Monday December 02 2019
Brushing your teeth regularly not only gives you a brilliant smile but can also reduce your risk of suffering from heart failure, a study suggests.
The NHS recommends brushing twice a day for healthy teeth and gums, but researchers have found that at least three times per day provides the biggest boost to your heart health.
The study examined the health of 161,286 people on the South Korean national health insurance system aged between 40 and 79. None had any history of atrial fibrillation — an irregular or abnormally fast heartbeat — or heart failure.
Researchers looked at their height, weight, illness history, oral health and tooth brushing habits. The subjects were given a routine health check in 2003 or 2004 and their progress was followed for ten and a half years on average. Three per cent went on to develop atrial fibrillation and 4.9 per cent had heart failure.
The study found that teeth brushing three or more times a day was associated with a 10 per cent lower risk of atrial fibrillation and a 12 per cent lower risk of heart failure.
These findings were independent of other factors, including age, alcohol consumption and exercise levels.
It is believed that poor oral hygiene can lead to more bacteria in the blood. This can cause inflammation, the body’s defence mechanism as it seeks to battle the bacteria. Although this is crucial in the healing process, long-term inflammation can irritate key pathways in the body, affecting the cardiovascular system and the brain.
The researchers said: “One possibility is that frequent tooth brushing reduces bacteria in the subgingival biofilm — bacteria living in the pocket between the teeth and gums — thereby preventing translocation to the bloodstream.”
Dr Tae-Jin Song of Ewha Womans University in Seoul said the study showed only a possible link and dentists should not start recommending tooth brushing for a healthier heart.
“While the role of inflammation in the occurrence of cardiovascular disease is becoming more evident, intervention studies are needed to define strategies of public health importance,” he said.
The study is published in the European Journal of Preventive Cardiology.
Gum disease has also been linked to a higher risk of Alzheimer’s disease.
November 27 2019
Drinking up to four coffees a day can significantly reduce the risk of type 2 diabetes, high blood pressure and obesity, according to a study.
Even decaffeinated coffee gave the health boost, researchers said, though the effect from either type disappeared after four cups. The team from the universities of Navarre in Spain and Catania in Italy found that there was an “association between coffee consumption and a decreased risk of type 2 diabetes” and added that “long-term coffee consumption is associated with a decreased risk of hypertension”.
They analysed existing studies on the link between coffee consumption and metabolic syndrome, which affects one in four adults. It is described by the NHS as a “particularly dangerous” combination of diabetes, high blood pressure and obesity, which raises the risk of heart disease and strokes.
Estefania Toledo, of Navarre University and Ciberobn, a Spanish biomedical centre, said the analysis showed that moderate coffee consumption could reduce the risk by 26 per cent on average, and the actual effect could range between 2 per cent and 44 per cent.
She said that all coffee, caffeinated or not, contained “compounds that may also have beneficial effects on health, including polyphenols, trigonelline and melanoidins”, all thought to have antioxidant or anti-inflammatory qualities.
Other studies have suggested that tea, particularly green tea, can help to alleviate metabolic syndrome.
The researchers, who were independent but were commissioned by the Institute for Scientific Information on Coffee, a body funded by coffee companies, said: “Further research is required to clarify the associations between coffee and metabolic syndrome.”
Consumer Affairs Correspondent | Sascha O’Sullivan
November 23 2019
Tens of thousands of families have seen their inheritances decimated after elderly relatives paid inflated prices for new retirement homes that have collapsed in value, an investigation by The Times has found.
Prices of retirement flats in developments built by some of Britain’s biggest housebuilders have plummeted by up to 90 per cent in the face of costly annual management charges and ground rents.
Analysis of Land Registry data suggests that £3 billion could have been wiped from the value of retirement homes built between 2001 and 2015. In one case, a flat bought for £197,000 in 2009 from builder McCarthy & Stone, a FTSE 250 company, was sold for only £26,000 six years later.
The owner, Miriam Savage, was paying £8,200 a year in service charges and ground rent to the managing agent.
The losses often become apparent to families only when their loved ones die and they try to sell their home. There are 150,000 retirement flats in the UK. They don’t have full-time nurses but most have communal areas and features to help residents live independently.
There is often 24-hour telephone support or wardens on site.
The properties are sold as leaseholds with the freeholds bought by the highest bidder. The freeholder collects an annual ground rent and appoints an agent to run the development. These companies have been accused of levying excessive fees and charges and leaving facilities to fall into disrepair.
Sebastian O’Kelly, of betterretirementhousing.com, said: “These flats routinely plummet in value and the reason is the leasehold system. The freeholder and property manager still get their ground rent and service fees irrespective of price. It’s deplorable that families are pouring money into these purchases, often in desperation, only to see their value evaporate.”
Retirement home builders say the value of the properties is not just financial. They say they reduce loneliness and the burden of maintenance and increase safety and security. McCarthy & Stone points out that since 2010 it has not allowed outside companies to manage its sites and this is protecting values.
Some families have concerns about how properties are sold. One complained that a 88-year-old relative was sold a flat while her daughter was on holiday. When the woman died, the flat wouldn’t sell. Land Registry data shows the average loss of value for flats in the block is £74,000.
The Times looked at nearly 500 retirement flats in 15 developments built between 2001 and 2015. Almost 80 per cent of the homes sold since their first purchase had fallen in value with an average loss of £38,846. The analysis suggests that flats built since 2010 have fared better with only 37 per cent experiencing losses. But one McCarthy & Stone flat built in 2015 lost £45,000 in value when it was sold this year. In the past four years McCarthy & Stone has made profits of £383 million.
