Feelings of fatigue predict early death in older adults
January 24, 2022
Science Daily/University of Pittsburgh
How fatigued certain activities make an older person feel can predict the likelihood death is less than three years away, according to research published today in the Journal of Gerontology: Medical Sciencesby University of Pittsburgh epidemiologists. It is the first study to establish perceived physical fatigability as an indicator of earlier mortality.
Older people who scored the highest in terms of how tired or exhausted they would feel after activities were more than twice as likely to die in the following 2.7 years compared to their counterparts who scored lower. Fatigability was assessed for a range of activities using the novel Pittsburgh Fatigability Scale.
"This is the time of year when people make -- and break -- New Year's resolutions to get more physical activity," said lead author Nancy W. Glynn, Ph.D., associate professor in the Department of Epidemiology at Pitt's Graduate School of Public Health. "I hope our findings provide some encouragement to stick with exercise goals. Previous research indicates that getting more physical activity can reduce a person's fatigability. Our study is the first to link more severe physical fatigability to an earlier death. Conversely, lower scores indicate greater energy and more longevity."
Glynn and her colleagues administered the Pittsburgh Fatigability Scale to 2,906 participants aged 60 or older in the Long Life Family Study, an international study that follows family members across two generations. Participants ranked from 0 to 5 how tired they thought or imagined that certain activities -- such as a leisurely 30-minute walk, light housework or heavy gardening -- would make them.
Follow-up for this work concluded at the end of 2019, to avoid any increased mortality impact from the COVID-19 pandemic, which gave the team an average of 2.7 years of data on each participant. After accounting for a variety of factors that influence mortality, such as depression, pre-existing or underlying terminal illness, age and gender, the team found that participants who scored 25 points or higher on the Pittsburgh Fatigability Scale were 2.3 times more likely to die in the 2.7 years after completing the scale, compared to their counterparts who scored below 25.
"There has been research showing that people who increase their physical activity can decrease their fatigability score," said Glynn, a physical activity epidemiologist. "And one of the best ways to increase physical activity -- which simply means moving more -- is by setting manageable goals and starting a routine, like a regular walk or scheduled exercise."
Beyond tying high fatigability to an earlier death, Glynn said the study demonstrates the value of the Pittsburgh Fatigability Scale, which she and colleagues created in 2014. It has since been translated into 11 languages.
"While the Pittsburgh Fatigability Scale has been widely adopted in research as a reliable, sensitive way to measure fatigability, it is underutilized in hospital settings and clinical trials," Glynn said. "My ultimate goal is to develop a physical activity intervention targeting a reduction in fatigability as a means to stem the downward spiral of impaired physical function common with the aging process. By reducing fatigability, one can change how they feel, potentially motivating them to do more."
Additional authors on this research are Theresa Gmelin, M.S.W., M.P.H., Yujia (Susanna) Qiao, Sc.M., Robert M. Boudreau, Ph.D., Kaare Christensen, M.D., and Anne B. Newman, M.D., all of Pitt; Sharon Renner, Ph.D., of Columbus State University; Mary F. Feitosa, Ph.D., of Washington University in St. Louis; Stephanie Cosentino, Ph.D., of Columbia University, and Stacy L. Andersen, Ph.D., of Boston University.
This research was supported by the National Institutes of Health's National Institute on Aging grants U01 AG023712, U01 AG023744, U01 AG023746, U01 AG023749, U01 AG023755, P01 AG08761, U19 AG063893, T32 AG000181 and K01 AG0057798.
https://www.sciencedaily.com/releases/2022/01/220124084616.htm
Trends in binge drinking among older men and women in the United States
December 8, 2021
Science Daily/Wiley
Binge drinking has increased in recent years among older U.S. men but not among older women, according to a study published in the Journal of the American Geriatrics Society.
The study included 18,794 adults aged 65 years and older who participated in the 2015-2019 National Survey on Drug Use and Health. Binge drinking was defined as consuming 5 or more drinks on the same occasion for men and 4 or more drinks for women.
Binge drinking among older men increased from 12.8% in 2015 to 15.7% in 2019 but remained stable among older women (7.6% to 7.3%). Having a college degree was associated with a higher risk of binge drinking among women but a lower risk among men. Men who were separated or divorced were also at higher risk, but women were not. Both men and women who reported use of tobacco or cannabis in the past month were at higher risks of binge drinking.
