The Future Of Nano Technology
- Alan Watts
- Anti-Aging Medicine
- David Sinclair
- Gene Medicine
- Gene therapy
- Genetic Medicine
- Genetic Therapy
- Hormone Replacement Therapy
- Human Genetic Engineering
- Human Reproduction
- Integrative Medicine
- Life Skills
- Longevity Medicine
- Machine Learning
- Medical School
- Nano Medicine
- Parkinson's disease
- Quantum Computing
- Regenerative Medicine
- Stem Cell Therapy
- Stem Cells
- Biogen boosts gene therapy strategy with Harvard pact focused on inherited eye disease – FierceBiotech
- Hansa Biopharma Gets up to 350M to Make Gene Therapy Work in Resistant… – Labiotech.eu
- FDA Grants Orphan Drug Designation to Neurogene’s Gene Therapy for the Treatment of CLN5 Batten Disease – BioSpace
- Tiny mineral particles are better vehicles for promising gene therapy – ScienceBlog.com
- The Wilderness of Rare Genetic Diseases and the Parents Navigating It – The New York Times
- avast warning for phishing
- the concept of race has no genetic or scientific basis” and that “race is a social concept not a scientific one” (Witt 2010)
- Nanomedicine-Nanotechnology Biology and Medicine
- what happened to jackson avery on greys
- broadcast schedule
- greys anatomy jackson child
- harris silver md
- heroes season 1 claires immortality
- pros and cons of human activity on plants and animals
- higher ed mcat
|Search Immortality Topics:|
Category Archives: Longevity Medicine
For many people, living to 100 is the ultimate goal, but becoming a centenarian is a byproduct of multiple variables. You've probably heard that longevity has a lot to do with good genes and a healthy lifestyle, but a new study found that there is more to it than that. Recent research conducted by scientists at Washington State University's (WSU) Elson S. Floyd College of Medicine found that where you live can have a significant impact on how likely you are to reach the big 1-0-0. So, what's the ideal environment? Highly walkable, mixed-age communities.
"Aging has been attributed to be only 2035 percent heritable," the authors wrote in the study, published in the International Journal of Environmental Research and Public Health. "Social and environmental factors, such as high educational attainment and socioeconomic status, also significantly contribute to longevity."
The study particularly found that people who live in highly walkable, mixed-age communities tend to be more likely to live to their 100th birthday. "Protective factors for becoming a centenarian were higher walkability index and living in areas with a higher percentage of working age population," the authors wrote. According to the research, people with a high probability of living to 100 tended to live in geographic clusters in urban areas and smaller towns with higher socioeconomic census tracts.
The study adds to existing evidence that social and environmental factors contribute heavily to longevity. According to study author Rajan Bhardwaj, a WSU medical student, "These findings indicate that mixed-age communities are very beneficial for everyone involved. They also support the big push in growing urban centers toward making streets more walkable, which makes exercise more accessible to older adults and makes it easier for them to access medical care and grocery stores."
RELATED: For more up-to-date information, sign up for our daily newsletter.
Additionally, "neighborhoods that offer more age diversity tend to be in urban areas, where older adults are likely to experience less isolation and more community support," the study's senior author Ofer Amram, an assistant professor who runs WSU's Community Health and Spatial Epidemiology (CHaSE) lab, said in a statement. So if you're looking to live to 100, set your sights on a location that enhances your quality of living. And for more health tips, check out 40 Tiny Health Adjustments That Can Change Your Life After 40.
Read the original here:
This One Thing Will Help You Live to 100, New Study Says - Best Life
Marco Bertorello via Getty Images
In March, as Vadim Gladyshev shifted through the reams of data detailing the kinds of people who were more likely to fall victim to Covid-19, the Harvard biochemist started to wonder if we were thinking about the viral infection in the wrong way.
In Europe, 95 per cent of those killed by the disease were aged 60 or over. According to the UN, the fatality rate for those over 80 is five times the global average. Although many infectious diseases impact older people disproportionately, with Covid-19 the skew towards older people is devastating. Given all this, Gladyshev wondered, why arent we treating Covid-19 as a disease of ageing?
