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Sir Muir Gray: Doing it for ourselves is key to living longer and ageing better

Professor Sir Muir Gray has said there needs to be a radical shift in the way healthcare is perceived if people are to live longer and better.
The public health and ageing expert has said governments and medical institutions like the NHS, need to focus more on disease prevention rather than just being seen as illness management specialists.
Sharing his views on ageing better on the latest Agetech World podcast, Sir Muir has suggested that GPs and the NHS should start prescribing wellness rather than just drugs.
Click here to listen to the latest Agetech World podcast
But the 79-year-old former NHS Chief Knowledge Officer said it’s not just professional services that need to step up and engage more in preventative treatment.
The public is also responsible for taking care of their health by staying physically and mentally active if they want to remain well for longer, in their own home, and out of the hospital system.
Sir Muir, who is a professor in the Nuffield Department of Primary Health Care at the University of Oxford, and a director of the recently launched The Goldster Health Service (GHS) – an online health and wellness club pioneering a systematic non-drug approach to well-being to help deal with the challenges, aspirations, and triumphs of ageing – said being active lies at the heart of his philosophy.
Speaking about the NHS, Sir Muir, who is an internationally renowned authority on healthcare who has advised governments of several countries outside the UK, told the Agetech World podcast: “We need the NHS for three things. For diagnosis. Is it breast cancer, or is it a heart attack, or is it Parkinson’s; for acute care, when you can’t stand and you’re acutely unwell with pneumonia or whatever; and for starting the right treatment.
“So I had a stent put in. They started the treatment right, and they gave me three months attendance at a gym. This was 11 years ago.
“But in the last 11 years, I haven’t had a single word from the NHS about diet or exercise, although I have had a thousand boxes of pills.
“So, what we are seeing now is that self-care is the most important type of care for prevention and for long-term condition management.
“And that’s our mission at Goldster Health Service, to complement and supplement the NHS and to say if you guys can do the diagnosis, acute stay and starting treatment…then after the right treatment has been started it’s up to the citizen to take responsibility.
“I think we need to be much clearer with the public about what their role is and what the role of the NHS is.”

Professor Sir Muir Gray
He suggested a culture change is needed as the NHS has over the past few decades increasingly focused on drugs and technology and people have become more passive about their own health.
“Geriatric medicine’s been wonderful. The speciality of geriatric medicine is very, very important, and it changed the way the medical profession thought. So, we have to be clear what the problem is.
“I have seen 20 reorganisations of the structure of the NHS, but actually structure is only one part of an organisation. You need systems; a system for living longer better, and then culture is even more important than structure.
“You have to be clear that we are trying to change culture.”
Some culture shifts have emerged in recent years, he argued. “It has certainly been very good that people are no longer denied treatment on the basis of their age, but what has happened is that the NHS assumes that every problem of an older person is due to some disease and requires clinical intervention.
“A result of this is what is called polypharmacy, people on numerous drugs. There is something called hyper-polypharmacy, where people have more than 10 drugs.
“Now, drugs are very important. I’m on six drugs a day for my various heart and other health problems, and I value them highly, but a very large number of people in their 80s and 90s are on eight, or nine, or 10 drugs a day, and it is estimated that 10% of those drugs do no good.”
The NHS is this year marking its 75th anniversary. Founded in July 1948, it was the first free at the point of delivery, universal health system available to all. Currently the NHS treats over a million people each day in England alone.
Whilst congratulating the NHS on the milestone, Sir Muir commented: “In 1948, the National Assistance Act, and the National Health Service Act, said that young disabled people….were to be given education to overcome their disabilities; the aged were to be given practical assistance. Don’t worry about it, just do things for them.
“But that is partly a failure to understand the biology of what is happening to us. So, our mission (at GHS) is a cultural revolution, really, as well as giving information to people, to support individuals.
“We are clear we have to change what other people think, because, I think it was Sartre who said, ‘hell is other people,’; we have to change how other people think as well as changing how older people think.”
He continued: “Our job in Goldster is clearly cultural revolution. Supposing I was in Manchester, or Paris, or Gateshead, speaking to a group of either the public or professionals, I would tell them, ‘I am going to rewire your brains. You are thinking the wrong way.’
“We know that your brain can be rewired at any age. You sometimes see a man or a woman down at the end of the road in that big green box with telephone wires. It’s amazing how they join them together. That is what we are going to do to your brains.
“We are very clear that we are in the brain rewiring business. So, giving people knowledge, for example, saying that ageing by itself is not a cause of problems, major problems until the late-90s, that’s knowledge.”
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AI can predict Alzheimer’s with almost 93% accuracy, researchers say

Alzheimer’s AI can predict the disease with nearly 93 per cent accuracy using more than 800 brain scans, researchers say.
The system identified anatomical changes in the brain linked to the onset of the most common form of dementia, a condition that gradually damages memory and thinking.
The findings build on years of research suggesting AI could help spot early Alzheimer’s risk, predict disease and identify patients whose condition has not yet been diagnosed.
Benjamin Nephew, an assistant research professor at the Worcester Polytechnic Institute in Massachusetts, said: “Early diagnosis of Alzheimer’s disease can be difficult because symptoms can be mistaken for normal ageing.
“We found that machine-learning technologies, however, can analyse large amounts of data from scans to identify subtle changes and accurately predict Alzheimer’s disease and related cognitive states.”
The study used MRI scans, a type of detailed brain imaging, from 344 people aged 69 to 84.
The dataset included 281 scans showing normal mental function, 332 with mild cognitive impairment, an early stage of memory and thinking decline, and 202 with Alzheimer’s.
The scans covered 95 of the brain’s nearly 200 distinct regions and used an AI algorithm to predict patients’ health.
Being able to use AI to help diagnose Alzheimer’s earlier could give patients and doctors crucial time to prepare and potentially slow the progression of the disease.
The analysis showed that one of the top predictive factors was brain volume loss, or shrinkage, in the hippocampus, which helps form memories, the amygdala, which processes fear, and the entorhinal cortex, which helps provide a sense of time.
This pattern held across age and sex, with both men and women aged 69 to 76 showing volume loss in the right part of the hippocampus, suggesting it may be an important area for early diagnosis, the researchers noted.
However, the research also found that the way brain regions shrink differs by sex.
In females, volume loss occurred in the brain’s left middle temporal cortex, which is involved in language and visual perception. In males, it was mainly seen in the right entorhinal cortex
The researchers believe this could be linked to changes in sex hormones, including the loss of oestrogen in women and testosterone in men.
These conclusions could help improve methods of diagnosis and treatment going forward, Nephew said.
More than 7.2m Americans are living with Alzheimer’s, according to the Alzheimer’s Association.
More research is being done to reveal other impacting factors.
Nephew said: “The critical challenge in this research is to build a generalisable machine-learning model that captures the difference between healthy brains and brains from people with mild cognitive impairment or Alzheimer’s disease.”
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