Study strengthens evidence that cognitive activity can reduce dementia risk

Are there any ways of preventing or delaying the development of Alzheimer's disease or other forms of age-associated dementia? While several previously published studies have suggested a protective effect for cognitive activities such as reading, playing games or attending cultural events, questions have been raised about whether these studies reveal a real cause-and-effect relationship or if the associations could result from unmeasured factors. 

30 aug 2016--To address this question, a Boston-based research team conducted a formal bias analysis and concluded that, while potentially confounding factors might have affected previous studies' results, it is doubtful that such factors totally account for observed associations between cognitive activities and a reduced risk of dementia.
"Our paper lends support to a potential role for late-in-life cognitive activity in prevention of Alzheimer's disease," says Deborah Blacker MD, ScD, director of the Gerontology Research Unit in the Massachusetts General Hospital Department of Psychiatry and senior author of the report in the September issue of the journal Epidemiology. "While it is possible that socioeconomic factors such as educational level might contribute to the association between cognitive activity and reduced risk, any bias introduced by such factors is probably not strong enough to fully account for the observed association."
Blacker and her colleagues from Harvard T.H. Chan School of Public Health maintain a database on the Alzheimer's Research Forum website cataloging evidence from observational studies and some clinical trials about known and proposed risk and protective factors for the devastating neurologic disorder. The current paper was developed from the database's systematic review of studies examining the impact of cognitive activity, conducted by lead author Guatam Sajeev, ScD, as part of his Harvard Chan school dissertation.
The research team analyzed 12 peer-reviewed epidemiologic studies that examined the relationship between late-in-life cognitive activities and the incidence of Alzheimer's disease or other forms of dementia. The studies were selected on the basis of prespecified criteria for the AlzRisk database, included almost 14,000 individual participants and consistently showed a benefit, sometimes substantial, for cognitive activity.
Since any observational studies are likely to be confounded by unmeasured factors - such as participants' socioeconomic level or the presence of conditions like depression - the researchers also conducted a bias analysis designed to evaluate how much such factors might influence reported associations between the amount of cognitive activity and dementia risk. This analysis indicated that bias due to unmeasured factors was unlikely to account for all of the association because the impact of such factors is likely to be considerably smaller than the observed effect.
The group also investigated the possible role of reverse causation - whether a reduction in cognitive activity among those already in the long phase of cognitive decline that precedes Alzheimer's dementia might have led to an apparent rather than a real causal relationship. The findings of that analysis could not rule out the possibility that reverse causation contributed substantially to the observed associations, but analyses restricted to studies with longer term follow-up might be better able to address this question, the authors note.
"Ultimately, clinical trials with long-term follow-up are the surest way to definitively address reverse causation," says co-author and AlzRisk co-director Jennifer Weuve, MPH, ScD, of Boston University School of Public Health. "Trials could also confront the vexing question of whether training to improve specific cognitive skills has benefits that extend into everyday functions. But not every question about cognitive activity is well-suited for a trial. To fill those gaps, innovations in epidemiology, such as the analytic techniques used in this study, should help us get even greater insights from available observational data."
Blacker adds, "Cognitive activity looks like it may offer some modest protection, and based on our bias analysis, I am somewhat less skeptical than I was previously. But remember that any impact will be relative, not absolute. I typically advise people to engage in cognitive activities that they find interesting and enjoyable for their own sake. There is no evidence that one kind of activity is better than another, so I would advise against spending money on programs claiming to protect against dementia."

More information: Gautam Sajeev et al, Late-life Cognitive Activity and Dementia, Epidemiology (2016). DOI: 10.1097/EDE.0000000000000513


Provided by Massachusetts General Hospital

Smartphone detects atrial fibrillation with existing hardware

Smartphones can be used to detect atrial fibrillation with existing hardware, according to research presented at ESC Congress 2016 today. A low-cost application (app) has been developed that uses the phone's own accelerometer and gyroscope to check for atrial fibrillation.

28 aug 2016--"Atrial fibrillation is a dangerous medical condition present in 2% of the global population and accounting for up to seven million strokes per year," said lead author Tero Koivisto, a vice-director of the Technology Research Centre (TRC), University of Turku, Finland. "In the European Union alone this heart rhythm disorder costs approximately USD $19 billion every year."
Around 70% of strokes due to atrial fibrillation could be avoided with pre-emptive medication. However, atrial fibrillation often occurs randomly on/off and is difficult to detect by visiting a doctor. There are relatively large and costly electrocardiogram (ECG) devices that patients can take home for long-term monitoring but they require a patch or wires that are clumsy to use and continuous contact with electrodes tends to irritate the skin.
Due to the above constraints, current methods for detection of atrial fibrillation are infeasible for wide-scale screening of populations or higher risk age groups (60 years and above).
The current study tested the ability of a smartphone to detect atrial fibrillation without any add-on hardware. The study included 16 patients with atrial fibrillation from the Turku Heart Centre. In addition, 20 recordings from healthy people were used as control group data to validate the developed algorithm.
To detect atrial fibrillation, a smartphone was placed on the chest of the patient, and accelerometer and gyroscope recordings were taken. Patients were advised to lie in a prone or supine position during the measurements.
Mr Koivisto said: "We use the accelerometer and gyroscope of the smartphone to acquire a heart signal from the patient. A measurement recording is taken, and the acquired data is pre-processed by signal processing methods. Multiple features such as autocorrelation and spectral entropy are then extracted from the pre-processed data. Finally, a machine learning algorithm (KSVM) is used to determine if the patient suffers from atrial fibrillation."
Using this technology the investigators detected atrial fibrillation with a sensitivity and specificity of more than 95%.
"We measure the actual motion of the heart via miniature accelerometers and gyroscopes that are already installed in today's smartphones," said Mr Koivisto. "No additional hardware is needed and people just need to install an app with the algorithm we developed."
He continued: "If people feel odd and want to check their cardiac status, they can simply lie down, place the phone on their chest, take an accelerometer and gyroscope measurement, then use the app to analyse the result. They will get a simple yes/no answer as to whether they have atrial fibrillation or not."
Mr Koivisto concluded: "This is a low cost, non-invasive way to detect atrial fibrillation that people can do themselves without any help from medical staff. Given the widespread use of smartphones, it has the potential to be used by large populations worldwide. In future, a secure cloud service could be created to store and analyse larger masses of data."

More information: "Detecting atrial fibrillation via existing smartphones without any add-ons" ESC Congress 2016.


Provided by European Society of Cardiology

Moderate physical activity linked with 50 percent reduction in cardiovascular death in over-65s

Moderate physical activity is associated with a greater than 50% reduction in cardiovascular death in over-65s, according to research presented at ESC Congress 2016 today. The 12 year study in nearly 2500 adults aged 65 to 74 years found that moderate physical activity reduced the risk of an acute cardiovascular event by more than 30%. High levels of physical activity led to greater risk reductions.

28 aug 2016--"The role of physical activity in preventing cardiovascular disease (CVD) in people of working age is well established," said Professor Riitta Antikainen, professor of geriatrics at the University of Oulu, Finland. "But relatively little is known about the effect of regular physical activity on CVD risk in older people."
The present study assessed the association between leisure time physical activity and CVD risk and mortality in 2456 men and women aged 65 to 74 years who were enrolled into the National FINRISK Study between 1997 and 2007.
Baseline data collection included self-administered questionnaires on physical activity and other health related behaviour, clinical measurements (blood pressure, weight and height), and laboratory measurements including serum cholesterol. Participants were followed up until the end of 2013. Deaths were recorded from the National Causes of Death Register and incident CVD events (coronary heart disease and stroke) were collected from the National Hospital Discharge register.
The researchers classified self-reported physical activity as:

• Low: reading, watching TV or working in the household without much physical activity.
• Moderate: walking, cycling or practising other forms of light exercise (fishing, gardening, hunting) at least four hours per week.
• High: recreational sports (for example running, jogging, skiing, gymnastics, swimming, ball games or heavy gardening) or intense training or sports competitions at least three hours a week.

