Four keys to healthy aging

by Florida International University

Credit: Unsplash/CC0 Public Domain

The "secrets" to healthy aging are anything but secret. They're the conventional medical recommendations most people will hear from their doctor at a typical checkup: exercise, eat a healthy diet and keep up-to-date with your doctors' visits and vaccinations.

26 sep 2021--Each year, more evidence emerges to help us determine what that healthy diet should look like and how much exercise is enough to age better and live longer.

"You need to do more exercise than you think," says Dr. Jorge Camilo Mora, director of geriatric medical education at the Herbert Wertheim College of Medicine.

Thirty minutes of exercise five days a week has traditionally been the recommendation for adults. But Mora said many people don't realize their daily walks are probably not enough.

"Exercise has to be more intense than a walk," he said. "Ideally, it would combine flexibility, strength, and balance."

A moderate-intensity, brisk 30-minute walk five days a week, plus a muscle-strengthening workout twice a week meets the Centers for Disease Control's recommendations, for example.

For diet, Mora recommends moving toward more plant-based meals. That is, getting more of your daily nutrition from fruits and vegetables and less of it from meat.

Adopting a plant-based diet is associated with a reduced risk of type 2 diabetes, cancer, heart disease and Alzheimer's disease, according to a 2020 article published in the Journal of the American College of Nutrition.

Mora notes that people who live in "Blue Zones," the parts of the world where people live longest, tend to eat diets rich in plant-based foods. These people have a much higher-than-average number of centenarians—people who live to 100 years or more. Why not borrow a bit of their wisdom and incorporate more vegetarian meals into your diet?

As we observe Healthy Aging Month this September, here are Mora's tips:

• Exercise! At least 150 minutes per week of moderate-intensity activity. Try to find activities that will also work on your strength and flexibility.
• Eat more plant-based foods rich in antioxidants and vitamins.
• Get your COVID-19 booster shot around 6 months after your completed dose. Not only are older adults more susceptible to the novel coronavirus, but their immune response to the vaccine is less than in younger people.
• Get social! Social isolation is a risk factor similar to smoking in older adults. Mora's advice? Join a group exercise class—You'll meet your exercise goals AND keep up your social life.
  

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More information: Hana Kahleova et al, Plant-Based Diets for Healthy Aging, Journal of the American College of Nutrition (2020). DOI: 10.1080/07315724.2020.1790442

Provided by Florida International University

 

New non-drug treatment holds promise for preventative therapies for Alzheimer's

by Tel Aviv University

Figure 1. HBOT reduces amyloid plaques in the hippocampal area of 6-month old 5XFAD mice. Amyloid plaques were visualized by immunostaining with anti-Aβ antibodies (4G8). (A) Representative images of Aβ in the hippocampal field of HBO-treated 5XFAD (n=10, lower panel) and control 5XFAD mice (n=10, upper panel); left and middle panels, x4 magnification, scale bar: 1000 μm; right panel, x20 magnification, scale bar: 200 μm. (B) Quantification of the percentage of hippocampal area occupied by plaques. (C) Number of plaques. (D) Mean size of plaques. (E, F) Soluble Aβ was initially extracted from hippocampi with TBS by ultracentrifugation and then insoluble Aβ was extracted with 70% formic acid (FA) after ultra-centrifugation. ELISA analysis of soluble (E) and insoluble (F) Aβ40 and Aβ42 in hippocampal lysates of HBO-treated 5XFAD and control 5XFAD mice (n = 5/group). (B, C, F) -t-test, (D, F)- welch correction t-test. Values represent means ± SEM. *P < 0.05, ** P < 0.01. Credit: DOI: 10.18632/aging.203485

Approximately 50 million people worldwide live with Alzheimer's or other related forms of dementia. Alzheimer's disease leads to memory loss and impairment in cognitive function, and is the most common cause of dementia among older adults. While certain treatments can help reduce symptoms and sometimes reduce disease progression, there is currently no way to prevent or cure Alzheimer's.

