Science and Serendipity

This blog was contributed by James Goodwin, Age UK’s Chief Scientist. 

Recently, I received the sad news of the death of a dear friend and colleague who through his example, leadership and support had helped to change the course of my career.  Dr Ken Collins, a notable researcher and physician of old age medicine was instrumental in evoking my interest in ageing, at a crucial time in my life.  Our meeting was as fortuitous as it was timely, a truly serendipitous moment.  Through it, he began my life-long dedication to ageing science but more so, he implanted the priceless notion that we must go beyond the simple necessity of high quality research – vital though that is – and seek to generate impact, to change society in its approach, in its thinking and in its behaviour, so that genuine benefits accrue to older people. Continue reading “Science and Serendipity”

A Lesson from Siberia

Portrait of a old woman in winter

In 1993, two friends and colleagues of mine alighted from an internal flight in the heart of Siberia. The light was failing and the temperature plummeted as they wound their way from the landing strip into an endless forest. They were lost. Eventually, coming upon a wooden settlement, they found shelter with the village teacher, the only English speaker for many, many miles.

Professor Bill Keatinge later confided in me that he had learned two lessons from this incident. One was to learn Russian (which he later did, with some panache). The second was to dress like the Russians. Because Yakutsk, the city which they had come to visit, is the coldest city in the world. During their trip, the temperature fell to a mere -26C. The lowest winter temperatures reach -60.

And what, may we ask, was the attraction of this cold Siberian city? Ironically, the inhospitable, intractable, bone gnawing cold was the motivation for their journey. They were part of the Eurowinter Group, a collection of Europe’s finest scientists, whose mission was to unravel the complicated story of winter deaths in Europe. Until that time, no-one had a convincing explanation (scientists call this a ‘model’) of the pattern of winter deaths in Europe which varied from one country to another. And the prime question was why on earth should the British Isles, with its temperate maritime climate, be the villain of the piece, with many more ‘excess winter deaths’ than its colder European neighbours? Continue reading “A Lesson from Siberia”

Understanding the Oldest Old

In 2012, the Office for National Statistics estimated that there are nearly 1.5 million people aged 85 and over in the UK. We are only at the beginning of an estimated escalation of numbers of people in this age group, projected to reach 5 million by 2050. What was formerly a small number of exceptional individuals is rapidly becoming a whole new generation for families in this country: the ‘Fourth Generation’.

Over recent years, through research, our contact with leading experts, and ourRea3 engagement with older people, it has become apparent to Age UK that we all need to know more about these ‘oldest old’. Often what we hear are stereotypes held over from days gone by – that these oldest people are all frail and in care homes, their useful life over. We are concerned that all of us who make decisions concerning their welfare need help to get up to date with their nature and needs.

So we asked experts to write summaries of what is known in their area of research about the ‘oldest old’. We’ve collected these lay-person summaries into a short book, ‘Understanding the Oldest Old.’ Continue reading “Understanding the Oldest Old”

One swallow does not make a summer

At the start of the winter, it might seem strange to write about swallows and summers, especially when 21,700 older people died of cold related illness last year. That wasn’t 2,170 people. It was ten times that number and over the last 10 years, an average of over 26,000 have died each winter. You might be tempted to think that these deaths would have happened anyway and that they are ‘just brought forward’ by the cold of winter. But all the evidence tells us that this is not the case.

Every single death is unnecessary, avoidable, preventable.  For any other preventable cause of death this would be a national scandal.  There would be outcry, protest, even outrage. And even more so when we know that this has been going on for over 150 years, since 1841 when the then registrar general, William Farr (who also happened to be Florence Nightingale’s statistician) first recorded an excess of winter deaths over the summer.  A conservative estimate tells us that this amounts to an all-time, truly shocking total of over some 3 million deaths.

440x210_Snow-in-Shepton-MalFor the last 30 years there has been a debate about cause but the evidence shows that the over-riding reason for these deaths is the personal exposure of the individual to cold temperatures.  This cause was first revealed by Curwen’s ‘regression model’ in 1997 when he showed that there were three factors most associated with excess winter deaths. These factors were secular trend (roughly equating to improvements in standard of living); influenza (only in epidemic years) and temperature. Of these three, the most strongly associated was temperature. Continue reading “One swallow does not make a summer”

World Health Day – Launch of knowledge transfer toolkit

7 April is World Health Day and this year the theme is active ageing.  Age UK and the World Health Organisation are marking the occasion by launching a ‘knowledge transfer toolkit’ to help low and middle-income countries address chronic illnesses. 

In many parts of the globe today, there are millions of older people who are suffering from chronic long-term illness.  This, you might think, is not surprising – it is widely known and appreciated that as we get older, the risk of illness increases.  However, for many older people in the poorer parts of the world, there is a cruel paradox.

They are the survivors of the AIDS epidemic which places them as the carers of their grandchildren, but they themselves may have an undiagnosed disease or an untreated condition.  The problem will continue to worsen as the population of low to middle-income countries (LMIC) ages.

