UK researcher wins $3.1 million grant to study proteins that go haywire and lead to dementia; one goal is early treatment of it

Maj-Linda Selenica, Ph.D., works in her lab on March 27, 2024. (UK photo by Carter Skaggs)

By Hilary Smith
University of Kentucky

A University of Kentucky professor has received a $3.1 million grant from the National Institute on Aging to continue her research that she thinks could lead to treatments for early dementia.

Maj-Linda Selenica, Ph.D., assistant professor in the UK College of Medicine and associate director of outreach and partnerships at UK’s Sanders-Brown Center on Aging, has been working on research surrounding misfolding of the protein TDP-43, which is common feature of many neurodegenerative diseases, including Alzheimer's disease.

The condition is found in 1 in 5 people over 80. When severe it is associated with episodic memory loss, mimicking Alzheimer's-type dementia, and hastens the cognitive decline in patients with co-existing Alzheimer's pathology, 

Proteins that fold into a different, incorrect shape than their normal functional form are often unable to perform their normal functions and can even become toxic to cells. They can clump, which can lead to neurodegenerative diseases like Alzheimer's.

“We have uncovered completely novel modification of TDP-43 that uniquely and irreversibly changes the cellular mechanisms in the brain,” said Selenica.

Scientists have few strategies to intervene in the disease process, but Selenica and her lab have discovered that peptidyl arginine deiminases (PADs) promote the conversion of amino acid arginine in TDP-43 to the amino acid citrulline. This process, called citrullination, modifies TDP-43 and may be a potential therapeutic target.

Selenica began her research at the University of South Florida, where her team made novel antibodies for the citrullinated TDP-43, which did not exist as research tools. The team was able to use these antibodies to start looking at the potential mechanisms.

“Alzheimer’s disease brains and dementia brains undergo longstanding stress, so we asked the same thing of the cellular models and cross-validated our findings in animal models,” said Selenica. “We obviously cannot mimic what happens in the human brain, but these models permit us to understand mechanisms that underlie the human disease.”

Selenica’s lab collaborated with Sanders-Brown’s Daniel Lee, an associate professor in the UK College of Medicine and co-investigator on the grant. He was first to investigate the effects of PAD-dependent tau citrullination in Alzheimer's. Their efforts now focus on better understanding how citrullination impacts TDP-43 and other proteins.

The terms “Alzheimer’s disease” and “dementia” are no longer interchangeable. Now scientists understand that a variety of diseases and disease processes contribute to dementia, which is why so much of the ongoing work within the labs at Sanders-Brown are connected in some way. Selenica and Lee’s laboratories are joining forces to focus on two prominent pathological hallmarks in dementia-related diseases.

Selenica’s colleague, Dr. Pete Nelson, a professor of pathology and laboratory medicine at UK and leader of neuropathology at Sanders-Brown, led a group of international experts who characterized TDP-43 effects as a new form of dementia. 

Selenica collaborated with Nelson to look at human brain tissues from the UK Alzheimer’s Disease Center Tissue Bank in Sanders-Brown. Nelson is also a co-investigator in this new grant.

Based on her research and the work that planned under the new NIA grant, Selenica is hopeful it can result in several therapeutic avenues to target TDP-43 early in the disease development process.

 “I’m hoping that several years from now we can develop disease-modifying therapeutic strategies and future biomarker assays targeting TDP-43 pathology,” Selenica said. And she doesn’t think the work will stop there. “I think this project will open the field to much more fruitful collaborations. It has us really thinking about, could we develop something to target all the pathologies at once?”

UK researcher says chemicals in plastics can speed Alzheimer's

Researchers at the University of Kentucky are studying chemical compounds used in the production of water bottles and their link to Alzheimer's disease. (Photo by monticelllo, iStock/Getty Images Plus)

By Lindsay Travis
University of Kentucky

Researchers at the University of Kentucky are studying how elements of our natural surroundings can be potential risk factors for Alzheimer’s disease — including chemicals widely used in plastics.

“Bisphenols can accelerate Alzheimer’s disease and lead to cognitive deficits. Simply: Be smart and stay smart by avoiding plastics,” says Anika Hartz, the UK professor leading the study.

Anika Hartz, Ph.D., is the lead resarcher. (Pete Comparoni, UK) 

“Identifying environmental risk factors for Alzheimer’s is critical to mitigate cognitive decline in humans,” said Hartz, who holds positions in the College of Medicine and the College of Pharmacy. She is also affiliated with UK's Sanders-Brown Center on Aging, one of the nation’s leading centers on aging, Alzheimer’s disease and related neurodegenerative disorders. It is one of 33 National Institute on Aging-funded Alzheimer’s research centers in the U.S.

The study is funded by a grant from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health.

Alzheimer’s is a progressive and irreversible neurological disorder. It’s estimated that 6.2 million Americans aged 65 and older are living with the disease that affects cognitive function, memory and behavior.

Hartz and her colleagues are examining three types of bisphenols, chemical compounds used in the production of polycarbonate plastics and epoxy resins. Theys are commonly found in food containers, water bottles and the lining of cans.

“Human exposure to bisphenols is inevitable due to their widespread presence in the environment,” said Hartz. “Our data show that bisphenols trigger blood-brain barrier dysfunction and memory problems, both hallmarks of Alzheimer’s, indicating that environmental bisphenols are a critical yet underrecognized risk factor for the disease.”

Hartz’s research team provided some of the first evidence that the chemicals are a clinically relevant environmental risk factor for Alzheimer’s. Bisphenols are a concern because previous research has shown they can affect the endocrine system, which regulates hormones. The brain plays a complex role in that system.

UK researchers want to better understand how the chemicals’ disruption of the endocrine system impacts the blood-brain barrier function, potentially driving cognitive decline and accelerating Alzheimer’s disease.

“The goal of this project is to develop fundamental knowledge of environmental impacts on human health that will help promote healthier lives and reduce the burden of diseases and conditions related to aging,” said Hartz. “New insights are expected from our study that will open the door for future evidence-based health management aimed at preserving cognition in health and disease.”

