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Which older adults are getting their flu shots and Covid boosters? – U-M

With two viruses threatening to make older adults sick this winter, a new poll shows most people over 50 have gotten vaccines to protect them against both influenza and coronavirus, or plan to. And a majority of those who have gotten the COVID-19 vaccine plan to get an additional dose to boost their level of protection.

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But the poll, taken in mid-October, also reveals major differences in vaccine attitudes between older adults of different age groups, racial and ethnic backgrounds, and other characteristics including personal political leaning.

The new findings come from the National Poll on Healthy Aging, based at the University of Michigan Institute for Healthcare Policy and Innovation, and supported by AARP and Michigan Medicine, U-M’s academic medical center.

The poll finds that 1 in 3 older adults feel it is more important to get vaccinated against the flu this year than in years before the COVID-19 pandemic. Almost all of the rest said the importance this year is the same.

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Tony

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Cutting 200 calories daily and exercising may improve heart health in obese older adults

Cutting just 200 calories a day with moderate exercise reaped bigger rewards than exercise alone for older, obese adults. Among older adults with obesity, combining aerobic exercise with a moderate reduction in daily calories resulted in greater improvements in aortic stiffness (a measure of vascular health, which impacts cardiovascular disease), compared to exercise only or to exercise plus a more restrictive diet, according to new research published today in the American Heart Association’s flagship journal Circulation.

Eat less; move more; live longer sounds very familiar here.


Modifiable lifestyle factors such as a healthy diet and regular physical activity may help offset age-related increases in aortic stiffness. Although aerobic exercise generally has favorable effects on aortic structure and function, previous studies have shown that exercise alone may not be sufficient to improve aortic stiffness in older adults with obesity.

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“This is the first study to assess the effects of aerobic exercise training with and without reducing calories on aortic stiffness, which was measured via cardiovascular magnetic resonance imaging (CMR) to obtain detailed images of the aorta,” said Tina E. Brinkley, Ph.D., lead author of the study and associate professor of gerontology and geriatric medicine at the Sticht Center for Healthy Aging and Alzheimer’s Prevention at Wake Forest School of Medicine in Winston-Salem, North Carolina. “We sought to determine whether adding caloric restriction for weight loss would lead to greater improvements in vascular health compared to aerobic exercise alone in older adults with obesity.”

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Insomnia may be a risk factor for fatal brain aneurysm rupture – AHA

Insomnia may be a potential risk factor for a brain bleed from a ruptured aneurysm along with more well known risk factors of smoking and high blood pressure, according to new research published in the Journal of the American Heart Association, an open access journal of the American Heart Association.

More than 3% of adults worldwide have unruptured blood vessel malformations in the brain called intracranial aneurysms, the majority of which will never rupture. About 2.5% of intracranial aneurysms will rupture, resulting in a subarachnoid hemorrhage (SAH), also called a brain bleed. SAH is a type of stroke that occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull.

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“Ruptured aneurysms are highly fatal. It is, therefore, extremely important to identify modifiable risk factors that can help prevent aneurysms from rupturing,” said study author Susanna C. Larsson, Ph.D., associate professor in the unit of cardiovascular and nutritional epidemiology at the Karolinska Institutet in Stockholm, Sweden, and the unit of medical epidemiology at Uppsala University in Uppsala, Sweden.

The researchers sought to determine whether various factors were associated with intracranial aneurysm and/or the aneurysm rupturing. They studied established risk factors such as smoking and high blood pressure and also assessed the link between aneurysms and coffee consumption, sleep, physical activity, body mass index (BMI), blood glucose levels, type 2 diabetes, blood pressure, cholesterol, chronic inflammation and kidney function.

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Gene linked to cognitive resilience in seniors

Many people develop Alzheimer’s or other forms of dementia as they get older. However, others remain sharp well into old age, even if their brains show underlying signs of neurodegeneration.

Among these cognitively resilient people, researchers have identified education level and amount of time spent on intellectually stimulating activities as factors that help prevent dementia. A new study by MIT researchers shows that this kind of enrichment appears to activate a gene family called MEF2, which controls a genetic program in the brain that promotes resistance to cognitive decline.

