But research has shown that the seeds of Alzheimer’s are planted years — even decades — earlier, long before the cognitive impairments surface that make a diagnosis possible. Those seeds are amyloid beta proteins that misfold and clump together, forming small aggregates called oligomers. Over time, through a process scientists are still trying to understand, those “toxic” oligomers of amyloid beta are thought to develop into Alzheimer’s.

A team led by researchers at the 91̽�� has developed a laboratory test that can measure levels of amyloid beta oligomers in blood samples. As they report in a published Dec. 9 in the Proceedings of the National Academy of Sciences, their test — known by the acronym SOBA — could detect oligomers in the blood of patients with Alzheimer’s disease, but not in most members of a control group who showed no signs of cognitive impairment at the time the blood samples were taken.

However, SOBA did detect oligomers in the blood of 11 individuals from the control group. Follow-up examination records were available for 10 of these individuals, and all were diagnosed years later with mild cognitive impairment or brain pathology consistent with Alzheimer’s disease. Essentially, for these 10 individuals, SOBA had detected the toxic oligomers before symptoms surfaced.

“What clinicians and researchers have wanted is a reliable diagnostic test for Alzheimer’s disease — and not just an assay that confirms a diagnosis of Alzheimer’s, but one that can also detect signs of the disease before cognitive impairment happens. That’s important for individuals’ health and for all the research into how toxic oligomers of amyloid beta go on and cause the damage that they do,” said senior author , a 91̽��professor of bioengineering and faculty member in the UW��. “What we show here is that SOBA may be the basis of such a test.”

SOBA, which stands for soluble oligomer binding assay, exploits a unique property of the toxic oligomers. When misfolded amyloid beta proteins begin to clump into oligomers, they form a structure known as an alpha sheet. Alpha sheets are not ordinarily found in nature, and past research by Daggett’s team showed that alpha sheets tend to bind to other alpha sheets. At the heart of SOBA is a synthetic alpha sheet designed by her team that can bind to oligomers in samples of either cerebrospinal fluid or blood. The test then uses standard methods to confirm that the oligomers attached to the test surface are made up of amyloid beta proteins.

The team tested SOBA on blood samples from 310 research subjects who had previously made their blood samples and some of their medical records available for Alzheimer’s research. At the time the blood samples had been taken, the subjects were recorded as having no signs of cognitive impairment, mild cognitive impairment, Alzheimer’s disease or another form of dementia.

SOBA detected oligomers in the blood of individuals with mild cognitive impairment and moderate to severe Alzheimer’s. In 53 cases, the research subject’s diagnosis of Alzheimer’s was verified after death by autopsy — and the blood samples of 52 of them, which had been taken years before their deaths, contained toxic oligomers.

SOBA also detected oligomers in those members of the control group who, records show, later developed mild cognitive impairment. Blood samples from other individuals in the control group who remained unimpaired lacked toxic oligomers.

Daggett’s team is working with scientists at , a 91̽��spinout company, to develop SOBA into a diagnostic test for oligomers. In the study, the team also showed that SOBA easily could be modified to detect toxic oligomers of another type of protein associated with Parkinson’s disease and Lewy body dementia.

“We are finding that many human diseases are associated with the accumulation of toxic oligomers that form these alpha sheet structures,” said Daggett. “Not just Alzheimer’s, but also Parkinson’s, type 2 diabetes and more. SOBA is picking up that unique alpha sheet structure, so we hope that this method can help in diagnosing and studying many other ‘protein misfolding’ diseases.”

Daggett believes the assay has further potential.

“We believe that SOBA could aid in identifying individuals at risk or incubating the disease, as well as serve as a readout of therapeutic efficacy to aid in development of early treatments for Alzheimer’s disease,” she said.

