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Badger MS. The Intersection of Geriatrics, Climate Change, and Wilderness Medicine: Education is Critical. Wilderness Environ Med 2024:10806032241245399. [PMID: 38850046 DOI: 10.1177/10806032241245399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
According to the US Census, for the first time in history, older adults are projected to exceed the number of children by 2035. These seniors are headed to the outdoors in increasing numbers and face unique risks. They benefit from careful pre-event evaluation planning to maintain their health in wilderness environments. Climate change is affecting all of us, but seniors are considered an especially vulnerable group. This vulnerability needs to be addressed not only when older adults head into the wilderness but also when the wilderness "comes to them" in areas where wilderness medicine and disaster medicine overlap. Education of both providers and patients is vital. This article aims to discuss the special needs of older adults/seniors /elders (defined as those over 65 unless otherwise indicated) in the wilderness as well as the vulnerability of older adults to climate change, both during planned wilderness activities and when the wilderness "comes to them" because of climate change, and to identify opportunities for education and adaptation of patients and education of physicians and wilderness and disaster responders to care for these older patients. The PubMed and Google Scholar Database search engines were utilized to review relevant English language publications between 2000 and 2023 that addressed individuals over 65 and explored the overlap of geriatrics (aged over 65), wilderness and disaster medicine, and climate change and create a perspective summary. Because of increased numbers of older adults heading into the wilderness for outdoor activities or having wilderness thrust upon them due to climate change, cross training of all specialties including the fields of emergency, geriatrics, wilderness medicine, and disaster medicine is needed in collaboration with other organizations and search and rescue. Response agencies must recognize that training in wilderness medicine provides a background for practitioners working in dangerous and remote settings and ought to seek out individuals with such skills when placing responders in the field. Climate change is making these intersections and the need for this education more urgent with time.
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Waisberg E, Ong J, Lee AG. El Niño and eye health: ophthalmic manifestations of changes in climate. Eye (Lond) 2024; 38:1233-1234. [PMID: 38177489 PMCID: PMC11076481 DOI: 10.1038/s41433-023-02907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Figueiredo T, Midão L, Rocha P, Cruz S, Lameira G, Conceição P, Ramos RJG, Batista L, Corvacho H, Almada M, Martins A, Rocha C, Ribeiro A, Alves F, Costa E. The interplay between climate change and ageing: A systematic review of health indicators. PLoS One 2024; 19:e0297116. [PMID: 38656926 PMCID: PMC11042704 DOI: 10.1371/journal.pone.0297116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/28/2023] [Indexed: 04/26/2024] Open
Abstract
Climate change and rapid population ageing pose challenges for communities and public policies. This systematic review aims to gather data from studies that present health indicators establishing the connection between climate change and the physical and mental health of the older population (≥ 65 years), who experience a heightened vulnerability to the impacts of climate change when compared to other age cohorts. This review was conducted according to the PICO strategy and following Cochrane and PRISMA guidelines. Three databases (PubMed, Scopus and Greenfile) were searched for articles from 2015 to 2022. After applying inclusion and exclusion criteria,nineteen studies were included. The findings indicated that various climate change phenomena are associated with an elevated risk of mortality and morbidity outcomes in older adults. These included cardiovascular, respiratory, renal, and mental diseases, along with physical injuries. Notably, the impact of climate change was influenced by gender, socioeconomic status, education level, and age-vulnerability factors. Climate change directly affected the health of older adults through ambient temperature variability, extreme and abnormal temperatures, strong winds, sea temperature variability, extreme El Niño-southern Oscillation (ENSO) conditions and droughts, and indirectly by air pollution resulting from wildfires. This review presents further evidence confirming that climate change significantly impacts the health and well-being of older adults. It highlights the urgency for implementing effective strategies to facilitate adaptation and mitigation, enhancing the overall quality of life for all individuals.