The work builds on preliminary data funded by a pilot grant from the UK Center for Appalachian Research in Environmental Sciences. Hartz said, “Without the pilot funding, the strong support of the UK-CARES leadership Drs. Ellen Hahn and Erin Haynes, the entire UK-CARES team, my colleagues Drs. Bjoern Bauer, Kevin Pearson, Richard Kryscio, Bernhard Hennig, Peter Nelson, Scott Stanley and the continuous support from Dr. Linda Van Eldik and the team at the Sanders-Brown Center on Aging, this would have not been possible.”

This study brings together a multidisciplinary group of researchers spanning the colleges of Medicine, Pharmacy, Public Health and Martin-Gatton College of Agriculture, Food and Environment.

First drug to slow Alzheimer's disease gets full FDA and Medicare approval for early-stage cases; drug is still in clinical trials at UK

Dr. Jim Jackson of Morehead receives a lecanemab infusion
at UK's Sanders-Brown Center on Aging. (UK file photo) 

By Melissa Patrick
Kentucky Health News

The U.S. Food and Drug Administration has granted full approval for the first drug to slow down the progression of Alzheimer's disease, opening the door for Medicare to pay for it.

"This is the first medicine ever that actually changes the disease in the brain, removes a component of the disease and can extend quality of life for patients who are developing and who are in the early stages of Alzheimer’s disease," Dr. Greg Jicha, director of clinical trials at the University of Kentucky Sanders-Brown Center on Aging, said at a news conference on Friday. 

Jicha stressed that the drug is not a cure, but instead has been shown in clinical trials to slow the disease process by 27% to 40%. 

Lecanemab, marketed by Japanese drug maker Eisai and U.S. partner Biogen under the brand Leqembi, is an antibody that targets amyloid plaques, which are found in brains of people with Alzheimer's. It is administered twice a month, intravenously; the firms have estimated treatment will cost $26,500 a year. 

The drug has been on the market since January 2023 under an accelerated approval from the FDA but was not broadly covered by Medicare. Following the FDA's full approval of the drug, Medicare, which primarily serves adults age 65 and older, will now cover it for those who qualify. 

With the Centers for Medicare and Medicaid Services' announcement, Jicha said the approval would make coverage more likely by other insurers, including Medicaid, which is a federal-state program.

Jicha also said he hopes Esail will have patient-assistance programs to ensure that anyone who qualifies for the drug has access to it. 

“I really think it behooves all of us to ensure that this medicine is accessible to everybody,” he said. “No matter what their socioeconomic status, no matter what their geographic limitations are, everyone who has early Alzheimer’s disease deserves the opportunity as long as the medicine is going to be safe for them.”

Dr. Jim Jackson, a retired pediatrician from Morehead, participated in an 18-month lecanemab study at UK and is now part of what his wife, Sharon, called an "extension study." 

"I felt that it was really a good opportunity to be part of something that can improve life for many, many people," he said at the news conference. Later adding, "I would be very happy to recommend this drug. I've been tickled to death to be in the study." 

Jicha said there are some side effects to the drug, including amyloid-relating imaging abnormalities (ARIA), typically a temporary swelling and/or bleeding in certain areas of the brain that usually resolve over time. He said people with two copies of a well-known Alzheimer's risk gene may be more at risk of ARIA. 

Sharon Jackson said her husband has responded well to the drug and has had no side effects. When he started the clinical trial, she said, "Jim had a little bit of memory issues and I can plausibly say that it has not progressed very much. . . . I can see that this medication, from what I understand about Alzheimer's, seems to be holding him pretty steady."

Who qualifies for the drug?

The medication will only be available to those in the early stages of the disease, and doctors willhave to verify that there is a buildup of amyloid in the brain before they can prescribe, Jicha said. Also, he said the drug must be administered by specialists who understand how to provide the treatment and to monitor for safety. 

“This medicine is only for those with mild memory problems, what we call mild cognitive impairment or folks that are in the mild stage of Alzheimer’s,” Jicha said, because benefits are uncertain for those in “a more moderate or severe stage.”

The drug is not available to people at risk of Alzheimer's, but Jicha said ongoing clinical trials are evaluating the usefulness of the drug for this group.   

The Alzheimer's Association promoted early detection and diagnosis in its press release celebrating the full approval of lecanemab. 

"With this approval, early detection and diagnosis are even more critical to ensure individuals receive the most benefit at the earliest point possible. If you or a loved one is experiencing memory changes, the Alzheimer’s Association strongly encourages speaking with a health care provider for a thorough evaluation and diagnosis and to discuss treatment options," says the release. 

In Kentucky, 75,000 people 65 and older are living with Alzheimer's and that number is expected to increase by 15% in the next few years, to 86,000 in 2025, according to the Alzheimer's Association. Further, the association says 11.2% of people aged 45 and older have subjective cognitive decline.

Some people have misgivings. "Providers and health researchers who have doubts about the drug’s safety and efficacy say the decision exemplifies broader problems with FDA’s approval process," Jessica Karins of Inside Health Policy reports. "The critics raise concerns with the safety profile of the early-stage Alzheimer’s treatment . . . and say the difficulty of measuring cognitive decline means it remains unclear how much the drug can slow the progression of Alzheimer’s disease."

Ky. is getting older; sees more deaths than births for several years

Kentucky State Data Center maps

Kentucky's population is getting older, and that is expected to put a strain on the state's health-care system, which already lacks enough primary-care providers, Sarah Ladd reports for the Kentucky Lantern. 

An analysis of new census data by the Kentucky State Data Center found that Appalachian Kentucky is aging faster than the rest of the state, possibly due to young people moving away, but the oldest counties are in West Kentucky, while counties with colleges and military clusters are home to the younger populations Ladd reports.

The data show that from 2010 to 2020, the median age of Kentuckians increased from 38.1 to 39.4 and the share of people 65 and older increased from 13.3% (just over one in eight) to 17% (just over one in six).

 “It’s not unexpected that the population is aging like this,” said KSDC director Matthew H. Ruther, a University of Louisville professor, told Ladd. 

Ruther said that the increase from 13% to 17% in people 65 and older is “a really big jump.”

“And it’s not done yet. We’re going to still be seeing this going into the future," estimating that the 65 and older population will eventually hit 20%, he told Ladd. 

“The peak of the baby boom was in 1957,” he explained. “Those people are now 66. And so you’re … still going to be seeing this older population get larger, both in absolute terms and as a percent of the population.”

Effects on health care and health

With Kentucky's aging population comes an influx of medical needs that the state and its health-care systems will have to consider, writes Ladd. 

