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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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Allergy season starts earlier each year due to climate change and pollen transport

Allergy sufferers are no strangers to problems with pollen. But now – due to climate change – the pollen season is lasting longer and starting earlier than ever before, meaning more days of itchy eyes and runny noses. Warmer temperatures cause flowers to bloom earlier, while higher CO2 levels cause more pollen to be produced.

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Allergy sufferers are no strangers to problems with pollen. But now – due to climate change – the pollen season is lasting longer and starting earlier than ever before, meaning more days of itchy eyes and runny noses. Warmer temperatures cause flowers to bloom earlier, while higher CO2 levels cause more pollen to be produced.

The effects of climate change on the pollen season have been studied at-length, and according to some scientists, has grown by as much as 20 days in the past 30 years, at least in the US and Canada. But one important element is often overlooked – “Pollen is meant to fly,” says Dr Annette Menzel, Professor of ecoclimatology at the Technical University of Munich. “Transport phenomena have to be taken into account.”

Along with her colleagues, she studied the transport of pollen in Bavaria, Germany, in order to better understand how the pollen season has changed over time. “The transport of pollen has important implications for the length, timing, and severity of the allergenic pollen season,” says Dr Ye Yuan, a coauthor on the study.

Menzel and her team focused on Bavaria – a state in southeast Germany – and used six pollen monitoring stations scattered around the region to analyze data. Their results were recently published in Frontiers in Allergy. They found that certain species of pollen, such as from hazel shrubs and alder trees, advanced the start of their seasons by up to 2 days per year, over a period of 30 years (between 1987 and 2017). Other species, which tend to bloom later in the year, such as birch and ash trees, moved their seasons 0.5 days earlier on average each year, across that same time period.

Pollen can travel hundreds of kilometers and, with changing weather patterns and altered species distributions, it’s possible that people are becoming exposed to “new” pollen species – meaning pollen that our bodies are unaccustomed to encountering each year.

While it can sometimes be difficult to differentiate between local and transported pollen, the researchers focused on pre-season transports. So, for example, if pollen from birch trees was present at the monitoring station, but local birch trees would not flower for at least another 10 days, that pollen was considered to be transported from far away.

“We were surprised that pre-season pollen transport is a quite common phenomenon being observed in two-thirds of the cases,” says Menzel. As for why it’s important to understand how much pollen is from far away, Yuan says that: “Especially for light-weight allergenic [pollen], long distance transport could seriously influence local human health.”

By examining another element besides simple pollen concentration, scientists can delve deeper into how exactly the pollen season is being affected by climate change. For example, Menzel says that the pollen season may be even longer than estimated based on flowering observations by “taking into account pollen transport, as it has been done in our current study.”

While the Munich study did not track how far pollen was transported, and only differentiated between local and long-range transport (meaning pollen coming from outside Bavaria), it provides a crucial key in our understanding of annual pollen patterns. Yuan says that future studies should account for “climate change scenarios [and] land use/land cover changes.” He also adds that citizen scientists may be able to contribute to pollen studies, who can help collect local observations and contribute to data collection.

It doesn’t look like the pollen season will shorten any time soon, but more research on the subject can provide a better understanding of global patterns and changes so that we can better address these issues in the future.

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Women better at reading minds than men – study

Mind-reading, sometimes referred to in psychology as ‘mentalising’, is an important ability enabling us to pick-up on subtle behavioural cues that might indicate that someone we are speaking to is thinking something that they are not saying (e.g. being sarcastic or even lying).

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Psychologists at the University of Bath, Cardiff, and London have developed the first ever ‘mind-reading questionnaire’ to assess how well people understand what others are really thinking.

A new approach to ‘mind-reading’ has been developed by researchers at the University of Bath, Cardiff, and London to improve how well we understand what others are thinking. And it transpires that women are much better than men at putting themselves in someone else’s shoes.

Mind-reading, sometimes referred to in psychology as ‘mentalising’, is an important ability enabling us to pick-up on subtle behavioural cues that might indicate that someone we are speaking to is thinking something that they are not saying (e.g. being sarcastic or even lying).

The researchers say that we all have different mind-reading abilities, with some of us inherently better than others. The fact that not all of us are good at mind-reading can cause challenges – in particular for people with autism where it can lead to social struggles in building or maintaining relationships.

