To bolster a new year's resolution, ask, don't tell

"Will you exercise this year?" That simple question can be a game-changing technique for people who want to influence their own or others' behavior, according to a recent study spanning 40 years of research.

31 dec 2015--The research is the first comprehensive look at more than 100 studies examining the 'question-behavior effect,' a phenomenon in which asking people about performing a certain behavior influences whether they do it in the future. The effect has been shown to last more than six months after questioning.
Writing in the Journal of Consumer Psychology, marketing researchers from the University of California, Irvine, the University at Albany, State University of New York, the University of Idaho and Washington State University examined why the effect occurs. Their findings offer guidance to social marketers, policy makers and others seeking to impact human behavior.

Why questions can influence behavior

"If you question a person about performing a future behavior, the likelihood of that behavior happening will change," said Dave Sprott, a co-author and senior associate dean of the Carson College of Business, Washington State University.
The basic idea is that when people are asked 'Will you recycle?' it causes a psychological response that can influence their behavior when they get a chance to recycle. The question reminds them that recycling is good for the environment but may also make them feel uncomfortable if they are not recycling. Thus, they become motivated to recycle to alleviate their feelings of discomfort.
Overall, the researchers' findings suggest questioning is a relatively simple yet effective technique to produce consistent, significant changes across a wide domain of behaviors. The technique can sway people toward cheating less in college, exercising more, recycling, or reducing gender stereotyping.

Benefits of using the technique

"We found the effect is strongest when questions are used to encourage behavior with personal and socially accepted norms, such as eating healthy foods or volunteering," said Eric R. Spangenberg, first author and dean of the Paul Merage School of Business, University of California, Irvine. "But it can be used effectively to even influence consumer purchases, such as a new computer."
"It is pretty easy to ask a question, and it can be done in a variety of means, such as ads, mailers, online media, and interpersonal communications," said Sprott.
The researchers found the question-behavior effect to be strongest when questions are administered via a computer or paper-and-pencil survey, and when questions are answered with a response of 'yes' or 'no.' They also found that those using the technique are better off not providing a specific time frame for the target behavior.
The study suggests that the technique will be less impactful on habits or behaviors that consumers have done a lot. The researchers also advise using caution asking about vices like skipping class or drinking alcohol. In their review, they found a study showing that people asked about vices later did them more than a control group

Tips for New Year's resolution makers and others

The researchers suggest the key to influencing someone's behavior is to ask a question rather than make a statement. For example, parents asking their high school-age children, 'Will you drink and drive?' should be more effective than when they say, 'Don't drink and drive.'
For people making New Year's resolutions, a question like, 'Will I exercise—yes or no?' may be more effective than declaring, 'I will exercise.'
More information: Eric R. Spangenberg et al. A meta-analytic synthesis of the question-behavior effect, Journal of Consumer Psychology (2015). DOI: 10.1016/j.jcps.2015.12.004


Provided by Washington State University

Self-control expert offers six tips for creating successful New Year's resolutions

Psychologists say that making resolutions can be helpful, but caution people to think carefully before deciding exactly what their goals will be.

Unfortunately, USC Dornsife researchers have not unlocked the key to keeping you from sleeping through your 5 a.m. spin class or avoiding the 4 p.m. trip to the vending machine.
But John Monterosso, an expert on the psychology and neuroscience of self-control as well as addiction, can offer insight on how to create more calculated resolutions—and keep yourself from going too far with a resolution that's making you miserable.

30 dec 2015--"I don't think any research on the topic is going to work like an advance in engineering—like 'Aha! If people do this or take this pill, they will keep their resolutions,'" said Monterosso, associate professor of psychology. "Realistically, what psychologists and neuroscientists are trying to do is learn how resolutions work. We know only a little about the brain mechanisms, but quite a bit about the psychology—enough that I do think we can offer some useful insights."
Monterosso, who leads the USC Dornsife's Addiction and Self Control Lab, explained that a resolution can be thought of as a special kind of plan.
"But what is special about a resolution is that it is made in response to a very particular anticipated obstacle—one's future self," he said. "You think, 'I want to quit smoking now, but I know I might go back on that in the future.' The resolution is supposed to guard against this happening."

Note to future-self

Monterosso suggested that you think of the resolution as a message you are sticking in a bottle and throwing out to your future self.
"'I know at some time that donut is going to seem like a good idea,' you might say to your future self. 'But don't eat it,"' Monterosso explained. "The hope is that when donut-smells fill your senses, and your mouth begins to water, you will not only remember the resolution, but you will also care enough to feel bound by it."
Or maybe not. Monterosso suggested resolutions may sometimes go too far.
If it's a fresh-baked donut from a world-famous pastry shop, it may be worth the indulgence. "Not all resolutions are good—some are counterproductive and even unhealthy," Monterosso said.
When making your resolutions in the next two weeks, Monterosso suggests you keep these six essentials in mind:

Failed resolutions are not harmless.

It feels bad to fail and undermines our confidence in our resolve, which can make us less able to succeed in keeping a future resolution.
Studies show that in some cases failure leads to worse behavior. Think of the recovering alcoholic who slips up, feels all is lost—and therefore disengages from any restraint, going on an extended bender.

Resolutions work by linking single decisions to a bigger picture.

Imagine someone who has resolved to quit smoking but craves a cigarette. The harm of just one cigarette is small and uncertain. Why not give in to the craving when the harm of just one cigarette is so small?
Successful resolutions guard against this logic by making the temptation an important test case. One thinks, "I resolved to quit. If I give in and smoke the cigarette, then my resolution is out the window." If one takes a resolution seriously, the health implication of the single cigarette feels significant, and the decision no longer feels like just this one.

Consider being less ambitious in your resolutions.

People tend to be wildly overconfident about a behavioral change at the time when they make a resolution. Even in an area in which we have a long history of failed resolutions, we often feel almost bizarrely optimistic that this time will be different.
The problem with overconfidence is that it can lead to setting unrealistically ambitious resolutions. An hour of yoga per day may not be realistic if your life is already packed with obligations. If it is not realistic, then resolving to do it is worse than worthless, given the potential harm from failure. Setting a good resolution requires knowing yourself well.

Resolutions should not be vague.

If a resolution leaves a lot open for interpretation, it won't be helpful. Consider a resolution such as, "Be nice to my spouse." What seems nice enough at the time of the resolution may not be the same as what seems nice enough a week later, particularly in the heat of a disagreement.
Similar to a contract between distinct people, a personal resolution that is not specific can't be enforced. Instead, try making a more specific resolution such as, "I will not raise my voice with my spouse."

The New Year is a fresh start.

While we tend to be overconfident when making resolutions, that confidence can leave us later when we feel tempted. We remember other failed resolutions, and the goal often feels out of reach, leading to 'oh-the-heck-with-it' moments in which we succumb to temptation.
It helps if there is something to set the recent resolution apart from unsuccessful ones that came before it. A New Year's resolution can accomplish this because we perceive Jan. 1 as a fresh start, meaning past failures might not seem as damning. After all, they are the failures of last year's you.

Even successful resolutions can be mistakes.

People can get so uptight and over-resolved that they continue sticking to things that are costly to themselves and to others. Whether it is restricting eating to the point of starvation, exercising to the point of bodily harm or saving money to the point you never enjoy spending it. In any domain, resolutions can go too far. Again, it comes down to judgment—to wisdom—and knowing yourself.

So are resolutions even a good idea?

"I think at their best, resolutions play a role in great human achievements," Monterosso said. "But, they can cause suffering, as well. It pays to be thoughtful in how they are used. Good resolving is a bit of an art."


Provided by University of Southern California

Eating healthy or feeling empty?

Eating too much is typically considered one of the prime culprits of obesity. A new study published in the Journal of the Association for Consumer Research, looked specifically at overconsumption of "healthy" foods which consumers often perceive as less filling. The researchers successfully found evidence to support their hypothesis that when people eat what they consider to be healthy food, they eat more than the recommended serving size because they associate "healthy" with less filling.