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The researchers observed this link between MEF2 and cognitive resilience in both humans and mice. The findings suggest that enhancing the activity of MEF2 or its targets might protect against age-related dementia.

“It’s increasingly understood that there are resilience factors that can protect the function of the brain,” says Li-Huei Tsai, director of MIT’s Picower Institute for Learning and Memory. “Understanding this resilience mechanism could be helpful when we think about therapeutic interventions or prevention of cognitive decline and neurodegeneration-associated dementia.”

Tsai is the senior author of the study, which appears today in Science Translational Medicine. The lead authors are recent MIT PhD recipient Scarlett Barker and MIT postdoctoral fellow and Boston Children’s Hospital physician Ravikiran (Ravi) Raju.

Protective effects

A large body of research suggests that environmental stimulation offers some protection against the effects of neurodegeneration. Studies have linked education level, type of job, number of languages spoken, and amount of time spent on activities such as reading and doing crossword puzzles to higher degrees of cognitive resilience.

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Daylight Savings Time Ends Tomorrow Morning

Just a reminder for those of you who still have clocks that don’t update automatically.

Daylight Savings Time ends Sunday, November 7 at 2:00 AM, so don’t forget to set your clock back and get that extra hour of sleep. You also won’t be arriving too early for your various dates on Sunday.

Ben Franklin created Daylight Savings Time in the 18th century to save an extra hour of daylight and preserve candles necessary for illumination.

A couple of years back new President Medvedev made Daylight Savings Time a permanent condition in Russia because he thought the nights seemed longer on Standard Time and contributed to his country’s high suicide rate. Apparently, he didn’t think living under communism had anything to do with the high suicide rate.


When you are resetting your clock this year, maybe you could rethink your weight management program and confirm that you are meeting your goals. Don’t be one of those folks who is digging his own grave with his fork ….

Tony

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Non-invasive imaging detects dangerous blood clots

  • Investigators have developed and tested a targeted contrast agent that can detect blood clots in the hearts of patients with atrial fibrillation, or an irregular heartbeat.
  • The strategy could be used to find clots in other parts of the body as well, such as in vessels that, when blocked, can lead to stroke.

Atrial fibrillation—an irregular and often rapid heart rate—is a common condition that can cause clots to form in the heart that may then dislodge and flow to the brain, potentially leading to a stroke. The standard way to detect these clots requires patients to be sedated and to have a fairly large tube inserted down the throat and esophagus for a transesophageal ultrasound. Investigators at Massachusetts General Hospital (MGH) have now developed and tested a targeted contrast agent to detect and image these clots noninvasively. They verified the potential of this strategy in a study published in JACC: Cardiovascular Imaging.

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The agent has a strong affinity for fibrin, a component of blood clots, and is detected with a radioactive copper tag. “The idea behind the technology is that the agent will find and bind to blood clots anywhere in the body—not just in the heart—and make the clots detectable like a bright star in the night sky,” says senior author David Sosnovik, MD, FACC, director of the Program in Cardiovascular Imaging within MGH’s Martinos Center for Biomedical Imaging and an associate professor of Medicine at Harvard Medical School. “In some ways this is analogous to doing a smart search with a search engine such as Google, where the search terms one uses guide the search. We inject the agent into a small peripheral vein and it circulates throughout the human body on its search for clots.” If it doesn’t find any clots, then it’s rapidly excreted from the body; however, if it finds a clot and binds to it, clinicians can detect it with an imaging technique known as positron emission tomography.

Sosnovik and his colleagues first examined how the agent reacts (specifically, its metabolism and pharmacokinetics) in eight healthy volunteers. After injection, the agent was initially stable within the body and then was cleared from tissues within several hours, suggesting that it was safe. Next, the team administered the agent to patients with atrial fibrillation, some with clots in the heart and some without. Imaging tests of the heart revealed bright signals within the clots that were not seen in patients without clots.

