Transforming Human Health at the COSI Labs

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By Sandra Flores, UCI Beall Applied Innovation
Photos: Julie Kennedy, UCI Beall Applied Innovation

THE COSI LABS ARE HOME TO THE CREATION, CLINICAL TRANSLATION AND COMMERCIALIZATION OF LASER TECHNOLOGY THAT CAN BE USED TO FIGHT DISEASE AND ILLNESS.

Diseases are constantly evolving in our modern world, and with their evolution comes the need for new technology to combat them and sustain quality human health.

The Convergence Optical Sciences Initiative (COSI) labs, located in the Cove @ UCI, specializes in the creation, clinical translation and commercialization of trailblazing optics and photonic technologies to transform human health. The labs are prioritizing the  creation of laser technology that could benefit the health of those fighting chronic illnesses.

“Here at the labs, the main focus is the intersection of multiple areas such as physical science, biology, engineering, industry and medicine, all
around photonics,” said Chris Barty, distinguished professor of physics and astronomy at the UCI School of Physical Sciences and senior faculty
member of the COSI labs.

One of the main activities Barty is currently spearheading is the Laser Compton X-ray, an X-ray machine that works similarly to a laser pointer and is highly tunable. The application of this extremely precise X-ray has the potential to revolutionize disease detection and treatment.

“If we do what we say we’re going to do correctly, you’ll never remove a breast, you’ll never remove a prostate again,” said Barty. “It’ll transform human health.”

Students pursuing UCI’s dual Ph.D./M.D. program study how to enable better medical applications, while Physics graduate students come up with new ways that could make the X-ray source even better. Since the pandemic, Barty and the COSI labs’ small team of graduate students are also working on a compact UVC laser that would be able to denature the virus on surfaces.

As the COSI labs move forward, Barty hopes to change the way medical professionals use X-rays and lasers, making UCI Beall Applied Innovation a hub for X-ray and laser technology for the Orange County ecosystem.

“I would be thrilled if we had an X-ray source sitting at Beall Applied Innovation that acts as a national center for advanced radiography and radiology,” said Barty. “Being a part of Applied Innovation makes it really easy to pursue this vision at UCI.”

Learn more about the COSI labs at bli.uci.edu/convergence-optical-science-initiative.

Read full article in UCI Beall Applied Innovation’s “Rising Tide” Magazine.

Samueli School Welcomes 12 New Faculty Members

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By Anna Lynn Spitzer, UCI Samueli School of Engineering

Twelve new faculty – ranging from assistant professors to experienced professionals, including three who have been appointed research center directors – are joining the Samueli School of Engineering for the 2020-21 academic year. This brings the total number of full-time faculty to 162.

BIOMEDICAL ENGINEERING

Thomas Milner
Professor, Biomedical Engineering and Surgery
Director, Beckman Laser Institute & Medical Clinic

Milner, an early investigator in photomedicine, has made important contributions in both surgery and diagnostics, including development of novel optical tomographic imaging modalities and laser surgical procedures for diagnosis and treatment of disease. An inventor on 55 U.S. patents, as well as five international patents licensed to six companies, he has authored 190 peer-reviewed articles and eight book chapters. Milner, who came to UCI from University of Texas, Austin, where he was the Joe King Professor at the Cockrell School of Engineering, is the recipient of the Coherent Young Investigator Award in Biomedical Optics, the Inventor of the Year award at the UT Austin and numerous grants from the National Institutes of Health. He is a fellow of the American Society for Laser Medicine & Surgery, the American Institute for Medical and Biological Engineering and the National Academy of Inventors.

