Author: leydenacademy

Zöldségek szemmagasságban! In other words: keep your veggies at eye level in the fridge. The book poster with practical tips for healthy ageing is now available in Hungarian. The poster is included in the bestseller A Guide for Growing Older. Let your environment do the work by professor Rudi Westendorp and David van Bodegom.

The translation was initiated by the Hungarian subsidiary of Aegon N.V., as part of an internal campaign to encourage a healthy lifestyle in the office environment. In this campaign, Aegon and Leyden Academy have also developed two videos about the effects of diseases of old age and how to make smart, healthier choices at work.

The Hungarian book poster can be viewed here.

The provision of healthcare: individual responsibility or collective choice?

During his public lecture on the 10^th of February at Leyden Academy, prof. Martin van Hees delved into thought-provoking questions around healthcare and more specifically, who is responsible for health?

The first question to answer in this debate that he raised during this lecture was: what is healthcare for? And following, what is justice in the allocation of healthcare? Relying on his extensive background in social justice, he proposed that four perspectives are usually referred to – although at times unconsciously – utilitarian, egalitarian, libertarian and capabilities. For instance, for utilitarians justice in healthcare allocation would be an allocation that maximizes utility, and utility may then be differently operationalized (such as maximum number of healthy life years, maximum number of individuals healthy and so on). For egalitarians, on the other hand, equality is the guiding principle and for instance an equal distribution of health, or equal healthcare access would be considered more important.

During this lecture, he discussed that in the case of healthcare one cannot speak about responsibility in a straightforward way. Responsibility consists of prospective and retrospective assessment of responsibility. In the assessment of responsibility of healthcare these two are often mingled. By way of example he posed the audience with a risk scenario in which a motorcyclist – being fully aware and knowing the higher risk for such an accident – got into an accident. Who is now responsible for the costs of care? The opinions in the audience were mixed. Knowing the risk, some contended that he should pay himself, whereas others contended that a risk is never ultimately the responsibility of the individual. Here on the one hand prospective responsibility comes in by way of things that one should be doing, or should not be doing in case it may happen. Following prospective responsibility, there is a moral duty to take care of your health. At the same time, arguments from a retrospective risk assessment are alluded to, because in how far can we hold individuals responsible for the bad things that happen to them?

Nevertheless, this is complicated since, as prof. Van Hees identified, there are certain issues that obscures this line of reasoning. More particularly, these kinds of responsibility assignments are set in an interactive environment and have an interactive nature. This is particularly important in the context of healthcare. Rather than accountability he proposed that a shift towards retrospective responsibility e.g. through insurance premiums may be an alternative solution. Although here again complications may arise as it may not only be about how you behave, but also how you behave towards others and vice versa.

Particularly interesting in this debate around accountability and responsibility, and perhaps even a way out, is according to prof. Van Hees the concept of quality of life. This may reshape the debate on distribution and social justice. He considers it an interesting starting principle because, accordingly, quality of life is politically neutral and it can draw attention to the budget without running the risk of becoming a polemic debate on justified allocation and individual responsibility.

All in all, the lecture gave a lot of food for thought about one’s own implicit assumptions in how healthcare should be divided. It also made the audience think about taking risks, responsibility and accountability in the context of care. As usual, in these kinds of challenging thought experiments one was left with even more questions. No wonder that the debate during the drinks afterwards was therefore lively and highly animated.

Prof. Martin van Hees is professor of ethics and head of the department of philosophy at the Vrije Universiteit Amsterdam.

How can we ensure that we stay healthy, even as we age? In their new book ‘A Guide for Growing Older’, professor Rudi Westendorp and David van Bodegom MD PhD present a practical recipe: small changes in your daily environment can make you live longer and healthier.

Many health problems such as cardiovascular disease, type 2 diabetes and osteoporosis seem inevitable, but they result mainly from our lifestyle. And the environment dictates that lifestyle. Due to the mismatch between our ‘old’ genes – our evolutionary legacy – and the modern environment, we are unable to resist the constant temptations around us. That is why blaming and shaming does not work.

We have to let the environment do the work. By making smart changes at home, on the road, at work, at school, and in the neighbourhood, we can – unconsciously – make the easy choice the healthier choice. In A Guide for Growing Older – Let Your Environment do the Work, the practical sequel to the bestseller Growing Older Without Feeling Old, Westendorp and Van Bodegom provide a series of tips for a longer healthy life. Each chapter features a full-colour illustration and the Dutch edition also includes a handy pull-out A3-sized poster, summarizing all the best tips.