"Our study brings the most up-to-date findings on trends in binge drinking in older age, especially the unnoticed importance of understanding the unique demographic characteristics of binge drinking that differ in men and women given gender norms and expectations of societies that are consistently evolving. For example, we noted an increased frequency in education among binge drinking older women. Women with more education may have more opportunities to drink and may be less constricted by gender norms against women consuming alcohol," said lead author Tala Al-Rousan, MD, MPH, of the University of California, San Diego. "Moreover, our findings would encourage health providers who care for older men and women with chronic conditions who are at risk of binge drinking to offer tailored messages that are targeted at certain chronic conditions."
https://www.sciencedaily.com/releases/2021/12/211208090023.htm
Poor sleep linked to feeling older and worse outlook on aging, which can impact health
November 22, 2021
Science Daily/University of Exeter
Poor sleep in the over 50s is linked to more negative perceptions of ageing, which in turn can impact physical, mental and cognitive health, new research has revealed.
A study led by the University of Exeter and found that people who rated their sleep the worst also felt older, and perceived their own physical and mental ageing more negatively.
Lead author Serena Sabatini, of the University of Exeter, said: "As we age, we all experience both positive and negative changes in many areas of our lives. However, some people perceive more negative changes than others. As we know that having a negative perception of ageing can be detrimental to future physical health, mental health, and cognitive health, an open question in ageing research is to understand what makes people more negative about ageing. Our research suggests that poor sleepers feel older, and have a more negative perception of their ageing. We need to study this further - one explanation could be that a more negative outlook influences both. However, it could be a sign that addressing sleep difficulties could promote a better perception of ageing, which could have other health benefits."
Researchers surveyed 4,482 people aged 50 and over who are part of the PROTECT study. Run by the University of Exeter and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, and funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, PROTECT is an innovative online study in which participants take regular cognitive tests and complete lifestyle questionnaires. The study aims to understand what helps people stay cognitively healthy in later life.
The research team noticed that many PROTECT participants were commenting on their relationship with sleep as part of standard questionnaires within the study. Comments included: "How I feel fluctuates widely depending on my sleep. I feel great if I get six hours so about half the time I feel younger and half the time I feel older!"
Another comment read: "I have chronic pain problems and get very little sleep which impacts on my life quite a lot."
As a result of such comments, the team decided to conduct a questionnaire looking specifically at sleep. In the research, published in Behavioral Sleep Medicine, participants were asked whether they had experienced a list of negative age-related changes, such as poorer memory, less energy, increased dependence on the help of others, decreased motivation, and having to limit their activities. They also rated their quality of sleep. The participants completed both questionnaires twice, one year apart.
Professor Clive Ballard, of the University of Exeter, said: "This research is an important part of the growing body of evidence about the crucial role of sleep in healthy ageing. We now need more people to sign up to PROTECT, to help us understand this further. We've got some exciting trials ahead on how to optimise sleep in some particularly vulnerable groups, such as people with dementia in care homes."
https://www.sciencedaily.com/releases/2021/11/211122135512.htm
A diet rich in plant-based products reduces the risk of cognitive impairment in the elderly
Metabolomics to study the impact of diet on health
December 9, 2021
Science Daily/University of Barcelona
A diet rich in plant products reduces the risk of cognitive impairment and dementia in the elderly. This is the result of a study by the Biomarkers and Nutritional Food Metabolomics Research Group of the Faculty of Pharmacy and Food Sciences of the University of Barcelona (UB) and the CIBER on Frailty and Healthy Aging (CIBERFES).
The paper, published in the journal Molecular Nutrition and Food Research, is led by Cristina Andrés-Lacueva, professor at the Faculty of Pharmacy and Food Sciences and head of the Biomarkers and Nutritional Metabolomics of Food Research Group of the UB and the Biomedical Research Network Center in Frailty and Healthy Aging (CIBERFES), which is also part of the Food Innovation Network of Catalonia (XIA).
This European study, part of the Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL), was carried out over 12 years with the participation of 842 people aged over 65 in the Bordeaux and Dijon regions (France).
Metabolomics to study the impact of diet on health
The study analyses the relationship between the metabolism of dietary components, intestinal microbiota, endogenous metabolism and cognitive impairment. As Mireia Urpí-Sardà, from the Department of Nutrition, Food Science and Gastronomy and CIBERFES, notes, "what we analysed in the cohorts under study is the modulating role of the diet in the risk of suffering cognitive impairment." Urpí-Sardà points out that "the results show a significant association between these processes and certain metabolites."
The results reveal a protective association between metabolites derived from cocoa, coffee, mushrooms and red wine, microbial metabolism of polyphenol-rich foods (apple, cocoa, green tea, blueberries, oranges or pomegranates) and cognitive impairment in the elderly.