During a median follow-up of 11.8 years, 197 participants died from CVD and 416 had a first CVD event.
When the researchers assessed the link between physical activity and outcome they adjusted for other cardiovascular risk factors (blood pressure, smoking and cholesterol) and social factors (marital status and education). To minimise reverse causality, where worse health leads to less physical activity, patients with coronary heart disease, heart failure, cancer, or prior stroke at baseline were excluded from the analysis.
The investigators found that moderate and high leisure time physical activity were associated with a 31% and 45% reduced risk of an acute CVD event, respectively. Moderate and high leisure time physical activity were associated with a 54% and 66% reduction in CVD mortality.
Professor Antikainen said: "Our study provides further evidence that older adults who are physically active have a lower risk of coronary heart disease, stroke, and death from cardiovascular disease. The protective effect of leisure time physical activity is dose dependent - in other words, the more you do, the better. Activity is protective even if you have other risk factors for cardiovascular disease such as high cholesterol."
She concluded: "Physical exercise may become more challenging with ageing. However, it is important for older people to still get enough safe physical activity to stay healthy after their transition to retirement."

More information: "Leisure time physical activity reduces the risk of cardiovascular death and an acute CVD event also among older adults" ESC Congress 2016.


Provided by European Society of Cardiology

How long do you want to live? Your expectations for old age matter

Credit: Peter Griffin/public domain

Why do some people want to live a very long time, while others would prefer to die relatively young? In a latest study, a team of researchers including Vegard Skirbekk, PhD, at the Robert N. Butler Columbia Aging Center, investigated how long young and middle-aged adults in the United States say they want to live in relation to a number of personal characteristics.

27 aug 2016-- The results showed that more than one out of six people would prefer to die younger than age 80, before reaching average life expectancy. There was no indication that the relationship between preferring a life shorter or longer than average life expectancy depended on age, gender or education.
The study is one of the first to investigate how younger adults perceiveand anticipate their own aging. Findings are published online in the journal Ageing and Society.
Using data from a telephone survey of over 1600 adults aged 18 to 64 years, the authors also found that one-third would prefer a life expectancy in the eighties, or about equal to average life expectancy, and approximately one-quarter would prefer to live into their nineties, somewhat longer than average life expectancy. The remaining participants said they hope to live to 100 or more years. Participants were on average 42 years old, half were women and 33 per cent were university graduates.
"We were particularly interested in whether how long people want to live would be related to their expectations about what their life in old age will be like," said Dr. Skirbekk, who is also a professor of Population and Family Health at Columbia University's Mailman School of Public Health.
The results, which were controlled for overall happiness, confirmed that having fewer positive old age expectations was associated with the preference to die before reaching average life expectancy. On the contrary, having fewer negative old expectations was associated with the preference to live either somewhat longer or much longer than average life expectancy.
"Having rather bleak expectations of what life will be like in old age seems to undermine the desire to live up to and beyond current levels of average life expectancy," said first author Catherine Bowen, PhD and expert on mental representations of old age and the aging process. "People who embrace the 'better to die young' attitude may underestimate their ability to cope with negative age-related life experiences as well as to find new sources of well-being in old age."
African-American participants were particularly likely to report wanting to live 100 or more years. People who identified themselves as Hispanic or as an ethnicity other than White/Caucasian,Black/African-American or Hispanic were more likely to indicate a preferencefor a life shorter than average life expectancy.
In spite of the fact that women live about five years longer than men, gender was unrelated to how long people say they want to live. The authors also found that education was unrelated to the preferred length of life, although people with more formal education tend to live longer.
"For many, it seems that the fear of becoming old may outweigh thefear of dying," observed Dr. Skirbekk.


Provided by Columbia University's Mailman School of Public Health

New research reveals cancers need a 'perfect storm' of conditions to develop

Graphical definition of stem cells. Credit: Cancer Research UK

Scientists have demonstrated for the first time the 'perfect storm' of conditions that cells need to start forming cancer, helping to explain why some organs are more susceptible to developing the disease, according to a new study published in Cell today.

26 aug 2016--The research, carried out by scientists at Cancer Research UK's Cambridge Institute at the University of Cambridge and St Jude's Children's Research Hospital in the United States, shows that cancers are more likely to start in stem cells - special cells that copy themselves so the body can grow new cells, repair damaged tissue and replace old cells.
But while these stem cells are more susceptible to developing into cancer, they also need to have accumulated DNA mistakes and be replicating to repair damage or wear and tear for cancers to start.
These DNA mistakes can happen randomly as stem cells replicate and they tend to build up with age, which is why cancer gets more common as we get older. They can also be caused by things in our environment such as tobacco smoke or UV radiation.
To find out how cancers start in different organs the researchers tagged one particular group of cells in mice with a fluorescent dye to track their behaviour. They then introduced DNA mistakes linked to different types of cancers into these cells.
Importantly, they found that DNA mistakes by themselves were not enough to cause cancer. In organs where DNA mistakes were introduced into dormant stem cells, there were no signs of cancer.

New research has demonstrated how cancers can start in stem cells. Credit: Cancer Research UK

Yet, in other organs that are exposed to lots of wear and tear - like the bowel - introducing DNA mistakes into the replicating stem cells caused cancer to start.
Professor Richard Gilbertson, lead researcher based at Cancer Research UK's Cambridge Institute at the University of Cambridge, said: "We can now say that cancer most likely starts in stem cells but is not just down to 'bad luck'. The development of cancer involves a 'perfect storm' of stem cells containing DNA mistakes that are replicating in response to damage or wear and tear.
"Although stem cells can sometimes go wrong by chance, our research shows that things in our environment that lead to more DNA mistakes or that damage organs, causing these stem cells to divide, increases the chances of the 'perfect storm' brewing. That's why behaviours like smoking or UV exposure raise the risk of developing cancer.
"Our work also shows why some types of cancer are more common than others, with tumours more likely to develop in organs with lots of replicating stem cells, for example the bowel."
"We hope finding out more about the way in which cancer develops will help us, and other scientists around the world, develop new ways to prevent and treat cancer."
Professor Karen Vousden, Cancer Research UK's chief scientist, said: "The study looks at the perplexing question of why we get cancer more often in some organs than others. This risk seems to be dictated by a combination of mutations in cancer-causing genes in stem cells, stem cell proliferation and tissue damage - which vary between different organs."

More information: Cell, DOI: 10.1016/j.cell.2016.07.045


Provided by Cancer Research UK

Society needs to challenge ageism more, says leading gericare expert

Credit: City University London

An interactive "dementia atlas" published online by the Department of Health needs to lead to society challenging ageism more, according to a leading expert on the care of older people at City University London.

23 aug 2016--According to the new government data, people with dementia are being let down by local services across the country and has revealed a postcode lottery in care for the chronic and degenerative brain disease according to experts.
The interactive resource, shows that standards of care vary significantly in different areas, with services failing to reach almost half the patients for check-ups even once a year in one area.
Speaking about the postcode lottery in care revealed by the dementia map, Julienne Meyer CBE, Professor of Nursing: Care for Older People at City University London and Executive Director: My Home Life programme, said:
"It is interesting that more people are not up in arms about the post code lottery for dementia care.  With the aging population and growing numbers of people with dementia, we are all likely to experience first-hand dementia in ourselves or our loved ones.  However, we tend to avoid the issue until it personally affects us.  By this late this stage, we are often lack capacity to take action.
"I just don't understand why society does not challenge ageism more in the same way that it seeks to challenge sexism or racism.  Older people, including those with dementia, are the largest client group for health and social care. We should take care not to tuck this fact away as a minority issue, it is a majority issue only acknowledged by the minority."