29 dec 2015--The research utilizes a multi-method approach to investigate the "healthy = less filling" intuition. The first study was conducted with 50 undergraduate students at a large public university and employed the well-established Implicit Association Test to provide evidence for an inverse relationship between the concepts of healthy and filling. The second study was a field study conducted with 40 graduate students at a large public university and measured participants' hunger levels after consuming a cookie that is either portrayed as healthy or unhealthy to test the effect of health portrayals on experienced hunger levels. The third study was conducted with 72 undergraduate students in a realistic scenario to measure the impact of health portrayals on the amount of food ordered before watching a short film and the actual amount of food consumed during the film. The set of three studies converges on the idea that consumers hold an implicit belief that healthy foods are less filling than unhealthy foods.
Specifically, the researchers demonstrate that portraying a food as healthy as opposed to unhealthy using a front-of-package nutritional scale impacts consumer judgment and behavior. When a food is portrayed as healthy, as opposed to unhealthy, consumers report lower hunger levels after consumption, order greater portion sizes of the food, and consume greater amounts of the food. Surprisingly, even consumers who say they disagree with the idea that healthy foods are less filling than unhealthy foods are subject to the same biases. In addition, the researchers introduce a novel tactic for reversing consumers' habit of overeating foods portrayed as healthy: highlighting the nourishing aspects of healthy food mitigates the belief that it is less filling.
These findings add to the burgeoning body of work on the psychological causes of weight-gain and obesity and point to a way of overturning the pernicious effects of the "healthy = less filling" assumption. Specifically, the findings suggest that the recent proliferation of healthy food labels may be ironically contributing to the obesity epidemic rather than reducing it. Consumers can use this knowledge to avoid overeating foods presented as healthy and to seek foods portrayed as nourishing when they want to feel full without overeating.
This article is published in the inaugural issue of the Journal of the Association for Consumer Research entitled "The Behavioral Science of Eating."

More information: Suher, Jacob, Raj Raghunathan and Wayne Hoyer (2016). Eating Healthy or Feeling Empty? How the" Healthy = Less Filling" Intuition Influences Satiety. The Journal of the Association for Consumer Research, 1.


Provided by Cornell Food & Brand Lab

Researchers see promising results in treating age-related decline in muscle mass and power

A proof-of-concept, phase 2 trial by an international research team has found promising results for a myostatin antibody in treating the decline in muscle mass and power associated with aging.

28 dec 2015--"Myostatin is a natural protein produced within the body that inhibits muscle growth," said Stuart Warden, a member of the research team who is also associate dean for research and associate professor in the School of Health and Rehabilitation Sciences at Indiana University-Purdue University Indianapolis. "It has been hypothesized for some time that inhibition of myostatin may allow muscle to grow, resulting in improved muscle mass and physical performance. The current study confirms these beliefs."
In the study, injections of a myostatin antibody, over a 24-week period resulted in an increase in lean (muscle) mass and improved performance on tasks requiring muscle power in patients older than 75 with low muscle strength, low muscle performance and a history of falling.
"This is the first study to show that myostatin antibody treatment improves performance on activities requiring muscle power," Warden said. "'Muscle power' refers to the ability to generate muscle forcequickly. During aging, it is lost more rapidly than muscle strength, contributing to disability, falls, reduced quality of life and, in some instances, death."
"Myostatin antibody treatment improved muscle power in the elderly, as indicated by improvements in the ability to climb stairs, walk briskly and rise repetitively from a chair," Warden said. "Treatment particularly benefited those who were most frail at baseline, a population who may not be receptive to conventional intervention such as resistance exercise."
Warden said the current study "provides proof-of-concept evidence to proceed to the larger studies that are required to demonstrate whether myostatin antibody treatment improves quality of life and reduces falls and their consequences during aging." He added: "This is an important and exciting first step."


Provided by Indiana University

Lifetime stress accelerates epigenetic aging

An important risk factor for accelerated aging and age-related diseases is excessive or chronic stress. Scientists at the Max Planck Institute of Psychiatry in Munich have now found how psychological stress, which accumulates over a lifetime, accelerates the aging process. The reason for this are epigenetic changes at binding sites of the receptor for the stress molecule glucocorticoid.

27 dec 2015--One plausible mechanism that may mediate the adverse effects of stress on the aging process is epigenetic regulation. Epigenetic actions do not change the actual genetic code but alter its accessibility by i.e. attaching chemical groups to or removing them from the DNA. A team supervised by Elisabeth Binder, director at the Max Planck Institute of Psychiatry, investigated the effect of lifetime stress on a DNA methylation-based age predictor in blood samples from a cohort of highly traumatized African American individuals.
"Glucocorticoids are molecular effectors of our response to stress and can exert actions in essentially every body organ via activation of the stress-hormone receptor. The stress hormone receptor regulates gene expression by binding to specific response elements in the DNA. This can also lead to long lasting "epigenetic reprogramming," explains Anthony Zannas, leading scientist in the current study. " We found that such a stress-induced reprogramming happens in sites that are associated with aging."
The study showed that individuals exposed to high levels of lifetime stress were epigenetically older than their true biological age. Such a premature "biological" aging has been shown to increase the risk for a number of age-related diseases. Exposure to stress may thus lead to more aging-related diseases by long-lasting epigenetic effects induced by the chronic activation of stress-hormone receptors.
Measuring the epigenetic age in peripheral blood cells may be a possibility to identify chronically stressed individuals at high risk for cardiovascular diseases or dementia and to initiate timely prevention programs.

More information: Anthony S. Zannas et al. Lifetime stress accelerates epigenetic aging in an urban, African American cohort: relevance of glucocorticoid signaling, Genome Biology (2015). DOI: 10.1186/s13059-015-0828-5


Provided by Max Planck Society

Scientists localize the Christmas spirit in the brain

An fMRI image with yellow areas showing increased activity. Credit: Wikipedia/ CC BY 3.0

The Christmas spirit has been located in the human brain, reveals a study published in The BMJ's Christmas issue this week.

25 dec 2015--The Christmas spirit has been a widespread phenomenon for centuries and is commonly described as feelings of joy and nostalgia mixed with associations to merry feelings, gifts, delightful smells, and good food.
However, the authors of the study estimate that "millions of people are prone to displaying Christmas spirit deficiencies," and refer to this as the 'bah humbug' syndrome.
"Accurate localisation of the Christmas spirit is a paramount first step in being able to help this group of patients," they say, and can advance "understanding of the brain's role in festive cultural traditions."
So the team of researchers from Rigshospitalet, a hospital affiliated with Copenhagen University, attempted to locate the 'Christmas spirit' in the brain using functional magnetic resonance imaging (fMRI).
An fMRI scan measures changes in blood oxygenation and flow that occur in response to neural activity, and can produce activation maps showing which parts of the brain are involved in a particular mental process.
The study involved 10 participants who celebrated Christmas, and 10 healthy participants who lived in the same area, but who had no Christmas traditions.
All participants were healthy, and did not consume eggnog or gingerbread before the scans.
Each participant was scanned while they viewed 84 images with video goggles.
Images were displayed for two seconds each, and after six consecutive images with a Christmas theme, there were six every day images (see link below for examples).
After the scans, all participants filled out a questionnaire about their Christmas traditions, feelings associated with Christmas, and ethnicity.
Based on these results, 10 participants were allocated to the 'Christmas group'—those who celebrated Christmas and had positive associations—and 10 to the 'non-Christmas group'—those who did not celebrate Christmas and had neutral feelings towards the festivities.
Differences in the brain activation maps from the scans of the two groups were analysed to identify Christmas specific brain activation.
Results showed five areas where the Christmas group responded to Christmas images with a higher activation than the non-Christmas group.
These included the left primary motor and premotor cortex, right inferior and superior parietal lobule, and bilateral primary somatosensory cortex.
These cerebral areas have been associated with spirituality, somatic senses, and recognition of facial emotion among many other functions.
For example, the left and right parietal lobules have been shown to play a role in self transcendence, the personality trait regarding predisposition to spirituality.
In addition, the frontal premotor cortex is important for experiencing emotions shared with others by mirroring or copying their body state, and premotor cortical mirror neurons even respond to observation of ingestive mouth actions.
Further research is necessary to understand the Christmas spirit, and other potential holiday circuits in the brain, say the authors, such as Easter, Chanukah, Eid, and Diwali.
"Although merry and intriguing, these findings should be interpreted with caution," they explain. "Something as magical and complex as the Christmas spirit cannot be fully explained by, or limited to, the mapped brain activity alone."

More information: Evidence of a Christmas spirit network in the brain: functional MRI study, The BMJ, www.bmj.com/cgi/doi/10.1136/bmj.h6266


Provided by British Medical Journal

Five easy ways to prevent overeating during the holiday family dinner

Despite the unseasonably warm weather, it's that time of the year again. People are scouring the malls for those last minute presents, holiday music is everywhere, kids are writing letters to Santa, and those who drew the short straw (or are masochists) are preparing to host their families for a big Christmas dinner. 

