BOSTON — Researchers from Hebrew SeniorLife’s Institute for Aging Research, Beth Israel Deaconess Medical Center, The National Heart Lung and Blood Institute’s Framingham Heart Study and Boston University have found that poor back muscle quality is not associated with worsening kyphosis (forward curvature or “hunch” of the upper spine) in older adults. The study was published today in the Journal of Gerontology: Medical Sciences.

Lead author Amanda Lorbergs, Ph.D, former post-doctoral fellow at IFAR explains, “We used computed tomography (CT) scans to measure spinal curvature in 1087 men and women (aged 50-85 years to determine whether age-related decline in trunk muscle size and quality contribute to the worsening of kyphosis. We found that adults with smaller and fat-infiltrated muscles in the mid-back, but not the low back, had a more accentuated forward curvature of the spine. Six years later, the age-related decline in mid-back and low back muscle mass and quality was not associated with kyphosis progression.”

The results of this study have led scientists to believe that further research is needed to understand how targeted resistance exercises can modify muscle properties and contribute to preventing kyphosis progression.

This study was supported with funding from the National Institute on Aging of the National Institutes of Health (R01 AG041658, R01 AR053986, R01 AR041398, T32-AG023480) and the National Heart, Lung, and Blood Institute’s Framingham Heart Study (HHSN268201500001I) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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 Musculoskeletal Center within IFAR studies conditions affecting bone, muscle, and joint health with aging.

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 - Hebrew SeniorLife (HSL) and Curry College have recently published a free curriculum guide to serve as a resource for senior living communities and nursing schools who are interested in creating programs for intergenerational learning in an effort to foster interest in geriatric nursing.

Funded by the Boston Foundation, The Intergenerational Learning Curriculum guide is based on lessons learned from partnerships between HSL’s Simon C. Fireman Community and Curry College’s Nursing Program, as well as HSL’s Center Communities of Brookline and Simmons College School of Nursing.

The partnerships introduce nursing students to the special needs of older patients providing the opportunity to learn firsthand from seniors themselves. The benefits of this intergenerational programming are enjoyed by both students and patients. As the students get to know the seniors they work with, relationships are forged and interest in serving the senior population is encouraged. The seniors enjoy the interaction with the young students while helping train the next generation of nurses.

Hebrew SeniorLife President and CEO Lou Woolf said, “We’re eager to freely share what we’ve learned so that others can replicate the program – all with the goal of increasing the number of caregivers who are trained in the specific needs of older adults.”

The guide, which includes classroom tools and a sample syllabus, can be downloaded at here.

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. Founded in Boston in 1903, the nonprofit, non-sectarian 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 https://www.hebrewseniorlife.org, follow us on Twitter @H_SeniorLife, like us on Facebook, or read our blog.

About Curry College

Founded in 1879, Curry College is a private, four-year, liberal arts-based institution located on a wooded 131-acre campus in Milton, MA, just seven miles from downtown Boston. We offer 24 undergraduate majors, over 60 minors and concentrations, as well as four graduate programs.

BOSTON – On a nice sunny day, Sylvia can be spotted in the gardens at Hebrew SeniorLife’s NewBridge on the Charles continuing care retirement community. For more than 10 years, Sylvia has enjoyed living here. “I relish the balance of independence and the growing community of very warm people,” she said. She added that nothing gives her greater joy than to spend a day in the gardens at NewBridge. “It’s the process I enjoy – watching things grow,” she added.

Sylvia is one of eight older adults featured in Hebrew SeniorLife’s (HSL) advertising campaign currently running in the Greater Boston market on TV, radio, local newspapers, and billboards, among other channels. As an organization that has supported the health and wellness of seniors for more than 100 years, HSL wants people to know that even a pandemic will not stop it from delivering on its mission of caring for seniors. In many ways, what HSL provides is more critical than ever, which is reflected in the campaign’s headline, “All we are for your best life. Now more than ever.”

Also seen in the ad campaign is Mel. “I have never in my life been more myself and doing things that I really enjoy,” said Mel, an independent living resident at Orchard Cove. Having moved here with his wife in March 2019, Mel fills his days writing poetry and prose, playing guitar, singing, and taking classes. He added, “I love the new people that I’ve met here and I could not be happier.”

“All our senior living communities offer seniors the benefit of enjoying their independence while being in a safe, supportive environment, even during this health care crisis,” said Kim Brooks, HSL’s Chief Operating Officer, Senior Living.

