News briefs

Exercise programs effective as falls prevention in older people

A new review published in the Cochrane Library provides strong evidence that the likelihood falls by people over 60 can be reduced by exercise programs. A team of researchers from the Universities of Sydney and Oxford summarised the results from 108 randomised controlled trials with 23 407 participants from 25 countries. The average age of the participants was 76 years, and 75% were women. Eighty‐one trials compared exercise of various types with control interventions (at most, gentle exercise not thought to reduce falls) in people living independently at home, in retirement villages, or in sheltered accommodation. The authors assessed the effect of exercise in two different ways. Firstly, they found that exercise reduced the number of falls over time by 23% (95% confidence interval [CI], 17–29%). This means that if there were 850 falls among 1000 older people over a year (a risk estimate based on control data from 59 studies), there would be 195 fewer falls among people undertaking fall‐prevention exercise. They also found that exercise reduced the number of people experiencing one or more falls by about 15% (95% CI, 11–19%); if 480 of 1000 people experienced at least one during a year, participating in exercise programs would reduce the number of fallers by 72 people. The reviewers found that exercise programs in group classes or done at home and prescribed by a health professional (such as a physiotherapist) or a trained exercise leader were effective. Exercises were mostly done while standing, as this better enhances balance and the ability to execute daily activities, such as standing up from a low chair or climbing stairs. Some effective exercise programs also used weights to make the exercises harder.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/full?highlightAbstract=

Links between gut microbes and depression

Specific gut bacteria were associated with depression in two different sample groups of more than 1000 people each, according to an analysis published in Nature Microbiology. The findings are based on bioinformatics analyses and need to be confirmed experimentally; however, they may help direct and streamline future microbiome–brain research. Gut microbiome–brain communication has mostly been explored in animal models, with human research lagging behind. Researchers from VIB‐KU Leuven in Belgium studied how microbiome features were correlated with quality of life and depression. The authors combined microbiome data with self‐reported and GP‐diagnosed depression data for 1054 people enrolled in the Flemish Gut Flora Project. They identified specific groups of gut bacteria that were positively or negatively correlated with mental health. The authors found that levels of two groups of bacteria, Coprococcus and Dialister, were consistently depleted in people with depression. This was validated in an independent group of 1063 individuals from the Dutch LifeLinesDEEP cohort. The authors also created a catalogue of gut microbiome functions based on the ability to produce or degrade molecules that potentially interact with the human nervous system. They applied this catalogue to faecal metagenome data from a subset of the sample group, including patients with treatment‐resistant major depression and healthy controls. The results indicated a positive association between the ability of the gut microbiome to synthesise a particular dopamine metabolite and mental quality of life.

https://www.nature.com/articles/s41564-018-0337