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Editor's e-Note
For some time, studies have linked the development of Alzheimer’s disease with vascular dysfunction during aging. A recent study suggests that this dysfunction could be driven by astrocyte dysfunction and/or pericyte loss, which results in a breakdown of the blood-brain barrier. But study results indicate that long-term aerobic exercise can mitigate age-related cognitive decline.

In addition to reading our E-newsletter, be sure to visit Today’s Geriatric Medicine’s website at, where you’ll find news and information that’s relevant and reliable. We welcome your feedback at Follow Today’s Geriatric Medicine on Facebook and Twitter, too.

— Barbara Worthington, editor
e-News Exclusive
Long-Term Aerobic Exercise Prevents Age-Related Brain Changes

A study of the brains of mice shows that structural deterioration associated with old age can be prevented by long-term aerobic exercise starting in midlife, according to the authors of a research article published in the Open Access journal PLOS Biology on October 29. Gareth Howell, PhD, Ileana Soto Reyes, PhD, and their colleagues at The Jackson Laboratory in Bar Harbor, Maine, found that structural changes that make the blood-brain barrier leaky and result in inflammation of brain tissues in old mice can be mitigated by allowing the animals to run regularly, thus providing a potential explanation for the beneficial effects of exercise on dementia in humans.

As with many other diseases, old age is the major risk factor for Alzheimer’s disease. Age-related cognitive deficits result in part from changes in neuronal function, but also correlate with deficiencies in the blood supply to the brain and with low-level inflammation.

In this study, the authors set out to investigate the changes in the brains of normal young and aged laboratory mice by comparing their gene expression profiles using a technique called RNA sequencing, and by comparing their structures at high resolution by using fluorescence microscopy and electron microscopy. The gene expression analysis indicated age-related changes in the expression of genes relevant to vascular function, including focal adhesion, vascular smooth muscle, and ECM-receptor interactions, and inflammation, especially related to the complement system, which clears foreign particles in the brain cortex.

Full story »
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In this e-Newsletter
Other Geriatrics News
Health Risk Assessments
May Benefit Elderly

Researchers suggest that a health risk assessment provides a valuable tool in improving older adults’ longevity and function, according to an article at Fox News online.

Data on Benefits of Lower Blood Pressure
Bring Clarity for Doctors and Patients

How low is too low for systolic blood pressure? A recent study produced new guidelines for blood pressure control.

Sleep Could Be the Missing Link
in Dementia

According to an article in the Chicago Tribune, researchers have found links between sleep disturbance and the risk of cognitive impairment and decline.

Why Doctors Need to Consider
Spiritual Health

An article in The Philadelphia Inquirer suggests that becoming attuned to patients’ spiritual health can improve physicians’ effectiveness in treating older adults.
Tech & Tools
Inovonics Waterproof Pendant
Inovonics has released a new waterproof pendant for older adults, which comes in tailored wrist and neck lanyard options. The EN1221S-60 model is suitable for use in continuing care retirement communities and other senior living settings. Residents wearing the pendant can press the button whenever assistance is needed, and the device notifies caregivers through an emergency call system. It is 60% smaller and 60% lighter than the company’s previous pendant. Learn more »

Dechoker has created a new antichoking device that can clear an obstructed airway. Available in two sizes, the device is placed over the mouth and nose and creates suction to dislodge food or debris blocking a patient’s airway. It also has a tube that holds the tongue back. Learn more »
Geriatrics Consult With Rosemary Laird, MD
Beers Criteria Provide
Key Prescribing Principles

“Start low and go slow.” For years this was the best-known advice for anyone prescribing medications for older adults. Sage advice and easily applied, it was, however, lacking the robust data required for modern discerning clinical practitioners. Decades of pharmaceutical study of medications that specifically excluded older adults led to limited information to guide use in elders. Amid this uncertainty, an astute and visionary geriatrician identified the need for this clarifying practice tool and launched the now legendary tool bearing his name.

In 1991, under the direction of the late Mark Beers, MD, the first Beers Criteria provided awareness of the need for unique caution in prescribing for the elderly. Now widely known and cited, the Beers Criteria are an invaluable resource tool. In 2012, the American Geriatrics Society (AGS) assumed responsibility for it and in October 2015 released the current revision along with several new companion tools to enhance understanding and expand use. I was honored to be a part of the 13-member panel convened to produce the update and companion materials. What I learned during the process gave me a more complete understanding of what the criteria mean and how I can apply them to daily care decisions.

Continue reading »
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