BOSTON – A study published today in the Journal of the American Medical Association Internal Medicine revealed that older persons are highly likely to be excluded from the majority of COVID-19 trials that seek to establish effective treatments, as well as find a preventive vaccine. This is despite the fact that older persons are overwhelmingly impacted by COVID-19. Globally persons 65 and older make up nine percent of the population, yet account for 30 – 40 percent of COVID-19 cases and 80 percent of COVID-19 deaths. Sharon K. Inouye, M.D., M.P.H., Director of the Aging Brain Center in the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, is senior author on the study.

Researchers viewed how often all the COVID-19 clinical trials registered in https://www.clinicaltrials.gov/ from October 1, 2019 to June 1, 2020 did not include older people. This was determined by reviewing direct age-based exclusions or exclusions that preferentially affect older persons, such as the presence of other diseases, or requiring Internet or smart phones to participate. Their findings indicate that older adults are highly likely to be excluded from more than 50 percent of COVID-19 clinical trials and 100 percent of vaccine trials. Inclusion of older adults in clinical trials is critical to ensure equitable access to these treatments.

According to the study, it is important that COVID-19 clinical trials enroll older persons to ensure effectiveness of treatments and to find the proper dosing in this age group, which can be different from other age groups due to physiological changes that come with age. The researchers who participated in this study are particularly concerned that exclusion of older adults from clinical trials may lead to treatments that are ineffective but may even be toxic for older adults.

“To be sure, some exclusions are needed to protect the health and safety of older adults-- such as poorly controlled comorbidities,” said Dr. Inouye. “However, many are not well-justified, and appear to be more for expediency or convenience of the trialists. We are concerned that the exclusion of older adults from clinical trials will systematically limit our ability to evaluate the efficacy, dosage, and adverse effects of COVID-19 treatments in this population.”

The study coauthors included Benjamin Helfand, MSc, of the University of Massachusetts Medical School, Margaret Webb, Sarah Gartaganis, M.S.W, M.P.H., and Lily Fuller of Hebrew SeniorLife, and Churl-Su Kwon, M.D., M.P.H of the Icahn School of Medicine at Mount Sinai. 

This study was supported in part by Grant R24AG054259 (SKI) from the National Institute on Aging and T32GM107000 (BKIH) [MD/PhD (MSTP) Training Program at the University of Massachusetts Medical School (UMMS)]. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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. Based in Boston, the nonprofit 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 and our blog, or follow us on Facebook, Instagram, Twitter, and LinkedIn.

BOSTON – A recent study of hip fracture rates in nursing homes in the U.S. reports a slight rise in the rate of hip fractures among long-stay residents in recent years. Researchers looked at data collected between 2007 and 2015 and found, despite a dip in 2013, rates have begun to rise again even though long- stay nursing home admissions have declined. Sarah T. Berry, M.D., M.P.H., Associate Director of the Musculoskeletal Research Center in the Hinda and Arthur Marcus Institute for Aging Research, is lead author on the paper recently published in the Journal of Bone and Mineral Research. The purpose of the study was to describe trends in hip fracture rates and post-fracture mortality among 2.6 million newly admitted U.S. nursing home residents from 2007 to 2015, and to examine whether these trends could be explained by differences in resident characteristics. Understanding the prevalence of fractures and what puts individuals at risk is important to reducing the incidence of fractures in this vulnerable population.

Thirty-six percent of nursing home residents with hip fractures will die within six months, and another 17.3 percent of ambulatory residents will become completely disabled. Among survivors, infections and pressure ulcers are common, leading to functional decline and a diminished quality of life.

Given the high morbidity, mortality, and financial expense associated with these fractures, hip fractures are a major public health concern. It is important then to characterize temporal trends of hip fractures to inform interventions and national policies aimed at ameliorating these fractures.

“Our findings underscore the magnitude of the hip fracture problem in the U.S. and should prompt widespread interventions to reduce the suffering associated with hip fractures in older adults,” said Dr. Berry.

