Study of Sleep in Older Adults Suggests Nixing Naps, Striving for 7-9 hours a Night

Laura Williamson wrote . . . . . . . . .

Napping, as well as sleeping too much or too little or having poor sleep patterns, appears to increase the risk for cardiovascular disease in older adults, new research shows.

The study, published Tuesday in the Journal of the American Heart Association, adds to a growing body of evidence supporting sleep’s importance to good health. The American Heart Association recently added sleep duration to its checklist of health and lifestyle factors for cardiovascular health, known as Life’s Essential 8. It says adults should average seven to nine hours of sleep a night.

“Good sleep behavior is essential to preserve cardiovascular health in middle-aged and older adults,” said lead author Weili Xu, a senior researcher at the Aging Research Center in the department of neurobiology, care sciences and society at the Karolinska Institute in Stockholm, Sweden. “We encourage people to keep nighttime sleeping between seven to nine hours and to avoid frequent or excessive napping.”

Prior research has shown poor sleep may put people at higher risk for a range of chronic illnesses and conditions affecting heart and brain health. These include cardiovascular disease, dementia, diabetes, high blood pressure and obesity. According to the Centers for Disease Control and Prevention, nearly 35% of U.S. adults say they get less than seven hours of sleep, while 3.6% say they get 10 or more hours.

Previous sleep duration studies show that sleeping too much or too little both may raise the risk for cardiovascular disease. But whether napping is good or bad has been unclear.

In the new study, researchers analyzed sleep patterns for 12,268 adults in the Swedish Twin Registry. Participants were an average of 70 years old at the start of the study, with no history of major cardiovascular events.

A questionnaire was used to collect data on nighttime sleep duration; daytime napping; daytime sleepiness; the degree to which they considered themselves a night person or morning person, based on the time of day they considered themselves most alert; and symptoms of sleep disorders, such as snoring and insomnia. Participants were followed for up to 18 years to track whether they developed any major cardiovascular problems, including heart disease and stroke.

People who reported sleeping between seven and nine hours each night were least likely to develop cardiovascular disease, a finding in keeping with prior research. Compared with that group, those who reported less than seven hours were 14% more likely to develop cardiovascular disease, and those who reported more than 10 hours were 10% more likely to develop cardiovascular disease.

Compared with people who said they never napped, those who reported napping up to 30 minutes were 11% more likely to develop cardiovascular disease. The risk increased by 23% if naps lasted longer than 30 minutes. Overall, those who reported poor sleep patterns or other sleep issues – including insomnia, heavy snoring, getting too much or too little sleep, frequent daytime sleepiness and considering themselves a night person – had a 22% higher risk

Study participants who reported less than seven hours of sleep at night and napping more than 30 minutes each day had the highest risk for cardiovascular disease – 47% higher than those reporting the optimal amount of sleep and no naps.

The jury is still out on whether naps affect cardiovascular risk across the lifespan, said Marie-Pierre St-Onge, center director for the Sleep Center of Excellence and an associate professor at Columbia University in New York City. She noted that the new research, which she was not involved in, was restricted to older adults.

Rather than trying to recoup sleep time by napping, people should try to develop healthier sleep habits that allow them to get an optimal amount of sleep at night, St-Onge said. This includes making sure the sleep environment is not too hot or cold or too noisy. Reducing exposure to bright light before going to sleep, not eating too late at night, getting enough exercise during the day and eating a healthful diet also help.

“Even if sleep is lost during the night, excessive napping is not suggested during the day,” Xu said. And, if people have persistent trouble getting enough sleep, they should consult a health care professional to figure out why, she said.

Source: American Heart Association

 

 

 

 

Early Alzheimer’s Detection Up to 17 years in Advance

A sensor identifies misfolded protein biomarkers in the blood. This offers a chance to detect Alzheimer’s disease before any symptoms occur. Researchers intend to bring it to market maturity.

The dementia disorder Alzheimer’s disease has a symptom-free course of 15 to 20 years before the first clinical symptoms emerge. Using an immuno-infrared sensor developed in Bochum, a research team is able to identify signs of Alzheimer’s disease in the blood up to 17 years before the first clinical symptoms appear. The sensor detects the misfolding of the protein biomarker amyloid-beta. As the disease progresses, this misfolding causes characteristic deposits in the brain, so-called plaques.

