Alarming' COVID-19 study shows 80 percent of respondents report significant symptoms of depression

Young adults across the United States took part in loneliness study

November 16, 2020

Science Daily/Taylor & Francis Group

A new national survey, looking at how the COVID-19 pandemic has impacted young US adults' loneliness, reveals "significant depressive symptoms" in 80% of participants.

Over 1,000 Americans aged 18-35 took part in the online anonymous questionnaire, which also asked the subjects to report on their anxiety and substance use.

The analysed findings, published in the peer-reviewed Journal of Psychoactive Drugs, show that "alarming" levels of loneliness are associated with significant mental health issues, asapproximately 61% of respondents reporting moderate (45%) to severe (17%) anxiety.

Meanwhile, 30% of interviewees disclosed harmful levels of drinking. And, although only 22% of the respondents reported using drugs, 38% of these reported severe drug use.

Therefore, a response with mental health care provision is "imperative," lead author Professor Viviana Horigian, from the University of Miami, states.

"The convergence of the COVID-19 pandemic and the loneliness and addiction epidemics in the US is here to stay," she said.

"These young adults are the future of our nation's social fabric. They need to be given access to psychological help, coupled with the development and dissemination of brief online contact-based interventions that encourage healthy lifestyles.

"Addressing mental health and substance use problems in young adults, both during and after the COVID-19 pandemic, is an imperative."

And co-author Renae Schmidt adds: "As we invest in developing the sense of cohesion and social connectedness in these generations, we can address social and physical resiliency in our communities at large.

"Students need sustaining online delivery of [relevant] coursework, increasing counseling services, and deploying outreach through telehealth services. For young adults not engaged in school, aggressive patient outreach by primary care physicians should be used to ensure screening and intervention, also via telehealth. Access to psychological help coupled with the development and dissemination of brief online contact-based interventions that encourage healthy lifestyles."

The online, 126-item, survey was carried out between April 22 and May 11. 1,008 participants took part, with the average age 28 and 86% being over 23.

Each symptom (loneliness, anxiety, depression, alcohol use, drug use) was measured against internationally recognized scoring systems.

To examine the associations between loneliness and the mental health conditions highlighted, the researchers used a model which looked at the direct effects of both loneliness and social connectedness on depression, anxiety, alcohol use, and drug use. They also looked at the indirect effects of loneliness and social connectedness on alcohol and drug use working through anxiety and depression. In addition, they characterized relationships in pre-COVID and post-COVID behaviors and psychosocial symptomatology.

The results show that most participants who reported an increase in feelings of loneliness also indicated an increase in drinking (58%), drug use (56%), anxiety (76%), and depression (78%), and a decrease in feelings of connectedness (58%).

Looking at general increases of mental health issues or substance use due to the pandemic, most issues were recorded by participants as rising, with their feelings of loneliness going up by 65%, lack of connectedness 53%, alcohol use 48%, drug use 44%, anxiety 62%, and depression 64%.

Overall, an "alarming" 49% of respondents reported a great degree of loneliness.

Most respondents (80%) reported drinking alcohol, with 30% revealing harmful and dependent levels of drinking. 19% of respondents reported binge drinking at least weekly and 44% reported binging at least monthly.

The team hopes that the results will now be used to guide intervention efforts.

"Social prescribing, which draws from and promotes usage of community resources, also shows promise of improving social and psychological wellbeing," Professor Horigian adds.

"This could be positioned to then encourage service to others, bringing social comfort and reward as a result of connecting with others in need.

"These efforts, and others, can help to alleviate the problems of loneliness and its manifestations; yet it may take an integrated, multi-faceted, and concerted approach, rooted, and supported by mental health prevention and wellbeing promotion boosted by workforce development and research on intervention development, to readdress these trajectories."

https://www.sciencedaily.com/releases/2020/11/201116112918.htm

Loneliness in youth could impact mental health over the long term

Children and adolescents more likely to experience higher rates of depression and anxiety during and after enforced isolation ends

November 19, 2020

Science Daily/Elsevier

A new review reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The COVID-19 pandemic has necessitated widespread social isolation, affecting all ages of global society. A new rapid review in the Journal of the American Academy of Child and Adolescent Psychiatry(JAACAP), published by Elsevier, reports on the available evidence about children and young people specifically, stating that loneliness is associated with mental health problems, including depression and anxiety-potentially affecting them years later.

The review, which synthesizes over 60 pre-existing, peer-reviewed studies on topics spanning isolation, loneliness and mental health for young people aged between 4 and 21 years of age, found extensive evidence of an association between loneliness and an increased risk of mental health problems for children and young people.

"As school closures continue, indoor play facilities remain closed and at best, young people can meet outdoors in small groups only, chances are that many are lonely (and continue to be so over time)," said lead author, Maria Loades, DClinPsy, Senior Lecturer in Clinical Psychology at the University of Bath, UK.

"This rapid review of what is known about loneliness and its impact on mental health in children and young people found that loneliness is associated with both depression and anxiety. This occurs when studies measured both loneliness and mental health at the same point in time; when loneliness was measured separately; and when depression and anxiety were measured subsequently, up to 9 years later," Dr. Loades added. "Of relevance to the COVID-19 context, we found some evidence that it is the duration of loneliness that is more strongly associated with later mental health problems."

From the selected studies there was evidence that children and young people who are lonely might be as much as three times more likely to develop depression in the future, and that the impact of loneliness on mental health outcomes like depressive symptoms could last for years. There was also evidence that the duration of loneliness may be more important, than the intensity of loneliness, in increasing the risk of future depression among young people.

For many young people, loneliness will decrease as they re-establish social contacts and connections as lockdown eases (e.g., as they return to school or college). For some a sense of loneliness may persist as they struggle to resume social life, particularly for those who were more vulnerable to being socially isolated before lockdown.

"It's key that children and young people are allowed to return to activities such as playing together, even if outdoors, as soon as possible, and that they are able to resume attending school, which gives them a structure for their day, and provides them with opportunities to see peers and to get support from adults outside of the nuclear family," said Dr. Loades. Furthermore, she added "children need more in their strategy for easing lockdown. Alongside this, the government could target children's wellbeing in public health messaging. And meanwhile, we should also continue to embrace technology as a way to keep in touch."

So whilst we do what we can to mitigate the effects of loneliness and re-establish social connections, we also need to prepare for an increase in mental health problems, in part due to loneliness, and also due to the other unintended consequences of lockdown, such as a lack of structure, physical inactivity and social and/separation anxiety that might be triggered when resuming social interactions outside of the home.

There are several levels at which we can prepare for the heightened demand:

• Take a universal approach to promoting wellbeing through public messaging, and by schools doing activities to promote wellbeing in children and young people as they resume normal activities.

• Seek to identify those who are struggling with loneliness as early as possible and do so by targeted interventions to help them overcome their struggles. This may be through the provision of extra support in schools, helping them overcome anxieties about returning to school, or giving them an extra hand with reconnecting socially with peers.

For those who continue to struggle over time, and can't get back to doing the things they normally do as a result of their struggles, we need to ensure that they are made aware that services are open, and can provide specialist help, and to make sure that they know how to access this help and are supported to do so.

https://www.sciencedaily.com/releases/2020/11/201119124626.htm

Does air pollution affect mental health later in life?

November 18, 2020

Science Daily/Wiley

In a study of women aged 80 years and older, living in locations with higher exposures to air pollution was associated with increased depressive symptoms. The findings are published in the Journal of the American Geriatrics Society.

When looking at individual air pollutants, a team led by investigators from of the University of Southern California found that long-term exposure to nitrogen dioxide or fine particulate air pollution was associated with increased depressive symptoms, but with only a small effect. Results also suggested that depressive symptoms might play a role in linking long-term air pollution exposure to memory decline more than 10 years after the exposure.

"This is the first study showing how air pollution exposures affect depressive symptoms as well as the interrelationship between the symptoms and subsequent memory decline that had not been found in older people aged less than 80 years," said lead author Andrew Petkus, PhD.

