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November 23, 2016

Hebrew SeniorLife's Dr. Marian Hannan Recieves Excellence in Investigative Mentoring Award

BOSTON – November 23, 2016 – The American College of Rheumatology has recently chosen Marian T. Hannan D.Sc., M.P.H. of Hebrew SeniorLife’s Institute for Aging Research as this year’s recipient of the Excellence in Investigative Mentoring Award.

The Excellence in Investigative Mentoring Award recognizes the importance of the mentor/mentee relationship. A dedicated mentor can significantly influence the successful development and career of a mentee. This award honors an active ACR or ARHP member for their contributions to the rheumatology profession through outstanding and ongoing mentoring.

Dr. Marian T. Hannan is Co-Director of the Musculoskeletal Research Center and Senior Scientist at the Institute for Aging Research at Hebrew SeniorLife, Professor of Medicine at Harvard Medical School and Associate Professor of Public Health at Harvard School of Public Health.

Dr. Hannan is currently conducting research on risk factors for foot disorders, arthritis, hip fractures and osteoporosis. In addition to her research, Dr. Hannan teaches Clinical Epidemiology to first-year HMS students and epidemiology courses at Harvard School of Public Health. Her mentoring of youth investigators includes many scientists in the Boston area as well as scientists across the U.S. through national venues.

Funding support for the Excellence in Investigative Mentoring Award is provided by the Rheumatology Research Foundation.

 

October 4, 2016

Dr. Sharon Inouye and Team of Delirium Experts Awarded Federal Grant to Develop Network to Advance Delirium Research Worldwide

BOSTON – A team of delirium experts led by Sharon K. Inouye, M.D., M.P.H., Professor of Medicine at Harvard Medical School and Director of the Aging Brain Center at the Institute for Aging Research (IFAR) at Hebrew SeniorLife, have been awarded a projected $3.7 million grant over five years. This award is the first of its kind from the National Institute on Aging / National Institutes of Health to build an interdisciplinary collaborative network of delirium researchers nationally and internationally. "We are delighted to support the launch of this team effort to build a research infrastructure advancing our understanding of how delirium impacts the aging brain," said NIA program officer Molly Wagster, Ph.D. "This highly collaborative and innovative effort promises to inform delirium research and clinical care for years to come."

Delirium is a common clinical syndrome in older adults, which presents as an acute mental condition characterized by confused thinking and disrupted attention.  Affecting over 2.6 million older adults in the U.S. each year, typically following surgery, hospitalization or acute illness, delirium can be serious and  life-threatening, often leading to loss of independence, cognitive decline, an increased risk of morbidity and mortality, and costing more than $164 billion per year in healthcare expenditures. Despite its importance for the health and wellbeing of older adults, delirium is not well understood and is vastly under-recognized.

Dr. Inouye, along with 12 leading experts in delirium research, will create an interdisciplinary Network for Investigation of Delirium across the U.S. (NIDUS) and beyond to foster collaboration and accelerate scientific discovery in delirium. NIDUS will unite delirium researchers from 27 organizations across the U.S. in focused collaborative efforts.  “The study of delirium is inherently difficult with multiple challenges that have influenced the pace of scientific discovery.  By bringing together multiple experts across disciplines--with varying approaches and skill sets-- I truly believe we will accelerate advancements in delirium,” says Inouye. Eva Schmitt, Ph.D. of Hebrew SeniorLife will serve as the overall Program Director, assisted by Program Coordinator, Kristen Erickson. 

NIDUS will be comprised of two resource cores. The Research Resources and Database Core, led by Edward Marcantonio, M.D., S.M., of Harvard Medical School, and Pratik Pandharipande, M.D., M.Sc., of Vanderbilt University Medical Center, will develop a database of ongoing delirium studies. “In creating such a database”, says Dr. Marcantonio “we will encourage multi-site collaboration, secondary analyses of existing delirium data, and facilitation of pilot studies, to catalyze advances in the field”. A second resource core, the Measurement and Harmonization Core, will develop resources to help researchers choose and compare tools for assessing delirium. This core is led by Richard Jones, Sc.D., of the Warren Alpert Medical School of Brown University, RI and Dale Needham, M.D., Ph.D., of Johns Hopkins University School of Medicine, and will ultimately assist in integrating information collected across multiple delirium studies. Thomas Travison, Ph.D., of Harvard Medical School and Hebrew SeniorLife, will provide support in development of databases to support these cores.

Three tasks forces will be established in NIDUS.  First, to encourage innovative research into new areas of study, the Pilots and Innovation Task Force will provide pilot grants each year. This task force is led by the joint efforts of Thomas Robinson, M.D., of the University of Colorado School of Medicine and Michael Avidan, M.B.B.Ch., of Washington University School of Medicine.  

The second Task Force, the Mentorship and Career Development Task Force, co-led by Donna Fick, Ph.D., M.S.N., of the Pennsylvania State University, and E. Wesley Ely, M.D., M.P.H., of Vanderbilt University Medical Center, will create an intensive training bootcamp for researchers new to the field of delirium, as well as provide ongoing opportunities for mentorship and career development. “This initiative will encourage new researchers to join this exciting and important field,” says Fick.

Andrew Auerbach, M.D., of the University of California San Francisco, and Jan Busby-Whitehead, M.D., of the University of North Carolina School of Medicine, will lead the Dissemination Task Force, which will hold an annual scientific symposium for delirium researchers and use social media and other approaches to communicate information about delirium research broadly. Dr. Auerbach notes that this task force “will help ensure that scientific efforts are disseminated with existing organizations, such as the American Delirium Society and European Delirium Association”.

NIDUS will also draw on the expertise of the 16-member external Scientific Advisory Board, chaired by Malaz Boustani, M.D., Professor of Medicine at Indiana University School of Medicine, and former President of the American Delirium Society. The Advisory Board will provide feedback on program activities twice a year. Its members include members of the European Delirium Association, as well as experts in a variety of relevant areas including geriatric medicine, nursing, anesthesiology, emergency and ICU medicine, psychiatry, neurology, neuropsychology, palliative care, epidemiology, and patient advocacy.

