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Better nutrition and tailored exercise programmes key to preventing care home falls

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Tailored exercise programmes, vitamin D supplements and better nutrition are proven to help prevent falls in aged care homes, new research has found.

A major international review led by Flinders University and published by the Cochrane Collaboration analysed data from 104 clinical trials involving nearly 69,000 older people living in care facilities across 25 countries to explore how to reduce falls.

Lead author Dr Suzanne Dyer said that it is the most comprehensive study of its kind and offers clear guidance for aged care providers, families, and policymakers.

Dr Dyer said: “Falls are one of the most common and serious health risks facing older Australians, they can lead to broken bones, hospital stays, and a loss of independence.

Dr Jenni Suen, another author of the review said: “Our findings show that preventing falls isn’t about a one-size-fits-all solution but there are some simple, easily deployed and targeted ways to make a real difference in reducing falls.”

The study found the most effective approaches to prevent falls in aged care homes were those tailored to each resident’s needs and delivered with strong support from aged care staff, but that exercise and nutrition were common themes.

“One of the most effective strategies was regular, supervised exercise,  which reduced falls even in residents with cognitive impairments, like dementia,” said Dr Suen.

“We found that this type of exercise, especially when done consistently, and in groups or for more than an hour a week, were shown to reduce the number of falls.”

Many older people in care have low vitamin D levels, which can affect muscle strength, and the addition of vitamin D supplements proved helpful in reducing the overall number of falls.

Nutrition also played a role with an increase in dairy servings that were high in calcium to strengthen bones resulting in fewer falls and fractures.

Dr Dyer said: By adding more calcium and protein-rich foods like milk, cheese, and yoghurt, aged care homes were able to improve residents’ bone health and stability”.

The study found that giving each resident an environmental assessment, medication review, and an exercise plan based on their individual needs, delivered with strong staff engagement significantly reduced falls.

“As part of our research, we wanted to see what types of programs weren’t working as effectively in preventing falls,” says Dr Dyer.

“Programmes such as improving medication use (deprescribing or reviewing prescriptions) and staff training, and changes to care models on their own didn’t consistently reduce falls.

“We now have strong evidence that some approaches work better than others,” she added.

The researcher concluded: “Tailored exercise programmes, vitamin D supplements, and better nutrition can make a real difference.

“With the right mix of strategies, it’s possible to reduce risks and help older people in care stay safer and more independent.”

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Researchers use prehistoric skeletons to study ageing

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An archaeologist from the University of York is leading a new study into how societies viewed ageing, wisdom and experience over thousands of years.

Dr Lindsey Büster’s research claims to be the first to focus on the lives and experiences of older adults in prehistoric and Roman Europe, examining skeletons and objects from collections including York Museums Trust.

The project, called Age-Old Stories, aims to challenge existing stereotypes and ageism by exploring how earlier societies viewed age, wisdom and experience.

“They have a very large collection of Roman human remains from across Yorkshire and that’s going to be a really important assemblage for us,” said Dr Büster.

The ultimate aim is for the research to provide strong examples of why making older adults more visible in policy-making and public life is so important,” said Dr Büster.

“Ageing is not a marginal experience, it is a central part of human history and we should have better strategies for valuing and celebrating it today.”

Archaeological discoveries already suggest that older adults were central figures in many past societies.

In Scarborough, the remains of Gristhorpe Man – Britain’s best-preserved Early Bronze Age skeleton – were analysed and suggested he was aged between 45 and 60 years, tall and muscular, and nourished by a rich diet.

“He is over 45 and he was buried in this log coffin, which would’ve been hugely time consuming, hugely labour intensive and he’s buried with a dagger,” said Dr Büster.

“These are all the trappings of a high-status individual.”

The project will work in partnership with York Museums Trust to create a new exhibition and public events, and will also collaborate with Age Friendly York.

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Weight loss jabs should be first-line obesity treatment in most cases, new guidance states

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Weight loss jabs Mounjaro and Wegovy are so effective they should be the first treatment for obesity “in almost all cases”, according to new medical guidance.

The European Association for the Study of Obesity praised the drugs’ effectiveness and wider health benefits in new guidance to doctors.

