Reducing Home Hazards Cuts Seniors’ Risk of Falling

Cara Murez wrote . . . . . . . . .

Nearly one-third of older people fall each year, most of them in their own homes. But it’s possible to reduce those numbers by a quarter, according to a new study.

Five steps can cut the risk of falls by 26%, the researchers reported in the Cochrane Database of Systematic Reviews. Those steps are: decluttering; reducing tripping hazards; improving lighting; and adding hand rails and non-slip strips to stairs.

“Falls are very common among older people. They can cause serious injury or even death, but they are preventable. In this review, we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home,” lead author Lindy Clemson, professor emeritus at the University of Sydney, Australia, said in a journal news release.

The review found that people most at risk of falls, such as those recently hospitalized for a fall or those needing support for daily activities, such as dressing, would benefit the most from decluttering.

Other measures — such as having the correct prescription glasses or special footwear — didn’t make a difference. Neither did education about falls.

For the study, the researchers analyzed 22 studies that included data on more than 8,400 people living at home.

Taking measures to reduce falls around the house reduced falls by 38% in people who were at a higher risk.

The reviewers estimated that if 1,000 people who had previously fallen had followed these measures for a year, there would have been 1,145 falls instead of 1,847.

“Having had a fall or starting to need help with everyday activities are markers of underlying risk factors, such as being unsteady on your feet, having poor judgment or weak muscles,” Clemson said. “These risk factors make negotiating the environment more challenging and increase the risk of a trip or slip in some situations.”

Clemson added that support from an occupational therapist is an important intervention for many people living at home.

People tend to not notice the clutter in their home or to realize that continuing to climb ladders as they always have comes with a potential fall risk if their mobility or balance is diminished, she noted.

“Preventing falls is a really important way of helping people to remain healthy and independent as they grow older, and our review also highlights the need for more research in this area,” Clemson said.

Source: HealthDay






How Does the Brain Age Across the Lifespan? New Studies Offer Clues.

Caitlin Gilbert wrote . . . . . . . . .

Do brains peak in childhood? Is it all downhill after 30? Can a 65-year-old brain keep up with an adolescent?

While growth charts tracking metrics like height and weight give a relatively clear picture of the range of human physical development, less has been known about the key milestones of normal brain aging.

To find out more, an international team of researchers collected brain scan data from multiple studies representing 101,457 brains at all stages of life. The youngest scan in the study came from a 16-week-old fetus; the oldest was from a 100-year-old.

Across this large data set, some striking milestones emerged.

  • The thickness of the cerebral cortex, the wrinkled outer layer of the brain, peaks at about age 2 — the region is involved in processes like perception, language and consciousness.
  • Gray matter volume, which represents the overall number of brain cells, peaks in childhood about age 7.
  • White matter, made up of the connections between neurons that allow for regions of the brain to quickly communicate, is at its highest volume at about age 30 and begins to decline in later adulthood.
  • The volume of ventricles, fluid-filled cavities within the brain, increases rapidly at later age — larger ventricle size has been associated with some neurodegenerative diseases.

Importantly, the study is meant to serve as a broad reference rather than an exact road map personalized to individual people, said Jakob Seidlitz, a study co-author and research scientist at the Lifespan Brain Institute of the Children’s Hospital of Philadelphia and University of Pennsylvania.

“Absolute differences in size in these features are somewhat meaningless,” Seidlitz said. “They’re useful insofar as mapping a reference for any given age, given how dynamic these processes are.”

Brain development also gets increasingly variable the older we get. Even different parts of the brain, like regions involved in vision vs. speech, hit their own milestones at different points in life, said Sahar Ahmad, a research instructor at the UNC School of Medicine who specializes in neuroimaging over development.

While some of these structural elements have been tied to behaviors — white matter has been associated with more efficient decision-making, for example — there are still more complex genetic, cellular and functional changes underpinning the big, structural shifts.

And, while the brain is largely set up by birth, with the creation of new neurons largely complete, how different parts of the brain communicate with one another change over life.

The good news is, that unlike other parts of the body, our brains are built to change over our lifetime, meeting the challenges set by every life stage. While nobody can predict the exact ages of brain development, here’s a general guide to how the brain may change at various ages.


Babies’ brains are like sponges, soaking up all kinds of environmental information, particularly from their parents or caregivers. In the first year or so, for example, babies can learn any language, but that capacity is quickly narrowed based on the sounds or signs they hear or see. That rapid fine-tuning is why it can be much more difficult to learn new languages later in life, particularly ones that are different from a native language.

Part of this sponginess is due to the huge number of synapses, or the connections between neurons, formed over the first couple years of life.

“Early in life, we have a whole lot of excitatory connections, so there’s a lot of learning potential,” said BJ Casey, professor of neuroscience and psychologist at Barnard College, who studies adolescent brain development.