The National Council on Aging said in March that about 95% of older adults have at least one chronic condition, such as diabetes or heart disease. And almost 80% have two or more chronic conditions, according to the Center on Aging.

"Yet large areas of Kentucky suffer from a lack of primary-care providers," Ladd notes. "The Kentucky Primary Care Association said in 2022 that 94% of the state’s 120 counties don’t have enough."

“People are already having trouble getting to doctors or hospitals because of supply issues,” Ruther told Ladd. “If nothing changed, then this is going to become more problematic in the future.”

Ladd also reports that deaths exceeded births in 2020, the first year of the pandemic, when there were nearly 4,000 more deaths than births in Kentucky. In 2021, deaths exceeded births by 8,089, according to the Centers for Disease Control and Prevention (CDC). 

That trend is slowing, but is continuing. Preliminary data released June 1 show that in 2022, Kentucky deaths (57,269) exceeded births (52, 219) by 5,050.

However, Kentucky was one of only 13 states that showed an increase in births in 2022, barely: five more births than in 2021, according to the preliminary data for 2022 and final numbers for 2021.  

Nationally, the number of births has plateaued after a modest increase in 2021, reports Tim Henderson of States Newsroom, Kentucky Lantern's parent organization, citing CDC data available May 30. 

Here are some simple tips to help you stay healthier as you age: Keep your mind and body active, keep exploring . . .

Photo illustration from iStock/Getty Images Plus

By Kelly Parsons
University of Kentucky

What goes up and never comes down? Your age!

September is Healthy Aging Month, an observance designed to celebrate the positive aspects of growing older.

Keeping in touch with your neighbors, community and world around lowers the risk of dementia. Staying social and engaged improves your brain health. There are many ways you can engage in activities, including programs at your local senior center, the Silver Sneakers program and volunteering.

Aging can be filled with opportunities for self-growth and exploration of the world around us. Healthy Aging Month reminds us that engaging in social and productive activities has been shown to lower blood pressure, improve mood and live longer.

We experience significant changes as we age: retirement, moving to a new area, changes in health status or mobility can all impact our ability to stay connected. These events can result in a loss of connection which can cause you to become isolated and/or feel lonely.

Here are five ways to celebrate Healthy Aging Month and promote healthy aging in your life:

Get active: The body is the vessel of the soul. That is why taking care of it is one of the most important elements of healthy aging. When it comes to exercising, keeping a routine is key. Finding a workout partner, joining a dance class, or getting outside and enjoying some fresh air are all great ways to stay active and have fun while doing it! Sooner than you know it you’ll be looking forward to your next workout. (Research on chimpanzees suggests it's physical inactivity that makes us frail, National Geographic reports.)

Keep your mind sharp: Keeping your mind active will allow you to stay as mentally sharp as you’ve ever been. Learning new recipes, playing word or number games, learning to play a musical instrument or joining a book club are fun ways to exercise your mind.

Keep exploring: Keep your life exciting by visiting new places, volunteering and traveling. Local libraries, senior centers and universities have programs for all interests. For example, the University of Kentucky has the Office of Lifelong Learning (OLLI) program, which offers educational and enrichment opportunities for people age 50 and older.

Stay on top of your health status: Over time, it can be easy to lose track of routine doctors' visits, but as we age it is more important than ever to stay on top of our health. Make this September the month to re-up on annual shots and checkups. Remember, Medicare will pay for your annual wellness visit. Keeping up with your health conditions can help prevent serious health issues.

Stay motivated: Sometimes, getting older can take a toll on your mental and emotional health. Know that you are not alone. Finding a community can help to keep you motivated.

Whether you're in your 40s or in your 80s, it's never too soon (or too late) to begin your journey of healthy aging. Celebrate Healthy Aging Month by making the choice to take care of yourself for yourself.

Feeling older than you are? You may not be getting enough sleep

Shutterstock

Getting plenty of sleep is important not just for physical health but also for your own perception of your health.

A study led by the University of Exeter in England found that people who rated their sleep the worst felt older and perceived their own physical and mental aging more negatively.

Researchers surveyed 4,482 people 50 and over in an online study in which participants take regular cognitive tests and complete lifestyle questionnaires. The study aims to understand what helps people stay cognitively healthy.

Lead author Serena Sabatini said, “Our research suggests that poor sleepers feel older, and have a more negative perception of their aging. We need to study this further – one explanation could be that a more negative outlook influences both. However, it could be a sign that addressing sleep difficulties could promote a better perception of aging, which could have other health benefits.”

The research team noticed that many participants were commenting on their relationship with sleep as part of standard questionnaires within the study. Comments included: “How I feel fluctuates widely depending on my sleep. I feel great if I get six hours, so about half the time I feel younger and half the time I feel older!”

Prompted by such comments, the team offered a questionnaire looking specifically at sleep. Participants were asked whether they had experienced a list of negative age-related changes, such as poorer memory, less energy, increased dependence on the help of others, decreased motivation, and having to limit their activities. They also rated their quality of sleep. The participants completed both questionnaires twice, one year apart. The research was published in the journal Behavioral Sleep Medicine, 

Walking is good for your health, but moderate to vigorous exercise boosts fitness three times as much, new research finds

A recent study found that "bouts of moderate to vigorous exercise … drastically improves a person's fitness, compared to milder forms of exercise," says the study report from Boston University.

The results may seem obvious, but according to lead researcher Dr. Matthew Nayor, the study of about 2,000 participants from Framingham, Mass., answers some lingering questions, such as how rigorously should a person work out to improve fitness or whether going to the gym can cancel out hours spent sitting at a desk.

The actual links between physical activity and fitness level are not very well understood, Nayor says, and the "study was designed to address this gap, but we also were interested in answering several specific questions." For example, the study found that sedentary time didn't affect fitness levels if the person achieved a higher-than-average daily step count or performed some moderate-to-vigorous physical activity. On top of that, activities with higher exertion improved both the participants' peak exercise performance and their ability to start and sustain lower-exertion activities better than simply walking.

However, Nayor adds that higher step counts are still "associated with higher fitness levels," a fact that is reassuring for older people or those with medical conditions that may prohibit high exertion. Still, if your goal is to become more fit or slow the decline in your fitness as you age, "performing at least a moderate level of exertion [through intentional exercise] is over three times more efficient than just walking" at a casual speed.

