Thursday, June 22, 2017

More frequent sexual activity can boost brain power in older adults, according to study

sex
More frequent sexual activity has been linked to improved brain function in older adults, according to a study by the universities of Coventry and Oxford.
Researchers found that people who engaged in more regular sexual activity scored higher on tests that measured their verbal fluency and their ability to visually perceive objects and the spaces between them.

22 jun 2017--The study, published today in the Journals of Gerontology, Series B: Psychological and Social Sciences, involved 73 people aged between 50 and 83.
Participants filled in a questionnaire on how often, on average, they had engaged in sexual activity over the past 12 months - whether that was never, monthly or weekly - as well as answering questions about their general health and lifestyle.
The 28 men and 45 women also took part in a standardised test, which is typically used to measure different patterns of brain function in older adults, focussing on attention, memory, fluency, language and visuospatial ability.
This included verbal fluency tests in which participants had 60 seconds to name as many animals as possible, and then to say as many words beginning with F as they could - tests which reflect higher cognitive abilities.
They also took part in tests to determine their visuospatial ability which included copying a complex design and drawing a clock face from memory.
It was these two sets of tests where participants who engaged in weekly sexual activity scored the most highly, with the verbal fluency tests showing the strongest effect.
The results suggested that frequency of sexual activity was not linked to attention, memory or language. In these tests, the participants performed just as well regardless of whether they reported weekly, monthly or no sexual activity.
This study expanded on previous research from 2016, which found that older adults who were sexually active scored higher on cognitive tests than those who were not sexually active.
But this time the research looked more specifically at the impact of the frequency of sexual activity (i.e. does it make a difference how often you engage in sexual activity) and also used a broader range of tests to investigate different areas of cognitive function.
The academics say further research could look at how biological elements, such as dopamine and oxytocin, could influence the relationship between sexual activity and brain function to give a fuller explanation of their findings.
Lead researcher Dr Hayley Wright, from Coventry University's Centre for Research in Psychology, Behaviour and Achievement, said:
"We can only speculate whether this is driven by social or physical elements - but an area we would like to research further is the biological mechanisms that may influence this.
"Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are, and whether there is a 'cause and effect' relationship between sexual activity and cognitive function in older people.
"People don't like to think that older people have sex - but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general wellbeing."

More information: Hayley Wright et al, Frequent Sexual Activity Predicts Specific Cognitive Abilities in Older Adults, The Journals of Gerontology: Series B (2017). DOI: 10.1093/geronb/gbx065


Provided by Coventry University

Monday, June 19, 2017

Worldwide consensus on the terminology that supports research into sedentary behavior

A worldwide network of scientists examining the links between sedentary lifestyles and health problems such as obesity and cardiovascular disease today announced a new dictionary of terms to support research into sedentary behaviour.

18 jun 2017--The results of the 'terminology consensus project' led by the Children's Hospital of Eastern Ontario Research Institute's (CHEO RI) Sedentary Behaviour Research Network (SBRN) are published today in the International Journal of Behavioral Nutrition and Physical Activity in a paper co-authored by 84 scientists from 20 countries.
"This is the world's most extensive agreement to date on consensus definitions for researchers examining sedentary behaviour, an emerging global public health priority," said lead author Dr. Mark Tremblay, director of the CHEO RI's Healthy Active Living and Obesity Research Group (HALO) and a professor at the University of Ottawa. "There is an urgent need for clear, common and accepted terminology worldwide to facilitate the interpretation and comparison of research. We have made tremendous progress by defining terms such as physical inactivity, stationary behaviour, sedentary behaviour, and screen time. These terms have already been translated into several languages for rapid global uptake."
The paper, entitled "Sedentary Behaviour Research Network: Terminology Consensus Project Process and Outcome", provides refined definitions to suit all age groups, including babies, young children and people with chronic disease or mobility impairment. It also describes how bouts, breaks and interruptions should be defined and measured in the context of assessing sedentary behaviour and in relation to health outcomes.
The conceptual framework described in the paper also illustrates how both energy expenditure and posture are important components and how the terms relate to movement behaviours throughout a 24-hour period, including physical activity and sleep. Examples provided distinguish between active and passive sitting, active and passive standing, sedentary and stationary behaviour, screen time and non-screen-based sedentary time. Sedentary behaviour for a baby, for example, includes sitting in a car seat with minimal movement and, for a toddler, watching TV while sitting, reclining or lying down.
The 84 SBRN co-authors, which include researchers, trainees, graduate students, health practitioners and government employees, agree that standardization of the terminology is crucial to advancing future research, especially since this rapidly growing field of health science involves multi-disciplinary researchers, practitioners and industries.
"These consensus definitions will help scientists and practitioners navigate and understand the rapidly evolving field of sedentary behaviour research, allowing for more consistent and robust exploration of behaviours across 24 hours - sleep, sedentary behaviours and various intensities of physical activity - and may facilitate future research exploring ways to alter behaviours to improve health," Dr. Tremblay said. "Our hope is that these will reduce confusion and advance research related to sedentary behaviour and, ultimately, promote healthy active living."
Dr. Tremblay will chair a discussion of the project's findings at a workshop today at the International Society of Behavioral Nutrition and Physical Activity annual meeting in Victoria, British Columbia. Consensus definitions have been translated into French, Spanish, Portuguese, Dutch, Korean, German, Greek, Traditional Chinese, and Japanese.