The analysis of plasma samples indicated that some metabolites are related to the progression of cognitive impairment and dementia. As Professor Cristina Andrés-Lacueva explains, "for example, 2-furoylglycine and 3-methylanthine, which are biomarkers of coffee and cocoa consumption, had a protective profile, while saccharin -derived from the consumption of artificial sweeteners- is associated with a damaging role."
Mercè Pallàs, professor at the Faculty of Pharmacy and Food Sciences and member of the Institute of Neurosciences (UBNeuro) of the UB, stresses that "the study of the relationship between cognitive impairment, the metabolism of the microbiota and food and endogenous metabolism is essential to develop preventive and therapeutic strategies that help to take care of our cognitive health."
Dietary changes for a healthy cognitive aging
Therefore, changes in lifestyle and diet are decisive as a strategy to prevent cognitive deterioration and its progression in neurodegenerative diseases such as Alzheimer's and other dementias. "A higher intake of fruits, vegetables and plant-based foods provides polyphenols and other bioactive compounds that could help reduce the risk of cognitive decline due to ageing," says Cristina Andrés-Lacueva.
https://www.sciencedaily.com/releases/2021/12/211209124448.htm
Trends in binge drinking among older men and women in the United States
December 8, 2021
Science Daily/Wiley
Binge drinking has increased in recent years among older U.S. men but not among older women, according to a study published in the Journal of the American Geriatrics Society.
The study included 18,794 adults aged 65 years and older who participated in the 2015-2019 National Survey on Drug Use and Health. Binge drinking was defined as consuming 5 or more drinks on the same occasion for men and 4 or more drinks for women.
Binge drinking among older men increased from 12.8% in 2015 to 15.7% in 2019 but remained stable among older women (7.6% to 7.3%). Having a college degree was associated with a higher risk of binge drinking among women but a lower risk among men. Men who were separated or divorced were also at higher risk, but women were not. Both men and women who reported use of tobacco or cannabis in the past month were at higher risks of binge drinking.
"Our study brings the most up-to-date findings on trends in binge drinking in older age, especially the unnoticed importance of understanding the unique demographic characteristics of binge drinking that differ in men and women given gender norms and expectations of societies that are consistently evolving. For example, we noted an increased frequency in education among binge drinking older women. Women with more education may have more opportunities to drink and may be less constricted by gender norms against women consuming alcohol," said lead author Tala Al-Rousan, MD, MPH, of the University of California, San Diego. "Moreover, our findings would encourage health providers who care for older men and women with chronic conditions who are at risk of binge drinking to offer tailored messages that are targeted at certain chronic conditions."
https://www.sciencedaily.com/releases/2021/12/211208090023.htm
Taking it easy as you get older? Wrong
New research outlines how longer lives are tied to physical activity
November 22, 2021
Science Daily/Harvard University
A team of evolutionary biologists and biomedical researchers lay out evolutionary and biomedical evidence showing that humans, who evolved to live many decades after they stopped reproducing, also evolved to be relatively active in their later years. The researchers say that physical activity later in life shifts energy away from processes that can compromise health and toward mechanisms in the body that extend it. They hypothesize that humans evolved to remain physically active as they age -- and in doing so to allocate energy to physiological processes that slow the body's gradual deterioration over the years. This guards against chronic illnesses such as cardiovascular disease, type 2 diabetes, and even some cancers.
Just about everyone knows that exercise is good for you. Some people can even rattle off reasons it keeps your muscles and joints strong, and how it fights off certain diseases. But how many people can tell you the story of why and how physical activity was built into human biology?
A team of evolutionary biologists and biomedical researchers from Harvard are taking a run at it (sometimes literally) in a new study published in PNAS. The work lays out evolutionary and biomedical evidence showing that humans, who evolved to live many decades after they stopped reproducing, also evolved to be relatively active in their later years.
The researchers say that physical activity later in life shifts energy away from processes that can compromise health and toward mechanisms in the body that extend it. They hypothesize that humans evolved to remain physically active as they age -- and in doing so to allocate energy to physiological processes that slow the body's gradual deterioration over the years. This guards against chronic illnesses such as cardiovascular disease, type 2 diabetes, and even some cancers.
"It's a widespread idea in Western societies that as we get older, it's normal to slow down, do less, and retire," said Harvard evolutionary biologist?Daniel E. Lieberman, the paper's lead author. "Our message is the reverse: As we get older, it becomes even more important to stay physically active."
The research team, which includes Aaron Baggish and I-Min Lee from Harvard Medical School, believes the paper is the first detailed evolutionary explanation for why lack of physical activity as humans age increases disease risk and reduces longevity.