24 dec 2015--I don't know what it is about large family gatherings, whether its Thanksgiving or Christmas, but overconsumption seems to be part of the tradition. If you are hosting your family dinner, there are a number of helpful tricks you can utilize to ensure your whole family is not in a food-induced coma by the end of the evening.
The following tips come courtesy of Dr. Brian Wansink who has done countless studies on how your immediate environment affects your dietary patterns. In his most recent book, Slim by Design, he breaks down numerous easily-actionable changes you can make to your home, workplace, or when shopping at grocery stores or dining at restaurants. Unlike most non-fiction self-help books that tend to be heavy on the theory and light on the actionable advice, Slim by Design is packed full of useful tips on every page.
Without further ado, here's what you can do to save your guests from overindulging during the family dinner:

• Give your guests smaller plates. According to Dr. Wansink's research, we tend to eat more food when it is placed on a large plate versus a small plate.
• Use smaller serving bowls. When food is served in a 3-quart bowl vs a 2-quart bowl, people will dish out an extra 17% of food.
• Use small serving spoons. Using large serving spoons leads to 14% greater consumption of calories. People will likely fatigue from multiple spooning, or will be prompted by another diner for the spoon so they can also serve themselves.
• Serve the food from the stove rather than from the table. Rather than placing all the available food in bowls within arm's reach on the dining table, simply serve each plate with a bit of everything and leave the bowls of remaining food on a separate counter or back in the kitchen. According to research, people who served from the stove or counter ate 19% less food by comparison to those who ate family style from the dining table.
• Regardless of the colour of wine guests are drinking, serve the wine in the narrow white-wine glasses. Since we focus more on the height of liquid in a container rather than its width, we pour 12% less wine into a white wine glass. The same holds true for serving drinks of any sort (juice, pop, etc.).

Armed with these 5 simple tips, you would have done your family a great service in making the healthy choice (not overeating) the easy choice. The beauty of it all? No one is likely to notice any of these subtle changes. But, at the end of the evening, they may notice that they can get off the couch with greater ease than expected.

Happy Holidays!

This story is republished courtesy of PLOS Blogs: blogs.plos.org.

Staying healthy while getting older

A 70-year old is crossing the street when suddenly, as if from nowhere, a car sounds its horn. It has come to a stop just a metres away - no harm has been done. The 70-year old did not see the car until then. These are the kinds of mishaps that some older people are unable to explain and which lead them to think that something might be wrong with them. This leaves them feeling uneasy or scared.

23 dec 2015--Noticing these signs of ageing can often be a source of worry for senior citizens. However, many of those affected do not want to go straight to a hospital, a neurologist or a psychiatrist with their questions. This may be because they are worried that if the results of a medical examination show a loss of function they will be passed on to the authorities, which may result in negative consequences, such as them losing their driving licence.

High demand for advice

The ageing process can be associated with many changes that lead to subjective or objective loss of cognitive or physical function. However, Prof. Dr. Frieder R. Lang, head of FAU's Institute of Psychogerontology explains, 'Many losses that older people experience do not require any specific medical treatment. Nevertheless, many people have a lot of questions and the demand for advice is often high.'
For this reason, IPG is launching an innovative consultation model - the first of its kind in Germany - in January 2016. The project is being funded by Theo und Friedl Schöller-Stiftung, based in Nuremberg, for a period of five years. The new concept, which is linked to the University but is explicitly non-clinical, is called 'Beratung für gesundes Altern' (BegA, advice for healthy ageing). It aims to provide prevention-orientated advice that is specially designed for older people, as well as their relatives. It will help those affected to prepare themselves to deal with possible losses of function due to ageing. BegA is being run by an interdisciplinary team of gerontologists, psychologists, doctors, social workers, occupational therapists and other specialists led by Prof. Dr. Frieder R. Lang and his colleague Dr. Roland Rupprecht.
The experts will provide advice on key topics related to the ageing process, such as what can I do to stay fit? How can I eat healthily at 50 and above? How can I maintain my independence? 'We have made our concept easily accessible in order to reach a lot of people,' Dr. Roland Rupprecht says.
Those affected will have the opportunity to discuss current questions and problems in a non-binding initial consultation session that is free of charge. The consultant will then determine whether the person requires further diagnosis or assistance. Participants will also be offered preventative courses and annual check-ups. The project will be strictly confidential, with participants being able to decide themselves how their data is used.

Research questions

The researchers aim to use the anonymised data that is collected as part of the BegA project to investigate a variety of research questions, such as how effective the preventative measures are for the participants and how the cognitive performance of people who decided to participate in BegA because of subjectively perceived memory problems changes in the long term. Another possible topic is how senior citizens deal with the voluntary decision to stop driving.


Provided by University of Erlangen-Nuremberg

Medical first: Discovery of warning symptoms for usually fatal heart rhythm malfunction

Human heart. Credit: copyright American Heart Association

More than half of patients who have a sudden cardiac arrest ignore symptoms occurring up to a month prior to the usually fatal heart rhythm malfunction even though medical intervention potentially could save their lives, according to new research published by the Annals of Internal Medicine.

22 dec 2015--Although medical science has long regarded sudden cardiac arrest as a deadly condition that strikes without warning, a new study led by an associate director of the Cedars-Sinai Heart Institute shows for the first time that many patients experience warning symptoms up to a month before having a cardiac arrest.
"Sudden cardiac arrest in middle age hits society hard since most who are affected are their families' primary breadwinners," said Sumeet S. Chugh, MD, medical director of the Heart Rhythm Center in the Cedars-Sinai Heart Institute and the Pauline and Harold Price Chair in Cardiac Electrophysiology Research. "Fewer than 7 percent survive a sudden cardiac arrest, which has historically made it difficult to pinpoint symptoms. These research findings suggest that we could use an entirely novel approach to predict and prevent this devastating condition."
The study performed in 839 patients between the ages of 35 and 65 outlines the most common symptoms, including intermittent chest pain and pressure, shortness of breath, palpitations and ongoing influenza-like indicators such as nausea and abdominal and back pain.
"These new findings give good reason not to ignore unusual sensations, as vague as they may be," said Eduardo Marbán, MD, PhD, director of the Cedars-Sinai Heart Institute. "Better to seek medical attention early than to risk dying suddenly."
Approximately 350,000 people in the U.S. die each year from sudden cardiac arrest, accounting for 50 percent of all cardiovascular deaths nationally.
Although 'heart attack' and 'sudden cardiac arrest' are often used interchangeably, the terms are not synonymous. A heart attack—myocardial infarction—is typically caused by clogged coronary arteries that reduce blood flow to the heart muscle. Sudden cardiac arrest is the result of defective electrical activity of the heart. Patients may have little or no warning, and the disorder usually causes instantaneous death. Sudden cardiac arrest has been blamed for the deaths of journalist Tim Russert and filmmaker John Hughes.
"We already have the implantable defibrillator, a surgically implanted device that is a long-term lifesaver for many patients who suffer sudden cardiac arrest down the road," Chugh said. "Now that we realize that sudden death may not be so sudden, there is also potential for new shorter-term approaches by increasing awareness and education of patients and their healthcare providers."
Over recent years, Chugh and his team of researchers have been the first to identify several risk factors for sudden cardiac arrest, including levels of sex hormones in the blood, genetic markers and electrical and structural abnormalities of the heart.
In addition to his leadership role at the Cedars-Sinai Heart Institute, Chugh heads the Oregon Sudden Unexpected Death Study, a comprehensive, 16-hospital, multiyear assessment of cardiac deaths in the Portland metropolitan area, home to 1 million people. The study has been underway for more than a decade. Data collected from it provides Chugh and his team with unique, community-based information to mine for answers to what causes sudden cardiac arrest.
In the new study, Chugh and his researchers analyzed data on 839 patients included in the Oregon assessment. The researchers also interviewed first responders and patients' family members. Results include:

• 51 percent of patients experienced warning symptoms, predominately chest pain, prior to the cardiac arrest.
• In the group that experienced symptoms, 93 percent experienced them again in the 24 hours preceding the cardiac arrest.
• Only 19 percent of those who experienced symptoms called emergency medical services.
• The patients who experienced symptoms and sought medical help had a survival rate of 32 percent. Those who did not seek medical treatment for symptoms had a survival rate of 6 percent.

Provided by Cedars-Sinai Medical Center

New genes associated with extreme longevity identified

This stylistic diagram shows a gene in relation to the double helix structure of DNA and to a chromosome (right). The chromosome is X-shaped because it is dividing. Introns are regions often found in eukaryote genes that are removed in the splicing process (after the DNA is transcribed into RNA): Only the exons encode the protein. The diagram labels a region of only 55 or so bases as a gene. In reality, most genes are hundreds of times longer. 