About the National Institute on Aging (NIA)

The NIA is one of 27 institutes and centers of the National Institutes of Health, which sponsors and conducts research on aging and the health and well-being of older adults. The five-year NIDUS grant will be overseen by NIA program officials Molly Wagster, Ph.D., Division of Neuroscience and Susan Zieman, M.D., Ph.D. and Basil Eldadah, M.D., Ph.D., Division of Geriatrics and Clinical Gerontology.

About the Institute for Aging Research at Hebrew SeniorLife

Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Aging Brain Center within IFAR studies cognitive aging and conditions affecting brain health. Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for providers since 1903.

 

September 28, 2016

Epigenetic Clock Predicts Life Expectancy

BOSTON — Why do some people lead a perfectly healthy lifestyle yet still die young? A new international study suggests that the answer lies in our DNA.

UCLA geneticist Steve Horvath led a team of 65 scientists in seven countries to record age-related changes to human DNA, calculate biological age and estimate a person’s lifespan. A higher biological age—regardless of chronological age—consistently predicted an earlier death.

The findings are published in today’s edition of the journal Aging.

“Our research reveals valuable clues into what causes human aging, marking a first step toward developing targeted methods to slow the process,” said principal investigator Horvath, a professor of human genetics and biostatistics at UCLA’s David Geffen School of Medicine and Fielding School of Public Health.

Drawing on 13 sets of data, including the landmark Framingham Heart Study and Women’s Health Initiative, a consortium of 25 institutions analyzed the DNA in blood samples collected from more than 13,000 people in the United States and Europe.

Applying a variety of molecular methods, including an epigenetic clock developed by Horvath in 2013, the scientists measured the aging rates of each individual. The clock calculates the aging of blood and other tissues by tracking methylation, a natural process that chemically alters DNA over time. By comparing chronological age to the blood’s biological age, the scientists used the clock to predict each person’s life expectancy.

“We were stunned to see that the epigenetic clock was able to predict the lifespan of Caucasians, Hispanics and African-Americans,” said first author Brian Chen, a postdoctoral fellow at the National Institute on Aging. “This rang true even after adjusting for traditional risk factors like age, gender, smoking, body-mass index, disease history and blood cell counts.”

The group’s findings, however, don’t bode well for everyone.

“We discovered that 5 percent of the population ages at a faster biological rate, resulting in a shorter life expectancy,” Horvath said. “Accelerated aging increases these adults’ risk of death by 50 percent at any age.”

For example, two 60-year-old men, Peter and Joe, both smoke to deal with high stress. Peter’s epigenetic aging rate ranks in the top 5 percent, while Joe’s aging rate is average. The likelihood of Peter dying within the next 10 years is 75 percent compared to 60 percent for Joe.

The preliminary finding may explain why some individuals die young – even when they follow a nutritious diet, exercise regularly, drink in moderation and don’t smoke.

“While a healthful lifestyle may help extend life expectancy, our innate aging process prevents us from cheating death forever,” Horvath emphasized. “Yet risk factors like smoking, diabetes and high blood pressure still predict mortality more strongly than one’s epigenetic aging rate.”

Scientists have long searched to identify biomarkers for biological age, according to coauthor Dr. Douglas Kiel, a professor at Harvard Medical School and a senior scientist for the Institute of Aging Research at Hebrew SeniorLife.

“In geriatric medicine, we are always struck by the difference between our patients’ chronological age and how old they appear physiologically,” said Kiel. “This study validates the use of DNA methylation as a biomarker for biological age. And if we can prove that DNA methylation accelerates aging, we can devise strategies to slow the rate and maximize a person’s years of good health.”

The precise role of epigenetic changes in aging and death, however, remains unknown, said coauthor Dr. Themistocles Assimes, an assistant professor of cardiovascular medicine at Stanford University School of Medicine.

“Do the epigenetic changes associated with chronological aging directly cause death in older people?” said Assimes. “Perhaps they merely enhance the development of certain diseases--or cripple one’s ability to resist the progression of disease after it has taken root. Future research is needed to address these questions.”

Larger studies focused only on cases with well-documented causes of death will help scientists tease out the relationship between epigenetic age and specific diseases, he added.

By 2017, according to the World Health Organization, the number of people worldwide over age 65 will outnumber those under age 5 for the first time in recorded history. By 2050, the proportion of the global population over 60 will double from 11 to 22 percent. Many countries will be ill-prepared to keep pace with the high costs associated with disease and disability as more people live longer, said Horvath.

“We must find interventions that prolong healthy living by five to 20 years. We don’t have time, however, to follow a person for decades to test whether a new drug works.” said Horvath. “The epigenetic clock would allow scientists to quickly evaluate the effect of anti-aging therapies in only three years.”

The University of California has applied for a provisional patent on the epigenetic clock.


September 27, 2016

Latest News Coverage - IFAR's Musculoskeletal Research Center :

Huffington Post: Smoking Causes Long-Term Damage to your DNA, Study Finds

Boston Magazine: Smoking Can Cause Long-Term DNA Damage, Study Finds

NBC New York: Smoking Leaves DNA Damage Years AFter Quitting, Study Finds

WCVB Boston: Smoking Leaves 30-Year Legacy on Your DNA


September 23, 2016

IFAR's Lewis A. Lipsitz to speak at 30th Annual Katz Lecture

Boston - Lewis A. Lipsitz, MD, MA, Director Institute for Aging Research, Hebrew Seniorlife; Professor of Medicine, Harvard Medical School; and Chief, Division of Gerontology, Beth Israel Deaconess Medical Center will be the featured speaker at Brown University School of Public Health's 30th Annual Katz Lecture. Dr. Lipsitz's lecture, entitled, "Improving Long-Term Care Quality in America: Two Experiments to Bring Geriatric Expertise to the Nursing Home," is free and open to the public.