Lead author on the study is Dylan Shea, a doctoral student in the 91̽��Department of Bioengineering’s Molecular Engineering Program. Co-authors are Elizabeth Colasurdo of the VA Puget Sound Health Care System; , a 91̽��research assistant professor of physiology and biophysics; , a student in the 91̽��Medical Scientist Training Program; Dr. , a 91̽��assistant professor of neurology; Dr. , a 91̽��professor of laboratory medicine and pathology; , a professor of neurosciences at the University of California, San Diego; Dr. , assistant professor of neurological surgery at the UW; and Ge Li and Dr. , both of the 91̽��Department of Psychiatry and Behavioral Sciences and the VA Puget Sound Health Care System. The research was funded by the National Institutes of Health, the Washington Research Foundation and the Northwest Mental Illness Research, Education and Clinical Center.

For more information, contact Daggett at daggett@uw.edu.

Now, a team led by researchers at the 91̽�� has developed synthetic peptides that target and inhibit those small, toxic aggregates. As they report in a published April 19 in the , their synthetic peptides — which are designed to fold into a structure known as an — can block amyloid beta aggregation at the early and most toxic stage when oligomers form.

The team showed that the synthetic alpha sheet’s blocking activity reduced amyloid beta-triggered toxicity in human neural cells grown in culture, and inhibited amyloid beta oligomers in two laboratory animal models for Alzheimer’s. These findings add evidence to the growing consensus that amyloid beta oligomers — not plaques — are the toxic agents behind Alzheimer’s disease. The results also indicate that synthetic alpha sheets could form the basis of therapeutics to clear toxic oligomers in people, according to corresponding author , a 91̽��professor of and faculty member in the 91̽��.

“This is about targeting a specific structure of amyloid beta formed by the toxic oligomers,” said Daggett. “What we’ve shown here is that we can design and build synthetic alpha sheets with complementary structures to inhibit aggregation and toxicity of amyloid beta, while leaving the biologically active monomers intact.”

Cellular proteins assume many different 3D structures, usually by first folding into certain types of basic shapes. The alpha sheet is a nonstandard protein structure, discovered by Daggett’s group using computational simulations. The research team has previously shown that alpha sheets are associated with aggregation of amyloid beta. These and related findings indicate that, in nature, alpha sheets likely occur in only rare instances when proteins fold incorrectly and interact in ways that disrupt cellular function, leading to so-called “” diseases like Alzheimer’s.

In this new paper, Daggett and her team provide evidence that amyloid beta oligomers form an alpha sheet structure as they aggregate into longer strands and plaques. Critically, the team’s synthetic alpha sheets can actually block this aggregation by specifically binding and neutralizing the toxic oligomers.

Using both novel and conventional spectroscopic techniques, Daggett’s team observed the individual stages of development of amyloid beta clusters, from monomers to six- and 12-protein oligomers all the way up to plaques, in human neural cell lines. The researchers confirmed that the oligomer stages were most toxic to the neurons, which agrees with clinical reports of amyloid beta plaques in the brains of people who don’t have Alzheimer’s.

“Amyloid beta definitely plays a lead role in Alzheimer’s disease, but while historically attention has been on the plaques, more and more research instead indicates that amyloid beta oligomers are the toxic agents that disrupt neurons,” said Daggett.

In addition, the researchers designed and built small, synthetic alpha sheet peptides, each made up of just 23 amino acids, the building blocks of proteins. The synthetic peptides folded into a hairpin-like structure and are not toxic to cells. But the synthetic alpha sheets neutralized the amyloid beta oligomers in human neural cell cultures, inhibiting further aggregation by blocking parts of the oligomers involved in the formation of larger clumps.

The peptides also protected laboratory animals from toxic oligomer damage. In brain tissue samples from mice, the team observed an up to 82% drop in amyloid beta oligomer levels after treatment with a synthetic alpha sheet peptide. Administering a synthetic alpha sheet to living mice triggered a 40% drop in amyloid beta oligomer levels after 24 hours. In the common laboratory worm , another model for Alzheimer’s disease, treatment with synthetic alpha sheets delayed the onset of amyloid beta-induced paralysis. In addition, C. elegans worms showed signs of intestinal damage when they were fed bacteria that express amyloid beta. That damage was inhibited when the scientists first treated the bacteria with their synthetic alpha sheets.