Provided by City University London

Physical training and social support reduce frailty and malnutrition

Physical training and social support reduce frailty and malnutrition. Credit: Medical University of Vienna

A training program for the reactivation of older and frail people established by MedUni Vienna has achieved remarkable success. It was revealed that physical training and addressing nutrition-relevant aspects with the aid of non-professional volunteers at home has had positive effects on the physical condition. Particularly the "social aspect" is of great significance.

22 aug 2016--According to studies, 11% of the over 65's in Austria are frail and 41% are pre-frail. Frailty is a geriatric symptom consisting of a combination of sarcopenia (reduced muscle mass and/or muscle power), malnutrition (undernourishment or overeating) and chronic inflammation and is associated with enormous health problems for the affected persons. Preventative programs, consisting of a combination of social support, nutrition and exercise intervention can prevent malnutrition and frailty and reduce isolation and loneliness, particularly in case of people who live alone and hardly ever leave the apartment.

Non-professional volunteers working in an honorary capacity "activate" frail people

MedUni Vienna (Institute for Social Medicine), together with the Vienna Hilfswerk (relief organisation) and Sportunion Austria, initiated the project "Healthy for life". The project was promoted by the Vienna Science and Technology Fund. Volunteers working in an honorary capacity (so-called "buddies") visited frail or malnourished people (average age 83 years) in their homes twice a week for a period of twelve weeks. The skilled buddies trained together with the frail people (strength training with a Thera ribbon) and discussed nutrition-related aspects. An active control group also received visits, but without nutrition and exercise intervention.
After twelve weeks, a significant improvement in the frailty status and malnutrition risk was recorded. The prevalence of impaired nutritional status in the training and nutrition group was reduced by 25%, frailty by 17%. It was remarkable that the control group, who only received social support, also recorded improvements (23% less impaired nutritional status and 16% less frailty).

An active social life is important for physical wellbeing at an advanced age

"The results show that healthy nutrition and physical activity particularly at an advanced age have a special significance for the promotion of health and wellbeing and maintaining autonomy", explains first author Eva Luger of the Institute for Social Medicine of MedUni Vienna; "one essential prerequisite for healthy nutrition and physical activity is social support, particularly in case of older people".
"An active social life and social contacts are important factors to remain autonomous for as long as possible", emphasises study leader Thomas E. Dorner from the Institute for Social Medicine. "It also became evident that trained non-professional volunteers achieve similarly good results with such a program as those conducted by health professionals."
As many frail people live alone and hardly ever leave their apartment, nutrition and exercise programs based on social support are a good solution for the prevention and reduction of frailty.

More information: Eva Luger et al. Effects of a Home-Based and Volunteer-Administered Physical Training, Nutritional, and Social Support Program on Malnutrition and Frailty in Older Persons: A Randomized Controlled Trial, Journal of the American Medical Directors Association (2016). DOI: 10.1016/j.jamda.2016.04.018


Provided by Medical University of Vienna

Calcium supplements linked to dementia risk in women with certain health conditions

Credit: CC0 Public Domain

According to a new study, calcium supplements may be associated with an increased risk of dementia in older women who have had a stroke or other signs of cerebrovascular disease. The research is published in the August 17, 2016, online issue of Neurology, the medical journal of the American Academy of Neurology.

18 aug 2016--Cerebrovascular disease is a group of disorders that affect blood flow in the brain. These diseases, including stroke, are the fifth leading cause of death in the United States and increase the risk of developing dementia.
"Osteoporosis is a common problem in the elderly. Because calcium deficiency contributes to osteoporosis, daily calcium intake of 1000 to 1200 mg is recommended. Getting this recommended amount through diet alone can be difficult, so calcium supplements are widely used," said study author Silke Kern, MD, PhD with the University of Gothenburg in Sweden. "Recently, however, the use of supplements and their effect on health has been questioned."
The study involved 700 dementia-free women between the ages of 70 and 92 who were followed for five years. Participants took a variety of tests at the beginning and end of the study, including tests of memory and thinking skills. A CT brain scan was performed in 447 participants at the start of the study.
Scientists also looked at the use of calcium supplements in the participants and whether they were diagnosed with dementia over the course of the study. A total of 98 women were taking calcium supplements at the start of the study and 54 women had already experienced a stroke. During the study, 54 more women had strokes, and 59 women developed dementia. Among the women who had CT scans, 71 percent had lesions on their brains' white matter, which is a marker for cerebrovascular disease.
The study found that the women who were treated with calcium supplements were twice as likely to develop dementia than women who did not take supplements. But when the researchers further analyzed the data, they found that the increased risk was only among women with cerebrovascular disease. Women with a history of stroke who took supplements had a nearly seven times increased risk of developing dementia than women with a history of stroke who did not take calcium supplements. Women with white matter lesions who took supplements were three times as likely to develop dementia as women who had white matter lesions and did not take supplements. Women without a history of stroke or women without white matter lesions had no increased risk when taking calcium supplements.
Overall, 14 out of 98 women who took supplements developed dementia, or 14 percent, compared to 45 out of 602 women who did not take supplements, or 8 percent. A total of six out of 15 women with a history of stroke who took supplements developed dementia, compared to 12 out of 93 women with a history of stroke who did not take supplements. Among the women with no history of stroke, 18 out of 83 who took supplements developed dementia, compared to 33 out of the 509 who did not take supplements.
"It is important to note that our study is observational, so we cannot assume that calcium supplements cause dementia," said Kern. The author also noted that the study was small and results cannot be generalized to the overall population, and additional studies are needed to confirm the findings.
Kern noted that calcium from food affects the body differently than calcium from supplements and appears to be safe or even protective against vascular problems.


Provided by American Academy of Neurology

It's true: Latinos age slower than other ethnicities

Credit: Peter Griffin/public domain

A UCLA study is the first to show that Latinos age at a slower rate than other ethnic groups. The findings, published in the current issue of Genome Biology, may one day help scientists understand how to slow the aging process for everyone.

17 aug 2016--"Latinos live longer than Caucasians, despite experiencing higher rates of diabetes and other diseases. Scientists refer to this as the 'Hispanic paradox,'" said lead author Steve Horvath, a professor of human genetics at the David Geffen School of Medicine at UCLA. "Our study helps explain this by demonstrating that Latinos age more slowly at the molecular level."
According to the Centers for Disease Control and Prevention, Latinos in the U.S. live an average of three years longer than Caucasians, with a life expectancy of 82 versus 79. At any age, healthy Latino adults face a 30% lower risk of death than other racial groups, reports a 2013 study in the American Journal of Public Health.
The UCLA team used several biomarkers, including an "epigenetic clock" developed by Horvath in 2013, to track an epigenetic shift linked to aging in the genome. Epigenetics is the study of changes to the DNA molecule that influence which genes are active but don't alter the DNA sequence itself.
Horvath and his colleagues analyzed 18 sets of data on DNA samples from nearly 6,000 people. The participants represented seven different ethnicities: two African groups, African-Americans, Caucasians, East Asians, Latinos and an indigenous people who are genetically related to Latinos. Called the Tsimane, the latter group lives in Bolivia.
When the scientists examined the DNA from blood-which reveals the health of a person's immune system—they were struck by differences linked to ethnicity. In particular, the scientists noticed that, after accounting for differences in cell composition, the blood of Latinos and the Tsimane aged more slowly than other groups.
According to Horvath, the UCLA research points to an epigenetic explanation for Latinos' longer life spans. For example, the biological clock measured Latino women's age as 2.4 years younger than non-Latino women of the same age after menopause.
"We suspect that Latinos' slower aging rate helps neutralize their higher health risks, particularly those related to obesity and inflammation," said Horvath, who is also a professor of biostatistics at the Fielding School of Public Health at UCLA. "Our findings strongly suggest that genetic or environmental factors linked to ethnicity may influence how quickly a person ages and how long they live."
The Tsimane aged even more slowly than Latinos. The biological clock calculated the age of their blood as two years younger than Latinos and four years younger than Caucasians. The finding reflects the group's minimal signs of heart disease, diabetes, hypertension, obesity or clogged arteries.
"Despite frequent infections, the Tsimane people show very little evidence of the chronic diseases that commonly afflict modern society," observed coauthor Michael Gurven, a professor of anthropology at UC Santa Barbara. "Our findings provide an interesting molecular explanation for their robust health."
In another finding, the researchers learned that men's blood and brain tissue ages faster than women's from the same ethnic groups.
The discovery could explain why women have a higher life expectancy than men.
Horvath and his colleagues next plan to study the aging rate of other human tissues and to identify the molecular mechanism that protects Latinos from aging.

