HKU Bulletin November 2009 (Vol. 11 No .1)

Cover Story 10 The University of Hong Kong Bulletin 11 November 2009 “People are living longer. You want them to live not just longer but in good health, with a good quality of life. This is why you have to develop better treatment for these ageing diseases. Better still is to be able to prevent them.” Even better could be to delay ageing and extend the average human lifespan. Current research suggests ageing may be due to the reduced function or dying off of stem cells. Dr Zhou Zhongjun, Associate Professor of Biochemistry, and his team are investigating this role in mice that have progenia, a syndrome that causes premature ageing. They surmised that oxidative stress may be harming stem cells so they injected the mice with a small molecule that has anti- oxidative properties, to see if this could rescue the stem cells. The results have been astonishing. “The signs of ageing in these mice appeared much later compared to untreated mice and they lived 30 to 40 per cent longer. Now we are trying to understand why this happens. We also want to see if the same beneficial effects can be seen in normal ageing,” Dr Zhou says. One of the most dreaded ageing- related diseases is Alzheimer’s, which is characterized by memory loss, disorientation and changes in mood and personality and affects the family as well as the patient. A multidisciplinary team from the Faculties of Medicine, Science and Social Sciences formed the Alzheimer’s Disease Research Network last year to investigate the causes and treatments of this disease, as well as the psycho-social issues faced by patients and their care givers. So far, they have found that men with low testosterone levels are more prone to Alzheimer’s even when they are in the early pre-dementia stage, opening up possibilities for diagnosis and treatment. They have also measured differences in blood flow and volume in the brains of sufferers using MRI and functional MRI, and are now using this tool to measure brain function, providing a much quicker way of assessing the disease’s progress than clinical observation. “We hope we can develop this technique so all normal elderly people can be screened each year to achieve early diagnosis of Alzheimer’s,” Dr Chu Leung-wing, chairman of the Alzheimer’s network and Honorary Clinical Associate Professor of Medicine, says. Researchers have also shown that a Chinese herb, known as wolfberry in English, is good for the brain and hope to test it in a clinical setting. They are also participating in multi-centre clinical trials of new Western medicine drugs. The Alzheimer’s Network was initiated under the strategic research theme, Healthy Ageing, which is focusing on four diseases common to Hong Kong: diabetes, coronary heart disease, degenerative diseases of the nervous system and osteoporosis. Professor Karen Lam Siu-ling, Rosie T.T. Young Professor in Endocrinology and Metabolism, is convenor of the theme and Head of the Department of Medicine, says longer life expectancies mean doctors will be seeing more ageing-related diseases. “In the past some of the residents in care and attention homes may have been physically and mentally able. Now those who are there are the ones with real social and medical needs,” he says. Meanwhile, Cadenza, a five-year project established by The Hong Kong Jockey Club Charities Trust with HKU and The Chinese University of Hong Kong, is pioneering and evaluating novel services to improve the care and quality of life for seniors in the community. The project has set up a primary care hub that integrates health and social needs in the community, including chronic disease management programmes to raise health literacy and empowerment and initiatives on health promotion and maintenance. The Cadenza Fellowship programme is also evaluating the outcomes of a community- based service in which elderly patients who are discharged from Queen Elizabeth Hospital receive visits and phone calls from trained volunteers for one month after discharge. Another HKU-related project also funded by the Jockey Club Charities Trust, Enable, has focused on a subject closely related to ageing – preparing for death. Researchers have been training frontline workers and educating the elderly, and they have also surveyed people on their attitudes to death and dying. While elderly people were willing to talk about the subject, young and middle-aged people regarded it as bad luck and thought it would hasten the end of their loved ones. More than a third of respondents also thought it was bad luck to visit the home or family of someone who had died in the previous few months. “Death is a big cultural taboo in Hong Kong, especially for the young and middle-aged,” Andy Ho, head researcher of the study and Research Officer with the Centre on Behavioural Health, says. “But it raises serious social problems. Families can’t get help when they need it, and it prevents advance care directives, setting up wills, funeral plans – any planning in that regard.” Mr Ho says they are considering ways to further develop the Enable project to break down the taboos among the young and the middle-aged and educate people to appreciate the meaning of life from a Chinese cultural perspective. “Preparing for death can avoid a lot of family dramas and arguments,” he says. OLDER... and healthier? Two questions are paramount when it comes to health and ageing: how can we stay healthy as we get older, and how can we live longer. HKU researchers are investigating.