When older adults become socially isolated, their health and well-being can suffer. Now a new study suggests a link between being socially isolated and osteoarthritis (arthritis), a condition that causes joint pain and can limit a person’s ability to get around.
The findings are published in the Journal of the American Geriatrics Society.
Arthritis patients often have other health issues which may increase their risk of becoming socially isolated. These include anxiety and depression, being afraid to move around (because arthritis makes moving painful), physical inactivity and being unable to take care of themselves.
About 30 percent of adults over 65 have arthritis to some degree, especially in their leg joints. Despite that, until now there has been little research on the link between arthritis and social isolation.
Researchers analyzed data from the European Project on OSteoArthritis (EPOSA) study. They wanted to examine any potential links between arthritis and social isolation, and to identify the disease’s contribution to social isolation.
EPOSA is a study of 2,942 adults between the ages of 65 to 85 years old who live in six European countries: Germany, Italy, the Netherlands, Spain, Sweden, and the UK. In all, 1,967 people, around the age of 73, participated in the study. Half of the participants were women, and almost 30 percent had arthritis.
The researchers looked at whether the participants were socially isolated at the beginning of the study as well as 12 to 18 months later. The participants completed questionnaires that kept track of how often they connected socially with friends and family members and how often they volunteered or participated in social activities.
At the start of the study, almost 20 percent were socially isolated. Those who weren’t socially isolated tended to be younger, had higher incomes and more education. They were also more likely to be physically active, had less physical pain, had faster walking times and were in better all-around health.
Of the 1,585 participants who weren’t considered socially isolated at the beginning of the study, 13 percent had become socially isolated 12 to 18 months later. They reported that their health and osteoarthritis had worsened, they were in more pain, had become less physically active, had slower walking times, and had depression and problems with thinking and making decisions.
The researchers say the findings suggest that osteoarthritis can increase the risk of social isolation. In particular, having problems with thinking and making decisions, as well as having slower walking times, is associated with an increased risk of becoming socially isolated.
Since social isolation can lead to poorer health, the researchers suggest that older adults with arthritis may benefit from engaging in physical activity and social activities. Specifically, they suggest that health care providers might refer people to senior centers where activities are specially designed for people with arthritis.
Source: American Geriatrics Society
A new study shows that people with a lower walking speed at the age of 45 have accelerated aging of both their bodies and their brains.
Using a 19-measure scale, researchers at Duke University found that in slower walkers, their lungs, teeth and immune systems tended to be in worse shape than the people who walked faster. MRI exams showed several indications that their brains were also older.
“The thing that’s really striking is that this is in 45-year-old people, not the geriatric patients who are usually assessed with such measures,” said lead researcher Line J.H. Rasmussen, a post-doctoral researcher in the Duke University Department of Psychology and Neuroscience.
“Doctors know that slow walkers in their seventies and eighties tend to die sooner than fast walkers their same age,” said senior author Terrie E. Moffitt, the Nannerl O. Keohane University Professor of Psychology at Duke University, and Professor of Social Development at King’s College London. “But this study covered the period from the preschool years to midlife and found that a slow walk is a problem sign decades before old age.”
The data come from a long-term study of nearly 1,000 people who were born during a single year in Dunedin, New Zealand. The 904 research participants in the current study have been tested, quizzed, and measured their entire lives, mostly recently from April 2017 to April 2019 at age 45.
Researchers note that neurocognitive testing that these individuals took as children predicted who would become slower walkers. At age 3, their scores on IQ, understanding language, frustration tolerance, motor skills, and emotional control predicted their walking speed at age 45, according to the researchers.
MRI exams during their last assessment showed the slower walkers tended to have lower total brain volume, lower mean cortical thickness, less brain surface area and higher incidence of white matter “hyperintensities,” small lesions associated with small vessel disease of the brain. In short, their brains appeared somewhat older, they said.
Adding insult to injury, the slower walkers also looked older to a panel of eight screeners who assessed each participant’s “facial age” from a photograph, the researchers reported.
Walking speed has long been used as a measure of health and aging in geriatric patients, but what’s new in this study is the relative youth of these study subjects and the ability to see how walking speed matches up with health measures the study has collected during their lives, the researchers explained.
“It’s a shame we don’t have gait speed and brain imaging for them as children,” Rasmussen said. (The MRI was invented when they were five, but was not given to children for many years after.)
Some of the differences in health and cognition may be tied to lifestyle choices these individuals have made, the researchers noted.
But the study also suggests that there are already signs in early life of who would become the slowest walkers, Rasmussen said.
“We may have a chance here to see who’s going to do better health-wise in later life.”
The study was published in JAMA Network Open.
Source: Duke University
Photo: A long-term study has found that signs of aging may be detected by a simple walking test at age 45, and that the brains of slower walkers were different at age 3. Credit: Duke University Communications.
People struggling with opioid addiction and chronic pain may experience fewer cravings and less pain if they use mindfulness techniques along with medication for opioid dependence, according to a new study published in the journal Drug and Alcohol Dependence.