The study’s researchers can only speculate at this point as to why nursing home fracture rates have not declined during the past decade. Among non-institutionalized older adults, a ten year downward trend in hip fracture incidence has been leveling out in the past few years. According to the paper, “available strategies exist to prevent falls and associated injuries, albeit, the success of falls prevention programs in the nursing home has been less than in the community setting. In general, nursing home residents are older and sicker, with more cognitive and functional impairment than community-dwellers. One possible explanation of these high rates is the underutilization of medications to treat osteoporosis.”

This study was funded by a National Institute on Aging grant – R01AG04544 - and in addition to Dr. Berry, included other researchers from the Marcus Institute, and researchers from Brown University and the University of Alabama at Birmingham.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Hinda and Arthur 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. Based in Boston, the nonprofit, non-sectarian organization has provided communities and healthcare 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 paper recently published online in the journal Chest reports on a study of the palliative ventilator withdrawal (PVW) procedure performed in intensive care units (ICU) at end of life. The study’s goal was to determine the level of distress patients experience and identify treatments that could bring relief. Findings show that up to one-third of PVW patients experience an episode of rapid breathing called tachypnea as a marker of distress, and administration of opiates before PVW could help with symptom control. Corey Fehnel, M.D., M.P.H., a palliative care researcher in the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, and Assistant Professor of Neurology at Harvard Medical School, is lead author on the paper.

On average, nearly one in five Americans will die in an ICU each year, and many of these deaths occur after the decision has been made to extubate and move from curative- to comfort-focused care. Although numerous professional societies and patient groups have advocated for improved management of ventilated ICU patients transitioning to palliative care, the process of PVW and the discomfort that patients experience has remained understudied. As a result, the practice varies widely across ICUs, and little is known about the indicators of patient distress and how to better control symptoms.

Monitoring symptoms of distress among hospitalized COVID-19 patients at end of life presents even more of a challenge. COVID-19 patients who are intubated on mechanical ventilation require providers to observe special aerosolized droplet isolation precautions. They must wear N95 masks, face shields, hats, gowns, and run HEPA filters in the room when opening the "circuit" to the ventilator or performing procedures, including extubation. These precautions make it difficult for critically ill patients to use non-verbal cues as a means of communication with their care providers.

In addition, patients are physically isolated with similar patients, and providers try to limit the number of times they enter the patient's room to prevent transmission of the virus. But most importantly, families are not allowed in the hospital to be with these patients during extubation, and they are an important part of easing patient distress and assuring patient comfort at end of life. Taken all together, the combined effect is a perfect storm of barriers to effective symptom assessment for these patients.

“We fervently hope that all patients will be comfortable at end of life in the ICU but unfortunately some people experience discomfort, and we identified one tactic to alleviate that distress,” said Dr. Fehnel. “The results of this study, which point to administration of opiates before PVW and in anticipation of distress, could help with symptom control and can be readily applied to COVID-19 and all critically ill patients during this time of great need.”

Dr. Fehnel’s research is supported by grant support from the National Institute on Aging: NIA K23AG066929 and R03AG060186. In addition to the Marcus Institute for Aging Research, researchers from Beth Israel Deaconess Medical Center, Wayne State College of Nursing, and University of Pittsburg Medical Center collaborated on this study.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Hinda and Arthur 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. Based in Boston, the nonprofit, non-sectarian organization has provided communities and healthcare 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 recent study titled “A meta-analysis of previous falls and subsequent fracture risk in cohort studies” found links between self-reported falls and increased fracture risk, and also that prior falls increased risk for fracture slightly more in men than women.

Published in Osteoporosis International, this international meta-analysis of data pooled from 46 prospective cohorts comprising over 900,000 individuals also recommended that previous falls are a factor that should be included in patients’ histories used by fracture risk assessment tools like the FRAX (Fracture Risk Assessment) Tool to calculate a person’s likelihood of getting a fracture over the next decade. FRAX is the most commonly used assessment to predict fracture risk.

“FRAX was developed using longitudinal data from studies around the world. Although previous falls have long been recognized as a significant risk factor for fractures, until now, they have not been factored into the FRAX algorithm,” said Douglas P. Kiel, M.D., MPH, director of the Musculoskeletal Research Center and senior scientist at the Hinda and Arthur Marcus Institute for Aging Research. “In this newly updated FRAX dataset, previous falls were included as a risk factor and were found to increase the risk for fracture. These findings underscore that falls are an important contributor to fracture in both men and women, but interestingly, slightly more in men.”