A Guide for Growing Older (‘Oud worden in de praktijk’) was published in the Netherlands in September 2015 by Atlas Contact. An English edition is expected later in 2016.

About the authors
David van Bodegom (1978) is an ageing researcher at Leyden Academy on Vitality and Ageing. Van Bodegom a medical doctor and historian. He and is convinced that the public environment rather than the consultation room holds the key to healthy ageing.

Rudi Westendorp (1959) is an internationally respected doctor and researcher and former director of Leyden Academy. In the bestseller Growing Older Without Feeling Old (2014, over 50,000 copies sold) he described how the ageing process works, that we will enjoy longer, healthier, and more productive lives, and how we can greet it with confidence. Westendorp now lives in Copenhagen, where he is affiliated with the university as Professor of Medicine at Old Age. 

The mortality rates of Dutch seniors differ significantly between the seasons, and are 21% higher in the winter compared to the summer. Medical care expenditure (MCE) rises with 13% from the summer to the winter. Herbert Rolden, researcher at Leyden Academy on Vitality and Ageing, concludes this based on research into seasonal variation in mortality, MCE and institutionalization in over 60,000 senior citizens in The Netherlands. The research was published in international peer-reviewed publication PLOS ONE.

The mortality rates of older people change with the seasons. However, it has not been properly investigated whether the seasons affect MCE and institutionalization. Seasonal variation in MCE is plausible, as health care costs rise exponentially before death. On the other hand, not all diseases are fatal. For instance, in cold months there are relatively more heart attacks and hip fractures, resulting in an increase in MCE and nursing home admissions.

In the study, Rolden and his fellow researchers found that the mortality risk and MCE of people over 65 years old in the working area of a regional Dutch health insurer are highest in the autumn and winter. If the search results are extrapolated to the entire population of senior citizens in Netherlands, this implies that there are annually about 7,000 more elderly deaths in autumn and winter, and that MCE in these seasons is more than 600 million euros higher than in spring and summer.

Possible causes
The seasonal variation in mortality, MCE and institutionalization in older people can have multiple causes. Most obvious are climate conditions such as temperature, humidity, air pressure and the presence or absence of sunlight. Rolden: "During extremely hot summer days, there is often a lot of media attention for the risks to elderly people. Our research suggests that the cold months are more dangerous. However, temperature cannot be the only reason for the discovered association. For instance, we see that the seasonal variation among residents of nursing homes, who stay inside most of the time, is similar to the elderly who live at home. " External factors can also play a role in the seasonal variation, such as air pollution or the flu virus, which is more common in winter: "Further research is needed on the precise impact that these factors have on mortality and disease among Dutch elderly."

The research ‘Seasonal variation in mortality, medical care expenditure and institutionalization in older people: Evidence from a Dutch cohort of older health insurance clients‘ by Herbert J.A. Rolden, Jos H.T. Rohling, David van Bodegom and Rudi G.J. Westendorp has been published in international, peer-reviewed, open-access, online publication PLOS ONE on Monday 16 November 2015: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0143154.

Contents
Adult ageing is at a crossroads. We are living through a period in which the options for how to live a long life have rarely been more open, yet at the same time are increasingly being shaped by forces not of our own choosing. How do we adapt to a society when generations are becoming approximately the same size? And, what is the purpose of a long life?
Lifecourse change requires that we take discontinuities that include new challenges and directions into account as well as continuity.  Changes in social policy also suggest a future that is more precarious and more vulnerable than it has been for immediately preceding generations. So how do we manage our ageing identities in this context, and what might be the implications for intergenerational relationships? This talk will explore some of the challenges and alternatives as we respond to societal and personal ageing. 

Background
Simon Biggs is Professor of Gerontology & Social Policy at Melbourne University, Australia. He has participated in several government briefings on dignity in later life and population ageing. Recent research has included age-friendly environments, midlife issues, mature age workers, dementia care, and intergenerational relations.