Link: Beckman Laser Institute & Medical Clinic

Liangzhong (Shawn) Xiang
Associate Professor, Biomedical Engineering, and Radiological Sciences, School of Medicine

Research Interests: X-ray-induced acoustic computed tomography for in vivo radiation dosimetry and radiology, fast proton-induced acoustic imaging for precision proton therapy, and electroacoustic tomography-guided electroporation

Education: Ph.D., electrical engineering, South China Normal University

Xiang, who is affiliated with both the Beckman Laser Institute & Medical Clinic and the Chao Family Comprehensive Cancer Center, was the Lloyd G. and Joyce Austin Presidential (Assistant) Professor in the Department of Electrical and Computer Engineering and the Stephenson Cancer Center at the University of Oklahoma. He is a recipient of the student-nominated Nancy L. Mergler Faculty Mentor Award for Undergraduate Research, a research scholar award from the American Cancer Society, a postdoctoral fellowship award in prostate cancer research from the U.S. Department of Defense and the Sylvia Sorkin Greenfield Award for best paper published in medical physics from the American Association of Physicists in Medicine. A former postdoctoral fellow at Stanford, he is a member of the Acoustical Society of America, the Radiological Society of North America, the American Association of Physicists in Medicine and the International Society for Optical Engineering.

Link: TRUE Lab

Read full article on the UCI Samueli School of Engineering website.

Cognitive decline distorts political choices, UCI-led study says

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Disconnect found between political affiliation, political decisions in the cognitively impaired

Identification along the liberal/conservative spectrum may last a lifetime, but cognitive decline distorts our political choices, according to the first-of-its-kind study led by the University of California, Irvine. For those who are cognitively impaired, identifying as being liberal or conservative loses its relationship to their political decision-making.

“We found that for the cognitively impaired, there was a significant loss of consistency between an individual’s political orientation and their political choices,” said Dr. Mark Fisher, neurology and political science professor and study corresponding author. “This interface of neurology and political science is highly relevant, given the questions surrounding voting by individuals with dementia.”

For the study – forthcoming in the Journal of the American Geriatrics Society – researchers evaluated the relationship between political ideology, political policy preferences and cognitive status. Study participants were 190 members of The 90+ Study, a UCI-led longitudinal investigation of the oldest-old, who are those aged 90 and older.

Participants completed a questionnaire indicating their political ideology and a variety of policy issues, ranging from federal spending on public schools and the environment to immigration rates and the death penalty. Six months later, they completed the same survey.

“Our analysis produced novel findings with important political implications,” said Davin Phoenix, associate professor of political science and study co-author. “Across the six-month survey interval, where individuals placed themselves ideologically remained quite consistent, whether or not they were cognitively impaired. However, among those with cognitive impairments, being liberal or conservative appears to function more as a self-identity label and less an orienting framework for judging policy. So the capacity of that ideological identification to help people make choices that are aligned with their true policy preferences comes into serious question.”

More than 90 percent of the survey participants voted in the 2016 election. This high level of civic engagement emphasizes the importance of understanding how cognitive decline affects the political behavior of older persons.

“Our findings suggest that older individuals experiencing cognitive decline have relatively stable ideological preferences, but these preferences lose their connection to political policy details. Future studies conducted during an election year may shed additional light on how this group of Americans is casting their ballot,” said Fisher.

The research team included Shawn Rosenberg, UCI professor of political science; Dana Greenia, UCI MIND research unit clinical research administrator; Maria M. Corrada-Bravo, UCI neurology professor; Dr. Claudia Kawas, UCI neurology professor; Annlia Paganini-Hill, UCI neurology project scientist; and Sierra Powell, political science professor, Mount San Antonio College. The study was supported by the National Institute on Aging, grant R01AG021055, and the UCI Medical Humanities Initiative.

Read full UCI News Press Release.

Kristen Kelly named chair of UCI Department of Dermatology

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Dr. Michael Stamos, dean of UCI School of Medicine, announced today that Kristen M. Kelly, MD, is the new official chair of the Department of Dermatology. Kelly has been serving as interim chair since June. She is professor of dermatology and surgery at the UCI School of Medicine, and works clinically at UCI Health Beckman Laser Institute & Medical Clinic and UCI Health Gottschalk Medical Plaza. Her appointment became official September 6.