When: Wednesday, September 28, 2016; 4:00-5:00pm (Reception to Follow)

Where: 121 S. Main Street, Room 375, Providence RI 02903

Please visit the event website for more information.


September 20, 2016

The Effects of Cigarette Use on DNA

BOSTON— Researchers from the Harvard Medical School - affiliated Hebrew SeniorLife Institute for Aging Research (IFAR) along with several other institutions have found evidence that smoking leaves a long-term signature on DNA. Findings from the study will be published in the October issue of Circulation: Cardiovascular Genetics, an American Heart Association journal.

IFAR’s Roby Joehanes Ph.D. and first author on the study explains, “Our study has found compelling evidence that smoking has a long-lasting impact on our molecular machinery, an impact that can last more than 30 years. The encouraging news is that once you stop smoking, the majority of DNA methylation signals return to never smoker levels after five years, which means your body is trying to heal itself of the harmful impacts of tobacco smoking.”

Stephanie J. London, M.D., Dr.P.H. last author and deputy chief of the Epidemiology Branch at the National Institute of Environmental Health Sciences, National Institutes of Health says, “These results are important because methylation, as one of the mechanisms of the regulation of gene expression, affects what genes are turned on, which has implications for the development of smoking-related diseases. Equally important is our finding that even after someone stops smoking, we still see the effects of smoking on their DNA.”

After conducting an analysis of genome-wide DNA, researchers concluded that cigarette smoking has a broad impact on DNA methylation which may persist even several years after a person has quit smoking. In addition, the discovery of these DNA methylation sites could lead to the development of new treatments for smoking related illnesses. Despite the drastic decline of smoking in recent years (In the US today, there are more former smokers than current smokers) smoking remains the leading cause of preventable death around the world.

Infrastructure for the CHARGE Consortium is provided by the National Heart, Lung, and Blood Institute grant R01HL105756. This work was supported in part by the Intramural Research Program of the NIH; National Institute of Environmental Health Sciences and the National Heart Lung and Blood Institute. Additional Sources of funding can be found in the manuscript.


September 20, 2016

Hebrew SeniorLife's Amanda Lorbergs receives ASBMR's Young Investigator Award.

Congratulations to Amanda Lorbergs, Post-Doctoral Research Fellow at Hebrew SeniorLife’s Institute for Aging Research for receiving the 2016 American Society for Bone Mineral Research (ASBMR) Young Investigator Award for the abstract presentation “Light intensity physical activity measured by accelerometer is associated with favorable bone microarchitecture and strength: The Framingham Study.”

The Young Investigator Award recognizes young investigators who submit top-ranking abstracts to an ASBMR Meeting. Dr. Lorbergs has been working on studies of bone health with post-doc mentor, Dr. Lisa Samelson, Associate Scientist in the Musculoskeletal Center in IFAR.


September 9, 2016

Hebrew SeniorLife’s Susan Mitchell wins David H. Solomon Award

BOSTON—Susan Mitchell, MD, MPH of Needham Massachusetts was recently presented with the 2016 UCLA David H. Solomon award. The award was named in honor of the former chair of medicine at University of California, Los Angeles and is awarded annually to an influential leader in the field of geriatrics.

Dr. Mitchell is Senior Scientist and Director of Palliative Care Research at Hebrew SeniorLife’s Institute for Aging Research and a Professor of Medicine at Harvard Medical School in Boston. She is a clinical epidemiologist and board certified geriatrician and internist in Canada and the United States. Dr. Mitchell's research interests focus on decision-making, health outcomes, and resource utilization for older people near the end-of-life, particularly those with dementia. She is the principal investigator on several large research projects funded by the National Institutes of Health to study the end-stages of dementia and has been a lead author on many articles in top peer-reviewed journals related to this topic.

Dr. Mitchell is active in the mentorship of young investigators and is the recipient of a NIH-NIA K24 Mid-Career Investigator Award. She is also a primary care provider for frail nursing home residents at Hebrew Senior Life and attending geriatrician at the Beth Israel Deaconess Medical Center.


August 29, 2016

The Decline of Tube Feeding in Dementia Patients

The New York Times features the work of IFAR's Susan L. Mitchell, M.D., MPH and its impact on decreasing feeding tube use in patients with end-stage dementia. Read the article here.


August 29, 2016

Prevent Delirium and You May Reduce Dementia Risk: 10 Tips for Seniors Before Surgery

Sharon K. Inouye, M.D., MPH outlines her top ten tips for reducing dementia risk in seniors for the Huffington Post. Read these important tips here.


August 22, 2016

After a Fracture, It's Time to Rethink Medications

BOSTON – With half of all women and a quarter of all men over fifty expected to suffer a fracture in the years ahead, the number of such injuries exceeds the incidence of heart attack, stroke, and breast cancer combined. By discouraging the use of medications that can cause dizziness or loss of balance and prescribing medications known to prevent bone loss, clinicians can help patients lower their risk of falls and fractures.

In a commentary published today in JAMA Internal Medicine, gerontologists at Beth Israel Deaconess Medical Center and Hebrew SeniorLife Institute for Aging Research underscore the importance of reviewing patients’ prescription medications in the wake of a fracture. Appearing alongside original research by Munson et al that finds few changes are made to patients’ prescription medications in the four months following a fracture, the commentary is a call for clinicians to coordinate care among orthopedics, rehabilitation services and primary care to reevaluate patients’ medication use.

“The findings of Munson et al suggests that far too often clinicians fail to perform a thoughtful medication review for patients with a fracture,” said corresponding author Sarah D. Berry, MD, MPH, assistant professor of medicine in the Division of Gerontology in the Department of Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School (HMS), as well as assistant scientist II at the Hebrew SeniorLife Institute for Aging Research. “It’s imperative that researchers and clinicians work together to narrow this treatment gap and reduce secondary fractures and their devastating consequences.”

More than 20 percent of older people who break a hip die within a year – a death rate two- to four-times higher than that among uninjured people the same age and sex. Other complications of broken bones among the elderly include pain, depression, infection, functional decline and subsequent fractures.