Key findings of the meta-analysis include:

• Increased Fracture Risk: Individuals with a history of falls within the past year were found to have a significantly higher risk of any clinical fracture, osteoporotic fracture, major osteoporotic fracture, and hip fracture. One or more previous falls were significantly associated with an increased risk of death among women and men.
• Sex Disparities: The association between previous falls and fracture risk was observed to vary by sex, with men exhibiting higher predictive values compared to women.
• Independent Risk Factor: The increased fracture risk linked to previous falls was largely independent of bone mineral density, emphasizing the standalone significance of falls as a risk factor. A previous fall in the past year confers a significantly increased risk of any clinical fracture, osteoporotic fracture, and hip fracture with the increase in risk varying between 36% and 59% depending on the fracture outcome and sex. 

These findings underscore the importance of incorporating previous falls into the FRAX algorithm,” Dr. Kiel added. Integrating this information into tools like FRAX can enhance their predictive accuracy and ultimately help health care providers to more accurately predict fracture risk and tailor preventive strategies accordingly, to improve patient outcomes.

The lead author was Liesbeth Vandenput, Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. 

Co-authors included:

• Helena Johansson, Mary McKillop Institute for Health Research, Australian Catholic University
• Eugene V. McCloskey, Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
• Enwu Liu, Mary McKillop Institute for Health Research, Australian Catholic University
• Marian Schini, Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield
• Kristina E. Åkesson, Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
• Fred A. Anderson, GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA
• Rafael Azagra, Department of Medicine, Autonomous University of Barcelona
• Cecilie L. Bager, Nordic Bioscience A/S, Herlev, Denmark
• Charlotte Beaudart, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
• Heike A. Bischoff‑Ferrari, Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland
• Emmanuel Biver, Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
• Olivier Bruyère, WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège
• Jane A. Cauley, Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
• Jacqueline R. Center, Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia
• Roland Chapurlat, INSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France
• Claus Christiansen, Nordic Bioscience A/S
• Cyrus Cooper, MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
• Carolyn J. Crandall, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles
• Steven R. Cummings, San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco
• José A. P. da Silva, Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
• Bess Dawson‑Hughes, Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston
• Adolfo Diez‑Perez, Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona
• Alyssa B. Dufour, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston  
• John A. Eisman, Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney
• Petra J. M. Elders, Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam Public Health Research Institute, Amsterdam
• Serge Ferrari, Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Switzerland
• Yuki Fujita, Center for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka
• Saeko Fujiwara, Department of Pharmacy, Yasuda Women’s University, Hiroshima
• Claus‑Christian Glüer, Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
• Inbal Goldshtein, Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv
• David Goltzman, Department of Medicine, McGill University and McGill University Health Centre, Montreal
• Vilmundur Gudnason, Icelandic Heart Association, Kopavogur, Iceland
• Jill Hall, MRC Centre for Reproductive Health, University of Edinburgh
• Didier Hans, Interdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital
• Mari Hoff, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
• Rosemary J. Hollick, Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, UK
• Martijn Huisman, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam
• Masayuki Iki, Department of Public Health, Kindai University Faculty of Medicine, Osaka
• Sophia Ish‑Shalom, Endocrine Clinic, Elisha Hospital, Haifa, Israel 
• Graeme Jones; Magnus K. Karlsson, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
• Sundeep Khosla, Robert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN
• Douglas P. Kiel, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston
• Woon‑Puay Koh, Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore
• Fjorda Koromani, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
• Mark A. Kotowicz, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia
• Heikki Kröger, Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
• Timothy Kwok, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong
• Olivier Lamy, Centre of Bone Diseases, Lausanne University Hospital, Switzerland
• Arnulf Langhammer, HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
• Bagher Larijani, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
• Kurt Lippuner, Department of Osteoporosis, Bern University Hospital, University of Bern, Switzerland
• Fiona E. A. McGuigan, Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
• Dan Mellström; Thomas Merlijn, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
• Tuan V. Nguyen, School of Medicine Sydney, University of Notre Dame Australia, Sydney
• Anna Nordström, School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
• Peter Nordström, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
• Terence W. O’Neill, National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
• Barbara Obermayer‑Pietsch, Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Austria
• Claes Ohlsson, Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
• Eric S. Orwoll, Department of Medicine, Oregon Health and Science University, Portland, OR
• Julie A. Pasco, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia
• Fernando Rivadeneira, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
• Anne‑Marie Schott, Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon
• Eric J. Shiroma, Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD
• Kristin Siggeirsdottir, Icelandic Heart Association, Kopavogur, Iceland
• Eleanor M. Simonsick, Translational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD
• Elisabeth Sornay‑Rendu, IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia
• Reijo Sund, Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
• Karin M. A. Swart, Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam
• Pawel Szulc, INSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France
• Junko Tamaki, Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka
• David J. Torgerson, York Trials Unit, Department of Health Sciences, University of York, UK
• Natasja M. van Schoor, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam
• Tjeerd P. van Staa, Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, UK
• Joan Vila, Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona
• Nicholas J. Wareham, MRC Epidemiology Unit, University of Cambridge, UK
• Nicole C. Wright, Department of Epidemiology, University of Alabama at Birmingham, AL
• Noriko Yoshimura, Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo
• M. Carola Zillikens, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
• Marta Zwart, PRECIOSA-Fundación Para La Investigación, Barberà del Vallés, Barcelona
• Nicholas C. Harvey, MRC Lifecourse Epidemiology Centre, University of Southampton, UK
• Mattias Lorentzon, Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne
• William D. Leslie, Department of Medicine, University of Manitoba, Winnipeg, MB, Canada
• John A. Kanis, Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne.