Kelly’s clinical and research specialties include vascular birthmarks, photodynamic therapy and light based imaging. She replaces Christopher B. Zachary, MD, MBBS, FRCP, who stepped down from the position after serving three, five-year terms as chair of the Department of Dermatology.

In 2006, one of Zachary’s first decisions was to appoint Kristen M. Kelly, MD, as residency program director, and within six months, the department was given full accreditation by ACGME.

Kelly is a board-certified dermatologist with more than 25 years of experience using lasers to treat vascular birthmarks, scars and other dermatologic conditions. She is at the forefront of research in the treatment of vascular skin conditions, and contributes to the development and implementation of the latest energy based technologies, techniques and treatments in dermatology.

Kelly has contributed to the work at the world-renowned UCI Health Beckman Laser Institute & Medical Clinic for over 20 years. She is also past president and board member of the American Society for Laser Medicine and Surgery and has lectured locally, nationally and internationally on the treatment of vascular lesions and light based treatments and diagnostics in dermatology.

Kelly received her medical degree from UCLA, and completed an internship in internal medicine from St. Mary Medical Center in Long Beach. She completed her residency in dermatology at UCI.

Read more about Kristen Kelly on the Institute website.

N95 masks may lead to greater adverse skin reactions

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By Kate Burba, Healio.com

There were greater changes in erythema, acne and roughness with the use of N95 masks compared with fabric and paper masks, according to a presentation at the American Society for Dermatologic Surgery annual meeting.

“Amidst the COVID-19 pandemic, health care workers and the general public are required to wear face masks for the protection of others and themselves,” Natasha Atanaskova Mesinkovska, MD, PhD, of UC Irvine, and colleagues wrote. “Current literature has reported an increase in facial skin temperature, acne flare, pruritus, discomfort and various other adverse skin reactions.”

In a prospective cohort, single-arm study, 21 participants wore a fabric, paper or N95 mask for 6 hours. High-resolution 3D imaging was used to obtain facial image analysis before and after wear to evaluate erythema, acne, roughness and rhytides. Additionally, participants were surveyed on facial comparison before and after mask use.

Subjectively, irritation, redness, acne and oiliness increased with all three mask types. Fabric masks led to an improvement in dryness, itching and skin texture.

Objectively, rhytide depth significantly increased around the chin with N95 masks vs. paper masks (P = .0379). With all three mask types, roughness, acne and erythema worsened, with the greatest changes for N95 masks.

Mesinkovska and colleagues wrote the changes in adverse skin reactions after N95 mask use were likely due to greater facial pressure and skin occlusion.

Read full article on Healio.com

The Real Deal on Collagen

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Can popping a pill or eating foods with collagen improve your skin, hair, nails, or joints?

By Sally Wadyka, Consumer Reports

Smoother skin, shinier hair, stronger nails, healthier joints, and more lean muscle mass—these are just a few of the benefits proponents claim collagen powders, pills, and foods can deliver.

Plenty of people are buying into the idea. Collagen is promoted as an anti-aging compound, as well as a beauty and performance enhancer, says Karen Formanski, an analyst with market research firm Mintel, making it appealing not just to middle-aged consumers but also to younger ones. According to projections by Nutrition Business Journal, collagen supplement sales in the U.S. will reach $298 million this year—up from $73 million in 2015.

Although collagen supplements have been around for quite a while, collagen has more recently popped up as an ingredient in foods. “The category of functional foods and drinks with added collagen has really exploded in the past couple of years,” Formanski says. “We see it as an offshoot of the overall trend of foods and drinks with added protein.” Energy bars, oatmeal, smoothies, coffee creamers, and popcorn are just a few of the foods that tout collagen on their labels.

But is eating more collagen really the quickest route to looking and feeling younger? Here’s what we know.

What Role Does Collagen Play in the Body?

