Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids / 11.11.2020

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark  MedicalResearch.com: What is the background for this study? Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today (more…)
Author Interviews, Frailty, Genetic Research, Geriatrics, University of Pittsburgh / 13.10.2020

MedicalResearch.com Interview with: Caterina Rosano, M.D., M.P.H. Professor of Epidemiology University of Pittsburgh Graduate School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most people think about dopamine’s role in mobility in the context of Parkinson’s disease, but not in normal aging. We were curious to see if a genetic predisposition to produce more or less dopamine was related to mobility in individuals who had some level of frailty, yet did not have dementia, parkinsonism or any other neurological condition. While several genetic elements control dopamine signaling, my team and I focused on a gene called COMT, which breaks down dopamine to control its levels within the brain. We also considered the frailty status of participants, which is a common consequence of aging marked by a decline in physiological function, poor adjustment to stressors and a susceptibility toward adverse health outcomes. We suspected that frail participants could be particularly vulnerable to COMT-driven differences in dopamine levels. We examined this gene in more than 500 adults above the age of 65 in Pennsylvania, North Carolina, California and Maryland, excluding any participants taking dopamine-related medications or diagnosed with Parkinson’s disease. We then looked for potential links between genotype, frailty and speed. We discovered that frail participants with a high-dopamine COMT genotype had a 10% faster walking speed compared with participants with the low-dopamine COMT genotype.  (more…)
Author Interviews, Geriatrics, Hearing Loss, JAMA / 28.08.2020

MedicalResearch.com Interview with: Cameron C. Wick, MD Assistant Professor, Otology/Neurotology Washington University School of Medicine St. Louis, MO MedicalResearch.com: What do you see as the primary message of your findings for the general public? Response:  Older adults not satisfied with their hearing aids achieved clinically meaningful improvement in both hearing and quality of life with a cochlear implant compared to an optimized bilateral hearing aid condition. MedicalResearch.com: Do you see your findings as changing the way older adults with hearing loss are managed? Response:   Yes and partially because this study is unique in its design and the outcomes that were measured. Specifically  the study is a prospective, multicenter clinical trial conducted at 13 locations across the United States. All patients were setup with a 30-day optimized hearing aid experience before cochlear implantation (context: sometimes hearing aids are not appropriately optimized so baseline testing may not reflect the "best" that hearing aids can do). This study assesses both hearing data as well as quality of life data before and 6-months after cochlear implantation. After implantation patients were tested in both the unilateral (cochlear implant alone) and bimodal (cochlear implant plus hearing aid in the opposite ear) conditions.  My paper is a subanalysis of adults 65 years and older (range 65 - 91 years) enrolled in the clinical trial. The principal investigator of the clinical trial is Dr. Craig Buchman. Dr. Buchman and myself are at Washington University in St. Louis which was the lead center for the clinical trial. The findings of the study are meaningful because they demonstrate clear superiority of cochlear implants over hearing aids in many key areas, such as understanding speech, hearing in background noise, and ability to communicate. Hearing loss, which becomes more prevalent as we age, can negatively impact communication leading to social isolation, depression, frustration, and possibly cognitive decline. This study highlights that if patients are not satisfied with their hearing aid performance then they should be referred to a center that can evaluate for cochlear implantation. Cochlear implant indications have evolved considerably since they were first FDA approved in 1984. This study emphasizes that patients do not have to be profoundly deaf to experience significant hearing and social benefits from cochlear implants. Also, it demonstrates that cochlear implant surgery is well tolerated even as adults age and acquire other health ailments.  (more…)
Author Interviews, Brigham & Women's - Harvard, Geriatrics, Lipids / 08.07.2020

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Assistant Professor of Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Statins are cholesterol lowering medications that have been proven to prevent heart attacks, strokes and death in middle-aged adults. Current guidelines for cholesterol lowering therapy are uncertain as to treatment for older adults due to a lack of available data, even though older adults are at the highest risk of heart disease and death. (more…)
Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Cost of Health Care, Geriatrics, JAMA, Medicare / 12.03.2020

