Planning for the Growing Older Population: Conducting Community Needs Assessments

Goals and Objectives: To describe the aging population of each community; To investigate the needs, interests and opinions of mature residents relating to their aging needs for age-related services in their respective communities; To provide recommendations to community partners and their stakeholders about how to create strong communities for older adults, based on needs assessment results; Generate reports and other documents to be used by the Department of Elder Services, other town offices, organizations that provide services, advocates, and community members

Living and Aging in Newton: Now and In the Future

This report describes collaborative efforts undertaken by the City of Newton Department of Senior Services, the Newton Council on Aging, The Senior Citizens Fund of Newton, Inc., and the Center for Social and Demographic Research on Aging, within the McCormack Graduate School at the University of Massachusetts Boston. Beginning in Fall 2013, these organizations partnered to conduct a needs assessment study to investigate the needs, interests, preferences, and opinions of the City’s older resident population, with respect to living and aging in Newton. The focus of this report is on two cohorts of Newton residents—those aged 50 to 59 (referred to as “Boomers”), and the cohort of individuals who are currently aged 60 and over (“Seniors”). During this assessment, multiple research methods were utilized to create a multidimensional overview of the City’s older residents that could be used to plan and implement current and future services for older adults in Newton. We began the process by examining public data from the U.S. Census Bureau to describe basic demographic characteristics, as well as economic traits, disability status, and living situations of older people living in the City. Early in the project we met with the Director of the City’s Department of Senior Services and members of the City’s Council on Aging to discuss and better understand their concerns about current and future aging-related needs of the City and their evaluation needs. We used information gathered at this meeting to develop the main research instrument—a resident survey, administered to a randomly selected sample of residents from both age cohorts. We also conducted two focus groups to obtain feedback from stakeholders who represent large ethnic minority groups (i.e., Chinese and Russian), regarding their issues and concerns about aging in Newton. Finally, we conducted a comparison of Senior Centers in five municipalities that are similar to Newton in order to assess how needs of older adults are met in other communities. Collectively, the contents of this report are intended to inform the Newton Department of Senior Services, other offices within the City that have a stake in the aging of Newton’s residents, and organizations that provide services to older people throughout the City. Additionally, those who advocate for older residents and community members at large will also find use for the information provided within this report

Neuroinflammation and regulation of glial glutamate uptake in neurological disorders

Oxidative stress, neuroinflammation, and excitotoxicity are frequently considered distinct but common hallmarks of several neurological disorders, including Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Alzheimer's disease. Although neuron degeneration and death are the ultimate consequences of these pathological processes, it is now widely accepted that alterations in the function of surrounding glial cells are key features in the progression of these diseases. In response to alteration in their local environment, microglia, commonly considered the resident immune cells of the nervous parenchyma, become activated and release a variety of soluble factors. Among these, proinflammatory cytokines and free radicals actively participate in the degenerative insults. In addition, excitotoxic neuronal damage resulting from excessive glutamate is frequently associated with impaired handling of extracellular glutamate by gliotic astrocytes. Although several research projects have focused on the biochemical mechanisms of the regulation of glial glutamate transporters, a relationship between activation of microglia and modulation of astrocytic glutamate uptake is now suggested. The aim of this review is to summarize and discuss the data showing an influence of inflammatory mediators and related free radicals on the expression and activity of glial glutamate transporters

Randomized trial of bilateral gene therapy injection for m.11778G>A MT-ND4 Leber optic neuropathy

Leber hereditary optic neuropathy (LHON) is an important example of mitochondrial blindness with the m.11778G>A mutation in the MT-ND4 gene being the most common disease-causing mtDNA variant worldwide. The REFLECT phase 3 pivotal study is a randomized, double-masked, placebo-controlled trial investigating the efficacy and safety of bilateral intravitreal injection of lenadogene nolparvovec in patients with a confirmed m.11778G>A mutation, using a recombinant adeno-associated virus vector 2, serotype 2 (rAAV2/2-ND4). The first-affected eye received gene therapy; the fellow (affected/not-yet-affected) eye was randomly injected with gene therapy or placebo. The primary end point was the difference in change from baseline of best-corrected visual acuity (BCVA) in second-affected/not-yet-affected eyes treated with lenadogene nolparvovec versus placebo at 1.5 years post-treatment, expressed in logarithm of the minimal angle of resolution (LogMAR). Forty-eight patients were treated bilaterally and 50 unilaterally. At 1.5 years, the change from baseline in BCVA was not statistically different between second-affected/not-yet-affected eyes receiving lenadogene nolparvovec and placebo (primary end point). A statistically significant improvement in BCVA was reported from baseline to 1.5 years in lenadogene nolparvovec-treated eyes: -0.23 LogMAR for the first-affected eyes of bilaterally treated patients (P < 0.01); and -0.15 LogMAR for second-affected/not-yet-affected eyes of bilaterally treated patients and the first-affected eyes of unilaterally treated patients (P < 0.05). The mean improvement in BCVA from nadir to 1.5 years was -0.38 (0.052) LogMAR and -0.33 (0.052) LogMAR in first-affected and second-affected/not-yet-affected eyes treated with lenadogene nolparvovec, respectively (bilateral treatment group). A mean improvement of -0.33 (0.051) LogMAR and -0.26 (0.051) LogMAR was observed in first-affected lenadogene nolparvovec-treated eyes and second-affected/not-yet-affected placebo-treated eyes, respectively (unilateral treatment group). The proportion of patients with one or both eyes on-chart at 1.5 years was 85.4% and 72.0% for bilaterally and unilaterally treated patients, respectively. The gene therapy was well tolerated, with no systemic issues. Intraocular inflammation, which was mostly mild and well controlled with topical corticosteroids, occurred in 70.7% of lenadogene nolparvovec-treated eyes versus 10.2% of placebo-treated eyes. Among eyes treated with lenadogene nolparvovec, there was no difference in the incidence of intraocular inflammation between bilaterally and unilaterally treated patients. Overall, the REFLECT trial demonstrated an improvement of BCVA in LHON eyes carrying the m.11778G>A mtDNA mutation treated with lenadogene nolparvovec or placebo to a degree not reported in natural history studies and supports an improved benefit/risk profile for bilateral injections of lenadogene nolparvovec relative to unilateral injections

Broadening the model of science - Recognizing different types of contributions

Resources for Society for the Improvement of Psychological Science (2016) Meeting - Diversity & Alternative Contribution