Berry and co-author Douglas P. Kiel, MD, MPH, professor of medicine in the Department of Medicine at BIDMC and HMS, and senior scientist and director of the Musculoskeletal Research Center at the Hebrew SeniorLife Institute of Aging Research, suggest a two-prong approach for clinicians considering patient medications after a fall or fracture.

First, clinicians should consider reducing or discontinuing the use of drugs linked to increased risk of falls or fractures – especially psychotropic medications such as sleep aids, sedatives and antidepressants that can cause dizziness or loss of balance. But when Munson et al looked at prescription drug use in the four months before and after a hip, forearm or wrist fracture in a group of older, community-dwelling Medicare beneficiaries, they found that more than 85 percent of them were taking one or more of the drugs known to increase fracture risk after their injury.

“Given the robust evidence linking psychotropic medications with falls and fractures, the lack of decline in the use of these medications after a fracture is alarming,” Berry and Kiel wrote.

Clinicians may avoid broaching the topic of reducing use of this class of medications based on a perception that patients may be dependent on them, the authors suggest. However, they cite previous research indicating that after patients were given a simple pamphlet describing the risks associated with the sedative benzodiazepine, 38 percent of study participants voluntarily discontinued using it, compared to just 11 percent of the control group.

Second, clinicians should prioritize prescribing drugs known to prevent the likelihood of fractures among this high-risk group, the authors wrote. The National Osteoporosis Foundation recommends osteoporosis medication for all adults over 50 who have fractured a hip. Yet Munson et al found that less than a quarter of hip fracture patients received a common osteoporosis medication known to reduce the risk of fracture. Another recent study using commercial insurance claims saw even lower numbers, around 15 percent.  

Berry and Kiel suggest that multiple care teams working across various medical settings can make it unclear which provider should conduct this post-fracture medication review. Primary care physicians are generally not involved in the immediate care of fractures, the authors wrote, but orthopedic specialists may not have the long-term relationship necessary to help make risk/benefit decisions about certain sleep or mood medications.

“Most clinicians wouldn’t dispute the importance of medication review for patients following a fracture but the question is who should do it,” Berry said. “We challenge all clinicians to work together to reduce the use of drugs linked to falls and fractures and to treat patients with drugs that can prevent subsequent fractures. We also encourage patients who have experienced a fall or fracture to initiate a discussion with their doctors about the risks and benefits of medications associated with falls and bone loss.


August 16, 2016

Tube-Feeding in Dementia Nursing Home Residents Drops Dramatically

BOSTON—August 16, 2016— The proportion of nursing home residents with advanced dementia and eating dependency who received feeding tubes decreased by approximately 50% between 2000 and 2014 according to a new study published in the Journal of the American Medical Association (JAMA).

Researchers from the Harvard Medical School affiliated Hebrew SeniorLife Institute for Aging Research (IFAR), Brown University’s Center for Gerontology and Health Care Research and University of Washington’s Cambia Palliative Care Center of Excellence conducted the study.

Investigators reviewed data on more than 71,000 advanced dementia residents in nursing homes across the U.S. From 2000 – 2014, researchers found that the proportion of residents receiving feeding tubes declined from 11.7% in 2000 to 5.7% in 2014. Among white patients, insertion rates declined from 8.6 to 3.1% while rates in black patients declined from 37.6-17.5%. For both cohorts, the proportion of residents with advanced dementia and eating dependency who received feeding tubes decreased by approximately 50% between 2000 and 2014.

According to Susan L. Mitchell MD, MPH, lead author of the study and Director of Palliative Care Research at IFAR, “This decline parallels the emergence of research, expert opinion, and recommendations by national organizations discouraging this practice.”  In the future, to ensure that expert recommendations are disseminated and racial disparities are reduced, researchers argue that fiscal and regulatory policies are needed to discourage tube-feeding and promote a palliative approach to feeding problems for people with dementia.

This study was supported by NIH-NIA P01AG02729. Dr. Mitchell is supported by NIH-NIA K24AG033640.


August 10, 2016

Trajectory of Functional Recovery after Postoperative Delirium

BOSTON—August 10, 2016— Researchers from the Harvard Medical School-affiliated Hebrew SeniorLife Institute for Aging Research (IFAR), in collaboration with scientists from Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Brown University, and Northeastern University, have discovered that postoperative delirium negatively impacts recovery in older adults. Results from this study were published in the Annals of Surgery.

Delirium is a common, serious, often fatal disorder occurring in 11% to 50% of hospitalized older patients, although it is significantly underdiagnosed. Delirium leads to an increased risk of institutionalization, caregiver burden, cognitive impairment and death. Despite the severity of delirium’s effects on those afflicted, the long-term consequences of delirium for physical functioning have not been well-established.

The study population was drawn from the Successful Aging after Elective Surgery (SAGES) study and included participants 70 years of age or older who were scheduled to undergo elective surgery with an anticipated stay of at least 3 days. Following surgery, patients were assessed for delirium using the Confusion Assessment Method, and their functional recovery was followed for 18 months.

Delirium was identified in 24% of the study participants. Over the following 18 months, these patients demonstrated lesser functional recovery than those who did not experience delirium. Both group’s physical function declined at one month after surgery, but those who developed delirium declined more significantly. After one month, both groups experienced improvements in physical function; however the delirium group demonstrated less improvement than its counterpart. After a full 18 months, the delirium group was unable to achieve the same functional progress as those who were unaffected.

The results of this study give further evidence to the severity of delirium and its potential effects on older patients. “Many older patients decide to undergo elective surgery because they want to be more functional afterwards. Our work shows just how important it is to prevent delirium so that these patients can feasibly achieve the function they were hoping for,” says Dr. Tammy Hshieh associate physician at Brigham and Women’s Hospital and first author for the study.

Whenever possible, clinicians should use preventive interventions to reduce risk factors that may lead to delirium. “This study emphasizes the importance of increased surveillance for delirium in the postoperative period and the consideration of tailored transitional care planning and extended rehabilitation for older patients,” States Dr. Sharon Inouye, principal investigator for the study.