Collagen is a type of protein. The word collagen derives from the Greek word kolla, which means glue. And true to its definition, collagen really is like an adhesive that holds many of the body’s tissues together. Skin, tendons, ligaments, bones, and cartilage—what are commonly known as connective tissue—are made up of collagen, says Keith Baar, PhD, professor of molecular exercise physiology at the University of California, Davis. When your body makes more collagen, these tissues are healthier, thicker, and spongier, he says, so they’re better able to support and protect your joints.

Where a lack of collagen may be most noticeable is in the skin. “Collagen—along with elastin—is what supports and sustains the dermis [the middle layer of skin],” says Maritza Perez, MD, clinical professor of dermatology at New York City’s Icahn School of Medicine at Mount Sinai and member of the Skin of Color Society board of directors.

As you age, your body becomes less efficient at making collagen, and getting too much ultraviolet light from the sun accelerates the natural decline. “Sun exposure leads to collagen breakdown and results in less new collagen being produced,” Perez says.

In people with fairer skin, collagen breakdown—evidenced by wrinkles and sagging or crepey skin—becomes visible around age 50, but in some people with darker skin (who have more natural protection against UV rays), it may happen a decade later.

How Does the Body Make Collagen?

All proteins are made up of tiny molecules called amino acids. When you eat protein, your body breaks it down into its individual amino acids. It then uses those amino acids, along with amino acids it can produce on its own, to make new proteins.“Amino acids are like building blocks, and the body puts some of them together in a specific pattern to form collagen,” says Lauri Wright, PhD, an associate professor of nutrition at the University of North Florida in Jacksonville. The three amino acids most prevalent in the formation of collagen are glycine, proline, and hydroxyproline.

Although collagen is found naturally in animal foods, your body can still make it if you don’t eat meat, dairy, or eggs. “As long as you eat a variety of plant proteins—such as legumes, soy, and quinoa—you will get all the essential amino acids your body needs to build collagen,” Wright says.

In addition to protein, your body also needs vitamin C, zinc, and copper to help it form collagen. “Vitamin C is especially important to regulate the synthesis of collagen,” Wright says. Vitamin C is plentiful in citrus fruits, bell peppers, and broccoli. You can get copper and zinc from nuts, seeds, and whole grains.

Does Eating More Collagen Build Your Collagen Reserves?

There’s no doubt that having ample collagen in your body is important. But the question remains as to whether taking supplements or eating foods that contain collagen translates directly to more collagen in your body. All protein you consume, collagen included, is processed by your body in the same way.

“Whether you ingest a collagen supplement or a steak, the body recognizes them as protein and breaks them down into amino acids in the digestive system,” Perez says. “There’s no guarantee that when you eat collagen, those amino acids will wind up in the skin [or ligaments] and produce collagen.”

Supplement proponents argue that in order for your body to make more collagen, it needs more of the specific amino acids (namely glycine and proline) the body uses to build collagen. How do you get more of those amino acids? By consuming more collagen. Many supplements and collagen-enhanced foods use hydrolyzed collagen (also called collagen peptides).

“There is some evidence the body can absorb these and use them to rebuild tissue,” says Donald K. Layman, PhD, professor emeritus in the food science and human nutrition department at the University of Illinois in Urbana. “Collagen also contains unique levels of glycine, an amino acid that may stimulate growth hormone, improving collagen synthesis.”

But even if eating collagen directly does lead to more collagen in your body, you don’t need special collagen foods or supplements to get it. Collagen is found in meat, poultry, fish, egg whites, and gelatin, as well as in stock or bone broth. The latter two are made from simmering animal bones for several hours, which leads to the collagen in the bones being released into the liquid.

It’s not really clear how much collagen you get from foods that contain it. For example, Purely Elizabeth Vanilla Pecan Collagen Protein Oats and Pact Glow With It Snack Bites have 10 grams of protein per serving. But in addition to collagen, protein-containing foods—such as nuts and seeds (in the oats) and egg white powder and pea protein (in the snack bites)—are on the ingredients list.

Does Collagen Really Do All the Things It’s Claimed to Do?

