Older people’s risk of abuse is rising. Can an ad campaign protect them?

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Elder abuse is an emerging public health and safety issue for communities of high-income countries.

The most recent data from Australia’s National Elder Abuse Prevalence Study, which surveyed 7,000 older people living in the community, found one in six self-reported being a victim of some form of abuse. But this did not include older people living in residential aged care or those with cognitive impairment, such as dementia – so is likely an underestimate.

This week the Australian government announced a multi-million dollar advertising campaign it hopes will address this serious and abhorrent abuse.

But is investing in community awareness of elder abuse the best use of scarce resources?

Nuttapong punna/Shutterstock

What is elder abuse?

The World Health Organization (WHO) defines elder abuse as

[…] a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.

Australia usually defines older people as those over 65. The exact age varies between countries depending on the overall health status of a nation and its vulnerable population groups. The WHO definitions of an older adult for sub-Saharan Africa, for example, is over 50. And there are communities with poorer health status and shorter lifespans within country borders, including our First Nations people.

Elder abuse can take on many different forms including physical, sexual, psychological, emotional, or financial abuse and neglect.

Living longer and wealthier

The number of older people in our society is greater than it has ever been. Around 17% Australians are aged 65 and over. By 2071, older Australians will make up between 25% and 27% of the total population.

People are living longer, accumulating substantial wealth and are vulnerable to abuse due to cognitive, physical or functional limitations.

Longer lifespans increase the time of possible exposure to abuse. Australian men aged 65 can expect to live another 20.2 years, while women aged 65 are likely to live another 22.8 years. (Life expectancy for First Nations men and women remains significantly shorter.)

Australian men are now 143 times more likely to reach the age of 100 than they were in 1901. Women are 82 times more likely.

Older people hold a large proportion of our nation’s wealth, making them vulnerable to financial abuse. Recent research by the Australian Council of Social Service and UNSW Sydney reveals older households (with people over 65) are 25% wealthier than the average middle-aged household and almost four times as wealthy as the average under-35 household.

Finally, older people have higher levels of impairment in their thinking, reasoning and physical function. Cognitive impairment, especially dementia, increases from one in 67 Australians under 60 to almost one in two people aged over 90.

Over half of Australians aged 65 years and over have disability. A particularly vulnerable group are the 258,374 older Australians who receive government-funded home care.

Who perpetrates elder abuse?

Sadly, most of the perpetrators of elder abuse are known to their victims. They are usually a member of the family, such as a life partner, child or grandchild.

Elder abuse causes significant illness and even early death. Financial abuse (across all ages) costs the community billions of dollars. Specific data for financial elder abuse is limited but indicates massive costs to individual survivors and the community.

Despite this, the level of awareness of elder abuse is likely to be much lower than for family violence or child abuse. This is partly due to the comparatively recent concept of elder abuse, with global awareness campaigns only developed over the past two decades.

Is an advertising campaign the answer?

The federal government has allocated A$4.8 million to an advertising campaign on television, online and in health-care clinics to reach the broader community. For context, last year the government spent $131.4 million on all media campaigns, including $32.6 million on the COVID vaccination program, $2 million on Japanese encephalitis and $3.2 million on hearing health awareness.

The campaign will likely benefit a small number of people who may be victims and have the capacity to report their perpetrators to authorities. It will generate some heartbreaking anecdotes. But it is unlikely to achieve broad community or systemic change.

There is little research evidence to show media campaigns alter the behaviour of perpetrators of elder abuse. And suggesting the campaign raises awareness of the issue for older people who are survivors of abuse sounds more like blaming victims than empowering them.

We don’t know how the government will judge the success of the campaign, so taxpayers won’t know whether a reasonable return on this investment was achieved. There may also be opportunity costs associated with the initiative – that is, lost opportunities for other actions and strategies. It could be more effective and efficient to target high-risk subgroups or to allocate funding to policy, practice reform or research that has direct tangible benefits for survivors. https://www.youtube.com/embed/DeK2kaqplTI?wmode=transparent&start=0 The Australian Human Rights Commission’s campaign from last year.