Provided by Children's Hospital of Eastern Ontario Research Institute

Saturday, June 17, 2017

Is white or whole wheat bread 'healthier?' Depends on the person

Is white or whole wheat bread 'healthier?' Depends on the person
This visual abstract shows the findings of Korem et al. who performed a crossover trial of industrial white or artisanal sourdough bread consumption and found no significant difference in clinical effects, with the gut microbiome composition remaining generally stable. They showed the glycemic response to bread type to be person specific and microbiome associated, highlighting the importance of nutrition personalization.
17 jun 2017--Despite many studies looking at which bread is the healthiest, it is still not clear what effect bread and differences among bread types have on clinically relevant parameters and on the microbiome. In the journal Cell Metabolism on June 6, Weizmann Institute researchers report the results of a comprehensive, randomized trial in 20 healthy subjects comparing differences in how processed white bread and artisanal whole wheat sourdough affect the body.
Surprisingly, the investigators found the bread itself didn't greatly affect the participants and that different people reacted differently to the bread. The research team then devised an algorithm to help predict how individuals may respond to the bread in their diets.
All of the participants in the study normally consumed about 10% of their calories from bread. Half were assigned to consume an increased amount of processed, packaged white bread for a week—around 25% of their calories—and half to consume an increased amount of whole wheat sourdough, which was baked especially for the study and delivered fresh to the participants. After a 2-week period without bread, the diets for the two groups were reversed.
Before the study and throughout the time it was ongoing, many health effects were monitored. These included wakeup glucose levels; levels of the essential minerals calcium, iron, and magnesium; fat and cholesterol levels; kidney and liver enzymes; and several markers for inflammation and tissue damage. The investigators also measured the makeup of the participants' microbiomes before, during, and after the study.
"The initial finding, and this was very much contrary to our expectation, was that there were no clinically significant differences between the effects of these two types of bread on any of the parameters that we measured," says Eran Segal, a computational biologist at the Weizmann Institute of Science and one of the study's senior authors. "We looked at a number of markers, and there was no measurable difference in the effect that this type of dietary intervention had."
Based on some of their earlier work, however, which found that different people have different glycemic responses to the same diet, the investigators suspected that something more complicated may be going on: perhaps the glycemic response of some of the people in the study was better to one type of bread, and some better to the other type. A closer look indicated that this was indeed the case. About half the people had a better response to the processed, white flour bread, and the other half had a better response to the whole wheat sourdough. The lack of differences were only seen when all findings were averaged together.
"The findings for this study are not only fascinating but potentially very important, because they point toward a new paradigm: different people react differently, even to the same foods," says Eran Elinav (@EranElinav), a researcher in the Department of Immunology at the Weizmann Institute and another of the study's senior authors. "To date, the nutritional values assigned to food have been based on minimal science, and one-size-fits-all diets have failed miserably."
He adds: "These findings could lead to a more rational approach for telling people which foods are a better fit for them, based on their microbiomes."
Avraham Levy, a professor in the Department of Plant and Environmental Sciences and another coauthor, adds a caveat to the study: "These experiments looked at everyone eating the same amounts of carbohydrates from both bread types, which means that they ate more whole wheat bread because it contains less available carbohydrates. Moreover, we know that because of its high fiber content, people generally eat less whole wheat bread. We didn't take into consideration how much you would eat based on how full you felt. So the story must go on."