“Currently, we’ve got this huge gap between what protein science tells us and what consumers who take collagen have been saying for years—back to ancient times in Asia,” Layman says. “There’s an amazing amount of subjective evidence saying it’s great, but there’s not a lot of science to prove it.”

There have been small studies looking at the effect of supplemental collagen on ligaments and other connective tissue that have shown some promise. A placebo-controlled study of 20 runners with Achilles tendon injuries found that those who took 2.5 grams of collagen twice daily had greater improvement in Achilles pain at the three-month mark and were able to return to running sooner than those taking a placebo. (This study was financially supported by a manufacturer of collagen supplements.) And another study of just eight people found that consuming a vitamin-C enriched collagen supplement, followed by 6 minutes of jump roping, led to increased collagen synthesis in ligaments. “Exercise is what helps deliver the amino acids into the ligaments,” says Baar at UC Davis.

As for skin benefits, a 2019 review of 11 studies on collagen supplementation published in the Journal of Drugs in Dermatology found that doses ranging from 2.5 to 10 grams per day did increase skin elasticity and hydration.

Still, the research is preliminary, and even studies that hint at positive results from ingesting collagen can’t conclusively prove cause and effect. “There is evidence it is absorbed, and that there is an increase in certain amino acids, but no direct evidence that taking a collagen supplement increases collagen in the skin,” says Natasha Mesinkovska, MD, assistant professor of dermatology at the University of California, Irvine, and author of the review study.

Are Collagen Supplements Safe?

Collagen supplements—as well as the collagen being sprinkled into various food products—are usually derived from the skin, hide, tendons, bones, cartilage, or other connective tissues of cows, pigs, chicken, or fish. Collagen claimed to be vegan is made from genetically modified yeast and bacteria, but there is little evidence that it would have the same potential benefits as animal-derived collagen.

As is the case with all dietary supplements, the Food and Drug Administration doesn’t verify that collagen supplements contain what they say they do or determine whether they’re contaminated with heavy metals, bacteria, or pesticides before they’re sold. Because heavy metals and toxins can collect in animal bones, it’s possible that supplements could be a source of compounds such as arsenic or lead.

For example, a recent analysis of 28 collagen supplements by the Clean Label Project found that 64 percent had detectable levels of arsenic, about one-third tested positive for lead, and 17 percent had cadmium. (Some research has found small amounts of lead and cadmium in bone broths, too.) Although, for the most part, these levels were low, heavy metals accumulate in the body over time, which is one reason experts say there’s no safe intake level for heavy metals.

That said, most studies have not found any serious adverse effects from collagen supplementation (although most involved relatively short-term use). Yet until there’s more conclusive evidence in favor of supplements or collagen-enhanced foods, the best solution may be to focus on eating a healthy diet that supplies adequate amounts of protein, and limiting sun exposure. “Right now, Baar says, “the business component of collagen is further along than the science component.”

Read full article in Consumer Reports.

Natasha Mesinkovska and colleagues featured as American Society for Laser Medicine and Surgery, Inc. Journal’s October Editor’s Choice

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Combining Deep Learning With Optical Coherence Tomography Imaging to Determine Scalp Hair and Follicle Counts

Hair plays a substantial role in defining one’s identity, representing age, social status, and even wisdom. Effluvium refers to a pathophysiological process that leads to either reversible or permanent hair loss. Not surprisingly, alopecia patients often encounter great amounts of psychological and social morbidity directly related to their illness. These patients’ grief and frustration have, in part, motivated the development of a wide range of hair loss treatment products; however, techniques to determine treatment efficacy are still lacking.  Current methods for monitoring hair loss are invasive and or biased in interpretation.

In this study, researchers used optical coherence tomography, or OCT.  OCT is a non‐invasive light‐based imaging technique that uses the interference properties of skin tissue and infrared light to achieve high‐resolution cross‐section images that can be evaluated in multiple dimensions, and has the added benefit of not requiring any hair colorization or shaving, allowing for a traceless procedure.  The relatively high‐resolution images generated by OCT make it a useful tool for evaluation and diagnosis for many skin conditions.