To identify those people who have difficulties and to provide them with appropriate support, the team at Bath designed a new mind-reading test, which draws on data from over 4,000 autistic and non-autistic people in the UK and US.

Results from their simple, four-step questionnaire were scored, ranging from 4 to 16 (with 4 indicating poor mind-reading abilities; 16 indicating excellent abilities). The average score for their questionnaire was between 12 and 13. After statistically confirming that the test was measuring the same thing in men and women, they found that females reported better mind-reading than males, whilst also confirming some of the well-reported social challenges faced by the autistic community.

Their method, which uses just four questions to assess individuals, is published in the journal Psychological Assessment.

Dr Punit Shah, senior author of the study and leading expert on social cognitive processing at the University of Bath’s Department of Psychology explained: “We will all undoubtedly have had experiences where we have felt we have not connected with other people we are talking to, where we’ve perceived that they have failed to understand us, or where things we’ve said have been taken the wrong way. Much of how we communicate relies on our understanding of what others are thinking, yet this is a surprisingly complex process that not everyone can do.

“To understand this psychological process, we needed to separate mind-reading from empathy. Mind-reading refers to understanding what other people are thinking, whereas empathy is all about understanding what others are feeling. The difference might seem subtle but is critically important and involves very different brain networks. By focussing carefully on measuring mind-reading, without confusing it with empathy, we are confident that we have just measured mind-reading. And, when doing this, we consistently find that females reported greater mind-reading abilities than their male counterparts.”

Lead researcher, Rachel Clutterbuck, emphasised the clinical importance of the questionnaire. She said: “This new test, which takes under a minute to complete, has important utility in clinical settings. It is not always obvious if someone is experiencing difficulties understanding and responding to others – and many people have learnt techniques which can reduce the appearance of social difficulties, even though these remain.

“This work has great potential to better understand the lived experience of people with mind-reading difficulties, such as those with autism, whilst producing a precise quantitative score that may be used by clinicians to identify individuals who may benefit from interventions.”

Dr Shah added: “This research has been about understanding more about our mind-reading abilities and providing solutions to those who might struggle, particularly the autistic community. We have created a freely available questionnaire which we hope can help identify people who are experiencing mental difficulties relevant to social situations.”

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Acid reflux disease may increase risk of cancers of the larynx and esophagus

Results from a large prospective study indicate that gastroesophageal reflux disease (GERD), which also causes heartburn symptoms, is linked with higher risks of various cancers of the larynx (or voice box) and esophagus.

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Results from a large prospective study indicate that gastroesophageal reflux disease (GERD), which also causes heartburn symptoms, is linked with higher risks of various cancers of the larynx (or voice box) and esophagus. The study is published in CANCER, a peer-reviewed journal of the American Cancer Society.

GERD, a gastrointestinal disorder that affects approximately 20 percent of U.S. adults, occurs when stomach acid flows back into the esophagus, where it can cause tissue damage. Research indicates that this damage may put patients at risk of developing a type of cancer called esophageal adenocarcinoma.

To provide additional insights concerning this link and potential links to other types of cancer, a team led by Christian C. Abnet, PhD, of the National Cancer Institute, part of the National Institutes of Health (NIH), examined information on 490,605 adults enrolled in the NIH-AARP Diet and Health Study, a prospective study that mailed questionnaires in 1995-1996 to 3.5 million AARP members, aged between 50 and 71 years who were living in California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or in the metropolitan areas of Atlanta, Georgia, and Detroit, Michigan.

Using Medicare claims data, the investigators estimated that 24 percent of participants had a history of GERD. Over the following 16 years after participants joined the study, 931 patients developed esophageal adenocarcinoma, 876 developed laryngeal squamous cell carcinoma, and 301 developed esophageal squamous cell carcinoma. People with GERD had about a two-times higher risk of developing each of these types of cancer, and the elevated risk was similar across groups categorized by sex, smoking status, and alcohol consumption. The investigators were able to replicate the results when they restricted analyses to the Medicare data subset of 107,258 adults.

The team estimated that approximately 17 percent of these cancers in the larynx and esophagus are associated with GERD.

“This study alone is not sufficient to result in specific actions by the public. Additional research is needed to replicate these findings and establish GERD as a risk factor for cancer and other diseases,” said Dr. Abnet. “Future studies are needed to evaluate whether treatments aimed at GERD symptoms will alter the apparent risks.”

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