It described them as slimming aids that can also cut the risk of related conditions such as high blood pressure and type 2 diabetes.

Three in ten Britons – around 16m adults – are obese, but only 1.5m use the injections, most bought privately at about £200 a month.

Trials have shown adults using semaglutide, the active ingredient in Wegovy and Ozempic, lost about 14 per cent of their body weight over 72 weeks.

Those taking tirzepatide – marketed as Mounjaro and sometimes dubbed the “king kong” of weight loss jabs – lost about 20 per cent over the same period.

Dr Andreea Ciudin, co-first author of the guidance from the Autonomous University of Barcelona, said the drugs were “completely transforming care of obesity and its complications”.

She added: “Even though there are several options on the market, the reality is that semaglutide and tirzepatide are so effective that they should be the first choice in almost all cases.”

The guidelines were produced by an international team of experts, including contributors from the UK.

They analysed existing studies and created an algorithm to help doctors decide the best treatment based on a patient’s weight and associated conditions.

They concluded that tirzepatide and semaglutide should be considered the “medications of choice” when a substantial level of total body weight loss is required.

When a lesser degree of weight loss is the aim, other medicines such as liraglutide, naltrexone–bupropion and phentermine–topiramate may be appropriate.

The guidance comes after health secretary Wes Streeting pledged this week to make injections available to millions more patients on the NHS.

Speaking at the Labour Party conference in Liverpool, he said it was unfair that wealthier people had been able to benefit from the drugs’ “transformative” effects “on their health, their confidence and their quality of life” while those unable to pay privately had gone without.

He added: “Weight-loss jabs could help us finally defeat obesity.

“Our mission is to ensure that the best science, the best healthcare and the best innovations are available not just to some, but to all.”

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Brain shape changes could offer early warning signs of dementia, study suggests

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Ageing alters the brain’s shape in measurable ways that could provide early warning signs of dementia, potentially years before symptoms appear, researchers say.

Analysis of more than 2,600 brain scans from adults aged 30 to 97 revealed significant alterations in brain geometry linked to declines in memory, reasoning and other cognitive functions.

The inferior and anterior parts of the brain expanded outward, while the superior and posterior regions contracted inward. These uneven shifts were most evident in older adults showing cognitive decline.

Researchers at the University of California, Irvine’s Centre for the Neurobiology of Learning and Memory found that people with more pronounced posterior compression performed worse in reasoning tests, suggesting these geometric markers directly relate to brain function.

“Most studies of brain ageing focus on how much tissue is lost in different regions,” said Niels Janssen, senior author and professor at Universidad de La Laguna in Spain and visiting faculty at the CNLM.

“What we found is that the overall shape of the brain shifts in systematic ways, and those shifts are closely tied to whether someone shows cognitive impairment.”

One important implication involves the entorhinal cortex – a small but vital memory hub in the medial temporal lobe.

The study suggests age-related reshaping may press this region against the hard base of the skull.

The entorhinal cortex is one of the first areas where tau, a toxic protein linked to Alzheimer’s disease, accumulates.

The findings raise the possibility that mechanical and gravitational forces may contribute to its vulnerability in Alzheimer’s – a potential disease mechanism not previously considered.

“This could help explain why the entorhinal cortex is ground zero of Alzheimer’s pathology,” said study co-author Michael Yassa, director of the CNLM and James L McGaugh endowed chair.

“If the ageing brain is gradually shifting in a way that squeezes this fragile region against a rigid boundary, it may create the perfect storm for damage to take root. U

“nderstanding that process gives us a whole new way to think about the mechanisms of Alzheimer’s disease and the possibility of early detection.”

The researchers say their geometric approach could eventually provide new markers for identifying dementia risk, potentially before symptoms emerge.

“This isn’t just about measuring brain shrinkage,” added Janssen.

“It’s about seeing how the brain’s architecture responds to ageing and how that architecture predicts who is more likely to struggle with memory and thinking.”

The patterns were replicated in two independent datasets, reinforcing the consistency of these shape changes as a hallmark of ageing.

“We’re just beginning to unlock how brain geometry shapes disease,” said Yassa.

“But this research shows that the answers may be hiding in plain sight – in the shape of the brain itself.”

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