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Why living in an almshouse could lead to a longer, happier life

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Almhouses have been providing charitable shelter to the elderly in the UK since medieval times.

The world’s oldest form of social housing. more than 1,000 years after they first opened their doors, they are still providing a place to live to over 36,000 mainly older residents in almost 2,600 almhouses across Britain. The sizes of these communities vary from a few dozen to several hundred residents.

The low-cost, self-sufficient community housing schemes aimed at local people in need are a singular success story.

But almshouses may be doing more than just providing a much-needed roof over the head for those in need.

A new study suggests living in an almshouse can boost the longevity of its residents by as much as two-and-a-half years compared to their counterparts in the general population.

The report from the Bayes Business School found that a 73-year-old male moving into an almshouse today, such as the Tudor-era Charterhouse in London, could expect to live an extra 15% of future lifetime at the point of joining compared to his peers from the same socioeconomic group who lived elsewhere.

When compared to others of the same age, residents of the best-performing almshouses in the study who are in the lowest socio-economic quintile were found to have the same life expectancy as the wealthiest 40% in society.

The Almshouse Longevity Study builds on a 2017 report that looked at life expectancy in Whiteley Village in Surrey, a purpose-built retirement community set in 225 acres opened during World War One, that showed the average resident lived longer in the almshouse-style cottages than the typical citizen in England and Wales of the same age, gender and socioeconomic background.

It was this report that prompted the Almshouse Association – the support organisation representing over 1,600 independent almshouse charities across the UK – to do a follow-up study to look at whether this effect could be seen across this particular social housing movement more generally.

Fifteen almshouses around the UK that primarily house men, women or couples of state pension age, were examined for this latest research, including Charterhouse, the Durham Aged Mineworkers Homes Association, the Royal Hospital Chelsea in central London – home of the iconic Chelsea Pensioners in their long scarlet coats and tricorne hats – Salisbury City Almshouse, and Trinity Hospital in West Retford, Nottinghamshire.

In a foreword to the report, the chief executive of the Almshouse Association, Nick Phillips, suggests this latest research “builds on past research pointing, perhaps, to the great value of companionship and strong micro-communities that this unique housing model embodies.

“I would like to suggest that, if we were to design a housing model which is the epitome of a good living environment today, it would include companionship, community and independent living in almshouses which are designed to underpin these values.”

This community spirit is reflected in the architectural design of traditional almshouses – often a three-sided quadrangle with doors and windows facing each other over a courtyard or community area – enabling a sense of togetherness and companionship, yet still allowing independence.

These design features are still commonly replicated in almshouses being built today.

They are run by charities and residents pay rent which is generally cheaper than that being charged by councils, housing associations or private landlords for local property.

Analysing up to 100 years’ worth of residents’ records from the various almshouses in England, this latest research suggests that living in these communities can reduce the negative impact on health and social wellbeing which is commonly experienced by the older population in lower socioeconomic groups, particularly those individuals who are living in isolation.

It shows that the disparity in longevity and health outcomes could be mitigated even after reaching retirement age, provided a suitable social infrastructure can be put in place.

Professor Ben Rickayzen, professor of Actuarial Science at Bayes Business School, and a co-author of the report, said: “It is well known that, on average, the lower a person’s socioeconomic status, the lower their life expectancy.

“However, intriguingly, our research has found that this doesn’t have to be  the case. We discovered that many almshouse residents receive a longevity boost when compared to their peers of the same socioeconomic status from the wider population.

“More research is needed to ascertain exactly what factors cause almshouse residents to have a longer life; however, we postulate that it is the sense of the community that is the most powerful ingredient.

“For example, a common theme within the almshouses included in the study is that they encourage residents to undertake social activities and responsibilities on behalf of their fellow residents. This is likely to increase their sense of belonging and give them a greater sense of purpose in their everyday lives while mitigating against social isolation.

“We would encourage the Government to invest in retirement communities, such as almshouses, which would be in keeping with their overarching levelling up agenda.

“While this agenda is commonly associated with enhancing equality on a regional basis, it is important that levelling up should also aim to combat health inequalities experienced by people from lower socioeconomic groups across the country.