Daggett’s team is continuing experiments with synthetic alpha sheets to engineer compounds that are even better at clearing amyloid beta oligomers. For the current study, the researchers also created a novel laboratory assay that uses a synthetic alpha sheet to measure levels of amyloid beta oligomers. They believe this assay could form the basis of a clinical test to detect toxic oligomers in people before the onset of Alzheimer’s symptoms.

“What we’re really after are potential therapeutics against amyloid beta and diagnostic measures to detect toxic oligomers in people,” said Daggett. “Those are the next steps.”

Lead author is , a 91̽��doctoral student in . Co-authors are 91̽��bioengineering undergraduate students , , and doctoral student Matthew Childers; and professor in the 91̽��Department of Chemistry; and associate professor with the University of Colorado Boulder; and with ; and and executive director with the . The research was funded by the National Institutes of Health, the 91̽��, the American Microscopy Society, the National Science Foundation and the Roskamp Institute.

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For more information, contact Daggett at daggett@uw.edu.

Grant numbers: R01GMS95808, R21AG049693

Lesbian and bisexual older women are more likely than heterosexual older women to suffer chronic health conditions, experience sleep problems and drink excessively, a new 91̽�� study finds.

In general, lesbian, gay and bisexual (LGB) older adults were found to be in poorer health than heterosexuals, specifically in terms of higher rates of cardiovascular disease, weakened immune system and low back or neck pain. They also were at greater risk of some adverse health behaviors such as smoking and excessive drinking. At the same time, however, findings point to areas of resilience, with more LGB adults engaging in preventive health measures, such as obtaining HIV tests and blood pressure screening.

The study is the first to use national, population-based data to evaluate differences in health outcomes and behaviors among lesbian, gay and bisexual older adults. Using two-year survey data of��33,000��heterosexual and LGB��adults ages 50 and older from a��probability-based study of��the U.S. Centers for Disease Control and Prevention, researchers from the 91̽��School of Social Work report noticeable health disparities between LGB and heterosexual adults.

The were published in the August issue of the .

While this study did not delve into what causes the poorer health outcomes, 91̽��social work professor pointed to other research, including the landmark longitudinal study, , that .

“The strong predictors of poor health are discrimination and victimization,” said Fredriksen-Goldsen, the principal investigator on Aging with Pride, which surveyed 2,450 adults aged 50 to 100, studying the impact of historical, environmental, psychological, social, behavioral and biological factors on LGBT older adult health and well-being.

The new 91̽��study relied on the 2013-14 National Health Interview Survey, which for the first time asked respondents about their sexual orientation. In the United States, approximately 2.7 million adults age 50 and older self-identify as lesbian, gay, bisexual or transgender. This number is expected to increase to more than 5 million by 2060.

Among the 91̽��study’s findings:

• Disability and mental distress are significantly more prevalent among lesbians or gay men than among their bisexual counterparts.
• Strokes, heart attacks, asthma, arthritis and lower back or neck pain affected significantly greater percentages of lesbian and bisexual women than heterosexual women. For example, 53 percent of lesbians and bisexual women experienced lower back or neck pain, versus not quite 40 percent of heterosexuals.
• Nearly 7 percent of gay and bisexual men, compared to 4.8 percent of heterosexual men, suffered chest pain related to heart disease.
• More LGB people reported weakened immune systems: about 17 percent of women, and 15 percent of men, compared to 10 percent of heterosexual women, and 5 percent of heterosexual men.
• Lesbian and bisexual women were up to two times as likely to engage in adverse health behaviors such as excessive drinking.
• More than three-fourths of gay and bisexual men, and almost half of lesbians and bisexual women, had received an HIV test. In contrast, roughly one-fourth of heterosexuals had obtained a test.
• Slightly more lesbian and bisexual women had health insurance than heterosexual women, a possible reflection of professional choices, financial independence or same-sex partner benefits.

But the health disparities among lesbian and bisexual women indicate a population that merits greater attention, Fredriksen-Goldsen said.