Important cellular and genetic processes are also underway. While most neurons are born by the time of birth, other types of cells in the brain such as glia are developing and maturing rapidly in the first years of life. Glial cells — which can help form synapses, insulate connections, provide nutrients and destroy pathogens in the brain — will continue to mature for several decades.

Both neurons and glia also accrue mutations throughout life, but the ones “occurring during [early] development seem to be very important at setting up risk for diseases later in life,” said Chris Walsh, professor of pediatrics and neurology at Harvard Medical School, who studies the genetics of brain development.

Childhood: 2 to 10 years

Starting at about 18 months to two years, the brain shifts toward learning, which involves both strengthening important connections and decreasing ones that aren’t being used. To help the brain prioritize certain experiences, more inhibitory connections, which act as brakes for information processing, develop across brain circuits.

To decrease connections, babies lose about half of those synapses they had just formed in a process known as synaptic pruning. To strengthen connections, myelination, the process by which neuronal connections are wrapped and insulated with the fatty protein, myelin rapidly increases throughout childhood and beyond.

This increased signal-to-noise ratio for information that corresponds with children’s experiences is especially important as they learn to process emotions, interact in social settings and develop more complex communication skills.

Because there is so much connection building and strengthening during childhood, the brain is particularly sensitive to interactions with caregivers and others in their environment. Stress stemming from trauma or neglect in this period can therefore have deeply profound effects on the rest of a child’s brain development over life.

Adolescence: 10 to 19

From the ages of about 10 to 19, there are dynamic changes in brain networks involved in learning how to process emotions and motivations around different experiences, as teens navigate life that begins to move away from the safety of home.

“During adolescence, you have to learn to fend for yourself,” as you won’t have the same protection from parents as you did when you were younger, Casey said. “Learning the boundaries of society’s rules is exactly what adolescence is about, preparing you to be a functioning adult.”

This heightened sensitivity to the environment is reflected in another bout of widespread synaptic pruning and myelination, but especially in circuits underlying emotion and reward processing. It’s why teens are incentivized to explore new experiences, no matter how risky or threatening they can be.

Young Adulthood: 20 to 39

The mid-to-late 20s are often thought of as a kind of “peak” of brain development or an example of when the brain has “matured.” This myth stems in part due to the observation that white matter volume, a proxy for the “speed” of information processing, reaches a high level at these ages.

Neuronal networks are continually honed and adjusted into young adulthood, especially those involved in rational thought and considering future consequences. Yet, the brain is by no means “done” with its development.

As the brain progresses into the 30s and 40s, adult synaptic plasticity, or the ability for connections to strengthen or weaken in response to activity changes, is thought to reprioritize rather than diminish.

“The system is just working differently. It’s moved into something that’s maybe a little more strategic and longer term, and not into ‘I need to remember exactly what this is and be really quick and sharp like I was in my 20s,’” said Mark Harnett, associate professor of brain and cognitive sciences at MIT who studies how neurons communicate in circuits and networks underlying complex behaviors. But those two things “are actually challenging to implement simultaneously.”

Late Adulthood: 40s and beyond

When you lose your keys or forget a name, it may feel like your brain isn’t working as well as it used to. But new research dispels the belief that plasticity, the brain’s capacity to respond to change, diminishes in the adult and aging brain.

Harnett’s lab recently showed the presence of “silent synapses,” connections that are inactive until they’re recruited to help form new memories, in adult mice. These synapses had long been associated with early development, but Harnett and his lab have now also confirmed their widespread presence in adult human brains across ages and different regions.

The findings, which suggest that your brain can dynamically change throughout adulthood, are changing the way scientists view the aging brain.

“Everyone feels like plasticity goes away as you get older and neurons just die,” Harnett said. “Here we found something that’s really robust. It’s like, hey, there’s all these silent synapses and all this extra plasticity capacity in the adult cortex. That’s awesome, we didn’t know that was there. That’s super exciting!”

40 to 65

In the 40s and beyond, life shifts toward the challenging roles of adulthood — career, caring for family and giving back to the next generation. Because of how variable individual experiences can be, brain milestones are also trickier to set at specific ages later in life.

Experiences such as engagement in a community, lifestyle choices or exposure to stress or toxins can drastically affect brain development and aging. A 50-year-old who is highly social and regularly exercising, traveling or volunteering might have a “younger” brain than a 50-year-old who is largely isolated from others and rarely engages in enriching activities.

Research suggests that older adults who engage in memory training tasks, crossword puzzles, and even video games can improve some cognitive functions, but the mechanisms underlying those findings are still unknown.

65 and beyond

Late in life, the brain does shrink in size and can begin to degenerate. Yet older individuals also have the potential for greater wisdom built off a lifetime of experiences. Some researchers have suggested that the brain circuitry tied to emotional processing and moral decision-making might be involved in different components of wisdom, although that research is still limited.