MedicalResearch.com Interview with: Rishi K. Wadhera, MD Harvard Medical Faculty Physicians Cardiovasular Diseases Beth Israel Deaconess Medical Center  MedicalResearch.com: What is the background for this study? Response: In the U.S., income inequality has steadily increased over the last several decades. Given widening inequities, there has been significant concern about the health outcomes of older Americans who experience poverty, particularly because prior studies have shown a strong link between socioeconomic status and health. In this study, we evaluated how health outcomes for low-income older adults who are dually enrolled in both Medicare and Medicaid have changed since the early 2000’s, and whether disparities have narrowed or widened over time compared with more affluent older adults who are solely enrolled in Medicare (non-dually enrolled). (more…)
Aging, Author Interviews, Cannabis, Geriatrics, JAMA, NYU / 24.02.2020

MedicalResearch.com Interview with: Benjamin H. Han, MD MPH Assistant Professor Division of Geriatric Medicine and Palliative Care New York University School of Medicine MedicalResearch.com: What is the background for this study? Response: In the past, the prevalence of cannabis use (both for recreational and for medicinal purposes) was very low among adults age 65 and older. As a reference, the national prevalence rate of past-year cannabis use among adults age 65 and older in 2006-2007 was 0.4%, it has increased dramatically since then. (more…)
Author Interviews, Endocrinology, Geriatrics, Thyroid Disease / 15.12.2019

MedicalResearch.com Interview with: Carol Chiung-Hui Peng, MD Department of Internal Medicine University of Maryland Medical Center Baltimore, MD  MedicalResearch.com: What is the background for this study? Response: In recently published meta-analyses, focusing on the general population, showed that both overt hypothyroidism and subclinical hypothyroidism were linked to higher all-cause and cardiovascular mortality. However, there is still debate and conflicting evidence on managing overt and subclinical hypothyroidism in the elderly. This study aimed to evaluate and confirm the association between hypothyroidism and mortality in the elderly population. (more…)
Author Interviews, Frailty, Geriatrics / 30.09.2019

MedicalResearch.com Interview with: Brian Clark, Ph.D. Executive Director, Ohio Musculoskeletal and Neurological Institute Osteopathic Heritage Foundation Harold E. Clybourne, D.O. Endowed Research Chair Professor of Physiology OHIO University MedicalResearch.com: What is the background for this study? Response: Muscle weakness strongly contributes to mobility limitations and physical disability. Over 40% of the 46 million older adults in the U.S. have one or more physical limitations when performing daily tasks essential for maintaining independence. Preserving physical function is a major public health priority as it will drastically reduce health care costs and improve quality of life. Over the past several decades, the scientific and medical communities have recognized that muscle weakness is a major factor in determining the incidence of physical limitations and general poor health in older adults. It has long been presumed by many that age-related weakness is principally caused by loss of muscle mass (i.e., sarcopenia). However, over the past 10-20 years the presumption has been questioned. For instance, a 2009 study reported that the decline in leg extensor muscle strength in older adults —observed longitudinally over 5 years—occurs more rapidly than the concomitant loss of quadriceps mass, and that in a subset of older adults that actually gained muscle mass there was still a substantial loss of strength. Findings of this nature clearly illustrate that that the loss of strength is only modestly associated with loss of mass in older adults. The mechanisms of muscle strength, however, are multifactorial and determined by a combination of both neurological and muscular factors (of which muscle mass is one of the factors). (more…)
Accidents & Violence, Author Interviews, Geriatrics / 13.08.2019

MedicalResearch.com Interview with: XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study was done among community-dwelling US Chinese older adults aged 60 and above living in the greater Chicago area. The baseline cohort consisted of 3,157 participants, and we followed up with them from 2011 to 2017. There were heterogeneities in the associations between the strictness of definitions and subtypes of elder mistreatment (EM) and yearly mortality.   (more…)
Author Interviews, Frailty, Geriatrics, Heart Disease / 29.07.2019

MedicalResearch.com Interview with: Dr-Dalgaard MedicalResearch.com: What is the background for this study? Response: We know that having atrial fibrillation puts you at a higher risk of falls, especially if you are elderly and frail. Additionally, some of the medications used to treat it can cause bradycardia (low heart rate), which could itself increase the risk of falls. Therefore, the aim of this study was to investigate if common medications used to treat atrial fibrillation in older patients were associated with fall-related injuries and syncope (fainting). The medications investigated were rate-lowering drugs (beta-blockers, digoxin, verapamil, diltiazem) and the anti-arrhythmic drugs (amiodarone, propafenone, and flecainide). (more…)
Annals Thoracic Surgery, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Primary Care / 23.07.2019