First Ky. Senior Hunger Summit brings awareness to issue, seeks solutions; nearly 3,000 Ky. seniors on waiting list for home meals

By Melissa Patrick
Kentucky Health News

One in six Kentuckians older than 60 have faced the threat of hunger in the past year, prompting state officials to hold the first-ever Kentucky Senior Hunger Summit Oct. 30 in Frankfort to raise awareness of the issue and to help connect people in communities to find solutions.

Shannon Gadd, commissioner of the Department for Aging and Independent Living, told Kentucky Health News that while the government can't fully fund or supply all of the resources needed to help all of these hungry seniors, it can act as a connector and catalyst to raise awareness of the issue and to marshal resources.

"To tackle food insecurity, it will require a grassroots, community-led effort. I believe that many resources already exist and there is much great work happening," Gadd said in an e-mail. "The first step to addressing the issue is bringing everyone to the table to discover that good work and how we can work together to tackle the problem. The summit was a kickoff and there will be more to come."

In Kentucky, 16.6 percent of those 60 and older suffer from food insecurity, a 10% increase over the last four years. Kentucky ranks 39th for food insecurity and 46th for home-delivered meals, according to the United Health Foundation's annual America's Health Rankings.

Gadd said there were 2,917 Kentucky seniors on a waiting list for home-delivered meals on June 30, the end of the 2018-19 fiscal year.

She said the need for such services is great in Kentucky because "we have a very high number of adults ages 60 and older with independent-living difficulty, which translates to a higher need for home-delivered meals and other supportive services."

Kentucky seniors rank 49th in physical inactivity and 45th in the percentage of seniors who are "able-bodied," according to the rankings.

Gadd said other factors to consider "include supporting an increasing 60-plus population while sustaining a decrease in funds, a previous practice of funding only hot meals rather than frozen or shelf-stable meals, and the use of multiple food providers across the state, rather than a single state contract."

Who's at risk and health consequences

James Ziliak, founding director of the Center for Poverty Research at the University of Kentucky, pointed out that because most seniors live on a fixed income, any increase in their out-of-pocket spending puts them at risk of becoming food-insecure.

James Ziliak

Ziliak, who has done research on food insecurity for more than a decade, noted that poverty is a substantial factor in whether a senior is food-insecure. For example, he said seniors with incomes under the federal poverty line ($12,490 for an individual and $16,910 for a couple) are 30% more likely to have food insecurity.

The risk of food insecurity is at least twice as high for minorities, Ziliak said. After controlling for age, income and race, the risk also increases for those with less education, those who have a disability, those who are divorced or separated, those who have a grandchild living in the home. In addition, he said that seniors who self-report as socially isolated have a 50% greater risk of food insecurity.

Ziliak also presented his and Craig Gunderson's research on the health consequences of senior hunger. Gunderson is from the University of Illinois at Urbana-Champaign.

They found that food-insecure seniors, compared to those who were food-secure, had a 60% higher risk for depression; 40% higher risk for congestive heart failure; 22% greater risk for coronary heart disease; 53% greater risk for a heart attack, and 37% greater risk for chest pain. They were also 52% more likely to report they had asthma, and 20% more likely to report fair or poor health.

"The health consequences are real," Ziliak said. "Feeding people feeds their soul, it feeds their mental health, it feeds their physical health. We need to make sure we are doing our job."

Feeding people can also help them live longer. A study co-authored by Ziliak and published in Health Affairs found that people in the Supplemental Nuitrition Assistance Program (SNAP, formerly known as food stamps) have 1 to 2 percentage points less risk of mortality.

Ziliak noted that Kentucky leads the nation for the number of people between the ages of 50 and 59 who are food insecure, and said this is something that Kentucky should be paying attention to.

"It's a tidal wave coming, people," he said. "One in five of Kentuckians between the ages of 50 and 59 are food insecure. That's astounding. We lead the nation."

A recent report by the Kentucky Center for Economic Policy, "SNAP is Good for Kentuckians' Health," cited research showing that food-insecure seniors had roughly the same quality of life as someone 14 years older -- and that SNAP participation leads to a 30% reduction in the likelihood that seniors will cut back on needed medications. It also cited a 2018 study of older adults, which concluded that getting SNAP benefits was associated with a 14% reduction in hospitalization and a 10% reduction in emergency-room use.

"SNAP is a really important tool, not only in our anti-poverty, anti-hunger toolbox, but also in our public health toolbox. And I think we would do well to start thinking of that more as a public health program," Dustin Pugel, author of the report, told Kentucky Health News.

A 2018 federal report shows food-insecure households spend about 45% more ($6,100) on medical care in a year than people in food-secure households ($4,200). And currently, the health-care costs for food insecurity in Kentucky are more than $854 million.

What can be done?

Ziliak suggested several solutions, including making sure that the 65% of seniors who are eligible for SNAP but don't use it get signed up; making it easier for them to sign up for the program and stay on it; changing federal regulations to give seniors more SNAP benefits; and changing the rules so mobility-challenged seniors can use SNAP to buy prepared food, not just in grocery stores.

In Kentucky, SNAP recipients over 65 must re-certify every two years, but those under 65 must do so annually. In 2017, 63,000 Kentuckians over 60 years old participated in SNAP, according to KCEP.

Pugel noted that the U.S. Department of Agriculture wants to restrict people with modest savings from getting SNAP, which would result in fewer seniors qualifying for the program. "If what we're trying to do is reduce food insecurity and improve health, especially among seniors, then that is a harmful policy; that is counterproductive to those goals," he said.

Roger McCann, executive director at Community Action Kentucky, said he hopes society is moving to a time when people recognize that food insecurity and other social determinants, like transportation and housing, play a significant role in a person's health and that addressing those determinants should be part of a person's medical care. He said this holistic approach would result in better health outcomes for everyone.

For example, he said, just like a person gets a prescription for a test or a drug, patients should also get prescriptions to have healthy meals delivered to them as they recover from a procedure if they live alone. "If you don't eat, your're not healthy," he said. "It is as simple as that."

Others spoke at the conference about innovative ways to address seniors' food insecurity, including a university program in Ohio that has a congregate meal program on its campus, and a hospital in Owensboro that donates its extra food to create frozen home-delivery meals. Gadd spoke about the need to work across state agencies to find solutions and the need to consolidate resources and to create a centralized database to help people.