“I don’t think that we provide the respect to the aging and the wisdom that they’ve accumulated throughout a life span,” Casey said.

Source : Washington Post





Getting a Good Night’s Sleep Can Add Years to Your Life

Cara Murez wrote . . . . . . . . .

Getting good sleep may have long-term benefits — even extending your life span, a new study suggests.

Researchers found that young people with better sleep habits were incrementally less likely to die early. About 8% of deaths from any cause could be attributed to poor sleep patterns.

Study co-author Dr. Frank Qian, a resident at Beth Israel Deaconess Medical Center in Boston and clinical fellow at Harvard Medical School, said his team found a “clear dose-response relationship.” Simply put: The better the sleep, the greater the protection from early death from all causes, including heart disease.

“These findings emphasize that just getting enough hours of sleep isn’t sufficient,” Qian said in an American College of Cardiology news release. “You really have to have restful sleep and not have much trouble falling and staying asleep.”

Researchers identified several sleep habits that made a difference: sleeping seven to eight hours a night; having trouble falling asleep or staying asleep no more than twice a week; not using any sleep medication, and feeling well rested on awaking at least five days a week.

“If people have all these ideal sleep behaviors, they are more likely to live longer,” Qian said. “So, if we can improve sleep overall, and identifying sleep disorders is especially important, we may be able to prevent some of this premature [deaths].”

For the study, researchers used data from more than 172,000 people (average age: 50), who were part of a nationwide health survey between 2013 and 2018. About two-thirds were white, almost 15% were Hispanic, about 13% Black, and nearly 6% Asian.

Researchers linked participants to national death records through December 2019, following each person for roughly 4.3 years.

More than 8,600 of survey respondents died — 30% from heart disease; 24% from cancer, and 46% from other causes.

The study controlled for risk factors for premature death, including lower income, smoking, alcohol use and other medical conditions.

When compared to those with zero to one beneficial sleep factors, participants with all five beneficial sleep factors were 30% less likely to die of any cause; 21% less likely to die from heart disease; 19% less likely to die from cancer; and 40% less likely to die of other causes, researchers found.

Other deaths are likely due to accidents, infections or neurodegenerative diseases, such as dementia and Parkinson’s disease, Qian said.

Life expectancy was 4.7 years greater for men and 2.4 years greater for women who had all five quality sleep measures compared to those who had none or just one.

It’s not clear why men had greater gains in life expectancy than women.

Researchers hope patients and clinicians will start talking about sleep as part of their overall health assessment.

They noted that sleep habits were self-reported and not studied in a controlled setting, which could affect accuracy of the results. No information about participants’ use of sleep aids or medicine was available.

The findings are scheduled for presentation at a joint meeting of the American College of Cardiology and World Congress of Cardiology, in New Orleans and online. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

Source: HealthDay





Cutting Calories May Slow Aging in Healthy Adults

Cara Murez wrote . . . . . . . . .

The key to living longer could be eating less.

In a new study published in the journal Nature Aging, researchers found that a calorie-restricted diet had substantial health benefits, including delayed aging.

“The main take-home of our study is that it is possible to slow the pace of biological aging and that it may be possible to achieve that slowing through modification of lifestyle and behavior,” senior study author Dr. Dan Belsky, an assistant professor of epidemiology at Columbia University’s Mailman School of Public Health in New York City, told NBC News.

The phase 2 clinical trial included 220 adults who either made a 25% calorie cut to their diet or no changes at all. The body mass index (BMI) for participants ranged from 22 to 27 (a BMI of 30 is the threshold for obesity).

In the first month, those in the calorie-restricted group were given three prepared meals each day so they would be familiar with portion sizes. They were counseled about their diet for the first 24 weeks of the two-year study.

The other group had no counseling or restrictions.

Despite the plan to cut about 500 calories in a 2,000-calorie daily diet, most cut only half that, said Dr. Evan Hadley, director of the geriatrics and clinical gerontology division at the National Institute of Aging (NIA), which funded the study.

“But that 12% was enough to have significant changes,” Hadley told NBC News.

Researchers used an algorithm based on past data for 1,000 people who were followed for 20 years, to see how certain DNA biomarkers changed in the study group.

The algorithm was like a “speedometer,” Belsky explained, to help gauge the pace at which participants aged.

Those who cut their calories slowed their aging by 2% to 3%, reducing the likelihood of dying early by 10% to 15%.

“We all have the power to change the trajectories of aging,” Belsky contends.

Researchers plan to follow those on the calorie-restricted diet for 10 years.

It’s not clear why eating less would slow aging, though it may prompt cellular changes, Belsky said.