Senior author Jiu-Chiuan Chen, MD, ScD, added, "We know late-life exposures to ambient air pollutants accelerate brain aging and increase the dementia risk, but our new findings suggest the oldest-old populations may respond to air pollution neurotoxicity in a different way that needs to be investigated further."

https://www.sciencedaily.com/releases/2020/11/201118080750.htm

Making the best decision: Math shows diverse thinkers equal better results

November 16, 2020

Science Daily/Florida State University

Whether it is ants forming a trail or individuals crossing the street, the exchange of information is key in making everyday decisions. But new Florida State University research shows that the group decision-making process may work best when members process information a bit differently.

Bhargav Karamched, assistant professor of mathematics, and a team of researchers published a new study today that tackles how groups make decisions and the dynamics that make for fast and accurate decision making. He found that networks that consisted of both impulsive and deliberate individuals made, on average, quicker and better decisions than a group with homogenous thinkers.

"In groups with impulsive and deliberate individuals, the first decision is made quickly by an impulsive individual who needs little evidence to make a choice," Karamched said. "But, even when wrong, this fast decision can reveal the correct options to everyone else. This is not the case in homogenous groups."

The paper is published in Physical Review Letters.

Researchers noted in the paper that the exchange of information is crucial in a variety of biological and social functions. But Karamched said although information sharing in networks has been studied quite a bit, very little work has been done on how individuals in a network should integrate information from their peers with their own private evidence accumulation. Most of the studies, both theoretical and experimental, have focused on how isolated individuals optimally gather evidence to make a choice.

"This work was motivated by that," Karamched said. "How should individuals optimally accumulate evidence they see for themselves with evidence they obtain from their peers to make the best possible decisions?"

Krešimir Josi?, Moores Professor of Mathematics, Biology and Biochemistry at the University of Houston and senior author of the study, noted that the process works best when individuals in a group make the most of their varied backgrounds to collect the necessary materials and knowledge to make a final decision.

"Collective social decision making is valuable if all individuals have access to different types of information," Josi? said.

Karamched used mathematical modeling to reach his conclusion but said there is plenty of room for follow-up research.

Karamched said that his model assumes that evidence accrued by one individual is independent of evidence collected by another member of the group. If a group of individuals is trying to make a decision based on information that is available to everyone, additional modeling would need to account for how correlations in the information affects collective decision-making.

"For example, to choose between voting Republican or Democrat in an election, the information available to everyone is common and not specifically made for one individual," he said. "Including correlations will require developing novel techniques to analyze models we develop."

https://www.sciencedaily.com/releases/2020/11/201116161222.htm

The long road to dementia

November 17, 2020

Science Daily/DZNE - German Center for Neurodegenerative Diseases

Alzheimer's disease develops over decades. It begins with a fatal chain reaction in which masses of misfolded beta-amyloid proteins are produced that in the end literally flood the brain. Researchers including Mathias Jucker from the Hertie Institute for Clinical Brain Research (HIH) in Tübingen and the German Center for Neurodegenerative Diseases (DZNE) show in the journal Nature Neuroscience that this chain reaction starts much earlier in mice than commonly assumed. This means that in addition to the well-known early phase of the disease with protein deposits but without symptoms of dementia, there is an even earlier phase in which the chain reaction is triggered by invisible tiny seeds of aggregation. If this is confirmed to occur also in humans, a treatment addressing the causes of disease would have to prevent this process. The scientists have already identified an antibody that might accomplish this.

To this end, they searched among the already known antibodies directed against misfolded beta-amyloid proteins for antibodies that can recognize and possibly also eliminate these early seeds of aggregation that currently escape biochemical detection. Of the six antibodies investigated, only aducanumab had an effect: Transgenic mice that were treated for only 5 days before the first protein deposits manifested, later on in life showed only half of the usual amount of deposits in their brains. "This acute antibody treatment obviously removes seeds of aggregation, and the generation of new seeds takes quite some time, so that much less deposits are formed in the weeks and months after the treatment." Mathias Jucker commented on the findings. "Indeed, the mice had only half the brain damage six months after this acute treatment."

Although research on Alzheimer's has been dealing with seeds of aggregation for quite some time, nobody really knows what they look like. They are currently only defined by their role as triggers for this fatal chain reaction. In this respect, they are similar to so-called prions that cause BSE in cattle, scrapie in sheep and Creutzfeldt-Jakob disease in humans. Pathogenic prions force their correctly folded peers into their abnormal shape. Jucker and coworkers therefore used the antibody aducanumab to learn more about the structure of the seeds of aggregation. They were able to show that aducanumab recognizes protein aggregates, but not individual beta-amyloid chains. The scientists now hope to use the antibody as a fishhook to isolate and better describe these seeds of aggregation.

"Our results suggest that we need to focus more on this very early phase of Alzheimer's and look for biomarkers for it. We also need more antibodies that recognize different types of the seeds of aggregation and help us to understand how they trigger the chain reaction and how they can be used for therapy," Jucker said.

There is currently consensus that treatment of Alzheimer's disease must begin earlier, not when memory decline has already begun. However, the results of the Tübingen scientists are now redefining the term "earliness" in mice. Until now, the phase with protein deposits but without symptoms of dementia has been considered to be "early." The new studies suggest that a treatment of Alzheimer's that addresses the causes should start much earlier.

https://www.sciencedaily.com/releases/2020/11/201117113056.htm

Link between Alzheimer's disease and gut microbiota is confirmed

November 13, 2020

Science Daily/Université de Genève

In recent years, the scientific community has suspected that the gut microbiota plays a role in the development of the disease. A team now confirms the correlation, in humans, between an imbalance in the gut microbiota and the development of amyloid plaques in the brain, which are at the origin of Alzheimer's disease.

Alzheimer's disease is the most common cause of dementia. Still incurable, it directly affects nearly one million people in Europe, and indirectly millions of family members as well as society as a whole. In recent years, the scientific community has suspected that the gut microbiota plays a role in the development of the disease. A team from the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG) in Switzerland, together with Italian colleagues from the National Research and Care Center for Alzheimer's and Psychiatric Diseases Fatebenefratelli in Brescia, University of Naples and the IRCCS SDN Research Center in Naples, confirm the correlation, in humans, between an imbalance in the gut microbiota and the development of amyloid plaques in the brain, which are at the origin of the neurodegenerative disorders characteristic of Alzheimer's disease. Proteins produced by certain intestinal bacteria, identified in the blood of patients, could indeed modify the interaction between the immune and the nervous systems and trigger the disease. These results, to be discovered in the Journal of Alzheimer's Disease, make it possible to envisage new preventive strategies based on the modulation of the microbiota of people at risk.

The research laboratory of neurologist Giovanni Frisoni, director of the HUG Memory Centre and professor at the Department of Rehabilitation and Geriatrics of the UNIGE Faculty of Medicine, has been working for several years now on the potential influence of the gut microbiota on the brain, and more particularly on neurodegenerative diseases. "We have already shown that the gut microbiota composition in patients with Alzheimer's disease was altered, compared to people who do not suffer from such disorders," he explains. "Their microbiota has indeed a reduced microbial diversity, with an over-representation of certain bacteria and a strong decrease in other microbes. Furthermore, we have also discovered an association between an inflammatory phenomenon detected in the blood, certain intestinal bacteria and Alzheimer's disease; hence the hypothesis that we wanted to test here: could inflammation in the blood be a mediator between the microbiota and the brain? "

The brain under influence

Intestinal bacteria can influence the functioning of the brain and promote neurodegeneration through several pathways: they can indeed influence the regulation of the immune system and, consequently, can modify the interaction between the immune system and the nervous system. Lipopolysaccharides, a protein located on the membrane of bacteria with pro-inflammatory properties, have been found in amyloid plaques and around vessels in the brains of people with Alzheimer's disease. In addition, the intestinal microbiota produces metabolites -- in particular some short-chain fatty acids -- which, having neuroprotective and anti-inflammatory properties, directly or indirectly affect brain function.