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Affiliation(s)
- Teodora Figueiredo
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Luís Midão
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Pedro Rocha
- CINTESIS@RISE, “Department of Behavioral Sciences”, ICBAS, University of Porto, Porto, Portugal
| | - Sara Cruz
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Gisela Lameira
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Paulo Conceição
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Rui J. G. Ramos
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Luísa Batista
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Helena Corvacho
- CONSTRUCT (LFC), Faculty of Engineering University of Porto, Porto, Portugal
| | - Marta Almada
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
| | - Ana Martins
- Faculty of Architecture, University of Porto, Porto, Portugal
| | - Cecília Rocha
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Anabela Ribeiro
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Sciences and Technology of the University of Coimbra, Coimbra, Portugal
| | - Fernando Alves
- CITTA–Research Centre for Territory, Transports and Environment, Department of Civil Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal
| | - Elísio Costa
- Porto4Ageing—Competence Center on Active and Healthy Ageing of the University of Porto, Faculty of Pharmacy of the University of Porto, Associate Laboratory i4HB—Institute for Health and Bioeconomy and UCIBIO—Applied Biomolecular Sciences Unit, Faculty of Pharmacy of the University of Porto, Porto, Portugal
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Pang P, Zhou X, Hu Y, Zhang Y, He B, Xu G. Time-series analysis of meteorological factors and emergency department visits due to dog/cat bites in Jinshan area, China. PeerJ 2024; 12:e16758. [PMID: 38250715 PMCID: PMC10800098 DOI: 10.7717/peerj.16758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Background Meteorological factors play an important role in human health. Clarifying the occurrence of dog and cat bites (DCBs) under different meteorological conditions can provide key insights into the prevention of DCBs. Therefore, the objective of the study was to explore the relationship between meteorological factors and DCBs and to provide caution to avoid the incidents that may occur by DCBs. Methods In this study, data on meteorological factors and cases of DCBs were retrospectively collected at the Shanghai Climate Center and Jinshan Hospital of Fudan University, respectively, in 2016-2020. The distributed lag non-linear and time series model (DLNM) were used to examine the effect of meteorological elements on daily hospital visits due to DCBs. Results A total of 26,857 DCBs were collected ranging from 1 to 39 cases per day. The relationship between ambient temperature and DCBs was J-shaped. DCBs were positively correlated with daily mean temperature (rs = 0.588, P < 0.01). The relative risk (RR) of DCBs was associated with high temperature (RR = 1.450; 95% CI [1.220-1.722]). Female was more susceptible to high temperature than male. High temperature increased the risk of DCBs. Conclusions The extremely high temperature increased the risk of injuries caused by DCBs, particularly for females. These data may help to develop public health strategies for potentially avoiding the occurrence of DCBs.
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Affiliation(s)
- Pei Pang
- Department of Medical Affairs, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiaoyong Zhou
- Department of Medical Affairs, Jinshan Hospital, Fudan University, Shanghai, China
- Emergency Department, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yabin Hu
- Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yin Zhang
- Shanghai Meteorological Service Center, Shanghai, China
| | - Baoshi He
- Key Laboratory of Watershed Geographic Sciences, Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences, Nanjing, China
| | - Guoxiong Xu
- Research Center for Clinical Medicine, Jinshan Hospital, Fudan University, Shanghai, China
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Bell V, Rodrigues AR, Antoniadou M, Peponis M, Varzakas T, Fernandes T. An Update on Drug-Nutrient Interactions and Dental Decay in Older Adults. Nutrients 2023; 15:4900. [PMID: 38068758 PMCID: PMC10708094 DOI: 10.3390/nu15234900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
In recent decades, the global demographic landscape has undergone a discernible shift that has been characterised by a progressive increase in the proportion of elderly individuals, indicative of an enduring global inclination toward extended lifespans. The aging process, accompanied by physiological changes and dietary patterns, contributes to detrimental deviations in micronutrient consumption. This vulnerable aging population faces heightened risks, including dental caries, due to structural and functional modifications resulting from insufficient nutritional sustenance. Factors such as physiological changes, inadequate nutrition, and the prevalence of multiple chronic pathologies leading to polypharmacy contribute to the challenge of maintaining an optimal nutritional status. This scenario increases the likelihood of drug interactions, both between medications and with nutrients and the microbiome, triggering complications such as dental decay and other pathologies. Since the drug industry is evolving and new types of food, supplements, and nutrients are being designed, there is a need for further research on the mechanisms by which drugs interfere with certain nutrients that affect homeostasis, exemplified by the prevalence of caries in the mouths of older adults. Infectious diseases, among them dental caries, exert serious impacts on the health and overall quality of life of the elderly demographic. This comprehensive review endeavours to elucidate the intricate interplay among drugs, nutrients, the microbiome, and the oral cavity environment, with the overarching objective of mitigating the potential hazards posed to both the general health and dental well-being of older adults. By scrutinising and optimising these multifaceted interactions, this examination aims to proactively minimise the susceptibility of the elderly population to a spectrum of health-related issues and the consequences associated with dental decay.