Mr O’Kelly said: “The situation may be improving as builders move to being service providers but these companies successfully lobbied government to retain ground rents on retirement sites, which doesn’t encourage the belief they have a long-term interest.”
This week Churchill Retirement Homes donated £150,000 to the Tories. The company is run by Spencer and Clinton McCarthy, the sons of John McCarthy, the co-founder of McCarthy & Stone. There is no suggestion that the donation was linked to the decision to exempt retirement home providers from a ban on ground rents. Spencer and Clinton McCarthy have been Tory supporters for ten years.
The industry says the sale of freeholds funds communal areas and without this system flats would cost more.
Sources at McCarthy & Stone insist it is a different company to the one that developed homes pre-2010. FirstPort is responsible for maintaining the developments built before 2010. It said that nine out of 10 customers say its properties improve their quality of life. It added: “Independent research by the Elderly Accommodation Counsel in 2019 found that new retirement properties typically increase in value. The vast majority of our managed properties increase in price on resale and they are more than just places to live.”
November 14 2019
Breathing in tiny particles of air pollution has been linked to an increased risk of brain cancer for the first time.
Research suggests that scores of brain tumours could be prevented in British cities if steps are taken to reduce levels of ultrafine particles (UFPs), commonly emitted by motor traffic and particularly diesel vehicles. Those living in the most heavily polluted areas may have a 50 per cent higher risk of developing brain cancer than those living in areas with fewer nanoparticles of pollution in the air.
Previous reports have found that these ultrafine pollutants are so small, at less than a tenth of a micrometre across, that they can make their way to the brain in “abundant” numbers.
Researchers have now measured the number of these ultrafine particles per cubic centimetre of air and found that every increase by 10,000 particles per cubic centimetre (cc) — the difference between a quiet and busy city street — is linked to one extra case of brain cancer per 100,000 residents.
Those living in areas with 50,000 particles per cc, a level commonly seen in major cities, have a 50 per cent higher risk of developing brain cancer compared with those living in quieter areas with 15,000. Across a city of millions it could lead to scores of extra tumours.
Researchers in Canada mapped the concentrations of ultrafine particles across Toronto and Montreal, finding that levels ranged between 6,000 and 97,000 particles per cc. They married this with census data, providing a sample of 1.9 million people whose medical records and air pollution exposure was tracked from 1991 to 2016. In total 1,400 tumours were identified that correlated with levels of pollution. The study could not prove that the pollution directly caused the tumours but concluded that increased levels of exposure to ultrafine particles correlated with greater odds of developing brain cancer.
The study, published in Epidemiology, concluded: “Ambient UFPs may represent a previously unrecognised risk factor for incident brain tumours in adults. Future studies should aim to replicate these results given the high prevalence of UFP exposures in urban areas.”
In a separate study, scientists from 35 universities warned that climate change and air pollution threatened lifelong damage to the health of children born today. The report, in The Lancet, said that pollution stunted lung development and could harm mental health.
November 22 2019
Half of women will provide unpaid support for a loved one by the time they reach their mid-forties, according to a report on caring.
They are also likely, on average, to take on caring responsibilities for an older, sick or disabled relative a decade earlier than men. Research shows that half of women will have caring responsibilities by the age of 46, compared with the average of 57 for men.
Overall, the research found that two thirds of adults in the UK can expect to become an unpaid carer during their lifetimes.
Helen Walker, chief executive of Carers UK, said: “Many of us don’t expect to become an unpaid carer but the reality is two in three of us will do it in our lifetimes.
“Our research shows women are disproportionately affected, facing difficult decisions about their loved ones’ health, family finances and how best to combine paid work and care more than a decade earlier than men.”
She called on the next government to ensure that the “gender gap” in caring responsibilities is addressed by giving carers the right to five to ten days paid care leave.
Researchers from Sheffield and Birmingham universities analysed data from 2001 to 2018 which showed that 65 per cent of adults had provided unpaid care for a loved one.
Women had a 70 per cent chance of becoming a carer while men stood at 60 per cent, according to the report entitled Will I Care. By the time they were 46, half of women had been a carer, the researchers found, while with men, it was not until they reached the age of 57 that they had the same 50-50 chance of being a carer.
Most carers were middle-aged — almost half (46 per cent) aged 46 to 65 — and the average person had a 50-50 chance of becoming a carer by the age of 50, the report said.
Of those working carers providing care for 50 hours or more a week, about 40 per cent were in semi-routine or routine occupations and 30 per cent in management and professional jobs.
Sue Yeandle, one of the authors of the report, said:“Caring is vital for us all and a precious support for those we love at critical times. Provided by millions of women, care also features strongly in the lives of men. Yet too often carers pay a heavy price for the support they give — financial strain, poorer health, social isolation.”
Separate research by Carers UK found that there were significant financial and emotional consequences for caring without support.
About half of those caring more than 50 hours a week said their finances had been negatively affected by their duties, 52 per cent said they had suffered poorer physical health and 77 per cent said they were suffering from stress and anxiety.
An Office for National Statistics report published earlier this year said that as people lived longer, they were increasingly likely to have a living parent and a grandchild. It said that in 2016, informal adult care was valued at £59.5 billion a year, with about two million adults in the UK receiving care.
The ONS said there was still an expectation in society for women rather than men to take on caregiving roles.
Most of the care that men provide is to their spouse or parents, whereas women are more likely to provide care to a broader range of people including non-relatives, the body added.