"To determine whether inflammation mediators and bacterial metabolites constitute a link between the gut microbiota and amyloid pathology in Alzheimer's disease, we studied a cohort of 89 people between 65 and 85 years of age. Some suffered from Alzheimer's disease or other neurodegenerative diseases causing similar memory problems, while others did not have any memory problems," reports Moira Marizzoni, a researcher at the Fatebenefratelli Center in Brescia and first author of this work. "Using PET imaging, we measured their amyloid deposition and then quantified the presence in their blood of various inflammation markers and proteins produced by intestinal bacteria, such as lipopolysaccharides and short-chain fatty acids."

A very clear correlation 

"Our results are indisputable: certain bacterial products of the intestinal microbiota are correlated with the quantity of amyloid plaques in the brain," explains Moira Marizzoni. "Indeed, high blood levels of lipopolysaccharides and certain short-chain fatty acids (acetate and valerate) were associated with both large amyloid deposits in the brain. Conversely, high levels of another short-chain fatty acid, butyrate, were associated with less amyloid pathology."

This work thus provides proof of an association between certain proteins of the gut microbiota and cerebral amyloidosis through a blood inflammatory phenomenon. Scientists will now work to identify specific bacteria, or a group of bacteria, involved in this phenomenon.

A strategy based on prevention 

This discovery paves the way for potentially highly innovative protective strategies -- through the administration of a bacterial cocktail, for example, or of pre-biotics to feed the "good" bacteria in our intestine. "However, we shouldn't be too quick to rejoice," says Frisoni. "Indeed, we must first identify the strains of the cocktail. Then, a neuroprotective effect could only be effective at a very early stage of the disease, with a view to prevention rather than therapy. However, early diagnosis is still one of the main challenges in the management of neurodegenerative diseases, as protocols must be developed to identify high-risk individuals and treat them well before the appearance of detectable symptoms." This study is also part of a broader prevention effort led by the UNIGE Faculty of Medicine and the HUG Memory Centre.

https://www.sciencedaily.com/releases/2020/11/201113124042.htm

Researcher examines benefits of supportive communities for older adults

November 17, 2020

Science Daily/University of Central Florid

The number of Americans age 65 and older continues to increase as the baby boom generation ages and people are living longer. At the same time, many seniors plan to "age in place," or continue living in their current homes, despite needing more assistance as they get older.

One strategy for aging in place is an emerging idea known as aging in community, in which older adults depend on a community support group or program for assistance. This can consist of situations like older adults or family and friends living in the same house or close by each other in communities where they can easily assist each other.

To find out just how well the aging-in-community strategy is working, a University of Central Florida health management and informatics researcher examined three aging-in-community programs in Florida. Her study, which is among the first to examine some key variables for these programs, was recently published in the journal Gerontology and Geriatric Medicine.

"Given the fast approaching 'super-aged society' in the U.S., there is a critical need to identify and assess the impact of aging-in-community programs aimed at helping older adults remain independent at home while also having a sense of belonging to their community," says Su-I Hou, professor and interim chair of UCF's Department of Health Management and Informatics and author of the study.

Hou examined two important factors for successful aging in community -- people's perceived ability to live independently and their perceived neighborhood social cohesiveness -- in three types of aging-in-community programs in Central Florida.

These were two village programs, Thriving-in-Place, in Celebration, and Neighbors Network, in Winter Park; the Seniors First Meals on Wheels Program in Orlando, which is a county neighborhood lunch program; and a university-based lifelong learning program, LIFE at UCF.

In a village program, older residents band together to help each other out with drives to the doctor, help with errands and to vet any outside services or assistance.

Countywide neighborhood lunch programs provide meals and nutritional services to older adults in a group setting.

The university-based lifelong learning program provides education for older adults and ways to connect with other people and engage in campus services and programs.

The researcher found that for the nearly 300 total older people she surveyed in the aging-in-community programs, the higher a person's education level was, the less likely they were to perceive themselves as having the ability to live independently.

She also found that people who were married had greater perceptions of social cohesiveness, or that they lived in a neighborhood where people helped each other out.

When comparing the three programs, study data showed that older adults participating in the neighborhood lunch program perceived a higher level of confidence that they can live independently at their own home, yet a lower level of neighborhood social cohesiveness, compared with older adults participating in the village or lifelong learning programs.

"The findings suggest 'remain independent at home' and 'having a sense of belonging to their community' may impact older adults with different characteristics or community-support systems differently," Hou says. "It calls attention to examine how these key factors operate in different programs promoting aging in community, as well as a need to promote confidence in living independently at home among higher-educated older adults, and to facilitate a sense of belonging to their own community for single, older adults."

https://www.sciencedaily.com/releases/2020/11/201117120725.htm

Mediterranean diet helps reduce effects of stress in animal model

November 16, 2020

Science Daily/Wake Forest Baptist Medical Center

Even before the pandemic and the presidential election, Americans reported some of the highest perceived levels of stress in the world, according to the American Psychological Association. Not only does stress have negative effects on work and personal relationships, it also increases the risk of many chronic conditions, such as heart disease and Alzheimer's disease, and is associated with higher mortality rates.

But eating a Mediterranean diet may provide a relatively easy way to help lessen the physiological effects of stress and promote healthy aging, according to a new study conducted by researchers at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

Findings from the study, the first preclinical trial to measure the effects of long-term consumption of a Western versus Mediterranean diet on stress under controlled experimental conditions, are published in the current online edition of the journal Neurobiology of Stress.

"It is very difficult to control or reduce stressors in our lives," said Carol A. Shively, Ph.D., professor of pathology and comparative medicine at Wake Forest School of Medicine and principal investigator of the study. "But we do know that we can control our diet, and previous observational studies have suggested that lower perceived stress is associated with high fruit and vegetable consumption.

"Unfortunately, Americans consume a diet rich in animal protein and saturated fat, salt and sugar, so we wanted to find out if that diet worsened the body's response to stress compared to a Mediterranean diet, in which much of the protein and fat come from plant sources."

The researchers studied the effects of the chronic stress of low social status and the acute stress of being socially isolated for 30 minutes in 38 middle-age animals that were fed either a Mediterranean or Western diet. The diets were formulated to closely reflect human diets, with protein and fat derived largely from animal sources in the Western group and primarily from plant sources in the Mediterranean group.

To determine the diets' effect on stress responses, the scientists measured changes in the sympathetic and parasympathetic nervous systems and in the adrenal gland hormone cortisol, in response to acute and chronic stress.

The sympathetic nervous system is involved in the "fight or flight" response and regulates bodily functions such as heart rate and blood pressure. The parasympathetic nervous system has opposite effects that help the body return to a calmer state. High sympathetic nervous system activity can be harmful to health, so maintaining a healthy balance between the two systems is important, Shively said.

Cortisol, the body's main stress hormone, helps the body access resources needed to fight or flee. However, if stress is continuous, cortisol levels stay high and damage tissues.

Compared to animals fed a Western diet, those fed the Mediterranean diet exhibited enhanced stress resilience as indicated by lower sympathetic nervous system and cortisol responses to stress, and more rapid recovery after the stress ended, Shively said.

"Our study showed that the Mediterranean diet shifted the balance toward the parasympathetic nervous system, which is good for health," Shively said. "By contrast, the Western diet increased the sympathetic response to stress, which is like having the panic button on all the time -- and that isn't healthy."

As the animals aged over the 31-month study, which is equivalent to about 9 years in humans, the research group noted that sympathetic nervous system activity increased. However, the Mediterranean diet slowed the aging of the sympathetic nervous system.

The study's findings suggest that population-wide adoption of a Mediterranean-like diet may provide a relatively simple and cost-effective intervention to reduce the negative impact of psychological stress on health and delay nervous system aging, Shively said.

https://www.sciencedaily.com/releases/2020/11/201116125603.htm

Sharp rise in sedentary time among newly retired women evident 2 plus years later

Rise more gradual among men, but longer term pattern is similar

November 16, 2020

Science Daily/BMJ

The sharp rise of more than 20 minutes a day in average sedentary time among newly retired women seems to be maintained 2 or more years later, reveals research published online in the journal Occupational & Environmental Medicine.