Mindfulness is the meditative practice of focusing on the present moment and accepting one’s thoughts, feelings and bodily sensations, without judgment.
The study, led by researchers from Rutgers University in New Jersey, looked at the effects of mindfulness techniques and methadone therapy on 30 patients with opioid addiction and chronic pain.
The research team found that participants who received methadone and a mindfulness training-based intervention were 1.3 times better at controlling their cravings and had significantly greater improvements in pain, stress, and positive emotions, compared to participants who only received standard methadone treatment and counseling.
The findings held true even though the mindfulness participants were more aware of their cravings.
“Methadone maintenance therapy (MMT) has been an effective form of medication treatment for opioid use disorder,” said Associate Professor Nina Cooperman, a clinical psychologist in the Division of Addiction Psychiatry at Rutgers Robert Wood Johnson Medical School.
“However, nearly half of individuals on MMT continue to use opioids during treatment or relapse within six months.”
Cooperman said that people with opioid addictions often experience chronic pain, anxiety and depression while on methadone maintenance, which is why mindfulness-based, non-drug interventions are promising treatments.
The researchers said mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain.
Individuals with an opioid addiction could also be taught to change their negative thought patterns and savor pleasant events, which may help them to regulate their emotions and experience more enjoyment.
In 2017, more than 70,000 people died from a drug overdose, making it a leading cause of injury-related death in the United States. Of those deaths, almost 68% (47,600 overdose deaths) involved a prescription or illicit opioid, according to the Centers for Disease Control and Prevention (CDC). Overdose deaths involving prescription opioids were five times higher in 2017 than in 1999.
Source: Rutgers University
Heart patients with depression, anxiety or stress are more likely to drop out of cardiac rehabilitation, according to a new Australian study published in the European Journal of Preventive Cardiology.
Cardiac rehabilitation is a medically supervised program designed to improve cardiovascular health for patients who have experienced a heart attack, heart failure, angioplasty or heart surgery.
For the study, researchers examined the prevalence and impact of depression, anxiety and stress in patients attending cardiac rehabilitation at two hospitals in Sydney, Australia between 2006 and 2017. A total of 4,784 patients completed the Depression Anxiety Stress Scale questionnaire.
The findings show that approximately 18%, 28% and 13% of participants had moderate to extremely severe depression, anxiety or stress, respectively.
Patients with moderate symptoms of depression (24% versus 13%), anxiety (32% versus 23%) or stress (18% versus 10%) were significantly more likely to quit cardiac rehabilitation compared to those with no or mild symptoms.
“Heart patients living with depression are more likely to feel despondent and hopeless, which reduces their ability to manage their symptoms,” said study author Angela Rao, of the University of Technology Sydney, Australia.
“They may minimize successes and exaggerate failures, thereby reducing their motivation to exercise and complete a cardiac rehabilitation program.”
“Anxiety may lead to fear of another cardiac event and stop people from being active,” she continued. “Depression and anxiety can also impair the ability to retain new information needed to make health-related behavior changes.”
After a heart attack or procedure to open blocked arteries, patients should be encouraged to quit smoking, take up exercise, improve their diet, reduce stress, and control blood pressure and cholesterol; these can be achieved through cardiac rehabilitation.
“Depression can dampen positive intentions to exercise even when receiving support from health professionals and being aware of the benefits,” said Rao.
“People with anxiety may underestimate their abilities, for example to walk on a treadmill during a rehabilitation class.”
Around one half of patients with moderate depression or anxiety who completed cardiac rehabilitation did not show significant improvements in these conditions.
Depression, anxiety and stress were related, with one increasing the likelihood of the other. Patients with anxiety or stress were more than four times more likely to be depressed than those without.
Anxiety was three times more common in patients with (versus without) depression and more than five times more frequent in patients with (versus without) stress.
“These relationships were independent of age, sex, clinical characteristics, medication use and quality of life,” said Rao.
Rao urges clinicians to screen for depression and anxiety at the beginning and end of rehabilitation to identify those needing extra help. Stress management, cognitive-behavioral therapies, meditation and mindfulness can be included to improve mental health and raise participation.
Source: European Society of Cardiology
Military veterans with post-traumatic stress disorder (PTSD) or concussion are much more likely to develop REM sleep behavior disorder (RBD) — a thrashing form of sleep behavior — compared to the general population, according to a new study published in the journal SLEEP.
Next, the researchers from the VA Portland Health Care System and Oregon Health & Science University (OHSU) want to investigate whether RBD might provide an early signal of neurodegenerative conditions such as Parkinson’s disease.
Typically, during REM (rapid eye movement) sleep, a person’s muscles are effectively paralyzed. In cases of RBD, however, the brain’s control of muscle paralysis is impaired, resulting in people acting out their dreams, sometimes causing injuries to themselves or their partners.
RBD is estimated to affect less than 1% of the general population. However, the researchers found that 9% of the 394 veterans in this study had RBD, and this number increased to 21% among those with PTSD.