November 13 2019
You can’t put a price on nature. You can’t quantify the uplifting effects of a walk in the Peak District or the way your soul soars at the sight of a stormy Cornish cliff.
Except, it turns out you can: it’s worth almost £5 trillion a year. Economists have calculated the mental health benefits of the world’s national parks, and concluded that on this measure alone they provide services amounting to a significant proportion of global GDP. And that is before you consider all the other environmental services they offer.
From the smooth cliffs of Yosemite to the jagged glaciers of Chamonix to the wild fenland of East Anglia, protected spaces improve our mood, reduce our work absences and keep us well. By quantifying the magnitude of this effect in Australia then using the tools of health economics to place a monetary value on it, researchers were able to extrapolate what they called a “conservative” global estimate of £4.67 trillion.
“Nature exposure improves human mental health and wellbeing,” the team from Griffith University, Australia, wrote. “Poor mental health imposes major costs on human economies. Therefore, parks have an additional economic value through the mental health of visitors.”
As unromantic as it sounds, economists believe that until nature has a value on a balance sheet it can be depleted and exploited without penalty. In recent years researchers have looked to calculate the value of the natural world in, for instance, flood protection, pollination and climate control.
The analysis, published in the journal Nature Communications, extended this further to consider mental health. The researchers looked at the improvement in wellbeing in 20,000 Australians that was attributable to visiting national parks, then translated this into quality adjusted life years, which is a measure of how easily people can live their lives. Finally, they extended the calculation to the world.
Dieter Helm, a University of Oxford economist who was appointed by the government to value Britain’s “natural capital”, has said in the past that figures such as these are by necessity imprecise, but not considering them in natural accounts is “precisely wrong”. He welcomed the new research.
“This is another bit in the mounting pile of evidence highlighting the huge health benefits, both mental and physical, from nature,” he said. There are great economic gains from investing in natural capital . . . It should be a major priority for the Treasury. It is not just concrete infrastructure that matters: green infrastructure has some of the highest returns.”
November 12 2019
At the age of 85 most catwalk models are content to look back on their careers without the need to strike a pose for demanding fashion shoots.
Leslie MacLennan believed that her modelling days were firmly behind her until a photographer whose work has appeared in Vogue chanced upon her while visiting another resident at her care home.
Mrs MacLennan rose to prominence in the 1950s and 1960s, when in her early twenties she worked for Yves Saint Laurent while he was finding his way as a designer. She continued to work with him as he led the fashion house Dior, posing for photographers and on the catwalk.
As she became frail in old age she settled down to life at Huntington House, a care home in Hindhead, Surrey, where she encountered a guest who happened to be a fashion photographer.
James Muller, who has worked for Vogue Italia and Elle, was immediately struck by her “beautiful hands and the way she carries herself”.
She told him about her modelling days, prompting him to ask her to revive her career for a photoshoot at an artist’s house.
Mrs MacLennan said that it had been her hands that prompted her mother to persuade her to see a modelling agent.
“It sounds crazy, doesn’t it?” she told The Times. “[The agent] advised me to have a training course. I don’t remember my first assignment. I would do anything they gave me.”
She moved to London and then to Paris, where her looks meant that she was in demand. She described Saint Laurent as a lovely man and working for Dior as a pleasure despite one occasion when they threatened her with legal action.
“They were going to sue me because I got so bored one day that I went along to Givenchy. They said they would sue me for seeing both collections. I wanted to see if I could [work for Givenchy]. Everybody wanted to.”
She said that she was scared by the threat and quickly returned to Dior.
Mr Muller, who is based in Farnham, Surrey, said that he wanted to capture her “poise and class” and arranged a fashion shoot more than 60 years after her career began.
“I met Leslie in passing and thought how amazing it would be to capture her beauty again,” he said. “When I asked her to look my way or turn her face, she did it with such grace — an absolute professional. She was very easy to direct.
“I kept wanting to bring her beautiful hands in to the frame and every time I asked her to, she did so with poise. I feel very honoured to have photographed Leslie. She has lived such a colourful life and to be a small part of it is magical. She’s an absolute delight.”
He said that Mrs MacLennan had held his hand at the end of the shoot and told him how much she had enjoyed working with him. “I was truly touched and will never forget that moment. This is something that will stay with me forever, something I’ll treasure.”
She said later that it had not all been smooth during the shoot. “That was wonderful, although it turned out to be rather a disappointment for me because the house was supposed to be beautiful but it wasn’t, it was shabby — cats everywhere.”
Many of those who live at the care home suffer from dementia, which carers said was alleviated by having “something that motivates [which] can have huge benefits for their wellbeing and state of mind”.
Photographs of Mrs MacLennan at the peak of her career show her modelling glamorous coats and large, furry hats.
Her recent modelling assignment included wearing a red and black Chinese print gown.
She said that Mr Muller had come up to the standards she expected in a photographer. “The red and black outfit was so vibrant, it was stunning. I just thought it was a dream.
“James made me feel perfectly at ease, he was the real McCoy. I would have said so if he wasn’t.”
November 14 2019
At the age of 85, Jeanne Calmet took up fencing. When she celebrated her 100th birthday, the Frenchwoman was still cycling. At 117, mindful of her health, she quit smoking. Maybe she should not have bothered; she died five years later in 1997.
Among people who live past 110 her story, one of unnaturally good health right up until death, is not unusual.
Now scientists may have unravelled the secret of not just the lifespan of this rarefied group but also their health span, showing that extremely long-lived people may have very different immune systems to the rest of us.