As he watched the global arms race to try and find a treatment which either neutralised the SARS-CoV-2 virus or dampen the overactive immune response which leads to many of the deaths, Gladyshev one of the worlds leading experts on the causes of ageing could not help but ponder if academics and pharmaceutical companies across the world were heading down the wrong path. If Covid-19 has the greatest impact on the elderly, rather than targeting the virus, should we not be focusing more on strengthening the host? he says.
Since the 1930s, scientists have sought clues on how to turn back the ageing process in humans by first trying to extend lifespan in rodents, with two drugs rapamycin and metformin showing signs of promise. While it is doubtful that these drugs would be useful in severe cases of Covid-19 where patients are already on ventilator support, Gladyshevs idea was simple. Could prescribing these drugs to the elderly as preventative measures could give the most vulnerable a better chance of fighting off Covid-19, and prevent them getting to that stage?
Since April, his idea has been taken up by a series of scientists across the US ranging from pharmacologists at Thomas Jefferson University to the Boston-based biotech company resTORbio, who are now testing forms of rapamycin in a series of clinical trials over the coming months.
While rapamycin and metformin are typically known for their clinical uses in cancer and diabetes respectively, the reason why Gladyshev and other longevity scientists think that these drugs could protect the elderly from covid-19 is linked to theories regarding biological age. We typically measure age chronologically based on the number of years a person has been alive, but there is a school of thought that biological age determined by biomarkers varying from DNA expression to the length of telomeres, the tips of chromosomes can vary depending on factors ranging from lifestyle to genetics.
Nir Barzilai, founder of the Institute of Ageing Research at the Einstein College of Medicine in New York, argues that the reason some people are less prone to age-related diseases such as cardiovascular disease, dementia, cancer and infections, is because their biological age is much younger. By the age of 65, half of people in Europe have two diseases or more, but half have less, says Barzilai. For me, this is due to their differing biological ages.
Most of the evidence that drugs might be able to reverse some of the hallmarks of ageing, and thus make an elderly person more resilient to viral infections, comes from studies either in human cells or rodents. This data suggests that rapamycin has the potential to revitalise the bodys natural defence mechanisms within the lungs, stimulating cells such as macrophages which are designed to seek out and remove viruses to work more efficiently.
But there have also been further findings in humans which has given longevity researchers increased confidence that they are on the right lines. Back in March, doctors in Wuhan published a study showing that diabetics taking metformin were much less likely to die of Covid-19 than diabetics not on the drug, an interesting finding which backed up previous epidemiological data showing that it can improve lifespan in diabetics. An earlier clinical trial conducted by resTORbio, using a formulation of rapamycin called RTB101, reported that it could reduce rates of respiratory viral infections in healthy people over 65.
Nevertheless when the Covid-19 pandemic began, few specialists outside of longevity research were aware of the anti-ageing properties of these drugs. At the start of April, Edwin Lam a pharmacology researcher at Thomas Jefferson University was looking at a study from molecular biologists across the US which used computer models to predict which drugs performed best when it came to helping the body remove the virus. To his surprise, rapamycin and metformin ranked top, ahead of many highly touted alternatives such as hydroxychloroquine.
Initially I thought this seemed far-fetched, says Lam. But then I looked further and found that some scientists had previously used a form of rapamycin called Sirolimus to treat people with severe cases of H1N1 bird flu. They saw a reduction in the viral load and better clinical outcomes. It had also shown antiviral activity in a preclinical model of Middle East Respiratory Syndrome. I presented this to my colleagues and we became really intrigued.
Lam has now designed a placebo-controlled clinical trial to see whether rapamycin can reduce the viral load in 20 patients with mild to moderate cases of Covid-19. A similar study is also taking place at the University of Cincinnati. ResTORbio are now looking at whether giving 550 nursing home residents an oral capsule of RTB101 each day over a period of one month, could protect them from becoming severely infected with the virus, and needing hospitalisation.