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Affiliation(s)
- Victoria Bell
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (V.B.)
| | - Ana Rita Rodrigues
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal; (V.B.)
| | - Maria Antoniadou
- Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, GR-15772 Athens, Greece; (M.A.); (M.P.)
- CSAP Executive Mastering Program in Systemic Management, University of Piraeus, GR-18534 Piraeus, Greece
| | - Marios Peponis
- Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, GR-15772 Athens, Greece; (M.A.); (M.P.)
| | - Theodoros Varzakas
- Food Science and Technology, University of the Peloponnese, GR-22100 Kalamata, Greece
| | - Tito Fernandes
- CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
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Sampath V, Shalakhti O, Veidis E, Efobi JAI, Shamji MH, Agache I, Skevaki C, Renz H, Nadeau KC. Acute and chronic impacts of heat stress on planetary health. Allergy 2023; 78:2109-2120. [PMID: 36883412 DOI: 10.1111/all.15702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
Heat waves are increasing in intensity, frequency, and duration causing significant heat stress in all living organisms. Heat stress has multiple negative effects on plants affecting photosynthesis, respiration, growth, development, and reproduction. It also impacts animals leading to physiological and behavioral alterations, such as reduced caloric intake, increased water intake, and decreased reproduction and growth. In humans, epidemiological studies have shown that heat waves are associated with increased morbidity and mortality. There are many biological effects of heat stress (structural changes, enzyme function disruption, damage through reactive oxygen or nitrogen species). While plants and animals can mitigate some of these effects through adaptive mechanisms such as the generation of heat shock proteins, antioxidants, stress granules, and others, these mechanisms may likely be inadequate with further global warming. This review summarizes the effects of heat stress on plants and animals and the adaptative mechanisms that have evolved to counteract this stress.
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Affiliation(s)
- Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Omar Shalakhti
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Erika Veidis
- Center for Innovation in Global Health, Stanford University, California, Stanford, USA
| | - Jo Ann Ifeoma Efobi
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Member of the German Center for Lung Research (DZL), Philipps-University Marburg, Marburg, Germany
- German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, Marburg, Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Member of the German Center for Lung Research (DZL), Philipps-University Marburg, Marburg, Germany
- German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, Marburg, Germany
- Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Kari C Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Bernhardt JM, Breakey S, Cox R, Olayinka O, Quinn L, Simmonds K, Atkin K, Sipe M, Nicholas PK. Development of a screening tool for assessment of climate change-related heat illness in the clinical setting. J Am Assoc Nurse Pract 2023; 35:291-298. [PMID: 37052622 DOI: 10.1097/jxx.0000000000000856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/16/2023] [Indexed: 04/14/2023]
Abstract
ABSTRACT Extreme heat contributes to heat-related illnesses resulting from heat intolerance, which is the inability to maintain a thermal balance to tolerate heat stress. In the United States, heat-related mortality for older persons has almost doubled in the past 20 years. Other populations at risk for heat-related illness (HRI) include children, pregnant people, those who work outside, young people participating in outdoor sports, and at-risk populations such as Black, indigenous, and populations of color. The classic heat tolerance test used for decades monitoring physiological responses to repetitive motions is impractical across large and potentially health challenged populations and does not identify environmental or social factors or specific vulnerable populations. To address this issue, we developed a heat-related illness screening tool (HIST) to identify individuals at risk for HRI morbidity and mortality based on their physical, environmental, and social vulnerabilities with an emphasis on populations of concern. The HIST has the potential to be used as routine clinical screening in the same way as other commonly used screening tools. Heat intolerance affects patient outcomes and quality of life; therefore, early screening with a simple, easy-to-administer screening tool such as the HIST can identify people at risk and refer them to services that address heat exposure and/or create safety nets to prevent heat-related illnesses.
