Author: leydenacademy

Glasgow, Scotland/Leiden, The Netherlands/Bern, Switzerland/Cork, Ireland/Copenhagen, Denmark, 3 April 2017 – A mildly underactive thyroid gland (subclinical hypothyroidism) is a common condition in older age, affecting up to one-in-ten older men and women. According to current guidelines, nine of every ten women with the condition receive thyroid hormone tablets, typically levothyroxine, which has become the most prescribed drug in the USA and the third most prescribed drug in the UK. A large 5-year European study now shows that the common treatment of this condition with levothyroxine provides no apparent benefits, calling for a re-evaluation of the guidelines. The main results of the study were launched today with a publication in The New England Journal of Medicine along with simultaneous presentation at the Endocrine Society meeting (ENDO 2017) in Orlando, USA.

European 5-year study of 737 older adults
A team of researchers from various European Universities, including Leyden Academy on Vitality and Ageing, initiated the study following 737 older adults (average age 74 years) to determine if levothyroxine provides clinical benefits for older people with subclinical hypothyroidism. This condition has been linked to various health problems in later life, such as tiredness or lethargy, problems with the blood circulation, muscle weakness, slowed speed of thinking, and increasing blood pressure and weight, but it is also argued that the condition causes little harm. Half of the older adults in the trial were allocated to a placebo and half to levothyroxine, and participants were followed up for at least a year. The 5-year study found that treatment with levothyroxine tablets did effectively restore a normal balance of thyroid function, but did not give any symptomatic benefits. There was also no improvement of muscle strength, speed of thinking or any effect on body weight or blood pressure. Specific advices for the oldest old (over 80 years old) will be available next year, when TRUST results will be combined with an ongoing trial among over 80s.

No worthwhile benefits from levothyroxine treatment
Based on these findings, the team concluded that there is now convincing evidence that older people with a mildly underactive thyroid do not get worthwhile benefits from levothyroxine treatment. Professor David Stott from the University of Glasgow, who led the international study, explains: “Our aim is to significantly improve the health and well-being of older people with subclinical hypothyroidism, by resolving uncertainties about how best to manage this condition. Treatment with levothyroxine is common in clinical practice, but controversial. Our study concludes this treatment provides no apparent benefits for older adults and should therefore no longer be started routinely for this condition. An update of the guidelines is necessary.”

About the TRUST research project
Thyroid Hormone Replacement for Subclinical Hypo-Thyroidism Trial (TRUST) is a European research project of experts in ageing, thyroid problems and vascular disease, investigating current treatment practices for people who suffer from a mildly underactive thyroid gland. Professor David Stott from Scotland leads the study, along with collaborators from the Netherlands (lead Professor Jacobijn Gussekloo), Switzerland (Professor Nicolas Rodondi), Ireland (Professor Patricia Kearney) and Denmark (Professor Rudi Westendorp, previously Leyden Academy on Vitality and Ageing). The data handling was performed at the Robertson Centre for Biostatistics at the University of Glasgow (lead Professor Ian Ford). The study was funded by the European Union and medicines were provided free of charge by Merck KGaA. For more information, please visit the TRUST website.

The article Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism by David Stott, Jacobijn Gussekloo, Nicolas Rodondi, Patricia Kearney, Rudi Westendorp et al. was published by The New England Journal of Medicine on 3 April 2017.

What is the impact of care internships on the image that first-year medical students have of older persons? Researchers from Leyden Academy on Vitality and Ageing, the Leiden University Medical Center (LUMC) and the Center for Healthy Aging of Copenhagen University examined this topic and published their findings on 20 January 2017 in international publication PLOS ONE. In the academic year 2012-2013, approximately 250 first-year medical students were surveyed, prior to and directly after their two-week compulsory care internship in a nursing home, rehabilitation centre, or psychogeriatric ward of a hospital.

The article When Contact Is Not Enough: Affecting First Year Medical Students’ Image Towards Older Persons by Sasmita Kusumastuti, Esther van Fenema, Eugenie Polman, Wilco Achterberg, Jolanda Lindenberg and Rudi Westendorp was published by international, peer-reviewed, open-access, online publication PLOS ONE on 20 January 2017.

