From NIH Research Matters

Neurodegenerative diseases can damage different parts of the nervous system, including the brain. This may lead to problems with thinking, memory, and/or movement. Examples include Alzheimer’s disease (AD), multiple sclerosis (MS), and Parkinson’s disease (PD). These diseases tend to happen late in life. There are few effective treatments.

Previous findings have suggested that viruses may play a role in certain neurodegenerative diseases. For example, a recent study found a link between Epstein-Barr virus infection and the risk of MS. There are also concerns about cognitive impacts from SARS-CoV-2, the virus that causes COVID-19.

A research team led by Drs. Mike Nalls, Kristin Levine, and Hampton Leonard of NIH’s Center for Alzheimer’s and Related Dementias examined links between viruses and neurodegenerative diseases more generally. To do so, they analyzed data from the FinnGen project. This is a repository of biomedical data, or biobank, from more than 300,000 people in Finland.

The team searched the biobank for people who had been diagnosed with one of six different conditions: AD, amyotrophic lateral sclerosis, generalized dementia, vascular dementia, PD, and MS. They then checked how many had been hospitalized for a viral illness before. To confirm their findings, they looked for the same associations in the UK Biobank, which contains data from almost 500,000 people in the United Kingdom. Results appeared in Neuron on Jan. 19, 2023.

The researchers found 45 associations between viruses and neurodegenerative diseases in FinnGen. Of these, 22 also appeared in the UK Biobank. The strongest association was between viral encephalitis — brain inflammation caused by a virus — and AD. A person with viral encephalitis in the FinnGen database was 30 times as likely to be diagnosed with AD as someone without encephalitis. Results were similar in the UK Biobank; people with viral encephalitis were 22 times as likely to develop AD as those without.

The team also found, in FinnGen, the association between Epstein-Barr virus and MS that was described before. The association wasn’t seen in the UK Biobank, but this may reflect how the different biobanks use hospital diagnostic codes; Epstein-Barr viruses are common and so often not noted.

Influenza with pneumonia was associated with all the neurodegenerative diseases except MS. The researchers only included cases of influenza severe enough to need hospitalization in the study. Thus, these associations only apply to the most severe cases of influenza.

FinnGen contains data on the same people over time. The team used this to examine how the associations depended on the time since infection. They found that some viral infections were associated with increased risk of neurodegenerative disease as much as 15 years later.

The researchers note that vaccines exist for some of the viruses they identified. These include influenza, varicella zoster (which causes chickenpox and shingles), and certain pneumonia-causing viruses. Vaccination might thus reduce some of the risk of the conditions they examined.

Reference: Levine KS, et al. Virus exposure and neurodegenerative disease risk across national biobanks. Neuron. 2023. Epub Jan 11. doi: 10.1016/j.neuron.2022.12.029.

by Carol Leish, MA

Consider nominating an exceptional business, organization, or individual that exemplifies commitment to service for: 1) Older Adults; 2) People with Disabilities; and/or, 3) Caregivers. Nominations are now being accepted by the Ventura County Area Agency on Aging between June 1^st-September 1^st, 2023. Award recipients will be announced in November, 2023.

The 2023 VC Area Agency on Aging Legacy Award Categories include: 1) Business/Organization; 2) Dementia-Friendly Business/Organization; and/or, 3) Community Member (Volunteer Based). The Legacy Awards are designed to recognize businesses, organizations, and community volunteers who have excelled in their roles to help improve the lives of older adults, individuals with disabilities and caregivers.

To nominate an individual, business, or organization, or faith-based organization for this award, the business must meet these requirements: 1) Must be doing business and serving clients within Ventura County: 2) Must be providing services for individuals 60 and older; and 3) Mus bet providing business to individuals with disabilities, and/or caregivers.

Nominating a Dementia Friendly Business/Organization must meet the criteria of: 1) Doing business and serving clients in Ventura County; 2) Exemplifying the Dementia Friendly Ventura County movement; and, 3) Making strides to better the customer service experience for individuals with dementia and their caregivers. The business or organization must also be providing services for individuals 60 and older, individuals with disabilities and/or caregivers.