26 sep 2021--Amid that backdrop, researchers from Tel Aviv University have developed a process for reversing the precursors of the disease, providing a promising foundation for new preventative therapies. This marks the first time that a non-drug therapy has proven effective in preventing the core biological processes that lead to the development of Alzheimer's, providing hope that we will now be able to fight one of the greatest challenges to the Western world.

Targeting the root of Alzheimer's

Using hyperbaric oxygen therapy (HBOT), in which subjects breathe 100% oxygen in a special chamber of high atmospheric pressure, the researchers were able to reverse brain damages associated with the biological hallmarks of Alzheimer's.

"By treating the root problem that causes cognitive deterioration with age, we are in fact mapping out the way to prevention," says co-lead researcher Prof. Shai Efrati.

Often used to treat carbon monoxide poisoning and infections that starve tissues of oxygen, hyperbaric therapy, when applied in a specific way, has previously been found capable of repairing damaged brain tissue and renewing growth of blood vessels and nerve cells in the brain. Therefore, the researchers tested its potential for Alzheimer's.

"After a series of hyperbaric treatments, elderly patients who were already suffering from memory loss showed an improvement of blood flow to the brain as well as a real improvement in cognitive performance," said co-lead investigator Prof. Uri Ashery.

The new approach devised by the researchers unequivocally improved characteristics commonly associated with Alzheimer's disease. Specifically, the hyperbaric treatment resulted in:

• Improved memory in 16.5% of patients on average
• Increased blood flow in 16%-23% of cases
• Improved attention and concentration in 6% of patients
• Improved information processing speed in 10.3% of all cases

A future without Alzheimer's?

"Our findings provide hope that we will now be able to fight one of the greatest challenges to the Western world. According to our findings, hyperbaric therapy given at a young age is likely to prevent this severe disease entirely," explains TAU team member Dr. Ronit Shapira.

The approach was first tested in laboratory settings followed by testing in patients over the age of 65 in stages of deteriorating mental function that often precede Alzheimer's and dementia. The therapy included a series of 60 treatments in hyperbaric chambers over a period of 90 days.

The study is part of a comprehensive research program focused on reversing processes of aging and its accompanying ailments. The researchers note that the findings are an encouraging step toward new approaches to preventing Alzheimer's by addressing not only the symptoms or targeting biomarkers, but the core pathology and biology responsible for the disease's development.

The findings were published in the journal Aging.

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More information: Ronit Shapira et al, Hyperbaric oxygen therapy alleviates vascular dysfunction and amyloid burden in an Alzheimer's disease mouse model and in elderly patients, Aging (2021). DOI: 10.18632/aging.203485

Provided by Tel Aviv University 

 

Postural hypotension in older adults related to poor cognition

by Karolinska Institutet

Credit: Gerd Altmann (Pixabay)

Postural hypotension, a drastic drop in blood pressure when standing up, is linked to an increased risk of dementia and accelerated progression from cognitive impairment to dementia, even in the absence of symptoms, for instance when feeling dizzy or faint. In a study published in the journal Hypertension, researchers from Karolinska Institutet show that postural hypotension could anticipate worse cognition in old age.

26 sep 2021--Postural hypotension has already been linked with falls and cardiovascular disease. The study further showed that postural hypotension, even asymptomatic, could anticipate worse cognition in old age.

Potential implications for the public

"Older adults should actively assess their postural blood pressure to detect this condition and implement a timely intervention," says Xin Xia, Ph.D. student at the Aging Research Center, Departmant of Neurobiology, Care Sciences and Society, and co-author of the study.

This is particularly relevant since postural hypotension is usually asymptomatic, and many older adults with this condition may not seek medical help. The study shows that postural hypotension, even asymptomatic, appears to be harmful to cognitive function (for example memory and thinking) among older adults. This has potential implications for health care practice.

"Healthcare professionals should pay attention to the detection of postural hypotension and offer advice for timely intervention, if postural hypotension is detected," Xin Xia says.