Sample Creative

To learn more about seniors living their best lives at one of Hebrew SeniorLife’s campuses, visit allweareforyou.org.

About Hebrew SeniorLife 
Hebrw 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 – Older adults benefit from enhanced partnerships between health care systems and affordable housing sites. These partnerships improve health care outcomes while reducing unnecessary spending and/or use, according to research published in the Health Services Research journal.  

“The effect of the Right Care, Right Place, Right Time (R3) initiative on Medicare health service use among older affordable housing residents” study was designed to evaluate the R3 program of Hebrew SeniorLife, a Harvard Medical School-affiliated nonprofit. The report was coauthored by Tavares, J. Simpson, L. Miller, EA, Nadash, P. and Cohen, M. of the LeadingAge LTSS Center @UMass Boston.

Seniors living in sites with the R3 program had lower hospitalization rates, days, payments and readmissions than residents living in similar control sites.  This is the first study to document a decline in 30-day re-hospitalization rates among low-income senior housing residents who have access to place-based wellness teams, when compared to low-income seniors in buildings without this level of support.

R3 embeds a wellness nurse and coordinator in senior housing.  The place-based team efficiently conducts assessments and routine proactive check-in calls, risk stratifies the population based on established key risk factors, puts services in place to meet needs, partners with organizations to strengthen care coordination and communication, and tracks/trends data to drive and monitor results.

Hebrew SeniorLife developed R3 to address the disconnect between housing and health systems in order to improve the health and wellbeing of seniors. Partners, including emergency responders, health plans, area agencies on aging, and government agencies, were able to leverage congregate senior housing to achieve positive outcomes. 

The research sought to determine the effect of this housing-based intervention on Medicare health service use among senior housing residents. R3 enrolled 400 participants across seven intervention sites, four operated by Hebrew SeniorLife and three operated by partner providers, including Milton Residences for the Elderly and WinnCompanies.

Program Impact

Researchers noted that: “The findings suggest that the combined focus on assessment, proactive outreach, and prevention (with special attention to high-risk individuals); coordination with off-site providers; and the strengthening of an ‘eyes-on’ culture, led to the positive results.”

“Both the comprehensive quantitative and qualitative analyses that we have undertaken demonstrate conclusively that the program is having a major and positive effect on residents and that health care payers also benefit from lower health care costs by having their members participate in the program,” said Marc A. Cohen, Co-Director of the LeadingAge LTSS Center at UMass Boston.  “The R3 program hits all success metrics.”

“This research demonstrates that R3 delivers much-needed health and quality-of-life improvements for residents of senior housing,” said Louis J. Woolf, president and CEO of Hebrew SeniorLife. “At the same time, R3 contributes to efforts that avoid unnecessary care and reduce costs for a system that is beset with labor challenges and struggling to provide both sufficient and affordable services.  We are encouraged by the fact that with this data, policy makers are giving serious consideration to the benefit of adopting R3-like programs across the Commonwealth.”

Researchers concluded: “Age-friendly health systems would do well to enhance partnerships with affordable housing sites to improve care and reduce service use for older residents.”

Funding and Recognition
This study was funded, in part, by Hebrew SeniorLife, which designed and piloted the R3 program and secured additional funding for the evaluation and intervention. Funders include the Massachusetts Health Policy Commission Health Care Innovation Investment and SHIFT Care Programs, Beacon Communities LLC, Boston Scientific Foundation, Coverys Community Healthcare Foundation, Enterprise Community Partners, Massachusetts Department of Housing and Community Development, and MassHousing.  

The Pioneer Institute 2017 Better Government Competition honored R3 with its Grand Prize and the John A. Hartford Foundation honored R3 with its 2021 Business Innovation Award.

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 LeadingAge LTSS
The LeadingAge LTSS Center @UMass Boston conducts research to help our nation address the challenges and seize the opportunities associated with a growing older population.  The LTSS Center is the first organization of its kind to combine the resources of a major research university with the expertise and experience of applied researchers working with providers of long-term services and supports (LTSS).

In June, the U.S. Census Bureau announced that the average age of the U.S. population reached a new high of nearly 39 years old. Today, roughly three million older adults who belong to a sexual and gender minority (individuals who self-describe as LGBTQ+ or as having discordant gender and sex assigned at birth) live in the U.S., a number that is projected to grow to more than five million by 2030. Prior studies have demonstrated that this demographic is at disproportionate risk of chronic conditions, mental health issues, cognitive decline, and health risk behaviors compared to the general population. However, there’s little data available to characterize the way this population is aging. 