State Agriculture Commissioner Ryan Quarles told the crowd that he has been working on this issue for several years through his Kentucky Hunger Initiative, a first-of-its-kind program that involves farmers, charitable organizations, faith groups, community leaders and government entities. "It affects every county, every city and every community in Kentucky," he said.

The Aging and Disability Resource Center provides information and resources about aging and disability issues.

The home-delivered meal program was titled C2 by the Older Americans Act. This table shows the breakdown of federal and state funds for each area development district for fiscal 2019-20. The numbers do not reflect state administrative costs. The program is overseen by the state Department for Aging and Independent Living, which provided the table. (Click on it for a larger version.)

Nursing home's volunteer program disbands due to dwindling numbers; only 19% of Kentucky seniors volunteer, worst in U.S.

Sunrise Manor volunteers used money from fees to buy items that residents could use. Here, Tickle Ragland, second row at left, and Rebekah Okeson, second row at right, are pictured with some residents sporting sweatshirts the organization purchased as a Christmas gift for every resident.

After 38 years, a volunteer program at the Signature Healthcare nursing home in Hodgenville has disbanded, Ron Benningfield reports for the LaRue County Herald-News.

The Sunrise Manor Volunteers were known as the "Redcoats" for the jackets they wore, Benningfield reports, noting three of the program's earliest volunteers.

He writes that the volunteers helped the nursing-home residents with a wide range of things, from making sure they got to planned activities to polishing their nails -- but most importantly, they spent time with them.

“One of the most important roles, though, was just to be there to give them a hug, a pat on the back, and let them know you cared about them,” said Ruth Ann Brown, one of the early volunteers.

Volunteers also paid membership fees to purchase items for residents, including Christmas presents. “Some of the residents didn’t have any living family and some had no one to visit them, so we wanted to make sure that every one of them knew we hadn’t forgotten them,” longtime volunteeer LaDean Self told Benningfield.

The volunteers, dressed in their red jackets, also sat as a group at many residents' funerals or lined up outside the church or funeral home as a post-service honor guard for the deceased.

Ragland told Benningfield that the program was once voted the best nursing-home volunteer group in Kentucky, but its numbers have dwindled from more than 100 to less than 50, with only 16 attending the last membership meeting.

The seasoned volunteers told Benningfield that lack of time and a dwindling desire to help old, sick people were reasons for their dwindling numbers.

Sonya Turner, quality of life director at Sunrise Manor, told Benningfield that Signature has its own volunteer program, and volunteers are still needed. And "just to set the record straight," she said, the Redcoat group did not disband because of Signature.

Turner said, “Being a volunteer doesn’t mean every day--just an hour or two once a week would be a blessing. We all know that love is spelled T-I-M-E.”

Seniors make great volunteers

AARP, formerly known as the American Association of Retired Persons, recently released a report saying that volunteers should be recruited among seniors, largely because they have the time to do so.

AARP graphic

The online survey of 1,522 adults looked at the behaviors and interest surrounding adult volunteering activities. It found that adults 65 and older were more likely than younger adults to volunteer frequently, with 32 percent volunteering weekly and 20% doing it monthly.

Seniors also volunteered more hours on a regular basis than younger adults, at an average of 10 hours per month, compared to nine hours for those 18-34 and eight hours for those 35-64. The main reason given by seniors for not being able to volunteer was health problems.

Only 18.9% of Kentucky's seniors volunteer, worst in the nation, according to America's Health Rankings. Kentucky's seniors rank 49th in health.

The AARP survey found that 69% of adults in the U.S. volunteer in some capacity. Of those, 29% said they helped a person in need and 23% said they helped an elderly person, but only 6% said they volunteered in a clinic, hospital or health-care facility.

Younger adults cited time constraints as their main reason for not volunteering, with work (25%) and family (22%) listed as the top two reasons. Among all adults, 21% volunteer weekly and 24% monthly.

The survey noted that volunteers tend to be more optimistic and engaged in their communities than non-volunteers: 45% and 27%, respectively. Volunteers were much more likely than non-volunteers to read newspapers: 62% and 34%, respectively.

It also found that a personal connection or a personal request was the best way to find more volunteers, with 23% in the survey reporting they volunteered with an organization because they knew someone who volunteers with that organization.

That said, a challenge for nursing homes seeking volunteers is that about half of adults say they're looking for ways to volunteer that don't involve personal engagement. The survey found that 52 % were very or somewhat interested in volunteering from home and the same percentage were interested in only volunteering small increments of time.

Geriatric doctor offers tips for aging optimally; it's much-needed advice for Kentucky seniors, who rank 49th for seniors' health

Everydayhealth.com photo

As life expectancy for both men and women keeps rising, it's important to adopt a handful of healthy habits that include things like exercising and staying social to ensure that you "age optimally."

That was the main message of Dr. Christian Furman, a geriatric physician from Louisville, on an episode of "Kentucky Health" with Dr. Wayne Tuckson on Kentucky Educational Television, Patrick Reed reports for KET.

Furman is interim chief of internal medicine, palliative medicine and medical education at the University of Louisville. She is also medical director of U of L’s Institute for Sustainable Health and Optimal Aging.

She told Tuckson that while “geriatric” applies officially to those age 65 and older, the field of geriatrics provides much of its expertise around what she called the "older old," those over 80. She added that most people can stay with their primary-care physician until they are 75, but should consider switching over to a geriatric physician at that age.

As for tips on living a long life, Furman said her advice is to adhere to the habits that are responsible for good health in general. She also noted that those who follow a healthy lifestyle during their youth and middle age are more likely to have a high quality of life during their senior years.

Here are her tips for "optimal aging" as reported by Reed:

• Exercise: She said, “You don’t have to do major exercise, just move," which she said could involve walking around the neighborhood.
• Follow a well-balanced diet: This means eating a diet that is low in red meat, avoiding foods that are high in cholesterol, and eating more fruits and vegetables.
• Eliminate tobacco use.
• Adhere to only moderate alcohol intake.
• Stay socially engaged: Furman says research shows that social isolation has negative health effects. “It’s like smoking 15 cigarettes a day, which is a lot of cigarettes,” she says.
• Yearly physicals and preventive screenings: Furman encouraged seniors to keep up with their yearly doctor's visits and preventive screenings, such as mammograms and colonoscopies.
• Regularly re-visit the need for each of your medications: “There is research that shows, the more medications you take, the more problems you will have,” she said. “About five or six is the tipping point. Once you get to six medicines, you will have more side effects and adverse drug reactions and problems.”