The rise is more gradual among newly retired men, but the longer term pattern is similar, and a cause for concern for both sexes, given the harmful impact on health of too much time spent sitting down, warn the researchers.

A predominantly sedentary lifestyle is associated with a heightened risk of long term conditions and death. And serial bouts of prolonged sedentary time, lasting 30 minutes or more, are linked to a heightened risk of cardiovascular disease, they highlight.

Previous research indicates that daily total sedentary time tends to increase as people move into retirement, but it's not clear if this includes periods of prolonged sitting time and if such patterns are kept up.

And most studies on long-term changes in sedentary time in the transition to retirement have been based on subjective assessment which is unreliable.

The researchers therefore set out to assess changes in daily total and prolonged sedentary time among older workers transitioning into retirement and to find out if these changes were maintained over the longer term, using objective measurements taken at the same time each year.

They included 689 out of 908 eligible participants in the Finnish Retirement and Aging Study (FIREA), an ongoing long term cohort study of retiring municipal workers in Finland, which began in 2013. Most (85%) of the participants were women, and in admin roles or professional jobs, with an average retirement age of 63.

To track the amount of sedentary time, they each wore an activity tracker (ActiGraph accelerometer) for 10 or more waking hours for 7 consecutive days in each of the few years before, and after, retirement.

To track the amount of sedentary time, participants wore an activity monitor (ActiGraph) for 7 consecutive days and nights, twice before retirement and twice afterwards.

These measurements were used to calculate daily averages of total sedentary time and the amount of time spent in prolonged (30 minutes or more) and in highly prolonged (60 minutes or more) sedentary bouts at each time point.

Among the women, daily total sedentary time, and prolonged and highly prolonged sedentary time didn't change much before retirement, but rose sharply at retirement and then levelled off afterwards.

In the transition period, total sedentary time increased by 22 minutes a day. Prolonged sedentary time rose by 34 minutes a day, while highly prolonged sedentary time rose by 15 minutes a day.

Increases in total and prolonged sedentary time were sharpest among women retiring from manual jobs. These changes persisted 2 or more years after retirement.

Among the men, daily total sedentary time, and prolonged and highly prolonged sedentary time increased in the year leading up to retirement by 21, 23, and 11 minutes, respectively, but no statistically significant changes were observed at retirement.

However, an overall increase in prolonged sedentary time of 33 minutes a day was observed 2 years after retirement. Men had significantly more daily total and prolonged sedentary time than women at all time points.

This is an observational study, so can't establish cause. But, note the researchers: "Our results extend previous knowledge by showing that previously observed higher daily total sedentary time after retirement concerns particularly prolonged sedentary time, which is more harmful for health compared with short sedentary bouts."

By way of an explanation, they suggest that social connections and meaningful activities may diminish after retirement, leading to increased time spent at home and in sedentary activities, such as watching TV. Added to which, physical activity during commuting and lunch breaks no longer interrupt periods of sitting.

Since an increase in prolonged sedentary behaviour increases the risk of cardiovascular disease and mortality dose dependently, retirees should be encouraged to break up sedentary activities," conclude the researchers.

https://www.sciencedaily.com/releases/2020/11/201116184447.htm

Study of infants finds that sleep differences by race, income emerge early

November 13, 2020

Science Daily/Brigham and Women's Hospital

A new stud takes a look at 24-hour sleep-wake cycles for infants across racial/ethnic and socioeconomic categories. The team found several distinct differences in sleep-wake patterns, largely explained by discrepancies in socioeconomic status.

As almost any new parent will attest, the issue of infant sleep can be a nightmare. But the challenges and consequential health effects of infant sleep problems may, like so many other health disparities, disproportionately affect families of different racial/ethnic backgrounds and household socioeconomic statuses. A new study led in part by researchers from Brigham and Women's Hospital takes a look at 24-hour sleep-wake cycles for infants across racial/ethnic and socioeconomic categories. The team found several distinct differences in sleep-wake patterns, largely explained by discrepancies in socioeconomic status. Findings are published in Sleep.

"What we knew before this study was that, in general, individuals with low socioeconomic backgrounds, as well as children and adults who are minorities, had shorter sleep than white individuals and higher socioeconomic individuals," said senior author Susan Redline, MD, MPH, of Brigham's Division of Sleep and Circadian Disorders. "What wasn't so clear was when those differences first emerged."

Previous studies have used responses from surveys of parents to draw conclusions about how sleep duration varies by race and socioeconomic status, but when such disparities arise was previously unknown. This study characterized sleep-wake patterns in infants at 1- and 6-months old using ankle-placed actigraphs and parent-completed sleep diaries, examining differences among infants with different racial/ethnic backgrounds and household socioeconomic statuses.

The study consisted of 306 infants -- 42.5 percent non-Hispanic white, 32.7 percent Hispanic, 17.3 percent Asian, and 7.5 percent Black. Between the ages of 1 and 6 months, night sleep duration increased by 65.7 minutes, night awakenings decreased by 2.2 episodes, and daytime sleep duration decreased by 73.3 minutes, confirming that night sleep increases and day sleep decreases overall in the first six months of life.

The team found several distinct differences in sleep-wake patterns across these categories:

• Black and Hispanic infants experienced less of an increase in night sleep length when compared to white infants;

• infants in families with lower maternal education and household income experienced less of an increase in night sleep duration;

• Asian infants exhibited more frequent night awakenings than all other racial categories.

• Additionally, Asian infants were the only group to still have a night sleep duration deficit compared to white infants at 6 months after adjusting for household socioeconomic status, meaning, unlike Hispanic and Black infants, Asian infant night sleep duration may not be explained by corresponding SES.

Car rides, parental rocking, and other environmental factors may reduce the accuracy of a sleep-wake assessment. Additionally, the numbers of Black and Asian families were relatively low, driving Redline to conclude that the disproportionate night awakenings recorded in Asian infants may have been by sheer chance. Such discrepancies still intrigue Redline, as they point to other avenues for exploration: parenting styles, environmental cues, maternal stress, and more.

"We know that there are these significant differences in sleep duration and sleep consolidation in older children and adults; we know those are associated with negative health outcomes and behaviors," said Redline. "Now we see that they emerge early in life, pointing to a totally new set of risk factors."

This study is one of four in a longitudinal collaborative effort to investigate the sleep-wake cycles of children ages 1 month through 2 years, with the primary goal of tracking weight gain.

https://www.sciencedaily.com/releases/2020/11/201113154613.htm

Dieting and weight worries on rise in teens

November 16, 2020

Science Daily/University College London

Significantly higher numbers of Generation Z boys and girls in the UK are dieting to lose weight, and are likely to overestimate their own weight, finds a new UCL-led study.

The research, published in JAMA Pediatrics, found that girls who are trying to lose weight are also more likely to experience depressive symptoms than in previous years.

In 2015, 42% of 14-year-old girls and boys said they currently were trying to lose weight, compared to 30% in 2005.

Lead author Dr Francesca Solmi (UCL Psychiatry) said: "Our findings show how the way we talk about weight, health and appearance can have profound impacts on young people's mental health, and efforts to tackle rising obesity rates may have unintended consequences.

"An increase in dieting among young people is concerning because experimental studies have found that dieting is generally ineffective in the long term at reducing body weight in adolescents, but can instead have greater impacts on mental health. We know, for instance, that dieting is a strong risk factor in the development of eating disorders."

The research team reviewed data from 22,503 adolescents in the UK, in three different decades, who are part of different cohort studies: the British Cohort Study (of people born in 1970; data was collected in 1986), the Children of the 90s study (born 1991-92, data collected in 2005), and Millennium Cohort Study (born 2000-02, data collected in 2015).

The adolescents were all asked questions about whether they were, or had been, trying to lose weight, whether they had dieted or exercised to lose weight, whether they perceived themselves to be underweight, about the right weight or overweight (which was compared to their actual height and weight measurements), and they filled out questionnaires that gauged depressive symptoms. The researchers found that in 2015, 44% and 60% of all participants had dieted or exercised to lose weight, respectively, compared to 38% and 7% in 1986.