This work was supported by the UK Medical Research Council (MC_PC_21003; MC_PC_21001). The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005. Funding for the MrOS USA study comes from the National Institute on
Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. Funding for the SOF study comes from the National Institute on Aging (NIA), and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), supported by grants (AG05407, AR35582, AG05394, AR35584, and AR35583). Funding for the Health ABC study was from the Intramural research program at the National Institute on Aging under the following contract numbers: NO1-AG-6–2101, NO1-AG-6–2103, and NO1-AG-6–2106.

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 $85 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 at 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.

A recent study published in Osteoporosis International sheds new light on the relationship between body mass index trajectories during middle adulthood and the risk of bone fractures in late adulthood.

The study, “Association of bone fracture with 30-year body mass index (BMI) trajectories: findings from the Framingham Heart Study,” provides valuable insights into the potential implications of BMI changes on fracture risk later in life.

The study analyzed data from the Framingham Original Cohort Study, involving 1772 participants with an average follow-up of 17.1 years. BMI trajectories were constructed using latent class mixed modeling, and their association with fracture risk after age 65 was explored using Cox regression.

Key findings of the study include:

• Participants transitioning from overweight to normal weight during middle adulthood had a higher risk of all fractures after age 65 compared to those who maintained a stable BMI.
• Similar patterns were observed for lower extremity fractures, including pelvis, hip, leg, and foot fractures.  

“These findings emphasize the importance of maintaining a stable BMI throughout adulthood to reduce the risk of fractures in later life,” said Douglas P. Kiel, MD, MPH, director of the Musculoskeletal Research Center and senior scientist at Hebrew SeniorLife's Hinda and Arthur Marcus Institute for Aging Research. “For overweight individuals, strategies to avoid bone loss during periods of weight loss during middle adulthood could be beneficial in terms of reducing fracture risk. This is especially true with the recent increases in the use of the new obesity drugs.”

This work is in part supported by the following grants: NIH R01DK122503, R01AG065299, and R01 AR041398.

Co-authors of the study include Zihao Xin, Department of Biostatistics, Boston University School of Public Health; Hanfei Xu, Department of Biostatistics, Boston University School of Public Health; Xiaoyu Zhang, Department of Biostatistics, Boston University School of Public Health; Elizabeth J. Samelson, PhD, associate scientist, Marcus Institute, Hebrew SeniorLife; Douglas P. Kiel, MD, MPH, senior scientist, Marcus Institute, Hebrew SeniorLife; and Ching-Ti Liu, PhD, professor of biostatistics, Department of Biostatistics, Boston University School of Public 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. 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; Jack Satter House, Revere, and Leyland Community, Dorchester. 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.