Centenarians show successful aging as they remain active and alert at very old ages. Scientists at Stanford University and the University of Bologna have begun to unravel the basis for longevity by finding genetic loci associated with extreme longevity.

20 dec 2015--Previous work indicated that centenarians have health and diet habits similar to the average person, suggesting that factors in their genetic make-up could contribute to successful aging. However, prior genetic studies have identified only a single gene (APOE, known to be involved in Alzheimer's disease) that was different in centenarians versus normal agers. The results from the current study indicate that several disease variants may be absent in centenarians versus the general population.
The report by Kristen Fortney and colleagues, published in PLOS Genetics, is an example of using Big Data to glean information about an extremely complicated trait such as longevity. To find the longevity genes, the authors first derived a new statistical method (termed 'informed GWAS') that takes advantage of knowledge from fourteen diseases to narrow the search genes associated with longevity. Using iGWAS, the scientists found five longevity loci that provide clues about physiological mechanisms for successful aging. These loci are known to be involved in various processes including cell senescence, autoimmunity and cell signaling, and also with Alzheimer's disease.
The incidence of nearly all diseases increases with age, so understanding genetic factors for successful aging could have a large impact on health. Future work may lead to a better understanding of how these genes promote successful aging. Also, future studies could identify additional longevity genes by recruiting more centenarians for analysis.

More information: PLOS Genetics, dx.doi.org/10.1371/journal.pgen.1005728


Provided by Public Library of Science

Research shows typical American diet can worsen chronic pain

“We need to be concerned about the consequences our diet has on our bodies, and not just immediately with problems like weight gain, but also with long-term complications. That’s what we set out to investigate in this study.”

Sufferers of chronic pain are more susceptible to prolonged and pronounced health issues when practicing poor diet habits, according to new research published by University of Alabama at Birmingham researcher Robert Sorge, Ph.D., and team in the Journal of Pain.

20 dec 2015--Sorge's study highlights the negative effects of poor diet quality with respect to recovery from hypersensitivity and susceptibility to chronic pain. The implications of the research could be significant.
"It is currently unknown whether increased pain is due to greater weight or poor diet quality, or both," said Sorge, an assistant professor in the Department of Psychology in UAB's College of Arts and Sciences. "This study shows us the direct link between poor diet quality and increased pain."
Sorge's team instigated the research looking to further explore the link between obesity and chronic pain. The two medical conditions are often comorbid, and their rates are rising.
In looking into the issue, the team focused on the effects of the Total Western Diet, in particular. TWD foods typically have fewer calories from protein and increased calories from carbohydrates and saturated and monounsaturated fats.
"They call it the Total Western Diet because it's a common pattern in societies in our part of the world—it's a problem particularly here in the U.S.," said Stacie Totsch, the paper's first author and a graduate student in Sorge's lab. "We need to be concerned about the consequences our diet has on our bodies, and not just immediately with problems like weight gain, but also with long-term complications. That's what we set out to investigate in this study."
Mice were fed the TWD so that researchers could investigate the functional and physiological consequences of a nutritionally poor diet in mice. After 13 weeks on the diet, the mice on the TWD showed a significant increase in fat mass and a decrease in lean mass.
Tests run on the mice also revealed increases in pro-inflammatory cytokines, signals that promote systemic inflammation, as well as increases in serum leptin, a hormone secreted by adipose tissue that acts to regulate long-term appetite and energy expenditure.
"Most obese people have increased levels of serum leptin and pro-inflammatory cytokines, so we saw the immediate health effects that the diet had on the mice," Sorge said. "Our next step was to look at how the unhealthy effects of the TWD corresponded to chronic pain. Did it make it any worse, and how?"
After utilizing the TWD, researchers introduced chronic pain to the study in order to better understand their link.
This part of the study showed that hypersensitivity to heat and touch was more pronounced and was significantly prolonged in the TWD-fed mice.
"Poor diet seems to have exacerbated the normal recovery period from this mild inflammatory insult," said Sorge. "Because poor diet heightens hypersensitivity, patients with chronic pain who regularly practice bad diet habits are likely to experience exaggerated pain responses and recovery from injury or surgery."
Specifically, prolonged exposure to poor diet quality resulted in an altered perception of pain through acute nociceptive sensitivity, systemic inflammation and persistent pain following chronic pain induction.
The paper detailing the research, "Total Western Diet alters mechanical and thermal sensitivity and prolongs hypersensitivity following Complete Freund's Adjuvant in mice," was published in the Journal of Pain online in October.
"A complete understanding of the impact of diet can aid in treatment and recovery dynamics in human clinical patients," said Sorge. "Now that we know more about the link between diet and inflammation, we can begin thinking about applications to solve the problem."
More information: Stacie K. Totsch et al. Total Western Diet (TWD) alters mechanical and thermal sensitivity and prolongs hypersensitivity following Complete Freund's Adjuvant in mice, The Journal of Pain (2015). DOI: 10.1016/j.jpain.2015.10.006


Provided by University of Alabama at Birmingham

Herpes zoster is linked to increased rates of both stroke and myocardial infarction

Herpes zoster (also called "shingles") is linked to a transient increased risk of stroke and myocardial infarction (MI) in the months following initial zoster diagnosis, according to a study published by Caroline Minassian and colleagues from the London School of Hygiene and Tropical Medicine, UK, published in this week's PLOS Medicine.

19 dec 2015--The researchers identified 42,954 Medicare beneficiaries aged ?65 years who had had a herpes zoster diagnosis and an ischemic stroke and 24,237 beneficiaries who had had a herpes zoster diagnosis and an MI during a 5-year period. They then calculated age-adjusted incidence ratios for stroke and MI during pre-defined periods up to 12 months after a diagnosis of zoster relative to time periods when the patient did not have recent zoster (the baseline period). Compared to the baseline period, there was a 2.4-fold increased rate of ischemic stroke and a 1.7-fold increased rate of MI in the first week after herpes zoster. The increased rate of acute cardiovascular events reduced gradually over the 6 months following herpes zoster. There was no evidence that MI or ischemic stroke incidence ratios varied between individuals who had been vaccinated against zoster and those who had not been vaccinated.
While the researchers used a self-controlled case series design that controls for fixed confounders, residual confounding by time-varying factors such as major life events or stress may limit the accuracy of the findings. Furthermore, only a few participants in the study were vaccinated, which limits the study's power to detect an effect of vaccination.
The authors say "These findings enhance our understanding of the temporality and magnitude of the association between zoster and acute cardiovascular events."

More information: Minassian C, Thomas SL, Smeeth L, Douglas I, Brauer R, Langan SM (2015) Acute Cardiovascular Events after Herpes Zoster: A Self-Controlled Case Series Analysis in Vaccinated and Unvaccinated Older Residents of the United States. PLoS Med 12(12): e1001919. DOI: 10.1371/journal.pmed.1001919


Provided by Public Library of Science

A few survival tips for holiday overeating

We've all been there – reaching for another heap of potatoes or ambrosia, sampling everything on the dessert tray, maybe one too many eggnogs, and suddenly we're more stuffed than the rib roast and feeling guilty. Don't beat yourself up, it happens to the best of us. Here are some ways to bounce back after a food flub.

18 dec 215--According to Len Kravitz, associate professor of Exercise Science at the University of New Mexico, portion control is key. However, if that ship has sailed, step away from the table and go for a walk. "When you eat more, move more," he said. "It will make you feel better. Most people tend to put on a few pounds during the holidays and without expending those calories, they'll keep the added weight on."
There is a new area of research called 'spontaneous movement' which indicates that people can burn upwards of 400 calories just by staying active during the day. By the way, that's one eggnog.
"Many new diet and exercise programs are starting with this 'move more' approach, and it seems to be very successful," Kravitz said.
Spontaneous movement refers to all non-exercise related movement such as walking from a distant parking spot to the mall; taking the stairs v. the elevator; doing a five minute power walk; even walking around the house from room to room. The research shows that people who just spontaneously keep moving during their waking day, are able to burn a lot of calories.
Peter Pribis, assistant professor of nutrition and dietetics in the UNM College of Education, Department of Individual, Family and Community Education believes we should just enjoy holiday get-togethers.
"A lot of atmosphere and memories are created around food. Maybe your family has a special pie or pudding recipe or other recipes that have been handed down over the years. What really matters for weight management and overall health is what we eat and do on a daily basis. "Eating junk food everyday matters, not over-indulging during the holidays. Instead of agonizing about overeating, I say eat, and then go for a group walk or do something a bit more active later."
Pribis suggests that in the days following excessive food intake, skipping lunch and having a light dinner can reduce about 30 percent of daily calorie expenditure and help curtail weight gain. Skipping breakfast is not ideal as the body has spent the night using up its supply of nutrients and energy and requires fuel to boost the metabolism.
When the holidays are over, and the New Year begins, Pribis recommends opting for more healthy choices and introducing more salads, vegetables, fruits and nuts into our general diet.
"Try to become healthier overall and realize that those few special days over the course of a year won't hurt you or add that much weight," Pribis said.