The researchers say other evidence suggests that engagement in vigorous physical activity has remained relatively stable among adolescents over the past few decades.

Senior author Dr Praveetha Patalay (Centre for Longitudinal Studies and MRC Unit for Lifelong Health & Ageing, UCL) said: "It seems that young people are exercising for different reasons than they did before -- more adolescents seem to be thinking of exercise predominantly as a means to lose weight rather than exercising for fun, socialising and feeling healthy. We suspect that recent controversial calls to add 'exercise-equivalent' labels on food packaging may exacerbate this."

While girls have consistently been more likely to diet to lose weight, the researchers found a greater increase over the years among boys, who were also becoming more likely to be trying to gain weight.

Dr Patalay said: "Societal pressures for girls to be thin have been around for decades, but body image pressures on boys may be a more recent trend. Our findings underscore the impact that societal pressures and public health messaging around weight can have on children's health behaviours, body image and mental health."

Both girls and boys also became more likely to over-estimate their weight from 1986 to 2005, and even more so by 2015, which the researchers say adds to their concerns that increased efforts to lose weight are not necessarily due to increased obesity rates.

The reported weight-related behaviours and weight misperception were associated with depressive symptoms, and among girls, this relationship was becoming even stronger over the three decades examined in this study. The findings could possibly be part of the explanation for increases in adolescent depressive symptoms that have been observed in recent decades.

Dr Solmi said: "Media portrayals of thinness, the rise of the fitness industry and the advent of social media may all partly explain our results, and public health messaging around calorie restriction and exercise might also be causing unintended harm.

"Public health campaigns around obesity should consider adverse mental health effects, and ensure they avoid weight stigma. By promoting health and wellbeing, as opposed to focusing on 'healthy weight', they could have positive effects on both mental and physical health."

https://www.sciencedaily.com/releases/2020/11/201116112855.htm

Worms reveal why melatonin promotes sleep

Research in C. elegans shows how melatonin activates the BK channel in the brain

November 16, 2020

Science Daily/University of Connecticut

Melatonin is used as a dietary supplement to promote sleep and get over jet lag, but nobody really understands how it works in the brain. Now, researchers at UConn Health show that melatonin helps worms sleep, too, and they suspect they've identified what it does in us.

Our bodies produce melatonin in darkness. It's technically a hormone, but you can readily buy melatonin as a supplement in pharmacies, nutrition stores, and other retail shops. It's widely used by adults and often in children as well.

Melatonin binds to melatonin receptors in the brain to produce its sleep-promoting effects. Think of a receptor as a keyhole, and melatonin as the key. The two keyholes for melatonin are called MT1 and MT2 in human brain cells. But scientists didn't really know what happens when the keyhole is unlocked. Now UConn Health School of Medicine neuroscientists Zhao-Wen Wang and Bojun Chen and their colleagues have identified that process through their work with C. elegans worms, as reported in PNASon Sept. 21. When melatonin fits into the MT1 receptor in the worm's brain, it opens a potassium channel known as the BK channel.

A major function of the BK channel in neurons is to limit the release of neurotransmitters, which are chemical substances used by neurons to talk to each other. In their search for factors related to the BK channel, the Wang and Chen labs found that a melatonin receptor is needed for the BK channel to limit neurotransmitter release. They subsequently found that melatonin promotes sleep in worms by activating the BK channel through the melatonin receptor. Worms that lack either melatonin secretion, the melatonin receptor, or the BK channel spend less time in sleep.

But wait -- worms sleep?

Indeed they do, says Chen. There's actually been quite a lot of research on worm sleep, and researchers found that sleep is similar between worms and mammals like humans and mice.

Wang and Chen next plan to see if the melatonin-MT1-BK relationship holds in mice. The BK channel is involved in all kinds of bodily happenings, from epilepsy to high blood pressure. By learning more about the relationships between the BK channel, sleep, and behavioral changes, the researchers hope both to understand melatonin better and also help people who suffer from other diseases related to the BK channel.

https://www.sciencedaily.com/releases/2020/11/201116092251.htm

Chronic alcohol use reshapes the brain's immune landscape, driving anxiety and addiction

November 16, 2020

Science Daily/Scripps Research Institute

Deep within the brain, a small almond-shaped region called the amygdala plays a vital role in how we exhibit emotion, behavior and motivation. Understandably, it's also strongly implicated in alcohol abuse, making it a long-running focus of Marisa Roberto, PhD, professor in Scripps Research's Department of Molecular Medicine.

Now, for the first time, Roberto and her team have identified important changes to anti-inflammatory mechanisms and cellular activity in the amygdala that drive alcohol addiction. By countering this process in mice, they were able to stop excessive alcohol consumption -- revealing a potential treatment path for alcohol use disorder. The study is published in Progress in Neurobiology.

"We found that chronic alcohol exposure compromises brain immune cells, which are important for maintaining healthy neurons," says Reesha Patel, PhD, a postdoctoral fellow in Roberto's lab and first author of the study. "The resulting damage fuels anxiety and alcohol drinking that may lead to alcohol use disorder."

Roberto's study looked specifically at an immune protein called Interleukin 10, or IL-10, which is prevalent in the brain. IL-10 is known to have potent anti-inflammatory properties, which ensures that the immune system doesn't respond too powerfully to disease threats. In the brain, IL-10 helps to limit inflammation from injury or disease, such as stroke or Alzheimer's. But it also appears to influence key behaviors associated with chronic alcohol use.

In mice with chronic alcohol use, IL-10 was significantly reduced in the amygdala and didn't signal properly to neurons, contributing to increased alcohol intake. By boosting IL-10 signaling in the brain, however, the scientists could reverse the aberrant effects. Notably, they observed a stark reduction in anxiety-like behaviors and motivation to drink alcohol.

"We've shown that inflammatory immune responses in the brain are very much at play in the development and maintenance of alcohol use disorder," Roberto says. "But perhaps more importantly, we provided a new framework for therapeutic intervention, pointing to anti-inflammatory mechanisms."

Alcohol use disorder is widespread, affecting some 15 million people in the United States, and few effective treatments exist. By examining how brain cells change with prolonged exposure to alcohol, Roberto's lab has uncovered many possible new therapeutic approaches for those with alcohol addiction.

In the latest study, Roberto's lab collaborated with Silke Paust, PhD, associate professor in the Department of Immunology and Microbiology. Paust and her team determined the precise immune cells throughout the whole brain that are affected by chronic alcohol use. The findings revealed a large shift in the brain immune landscape, with increased levels of immune cells known as microglia and T-regulatory cells, which produce IL-10.

Despite a higher number of IL-10-producing cells in the whole brain of mice with prolonged alcohol use, the amygdala told a different story. In that region, levels of IL-10 were lower and their signaling function was compromised -- suggesting that the immune system in the amygdala responds uniquely to chronic alcohol use.

This study complements recent findings by the Roberto lab demonstrating a casual role for microglia in the development of alcohol dependence.

Future studies will build on these findings to identify exactly how and when IL-10 signals to neurons in the amygdala and other addition-related brain circuits to alter behavior.

https://www.sciencedaily.com/releases/2020/11/201116132248.htm

Healthy sleep habits help lower risk of heart failure

November 16, 2020

Science Daily/American Heart Association

Adults with the healthiest sleep patterns had a 42% lower risk of heart failure regardless of other risk factors compared to adults with unhealthy sleep patterns, according to new research published today in the American Heart Association's flagship journal Circulation. Healthy sleep patterns are rising in the morning, sleeping 7-8 hours a day and having no frequent insomnia, snoring or excessive daytime sleepiness.

Heart failure affects more than 26 million people, and emerging evidence indicates sleep problems may play a role in the development of heart failure.

This observational study examined the relationship between healthy sleep patterns and heart failure and included data on 408,802 UK Biobank participants, ages 37 to 73 at the time of recruitment (2006-2010). Incidence of heart failure was collected until April 1, 2019. Researchers recorded 5,221 cases of heart failure during a median follow-up of 10 years.