Population-based cohort study

The study used data from from the Swedish National study on Aging and Care in Kungshomen (SNAC-K), where approximately 2500 subjects (age ≥60 years) were regularly followed. At the beginning of the follow-up, the physicians measured the participants' blood pressure when they lie down and then when they stand up after lying down for five minutes.

The drop in blood pressure was calculated when the participants stood up. The participants were then divided into two groups, one group with postural hypotension, and one without. The participants were followed for approximately 12 years, period after which the dementia risk was compared between the two groups. Later on, the subjects were divided into three groups, one group without postural hypotension, one with symptom-free postural hypotension and one with symptomatic hypotension, and subsequently their dementia risk was compared.

What happens now?

Postural hypotension in older adults may reflect poor cardiovascular health, which is what Xin Xia's research project is focused on.

"In the next step, we plan to further evaluate if ideal cardiovascular health is related to better cognitive function and a reduced risk of dementia in older adults," Xin Xia says.

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More information: Xin Xia et al, From Normal Cognition to Cognitive Impairment and Dementia: Impact of Orthostatic Hypotension, Hypertension (2021). DOI: 10.1161/HYPERTENSIONAHA.121.17454

Provided by Karolinska Institutet 

 

Using internet in retirement boosts cognitive function

by Lancaster University

Credit: Unsplash/CC0 Public Domain

Using the internet during your retirement years can boost your cognitive function, a new study has found.

26 sep 2021--Researchers from Lancaster University Management School, the Norwegian University Science and Technology and Trinity College Dublin examined the cognitive function of more than 2,000 retired people from across Europe, and found that post-retirement internet usage is associated with substantially higher scores on tests.

The study, published in the Journal of Economic Behavior and Organization, uses data drawn from the Survey of Health, Aging and Retirement in Europe (SHARE) that collects information about the health, employment history and socio-economic status of older people.

Focusing on a sample of 2,105 older people from Austria, Belgium, Denmark, France, Germany, Italy, Israel, Spain, Sweden and Switzerland who have been retired since 2004, researchers examined retirees' cognitive function in both 2013 and 2015. They specifically focused on a word recall test, where individuals were asked to recall a list of 10 words immediately, and then again five minutes later.

Results found that, on average, people who used the internet after they retired were able to recall 1.22 extra words in the recall test compared to non-internet users. However, retirees who used the internet were also more likely to be male, younger, better educated, and have been retired for a shorter period. They also appear to be in better health—even though they drink and smoke more.

Dr. Vincent O'Sullivan, a co-author from Lancaster University Management School said: "Our results reveal that using the internet, post-retirement, leads to a marked reduction in the rate of cognitive decline.

"Interestingly, this protective effect was found to be most significant amongst women, with female retirees who regularly surfed the internet able to recall 2.37 more words compared to women who didn't go online. The results were also consistent among men, with retired internet users able to recall 0.94 more words than men with similar characteristics who didn't use the internet.

"We also found that retirees who used computers in their jobs before retirement were more likely to keep using computers once they retired, and hence had better cognitive function."

Researchers compared the cognitive function of retirees who used to work in jobs where computers were commonplace to retirees who worked in jobs where computers weren't often used. For example, among teachers, computers became common in the workplace much later than sectors such as financial services. Their results revealed that people with pre-retirement exposure to computers were more likely to continue to use them once they retired.

Among the overall results, the researchers also found a stark difference in the patterns of internet usage between European countries, with no more than 12% of retirees using the internet in Italy, compared to over 60% in Denmark.

"Research has shown that retirement from the workforce is a critical period for cognitive function, which declines with age and can be a predictor for a range of key health outcomes among older people," said co-author Likun Mao, formerly a Ph.D. student at Lancaster but now at Trinity College Dublin. "Although there is a widespread belief that computer usage improves older people's cognitive function—such as memory, attention, spatial abilities and problem solving—there has been mixed evidence from previous studies.