“Most people think gay and bisexual men would have more adverse health effects, because of the HIV risk,” she said. “Lesbian and bisexual women tend to be more invisible, less often considered when it comes to health interventions. This is a population that isn’t getting the attention it deserves,” she said.

Bisexual men and women, meanwhile, may be marginalized not only in the general population, but also within gay and lesbian communities. As a result, bisexuals report feeling more isolated and experience greater stress, which, in turn, could lead to more adverse health conditions associated with stress as well as frequent risky health behaviors, Fredriksen-Goldsen said.

Like Aging with Pride, this new national study brings to light the need to target prevention efforts and health care services to improve health and the quality of life of LGB older adults, Fredriksen-Goldsen said.

The study was funded by the National Institute on Aging. Other authors were Hyun-Jun Kim, Chengshi Shiu and Amanda E.B. Bryan, all of the 91̽��School of Social Work.

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For more information, contact Fredriksen-Goldsen at fredrikk@uw.edu��or 206-543-5722.

Grant number: R01AG026526

The number of lesbian, gay, bisexual, transgender and queer (LGBTQ) older adults in Seattle and King County is expected to double by 2030, and they face higher risks of disability, poor health, mental distress and isolation — along with a social service sector unequipped to deal with their needs.

That’s the conclusion of a study released Oct. 6 and led by professor and colleagues at the The study identifies widespread social and health disparities experienced by LGBTQ older adults in Seattle and King County who, Fredriksen-Goldsen said, have unique needs and multiple barriers to accessing appropriate care.

“LGBTQ older adults face very high levels of victimization and discrimination, which increase their risk of significant social and health disparities,” said Fredriksen-Goldsen, a 91̽��professor of social work and director of the school’s Hartford Center for Excellence.

“The obstacles and inequalities they face can jeopardize their health in later life and make them reluctant to seek out aging and other support services.”

The study surveyed 203 LGBTQ people aged 50 to 85 in Seattle and King County and found that:

• More than two-thirds of participants have experienced three or more incidents of victimization in their lifetimes; almost 70 percent had been verbally assaulted and 40 percent threatened with physical violence.
• More than one in five participants visited the emergency room in the previous year.
• Despite the majority of respondents being college graduates, nearly one-quarter were living below 200 percent of the federal poverty level.
• Participants were at high risk of social isolation — more than 45 percent live alone.
• Most human service providers lack adequate training to serve LGBTQ older adults; 16 percent of participants reported being denied services or given inferior care based on their actual or perceived sexual orientation or gender identity.
• One in six participants were fearful of obtaining services outside the LGBTQ community.

One of the main barriers facing LGBTQ older adults is a lack of service providers skilled at understanding them and their particular needs, Fredriksen-Goldsen said.

“Many providers lack the communication skills to talk with LGBTQ older adults about their lives,” she said. “For example, if a transgender older adult needs nursing home care, the staff often has no idea how to treat the person respectfully and ensure appropriate care.

“So LGBTQ older adults are often reluctant to seek services and may be forced back into the closet, because they don’t know if they’re going to have culturally appropriate providers.”

And while societal awareness about LGBTQ people has increased dramatically in the past few decades, Fredriksen-Goldsen said the older members of that population remain largely invisible.

“People don’t think they exist,” she said. “When they think of LGBTQ people, they think of young people. What we often hear from providers is, ‘I really want to help support those people, but we don’t have any of them here.’”

On the upside, the survey found that despite their challenging circumstances, many LGBTQ older adults have developed supportive communities and 90 percent were satisfied with their lives. The majority exercised regularly, and nearly half attended religious services or participated in spiritual activities.

The study is part of a , The National Health, Aging and Sexuality Study: Caring and Aging with Pride over Time, that��Fredriksen-Goldsen and colleagues are conducting.��Launched in 2010, the��project involves surveying more than 2,400 LGBTQ adults aged 50 to 99 across the United States and is the first��nationwide longitudinal study examining the health and well-being of LGBTQ aging adults.

