BOSTON – A new study published today in the Journal of Gerontology: Medical Sciences found that multifaceted interventions, particularly cohorting of residents, in addition to adherence to proper infection control procedures, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents. Earlier studies found that high-risk nursing home residents, especially those who were Black or were suffering from dementia, tended to have higher infection rates for COVID-19.

Alyssa B Dufour, Ph.D., Assistant Scientist II at the Hinda and Arthur Marcus Institute for Aging Research, was the lead author of the study, “The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes.”

Dr. Dufour’s study sought to look at the potential of a state-wide Massachusetts infection control intervention to reduce COVID-19 infection rates of nursing home residents, especially those who were Black or suffered from dementia – two populations at highest risk of serious coronavirus infections. As of May 2021, 50 percent of COVID-19 infections occurred in people who identified as Black while deaths among people with dementia increased 16 percent. Prior studies have shown that persons with dementia are at higher risk for infection and are more likely to experience severe infection and complications – even if not COVID-19-related – compared to those without dementia.

In order to improve infection control in Massachusetts nursing homes, Hebrew SeniorLife and the Massachusetts Senior Care Association partnered to conduct a COVID-19 infection control intervention in 360 Massachusetts nursing homes over a nine-week period. As part of the intervention, nursing homes were offered weekly webinars, answers to infection control questions, resources to acquire personal protective equipment (PPE), backup staff, and COVID-19 testing. Researchers obtained data from four state audits using infection control checklists, weekly infection rates, and used a federally-mandated assessment instrument (Minimum Data Set) to obtain variables on race and dementia, to determine whether adherence to best infection control practices was associated with a decline in average weekly rates of new COVID-19 infections.

Researchers found the overall effect of the intervention did not differ by nursing homes’ racial composition. However, proper cohorting of residents – such as isolating COVID-19-positive or suspected residents in dedicated wings/units or in separate rooms – was associated with a greater reduction in infection rates among facilities where more than 20 percent of residents were Black or Hispanic. 

Facilities in which more than half of residents had dementia had the largest reduction in infection rates when the nursing homes followed infection control recommendations. Cohorting patients with dementia in those facilities was also associated with greater reductions in infection rates.

“We found that adherence to infection control guidelines, especially proper cohorting of COVID-19 cases and proper PPE use, can effectively reduce COVID-19 infection rates, even in high-risk nursing home residents who are Black or Hispanic or with dementia,” Dr. Dufour said.

Brown University collaborated with Hebrew SeniorLife on the study.

Dr. Dufour’s research was supported by the U.S. Department of Health and Human Services/National Institutes of Health/National Institute on Aging (grant: U54 AG063546-02S3).

About the Hinda and Arthur Marcus Institute for Aging Research

Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.

About Hebrew  SeniorLife

Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 3,000 seniors a day across six campuses throughout Greater Boston. Our locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; and Jack Satter House, Revere. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $63 million, making it the largest gerontological research facility in the U.S. in a clinical setting. It also trains more than 1,000 geriatric care providers each year. For more information about Hebrew SeniorLife, visit https://www.hebrewseniorlife.org or follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.

BOSTON – Harvard Medical School affiliate Hebrew SeniorLife (HSL), a nonprofit organization committed to improving the lives of older adults, today announced Dr. Nadia Ali has joined HSL’s Department of Medicine. Dr. Ali is a Geriatric Specialist in the Rehabilitative Services Unit at HSL’s NewBridge on the Charles in Dedham, Mass. She also serves as Medical Director of the Skilled Nursing Facility at Orchard Cove, HSL’s continuing care retirement community in Canton, Mass.

“Dr. Ali already exemplifies one of our core cultural beliefs, Grow Professionally,” said Helen Chen, M.D., Chief Medical Officer for the Department of Medicine at Hebrew SeniorLife. “She recently received her Certified Medical Director (CMD) credentials through the American Board of Post-Acute and Long-Term Care Medicine. We welcome Dr. Ali to the Department of Medicine and look forward to her success as we help seniors live their best lives.”

Dr. Ali recently relocated from Texas, where she was Clinical Assistant Professor of Medicine at Texas A&M Health Science Center, Division of Geriatrics, and Medical Director, Cornerstone Gardens. She was also a member of the Baylor University Scott & White Diversity and Pharmacy and Therapeutics Committees. Dr. Ali completed her fellowship and residency in geriatric medicine at Albert Einstein College of Medicine of Yeshiva University/Montefiore Medical Center in the Bronx, New York. Dr. Ali graduated from Rawalpindi Medical College, Pakistan, with distinction in internal medicine, pathology, and ophthalmology.

“My grandmother’s hip fracture and the resulting post-care impact on her health inspired me to pursue a career in geriatrics, particularly in preventing falls,” said Dr. Ali. “I am joining HSL because the organization is leading the way in reshaping care delivery for seniors and I know I can make a difference here in the field of aging.”

