Do We Simply Not Care About Old People?
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The covid-19 pandemic would be a wake-up call for America, advocates for the elderly predicted: incontrovertible proof that the nation wasn’t doing enough to care for vulnerable older adults.
The death toll was shocking, as were reports of chaos in nursing homes and seniors suffering from isolation, depression, untreated illness, and neglect. Around 900,000 older adults have died of covid-19 to date, accounting for 3 of every 4 Americans who have perished in the pandemic.
But decisive actions that advocates had hoped for haven’t materialized. Today, most people — and government officials — appear to accept covid as a part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for covid, and most older adults in nursing homes aren’t getting updated vaccines. Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and the availability of staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of covid, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.
In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to covid — a group that would fill more than 10 large airliners — according to data provided by the CDC. But the alarm that would attend plane crashes is notably absent. (During the same period, the flu killed an additional 1,201 seniors, and RSV killed 126.)
“It boggles my mind that there isn’t more outrage,” said Alice Bonner, 66, senior adviser for aging at the Institute for Healthcare Improvement. “I’m at the point where I want to say, ‘What the heck? Why aren’t people responding and doing more for older adults?’”
It’s a good question. Do we simply not care?
I put this big-picture question, which rarely gets asked amid debates over budgets and policies, to health care professionals, researchers, and policymakers who are older themselves and have spent many years working in the aging field. Here are some of their responses.
The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University.
“I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.’”
“A lot of us felt isolated and threatened during the pandemic. It made us sit there and think, ‘What I really care about is protecting myself, my wife, my brother, my kids, and screw everybody else,’” said W. Andrew Achenbaum, 76, the author of nine books on aging and a professor emeritus at Texas Medical Center in Houston.
In an environment of “us against them,” where everybody wants to blame somebody, Achenbaum continued, “who’s expendable? Older people who aren’t seen as productive, who consume resources believed to be in short supply. It’s really hard to give old people their due when you’re terrified about your own existence.”
Although covid continues to circulate, disproportionately affecting older adults, “people now think the crisis is over, and we have a deep desire to return to normal,” said Edwin Walker, 67, who leads the Administration on Aging at the Department of Health and Human Services. He spoke as an individual, not a government representative.
The upshot is “we didn’t learn the lessons we should have,” and the ageism that surfaced during the pandemic hasn’t abated, he observed.
Ageism is pervasive. “Everyone loves their own parents. But as a society, we don’t value older adults or the people who care for them,” said Robert Kramer, 74, co-founder and strategic adviser at the National Investment Center for Seniors Housing & Care.
Kramer thinks boomers are reaping what they have sown. “We have chased youth and glorified youth. When you spend billions of dollars trying to stay young, look young, act young, you build in an automatic fear and prejudice of the opposite.”
Combine the fear of diminishment, decline, and death that can accompany growing older with the trauma and fear that arose during the pandemic, and “I think covid has pushed us back in whatever progress we were making in addressing the needs of our rapidly aging society. It has further stigmatized aging,” said John Rowe, 79, professor of health policy and aging at Columbia University’s Mailman School of Public Health.
“The message to older adults is: ‘Your time has passed, give up your seat at the table, stop consuming resources, fall in line,’” said Anne Montgomery, 65, a health policy expert at the National Committee to Preserve Social Security and Medicare. She believes, however, that baby boomers can “rewrite and flip that script if we want to and if we work to change systems that embody the values of a deeply ageist society.”
Integration, not separation, is needed. The best way to overcome stigma is “to get to know the people you are stigmatizing,” said G. Allen Power, 70, a geriatrician and the chair in aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada. “But we separate ourselves from older people so we don’t have to think about our own aging and our own mortality.”
The solution: “We have to find ways to better integrate older adults in the community as opposed to moving them to campuses where they are apart from the rest of us,” Power said. “We need to stop seeing older people only through the lens of what services they might need and think instead of all they have to offer society.”
That point is a core precept of the National Academy of Medicine’s 2022 report Global Roadmap for Healthy Longevity. Older people are a “natural resource” who “make substantial contributions to their families and communities,” the report’s authors write in introducing their findings.