But the campaign can’t hurt, right?

Actually, the dangers that could come with an advertising campaign are two-fold.

First it may well oversimplify a highly complex issue. Identifying and managing elder abuse requires an understanding of the person’s vulnerabilities, their decision-making capacity and ability to consent, the will and preferences of victim and the role of perpetrator in the older person’s life. Abuse happens in the context of family and social networks. And reporting abuse can have consequences for the victim’s quality of life and care.

Consider the complexities of a case where an older person declines to have her grandson reported to police for stealing her money and medication because of her fear of becoming socially isolated. She might even feel responsible for the behaviour having raised the grandson and not want him to have a criminal record.

Secondly, a public campaign can create the illusion government and our institutions have the matter “in hand”. This might slow the opportunity for real change.

Ideally, the campaign will strengthen the argument for better policies, reporting procedures, policing, prosecution and judgements that are aligned. But these ends will also need investment in more research to build better communities that take good care of older people.

Joseph Ibrahim, Professor, Aged Care Medical Research Australian Centre for Evidence Based Aged Care, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Why are tall people more likely to get cancer? What we know, don’t know and suspect

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    People who are taller are at greater risk of developing cancer. The World Cancer Research Fund reports there is strong evidence taller people have a higher chance of of developing cancer of the:

    • pancreas
    • large bowel
    • uterus (endometrium)
    • ovary
    • prostate
    • kidney
    • skin (melanoma) and
    • breast (pre- and post-menopausal).

    But why? Here’s what we know, don’t know and suspect.

    Pexels/Andrea Piacquadio
    A tall woman and her partner are silhoutted against the sunset.
    Height does increase your cancer risk – but only by a very small amount. Christian Vinces/Shutterstock

    A well established pattern

    The UK Million Women Study found that for 15 of the 17 cancers they investigated, the taller you are the more likely you are to have them.

    It found that overall, each ten-centimetre increase in height increased the risk of developing a cancer by about 16%. A similar increase has been found in men.

    Let’s put that in perspective. If about 45 in every 10,000 women of average height (about 165 centimetres) develop cancer each year, then about 52 in each 10,000 women who are 175 centimetres tall would get cancer. That’s only an extra seven cancers.

    So, it’s actually a pretty small increase in risk.

    Another study found 22 of 23 cancers occurred more commonly in taller than in shorter people.

    Why?

    The relationship between height and cancer risk occurs across ethnicities and income levels, as well as in studies that have looked at genes that predict height.

    These results suggest there is a biological reason for the link between cancer and height.

    While it is not completely clear why, there are a couple of strong theories.

    The first is linked to the fact a taller person will have more cells. For example, a tall person probably has a longer large bowel with more cells and thus more entries in the large bowel cancer lottery than a shorter person.

    Scientists think cancer develops through an accumulation of damage to genes that can occur in a cell when it divides to create new cells.

    The more times a cell divides, the more likely it is that genetic damage will occur and be passed onto the new cells.

    The more damage that accumulates, the more likely it is that a cancer will develop.

    A person with more cells in their body will have more cell divisions and thus potentially more chance that a cancer will develop in one of them.

    Some research supports the idea having more cells is the reason tall people develop cancer more and may explain to some extent why men are more likely to get cancer than women (because they are, on average, taller than women).

    However, it’s not clear height is related to the size of all organs (for example, do taller women have bigger breasts or bigger ovaries?).

    One study tried to assess this. It found that while organ mass explained the height-cancer relationship in eight of 15 cancers assessed, there were seven others where organ mass did not explain the relationship with height.

    It is worth noting this study was quite limited by the amount of data they had on organ mass.

    A tall older man leans against a wall while his bicycle is parked nearby.
    Is it because tall people have more cells? Halfpoint/Shutterstock

    Another theory is that there is a common factor that makes people taller as well as increasing their cancer risk.

