Diet soda linked to increases in belly fat in older adults

19 mar 2015--A new study published in the Journal of the American Geriatrics Society shows that increasing diet soda intake is directly linked to greater abdominal obesity in adults 65 years of age and older. Findings raise concerns about the safety of chronic diet soda consumption, which may increase belly fat and contribute to greater risk of metabolic syndrome and cardiovascular diseases.

Metabolic syndrome—a combination of risk factors that may lead to high blood pressure, diabetes, heart disease, and stroke—is one of the results of the obesity epidemic. In fact, the World Health Organization (WHO) estimates that 1.9 billion adults were overweight (body mass index [BMI] of 25 or more) in 2014. Of this group, 600 million people fell into the obese range (BMI of 30 or more)—a figure that has more than doubled since 1980.

In an effort to combat obesity, many adults try to reduce sugar intake by turning to nonnutritive or artificial sweeteners, such as aspartame, saccharin, or sucralose. Previous research shows that in the past 30 years, artificial sweeteners and diet soda intake have increased, yet the prevalence of obesity has also seen a dramatic increase in the same time period. Many of the studies exploring diet soda consumption and cardiometabolic diseases have focused on middle-aged and younger adults.

"Our study seeks to fill the age gap by exploring the adverse health effects of diet soda intake in individuals 65 years of age and older," explains lead author Sharon Fowler, MPH, from the University of Texas Health Science Center at San Antonio. "The burden of metabolic syndrome and cardiovascular disease, along with healthcare costs, is great in the ever-increasing senior population."

The San Antonio Longitudinal Study of Aging (SALSA) enrolled 749 Mexican- and European-Americans who were aged 65 and older at the start of the study (1992-96). Diet soda intake, waist circumference, height, and weight were measured at study onset, and at three follow-ups in 2000-01, 2001-03, and 2003-04, for a total of 9.4 follow-up years. At the first follow-up there were 474 (79.1%) surviving participants; there were 413 (73.4%) at the second follow-up and 375 (71.0%) at the third follow-up.

Findings indicate that the increase in waist circumference among diet soda drinkers, per follow-up interval, was almost triple that among non-users: 2.11 cm versus 0.77 cm, respectively. After adjustment for multiple potential confounders, interval waist circumference increases were 0.77 cm for non-users, 1.76 cm for occasional users, and 3.04 cm for daily users. This translates to waist circumference increases of 0.80 inches for non-users, 1.83 inches for occasional users, and 3.16 inches for daily users over the total 9.4-year SALSA follow-up period.

"The SALSA study shows that increasing diet soda intake was associated with escalating abdominal obesity, which may increase cardiometabolic risk in older adults," Fowler concludes. The authors recommend that older individuals who drink diet soda daily, particularly those at high cardiometabolic risk, should try to curb their consumption of artificially sweetened drinks.

More information: "Diet Soda Intake Is Associated with Long-Term Increases in Waist Circumference in a Biethnic Cohort of Older Adults: The San Antonio Longitudinal Study of Aging." Sharon P.G. Fowler, Ken Williams and Helen P. Hazuda.Journal of the American Geriatrics Society; Published Online: March 17, 2015 .DOI: 10.1111/jgs.13376)

Provided by Wiley

New MIND diet may significantly protect against Alzheimer's disease

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

18mar 2015--A new diet, appropriately known by the acronym MIND, could significantly lower a person's risk of developing Alzheimer's disease, even if the diet is not meticulously followed, according to a paper published online for subscribers in March in the journal Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

Rush nutritional epidemiologist Martha Clare Morris, PhD, and colleagues developed the "Mediterranean-DASH Intervention for Neurodegenerative Delay" (MIND) diet. The study shows that the MIND diet lowered the risk of AD by as much as 53 percent in participants who adhered to the diet rigorously, and by about 35 percent in those who followed it moderately well.

"One of the more exciting things about this is that people who adhered even moderately to the MIND diet had a reduction in their risk for AD," said Morris, a Rush professor, assistant provost for Community Research, and director of Nutrition and Nutritional Epidemiology. "I think that will motivate people."

Morris and her colleagues developed the MIND diet based on information that has accrued from years' worth of past research about what foods and nutrients have good, and bad, effects on the functioning of the brain over time. This is the first study to relate the MIND diet to Alzheimer's disease.

"I was so very pleased to see the outcome we got from the new diet," she said.

The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, both of which have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke. Some researchers have found that the two older diets provide protection against dementia as well.

In the latest study, the MIND diet was compared with the two other diets. People with high adherence to the DASH and Mediterranean diets also had reductions in AD—39 percent with the DASH diet and 54 percent with the Mediterranean diet—but got negligible benefits from moderate adherence to either of the two other diets.