Nursing home residents have a very high risk of dying from Covid-19, says Joan Mannick, co-founder and chief medical officer of resTORbio. This elevated mortality has made the public acutely aware of the dysfunction of the aging immune system. I think the pandemic has the potential to catalyse interest in therapeutics that target aging biology as a new way to improve the function of aging organ systems.
But other scientists looking at ways to protect the elderly from Covid-19 caution that while they will be monitoring the results of the trials with interest, the evidence regarding the effectiveness of anti-ageing drugs remains limited. Its an interesting approach, but the data will have to speak for itself, says Ofer Levy, who heads the Precision Vaccines Program at Boston Childrens Hospital. Its all about safety and efficacy. Is it safe, how long can they be on it, and then is it effective? But its something to consider.
Levy points to another potentially promising approach for protecting the elderly from Covid-19, vaccines which are specifically designed for older people. These typically contain additional chemicals known as adjuvants to try and kick-start the ageing immune system. Its an approach which was successfully used by British pharma company GlaxoSmithKline to create the Shingrix vaccine in the past five years. This has shown to be highly effective in preventing shingles in people over 50, and Levy is looking to apply this strategy to a Covid-19 vaccine.
One of the ironies of vaccine development is that while over 65s stand to benefit most from immunisation, research has often shown that vaccines against influenza and other infections are at their least effective in the very old. This is thought to be due to changes in the blood which affect the immune response. As we age, the blood plasma changes and we tend to develop a low level of inflammation in our bloodstream, Levy says. Because of this, when you try to immunise someone, you often get an incomplete response to the vaccine.
Instead, Levys group is designing a vaccine which is specifically modelled on older immune systems. Our approach is to take blood donations from elderly volunteers, and then we isolate the immune cells in a dish, he says. We then screen lots of small molecules until we find ones which are like rocket fuel to the immune system, we add them to the vaccine and select the formulations which seem to work best against the coronavirus. This is completely different to normal vaccine development as were actually designing it with the ageing immune system in mind.
He hopes that such a vaccine could be in clinical trials by autumn 2021. Barzilai points out that in the meantime there is some evidence to suggest that supplementary treatment with rapamycin could enhance the effectiveness of the first wave of vaccines when they become available, with Japanese company AnGes hoping to make their Covid-19 vaccine available at the start of next year. Rapamycin has previously been shown to enhance the effectiveness of the influenza vaccine. Im sure that the initial vaccines will not be effective in the elderly, because their designs ignore their immune deficiencies, Barzilai says. But rapamycin could make a difference.
With the increased interest in rapamycin, longevity scientists predict that Covid-19 could prove to be a major boon for the field of anti-ageing research, a sector which has already been benefiting from injections of funding in recent years. Last year Barzilai received $75 million (60.5m) to conduct the TAME clinical trial, looking at whether giving metformin to elderly people over a period of four to five years can give them more years of good health. Gladyshev says that the three Covid-19 clinical trials involving rapamycin could provide a whole host of information regarding its ability to reduce biological age.
However, Barzilai is still frustrated that many within the medical community appear to be unaware of the potential of these drugs. He points to the Wuhan study in March, saying that while similar findings have been observed in Italy and Spain, no one has conducted a clinical trial looking at whether administering metformin to the elderly population in general, can offer protective benefits against Covid-19.
The major problem is that our health organisations are in silo and so ageing is often overlooked as a risk factor in these diseases, he says. For me, the question is why are we not using these two drugs on a wider scale to try and protect the vulnerable, when we already have information that they can offer benefit? Metformin has been used clinically for 60 years, its already known to be safe. If we just focus on stopping the disease in older people, the whole mortality issue would be different, the lockdowns wouldnt need to happen, and the economic impacts would be less as well.
Google got rich from your data. DuckDuckGo is fighting back
The Animal Crossing fans running in-game businesses
Inside the 'bullshit' get-rich-quick world of dropshipping
The secret behind the success of Apple's AirPods
The UK's lockdown rules, explained
Follow WIRED on Twitter, Instagram, Facebook and LinkedIn
Get The Email from WIRED, your no-nonsense briefing on all the biggest stories in technology, business and science. In your inbox every weekday at 12pm sharp.