More information: Cell Metabolism, Korem et al: "Bread affects clinical parameters and induces gut microbiome-associated personal glycemic responses." http://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30288-7 , DOI: 10.1016/j.cmet.2017.05.002


Provided by Cell Press

Tuesday, June 13, 2017

Older adults are good Samaritans to strangers

NUS study: Older adults are good Samaritans to strangers
A study conducted by Asst Prof Yu Rongjun (right) and Dr Narun Pornpattananangkul (left) from the National University of Singapore found that older adults, compared to young adults, are more generous towards strangers.
13 jun 2017--People tend to become more generous as they age. This certainly holds true when it comes to helping strangers, according to a recent study by researchers from the National University of Singapore (NUS). Findings from the study showed that while the older adults treat their kin and friends the same as younger adults do, the elderly donate more to strangers than younger adults, even when their generosity is unlikely to be reciprocated.
"Greater generosity was observed among senior citizens possibly because as people become older, their values shift away from purely personal interests to more enduring sources of meaning found in their communities," explained Assistant Professor Yu Rongjun, who led the study. Asst Prof Yu is from the Department of Psychology at the NUS Faculty of Arts and Social Sciences, as well as the Singapore Institute for Neurotechnology at NUS.
The research results were first reported online in Journals of Gerontology: Psychological Sciences on 5 April 2017.

Generosity towards strangers is a function of age

Studies have shown that as people age, they are inclined to volunteer more frequently, are more attentive to ecological concerns, and are less interested in becoming rich. However, there is a lack of understanding of the core motive behind such altruistic behaviour. The team led by Asst Prof Yu sought to address this knowledge gap by looking at how social relationships with others influence how much older adults donate in comparison with younger adults.
The study, which was conducted from March 2016 to January 2017, involved 78 adults in Singapore. 39 of them were older adults with an average age of 70, while the other 39 were younger adults who were about 23 years old.
The NUS research team employed a framework known as social discounting to quantify generosity towards people. The framework works on the principle that people treat those they are closer with better than those whom they are more distantly acquainted, and much better than total strangers. The participants had to rate how close they were to people in their social environment, and the amount of money they would give to each respective person. Using a computational model, the NUS research team calculated the amount of money that the participants are willing to give to another person as a function of social distance.
The results revealed that both younger and older adults are equally generous to people who are close to them, such as family members or close friends. However, senior citizens are more generous to those who are more socially distant, such as total strangers, and the seniors' level of generosity does not decrease with distance as quickly as that of the younger adults. In addition, older adults are more likely to forgo their resources to strangers even when their generosity is unlikely to be reciprocated.
Dr Narun Pornpattananangkul, the first author of the research paper, said, "In psychology, the motivation to contribute to the greater good is known as an "ego-transcending" motivation. In our earlier work, we found that there is an enhancement of this motivation after people received oxytocin, a hormone related to maternal love and trust. In this study, we found a similar pattern of an ego-transcending motivation among the older adults, as if the older adults received oxytocin to boost their generosity. We speculate that age-related changes at the neurobiological level may account for this change in generosity." Dr Pornpattananangkul is a research fellow from the Department of Psychology at the NUS Faculty of Arts and Social Sciences.
Asst Prof Yu added, "Our findings shed light on the age-related changes among the elderly, and provide an understanding of why they are more inclined to lend a helping hand to strangers. Providing older adults with more opportunities to help others is not only beneficial to our society, but it might also be a boon to the well-being of older adults themselves. Future studies with direct well-being measures should further examine this hypothesis."

Future studies to examine neural mechanisms involved in decision making

To further their understanding on how decision making shifts among the elderly, Asst Prof Yu and his team at NUS are embarking on studies to examine the neural mechanisms underlying the changes in decision making by using brain-imaging technologies. Research findings from these studies have the potential to be translated into effective intervention programmes to promote healthy ageing, and may help tackle age-related conditions such as Parkinson's disease and Alzheimer's disease, which are often characterised by deficits in decision making.