“Our goal is to determine the risk of developing Alzheimer’s dementia at a later stage with a simple blood test even before the toxic plaques can form in the brain, in order to ensure that a therapy can be initiated in time,” says Professor Klaus Gerwert, founding director of the Centre for Protein Diagnostics (PRODI) at Ruhr-Universität Bochum. His team cooperated for the study with a group at the German Cancer Research Centre in Heidelberg (DKFZ) headed by Professor Hermann Brenner.

The team published the results obtained with the immuno-infrared sensor in the journal “Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association”. This study is supported by a comparative study published in the same journal on 2 March 2022, in which the researchers used complementary single-molecule array (SIMOA) technology.

Early detection of symptom-free people with a high risk of Alzheimer’s disease

The researchers analysed blood plasma from participants in the ESTHER study conducted in Saarland for potential Alzheimer’s biomarkers. The blood samples had been taken between 2000 and 2002 and then frozen. At that time, the test participants were between 50 and 75 years old and hadn’t yet been diagnosed with Alzheimer’s disease. For the current study, 68 participants were selected who had been diagnosed with Alzheimer’s disease during the 17-year follow-up and compared with 240 control subjects without such a diagnosis. The team headed by Klaus Gerwert and Hermann Brenner aimed to find out whether signs of Alzheimer’s disease could already be found in the blood samples at the beginning of the study.

The immuno-infrared sensor was able to identify the 68 test subjects who later developed Alzheimer’s disease with a high degree of test accuracy (0,78 AUC, Area under Curve). For comparison, the researchers examined other biomarkers with the complementary, highly sensitive SIMOA technology – specifically the P-tau181 biomarker, which is currently being proposed as a promising biomarker candidate in various studies. “Unlike in the clinical phase, however, this marker is not suitable for the early symptom-free phase of Alzheimer’s disease,” as Klaus Gerwert summarises the results of the comparative study. “Surprisingly, we found that the concentration of glial fibre protein (GFAP) can indicate the disease up to 17 years before the clinical phase, even though it does so much less precisely than the immuno-infrared sensor.” Still, by combining amyloid-beta misfolding and GFAP concentration, the researchers were able to further increase the accuracy of the test in the symptom-free stage to 0,83 AUC.

Start-up aims to bring immuno-infrared sensor to market maturity

The Bochum researchers hope that an early diagnosis based on the amyloid-beta misfolding could help to apply Alzheimer’s drugs at such an early stage that they have a significantly better effect – for example, the drug Aduhelm, which was recently approved in the USA. “We plan to use the misfolding test to establish a screening method for older people and determine their risk of developing Alzheimer’s dementia,” says Klaus Gerwert. “The vision of our newly founded start-up betaSENSE is that the disease can be stopped in a symptom-free stage before irreversible damage occurs.” Even though the sensor is still in the development phase, the invention has already been patented worldwide. BetaSENSE aims to bring the immuno-infrared sensor to market and have it approved as a diagnostic device so that it can be used in clinical labs.

Clinical trials with Alzheimer’s drugs often fail

Approved by the FDA in the USA in spring 2021, the drug Aduhelm has been shown to clear amyloid-beta plaques from the brain. However, previous studies showed it had only a minor effect on clinical symptoms such as memory loss and disorientation. Consequently, the European Medicines Agency decided in winter 2021 not to approve the drug in Europe. “Up to now, clinical trials for Alzheimer’s drugs have been failing by the dozen, apparently because the established plaque tests used in the trials don’t flag up the disease in time,” says Gerwert. “It seems that once plaques are deposited, they induce irreversible damage in the brain.” In the tests used to date, the plaques are either detected directly in the brain with the complex and expensive PET scan technology or indirectly determined in a less complex way using protein biomarker concentrations in invasively obtained cerebrospinal fluid with ELISA or mass spectrometry technology. In contrast to established plaque diagnostics, the immuno-infrared sensor indicates the earlier misfolding of amyloid-beta, which causes the later plaque deposition. “However, it is still controversially discussed whether this misfolding is the cause of Alzheimer’s disease or if it’s just an accompanying factor,” points out Gerwert. “For the therapeutic approach, this question is crucial, but it is irrelevant for the diagnosis. The misfolding indicates the onset of Alzheimer’s disease.”

“The exact timing of therapeutic intervention will become even more important in the future,” predicts Léon Beyer, first author and PhD student in Klaus Gerwert’s team. “The success of future drug trials will depend on the study participants being correctly characterised and not yet showing irreversible damage at study entry.”