Researchers who study these people, known as supercentenarians, consistently report the same findings — they do not just live longer, they die healthier.
People who reach 110 are generally unafflicted by the protracted ill health, cancer, dementia and other conditions considered to be markers of old age.
Now a paper in the journal Proceedings of the National Academy of Sciences has analysed the immune systems of seven of them, in an attempt to see how they do it.
“Supercentenarians are endowed with high resistance to lethal diseases such as cancer, stroke and cardiovascular disease,” Kosuke Hashimoto, from the Riken Centre for Integrative Medical Science in Yokohama, Japan, said.
“Exceptionally long-lived people such as supercentenarians tend to spend their entire lives in good health, implying that their immune system remains active to protect against infections and tumours.”
The sample size was inevitably low — at any one time there are fewer than 100 verified supercentenarians in the world — but the difference that the researchers found compared with younger people was marked.
There was a highly unusual signature in a particular type of immune cell, called CD4+ T-cells in their blood. Normally, these perform a “helper” role, activating other cells. In the supercentenarians, 4 to 5 times as many of them were found to instead have a cytoxic role, meaning that they directly attacked cancer and invading viruses themselves. “The findings suggest how the immune system of supercentenarians might protect against viral infections and tumour development to confer exceptional longevity,” Dr Hashimoto said. Scientists now want to see if this information can be used to help us all. “If we can find the link between the immune system and ageing and longevity, we may be able to contribute to prolonging healthy life expectancies.”
Teams around the world have been trying to understand what it is that makes supercentenarians special. James Clement, from the Supercentenarian Research Study, has travelled the world collecting their DNA. “Some of the supercentenarians I’ve met were still riding bicycles at 106, driving their own cars until 108 and enjoying dancing and playing pool at 109,” he said.
To take one example, Ralph Tarrant, who at his death in 2013 at 110 was Britain’s oldest man, was doing The Times’ crossword up until the age of 108, and only stopped because he wanted one with larger type.
Dan Davis, an immunologist from the University of Manchester, who was not involved in the latest research, said that the findings were “unexpected and fascinating”. “It is especially striking that supercentenarians have increased numbers of a particular type of immune cell which have the power to directly kill other cells.”
However, Professor Davis, author of a book about the immune system The Beautiful Cure, said that it was too early to start putting these cells in immortality pills.
“This doesn’t mean that having these cells will help you live longer — it may just be something that happens, in the same way that having grey hair doesn’t help,” he said. “The next steps in this research are crucial: knowing what these immune cells are capable of attacking will help us really understand what’s going on.”
November 14 2019
People are almost 50 per cent more likely to have dementia diagnosed in the three months after the death of a partner, a study has found.
Researchers suggested that while bereavement does did not itself cause dementia, the removal of the support of a loving partner, as well as more contact with other family members, could make existing symptoms more apparent.
The study looked at the medical records of almost 250,000 older people in the UK, half of whom had experienced the death of a partner. By comparing the widows and widowers to similar people whose partners were alive, scientists were able to see the effect of a bereavement on health and found that in the three months after someone lost their partner there was a 43 per cent higher chance that they received a dementia diagnosis.
There were 367 bereaved patients who had received a diagnosis in that period, compared with 254 non-bereaved patients. In the six months afterwards, the research, published in the Journal of Alzheimer’s Disease, found that the effect persisted, with a 24 per cent higher risk of diagnosis.
Dementia can take years or even decades to develop. Harriet Forbes, from the London School of Hygiene and Tropical Medicine and the lead author on the research, said that it seemed implausible that the shock of the death was causing it to appear in a few months. “We think simply that it may be that your partner has been covering for you, enabling you to cope without the dementia being noticed by other people. After their death perhaps you will also be in contact with GP services and your family more, together increasing the chance of undiagnosed dementia getting noticed,” she said.
Past studies have estimated that between a third and a half of people in the UK who have dementia are not diagnosed. There has been a push by Alzheimer’s charities to improve this figure, so that both dementia sufferers and their family members can get the support they need.
November 14 2019
Reading really does nourish the mind. A study has found that people who are literate had a third the risk of developing dementia compared with those who had never learnt to read and write.
The scientists behind the study suggested that learning to read may reveal new intellectual worlds and promote a life of the mind that might help to keep brains sharp into old age.
“If one acquires the ability to read and write, that opens up opportunities to engage in cognitively stimulating activities,” Miguel Arce Rentería, from Columbia University Medical Centre, said. “Even with low education, you can read newspapers and books. That provides opportunities for constant stimulation, that can last for the rest of your life. Maybe that might confer protection and mitigate the effects of dementia.”
The research, published in the journal Neurology, looked at almost 1,000 older people in New York, chosen because they had received little education as children. The average age was 77, and more than 90 per cent were immigrants. All of them had had four years or less of education, with about a quarter describing themselves as illiterate.
Among those who did not read, 35 per cent had dementia at the start of the study, increasing to 48 per cent four years later. Among the literate respondents, 18 per cent had dementia at the outset, rising to 27 per cent.
After adjusting for social class, age and other risk factors, the scientists calculated that illiterate people were three times more likely to have dementia. They were also twice as likely to contract it over the four years of the investigation.
It is impossible to say for certain that the link means that literacy staves off dementia. It may be that people who managed to get a better education before arriving in the US were also different in other ways. However, Dr Arce Rentería said: “What this provides is strong evidence for a pretty strong link.
“Quite a bit of research already shows greater years of education protect individuals from developing dementia,” he added. “Similar findings suggest higher reading levels could perhaps also have a benefit.”
