{"id":119743,"date":"2024-02-20T15:45:00","date_gmt":"2024-02-20T20:45:00","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/camed\/?p=119743"},"modified":"2024-02-20T15:45:00","modified_gmt":"2024-02-20T20:45:00","slug":"symposium-examines-resiliency-in-aging","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2024\/02\/20\/symposium-examines-resiliency-in-aging\/","title":{"rendered":"Symposium Examines Resiliency in Aging"},"content":{"rendered":"

There is no magic formula to a long, healthy life, concluded panelists at an online symposium, Resiliency in Aging, held Thursday, Feb. 15. Instead, longevity is a combination of genetics, healthy living and positive aging, and effective interactions with healthcare.<\/p>\n

\"thomas
Thomas Perls<\/figcaption><\/figure>\n

\u201cAging is very complicated, with many, many different biological mechanisms and interactions with environmental factors at play\u2026so there isn\u2019t one answer,\u201d said Resiliency in Aging panelist Thomas Perls<\/a>, MD, MPH, FACP, professor of medicine and founder and director of the New England Centenarian Study<\/a>.<\/p>\n

Perls summarized the major determinants of longevity according to his acronym SAGEING: Sleep; Attitude, especially optimism and managing stress; Genetics, including a review of family history to screen and prevent potential familial health issues; Exercise, especially strength training for older people; Interests, nurture new and cognitively challenging interests to build cognitive resilience; Nutrition, to be at a healthy weight and minimize red meat; and, Get rid of smoking and anti-aging quackery.<\/p>\n

\u201cNo testosterone, no human growth hormone and a slew of other nostrums that hucksters try to sell that do not work and are more than likely bad for you,\u201d said Perls.<\/p>\n

\"Head
Hollis Day<\/figcaption><\/figure>\n

Attended by nearly 140 people, the virtual symposium was introduced by medical school Dean and BUMC Provost Karen Antman, MD, and was moderated by Hollis Day<\/a>, MD, MS, MHPE, associate professor of medicine and chief of geriatrics at Medical Center (BMC). Along with Perls, panelists included Lisa Caruso<\/a>, MD, MPH, associate professor of medicine and vice chair of quality and patient safety at BMC; Lewina Lee<\/a>, PhD, associate professor of psychiatry and an investigator at the National Center for PTSD based at VA Boston Healthcare System.<\/p>\n

Day noted there is a shortage of geriatricians (primary care doctors with specialized training in treating older patients). There are currently just 7,300 board-certified geriatricians, but with an aging U.S. population, an estimated 30,000 will be needed over the coming decade. Day said BU is helping to fill that gap.<\/p>\n

\u201cBU is a genuine national leader. The required fourth-year geriatrics clerkship is the envy of many of my colleagues across the country,\u201d said Day, who praised the longest-standing home care program in the United States that has medical students accompany geriatrics faculty on home visits to patients and instills in students the importance of social determinants of health.<\/p>\n

\u201cGoing to a home really helps us all understand why our older patients, and their younger family members, may or may not be resilient,\u201d said Day.<\/p>\n

\"Headshot
Lewina Lee<\/figcaption><\/figure>\n

Lee pointed out that while the human lifespan is becoming longer, that does not necessarily translate into more years in good health as medical science gets better at acute interventions to save lives. The more desirable outcome is to increase the number of years in good health and spend fewer years with disease and disability.<\/p>\n

While primary, secondary and tertiary intervention can delay the onset of disability, frailty and diseases, Lee emphasized the importance of \u201cgoing upstream\u201d through primordial interventions that tackle risk factors and pathological processes before disease onset. She described a study that demonstrated having greater socioeconomic resources and fewer stressors in early life could foster an optimistic outlook, which in turn was associated with longevity. In another study based on two large cohorts for up to 30 years, \u201cthe most optimistic men and women had 1.5 to 1.7 times greater odds of living beyond age 85 than the least optimistic individuals,\u201d said Lee.<\/p>\n

Perls said that many of the behaviors highlighted by the SAGEING acronym are emulated by Seventh Day Adventists who as a result have an average life expectancy of close to 90 years. \u00a0The Centenarian Study shows, however, that living well beyond 90 and into the early hundreds likely involves combinations of protective genes, each with individually modest effects, but in the right combination they can have a strong effect.<\/p>\n

\u201cAbout 75% of the variation in survival to around age 90 is due to differences in health-related behaviors. Getting to 105 and older probably entails the opposite, where 75% of the variation in survival is because of these relatively rare genetic signatures,\u201d said Perls.<\/p>\n

Perls said the Centenarian Study also is looking at individuals who have cognitive function that meets the norms of people 30 years younger. They are called cognitive . Additional studies of these individuals include brain MRI scans and gene expression studies on samples from post-mortem donated brains. One particularly interesting study, done in collaboration with Associate Professor of Medicine George Murphy, PhD, at the BU-BMC Center for Regenerative Medicine, uses pluripotent stem cells derived from blood samples to figure out the biological mechanisms underlying centenarian resiliency against aging-related diseases like Alzheimer\u2019s.<\/p>\n

While some older adults may have the genetics and lifestyle to avoid hospitals and nursing homes, others are not as fortunate.<\/p>\n

\"Headshot
Lisa Causo<\/figcaption><\/figure>\n

\u201cIt\u2019s going to be inevitable,\u201d said Caruso. \u201cI\u2019ve spent my career caring for older adults in one of the most dangerous, precarious health care settings for them, which is the hospital\u2026We (geriatricians) try to eliminate or minimize stressors so that they can more readily rely upon their reserves to get through what put them in the hospital in the first place.\u201d<\/p>\n

Caruso said there are evidence-based interventions to accomplish that, and pointed to what she calls the \u201c4 M\u2019s\u201d: What Matters, Medication, Mentation and Mobility.<\/p>\n

\u201cFor What Matters, prioritize care decisions to what matters most to the patient,\u201d she explained. \u201cFor medication, proactively look at medication lists and eliminate those with bad side effects. For mentation, prevent, identify, treat and manage as optimally as possible cognitive issues like dementia, depression and delirium. And finally, for mobility, ensure that older adults move safely every day to maintain function.\u201d<\/p>\n

One-quarter of BMC admissions are patients over age 65, approximately 400 per month, and the geriatricians helped the hospital take an interdisciplinary approach \u2013 with pharmacists reviewing medications, nurses trained to perform assessments for confusion and a delirium prevention and care plan, and a team performing mobility assessments with a daily mobility goal.<\/p>\n

\u201cIt\u2019s taken a village to care for older adults in the hospital,\u201d said Caruso.<\/p>\n","protected":false},"excerpt":{"rendered":"

Longevity is a combination of genetics, healthy living, positive aging and effective interactions with healthcare.<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[124,91],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/119743"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=119743"}],"version-history":[{"count":1,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/119743\/revisions"}],"predecessor-version":[{"id":119744,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/119743\/revisions\/119744"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=119743"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=119743"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=119743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}