The MIND diet is also easier to follow than, say, the Mediterranean diet, which calls for daily consumption of fish and 3-4 daily servings of each of fruits and vegetables, Morris said.

The MIND diet has 15 dietary components, including 10 "brain-healthy food groups"—green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine—and five unhealthy groups that comprise red meats, butter and stick margarine, cheese, pastries and sweets, and fried or fast food.

With the MIND diet, a person who eats at least three servings of whole grains, a salad and one other vegetable every day—along with a glass of wine—snacks most days on nuts, has beans every other day or so, eats poultry and berries at least twice a week and fish at least once a week and benefit. However, he or she must limits intake of the designated unhealthy foods, especially butter (less than 1 tablespoon a day), cheese, and fried or fast food (less than a serving a week for any of the three), to have a real shot at avoiding the devastating effects of AD, according to the study.

Berries are the only fruit specifically to make the MIND diet. "Blueberries are one of the more potent foods in terms of protecting the brain," Morris said, and strawberries have also performed well in past studies of the effect of food on cognitive function.

The MIND diet was not an intervention in this study, however; researchers looked at what people were already eating. Participants earned points if they ate brain-healthy foods frequently and avoided unhealthy foods. The one exception was that participants got one point if they said olive oil was the primary oil used in their homes.

The study enlisted volunteers already participating in the ongoing Rush Memory and Aging Project (MAP), which began in 1997 among residents of Chicago-area retirement communities and senior public housing complexes. An optional "food frequency questionnaire" was added from 2004 to February 2013, and the MIND diet study looked at results for 923 volunteers. A total of 144 cases of AD developed in this cohort.

AD, which takes a devastating toll on cognitive function, is not unlike heart disease in that there appear to be "many factors that play into who gets the disease," including behavioral, environmental and genetic components, Dr. Morris said.

"With late-onset AD, with that older group of people, genetic risk factors are a small piece of the picture," she said. Past studies have yielded evidence that suggests that what we eat may play a significant role in determining who gets AD and who doesn't, Morris said.

When the researchers in the new study left out of the analyses those participants who changed their diets somewhere along the line—say, on a doctor's orders after a stroke—they found that "the association became stronger between the MIND diet and [favorable] outcomes" in terms of AD, Morris said. "That probably means that people who eat this diet consistently over the years get the best protection."

In other words, it looks like the longer a person eats the MIND diet, the less risk that person will have of developing AD, Morris said. As is the case with many health-related habits, including physical exercise, she said, "You'll be healthier if you've been doing the right thing for a long time."

Morris said, "We devised a diet and it worked in this Chicago study. The results need to be confirmed by other investigators in different populations and also through randomized trials." That is the best way to establish a cause-and-effect relationship between the MIND diet and reductions in the incidence of Alzheimer's disease, she said.

Provided by Rush University Medical Center

The 10-point guide to the integral management of menopausal health

Elsevier journal Maturitas, today announced the publication of a position statement by the European Menopause and Andropause Society (EMAS) covering the ten- point guide to the integral management of menopausal health. This has been written to mark the 10th EMAS Congress in Madrid May 20-22, 2015.

17 mar 2015--With increased longevity and more women becoming centenarians, management of the menopause and post-reproductive health is of growing importance as it has the potential to help promote health over several decades. Women have individual needs and the approach needs to be personalized. The position statement provides a short integral guide for all those involved in menopausal health.

For most women the menopause is a natural and inevitable process due to ovarian ageing which usually occurs in women in their late 40s or early 50s. However, it can be induced earlier by medical intervention such as bilateral oophorectomy or iatrogenic ablation of ovarian function by chemotherapy, radiotherapy or treatment with gonadotrophin-releasing hormone analogues. Discussions with patients about the menopause are becoming more complex because of the wide range of therapeutic options, the controversies regarding menopausal hormone therapy and the increasing use of alternative and complementary therapies.

EMAS is therefore producing a simple ten point guide to help physicians and allied health professionals from all specialties deal with menopausal and post-reproductive health. It covers diagnosis, screening for diseases in later life, treatment and follow up.

It must be remembered that women have individual needs and the approach needs to be personalized.

These and other recommendations presented in EMAS' position statement are published in the article: "EMAS Position statement: the ten point guide to the integral management of menopausal health" (doi:10.1016/j.maturitas.2015.02.003) inMaturitas published by Elsevier.

Provided by Elsevier

Healthy eating, exercise, and brain-training

A comprehensive programme providing older people at risk of dementia with healthy eating guidance, exercise, brain training, and management of metabolic and vascular risk factors appears to slow down cognitive decline, according to the first ever randomised controlled trial of its kind, published in The Lancet.