This study was supported by Grant Numbers P01AG031720, K07AG041835, T32AG000158, from the National Institute on Aging from the National Institutes of Health.


August 3, 2016

Nutrition Advice for Active Seniors: An interview with celebrity nutritionist Keri Glassman and HSL researcher Dr. Shivani Sahni

In a recent interview for CapeCod.com, Dr. Shivani Sahni, a Nutritional Epidemiologist from Hebrew SeniorLife's Institute for Aging Research along with Keri Glassman, R.D., M.S., a celebrity nutritionist and registered dietitian gave their advice on healthy eating tips for seniors. Read their thoughts here.


August 2, 2016

Heritability of Thoracic Spine Curvature

BOSTON – August 2, 2016 – Researchers from the Harvard affiliated Hebrew SeniorLife Institute for Aging Research (IFAR) recently published a study in the Journal of Bone and Mineral Research, suggesting that hyperkyphosis may be heritable, or passed on from parents to offspring.  

"Hyperkyphosis is a serious condition characterized by extreme forward curvature of the upper spine. It affects as many as 20 to 40 percent of older individuals. However, the causes are poorly understood," said Lisa Samelson, senior investigator for the study, and associate scientist at IFAR and assistant professor at Harvard Medical School.  

Samelson’s team used computed tomography (CT) images to evaluate thoracic spine curvature, muscle size, and other spine traits in more than 2,000 older adults. Data for the research was collected in two generations of families enrolled in the Framingham Heart Study. 

Michelle Yau, a post-doctoral research fellow at IFAR and lead author of the study, added, “Our study is important because it advances our understanding of hyperkyphosis in two ways. First, we found evidence of a strong influence of heredity on hyperkyphosis. Heritability was 54% which suggests that more than half the variation in thoracic spine curvature may be under genetic control. Second, we found that the genetic determinants of hyperkyphosis may also be responsible for bone and muscle loss of the spine that occurs with aging."  

Hyperkyphosis can cause disfigurement as well as difficulties with breathing, walking, and carrying out activities of daily life. By quantifying the contribution of genetic factors to development of excessive forward curvature in older adults, this study provides important new insight into the etiology of hyperkyphosis that may help inform prevention efforts in the future. 

Funding was supported by the National Institute on Aging (NIA) under grant number R01AG041658 and T32AG023480, the National Heart, Lung and Blood Institute's Framingham Heart Study (Contract No. HHSN268201500001I), and the Friends of Hebrew SeniorLife. 


July 28, 2016

Severity of Kyphosis and Decline in Lung Function

BOSTON—July 28, 2016— Researchers from the Harvard affiliated Hebrew SeniorLife Institute for Aging Research (IFAR), have published a recent article in Journals of Gerontology: Medical Sciences, suggesting that preventing or slowing progression of hyperkyphosis may reduce pulmonary decline in older adults. Hyperkyphosis is a poorly understood condition that causes an extreme forward curvature of the spine and affects as many as 20 to 40 percent of older individuals.  “Clinically, we know hyperkyphosis restricts expansion of the lungs and causes difficulty in breathing, as well as other serious health problems,” said Amanda Lorbergs, a post-doctoral scientist at IFAR and lead author of the study.  Lisa Samelson, senior investigator for the study and associate scientist at IFAR and assistant professor at Harvard Medical School, added, “Our findings are highly important, because they are based on pulmonary function data collected in a prospective cohort followed over a long period, allowing us, for the first time, to quantify the impact of hyperkyphosis on declines in lung function.”

Samelson’s team used data from the Framingham Heart Study that has collected information from generations of Framingham residents and their offspring since the 1940s.  These data include measurements of kyphosis from spine radiographs taken at the beginning of the study and pulmonary function (spirometry) tests performed on four occasions over the next 16 years.  The researchers found that women who had the most severe kyphosis had the greatest declines in lung function.  Moreover, this loss of lung function that may be due to hyperkyphosis is comparable with the amount associated with smoking up to 15 cigarettes per day.  Pulmonary impairment is a leading cause of morbidity and mortality in older adults.  By quantifying the impact hyperkyphosis can have on pulmonary impairment, this study highlights the importance of developing approaches to prevent or reduce hyperkyphosis. 

This studey was supported by the National Institute on Aging and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, of the National Institutes of Health, under award numbers R01AG041658 and R01AR041398


July 20, 2016

A Cinderella Tale: Can New Shoes Change the Life of a Person With Knee Osteoarthritis?

Dr. Marian T. Hannan, Co-Director of Musculoskeletal Research Center at IFAR contributed this editorial in the Annals of Internal Medicine detailing findings from a randomized trail that compared shoes designed to unload the knee versus new, conventional shoes. Read more here.


July 14, 2016

Delirium in Older Patients after Surgery May Lead to Long-Term Cognitive Decline

BOSTON— July 14, 2016— Researchers from the Harvard Medical School - affiliated Hebrew SeniorLife Institute for Aging Research (IFAR) have found increasing evidence that delirium in older surgical patients may be associated with long-term cognitive decline. Findings from the study were published today in the July 2016 issue of Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

“This study is highly significant in demonstrating that delirium is associated with subsequent long-term cognitive decline at a pace similar to that of mild cognitive impairment, even in those with normal cognitive function at baseline,” says Sharon K. Inouye, M.D., M.P.H., Director of the Aging Brain Center at the Institute for Aging Research, Hebrew SeniorLife, a faculty member in the Division of Gerontology at Beth Israel Deaconess Medical Center, and Professor of Medicine at Harvard Medical School. “Whether or not delirium is causative, it identifies those at risk for subsequent cognitive decline and warrants both close clinical follow-up and preventive interventions.”


June 29, 2016

Sub-Sensory vibratory noise augments the physiologic complexity of postural control in older adults.

