Noticias

The European network APTITUDE - Acting for Trans-Pyrenees Prevention of Dependency in Seniors – is gathering in Pamplona on Wednesday, 3 July for a scientific seminar that is expected to draw more than 200 experts in active ageing and frailty. The seminar will take place at the Tres Reyes Hotel in Pamplona, starting at 8.15am. In addition, there will be side workshops organised with the Navarra Red Cross for the general public, at Rincón de la Aduana and Paseo del Doctor Arazuri, starting at 10am.

These events were introduced this morning at the biomedical research centre Navarrabiomed, the network’s leading institution in Navarra, along with the Public University of Navarre (UPNA), the Navarra Hospital Complex (CHN) and the Navarra Red Cross. At the press conference were Nicolás Martínez Velilla, APTITUDE Coordinator in Navarra and Head of the Geriatrics Unit at CHN, Juan José San Martín Baquedano, Coordinator of the Navarra Red Cross, and Jorge Marín Vidondo, Project Manager at Navarrabiomed.

Martínez Velilla said the seminar would be the third APTITUDE meeting – and the first to take place in Pamplona. It will gather primary health care professionals and representatives of hospitals and research centres, universities, nursing homes and businesses from Occitanie in France, Catalonia and Navarra in Spain, and Andorra.
At the seminar, experts will discuss the concept of intrinsic capacity in older individuals – that is, the set of physical and mental skills an individual can apply at any given moment, plus the functional capacity, which is the way in which an individual relates to and interacts with the environment – proposed by the World Health Organisation (WHO). Also, they will talk about the multi-component training offered by the project, targeted at health and social care practitioners working with frail seniors, so that they can prescribe the adequate physical activity routines, make cognitive stimulation interventions, give healthy diet guidelines, make psycho-social interventions, etc.

Keynote speakers include Norman Lazarus and Stephen Harridge, from King’s College London, who have broad experience in physical activity, anti-ageing and muscle deterioration in geriatric care and other sectors, like aerospace, where they have worked with NASA.

Open workshops

On Wednesday, between 10am and 2pm, there will be open workshops at Rincón de la Aduana and Paseo del Doctor Arazuri, Pamplona. Under the title ‘Active, healthy seniors/Tailerrak: Adineko aktibo eta osasuntsuak’, they are targeted at people over 65, but they can also be of interest to caretakers, relatives or volunteers. The workshops are free and no prior registration is required.

In addition, there will be APTITUDE-Red Cross Tents, hosting functional assessment, cognitive stimulation and adapted leisure activities for the elderly, giving information about support devices and healthy habits, and giving out supplementary material with workout routines.

Ageing and functional decline

According to INE data from 2018, the population of Navarra amounts to 647,219 people, 19.5 per cent are 65 or above. The region has one of the longest life expectancies in Europe: 86.6 years for women and 81 years for men. However, the quality of life varies: whereas women tend to live longer lives, they become more dependent than men after 65.

According to the World Health Organisation, the main causes of mild or severe disability in old age are sensory impairment, back or neck pain, chronic obstructive pulmonary disease (COPD), depression, falls, diabetes mellitus, dementia and osteoarthritis. Moreover, more than 50 per cent of the elderly suffer from a combination of illnesses and take three to five medicines together.

Initiatives like APTITUDE advocate a change of paradigm in elderly care. Caretakers should face the challenge of setting illness aside to focus on functional capacity and its maintenance or improvement. APTITUDE promotes healthy habits, physical activity and cross-generational, adapted leisure both in urban centres and rural environments, in an effort to combat loneliness, depopulation in rural areas and the stereotypes associated with ageing.

About APTITUDE

APTITUDE was established in 2018 as a three-year network to foster cross-border cooperation in four regions (Occitanie, Catalonia, Navarra and Andorra) by building its own local networks with a total budget of 2 million Euro.
The APTITUDE project, which includes the APTITUDE network in Navarra, gets 65 per cent of its funds from the European Regional Development Fund (ERDF), through the Interreg V-A Spain-France-Andorra (POCTEFA) cooperation programme, aimed at the development of cross-border economic, social and environmental action by means of joint strategies to promote sustainable territorial development.

APTITUDE partners:

Gérontopôle - Centre Hospitalier Universitaire (CHU) de Toulouse
Fundació Salut i Envelliment - Universitat Autònoma de Barcelona (UAB)
Servei Andorrà d’Atenció Sanitària
Complejo Hospitalario de Navarra (CHN) - Navarrabiomed

More information: www.aptitude-net.com

Photo: From left to right: Jorge Marín (Navarrabiomed), Nicolás Martínez (CHN-Navarrabiomed) and Juan José San Martín (Navarra Red Cross).

• The programme will offer support to the development of studies in digestive medicine, geriatrics, neuroscience and oncology that will bring advancement and excellence in these fields of research.
• ‘la Caixa’ Foundation and Caja Navarra Foundation are channelling 1.2 million Euro into this programme, to be run by the biomedical research centre Navarrabiomed, where four doctors from the Navarra Health System-Osasunbidea (SNS-O) will carry out quality biomedical research studies.
• Through this programme, ‘la Caixa’ Foundation and Caja Navarra Foundation will give support to the leading research centres in Navarra during the 2017-2021 period. Universities and research centres will thus get a total 6.4 million Euro.