Biomarkers for Parkinson’s and ALS

Misfolded proteins play a central role in many neurodegenerative diseases, such as Parkinson’s disease, Huntington’s disease and amyotrophic lateral sclerosis (ALS). As the researchers have showed, the immuno-infrared sensor can in principle also be used to detect other misfolded proteins, such as TDP-43, which is characteristic of ALS. They don’t measure the concentration of a specific protein, but detect its misfolding using disease-specific antibodies. “Most importantly, this platform technology enables us to make a differential, precise biomarker-based diagnosis in the early stages of neurodegenerative diseases, in which the currently applied symptom-based diagnosis is very difficult and prone to errors,” stresses Gerwert.

Source: Ruhr-Universität Bochum Germany

 

 

 

 

Keep Bones Healthy Over 65

It’s true that our bones tend to lose strength as we get older. But even in later years, there’s plenty we can do to prevent falls and fractures.

Stay active

Being inactive makes your muscles and bones lose strength. This increases your risk of osteoporosis, falls and fractures.

Moderate-intensity exercise

People over 65 should try to get 150 minutes (2 and a half hours) of moderate-intensity exercise every week. It’s best to do some exercise every day, spread across the day. Doing something is always better than doing nothing. Exercise outdoors if you can and build up slowly.

Moderate activity will raise your heart rate and make you breathe faster and feel warmer.

One way to tell if you’re exercising at a moderate level is if you can still talk but can’t sing the words to a song.

Examples of moderate-intensity activities include:

  • walking
  • water aerobics
  • ballroom and line dancing
  • riding a bike on level ground or with few hills
  • playing doubles tennis
  • pushing a lawn mower

Activities for strength

You should also try to do activities to improve muscle strength at least twice a week.

This could include:

  • lifting weights
  • dancing
  • carrying groceries
  • going up and down stairs
  • exercising to music
  • heavy gardening, such as digging or shovelling
  • yoga

Activities for balance and flexibility

It’s also a good idea to do activities to improve balance and flexibility twice a week as this can reduce your risk of falling.

Activities such as yoga or tai chi are best for this. These types of activity can also ease stiffness and unsteadiness associated with painful joints.

You can do activities twice a week that combine moderate-intensity exercise with improving your strength, balance and flexibility or you can do different activities.

You should also try to avoid sitting around for long periods. If you find you have been sitting for more than about 20 to 30 minutes, get up and go for a stroll.

If you have a health condition such as heart disease or arthritis, you may be able to join a suitable group exercise class.

Exercising with osteoporosis

If you have a high fracture risk or spinal fractures caused by osteoporosis, you need to look after your back.

It’s especially important to bend your knees when lifting objects. Avoid movements that involve awkward bending and lifting movements.

You may need to be cautious about some types of high impact exercises. Your GP can advise you about this.

Eating for healthy bones

Some people find their appetite starts to drop as they get older. Eating less can make it more difficult to get the nutrients you need to keep muscles and bones healthy.

Staying active will help to keep your appetite up. But if you don’t feel like eating much some days, it’s still important to try to stick to a healthy, balanced diet.

For healthy muscles and bones, you need calcium, vitamin D and protein:

  • calcium keeps our bones and teeth healthy
  • vitamin D helps our bodies to absorb calcium
  • protein is important for muscle maintenance

Another reason to eat a balanced diet is that it will help you to maintain a healthy body weight. Keep your weight up. Being underweight is linked to a higher risk of fractures.

If your diet isn’t as good as it should be, you may want to consider taking a dietary supplement.

Go for one that contains calcium and vitamin D. Your GP or pharmacist can help you choose one that’s suitable for you.

Some medicines can affect your appetite. If you think a medicine you’re taking may be affecting your appetite, perhaps because it makes you feel nauseous, talk with your pharmacist or GP. They may be able to suggest an alternative.

Vitamin D

Vitamin D is important for both strong muscles and healthy bones. Our bodies make vitamin D from the action of the summer sunlight (from late March/April to the end of September) on our skin. All adults are advised to consider taking a daily vitamin D supplement, particularly during the winter months (October to March).

People who are not often exposed to the sun should take a daily vitamin D supplement throughout the year.

These include people who:

  • are not often outdoors, such as those who are frail or housebound
  • are in an institution, such as a care home
  • usually wear clothes that cover up most of their skin when outdoors

People with dark skin, such as those of African, African-Caribbean and south Asian origin, might not get enough vitamin D from sunlight, so they should consider taking a supplement throughout the year.

Some foods contain vitamin D. These include oily fish such as mackerel and salmon, eggs, foods fortified with vitamin D such as fat spreads, and some breakfast cereals.