Those contributions include financial support to families, caregiving assistance, volunteering, and ongoing participation in the workforce, among other things.
“When older people thrive, all people thrive,” the report concludes.
Future generations will get their turn. That’s a message Kramer conveys in classes he teaches at the University of Southern California, Cornell, and other institutions. “You have far more at stake in changing the way we approach aging than I do,” he tells his students. “You are far more likely, statistically, to live past 100 than I am. If you don’t change society’s attitudes about aging, you will be condemned to lead the last third of your life in social, economic, and cultural irrelevance.”
As for himself and the baby boom generation, Kramer thinks it’s “too late” to effect the meaningful changes he hopes the future will bring.
“I suspect things for people in my generation could get a lot worse in the years ahead,” Pillemer said. “People are greatly underestimating what the cost of caring for the older population is going to be over the next 10 to 20 years, and I think that’s going to cause increased conflict.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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I’ve been diagnosed with cancer. How do I tell my children?
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With around one in 50 adults diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most worried about telling their children.
It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or blame themselves. Over time, supportive family relationships and open communication help children adjust to their parent’s diagnosis and treatment.
It’s natural to feel you don’t have the skills or knowledge to talk with your children about cancer. But preparing for the conversation can improve your confidence.
Benjamin Manley/Unsplash Preparing for the conversation
Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones.
For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk.
Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you.
Choose the time and location when your children feel comfortable. Craig Adderley/Pexels Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax.
Also consider what you might need to support yourself.
Preparing the words
Parents might be worried about the best words or language to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track.
The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud.
Ask family and friends for their feedback on what you want to say. Make use of guides by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”.
Having the conversation
Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The amount and type of information you give will be based on their age and previous experiences with illness.
Remember, if things don’t go as planned, you can always try again later.
Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment.
Let them know what to expect in the coming weeks and months. Balance hope with reality. For example:
The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick.
Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a serious illness. Young children may worry about becoming unwell themselves, or other loved ones becoming sick.
Young children might worry about other loved ones becoming sick. Pixabay/Pexels Older children and teenagers may have experiences with cancer through other family members, friends at school or social media.
This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault.
Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example:
You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment.
If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”.
Finally, tell children you love them and offer them comfort.
How might they respond?
Be prepared for a range of different responses. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you.
Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable.
Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family.
What’s next?
Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions.
Resources might also help; for example, The Cancer Council’s app for children and teenagers and Redkite’s library of free books for families affected by cancer.
If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.
Cassy Dittman, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, CQUniversity Australia; Govind Krishnamoorthy, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, University of Southern Queensland, and Marg Rogers, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, University of New England
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Ramadan is almost here. 5 tips to boost your wellbeing and energy levels if you’re fasting
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Ramadan is one of the most significant months of the Islamic lunar calendar. It marks the time when the Quran was revealed to Prophet Mohammed (peace be upon him).
Almost 2 billion Muslims worldwide observe this month of prayer and reflection, which includes fasting between two prayers, Fajr at dawn and Maghrib at sunset.
Ramadan is about purifying the mind, body and soul, and practising self-restraint. It’s a time for spiritual growth and dedication to God (or Allah in Arabic). Ramadan also brings people together for meals and celebrations, with a focus on helping those less fortunate.
Depending on where you live, Ramadan can mean going 12 to 19 hours without eating or drinking anything, including water.
Our research shows choosing balanced, nutrient-dense foods and drinks can result in better wellbeing and greater energy levels than following your usual diet during Ramadan.
Here’s what to consider if you’re fasting for Ramadan.
Do you have any health issues?
Healthy Muslims are expected to fast during Ramadan once they have reached puberty.
Frail older adults are exempt from fasting, as are pregnant, breastfeeding and menstruating women. Anyone who cannot participate in fasting can make up for the missed fasting days later.
People with chronic illness or mental health may be exempt if fasting poses a risk to their health. If you suffer from chronic illness, such as diabetes, heart disease or kidney problems, and want to fast, consult your GP first.
Fasting can have severe health consequences for people with certain medical conditions and those who rely on prescription medication. Some medications need to be taken at a specific time (and some with food) to be safe and effective.