16 mar 2015--In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, researchers led by Professor Miia Kivipelto from the Karolinska Institutet in Stockholm, Sweden, National Institute for Health and Welfare in Helsinki, and University of Eastern Finland, assessed the effects on brain function of a comprehensive intervention aimed at addressing some of the most important risk factors for age-related dementia, such as high body-mass index and heart health.

1260 people from across Finland, aged 60-77 years, were included in the study, with half randomly allocated to the intervention group, and half allocated to a control group, who received regular health advice only. All of the study participants were deemed to be at risk of dementia, based on standardised test scores.

The intensive intervention consisted of regular meetings over two years with physicians, nurses, and other health professionals, with participants given comprehensive advice on maintaining a healthy diet, exercise programmes including both muscle and cardiovascular training, brain training exercises, and management of metabolic and vascular risk factors through regular blood tests, and other means.

After two years, study participants' mental function was scored using a standard test, the Neuropsychological Test Battery (NTB), where a higher score corresponds to better mental functioning. Overall test scores in the intervention group were 25% higher than in the control group. For some parts of the test, the difference between groups was even more striking—for executive functioning (the brain's ability to organise and regulate thought processes) scores were 83% higher in theintervention group, and processing speed was 150% higher. Based on a pre-specified analysis, the intervention appeared to have no effect on patients' memory. However, based on post-hoc analyses, there was a difference in memory scores between the intervention and control groups.

According to Professor Kivipelto, "Much previous research has shown that there are links between cognitive decline in older people and factors such as diet, heart health, and fitness. However, our study is the first large randomised controlled trial to show that an intensive programme aimed at addressing these risk factors might be able to prevent cognitive decline in elderly people who are at risk of dementia."

The study participants will now be followed for at least seven years to determine whether the diminished cognitive decline seen in this trial is followed by reduced levels of dementia and Alzheimer's diagnoses. The researchers will also be investigating possible mechanisms whereby the intervention might affect brain function.

More information: The Lancet, www.thelancet.com/journals/lan… (15)60461-5/abstract

Provided by Lancet

'Perfect storm' of stress, depression may raise risk of death, heart attack for heart patients

The combination of stress and heavy depression can significantly increase heart patient's risk of death or heart attack, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

15 mar 2015--The study examined the effect of high stress levels and high depressive symptoms among nearly 5,000 heart patients. Researchers concluded that risk is amplified when both conditions are present, thus validating the concept of a "psychosocial perfect storm."

"The increase in risk accompanying high stress and high depressive symptoms was robust and consistent across demographics, medical history, medication use and health risk behaviors," said Carmela Alcántara, Ph.D., lead author of the study and associate research scientist at Columbia University Medical Center for Behavioral Cardiovascular Health in New York.

Study participants included 4,487 coronary heart disease patients, 45 years and older, enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.

During in-home examinations and self-administered questionnaires from 2003-07, participants were asked how often during the past week they felt depressed, lonely or sad, or had crying spells. To determine stress levels, participants were asked how often during the past month they felt they were unable to control important things in their lives, felt overwhelmed, felt confidence in their ability to handle personal problems and felt things were going their way.

About 6 percent reported both high stress and high depression.

During an average six-year follow-up, 1,337 deaths or heart attacks occurred. Short-term risk of death or heart attack increased 48 percent for those in the high stress-high depressive symptoms group compared with those in the low stress-low depressive symptoms group.

The elevated risk was most strongly associated with death rather than heart attack; additional result suggest the deaths may have been cardiovascular-related, but more research is needed, researchers said. The risk was significant only during the first two-and-half years from the initial home visit, and wasn't significant for those experiencing either high stress or high depressive symptoms alone, but not both at the same time.

Study findings may challenge traditional research paradigms that only focus on depression and its impact on patients with heart disease, Alcántara said. Behavioral interventions also should be considered to help heart disease patients manage both stress and depression better.

Provided by American Heart Association

Exercise may help keep seniors moving longer despite old age brain decline

Credit: Peter Griffin/public domain

13 mar 2015--Older people who are physically active may be protecting themselves from the effects of small areas of brain damage that can affect their movement abilities, according to a new study published in the March 11, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology.

Many older people have small areas of damage in their brains seen on magnetic resonance imaging (MRI) as white matter hyperintensities. Higher levels of this damage have been linked to more problems with movement, such as difficulty walking. But this new study found that people who were the most physically active did not have a drop-off in their movement abilities, even when they had high levels of brain damage.