The purpose of this research was to construct and evaluate a machine‐learning algorithm that could use data obtained from OCT images to accurately count hairs, hair‐bearing follicles, and non‐hair‐bearing follicles.  The process automatically returns all counts within seconds of completing the OCT scan of a patch of the scalp and with an accuracy that is within the discrepancy range of human raters.

This research suggests that this approach is well‐positioned to become the standard for non‐invasive evaluation of hair growth treatment progress in patients, saving significant amounts of time and effort compared with manual evaluation.

Read full publication.

Startups & Innovations – Financing

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By Jessie Yount, Orange County Business Journal

Cactus Medical LLC, an Irvine-based medical device maker, received a $1 million Phase II grant from the National Science Foundation.

Cactus Medical is developing a device to detect fluid in the ear to improve the diagnosis for ear infections in children, as well as prevent the over-prescription of antibiotics due to misdiagnosis.

The new funds will be used to complete device development and safety work for submission to the FDA.

Cactus Medical paused its clinical work earlier this year, according to Chief Executive Samir Shreim, and used the time to create a better, more cost-effective design to provide to the end-user: pediatricians in primary care and emergency room settings.

When it is safe to resume clinical work, Shreim said the company expects to enroll at least 90 children in a six to nine-month trial at UCI Medical Center and La Veta Surgery Center in Orange.

The recent award brings the firm’s total funds to nearly $1.5 million, with support from the National Institutes of Health and the West Coast Consortium for Technology and Innovation in Pediatrics, an FDA-sponsored accelerator based out of Children’s Hospital of Los Angeles.

Read full article in the Orange County Business Journal.

How to Cover a Sick Old Man

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By Ben Smith, The New York Times
Photo credit: Anna Moneymaker, The New York Times

The president is hospitalized and reporters are fighting for basic facts. What should elderly leaders — many of America’s top politicians are over 80 — reveal about their health?

When John Bresnahan was starting out as a reporter in the mid-1990s, he approached Senator Strom Thurmond of South Carolina, who had run for president in 1948 as a segregationist and was still shuffling through the Capitol. Senator Thurmond, born in 1902, gave no indication that he’d understood Mr. Bresnahan’s question and responded with a non sequitur.

The young reporter saw his older colleagues shaking their heads and snickering. The kid had expected the elderly senator to be able to carry on a conversation! They didn’t report on Senator Thurmond’s infirmity — that wasn’t how things were done — but they all knew about it.

These days, Mr. Bresnahan is the congressional bureau chief for Politico. A Navy veteran with the demeanor of a guy you’ve dragged out of a dive bar in the eighth inning of the Yankees game, he has become Capitol Hill’s grim reaper, a rare reporter with the stomach to print some obvious truths: that some top lawmakers aren’t all there.

In 2017, Mr. Bresnahan and his colleague Anna Palmer wrote that the powerful Republican chairman of the Senate’s appropriations committee, Thad Cochran, was “frail and disoriented,” a story that sped his retirement. Last month, Mr. Bresnahan and Marianne LeVine reported that fellow Democrats were worried whether Dianne Feinstein was up to leading her side of the Amy Coney Barrett confirmation hearings because she gets “confused by reporters’ questions, or will offer different answers to the same question depending on where or when she’s asked.”

This kind of reporting is impolite. It’s also totally obvious, and a natural feature of America’s recent slide toward gerontocracy. On Capitol Hill, everyone “knows this stuff,” Mr. Bresnahan said. “I just am the one to write it.”

I was thinking of Mr. Bresnahan as I watched reporters arrayed at Walter Reed military hospital on Sunday facing yet another moment of crisis for the news media, one even more basic than many of the hard challenges of the Trump era. The White House press corps is trying to perform a fundamental job of journalism — delivering simple facts about President Trump’s condition — in the face of Mr. Trump’s years of casual fabrication and his doctors’ clumsy evasions and contradictions. They’re covering the biggest policy failure of his administration in the most literal sense imaginable.