BOSTON— Researchers from the Harvard affiliated Hebrew SeniorLife Institute for Aging Research (IFAR), have published a recent article in the Journal of NeuroEngineering and Rehabilitation which gives evidence that sub-sensory vibrations delivered to the foot sole of older adults significantly augmented the physiologic complexity of postural control and led to improvement in a given mobility assessment. Researchers came to this conclusion by applying vibrating soles to the feet of 12 healthy adults at various sensory thresholds over the course of three visits. After the vibrations were delivered, researchers tested postural sway complexity during eyes open and eyes closed standing assessments. They then evaluated mobility using the timed up and go (TUG) assessment. Findings of the study show that foot sole vibrations at 70 and 85% of sensory threshold increased postural sway complexity. Moreover, these increases correlated with improved TUG times for participants.

When standing, the feet are the only points of contact with the external environment. Therefore, standing postural control is dependent upon the nervous system to detect characteristics of the ground below the foot and deliver that information back to the central nervous system. Vibratory noise increases the sensory input from the foot soles to the postural control system, which leads to greater postural control and improved mobility.

This study was supported by Merck Sharp and Dohme, the National Institute on Aging (AG025037 and AGO41785) and KL2 Medical Research Investigator Training (MeRIT) award (1KL2RR025757-04) from Harvard Catalyst/The Harvard Clinical and Translational Science Center (UL1RR025758).


June 22, 2016

Call for applications: 2016 Delirium Boot Camp

Delirium Research Boot Camp - applications due July 15, 2016: CEDARTREE will be hosting a three-day intensive course on delirium research November 6-8, 2016 at the Inn at Longwood Medical in Boston, MA. Recognized experts in the field will discuss cutting edge research approaches, from assessment and methodology to novel technologies and interventions. Attendees will have the opportunity to network with world-renowned experts in delirium and related fields. This year, CEDARTREE will also be offering two Pilot Awards, prestigious awards for new research projects related to delerium. For more details, click here. Contact agingbraincenter@hsl.harvard.edu with questions. 

 

June 6, 2016

Osteoporosis drugs not taken by many who need them: reports

Fear and a lack of awareness in many older adults that they have the bone-weakening disease osteoporosis has led to a growing public health concern by leading medical organizations.

In a joint statement, the American Society for Bone and Mineral Research, National Osteoporosis Foundation and National Bone Health Alliance, announced their concerns.

“Untreated osteoporosis is a public health crisis. Many of us see firsthand the ravages of this disease every day - pain, fractures, loss of mobility and independence, and diminished quality of life,” said Dr. Douglas P. Kiel, ASBMR president and director of the Musculoskeletal Research Center and Senior Scientist for the Institute for Aging Research at Hebrew SeniorLife. “These results build on mounting evidence that identifying and treating patients after the first fracture is crucial to preventing suffering.”


June 6, 2016

Videoconferencing between hospital staff, nursing home staff offers new dementia treatment

Nursing homes in the United States care for increasing numbers of people with dementia, yet many lack access to geriatric psychiatrists, behavioral neurologists and other specialists who may help manage symptoms associated with dementia, including behavioral issues. As a result, nursing home staff may resort to physical restraints or antipsychotic medications to manage behavioral challenges, which can significantly compromise a patient's health, autonomy and dignity.

 

June 4, 2016

A new approach to dementia care

Dementia patients who punch and kick other nursing home residents and staff often are prescribed powerful medications to control their behaviors, but those drugs come with dangerous and sometimes lethal side effects.

Now, a new study from Boston researchers suggests one way that can significantly reduce use of those potent sedatives: by linking nursing home staff with specialists in dementia care, via video consultations.

In a small group of Massachusetts nursing homes where staff used the twice-monthly video conferences, residents were 17 percent less likely to be prescribed the antipsychotic medications, compared with residents in nursing homes not in the program, according to the study by researchers at Beth Israel Deaconess Medical Center and Hebrew SeniorLife.


May 26, 2016

The Real Secret of Youth Is Complexity

Simplicity, simplicity, simplicity!” Henry David Thoreau exhorted in his 1854 memoir Walden, in which he extolled the virtues of a “Spartan-like” life. Saint Thomas Aquinas preached that simplicity brings one closer to God. Isaac Newton believed it leads to truth. The process of simplification, we’re told, can illuminate beauty, strip away needless clutter and stress, and help us focus on what really matters.

It can also be a sign of aging. Youthful health and vigor depend, in many ways, on complexity.


June 4, 2015

The perils of delirium

The Washington Post 

Federal health authorities, who are seeking ways to reduce hospital-acquired complications, are pondering what actions to take to reduce the incidence of delirium, which is not among the complications for which Medicare withholds payment or for which it penalizes hospitals. Delirium is estimated to cost more than $143 billion annually, mostly in longer hospital stays and follow-up care in nursing homes. Sharon Inouye, professor of medicine at Hebrew SeniorLife, is quoted.


May 13, 2015

Call for applications: 2015 Delirium Boot Camp, Pilot Research Grants, and Best Delirium Paper Awards

The Center of Excellence for Delirium in Aging: Research, Training, and Educational Enhancement (CEDARTREE) is pleased to announce the third annual Delirium Boot Camp.  This highly-rated, two-day, intensive course in delirium research is scheduled for November 12-13, 2015 at Harvard Medical School/Beth Israel Deaconess Medical Center in Boston, MA.  Boot Camp attendees will learn about important topics in delirium research from assessment and methodology to novel technologies and interventions, as well as network with colleagues and experts in delirium and related fields.  Applications are due by July 17, 2015 and are available at http://www.hospitalelderlifeprogram.org/cedartree/delirium-bootcamp.

This year, CEDARTREE will be offering two Pilot Research Grants of $2000 each and two Best Delirium Paper Awards of $500 each for Boot Camp applicants.  Applications for the Pilot Research Grants and Best Delirium Paper Awards are due September 21, 2015 and are available at http://www.hospitalelderlifeprogram.org/cedartree/pilot-grants/.