Thank You. You have successfully subscribed to our newsletter. You will hear from us shortly.
Sorry, you have entered an invalid email. Please refresh and try again.
As people start planning for retirement, there are a number of decisions that they must make.
One of the first steps is deciding what an ideal retirement will look like. Many boomers have a different goal than their parents had. Merrill Lynch surveyed affluent boomers between ages 46 and 64. A large majority expected a more active lifestyle, a different look and a higher standard of living.
About 70% planned to keep working and 20% expected to start or further their own businesses. Most that have success running a business in retirement were already doing so before retirement. There is a huge failure rate in new business startups.
There are some gender expectation differences, as the survey found more women hoping to travel, pursue a hobby, be involved in community and charity work. More men thought of starting or furthering a business. Some goals and hobbies require a larger monetary commitment than others.
Other decisions, such as where to live, might be up for consideration. This can be influenced by family location, cost-of-living and climate conditions. Taxes can be another influencing factor.
Once you have a picture of what retirement will look like, you need to determine the monthly income needed to support it. Once you have these totals, you need to compare with the sources of income that will be coming in. This might be from Social Security and pensions. If these two fixed-income sources cover all of your expected cash needs, you are probably in good shape. Often, there is a shortfall. This gap must be made up from other sources.
Some might come from investments such as 401(k)s, Individual Retirement Accounts or brokerage accounts. You may have a Roth IRA. It is important to take money from the right accounts to minimize taxes so that you have more to spend on your needs and desires.
You may have rental income, royalties or may plan to work part time. By factoring in any of these sources, see if your income gap is covered. If not, you may have to consider some adjustments to your desired retirement. Make sure you plan for inflation protection. Many people use 3% for their plans. Without this element, your purchasing power will slowly erode away.
There are three main risks in retirement. First is longevity. That is the possibility of running out of money. Unless you come from a family with very short life expectancy or are currently very ill, you should provably plan on living until age 95. With modern medicine and improved environmental conditions, centurions are one of the fastest-growing segments in our society.
The second major risk is market risk. If the market crashes right before or soon after retirement starts, you could get wiped out in your investment accounts. This sequence of risk can be a death blow. Many people just got an unusual second opportunity. Never before have we seen the stock market crash so fast and recover so quickly. That will probably not happen the next time there is a major correction.
The third major risk is taxes. FINRA identified this as being the largest risk to your retirement. Proactive tax planning is necessary to reduce your overall tax burden. Future tax rates will have to increase significantly to pay for all of the government spending on COVID-19.
Do a comprehensive review of your financial positions a few years before retirement to make sure that you are ready. This will help to eliminate many of the surprises.
Gary Boatman is a Monessen-based certified financial planner and the author of Your Financial Compass: Safe passage through the turbulent waters of taxes, income planning and market volatility.
View original post here:
Thinking of retirement? Review your financial positions | Business - Observer-Reporter
Theres a point, sometimes, when you need to close your laptop and just walk away from it all. Give yourself a break. Clear your head of all the noise thats bouncing around in there, polluted as it is by duelling opinions, lies, damn lies and statistics.
I could be referring to the general, day-to-day existence of the average person, whose COVID-19 isolation might mean too many hours going down rabbit holes on Twitter, subjecting themselves to too many head-shaking comments. Too many what the moments.
Im not talking about that, though.
Im going on about selecting another best of list. This time, its the CFLs All-Decade Team presented by LeoVegas.
MORE ON THE ALL-DECADE TEAM
CFL to honour the best of the last decadeVote Now: Receivers, Defensive Backs and SafetiesFull list of nominees at each positionADT Voting schedule
Ive always felt honoured to be asked to help compile these lists over the years; CFL All-Stars and yearly award winners, TSNs Top 50 players. Things like that.