MedicalResearch.com Interview with: Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age.  The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017,  a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation. (more…)
Author Interviews, Geriatrics, Heart Disease, Lipids / 18.07.2019

MedicalResearch.com Interview with: Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy. (more…)
Author Interviews, Biomarkers, Geriatrics, Heart Disease, JACC / 02.07.2019

MedicalResearch.com Interview with: Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark  MedicalResearch.com: What is the background for this study?   Response: The background for the study is a combination of two things: First, the proportion and number of elderly people 65 years of age or older are increasing fast worldwide. Second, given the dominant impact of age on estimated risk for cardiovascular disease, nearly all elderly individuals eventually become statin eligible under current guidelines – just because of aging alone. Thus, to limit overtreatment of elderly individuals, we wanted to find “negative” risk markers that can be used to identify elderly individuals at truly low cardiovascular risk who are less likely to benefit from statin therapy despite advancing age. (more…)
Anesthesiology, Author Interviews, Geriatrics, NEJM / 23.06.2019

MedicalResearch.com Interview with: Yahya Shehabi  PhD, FANZCA, FCICM, EMBA, GAICD Director of Research, Critical Care and Peri-operative Medicine, Monash Health Professor, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University Professor Intensive Care Medicine, Clinical School of Medicine, University New South Wales Critical Care and Peri-Operative Medicine Lead – Monash Health Translational Precinct MedicalResearch.com: What is the background for this study? Response: SPICE III was the final phase of a series of SPICE studies. SPICE I showed 2 important findings, first, deep sedation in the first 48 hours is strongly associated with higher mortality, longer ventilation time and higher risk of delirium. Second; that Dexmedetomidine is mainly used as an adjunct secondary agent 3-4 days after commencing mechanical ventilation and not as a primary sedative agent. In addition, albeit with several limitations, previous RCTs comparing Dexmedetomidine with conventional sedatives showed reduced iatrogenic coma, shortened ventilation time and reduced delirium with Dexmedetomidine treatment. So based on the above we hypothesized that using Dexmedetomidine soon after commencing ventilation as a primary sedative agent, through reducing early iatrogenic coma, ventilation time and delirium, would impact 90 day-mortality. (more…)
Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Michigan / 21.06.2019

MedicalResearch.com Interview with: Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan  MedicalResearch.com: What is the background for this study?   Response: This study came out of data collected as part of the National Poll on Healthy Aging (NPHA). The NPHA is funded by AARP and the Institute for Healthcare Policy and Innovation at the University of Michigan to inform the public, healthcare providers, and policymakers on a variety issues related to health. The vision survey, conducted in March 2018, was just one of many NPHA surveys. Due to aging of the population, the number of older U.S. adults with blindness and vision impairment is expected to double over the next 30 years. Thus, this study was designed to provide crucial data  on contemporary data on patterns of eye care utilization in older adults. (more…)
Author Interviews, Geriatrics, Hip Fractures, JAMA, Orthopedics, Osteoporosis / 17.06.2019

MedicalResearch.com Interview with: Kristine E. Ensrud MD MPH Professor of Medicine and Epidemiology and Community Health University of Minnesota Core Investigator, Center for Care Delivery and Outcomes Research Minneapolis VA Health Care System  MedicalResearch.com: What is the background for this study? Response: Women aged 80 years and older, a rapidly growing segment of the population, account for the majority of hip fractures in the United States. Hip fractures account for 72% of fracture-related health care expenditures and lead to significant morbidity and mortality. However, many late-life women at high risk of hip fracture are undiagnosed. Clinicians have difficulty identifying late-life women most likely to benefit from osteoporosis screening and interventions to prevent hip fracture in part due to concerns about comorbidity burden and prognosis in this patient population. (more…)
Accidents & Violence, Author Interviews, Exercise - Fitness, Geriatrics, JAMA / 05.06.2019