And yet they’re also doing something obviously uncomfortable. It’s hard not to feel some human revulsion for the sight of healthy, TV-ready young journalists braying for the vital signs of a sick old man. But there is no question that this prying is in the urgent public interest, and the White House press corps is working with admirable aggression and openness. We need to know who is in charge of the government, and to understand the outcome of President Trump’s long evasion of the coronavirus crisis as Americans begin to vote.

By refusing to speak honestly about basic facts, the White House is really “annihilating the press’s role,” said Elizabeth Drew, a former New Yorker Washington correspondent who covered President Ronald Reagan’s shooting in 1981 and his staff’s success at playing down the grave risk to his life.

Physical decline is likely to be a major feature of the next few years of American politics, at least. The current line of succession, after Mr. Trump and Vice President Mike Pence, features Speaker Nancy Pelosi, who is 80, and the Senate president pro tempore, Charles Grassley, 87, who also runs the Senate Finance Committee. Ms. Pelosi’s two most powerful deputies in the House, James Clyburn and Steny Hoyer, are both 80 or older. Over in the Senate, the chairman of the Armed Services Committee is 85 and coasting to re-election. The chairman of the Appropriations Committee is 86. Joe Biden, who turns 78 next month, is nearly a year younger than the Senate majority leader, Mitch McConnell, who is also seeking re-election in November.

This concentration of power in the hands of the old is an American phenomenon, Derek Thompson recently wrote in The Atlantic, noting that our leaders are getting older as European leaders get younger.

“If government of the elderly, by the elderly, and for the elderly will not perish from the Earth, the rest of us might suffer instead,” he lamented.

But it also means that journalists must get past the taboos and be frank about the normal process of aging, and must emulate Mr. Bresnahan’s stomach for blunt truths. Typically, whispers about age and health have remained on the margins of the political conversation, often driven by the right-wing aggregator Matt Drudge, whose visceral grasp of news has always included obsessions with age and health. In 2007, Mr. Drudge briefly capsized the presidential campaign with news of a new spot on John McCain’s head, for instance. His site is consumed, to the dismay of Mr. Trump’s supporters, with the president’s illness. (One of Drudge’s 18 headlines about Mr. Trump’s condition on Sunday morning: “Blind mystic predicted it!”)

Among the people scrambling this weekend at American newspapers are obituary writers, as major outlets assigned top reporters to update Mr. Trump’s obituary — Peter Baker at The New York Times, Marc Fisher at The Washington Post and Mark Z. Barabak at The Los Angeles Times, people at each paper told me. But the easiest solution to this media quandary is for citizens to elect leaders of working age. A friend recently told me sadly how nice it had been to see a national politician, Kamala Harris, jog down a few stairs.

But for the next few years, at least, our leaders’ age and health will remain big news. We need a reporting culture that’s ready to handle the public decline of this generation of leaders, as long as they insist on declining in public. Searching questions about everything from sleep to cognition shouldn’t be off limits.

“It will help if reporters are medically knowledgeable, and ask the right questions, e.g. blood pressure, heart rhythm, sleep disorders,” Dr. Mark Fisher, a professor of neurology and political science at the University of California, Irvine, told me on Sunday. “The more specific and precise questions reporters ask, the better. A robust fund of knowledge by the reporter is a great advantage.”

When politicians won’t share honest results, health experts’ long-range diagnoses should be treated as news. The whispers by reporters and lawmakers’ aides about feeling as if they work in a nursing home should find their way onto the record. And the most powerful people in the country should learn from Mr. Trump’s disastrous example that if you lie consistently about your health, nobody will believe you in a crisis.

None of this comes easily.

“Reporters are human beings and we cover these people,” Mr. Bresnahan told me. “You have respect for who the person was. It’s difficult.”