Baggish, 47, who also serves as team cardiologist for the New England Patriots and U.S. Soccer, and Lieberman, 57, are longtime running buddies and often discussed the ideas that went into the paper during 5-to-10-mile morning runs.
The study uses humans' ape cousins as a jumping off point. The researchers point out that apes, which usually live only about 35 to 40 years in the wild and rarely survive past menopause, are considerably less active than most humans, suggesting that there was selection in human evolution not just to live longer but also to be more physically active.
"We evolved basically from couch potatoes," said Lieberman, who has twice observed wild chimpanzees in Tanzania and been surprised by how much of their day is spent "sitting on their butts, digesting."
This is especially jarring when contrasted against contemporary hunter-gatherers, who average about 135 minutes of moderate to vigorous physical activity a day. That level of movement -- about six to ten times more than average Americans -- may be one of the keys to why hunter-gatherers who survive childhood tend to live about seven decades, approximately 20 years past the age at which humans generally stop having children. Fossil evidence indicates that these extended lifespans were common by 40,000 years ago, contrary to the belief that human lifespans until recently were short.
The team emphasized that the key health benefit of physical activity is to extend the human healthspan, which is defined as the years of life spent in good health.
Researchers examined two pathways by which lifelong physical activity reallocates energy to improve health. The first involves dealing excess energy away from potentially harmful mechanisms, like excess fat storage. The team also identified how physical activity allocates energy to repair and maintenance processes. The paper shows that besides burning calories, physical activity is physiologically stressful, causing damage to the body at the molecular, cellular, and tissue levels. The body's response to this damage, however, is essentially to build back stronger.
This includes repairing tears in muscle fibers, repairing cartilage damage, and healing microfractures. The response also causes the release of exercise-related antioxidants and anti-inflammatories, and enhances blood flow. In the absence of physical activity, these responses are activated less. The cellular and DNA repair processes have been shown to lower the risk of diabetes, obesity, cancer, osteoporosis, Alzheimer's, and depression.
"The key take-home point is that because we evolved to be active throughout our lives, our bodies need physical activity to age well. In the past, daily physical activity was necessary in order to survive, but today we have to choose to exercise, that is do voluntary physical activity for the sake of health and fitness," Lieberman said.
The research team, which includes the graduate students Timothy Kistner and Daniel Richard, hope the study makes that message harder to ignore.
Physical activity levels have been decreasing worldwide as machines and technology replace human labor. A recent study from Lieberman's lab showed that Americans are engaging in less physical activity than they did 200 years ago.
The researchers' advice? Get out of your chair and get in some exercise.
"The key is to do something, and to try to make it enjoyable so you'll keep doing it," Lieberman said. "The good news is that you don't need to be as active as a hunter-gatherer. Even small amounts of physical activity -- just 10 or 20 minutes a day -- substantially lower your risk of mortality."
https://www.sciencedaily.com/releases/2021/11/211122172720.htm
Ground-breaking trial prevents loneliness among older people during Covid pandemic
October 12, 2021
Science Daily/University of York
A simple form of talking therapy, delivered by trained support workers over the telephone, reduced loneliness in older people left isolated during the pandemic, the initial results of a new study has revealed.
People were contacted weekly and were encouraged to maintain their social contacts and to stick to a daily schedule, which included both routine and enjoyable activities.
The intervention developed in the BASIL-C19 (Behavioural Activation in Social Isolation) study lasted for eight weeks and was designed in partnership with older people who had direct experience of social isolation, loneliness and depression during the pandemic.
The pandemic, and the restrictions that were imposed, has highlighted the importance of good mental health and social connection. Research conducted before the pandemic struck identified 1.4million older adults in England as experiencing significant loneliness with impacts on their mental health. Research since the pandemic shows that rates of loneliness and depression have increased, particularly for those who were self-isolating.
A team of leading researchers and clinicians anticipated the impacts of the pandemic on mental health and re-focussed their research expertise to examine the psychological impact of enforced isolation, disruption to daily routines, loss of social contact and loneliness.
The team included academics from the universities of York, including Hull York Medical School, Leeds, Keele and Manchester, and Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust, in partnership with leading charity, AgeUK.
They designed a very brief telephone delivered intervention to combat depression and loneliness. Older people appreciated the offer of telephone contact and they found the intervention to be helpful in maintaining daily routines and social contact.
The preliminary results have now been published in the leading journal PLOS Medicine. The research team found that there was evidence of improved mental health, and a strong indication that rates of loneliness are reduced substantially in the first three months. Building on these exciting early results, a much larger trial follow-on trial is currently recruiting at over 12 sites across England and Wales. The study will include over 600 older people and is the largest study ever undertaken to tackle loneliness and depression in this way.