In order to nominate a Community Member (Volunteer Based), the person nominated or selected to receive the Legacy Award must be living within Ventura County and must be working solely as a volunteer. This individual cannot be receiving pay for work performed on behalf of their fellow Ventura County residents. This person being nominated for this award mut be 60 years old or older and must be providing services for individuals 60 and older, individuals with disabilities, and/or caregivers.

For more information, such as the nominating form, or to learn about past winners of the Legacy Awards, visit https//vcaaa.org/legacy. Or, call: (805) 477-7306. And, submit your nomination form to [email protected].

by Leslie Sokol

Summertime is here and with it comes the desire to get outdoors, breathe fresh air, soak up some sun, and have fun. Enjoying outdoor time and activities with family and friends is sure to lift your spirits and help you maintain your health and vitality, even in later stages of life. Physical exercise will give you power, make you feel stronger and more confident, improve your cognitive skills, and increase energy.

Harness the Power

Whether you’re savoring a stunning sunset or watching your grandbaby take her first steps, the feeling of being in the presence of something bigger than yourself is the definition of awe. Awe reduces stress, decreases physical pain, and expands your sense of time. Live in the moment, get your body moving and enjoy nature – it is so beneficial and satisfying. Spend time with friends and family or start a new hobby – having social engagement benefits your mental and physical well-being.

There is always a lot more to do at this time of year as people shake off the winter blahs. Activities such as barbecues, picnics, beach gatherings and more start happening on a regular basis. Use this time to incorporate outdoor workouts. Walking on the beach, throwing a ball or frisbee, hiking on trails or in the woods, exploring nature with family and friends is a chance to bond with loved ones and get in shape at the same time. Whatever you choose to do this summer, make sure you have fun!

Here is a list of some suggested outdoor exercise and activities:

• Yoga
• Dance Class
• Swimming
• Water Exercise
• Golf
• Gardening
• Hiking
• Pickleball
• Croquet
• Tennis

Healthy Tips for Summer Outdoor Workouts

1. Increase your hydration levels. Drink before, during and after you exercise. Water is one of the best fluids to drink when engaged in activity. Sports drinks with electrolytes and nutrients help replenish vital minerals that you sweat out. You can also rehydrate by eating summer fruits that contain water, such as watermelon, strawberries, grapefruit and peaches, just to name a few. Be sure to bring one of these healthy snacks with you the next time you workout outside.
2. Wear comfortable activewear, clothes and shoes that breathe.
3. Always apply sunscreen and wear a hat if possible.
4. Recognize when it is better to exercise indoors due to hot weather.
5. Inform others of your plans and when you anticipate to return.
6. Avoid slips, trips and falls. Always wear appropriate shoes, stay alert, and take your walker with you (if you are using one).
7. Get out early before it heats up.

Get ready, get set for the best summer yet!

Leslie Sokol is the creator and founder of the adult dance and fitness program For the Young at Heart. She has been teaching adults and children for forty-five years. You can watch For the Young at Heart by visiting her YouTube Channel or on TVSB. She also teaches in retirement communities throughout Santa Barbara and Ventura Counties.

For more information contact Leslie at [email protected] 805-312-8089
or visit the website: www.LeslieSokolDance.com

by Katy Krul of Oxnard Family Circle (appeared in LIVEWell)

Adult Day Health Care centers in Ventura County are critical providers of long-term care services in a congregated community-based setting for individuals with cognitive or physical impairments that are cost-effective and great alternatives to institutional care. The centers are licensed by the California Department of Public Health. There are five centers in Ventura County that serve residents over 18 years old with no age limit.

The centers provide activities, health monitoring, socialization, and assistance with daily activities, which allow participants to live in their homes, enhance their quality of life, and receive needed care in a supportive, professionally staffed, safe, and secured environment. This setting allows respite for family caregivers who often neglect their health and social needs by prioritizing the needs of their loved ones. The caregivers’ self-neglect harms their health and affects their loved ones’ well-being. The caregivers are offered resources, education, and support groups that help to navigate “aging in place” for their family members.