    One possibility is a hormone called insulin-like growth factor 1 (IGF-1). This hormone helps children grow and then continues to have an important role in driving cell growth and cell division in adults.

    This is an important function. Our bodies need to produce new cells when old ones are damaged or get old. Think of all the skin cells that come off when you use a good body scrub. Those cells need to be replaced so our skin doesn’t wear out.

    However, we can get too much of a good thing. Some studies have found people who have higher IGF-1 levels than average have a higher risk of developing breast or prostate cancer.

    But again, this has not been a consistent finding for all cancer types.

    It is likely that both explanations (more cells and more IGF-1) play a role.

    But more research is needed to really understand why taller people get cancer and whether this information could be used to prevent or even treat cancers.

    I’m tall. What should I do?

    If you are more LeBron James than Lionel Messi when it comes to height, what can you do?

    Firstly, remember height only increases cancer risk by a very small amount.

    Secondly, there are many things all of us can do to reduce our cancer risk, and those things have a much, much greater effect on cancer risk than height.

    We can take a look at our lifestyle. Try to:

    • eat a healthy diet
    • exercise regularly
    • maintain a healthy weight
    • be careful in the sun
    • limit alcohol consumption.

    And, most importantly, don’t smoke!

    If we all did these things we could vastly reduce the amount of cancer.

    You can also take part in cancer screening programs that help pick up cancers of the breast, cervix and bowel early so they can be treated successfully.

    Finally, take heart! Research also tells us that being taller might just reduce your chance of having a heart attack or stroke.

    Susan Jordan, Associate Professor of Epidemiology, The University of Queensland and Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Does intermittent fasting increase or decrease our risk of cancer?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Research over the years has suggested intermittent fasting has the potential to improve our health and reduce the likelihood of developing cancer.

    So what should we make of a new study in mice suggesting fasting increases the risk of cancer?

    Stock-Asso/Shutterstock

    What is intermittent fasting?

    Intermittent fasting means switching between times of eating and not eating. Unlike traditional diets that focus on what to eat, this approach focuses on when to eat.

    There are lots of commonly used intermittent fasting schedules. The 16/8 plan means you only eat within an eight-hour window, then fast for the remaining 16 hours. Another popular option is the 5:2 diet, where you eat normally for five days then restrict calories for two days.

    In Australia, poor diet contributes to 7% of all cases of disease, including coronary heart disease, stroke, type 2 diabetes, and cancers of the bowel and lung. Globally, poor diet is linked to 22% of deaths in adults over the age of 25.

    Intermittent fasting has gained a lot of attention in recent years for its potential health benefits. Fasting influences metabolism, which is how your body processes food and energy. It can affect how the body absorbs nutrients from food and burns energy from sugar and fat.

    What did the new study find?

    The new study, published in Nature, found when mice ate again after fasting, their gut stem cells, which help repair the intestine, became more active. The stem cells were better at regenerating compared with those of mice who were either totally fasting or eating normally.

    This suggests the body might be better at healing itself when eating after fasting.

    However, this could also have a downside. If there are genetic mutations present, the burst of stem cell-driven regeneration after eating again might make it easier for cancer to develop.

    Polyamines – small molecules important for cell growth – drive this regeneration after refeeding. These polyamines can be produced by the body, influenced by diet, or come from gut bacteria.

    The findings suggest that while fasting and refeeding can improve stem cell function and regeneration, there might be a tradeoff with an increased risk of cancer, especially if fasting and refeeding cycles are repeated over time.

    While this has been shown in mice, the link between intermittent fasting and cancer risk in humans is more complicated and not yet fully understood.

    What has other research found?

    Studies in animals have found intermittent fasting can help with weight loss, improve blood pressure and blood sugar levels, and subsequently reduce the risks of diabetes and heart disease.

    Research in humans suggests intermittent fasting can reduce body weight, improve metabolic health, reduce inflammation, and enhance cellular repair processes, which remove damaged cells that could potentially turn cancerous.

    However, other studies warn that the benefits of intermittent fasting are the same as what can be achieved through calorie restriction, and that there isn’t enough evidence to confirm it reduces cancer risk in humans.