More information: Narun Pornpattananangkul et al, Social Discounting in the Elderly: Senior Citizens are Good Samaritans to Strangers, The Journals of Gerontology: Series B (2017). DOI: 10.1093/geronb/gbx040


Provided by National University of Singapor

Saturday, June 10, 2017

First large-scale population analysis reinforces ketamine's reputation as antidepressant

ketamine

Better known as an anesthetic or as an illicit hallucinogenic drug, ketamine has also long been noted for alleviating depression. But ketamine has not been tested in a large clinical trial, and all evidence of its antidepressant effects has come from anecdotes and small studies of fewer than 100 patients. 

10 jun 2017--Now, in the largest study of its kind, researchers at Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California San Diego mined the FDA Adverse Effect Reporting System (FAERS) database for depression symptoms in patients taking ketamine for pain. They found that depression was reported half as often among the more than 41,000 patients who took ketamine, as compared to patients who took any other drug or drug combination for pain.
The study, published May 3 in Scientific Reports, also uncovered antidepressant effects for three other drugs typically used for other purposes—Botox, the pain reliever diclofenac and the antibiotic minocycline.
"Current FDA-approved treatments for depression fail for millions of people because they don't work or don't work fast enough," said senior author Ruben Abagyan, PhD, professor of pharmacy. "This study extends small-scale clinical evidence that ketamine can be used to alleviate depression, and provides needed solid statistical support for wider clinical applications and possibly larger scale clinical trials."
Abagyan led the study with pharmacy students Isaac Cohen and Tigran Makunts, and Rabia Atayee, PharmD, associate professor of clinical pharmacy, all at Skaggs School of Pharmacy.
The FAERS database contains more than 8 million patient records. The research team focused on patients in the database who received ketamine, narrowing their study population down to approximately 41,000. They applied a mathematical algorithm to look for statistically significant differences in reported depression symptoms for each patient.
"While most researchers and regulators monitor the FAERS database for increased incidences of symptoms in order to spot potentially harmful drug side effects, we were looking for the opposite—lack of a symptom," Cohen said.
The team found that the incidence of depression symptoms in patients who took ketamine in addition to other pain therapeutics dropped by 50 percent (with an error margin less than 2 percent) compared to the patients who took any other drug or drug combination for pain. Patients who took ketamine also less frequently reported pain and opioid-associated side effects, such as constipation, as compared to patients who received other pain medications.
According to Abagyan, it is possible that another factor common to patients taking ketamine was driving the antidepressant effect, such as the fact that ketamine also relieves pain. That's why they compared ketamine patients with patients taking other pain medications. That control group eliminated the possibility that people who take ketamine have less depression because they have less pain. Abagyan says it's still possible, though unlikely, the effect could be due to a still unidentified confounding factor.
Three other drugs with previously under-appreciated antidepressant effects also emerged from this analysis: Botox, used cosmetically to treat wrinkles and medically to treat migraines and other disorders; diclofenac, a nonsteroidal anti-inflammatory drug (NSAID); and minocycline, an antibiotic.
After the diclofenac finding, Abagyan and team went back and looked at ketamine patients who did not also take NSAIDs and compared them to patients who took any other combination of drugs for pain except NSAIDs. Depression rates in patients taking ketamine remained low.
The researchers hypothesize that the antidepressant effects of diclofenac and minocycline may be due, at least in part, to their abilities to reduce inflammation. For Botox, the potential mechanism for reducing depression is less clear. The team is now working to separate Botox's beauty effects (which could indirectly make a person feel better emotionally) and its antidepressant effects. To do this, they are first using FAERS data to determine if collagen fillers and other cosmetic treatments similarly affect depression rates.
According to the World Health Organization, more than 300 million people experience depression worldwide. If not effectively treated, depression can become a chronic disease that increases a person's risk of mortality from suicide, heart disease or other factors. Depression is currently treated with five classes of antidepressants, most commonly serotonin reuptake inhibitors.
For financial and ethical reasons, ketamine has never been tested for its safety and effectiveness in treating depression in a large-scale clinical trial, but it reportedly works much more rapidly than standard antidepressants. Ketamine is relatively inexpensive and is covered by most health insurance plans if three other antidepressants fail.
"The approach we used here could be applied to any number of other conditions, and may reveal new and important uses for thousands of already approved drugs, without large investments in additional clinical trials," Makunts said.