More information: Steve Horvath et al. An epigenetic clock analysis of race/ethnicity, sex, and coronary heart disease, Genome Biology (2016). DOI: 10.1186/s13059-016-1030-0


Provided by University of California, Los Angeles

Signs of pure altruism converge in the brain and increase with age

University of Oregon doctoral student Jason Hubbard, left, talks with Ulrich Mayr, professor and head of the university's psychology department, in the control room of the university's Lewis Center for Neuroimaging. The two researchers were part of a team that searched for evidence of true altruism in the brain. Credit: University of Oregon

Combining insights from psychology, behavioral economics and neuroscience, University of Oregon researchers have found converging signs of pure altruism and behavior that increase with age in the brain.
People give to charity for numerous non-altruistic reasons, such as showing off their generosity to others. To isolate pure altruism from other motivations, researchers triangulated methods from the three fields.

16 aug 2016--Their goal was to find a sweet spot where altruism is done for the simple joy of seeing others benefit without expecting personal rewards or recognition, said Ulrich Mayr, head of the UO Department of Psychology and lead author on a paper online ahead of print in the Journal of Experimental Psychology: General.
In an experiment with 80 men and women, ages 18-67, all with similar work and life experiences, the participants made real decisions about either giving cash to a charity or keeping it for themselves. This method, said co-author William T. Harbaugh, was based on a basic principle of economic research: "Look at what people do, not what they say."
The researchers also used functional MRI to look at brain regions associated with value and rewards as each subject watched various scenarios involving money going either to themselves or to charities. The participants also took detailed psychological assessments of their personality traits.
Replicating an earlier study by Mayr, Harbaugh and UO doctoral student Daniel Burghart and published in the journal Science in 2007, the results showed that for some people neural reward areas were more active when money went to themselves than to charities. This, Mayr said, can be interpreted as a self-interested neural response.
Others showed more neural reward when they witnessed money going to a charity. These individuals, whose neural responses suggest altruistic tendencies, also gave more money when they had a choice. They also showed a stronger expression of pro-social personality traits.
The five-member research team said the pattern points to a strong underlying dimension that they labeled as general benevolence, which reflects altruistic tendencies based on measures drawn from neuroscience, behavioral economics and psychology.
General benevolence is more strongly expressed in the second half of the life span, the researchers found. People older than 45 receive more neural reward from seeing others better off, they give more money away and they score higher on pro-social personality traits than those under 45.
"Our approach allowed us to look at commonalities in the different approaches to assess altruism," Mayr said. "It is exciting that the three very different methods converge on a common general benevolence dimension and that we can reliably measure pure altruism."
Religiosity also showed a moderate, positive relationship, but gender, political orientation and annual income did not. The finding that income was not a factor, the researchers said, indicated that the correlation they saw with age "was not simply due to older adults being generally wealthier."
The approach also made it possible to identify brain areas associated with each of the different behavioral signs of general benevolence and where they converge, said co-author Jason Hubbard, a doctoral student in psychology.
Since general benevolence increases with age, Mayr said, it suggests the possibility that life experiences may plant the seeds of pure altruism in people, allowing them to grow into the desire to contribute to the public good.
"There has been a lot of interest in the role that personality plays in important policy goals," said co-author Sanjay Srivastava, a professor of psychology. "There are two big questions: what affects how personality develops, and what are the consequences of developing in different ways?
"This research is part of that second prong: It gives us a deeper look at the people who give to charity and altruistically contribute to society," he said. "If as a society we want to strengthen communities and have a world where people look out for each other, we can go back and ask what kinds of policies and social conditions can help people get there."
The new study used the costly MRI technology on 80 subjects versus the pool of 19 in the earlier study. While the higher number of subjects helps make the case that the findings are robust, Mayr said, larger studies still are needed to gather more confirmation on the group's conclusions.
Statistician David Degras, formerly a courtesy research associate at the UO and with the University of Massachusetts at Boston, was also a co-author.

More information: Jason Hubbard et al, A General Benevolence Dimension That Links Neural, Psychological, Economic, and Life-Span Data on Altruistic Tendencies., Journal of Experimental Psychology: General (2016). DOI: 10.1037/xge0000209


Provided by University of Oregon

Virtual reality and treadmill training could help prevent falls in older adults

Combining virtual reality and treadmill training helps prevent falls in older adults better than treadmill training alone, according to a new randomised controlled trial published in The Lancet. The authors say that the intervention, which combines the physical and cognitive aspects of walking, could potentially be used in gyms, rehabilitation centres or nursing homes to improve safe walking and prevent falls in older adults or people with disorders which affect movement such as Parkinson's disease.

15 aug 2016--Falls in adults aged 65 and over account for 1-2% of all healthcare expenditure in high-income countries. 30% of older adults living in the community, and as many as 60-80% of older adults with mild cognitive impairment, dementia or Parkinson's disease, fall at least once a year. Falls can cause injuries, loss of independence, disability, institutionalisation, and death. Even without injuries, falls often lead to fear of falling, avoiding leaving the house and depression, which in turn often leads to inactivity, muscle weakness, impaired balance and gait, more falls and more social isolation.
In this trial, researchers analysed data from 282 participants from five clinical sites in Belgium, Israel, Italy, the Netherlands, and the UK between 2013 and 2015. All participants were aged 60-90, were able to walk at least 5 minutes unassisted, on stable medication, and had reported at least 2 falls in the 6 months before the start of the study. Nearly half of all participants (130) had Parkinson's disease, and some (43) had mild cognitive impairment.
Participants were assigned to treadmill training with virtual reality (146), or treadmill training alone (136). The virtual reality component consisted of a camera that captured the movement of participants' feet and projected it onto a screen in front of the treadmill, so that participants could 'see' their feet walking on the screen in real time. The game-like simulation was designed to reduce the risk of falls in older adults by including real life challenges such as avoiding and stepping over obstacles like puddles or hurdles, and navigating pathways (see figure 1 & link to images/videos provided below).
On average, participants in each group took part in 16 training sessions over six weeks, with each session lasting about 45 minutes. Fall rates were recorded in the six months following the end of training. Prior to training, participants in the treadmill only group had an average of 10.7 falls per six months, and participants in the treadmill plus virtual reality group averaged 11.9 falls per six months.
During the six months after training, the incidence rate of falls decreased in both groups, but the decrease was only statistically significant (i.e. better than chance) in the treadmill plus virtual reality group (11.9 to 6.0 falls in the virtual reality group - a 42% reduction; compared to a decrease from 10.7 to 8.3 in the treadmill only group) (table 2 and figure 3).
"Falls in older people often occur because of tripping and poor obstacle negotiation while walking. Falls often start a vicious cycle, which has many important negative health consequences. Older people's ability to negotiate obstacles can be impaired because of age-related decline in cognitive abilities like motor planning, divided attention, executive control, and judgement, yet current interventions for falls in older adults typically focus on improving muscle strength, balance, and gait," explains study author Dr Anat Mirelman, Center for the study of Movement, Cognition and Mobility (CMCM), Neurology Institute, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
She adds: "Our approach combines treadmill exercise and virtual reality to help improve both physical mobility and cognitive aspects that are important for safe walking. We found that virtual reality plus treadmill training helped to reduce fall frequency and fall risk for at least six months after training."
The biggest improvement was seen in participants with Parkinson's disease, and the authors suggest that this could be due to a number of factors, including that they had higher rates of falls at the start of the study, or that virtual reality was able to help improve cognitive and motor skills which are affected in Parkinson's disease. However, although these are interesting findings, the authors warn that the study was not powered to measure differences in between sub-groups, so further research is needed to verify these explanations.
The authors also caution that the follow-up period for participants in this trial was only six months per patient, so further research will be needed to see if there is a long term effect and whether maintaining the training period could help to extend the benefits of training. Although this is the largest study of its kind so far, the number of participants involved was small, and included older people who had a history of multiple falls.
Dr Mirelman says: "Treadmills are widely available, and the additional cost of treadmill training plus virtual reality is about 4000 euros for the set-up. Our study used personalised supervision, but this might not be necessary in everyday practice where group training might be more suitable. Further studies will need to examine whether treadmill training plus virtual reality could be used as part of a prevention package to treat fall risk before falls become common and before injuries occur."
Writing in a linked Comment, Professor Stephen R. Lord, University of New South Wales, Randwick, New South Wales, Australia, says: "The finding of a 42% reduction in falls is in line with the most effective fall preventions that have assessed more traditional group-based and homed-based exercise interventions in older people and well above the average reduction of 17% for exercise interventions reported in systematic reviews. It is also notable that the reduction in falls reported in the current trial is made in comparison to a treadmill walking intervention of similar intensity, as opposed to no intervention or usual care... Mirelman and colleagues' findings have important implications for clinical practice. No serious adverse events occurred and adherence was good. A health economic analysis was not presented, and although it is the case that VR training is not substantially more resource-intensive than treadmill training, one-on-one supervision was used in this study. It is conceivable, however, that treadmill training with a VR component could be administered in community gyms and rehabilitation clinics, and since the intervention is relatively short term in nature, throughput of many people would be possible."