If you’re not drinking enough water during Ramadan, your body might also handle some medications differently: they may not work as well or cause side effects.
For people who can safely fast, here are five tips to maintain your wellbeing during Ramadan.
1. Plan ahead
In preparation for Ramadan, stock up on essentials. Plan your meals and hydration in advance, to stay on top of your nutritional intake.
Start reducing your caffeine gradually in the week leading to Ramadan, so your body can adjust. This can help prevent or reduce the fasting headaches that many experience at the beginning of Ramadan.
Move your meals gradually towards Suhoor and Iftar times, so your body gets used to the new mealtimes.
Plan your meals ahead of time. Ground Picture/Shutterstock 2. Stay hydrated
Staying hydrated is important during Ramadan. Women should aim to drink 2.1 litres of water or fluids (such as coconut water, clear soups, broths or herbal teas) each day. Men should aim for 2.6 litres.
Limit the intake of sugary or artificially sweetened drinks and enjoy fresh fruit juice only in moderation. Sugary drinks cause a rapid increase in blood sugar levels. The body responds by releasing insulin, causing a drop in blood sugar, which can leave you feeling fatigued, irritable and hungry.
Increase your hydration by including water-rich foods, such as cucumbers and watermelon, in your diet.
3. Get your nutrients early
Before dawn, have a nutrient-rich, slow-digesting meal, along with plenty of water.
Select healthy nutrient-dense food with proteins and fats from lean meats, fish, chickpeas, tofu, nuts and seeds.
Choose whole grain products, a variety of vegetables and fruits, and fermented foods, such as kimchi and pickles, which can support your digestion.
When you prepare your meals, consider grilling, steaming or air frying instead of deep frying.
Stay away from processed foods such as cakes, ice cream, chips and chocolates, as they often lack essential nutrients and are high in sugar, salt and fat. Processed foods also tend to be low in fibre and protein, which are crucial for maintaining a feeling of fullness.
4. Avoid the temptation to overeat in the evening
At sunset, many Muslims come together with family and friends for the fast-breaking evening meal (Iftar). During these occasions, it may be tempting to overindulge in sweets, salty snacks and fatty dishes.
But overeating can strain the digestive system, cause discomfort and disrupt sleep.
Start with something small. Tekkol/Shutterstock Instead, listen to your body’s signals, control your portions, and eat mindfully – this means slowly and without distractions.
Start with something small, such as a date and a glass of water. You may choose to complete the Maghrib prayer before returning for your main meal and more fluids.
5. Keep moving
Finally, try to include some light exercise into your schedule, to maintain your fitness and muscle mass, and promote sleep.
But avoid heavy workouts, sauna and intensive sports while fasting, as these may increase dehydration, which can increase your risk of feeling faint and falling.
Romy Lauche Deputy Director (Research), National Centre for Naturopathic Medicine, Southern Cross University
Fatima El-Assaad Senior Research Fellow, Microbiome Research Centre, UNSW Sydney
Jessica Bayes Postdoctoral Research Fellow at the National Centre for Naturopathic Medicine, Southern Cross UniversityThis article is republished from The Conversation under a Creative Commons license. Read the original article.
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For Many Rural Women, Finding Maternity Care Outweighs Concerns About Abortion Access
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BAKER CITY, Ore. — In what has become a routine event in rural America, a hospital maternity ward closed in 2023 in this small Oregon town about an hour from the Idaho border.
For Shyanne McCoy, 23, that meant the closest hospital with an obstetrician on staff when she was pregnant was a 45-mile drive away over a mountain pass.
When McCoy developed symptoms of preeclampsia last January, she felt she had the best chance of getting the care she needed at a larger hospital in Boise, Idaho, two hours away. She spent the final week of her pregnancy there, too far from home to risk leaving, before giving birth to her daughter.
Six months later, she said it seems clear to her that the health care needs of rural young women like her are largely ignored.