In a new study led by Chelsea N. Wong, M.D., an advanced geriatric medicine fellow at Beth Israel Deaconess Medical Center, investigators developed an index to describe and compare frailty—a measure of physiological reserve or vulnerability—between older sexual and gender minority (OSGM) adults and non-OSGM participants. Using the frailty index they constructed, Wong and colleagues showed that, overall, OSGM had higher rates of frailty, starting at younger ages and continuing into older age, compared to non-OSGM. The team’s work appears in the Journal of Gerontology: Medical Sciences. 

“We found that older individuals who belong to sexual and gender minorities have a higher burden of frailty, maintained across the lifespan and a higher magnitude of mortality risk,” said Wong, who is also entering a T32 post-doctoral fellowship with the Harvard Translation Research in Aging Training Program at Hebrew SeniorLife. “To our knowledge this is the first study to examine frailty among this marginalized population.”

Frailty is the state of vulnerability caused by age-associated decline across multiple functions, and it is associated with an increased risk of falls, disability, hospitalization, and mortality. While no single symptom confirms a frailty diagnosis, it commonly involves muscle loss and weakness, fatigue, slow walking speed, and impaired cognition. Taken together, the symptoms of frailty can lead to social isolation or make independent living impossible. 

Wong and colleagues constructed their frailty index using data from the All of Us Research Program, a program funded by the National Institutes of Health designed to recruit a diverse cohort of participants who have been historically underrepresented in biomedical research. The team built their frailty index to calculate based on 33 factors where individuals may experience deficits, including cognition, cardiovascular diseases, the ability to bathe or run errands alone, maintain a social life, fatigue, anxiety and depression, hearing and sight. 

When the researchers applied the Frailty Index to a sample of more than 76,000 eligible All of Us participants, they saw clear patterns. The 9,110 OSGM participants had a higher burden of frailty than their counterparts, with 41 percent robust (not frail), 34 percent pre-frail, and 26 percent frail. In comparison, non-OSGM participants, 50 percent were robust, 32 percent were pre-frail and 19 percent were frail. Further, the risk of mortality associated with frailty was higher among OSGM compared to non-OSGM. 

These disparities, the authors note, are understood through the minority stress theory, which describes how the external stressors of discrimination become internalized. Previous research has demonstrated that minority stress is associated with negative health consequences, including changes in inflammation immune and endocrine function, which in turn contribute to poor cardiovascular, metabolic, and immunologic clinical outcomes. 

“This current generation of older adults who identify as sexual and gender minorities experienced significant events specific to their minority identity, including homosexuality being officially labeled as a mental illness, the Lavender Scare where there was mass dismissal of SGM workers from U.S. government employment, and the advent of the HIV/AIDS epidemic,” said Wong. “The minority stress experience of chronic additive stress associated with social stigmatization and discrimination may lead to systematic inflammation and contribute to the development of frailty at relatively younger ages. These findings emphasize the need for early geriatric assessment among OSGM and future work should identify potential targets to mitigate frailty.” 

Co-authors included Michael P. Wilczek, PhD, Louisa H. Smith, PhD, Robert Cavanaugh, M.S., PhD, Justin Manjourides, PhD, Brianne Oliveri-Mui, PhD, and Jordon D. Bosse, PhD, R.N., of Northeastern University; Erin L. Richard, PhD of University of California San Diego; and Ariela R. Orkaby, M.D., MPH, of Veterans Affairs Boston Healthcare System and Brigham & Women’s Hospital. 

Orkaby is supported by the U.S. Department of Veterans Affairs (grant VA CSR&D CDA-2 award IK2-CX001800). The All of Us Research Program is supported by the National Institutes of Health (NIH). Please see the publication for a complete list of grants. The authors report no conflicts of interest.  

About Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center is a leading academic medical center, where extraordinary care is supported by high-quality education and research. BIDMC is a teaching affiliate of Harvard Medical School, and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding. BIDMC is the official hospital of the Boston Red Sox.

Beth Israel Deaconess Medical Center is a part of Beth Israel Lahey Health, a health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,800 physicians and 36,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.

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 $85 million, making it one of the largest gerontological research facilities 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.