"We were able to discern that pre-retirement computer usage does not directly influence post-retirement cognitive decline, and we ensured our results referred only to post-retirement internet usage."

Professor Colin Green, of the Norwegian University Science and Technology, added: "Within our study we estimated statistical models which controlled for individuals' ages, education levels, occupational skills and years since retirement, so we are confident that our results are robust and relate only to the use of the internet, post retirement.

"This sets it apart from other studies and raises the interesting question of what it is about internet use exactly, that drives this positive effect on cognitive function. Interacting with others online, finding out information in order to attend social activities or simple tasks like shopping online can all make life easier for retirees, but we are yet to understand which, if any, of these tasks actually go as far as improving cognitive performance."

More information: Colin P. Green et al, Internet usage and the cognitive function of retirees, Journal of Economic Behavior & Organization (2021). DOI: 10.1016/j.jebo.2021.08.013

Provided by Lancaster University 

 

MIND diet linked to better cognitive performance

by Rush University Medical Center

Credit: CC0 Public Domain

Aging takes a toll on the body and on the mind. For example, the tissue of aging human brains sometimes develops abnormal clumps of proteins that are the hallmark of Alzheimer's disease. How can you protect your brain from these effects?

26 sep 2021--Researchers at Rush University Medical Center have found that older adults may benefit from a specific diet called the MIND diet even when they develop these protein deposits, known as amyloid plaques and tangles. Plaques and tangles are a pathology found in the brain that build up in between nerve cells and typically interfere with thinking and problem-solving skills.

Developed by the late Martha Clare Morris, ScD, who was a Rush nutritional epidemiologist, and her colleagues, the MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Previous research studies have found that the MIND diet may reduce a person's risk of developing Alzheimer's disease dementia.

Now a study has shown that participants in the study who followed the MIND diet moderately later in life did not have cognition problems, according to a paper published on Sept. 14 in the Journal of Alzheimer's Disease.

"Some people have enough plaques and tangles in their brains to have a postmortem diagnosis of Alzheimer's disease, but they do not develop clinical dementia in their lifetime," said Klodian Dhana, MD, Ph.D., lead author of the paper and an assistant professor in the Division of Geriatrics and Palliative Medicine in the Department of Internal Medicine at Rush Medical College .

"Some have the ability to maintain cognitive function despite the accumulation of these pathologies in the brain, and our study suggests that the MIND diet is associated with better cognitive functions independently of brain pathologies related to Alzheimer's disease.

In this study, the researchers examined the associations of diet—from the start of the study until death—brain pathologies and cognitive functioning in older adults who participated in the Rush Alzheimer's Disease Center's ongoing Memory and Aging Project, which began in 1997 and includes people living in greater Chicago. The participants were mostly white without known dementia, and all of them agreed to undergo annual clinical evaluations while alive and brain autopsy after their death.

The researchers followed 569 participants, who were asked to complete annual evaluations and cognitive tests to see if they had developed memory and thinking problems. Beginning in 2004, participants were given an annual food frequency questionnaire about how often they ate 144 food items in previous year.

Using the questionnaire answers, the researchers gave each participant a MIND diet score based on how often the participants ate specific foods. The MIND diet has 15 dietary components, including 10 "brain-healthy food groups" and five unhealthy groups—red meat, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.

To adhere to and benefit from the MIND diet, a person would need to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day—along with a glass of wine—snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week. A person also must limit intake of the designated unhealthy foods, limiting butter to less than 1 1/2 teaspoons a day and eating less than a serving a week of sweets and pastries, whole fat cheese, and fried or fast food.

Based on the frequency of intake reported for the healthy and unhealthy food groups, the researchers calculated the MIND diet score for each participant across the study period. An average of the MIND diet score from the start of the study until the participant's death was used in the analysis to limit measurement error. Seven sensitivity measures were calculated to confirm accuracy of the findings.