One in five adults in Britain struggles with very basic reading tasks. The findings imply that this may affect not only their day to day life but also their old age.
Sara Imarisio, head of research at Alzheimer’s Research UK, said that the latest paper “suggests that education could boost cognitive reserve, a type of resilience that allows our brains to resist damage for longer as we get older.”
She added: “About nine million adults in the UK are thought to have very poor literacy skills and this may limit their ability to take part in socially and cognitively engaging activities, which have been associated with a reduced risk of dementia.
“While age and genetics influence our risk of developing dementia, there are lifestyle factors we can change to reduce our risk including things to boost our cognitive reserve. The best evidence indicates that staying both physically and mentally active, not smoking, controlling blood pressure and cholesterol, only drinking only within recommended guidelines and eating a balanced diet are all linked to better brain health as we age.”
August 20 2019
Care home residents die from falls or other serious accidents at a rate of one every two days in Scotland
There were 187 deaths last year as a result of accidents, falls, poisoning, self-harm and assault, according to National Records of Scotland figures, with the vast majority involving falls.
Those who died after they were taken to hospital are not included in the official statistics, so the scale of preventable deaths in Scottish care homes will be higher.
The number of injuries has risen by more than 50 per cent in the past five years, up from 882 in 2014-15 to 1,325 last year, according to separate figures from the Care Inspectorate.
There were also 7,400 occasions when elderly people could have suffered “harm or loss” and almost 3,000 times when they were involved in accidents. Twelve enforcement notices were sent to care homes for the elderly in the year to March 2019.
Councils have also recorded incidents involving older people being hurt in care homes as a result of medication errors, attacks by other residents, being injured by “flying” or “moving objects”, choking or coming into contact with harmful substances.
Lesley Carcary, of the charity Action on Elder Abuse, said: “All too often we come across horror stories such as these where elderly residents are regularly harmed, abused or neglected in the very place they should feel safe. Our elderly population deserve to feel safe and protected in care homes, not living in fear and distress.
“Action on Elder Abuse wants the harm and abuse of older people to be as socially unacceptable as other forms of abuse.”
A Care Inspectorate spokesman said: “We expect all care experienced by people to meet the national health and social care standards. We work closely with care providers to share good practice on how to reduce risks and keep people safe. While the majority of care services in Scotland perform well, we do not hesitate to take action where people experience care that is not as good as it should be.”
Chief Political Correspondent
November 11 2019
Local authorities will need billions of pounds of extra funding over the next five years to meet rising social care costs even if they put up council tax, a leading think tank has warned.
The Institute for Fiscal Studies (IFS) said that the cash would be needed even if council tax were to increase at double the rate of inflation.
Councils and central government fund care for older people, including in nursing homes, for those who are judged not to be able to afford it themselves. They also fun support services for other adults and children. The sector serves a growing elderly population and an increasing number of disabled adults. Costs are also being pushed up by rising wages and other overheads.
The extra money would be needed just to keep the level of service provided at present, the IFS said.
The issue of how to pay for social care proved toxic for Theresa May at the last election, when she suggested a floor instead of a cap on the costs that people would have to pay to help to fund the service. The policy was almost immediately dubbed the “dementia tax” and had to be scrapped days later — but the damage had been done.
The IFS warns that with councils now largely dependent on only two sources of income, council tax and business rates, “a growing gap is likely to open up between their income and what they need to meet the rising costs of service provision, especially for adult social care”.
If council tax continues to rise in line with inflation councils will need an extra £4 billion a year from the government within five years. This figure would rise to £18 billion a year by the mid 2030s.
Even with council tax rising by 4 per cent a year — double the rate of inflation — councils may need an additional £1.6 billion a year in real-terms funding by 2024–25. This would grow to £8.7 billion by the mid-2030s. Labour’s plans to offer free personal care for the over-65s would cost even more.
The IFS quotes another think tank, the King’s Fund, which says the cost of Labour’s plan would be £6 billion if introduced next year, increasing to £8 billion in real terms by 2030.
Councils have been given an extra £1.3 billion next year and those with social care responsibilities can increase council tax by up to 4 per cent.
David Phillips, an associate director at the IFS, said: “Detailed public spending plans for 2021–22 and beyond have not yet been published. But we do know that councils will rely on council tax and business rates for more of their funding going forwards. And those revenues just don’t look like they will keep pace with the rising costs of services like adult social care.”
Labour’s plans, announced at its annual conference in September, would introduce free personal care for all older people. It would provide help with daily tasks such as getting in and out of bed and preparing meals.
November 11 2019
Dementia-friendly prisons with bright decor and soft furnishings will be included in a £2.5 billion expansion programme to accommodate the rising number of older inmates.
They will be equipped with lifts for wheelchair-bound prisoners and the decor is to be finished in contrasting colours to help those with poor sight or memory loss. Experts said that blues could be used to create a sense of calm or yellows for stimulation.
Communal areas will be acoustically treated with sound-absorbing curtains and soft furnishings to absorb noise, which can be disorientating.
The Ministry of Justice has said that older prisoners’ requirements have led to improvements into the design of new jails at Wellingborough, Northamptonshire, and Glen Parva, Leicestershire.
Work has started at Wellingborough, which will house 1,680 inmates, and is about to begin on Glen Parva, which will have 1,600.
Longer sentences and the rise in the number of sex offenders, particularly those convicted of historical crimes, are the main reasons for the increase in older inmates in recent years.