These so-called LMICs have health systems which have been set up to deal with and prevent communicable disease – malaria, water-borne diseases, TB and HIV/AIDS.  This emphasis is increasingly successful.  As the risks are reduced and the survival rate improves, more will progress into later life where they may develop chronic long-term illnesses. Continue reading “World Health Day – Launch of knowledge transfer toolkit”

A Spark of Genius from the Minds of Many

Some years ago, after a very congenial dinner, a colleague of mine berated scientists for the many authors’ names which appear on their publications.  ‘Surely’, he said, ‘like those of us in the arts, brilliant minds should be able to publish independently – with just a single author’.  His remarks made me pause and think. I thought of the history of science and how many great minds have paved the road of progress with their milestone discoveries:  Newton with gravity; Lavoisier with oxygen; Darwin with evolution and Einstein with relativity.  Their names are endless and their achievements epic.  All of them individuals with the stroke of genius on their side.

Then yesterday, I pondered again, as I read the new paper in Nature by Professor Ian Deary – and no less than 19 of his fellow investigators.  Nineteen scientists to write a single article?  And not just 19 scientists: 5 institutions across two continents.  It was certainly a milestone paper. (For those of you who are not academics, ‘Nature’ is the world’s leading scientific journal. Publish in Nature and you are made.  No-one can argue with the level of your work).

Ian Deary heads up the ‘Disconnected Mind’, a project investigating why we ‘lose our marbles’ as we get older – more properly called cognitive ageing – a condition which every one of us will face.  It is also a complex one of which very little is known and in which there is little funding.   But since its inception in 2008, the project has prospered and grown to the point where Ian and his team in Edinburgh were able to publish their findings in Nature, together with their Australian colleagues.  A stunning achievement. Continue reading “A Spark of Genius from the Minds of Many”

The Tip of the Iceberg

In 1841, Registrar General William Farr, a distinguished mathematician and physician who famously said to Florence Nightingale, ‘Statistics should be as dry as dust’ produced the first report which identified a seasonal excess of deaths in the British winter.  Some 170 years later, we are still recording a yearly excess of between 20 and 40,000 winter deaths.  And by far the greatest numbers of those dying in the winter are those over 65, for many of whom both physiology and social conditions create a special vulnerability.

It has taken generations of scientists to unravel the causes of winter mortality.  The evidence is now clear on cause – it is the cold that is the killer.  All other factors, except in conditions of epidemic influenza, pale into insignificance.  So precise is this relationship that it has been calculated at 8,027 extra deaths for every 1°C the winter is colder than the average.  Paradoxically, this algorhythm applies only to the United Kingdom.  The irony is that the colder countries of the world – such as the Nordic lands, Russia, Canada and so on – have much lower winter mortality than the ‘warm’ UK.  It is an amazing truth that Yakutsk, the coldest city on earth with average winter temperatures of – 30°C, has virtually no seasonal fluctuation in mortality.  How can this be?

The answers are peculiarly British. Our heritage of an old and poorly insulated housing stock has meant that for years many have been consigned to winters spent in indoor cold, unable to afford their heating bills.  Add to that the exceptionally cold winters of recent years, rising energy prices and declining winter fuel benefits, we have a lethal cocktail of risk.  Fuel poverty is a real and vital issue for increasing numbers of older people.

But the evidence shows that indoor cold is only half of the story.  Deaths in the winter are largely due to respiratory illness and disease caused by blood clotting, the so-called ‘thrombotic illnesses’ of heart attack and stroke. Over the last few decades we have seen a reduction in deaths from respiratory illness in the winter, brought about it is thought by improving indoor warmth.  What has not declined is the mortality through heart attack and stroke.  These conditions are more dependent on going out into the cold, insufficiently protected by our winter clothes.  If you doubt this, look at the typical British wardrobe: how many of us have a separate winter edition? And how many of us frequently take trips outside without hat, scarf, gloves and coat? And so we are ambushed by winter cold.

Even a conservative estimate shows that the British winter, since Farr’s first report, will have been responsible for over 3 million deaths, deaths which we now know are entirely avoidable.  No wonder research tells us that older people in Britain fear the winter more than any of their European neighbours.  The question is, then, how may these deaths be avoided? Physiologists will tell you that ‘man is a tropical animal’: we must stay warm in order to stay well.  That is why Age UK, working with the Met Office, has taken the best scientific advice to launch its campaign ‘Spread the Warmth’. On the basis of new and compelling evidence, we are advising older people of the risks of both indoor and outdoor cold in an effort to stem the ‘British disease’.   And with DH, we are joining the Met Office as it seeks to alert the public of impending severe cold.  

Some estimates have said that 2,700 people every winter die because of fuel poverty. This is only the tip of a huge iceberg of winter deaths brought about by cold.  By translating the best research evidence into practice and by working with others, we are attempting win the war against the British winter.

Find out more about the Spread the Warmth campaign

Read Met Office guest blog