Provided by Lancet

High and low levels of 'good cholesterol' may cause premature death

Commonly touted as "good cholesterol" for helping to reduce risk of stroke and heart attack, both high and low levels of high-density lipoprotein (HDL) cholesterol may increase a person's risk of premature death, according to new research at Washington University School of Medicine in St. Louis and Veterans Affairs St. Louis Health Care System.

13 aug 2016--Conversely, intermediate HDL cholesterol levels may increase longevity, according to the research.
The large-scale epidemiological study is published Aug. 11 in the Clinical Journal of the American Society of Nephrology.
"The findings surprised us," said Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University and the study's senior author. "Previously it was thought that raised levels of the good cholesterol were beneficial. The relationship between increased levels of HDL cholesterol and early death is unexpected and not fully clear yet. This will require further study."
Cholesterol is a fatty substance found in blood that can narrow and block heart vessels, causing cardiovascular disease and stroke. For years, HDL cholesterol has been credited with helping to remove plaque-building "bad cholesterol" from arteries.
For this study, researchers studied kidney function and HDL cholesterol levels in more than 1.7 million male veterans from October 2003 through September 2004. Researchers then followed participants until September 2013.
Patients with kidney disease frequently have lower levels of HDL cholesterol, which might explain their increased risk of early death; however, the association between elevated HDL cholesterol levels and premature death in these patients has been unclear. In the current study, the researchers showed that both high and low HDL cholesterol levels were associated with an increased risk of dying among study participants with all levels of kidney function.
"The findings may explain why clinical trials aimed at increasing HDL cholesterol levels failed to show improved outcomes," said Al-Aly, who also is the VA's associate chief of staff for research and education and co-director of the VA's Clinical Epidemiology Center in St. Louis.
Such findings regarding HDL cholesterol and premature death have not been reported in other large epidemiologic studies that have advanced understanding of the relationship between cholesterol parameters and clinical outcomes, Al-Aly said.
"However, the previous studies are limited in that the number of patients in those cohorts is relatively small compared with what a big data approach enabled us to see in our new research," he said. "Big data allow a more nuanced examination of the relationship between HDL cholesterol and risk of death across the full spectrum of HDL cholesterol levels."
Research data showed a relationship between HDL cholesterol levels and mortality as a U-shaped curve with the risk of death increased at both ends of the spectrum. "Too low and too high are both associated with higher risk of death," Al-Aly said.
Whether maintaining intermediate HDL cholesterol levels may increase longevity will need to be explored in future studies, Al-Aly said.
"A large database is critical in allowing us to research and challenge prior knowledge in our continuing efforts to create a better understanding of HDL cholesterol levels and risk of death," he said.

More information: B. Bowe et al, High Density Lipoprotein Cholesterol and the Risk of All-Cause Mortality among U.S. Veterans, Clinical Journal of the American Society of Nephrology (2016). DOI: 10.2215/CJN.00730116


Provided by Washington University School of Medicine

Car drivers are four kilograms heavier than cyclists, new study reveals

Credit: Imperial College London

People who drive cars as their main form of transport are on average heavier than those who cycle, according to an ongoing Europe-wide study.
Researchers have so far monitored 11,000 volunteers in seven European cities, asking them how they move around the city, which mode of transport they use and how much time they spend travelling.
The project also asks volunteers to record their height and weight, and to provide information about their attitudes towards walking and bicycling.

12 aug 2016--An analysis of the data so far shows that those people who drive cars as their main form of transport are on average four kilograms (8.8 lbs) heavier than those who cycle.
The EU-funded Physical Activity through Sustainable Transport Approaches (PASTA) project - led by an international group of experts, including Imperial College London and the World Health Organization - is studying how different forms of transport relate to levels of physical activity, and consequently people's health.
While the researchers cannot yet draw a causal link between the type of transport people choose and their weight, they said the initial results are intriguing, and hope that by following more people they can draw some firmer conclusions.
PASTA researchers are still looking for volunteers, and plan to follow 14,000 volunteers in seven cities around Europe: Antwerp, Barcelona, London, Orebro in Sweden, Rome, Vienna and Zurich.
Imperial's project lead Dr Audrey de Nazelle from the Centre for Environmental policy, said: "We don't have cause and effect yet, but we hope this first finding will encourage more people to take part in the survey so that we can get more data over time and make a link between transport decisions and health."
Dr Adrian Davis, a UK transport and health expert and member of PASTA's advisory board, said: "People who are physically inactive are at higher risk of developing chronic diseases, such as cancer, stroke and heart attacks, as well as becoming overweight.
"Our research shows that factors like urban design, how we move in cities, and the use of cars, bikes or walking could all play an important role in determining the level of people's daily physical activity."
Dr de Nazelle added: "If people can integrate this into their daily lives, such as going to work or going shopping, then it means you don't have to make special time commitments and it's more affordable for everybody.
"Getting people to walk and bike as part of their daily transport modes is really an ideal solution to try to tackle this epidemic of physical inactivity."
The survey also aims to determine how people make transport decisions, and what measures cities can take to encourage walking and cycling.
Dr de Nazelle said: "Cycling is at low levels in the UK – when you compare that to places like northern Europe you can see there's really huge potential to increase the levels."

More information: To take part in the research, sign up at the PASTA project website: survey.pastaproject.eu/


Provided by Imperial College London

Ageing well in the real world

Credit: Heriot-Watt University

Heriot-Watt psychologists are to carry out a new study to look across the board at what sort of 'real-world' activities might best protect thinking and memory skills into old age.
The three year study, supported by Velux Stiftung, a Swiss charitable foundation that supports research on healthy ageing, will look at how increasing mental, physical or social engagement might improve cognitive skills in older people.

11 aug 2016--Study leader Dr Alan Gow said that while a range of lifestyle factors might be beneficial, a large part of the research developing these findings into interventions remains lab-based. The aim of the new study is to provide evidence about the sorts of activities which are already widely available in the community and which might offer people the best opportunities for a mentally active old age.
"Keeping intellectually, socially or physically engaged have all been proposed as potentially protective. Many laboratory studies have also been undertaken, but can be difficult for people to relate these to their own lives and what is available to them.
"What we want to look at is the sort of activities which are available to people in the real world, options like language classes, dancing or social groups, and within a single study look at the effects of such mental, physical and social stimulation, individually or in combination.
"We will then be in a position to offer the sort of evidence-based advice that people can choose to act on within their own communities."