MedicalResearch.com Interview with: Teresa Liu-Ambrose, PT, PhD Canada Research Chair (Tier II), Physical Activity, Mobility, and Cognitive Neuroscience Director, Aging, Mobility, and Cognitive Neuroscience Laboratory University of British Columbia MedicalResearch.com: What is the background for this study? Response:  Falls in older adults are the third-leading cause of chronic disability and the leading cause of hospitalization for adults over age 65. Older adults who experience multiple falls are at increased risk for disability, loss of independence, and even death. How to best prevent falls in this high risk group is not well established.  (more…)
Author Interviews, Geriatrics, Kidney Disease / 05.05.2019

MedicalResearch.com Interview with: Dr. Luciano da Silva Selistre MD MS PhD Professor de Medicina - UCS MedicalResearch.com: What is the background for this study? What are the main findings? Response:   We have found that no equation for estimating renal function in the elderly is fully accurate. There are important mistakes between them. (more…)
Author Interviews, Diabetes, Geriatrics, Stroke / 06.04.2019

MedicalResearch.com Interview with: Philippe Girard, MD, Gérontopôle de Toulouse, CHU Toulouse Toulouse, France MedicalResearch.com: What is the background for this study? Response: The idea for this study came about in 2016 when a systematic review assessing acetaminophen’s adverse event (AEs) profile came out with results suggesting increased mortality and morbidity (Paracetamol: not as safe as we thought? A systematic literature review of observational studies, PMID: 25732175). Pr Yves Rolland had collected data from his IQUARE study (Improving the Quality of Care of Long-Stay Nursing Home Residents in France, PMID: 26782872) including all prescriptions from over 6000 nursing home residents and all their medical history over an 18 month follow-up period. We thought it would be a good idea to assess the safety profile of acetaminophen on this geriatric population.  (more…)
Author Interviews, Exercise - Fitness, Geriatrics, Nutrition, Protein, Weight Research / 18.02.2019

MedicalResearch.com Interview with: Kristen M. Beavers PhD, MPH, RD Assistant Professor, Department of Health and Exercise Science Department of Biostatistical Sciences Wake Forest School of Medicine Winston-Salem, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Weight loss recommendation for older adults with obesity is controversial, in part because overall weight loss is accompanied by loss of muscle and bone, which may exacerbate age-related risk of disability and fracture. Identification of interventions that can preserve muscle and bone while promoting fat loss should maximize cardiometabolic benefit, while minimizing potential harm to the musculoskeletal system. This randomized controlled trial was originally designed to test whether a higher protein, nutritionally complete meal plan could preserve lean mass and mobility in older adults undergoing a six month intentional weight loss program. Four publications have resulted from this study: * “Effect of an Energy-Restricted, Nutritionally Complete, Higher Protein Meal Plan on Body Composition and Mobility in Older Adults with Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print June 21, 2018 * “Effect of a Hypocaloric, Nutritionally Complete, Higher-Protein Meal Plan on Bone Density and Quality in Older Adults With Obesity,” American Journal of Clinical Nutrition, published online in advance of print Jan. 9, 2019 * “Effect of Intentional Weight Loss on Mortality Biomarkers in Older Adults With Obesity,” Journals of Gerontology: Medical Sciences, published online in advance of print Aug. 20, 2018 * “Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity,” Annals of Nutrition and Metabolism, published online in advance of print Feb. 11, 2019 Across the four publications, we found that: * Participants lost about 18 pounds, most of it fat (87 percent), and preserved muscle mass. The control group lost about half a pound. * Even when participants lost weight, they maintained bone mass. In fact, trabecular bone score, a measure of bone quality which predicts fracture risk, seemed to improve. * Fat was lost in the stomach, hips, thighs and rear, which is important for preventing or controlling cardiometabolic diseases such as diabetes and stroke. * Participants’ score on the Healthy Aging Index, which measures biomarkers that predict mortality and longevity, improved by 0.75 points. (more…)
Aging, Author Interviews, Geriatrics, Lancet, Nutrition, UC Davis, Weight Research / 15.01.2019

MedicalResearch.com Interview with: Valter Longo, PhD Edna M. Jones Professor of Gerontology Professor of Biological Sciences Leonard Davis School of Gerontology Director of the USC Longevity Institute USC MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of a low calorie diet that mimics fasting for 4 days twice a month starting at middle age can extend lifespan and rejuvenate mice. In humans a similar diet once a month causes improvements in cholesterol, blood pressure , inflammation, fasting glucose etc consistent with rejuvenation (more…)
Author Interviews, Diabetes, Geriatrics, JAMA, Kidney Disease / 01.12.2018