Researchers analyzed sleep quality as well as overall sleep patterns. The measures of sleep quality included sleep duration, insomnia and snoring and other sleep-related features, such as whether the participant was an early bird or night owl and if they had any daytime sleepiness (likely to unintentionally doze off or fall asleep during the daytime).

"The healthy sleep score we created was based on the scoring of these five sleep behaviors," said Lu Qi, M.D., Ph.D., corresponding author and professor of epidemiology and director of the Obesity Research Center at Tulane University in New Orleans. "Our findings highlight the importance of improving overall sleep patterns to help prevent heart failure."

Sleep behaviors were collected through touchscreen questionnaires. Sleep duration was defined into three groups: short, or less than 7 hours a day; recommended, or 7 to 8 hours a day; and prolonged, or 9 hours or more a day.

After adjusting for diabetes, hypertension, medication use, genetic variations and other covariates, participants with the healthiest sleep pattern had a 42% reduction in the risk of heart failure compared to people with an unhealthy sleep pattern.

They also found the risk of heart failure was independently associated and:

• 8% lower in early risers;

• 12% lower in those who slept 7 to 8 hours daily;

• 17% lower in those who did not have frequent insomnia; and

• 34% lower in those reporting no daytime sleepiness.

Participant sleep behaviors were self-reported, and the information on changes in sleep behaviors during follow-up were not available. The researchers noted other unmeasured or unknown adjustments may have also influenced the findings.

Qi also noted that the study's strengths include its novelty, prospective study design and large sample size.

https://www.sciencedaily.com/releases/2020/11/201116075728.htm

Bursts of exercise can lead to significant improvements in indicators of metabolic health

November 16, 2020

Science Daily/Massachusetts General Hospital

Short bursts of physical exercise induce changes in the body's levels of metabolites that correlate to, and may help gauge, an individual's cardiometabolic, cardiovascular and long-term health, a study by Massachusetts General Hospital (MGH) has found. In a paper published in Circulation, the research team describes how approximately 12 minutes of acute cardiopulmonary exercise impacted more than 80% of circulating metabolites, including pathways linked to a wide range of favorable health outcomes, thus identifying potential mechanisms that could contribute to a better understanding of cardiometabolic benefits of exercise.

"Much is known about the effects of exercise on cardiac, vascular and inflammatory systems of the body, but our study provides a comprehensive look at the metabolic impact of exercise by linking specific metabolic pathways to exercise response variables and long-term health outcomes," says investigator Gregory Lewis, MD, section head of Heart Failure at MGH and senior author of the study. "What was striking to us was the effects a brief bout of exercise can have on the circulating levels of metabolites that govern such key bodily functions as insulin resistance, oxidative stress, vascular reactivity, inflammation and longevity."

The MGH study drew on data from the Framingham Heart Study to measure the levels of 588 circulating metabolites before and immediately after 12 minutes of vigorous exercise in 411 middle-aged men and women. The research team detected favorable shifts in a number of metabolites for which resting levels were previously shown to be associated with cardiometabolic disease. For example, glutamate, a key metabolite linked to heart disease, diabetes and decreased longevity, fell by 29%. And DMGV, a metabolite associated with increased risk of diabetes and liver disease, dropped by 18%. The study further found that metabolic responses may be modulated by factors other than exercise, including a person's sex and body mass index, with obesity possibly conferring partial resistance to the benefits of exercise.

"Intriguingly, our study found that different metabolites tracked with different physiologic responses to exercise, and might therefore provide unique signatures in the bloodstream that reveal if a person is physically fit, much the way current blood tests determine how well the kidney and liver are functioning," notes co-first author Matthew Nayor, MD, MPH, with the Heart Failure and Transplantation Section in the Division of Cardiology at MGH. "Lower levels of DMGV, for example, could signify higher levels of fitness."

The Framingham Heart Study, which began in 1948 and now embraces three generations of participants, allowed MGH researchers to apply the same signatures used in the current study population to stored blood from earlier generations of participants. By studying the long-term effects of metabolic signatures of exercise responses, researchers were able to predict the future state of an individual's health, and how long they are likely to live.

"We're starting to better understand the molecular underpinnings of how exercise affects the body and use that knowledge to understand the metabolic architecture around exercise response patterns," says co-first author Ravi Shah, MD, with the Heart Failure and Transplantation Section in the Division of Cardiology at MGH. "This approach has the potential to target people who have high blood pressure or many other metabolic risk factors in response to exercise, and set them on a healthier trajectory early in their lives."

https://www.sciencedaily.com/releases/2020/11/201116125606.htm

Burnout can exacerbate work stress, further promoting a vicious circle

November 10, 2020

Science Daily/Johannes Gutenberg Universitaet Mainz

Work stress and burnout are mutually reinforcing / Surprisingly, the effect of work stress on burnout is much smaller than the effect of burnout on work stress.

Stress and overload in the workplace are increasing worldwide and are often considered a cause of burnout. Indeed, a new study shows that work stress and burnout are mutually reinforcing. However, contrary to popular belief, burnout has a much greater impact on work stress than vice versa. "This means that the more severe a person's burnout becomes, the more stressed they will feel at work, such as being under time pressure, for example," said Professor Christian Dormann of Johannes Gutenberg University Mainz (JGU). Employees suffering from burnout should be timely provided with adequate support in order to break the vicious circle between work stress and burnout.

Symptoms of burnout include exhaustion, cynicism, and reduced performance. "The most important burnout symptom is the feeling of total exhaustion -- to the extent that it cannot be remedied by normal recovery phases of an evening, a weekend, or even a vacation," said Dormann. "To protect themselves from further exhaustion, some try to build a psychological distance to their work, that is, they alienate themselves from their work as well as the people associated with it and become more cynical," added Dr. Christina Guthier. She conducted the study as part of her doctoral thesis in Dormann's research group and was awarded with the dissertation prize of the Alfred Teves Foundation in 2020. The study has recently been published in Psychological Bulletin.

For the joint publication with Professor Christian Dormann and Professor Manuel Völkle of Humboldt-Universität zu Berlin, Christina Guthier evaluated 48 longitudinal studies of burnout and work stress comprising 26,319 participants. The average age in the initial survey was about 42 years, 44 percent of the respondents were men. The longitudinal studies from 1986 to 2019 came from various countries, including predominantly European countries as well as Israel, the USA, Canada, Mexico, South Africa, Australia, China, and Taiwan.

Stopping the downward spiral and reducing the effect of burnout on work stress

The results challenge, or at least relativize, the common perception that work stress is the driving force behind burnout. "Burnout can be triggered by a work situation, but that is not always the case," Dormann pointed out. Once burnout begins, it develops only very gradually, building up slowly over time. Ultimately it leads to work being increasingly perceived as stressful: The amount of work is too much, time is too short, and work stress is too great. "When exhausted, the ability to cope with stress usually decreases. As a result, even smaller tasks can be perceived as significantly more strenuous," explained Guthier, the first author of the article. "We expected an effect of burnout on work stress; the strength of the effect was very surprising," she noted. The effect of burnout on perceived work stress can be somewhat mitigated if employees have more control over their own work and receive support from colleagues or superiors.

According to Dormann, a new research area is emerging on the basis of this unique data because the strong boomerang effect of burnout on work stress has not yet been investigated. Key questions that need to be addressed are: how can the effects of burnout on perceived work stress be reduced and how can the development of this vicious circle be prevented? Dormann and Guthier suggest that the place to start is with management behavior. Employees should have the opportunity to give feedback on their work stress at any time and be appreciated. Last but not least, proper recovery could also help to stop the downward spiral.

https://www.sciencedaily.com/releases/2020/11/201110112522.htm

Emergency care doctors not getting sufficient 'down time'

November 2, 2020

Science Daily/University of Plymouth

A survey of more than 4,000 UK emergency care doctors has shown that they need more support to recover from work pressures between shifts.