Provided by University of New Mexico

Beyond early adversity: A multidimensional approach linking early experiences to successful aging

Adverse childhood experiences such as poverty, abuse and neglect have been linked to poor mental and physical health outcomes in adulthood. However, characterizing early experiences only in terms of extreme stressors fails to capture the full spectrum of childhood for most people.

17 dec 2015--In fact, a recent study by Lee et al. (2015) in Psychology and Aging suggests that looking at early adversity only tells part of the story. Using a novel person-centered approach, the authors reported three prototypic patterns based on recalled positive and negative childhood experiences across multiple domains, labeled as cherished (nurturing environment with some losses), harshly disciplined (potentially abusive parental discipline and non-normative stressors, such as sexual molestation) and ordinary (few stressors and low parental attention). Compared with the other groups, cherished children were better able to form and maintain supportive relationships in midlife, which in turn were related to greater life satisfaction, positive mood, feelings of competence and more positive relations in older ages. A key take-home message is that it is not a lack of early adversity per se, but dealing with stressors in the context of strong familial and external support, which allows children to learn healthy ways of coping with hardship and garnering support, thus promoting well-being across the lifespan.
A person-centered approach has the advantage of allowing researchers to consider multiple aspects of the childhood environment simultaneously, which can help identify a set of co-occurring factors that influence subsequent development. In this study, the authors applied latent class analysis to questionnaire items covering multiple domains of early experiences, including close relationships, significant life events, parental discipline, extracurricular activities, parental positive regard, and self-perceptions from birth to age 19. They examined whether specific patterns of experiences were differentially related to successful aging, defined as greater psychological well-being in later life. They also evaluated whether social support in midlife served as the link between early experiences and psychological well-being in later life. The study was based on 1,076 men from the Veterans Affairs Normative Aging Study, a cohort of community-dwelling men in the Boston area who were born between 1903 and 1945 and have been followed since the 1960s.
The finding of successful aging among the cherished children - those who enjoyed the most nurturing early environment but also suffered serious losses - underscores the notion that focusing solely on adversity does not fully capture the heterogeneity of early experiences. This study provides the impetus to approach early experiences as a multidimensional construct encompassing positive, neutral, and negative events, as well as normative and less typical experiences spanning the personal, familial, school and community domains. Researchers, educators, practitioners and policy-makers are encouraged to consider the interplay among different facets of early experiences and how such combinations influence developmental outcomes.

More information: Lewina O. Lee et al. Do cherished children age successfully? Longitudinal findings from the Veterans Affairs Normative Aging Study., Psychology and Aging (2015). DOI: 10.1037/pag0000050


Provided by American Psychological Association

In aging, one size does not fit all

Conventional measures of age usually define people as 'old' at one chronological age, often 65. In many countries around the world, age 65 is used as a cutoff for everything from pension age to health care systems, as the basis of a demographic measure known as the 'old-age dependency ratio,' which defines everyone over 65 as depending on the population between ages 20 and 65.

16 dec 2015--In new study in the journal Population and Development Review, IIASA researchers Warren Sanderson and Sergei Scherbov provide new measures to replace the old-age dependency ratio.
"There are better measures available for every aspect of population aging to which it is applied," says Sanderson. "Aging is a suite of multidimensional phenomena. In this study we deal with a number of aspects of aging and show that better measures exist for all of them."Previous research by the team has shown that defining people as 'old' at age 65 no longer fits the real-world data, as people live longer, healthier lives around the world. The new study pulls together a collection of demographic methods that replace the old-age dependency ratio for a variety of purposes, providing more useful information for policymakers as well as demographic research.
For example, health care costs on average increase significantly for people in their last few years of life. Yet as people live longer, those last few years come later and later, and people may stay healthy well into their 60s and 70s. When projections of future health care costs use age 65 as the cutoff, they may massively overestimate future costs to a health care system. The new study therefore proposes a health-care specific calculation that takes into account the postponement of deaths that occur because of the increase in life expectancy. The old-age dependency ratio is also based in part on traditional retirement age being around 65. But today, a growing number of people over 65 are still working, and in response to increased life expectancy, many countries have begun increasing their public pension ages. Yet increasing pension ages can be unfair to younger generations, who may work longer and get less retirement money than previous generations. The study includes a new proposal for an 'intergenerationally equitable pension age,' in which each generation receives as much in pension payouts as they pay in, the average pension as a percentage of salary is the same for all generations, and the pension tax remains the same. "There are many policy issues for which good estimates of the future consequences of aging are needed," says Scherbov. "In some instances, the large exaggerations in the extent of aging produced by the conventional measures could lead to inappropriate policies."

More information: Sanderson W, Scherbov S (2015). Are we overly dependent on conventional dependency ratios? Population and Development Review. 41(4): 687–708. 15 December 2015. onlinelibrary.wiley.com/doi/10.1111/j.1728-4457.2015.00091.x/abstract


Provided by International Institute for Applied Systems Analysis

Stress in older people increases risk for pre-Alzheimer's condition

Feeling stressed out increases the likelihood that elderly people will develop mild cognitive impairment—often a prelude to full-blown Alzheimer's disease. 

15 dec 2015--In a new study, scientists at Albert Einstein College of Medicine and Montefiore Health System found that highly stressed participants were more than twice as likely to become impaired than those who were not. Because stress is treatable, the results suggest that detecting and treating stress in older people might help delay or even prevent the onset of Alzheimer's. The findings were published online today in Alzheimer Disease & Associated Disorders.
Each year, approximately 470,000 Americans are diagnosed with Alzheimer's dementia. Many of them first experience mild cognitive impairment—a pre-dementia condition that significantly increases the risk of developing Alzheimer's in the following months or years. This study looked at the connection between chronic stress and "amnestic mild cognitive impairment" (aMCI), the most common type of MCI, which is primarily characterized by memory loss.
"Our study provides strong evidence that perceived stress increases the likelihood that an older person will develop aMCI," said Richard Lipton, M.D., senior author of the study, vice chair of neurology at Einstein and Montefiore, and professor in the Saul R. Korey Department of Neurology and the Edwin S. Lowe Chair of Neurology at Einstein. "Fortunately, perceived stress is a modifiable risk factor for cognitive impairment, making it a potential target for treatment."
"Perceived stress reflects the daily hassles we all experience, as well as the way we appraise and cope with these events," said study first author, Mindy Katz, M.P.H., senior associate in the Saul R. Korey Department of Neurology at Einstein. "Perceived stress can be altered by mindfulness-based stress reduction, cognitive-behavioral therapies and stress-reducing drugs. These interventions may postpone or even prevent an individual's cognitive decline."
The researchers studied data collected from 507 people enrolled in the Einstein Aging Study (EAS), a community-based cohort of older adults. Since 1993, the EAS has systematically recruited adults 70 and over who live in Bronx County, NY. Participants undergo annual assessments that include clinical evaluations, a neuropsychological battery of tests, psychosocial measures, medical history, assessments of daily-living activities and reports (by participants and those close to them) of memory and other cognitive complaints.
Starting in 2005, the EAS began assessing stress using the Perceived Stress Scale (PSS). This widely used 14-item measure of psychological stress was designed to be sensitive to chronic stress (due to ongoing life circumstances, possible future events and other causes) perceived over the previous month. PSS scores range from 0 to 56, with higher scores indicating greater perceived stress.
The diagnosis of aMCI was based on standardized clinical criteria including the results of recall tests and reports of forgetfulness from the participants or from others. All 507 enrollees were free of aMCI or dementia at their initial PSS assessment and subsequently underwent at least one annual follow-up evaluation. They were followed for an average of 3.6 years.
Seventy-one of the 507 participants were diagnosed with aMCI during the study. The greater the participants' stress level, the greater their risk for developing aMCI: for every 5 point increase in their PSS scores, their risk of developing aMCI increased by 30 percent. Similar results were obtained when participants were divided into five groups (quintiles) based on their PSS scores. Participants in the highest-stress quintile (high stress) were nearly 2.5 times more likely to develop aMCI than were people in the remaining four quintiles combined (low stress). When comparing the two groups, participants in the high-stress group were more likely to be female and have less education and higher levels of depression.
To confirm that stress was independently increasing risk for aMCI in this study, the researchers assessed whether depression—which increases the risk for stress as well as for cognitive impairment and Alzheimer's disease—might have influenced the results. They found that depression did not significantly affect the relationship observed between stress and the onset of aMCI. Similarly, stress's impact on cognitive status was unaffected if participants possessed at least one e4 allele of the APOE gene, which increases their risk for developing late-onset Alzheimer's.
The study is titled "Influence of perceived stress on incident amnestic mild cognitive impairment: Results from the Einstein Aging Study."


