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Exercise classes reduce loneliness, social isolation in seniors

Seniors face increased risk for developing serious health issues or even death if they lack social connections or feel alone. Loneliness is connected to higher rates of depression, anxiety and suicide. Experts say social isolation can have the same impact on an older person’s health as smoking 15 cigarettes a day.

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Older adults who joined group exercise classes experienced decreased loneliness and social isolation, according to a new Cedars-Sinai study conducted before the COVID-19 pandemic. The classes have continued virtually since March, and early results suggest the online versions are also effective.

Seniors face increased risk for developing serious health issues or even death if they lack social connections or feel alone. Loneliness is connected to higher rates of depression, anxiety and suicide. Experts say social isolation can have the same impact on an older person’s health as smoking 15 cigarettes a day.

Both loneliness and social isolation are widespread issues, where more than a third of adults 45 and older feel lonely and nearly a quarter of those 65 and older are socially isolated, according to the National Academies of Sciences, Engineering, and Medicine. But few studies have examined the most effective ways to improve social connectedness among seniors.

“As the demographics of our country shift, more people are living alone than ever before,” said the study’s lead author, Allison Moser Mays, MD, a Cedars-Sinai geriatrician. “The number of adults over the age of 65 in the U.S. is expected to reach more than 70 million by 2030 – double what it is now. We need sustainable ways to help this burgeoning population thrive as they age, or there will be widespread consequences.”

Mays and her co-investigators partnered with local community groups to enroll participants in evidence-based exercise and health management classes for people over 50 at nine sites in Los Angeles neighborhoods with a known concentration of low-income older adults. All locations – which included libraries, senior centers and recreation centers – were accessible for those with mobility limitations and had access to parking and public transit.

The study tracked 382 participants ages 52 to 104 from July 2018 through March 2020, when the pandemic forced the classes to move online. Some people were referred by their Cedars-Sinai physician during an office visit. Others found the program through community outreach.

All participants met with a health coach who assessed their needs and helped them select one of four courses, which research has shown improve other aspects of health: Arthritis Exercise, EnhancedFitness, Tai Chi for Arthritis, and Chronic Disease Self-Management. The three exercise classes proved the most popular, and individuals had to attend at least one session to be included in the study.

Participants completed questionnaires about their social connections and loneliness prior to starting their course and after six months. At the end of that period, investigators found a 6.9% decrease in loneliness and a 3.3% improvement in social connectedness, after adjusting for age, gender and other characteristics. The study was published in the American Journal of Geriatric Psychiatry.

“These classes had already been shown to reduce the risk of falls in seniors, and this was the first demonstration that they also reduce social isolation, to the best of our knowledge,” Mays said.

The Leveraging Exercise to Age in Place (LEAP) classes have been supported by a three-year grant from the AARP Foundation. Cedars-Sinai has adopted the successful programming under the Community Engagement Department.

“The results of this study are very exciting because we’ve provided a model that other health systems can easily replicate by integrating evidence-based programs in the community with their organizations. They don’t need to reinvent the wheel,” said senior study author Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai. “The health coach is the key ingredient because they make sure that nobody falls through the cracks.”

The health coach has been especially crucial since the pandemic began when classes moved online and participants sometimes have needed help figuring out how to log on to the platform. That effort has been paying off.

Of the 59 participants who continued with the virtual workouts, there has not been a statistically significant change in loneliness or social isolation one month after stay at home orders began, according to data Mays presented over the weekend at the Gerontological Society of America’s annual meeting. The investigators will analyze further data as the classes continue. They’re also piloting another program that pairs older adults with younger participants for one-on-one workout sessions online.

“Cedars-Sinai treats more patients over the age of 80 than any other academic health system in the country,” Rosen said. “We’re really at the epicenter of this growing population of older adults and figuring out the best ways to care for them so they can successfully age in place.”

Rosen said efforts like the LEAP program helped Cedars-Sinai earn its designation as an Age-Friendly Health System Committed to Care Excellence earlier this year. The distinction, which highlights care tailored to older adults, is part of a national initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States.

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The look and feel of your neighborhood may affect your sleep

Those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape.

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Your neighborhood’s “streetscape”—the physical environment of your street—is something that you have probably never consciously thought about, despite seeing it every day. But what if the streetscape was affecting you on a subconscious level and disrupting your sleep? 

This intriguing question is posed by the findings of a study led by Professor Daisuke Matsushita of the Graduate School of Human Life and Ecology at Osaka Metropolitan University. The research team used AI to analyze more than 200,000 Google Street View images to identify visual neighborhood characteristics. They then linked these characteristics to the self-reported sleep of 1,089 working adults living on the lower floors of apartments in Tokyo, who were most likely to be affected by the streetscape.  

They found that those living in neighborhoods rated as having a stronger sense of safety tended to sleep longer, and that this rating appeared to be shaped by the streetscape. Generally, people slept longer in areas with lots of greenery, such as leafy trees, on the street. Similarly, high “enclosure”—meaning many tall vertical buildings and few wide-open spaces—was also associated with longer sleep and fewer insomnia symptoms. 