About Hebrew SeniorLife

Hebrew SeniorLife, a Harvard Medical School affiliate, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Founded in Boston in 1903, the nonprofit organization today provides communities and health care for seniors, research into aging, and education for geriatric care providers. For more information about Hebrew SeniorLife, visit http://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook, or read our blog.

BOSTON – Researchers from Hebrew SeniorLife’s Institute for Aging Research have developed and validated a new assessment to predict the risk of falls in long-term care patients. The study on the assessment titled “Fracture Risk Assessment in Long-term Care (FRAiL)” was published today in the Journal of Gerontology Medical Science.

The FRAiL model was developed by following a large cohort of nursing home residents over a 2 year period to identify which risks most often led to hip fractures for those living in a nursing home. By studying a sample of only nursing home residents, the FRAiL model was able to identify those fracture risks which are unique to nursing home residents, and ultimately differ quite a bit from the fracture risks facing seniors living independently.

What the study revealed is a collection of characteristics that are significant predictors of hip fracture in nursing home residents. These factors are: older age, white race, female, impaired cognition, independence in the activities of daily living, locomotion independence, urinary continence, previous falls, transfer independence, easily distractible, proclivity towards wandering, and others. For both men and women in nursing homes, it seems that the more independently mobile one is, the more apt they are to fall and incur a hip fracture. This is in direct opposition to seniors who live outside of the nursing home, who are more apt to fall and incur a fracture if they are less independent in their daily living skills.

The new FRAiL assessment is an important tool for senior long-term care providers as nearly 10% of hip fractures occur among nursing home residents. Of those nursing home residents who incur fractures, 36% will die within 6-months, and another 17.3% will become completely disabled. If service providers can screen for falls risk early on, they may be able to prevent debilitating and life threatening hip fractures before they occur.

Sarah D. Berry, MD, MPH and lead author of the study said, “The FRAiL model is the first clinical tool that could be used to discriminate residents at high risk for fracture and standardize fracture prevention efforts in the nursing home.”

This study was supported by the National Institute on Aging (R01).

About Institute for Aging Research

Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making. The Aging Brain Center within IFAR studies cognitive aging and conditions affecting brain health.

About Hebrew SeniorLife

Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit http://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook or read our blog.

BOSTON – A ground-breaking new study has succeeded in compiling an atlas of genetic factors associated with estimated bone mineral density (BMD), one of the most clinically relevant factors in diagnosing osteoporosis. The paper, published in Nature Genetics, identifies 518 genome-wide loci, of which 301 are newly discovered, that explain 20% of the genetic variance associated with estimated BMD. Identifying so many genetic factors offers great promise for the development of novel targeted therapeutics to treat osteoporosis and reduce the risk of fracture.

“Our findings represent the largest genetic study of genetic associations with the density of bone. This large study provides potential future targets for drug development to treat osteoporosis,” explains Douglas Kiel, M.D., M.P.H., one of the authors on the study and Director of the Geriomics Program at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife and Professor of Medicine at Harvard Medical School. Although there are available treatments for the osteoporosis patients who Dr. Kiel treats, many of the drugs have side effects that deter patients from receiving treatment. According to Dr. Kiel, “Our patients need additional therapies to treat their osteoporosis, and genetic studies like ours can identify new biologic pathways related to bone that can be leveraged to develop new drugs capable of preventing fractures.”

Osteoporosis is a very common age-related condition characterized by the progressive reduction of bone strength, which increases the risk of sustaining a fracture. Especially among older patients, fractures can have severe consequences, such as disability with loss of personal independence, and in some cases death. Among all sufferers, fractures impose major burdens of hospitalization, extended rehabilitation, mobility limitations and even destitution. As the population ages, the urgency of improving preventive measures becomes all the more intense.

This was the largest study ever undertaken of the genetic determinants of osteoporosis, assessing more than 426,000 individuals who were part of a large study called the UK Biobank. After analyzing the data, the researchers further refined their findings to isolate a set of genes that are very strongly enriched for known drug targets. This smaller set of target genes can form the basis for the development of treatments to increase bone density to prevent fractures. Also the findings in humans were tested in a unique set of mice who had these genes altered to see if they had weak skeletons.

“Although it might seem overwhelming to sort through the many genes we found to be associated with bone density, we are able to focus on those with the greatest effect to potentially target for drug development. Another value of our study is that it can be used to estimate a person’s risk for having weaker bones, thereby alerting them to the need for adapting healthy lifestyle choices such as physical activity and diet, and to make sure they get screened with bone density testing,” said Dr. Kiel

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Based in Boston, the non-profit, non-sectarian organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit https://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook or read our blog.

While tai chi is understood to be beneficial for functional mobility and balance in older adults, such benefits are not well understood due to large variance in research study protocols and observations.

Now, a new research review and analysis shows that tai chi can indeed induce greater improvement in functional mobility and balance in relatively healthy older adults compared to conventional exercise.

