elderly

Lab Notes — Fall 2019

The Key to Allergies

An unexpected source drives severe allergies, researchers from UConn Health, The Jackson Laboratory for Genomic Medicine, and Yale University report in Science. An antibody known as high-affinity IgE is often behind the most severe food allergies, triggering anaphylactic shock. The researchers looked at mice with a genetic immune problem that causes severe food allergies including anaphylaxis. They found a subtype of immune cells called Tfh13 signal to B cells, another category of immune cell, telling them to make high-affinity IgE. When the researchers deleted Tfh13 cells in mice, the allergies disappeared. People with severe allergies tend to have elevated Tfh13 levels compared with nonallergic peers. The findings could point the way to better allergy testing and perhaps new approaches for treating allergies.


Just Breathe

Yoga practice that emphasizes mental relaxation and breathing techniques can have as much of a beneficial impact on high blood pressure as aerobic exercise, according to research by Yin Wu, Ph.D., a postdoctoral fellow in UConn’s Department of Kinesiology. The study, published in Mayo Clinic Proceedings, highlights the potential for yoga as an alternative antihypertensive therapy, particularly for those unable or unwilling to perform aerobic exercise. “We are not telling people to use yoga to substitute for aerobic exercise,” says Wu. “Aerobic exercise is the gold standard for antihypertensive lifestyle therapy. But yoga provides an additional option that can be just as effective.”


Caution: Falls Ahead

Antidepressant drugs known as selective norepinephrine reuptake inhibitors, or SNRIs, can lead to adverse events in adults over 65, according to a team of researchers from UConn School of Pharmacy, UConn Health, and Yale University. Among this drug class, duloxetine, which is commonly known as Cymbalta, was shown to most likely increase the risk of falls over time, according to the study published in the Journal of the American Geriatric Society. SNRIs, particularly duloxetine, should be avoided or used with caution in older adults, the researchers say.


Halting Hypertension’s Effects

Elderly people with hypertension who took a high dosage of medicine to manage their high blood pressure showed significantly less accumulation of harmful brain lesions compared to those taking a lower dose of the same medicine, UConn Health researchers reported at the American College of Cardiology’s 68th Annual Scientific Session. However, the reduction in brain lesions did not translate to a significant improvement in mobility and cognitive function. The INFINITY study is the first to demonstrate an effective way to slow the progression of cerebrovascular disease, a condition common in older adults that restricts the flow of blood to the brain. In addition to seeing beneficial effects in the brain, those who kept their blood pressure lower also were less likely to suffer major cardiovascular events, such as a heart attack or stroke.

Blood Test Can Alert Doctors to Delirium Risk

artsy photo depicting two nurses walking down hospital corridor in the view point of someone experiencing the effects of confusion or delirium


Researchers at UConn Health and Beth Israel Deaconess Medical Center have found that a blood test could make it easier to identify patients at risk for delirium, the sudden, acute state of confusion that most often affects older adults and incurs $6.9 billion in medical costs each year in the U.S. Their study, published online in The Journal of Gerontology: Medical Sciences, reports that elevated blood levels of specific proteins called cytokines can hint that a patient will develop delirium during a hospital stay.

If you do things such as improve a patient’s vision and hearing, reorient them to where they are regularly, promote restful sleep, increase mobility, and stop medications that could be making the delirium worse, all that can help.

Dr. George Kuchel, director of the UConn Center on Aging and one of the authors of the study, says the suspected blood signature for delirium shows two cytokines at higher-than-normal levels in patients who develop delirium. Both cytokines are associated with inflammation.

Researchers don’t yet know exactly how inflammation and delirium are linked. The two cytokines the researchers saw in the blood signature, interleukin-6 and interleukin-2, can cause swelling of the membrane around the brain. Chronic stress from low-level illness can also elevate both cytokines and stress hormones such as cortisol, which over the long term can shrink part of the brain and perhaps increase an elderly person’s susceptibility to delirium.

Kuchel and his colleagues worked with patients who participated in the Successful Aging after Elective Surgery (SAGES) study to get a better handle on the relationship between inflammation and delirium. This large study, sponsored by the National Institute on Aging, has been following 566 surgical patients over the age of 70 for the past five years, with the goal of finding new approaches to prevent delirium and its long-term consequences in older adults.

The UConn study found that patients who developed delirium had higher levels of interleukin-2 than non-delirium patients at all times they were tested: before surgery, in the first two days afterward, and one month later.

This is the first study to look at cytokine levels in older surgical patients at several points in time, both before and after surgery. The results need to be replicated in other studies, but if they prove to be generally true, the blood signature could provide a quick way to alert doctors and nurses to seniors at higher risk of delirium. They can then take extra precautions to keep the patients oriented.

“If you do things such as improve a patient’s vision and hearing, reorient them to where they are regularly, promote restful sleep, increase mobility, and stop medications that could be making the delirium worse, all that can help,” says Kuchel.