On Thursday 1 December, the online course Healthy Ageing in 6 Steps was launched on learning platform edX.org. This massive online open course (MOOC), developed by Leyden Academy in cooperation with EIT Health and TU Delft, immediately welcomed many visitors and from the start many participants engaged in lively discussions on the discussion boards of the course. At the end of the second week of the course, we now have 2,748 participants enrolled from 128 different countries.

Youngest participant 16, oldest 85 years old
The participants come from all over the world: most students are from the US (21 percent), while the Netherlands (8 percent) and India (6 percent) are also well represented. The median age of the students in 39 years, with the youngest student being 16 years and the most senior student 85 years old. That the course has a very mixed crowd, is also reflected in the education levels: about 15 percent has finished high school, almost half of the participants have completed a higher education. Approximately 60 percent of the course participants are male, 40 percent are female.

World map of fridges
On the discussion boards, participants collectively share their ideas on the content of the course and their personal experiences with (un-)healthy ageing. They respect each other’s contributions and motivate each other to think about a healthier lifestyle. Also, participants use the platform to get in touch with each other and engage in interesting discussions. Physicians, civil servants, law students, retirees, athletes, ICT-professionals, occupational therapists and many others share their views on how to age in a more healthy way. Moreover, the students take the exercises and assignments very seriously. For example, many people uploaded photos of their fridges on the interactive world map.

You can still join the course!
Every week, new course content is published, but it is certainly not too late to enroll in the course. The course lasts six weeks and even afterwards, it is still possible to enroll and complete the course at your own pace. There is also a possibility to obtain an edX certicificate of the course!

Below, please find some interesting comments from the MOOC so far:

“Very good analogy to the car industry and prevention. It will take a real change in mindset to move us from the mindset of doctors and pills. I love the challenge!”

“I am heavier than I have ever been and being 61 is not an excuse. I am moving to more cooking at home, and not cooking meat at home. I walk about 10,000 steps a day.”

“The BMI level of old Ghanaians is impressive. Here in China people keep a very high index even at a very young age. And for mid-30s the working people I think are very critical in this area.”

“I’m 68 now. I’m convinced that sitting long hours in a chair is one of the biggest threats to healthy life. (…) Too much chair has made my spine sick.”

“I migrated to the USA from Mexico 25 years ago. The idea of mismatch makes sense to me. As the years progress in my new homeland, I have gained weight. I have realized that not only becoming a mature woman affects my metabolism, but also I do not eat the same diet as in my Mexican life. USA has so much processed food and restaurants use an insane amount of salt in their cooking. I agree that also physical activity adds to keep those pounds down. I do not walk as much as I used to do in my younger years. It is all related.”

“As the old saying had it: an ounce of prevention is worth a pound of cure.”

“It is somewhat difficult for old men (I cannot speak for women), to make new connections once the old friends evaporate away. The reason I take these MOOCs is to be able to communicate. Incidentally I completed about 160.”

“Before I book my ticket to Ghana, how do Ghanaians fare in terms of incidence of the different types of dementia?”

What is important to older individuals, what are their wishes and ambitions? How can you create better services and products by focusing on their quality of life? Today, over 40 participants come together in Leiden for the blended course Wellbeing of seniors, part of the EIT Health Campus programme. Instructors are Professor Joris Slaets (Leyden Academy), Professor Rudi Westendorp (University of Copenhagen), Professor James Goodwin (AGE UK), Professor Ruut Veenhoven (Erasmus University Rotterdam), Dr. Theodore Cosco (Oxford Institute of Population Ageing), and many more.

After this intense day of lectures and workshops, the Dutch, Swedish, Greek, French, Danish, Polish and German participants will return to their respective organisations to work on a plan of action, supported by online coaching, literature, videos and assignments.

Learn how to make healthy choices and adjustments to your lifestyle and environment to help you live a healthier, happier and longer life. Join the EIT Health Campus MOOC ‘Healthy Ageing in 6 Steps. Let your environment do the work’, that starts as of 1 December 2016.