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Affiliation(s)
- Jean M Bernhardt
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Suellen Breakey
- Center for Climate Change, Climate Justice, and Health, MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Rachel Cox
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | | | - Lisa Quinn
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Katherine Simmonds
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Kathryn Atkin
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Margie Sipe
- MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
| | - Patrice K Nicholas
- Center for Climate Change, Climate Justice, and Health, MGH Institute of Health Professions School of Nursing, Boston, Massachusetts
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Wang Y, Zhang C, Hikichi H, Kawachi I, Li X. Longitudinal Associations Between Disaster Damage and Falls/Fear of Falling in Older Adults: 9-Year Follow-Up of Survivors of the 2011 Great East Japan Earthquake and Tsunami. Innov Aging 2023; 7:igad020. [PMID: 37056712 PMCID: PMC10089294 DOI: 10.1093/geroni/igad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Indexed: 03/06/2023] Open
Abstract
Background and Objectives Fear of falling and falls are common in older adults. However, their associations with natural disaster exposures remain poorly understood. This study aims to examine longitudinal associations between disaster damage with fear of falling/falls among older disaster survivors. Research Design and Methods In this natural experiment study, the baseline survey (4,957 valid responses) took place 7 months before the 2011 Great East Japan Earthquake and Tsunami, and 3 follow-ups were conducted in 2013, 2016, and 2020. Exposures were different types of disaster damage and community social capital. Outcomes were fear of falling and falls (including incident and recurrent falls). We used lagged outcomes in logistic models adjusting for covariates and further examined instrumental activities of daily living (IADLs) as a mediator. Results The baseline sample had a mean (standard deviation) age of 74.8 (7.1) years; 56.4% were female. Financial hardship was associated with fear of falling (odds ratio (OR), 1.75; 95% confidence interval (CI) [1.33, 2.28]) and falls (OR, 1.29; 95% CI [1.05, 1.58]), especially recurrent falls (OR, 3.53; 95% CI [1.90, 6.57]). Relocation was inversely linked with fear of falling (OR, 0.57; 95% CI [0.34, 0.94]). Social cohesion was protectively associated with fear of falling (OR, 0.82; 95% CI [0.71, 0.95]) and falls (OR, 0.88; 95% CI [0.78, 0.98]) whereas social participation increased the risk of these issues. IADL partially mediated observed associations between disaster damage and fear of falling/falls. Discussion and Implications Experiences of material damage rather than psychological trauma were associated with falls and fear of falling, and the increased risk of recurrent falls revealed a process of cumulative disadvantage. Findings could inform targeted strategies for protecting older disaster survivors.
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Affiliation(s)
- Yuhang Wang
- Department of Sociology, Tsinghua University, Beijing, China
| | - Chenggang Zhang
- Department of Sociology, Tsinghua University, Beijing, China
| | - Hiroyuki Hikichi
- School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Ichiro Kawachi
- Department of Sociology, Tsinghua University, Beijing, China
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Xiaoyu Li
- Department of Sociology, Tsinghua University, Beijing, China
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