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
New research suggests hope is a trait that can predict resilience and recovery from anxiety disorders.
In a new study, clinical psychologist Dr. Matthew Gallager and colleagues examined the role of hope in predicting recovery in a clinical trial of adults in cognitive behavior therapy (CBT) for common anxiety disorders.
Historically, the concept of hope has long stirred opinion. In the 16th century, German theologian Martin Luther celebrated its power, claiming “Everything that is done in this world is done by hope.” Two centuries later, Benjamin Franklin warned that “He that lives upon hope will die fasting.”
In the study, Gallagher — University of Houston associate professor of clinical psychology — assessed the role of hope in predicting recovery among a clinical trial of 223 adults. In the trial, adults were receiving cognitive-behavior therapy (CBT) for one of four common anxiety disorders: social anxiety disorder, panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.
Gallagher discovered that psychotherapy can result in clear increases in hope and that changes in hope are associated with changes in anxiety symptoms. His findings appear in the journal Behavior Therapy.
“In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery,” said Gallagher. He also reports that moderate-to-large increases in hope and changes in hope were consistent across the five separate CBT treatment protocols.
In terms of psychotherapy, hope represents the capacity of patients to identify strategies or pathways to achieve goals and the motivation to effectively pursue those pathways.
Significantly, the results of this study indicate that hope gradually increases during the course of CBT, and increases in hope were greater for those in active treatment than for those in the waitlist comparison.
The magnitude of these changes in hope were consistent across different CBT protocols and across the four anxiety disorders examined, which underscores the broad relevance of instilling hope as an important factor in promoting recovery during psychotherapy.
“Our results can lead to a better understanding of how people are recovering and it’s something therapists can monitor. If a therapist is working with a client who isn’t making progress, or is stuck in some way, hope might be an important mechanism to guide the patient forward toward recovery,” said Gallagher.
Hope is closely related to other positive psychology constructs, such as self-efficacy and optimism, that have also been shown to have clear relevance to promoting resilience to and recovery from emotional disorders, said Gallagher.
Gallagher’s research is part of a larger project examining the efficacy of CBT for anxiety disorders led by Dr. David H. Barlow, founder and director emeritus of the Boston University Center for Anxiety and Related Disorders.
Source: University of Houston
It is well known that regular exercise can help prevent and treat many forms of heart disease, but less commonly known are the benefits of physical activity for cancer patients.
A new initiative called Moving Through Cancer — led by Dr. Kathryn Schmitz, professor of public health sciences at Penn State College of Medicine, and an international team of health practitioners and researchers — is hoping to change that.
According to the researchers, exercise is important for cancer prevention, as it can lower the risk of developing colon, breast, endometrial, kidney, bladder, esophagus and stomach cancers.
Exercise during and after cancer treatment can also help improve fatigue, anxiety, depression, physical function, and quality of life and can also help increase survival rates after a breast, colon or prostate cancer diagnosis.
In their new paper published in CA: A Cancer Journal for Clinicians, Schmitz and her team outline new exercise recommendations for people living with and beyond cancer.
“With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer and better understand how exercise may help prevent and control cancer,” said Schmitz, who is also a member of the Penn State Cancer Institute.
“This esteemed, multidisciplinary group of leaders on the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice.”
Depending on each patient’s activity levels and abilities, the researchers generally recommend 30 minutes of moderately intense aerobic exercise three times a week and 20 to 30 minutes of resistance exercise twice a week.
But, Schmitz said health care professionals can also customize exercise prescriptions to individual patients.
“Through our research, we’ve reached a point where we can give specific FITT exercise prescriptions — which means frequency, intensity, time and type — for specific outcomes like quality of life, fatigue, pain and others,” Schmitz said.
“For example, if we’re seeing a head and neck cancer patient with a specific set of symptoms, we could give them an exercise prescription personalized to them.”
Schmitz said the recommendations will help with one of the premier goals of Moving Through Cancer: raising public awareness about the benefits of exercise for people living with and beyond cancer by 2029.
“Currently, an average person on the street will know that exercise is good for preventing and treating heart disease, but not for melanoma,” Schmitz said. “We want to change that. When researchers in the 1950s built an evidence base for exercise and heart disease, there was a shift in public knowledge about that connection. It’s now time for the same thing to happen with exercise and cancer.”