But it’s difficult to get enough vitamin D from food alone.

If you have osteoporosis, your GP may prescribe a calcium supplement, too.

Other ways to protect your bones

Other things to consider to help prevent falls and fractures:

  • quit smoking and try these tips to help you cut down on alcohol
  • go for an eye test – poor eyesight can affect mobility and balance
  • get your hearing checked – ear problems can affect your balance
  • look after your feet – foot pain can affect your mobility
  • review your medicines with your GP or pharmacist – some medicines can make you feel dizzy or drowsy
  • make your home safer to avoid accidents

It’s important you do not stop taking a medicine without getting advice from a qualified health professional.

Source: NHS

 

 

 

 

Loss of Male Sex Chromosome With Age Leads to Earlier Death for Men

Approximately 40% of men will lose their male sex chromosome in certain cells by age 70, and that can lead to deadly heart failure, a new study finds.

The loss of the male sex chromosome as many men age causes the heart muscle to scar and can lead to deadly heart failure, new research from the University of Virginia School of Medicine shows. The finding may help explain why men die, on average, several years younger than women.

UVA researcher Kenneth Walsh, PhD, says the new discovery suggests that men who suffer Y chromosome loss – estimated to include 40% of 70-year-olds – may particularly benefit from an existing drug that targets dangerous tissue scarring. The drug, he suspects, may help counteract the harmful effects of the chromosome loss – effects that may manifest not just in the heart but in other parts of the body as well.

On average, women live five years longer than men in the United States. The new finding, Walsh estimates, may explain nearly four of the five-year difference.

“Particularly past age 60, men die more rapidly than women. It’s as if they biologically age more quickly,” said Walsh, the director of UVA’s Hematovascular Biology Center. “There are more than 160 million males in the United States alone. The years of life lost due to the survival disadvantage of maleness is staggering. This new research provides clues as to why men have shorter lifespans than women.”

Y CHROMOSOME LOSS AND HEART HEALTH

While women have two X chromosomes, men have an X and a Y. But many men begin to lose their Y chromosome in a fraction of their cells as they age. This appears to be particularly true for smokers. The loss occurs predominantly in cells that undergo rapid turnover, such as blood cells. (Loss of the Y chromosome does not occur in male reproductive cells, so it is not inherited by the children of men who exhibit Y chromosome loss.) Scientists previously observed that men who suffer Y chromosome loss are more likely to die at a younger age and suffer age-associated maladies such as Alzheimer’s disease. Walsh’s new research, however, is believed to be the first hard evidence that the chromosome loss directly causes harmful effects on men’s health.

Walsh, of UVA’s Division of Cardiovascular Medicine and Robert M. Berne Cardiovascular Research Center,and his team used cutting-edge CRISPR gene-editing technology to develop a special mouse model to better understand the effects of Y chromosome loss in the blood. They found that the loss accelerated age-related diseases, made the mice more prone to heart scarring and led to earlier death. This wasn’t the result of just inflammation, the scientists determined. Instead, the mice suffered a complex series of responses in the immune system, leading to a process called fibrosis throughout the body. This tug-of-war within the immune system, the researchers believe, may accelerate disease development.

The scientists also looked at the effects of Y chromosome loss in human men. They conducted three analyses of data compiled from the UK Biobank, a massive biomedical database, and found that Y chromosome loss was associated with cardiovascular disease and heart failure. As chromosome loss increased, the scientists found, so did the risk of death.

POTENTIAL TREATMENT

The findings suggest that targeting the effects of Y chromosome loss could help men live longer, healthier lives. Walsh notes that one potential treatment option might be a drug, pirfenidone, that has already been approved by the federal Food and Drug Administration for the treatment of idiopathic pulmonary fibrosis, a form of lung scarring. The drug is also being tested for the treatment of heart failure and chronic kidney disease, two conditions for which tissue scarring is a hallmark. Based on his research, Walsh believes that men with Y chromosome loss could respond particularly well to this drug, and other classes of antifibrotic drugs that are being developed, though more research will be needed to determine that.

At the moment, doctors have no easy way to determine which men suffer Y chromosome loss. Walsh’s collaborator Lars A. Forsberg, of Uppsala University in Sweden, has developed an inexpensive polymerase chain reaction (PCR) test, like those used for COVID-19 testing, that can detect Y chromosome loss, but the test is largely confined to his and Walsh’s labs. Walsh, however, can foresee that changing: “If interest in this continues and it’s shown to have utility in terms of being prognostic for men’s disease and can lead to personalized therapy, maybe this becomes a routine diagnostic test,” he said.