Published today in the BMJ Open, the study highlighted how the doctors' 'need for recovery' was higher than anything recorded in previous studies of a similar nature -- and could be helped by factors such as reducing the number of antisocial shift patterns and improving access to leave.

Led by a newly formed Trainee Emergency Research Network, sponsored by University Hospitals Plymouth NHS Trust (UHPNT), and with collaboration from the University of Plymouth and the Royal College of Emergency Medicine, the research asked a total of 4,247 doctors in emergency departments from 112 NHS Trusts around the UK to complete a validated Need for Recovery (NFR) Scale. This 11-item questionnaire assesses how work affects inter-shift recovery, with items compiled to form a score between 0 and 100.

The median average NFR result was 70 -- higher than any scores reported in other professions or populations to date.

In addition, a higher proportion of antisocial working was associated with a higher NFR score, suggesting that any reduction in antisocial shifts could help improve wellbeing.

Known as the TIRED study, it was the largest healthcare study to date of a tool that assesses the need for staff to physically and psychologically recuperate following a period of work. The authors also propose that the use of this tool could identify staff wellbeing issues before they progress to burnout.

The research took place in 2019 before the COVID-19 pandemic, but authors suggest the study findings remain relevant given that pressures on emergency care doctors are only likely to have increased.

Lead author Dr Laura Cottey, Chief Investigator for the Trainee Emergency Research Network study, said: "We all know that emergency care can be a high-pressure environment, but these results provide the evidence of the impact this work demand is having on staff wellbeing. Previous Need for Recovery scores among a variety of population groups were reported between 36 and 44, so for the median score to be 70 among over 4,000 doctors is definitely something that needs to be addressed.

"Among our respondents, we saw that NFR scores were increased by difficulty accessing annual and study leave, as well as an increased proportion of antisocial working -- such as night shifts. Better access to leave and any reduction in antisocial shifts might result in direct improvements in NFR and help protect against the development of burnout."

Co-author Dr Blair Graham, Lecturer in Urgent and Emergency Care at the University of Plymouth and Specialty Registrar in Emergency Medicine at UHPNT, said: "The first step to overcoming any problem is recognising that there is one -- so having these results is a good start. Even if fewer antisocial shifts cannot be achieved, acknowledgement of a problem and the provision of rest facilities may help to mitigate the issue.

"The next step would be for us to carry out the research at different times of year to understand whether the results are seasonal, or affected by other factors. Although this study was conducted prior to COVID-19 arriving in the UK, we believe the findings still need to be taken into account as pressures on emergency care doctors are only likely to have increased during the pandemic."

Professor Gary Minto, Director of Research and Development at UHPNT, said: "Here at University Hospitals Plymouth, our research strategy is that, in addition to our longstanding strength in running clinical trials, we also expand our focus into other areas of social care, health and wellbeing. The TIRED study, which addresses mental health in Emergency Doctors, is a great example. This prominent nationwide study, initiated, led and delivered by doctors in training contains important messages about downtime and shift patterns which are relevant across the UK, particularly as the COVID-19 situation evolves."

https://www.sciencedaily.com/releases/2020/11/201102120031.htm

Exercise classes can reduce loneliness, social isolation in seniors

November 12, 2020

Science Daily/Cedars-Sinai Medical Center

Seniors who joined group exercise classes experienced decreased loneliness and social isolation, according to a new study conducted before the COVID-19 pandemic. The classes have continued virtually since March, and early results suggest the online versions are also effective.

Older adults who joined group exercise classes experienced decreased loneliness and social isolation, according to a new Cedars-Sinai study conducted before the COVID-19 pandemic. The classes have continued virtually since March, and early results suggest the online versions are also effective.

Seniors face increased risk for developing serious health issues or even death if they lack social connections or feel alone. Loneliness is connected to higher rates of depression, anxiety and suicide. Experts say social isolation can have the same impact on an older person's health as smoking 15 cigarettes a day.

Both loneliness and social isolation are widespread issues in the U.S., where more than a third of adults 45 and older feel lonely and nearly a quarter of those 65 and older are socially isolated, according to the National Academies of Sciences, Engineering, and Medicine. But few studies have examined the most effective ways to improve social connectedness among seniors.

"As the demographics of our country shift, more people are living alone than ever before," said the study's lead author, Allison Moser Mays, MD, a Cedars-Sinai geriatrician. "The number of adults over the age of 65 in the U.S. is expected to reach more than 70 million by 2030 -- double what it is now. We need sustainable ways to help this burgeoning population thrive as they age, or there will be widespread consequences."

Mays and her co-investigators partnered with local community groups to enroll participants in evidence-based exercise and health management classes for people over 50 at nine sites in Los Angeles neighborhoods with a known concentration of low-income older adults. All locations -- which included libraries, senior centers and recreation centers -- were accessible for those with mobility limitations and had access to parking and public transit.

The study tracked 382 participants ages 52 to 104 from July 2018 through March 2020, when the pandemic forced the classes to move online. Some people were referred by their Cedars-Sinai physician during an office visit. Others found the program through community outreach.

All participants met with a health coach who assessed their needs and helped them select one of four courses, which research has shown improve other aspects of health: Arthritis Exercise, EnhancedFitness, Tai Chi for Arthritis, and Chronic Disease Self-Management. The three exercise classes proved the most popular, and individuals had to attend at least one session to be included in the study.

Participants completed questionnaires about their social connections and loneliness prior to starting their course and after six months. At the end of that period, investigators found a 6.9% decrease in loneliness and a 3.3% improvement in social connectedness, after adjusting for age, gender and other characteristics. The study was published in the American Journal of Geriatric Psychiatry.

"These classes had already been shown to reduce the risk of falls in seniors, and this was the first demonstration that they also reduce social isolation, to the best of our knowledge," Mays said.

The Leveraging Exercise to Age in Place (LEAP) classes have been supported by a three-year grant from the AARP Foundation. Cedars-Sinai has adopted the successful programming under the Community Engagement Department.

"The results of this study are very exciting because we've provided a model that other health systems can easily replicate by integrating evidence-based programs in the community with their organizations. They don't need to reinvent the wheel," said senior study author Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai. "The health coach is the key ingredient because they make sure that nobody falls through the cracks."

The health coach has been especially crucial since the pandemic began when classes moved online and participants sometimes have needed help figuring out how to log on to the platform. That effort has been paying off.

Of the 59 participants who continued with the virtual workouts, there has not been a statistically significant change in loneliness or social isolation one month after stay at home orders began, according to data Mays presented over the weekend at the Gerontological Society of America's annual meeting. The investigators will analyze further data as the classes continue. They're also piloting another program that pairs older adults with younger participants for one-on-one workout sessions online.

"Cedars-Sinai treats more patients over the age of 80 than any other academic health system in the country," Rosen said. "We're really at the epicenter of this growing population of older adults and figuring out the best ways to care for them so they can successfully age in place."

Rosen said efforts like the LEAP program helped Cedars-Sinai earn its designation as an Age-Friendly Health System Committed to Care Excellence earlier this year. The distinction, which highlights care tailored to older adults, is part of a national initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States.

https://www.sciencedaily.com/releases/2020/11/201112155830.htm

Social distancing is increasing loneliness in older adults

November 9, 2020

Science Daily/University of Stirling

Social distancing introduced in response to COVID-19 is increasing feelings of loneliness in Scotland's older population and impacting their wellbeing, according to a new University of Stirling study.

The research has identified a link between increases in loneliness in over 60s and the worsening of wellbeing and health. Increasing loneliness due to social distancing was associated with a smaller social network, lower perceived social support and a decrease in wellbeing, the study found.

The findings emerge from research launched under the Scottish Government's Chief Scientist Office Rapid Research in COVID-19 programme in May. Professor Anna Whittaker, of the University's Faculty of Health Sciences and Sport, led the work and hopes it will help to inform decision-making on the virus and support post-pandemic recovery strategies.