Ana Díez Fontana, Regional Director of CaixaBank in Navarra; Javier Miranda, Chairman of Caja Navarra Foundation; and Iñigo Lasa, Director of Navarrabiomed, announced the research lines to be developed by doctors Eduardo Albéniz Arbizu, Nicolás Martínez Velilla, Maite Mendióroz Iriarte and Antonio Viudez Berral, who were selected by an external evaluation committee from 12 candidates.

The specialists in the programme will be relieved from part of their medical activity so that they can do research. They need time to develop their scientific projects and produce new knowledge in their medical specialties. The initiative enables the establishment of a critical mass of professionals that combine medical activity with research jobs, thus promoting translational medicine to the benefit of patients and society as a whole.

The four doctors selected to join the programme will soon start working at the labs of Navarrabiomed – the joint biomedical research centre of the Government of Navarra and the Public University of Navarra (UPNA). They will establish separate research units for the development of their projects, based on clinical practice at the Navarra Hospital Complex (CHN), with support from other Navarrabiomed units and platforms.

In addition to streamlining research activities in the respective units, they will encourage the participation of resident medical interns (MIRs) by getting them involved in biomedical research projects, trials and programmes.

Four excellent research projects in digestive medicine, geriatrics, neuroscience and oncology

Eduardo Albéniz Arbizu has worked in a number of hospitals across Spain. He received training in advanced endoscopy in France, Japan and China. Currently, he is working at the Gastrointestinal Endoscopy Unit of the CHN Digestive Medicine Service.

Dr Albéniz specialises in endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for the removal of early-stage gastrointestinal tumours. These advanced procedures reduce the number of surgical and other more invasive interventions in the treatment of superficial neoplastic lesions. Resection of colorectal polyps, for example, is the procedure with the highest survival rates observed in screening studies for colorectal cancer carried out in Navarra.
The goal of the project led by Dr Albéniz is to provide evidence for the identification of predicting factors for the effectiveness of resection procedures and other factors associated with potential complications that might be minimised.

Nicolás Martínez Velilla has been the Head of the Geriatrics Unit at CHN since 2015. In 2013, he was appointed head of a team partnered with Navarrabiomed for the promotion of research into different aspects of geriatric medicine.

Dr Martínez Velilla’s proposal includes a thorough study for the prevention of old-age frailty and disability or dependency in hospitals and in the community at large. Furthermore, it includes the creation of a European cross-border network to deal with various aspects of ageing. The project is aimed at rethinking hospitalisation of older adults, prescribing exercise to older patients in hospitals so as to improve their quality of life and increasing the sustainability of the health system.

Maite Mendióroz Iriarte has built her professional career as a doctor and researcher in Pamplona, Barcelona, San Sebastián and New York. Since 2010, she has been a member of the Neurology Department at CHN. Over the past few years, she has received grants from ‘la Caixa’ Foundation, Caja Navarra Foundation and the Government of Navarra to boost activity in the Neuroepigenetics Unit at Navarrabiomed.

Between 2018 and 2021, Mendióroz Iriarte will develop a project whose goal is to identify a potential blood-based epigenetic biomarker for early detection and treatment of Alzheimer’s disease. Her study might become the first step towards the implementation of precision medicine in neurodegenerative diseases.

Antonio Viudez Berral has developed his professional career in Navarra, Catalonia and Baltimore, USA. In 2010, he joined the Medical Oncology Service at CHN. Since then, he has been a researcher at Navarrabiomed as well.

Dr Viudez’s project will study pancreatic neuroendocrine tumours to find accurate markers that predict the effectiveness of certain therapies.

In addition, the Medical Oncology Service will be able to strengthen its scientific activity, establishing new lines of research for the improvement of diagnosis, prognosis and prediction of treatment response and toxicity.

From left to right: Luis Gabilondo, Ana Díez, Maite Mendióroz, Eduardo Albéniz, Antonio Viudez, Nicolás Martínez, Javier Miranda and Iñigo Lasa.

Professionals at the Navarra Hospital Complex (CHN) from the Public University of Navarra (UPNA) and Navarrabiomed are participating in the establishment of a European network for preventing old-age dependency and promoting active ageing. Hospitals and research centres from France, Spain (Navarra and Catalonia) and Andorra are part of this project, named APTITUDE (Acting for Trans-Pyrenees Prevention of Dependency in Seniors). As announced today, the network in Navarra is being coordinated by Navarrabiomed-Miguel Servet Foundation.

The three-year cross-border project will develop local networks in France, Navarra, Catalonia and Andorra. The project has been assigned a 2-million-Euro budget, with 1 million going to Spain (and 400,000 to Navarra). 65 per cent of the funds are being contributed by the European Regional Development Fund (ERDF) through the Interreg V-A Spain programme.