The number of over-50s in jails in England and Wales went from 7,548 in 2009 to 13,890 at the end of September this year, an increase of 80 per cent. In the same period the proportion of over-50s rose from 9 per cent to 16 per cent, according to the Ministry of Justice. Some 1,913 prisoners are over 70.
Older prisoners have complained of gangs intimidating them at mealtimes and in queues for medical appointments. Disabled inmates are often confined to their cells.
Prison governors have developed their own policies to accommodate frail inmates, including creating palliative care suites for those who wish to die in prison. Walking frames, thermal underwear, wedge pillows and chair raisers are provided at Frankland in Co Durham and a stairlift has been installed to help inmates to go to the library and to classes.
Prisons have also set up “come and meet everyone centres” where reminiscence events focusing on classic films or history are held along with sessions on geography and handicrafts. Raised gardens can be tended by inmates unable to bend down.
Recoop, a charity that helps older prisoners, has trained inmates in three jails in the southwest to be “buddies” to those older or frailer than them. They collect meals, make tea, read letters to the partially sighted and clean cells, although they are not allowed to carry out “intimate” care.
Paul Grainge, director of Recoop, hopes that the government will consider providing dedicated houseblocks for the elderly with wider doors, grab rails, non-slip surfaces, dementia-friendly colours and good lighting.
November 12 2019
The more a woman eats after 6pm the greater her risk of developing heart diseas a study has found, suggesting that it is better to consume most of your calories earlier in the day.
A conference of the American Heart Association (AHA) will hear research this week suggesting that early menopause and eating a high proportion of your calories in the evening have been linked separately with a higher risk of heart problems in women.
The event will also hear that the more severe someone’s depression, the greater their risk of heart disease.
A study of 112 women, led by scientists at Columbia University in New York, found that heart health declined by a statistically significant amount with every 1 per cent increase in calories eaten after 6pm. “Women who consumed more of their calories after 6pm were more likely to have higher blood pressure, higher body mass index and poorer long-term control of blood sugar,” the scientists said.
Dr Nour Makarem, a research scientist at Columbia’s Vagelos College of Physicians and Surgeons, said: “Proportion of calories in evening meals may represent a simple, modifiable behaviour that can help lower heart disease risk.”
The trial examined 112 women with an average age of 33, 44 per cent of whom were of Hispanic background.
They were asked to keep a food diary documenting one week at the start of the study and another a year later. Their heart health was assessed using a measure devised by the AHA. The heart disease association with eating later was strongest in Hispanic women. Dr Makarem said that the study would need to be repeated in a larger sample.
A separate presentation will look at heart disease in women who experience menopause before the age of 40. That study found that such women were more likely to develop high blood pressure, type 2 diabetes and high levels of “bad” cholesterol, risks not reduced by hormone treatments.
The risks were higher in women who had early menopause as a result of surgery compared with those who were early naturally. Dr Michael Honigberg, lead author of the study and a fellow at Harvard Medical School, said: “Women should make sure their physician knows their menopause history, particularly if they experienced menopause before age 40.”
A third presentation will suggest that the severity of a person’s depression may increase their odds of suffering from heart disease or a stroke.
Researchers at the AHA examined data for 11,000 adults who were diagnosed with depression and categorised their condition as mild, moderate, moderately severe or severe.
Each increasing grade brought a 24 per cent increase in the odds of suffering from heart disease or stroke. The researchers said that they needed further studies to examine whether depression can cause heart disease or vice versa.
Dr Yosef Khan, of the AHA, said: “The implications of such an increase are vast. By understanding the relationship and degree of impact, we can properly identify, prevent, treat and create policies and strategies to help decrease cardiovascular diseases and improve lives by tackling mental health and heart disease together.”
Hit the gym in middle age to boost heart
Pumping iron in middle age could help men to reduce their risk of heart attack and stroke, according to a study.
Those in the top third for muscle mass were about a fifth as likely to develop heart disease as those in the bottom third, it found.
Researchers in Spain recruited 2,020 Greek adults without heart disease, including just over 1,000 aged 45 and older, and tracked them over ten years. They took lifestyle information including their diets and how much they exercised, as well as medical measures such as blood pressure, body mass index and how much skeletal muscle they had.
Among those who were 45 or older at the start of the study 272 people developed cardiovascular disease, with men four times more likely to fall victim.
The study, reported in the Journal of Epidemiology & Community Health, could not establish cause but suggests that resistance training and a protein-rich diet could improve health in old age. The researchers said: “Prevention of skeletal muscle mass decline, increasingly prevalent among middle-aged and older populations, may [promote] cardiovascular health.”
November 4 2019
Ashley Jones knew something had to be done about the epidemic of loneliness among older people when he met 89-year-old Sylvia in Bristol.
The widow had given away more than £25,000 of her life savings to a con artist because his daily phone calls were her only human interaction.
Mr Jones, a detective sergeant with Avon & Somerset police, set up a scheme where public benches could be designated as “Happy to Chat” seats, with signs letting people know that anyone sitting there was content to talk.
The first simple laminated sign that Mr Jones tied to a bench in the seaside town of Burnham-on-Sea, Somerset, in May read: “The ‘Happy to Chat’ bench. Sit here if you don’t mind someone stopping to say hello.” It featured on the town’s website and was picked up by the US broadcaster CNN, which beamed it around the world.
It has spawned a global movement, with benches springing up across Britain and as far afield as the US, Canada, Australia, Switzerland and Ukraine.