More information: Isaac V. Cohen et al, Population scale data reveals the antidepressant effects of ketamine and other therapeutics approved for non-psychiatric indications, Scientific Reports (2017). DOI: 10.1038/s41598-017-01590-x


Provided by University of California - San Diego

Sunday, June 04, 2017

Burden of multiple chronic illness told through new chartbook

Burden of multiple chronic illness told through new chartbook
From the report 'Multiple Chronic Conditions in the United States.' 
A new publication illustrates the burden that chronic illnesses impose on American society, demonstrating through charts and graphics how 60 percent of American adults suffer from at least one chronic health condition and 42 percent have more than one.

04 jun 2017--The chartbook updates previous compendiums with more-recent information about the prevalence of multiple chronic conditions, as well as the associated health care utilization and spending.
The data confirms that the prevalence of multiple chronic conditions is highest among older adults. Women are more likely than men to have multiple chronic conditions, as many women live longer than men do.
A chronic condition is a physical or mental health condition that lasts more than one year and causes functional restrictions or requires ongoing monitoring or treatment.
When a patient has more than one chronic condition—such as diabetes, high blood pressure and depression—treatment can be difficult to manage, researchers say. Treatment strategies or drug regimens may be similar, but one chronic condition often is managed better than the others.
"We hope this updated chartbook helps both health professionals and the public better understand that chronic disease is a burden not only for patients, but also for the health care system overall," said Christine Buttorff, lead author of the study and an associate policy researcher at RAND, a nonprofit research organization.
The project was supported by the Partnership to Fight Chronic Disease. The report, "Multiple Chronic Conditions in the United States," is available at http://www.rand.org. Other authors of the report are Teague Ruder and Melissa Bauman.


Provided by RAND Corporation

Saturday, June 03, 2017

Frailer patients at much greater risk of institutional care and death after discharge from hospital

Independent of age, frail patients are almost twice as likely to die in the year following admission to critical care, and even more likely to need nursing home care after discharge from hospital, compared with patients who are not frail, according to new research presented at this year's Euroanaesthesia Congress in Geneva (3-5 June).

03 jun 2017--Frailty (a decline in physiological reserve and function leading to increased vulnerability to poor health outcomes) is very common, affecting up to 1 in 10 people over 70 years old. While people who are frail are not disabled, they have reduced strength and endurance and find it difficult to carry out normal daily activities. Frailty is linked to earlier death, poor function, and increased hospitalisations. However, the role of frailty in critical care outcomes is unclear.
In this study, Professor Gary Mills from the University of Sheffield, UK and colleagues looked at data over a 3-year period for 7,732 adults aged 17 to 104 years old, who had been admitted to critical care departments in two hospitals in Sheffield, UK. They measured the effect of frailty on the risk of death in the year after hospitalisation. Smaller samples of patients were also assessed for changes to residence (3,469 patients) and differences in dependency (2,387) before and after admission. Of 7,732 patients 1,726 were considered to be frail with an average age of 72.5 years, based on an assessment of their health and function in line prior to this illness episode, using the Rockwood frailty score.
Results showed that around 40% of frail patients had died within one year of admission compared to 15% of non-frail patients. Analysis of the data showed that frail patients were at almost twice the risk of dying in the year after admission to critical care compared to non-frail patients, even after accounting for important characteristics like age, the number of organs supported during care and major comorbidities like metastatic disease or kidney failure. Frail patients were also nearly 2.5 times as likely to need institutional care and became more dependent after discharge from hospital.
The authors conclude: "Our findings suggest that being frail is associated with poorer outcomes after critical illness and this could affect decision making regarding appropriate care by patients. This study should trigger further research and quality improvement efforts aimed at improving the care and outcomes of the growing population of frail patients with critical illness."


Provided by European Society of Anaesthesiology