The study was led from York by Professor Simon Gilbody, Director of the Mental Health & Addictions Research Group (MHARG) at the University of York and Hull York Medical School, and Professor David Ekers, Clinical Director for research and development at TEWV NHS Foundation Trust and Honorary Professor at the University of York.
Professor Gilbody said: "Our University-NHS partnership was ideally placed to respond to societal challenges of COVID-19.
"Older people and those with long term conditions entered enforced isolation, and this was very disruptive to people's lives.
"We predicted increased rates of loneliness and depression for this vulnerable population, and we knew what might work to prevent this. Care in the NHS must be informed by the highest quality of evidence and we did not waste any time in deciding to set up a clinical trial to test this out.
"The research undertaken in the NHS is acknowledged to be world-leading in terms of its scale, rigour and impact. The NHS has led the way in understanding how best to respond to the pandemic.
"The first results of the pilot trial are now available, and there is now emerging evidence that it is possible to prevent loneliness and potentially improve mental health."
Professor Carolyn Chew-Graham, a GP and leading researcher in the mental health of older people, based at Keele University added: "COVID-19 has unfortunately impacted on the mental health of older people. We know that social isolation can cause people to suffer from loneliness, low mood and anxiety. In this study, we tested how we can maintain older people's mental health during this difficult time."
Professor David Ekers added: "We have been researching in this area for the past 10 years, and we are ideally placed to help establish 'what works' in maintaining good mental health during the lockdown.
"This represents a great alliance between the Universities and the NHS to address the major challenges posed by COVID. Even as restrictions are lifted, many people remain socially isolated. The results of our research programme will be useful in the future in tackling the epidemic of loneliness.''
The research, which is published just days after World Mental Health Day, was funded by a £2.6M grant from the National Institute for Health Research. The BASIL-C19 trial was the first trial of its kind to test the effectiveness of a psychological intervention to maintain population mental health during the pandemic.
https://www.sciencedaily.com/releases/2021/10/211012150031.htm
Higher levels of education and higher income mean better health for older adults
October 7, 2021
Science Daily/Trinity College Dublin
A new cross-national study comparing multimorbidity disease cluster patterns, prevalence and health risk factors across Ireland, England, The United States and Canada, reveal important findings that could have health implications for public health policy.
The study led by TILDA: the Irish Longitudinal Study on Ageing offers fresh insight to help health authorities better understand the complex nature of multimorbidity (a co-occurrence of two or more chronic diseases), and to identify and improve appropriate prevention and management strategies for treating these diseases across countries. All four countries ranked globally in the top 14 of the 2018 UN Human Development Index, allowing for suitable comparison across the range of public healthcare delivery systems of North America and Europe.
The study investigates lifetime prevalence of 10 common chronic, cardiovascular and mental health conditions among 62,111 older adults aged 52-85 years of age across the four countries, and uncovers how differences in demographics, socio-economic status and health behaviours affect the combination of diseases within and across four countries. The findings are a good news story for Ireland, who had the lowest prevalence for 6 out of 10 diseases compared to the other countries.
Multimorbidity is a term used to describe conditions that affect people living with two or more long-term or chronic diseases and is associated with poor health outcomes such as physical and functional decline, mortality, decreased quality of life and increased healthcare use and cost.
WHAT DID THE STUDY SHOW?
The study found that multimorbidity among those aged 52-85 years old was highest in the U.S. at 60.7% and lowest in Ireland at 38.6%. Five predominant multimorbidity patterns for each country were identified in the study, with researchers discovering that socio-economic disparity existed across all four countries, where those who had higher levels of education and higher income in general had better health. Elevated Body Mass Index (BMI) was also identified as a risk factor for high disease burden and multimorbidity across all countries.
KEY FINDINGS
The U.S. had significantly higher prevalence of hypertension, stroke, angina, heart attacks, arthritis, cancer, lung disease and psychiatric illnesses.
Despite the U.S. spending more per capita on health care than Ireland, Canada, and England, and it had the highest prevalence for 9 out of 10 common chronic, cardiovascular, and mental health conditions when compared to Ireland.
Ireland had the lowest prevalence for 6 out of 10 diseases compared to the other countries.
The U.S. had a higher prevalence of multimorbidity even after adjustments for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history.
The odds of having diabetes in the U.S. was double that of Ireland or England even after controlling for factors such as age, sex, education, income, employment status, B.M.I., smoking and alcohol consumption.
Ireland had the highest prevalence of osteoporosis of all four countries.
The link between health and wealth was present across all four countries but was most pronounced in the U.S., with higher income and higher education levels associated with lower disease prevalence and lower probability associated with multimorbidity clusters.