While Seattle is known as one of the most progressive cities in the country, Fredriksen-Goldsen said it is surprisingly lacking in services for aging LGBTQ people. Accordingly, she is leading a proposal to develop and test an evidence-based training program for health and human services professionals in Seattle and King County. The one-year pilot program would provide support, resources and referrals for LGBTQ older adults and their families and caregivers, and would aim to train 100 practitioners.

Seattle City Councilmember Tom Rasmussen is proposing that the city provide half the cost of funding for the program, or $75,000. The remainder would be provided in-kind by Aging with Pride. Rasmussen’s proposal must still be approved by the city council and Mayor Ed Murray.

The pilot program would increase the knowledge and skills of service providers and could translate to a significant improvement in the quality of care provided to LGBTQ aging adults, Fredriksen-Goldsen said.

“As Seattle and King County’s population ages and becomes increasingly diverse, there is a growing need for providers who are trained to work with LGBTQ older adults,” she said. “This initiative is an important first step in helping to address that need.”

Finding from the study can be found in the report .” Report co-authors are 91̽��School of Social Work research associate Chengshi Shiu, research scientist Hyun-Jun Kim, professor Charles Emlet and project manager Jayn Goldsen.

The study is funded by the National Institutes of Health and the National Institute on Aging. Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG026526 (Fredriksen-Goldsen, PI).

Alzheimer’s Coordinating Center director talks about burden of dementia

91̽��epidemiologist William Kukull has devoted his public health career to the study of Alzheimer’s disease. In a personal profile, he mentions what led him to this field, and the ramifications of the disorder as more Americans live longer.

Blood sugar drives brain’s response to sight of food

Our brain’s response to the sight of food appears driven more by our blood sugar level at the moment than our upbringing or genetics, according to a 91̽��study of identical twins.

“The finding suggests our brains have a way to override genetic inheritance, upbringing and habits to respond to our immediate nutritional needs,” said Dr. , 91̽��assistant professor of medicine, who led the research.

Harborview trauma director discusses brain-injury study, consent law exemptions

Harborview is one of 10 U.S. and Canadian trauma centers planning a study of a therapeutic drug for patients suspected of having sustained a traumatic brain injury. Harborview’s trauma director explains how the public is being notified about the study before it starts, due to consent law exemptions for trauma patients who are unconscious.

Workshop is first mind-meld of UW, Allen Brain Institute

For the first time, two Seattle brain research powerhouses are collaborating to teach the next generation of neuroscientists. The UW’s Computational Neuroscience program and the Allen Institute for Brain Science will jointly offer��a “Summer Workshop on the Dynamic Brain” Aug. 24 through Sept. 7 at Friday Harbor Laboratories.

Physician offers advice to peers on avoiding burnout

Health professionals devoted to caring for others sometimes neglect their own needs for restorative rest and relaxation. A 91̽��physician offers tips for keeping mental and emotional exhaustion at bay in a demanding career.

AIDS-free generation is aim of new guidelines for clinician

Many tools to prevent HIV are available but are not being used like they should. An interdisciplinary panel of experts created a simple framework of best clinical practices to try to achieve an AIDS-free generation. The guidelines, published in the Journal of the American Medical Association, integrate biomedical advances and evidence-based behavioral interventions for people with HIV or at high risk for HIV infection.

Turn your head and cough…into the phone?

You may soon hold diagnostic tests in the palm of your hand. Several 91̽��inventors are designing mobile applications that can perform a variety of tests, and then send the results to your physician. One, for example, alerts your physician of orange skin tones in your newborn. This color change can indicate high bilirubin levels. Jaundice in infants is easy to treat, but dangerous if undetected. ��Another app helps people with irritable bowel syndrome track the gut-wrenching effects of certain foods in their diet.

Learn about these and other medical apps being developed at the UW:

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Anti-craving drug and counseling lower alcohol harm in homeless, without sobriety demands

Chronically homeless, alcohol-dependent individuals might benefit from a new intervention that does not require them to stop or even reduce drinking, according to the results of a preliminary study in Seattle.