Provided by Albert Einstein College of Medicine

Who's too old for major treatment? Age not always a barrier

Aortic valve surgery patient Irwin Weiner poses for a photo, Friday, Dec. 11, 2015, at his home in Boca Raton, Fla. Very old age is no longer an automatic barrier for aggressive therapies, from cancer care, to major heart procedures, joint replacements and even organ transplants. 

14 dec 2015--Irwin Weiner felt so good after heart surgery a few weeks before turning 90 that he stopped for a pastrami sandwich on the way home from the hospital. Dorothy Lipkin danced after getting a new hip at age 91. And at 94, William Gandin drives himself to the hospital for cancer treatments.

Jimmy Carter isn't the only nonagenarian to withstand rigorous medical treatment. Very old age is no longer an automatic barrier for aggressive therapies, from cancer care like the former president has received, to major heart procedures, joint replacements and even some organ transplants.
In many cases, the nation's most senior citizens are getting the same treatments given to people their grandchildren's age—but with different goals.
"Many elderly patients don't necessarily want a lot of years, what they want is quality of life," said Dr. Clifford Kavinsky, a heart specialist at Rush University Medical Center in Chicago. "They want whatever time is left for them to be high quality. They don't want to be dependent on their family. They don't want to end up in a nursing home."
Treatment for Carter, 91, has included surgery, radiation and a new cancer drug with fewer side effects than traditional chemotherapy. It seems to be working—Carter announced Dec. 6 that brain scans show no signs of the melanoma that was found in August.
The nation's 90-and-up population, about 2 million people, nearly tripled in recent decades, and the pace is expected to continue. Many are struggling with more than one age-related illness that make them poor candidates for aggressive and often costly care. But plenty remain robust enough to give it a try.
Lipkin, now 93, had hip replacement surgery two years ago in the Philadelphia area. Arthritis made walking difficult and painful. She'd been a good dancer in her younger days, and had tried to remain active, so her doctor recommended the operation.
"Otherwise I was going to be in a wheelchair the rest of my life," Lipkin said. Soon after, she made a video doing a line dance to show how well she was healing.
In the winter, she lives in Florida, walks at least half an hour daily and leads "a normal life."
Lipkin says having such major surgery at her age should be an individual decision.

Aortic valve surgery patient Irwin Weiner poses for a photo with his partner, Lauree Gable, Friday, Dec. 11, 2015, at their home in Boca Raton, Fla. Very old age is no longer an automatic barrier for aggressive therapies, from cancer care, to major heart procedures, joint replacements and even organ transplants. (AP Photo/Alan Diaz)

Doctors agree. Some 90-year-olds are fitter than some 60-year-olds but they say other considerations need to be in the mix.
At MD Anderson Cancer Center in Houston, the oldest patients are evaluated by geriatricians—specialists in medical care of the elderly—to make sure they're able to tolerate harsh treatments. Physical and mental health are assessed; so is social support—whether there are family members or friends available to help during treatment and recovery.
"We do believe that cancer care should not be limited by age," said Dr. Beatrice Edwards.
While many elderly patients are healthy enough to tolerate conventional treatments, advances including more targeted, less toxic drugs and minimally invasive surgery techniques are opening the door to others.
Gandin, the 94-year-old, was diagnosed more than 10 years ago with prostate cancer. Treatment with radiation and chemotherapy failed to stop cancer from spreading to his lungs and bones. He's now on hormone treatment that he said is controlling the disease.
A retired Exxon Mobil auditor, Gandin helps take care of his wife of 74 years in their assisted living home in Houston and is not ready to give up on treatment. "I'm an eternal optimist—that's what has carried me through," he said.
Weiner, a retired furniture manufacturer representative, had a hardened, leaky aortic valve—a common condition in the elderly that can lead to disability and death. Open-heart surgery is a common option for heart-valve surgery, but some doctors hesitate to perform it in the elderly, said Kavinsky, the Chicago heart specialist.
Dr. Joseph Lamelas, Weiner's surgeon at Mount Sinai Medical Center in Miami Beach, Florida, used a newer approach, implanting a new valve through a small incision on the right side of the chest.
After four days in the hospital last January, Weiner was back home in Boca Raton, Florida, and was well enough to have two big 90th birthday celebrations less than a month later.
Organ transplants are less common but not unheard of in the very old. Since 2013, there have been more than 100 kidney transplants in patients aged at least 80, including one in an 88-year-old, according to the United Network for Organ Sharing. Its records show that since 1987, the nation's oldest kidney transplant recipient was a 96-year-old.
There are generally no strict age limits on transplants. Dr. Dorry Segev, a Johns Hopkins Medicine transplant specialist, said frailty is a more important factor and his center measures it rigorously, including assessing patients' grip strength, walking speed and muscle mass.
Ethical issues complicate decisions on providing treatments costing tens of thousands of dollars to the very old and life expectancy has to be considered, Kavinsky said.
"When you start doing procedures on a 90-year old, you have someone who has already exceeded the average lifespan in America," he said. "How far should we go to keep them going?"
Dr. Joseph Dearani, chairman of cardiac surgery at the Mayo Clinic in Rochester, Minnesota, said a good gauge is whether treatment would likely help patients live well for at least another two years.
He said costs to the patient, their family and society also should be weighed, so that treatment is given to right patients, and "for the most part, that happens."

More information: National Institute on Aging: www.nia.nih.gov/

Singing is beneficial for memory and mood especially in early dementia

Researchers led by Dr. Teppo Särkämö at University of Helsinki, Finland have revealed that caregiver-implemented musical leisure activities, particularly singing, are cognitively and emotionally beneficial especially in the early stages of dementia. The findings could help improve dementia care and better target the use of music in different stages of dementia. The research was published today in the Journal of Alzheimer's Disease.

13 dec 2015--Initially, the researchers recruited 89 dyads of persons with mild to moderate dementia and their caregivers to a single-blind randomized controlled trial in which they received a 10-week music coaching intervention involving either regular singing or listening to familiar songs or standard care. Previously, the results from a 9-month longitudinal follow-up with neuropsychological tests and mood questionnaires showed that the musical activities were able to enhance various cognitive skills, such as working memory, executive functions, and orientation, and alleviate depression compared to standard care.
Here, the focus of the researchers was to uncover how different clinical and demographic factors influence the specific cognitive and emotional effects of the two music interventions and, thereby, determine who benefits most from music. Looking at the backgrounds of the dementia patients, the researchers systematically evaluated the impact of dementia severity, etiology, age, care situation, and previous musical hobbies on the efficacy of the music interventions.
Singing was found to be beneficial for working memory, executive function, and orientation especially in persons with mild dementia and younger (< 80 years) age, whereas music listening was associated with cognitive benefits only in persons with a more advanced level of dementia. Both singing and music listening were more effective in alleviating depression especially in persons with mild, Alzheimer-type dementia. Importantly, the musical background of the persons with dementia (whether they had sung or played an instrument before) did not influence the efficacy of the music interventions.
"Given the increasing global prevalence and burden of dementia and the limited resources in public health care for persons with dementia and their family caregivers, it is important to find alternative ways to maintain and stimulate cognitive, emotional, and social well-being in this population. Our findings suggest that musical leisure activities could be easily applied and widely used in dementia care and rehabilitation. Especially stimulating and engaging activities, such as singing, seem to be very promising for maintaining memory functioning in the early stages of dementia," Särkämö concludes.

More information: Clinical and Demographic Factors Associated with the Cognitive and Emotional Efficacy of Regular Musical Activities in Dementia. J Alzheimers Dis. 2015 Oct 19. [Epub ahead of print].www.ncbi.nlm.nih.gov/pubmed/26519435

Seven behaviors suggested to improve 'art of medicine'

12 dec 2015—Seven behaviors should be implemented to improve the art of medicine, which can help improve relationships with patients, according to an article published in Family Practice Management.
Thomas R. Egnew, Ed.D., from the University of Washington School of Medicine in Seattle, reviewed the literature and delineated seven behaviors that promote more consistent practice of the interpersonal aspects of medicine.
Egnew describes seven behaviors that include focusing on the patient, ideally taking a moment to prepare before entering the office, and establishing a connection with the patient, preferably before opening the electronic medical record in the first few minutes of the consultation. Other tips include assessing the patient's response to illness and suffering, use of communication to foster healing, use of the power of touch, use of humor and laughter, and showing empathy.
"The behaviors recommended are based on empirical data," Egnew writes. "They incorporate a patient-centered approach to communicating with patients, which has been shown to improve health outcomes, increase patient satisfaction, and decrease malpractice liability."

