Yoga-based exercise can improve well-being for older people

This blog was first published on the National Institute for Health Research (NIHR) Dissemination Centre Discover Portal. Read the corresponding Age and Ageing paper Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials.

Yoga-based exercise offers a safe and accessible way to improve health-related quality of life and mental well-being for people over 60. Evidence for a moderate benefit of yoga in later life now extends beyond improved balance and flexibility.

Yoga includes stretches, poses, breathing routines and meditation. This review focused on the physical exercise/activity components. Most of the 12 included trials took place in Western countries and classes were all run by qualified yoga instructors as in the UK. Class attendance was high for eight weeks or more (50 to 96%). However, women outnumbered men by three to one, implying that yoga classes may need adapting to appeal to older men.

Yoga classes are widely available and could offer an accessible way to improve older people’s activity levels and well-being. The research was moderate to high quality, but it cannot yet show exactly how much yoga or which kind works best for particular groups of people. However, the good news is that these approaches seem effective.

The link between frailty and losing teeth

Jess Walter is a freelance writer and mother. She loves the freedom that comes with freelance life and the additional time it means she gets to spend with her family and pets.

Bacteria accumulates in the mouth on a daily basis, and if patients don’t get rid of it by brushing and flossing twice a day, they could put themselves at risk of many health conditions. These include diabetes, aspiration pneumonia, and heart disease. According to stats published in Healthy Magazine, one in four adults in the UK don’t brush their teeth every day, while one in three have never flossed their teeth. Not cleaning between the teeth can leave up to 40 percent of the tooth exposed to bacteria. Imagine all that bacteria getting into the bloodstream where it can cause disease in the rest of the body. Now, a recent study has found that losing teeth could even result in frailty, which is especially a concern for seniors.

Comprehensive Care – NIHR themed review of research into older people with frailty in hospitals

John Gladman is Professor of the Medicine of Older People, Division of Rehabilitation and Ageing and Honorary Consultant in Health Care of Older People at Nottingham University Hospitals NHS Trust.

Vast sums are spent on research into the care of older people, but they are wasted if the findings are not put into practice.

I had an epiphany a few years ago. I looked at my carefully curated curriculum vitae, and noted that I had over 100 peer reviewed papers to my name. But I suddenly felt deflated when I realised that hardly anybody (apart from the journals’ editors) had ever read them. Deflation was followed by shame as I realised that I had made no effort to disseminate my findings to those who might find them useful, or to encourage the application of the findings in practice. I recovered a bit when I realised that it wasn’t just me. There is a real problem as the amount of research being published is monstrously huge. But I returned to shame again when I thought about how little effort I have taken to ensure that I keep up to date with other people’s research.

HIV and Older People

World AIDS Day is dedicated to fighting stigma and discrimination, and raising awareness of the HIV/AIDS pandemic. We mark this day by, in turn, raising awareness of older people with HIV.

Incidence and prevalence of HIV in older people is increasing. In the UK one in five adults with HIV is aged over 50. This is a consequence both of the expansion in uptake of HIV testing and diagnosis and major improvements in treatments which are helping people with HIV to live longer.

The fact that older people with HIV are living longer where there is access to treatment is a cause for celebration but it also brings challenges for geriatric medicine. Older people with HIV commonly experience co-morbidities such as cardiovascular disease, osteoporosis and dementia. Medical management of HIV in older people requires considerations of complex drug interactions and co-morbidities.

Early diagnosis of HIV is key to improving prognosis. Treatment with highly active anti-retroviral therapy (HAART) significantly prolongs life expectancy, however it is associated with an increased risk of side effects in older patients.

Fitter individuals are at the highest risk of death associated with delirium

Melanie Dani is a trainee in geriatric medicine in the North West Thames deanery. She is also completing a PhD at Imperial College London studying biomarkers in Alzheimer’s Disease, and has an interest in cognition and dementia.