“There is an opportunity to improve the Government’s levelling up agenda by incorporating the best features of communal living into their social housing policy. This should make a significant difference to the quality of life experienced by the older population across the UK.

“The findings from this research are important as they could offer solutions to the social care problems currently being experienced in the UK.”

The authors of the report, sponsored by the Dunhill Medical Trust and the Justham Trust, and supported by the Almshouse Association, write that two of the best-performing almshouses, Charterhouse and Morden College, both in London, “have a very focused centre physically as they are both based in one or two main buildings, and also communally as, for example, Charterhouse and Morden College both have community dining rooms where residents can eat and socialise together.

“We speculate that this strong sense of community and interaction is combatting the loneliness ‘epidemic’ that previous research has identified as being especially prominent among older age groups, with those aged 70-79 most affected by social isolation.”

The authors added: “If we consider all the almshouses that participated in the study, a common theme is that they have all created a strong sense of community. We believe that this is one of the major contributors to the boost in life expectancy of almshouse residents when compared to similar people from the same socio-economic groupings.”

The authors acknowledge that further research is needed to “determine a full outline of the factors that may be contributing to the longevity boost.”. They also admit that almshouse living may not suit everyone, and that it wouldn’t provide an automatic boost in longevity to all.

“The social interaction that we believe could be a significant reason why living in an almshouse might boost longevity will only work if residents enjoy this type of environment,” the authors write.

Alison Benzimra, a co-author of the report and head of research at United St Saviour’s Charity, which supports the people and communities of north Southwark in London, said: “Many almshouse trustees and staff members anecdotally believe that almshouse living is beneficial for residents.

“The results from this study demonstrate that the community spirit provided by almshouses does in fact result in longer life expectancy.

“These findings are encouraging to those living and working in the almshouse community and provide the motivation to continue to explore what it is about almshouses’ physical design and support services that result in positive outcomes for older residents.

“This study strengthens the case that this historic form of housing is addressing the evolving needs of older people living in our modern-day society.”

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Tai chi outperforms conventional exercise for seniors

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New findings from 12 studies involving 2,901 participants have demonstrated that tai chi outperforms conventional exercise in improving mobility and balance in seniors.

While tai chi is understood to be beneficial for functional mobility and balance in older adults, such benefits are not well understood due to large variance in research study protocols and observations.

This new review and analysis has now shown that tai chi can induce greater improvement in functional mobility and balance in relatively healthy older adults compared to conventional exercise.

The findings showed the following performance results:

  • The time to complete 50-foot walking was 1.84 seconds faster. 
  • The time to maintain a one-leg stance was 6 seconds longer when eyes were open and 1.65 seconds longer when eyes were closed. 
  • Individuals improved their timed-up-and-go test performance by 0.18 points, indicating quicker standing, walking, and sitting.
  • Individuals taking the functional reach test showed significant improvement with a standardised mean difference of 0.7, suggesting a noteworthy positive impact on the ability to reach and perform daily activities.

Secondary analyses revealed that the use of tai chi with relatively short duration of less than 20 weeks, low total time of less than 24 total hours, and/or focusing on the Yang-style of this ancient form of Chinese martial arts were particularly beneficial for functional mobility and balance as compared to conventional exercise.

“This systematic literature review and meta-analysis are exciting because they provide strong evidence that tai chi is a more efficient strategy to improve functional mobility and balance in relatively healthy older adults, as compared to conventional exercise,” said Brad Manor, Ph.D., director of the Mobility and Falls Program at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research, and associate professor of medicine, Harvard Medical School and Beth Israel Deaconess Medical Center.

“This research suggests that tai chi should be carefully considered in future studies and routines of rehabilitative programs for balance and mobility in older adults,” said Bao Dapeng, professor at Beijing Sport University.

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New standards for biomarkers of ageing

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A paper has put forward a new framework for standardising the development and validation of biomarkers of ageing to better predict longevity and quality of life.

Led by Harvard researchers, the team has zeroed in on biomarkers of ageing using omic data from population-based studies. 