Participants in the 12-week pilot program received monthly injections of an anti-craving medication, extended-release naltrexone. They also met regularly with study physicians to set their own goals for treatment and to learn to be safer in their use of alcohol.

“Abstinence-based alcohol treatment has not been effective for or desirable to many homeless people with alcohol dependence ,” said Susan Collins of the 91̽��Department of Psychiatry and Behavioral Sciences. She is the lead researcher on a published report in the journal Substance Abuse.

Read more in HSNewsBeat:

Attention, finally for overlooked elderly with chronic disabilities

American society has lavished attention for decades on the expansive “boomer” population – its dreams, careers, families, habits, midlife crises and now its retirement. Many millions of research dollars have been spent divining strategies for the vast group’s “healthy aging.”

​An important group in this aging generation has been overlooked : those with a long-term physical disability.

A 91̽��rehabilitation medicine expert has received a five-year grant to promote healthy aging among people with long-term neuromuscular problems, specifically multiple sclerosis, muscular dystrophy, spinal cord injury and post-polio syndrome.

See how wellness can be enhanced for older adults with chronic disabilities:

The latest findings from the Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE study, are reported in the January 2014 issue of the Journal of the American Geriatrics Study.

The researchers had published previous papers on the results of the training at earlier points in the study.

This is the first large-scale, randomized control trial of cognitive training in healthy older adults.�� Most previous clinical trials of this nature were with adults with mild cognitive impairments, dementia, a functional limitation, or another disorder.�� ACTIVE was a scientific evaluation of the effects of three theory-based training programs.

This project followed healthy, independent-living older adults from six cities – Baltimore, Birmingham, Ala., Boston, Detroit, State College, Pa., and Indianapolis.�� The 2,832 original volunteers averaged 74 years of age at the start of the study and 14 years of formal education. Of the group, 75 percent were women, 74 percent were white, and 26 percent were African-American.

The tenth-year follow-ups, part of an annual evaluation of participants throughout the study period, took place with 44 percent of the original sample from April 1998 to October 2010. The average age of the remaining participants a the end of the study was�� 82.

Sherry L. Willis, 91̽�� professor of psychiatry and behavioral sciences, was one of seven investigators on the trial. The National Institute on Aging and the National Institute of Nursing, both part of the National Institutes of Health, funded the project.

Willis, and her colleagues George Rebok of Johns Hopkins University, and Karlene Ball, of the University of Alabama at Birmingham, put together the training programs used in the study. They plan to continue to work on these programs and to make them more widely available.�� They also hope to measure the effects of ACTIVE cognitive training with elderly people who have risk factors for cognitive decline.

The researchers noted that the search for intervention and prevention strategies to postpone mental decline later in life is growing. ��Many researchers are interested in pursuing cognitive training as a possible way to help older people live at home for as long as possible.

The ACTIVE study volunteers were divided into three training groups – memory, reasoning, and speed-of processing, or performing a mental task quickly. There was also a control group who did not receive training. Over 5 to 6 weeks, the training groups participated in ten training sessions, each lasting about 60 to 70 minutes. Later, some of the participants were then randomly assigned to booster sessions.�� The effects of the training were measured immediately at the end of the sessions, and 1, 2, 3, 5 and 10 years afterward.

The researchers checked to see whether the training had an effect on the participants’ ability to carry out some of the routine and complex tasks of daily living. They used standard measures to assess time and efficiency in performing everyday tasks, and also asked the volunteers to describe their ability to prepare meals, use the telephone, manage their finances, shop and travel, and whether they needed assistance in dressing and other personal care.

By the end of the study, all of the groups, now 10 years older, showed decline in their reasoning, memory, and speed of processing, compared to their tests at earlier points in the study.�� Nevertheless, those who had received training in reasoning and speed of processing showed less decline than the memory-training or control group.

Cognitive testing at the 10 year mark showed that 73.6 percent of the participants who had received reasoning training were still performing reasoning tasks better than before they started the training, compared to 67.3 percent of the control group, who had no training but who did have experience taking the test.�� Among the speed trained volunteer, 70.7 percent performed above their pre-study baseline level, compared to 48.8 percent of the controls.