More information: Full Text

Five surprising findings about death and dying

Just thinking about death triggers odd behaviour, shows research. 

In this world nothing can be said to be certain, except death and taxes, as Benjamin Franklin famously wrote. Few of us find taxes exciting, but death – even just thinking about it – affects us profoundly in many different ways. This is why researchers across so many different fields study it from their perspectives.

10 dec 2015--Here are five research findings – biochemical, medical, genetic, sociological and psychological – that you may not be aware of.

1. Decomposing human flesh smells (sickly) sweet
It is difficult to describe what the stench of death is like, but most people agree it is bad. However, the smell of human decomposition is actually very complex, involving over 400 volatile chemical compounds.
We share many of these with other animals, but a recent study found that there might be five esters – organic compounds that react with water to produce alcohols and acids – that are unique to humans. This is compared to 26 in other animal species from frogs and robins to pigs. The interesting thing about them is that they are also produced by fruits, especially when they rot. Those familiar with the smell, such as forensic scientists or morticians, often report a "sickly sweet" smell when describing corpses. Now we might know why.

2. No, your nails and hair won't keep growing
You may have heard that our nails and hair keep growing – at least for a while – after we die. This conjures up creepy images of exhumed corpses with an urgent need for barbers or pedicurists. The idea probably came from actual observations of hair and nail "growth", but it's all an illusion. The truth is that the rest of our bodies shrink due to dehydration, making the nails and hair look longer.

Shorter chromosome ends (telomeres) means shorter lifespan. Credit: AJCann/Flickr, CC BY

What we think of as hair and nails are actually already dead: the only living parts are the the hair follicle and nail matrix under the skin. But these organs require hormonal regulation to produce hair and nails, not to mention the supply of ingredients like proteins and oils which cease upon death, or very soon after.

3. Telomere length predicts lifespan
For a long time we thought that our cells might be immortal, and that under the right environmental conditions, they would go on replicating forever. But, as discovered in 1961, they don't: after some 50 to 70 divisions, they stop. A decade later a hypothesis was put forward: telomeres – repeated DNA sequences at the ends of our chromosomes – shorten with every division, and when they get too short, divisions stop and the cells die.
Since then, there has been increasing evidence that telomere length can be used to predict lifespan, and not just in humans. However, not all research confirms this, and it is not yet clear whether shortened telomeres are the cause of ageing or just a symptom. If telomere length does control ageing, then it may be possible to significantly lengthen lifespans by manipulating their length. At the moment we still know too little about telomeres to do this, but watch this space.

4. The fear of death declines with age
It seems counter-intuitive to think that we would fear death less as we get older, but studies run in the United States have shown this is the case. One study found that people in their 40s and 50s, expressed greater fears of death than those in their 60s and 70s. Similarly, another study found that people in their 60s reported less death anxiety than both people in middle age (35 to 50 years) and young adults (18 to 25 years).

Does regular contemplation of death make you a bigot? Credit: JDHancock/Flickr, CC BY

Yet another study found that after a peak in their 20s, participants' death anxiety tended to decline with age. For men, the decline plateaued in their 60s, whereas for women, there was some evidence for a slight bump between their 40s and 50s. I found similar patterns in my own research for a forthcoming book – but only in the United States. I saw no such trends in Brazil, the Philippines, Russia, and South Korea.
All of these studies also survey people of different ages but fail to follow individuals across their lifespans. It is therefore possible that the relationship between age and death anxiety is driven by a generational effect: maybe our forebears were just made of sterner stuff than we are.

5. Thinking about death makes us prejudiced
Briefly describe the emotions that the thought of your own death arouses in you. Jot down what you think will happen to you physically as you die and once you are physically dead. These are instructions that have been given to thousands of people across over 200 studies over the past 25 years.
The results suggest that thinking about death – compared to thinking about more banal stuff, or even other sources of anxiety – makes people more tolerant of racists; harsher toward prostitutes; less willing to consume foreign goods; and even makes liberals less supportive of LGBT rights..
However, it also makes people want to have more children and to name their children after themselves. In other words, thinking about death makes us want to pursue symbolic immortality, the vicarious living on through our offspring or through groups we identify with. There is even some evidence that, in the face of death, nonreligious people are more willing to believe in God and an afterlife.

This story is published courtesy of The Conversation (under Creative Commons-Attribution/No derivatives).


Source: The Conversation

Living longer and healthier in mind but not in body

Credit: George Hodan/public domain

Women are now spending fewer years with cognitive impairment but more years with disability compared to 20 years ago, new research has revealed.

09 dec 2015--Experts have shown that between 1991 and 2011 women's life expectancy at age 65 increased by 3.6 years but they identified that the female body doesn't age as well as its mind.
A study by Newcastle University, UK, and the University of Cambridge, UK, published in The Lancet, has revealed that women lived approximately 2.5 months less with moderate or severe cognitive impairment and six months fewer with mild cognitive impairment, such as problems with memory and thinking.
However, this is balanced by the fact that at age 65 females now spend around seven months more with moderate or severe disability and 2.5 years more with mild disability.
Meanwhile, overall men's life expectancy increased by 4.5 years but they had only 1.3 years more with mild disability and there was no increase in the years spent with moderate or severe disability, or mild or worse cognitive impairment.
Professor Carol Jagger, from Newcastle University's Institute for Ageing, led the analysis of the research.
She said: "The big unanswered question is whether our extra years of life are healthy ones and the aim of our research was to investigate how health expectancies at age 65 years and over changed between 1991 and 2011.
"One possibility for the increased years women are living with mild disability might be the rise in obesity levels over the decades, but there may also be particular conditions, or just more multiple diseases, which are a feature of very old age."
The research team compared two rounds of the Cognitive Function and Ageing Study, done in England in 1991 and 2011.
Health expectancy was measured in three ways: self-perceived health, life without disability, and time free from cognitive impairment. For the study a total of 7,635 people aged 65 and over were analysed in Newcastle, Cambridge and Nottingham.
Analysis of the Health Survey for England for those aged 65+ over a similar time period showed problems with vision and hearing did not account for increases in disability.
Nevertheless, stability in self-care activities, like cooking, and increases in mobility limitations, such as walking 200 yards and climbing stairs, may contribute to gains in mild disability.
Professor Carol Brayne, from the University of Cambridge, was overall lead for the study.
She said: "The findings suggest a compression of cognitive morbidity when comparing older people now compared to 20 years ago in England. This is very good news and consistent with our earlier reporting of a reduction in age specific prevalence of dementia across two decades."
Health expectancies are important indicators to monitor population health trends and inequalities internationally, nationally and regionally.
It is necessary for Government to get a clear indication if people are living longer, healthier lives as it can have an impact on the economy, housing and employment opportunities.
Future work will examine the reasons for the increase in years with disability. The researchers will look at which diseases and conditions are responsible for the rise in mild disability and whether patterns prevail across all the regions studied.
Professor Jagger added: "Our findings have important implications for Government, employees and individuals with respect to raising the state pension age and extending working life.
"It is also necessary for community care services and family carers who predominantly support those with mild to moderate disability to enable them to continue living independently."
In most developed countries worldwide life expectancy is increasing at the rate of at least two years every decade, and, for life expectancy at age 60, shows no sign of slowing down.
Newcastle University's Institute for Ageing held a conference today (Tuesday, December 8), which focused on 'The economic and social impact of ageing' - Professor Jagger opened the event.