Programme
Tuesday 13 October 2015, 16.00-18.00 hrs.
16.00 – Introduction by Dr. Jolanda Lindenberg Leyden Academy
16.10 – Lecture by Prof. Simon Biggs
17.00 – Discussion
17.15 – Drinks

Location
Leyden Academy on Vitality and Ageing
Poortgebouw ‘Zuid’, room 0.15
Rijnsburgerweg 10
2333 AA Leiden
The Netherlands
Please click here for directions.

Registration
Send an e-mail by 5 October to register for this free academic lecture: ageing@leydenacademy.nl.

Each year alternatingly a vital older man or woman is chosen as the ‘face’ of Leyden Academy. For this year (from 11-11-2015 through 11-11-2016) we are looking for:

• An older gentleman of about 70-80 years, preferably with an ethnic background.
• Important above all is that the person is vital and has a lust for life.
• Several photos of multiple subjects may be submitted.
• The management and communication department at Leyden Academy will choose the ‘winning’ portrait.
• The portrait will be revealed during the birthday celebration of Leyden Academy on 11 November 2015 and will be used for communication purposes from that moment on (e.g. for website, brochures, banners etc.).
  
• The picture is royalty-free and will be used exclusively by Leyden Academy.

Photos can be emailed no later than Monday 28 September 2015 to Yvonne Schinkel-Koemans at koemans@leydenacademy.nl.

It was approximately three years ago that my father told me about a professor who founded the Leyden Academy on Vitality and Ageing. This professor made a few interesting remarks. Remarks that kept me busy and made me wonder if there was more to ageing than I initially thought. This thought intrigued me and not long after obtaining my bachelor degree in Health Sciences, I enrolled in the master programme Vitality and Ageing.

At day one, I realised that the master students came from all over the world. To me, this was an absolute perk since I got to know people with different cultures and improve my English vocabulary at the same time. Although my English improved significantly, the process of this improvement did result in a few awkward moments when I forgot to switch back to Dutch while trying to communicate with a sixteen-year-old employee in a Dutch supermarket. Fortunately, this didn’t happen too often.   

After a brief introduction, the real ‘work’ started. The different courses were based on different disciplines. This allowed me to assess situations from different angles and to gain great insights in what ageing actually entails. For instance, during the master I learned what ageing is all about in a biological sense, but I also learned how to approach ageing in a more anthropological, sociological, and demographical way. The absolute strength of the master is that a lot of this knowledge is provided by guest lectures. These guest lecturers were, sometimes, literally flown in from around the globe (Sydney). It was great to experience that many of these guest lecturers were just as enthusiastic as we, the students, were.
However, we did not merely gained knowledge about ageing but also about vitality, entrepreneurship, models of care, finance, and clinical epidemiology. In addition, we were trained in academic writing, presenting, crisis communication, and leadership. All these different courses helped me to put things in perspective, allowed me to understand group dynamics, and offered me a chance to present new ideas in a proper manner so that designated target groups would understand it.    

Besides gaining knowledge and improving skills, I also met a lot of interesting people. People with whom I went to Texel to celebrate Sinterklaas, with whom I ate lunch, drank a lot of coffee, and shared stressful moments. People who bought me a birthday cake and with whom I had a lot of fun in Budapest during our study trip. To me, the moments I shared with all these unique individuals made the master a remarkable experience. An experience I can absolutely recommend!

The Dutch ministry of Education, Culture and Science has decided to fund the MSc programme Vitality and Ageing as of academic year 2016-2017. This is a wonderful recognition of this unique education programme, which provides pioneers with a holistic view of ageing and care for the elderly. The knowledge gained will prove invaluable in a domain with great importance in the decades to come.

Leyden Academy on Vitality and Ageing developed the MSc programme in 2009 with the aim of providing an annual class of talented young doctors and scientists with the latest insights in the field of vitality and ageing. Leyden Academy works together closely with Leiden University Medical Centre (LUMC) and Leiden University. Over the past six years, many dozens of students have completed the one-year master. They now apply their acquired knowledge and skills in (inter)national health care, scientific research and knowledge centres in the field of aging and elder care. The master’s programme has alumni from all over the world: from Mexico to Tanzania, from China to the UK.

The new funding rules of the MSc programme Vitality and Ageing will take effect as of 1 September 2016, with the start of academic year 2016-2017. From this date on, the tuition fees for the programme may vary depending on the student’s country of origin and personal circumstances (e.g. a first or second master). For more details, please visit the website Masters in Leiden.