Overall, Furman encouraged older folks to continue doing everything that they have always done that brings them pleasure and fulfillment, if they are able to -- including sexual relations, Reed writes.

“You want people to be sexually active,” she said. “Sometimes sexual activity is different for different people, sometimes it’s cuddling, being intimate through skin contact. Sometimes the actual intercourse is hard for older people, but it doesn’t have to be.”

Furman said the goal is to keep older folks as functionally independent as they can for as long as they can, recognizing that they will not be able to function at the same pace or intensity as they did when they were younger, Reed reports.

“They should still do the things they love, but take a rest,” Furman said. “Sit, recuperate, and get up and do it again. They can still cook dinner, or decorate for the holidays. But for people who used to decorate three rooms, three Christmas trees – well, just do one room, and one Christmas tree. Everything in moderation. It’s really very individualized, but it’s totally not based on their age.”

All of this advice is especially important for Kentucky seniors, who are among some of the most unhealthy seniors in the nation. According to the most recent America's Health Rankings Report, Kentucky ranks 49th for senior's health and has been in the bottom 10 states for this measure since 2013, the first year AHR did the report.

By 2030, the U.S. Census Bureau projects that one in every five people in the United States will be 65 or older and by 2035 older people are projected to outnumber children for the first time in U.S. history.

University of Louisville to hold free event in Oldham County on May 10 to discuss aging, pain management and addiction

Kaiser Health News photo

The University of Louisville Trager Institute will offer a free community event to discuss the dangers of medication misuse and addiction for older adults, alternative solutions to chronic pain management and advocacy for making alternative pain strategies accessible for older adults.

“There is often a stigma around talking about pain and pain management, in addition to lack of understanding of options beyond opioids,” Mona Huff, the institute's community organizer, said in a news release. “Good health starts with self-care and loving yourself. It means asking for help when you need it. Asking for help is not a sign of weakness, but rather a sign of strength.”

The event, "Reconciling Pain and Giving Hope to Seniors,” will be held Monday, May 13 from 10 a.m. to 3 p.m. at the John W. Black Community Center in Oldham County.

Lunch will be provided for those who RSVP to the symposium by May 7. For more information contact Mona Huff at 502-845-6849 or rjhuff01@louisville.edu.

This event is held in partnership with the Kentucky Coalition for Healthy Communities, Tri-County Community Action Partnership, Barren River Area Development District, and the Kentuckiana Regional Planning and Development District.

People with positive attitudes about aging live longer and have better health; Kentucky seniors' health is ranked 48th in nation

How you think about growing old can influence how well you age, says a growing body of scientific research and global data collected and analyzed by nonprofit journalism organization Orb Media. That's especially relevant in Kentucky, where seniors' health ranks 48th among the 50 states, according to America's Health Rankings.

"Individuals with a positive attitude towards old age are likely to live longer and in better health than those with a negative attitude. And those with a negative view of aging are more likely to suffer a heart attack, a stroke or die several years sooner," Jim Rendon and Olufemi Terry write for Orb. "Older people in countries with low levels of respect for the elderly are at risk for worse mental and physical health and higher levels of poverty."

Projected percentage of country population over 65 in 2050. Source: United
Nations World Population Prospects. (Orb Media graphic)

Why does it matter?

Orb reports that if population trends continue, by 2050 nearly one of six people in the world will be over 65, and close to half a billion will be older than 80. In 2050, seniors would make up nearly 16 percent of the world's population, compared to today's 8 percent.

In the U.S., the Census Bureau estimates that one in five people will be over the age of 65 by 2030, and by 2035, seniors will outnumber children younger than 18.

Those are the basic figures, reflecting quantity, but what about quality of life for those people? Research shows that a simple shift in attitude can make a difference in how well we age, especially in a world that often has negative views about growing older.

A World Health Organization analysis found that 60 percent of people surveyed across 57 countries reported relatively low levels of respect for older people. A separate Orb analysis found that the level of respect for seniors varied "significantly from country to country."

Of the 58 countries ranked in the Orb study -- in order of how they respect their elderly, with 1 being "very low" and 5 being "very high" -- the United States ranked 50th, scoring 3.29.

Becca Levy, a professor of epidemiology at the Yale School of Public Health, and a leading researcher in the field, has found "Those with positive views about old age live longer and age better," Orb reports. "They are less likely to be depressed or anxious, and they show increased well-being and recover more quickly from disability. They also are less likely to develop dementia and the markers of Alzheimer’s disease."

"In one study, Levy found that Americans with more positive views on aging who were tracked over decades lived 7.5 years longer than those with negative views," Orb reports, adding that studies in Germany and Australia have found similar results. In addition, other studies have shown that "the cells of those who have more positive views of the elderly actually aged more slowly than those who had negative views."

Levy told Orb that people with negative views of aging have higher levels of stress, which has been linked to a range of health problems. She added that those with more positive views of aging are also more likely to exercise, eat a balanced diet and go to the doctor. She also said people can decide for themselves how they think about aging, and that her research has found that people who who watch less TV, participate less in social media, and have more resistant personalities are more likely to hold more positive views of aging.

Ky.'s oldest working dentist, 97, dies; may have been U.S.'s oldest

Dr. J.M. Stephenson

Julius Middleton Stephenson, who was Kentucky's oldest working dentist, and may have been the oldest in the nation, died May 5 in Bowling Green. He practiced in the Cumberland River town of Burkesville, population 1,500.

Stephenson worked in his office as recently as March. He was a fixture at the state high school basketball tournament well into his 90s, and was secretary-treasurer of the South Central Kentucky Dental Society for 40 years. His son and daughter, who survive, are both dentists.

His funeral service will be held at 2 p.m. Wednesday at Burkesville First United Methodist Church with burial in Burkesville Cemetery with military honors. Flowers are welcome, but donations are encouraged to Lindsey Wilson College in Columbia.

Full disclosure: In his youth, the writer of this post was a patient of Dr. Stephenson.