For McCoy and others, figuring out how to obtain adequate care to safely have a baby in Baker City has quickly eclipsed concerns about another medical service lacking in the area: abortion. But in Oregon and elsewhere in the country, progressive lawmakers’ attempts to expand abortion access sometimes clash with rural constituencies.
Oregon is considered one of the most protective states in the country when it comes to abortion. There are no legal limits on when someone can receive an abortion in the state, and the service is covered by its Medicaid system. Still, efforts to expand access in the rural, largely conservative areas that cover most of the state have encountered resistance and incredulity.
It’s a divide that has played out in elections in such states as Nevada, where voters passed a ballot measure in November that seeks to codify abortion protections in the state constitution. Residents in several rural counties opposed the measure.
In Oregon, during the months just before the Baker City closure was announced, Democratic state lawmakers were focused on a proposed pilot program that would launch two mobile reproductive health care clinics in rural areas. The bill specified that the van-based clinics would include abortion services.
State Rep. Christine Goodwin, a Republican from a southwestern Oregon district, called the proposal the “latest example” of urban legislators telling rural leaders what their communities need.
The mobile health clinic pilot was eventually removed from the bill that was under discussion. That means no new abortion options in Oregon’s Baker County — and no new state-funded maternity care either.
“I think if you expanded rural access in this community to abortions before you extended access to maternal health care, you would have an uprising on your hands,” said Paige Witham, 27, a member of the Baker County health care steering committee and the mother of two children, including an infant born in October.
A study published in JAMA in early December that examined nearly 5,000 acute care hospitals found that by 2022, 52% of rural hospitals lacked obstetrics care after more than a decade of unit closures. The health implications of those closures for young women, the population most likely to need pregnancy care, and their babies can be significant. Research has shown that added distance between a patient and obstetric care increases the likelihood the baby will be admitted to a neonatal intensive care unit, or NICU.
Witham said that while she does not support abortion, she believes the government should not “legislate it away completely.” She said that unless the government provides far more support for young families, like free child care and better mental health care, abortion should remain legal.
Conversations with a liberal school board member, a moderate owner of a timber company, members of Baker City’s Republican Party chapter, a local doula, several pregnant women, and the director of the Baker County Health Department — many of whom were not rigidly opposed to abortion — all turned up the same answer: No mobile clinics offering abortions here, please.
Kelle Osborn, a nurse supervisor for the Baker County Health Department, loved the idea of a mobile clinic that would provide education and birth control services to people in outlying areas. She was less thrilled about including abortion services in a clinic on wheels.
“It’s not something that should just be handed out from a mobile van,” she said of abortion services. She said people in her conservative rural county would probably avoid using the clinics for anything if they were understood to provide abortion services.
Both Osborn and Meghan Chancey, the health department’s director, said they would rank many health care priorities higher, including the need for a general surgeon, an ICU, and a dialysis clinic.
Nationally, reproductive health care services of all types tend to be limited for people in rural areas, even within states that protect abortion access. More than two-thirds of people in “maternity care deserts” — all of which are in rural counties — must drive more than a half-hour to get obstetric care, according to a 2024 March of Dimes report. For people in the Southern states where lawmakers installed abortion bans, abortion care can be up to 700 miles away, according to a data analysis by Axios.
Nathan Defrees grew up in Baker City and has practiced medicine here since 2017. He works for a family medicine clinic. If a patient asks about abortion, he provides information about where and how one can be obtained, but he doesn’t offer abortions himself.
“There’s not a lot of anonymity in small towns for physicians who provide that care,” he said. “Many of us aren’t willing to sacrifice the rest of our career for that.”
He also pointed to the small number of patients requesting the service locally. Just six people living in Baker County had an abortion in 2023, according to data from the Oregon Department of Public Health. Meanwhile, 125 residents had a baby that year.
A doctor with obstetric training living in another rural part of the state has chosen to quietly provide early-stage abortions when asked. The doctor, concerned for their family’s safety in the small, conservative town where they live, asked not to be identified.
The idea that better access to abortion is not needed in rural areas seems naive, the doctor said. People most in need of abortion often don’t have access to any medical service not already available in town, the doctor pointed out. The first patient the doctor provided an abortion for at the clinic was a meth user with no resources to travel or to manage an at-home medication abortion.
