Marching to a Different Beat: No Pulse, No Problem

Image from University Health Care System

By Amy McKean

We have seen it in countless movies and tv shows. The protagonist walks in and sees someone they care about lying down and unresponsive. This hero immediately rushes over to see if they are alive by checking for a pulse, but that may not be enough information anymore. Research into left ventricular assist devices (LVADs) have shown that we do not need a pulse to live.

Most of us have heard of pace makers, devices that can be used to aid or replace the electrical system in the heart. The electrical signal is responsible for causing muscle contractions that lead to the heart beating and the movement of blood throughout the arteries and veins of the circulatory system. Pace makers can be used when the only problem is with the electrical signal. With Heart Failure, the muscle of the heart is weak or damaged and therefore unable to sufficiently pump blood throughout the body. In this case, the problem requires more than an electrician; we need a plumber to work on the blood flow.

Many cases of Heart Failure do not require the replacement of an entire heart, but rather, the heart just needs some help. LVADs have been providing this assistance for a few decades now. They provide an alternative path for blood to travel and be pumped throughout the body. Initially these devices attempted to mimic the pumping action of the heart by using positive displacement pumps. This style of pump has a chamber that fills with liquid and is forced out by the chamber reducing in size. While these pumps worked to an extent, there were still problems such as size and reliability. A better pump required marching to a different beat.

Centrifugal and axial flow pumps are different than positive displacement pumps and work by the rotation of an impeller blade. The blood flowing through such a device will move continuously and not have the natural beat pattern observed in our heart. The full effects of removing an individuals pulse are still under investigation, but what is known is that these devices can be used to help prolong an individual’s lives successfully. If you come across someone alive, but without a pulse, they are probably not a zombie. They likely are closer to a cyborg, with a mechanical device operating in place of their heart.

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2 different types of LVAD (Rogers et al., 2017)

The little-known link between hearing loss and depression

Comic by Stromoski, continued below

By Maryse Thomas

Hearing loss is often thought of as an inevitable, harmless, and sometimes comical part of aging. However, research is increasingly linking age-related hearing loss to several other chronic health conditions, showing a need for it to be taken more seriously. These include depression, cognitive decline, dementia, diabetes, and heart disease. Among these conditions, depression is one of the most prevalent and is present in 5-10% of hearing impaired individuals.

A possible link between depression and hearing loss may relate to the social aspects of being hard of hearing. People with hearing loss frequently experience difficulties with communication, which can result in strained personal relationships, social isolation, and loneliness. In turn, feelings of loneliness can lead to anxiety, depression, and a diminished overall quality of life. Problems with communication can also negatively affect the lives of family members and caregivers, something that hearing-impaired persons are not always aware of.

Although this path from hearing loss to depression makes sense, it is important to point out that most studies linking depression and hearing loss cannot establish the direction of the relationship. More explicitly, it is still unknown whether hearing loss causes depression, depression causes hearing loss, or whether both hearing loss and depression are caused by something else. This is also true for other chronic conditions that have been linked to hearing loss, indicating that more research is needed to fully understand the connection.

Regardless of the direction of the relationship, treating hearing loss using hearing aids has been shown to have a positive effect on quality of life and to reduce symptoms of depression, loneliness, and anxiety. While some people may feel uneasy about wearing a hearing aid at first, the earlier their hearing can be corrected, the better the outcome for their mental health. Knowing that hearing loss is a risk factor for various chronic conditions, it is important to look out for their symptoms so that Grandpa’s inability to keep up with conversation at the dinner table can be treated instead of endearingly laughed off.

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Physiological Age: The Age That Matters

By Palina Piankova

“You should worry about inner beauty!”

Isn’t that what all mothers had to say at some point? Now, what if I told you that science agrees? Science agrees that a distinction exists between chronological age (the one marked by your birthday cake) and physiological age (determined by how well your body functions). This “inner beauty” (aka the physiological age) is the one that will carry you through retirement. It is the one that affects your longevity. Physiological age can be greater than the chronological one in the case of poor lifestyle choices, or on the opposite, can be found to be remarkable with good ones.

With the era of personalized health care moving upon us, many institutions have generated “calculators” that will estimate this “body age” based on a series of parameters that can be obtained from patient blood samples.

More and more, medicine agrees that patient standard care should be tailored to this physiological age. What can the body take on? How vulnerable it is to different stressors?

There is a normal increase in the body’s vulnerability state that appears with age, but it appears at different rates in different people based on the overall fitness of the body. Here, “fitness” does not refer to the number of benches presses you can do, but rather to how efficiently your body can work. This increased vulnerability increases the physiological age.

One of the factors that contributes to this normal decline as a result of age is known to the medical field as “frailty”. How fragile is your body? Can it easily break under pressure like a vase, or is it resistant as a rock?

Several scales attempt to quantify frailty. They include physical and cognitive components that yield in a score that can predict patient mortality after a year as an example.

Frailty indirectly permits to assess this physiological age and guide patient intervention. Will your body resist to the stress of an aggressive open-heart surgery, or will it rather prefer a more gentle approach?

In some cases, these less invasive approaches can buy you more time, but less autonomy in your daily activities. Or it can even buy you no time at all… There is a trade off to make. Time, quality, and the physical ability to withstand stress, all must be weighed in for the optimal clinical decision.

So how do you become strong on the inside, and ensure yourself more chronological years to follow, and increased vitality to (hopefully) enjoy your early retirement?

Again, mothers know best: eat well and exercise. No spoilers there! No secret trick, no Botox for the “insides”, no cheating is possible.

Your physiological age isn’t the one you can go against. Your body will remember, such is life. Science can do its best to quantify and estimate the phenomenon, and help tailoring health care interventions, but it cannot stop it, or turn the clock backwards.

The hope is to stay aware of such concepts and act in time by focusing on our “inner beauty”. Sixties can become the new twenties!

Thanks Mom.

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Blog authors are solely responsible for the content of the blogs listed in the directory. Neither the content of these blogs, nor the links to other web sites, are screened, approved, reviewed or endorsed by McGill University. The text and other material on these blogs are the opinion of the specific author and are not statements of advice, opinion, or information of McGill.