Through training programmes, awareness-raising activities and scientific evidence, the project is aimed at improving the quality of life of elderly people, encouraging the adoption of healthy habits and reducing the loss of functional autonomy, as explained by Antonio Merino Díaz de Cerio, CHN Managing Director, and Nicolás Martínez Velilla, Head of the Geriatrics Department, researcher at the Geriatrics Unit in Navarrabiomed and leader of APTITUDE in Navarra. In the words of Martínez Velilla, ‘the primary goal of the network is to prevent old-age dependency by trying to mitigate frailty in the elderly population.’

Antonio Merino stressed the importance of this type of European projects where protocols, good practices and procedures are shared for the benefit of all the participating institutions and society at large.

Specific actions by APTITUDE Navarra

Álvaro Casas Herrero, geriatrician at CHN and President of the Spanish Geriatrics Society, and Maite Soria Sarnago, Nursing Director at CHN, announced the actions to be undertaken in our community in the forthcoming months.

On Tuesday, 20 November, the project will be presented at a talk in the function room of the School of Medical Sciences, titled ‘Active and healthy seniors: Keys for adopting healthy habits’. The talk will start at 4pm and finish at 6.30pm. Admission is free, but there will be a limited number of seats available. It will also be streamed on the Navarrabiomed YouTube channel.

At the event, the leaders of the project will talk about healthy habits and good practices for improving the quality of life of old people. The President of Club Atlético Osasuna, Luis Sabalza Iriarte, will talk about ‘Working beyond retirement age’. He will share experiences from his career in the Club.

In addition, three strategic actions will take place in the upcoming months in Navarra. Firstly, a cross-border record will be established of people aged 65 and over who are interested in getting information or taking part in gerontechnology and clinical research programmes.

Simultaneously, Clinical and Innovation Research Travelling Teams will be established where professionals specialising in various medical fields will transfer clinical and research practice to urban and rural areas, thus ensuring broader penetration and larger participation for the population. The teams will be made of doctors, nurses, physiotherapists and occupational therapists.

Also, a database will be created with data provided voluntarily by frail old people and old adults with memory disorders, which will be used to design research projects involving all the centres participating in the project.

Lastly, the members of the project will participate in the validation of a new concept, ‘intrinsic capacity’, as defined by the World Health Organisation (WHO), which might be used in the clinical assessment of old people.

Recently published studies

The actions framed within the project are in line with the conclusions drawn in a study published recently in JAMA Internal Medicine, the peer-reviewed medical journal of the American Medical Association.

Professor Mikel Izquierdo Redín, Director of the Department of Medical Sciences at UPNA and senior researcher from the Physical Exercise and Frailty Research Unit at Navarrabiomed, presented a study that shows that a tailored physical activity plan for in-patients aged 75 or older reduces functional decline. The clinical trial consisted in a three-year follow-up of 370 patients in the Geriatrics Service of CHN.

The study reveals that preadmission health and functional status can indicate the risk of functional decline associated with hospitalisation. This clinical sign might be negatively affected by bed rest during hospitalisation.

Simultaneously, the team is participating in the DIABFRAIL LATAM European project, funded by the European Commission in the context of the Horizon 2020 European research project. DIABFRAIL LATAM focuses on pre-frail and frail old people with diabetes in Latin America. At present, 40 per cent of people aged 65 and older are affected by diabetes.

The project’s goal is to implement a treatment model in Colombia, Chile, Mexico, Peru and Argentina, consisting of physical exercise, education and a nutrition plan, plus blood sugar level and blood pressure goals adjusted to old adults with diabetes, who are particularly vulnerable as a result of their frailty. More than 1000 pre-frail and frail old people with type 2 diabetes are taking part in the clinical trial.

www.aptitude-net.com / aptitude@navarra.es

Imanol Arozarena, senior researcher from the Cancer Signalling Unit at the Navarrabiomed biomedical research centre and a member of Instituto de Investigación Sanitaria de Navarra (IdiSNA), has recently published a melanoma review with University of Manchester Professor Claudia Wellbrock.

The two scientists were asked by the renowned scientific journal Nature Reviews: Cancer to write an article on the latest findings in melanoma cell distinct phenotypes and their relevance for melanoma development and response to therapy.

As many as 4000 new melanoma cases are diagnosed in Spain every year. Malignant melanoma is a serious type of skin cancer that is usually metastatic. It is notorious for its intra- and inter-tumour heterogeneity.

Such variability results from the ability of melanoma cells (melanocytes) to adjust to changing environmental conditions by reprogramming their genetic expression. Thus, melanocytes develop resistance to both targeted therapy and immunotherapy, and their plasticity plays a role in metastasis development.

In their article, the authors reveal the importance of combining recent developments in genomic technologies and the availability of large gene expression datasets for a precise definition of the gene signatures that characterise changes in each patient’s tumours and the prognostic relevance for tumour development and response to therapy.

According to Arozarena, ‘By understanding the molecular mechanisms that adapt melanoma cells to anti-tumour drugs, we will be able to prevent both therapy resistance and the progression of metastatic melanoma.

• www.navarra.es
• Review Article - Phenotype plasticity as enabler of melanoma progression and therapy resistance