"We found that a higher MIND diet score was associated with better memory and thinking skills independently of Alzheimer's disease pathology and other common age-related brain pathologies. The diet seemed to have a protective capacity and may contribute to cognitive resilience in the elderly." Dhana said.

"Diet changes can impact cognitive functioning and risk of dementia, for better or worse," he continued. "There are fairly simple diet and lifestyle changes a person could make that may help to slow cognitive decline with aging, and contribute to brain health."

More information: Klodian Dhana et al, MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults, Journal of Alzheimer's Disease (2021). DOI: 10.3233/JAD-210107

Provided by Rush University Medical Center 

 

Important signs of blood clots in the lungs missed in patients with dementia

by University of California, Los Angeles

Credit: Pixabay/CC0 Public Domain

Patients with dementia who had signs and risk factors of a pulmonary embolism, or a blood clot in the lungs, were much less likely to be tested for pulmonary embolism than patients without dementia who had the same signs and risk factors. For example, physicians at baseline were about 1 percentage point less likely to test patients with dementia for pulmonary embolism than patients without dementia, and physicians were an additional 2.6 percentage points less likely to test patients with dementia who had an elevated heart rate—a possible sign of a pulmonary embolism—than to test those without dementia who had an elevated heart rate.

26 sep 2021--The researchers sought to determine if the presence of dementia makes a difference in how physicians evaluate patients with shortness of breath for their risk of a potentially fatal pulmonary embolism. Specifically, they examined if clinical signs and risk factors of pulmonary embolism, such as a prior history of blood clots, recent cancer, recent surgery, and elevated heart rate, were evaluated differently for patients with dementia.

The researchers studied 593,000 emergency department visits to 104 Veterans Affairs hospitals between 2011 and 2018. The sample included 7100 physicians. Patients were age 60 and older and presented with shortness of breath.

The researchers note that the study was observational and there may have been other, non-observable factors that contributed to these results. The data also did not include care wishes of patients or their caregivers, and the results may be specific to VA patients and physicians and not applicable to non-VA populations.

Physicians may miss factors associated with pulmonary embolisms, or fail to use these factors in making medical decisions, in patients who have dementia. An understanding of how physicians evaluate and make decisions in these circumstances may lead to improved care for patients with dementia.

The study is published in the peer reviewed Journal of the American Geriatrics Society.

More information: Dan P. Ly et al, How physicians evaluate patients with dementia who present with shortness of breath, Journal of the American Geriatrics Society (2021). DOI: 10.1111/jgs.17438

Provided by University of California, Los Angeles 

 

Intermittent fasting can help manage metabolic disease

by The Endocrine Society

Credit: CC0 Public Domain

Eating your daily calories within a consistent window of 8-10 hours is a powerful strategy to prevent and manage chronic diseases such as diabetes and heart disease, according to a new manuscript published in the Endocrine Society's journal, Endocrine Reviews.

26 sep 2021--Time-restricted eating is a type of intermittent fasting that limits your food intake to a certain number of hours each day. Intermittent fasting is one of the most popular diet trends, and people are using it to lose weight, improve their health and simplify their lifestyles.

"People who are trying to lose weight and live a healthier lifestyle should pay more attention to when they eat as well as what they eat. Time-restricted eating is an easy-to-follow and effective dietary strategy that requires less mental math than counting calories," said Satchidananda Panda, Ph.D., of the Salk Institute for Biological Studies in La Jolla, Calif. "Intermittent fasting can improve sleep and a person's quality of life as well as reduce the risk of obesity, diabetes and heart disease."

In the manuscript, the researchers explore the science behind time-restricted eating, recent clinical studies and the scope for future research to better understand its health benefits. Recent research has revealed that genes, hormones and metabolism rise and fall at different times of the 24-hour day. Aligning our daily habit of when we eat with the body's internal clock can optimize health and reduce the risk or disease burden of chronic conditions like diabetes, heart disease and liver disease.

