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“Without the health of the planet, it is hopeless to achieve healthy ageing in the future”

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King Arthur’s knights famously set out on a quest to find the Holy Grail, spurred on by the cup of Christ’s fabled healing powers and promise of eternal youth.

Fast forward 1,500 years, and we’re still pursuing the anti-ageing pot of gold.

A staggering $64bn is expected to be spent this year globally on products and services aimed at holding back the years, visibly if not necessarily physically. And that figure is predicted to grow to nearly $110bn in the next decade.

Ageing is something of an obsession of Dr Saori Kashima’s. But the environmental health expert and director of the Centre for the Planetary Health and Innovation Science (PHIS) at Hiroshima University’s IDEC Institute in Japan, isn’t interested in the latest retinol product for lines and wrinkles, botox fillers, hyaluronic moisturisers, pro-collagen serums, or any of the myriad of pharmaceutical interventions currently being developed to help modulate ageing.

She is one of a network of front-line researchers and practitioners working across disciplines who are looking to nurse the planet back to health – and in the process hopefully improve ours too.

Dr Kashima is taking on the task of discovering what healthy ageing looks like and driving the national and local actions needed to achieve it.

Her new undertaking aligns with the United Nations Decade of Healthy Ageing, a global collaboration launched in 2021 and lasting until 2030 that aims to better the lives of older people, their families, and the communities they dwell in.

Focusing on changing how we all think, feel, and act towards growing older, it’s hoped that by the end of the decade more age-friendly environments will have been cultivated; better integrated and responsive health care systems and services created; and that those who need it will have access to the right kind of long-term care offering the support required to live with dignity, meaning and rights.

It is being hailed by the UN as an unprecedented opportunity for people across the spectrum to come together to find the solutions essential for people to lead a meaningful life as they age.

Dr Saori Kashima

And Dr Kashima is playing her part by turning to planetary health science for guidance.

As she says: “Without the health of the planet, it is hopeless to achieve ‘healthy ageing’ in the future.”

To understand her thinking, it is necessary to turn the clock back to earlier this year. Days before the G7 Hiroshima Summit in May, scholars delivered a call to act on the planet’s health.

This was fittingly undertaken at the Hiroshima Peace Memorial Park, a monument dedicated to the estimated 140,000 people killed when the United States launched the world’s first atomic attack on the city on Japan’s Honshu Island on August 6, 1945, at the end of World War Two.

It was this apocalyptic event and the subsequent detonation of a second atomic bomb three days later over the city of Nagasaki on the Japanese island of Kyushu, that prompted one of the most influential scientists of the 20th Century, Albert Einstein, to utter in 1946 his oft-quoted plea for humanity’s survival: “…a new type of thinking is essential if mankind is to survive and move toward higher levels.”

Three-quarters of a century on, with human activity having breached seven of the eight boundaries (which include water availability, land use change, ozone depletion, and climate change), ensuring Earth’s safety, academics are making a similar appeal.

Writing in the Hiroshima Planetary Health Declaration 2023, they said: “We are now facing a ‘Great Transition’ in tackling various global issues, such as climate change, biodiversity loss, environmental pollution, and conflicts.

“Educational and academic institutes are required to take on the challenge of new scientific approaches that go beyond existing ordinary thinking.”

Nine years ago, the new science of planetary health was born to do just that; to begin seeing our interconnectedness with nature through collaboration.

Just how important it is that the currently ailing world we rely on is returned to fitness, has been eloquently summed up by Dr Maria Neira, director of the Department of Public Health and Environment at the World Health Organisation. She has said: “Every day we depend on biodiversity (the sheer variety of life found on Earth) to keep us alive and healthy. The air we breathe, the water we drink, the foods we eat and the medications we take are all by-products of a healthy planet.

“But our world, and the diversity of life it supports, is under threat. Deforestation, pollution, greenhouse gas emissions, draining of wetlands, climate change, globalization and other factors of modern life are wiping out species and damaging ecosystems at unprecedented rates.

“When we damage the Earth, we damage our own health. Human beings are as susceptible as any other species.”