The regular day for a participant at an Adult Day Health Care center starts in the morning when the center’s transportation arrives at the individual’s residence for a pickup. Upon arriving at a center, participants are greeted by the staff, and the services begin. The center’s staff is there to make sure that the needs of every participant are met and are helping with all the activities of daily living, including eating, personal hygiene, and toileting. Those who require the administration of medicines, or other treatments before breakfast, are guided to the nursing room. After a hot breakfast, there are many exciting events, such as exercise groups, arts and crafts tables, games, music, and various other stimulating activities. During the same time, physical, occupational, and speech therapies, nursing treatments, social work groups, and counseling are offered per individual care plans. A hot, nutritious lunch follows. The meals are delicious, culturally appropriate, and served according to individual diets ordered by the staff dietitian. After lunch, transportation is ready to take participants home.

Every Adult Day Health Care center has a medical director on staff; however, nurses, social workers, and therapists communicate with participants’ doctors, take orders, follow up with effectiveness, and report provided treatments.

Traditionally, services at Adult Day Health Care centers are offered in the congregated setting. However, the industry keeps evolving. As a result of current public health developments, regulations allow providing remote/telehealth services and services at the doorstep in case of an emergency, including the deliveries of meals. This change in regulations would allow continuity of care when an individual cannot receive care in person in case of a crisis.

Adult Day Health Care is covered for qualified individuals by Medi-Cal/GCHP, Tri-Counties Regional Center, Veterans Affairs, long-term care insurances, and private funds. Some individuals, who do not have any of these coverages and cannot afford to pay privately, often wrongfully assume that they do not qualify for Medi-Cal. However, changes in the income threshold, asset limit, and immigration status went into effect in 2022, and the eligibility for Medi-Cal changed for the better. It is worth reaching out to the Health Insurance Counseling Advocacy Program at the Ventura County Area Agency on Aging or contacting social workers at an Adult Day Health Care center near you if you have questions about your eligibility.

To find out if you or your loved one may benefit from Adult Day Health Care, please schedule a visit to two or three of your closest centers and see if the environment and atmosphere are right for you. The centers provide care that does not vary in quality because of gender, ethnicity, race, nationality, or socioeconomic status.

From NIH Research Matters

During the COVID-19 pandemic, residents of skilled nursing facilities have been at particular risk of dying from the disease. These nursing facilities are for people who need daily medical care from trained professionals. Although less than 2% of the U.S. population either lives or works in such facilities, they accounted for more than 20% of the deaths from COVID-19 through 2021.

Staff members who contracted an infection outside of work likely seeded most COVID-19 outbreaks in skilled nursing facilities. Modeling studies have suggested that frequent testing of staff members could help reduce this risk, so such approaches have been widely adopted. But few studies have examined how well this strategy worked in real life.

In new NIH-funded research, a team led by Dr. Brian McGarry from the University of Rochester and Dr. Michael Barnett from Harvard University looked at data collected and reported by more than 13,000 skilled nursing facilities during the pandemic. The team examined rates of staff COVID-19 testing during three main periods between November 2020 and March 2022: before vaccines became available, after vaccines were widely distributed but before the Omicron wave, and during the Omicron wave. Tests included rapid antigen testing done on-site and PCR testing, which had to be sent to an outside lab.

The researchers compared the facilities’ rates of COVID-19 infections and deaths with their frequency of staff testing for COVID-19. Results were published on March 23, 2023, in the New England Journal of Medicine.

During the entire period studied, facilities that did the most testing (top 10%) had about 43 deaths per 100 outbreaks, compared to about 50 deaths per 100 outbreaks in facilities that did the least testing (bottom 10%). Facilities that did the most testing detected about 15% more COVID-19 infections among staff than those that did the least. This suggests that frequent testing captured more asymptomatic staff infections that could seed outbreaks.

Before vaccines were available, these numbers translated to an approximately 30% reduction in the number of cases among facility residents and a 26% reduction in deaths. During the Omicron wave, frequent testing continued to reduce the number of cases among residents, but no longer impacted the number of deaths. This change reflects the effectiveness of vaccines against the virus.

The number of observed deaths didn’t differ between facilities that used rapid testing or PCR testing. However, a faster turnaround time for PCR testing was associated with fewer resident deaths. In the period before widespread vaccination, those facilities that received their testing results in two days or less had fewer deaths per outbreak than those that got them back in three or more days.

“This research demonstrates that frequent COVID surveillance testing protected nursing home residents and undoubtedly saved lives by detecting more infected staff, potentially earlier in the disease course, and disrupting potential viral transmission chains,” McGarry says.

— by Sharon Reynolds

This research was supported in part by NIA grant AG058806.