Schmitz said the second piece of the initiative is resources and programs to help get cancer patients moving. The Moving Through Cancer website has an exercise program registry that can help patients, families, health care providers and others find programs near them.
The final piece is policy, Schmitz said, which could be used to increase the chances that health care professionals will talk to their patients about exercise and that patients will be adequately referred as they move through cancer.
“This is the center of my professional heart,” Schmitz said. “My mission for a decade now has been that I want exercise to be as ubiquitous in cancer care as it is in cardiac disease care, only better. The new recommendations and guidance are a tool that can help make that a reality.”
Source: Penn State
Going for that pint of ice cream after a bad breakup may not do as much damage as you think. A new study shows that despite the emotional turmoil, people on average do not report gaining weight after a breakup.
The study, which included researchers from Penn State, investigated the German concept of “kummerspeck” — excess weight gain due to emotional eating — which literally translates to “grief bacon.”
According to the researchers, although hoarding food after a breakup may have made sense for humans thousands of years ago, modern humans may have grown out of the habit.
“Food was much scarcer in the ancestral environment, so if your partner abandoned you, it could have made gathering food much harder,” said Dr. Marissa Harrison, associate professor of psychology at Penn State Harrisburg.
“It may have made sense if our ancestors hoarded food after a breakup. But our research showed that while it’s possible people may drown their sorrows in ice cream for a day or two, modern humans do not tend to gain weight after a breakup.”
The findings are published in the Journal of the Evolutionary Studies Consortium.
The researchers say it is well documented that people sometimes use food as a way to cope with negative feelings and that emotional eating can lead to unhealthy food choices. Because breakups can be stressful and emotional, it could potentially trigger emotional eating.
In addition, ancient relationship dynamics may have made packing on the pounds after a breakup evolutionarily advantageous.
“Modern women of course have jobs and access to resources now, but back then, it was likely that women were smaller and needed more protection and help with resources,” Harrison said.
“If their partner left or abandoned them, they would be in trouble. And the same could have gone for men. With food not as plentiful in the ancestral world, it may have made sense for people to gorge to pack on the pounds.”
Harrison also noted that the existence of the word “kummerspeck” itself suggested that the phenomenon existed.
The research team conducted two studies to test the theory that people may be more likely to gain weight after a relationship breakup. In the first experiment, they recruited 581 people to complete an online survey about whether they had recently gone through a breakup and whether they gained or lost weight within a year of that breakup.
Most of the participants — 62.7 percent — reported no weight change. The researchers were surprised by this result and decided to perform an additional study.
For the second experiment, the researchers recruited 261 new participants to take a different, more extensive survey than the one used in the first study. The new survey asked whether participants had ever experienced the dissolution of a long-term relationship, and whether they gained or lost weight as a result.
The survey also asked about participants’ attitudes toward their ex-partner, how committed the relationship was, who initiated the breakup, whether the participants tended to eat emotionally, and how much participants enjoy food in general.
While all participants reported experiencing a break up at some point in their lives, the majority of participants — 65.13 percent — reported no change in weight after relationship dissolution.
“We were surprised that in both studies, which included large community samples, we found no evidence of kummerspeck,” Harrison said. “The only thing we found was in the second study, women who already had a proclivity for emotional eating did gain weight after a relationship breakup. But it wasn’t common.”
Harrison added that the results may have clinical implications.
“It could be helpful information for clinicians or counselors with patients who tend to eat emotionally,” Harrison said. “If your client is going through a breakup and already engages in emotional eating, this may be a time where they need some extra support.”
Victoria Warner, a Penn State Harrisburg graduate student, was the lead author of this study. Samantha Horn from Penn State Harrisburg and Susan Hughes from Albright College also participated in this work.
Source: Penn State
Emerging research suggests a longer period of estrogen replacement therapy provides a prolonged cognitive benefit. However, investigators acknowledge that the risk-to-benefit balance of hormone therapy use is complicated and must be individualized.
Research has determined that estrogen has a significant role in overall brain health and cognitive function. This knowledge has fostered various studies on the prevention of cognitive decline as related to reduced estrogen levels during the menopause transition.
The new study suggests a cognitive benefit from a longer reproductive window complemented with hormone therapy. The study, “Lifetime estrogen exposure and cognition in late life: The Cache County Study,” appears online in Menopause, the journal of The North American Menopause Society (NAMS).