It is well-recognised that delirium is associated with increased mortality. It’s less clear, though, whether this is the case across the spectrum of frailty. There is an idea that delirium might have bimodal outcomes – worse in frailer people, but may be protective in fitter individuals by highlighting an underlying problem early and (potentially) prompting earlier treatment.

While past studies have accounted for chronic diseases and acute illness severity, few have accounted for both. We wanted to see whether the associations of delirium with mortality remained so even after accounting for acute and chronic health factors, so we modelled both these together in a frailty index. This included 31 variables encompassing chronic disease, acute illness parameters, and functional status and was applied in a large cohort of acute medical older inpatients.

Older people are living longer than before, but are they living healthier?

Ruby Yu is a research assistant professor at the Chinese University of Hong Kong (CUHK), specialising in gerontology and geriatrics. She is also a research fellow at the CUHK Jockey Club Institute of Ageing. Her recent paper Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: An Age-period-cohort Analysis was published today in Age and Ageing journal.

There is no doubt that people from countries all over of the world are living longer, but there is little evidence to suggest that older people today are living healthier than their predecessors did at the same age. This is a major cause of concern for many governments around the world because if the added years of people today are dominated by chronic diseases and functional disabilities, there will be negative implications (e.g., extended treatment for older people which increases the health and social care cost to society).

Hidden Carers – sharing the stories of older male carers

Louise Bate is an Engagement and Communications Officer with Healthwatch Dorset. Healthwatch is an independent watchdog, working to help people get the best out of their local health and social care services. Healthwatch enables local people to influence the delivery and design of local services, by sharing their views with health and care commissioners and providers: www.healthwatchdorset.co.uk 

More than 51,000 carers in England are men aged over 85; a number that has more than doubled in the last decade. It’s such a huge number of people that it’s hard to imagine. We wanted to make the numbers real – so we’ve been working with Bournemouth University and the Carers Support Service to listen to older male carers, gather their stories and give them a stronger voice.

Carers over the age of 85 are the only demographic of carers where men outnumber women (59%). Men are more likely to become carers in older age than at other times in their life and usually as a result of caring for their partners.

Retirees leaving sociable workplaces may experience accelerated cognitive decline

A study published recently in Age and Ageing, the scientific journal of the British Geriatrics Society, provides new evidence that workers retiring from occupations which involve high levels of social stimulation may be at greater risk of accelerated cognitive decline in later life.

The study, which was conducted by researchers at University of Liège, in collaboration with the Universities of Bordeaux and South Florida, surveyed 1,048 individuals over the age of 65 from Bordeaux. Participants were evaluated at 2 year intervals for a period of 12 years. Psychologists’ evaluations included detailed assessments of subjects’ mental cognition, general health and information about their former occupation. Three independents raters were asked to evaluate the level of social and intellectual stimulation for each occupation.

The Challenges of Research in the Care Home Setting

Annabelle Long is a Chartered Physiotherapist working as a Research Assistant at the University of Nottingham on a Dunhill Medical Trust funded PEACH study, which considers the role of Comprehensive Geriatric Assessment in UK care homes. She has a developing research interest in wellbeing for people with dementia in community environments. In this blog she outlines the potential challenges and solutions in doing research at the health and social care interface.

As practitioners and researchers in care of older people, it is important for us to be continually working to include more dependent groups in research. The reason for doing so is to ensure that the evidence base can reliably be applied to the patients we see in everyday practice. However involving older people with dependency in research can be challenging because cognitive and physical impairments can make standard procedures for recruitment and data collection difficult.

Walking now prevents dementia later, study finds

A new study published in Age and Ageing, the scientific journal of the British Geriatrics Society, suggests maintaining a higher level of physical activity during middle age may be a key strategy for the prevention of dementia in older age.

Past studies have suggested that physical activity such as walking can be a protective factor against dementia but this study suggests that maintaining a higher level of physical activity before older age is more important for the prevention of dementia than physical activity only in older age.