The researchers noted that the findings suggest that even relatively brief training can be effective in producing durable improvements in the mental performance of people age 65 and older Without singling any program beyond the training approaches studied, the results also suggest that people who seek to keep their mental functioning strong might consider engaging in mental exercise.�� At the same time, the researchers caution that consumers should insist that any cognitive training program offer scientific evidence of its effectiveness. Many products currently available have not undergone rigorous evaluation.

the Journal of the American Geriatrics Society paper “Ten Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Function” ��by�� G. W. Rebok et al.

A version of the speed-of-processing program is available from Posit Science. Manuals for the reason and memory training have also been developed.

The research was�� funded by grants U01 AG14263, U01NR04507, U01NR04508, U01AG 14260, U0AG14282, U01AG14263, U01AG14289, and U01AG14276 from the�� National Institute on Aging and National Institute for Nursing Research of the National Institutes of Health.

It sounds simple: get outside and take a walk. Walking on its own is known to offer numerous health benefits, everything from lower blood pressure to less aches and pains. For some people, though, getting outside and taking that walk can be a challenge. This is especially true for the elderly or those with disabilities. How will I get to my destination? Is it a safe place to walk? Are there street lights? Will sidewalk cracks make it harder for my walker to roll?

These questions are pondered by millions of Americans who live with physical mobility challenges. After all, more than 40 percent of adults�� age 45 or older have difficulty with physical movement, and 58 percent of adults age 65 or older have a disability, according to a recent paper appearing in The Gerontologist

The report covers study findings from the 91̽�� schools of nursing and public health. The work was led by Basia Belza, professor of biobehavioral nursing and health systems, and Dori Rosenberg, a postdoctoral fellow in rehabilitation medicine and an affiliate assistant professor of health services, based at Group Health Research Institute.

Their research team sought to ��better understand the needs of adults with mobility disabilities related to neighborhood walkability. The investigators interviewed older adults with mobility disabilities about their experiences and impressions of trying to get about in built environments – the settings in which human activities take place.�� The researchers learned that poorly lit neighborhoods, lack of public transportation, sidewalks in disrepair, and unmarked or poorly marked intersections prevent people with disabilities from taking advantage of the benefits of walking.

Belza said that older adults, who are the fastest growing demographic, are also the most physically inactive group and the age group most likely to face chronic disease due to inactivity.

“People who are inactive in general have a higher incidence of chronic disease such as stroke, heart disease, arthritis,” Belza said. “Regular engagement in physical activities leads to better health outcomes, including improved mobility, weight loss and fewer ��falls. This is especially important in older adults who may already be dealing with health challenges.”

Belza noted that one study participant who lives in the Phinney Ridge neighborhood of Seattle has already approached the Seattle City Council to ask for neighborhood improvements.

In another related project, Belza partnered with an Easter Seals project, called Accessible Community Transportation in Our Nation, and the Centers for Disease Control and Prevention Healthy Aging Research Network to create a . This guide was designed to show people ways to check out their neighborhoods and assess the state of sidewalks, transportation, street lights and other factors that could encourage or discourage neighborhood walking.

“The guide is a great way for people to get out in their neighborhoods and learn to be more active in general while also helping others,” Belza said.

The guide encourages people to consult with their city and town governments to share ideas for ��improvement, with the hope that this will encourage cities to invest more in communities. Belza continues to look for ways to improve access to the built environment and increase physical activity in older adults. She and her colleagues in the Centers for Disease Control and Prevention Healthy Aging Network are doing a systematic review to better understand how older adults use technology to find their way.

Belza believes that with improved information and resources, will reap the benefits of walking, which has long been reported by adults as the most preferred way to be physically active and applauded by health experts as one of the best ways to improve overall health.

“Walking is a great way to decrease your risk for many chronic conditions, including heart disease, obesity and other health challenges,” she said. “We hope that our guide will help people improve their health by finding new and safe places to walk.”

The project was funded by the 91̽��Health Promotion Research Center, a Prevention Research Center.

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