“It seemed entirely inappropriate for me to turn her away for care I had the training and the tools to do,” the doctor said.
Defrees said it has been easier for Baker County residents to get an abortion since the U.S. Supreme Court overturned Roe v. Wade.
A new Planned Parenthood clinic in Ontario, Oregon, 70 miles away in neighboring Malheur County, was built primarily to provide services to people from the Boise metro area, but it also created an option for many living in rural eastern Oregon.
Idaho is one of the 16 states with near-total bans on abortion. Like many states with bans, Idaho has struggled to maintain its already small fleet of fetal medicine doctors. The loss of regional expertise touches Baker City, too, Defrees said.
For example, he said, the treatment plan for women who have a desired pregnancy but need a termination for medical reasons is now far less clear. “It used to be those folks could go to Boise,” he said. “Now they can’t. That does put us in a bind.”
Portland is the next closest option for that type of care, and that means a 300-mile drive along a set of highways that can be treacherous in winter.
“It’s a lot scarier to be pregnant now in Baker City than it ever has been,” Defrees said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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The Coffee-Cortisol Connection, And Two Ways To Tweak It For Health
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Health opinions on coffee vary from “it’s an invigorating, healthful drink” to “it will leave you a shaking frazzled wreck”. So, what’s the truth and can we enjoy it healthily? Dr. Alan Mandell weighs in:
Enjoy it, but watch out!
Dr. Mandell is speaking only for caffeinated coffee in this video, and to this end, he’s conflating the health effects of coffee and caffeine. A statistically reasonable imprecision, since most people drink coffee with its natural caffeine in, but we’ll make some adjustment to his comments below, to disambiguate which statements are true for coffee generally, and which are true for caffeine:
- Drinking
coffeecaffeine first thing in the morning may not be ideal due to dehydration from overnight water loss. Coffeecaffeine is a diuretic, which means an increase in urination, thus further dehydrating the body.- Coffee contains great antioxidants, which are of course beneficial for the health in general.
- Cortisol, the body’s stress hormone, is generally at its peak in the morning. This is, in and of itself, good and correct—it’s how we wake up.
Coffeecaffeine consumption raises cortisol levels even more, leading to increased alertness and physical readiness, but it is possible to have too much of a good thing, and in this case, problems can arise because…- Elevated cortisol from early
coffeecaffeine drinking can build tolerance, leading to the need for morecoffeecaffeine over time. - It’s better, therefore, to defer drinking
coffeecaffeine until later in the morning when cortisol levels naturally drop. - All of this means that drinking
coffeecaffeine first thing can disrupt the neuroendocrine system, leading to fatigue, depression, and general woe. - Hydrate first thing in the morning before consuming
coffeecaffeine to keep the body balanced and healthy.
What you can see from this is that coffee and caffeine are not, in fact, interchangeable words, but the basic message is clear and correct: while a little spike of cortisol in the morning is good, natural, and even necessary, a big spike is none of those things, and caffeine can cause a big spike, and since for most people caffeine is easy to build tolerance to, there will indeed consistently be a need for more, worsening the problem.
In terms of hydration, it’s good to have water (or better yet, herbal tea) on one’s nightstand to drink when one wakes up.
If coffee is an important morning ritual for you, consider finding a good decaffeinated version for at least your first cup (this writer is partial to Lavazza’s “Dek Intenso”—which is not the same as their main decaf line, by the way, so do hold out for the “Dek Intenso” if you want to try my recommendation).
Decaffeinated coffee is hydrating and will not cause a cortisol spike (unless for some reason you find coffee as a concept very stressful in which case, yes, the stressor will cause a stress response).
Anyway, for more on all of this, enjoy:
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A drug that can extend your life by 25%? Don’t hold your breath
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Every few weeks or months, the media reports on a new study that tantalisingly dangles the possibility of a new drug to give us longer, healthier lives.
The latest study centres around a drug involved in targeting interleukin-11, a protein involved in inflammation. Blocking this protein appeared to help mice stave off disease and extend their life by more than 20%.
