champaign.

To explore links between body composition and alcohol elimination rates, the team conducted a secondary analysis of data from a study performed at the U. of I and another at Indiana University, Indianapolis. Both projects used similar methods to estimate the rate at which alcohol is broken down in the body.

The combined sample from the studies used in the analysis included 143 women who ranged in age from 21 to 64 and represented a wide range of body mass indices -- from healthy weights to severe obesity. Among these were 19 women who had undergone different types of bariatric surgery.

In a subsample of 102 of these women, the researchers had measured the proportions of lean and fat tissue in their bodies and calculated their body mass indices. Based on their BMI, those in the subsample were divided into three groups: normal weight, which included women with BMI ranging from 18.5-24.9; overweight, those with BMI ranging from 25-29.9; and obese, participants with BMI above 30.

As the researchers expected, women with higher BMI had not only more fat mass than women of healthy weights, they also had more lean mass. On average, the group with obesity had 52.3 kg of lean mass, compared with 47.5 kg for the normal weight group.

The two studies both used an alcohol clamp technique, where participants received an intravenous infusion of alcohol at a rate controlled by a computer-assisted system. The system calculated personalized infusion rates based upon each participant's age, height, weight and gender and was programmed so they would reach a target blood alcohol concentration of .06 percent within 15 minutes and maintain that level for about two hours

Using a breathalyzer, breath samples were collected at regular intervals throughout the experiments to estimate participants' blood alcohol concentration and provide feedback to the system.

"We found that having a higher fat-free body mass was associated with a faster alcohol elimination rate, particularly in women in the oldest subgroups," said Neda Seyedsadjadi, a postdoctoral fellow at the university and the first author of the study.

"The average alcohol elimination rates were 6 grams per hour for the healthy weight group, 7 grams for the overweight group, and 9 grams for the group with obesity," she said. "To put this in perspective, one standard drink is 14 grams of pure alcohol, which is found in 12 ounces of beer, 5 ounces of table wine or 1.5 ounces shot of distilled spirits."

The interaction between participants' age and lean body mass accounted for 72% of the variance in the time required to eliminate the alcohol from their system, the team found.

Pepino, who also holds an appointment as a health innovation professor at Carle Illinois College of Medicine, has conducted several studies on alcohol response in bariatric surgery patients.

The findings also shed light on alcohol metabolism and body composition in women who have undergone weight loss surgery. Researchers have long known that bariatric surgery alters women's response to alcohol but were uncertain if it affected how quickly they cleared alcohol from their systems.

Some prior studies found that these patients metabolized alcohol more slowly after they had weight loss surgery. The new study's findings indicate that these participants' slower alcohol elimination rates can be explained by surgery-induced reductions in their lean body mass. Weight loss surgery itself had no independent effects on patients' alcohol elimination rates, the team found.

https://www.sciencedaily.com/releases/2023/06/230626164151.htm