CEDARTREE was founded in 2013 by Dr. Sharon K. Inouye, Director of the Aging Brain Center at the Institute for Aging Research, with the goals of advancing research and training, fostering dissemination of research findings, and serving as a local and national resource for delirium research.


March 12, 2015
NEJM - Atrial fibrillation is a critical public health issue, and its clinical burden and related costs will only grow as the aging of the U.S. population increases its prevalence and the risk of resulting stroke and systemic embolism. Several investigators have tried to prevent complications of atrial fibrillation using medical devices designed to prevent embolization of clots formed in the left atrial appendage. Although such devices have been available for nearly a decade in Europe, they are not yet approved in the United States. Examination of the review conducted by the Food and Drug Administration (FDA) of one device for closure of the left atrial appendage provides insight into differences in medical-device regulation between the United States and the European Union (EU) and highlights the urgency of monitoring devices in a coordinated and rigorous manner.

February 6, 2015

BOSTON - The patient was an older man, living at a nursing facility. He’d originally been admitted to the hospital for surgery to treat a urinary tract infection. But now, lying in his bed at the hospital after the operation, he was convinced that two people were standing outside his room and planning to blow it up.


February 2, 2015

Delirium – the sudden onset of confusion frequently seen in older patients – can increase a person’s risk of falls, lead to prolonged hospital stays and may contribute to over $164 billion in healthcare costs.

A new study led by researchers at Brigham and Women’s Hospital (BWH) and Hebrew SeniorLife’s Institute for Aging Research suggests that delirium is also preventable, and that non-medication strategies can reduce risk and improve outcomes. This meta-analysis of 14 studies involving multi-component non-pharmacologic interventions is published this week in JAMA Internal Medicine.


February 1, 2015

Program to prevent delirium in ICU patients will soon be implemented in 60 hospitals.

What serious hospital-acquired condition affects 25% of patients over age 70 and up to82% of patients in the ICU?


January 2015

Subsensory vibratory stimulation applied to the soles of older adults' feet can improve key indicators of balance, potentially reducing fall risk.

Falls create a substantial concern among elderly patients, with, in each year, one in three older adults experiencing a fall.  New research, however, indicates that subsensory vibratory stimulation applied to the sole of the foot can improve key indicators of balance, which holds promise for reducing falls among older adults. 


January 9, 2015

Deborah L. Lemmerman, vice president for human resources at Hebrew SeniorLife in Boston, believes in the benefits of target-date retirement funds. Over the last 15 years, in her current post and in previous ones, she has seen employees embrace these investments.


December 17, 2014

BOSTON - It’s important to strive for a healthy diet throughout life, but as our bodies change after middle age, it becomes especially important to consume an overall healthy diet to ensure intake of vital nutrients. Shivani Sahni, MS, PhD, of Hebrew SeniorLife’s Institute for Aging Research and Beth Israel Deaconess Medical Center’s Department of Medicine, is examining the role of nutrition in the prevention of chronic diseases of aging. She offers a list of the top 10 foods and drinks for healthy aging, noting that different nutrients have important effects on several health outcomes related to aging.


December 17, 2014

BOSTON - Falling can be scary. It can happen on a slippery surface, on ice, or when you’re simply not paying attention. But often times, it happens to older adults, in any location, on any surface.


November 18, 2014

BOSTON, NEW YORK - Eleanor Hammer, 92, executes a tightly choreographed, slow-motion pas de deux with her walker during meal times at The Sequoias, a retirement community in San Francisco.


November 11, 2014

Study found patients who had both before procedure were 21 percent more likely to become disoriented.

HealthDay News -- Pain and depression before an operation may increase seniors' risk for delirium after surgery, a new study suggests.


November 3, 2014

After a fall, life is upended in an instant — a sudden loss of independence, an awkward reliance on family and friends, and a new level of fear for those who fall, and their contemporaries. 

SAN FRANCISCO — Joan Rees, 79, had hardly been ill a day in her life. Her biggest problem was arthritis, mostly in her knees, but at home in San Francisco she walked every day and she traveled frequently.


November 2, 2014

As the population ages and people live longer in bad shape, the number of older Americans who fall and suffer serious, even fatal, injuries is soaring.

SAN FRANCISCO — Eleanor Hammer, 92, executes a tightly choreographed, slow-motion pas de deux with her walker during meal times at The Sequoias, a retirement community here. She makes her way to the buffet, places her food on the walker’s built-in tray and returns to her table.


October 30, 2014

BOSTON — New research reports that preoperative pain and depressive symptoms in older adults place them at greater risk of delirium following surgery.  According to the findings published today in The Lancet Psychiatry journal, both pain and depression are independent and interactive risk factors for delirium, suggesting a cumulative effect.


October 29, 2014

BOSTON — “Tuesdays With Morrie” author Mitch Albom, humorist Mo Rocca, and nutritionist Keri Glassman joined Boston-area businesspeople, philanthropists, and folks from Hebrew SeniorLife’s Institute for Aging Research for an evening of networking and talking at the Calderwood Pavilion. (An affiliate of Harvard Medical School, Hebrew SeniorLife is dedicated to rethinking, researching, and redefining the possibilities of aging.) Tuesday’s event was moderated by Dan Harris, “Nightline” “coanchor and “Good Morning America” weekend anchor.


October 29, 2014

The insoles were found to decrease falling by 70 percent.

BOSTON - Falling is scary, and for adults over the age of 65, a fall can do a lot more than cause a bruise. According to the CDC, one in three seniors that fall each year suffer moderate to severe injuries such as hip fractures and head traumas, and only 25 percent of those patients fully recover.


October 28, 2014
Study Shows Vibrating Insoles Could Reduce Falls Among Seniors
Boston researchers find vibratory stimulation applied to the sole of the foot using novel piezoelectric technology shows promise for fall prevention.