As the world's population is ageing and expanding rapidly, identifying early treatment and management of disease is a priority for healthcare policymakers and providers. While patients living with multimorbidity often have complex medical needs, this can result in challenges to health system capacity worldwide, requiring significant healthcare resources to meet cost, and provision of care. Preventing and improving how multimorbidity and age-related diseases are managed and treated is crucial to enhance development of sustainable and safe models of care.
Dr Belinda Hernandez, senior research fellow at TILDA, and lead author said:
"Chronic illnesses are the leading cause of death worldwide. These conditions rarely happen in isolation and commonly occur together which is known as multimorbidity. This is a particularly important issue for our health care service and for public health policy in ageing societies as multimorbid people tend to have more complex health care needs and poorer health outcomes such as reduced physical functioning and higher rates of mortality. The findings of this study can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating the unique patterns of non-communicable disease in these respective countries."
Professor Rose Anne Kenny, Principal Investigator of TILDA and co- author said:
"The findings of this study clearly outline the health concerns that affect our ageing population and are particularly relevant for those tasked with strengthening healthcare delivery in Ireland and further afield. Having an informed understanding of disease patterns for a given country can bring about a better understanding of the complex nature of multimorbidity and disease. Furthermore, research shows that preventing the development of chronic diseases may be beneficial in delaying or preventing dementia-related disease or cognitive impairment. We know that Ireland has the second highest rate of obesity in the EU, while dementia rates are estimated to more than double in the next 25 years, to over 150,000 by 2045. This research clearly outlines why targeted health interventions and campaigns are needed to encourage healthier habits and behaviours to help prevent or delay the development of disease, while supporting better health and longevity for those who age."
https://www.sciencedaily.com/releases/2021/10/211007122200.htm
Age and aging have critical effects on the gut microbiome
Study examines age-related changes to the small bowel
October 1, 2021
Science Daily Cedars-Sinai Medical Center
Researchers at Cedars-Sinai have found that aging produces significant changes in the microbiome of the human small intestine distinct from those caused by medications or illness burden. The findings have been published in the journal Cell Reports.
"By teasing out the microbial changes that occur in the small bowel with age, medication use and diseases, we hope to identify unique components of the microbial community to target for therapeutics and interventions that could promote healthy aging," said Ruchi Mathur, MD, the study's principal investigator.
Research exploring the gut microbiome, and its impact on health, has relied predominantly on fecal samples, which do not represent the entire gut, according to Mathur. In their study, investigators from Cedars-Sinai's Medically Associated Science and Technology (MAST) Program analyzed samples from the small intestine-which is over 20 feet in length and has the surface area of a tennis court-for examination of the microbiome and its relationship with aging.
"This study is the first of its kind to examine the microbial composition of the small intestine of subjects 18 years of age to 80. We now know that certain microbial populations are influenced more by medications, while others are more affected by certain diseases. We have identified specific microbes that appear to be only influenced by the chronological age of the person," said Mathur, an endocrinologist and director of the Diabetes Outpatient Treatment & Education Center.
The 21st century has been referred to as the "era of the gut microbiome" as scientists turn considerable attention to the role trillions of gut bacteria, fungi and viruses may play in human health and disease. The microbiome is the name given to the genes that live in these cells. Studies have suggested that disturbances in the constellations of the microbial universe may lead to critical illnesses, including gastroenterological diseases, diabetes, obesity, and some neurological disorders.
While researchers know that microbial diversity in stool decreases with age, Cedars-Sinai investigators identified bacteria in the small bowel they refer to as "disruptors" that increase and could be troublesome.
"Coliforms are normal residents of the intestine. We found that when these rod-shaped microbes become too abundant in the small bowel-as they do as we get older-they exert a negative influence on the rest of the microbial population. They are like weeds in a garden," said study co-author Gabriela Leite, PhD.
Investigators also found that as people age, the bacteria in the small intestine change from microbes that prefer oxygen to those that can survive with less oxygen, something they hope to understand as the research continues.
"Our goal is to identify and fingerprint the small intestinal microbial patterns of human health and disease. Given the important role the small bowel plays in absorption of nutrients, changes in the microbiome in this location of the gut may have a greater impact on human health, and warrants further study," said Mark Pimentel, MD, director of the MAST program and a co-author of the study.
This research is part of Cedars-Sinai's ongoing REIMAGINE study: Revealing the Entire Intestinal Microbiota and its Associations with the Genetic, Immunologic, and Neuroendocrine Ecosystem.
https://www.sciencedaily.com/releases/2021/10/211001135901.htm
Comparing seniors who relocate long-distance shows where you live affects your longevity
Analysis of Medicare data finds location matters, not just past health behavior.