Free symposium on aging and dementia has sessions for health industry at UK Nov. 3, general public at Lexington Center Nov. 4

Want to know more about Alzheimer's disease and other forms of dementia? The seventh annual Markesbery Symposium on Aging and Dementia offers opportunities for people in the health-care industry on Nov. 3 and for the general public on Nov. 4.

The scientific symposium and poster session will be held from 10 a.m. to 3 p.m. Friday, Nov. 3, in the Pavilion A Auditorium of the University of Kentucky's Albert B. Chandler Hospital.

The community session will be held from 8:30 to noon Saturday, Nov. 4, at the downtown Lexington Convention Center's Bluegrass Ballroom. It will include an "ask the experts" question-and-answer session, and a free continental breakfast.

Both sessions are sponsored by UK's Sanders-Brown Center on Aging, but registration for them is separate, at http://www.uky.edu/coa/.

Dr. Linda Van Eldik, director of the center, writes in the Lexington Herald-Leader, "Why do some people stay intellectually sharp into their 90s, while others have memory problems? Is there anything we can learn from their lifestyles that can help everyone age successfully? Typically we focus on who gets dementia and why, but we can learn just as much from the people who don’t get Alzheimer’s." She mentions the two keynote speakers:

▪  Dr. Claudia Kawas of the 90+ Study follows the fastest-growing age group in the U.S.: “the oldest old.” Dr. Kawas appeared in a 2014 “60 Minutes” episode called Living to 90 and Beyond that explored the secrets to a long and happy life.
▪  Rachel Whitmer, a national expert on risk factors for dementia, including obesity and diabetes. Dr. Whitmer was also featured on “60 Minutes” in a 2016 story about an extended family in Colombia with a genetic mutation that causes Alzheimer’s disease.

"Dementia is a disease, not an inevitable part of aging," Van Eldik writes. "There is much you can do to reduce your risk of getting Alzheimer’s or other dementias. "Information at the Markesbery Symposium will empower you to take control of your life and maximize your ability to age successfully."

Cabinet for Health and Family Services promotes health and wellness at state fair, and collects duffel bags for foster kids

helpourkidsinc.org

The Kentucky State Fair is not just a great place to support Kentucky's agriculture or to spend the day on the midway; it's also a great place to learn about some of the state's health and wellness initiatives and to donate a new duffel bag or backpack to a foster child.

“Often times, when children are removed from their home and placed into state care, all their belongings are literally stuffed into a black garbage bag,” Health Secretary Vickie Yates Brown Glisson said in a news release. "This effort changes that. Donating a duffel bag or backpack is a small but meaningful way to help foster children and give them the dignity of carrying their possessions in a new bag that is all their own.”

New duffel bags and backpacks will be collected at the Cabinet for Health and Family Services' exhibit in the Health Horizons area of the South Wing B. The fair runs through Aug. 27 at the Kentucky Exposition Center in Louisville.

The cabinet's exhibit will offer daily interactive displays that features learning activities for children and adults, free health screenings and on-site health educators who can speak to individuals about wellness and prevention. It will also offer free dental screenings for children with signed consents who are entering public school kindergarten or first grade from 10 a.m. to 2 p.m. daily.

In addition to these daily health initiatives, they will also have special "focus days," including:

• Tuesday, Aug. 22: Services for Seniors, including Adult Protective Services, Aging and Independent Living/Long Term Care Ombudsman, and the Kentucky Prescription Assistance Program
• Wednesday, Aug. 23: Focus on Foster Care and Adoption, 10 a.m. to noon
• Thursday, Aug. 24: Focus on Zika Education and Mosquito Control, 10 a.m. to noon
• Friday, Aug. 25: Focus on Substance Use Disorder Strategies and Services, 10 a.m. to noon

Exhibit buildings are open daily from 9 a.m. to 9 p.m. Sunday through Thursday and until 10 p.m. Friday and Saturday. Admission at the gate is $10 for adults, seniors and children; free for children 5 years and under. Parking at the gate is $10 per car.

Vigorous exercise keeps aging cells biologically younger, but resistance training is what may help seniors stay in their homes

Everyday Health

By Melissa Patrick
Kentucky Health News

If you are willing to exercise regularly at a "high level," you may be able to slow down the aging process in your cells, according to a study.

"Just because you're 40 doesn't mean you're 40 years old biologically," Larry Tucker, a professor of exercise science at Brigham Young University, said in a BYU news release. "We all know people that seem younger than their actual age. The more physically active we are, the less biological aging takes place in our bodies."

The study, to be published in the journal Preventive Medicine, found that "People who have consistently high levels of physical activity have significantly longer telomeres than those who have sedentary lifestyles, as well as those who are moderately active."

Telomeres are tiny caps on the ends of human chromosomes that protect them from deterioration and progressively shorten with age. They are often compared to the plastic tip on the end of a shoelace that keeps your shoelace from fraying.

Researchers analyzed data from more than 5,800 adults in a multi-year Centers for Disease Control and Prevention survey and found that the adults with high physical activity levels had telomeres that were biologically nine years younger than the adults who were sedentary, and seven years younger than those who were moderately active. High activity was defined as 30 minutes of jogging a day for women and 40 minutes a day for men, five days a week.

The study found that there was "no significant difference in telomere length between those with low or moderate physical activity and the sedentary people," says the release.

"If you want to see a real difference in slowing your biological aging, it appears that a little exercise won't cut it. You have to work out regularly at high levels," Tucker said.

The release notes that it is not yet known how exercise preserves telomeres, but researchers think it may be tied to inflammation and oxidative stress, which exercise is known to suppress. "We know that regular physical activity helps to reduce mortality and prolong life, and now we know part of that advantage may be due to the preservation of telomeres," Tucker said.

A similar study at the University of California San Diego that analyzed telomere length and activity levels in 1,500 older women found that older women who had less than 40 minutes of moderate-to-vigorous physical activity per day and were sedentary for more than 10 hours a day were biologically eight years older than women in the study who were more active.

Resistance training could help keep seniors in their homes

National Institute on Aging

Another study found the best exercise for seniors to help them live independently includes some resistance training because "a decline in muscle strength due to age and a sedentary lifestyle is often what undermines older adults' ability to live independently," says an Indiana University news release.

"Exercise, in general, is good for older people," said Chiung-ju "CJ" Liu, an associate professor in the School of Health and Rehabilitation Sciences at Indiana University-Purdue University Indianapolis. "It's good for their health and good for their independence. But when we were helping older people become more independent, just exercise didn't seem so efficient."