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Tony

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Eat to boost immunity – Tufts

Like everything else in our bodies, the immune system depends on nutrients to function properly. According to a paper by Simin N. Meydani, PhD, a professor at the Friedman School and director of the Nutritional Immunology Laboratory at the Human Nutrition Research Center on Aging, and her colleagues, mounting evidence suggests ensuring you get adeqate amounts of certain nutrients may help optimize immune function, including improving resistance to infection. Here is what we know so far:

Vitamin E is an antioxidant that protects cells, including immune cells, from oxidative damage. Evidence suggests vitamin E supports optimal immune function. While vitamin E supplementation can increase risk for bleeding and stroke, dietary intake is perfectly safe.

Vitamin E is found naturally in foods like plant oils (especially sunflower, safflower, and wheat germ oil), nuts, and seeds. This vitamin is sometimes added to processed foods like breakfast cereals (check Nutrition Facts labels). Green vegetables, such as spinach and broccoli, also provide some vitamin E.

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Vitamin D receptors are found in most immune cells. Adequate vitamin D levels may help maintain the body’s defense against infection.

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Scientists identify cause of Alzheimer’s progression in the brain

As a person with several cases of Alzheimer’s Disease and other forms of dementia on both sides of his family, I have worked diligently to keep up with facts on possible prevention or, at least, slowing of cognitive impairment. I have written repeatedly about cognition and the value exercise in helping the brain to maintain its full function.

For the first time, researchers have used human data to quantify the speed of different processes that lead to Alzheimer’s disease and found that it develops in a very different way than previously thought. Their results could have important implications for the development of potential treatments.

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The international team, led by the University of Cambridge, found that instead of starting from a single point in the brain and initiating a chain reaction which leads to the death of brain cells, Alzheimer’s disease reaches different regions of the brain early. How quickly the disease kills cells in these regions, through the production of toxic protein clusters, limits how quickly the disease progresses overall.

The researchers used post-mortem brain samples from Alzheimer’s patients, as well as PET scans from living patients, who ranged from those with mild cognitive impairment to those with full-blown Alzheimer’s disease, to track the aggregation of tau, one of two key proteins implicated in the condition.

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Huge real world study of third dose COVID-19 vaccine effectiveness

The Clalit Research Institute, in collaboration with researchers from Harvard University, analyzed one of the world’s largest integrated health record databases to examine the effectiveness of the third dose of the Pfizer/BioNTech BNT162B2 vaccine against the Delta variant of SARS-CoV-2. The study provides the largest peer-reviewed evaluation of the effectiveness of a third “booster” dose of a COVID-19 vaccine in a nationwide mass-vaccination setting. The study was conducted in Israel, an early global leader in third-dose COVID-19 vaccination rates. 


    
Many countries are currently experiencing a resurgence of SARS-CoV-2 infections despite hitherto successful vaccination campaigns. This may be due to the greater infectiousness of the delta (B.1.617.2) variant of SARS-CoV-2, and to waning immunity of vaccines administered months earlier. In the face of the current resurgence, several countries are planning to administer a third booster dose of mRNA COVID-19 vaccine. 

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This study suggests that a third vaccine dose is effective in reducing severe COVID-19-related outcomes compared to individuals who have received two vaccine doses at least 5 months ago. It is the first to estimate the effectiveness of a third dose of an mRNA COVID-19 vaccine—BNT162b2 specifically—against severe outcomes with adjustment for various possible confounders, including comorbidities and behavioral factors. The study’s large size also allows a more precise assessment of the vaccine’s effectiveness across different time periods, different subpopulations (by sex, age and number of comorbidities), and different severe outcomes (which are rarer and thus require greater sample size). A recent clinical trial conducted by BioNTech included a smaller sample size and did not estimate the third-dose’s effects for more severe outcomes.

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New guidelines may help doctors diagnose chest pain – AHA

Chest pain is about more than pain in the chest. But when it comes on suddenly, experts behind new guidelines on evaluating and diagnosing it don’t want you pondering nuances. They want you to act. Now.