“This is important because, in the general population, RBD has been linked to Parkinson’s disease, and RBD often precedes classic symptoms of Parkinson’s by years,” said senior author Miranda Lim, M.D., Ph.D., a staff physician at the VA and assistant professor of neurology, medicine and behavioral neuroscience in the OHSU School of Medicine.
“We don’t know whether veterans who have PTSD and higher rates of RBD will go on to develop Parkinson’s, but it is an important question we need to answer.”
Researchers suspect chronic stress on the brain may play a role in causing the sleep disorder in veterans with PTSD, as many veterans have been exposed to concussion which potentially accelerates neurodegenerative processes.
Each participant underwent an overnight sleep study at the VA Portland Health Care System between 2015 and 2017 to determine the presence of dream enactment during episodes of REM sleep. Muscle activity was monitored constantly during the 8 hours of the study in order to diagnose RBD. The findings show that participants with PTSD had over 2-fold increased odds of RBD compared to veterans without PTSD.
“RBD seems to be highly prevalent in veterans with a history of trauma,” said lead author Jonathan Elliott, Ph.D., a research physiologist at the Portland VA and assistant professor of neurology in the OHSU School of Medicine.
Doctors involved in the study, including co-authors Kristianna Weymann, Ph.D., R.N., a clinical assistant professor in the OHSU School of Nursing, and Dennis Pleshakov, a student at the OHSU School of Medicine, will continue to track research participants with RBD, looking for early signs of Parkinson’s or other neurodegenerative conditions.
Although there are several approaches to ease certain Parkinson’s symptoms, including tremor and fatigue, there is no definitive therapy to prevent the condition.
Clinical trials for promising therapies are usually conducted well after patients have been diagnosed with Parkinson’s, at a stage which may be too late to reverse the symptoms. Lim said that identifying patients with RBD presents an opportunity to identify people earlier in the disease course, and potentially provides a more viable window to test promising interventions.
“By the time a patient shows classic symptoms of Parkinson’s, it may be too late,” Lim said. “If you could intervene when people first start to show RBD, maybe you could prevent later symptoms of Parkinson’s.”
Source: Oregon Health & Science University
New research has identified brain circuitry differences that might be associated with suicidal behavior in individuals with mood disorders.
The study provides a promising lead toward tools that can predict which individuals are at the highest risk for suicide, according to researchers at the University of Utah Health and the University of Illinois at Chicago.
Suicide rates are rising steadily among young adults, especially those with mood disorders, such as depression. More than half of individuals who commit suicide saw a health professional within the past 30 days, but they did not necessarily seek care for mood problems, the researchers note.
“At present, we have very few tools to identify individuals who may be at high risk for suicide-related behavior,” said Dr. Scott Langenecker, a professor of psychiatry at the University of Utah Health and senior author on the study. “Right now, we go on self-report and clinician judgment. Those are good, but they’re not great.”
Previous studies identified brain circuits associated with mood disorders: The cognitive control network (CCN), which is involved in executive function, problem-solving and impulsivity; the salience and emotional network (SEN), which is involved in emotion processing and regulation; and the default mode network (DMN), which is active when individuals are engaged in self-focused thought.
However, these studies focused primarily on depression, according to the researchers.
“This is one of the first studies to try to understand brain mechanisms that may be relevant to suicide risk,” said Dr. Jonathan Stange, an assistant professor of psychiatry at the University of Illinois at Chicago and first author on the study.
The study used resting-state functional MRI (fMRI), which captured brain images while participants were rested and calm, to assess the connectivity of these circuits in 212 young adults at the University of Illinois at Chicago and the University of Michigan.
“For risk factors involved in suicide, the tasks we have to measure are pretty nonspecific and inexact,” Langenecker said. “If we go to the level of the resting-state networks, we’re actually asking the brain to tell us which brain networks and connections are most relevant.”
The study included individuals with mood disorders and a history of suicide attempts, those with mood disorders and a history of suicidal thoughts, those with mood disorders and no history of suicidal behavior or thoughts, and healthy controls. All study participants with mood disorders were in remission, the researchers noted.
Compared with other study participants — even those with mood disorders and a history of suicidal thoughts — people with a history of suicide attempts showed less connectivity in the CCN and between the CCN and DMN, neural circuitry associated with cognitive control and impulsivity, according to the study’s findings.
These differences could present a target for treatment, according to the researchers.
“If we could figure out how to improve connectivity within this brain circuit, we might be able to reduce suicide risk in the future,” Stange said.
Stange and Langenecker emphasize the research is still in its early stages. This was a small study, with only 18 participants with mood disorders and a history of suicide attempts. It will have to be replicated in a larger number of participants, they said.
In addition, the researchers note it is not yet clear whether individuals with mood disorders and at risk for suicide have a different disease from those without such risk, or whether all individuals with mood disorders are at varying degrees of risk for suicide.
The study was published in Psychological Medicine.
Source: The University of Illinois at Chicago