With the goal of helping older people remain independent, Liu, an occupational therapist, created a 10-week "3-Step Workout for Life" exercise program that uses what people already had in their homes to do the exercises. And the exercises were always able to link back to senior's daily living activities.

The first step in the program involves resistance exercises like bicep curls; the second step links these exercises to the participant's activities of daily living; and the third step challenges the senior to increase their resistance activities.

Liu's study found that "the results at the end of the 10-week three-step workout program were similar to that of a 10-week resistance-only exercise program.But older adults retained the benefits of the 3-Step Workout for Life when they were tested six months later, while the benefits of the resistance exercise program had significantly decreased."

Click here for some strength exercises for seniors that can be done at home.

Study says older adults with arthritis need 45 minutes of moderate activity per week, much less than federal guidelines recommend

Daily Mail photo

Older adults with arthritis need 45 minutes of "moderate activity" a week to maintain functional independence, a study has concluded.

That's about one-third the amount called for by federal guidelines, which say people need 150 minutes of moderate activity per week. Only one in 10 older Americans with arthritis in their knees meet that guideline, says the news release from Northwestern University, where the research was conducted.

“Even a little activity is better than none,” Dorothy Dunlop, the study's lead author, said in the release. “For those older people suffering from arthritis who are minimally active, a 45-minute minimum might feel more realistic.” Researchers said more than 20 minutes of exercise a day is "daunting" for people as they age, especially with arthritis.

The study found that approximately one-third of people in the study improved or had higher function after two years of increased exercise, and those who had at least 45 minutes of moderate activity, like brisk walking, had the best results: 80 percent of them were more likely to improve or sustain a high level of functioning over two years, compared to those who did less.

The study, published online in the journal Arthritis Care & Research, used movement-monitoring equipment to measure the physical activity of 1,600 adults who had pain, aching or stiffness in their bones, knees or feet.

The federal guidelines say 150 minutes a week of moderate activity, in sessions last at least 10 minutes, is good for cardiovascular health. This study found that if the goal is to maintain functionality, the 45 suggested minutes of moderate activity could be spread out and did not have to be done in 10-minute sessions.

“We’re looking for an older population who can be functionally independent,” Dunlop said. “And we were interested in seeing what kind of physical activity might be beneficial to promote good function down the road. We found moderate-intensity activity rather than light activity, such as pushing a grocery cart, to be more valuable to promote future function.”

Apollo 8 and 13 astronaut Jim Lovell to speak at UK Center on Aging Foundation's annual fund-raising dinner April 7

Capt. Jim Lovell

Apollo 8 and 13 astronaut Jim Lovell will be the keynote speaker at the University of Kentucky Center on Aging Foundation annual dinner at the Lexington Center's Bluegrass Ballroom April 7. Proceeds from the event will support Alzheimer's disease research, education and clinical programs at the center.

Lovell, 87, is best known for his calm, careful command of his final space flight to the moon on Apollo 13 in 1970 when he reiterated those famous words, "Houston, we've had a problem." This happened after an explosion two days into the flight caused the mission to be aborted and Lovell and his crew had to convert their lunar module "Aquarius" into a lifeboat to get home safely.

Lovell was the pilot on Gemini 7, which involved the first manned spacecraft rendezvous; commander of Gemini 12; and command module pilot of Apollo 8, the first manned mission to orbit the moon. Lovell and his two crewmates gave humans their first long-range view of our planet and read a passage from the creation story in Genesis on Christmas Eve.

Individual tickets to the event are $175 and table sponsorships start at $1,500. For more information contact the foundation office at 859-323-5374 or click here for more information.

U of L gets grant for care for seniors, Alzheimer's and Hispanics in Barren, Hart, Metcalfe, Bullitt, Shelby and Henry counties

The U.S. Department of Health and Human Services has awarded the Institute for Sustainable Health & Optimal Aging at the University of Louisville $2.55 million to create the Kentucky Rural & Underserved Geriatric Interprofessional Program.

The three-year initiative will include partnering organizations from six rural counties: Hart, Metcalfe and Barren in Southern Kentucky; and Bullitt, Henry and Shelby, counties in the Louisville metropolitan area with large rural populations.

The project will addresses the shortage of workers in geriatric and primary care, the need to train health-care providers for culturally appropriate services to Kentucky’s growing Hispanic population, the need to decrease the chronic disease burden in rural Kentucky, the lack of supportive environments to promote health among seniors, and the need for supportive education and resources in Alzheimer’s disease and related dementias.

The institute, created in 2014, will develop an interprofessional education center for geriatric education for students and professionals in medicine, nursing, social work, dentistry, pharmacy, community health and law; help primary care sites deliver integrated patient-centered geriatric primary care; and provide training and community engagement resources for Alzheimer's and other dementias in the six counties.

“This project is unique in its integration of community health teams and mental health specialists within geriatric primary care delivery systems,” Institute Executive Director Anna Faul said in a press release. “We are going to use a systemic approach of collaborative care and develop an inter-agency consortium that strengthen the links among related services for older adults.”

Partner sites in the first year will be Glasgow Family Medicine Clinic serving Barren, Hart and Metcalfe counties; Shelby Family Medicine and Mercy Medical in Shelby County; Kentucky River Medical Partners in Henry County and UofL Geriatrics Home Care Practice in Bullitt County.

'Mind Matters' Health Fair in Lexington May 18 will focus on brain and nutrition; famous chef will make free "brain healthy" food

Ouita Michel

Nationally known Bluegrass chef Ouita Michel of Midway, who owns seven Lexington-area eateries, will be cooking up free "brain healthy" food at the seventh annual "Mind Matters" Health Fair Monday, May 18 at the Fayette County Extension Office, 1140 Red Mile Place, Lexington.

The fair, sponsored by the University of Kentucky's Sanders-Brown Center on Aging, will run from 10 a.m. to 2 p.m. Its focus of this year is proper nutrition for a healthy brain, providing information on how diet can help promote healthy brain aging and prevent age-related brain disease.

In addition to Michel's free "brain healthy" food, the event will also feature interactive exhibits, health and memory screenings, and presentations about healthy brain aging, Alzheimer's and music therapy.

The event is free and open to the public. For more information contact Sarah Tarrant at (859) 323-1331.