“The DNA of all our cells inevitably accumulate mutations as we age. This includes the loss of the entire Y chromosome within a subset of cells within men. Understanding that the body is a mosaic of acquired mutations provides clues about age-related diseases and the aging process itself,” said Walsh, a member of UVA’s Department of Biochemistry and Molecular Genetics. “Studies that examine Y chromosome loss and other acquired mutations have great promise for the development of personalized medicines that are tailored to these specific mutations.”

The researchers have published their findings in the journal Science.

Source: University of Virginia

 

 

 

 

Aching Backs in Seniors: An Expert’s Guide to Pain Meds

Amy Norton wrote . . . . . . . . .

Back and neck pain are often an unfortunate part of aging, but older adults can safely find relief with various medications, a new research review concludes.

The review of 138 clinical trials breaks down the evidence on medication options for seniors with “spine-related” pain — essentially any aches along the neck and back.

An overarching point is, there is no one-size-fits-all remedy, according to senior researcher Dr. Michael Perloff, a neurologist at Boston University School of Medicine and Boston Medical Center.

Medication choices, he said, depend partly on the underlying cause of the pain. But particularly with older adults, any co-existing health conditions and medications they are taking are also a factor.

“You do have to be careful about medication interactions and side effects,” Perloff said.

At the same time, those issues should not bar older adults from getting pain relief, he stressed.

“If you’re an older person and you’ve been told there are no options for managing your pain, you may need to see a pain specialist,” Perloff noted.

“There’s a lot we can do with the weapons of medication, injections, physical therapy and, in some cases, surgery,” he added.

With younger adults, back and neck aches are often muscle-related. While that can be true for older adults, too, Perloff said, they often have pain related to degenerative changes in the spine — such as wear-and-tear breakdown in the discs or cartilage cushioning the spinal joints.

For that type of pain, common painkillers, including nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, can help, the review found.

NSAIDs, like ibuprofen and naproxen (Motrin, Aleve), are more effective than acetaminophen (Tylenol), Perloff said. But acetaminophen may be the safer choice for some seniors, including those who are at increased risk of stomach bleeding, or who have kidney or heart disease.

With NSAIDs, limited use is key. Perloff’s team recommends that older people take them for two or three days during a pain flare-up, but avoid using them for weeks at a time.

“With chronic pain, it’s often up and down,” Perloff noted. “So your treatment needs are different at different times.”

In some cases, pain stems from a pinched nerve. One example is sciatica, where the sciatic nerve is compressed — often by a disc in the lower spine that slips out of place. That can cause pain that radiates from the lower back down the back of the leg.

NSAIDs can help ease sciatica, the review found. But another option, Perloff said, is medication specific to nerve pain — namely, gabapentin and pregabalin.

Those medications come with their own potential side effects, including dizziness and balance problems. So, the review found, any benefits have to be weighed against those risks, especially for older people who are taking other medications that can cause dizziness and falls, such as benzodiazepines.

Among the other findings:

  • Certain muscle relaxants, like carisoprodol and chlorzoxazone, carry a risk of sedation and falls. But some others, including tizanidine and baclofen, can safely ease older adults’ neck or back pain, in low doses.
  • For chronic low back pain, some antidepressants — especially duloxetine (Cymbalta) — have proven helpful in trials. They may be good choices, Perloff said, when an older adult has both pain and depression symptoms.
  • When oral drugs fail, injections of painkillers or anti-inflammatory corticosteroids may help with chronic pain.

The review, published recently in the journal Drugs & Aging, focused on medications. But Perloff said that when his patients have chronic pain — generally three months or more — he’s probably also prescribing physical therapy.

“Physical therapy can be valuable for optimizing and maintaining function,” agreed Dr. Robert Griffin, an anesthesiologist at the Hospital for Special Surgery in New York City who specializes in evaluating and treating back and neck issues.

Griffin, who reviewed the findings, also pointed to some other options. They include trigger point injections, where medication is injected into painful “knots” in the muscles; radiofrequency ablation, where radio-wave heat is applied to specific nerve tissue, to decrease pain signals from that area; and acupuncture and meditation, which may help ease symptoms or provide help in coping with them.

As for when people should see a health care provider for a painful back or neck, Griffin said “anytime they feel help is needed.”

He stressed, though, that people should seek medical care right away if they have additional symptoms that could indicate a serious health condition. Those include limb weakness, changes in bladder or bowel function, fever or unexplained weight loss.

Source: HealthDay