Keeping engaged

Dr Gow added, "As we age, we may experience general declines in our thinking, memory and reasoning skills, what we call cognitive ageing. There is, however, large variation in the degree of decline experienced.
"Cognitive ageing is one of the most feared aspects of growing older, and is related to lower quality of life and loss of independence. Keeping intellectually, socially or physically engaged have all been proposed as potentially protective, but we still need to better understand the relative importance of these different factors to provide advice and support for older adults.
"Given international trends towards increased longevity, ensuring the health and wellbeing of an older population will remain a priority. This project's community-based setting has been designed to reduce barriers for people to apply the findings to their own lives for real-world benefit."
The study, by the Aging Lab team at Heriot-Watt, will involve 300 people aged between 65 and 75, and will work closely with local government, older people's organisations and charities, in addition to an internationally-recognised advisory panel of leading experts in psychology, gerontology, public health and cognitive interventions.


Provided by Heriot-Watt University

Higher weekly activity levels linked to lower risk of 5 chronic diseases

Higher levels of total physical activity are strongly associated with lower risk of five common chronic diseases - breast and bowel cancer, diabetes, heart disease and stroke, finds a study in The BMJ today.

10 aug 2016--Many studies have shown the health benefits of physical activity. This has led the World Health Organization (WHO) to recommend a minimum total physical activity level of 600 metabolic equivalent (MET) minutes a week across different 'domains' of daily life.
This can include being more physically active at work, engaging more in domestic activities such as housework and gardening, and/or engaging in active transportation such as walking and cycling.
But we still do not definitively know how much the type and quantity of physical activity reduces the risk of common conditions.
So a team of researchers based in the US and Australia analysed the results of 174 studies published between 1980 and 2016 examining the associations between total physical activity and at least one of five chronic diseases - breast cancer, bowel (colon) cancer, diabetes, ischemic heart disease, and ischemic stroke.
They found that a higher level of total weekly physical activity was associated with a lower risk of all five conditions.
Most health gains occurred at a total activity level of 3000-4000 MET minutes a week, with diminishing returns at higher activity levels.
A person can achieve 3000 MET minutes a week by incorporating different types of physical activity into their daily routine - for example, climbing stairs for 10 minutes, vacuuming for 15 minutes, gardening for 20 minutes, running for 20 minutes, and walking or cycling for 25 minutes.
The results suggest that total physical activity needs to be several times higher than the current recommended minimum level of 600 MET minutes a week to potentially achieve larger reductions in risks of these diseases, say the authors.
Although they cannot tell us about cause and effect, meta-analyses involving observational research are useful for pulling evidence together. And the authors say their findings have several important implications.
"With population ageing, and an increasing number of cardiovascular and diabetes deaths since 1990, greater attention and investments in interventions to promote physical activity in the general public is required," they write.
"More studies using the detailed quantification of total physical activity will help to find a more precise estimate for different levels of physical activity," they conclude.
In a linked editorial, researchers at the University of Strathclyde and the International Prevention Research Institute in Lyon, France say this study "represents an advance in the handling of disparate data on a lifestyle factor that has considerable importance for the prevention of chronic diseases."
But they point out that "it cannot tell us whether risk reductions would be different with short duration intense physical activity or longer duration light physical activity."
They conclude: "Future studies must streamline their measurement and reporting for real gains in knowledge."

More information: The BMJ. www.bmj.com/content/354/bmj.i3857


Provided by British Medical Journal

Diabetics should be wary of paleo diet, expert warns

A paleo diet recommends cutting out whole grains and dairy.

People with type 2 diabetes should be wary of social media hype about the benefits of going on the paleo diet, a University of Melbourne researcher says.
Writing in the Medical Journal of Australia, Associate Professor Sof Andrikopoulos says despite dozens of websites urging diabetes sufferers to go paleo, there have been no trials lasting beyond 12 weeks on type 2 diabetes sufferers.

09 aug 2016--"There have been only two trials worldwide of people with type 2 diabetes on what looks to be a paleo diet," said Associate Professor Andrikopoulos, a researcher at the University of Melbourne Department of Medicine, based at the Austin Hospital.
"Both studies had fewer than 20 participants, one had no control diet, and at 12 weeks or less, neither study lasted long enough for us to draw solid conclusions about the impact on weight or glycemic control."
Associate Professor Andrikopoulos, who is also President of the Australian Diabetes Society, recommended people with type 2 diabetes seek advice from their GPs, registered dietitians and diabetes organisations.
"Most paleo diets insist on avoiding refined sugar and processed food, which is consistent with dietary guidelines worldwide," he said.
"But when you start cutting out whole grains and dairy, which are absent from many forms of the paleo diet, you may forgo important sources of fibre and calcium.
"And high-fat, zero-carb diets promoted by some celebrities make this worse, as they can lead to rapid weight gain, as well as increase your risk of heart disease."
Associate Professor Andrikopoulos says people with diabetes benefited most from regular exercise and the Mediterranean diet—olive oil, fats from fish, legumes and low in refined sugar.
"While it's tempting to emulate celebrities who look great and can spend a lot of time at the gym, if you're already overweight or you live a sedentary life, it may be quite risky to adopt a high-fat diet… and if you have diabetes, it's downright dangerous.
"The internet is full of testimonials from people saying a particular diet worked for them because they cut calories and lost weight, but people with diabetes in particular need to approach those claims with caution and seek advice from their health care professional."


Provided by University of Melbourne

Exercise results in larger brain size and lowered dementia risk

Credit: CC0 Public Domain

Using the landmark Framingham Heart Study to assess how physical activity affects the size of the brain and one's risk for developing dementia, UCLA researchers found an association between low physical activity and a higher risk for dementia in older individuals. This suggests that regular physical activity for older adults could lead to higher brain volumes and a reduced risk for developing dementia.

07 aug 2016--The researchers found that physical activity particularly affected the size of the hippocampus, which is the part of the brain controlling short-term memory. Also, the protective effect of regular physical activity against dementia was strongest in people age 75 and older.
Though some previous studies have found an inverse relationship between levels of physical activity and cognitive decline, dementia and Alzheimer's disease, others have failed to find such an association. The Framingham study was begun in 1948 primarily as a way to trace factors and characteristics leading to cardiovascular disease, but also examining dementia and other physiological conditions. For this study, the UCLA researchers followed an older, community-based cohort from the Framingham study for more than a decade to examine the association between physical activity and the risk for incident dementia and subclinical brain MRI markers of dementia.
The researchers assessed the physical activity indices for both the original Framingham cohort and their offspring who were age 60 and older. They examined the association between physical activity and risk of any form of dementia (regardless of the cause) and Alzheimer's disease for 3,700 participants from both cohorts who were cognitively intact. They also examined the association between physical activity and brain MRI in about 2,000 participants from the offspring cohort.
What this all means: one is never too old to exercise for brain health and to stave off the risk for developing dementia.
The study appears in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences.


Provided by University of California, Los Angeles

Eating more plant protein associated with lower risk of death

Credit: Maliz Ong

The largest study to examine the effects of different sources of dietary protein found that a high intake of proteins from animal sources - particularly processed and unprocessed red meats - was associated with a higher mortality rate, while a high intake of protein from plant sources was associated with a lower risk of death. Results from the study - which analyzed data from two long-term epidemiologic studies - appears in the August 1 issue of JAMA Internal Medicine.