Mr Jones, 49, who set up the charity Senior Citizen Liaison Team (SCLT) to educate older people about financial exploitation, has been inundated with requests for help in setting up chat benches. “It’s such an easy thing that anyone can do it. On our charity website you can download your own sign,” he said. He can vividly remember his heartbreaking encounter with Sylvia. “She said, ‘I know I am giving this money away as part of a scam but I have got the money and this is the only person that I get to speak to on any sort of regular basis’. That was a tragic indictment of the society we live in today.”
Allison Owen-Jones, 53, began setting up her own Happy to Chat benches in Cardiff after watching an elderly man sitting alone on a park bench for 40 minutes while no one stopped to talk to him. “There are lots of residential homes near by and it looked like he had made a real big effort to come outside,” she said. “I thought about what I could do.”
Jon Williams, a sergeant with Gwent police and a member of the SCLT charity, said that a chat bench in Abergavenny had saved the life of a widow in her 50s whose husband had killed himself and left her suicidal. He said: “She told me, ‘If those benches hadn’t been there, I don’t think I would have made it here today.’ She was only in her early 50s but it was somewhere people felt they could just go and have some decent, ordinary human interaction with somebody.”
November 1 2019, The Times
It’s well known that a good night’s sleep is good for your health but it could also be the key to avoiding Alzheimer’s — by quite literally brainwashing us.
Scientists have found that our brains are rhythmically rinsed in a watery fluid after we drift off each evening. The process, which is thought to play a part in keeping cognitive functions sharp, could offer the best explanation yet of why we need to rest and why a broken night’s sleep leaves one foggy-headed. It could also help to flesh out the enigmatic association between sleep disorders and degenerative conditions such as Alzheimer’s disease.
As scientists have struggled to find a drug to counter the effects of Alzheimer’s, the link between sleep and dementia has become a focus for research.
One study published in June suggested that analysing brain waves while we doze could be a means of diagnosing the condition, long before clinical symptoms become apparent.
The latest study was published yesterday in the journal Science. After monitoring 11 sleeping volunteers using MRI scans, scientists found that the process begins with brain cells reducing their electrical activity. A few seconds later, a certain amount of blood flows from the head into the body.
This leads to lower pressure, allowing a watery liquid, cerebrospinal fluid (CSF), to flow in. It appears to wash through the brain in rhythmic, pulsing waves.
The study was the first to show this pulsing activity. It also revealed the close association with both brain wave activity and blood flow.
“We’ve known for a while that there are electrical waves of activity in the neurons,” Laura Lewis, an assistant professor of biomedical engineering at Boston University and a co-author of the paper, said. “But before now we didn’t realise that there are actually waves in the cerebrospinal fluid, too.”
The findings back up earlier studies, which have suggested that both cerebrospinal fluid and brain wave activity may help to flush toxic, memory-impairing proteins from the brain.
As people age, it appears that their brains tend to generate fewer, slower brain waves. This, in turn, may affect the blood flow in the brain and reduce the pulsing of cerebrospinal fluid during sleep, leading to a build-up of toxic proteins and a decline in faculties such as memory.
The team behind yesterday’s finding now plan to explore how the brain-washing process is controlled. “The neural change always seems to happen first, and then it’s followed by a flow of blood out of the head, and then a wave of CSF into the head,” Dr Lewis said.
One explanation may be that when the brain cells become less active they require less oxygen, so blood leaves the area. Pressure in the brain then drops and cerebrospinal fluid rapidly flows in to maintain pressure at a safe level.
“But that’s just one possibility,” Dr Lewis said. “What are the causal links? Is one of these processes causing the others? Or is there some hidden force that is driving all of them?”
Previous studies involving animals have indicated that one of the waste products removed from the brain during sleep is beta amyloid, a protein closely associated with Alzheimer’s disease.
The brain-rinsing occurs during what is known as non-REM sleep soon after a person drifts off.
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The Times 29/10/2019
Taking two painkillers a day can reduce the symptoms of depression, a study has suggested. The findings have prompted calls for trials on whether over-the-counter pills could be prescribed for mental health disorders.
Scientists reviewed 26 previous studies to look at the effect of anti-inflammatory drugs, including ibuprofen and aspirin, on the symptoms of “major depressive disorder”. These include low moods and the inability to feel pleasure.
Researchers from the University of Science and Technology in Wuhan, China, found that the drugs were 79 per cent more effective at eliminating symptoms and 52 per cent more effective at reducing their overall severity than a placebo.
The scientists also looked into trials that involved other drugs, including statins and treatments for sleep disorders.
Although they did not determine the dosage of anti-inflammatory drugs required to reduce depression, the trials they studied looked at patients who took daily doses of between 20mg and 30mg of statins and others who took 400mg of the painkiller celecoxib, defined as a “non-steroidal anti-inflammatory drug”, a class that includes aspirin and ibuprofen. Celecoxib and ibuprofen are commonly sold in 200mg pills.
There were also studies involving patients taking 200mg of minocycline, used to treat bacterial infections such as acne and chlamydia, and up to 400mg of modafinil, used to treat sleep disorders. The most effective treatments were found to be non-steroidal anti-inflammatory drugs, such as over-the-counter painkillers, statins, omega-3 fatty acids and minocyclines. The effect was more pronounced if the drugs were used with anti-depressants.
Depression is not deemed to be an inflammatory disorder, but some patients with the illness show signs of inflammation in the brain. Scientists have suggested that some cases of depression may be linked to infections or other conditions that cause inflammation in the body.
The authors of the new report said: “The results of this systematic review suggest that anti-inflammatory agents play an antidepressant role in patients with major depressive disorder and are reasonably safe.” The study, published in the Journal of Neurology, Neurosurgery and Psychiatry, cautioned that in five trials examined as part of the analysis, in which women took the painkiller celecoxib and omega 3 fatty acids, “no difference in change of depression scores was found”.