Professor Whittaker said: "Previous studies have demonstrated the negative impacts of social isolation and loneliness. This is a key issue for older adults who may be more likely to have few social contacts. We know that social distancing guidelines introduced in response to COVID-19 have restricted social activity engagement and impacted vulnerable groups, including older adults.

"Our study, which involved a survey of more than 1,400 older people, examined the impact of social distancing during the pandemic on social activity, loneliness and wellbeing. The majority of survey participants reported that social distancing has made them experience more loneliness, social contact with fewer people, and less social contact overall.

"We found that a larger social network and better perceived social support seems to be protective against loneliness and poorer health and wellbeing, due to social distancing. This underlines the importance of addressing loneliness and social contact in older adults, but particularly during pandemics or situations where the risk of isolation is high."

Of the 1,429 survey participants, 84 percent were aged 60 or over and had an average social network of five people. On average, the participants socialised five days per week, for more than 6.6 hours per week. Fifty-six percent reported that social distancing regulations made them experience more loneliness -- with scores that were significantly higher than reported norms; the same quality of perceived support; but social contact with fewer people and less social contact overall.

Greater loneliness was significantly associated with a smaller social network, lower perceived social support, and a decrease in social support frequency, quality, and amount -- and a worsening of wellbeing and health.

Physical activity

Using the same survey data, the research also considered the impact of social distancing on physical activity. The majority of participants reported continuing to meet physical activity guidelines during lockdown -- with 35 percent moderately active and 41 percent highly active. Walking was the greatest contributor to total physical activity, with just over a quarter (26.4%) walking more than before lockdown. Those living in rural areas reported greater volumes of physical activity.

Forty percent of people said they were walking less, compared to before lockdown, and a similar proportion were engaging in less moderate physical activity. Those who reported in engaging in lower physical activity had poorer wellbeing.

Individuals who reported no change in moderate physical activity were the most active pre-lockdown and those who reported no change in walking had significantly higher levels of total physical activity pre-lockdown.

Professor Whittaker said: "Physical activity engagement during lockdown varied and this study indicates a positive link with wellbeing -- supporting the notion that physical activity should be considered an important contributor in recovery strategies targeted at older adults as we emerge from the pandemic.

"There appears to be a relationship between pre-lockdown physical activity and physical activity changes due to lockdown. This may be of significance in the context of trying to get older adults to maintain or increase physical activity, where appropriate, as we emerge from this pandemic, given our understanding of the benefits of physical activity in this age group.

"Additionally, irrespective of pre-lockdown physical activity, older adults should continue to be encouraged to be active, and particularly to engage in some sort of strength and balance training -- such as tai chi, yoga, or weights -- which was very low in the sample but is vital for maintaining balance and physical function. Just 12 percent of the sample met the physical activity guidelines, which indicate strength training should be undertaken at least twice per week."

https://www.sciencedaily.com/releases/2020/11/201109110230.htm

Study helps explain why motivation to learn declines with age

Research on mice suggests aging affects a brain circuit critical for learning to make some types of decisions

October 28, 2020

Science Daily/Massachusetts Institute of Technology

As people age, they often lose their motivation to learn new things or engage in everyday activities. In a study of mice, MIT neuroscientists have now identified a brain circuit that is critical for maintaining this kind of motivation.

This circuit is particularly important for learning to make decisions that require evaluating the cost and reward that come with a particular action. The researchers showed that they could boost older mice's motivation to engage in this type of learning by reactivating this circuit, and they could also decrease motivation by suppressing the circuit.

"As we age, it's harder to have a get-up-and-go attitude toward things," says Ann Graybiel, an Institute Professor at MIT and member of the McGovern Institute for Brain Research. "This get-up-and-go, or engagement, is important for our social well-being and for learning -- it's tough to learn if you aren't attending and engaged."

Graybiel is the senior author of the study, which appears today in Cell. The paper's lead authors are Alexander Friedman, a former MIT research scientist who is now an assistant professor at the University of Texas at El Paso, and Emily Hueske, an MIT research scientist.

Evaluating cost and benefit

The striatum is part of the basal ganglia -- a collection of brain centers linked to habit formation, control of voluntary movement, emotion, and addiction. For several decades, Graybiel's lab has been studying clusters of cells called striosomes, which are distributed throughout the striatum. Graybiel discovered striosomes many years ago, but their function had remained mysterious, in part because they are so small and deep within the brain that it is difficult to image them with functional magnetic resonance imaging (fMRI).

In recent years, Friedman, Graybiel, and colleagues including MIT research fellow Ken-ichi Amemori have discovered that striosomes play an important role in a type of decision-making known as approach-avoidance conflict. These decisions involve choosing whether to take the good with the bad -- or to avoid both -- when given options that have both positive and negative elements. An example of this kind of decision is having to choose whether to take a job that pays more but forces a move away from family and friends. Such decisions often provoke great anxiety.

In a related study, Graybiel's lab found that striosomes connect to cells of the substantia nigra, one of the brain's major dopamine-producing centers. These studies led the researchers to hypothesize that striosomes may be acting as a gatekeeper that absorbs sensory and emotional information coming from the cortex and integrates it to produce a decision on how to act. These actions can then be invigorated by the dopamine-producing cells.

The researchers later discovered that chronic stress has a major impact on this circuit and on this kind of emotional decision-making. In a 2017 study performed in rats and mice, they showed that stressed animals were far more likely to choose high-risk, high-payoff options, but that they could block this effect by manipulating the circuit.

In the new Cell study, the researchers set out to investigate what happens in striosomes as mice learn how to make these kinds of decisions. To do that, they measured and analyzed the activity of striosomes as mice learned to choose between positive and negative outcomes.

During the experiments, the mice heard two different tones, one of which was accompanied by a reward (sugar water), and another that was paired with a mildly aversive stimulus (bright light). The mice gradually learned that if they licked a spout more when they heard the first tone, they would get more of the sugar water, and if they licked less during the second, the light would not be as bright.

Learning to perform this kind of task requires assigning value to each cost and each reward. The researchers found that as the mice learned the task, striosomes showed higher activity than other parts of the striatum, and that this activity correlated with the mice's behavioral responses to both of the tones. This suggests that striosomes could be critical for assigning subjective value to a particular outcome.

"In order to survive, in order to do whatever you are doing, you constantly need to be able to learn. You need to learn what is good for you, and what is bad for you," Friedman says.

"A person, or this case a mouse, may value a reward so highly that the risk of experiencing a possible cost is overwhelmed, while another may wish to avoid the cost to the exclusion of all rewards. And these may result in reward-driven learning in some and cost-driven learning in others," Hueske says.

The researchers found that inhibitory neurons that relay signals from the prefrontal cortex help striosomes to enhance their signal-to-noise ratio, which helps to generate the strong signals that are seen when the mice evaluate a high-cost or high-reward option.

Loss of motivation

Next, the researchers found that in older mice (between 13 and 21 months, roughly equivalent to people in their 60s and older), the mice's engagement in learning this type of cost-benefit analysis went down. At the same time, their striosomal activity declined compared to that of younger mice. The researchers found a similar loss of motivation in a mouse model of Huntington's disease, a neurodegenerative disorder that affects the striatum and its striosomes.

When the researchers used genetically targeted drugs to boost activity in the striosomes, they found that the mice became more engaged in performance of the task. Conversely, suppressing striosomal activity led to disengagement.

In addition to normal age-related decline, many mental health disorders can skew the ability to evaluate the costs and rewards of an action, from anxiety and depression to conditions such as PTSD. For example, a depressed person may undervalue potentially rewarding experiences, while someone suffering from addiction may overvalue drugs but undervalue things like their job or their family.

The researchers are now working on possible drug treatments that could stimulate this circuit, and they suggest that training patients to enhance activity in this circuit through biofeedback could offer another potential way to improve their cost-benefit evaluations.

"If you could pinpoint a mechanism which is underlying the subjective evaluation of reward and cost, and use a modern technique that could manipulate it, either psychiatrically or with biofeedback, patients may be able to activate their circuits correctly," Friedman says.

https://www.sciencedaily.com/releases/2020/10/201028171435.htm