    What about in people with cancer?

    In studies of people who have cancer, fasting has been reported to protect against the side effects of chemotherapy and improve the effectiveness of cancer treatments, while decreasing damage to healthy cells.

    Prolonged fasting in some patients who have cancer has been shown to be safe and may potentially be able to decrease tumour growth.

    On the other hand, some experts advise caution. Studies in mice show intermittent fasting could weaken the immune system and make the body less able to fight infection, potentially leading to worse health outcomes in people who are unwell. However, there is currently no evidence that fasting increases the risk of bacterial infections in humans.

    So is it OK to try intermittent fasting?

    The current view on intermittent fasting is that it can be beneficial, but experts agree more research is needed. Short-term benefits such as weight loss and better overall health are well supported. But we don’t fully understand the long-term effects, especially when it comes to cancer risk and other immune-related issues.

    Since there are many different methods of intermittent fasting and people react to them differently, it’s hard to give advice that works for everyone. And because most people who participated in the studies were overweight, or had diabetes or other health problems, we don’t know how the results apply to the broader population.

    For healthy people, intermittent fasting is generally considered safe. But it’s not suitable for everyone, particularly those with certain medical conditions, pregnant or breastfeeding women, and people with a history of eating disorders. So consult your health-care provider before starting any fasting program.

    Amali Cooray, PhD Candidate in Genetic Engineering and Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Wholewheat Bread vs Seeded White – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing wholewheat bread to seeded bread, we picked the wholewheat.

    Why?

    First, we will acknowledge that this is a false dichotomy; it is possible to have seeded wholewheat bread. However, it is very common to have wholewheat bread that isn’t seeded, and white bread that is seeded. So, it’s important to be able to decide which is the healthier option, since very often, this false dichotomy is what’s on offer.

    We will also advise checking labels (or the baker, if getting from a bakery) to ensure that visibly brown bread is actually wholewheat, and not just dyed brown with caramel coloring or such (yes, that is a thing that some companies do).

    Now, as for why we chose the wholewheat over the seeded white…

    In terms of macronutrients, wholewheat bread has (on average; individual breads may vary of course) has 2x the protein and a lot more fiber.

    Those seeds in seeded bread? They just aren’t enough to make a big impact on the overall nutritional value of the bread in those regards. Per slice, you are getting, what, 10 seeds maybe? This is not a meaningful dietary source of much.

    Seeded bread does have proportionally more healthy fats, but the doses are still so low as to make it not worth the while; it just looks like a lot of expressed as a percentage of comparison, because of the wholewheat bread has trace amounts, and the seeded bread has several times those trace amounts, it’s still a tiny amount. So, we’d recommend looking to other sources for those healthy fats.

    Maybe dip your bread, of whatever kind, into extra virgin olive oil, for example.

    Wholewheat bread of course also has a lower glycemic index. Those seeds in seeded white bread don’t really slow it down at all, because they’re not digested until later.

    Want to learn more?

    You might like to read:

    Enjoy!

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  • Kidney Beans or Black Beans – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing kidney beans to black beans, we picked the black beans.

    Why?

    First, do note that black beans are also known as turtle beans, or if one wants to hedge one’s bets, black turtle beans. It’s all the same bean. As a small linguistic note, kidney beans are known as “red beans” in many languages, so we could have called this “red beans vs black beans”, but that wouldn’t have landed so well with our largely anglophone readership. So, kidney beans vs black beans it is!

    They’re certainly both great, and this is a close one today…

    In terms of macros, they’re equal on protein and black beans have more carbs and/but also more fiber. So far, so equal—or rather, if one pulls ahead of the other here, it’s a matter of subjective priorities.

    In the category of vitamins, they’re equal on vitamins B2, B3, and choline, while kidney beans have more of vitamins B6, B9, C, and K, and black beans have more of vitamins A, B1, B5, and E. In other words, the two beans are still tied with a 4:4 split, unless we want to take into account that that vitamin E difference is that black beans have 29x more vitamin E, in which case, black beans move ahead.