Osteoporosis and cardiovascular disease tend to co-occur in older adults. A new study published in the Journal of Bone and Mineral Research measured vascular dysfunction in relation to bone loss and deterioration in bone microarchitecture to investigate whether this is due to shared risk factors or if there is a causal pathway by which vascular dysfunction with aging leads to skeletal fragility.

Researchers used data collected from 1,391 participants in the Framingham Heart Study to evaluate the link between blood vessel function and bone health. They used special tools to assess bone density and microstructure by measuring blood flow and pressure and advanced imaging called high-resolution peripheral quantitative computed tomography (HR-pQCT).

Entitled “Vascular function and skeletal fragility: A study of tonometry, brachial hemodynamics, and bone microarchitecture,” the study found that while people with impaired blood vessel function tend to have lower bone density and worse deterioration in bone micro-structure, the association did not remain after statistically controlling for age, sex, and other confounders. Although cardiovascular disease frequently co-occurs with osteoporosis, Ilana Usiskin, MD, lead author and clinical fellow at Brigham and Women’s Hospital, explained that “the results indicate that vascular function may not independently predict skeletal fragility independently of shared risk factors.”  

Elizabeth (Lisa) Samelson, PhD, principal investigator for the NIH-funded study, associate scientist at Hebrew SeniorLife‘s Hinda and Arthur Marcus Institute for Aging Research, and associate professor at Harvard Medical School, added, “Cardiovascular disease and osteoporosis are highly prevalent conditions in older adults and responsible for significant morbidity and mortality. Our goal was to better understand whether or not vascular dysfunction plays a role in the development of osteoporosis, as early recognition of risk factors can lead to intervention and fracture prevention.”

The Framingham Heart Study, Boston University, Beth Israel Deaconess Medical Center, and the Marcus Institute at Hebrew SeniorLife collaborated on this study.

This study was supported by R01 AG065299, R01 AR061445, National Heart, Lung, and Blood Institute (NHLBI) contracts N01‐HC‐25195, HHSN268201500001I, and 75N92019D00031 and by DK080739, HL107385, HL126136‐01A1, HL93328, HL142983, HL143227, HL131532, HL70100, HL092577, 2U54HL120163, and AG066010.

Co-authors of the study include: Ilana M. Usiskin, MD, Division of Rheumatology, Inflammation, and Immunity at Brigham and Women’s Hospital; Gary F. Mitchell, MD, president of Cardiovascular Engineering Inc.; Mary L. Bouxsein, PhD., professor of orthopedic surgery at Beth Israel Deaconess Medical Center and Harvard Medical School; Ching-Ti Liu, PhD, professor of biostatistics at the Department of Biostatistics of Boston University School of Public Health; Douglas P. Kiel, MD, MPH, director of the Musculoskeletal Research Center and senior scientist at the Marcus Institute at Hebrew SeniorLife; and Elizabeth J. Samelson, PhD.

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 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; Jack Satter House, Revere; and Leyland Community, Dorchester. 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 American Medical Directors (JAMDA) found that the risk of severe COVID-19 illness among nursing home residents with complete vaccination are low. The study found that residents aged 85 and older with certain comorbidities like heart disease and kidney disease were more vulnerable but that the risk of breakthrough COVID among fully vaccinated residents was less than 10%.

Examining data of 23,172 fully vaccinated residents from 984 nursing homes from March through November 2021, the study, entitled “Resident Factors Associated with Breakthrough SARS-COV-2 Infections,” found that just 5% developed an incident of breakthrough infection (BTI) of COVID-19 irrespective of variant during the time frame. 

The study also found that less than 10% of vaccinated residents with a breakthrough infection required hospitalization or died within 30 days (8.6%). Residents with severe infection were more likely to be aged 85 years and older and to have certain comorbidities, like heart disease and kidney disease.