More information: A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II, dx.doi.org/10.1016/S0140-6736(15)00947-2

Provided by Newcastle University

USPSTF: Insufficient evidence for visual skin cancer screening

06 dec 2015—The U.S. Preventive Services Task Force has found that there is currently insufficient evidence to weigh the benefits and harms of visual skin cancer screening in adults. These findings form the basis of a draft recommendation statement published online Nov. 30 by the USPSTF.
Noting that an estimated 74,000 U.S. men and women will develop melanoma in 2015 and 9,940 will die from the disease, researchers from the USPSTF reviewed the evidence for the benefits and harms of visual skin cancer screening in adults.
The researchers found that visual skin examination by clinicians has modest sensitivity and specificity for detecting melanoma. However, the evidence is currently insufficient to assess the balance of benefits of visual screening. Adequate evidence suggests that visual skin cancer screening may lead to harms; the magnitude of these harms could not be quantified based on current data. Based on these findings, the USPSTF concluded that the current evidence is inadequate to determine the balance of benefit and harms of visual skin examination for asymptomatic adults.
"The Task Force is dedicated to helping Americans avoid skin cancer and lead healthy lives," Task Force member Michael P. Pignone, M.D., M.P.H., said in a statement. "Until we have more research to better understand the balance of benefits and harms of a clinical visual skin exam, we encourage patients to talk to their doctor about any concerns they have about their skin."
More information: Draft Evidence Review
Draft Recommendation Statement
Comment on Recommendation

The science of aging

Credit: Peter Griffin/public domain

05 dec 2015—As the year comes to a close so too do thoughts of time itself and for some that can lead to musing about our own mortality—for others it might mean worrying about how much time they have left with a loved one or perhaps a much loved cat or dog. In either event, it all comes back to the same thing, none of us are immortal. But it also begs the question of why animals have such different life spans—a topic covered by David Grimm in a recent News post in the journal Science.
He notes the history of the search for answers and outlines some possible ideas, such as the notion that some animals face fewer threats than others—mice who have very short life-spans tend to die in the teeth of predators, while elephants and whales live long relatively risk-free lives. But what about anomalies, such as why do cats live longer than dogs?
Science has released a video asking that very question and then discussing it at length. It might be due to the fact that cats do not as a rule live in packs—by keeping to themselves they avoid many of the diseases that plague canines. But then, it could be something completely different.
On the other hand, while philosophical discussions are nice and all, what about cold hard science? Are we getting any closer to understanding how and why we age and better yet, putting a stop to it? Jeffrey Kluger recently offered a rundown in Time, describing the current state of age research—what scientists know and do not know, and outlining promising areas of research. He suggests some believe it all comes down to microbes in our gut, stem cells, telomeres or mitochondrial breakdown. Figuring out how these systems work, and then how to change them might just lead to not only extending our lives, but to extending the number of high quality years as well.
In the meantime, as the Telegraph recently reported, some researchers are pushing forward with testing different drugs to see if they have an impact on aging, a new study, they note, is about to start trials involving giving a drug called rapamycin to test dogs—there has been some evidence it extends the life of mice by approximately 25 percent.
What scientists cannot tell us of course is what we might all do with those extra years if they are suddenly given to us—fortunately, we have a New Year just around the corner, giving us the opportunity to navel gaze, sip a few beers and make promises about how we will do better this time around, and at some point remind ourselves, that no one really knows what the future holds, that only time will tell.
More information: www.sciencemag.org/content/350/6265.toc#SpecialIssue

Palliative care specialist explains how end-of-life conversations help families and patients alike

In the late 1990s, Dawn M. Gross was headed for a prominent career in immunology. As a dual M.D./Ph.D. candidate at Tufts School of Medicine, she worked with scientists Allen Steere and Brigitte Huber and was the sole student researcher on a scientific breakthrough that identified the precise cause of an autoimmune reaction in the joints of patients with arthritis due to Lyme disease.

04 dec 2015--Then Gross' career took a sharp turn. During medical school, she found herself drawn to patients undergoing bone marrow transplants, an arduous and risky procedure. The candid discussions she had with them led her to think about death and dying, and she found working with these patients immensely rewarding.
She decided to become a practicing physician after receiving her M.D. and Ph.D. in 2000. Now she is the attending physician in the palliative care service at the University of California, San Francisco School of Medicine and a member of the board of directors of the Zen Hospice Project. She is also working on a book about the end of life.
She has written extensively about death and dying, and urges her patients to have frank talks with family and friends about the issue. She's spreading the word. The New York Times published an essay of hers this summer in which she encouraged doctors to find out what their patients' end-of-life wishes are.
She spoke to Tufts Now about why she changed careers, and what she thinks people should do to prepare for their deaths.
Tufts Now: Why did you make the change from research scientist to physician?
Dawn Gross: I didn't envision myself being a practicing physician. I was going to be a scientist, a lab rat. I was very focused and very curious as a scientist, and as I was approaching my fourth year of medical school, I was looking for a match between my science background and my interest in medicine. My husband, who had already finished medical school and knew me well, introduced me to bone marrow transplants, which are complicated and intense. The science was there, and it's an utterly amazing process involving immunology.
What was your experience during the transplant rotation?
It blew me away. I was with people who had the most profound courage I had ever seen in my life. For the most part, they seemed to be really aware of the life-threatening illness they had been diagnosed with, and they knew they were undergoing a risky procedure to treat it. And furthermore, they were in the hospital, isolated for a long time because of the nature of how transplants were done at that time. You would see the same people in the same room for weeks, if not months, at a time; they couldn't even leave their room and were in complete isolation.
How did this affect your career choice?
The level of trust and courage and the intensity of those relationships were unlike anything I had seen in medicine. I did not expect that. What surprised me, and what I can't really explain, is my gravitation toward conversations I now realize are called "goals of care." I found myself becoming a black sheep in the field. I started to have conversations with my patients that I'd never seen anyone have.
What were you doing that was different from other physicians?
I would ask people why they wanted chemo or a transplant instead of assuming they did, and talk to them about what it meant, and make sure they really knew. With a transplant, you may never go home again. The way the immune system works is to recognize things that don't belong in your body. No matter how close the match, the body is good at picking up what's different. No matter how hard we try to quiet the immune system, the body can ultimately reject the transplant and kill you. So I became interested in people and how they make these choices. My colleagues weren't having these conversations.
Can you give an example of these conversations?
One husband and wife in particular clearly hadn't talked about it. The husband asked if it would be possible to have his wife, who was undergoing chemo, be admitted to the hospital when the time came for her to die, because he didn't want her to die at home. I looked at the wife and asked her in front of him, "Have you thought about where you would like to die?" He was shocked that I asked the question, and he tried to answer for her. But she said, "I want to die at home." They had never talked about it. It was an epiphany for me to watch this couple listen to each other for the first time, simply because I wasn't afraid to ask this question in front of them.
What else influenced your career change?
At the same time I was talking to people who were dying, my father was relapsing from cancer, and was entering the last six months of his life. I started to have conversations with him and he told me he didn't want any heroic measures taken. While he was in his last six months of life he taught me how to ask questions about what he needed versus what he wanted. He ultimately requested hospice from his primary care physician four days before he died. I still had not learned how to recognize that as an option and therefore had no ability to offer or suggest it even though I knew he was dying.
At the same time, I began to notice how much I actually—and unexpectedly—enjoyed being a clinician and particularly how much I liked having end-of-life conversations that can make a profound difference for people in the moment, which was very different from working in the lab on a question that will likely take years to resolve. It's a time when people are their most authentic. What's essential becomes paramount, and everything else falls away.
How are you getting the word out about that?
I'm writing a book about end-of-life care. It's a collection of true stories about patients I have been honored to care for as well as stories from the last six months of my father's life. I am also creating a live radio program as another way to invite people to engage in these conversations. Everyone has a unique life, and each story is a perspective that allows all of us to find resonance in our own lives, to see we are not alone here. These conversations may seem scary, but they give us our lives, the legacy we give to our families and those we love.
What do you want people to know?
There are ways to approach the end of life that don't have to be scary or taboo. The legacy we leave people by not having conversations is damaging, creating a burden on families for the rest of their lives, wondering if they did the right thing, wondering if they should have done something else.
Having conversations with people when we are healthy and not in crisis is what gives life meaning. It's not about death at all; it's about what's extraordinary. What's amazing is when people start telling their stories, they are the deepest, richest, most gratifying stories.
What can people do who have trouble talking about end of life?
My favorite tool is a deck of cards called "Go Wish" that facilitates this conversation. The cards have simple phrases that ask people what they want, such as "to be with my family," "to maintain my sense of humor," "to have my finances in order." People then ask questions based on the cards. By being curious, we invite the stories of our lives to be shared. This isn't ultimately about what you want when you die, it is actually about what matters most while you are alive.
For example, one of my favorite cards is "to have family with me." But the next question would be, "Who is family? Do you want them in the house? In your room? Do you want them 24/7? Do you want everyone at once?" You get really specific, and, importantly, it's not a one-time thing that you write down and you're done. It's a lifelong conversation when we are well, because our priorities change. Your life is not static, so what matters changes.
I often tell people death is for the living. I never had anyone tell me how it went for them, but I sure as heck know how it went for those who are still here, and that's what they live with for the rest of their lives.


Provided by Tufts University