MedicalResearch.com Interview with: Dr. Ziyad Al-Aly, MD Associate Chief of Staff for Research and Education Veterans Affairs St. Louis Health Care System Institute for Public Health Washington University, St. Louis MO MedicalResearch.com: What is the background for this study? Response: A lot has changed in the US over the past 15 years including aging, population growth, and increased exposure to risk factors such as obesity, elevated blood pressure, etc. With all of these changes, we wondered, how did the burden of kidney disease change in the United States over the past 15 years. (more…)
Author Interviews, Geriatrics, JAMA, Pharmacology / 14.11.2018

MedicalResearch.com Interview with: Cara Tannenbaum, MD, MSc Director | Directrice Canadian Deprescribing NetworkCara Tannenbaum, MD, MSc Director | Directrice Canadian Deprescribing Network MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The D-Prescribe trial was driven by the need to show that seniors can cut down on their medication in a safe and effective manner. Pharmacists intervened in a proactive way to flag patients who were on potentially risky meds such as sleeping pills, NSAIDs and glyburide and to inform them of the risks, using an educational brochure. Pharmacists also communicated with their physician using an evidence-based pharmaceutical opinion to spark conversations about deprescribing. As a result, 43% of patients succeeded in discontinuing at least one medication over the next 6 months.   (more…)
Author Interviews, Exercise - Fitness, Frailty, Geriatrics, JAMA / 13.11.2018

MedicalResearch.com Interview with: "COUCHair for physical therapy" by ewa garniec is licensed under CC BY-NC-ND 3.0Mikel Izquierdo PhD Head and Full professor Department of Health Sciences Public University Navarra, Spain  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Acute hospital admissions are a major contributor to disability in the elderly. Despite resolution of the reason for hospitalization, patients (especially those who are frail) are often discharged with a new major disability. This is a problem that providers of health care and policy makers should prioritize given the expectations of further growth of the population segment composed by old people.  Traditional models of acute hospitalization for older adults seldom include a comprehensive approach to prevent hospitalization-associated impairment in functional and cognitive capacity. In contrast, exercise and early rehabilitation protocols applied during acute hospitalization can prevent functional and cognitive decline in older patients and are associated with a reduced length of stay and lower costs. Yet, patients with cognitive impairment or multimorbidity at baseline are commonly excluded from exercise intervention trials and only ‘conservative’ or ‘traditional’ programs (i.e., focusing on light walking while avoiding resistance training) have been typically applied to elders who are acutely hospitalized. Our intervention proved safe and effective to reverse the aforementioned impairment. We therefore propose that an individualized prescription of multicomponent exercise should become an inherent part of the routine management of hospitalized older adults.  (more…)
Author Interviews, Cost of Health Care, Duke, Geriatrics, Hearing Loss, Hospital Readmissions, JAMA / 08.11.2018

MedicalResearch.com Interview with: Nicholas S. Reed, AuD Assistant Professor | Department of Otolaryngology-Head/Neck Surgery Core Faculty | Cochlear Center for Hearing and Public Health Johns Hopkins University School of Medicine Johns Hopkins University Bloomberg School of Public Health MedicalResearch.com: What is the background for this study? Response: This study was a true team effort. It was funded by AARP and AARP Services, INC and the research was a collaboration of representatives from Johns Hopkins University, OptumLabs, University of California – San Francisco, and AARP Services, INC. Given all of the resent research on downstream effects of hearing loss on important health outcomes such as cognitive decline, falls, and dementia, the aim was to explore how persons with hearing loss interacted with the healthcare system in terms of cost and utilization. MedicalResearch.com: What are the main findings? Response: Over a 10 year period, untreated hearing loss (hearing aid users were excluded from this study as they are difficult to capture in the claims database) was associated with higher healthcare spending and utilization. Specifically, over 10 years, persons with untreated hearing loss spent 46.5% more, on average, on healthcare (to the tune of approximately $22000 more) than those without evidence of hearing loss. Furthermore, persons with untreated hearing loss had 44% and 17% higher risk for 30-day readmission and emergency department visit, respectively. Similar relationships were seen across other measures where persons with untreated hearing loss were more likely to be hospitalized and spent longer in the hospital compared to those without evidence of hearing loss. (more…)
Aging, Author Interviews, Frailty, Geriatrics, Nutrition, Protein / 05.11.2018