    When it comes to minerals, finally the winner becomes apparent; while kidney beans have a little more manganese and zinc, on the other hand black beans have more calcium, copper, iron, magnesium, phosphorus, potassium, and selenium. However, it should be noted that honestly, the margins aren’t huge here and kidney beans are almost as good for all of these minerals.

    In short, black beans win the day, but kidney beans are very close behind, so enjoy whichever you prefer, or better yet, both! They go great together in tacos, burritos, or similar, by the way.

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    Take care!

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  • Can You Step Backwards Without Your Foot Or Torso Turning Out?

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    Walking backwards is often overlooked, but research shows it can enhance forward walking, especially in stroke patients; it has other benefits for everyone else, too. The physiotherapists at Fitness4Life Physical Therapy explain:

    …and one step back

    How it works: walking backwards heightens proprioception and stimulates muscles, improving balance and posture. Additionally, our daily lives tend to involve forward-leaning postures, causing upper back bending, and walking backwards helps counterbalance this.

    Extra benefits: training to walk backwards can reduce the risk of falls, as stepping back is a common movement that is often untrained.

    Exercise: try doing backwards lunges, to assess your skill and balance while moving backward. If foot rotation or torso rotation occurs during the exercise, then there’s room for improvement. Correcting these movements is then simply a matter of practicing backward lunges without turning.

    10almonds tip: any exercise is only as good as your will to actually do it. For this reason, dancing is a great exercise in this case, as almost all forms of dance involve stepping backwards (in order to have steps without travelling somewhere, forwards steps are usually balanced with backwards ones)

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    Fall Special ← About how to avoid falling, and how to avoid (and failing that, at least minimize) injury if you do fall. If you think this only happens to other/older people, remember, there’s a first time for everything, so it is better to be prepared in advance!

    Take care!

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  • Less Common Oral Hygiene Options

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    Less Common Alternatives For Oral Hygiene!

    You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.

    There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.

    Tooth soap

    The idea here is simplicity, and brushing with as few ingredients as possible. Soap cleans your teeth the same way it cleans your (sometimes compositionally quite similar—enamel and all) dishes, without damaging them.

    We’d love to link to some science here, but alas, it appears to have not yet been done—at least, we couldn’t find any!

    You can make your own tooth soap if you are feeling confident, or you might prefer to buy one ready-made (here’s an example product on Amazon, with various flavor options)

    Oil pulling

    We are getting gradually more scientific now; there is science for this one… But the (scientific) reviews are mixed:

    Wooley et al., 2020, conducted a review of extant studies, and concluded:

    ❝The limited evidence suggests that oil pulling with coconut oil may have a beneficial effect on improving oral health and dental hygiene❞

    Source: The effect of oil pulling with coconut oil to improve dental hygiene and oral health: A systematic review

    The “Science-Based Medicine” project was less positive in its assessment, and declared that all and any studies that found oil pulling to be effective were a matter of researcher/publication bias. We would note that SBM is a private project and is not without its own biases, but for balance, here is what they had to offer:

    SBM | Oil Pulling Your Leg

    A more rounded view seems to be that it is a good method for cleaning your teeth if you don’t have better options available (whereby, “better options” is “almost any other method”).

    One final consideration, which the above seemed not to consider, is:

    If you have sensitive teeth/gums, oil-pulling is the gentlest way of cleaning them, and getting them back into sufficient order that you can comfortably use other methods.

    Want to try it? You can use any food-grade oil (coconut oil or olive oil are common choices).

    Chewing stick

    Not just any stick—a twig of the Salvadora persica tree. This time, there’s lots of science for it, and it’s uncontroversially effective:

    ❝A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties.

    Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva.

    Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush❞

    ~ Hague et al.

    Read in full: A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health

    And about the efficacy vs using a toothbrush, here’s an example:

    Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health

    Want to try the miswak stick? Here’s an example product on Amazon.

    Enjoy!

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