And every time Im invited, I feel the same sense of giddy anticipation, the same sense of eagerness, the same sense of, you know, UNFETTERED POWER. Id be delighted to take part, is always my reply. Thank you for choosing lil ol me.
But every time every single time I begin to whittle the ballot down, a sense of uncertainty grows, at first just a wee sprout. But by the time the process is finished? Its a mighty oak of anxiety, with its sprawling canopy blotting out the sun.
Im sure youll understand the feeling as you wind your way through the positions, yourself. Some guys are locks, right? S.J. Greens gonna be on the list, yes? Brendon LaBatte, too, right? Solomon Elimimian? Yuppers.
There will be more names that youll decide are easy to click on. But dont get cocky. Because if youre really going to be thoughtful about it, youre in for a torturous game of everlasting mental ping pong.
I begin my game with the cockeyed optimism of Clark Griswold, piling everyone into the Family Truckster for what would certainly be a breezy, fun-filled journey to Walley World. Hurray for the best-laid plans. I thanked the CFL for putting me on the media panel. There are some good folks at the leagues head office and Im proud to associate with them.
Then, I start filling out my ballot and after one afternoon of bouncing back and forth on a rather large number of selections, my mood turns sour. I start cursing the same people whod invited me to take part. Miserable sadists. Why couldnt they just leave me alone?
At least they delivered a detailed stats pack to my inbox, to make the job easier, I guess. Except that it doesnt. Statistics guide you, at first, sure. But the more you look at them, the more they start whispering other things in your ear, one on top of the other. Before you know it, youre sitting on your back deck with your hands over your ears, trying to get the voices to stop. What about YAC? those voices say. What about forced fumbles? Touchdown to interceptions ratio? What about, what about, what about?
It occurs to me that handing over a detailed stats pack and asking for a definitive all-decade team is like your butcher throwing down a whole side of beef on your porch and saying here are your steaks. Enjoy your barbecue.
Soon enough, you realize that its not about the locks, its about the close competition below. Youve got five receivers to pick. Your list will be very good. But then, youll look at number six and number seven, and wonder how you can leave them off the all-decade team. And you know what? Number eight aint half bad, neither.
Its like having a jigsaw puzzle with pieces that are all the same shape. You plop em into place and think what a pretty picture that is. But what if I take this piece out and replace it with this one over here? Yeah, thats better.
Jamel Richardson Weston Dressler, Byron Parker and Keon Raymond headline a star-studded group of receivers and DBs eligible for the All-Decade Team presented by LeoVegas (CFL.ca).
Five minutes later, youre pulling that piece out and putting the original one right back in there. Then you think about the third piece you havent even tried.
Once more, this process has been an exercise of repetitive stress. Time is a flat circle and Im the marble rolling endlessly around its circumference. I whittle my linebackers list down to seven, for some reason, even though Ill ultimately select just three. That logic doesnt matter, though, because I end up spending some more time agonizing over the two or three that remain just outside my list of seven. Whats wrong with me?
Desperate for some kind of clarity on a few selections, I decide to go on-line to a Magic Eight-Ball website, which is a thing that really exists and that you can find. You can type in a question and youll get your answer, it promises. Excellent. Just end this, I think, zeroing in on a quarterback.
I type in: Mike Reilly or Bo Levi Mitchell?
The eight-ball shoots back: Reply hazy. Try again. Honest to goodness, thats what it said. So I do try again. It replies: Without a doubt.
Wait. What? I try a third time. Without a doubt, it tells me. Three more times I ask it. Three more times it replies: Without a doubt. What the hell?
I decided to shift gears and offer up some defensive tackles. Ted Laurent or Micah Johnson?
Ask again later, the eight-ball replies. I know how it feels. I type in: This is hard, isnt it? Eight-ball returns with: It is decidedly so.
Now, I think the eight-ball is just mocking me with its ham-fisted attempt at irony so I decide to head to other places on the internet, searching for signs that will sharpen the focus on who my fifth receiver ought to be. I tumble down the rabbit hole of highlight reels, Twitter threads, feature articles and Wikipedia pages.