“The most important thing people need to know about chest pain is that if they experience it, they should call 911,” said Dr. Phillip Levy, a professor of emergency medicine and assistant vice president for research at Wayne State University in Detroit. “People shouldn’t waste time trying to self-diagnose. They should immediately go to the nearest hospital. And if they’re going to go to the nearest hospital to get evaluated for chest pain, ideally, it should be by an ambulance.”

Levy helped lead the committee that wrote the new guidelines from the American Heart Association and American College of Cardiology. The recommendations aim to help patients and health care professionals act faster, make smarter choices and communicate better about chest pain.

Part of that is spreading the word that some people may not report chest “pain” but rather chest “discomfort,” which may include pressure or tightness in the chest but also in other areas, including the shoulders, arms, neck, back, upper abdomen or jaw.

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Potentially harmful chemicals found in fast food

Chicken nuggets, burritos and other popular items consumers buy from fast food outlets in the United States contain chemicals that are linked to a long list of serious health problems, according to a first-of-its-kind study.

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Researchers at the George Washington University and their colleagues bought fast foods from popular outlets and found 10 of 11 potentially harmful chemicals in the samples, including phthalates, a group of chemicals that are used to make plastics soft and are known to disrupt the endocrine system. The research team also found other plasticizers, chemicals that are emerging as replacements to phthalates.

“We found phthalates and other plasticizers are widespread in prepared foods available at U.S. fast food chains, a finding that means many consumers are getting a side of potentially unhealthy chemicals along with their meal,” Lariah Edwards, lead author of the study and a postdoctoral scientist at GW, said. “Stronger regulations are needed to help keep these harmful chemicals out of the food supply.”

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DOD funds study to improve sleep, clearance of the brain

The U.S. Department of Defense is funding the first human trial of a device to speed up and enhance the natural system of brain cleansing that occurs when we sleep. 

The trial will be conducted among 90 people at three trial sites – University of North Carolina, University of Washington School of Medicine, and a collaboration between Oregon Health & Science University and the Brain Electrophysiology Laboratory (BEL). Results are expected in the fall of 2022.

Functional prototype to test in-home sleep treatment. Electronics and battery are perched on top of the head. Next generation of the device will have electronics/battery integrated in the headband.

Recent discoveries point to the importance of quality sleep for clearance of brain metabolic waste through the newly-discovered brain glymphatic system. If sleep is disrupted, so are these crucial processes, leading to cognitive impairment – things like faulty motor coordination, attention deficits, slower processing speed, decreased decision-making capabilities, and hampered short-term memory, in addition to increasing risk of neurodegenerative disease later in life. These issues can have life-or-death consequences for service members in the U.S. military, which is why the Department of Defense is funding innovative research initiatives, including this three-year, $4.3-million, project with the ultimate goal of helping service members overcome acute sleep deprivation and chronic sleep restriction.

The scientists leading this effort are from UNC-Chapel Hill, the University of Washington School of Medicine, the Brain Electrophysiology Lab Oregon Health & Science University, and Montana State University.

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Weekend funnies …

Halloween edition … have a scary weekend!

Tony

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Your doctor may prescribe spending more time in nature instead of drugs – AHA

Dr. Robert Zarr loves to write prescriptions that you don’t have to take to the pharmacy.

Instead, he sends patients outside to soak in the healing powers of nature, combining the benefits of exercise with the therapeutic effects of fresh air and green space, according to the American Heart Association News.

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“Going back millions of years, we’ve evolved outdoors,” said Zarr, a pediatrician who recently relocated to Ottawa, Canada, from Washington, D.C. “Why should we exist indoors? We need to be outdoors. The health benefits of being in nature are obvious.”

The idea isn’t new. The 16th century Swiss physician Paracelsus declared that “the art of healing comes from nature, not from the physician.” In Japan, public health experts promote shinrin-yoku, or forest bathing, as a key to physical and psychological health.

The premise is backed up with science. A 2018 meta-analysis in the journal Environmental Research reviewed more than 140 studies and found exposure to green space was associated with wide-ranging health benefits, including lower blood pressure and cholesterol, and lower rates of diabetes, stroke, asthma, heart disease and overall death.

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