Leading the way in this growing scientific field is Dr Kashima. She told Agetech World: “Many factors are intertwined and connected. I think that people have to recognise the connection more. This does not occur only within one country but across borders.

“Our daily life is connected to people’s lives in African countries and other areas.”

Dr Kashima, who has worked with the health ministries in Senegal and Madagascar as a Japan International Cooperation Agency volunteer, added: “For tackling climate change, the current reductionist or siloed approaches are not providing enough solutions.”

Global statistics show that the number of countries where a fifth of the population is aged over 70 is continuing to grow.

Japan’s ‘super-ageing’ society ranks as the oldest in the world, with data released in September 2022 revealing the number of over-75s has now risen to 19.37 million – more than 15% of the country’s population.

The number of over-65s has also increased to 36.27 million – 29.1% of the nation’s people.

This puts Japan well ahead of the second-placed country, Italy, on 24.1%, when it comes to having the oldest society by proportion of over-65s. In third place is Finland on 23.3%.

But while the average life span in 2020 had risen by nearly three decades to 73 compared to just 47 in 1950, people’s health span, which refers to the number of years we can expect to live in reasonably good physical condition, has lagged way behind.

Environmental pollution and climate change-fuelled extreme weather are known to unequally disadvantage the vulnerable, which includes older people.

This is a problem that Dr Kashima understands well.

Dr Saori Kashima (centre) with her students at Hiroshima University’s Centre for the Planetary Health and Innovation Science

In 2022 she co-authored a study on the impact of the 2018 floods in western Japan, the most severe recent water-related disaster to hit the nation, which killed 237 people, injured another 433, and destroyed nearly 7,000 houses.

Many of the deaths were among vulnerable older people.

The study’s findings also showed how calamities are a potential risk factor for dementia in the elderly.

In another study, Dr Kashima and her co-researchers found that natural disasters increase the likelihood of nursing home admissions. In the conclusion, they urged policymakers to prepare for this emerging risk factor.

Now Dr Kashima and her PHIS colleagues from the fields of science, engineering, and agriculture, among others, are working with community and government partners to develop a Planetary Healthy Ageing Index (PHAI).

It will serve as a community-orientated guide to measure, monitor, and evaluate progress in attaining healthy ageing for both the planet and the eight billion-plus people who call it home.

She said: “Japan’s traditional culture is nature worship such as ‘satochi’, ‘satoyama’, and ‘satoumi.’ Recognising these traditions passed down to children and grandchildren is also one of the practical approaches to planetary health.”

Satochi, satoyama, and satoumi are portmanteaus that pair the Japanese words for earth (chi), mountain (yama), and sea (umi) with village (sato).

These are spaces embodying the harmonious co-existence of human societies and nature.

“We hope that while developing the PHAI with the community, existing solutions like this will be reaffirmed. Such local solutions exist not only in Japan but also in other countries and regions,” she explained.

Dr Kashima wants countries to adopt an index like PHAI that incorporates Earth’s health into their agenda.

She said: “Even if we develop local policies and actions considering human health…people need a fundamental shift, a great transition, in how we live on Earth.”

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On a mission to show that hearing loss is not inevitable

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The world’s largest investigation into the effectiveness of hearing training kicks off this week – as part of a movement to prove that hearing loss is not an inevitable part of ageing.

The research project aims to attract a minimum of 10,000 participants to better understand how hearing training impacts auditory processing skills like speech comprehension and the ability to locate where sounds are coming from.

Researchers are interested in the impact of hearing training on users who start training with different hearing ability levels, as well as training adherence in groups with different attitudes to smartphone technology.

Their aim is to find new ways to deliver and improve auditory training at scale and for a wider range of hearing skills; and to measure factors which influence training engagement.

The research is led by health tech firm Eargym. Co-founder Andy Shanks says:  Contrary to popular belief, hearing loss is not an inevitable consequence of ageing. We can take steps to improve and protect our hearing throughout our lives, yet preventative measures like hearing training have traditionally been under-researched.