Researchers examined 12 studies involving 2,901 participants. Generally, tai chi, compared to conventional exercise, produces the following performance results:

• The time to complete 50-foot walking was 1.84 seconds faster. 
• The time to maintain a one-leg stance was 6 seconds longer when eyes were open and 1.65 seconds longer when eyes were closed. 
• Individuals improved their timed-up-and-go test performance by 0.18 points, indicating quicker standing, walking, and sitting.
• Individuals taking the functional reach test showed significant improvement with a standardized mean difference of 0.7, suggesting a noteworthy positive impact on the ability to reach and perform daily activities.

Secondary analyses revealed that the use of tai chi with relatively short duration (<20 weeks), low total time (≤24 total hours), and/or focusing on the Yang-style of this ancient form of Chinese martial arts were particularly beneficial for functional mobility and balance as compared to conventional exercise.

“This systematic literature review and meta-analysis are exciting because they provide strong evidence that tai chi is a more efficient strategy to improve functional mobility and balance in relatively healthy older adults, as compared to conventional exercise,” said Brad Manor, Ph.D., director of the Mobility and Falls Program at Hebrew SeniorLife’s Hinda and Arthur Marcus Institute for Aging Research, and associate professor of medicine, Harvard Medical School and Beth Israel Deaconess Medical Center; and Junhong Zhou Ph.D., assistant scientist II at the Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, and assistant professor of medicine, Harvard Medical School and Beth Israel Deaconess Medical Center.

“This research suggests that tai chi should be carefully considered in future studies and routines of rehabilitative programs for balance and mobility in older adults,” said Bao Dapeng, professor, Beijing Sport University.

Researchers were affiliated with the Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School; School of Sport Medicine and Physical Therapy, Beijing Sport University; Sports Coaching College, Beijing Sport University; College of Physical Education and Health Science, Chongqing Normal University; and the China Institute of Sport and Health Science, Beijing Sport University.

Findings were published in the article, “The comparison between effects of taichi and conventional exercise on functional mobility and balance in healthy older adults: a systematic literature review and meta-analysis,” which appeared in Frontiers.

About Hebrew SeniorLife

Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across six campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; and Jack Satter House, Revere. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $98 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Threads, and LinkedIn.

About the Hinda and Arthur Marcus Institute for Aging Research

Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.

BOSTON – A new study published in the Journal of Clinical Endocrinology and Metabolism found that age-related accumulation of abdominal fat is associated with lower muscle density.  Low muscle density means the muscle has more fat in it, which can lead to less effective muscle function that in turn may lead to more falls. According to the study, individuals with the greatest 6-year accumulation of visceral adipose tissue (VAT), found in the abdomen, had significantly lower muscle density.  Since VAT accumulation is a preventable risk factor for poor musculoskeletal outcomes associated with aging, these findings add to the growing dangers of accumulating fat in the body.

Entitled “Accumulation in Visceral Adipose Tissue Over 6 Years Is Associated With Lower Paraspinal Muscle Density,” it is the first large, longitudinal study of the association between changes in VAT and muscle density. 

“Most obesity research has focused on metabolic and cardiovascular outcomes such as diabetes, hyperlipidemia, hypertension, coronary heart disease, and osteoarthritis. But there is considerably less consensus on the role of obesity on the risk for low muscle mass or muscle density,” said Lead Author Ching-Ti Liu, Ph.D., Professor in the Department of Biostatistics at Boston University School of Public Health, and Senior Author Douglas P. Kiel, M.D., M.P.H., Director, Musculoskeletal Research Center and Senior Scientist, Hinda and Arthur Marcus Institute for Aging Research.

The study found that VAT may represent a modifiable risk factor for poor musculoskeletal outcomes with aging. 

“The study adds important new information to public health efforts to reverse the trend of the growing obesity problem in the United States and worldwide,” the authors said. “Fat that accumulates in the abdomen sometimes referred to as the ‘male pattern,’ was shown to produce less dense muscle surrounding the spine, resulting in less-effective muscle function.”

The other researchers on the study were Timothy Tsai, M.P.H., Research Software Engineer II at the Hinda and Arthur Marcus Institute for Aging Research; Brett T. Allaire, Research Assistant III at the Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center; Mary L. Bouxsein, Ph.D., Professor of Orthopedic Surgery, Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center; Marian T. Hannan, D.Sc., M.P.H., Senior Scientist, Hinda and Arthur Marcus Institute for Aging Research; and Thomas G. Travison, Ph.D., Director of Biostatistics and Data Sciences, Co-Director of the Interventional Studies in Aging Center, Senior Scientist, Hinda and Arthur Marcus Institute for Aging Research.

The study was approved by Boston University Medical Campus and the Hebrew SeniorLife institutional review boards.

Funding came from a National Institutes of Health’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) (R01 AR041398).

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, was founded in 1903 and today is a national leader dedicated to empowering seniors to live their best lives. Hebrew SeniorLife cares for more than 3,000 seniors a day across six campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline; and Jack Satter House, Revere. Hebrew SeniorLife also trains more than 1,000 future health care professionals each year, and conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a robust research portfolio whose NIH funding in 2021 places it in the top 10% of NIH-funded institutions. For more information about Hebrew SeniorLife, visit our website or follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.