BOSTON — Findings published in the Archives of Physical Medicine and Rehabilitation show that imperceptible vibratory stimulation applied to the soles of the feet improved balance by reducing postural sway and gait variability in elderly study participants. The vibratory stimulation is delivered by a urethane foam insole with embedded piezoelectric actuators, which generates the mechanical stimulation. The study was conducted by researchers from the Institute for Aging Research (IFAR) at Hebrew SeniorLife, Beth Israel Deaconess Medical Center, the Wyss Institute for Biologically Inspired Engineering at Harvard University, and Harvard Medical School, all of Boston, Massachusetts; and Merck Sharpe and Dohme (MSD) Consumer Care, Inc., of Memphis, Tennessee.


August 24, 2014
Harvard and Brown-Affiliated Researchers Receive $4.5M Grant to Test Videos for Advance Directives
A new NIH-funded project will assess whether videos can help nursing home residents, family members and staff have the difficult but important conversations about advanced directives for care.

BOSTON – Advanced directives help to clarify appropriate care for elderly nursing home residents at critical moments for their health, but the process of having the necessary conversations between residents, family members and home staff is hardly routine. With a new grant from the National Institutes of Health (http://www.nih.gov/news/health/aug2014/nccam-20.htm), Susan Mitchell, M.D., M.P.H., director of the Palliative Care Research Center in Harvard-affiliated Hebrew SeniorLife’s Institute for Aging Research along with colleagues from Brown University and Massachusettes General Hospital plan a big test of whether a suite of videos can help.


July 25, 2014
Could Age of First Period Influence Development of Diseases in Older Women?
Genetics involved with menarche may hold keys to preventing diabetes or osteoporosis in later life

BOSTON – A novel study shows that the age girls reach puberty is influenced by 'imprinted genes‘—a subset of genes whose activity differs depending on which parent contributes the gene. This is the first evidence that imprinted genes can control the rate of development after birth and details of this study were published today in the journal Nature.


April 15, 2014
Boston-Area Researchers Develop New Delirium Severity Measure for Older Adults
New method to measure delirium offers potential to improve clinical care, prognosis and response to treatment

BOSTON – A new method for measuring delirium severity in older adults has been developed by researchers from Harvard, Brown, and UMASS. The new scoring system, CAM-S, is based on the Confusion Assessment Method (CAM) and standardizes the measurement of delirium severity for both clinical and research uses. Details of this study are published in Annals of Internal Medicine.


April 15, 2014
Researchers Develop Criteria to Identify Muscle Loss, Weakness in Older Adults
Improved Diagnosis Aids in Prevention and Treatment of Mobility Issues from Frailty

BOSTON – Scientists from Harvard Medical School–affiliated Hebrew SeniorLife Institute for Aging Research (IFAR) took part in a collaborative effort by U.S. researchers to develop criteria for diagnosing sarcopenia—a common and disabling condition of low muscle mass and weakness in older adults. Findings from the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium Sarcopenia Project are published in The Journals of Gerontology and suggest evidence-based cut-points of grip strength and lean mass could be used to identify sarcopenia in seniors.


January 16, 2014
Research Sheds New Light on Heritability of Disease
Study explores the role DNA plays to predispose individuals to diseases such as type 2 diabetes

BOSTON - A group of international researchers, led by a research fellow in the Harvard Medical School-affiliated Institute for Aging Research at Hebrew SeniorLife, published a paper today in Cell describing a study aimed at better understanding how inherited genetic differences, or variants, predispose certain individuals to develop diseases such as type 2 diabetes. The study integrated computational methodology with experimentation to address and prove underlying genetic causes of type 2 diabetes. In principle, the new methodology can be applied to any common disease, including osteoporosis, Alzheimer’s disease and cancer. The hope is that with better understanding of how DNA functions in these individuals, new treatments will follow.


September 24, 2013
Managed Care Reduces Hospitalizations Compared to Traditional Fee-for-Service Insurance in Nursing Home Residents with Advanced Dementia

BOSTON – Nursing home residents with advanced dementia commonly experience burdensome, costly interventions that do not improve their quality of life or extend their survival. Now a new study suggests that providing intensive primary care services may result in less burdensome and less costly care for these terminally ill residents.


September 19, 2013
Sharon K. Inouye, M.D., M.P.H., granted Leadership Award by the National Institute on Aging to build nation’s first delirium research center
Kick-off event slated for October 30, 2013

Sharon K. Inouye, M.D., M.P.H., Director of the Aging Brain Center in the Institute for Aging Research at Hebrew SeniorLife, professor of Medicine at Harvard Medical School, and a faculty member in the Division of Gerontology at Beth Israel Deaconess Medical Center (BIDMC), recently received the prestigious Academic Leadership Award (K07) from the National Institutes of Health to build the nation’s first Center of Excellence for Delirium Research. The Center, which will be called CEDARTREE (Center of Excellence for Delirium in Aging: Research, Training and Educational Enhancement) will be located at Hebrew SeniorLife and will operate under the direction of a national advisory board in close collaboration with Harvard Medical School and other academic institutions throughout Massachusetts.


March 11, 2013
Hebrew SeniorLife Researchers Find Link between Nonbenzodiazepine Hypnotic Drugs and Hip Fractures in Nursing Home Residents
Study Suggests Caution Should be Exercised when Prescribing Sleep Medications

BOSTON —The risk for hip fracture is elevated among nursing home residents using sleep medications, according to a study by researchers at The Institute for Aging Research at Hebrew SeniorLife, an affiliate of Harvard Medical School. Researchers state this is likely due to an increased risk of falling associated with drug use.


February 1, 2013
New Study Sheds Light on Link Between Dairy Intake and Bone Health
Researchers at the Institute for Aging Research find not all dairy products are equal in maintaining strong bones

BOSTON – A study by researchers at the Institute for Aging Research (IFAR) at Hebrew SeniorLife, an affiliate of Harvard Medical School (HMS), has found that dairy intake —specifically milk and yogurt —is associated with higher bone mineral density (BMD) in the hip, but not the spine. Cream, on the other hand, may be associated with lower BMD overall. Published today in the journal Archives of Osteoporosis, these findings suggest that not all dairy products are equally beneficial in promoting bone strength.


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