Wikipedia? Yes. And you can find some crucial all-decade team decision-making tools there.
For instance, did you know that Manny Arceneaux belonged to the Phi Alpha Phi fraternity when he was at Alcorn State? Im not sayin thats a deciding factor, Im just sayin.
When it comes to deciding close races, its really easy to go around and around and around. Breaking the impasse might take some creativity on your part. It will certainly take swallowing some hard medicine.
For me, longevity is an important part of the selection process. Its not the be-all and end-all, but Ive granted it lots of weight as I cast my ballots for each position.
EPISODE OVERVIEW:Davis and Donnovan are joined by CFL.ca columnist Matt Cauz to dissect and debate a few of their picks for The All-Decade Team presented by LeoVegas.
For others, it might come down to a stat that they hold more dearly over the others. Or that a players career numbers came despite being on mediocre teams. The number of all-star selections. Awards. Big, memorable performances. A reel of eye-popping plays.
Whatever the process, what starts out as an easy task inevitably becomes a serpentine tangle of yeah buts, on the other hands, and well maybes.
And when you finally do get to Walley World, the place is closed, for crying out loud. A day after submitting my picks, I wondered if I should get in touch with someone at the CFL to change a selection or two. This is a gift that keeps on giving.
Next time, Ill just decline the invitation and make life a whole lot easier.
Now if youll excuse me, I need to research some receivers and their college fraternities, to see how they match up with Alpha Phi Alpha.
Read the rest here:
Landry: Selecting the best of the decade a mind-bending exercise - CFL.ca
I understand why my patient is scared to lose her hair: it signals the loss of life as she knows it – The Guardian
I think you will need some chemotherapy soon, I say gently. Im painfully aware of the tsunami of emotions this will provoke. Chemotherapy patients have many worries, notably how it will make them feel and how much of their time will sink into travelling and waiting.
Every day I have conversations about chemotherapy that involve a balance sheet of risk and benefit, with the hope of convincing myself and my patients that the ledger lies in their favour. But my recommendations are in the end just that, because no can say with certainty that this chemotherapy will help that patient in exactly the way the studies claim. Maybe this is natures way of keeping oncologists humble.
The truth is that chemotherapy is a tricky thing that I prescribe, and the patient undertakes. We are in it together, I say, but this sounds glib because what really happens is that I watch from the sidelines and do my best to avert tragedy. I dont want the we to sound fake, but I dont want the you to be lonesome. And ultimately, it is through being inclusive that doctors learn what really matters to their patients.
Let me walk you through what chemotherapy involves, I offer.
Will I lose my hair? my patient stammers, and catches me by surprise because its not the first thing people usually ask. Her hands clasp her hair and the tears start welling, which transports me to an early experience in my training when a woman was threatening to walk out.
She doesnt want to lose her hair, I relayed to the consultant. What should I do?
He leaned back in his chair and rolled his eyes. Well, she can die with good hair then.
He was exasperated but the remark was not worth repeating to the patient. I failed in my negotiations and never saw her again. Much later, I realised I had tried to use intellect to bulldoze through sentiment. Countering her grief with images of wigs and scarves and, desperately, cancer recurrence rates was never going to work. But back then, thats all I had earnest facts and figures to combat existential dread.
When younger, I was sometimes incredulous that patients could really choose preserving hair over longevity or favour supportive care instead of active treatment, even if the chance of success was small. But the older I grow, the more I understand that the most consequential decisions we make in life are rarely binary. It has taken ageing parents, dependent children and the cumulative experience of thousands of patients navigating enormous challenges to realise this obvious truth.
I now know that patients can lose their hair and still succumb to disease. People who brave the same treatment can have entirely different outcomes. Those who elevate quality of life over a drawn-out, painful existence are being courageous, not defeatist. And when suffering patients say, I might as well die, they are not always depressed but have assessed their life thoroughly and concluded that their best days are past.