“The goal of the study was to examine how often breakthrough infections and severe illness occur among nursing home residents who have received the COVID-19 vaccination series,” said the study’s co-author, Sarah D. Berry, M.D., M.P.H., Associate Director, Musculoskeletal Research Center and Associate Scientist, Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife.

“Despite changes in the COVID-19 virus, the risk of severe infection in vaccinated older adults in nursing homes is low. Given that the pandemic continues and testing policies have relaxed, this data provides prognostic information for nursing home facilities faced with continued outbreaks,” Dr. Berry added.

The study’s findings are significant, Dr. Berry said, because “rates of BTI and serious illness may vary with other variants, but risk factors for serious illness are likely similar and may help providers predict who will get sick during future outbreaks.”

Brown University, NYU, and the University of Michigan collaborated in this retrospective cohort study.

Ana Montoya, M.D., M.P.H., C.M.D., Clinical Assistant Professor, Geriatric and Palliative Medicine, Medical Director, Sub-Acute Service and Medical Director, Glacier Hills Care and Rehabilitation Center, University of Michigan School of Medicine, was the first author of the study. Other authors included: Vincent Mor, Ph.D., Professor of Health Services, Policy & Practice and the Florence Pirce Grant University Professor, Brown University School of Public Health; Elizabeth (Betsy) White, A.P.R.N., Ph.D., Assistant Professor of Health Services, Policy, and Practice, Brown University School of Public Health; and Jasmine L. Travers, A.G.P.C.N.P.-B.C., C.C.R.N., Ph.D., R.N., Assistant Professor of Nursing, NYU Rory Meyers College of Nursing.

Funding came from grants from NIA/NIH (3U54 AG063546).

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. 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 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.

Boston, MA - New research suggests that having a stronger purpose in life (PiL) may promote cognitive resilience among middle-aged adults. Cognitive resilience refers to the capacity of the brain to cope with stressors, injuries, and pathology, and resist the development of symptoms or disabilities. Furthermore, having a purposeful life implies changes in the organization of the brain with one specific brain network, the dorsal default mode network, showing greater functional connections within its components and with other brain areas. This may represent a neuroprotection mechanism that ultimately ensures better cognitive function into old age.

These are among the findings in the article, “Purpose in Life Promotes Resilience to Age-Related Brain Burden and Neuroprotection Through Functional Connectivity in Middle-Aged Adults,” published in the journal Alzheimer's Research & Therapy.

“The present data extend previous findings found in advanced age and pathological aging, such as Alzheimer’s disease, revealing that having a strong sense of purpose might confer resilience already in middle age,” said author Dr. Kilian Abellaneda-Pérez, from the Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.

“The fact that individuals in the higher purpose in life group had greater connectivity between specific dorsal default- mode network nodes, which correlated with cognitive performance, suggest such changes in the functional organization of the brain may represent the mechanism by which a greater purpose in life promotes brain health and protects the brain from dysfunction even in the face of stress, adversity, and illness,” said Dr. Alvaro Pascual-Leone, medical director, The Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife; and Department of Neurology, Harvard Medical School.  He concludes, “What is also exciting is that each of us, with appropriate guidance and support, can develop and sustain a robust sense of purpose and thus contribute to our brain health and wellbeing.”

Background

Disease-modifying agents to counteract cognitive impairment in older age remain elusive. Hence, identifying modifiable factors promoting brain reserve and resilience is paramount. In Alzheimer’s disease, education and occupation are typical reserve proxies. However, the importance of psychological factors is being increasingly recognized, as their operating biological mechanisms are elucidated. Purpose in life, one of the pillars of psychological well-being, has previously been found to reduce the deleterious effects of Alzheimer’s Disease-related pathological changes on cognition. However, whether purpose in life operates as a cognitive resilience factor in middle-aged individuals, and what are the underlying neural mechanisms, remains unknown.

Methods

Data was obtained from 624 middle-aged adults (mean age 53.71±6.9; 303 women) from the Barcelona Brain Health Initiative cohort. Individuals with lower (N=146) and higher (N=100) purpose in life (PiL) rates, according to the division of this variable into quintiles, were compared in terms of cognitive status, a measure reflecting brain burden (white matter lesions; WMLs), and resting-state functional connectivity (rs-FC), examining system segregation (SyS) parameters using 14 common brain circuits.