“Our data shows the transformative impact hearing training can have on our ability to process sounds. Now, we want to deepen and widen our research and use our platform to make hearing training even more effective and accessible. Imagine improving and maintaining your hearing by up to 20% or more: it could make a big difference to the lives of so many people.”

The games on the Eargym app include a “busy barista” exercise, where users must discern speech over a cafe’s bustling background noise; and a “sound seeking” exercise, where users make their way through forests, jungles and oceans to locate the sources of different sounds. Each game is designed to be immersive and to help users practise specific auditory processing skills regularly.

Eargym was set up by former NHS CEO Amanda Philpott and DJ Andy Shanks in 2020, after they were both diagnosed with hearing loss. Amanda has moderate age related hearing loss, whilst Andy has “notch” or noise-induced hearing loss due to DJ-ing. Both found hearing loss isolating and it impacted their ability to socialise and communicate. They created eargym to empower others to better understand their hearing health and take proactive steps to protect it.

Hearing loss currently affects 18 million adults in the UK, with around one billion young people at risk of developing hearing loss due to increased use of headphones. Hearing loss is closely associated with increased dementia risk. Despite this, people wait an average ten years before seeking help for hearing loss.

Eargym plans to publish the findings of its research in early 2025.

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Interview: Exploring electrical stimulation for Parkinson’s disease

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The STEPS II study is investigating functional electrical stimulation (FES) in people with Parkinson’s disease to help improve their walking. Dr Paul Taylor, co-founder and Clinical Director of Odstock Medical Ltd (OML), spoke to Agetech World to tell us more.

Bradykinesia – slowness of movement which can lead to difficulty walking – affects many people living with Parkinson’s disease. The symptom can cause Parkinson’s patients to walk or move slowly, increasing the risk of falls, leading to a reduced quality of life and an increased dependence on others. 

Funded by the National Institute for Health and Care Research, sponsored by Salisbury NHS Foundation Trust, and managed by the University of Plymouth’s Peninsula Clinical Trials Unit, the STEPS II study is exploring the use of an FES device in Parkinson’s patients to help improve bradykinesia. 

The FES device, which has been pioneered by Salisbury researchers as a drop foot treatment for stroke and MS patients, is attached to the patient’s leg and produces small electrical impulses that improve movement.

“If you have Bradykinesia you’re moving slowly. The predominant treatment for Parkinson’s is medication and these can be very effective, but they have the problem of not working all the time,” explains Taylor, co-founder of Odstock Medical Ltd, a company owned by Salisbury NHS Foundation Trust.

”The effects of the drugs will wear off and after a period of time they become less effective, so, there’s a need for improvement.”

Taylor explains that deep brain stimulators are currently available, however, they are very invasive, expensive and can be risky. 

“We’re trying to do something which is a bit simpler and cheaper, which may possibly be able to help people at an earlier stage of Parkinson’s,” Taylor says.

“We’re stimulating the common peroneal nerve, which is the nerve that goes down the leg to the muscles, using a device called a drop foot stimulator. The device is commonly used for stroke and multiple sclerosis.”

A small feasibility study has already been conducted, which showed that FES can help patients walk faster and reduce some symptoms of Parkinson’s. 

In the STEPS II study, researchers hope to confirm the long-term effects of FES on walking speed and daily life with 234 participants at sites across Salisbury, Birmingham, Prestwick, Leeds, Swansea and Carlisle.

Taylor continues: “Our original idea was that we could use electrical stimulation to overcome freezing – which is the effect where people with Parkinson’s will stop walking, particularly when they come to doorways or very narrow areas. It’s to do with the processing of information from the outside world. 

“We wanted to see if we could use electrical stimulation to overcome that freezing and, to a certain extent, we did find that is the case for some patients, but more commonly and with a greater number of patients FES affected bradykinesia – speeding up their movement and helping with more effective walking.”

For the STEPS II study, participants will be randomised into a care as normal group, or a care as normal plus FES group. They will use the stimulator if they are in the FES group for 18 weeks, then the stimulator is taken away, with patients followed up one month later to see if the effects are continued.

