Tag Archives: Seniors

New online calculator estimates how long seniors have left to live

Credit: Pixabay.

Although most elderly adults in developed nations die of predictable causes, only a small fraction of people receive a physician home visit in their last year of life. In order to meet the changing care needs of older adults, researchers from Canada have developed a robust online tool that allows physicians to calculate how long seniors have left to live.

The calculator, known as Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool (RESPECT), can predict death within six months and was validated on a dataset involving 491,000 community-dwelling older adults who used home care between 2007 and 2013.

The tool aggregates numerous risk factors and then employs a ‘big data’ approach to estimate the odds of survival of an elderly person. These factors include a person’s comorbidities such as hypertension (60.8% of respondents suffered from this illness), coronary artery disease (26.8% of respondents), and Alzheimer’s or other dementias (23.4% of respondents). The average age of the respondents was 79.7 years and 65% identified as female.

However, the researchers found that declines in a person’s ability to carry out activities of daily living, such as hygiene, using the toilet, and locomotion, were stronger predictors of 6-month mortality than the diseases that a person has.

When the calculator was applied to a cohort of 435,009 adults, the researchers were able to identify 122,823 deaths within six months of assessment with 95% confidence. In another cohort representing 139,388 adults, the tool identified 20,015 deaths within six months of assessment.

Estimated median survival varied from 28 days (11 to 84 days at the 25th and 75th percentiles) in the highest risk group to over 8 years (1925 to 3420 days) in the lowest risk group.

“The RESPECT calculator allows families and their loved ones to plan,” says Dr. Amy Hsu, investigator at the Bruyère Research Institute in Canada, affiliate investigator at The Ottawa Hospital, and faculty in the Department of Family Medicine at the University of Ottawa. “For example, it can help an adult child plan when to take a leave of absence from work to be with a parent or decide when to take the last family vacation together.”

Knowing how long a person has left to live may help family, caretakers, and physicians make more informed decisions. Doctors may want to change treatments while the family could use the notice to prepare emotionally for their dearly beloved impending death. For instance, knowing that your parents or grandparents only have six months to live would motivate you to plan and embark on the last family vacation together.

However, there may also be important downsides and ethical dilemmas to knowing the timeline of a person’s final moments. If a person is informed of how long they have left to live, they may change their behavior for the better or worse.

“We have learned before the pandemic and particularly with the pandemic, that there’s tremendous inherent biases within health care, access, distribution and algorithms for vulnerable people, racialized people, lower socioeconomic classes,” said Kerry BOwman, a bioethicist at the University of Toronto.

“Using a tool like this without doing due diligence with social, cultural, and ethical analysis is not a smart thing to do.”

You can use the RESPECT tool by visiting the official website.

Harar Old Man.

Proper hydration helps seniors get the full benefit of exercise and keeps their minds limber

When your hairs start turning gray, the water bottle should be your mainstay — at least while exercising. New research shows that middle-aged and older adults should drink more water to gain the full benefits of exercise.

Harar Old Man.

Image credits Gustavo Jeronimo / Wikimedia.

Few things will ruin your workout quite like dehydration. Even if you power through and keep to your routine despite the cottonmouth, you won’t benefit that much from it: dehydration has been shown to impair exercise performance and brain function in young people. However, the effect of dehydration during exercise for older individuals was poorly studied, and thus poorly understood, as there are some key metabolic differences between these age groups.

“Middle-age and older adults often display a blunted thirst perception, which places them at risk for dehydration and subsequently may reduce the cognitive health-related benefits of exercise,” the authors wrote.

Age slows down our metabolic rate, meaning we need fewer calories. Coupled with the fact that we generally tend not be as physically active as we age, elderly people tend to experience a decrease in appetite too. By eating less food, they get less hydration from solid food sources — humans generally get about half their daily water requirement from solid foods, as well fruit and vegetable juices.

To get a better understanding of how this impacts the health benefits of exercise, the New England-based team of researchers recruited recreational cyclists who took part in a large cycling event on a warm day (78-86°F or 25.5-30°C). The participants’ average age was 55.

The cyclists were asked to go through a “trail-making” executive function test: they had to connect numbered dots on a piece of paper, being graded both on their speed and accuracy. Executive functions are a set of processes that all have to do with managing oneself and one’s resources in order to achieve a goal. They include the ability to plan, focus, remember, and multitask. Exercise has been shown to improve intellectual health, including executive function.

The team also tested the volunteers’ urine before they exercised, and divided them into two groups based on the results — either in the ‘normal hydration’ or the ‘dehydrated’ groups.

Those in the normal hydration group showed a noticeable improvement in completion speed of the trail-making test after cycling (relative to their initial results). The dehydrated group also completed the task more quickly after cycling, but the difference in completion times wasn’t significant, the researchers noted.

“This suggests that older adults should adopt adequate drinking behaviors to reduce cognitive fatigue and potentially enhance the cognitive benefits of regular exercise participation,” the researchers wrote.

The paper “Dehydration impairs executive function task in middle-age and older adults following endurance exercise” was presented on Sunday, April 22, at the American Physiological Society (APS) annual meeting Experimental Biology 2018 in San Diego.