Results

Neuropsychological status and WMLs burden did not differ between PiL groups. However, in the lower PiL group greater WMLs entailed a negative impact on executive functions. Subjects in the higher PiL group showed lower SyS of the dorsal DMN (dDMN), indicating lesser segregation of this network from other brain circuits. Specifically, higher PiL individuals had greater inter-network connectivity between specific dDMN nodes, including the frontal cortex, the hippocampal formation, the midcingulate region, and the rest of the brain. Greater functional connectivity in some of these nodes positively correlated with cognitive performance.

Authors 

Kilian Abellaneda-Pérez¹,²,³, Gabriele Cattaneo3, María Cabello-Toscano¹,²,³, Javier Solana³, Lídia Mulet-Pons¹,², Lídia Vaqué-Alcázar¹,², Cristina Solé-Padullés¹,², Núria Bargalló⁴,⁵, Josep M. Tormos3, Alvaro Pascual-Leone6,7, David Bartrés-Faz¹,²,³

Affiliations

¹Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain. 
²Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
³Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain. 
⁴Neuroradiology Section, Radiology Department, Diagnostic Image Center, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
⁵Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain.
⁶Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA. 
⁷Department of Neurology, Harvard Medical School, Boston, MA, USA.

Ethics Approval and Consent to Participate

This study was approved by the Comité d’Ètica i Investigació Clínica de la Unió Catalana d’Hospitals (ref. CEIC 17/06). All study participants provided signed informed consent.

Competing Interests

Alvaro Pascual-Leone is listed as an inventor on several issued and pending patents on the real-time integration of transcranial magnetic stimulation with electroencephalography and magnetic resonance imaging. He is co-founder of Linus Health and TI Solutions AG and serves on the scientific advisory boards for Starlab Neuroscience, Magstim Inc., Hearts Radiant, MedRhythms, TetraNeuron, and Skin2Neuron. 

Funding

The research leading to these results has received funding from “la Caixa” Foundation (grant agreement n° LCF/PR/PR16/11110004). This study is also partly supported by the Spanish Ministry of Science and Innovation (RTI2018-095181-B-C2), and the National Institutes of Health (R24AG06142, and P01AG031720).

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. 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 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.
 

BOSTON – Results of a study published in the American Journal of Clinical Nutrition indicate that regularly consuming a diet of pro-inflammatory foods (e.g., those rich in simple carbohydrates or in saturated fats) is associated with increased likelihood of developing frailty in middle-aged and older adults. Frailty affects between 10-15 percent of community-living older adults – making it a significant public health issue.

Courtney L. Millar, Ph.D., a Post-Doctoral Research Fellow, Hinda and Arthur Marcus Institute for Aging Research, and a Research Fellow, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, is the lead author of the study, “A Pro-Inflammatory Diet is Associated with Increased Odds of Frailty after 12-Year Follow-up in a Cohort of Adults.”

Approximately 1 in 6 community-dwelling older adults will develop frailty, a serious condition of impaired function of ability, which carries increased risk of falls, hospitalizations, and mortality. Previous studies linked specific nutrients with frailty or physical function but did not capture an individual’s entire diet and its impact on frailty over time. To address this concern, the researchers calculated dietary inflammatory index (DII®) score that reflects the overall inflammatory potential of one’s diet. This study, led by Dr. Millar, looked at the role of diet-associated inflammation on the likelihood of developing frailty. 

The study of 1,701 relatively healthy participants from the Framingham Heart Study found that a pro-inflammatory diet was associated with increased odds of frailty over a 12-year period. A one-point higher DII score (on a roughly 16-point scale) was associated with 16 percent higher odds of developing frailty over 12 years. The quarter of participants consuming the most pro-inflammatory diet were more than twice as likely to develop frailty as the quarter of participants who ate the most anti-inflammatory diet.