05 aug 2016--"Overall, our findings support the importance of the sources of dietary protein for long-term health outcomes," says Mingyang Song, MD, ScD, a research fellow in the Massachusetts General Hospital (MGH) Clinical and Translational Epidemiology Unit (CTEU) and Division of Gastroenterology and corresponding author of the report. "While previous studies have primarily focused on the overall amount of protein intake - which is important - from a broad dietary perspective, the particular foods that people consume to get protein are equally important. Our findings also have public health implications and can help refine current dietary recommendations about protein intake, in light of the fact that it is not only the amount of protein but the specific food sources that is critical for long-term health."
While several studies have suggesting that substituting proteins for carbohydrates in the diet has several health benefits - including weight management, reducing blood pressure and other cardiovascular risk factors - the authors note, few studies have examined the specific sources of protein. Those that have were relatively small and based on one-time assessment of participants' diets. The current study analyzes data from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS), which have compiled comprehensive health data on more than 170,000 participants since the 1980s. In addition to completing overall health questionnaires every two years, participants provide information on their dietary intake - specifically how often they consumed portions of particular types of food during the preceding year - every four years.
The researchers analyzed more than 30 years of data for NHS participants and 26 years of data for HPFS participants, totaling more than 3.5 million person-years. During those time periods more than 36,000 deaths were documented among study participants - almost 9,000 from cardiovascular disease, around 13,000 from cancer and about 14,000 from other causes. After adjustment for lifestyle and other dietary risk factors, a high consumption of protein from animal sources - any types of meat, eggs or dairy - was weakly associated with an increased rate of death, while high consumption of protein from plant sources - breads, cereals, pasta, beans, nuts and legumes - was associated with a lower mortality rate.
More careful analysis revealed that the association of animal protein intake with an elevated mortality risk only applied to participants with at least one factor associated with an unhealthy lifestyle - being either obese or underweight, heavy alcohol consumption, a history of smoking, or physical inactivity. In fact, the association disappeared in participants with a healthy lifestyle. Analysis based on specific sources of protein indicated that the animal-protein-associated mortality risk applied primarily to processed and unprocessed red meats, which include both beef and pork products, and not to protein from fish or poultry.
"While we expected we might find the associations to be weaker in the healthy lifestyle group, we did not expect them to completely disappear," says Song. "But when we looked deeper into the data, we found that - at similar levels of animal protein intake - those in the unhealthy lifestyle group consumed more red meats, eggs and high-fat dairy, while the healthy lifestyle group consumed more fish and poultry. So we suspect the different sources of animal protein between the two groups may contribute to the stronger results in the unhealthy lifestyle group."
He adds, "Our findings suggest that people should consider eating more plant proteins than animal proteins, and when they do choose among sources of animal protein, fish and chicken are probably better choices. Future studies should examine the mechanisms underlying the different effects of plant and animal proteins - along with different sources of animal proteins - on overall health."

More information: JAMA Intern Med. Published online August 1, 2016. DOI: 10.1001/jamainternmed.2016.4182


Provided by The JAMA Network Journals

Brains of overweight people 'ten years older' than lean counterparts at middle-age

Comparison of grey matter (brown) and white matter (yellow) in sex-matched subjects A (56 years, BMI 19.5) and B (50 years, BMI 43.4) Credit: Lisa Ronan

From middle-age, the brains of obese individuals display differences in white matter similar to those in lean individuals ten years their senior, according to new research led by the University of Cambridge. White matter is the tissue that connects areas of the brain and allows for information to be communicated between regions.

04 aug 2016--Our brains naturally shrink with age, but scientists are increasingly recognising that obesity - already linked to conditions such as diabetes, cancer and heart disease - may also affect the onset and progression of brain ageing; however, direct studies to support this link are lacking.
In a cross-sectional study - in other words, a study that looks at data from individuals at one point in time - researchers looked at the impact of obesity on brain structure across the adult lifespan to investigate whether obesity was associated with brain changes characteristic of ageing. The team studied data from 473 individuals between the ages of 20 and 87, recruited by the Cambridge Centre for Aging and Neuroscience. The results are published in the journal Neurobiology of Aging.
The researchers divided the data into two categories based on weight: lean and overweight. They found striking differences in the volume of white matter in the brains of overweight individuals compared with those of their leaner counterparts. Overweight individuals had a widespread reduction in white matter compared to lean people.
The team then calculated how white matter volume related to age across the two groups. They discovered that an overweight person at, say, 50 years old had a comparable white matter volume to a lean person aged 60 years, implying a difference in brain age of 10 years.
Strikingly, however, the researchers only observed these differences from middle-age onwards, suggesting that our brains may be particularly vulnerable during this period of ageing.
"As our brains age, they naturally shrink in size, but it isn't clear why people who are overweight have a greater reduction in the amount of white matter," says first author Dr Lisa Ronan from the Department of Psychiatry at the University of Cambridge, "We can only speculate on whether obesity might in some way cause these changes or whether obesity is a consequence of brain changes."
Senior author Professor Paul Fletcher, from the Department of Psychiatry, adds: "We're living in an ageing population, with increasing levels of obesity, so it's essential that we establish how these two factors might interact, since the consequences for health are potentially serious.
"The fact that we only saw these differences from middle-age onwards raises the possibility that we may be particularly vulnerable at this age. It will also be important to find out whether these changes could be reversible with weight loss, which may well be the case."
Despite the clear differences in the volume of white matter between lean and overweight individuals, the researchers found no connection between being overweight or obese and an individual's cognitive abilities, as measured using a standard test similar to an IQ test.

More information: Lisa Ronan et al, Obesity associated with increased brain-age from mid-life, Neurobiology of Aging (2016). DOI: 10.1016/j.neurobiolaging.2016.07.010


Provided by University of Cambridge

Study: Specialized brain training may forestall dementia onset for years

Diagram of the brain of a person with Alzheimer's Disease. Credit: Wikipedia/public domain.

If you're intent on keeping dementia at bay, new research suggests you'll need more than crossword puzzles, aerobic exercise and an active social life. In a study released this week, researchers found that older adults who did exercises to shore up the speed at which they processed visual information could cut by nearly half their likelihood of cognitive decline or dementia over a 10-year period.