Having a good sense of smell is associated with slower loss of brain volume and cognitive decline in older adults, and the link between sense of smell and brain and cognitive changes may be especially pronounced among those who develop cognitive impairment or dementia. These are the key findings from NIA-led research published recently in Neurology.

The sense of smell declines with age, and loss of olfactory function is also an early symptom of neurodegenerative diseases such as Parkinson’s and Alzheimer’s. While previous research found the sense of smell was associated with brain volume and function, no studies had examined longitudinal changes within an individual across the whole brain and by cognitive status.

In this study, scientists analyzed sense of smell, brain imaging, and cognitive performance data from participants in the NIA Baltimore Longitudinal Study of Aging. The researchers examined whether sense of smell, as reflected by odor identification scores, was associated with longitudinal changes in regional brain volumes and changes to cognitive function. To examine the association between sense of smell and brain volume, they compared odor identification scores and brain MRI scans from a subset of 567 participants. The association between sense of smell and cognitive function was analyzed by comparing odor identification scores and cognitive evaluations from a subset of 754 participants. The subsets were analyzed separately but included 565 overlapping participants with both brain MRI scans and cognitive assessment data.

Participants who developed cognitive impairment or dementia had worse odor identification scores than those who did not. Better odor identification scores were associated with slower loss of brain volume, particularly in the frontal and temporal regions — areas important for thinking and memory. Better scores were also associated with slower decline in memory, attention, processing speed, and sensorimotor integration skills over time. However, when data points after a diagnosis of cognitive impairment or dementia were excluded from analysis, the associations between sense of smell with brain volume and cognitive functioning were not as strong.

These study findings add to evidence that sense of smell is related to cognitive impairment and dementia and demonstrate longitudinal relationships with brain volume loss in specific brain areas and cognitive decline in specific domains. Future studies with longer follow-ups of change over time may help researchers better understand the potential for using sense of smell as an early biomarker of cognitive decline and the role of specific brain regions in this association.

These activities relate to NIH’s Alzheimer’s and Related Dementias Research Implementation Milestones:

by Leslie Sokol

When it comes to exercise, you might be struggling to figure out which is more important – quality or quantity of your workouts? No matter what age you are, both of these factors come into play when creating a fitness routine. Of course, as one might expect, quality exercise will always be better than a half-hearted workout. And some quantity of exercise is important to maintain general consistency that produces real and long-lasting results.

If you are starting a new exercise program, begin slowly and be as efficient as you can. Consistency (aka “quantity”) is important, but the quality of your workouts is crucial, especially in the beginning. As the saying goes, “Variety is the spice of life,” and this is especially true when it comes to designing your fitness routine. How each of these factors fit into your routine will depend on your specific fitness goals. Let’s dig a little deeper to see what this means to you!

Why Quality Exercise is Important

Quality exercise means a few things: first, it means to move well and exercise with proper form and technique. Take your time and focus on the movement you are performing. For example, when stretching, do not force or move the muscles too abruptly. Hold your stretch, relax, and ease into it. Keep your back flat, shoulders down, chest out and stomach pulled in to promote good posture. This will prevent injury, improve flexibility and increase mobility.

Second, quality exercise means putting your best effort into your workouts. You might feel lazy some days, thinking you can get away with having one foot in and one foot out of your workout session. Make sure you keep both feet in!

Third, more reps of a particular exercise or exercising more frequently isn’t always better. You want to be doing a variety of exercises that works the entire body and utilizes all of your muscles.

Why Quantity of Exercise is Important

While quality exercise is extremely important, quantity should have a place in your exercise routine as well. Without consistency, progress is difficult, if not impossible. Schedule regular workout sessions to build your fitness and ensure those results keep racking up.

Both quality and quantity complement each other. They are essential elements that need to be in everyone’s exercise program. So make sure to incorporate both and enjoy your workouts!

Leslie Sokol is the creator and founder of the adult dance and fitness program For the Young at Heart. She has been teaching adults and children for forty-five years. You can watch For the Young at Heart by visiting her YouTube Channel or on TVSB. She also teaches in retirement communities throughout Santa Barbara and Ventura Counties.
For more information contact Leslie at [email protected] 805-312-8089
or visit the website: www.LeslieSokolDance.com