“The study indicated that regularly eating foods that contain nutrients such as dietary fiber and dietary antioxidants (such as vitamin C, vitamin E, and flavonoids) may prevent older adults from becoming frail,” Dr. Millar said. “While more studies are necessary, guidelines based on an anti-inflammatory diet may help reduce the percentage of older adults who may develop frailty and related conditions such as falls and fractures, which can improve their quality of life.”

Co-authors included:

• Alyssa B. Dufour, Ph.D., Marcus Institute, Hebrew SeniorLife, and Department of Medicine, Beth Israel Deaconess Medical Center.
• Nitin Shivappa, Ph.D., M.P.H., Arnold School of Public Health, University of South Carolina, Columbia, S.C. and Connecting Health Innovations LLC, Columbia, S.C. 
• Daniel Habtemariam, M.P.H., Data Scientist; Marcus Institute, Hebrew SeniorLife.
• Joanne M. Murabito, M.D., Boston University School of Medicine and Public Health and the National Heart, Lung, and Blood Institute’s (NHLBI) Framingham Heart Study. 
• Emelia J. Benjamin, M.D., M.Sc., Boston University School of Medicine and Public Health and the NHLBI’s Framingham Heart Study
• James R. Hebert, D.Sc., M.S.P.H., Arnold School of Public Health, University of South Carolina, Columbia, S.C. and Connecting Health Innovations LLC, Columbia, S.C. 
• Douglas P. Kiel, M.D., M.P.H., Marcus Institute, Hebrew SeniorLife, and Department of Medicine, Beth Israel Deaconess Medical Center.
• Marian T. Hannan, D.Sc., M.P.H., Marcus Institute, Hebrew SeniorLife, and Department of Medicine, Beth Israel Deaconess Medical Center.
• Shivani Sahni, Ph.D., Marcus Institute, Hebrew SeniorLife, and Department of Medicine, Beth Israel Deaconess Medical Center.

Dr. Millar’s research was supported by the National Institute of Aging (NIA) grant no. T32-AG023480) and the Beth and Richard Applebaum Research Fund. This study was funded by the National Institute of Aging (NIA) AG051728 and the Heart, Lung and Blood Institute's Framingham Heart Study (NHLBI) contract numbers HHSN268201500001I and N01-HC 25195. 

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 – Transcranial Magnetic Stimulation (TMS) can be a safe, effective nonpharmacological intervention that can treat older adults who suffer from geriatric depression even when they also have other chronic health conditions, such as dementia or Alzheimer’s disease.

This is a key finding of a recent Hebrew SeniorLife study entitled, “Transcranial Magnetic Stimulation for Geriatric Depression” that was published in Ageing Research Reviews. Davide Cappon, M.S., Ph.D., Post-Doctoral Research Fellow at the Hinda and Arthur Marcus Institute for Aging Research and a Neuropsychologist at the Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife, was the lead author of the study.

Depression is widespread among older adults, but it is not a normal part of the aging process. Depression is a treatable medical condition and treatment can be more challenging in older adults than in younger people because antidepressant drugs can mix with other medications, and antidepressants are less effective and more likely to have side effects in the elderly.

TMS is a form of non-invasive brain stimulation by which a brief magnetic field pulse passes through the scalp and induces an electrical current in the cerebral cortex that can modulate  brain activity in targeted brain networks and interactions between networks. In a systematic review of the evidence for TMS in treating geriatric depression, Dr. Cappon and his colleagues found that TMS treatment for geriatric depression is safe, well-tolerated, and shows encouraging efficacy outcomes. The study also found that TMS parameters adopted between different trials varied significantly and that TMS clinical efficacy for geriatric depression is highly variable between different trials.

Another key finding is that most of the reviewed studies significantly underdosed TMS for geriatric depression. It is important to optimize TMS treatment by considering the changes of the brain as patients age. Dr. Cappon said, “We recognized that properly dosing the TMS procedure for older adults is critical.”

The Wolk Center for Memory Health offers the only TMS program in New England that specializes in treating geriatric depression. The treatment is covered by most private insurance and Medicare. Call 617-363-8600 or contact us online to learn more.

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. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research and trains more than 1,000 geriatric care providers each year. Follow us on our blog, Facebook, Instagram, Twitter, and LinkedIn.