Because women comprise two-thirds of the 5.5 million cases of Alzheimer disease in the United States, researchers have long suspected that sex-specific factors such as estrogen may contribute to women’s increased risk for the disease. Moreover, multiple studies have suggested a role for estrogen in promoting memory and learning.
In this newest study involving more than 2,000 postmenopausal women, researchers followed participants over a 12-year period to examine the association between estrogen and cognitive decline.
More specifically, they focused on the duration of a woman’s exposure to estrogen, taking into account such factors as time of menarche to menopause, number of pregnancies, duration of breastfeeding, and use of hormone therapy.
Investigators concluded that a longer duration of estrogen exposure is associated with better cognitive status in older adult women. Furthermore, they documented that these beneficial effects are extended with the use of hormone therapy, especially in the oldest women in the sample.
Women who initiated hormone therapy earlier showed higher cognitive test scores than those who started taking hormones later, providing some support for the critical window hypothesis of hormone therapy.
“Although the assessment of the risk-to-benefit balance of hormone therapy use is complicated and must be individualized, this study provides additional evidence for beneficial cognitive effects of hormone therapy, particularly when initiated early after menopause.
This study also underscores the potential adverse effects of early estrogen deprivation on cognitive health in the setting of premature or early menopause without adequate estrogen replacement,” says Dr. Stephanie Faubion, NAMS medical director.
Source: The North American Menopause Society (NAMS)
Prisoners who are held in restrictive housing (i.e., solitary confinement) face an increased risk of death after their release, according to a new study led by researchers from the University of North Carolina (UNC) at Chapel Hill.
The findings show that incarcerated individuals who were placed in restrictive housing in North Carolina from 2000 to 2015 were 24% more likely to die in the first year after their release, compared to those who were not held in restrictive housing.
In addition, those held in restrictive housing were 78% more likely to die from suicide, 54% more likely to die from homicide, and 127% more likely to die from an opioid overdose in the first two weeks after their release.
Further, the number of restrictive housing placements and spending more than 14 consecutive days in restrictive housing were associated with an even greater increase in the risk of death and reincarceration.
“For the first time ever, using data shared with us from our partners at the North Carolina Department of Public Safety, we’ve been able to demonstrate a connection between restrictive housing during incarceration and increased risk of death when people return to the community,” said lead author Lauren Brinkley-Rubinstein, PhD, an assistant professor of social medicine in the UNC School of Medicine.
“In addition, our study found that the more time people spent in restrictive housing the higher the risk of mortality after release. This study provides empirical evidence to support ongoing nationwide reforms that limit the use of restrictive housing.”
“North Carolina is a leader in this thinking as the Department of Public Safety has preemptively implemented multiple reforms that have resulted in the limited use of restrictive housing.”
“We appreciate this research collaboration and recognize the importance of these results in shaping policy and practice,” said Gary Junker, PhD, Director of Behavioral Health for the N.C. Department of Public Safety Adult Correction and Juvenile Justice.
“Since 2015, the department has initiated several programs to divert people from restrictive housing, including Therapeutic Diversion Units for those with mental illness. While safety and security must remain our top priority, we recognize that reduced use of restrictive housing will likely improve post-release outcome.”
These findings, published in the journal JAMA Network Open, are from a retrospective cohort study conducted by Brinkley-Rubinstein and co-authors from UNC, Emory University, the N.C. Department of Public Safety and the N.C. Department of Public Health.
Incarceration data for people who were confined in North Carolina between 2000 and 2015 were matched with death records from 2000 to 2016.
“We also found that non-white individuals were disproportionately more likely to be assigned to restrictive housing than their white counterparts,” said co-author Shabbar Ranapurwala, PhD, MPH, an assistant professor of epidemiology in the UNC Gillings School of Global Public Health and a core faculty member of the UNC Injury Prevention Research Center.
“In fact, the mortality and reincarceration outcomes after release were also quite different between these racial groups. The post-release opioid overdose and suicide death outcomes among those receiving restrictive housing were more pronounced among white individuals compared to non-whites, while the all-cause and homicide death and reincarceration outcomes were higher among non-white Americans compared to whites.”
Given the observational nature of the study, establishing cause and effect may be difficult, yet, the strength and consistency of the findings points to the fact that restrictive housing is an important marker of increased mortality risk among formerly incarcerated individuals.
Source: University of North Carolina Health Care