Instructor David van Bodegom explains: “Many health complaints, such as cardiovascular disease, diabetes or joint problems seem inescapable diseases of old-age, but originate mostly from our lifestyle. A lifestyle that is dictated much in part by our environment. The mismatch between our ‘old’ genes – our evolutionary heritage – and the ‘modern’ environment is the reason that we cannot resist the constant stimuli that seduce us to make unhealthy choices. Do’s and don’ts cannot help us.”
His co-instructor Rudi Westendorp adds :“This health course will take a radically different approach to showing you how to secure a lifestyle, which will keep you healthy as you grow older. We have to let the environment do the work for us. By making small changes at our home, work, school or neighbourhood, healthier choices can become easier or even unconscious.”

Practical assignments will provide you with the skills to re-design your daily environments to promote healthy, longer lives for you and your family, colleagues and neighbours – all the people with whom you share your re-designed environments. You will learn how to create your own healthy living zone. Via the course video’s you will go on virtual excursions to Copenhagen, Denmark and to Ghent, Belgium to watch and learn how the environment can help you live a longer, healthier and happier life!

Course details
Course length: 6 modules
Student work load: 2-3 hours per week
Language: English
Level: Introductory
Price: Free, or add a verified certificate for $49

Course instructors

• David van Bodegom MA MD PhD is trained as a physician and historian, and works as one of the ageing scientists at Leyden Academy. He is also a lecturer at the Leiden University Medical Center and TEDx Utrecht speaker on ‘Nudging Healthy Ageing’.
• Professor Rudi Westendorp, an internationally renowned physician, researcher and currently serves as a Professor of Medicine of Old Age at the Health and Medical Sciences Faculty of the University of Copenhagen. Westendorp wrote the international bestseller Growing Older Without Feeling Old.
• Remon Rooij holds a MSc degree in urban design & planning and real estate & construction management. Remon is experienced in researching and teaching (strategic) spatial planning at TU Delft.
• and many more inspiring guest lecturers.

Course providers
This free course ‘Healthy Ageing in 6 Steps’ is brought to you by EIT Health Campus with EIT Health partners Leyden Academy on Vitality and Ageing, University of Copenhagen and TU Delft.
The course is published on edX, an online learning platform founded by Harvard University and MIT in 2012. EdX is one of the largest MOOC (massive open online course) providers and offers high-quality courses from the world’s best universities and institutions to learners everywhere. In 2016, edX has more than 7 million students taking more than 700 courses online.

Sign up for this free course Healthy Ageing in 6 Steps. Join the course on edX.

As a knowledge institute with the mission to improve the quality of life of older people, Leyden Academy is represented by a vital older person every year. For our new year, running from 11 November 2016 to 11 November 2017, we are looking for a vital lady (from 75 years onwards) who radiates pleasure and a zest for life. Her portrait will be featured on the homepage of our website, our social media accounts and various means of communication.

Are you, or do you know a potential candidate? Please email your photo to Yvonne Schinkel-Koemans before Monday 26 September 2016. The management and communications department at Leyden Academy will select the ‘winning’ portrait which will be added to the gallery of respected predecessors pictured above.

Olympic athletes with an early and extraordinary peak performance, have shorter life expectancies

Leiden, The Netherlands/Copenhagen, Denmark, 21 August 2016 – Many personal records were broken in Rio’s Olympic arena in the past three weeks. Athletes who managed to achieve this at a relatively later age, may receive a special bonus: on average they live longer than their competitors who peak at an earlier age. This was concluded by researchers of Leyden Academy on Vitality and Ageing and University of Copenhagen in an article published in scientific journal Aging on 19 August 2016.

Peaking early comes with a cost
The researchers analysed the achievements and life expectancy of over one thousand athletes who competed in the 1896 Olympics in Athens to and including the 1936 Olympics in Berlin, in 58 disciplines including running, long jump and discus throw. The last of these Olympians passed away in 2010. The researchers established at what age these athletes achieved their personal records; the moment of which can be assumed that the athlete reached his or her maximal physiological capacity. Athletes who reached this peak at a relatively early age, showed 17-percent increased mortality rates compared to athletes who peaked at a later age. Also, athletes who ranked higher showed 11-procent increased mortality rates. Male athletes who had both an early and extraordinary peak performance suffered a cost of nearly 5 years at the end of their lives compared to those who peaked late and not extraordinarily. Peaking early in life comes with a cost.