03 aug 2016--The new clinical trial results, presented Sunday at the Alzheimer's Association's International Conference in Toronto, establish specialized brain training as a potentially powerful strategy to prevent Alzheimer's disease and other afflictions, including normal aging, that sap memory and reduce function.
With 76 million baby boomers reaching the age of maximum vulnerability to Alzheimer's and with no effective treatments available to alter the disease's progression, researchers are keen to find ways to prevent or delay the onset of the memory-robbing disease. The new research suggests that even years after it is administered, an inexpensive intervention without unwanted side effects might forestall dementia symptoms.
The latest results emerged from a 10-year study that compared the effects of three forms of brain training in a group of 2,802 cognitively healthy seniors. The ACTIVE study - short for Advanced Cognitive Training for Independent and Vital Elderly - was funded by the National Institute on Aging.
A quarter of the participants, who had an average age of 73.4 at the study's start, got no training at all. The remaining participants were divided into three groups, and over five weeks, each group got 10 hourlong training sessions. One group got a classroom-based course designed to impart strategies aimed at boosting memory; a second got a classroom-based course designed to sharpen participants' reasoning skills.
A third group was given computerized training designed to increase the speed at which the brain picks up and processes cues in a person's field of vision. Speed of visual processing is a cognitive skill that declines with age, a trend that some neuroscientists attribute to the increasing "noise" in electrical communications between cells and among regions in the brain.
Over the study's 10-year follow-up, 14 percent of participants in the control group suffered significant cognitive decline or dementia, compared with 11.4 percent in the memory-strategies training group, 11.7 percent in the reasoning-strategies training group and 10.5 percent in the speed-of-processing group. Cognitive decline or dementia was not only less among those in the speed-of-processing group; when it appeared, it came later.
Statistically, the trial's four groups experienced sizable differences in cognitive aging. For those who got the commercially available brain-training exercises, the cumulative risk of developing cognitive decline or dementia over 10 years was 33 percent lower than for participants who got no training at all. Among a smaller group of computerized-training participants who got "booster sessions" - at least one refresher class 11 and 35 months after the initial training - the risk of cognitive decline or dementia went down even further. Compared to study participants who got no training at all, recruits who went through more than 10 of the computerized brain-training sessions were 48 percent less likely over 10 years to experience dementia or cognitive decline.
Participants who took part in the other two training regimens, which focused on teaching strategies for remembering and for reasoning, were as a group slightly less likely than the control group to suffer cognitive decline or dementia over the study's 10-year span. That was particularly true for those who got 10 sessions to improve reasoning-strategies. But the results of those training regimens were less robust than those for the computerized training, and researchers could not rule out the possibility they were caused by chance.
In the ACTIVE trial, participants' cognitive health was measured at one, two, three, five and 10 years after initial training took place, using several standardized batteries. Researchers gauged participants' mood, confidence and self-rated health, and surveyed their ability to conduct such daily tasks as preparing meals, driving and taking care of finances.
The computerized brain-training exercise is commercially available as the "Double Decision" game, one of a suite of cognitive exercises marketed online by the San Francisco-based Posit Science Corp. The game exercises an individual's ability to detect, remember and respond to cues that appear and disappear quickly in varying locations on a computer screen. It uses colorful graphics and challenges players with escalating difficulty as their proficiency increases.
In an interview, University of California, San Francisco neuroscientist Michael Merzenich, chief scientific officer of Posit Science, said that the seemingly narrow skill of processing visual cues appears to be a pretty good indication of a person's overall cognitive health. The new study suggests that when visual processing skills are improved by programs designed to build up those mental "muscles," people not only perform better in tests of that specific skill, they get better at a wide range of complex behaviors, he said. The cognitive benefits, in short, appear to be "generalized."
For companies marketing computer-based brain-training programs, now a multimillion industry, claims of such generalized cognitive benefits have generated criticism and controversy. In 2014, neuroscientists gathered under the auspices of the Stanford Center on Longevity took the brain-training industry to task for promising results that were "frequently exaggerated and at times misleading."
Though such exercises can produce performance improvements in the lab, they wrote, "these small, narrow and fleeting advances are often billed as general and lasting improvements of mind and brain." Despite bold marketing claims, "compelling evidence of general and enduring positive effects on the way people's minds and brains age has remained elusive," they wrote in a December 2014 consensus statement.
University of South Florida associate professor Jerri Edwards, first author of the new study, said the ACTIVE study's findings appears to be a milestone - "the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomized, controlled trial."
Among the study's most intriguing findings, said Edwards, was the suggestion that with continued brain training - an increased dose - older people might further boost their protection against dementia.
"Next," she said, "we'd like to get a better grasp on what exactly is the right amount of cognitive training to get the optimal benefits."
The ACTIVE study was one of several unveiled Sunday in Toronto, where Alzheimer's disease researchers and activists met to review the progress of research into the disease.
Included in the findings presented Sunday was data suggesting that people whose work requires complex thinking and/or activities are better able to withstand the onset of Alzheimer's disease.
In one such study, researchers from the Wisconsin Alzheimer's Institute scanned the brains of 284 people in late middle age who were cognitively healthy, looking for injury to connective tissue that is a marker for Alzheimer's disease. Among those who showed evidence of the diseased "white matter," they found that those who worked primarily with other people, rather than with things or data, had maintained the highest cognitive function.
"These new data add to a growing body of research that suggests more stimulating lifestyles, including more complex work environments with other people, are associated with better cognitive outcomes in later life," said Maria C. Carrillo, chief science officer of the the Alzheimer's Association.

End of life plans added to healthy ageing study

Massey researchers have been surveying older people about their health and wellbeing for 10 years.

It is 10 years since Massey University researchers launched the first comprehensive survey to find out how well New Zealanders are ageing – now they want the next generation of people aged 55 and over to sign up.

01 aug 2016--The latest Health, Work and Retirement longitudinal survey, run by the Health in Ageing Research Team (HART) at Massey's School of Psychology, is the seventh since the project began 10 years ago. This year's 24-page multi-choice questionnaire has been updated to include new questions about dental health and end-of-life planning.
Researchers are hoping to recruit 4000 more people aged between 55 and 70 to take part in the study who were previously too young or have not been surveyed.
The survey was recently posted out to nearly 8000 households around the country from a selected pool across diverse geographic and socio-economic backgrounds, using the electoral role. Researchers are hoping for a strong uptake and are urging survey recipients to complete and return it as soon as possible.
Responses to survey questions provide valuable information about social connections, health, housing, work and other issues of growing older, researcher Dr Joanne Allen says. Reports – based on data from the surveys – are designed to provide information and insights to help shape and inform government policy and assist social agencies on issues affecting New Zealand's rapidly increasing ageing population.
The inclusion of end-of-life planning questions reflects changes in attitude towards the need for more open conversations on the topic.

Deeper understanding of what it's like to get older

The survey covers a wide range of themes including lifestyle and daily habits to how people perceive their lives and circumstances – from family and neighbourhood relationships to safety, medication and alcohol consumption, transport and even purpose in life and reasons for living.
"It gives us a view beyond the basic statistics – we can get an in-depth understanding of the experiences of getting older," Dr Allen says.
Results from three earlier (2010, 2012 and 2014) segments of the study have provided evidence for reports and policy recommendations on specific issues, such as being a caregiver, access to and use of the internet, the needs and concerns of older workers, housing, and survival and well-being after the Christchurch earthquakes.
HART co-leader Professor Christine Stephens says researchers are "very grateful to our participants who have been taking part in the surveys across ten years.
"They have contributed a rich source of information about the changing needs of older New Zealanders and we look forward to being in contact again. We are now seeking new participants around the ages of 55 to 56 to contribute the voices of the coming cohort of ageing New Zealanders to government and health policy."

Information on ageing valuable as NZ's 65+ population grows

The need for research is highlighted by growth of New Zealand's older population, she says, with the number of people aged 65 and over doubling between 1981 and 2013 – from 309,795 to 607,032 people – according to 2013 Census results released by Statistics New Zealand a year ago. This age group increased from 9.9 per cent to 14.3 per cent of the population in that period, and is projected to grow to 23.8 per cent in 30 years.
The Health and Aging Research Team's datasets comprise the Health, Work, and Retirement (HWR), New Zealand Longitudinal Study of Ageing (NZLSA) and Independence Contribution Connection (ICC) surveys. Their work is funded by the Ministry of Business, Innovation and Employment.
Some of the key findings from the HART surveys since 2006:

• Lower living standards equate with poorer health.
• Living standards affect all aspects of health and wellbeing, including a link between poverty and loneliness.
• Older people with vision impairments experience poorer economic, physical, and mental health status, lack of social support, and greater social isolation.
• Mobility is a key factor for the quality of life among older visually impaired people.
• Volunteering is related to increased happiness. People with lower living standards who volunteer have levels of happiness almost as high as people with high living standards. But it is more difficult for older people with low living standards to do volunteering.
• Types of social networks are related to the types of social support that they receive, and is related in turn to both physical and mental health.
• The internet is important for nurturing social networks that contribute to health and wellbeing in older age. The internet is used by over 80 per cent of older people and most often used for social reasons, though not to make new friends – largely to support existing social networks.
• Housing, and the differences in health between renters and homeowners: renters reported lower quality of life and higher levels of depression. Gaps widened over time: over four years the home owners' mental health improved, while the renters' poorer mental health remained the same.
• Home owners who reported loneliness did not experience changes in health. But loneliness for renters was associated with worsening mental and physical health over four years.
• Older caregivers cope better and report better health, greater life satisfaction and less loneliness when they are financially better off. Only a quarter of working caregivers are aware of their rights to caregiving leave, while one third use sick leave, unpaid leave and annual leave to care for others.

More information: Check the HART website for more information: www.massey.ac.nz/massey/learning/departments/school-of-psychology/research/hart/hart_home.cfm


Provided by Massey University