Tag Archives: Elderly

Top New Books On Aging: “Exercised” By Daniel E. Lieberman – “Extending Longevity” (Harvard)

HARVARD MAGAZINE (SEPT – OCT 2020): From the book EXERCISED: Why Something We Never Evolved to Do Is Healthy and Rewarding by Daniel E. Lieberman, to be published on September 8, 2020 by Pantheon Books:

‘….many of the mechanisms that slow aging and extend life are turned on by physical activity, especially as we get older. Human health and longevity are thus extended both by and for physical activity.’

What Happens When We Exercise?
The graph breaks total energy expenditure (TEE) into two parts: active energy expenditure, and resting metabolism. Resting metabolism remains elevated for hours even after exercise ceases, burning additional calories in a phase known as excess post-exercise oxygen consumption (EPOC).

Exercise is like scrubbing the kitchen floor so well after a spill that the whole floor ends up being cleaner. The modest stresses caused by exercise trigger a reparative response yielding a general benefit.

In order to elucidate the links between exercise and aging, I propose a corollary to the Grandmother Hypothesis, which I call the Active Grandparent Hypothesis. According to this idea, human longevity was not only selected for but was also made possible by having to work hard during old age to help as many children, grandchildren, and other younger relatives as possible survive and thrive. That is, while there may have been selection for genes (as yet unidentified) that help humans live past the age of 50, there was also selection for genes that repair and maintain our bodies when we are physically active.

Daniel E. Lieberman is a paleoanthropologist at Harvard University, where he is the Edwin M Lerner II Professor of Biological Sciences, and Professor in the Department of Human Evolutionary Biology. He is best known for his research on the evolution of the human head and the evolution of the human body.

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The Elderly & Dementia: “Managing Daily Activities & Fall Prevention” (UCSF)

Presented by Sarah Dulaney, RN, CNS, a nurse at the UCSF Memory and Aging Center, and Helen Medsger, a family caregiver and LBD support group leader, as part of the Lewy Body Dementia Caregiver Webinar Series supported by the UCSF Memory and Aging Center and the Administration for Community Living.

Elderly & Coronavirus: Nursing Homes Increase Guest Symptom, Travel And Exposure Reviews

From a Harvard Gazette online article (March 10, 2020):

Harvard Gazette Elderly Coronavirus Risk Article March 10 2020There’s a symptom review, there’s a travel review, and there’s an exposure review. And if the answer to any of those questions is yes, then you’re asked to not come in. And so far people have been compliant and have left. So that is a good thing.

If you have a cough and a fever, if you’ve got respiratory symptoms and you’re short of breath, if you’ve traveled to a place of concern or if you may have been exposed to someone who did — especially if you’re symptomatic — then I would definitely ask, “Do I really need to visit my grandma today? Can I wait and can I Skype her? Can I do FaceTime?”

I know that’s hard for some of our older adults who aren’t technologically savvy, but maybe now is the time to get them hooked up. It really would be heartbreaking if, in wanting to do something positive for someone’s emotional or mental health, you ended up infecting them.

Harvard-affiliated Hebrew SeniorLife offers a continuum of care for 3,000 elderly people daily, with a range of services including residential assisted living, short-term rehabilitation, outpatient services, and long-term care for those with chronic illness. In a Q&A interview aimed at understanding the challenges involved, Harvard Medical School Assistant Professor Helen Chen, Hebrew SeniorLife’s chief medical officer, discussed steps the facility has taken to combat the virus and the outlook going forward.

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Studies: Elderly In 3rd Highest Level Of Exercise Reduce Brain Shrinkage, Aging By 4 Years (AAN)

From a March 5, 2020 American Academy of Neurology release:

American Academy of Neurology (AAN) Logo“These results are exciting, as they suggest that people may potentially prevent brain shrinking and the effects of aging on the brain simply by becoming more active,” said study author Yian Gu, Ph.D., of Columbia University in New York and a member of the American Academy of Neurology.

“Recent studies have shown that as people age, physical activity may reduce the risk of cognitive decline and dementia. Our study used brain scans to measure the brain volumes of a diverse group of people and found that those who engaged in the top third highest level of physical activity had a brain volume the equivalent of four years younger in brain aging than people who were at the bottom third activity level.”

Older people who regularly walk, garden, swim or dance may have bigger brains than their inactive peers, according to a preliminary study to be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, April 25 to May 1, 2020. The effect of exercise was equal to four fewer years of brain aging. The study used magnetic resonance imaging (MRI) scans to measure the brains of people with a range of activity levels, including those who were inactive to those who were very active. The scans showed less active people had smaller brain volume.