"Eating at random times breaks the synchrony of our internal program and make us prone to diseases," said Panda. "Intermittent fasting is a lifestyle that anyone can adopt. It can help eliminate health disparities and lets everyone live a healthy and fulfilling life."

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More information: Emily Manoogian et al, Time-restricted eating for the prevention and management of metabolic diseases, Endocrine Reviews (2021). doi.org/10.1210/endrev/bnab027

Provided by The Endocrine Society

 

Pelvic floor experts issue new recommendations for magnetic resonance defecography

by Wolters Kluwer Health

Credit: CC0 Public Domain

Magnetic resonance defecography (MRD) has emerged as a powerful, noninvasive imaging technique to evaluate the many possible causes of problems in passing bowel movements. A new set of consensus recommendations for performing and interpreting the results of MRD has been published by Diseases of the Colon & Rectum (DC&R), the official journal of the American Society of Colon and Rectal Surgeons (ASCRS).

26 sep 2021--The recommendations were developed by the Pelvic Floor Disorders Consortium (PFDC), a multidisciplinary organization representing the wide range of professionals involved in diagnosis and treatment of pelvic floor disorders. The new recommendations are now available on the DC&R website and appear in the journal's October issue. Liliana Bordeianou, MD, MPH, of Massachusetts General Hospital Pelvic Floor Disorders Center and Harvard Medical School was senior author of the consensus statement.

Recommendations include consensus definitions and interpretation templates for MRD

Magnetic resonance defecography is a special type of MRI scan that provides detailed, high-contrast images of the complex anatomy of the pelvic floor. Images are obtained at various stages of defecation, providing detailed information for physicians to diagnose the cause of incontinence, constipation, pelvic organ prolapse, and other conditions that interfere with the ability to pass stool. Compared to other tests, MRD provides both functional and structural information in patients with symptoms of defecatory dysfunction

Previous guidelines for performing MRD have lacked input from the many specialties—including colon and rectal surgeons, gynecologists, radiologists, urologists, and others—involved in the diagnosis and treatment of pelvic floor disorders. Differences between and among specialties may lead to variations in how the physicians interpret and use the findings of MRD. That's a special concern in the care of patients with pelvic floor disorders, who often have complex symptoms and seek care from several different professionals.

The recommendations were developed "with the explicit goal of inviting and including representatives from all relevant clinical specialties for whom MRD holds clinical significance," according to the new statement. The PFDC Working Group comprised an international roster of 24 multidisciplinary experts, who followed a formal process to develop and approve consensus recommendations in key areas.

The recommendations address important factors in performing the MRD technique, including patient positioning and the use of contrast material to provide high-quality images of the pelvic floor anatomy and function. The Working Group emphasizes the importance of education and coaching to ensure that patients understand and can follow the maneuvers needed to perform the examination.

The new document includes recommendations for interpretation of MRD scans, enabling identification and grading of any abnormalities: For example, problems with movement of the pelvic floor muscles (dyssynergia) or abnormalities interfering with stool evacuation (such as rectocele, intussusception, or rectal prolapse).

Figures and videos illustrating the MRD appearance of these findings are included in the print and online versions of the new document. The report also presents a standard template for reporting the findings and interpretation of the MRD, with the goal of promoting shared understanding and improved communication among all professionals involved in the care of patients with pelvic floor disorders. Endorsed by six national and international medical societies including ASCRS, the consensus statement is being simultaneously published in four leading specialty journals.

"The goal of this effort was to create a universal set of recommendations and language for MRD technique, interpretation, and reporting that can be utilized and carry the same significance across disciplines," Dr. Bordeianou and coauthors conclude. While the recommendations are not comprehensive, they "should be advocated as the minimum requirements when performing and interpreting MRD in patients with evacuation disorders of the pelvic floor."

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More information: Brooke H. Gurland et al, Consensus Definitions and Interpretation Templates for Magnetic Resonance Imaging of Defecatory Pelvic Floor Disorders, Diseases of the Colon & Rectum (2021). DOI: 10.1097/DCR.0000000000002155