Ed Bullmore, head of the department of psychiatry at the University of Cambridge, welcomed the study and said: “This should encourage further consideration of ways in which we could use a range of anti-inflammatory interventions to help people with depression, perhaps especially people who are already taking a conventional antidepressant drug with limited benefit.
“However, as the authors conclude, further trials will be needed to support licensing and medical prescription of these and other anti-inflammatory agents for depression.”
Carmine Pariante, professor of biological psychiatry at King’s College London, said that the analysis was robust but added: “It also tells us something new and worrying: that this strategy does not seem to work in women.” He said that the most important question now was to find out “how can we predict who will and who will not respond to this specific combination therapy” of anti-inflammatory and antidepressant drugs.
“Should it be restricted only to those with increased inflammation, and if so, measured how?”
David Curtis, honorary professor at University College London, said: “The most effective anti-inflammatory agents used were non-steroidal anti-inflammatory drugs. Although problems are rare, every year thousands of people die from the side-effects of these medications, which are usually taken for chronic pain and are especially risky if taken for long periods of time.”
When the body suffers an injury or infection an inflammatory response is triggered. In the short term this aids healing, but prolonged periods of inflammation are believed to cause damage. Scientists have suggested that increased inflammation in middle age can lead to increased brain shrinkage later in life, possibly causing dementia.
Doctors have welcomed a “turning point” in the treatment of Alzheimer’s disease after the development of a drug apparently able to slow the condition if it is caught in its earliest stages.
Biogen’s drug, aducanumab, would also be one of the most stunning reversals in the history of pharmaceutical development. Like several similar products, it had originally failed in trials.
However, other experts said more information was needed and they were awaiting the opinion of US regulators, who are in talks with the drug’s owner. One concern was that the findings relied on only a subset of patients, an approach that can produce false positives.
Michel Vounatsos, Biogen’s chief executive, said that it hoped to offer patients “the first therapy to reduce the clinical decline of Alzheimer’s disease”.
Although the drug had failed in trials at first, he said that the new, bigger analysis involving more than 3,000 people showed that at high doses it reduced symptoms in patients caught early. In one measure of a range of mental abilities, those on the drug experienced 25 per cent less decline after 18 months.
Biogen said that these patients who took aducanumab had better cognition, memory and language and were able to live independently for longer, including performing household chores and travelling on their own.
They also had reduced levels of a toxin called amyloid beta in their brains.
Anton Porsteinsson, director of the University of Rochester’s Alzheimer’s programme in New York state and lead investigator in the study, said it provided new hope for families. “There is tremendous unmet need and the Alzheimer’s disease community has been waiting for this moment,” he added.
Both the UK’s main Alzheimer’s charities said that they were excited by the announcement. Hilary Evans, chief executive at Alzheimer’s Research UK, said: “People affected by Alzheimer’s have waited a long time for a life-changing new treatment and this exciting announcement offers new hope that one could be in sight.”
James Pickett, head of research at the Alzheimer’s Society, said that while they were looking forward to seeing more data, the drug had “the potential to be a transformative discovery”.
The news comes after five years in which drug companies have watched promising treatments fail in their final stages, leading some firms to pull out of the field entirely. The lack of success was not only frustrating on its own terms but implied that the entire approach to the disease, which involved targeting amyloid beta, could be wrong.
Bart de Strooper, director of the UK Dementia Research Institute at UCL, said the drug trial could re-energise the field. “It is fantastic to hear of these new positive results emerging from the aducanumab trials. We have no effective treatments to slow or halt the progression of Alzheimer’s disease and I hope this signifies a turning point,” he said.
Recently, efforts have moved on to treating people before they became symptomatic in the hope that the previous failures could be down to catching the amyloid beta too late.
Biogen’s showing of results among patients with the first symptoms suggests that there is merit in this approach, the ultimate goal of which is to delay the disease to such an extent that people never suffer its effects.
After Biogen’s announcement the company’s value rose nearly $18 billion as investors bet that the US Food and Drug Administration would give the treatment the green light.
Brian Skorney, an analyst at Baird, a US investment bank, said that Biogen would, however, “have an uphill climb” to convince regulators that positive outcomes in the new studies “were anything more than random chance”.
More than 25 years ago John Hardy, from the UCL Queen Square Institute of Neurology, was one of the originators of the amyloid beta hypothesis.
He said yesterday that he had been in the field long enough to be wary. “Can one be cautiously excited?” he said.
“If this is the first crack in the wall, it is wonderful.” He added that even if the benefit to patients proved to be tiny, the significance could be huge. “It will show everyone we are on the right track.”
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".....it is very sad that so many older people died before they received the social care they had asked for and it makes you wonder what their quality of life was like as they approached the end of their lives....."
".....there's no doubt that good social care extends the lives of frail older people. Giving older people practical support with the essentials of daily life, including eating and drinking - and doing it with kindness - makes an enormous difference to their capacity to 'keep going' even when they face big health challenges."
Almost ninety people a day died while waiting for care to be arranged for them at home, according to new figures. Data published for the first time by the Department of Health and Social Care (DHSC) shows that in the past year 32,115 adults dies before they could get the care they required.
At Caring Connections we strongly believe that we make a difference. We not only help you in and around the home, but we also care for your four legged members of family.
Professor Martin Green, chief executive of Care England, the trade body for care homes, said: ".....family shows what is possible when everybody works together"