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Studies: Dementia Risk Is Up To 11 Times Greater With Declines In Both Memory And Gait (JAMA)

From a JAMA Network Open online release (February 21, 2020):

JAMA Network OpenAcross the 6 studies of 8699 participants, mean age ranged between 70 and 74 years and mean gait speed ranged between 1.05 and 1.26 m/s. Incident dementia ranged from 5 to 21 per 1000 person-years. Compared with usual agers, participants with only memory decline had 2.2 to 4.6 times higher risk for developing dementia… 

Those with only gait decline had 2.1 to 3.6 times higher risk. Those with dual decline had 5.2 to 11.7 times the risk…

Impaired mobility, such as slow gait, is associated with an increased risk of dementia, but the effect size of this association is generally modest.16 Identifying persons who experience both mobility decline and memory decline, a main symptom in the early stage of dementia, may have a greater prognostic value in assessing risk of dementia because the combination could identify a group in whom gait speed decline is at least in part caused by neurodegenerative pathologic conditions of the central nervous system rather than local musculoskeletal problems, such as sarcopenia or osteoarthritis.79 A recent study of 154 participants with mild cognitive impairment reported that those who declined in both cognition and gait speed had the highest risk of dementia.

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Study: “Med-Diet” Alters Gut Microbiota, Lowers Frailty & Inflammation, Improves Cognition (BMJ)

From BMJ Journal “Gut” study (February 17, 2020):

BMJ Journal GUT Februrary 2020We observed that increased adherence to the MedDiet modulates specific components of the gut microbiota that were associated with a reduction in risk of frailty, improved cognitive function and reduced inflammatory status.

Objective Ageing is accompanied by deterioration of multiple bodily functions and inflammation, which collectively contribute to frailty. We and others have shown that frailty co-varies with alterations in the gut microbiota in a manner accelerated by consumption of a restricted diversity diet. The Mediterranean diet (MedDiet) is associated with health. In the NU-AGE project, we investigated if a 1-year MedDiet intervention could alter the gut microbiota and reduce frailty.

Design We profiled the gut microbiota in 612 non-frail or pre-frail subjects across five European countries (UK, France, Netherlands, Italy and Poland) before and after the administration of a 12-month long MedDiet intervention tailored to elderly subjects (NU-AGE diet).

Results Adherence to the diet was associated with specific microbiome alterations. Taxa enriched by adherence to the diet were positively associated with several markers of lower frailty and improved cognitive function, and negatively associated with inflammatory markers including C-reactive protein and interleukin-17. Analysis of the inferred microbial metabolite profiles indicated that the diet-modulated microbiome change was associated with an increase in short/branch chained fatty acid production and lower production of secondary bile acids, p-cresols, ethanol and carbon dioxide. Microbiome ecosystem network analysis showed that the bacterial taxa that responded positively to the MedDiet intervention occupy keystone interaction positions, whereas frailty-associated taxa are peripheral in the networks.

Conclusion Collectively, our findings support the feasibility of improving the habitual diet to modulate the gut microbiota which in turn has the potential to promote healthier ageing.

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Elder-Care Crisis: Early Screening For Dementia, Increased Preventative Primary-Care Are Needed

From a Wall Street Journal Opinion article (Feb 10, 2020):

How to address the elder-care crisis? Ideally, doctors would screen older patients for dementia. An early diagnosis helps patients understand treatment options, plan for the future and receive appropriate care in the hospital. 

Costs of Long-Term Elderly Care Kaiser Infographic

Other steps include: more preventive care, changes to Medicare’s rehabilitation policies, adopting new reimbursement methods, and developing new measures of success. Primary-care offices can prevent hospital visits, but Americans seeking primary care face an average wait time of 24 days. This might not be a problem for a patient in need of an annual physical, but conditions like chest pain or infections require prompt treatment. Primary-care offices that offer same-day sick visits, home visits for bed-bound older adults, or at-home monitoring of conditions could reduce emergency department volumes.

Read full article by Elizabeth Goldberg MD

New Books On Ageing: “The Changing Mind” By Daniel Levitin (February 2020)

The Changing Mind A Neuroscientist's Guide To Ageing Well Daniel Levitin Feb 2020Challenging widely held assumptions about the diminishing abilities of an ageing brain, leading neuroscientist Daniel Levitin argues that we should view getting older as a beneficial experience rather than a form of cognitive entropy. Persuasively argued and consistently surprising, The Changing Mind will alter your perception of the relationship between age and intellect.

We have long been encouraged to think of old age as synonymous with deterioration. Yet, recent studies show that our decision-making skills improve as we age and our happiness levels peak in our eighties. What really happens to our brains as we get older?

More of us are living into our eighties than ever before. In The Changing Mind, neuroscientist, psychologist and internationally-bestselling author Daniel Levitin invites us to dramatically shift our understanding of growing older, demonstrating its many cognitive benefits. He draws on cutting-edge research to challenge common and flawed beliefs, including assumptions around memory loss and the focus on lifespan instead of ‘healthspan’.

Levitin reveals the evolving power of the human brain from infancy to late adulthood. Distilling the findings from over 4000 papers, he explains the importance of personality traits, lifestyle, memory and community on ageing, offering actionable tips that we can all start now, at any age.

Featuring compelling insights from individuals who have thrived far beyond the conventional age of retirement, this book offers realistic guidelines and practical cognition-enhancing tricks for everyone to follow during every decade of their life. This is a radical exploration of what we all can learn from those who age joyously.

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