September 1, 2021
Science Daily Massachusetts Institute of Technology
Moving to certain locations in the U.S. can have a significant impact on the longevity of senior citizens, according to new research.
Would you like to live longer? It turns out that where you live, not just how you live, can make a big difference.
That's the finding of an innovative study co-authored by an MIT economist, which examines senior citizens across the U.S. and concludes that some locations enhance longevity more than others, potentially for multiple reasons.
The results show that when a 65-year-old moves from a metro area in the 10th percentile, in terms of how much those areas enhance longevity, to a metro area the 90th percentile, it increases that person's life expectancy by 1.1 years. That is a notable boost, given that mean life expectancy for 65-year-olds in the U.S. is 83.3 years.
"There's a substantively important causal effect of where you live as an elderly adult on mortality and life expectancy across the United States," says Amy Finkelstein, a professor in MIT's Department of Economics and co-author of a newly published paper detailing the findings.
Researchers have long observed significant regional variation in life expectancy in the U.S., and often attributed it to "health capital" -- tendencies toward obesity, smoking, and related behavioral factors in the regional populations. But by analyzing the impact of moving, the current study can isolate and quantify the effect that the location itself has on residents.
As such, the research delivers important new information about large-scale drivers of U.S. health outcomes -- and raises the question of what it is about different places that affects the elderly's life expectancy. One clear possibility is the nature of available medical care. Other possible drivers of longevity include climate, pollution, crime, traffic safety, and more.
"We wanted to separate out the role of people's prior experiences and behaviors -- or health capital -- from the role of place or environment," Finkelstein says.
The paper, "Place-Based Drivers of Mortality: Evidence of Migration," is published in the August issue of the American Economic Review. The co-authors are Finkelstein, the John and Jennie S. MacDonald Professor of Economics at MIT, and Matthew Gentzkow and Heidi Williams, who are both professors of economics at Stanford University.
Comparing movers to see how place matters
To conduct the study, Finkelstein, Gentzkow, and Williams analyzed Medicare records from 1999 to 2014, focusing on U.S. residents between the ages of 65 and 99. Ultimately the research team studied 6.3 million Medicare beneficiaries. About 2 million of those moved from one U.S. "commuting zone" to another, and the rest were a random 10 percent sample of people who had not moved over the 15-year study period. (The U.S. Census Bureau defines about 700 commuting zones nationally.)
A central element of the study involves seeing how different people who were originally from the same locations fared when moving to different destinations. In effect, says Finkelstein, "The idea is to take two elderly people from a given origin, say, Boston. One moves to low-mortality Minneapolis, one moves to high-mortality Houston. We then compare how long each lives after they move."
Different people have different health profiles before they move, of course. But Medicare records include detailed claims data, so the researchers applied records of 27 different illnesses and conditions -- ranging from lung cancer and diabetes to depression -- to a standard mortality risk model, to categorize the overall health of seniors when they move. Using these "very, very rich pre-move measures of their health," Finkelstein notes, the researchers tried to account for pre-existing health levels of seniors from the same location who moved to different places.
Still, even assessing people by 27 measures does not completely describe their health, so Finkelstein, Gentzkow, and Williams also estimated what fraction of people's health conditions they had not observed -- essentially by calibrating the observed health of seniors against health capital levels in places they were moving from. They then consider how observed health varies across individuals from the same location moving to different destinations and, assuming that differences in unobserved health -- such as physical mobility -- vary in the same way as observed differences in health, they adjust their estimates accordingly.
All told, the study found that many urban areas on the East and West Coasts -- including New York City, San Francisco, and Miami -- have positive effects on longevity for seniors moving there. Some Midwestern metro areas, including Chicago, also score well.
By contrast, a large swath of the deep South has negative effects on longevity for seniors moving there, including much of Alabama, Arkansas, Louisiana, and northern Florida. Much of the Southwest, including parts of Texas, Oklahoma, New Mexico, and Arizona, fares similarly poorly.
The scholars also estimate that health capital accounts for about 70 percent of the difference in longevity across areas of the U.S., and that location effects account for about 15 percent of the variation.
"Yes, health capital is important, but yes, place effects also matter," Finkelstein says.
The Charlotte Effect: What makes a difference?
Indeed, the significance of place effects on life expectancy is also evident in another pattern the study found. Some locations -- such as Charlotte, North Carolina -- have a positive effect on longevity but still have low overall life expectancy, while other places -- such as Santa Fe New Mexico -- have high overall life expectancy, but a below-average effect on the longevity of seniors who move there.