If only defying the ravages of time could be achieved through such a simple and effort-free way – by taking a pill. But as is so often the case, the real-world significance of these findings falls a fair way short of the hype.
Halfpoint/Shutterstock The role of inflammation in disease and ageing
Chronic inflammation in the body plays a role in causing disease and accelerating ageing. In fact, a relatively new label has been coined to represent this: “inflammaging”.
While acute inflammation is an important response to infection or injury, if inflammation persists in the body, it can be very damaging.
A number of lifestyle, environmental and societal drivers contribute to chronic inflammation in the modern world. These are largely the factors we already know are associated with disease and ageing, including poor diet, lack of exercise, obesity, stress, lack of sleep, lack of social connection and pollution.
While addressing these issues directly is one of the keys to addressing chronic inflammation, disease and ageing, there are a number of research groups also exploring how to treat chronic inflammation with pharmaceuticals. Their goal is to target and modify the molecular and chemical pathways involved in the inflammatory process itself.
What the latest research shows
This new interleukin-11 research was conducted in mice and involved a number of separate components.
In one component of this research, interleukin-11 was genetically knocked out in mice. This means the gene for this chemical mediator was removed from these mice, resulting in the mice no longer being able to produce this mediator at all.
In this part of the study, the mice’s lives were extended by over 20%, on average.
Another component of this research involved treating older mice with a drug that blocks interleukin-11.
Injecting this drug into 75-week old mice (equivalent to 55-year-old humans) was found to extend the life of mice by 22-25%.
These treated mice were less likely to get cancer and had lower cholesterol levels, lower body weight and improved muscle strength and metabolism.
From these combined results, the authors concluded, quite reasonably, that blocking interleukin-11 may potentially be a key to mitigating age-related health effects and improving lifespan in both mice and humans.
Why you shouldn’t be getting excited just yet
There are several reasons to be cautious of these findings.
First and most importantly, this was a study in mice. It may be stating the obvious, but mice are very different to humans. As such, this finding in a mouse model is a long way down the evidence hierarchy in terms of its weight.
Research shows only about 5% of promising findings in animals carry over to humans. Put another way, approximately 95% of promising findings in animals may not be translated to specific therapies for humans.
Second, this is only one study. Ideally, we would be looking to have these findings confirmed by other researchers before even considering moving on to the next stage in the knowledge discovery process and examining whether these findings may be true for humans.
We generally require a larger body of evidence before we get too excited about any new research findings and even consider the possibility of human trials.
Third, even if everything remains positive and follow-up studies support the findings of this current study, it can take decades for a new finding like this to be translated to successful therapies in humans.
Until then, we can focus on doing the things we already know make a huge difference to health and longevity: eating well, exercising, maintaining a healthy weight, reducing stress and nurturing social relationships.
Hassan Vally, Associate Professor, Epidemiology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low
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An article published this week in the prestigious journal Nature Medicine documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person.
The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors.
Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s.
The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop Creuztfeldt-Jakob disease (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million.
What’s CJD got to do with Alzehimer’s?
CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell.
Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised public health concerns over the eating of beef products in the United Kingdom in the 1980s.
Human growth hormone used to come from donated organs
Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue.
But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around 16,000 donated glands.
An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people.
hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk.
Human growth hormone is now produced in a lab.
National Cancer Institute/UnsplashWhat are the latest findings about Alzheimer’s disease?
The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission.
The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease.
They considered other explanations for the findings but concluded donated hGH was the likely cause.
Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease.
Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is increasing evidence these proteins spread in the brain in a similar way to prion diseases. So the mode of transmission the authors propose is certainly plausible.
However, given the amyloid protein deposits in the brain at least 20 years before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident.
When was this process used in Australia?
In Australia, donated pituitary material was used from 1967 to 1985 to treat people with short stature and infertility.
More than 2,000 people received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch.
The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are considered to be incredibly small.
Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for around 5% of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution.
Early onset Alzheimer’s means it occurs before age 65.
perfectlab/ShutterstockThe risk is very low – and you can’t ‘catch’ it like a virus
The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide.
Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk.
The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.
Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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