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Weight loss may mean a risk of death for older adults, study shows

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As much as people may celebrate their own weight loss, it is not always healthy.

A new study shows that weight loss in older adults is associated with early death and life-limiting conditions.

Weight gain, on the other hand, was not associated with mortality, according to the study published Monday in JAMA Network Open.

Medical professionals have known to be concerned when older people with health conditions lose weight but researchers have not fully understood the impact of weight change on healthy older adults, according to lead study author Dr. Monira Hussain, a clinical epidemiologist and senior research fellow in public health and preventative medicine at Monash University in Melbourne, Australia.

The study looked at nearly 17,000 adults at least 70 years old in Australia and more than 2,000 adults in the United States who were at least 65 years old. Everyone who participated in the study was weighed at their annual checkup between 2010 and 2014, according to the study.

“Our study found that even a 5% weight loss increases mortality risk, particularly in older men,” Hussain said.

Weight gain in healthy older people, on the other hand, showed no association, she added.

The association was found across starting weights, meaning people who are medically classified as obese also were at an increased risk when losing weight, said Perri Halperin, the clinical nutrition director for the Mount Sinai Health System. Halperin was not involved in the study.

OTHER HEALTH ISSUES

The study was able to account for health issues at the start. It excluded people who had conditions like cardiovascular disease, dementia, physical disabilities or chronic illness, Hussain said.

“It also excluded those with recent hospitalizations, which is important because hospitalization is often followed by weight loss due to acute conditions,” Halperin said in an email.

But the study wasn’t able to distinguish if people involved lost weight intentionally or unintentionally, Hussain added.

“No questions were asked about changes in activity level and diet quality between the baseline study visit and subsequent study visits, so we do not have any information on how those factors may have impacted the results,” Haperin said.

WHY WEIGHT LOSS CAN BE A RISK

Weight loss may be a risk factor for mortality because it can signal underlying issues.

Weight loss may be a warning sign for conditions like cancer and dementia, and it is “often linked to reduced appetite influenced by inflammation and hormones,” Hussain said.

Underlying chronic health conditions can also trigger weight loss in older adults by impacting appetite, metabolism and eating habits, Halperin said. Mobility issues and medication side effects can also affect weight.

Changes in weight can also signal concerns in lifestyle, Halperin said.

“A major contributing factor to weight loss in older adults is social isolation. Other concerns include financial constraints and pain and discomfort,” she added.

In studies like these, remembering that correlation is not causation is important, Halperin said. Weight loss was associated with mortality, which means it’s correlated — but that doesn’t mean the weight loss caused a person’s death.

“It’s also important to say that the opposite cannot be extrapolated nor recommended — ie gaining weight would not necessarily decrease your mortality risk,” she said in an email. “As always, discuss your weight changes with your doctor or other medical professional.”

The takeaway is for older adults to monitor their weight change, Halperin said.

“If they notice a decrease in the number on the scale (weight loss) or perhaps pants that were once snug fitting looser (decreased waist circumference),” she added, “bring it up with their doctor for possible further screening or testing.”

But the advice also goes for the medical community, she said. Doctors and health-care providers need to know that changes in weight require further investigation.

 

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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