“It may induce sort of mechanisms of survival responses in the body that have the effect of cleaning up intracellular garbage,” Belsky explained. “It’s a signal to the body, saying, ‘Hey, pay attention. There are resource stresses in the environment. We need to make sure that we are using all of the resources available to us most efficiently.'”

Still, long-term limits on calories have been shown in animals to be harmful, including reduced muscle strength, slower metabolism and an impaired immune system, Valter Longo, director of the Longevity Institute at the University of Southern California, told NBC News. Longo was not involved in this study.

“It may cause powerful anti-aging effects, but also probably some degree of frailty or other issues that may not be so beneficial,” Longo said.

People should not starve themselves, Pankaj Kapahi, a researcher at the Buck Institute for Research on Aging, told NBC News. He was not involved in the study.

Kapahi noted that exercise and balanced eating are important for aging.

“Calorie restriction has to be done at a marginal level,” he said.

Source: HealthDay





Living Long, Despite the Odds

HKU researchers have revealed why Hong Kong has the longest life expectancy in the world: unlike most other places, it has attained a unique combination of economic development and successful tobacco control. Making the most of those extra years is another matter.

Since 2013, life expectancy at birth in Hong Kong has been the highest in the world – 88.1 years for women and 82.7 years for men (as of 2020). And this has posed a conundrum for public health scientists and practitioners. Hong Kong has one of the highest income inequalities in the developed world, one of the highest population densities and its people work some of the longest hours. Hong Kong people also come 81st in the world when ranking their quality of life, according to a 2022 Gallup report. Plus, Hong Kong has kept its health expenditure as a fraction of gross domestic product at 5.9 per cent (lower than other high-income regions); its air quality is also not stellar. So why are people living so long?

It’s a question of interest not only locally but internationally, as a commentary in the US National Academy of Medicine in 2020 put it: “there could not be a more important puzzle to solve for the rest of the world.”

Now, a solution has been found through the work of Dr Michael Ni Yuxuan, Clinical Associate Professor in the School of Public Health and colleagues. Dr Ni conducted the largest and most comprehensive assessment of Hong Kong’s longevity to date, which has been published in The Lancet Public Health.

“Explanations for longevity in Hong Kong have included economic prosperity, our universal health coverage, and our very low maternal and infant mortality. But these things are true for many high-income regions, including in Asia. What really distinguishes us is that we have attained a low smoking prevalence for both men and women,” he said. “For the first time, we showed that successful tobacco control was the reason why Hong Kong’s life expectancy has surpassed all other populations.”

Vigilance still needed

Using life expectancy data from 18 high-income countries from 1960 to 2020 and mortality data for 263 million deaths, they demonstrated that Hong Kong had the lowest mortality for cardiovascular diseases among high-income regions and one of the lowest mortalities for cancer in women – both of which are linked to smoking.

Only about 10 per cent of Hong Kong people smoke, versus 28 per cent in France, 20 per cent in South Korea and 16 per cent each in the UK and US. In China 42 per cent of men smoke. On average, smokers die 10 years younger than non-smokers.

For Dr Ni, the results show that there is a continued need for vigilance against tobacco around the world (see also Snuffing out Alternative Tobacco Products).

But he cautioned Hongkongers against being too celebratory about the achievement just yet. “A caveat to this whole story is that although we have ranked first in the world in longevity for the past eight years, a global survey has shown that mental well-being in Hong Kong was among the worst. We have a very long life expectancy, but on average it may not be a very prosperous, fulfilling and happy life,” he said.

Mental health remains a concern

Dr Ni’s team has been studying this aspect of health, too. Using the FAMILY Cohort of 46,000 participants, they have conducted multiple surveys on physical, mental and social well-being in Hong Kong – the key domains of health as defined by the World Health Organization (life expectancy being only one measure of health). The FAMILY Cohort serves as a health and well-being barometer for Hong Kong, having tracked the evolution of physical, mental, and social well-being with more than 20 longitudinal follow-ups since 2008.

Notably, the FAMILY Cohort has shown that while Hong Kong had the lowest levels of depression in 2011–2014, these have risen significantly since and have not dropped back to the baseline. High levels of depression and anxiety were recorded during the fifth pandemic wave this spring, when Hong Kong had the highest daily COVID-19 mortality rate in the world.

Dr Ni believes mental well-being should be a factor guiding health policies during and after COVID-19 since mental health disorders are the leading cause of disability in the world and affect one in four people.

“There is evidence that actions to address inequalities, poverty, and urban systems, and taking a lifelong course approach to mental health from birth are important. We’ve found that among all the determinants of mental health, some of the most important are the social determinants,” he said.

“The next phase is to look at how we can prevent the onset of mental health disorders because they are so chronic and disabling, and how to improve the mental health of populations.”

Source : HKU