Again, the life expectancy of an area's population is not the same thing as that location's effect on longevity. In places where, say, smoking is highly prevalent, population-wide longevity might be subpar, but other factors might make it a place where people of average health will live longer. The question is why.
"Our [hard] evidence is about the role of place," Finkelstein says, while noting that the next logical step in this vein of research is to look for the specific factors at work. "We know something about Charlotte, North Carolina, makes a difference, but we don't yet know what."
With that in mind, Finkelstein, Gentzkow, and Williams, along with other colleagues, are working on a pair of new studies about health care practices to see what impact place-based differences may have; one study focuses on doctors, and the other looks at the prescription opioid epidemic.
In the background of this research is a high-profile academic and policy discussion about the impact of health care utilization. One perspective, associated with the Dartmouth Atlas of Health Care project, suggests that the large regional differences in health care use it has documented have little impact on mortality. But the current study, by quantifying the variable impact of place, suggest there may be, in turn, a bigger differential impact in health care utilization yet to be identified.
For her part, Finkelstein says she would welcome further studies digging into health care use or any other factor that might explain why different places have different effects on life expectancy; the key is uncovering more hard evidence, wherever it leads.
"Differences in health care across places are large and potentially important," Finkelstein says. "But there are also differences in pollution, weather, [and] other aspects. … What we need to do now is get inside the black box of 'the place' and figure out what it is about them that matters for longevity."
https://www.sciencedaily.com/releases/2021/09/210901113734.htm
Key mental abilities can actually improve during aging
August 19, 2021
Science Daily Georgetown University Medical Center
It's long been believed that advancing age leads to broad declines in our mental abilities. Now new research from Georgetown University Medical Center offers surprisingly good news by countering this view.
The findings, published August 19, 2021, in Nature Human Behaviour, show that two key brain functions, which allow us to attend to new information and to focus on what's important in a given situation, can in fact improve in older individuals. These functions underlie critical aspects of cognition such as memory, decision making, and self-control, and even navigation, math, language, and reading.
"These results are amazing, and have important consequences for how we should view aging," says the study's senior investigator, Michael T. Ullman, PhD, a professor in the Department of Neuroscience, and Director of Georgetown's Brain and Language Lab.
"People have widely assumed that attention and executive functions decline with age, despite intriguing hints from some smaller-scale studies that raised questions about these assumptions," he says. "But the results from our large study indicate that critical elements of these abilities actually improve during aging, likely because we simply practice these skills throughout our life."
"This is all the more important because of the rapidly aging population, both in the US and around the world," Ullman says. He adds that with further research, it may be possible to deliberately improve these skills as protection against brain decline in healthy aging and disorders.
The research team, which includes first author João Veríssimo, PhD, an assistant professor at the University of Lisbon, Portugal, looked at three separate components of attention and executive function in a group of 702 participants aged 58 to 98. They focused on these ages since this is when cognition often changes the most during aging.
The components they studied are the brain networks involved in alerting, orienting, and executive inhibition. Each has different characteristics and relies on different brain areas and different neurochemicals and genes. Therefore, Ullman and Veríssimo reasoned, the networks may also show different aging patterns.
Alerting is characterized by a state of enhanced vigilance and preparedness in order to respond to incoming information. Orientinginvolves shifting brain resources to a particular location in space. The executive network inhibits distracting or conflicting information, allowing us to focus on what's important.
"We use all three processes constantly," Veríssimo explains. "For example, when you are driving a car, alerting is your increased preparedness when you approach an intersection. Orienting occurs when you shift your attention to an unexpected movement, such as a pedestrian. And executive function allows you to inhibit distractions such as birds or billboards so you can stay focused on driving."
The study found that only alerting abilities declined with age. In contrast, both orienting and executive inhibition actually improved.
The researchers hypothesize that because orienting and inhibition are simply skills that allow people to selectively attend to objects, these skills can improve with lifelong practice. The gains from this practice can be large enough to outweigh the underlying neural declines, Ullman and Veríssimo suggest. In contrast, they believe that alerting declines because this basic state of vigilance and preparedness cannot improve with practice.
"Because of the relatively large number of participants, and because we ruled out numerous alternative explanations, the findings should be reliable and so may apply quite broadly," Veríssimo says. Moreover, he explains that "because orienting and inhibitory skills underlie numerous behaviors, the results have wide-ranging implications."
"The findings not only change our view of how aging affects the mind, but may also lead to clinical improvements, including for patients with aging disorders such as Alzheimer's disease," says Ullman.
https://www.sciencedaily.com/releases/2021/08/210819113017.htm