First time physical trade-off is found in humans
Life history theory postulates a trade-off between development and maintenance. This trade-off is observed when comparing life histories of different animal species. In humans, however, it is debated if variation in longevity is explained by differences in developmental traits. Observational studies found a trade-off between early and high fecundity and longevity in women. However, development encompasses more than fecundity and also concerns growth and physical performance. Researcher Paul van de Vijver of Leyden Academy explains: “This is the first time a life history trade-off between physical performance and longevity is found in humans. We have seen a life history trade-off between early and above average physical performance and longevity in male Olympic athletes. This is not due to a direct cost of intense training and fierce competition, but to underlying biological mechanisms that help an individual reach his physical peak earlier, but come with a higher pace of aging. A fascinating finding that needs to be further unravelled.”

The article Early and extraordinary peaks in physical performance come with a longevity cost by Paul van de Vijver, David van Bodegom and Rudi G.J. Westendorp was published by scientific journal Aging on 19 August 2016.

If you have any questions, please contact Niels Bartels (Communications Manager) by phone +31 (0)71 524 0960 / +31 (0) 63461 4817 or by email.

This morning, we welcomed a delegation of twenty pre-medical students from Union College in New York. The group is currently touring the Netherlands to get a thorough impression of the Dutch healthcare system. This was the third consecutive year that students from Union College visited Leyden Academy in the summer.

Communications manager Niels Bartels provided the students with an introduction of Leyden Academy and some background on the demographic revolution in The Netherlands, with life expectancy rising and the baby boom generation reaching retirement ages. These developments raise interesting challenges that require innovative solutions. Scientific staff member Lex van Delden explained how our modern environment is making it difficult for us to maintain a healthy lifestyle, and argued we can make healthier and more social choices by making subtle changes in our daily work and home environments. Finally, the students experienced some of the impairments of old age by trying on the ‘ageing suit’. Seeing your classmates age radically before your eyes and being unable to perform simple daily tasks, turned out to be a hilarious end to an informative morning.

Studies show that happy people live a longer and more satisfying life. Check the infographic for the facts and figures, and below for the corresponding references.

References
1. Veenhoven 2012; 2. Zelenski, Muprhy & Jenkins 2008; Oswal, Proto & Sgroi 2009; 3. Koivumaa-Honkonen et al. 2004; Rissanen et al. 2011. 4. Dolan, Metcalfe and Powdthavee 2008; Flavin & Keane 2012. 5. Steptoe & Wardle 2001. 6. Cohen et al. 2003. 7. Davidson, Mostofsky and Whang 2010, open access. 8. Steptoe et al. 2014. 9. Thoits & Hewitt 2001. 10. Ryff et al. 2004. 11. Grant et al. 2009. 12. Siahpush, Spittal & Singh 2008.

On Wednesday 22 June, we celebrated the graduation ceremony of the master’s programme Vitality and Ageing. In the past academic year, eleven ambitious students attended this one-year English-taught MSc programme, which is characterized by a holistic approach to human ageing and care for older people.

Shared passion for the elderly
The master’s titles were awarded in the historical Academiegebouw in Leiden by professor Joris Slaets, director of Leyden Academy, to students with diverse educational backgrounds, ages and countries of origin: ranging from the Netherlands and Mexico to India and Nigeria. United by a shared passion for the elderly, the students have advanced in the areas of vitality and ageing. We are convinced that they will apply their acquired knowledge and experience to making a valuable contribution to the quality of life of older people, in their home countries or elsewhere in the world.

Master adopted by the LUMC as of 1 September
As of the academic year 2016-2017, the MSc Vitality and Ageing will be adopted by the Leiden University Medical Centre (LUMC) as a fully funded regular master’s programme. We are proud and delighted that after six successful editions at Leyden Academy, this unique programme will become an integral part of the LUMC curriculum. This will allow more medical students, students in biomedical sciences and health sciences to enrol in the programme and become pioneers in future care for the elderly.

For more information on the master’s programme Vitality and Ageing, please visit the website Masters in Leiden.