The team included ageing and longevity expert Alex Zhavoronkov, PhD, founder and CEO of AI-driven drug discovery company Insilico Medicine, and the findings appeared in Nature Medicine

Ageing is associated with a number of biological changes including increased molecular and cellular damage, however, researchers do not yet have a standardised means to evaluate and validate biomarkers related to ageing. 

In order to create those standards as well as actionable clinical tools, the team analysed population-based cohort studies built on omic data (data related to biological molecules which can include proteomics, transcriptomics, genomics, and epigenomics) of blood-based biomarkers of ageing. The researchers then compared the predictive strength of different biomarkers, including study design and data collection approaches, and looked at how these biomarkers presented in different populations. 

In order to better assess the impact of ageing using biomarkers, the researchers found that clinicians needed to expand their focus to consider not only mortality as an outcome, but also how biomarkers of aging are associated with numerous other health outcomes, including functional decline, frailty, chronic disease, and disability. They also call for the standardisation of omic data to improve reliability. 

“Omics and biomarkers harmonisation efforts, such as the Biolearn project, are instrumental in validation of biomarkers of aging” said co-first author Mahdi Moqri, PhD, of the Division of Genetics. 

Biolearn is an open-source project for biomarkers of aging and is helping to harmonise existing ageing biomarkers, unify public datasets, and provide computational methodologies.

The team also emphasised the importance of continued collaborations among research groups on “large-scale, longitudinal studies that can track long-term physiological changes and responses to therapeutics in diverse populations”, and that further work is required to understand how implementation of biomarker evaluation in clinical trials might improve patient quality of life and survival.

“If we hope to have clinical trials for interventions that extend healthy lifespan in humans, we need reliable, validated biomarkers of ageing,” said co-first author Jesse Poganik, PhD, of the Division of Genetics. 

“We hope that our framework will help prioritise the most promising biomarkers and provide health care providers with clinically valuable and actionable tools.”

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Healthy aging research to receive $115 million

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Global non-profit Hevolution Foundation has announced $115 million in funding that makes up 49 new awards under its Geroscience Research Opportunities (HF-GRO) programme.  

As part of Hevolution’s mission to catalyse the healthspan scientific ecosystem and drive transformative breakthroughs in healthy aging, HF-GRO is funding promising pre-clinical research in aging biology and geroscience. 

Through this first wave of HF-GRO awards, Hevolution will invest up to $115 million in this first cohort of 49 selected projects over the next five years. Its second call for proposals under HF-GRO will be announced later this year, offering an additional $115 million to address the significant funding gaps in aging research.  

Dr. Felipe Sierra, Hevolution’s Chief Scientific Officer stated: “These 49 important research projects represent a significant step forward in deepening our understanding of healthy aging. Hevolution’s prime objective is to mobilise greater investment around uncovering the foundational mechanisms behind biological aging. 

“We are steadfast in our belief that by examining the root causes of aging, rather than solely focusing on its associated diseases, we can usher in a brighter future for humanity.” 

HF-GRO awardees include researchers at prestigious institutions across the United States, Canada, and Europe, including the U.S. National Institute on Aging, Brigham and Women’s Hospital, the Buck Institute, the Mayo Clinic, New York University, and the University of California San Francisco, among many others. 

The American Federation for Aging Research is providing programmatic support for the HF-GRO program, with grantees selected through a rigorous two-stage peer-review process involving 100 experts in aging biology and geroscience. 

Dr Berenice Benayoun, an HF-GRO grant recipient at the University of Southern California, stated: “I am extremely honored and excited that Hevolution selected our project for funding. This is a project close to my heart, which aims at understanding why and how the female and male innate immune aging differs. 

“This funding will support us as we start laying the foundation for a lasting improvement of women’s health throughout aging.” 

To date, Hevolution has committed approximately $250 million to transform the healthy aging sector, including the $40 million for specialised research and development in healthspan science recently announced at Hevolution’s Global Healthspan Summit. 

Hevolution is ramping up its investments to enable healthier aging for all and is now the second largest funder of aging biology research worldwide.  

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