MedicalResearch.com Interview with: ""Trash Fish" Sustanable Seafood Dinner" by Edsel Little is licensed under CC BY-SA 2.0Nuno Mendonça RD, PhD Campus for Ageing and Vitality Newcastle‐upon –Tyne United Kingdom  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Very old adults, those aged 85 and older, are the fastest growing age group in most western societies and are more likely to develop disability. Dietary protein is a sensible candidate because it may slow decreases in muscle mass and functional decline with aging. Although we know that protein intake is, on average, lower in older adults (a mean of 66 grams per day) compared to younger adults (a mean of 91 grams per day), research exploring protein intake and disability progression in very old adults is limited. We found that our participants from North-East England had four different disability trajectories between the ages of 85 and 90: a) a constant very low disability trajectory (difficulty with none or 1 activity of daily living (ADL))  over the 5 years; b) a low disability trajectory (difficulty with 2 ADLs) that steadily progressed to mild disability (5 ADLs); c) a mild disability score (4 ADLs) at 85 that increased to moderate disability (10 ADLs) by age 90; and d) a moderate disability score (9 ADLs) at baseline that progressed to severe disability (14 ADLs) after 5 years. We found that those with higher protein intake, especially those at or above 1 g per kg of body weight per day (70g of protein per day for a 70 kg person), were less likely to belong to a worse disability trajectory. (more…)
Author Interviews, CMAJ, Geriatrics, Global Health / 05.11.2018

MedicalResearch.com Interview with: "Drapeau au Parlement du Canada" by abdallahh is licensed under CC BY 2.0Dr. Justin Lang, PhD Research Analyst, Public Health Agency of Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is based on the Global Burden of Disease Study, which is led by the Institute of Health Metrics at the University of Washington. In this study, we present estimates from the Global Burden of Disease Study to describe the major causes of health loss among Canadians, and how these have changed from 1990 to 2016. In 2016, cancers, cardiovascular diseases, musculoskeletal disorders, and mental and substance use disorders, combined, resulted in over half of the total health loss among Canadians as measured by disability adjusted life years. Disability-adjusted life years is a measure that combines both mortality, through years of life lost, and morbidity, through years lived with disability, into a single measure that allows us to compare health loss from different causes using the same metric. The all-cause age-standardized years of life lost rate declined 12% between 2006 and 2016, while the all-cause age-standardized years lived with disability rate remained stable (+1%) and the all-cause age-standardized disability-adjusted life year rate declined by 5%. Finally, between 1990 and 2016, there has been a shift in what contributes to health loss in Canada from premature mortality to disability. In 1990, 45% of total all-cause disability-adjusted life years were due to years lived with disability. By 2016, this proportion grew to 52%.  (more…)
Aging, Author Interviews, Geriatrics, Social Issues / 29.10.2018

MedicalResearch.com Interview with: "Elderly woman speaks about Water Supply and Sanitation program in Nepal" by World Bank Photo Collection is licensed under CC BY-NC-ND 2.0Dr Sharon Leitch | MBChB, DCH, PGDipGP, FRNZCGP General Practitioner, Clinical Research Training Fellow Department of General Practice and Rural Health University of Otago New Zealand MedicalResearch.com: What is the background for this study? Response: Loneliness is associated with poor health, reduced quality of life, and increased mortality. Loneliness typically worsens with age. We were curious to learn what the prevalence of loneliness was among older New Zealanders, if there were age-specific associations with loneliness, whether there were any associations between demographic and psychosocial variables and loneliness, and we also wanted to compare centenarians (100 years or older) with elderly people (aged 65-99 years). Centenarians are a particularly interesting group to study because they are a model of successful ageing. The international Resident Assessment Instrument-Home Care (interRAI-HC) assessment has been mandatory in New Zealand for anyone undergoing assessment for publically funded support services or residential care since 2012, providing us with a comprehensive data set. We conducted a retrospective, observational, cross-sectional review of the interRAI-HC data from over 70,000 people living in the community who had their first assessment during the study period (January 2013-November 2017). We analysed eight items from the interRAI-HC data set to describe the population and evaluate the core psychosocial components of aging; age, gender, ethnicity, marital status, living arrangements, family support, depression and loneliness. (more…)