Measurements of walking speed and movement will be analysed, along with sensory perception, balance, coordination, muscle strength, as well as secondary effects such as how the device impacts daily living and quality of life.

OML has established clinics around the country with trained therapists where the device will be used if the study is successful. 

“There’s a network of clinics already experienced in using the treatment so we plan to reach those clinics to include Parkinson’s patients in their cohorts,” says Taylor. “Then we’ll work with our contacts to see if we can get it overseas as well.”

OML is currently recruiting participants for the study, to find out more please visit: https://www.plymouth.ac.uk/research/penctu/steps-2 

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Quit Googling to stave off dementia onset, expert urges

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Resisting the temptation to search the web for information that could otherwise be recalled be exercising your brain could help to reduce the risk of dementia.

That is according to Canadian academic Professor Mohamed I. Elmasry who believes simple daily habits such as afternoon naps, memory ‘workouts’ and not reaching for a smartphone can increase the odds of healthy aging.

His new book, iMind: Artificial and Real Intelligence, says the focus has shifted too far away from RI (natural, or real) intelligence in favour of AI (machine, or artificial) intelligence. Elmasry instead calls us to nurture our human mind which, like smartphones, has ‘hardware’, ‘software’ and ‘apps’ but is many times more powerful – and will last much longer with the right care.

Professor Elmasry, an internationally recognised expert in microchip design and AI, was inspired to write the book after the death of his brother-in-law from Alzheimer’s and others very close to him, including his mother, from other forms of dementia.

Although he says that smart devices are ‘getting smarter all the time’, he argues in iMind that none comes close to ‘duplicating the capacity, storage, longevity, energy efficiency, or self-healing capabilities of the original human brain-mind’.

He writes that: “The useful life expectancy for current smartphones is around 10 years, while a healthy brain-mind inside a healthy human body can live for 100 years or longer.

“Your brain-mind is the highest-value asset you have, or will ever have. Increase its potential and longevity by caring for it early in life, keeping it and your body healthy so it can continue to develop.

“Humans can intentionally develop and test their memories by playing ‘brain games,’ or performing daily brain exercises. You can’t exercise your smartphone’s memory to make it last longer or encourage it to perform at a higher level.”

In iMind: Artificial and Real Intelligence Professor Elmasry shares an anecdote about his grandchildren having to use the search engine on their smartphones to name Cuba’s capital—they had just spent a week in the country with their parents.

The story illustrates how young people have come to rely on AI smartphone apps instead of using their real intelligence (RI), he says, adding: “A healthy memory goes hand-in-hand with real intelligence. Our memory simply can’t reach its full potential without RI.”

Published by Routledge, iMind: Artificial and Real Intelligence includes extensive background on the history of microchip design, machine learning and AI and their role in smartphones and other technology.

The book also explains how both AI and human intelligence really work, and how brain function links the mind and memory. It compares the human mind and brain function with that of smartphones, ChatGPT and other AI-based systems.

Drawing on comprehensive existing research, iMind aims to narrow the knowledge gap between real and artificial intelligence, to address the current controversy around AI, and to inspire researchers to find new treatments for Alzheimer’s, other neurodegenerative conditions and cancer.

It argues that current or even planned AI cannot match the capabilities of the human brain-mind for speed, accuracy, storage capacity and other functions. Healthy aging, Professor Elmasry notes, is as important as climate change but doesn’t attract a fraction of the publicity.

He calls for policymakers to adopt a series of key reforms to promote healthy aging. Among such changes, he suggests that bingo halls could transition from their sedentary entertainment function to become active and stimulating learning centers.

As well as napping to refresh our memories and other brain and body functions, he also outlines a series of practical tips to boost brain power and enhance our RI (Real Intelligence).

These include building up ‘associative’ memory – the brain’s ‘dictionary of meaning’ where it attaches new information to what it already knows. Try reading a book aloud, using all of your senses instead of going on autopilot and turning daily encounters into fully-lived experiences.

Other techniques include integrating a day for true rest into the week, reviewing your lifestyle as early as your 20s or 30s, adopting a healthy diet, and eliminating or radically moderating alcohol consumption to reduce the risk of dementia.

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