However, the study also made a surprising finding. The researchers found that highly walkable streetscapes, such as those with more sidewalks and traffic signs, were associated with a lowered sense of safety and shortened sleep duration.  

This suggests that walkability does not always represent a reassuring environment. Instead, a possible explanation is that streets with extensive pedestrian infrastructure are often busier, more crowded, and used by more strangers, which may be perceived as less safe or less relaxing than quieter residential streets.  

“This study demonstrates the potential for evaluating streetscape characteristics across large geographic areas in a cost-effective manner,” Dr. Matsushita said. “Based on the technique used in this study, cities could potentially measure perceived safety, beauty, liveliness, and enclosure as well as pollution and noise.”  

“We hope that opening up this new perspective creates further possibilities for designing healthier neighborhoods,” he concludes.  

The findings were published in Building and Environment.

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Workout or nap? Either can help your sleepless brain, study finds

People who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither.

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A short workout or a nap can help protect memory after a sleepless night, a McGill University-led study has found.

Researchers found people who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither. The findings, published in Proceedings of the National Academy of Sciences (PNAS), point to practical ways to counter the effects of sleep deprivation.

“Sleep loss affects nearly every aspect of how we think and function, but many people can’t simply stop what they’re doing and get more sleep,” said senior author Marc Roig, Professor in McGill’s School of Physical and Occupational Therapy. “Our findings show that even a brief bout of exercise may help preserve one of our most important cognitive abilities.”

The study involved 54 healthy young adults who stayed awake for 30 consecutive hours under lab supervision. Participants were then assigned to one of three groups: a 20-minute cycling session, a 90-minute nap or a control condition. Three days later, researchers tested their memory for images they had viewed immediately after the intervention. Those who exercised or napped remembered significantly more images than participants who did neither.

Same result, different pathways

While the memory benefits were nearly identical, brain recordings revealed that exercise and napping helped in different ways.

Napping appeared to help the brain recharge, making it easier to take in and remember new information. Exercise, by contrast, helped the brain use its remaining resources more efficiently, without making participants feel more tired.

The findings could eventually inform fatigue-management strategies in workplaces where sleep loss is common and mistakes can have serious consequences, such as health care, transportation and emergency response.

“A nap isn’t always possible in the middle of a shift,” said first author Madhura Lotlikar, a doctoral candidate in McGill’s Department of Neurology and Neurosurgery. “Exercise is accessible, inexpensive and easy to implement. That makes it a promising tool to help people stay cognitively sharp when sleep is limited.”

The researchers emphasize that exercise cannot replace sleep, but it may help people function better when getting enough rest isn’t possible.

About the study

Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions” by Madhura Lotlikar and Marc Roig et al., was published in Proceedings of the National Academy of Sciences of the United States of America.

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Study links coffee consumption to metabolic health and sex hormones

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

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Coffee is one of the world’s most widely consumed beverages, and previous research has linked its consumption to a lower risk of conditions such as type 2 diabetes and cardiovascular disease. However, the biological mechanisms behind these benefits remain unclear. A new Finnish study links habitual coffee consumption to healthier body composition and metabolic markers, while revealing distinct associations with sex hormones in men and women.

The study, conducted at the University of Oulu, analysed data from 2,264 participants aged 46 in the Northern Finland Birth Cohort 1966. Researchers examined how habitual coffee consumption was associated with circulating metabolites, cardiometabolic risk markers and sex hormones.

Despite having a similar body mass index (BMI), individuals with higher coffee consumption had lower total and visceral fat and greater skeletal muscle mass than those who consumed less coffee.

In both men and women, higher coffee consumption was correlated with lower circulating levels of branched-chain amino acids, biomarkers that have previously been linked to insulin resistance and an increased risk of type 2 diabetes when chronically elevated.

The strongest sex-specific associations were observed in men. Higher coffee consumption was linked to a more favourable glucose–insulin profile, higher concentrations of total and bioavailable testosterone, and increased levels of sex hormone-binding globulin (SHBG). At the same time, free testosterone and the free androgen index were modestly lower. In women, hormonal associations were more limited and were primarily characterised by higher SHBG and lower measures of free androgens.

“Coffee is consumed by millions of people every day, yet we still know surprisingly little about how it relates to our metabolism and hormones. What stood out in our findings was a distinct hormonal signature that didn’t disappear even after we took into account BMI and lifestyle factors, with several of these associations differing between men and women,” says Luca Verroest, lead author of the study and Doctoral Researcher at the University of Oulu.

The results suggest that hormonal pathways may partly explain the relationship between coffee consumption and metabolic health. However, as this was an observational study, the findings demonstrate associations rather than cause-and-effect relationships.

The study is particularly relevant in Finland, one of the world’s highest coffee-consuming countries, where annual consumption averages around 11.8 kilograms per person.

The researchers say the findings provide a foundation for future studies aimed at determining whether coffee itself drives these biological changes and identifying the compounds responsible. These questions are currently being investigated in animal models, with the long-term goal of progressing to human intervention studies. Further research will be needed before the findings could inform dietary recommendations.

The study, Associations of habitual coffee intake with testosterone and cardiometabolic markers: the Northern Finland Birth Cohort 1966 study, has been published in the European Journal of Nutrition.

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