The invincibility and impatience of youth has been slowly but surely replaced by a deeper understanding of what patients mean when they say they dont want to lose their hair, dont want to go to hospital and will never undergo another surgery. Now, my response is no longer Why not? but Tell me more. This single phrase, more than any other, has opened up world views that I may not necessarily agree with but which nonetheless illuminate my thinking.
Each year, a few patients reject conventional treatment with a staunch belief in alternative therapies which range from being decidedly odd to downright deadly. (Once, a patient insisted it wasnt chemotherapy but an anticancer powder working its magic and urged me to become an agent. The only reply shed accept is that the hospital wouldnt allow it.) A few patients are permanently conflicted, seek opinions that never satisfy them and make unreasonable demands on the energies of staff. The issues vary but if there is a constant, it is the presence of fear. People behave in seemingly irrational ways under the influence of fear. The fear of complications; the fear of the unknown; the fear of dying.
When the philosopher Seneca observed, They lose the day in expectation of the night and the night in fear of the dawn, he might well have been talking about many of my patients. But medical training doesnt really teach us to be comfortable around the fears of patients. Much easier to ignore or discount something than try to understand it. Except in medicine it makes for unsatisfactory care and unpleasant memories.
Once a patient flatly refused to have his diabetic foot amputated, frustrating his doctors. In response to the text-book arguments about the dangers, he shrugged, I really like my foot. It was as poignant a reason as I ever heard. At 90, he was afraid of being sent to a nursing home minus his foot but would willingly submit to sepsis. Eliciting this fear made the difference between treating him with compassion and labelling him obstinate.
Having seen enough such incidents, I am determined to not lose another patient over an argument about hair.
I can tell your hair really matters to you, I offer. I am going to think of options. Her whole body relaxes as if I have promised her the world, although I have not.
I ask her son to help me understand her distress. Its not vanity, he thoughtfully explains. She is a widow. Most of her friends dont know her longstanding diagnosis and she fears they may judge her if they do. If not, they may still talk about her, and she seeks friendship, not pity. Now, what seemed a whim assumes a whole new significance.
From a purely medical standpoint it may be dispensable, but to my patient the loss of a beautiful head of hair signals the loss of life as she knows it, the beginning of the great unravelling. When the hair on the floor reminds you of your mortality, it mustnt be so easy to sweep it up.
Slowly, the factual points I had marshalled take a back seat as I see that what she needs most is empathy and time to figure out her own mind. Maybe she will delay the chemotherapy and keep her hair. Or lose her hair but also her peace. Maybe she will regret the hair loss and curse the day she agreed to it, or maybe she will acquire a colourful scarf and say it was worth it.
The truth is, I dont know and wont pretend to know. These are some of the hardest decision points in medicine. The only assurance I can offer is that I will respect her choice, noting that while I may be the doctor, she knows herself best.
Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
The incidence of anemia increases with aging, and it is considered to affect mortality through complex pathophysiological outcomes. Although it has been suggested that self-rated health may also contribute to the prognosis of anemia in older people, the relationship between anemia and self-rated health is not well understood. This study thus examined the actual status of anemia in older community-dwelling Japanese people and clarified the relationship between anemia and self-rated health.We conducted medical interviews, physical measurements and blood testing in 2083 people aged 69-91years who participated in the long-term observational Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Subjects were divided into two groups according to whether they had anemia. Logistic regression analyses were used to assess the relationship between anemia and self-rated health after adjusting for possible confounding factors.The prevalence of anemia was 22.3% in all participants, 7.2% in men and 11.6% in women aged 69-71years, 27.4% in men and 26.3% in women aged 79-81years, and 55.8% in men and 44.9% in women aged 89-91years. Multivariate analysis revealed a correlation between the presence of anemia and poor self-rated health in all (odds ratio 0.67, 95% confidence interval 0.48-0.93) and aged 69-71years (odds ratio 0.47, 95% confidence interval 0.25-0.86).Anemia was associated with self-rated health in older Japanese people, suggesting that careful management of anemia may contribute to health and longevity. Geriatr Gerontol Int 2020; : -. 2020 Japan Geriatrics Society.