"These results underscore the importance of efforts to encourage a more active lifestyle in older people to prevent movement problems, which is a major public health challenge," said study author Debra A. Fleischman, PhD, of Rush University Medical Center in Chicago. "Physical activity may create a 'reserve' that protects motor abilities against the effects of age-related brain damage."

The study involved 167 people with an average age of 80. The participants wore movement monitors on their wrists for up to 11 days to measure both exercise and non-exercise activity. They also took 11 tests of their movement abilities. MRI scans were used to determine the volume of white matter hyperintensities in the brain.

Compared to those at the 50th percent in activity level measured using the movement monitors, those in the top 10 percent had activity equal to walking at 2.5 mph for an additional 1.5 hours each day.

For the people in the top 10 percent, having greater amounts of brain damage did not change their scores on the movement tests. But for those at the 50th percent activity level, having greater amounts of brain damage was associated with significantly lower scores on the movement tests. For all the participants, the average score on the movement tests was 1.04. For people at the 50th percent activity level, scores ranged from 1.16 for those with the lowest amount of brain damage to 0.9 for those with the highest amount of brain damage. The detrimental effect was even stronger for those with the lowest levels of physical activity.

The results remained the same after researchers adjusted for other factors that could affect the relationship, such as body mass index (BMI), depression and vascular disease.

Fleischman noted that the study does not determine whether physical activity causes people to preserve their movement abilities; it only shows the association.

Provided by American Academy of Neurology

GPS technology provides peace of mind for families coping with dementia

Allison Warman wears a GPS device that tracks her movements to help her from getting lost during her regular walks through her Calgary neighbourhood. Warman is a participant in the Locator Device Project, a partnership between the U of A and AHS, that uses GPS technology to help families affected by dementia. Credit: Lyle Aspinall

13 mar 2015--It was a phone call that changed everything. Two years ago, while Allison Warman was driving from Edmonton to her house in Calgary, she became confused and disoriented to the point that she couldn't remember the way home.

She pulled over at the halfway point, in Red Deer, and called her husband Tim, who dropped everything to pick her up. It was the first warning sign something was wrong cognitively, a diagnosis that was later confirmed as dementia.

At just 53 years old, Allison—an active, vibrant mother of three and accomplished costume designer whose creations have been worn by figure skating champions Kurt Browning and  Kristi Yamaguchi, and the Alberta Ballet—is increasingly housebound, unable to work, drive or even read anything longer than a headline.

"It's been devastating to watch this happen to such an energetic and talented and creative person—she's always been an active person, doing things for people she loves—to have all that taken away from you is brutal," Tim says.

Not everything has been taken. Walking remains one of Allison's true passions, keeping her body and mind refreshed. But the risk of wandering or getting lost is a real concern for people with dementia.

Locator device project

Fortunately for Allison, Tim and the couple's teenaged children, she can continue going on her daily outings without fear, thanks to SafeTracks GPS technology in a phone-like device she wears around her neck. The device, and others like it worn in a shoe or as a watch, provide real-time location information viewable on Google Maps and can send text messages or emails to family if Allison veers outside a designated safe zone.

The device was given to Allison when she joined the Locator Device Project, a 12-month trial to evaluate GPS technology in preventing people with cognitive impairments from getting lost or wandering. The project is a partnership between the University of Alberta's Faculty of Rehabilitation Medicine and Alberta Health Services, with 40 participants from Calgary and Grande Prairie.

Allison Warman with a sample of her figure skating costume designs. Credit: Lyle Aspinall

"The technology provides peace of mind for families," says Lili Liu, lead researcher, professor and chair of the Department of Occupational Therapy. "Even if there is an accident or an incident, knowing that their loved one has a GPS device helps family members feel more at peace."

More than 40,000 Albertans have dementia of some form, and about three out of every five seniors with dementia living in the community experience wandering. The number of Alberta seniors with dementia is expected to exceed 100,000 by 2038.

"We have a responsibility to provide Albertans who are at risk with supports that will enable them to enjoy their independence without coming to harm," says Don Juzwishin, director of health technology assessment and innovation for AHS. "And we believe the locator project, which uses sophisticated GPS technology, will also support family caregivers and emergency responders to assist dementia clients who have wandered or become lost."

Liu's team, which includes several graduate students based in the Department of Occupational Therapy's satellite site in Calgary, has visited the homes of families participating in the project, answering questions and offering support. The data they're collecting are still being analyzed, but could be used to inform technology options for home-care clients and families.

To her knowledge, this is the first study of its kind in Canada, says Liu, and one she wants to eventually expand to a national level.

For the Warman family, participating in the study and using the technology has afforded Allison a precious sense of dignity.

"The best thing that has happened to her is being able to go out on her own and still be safe," says Tim, who believes the technology could benefit other individuals and families coping with dementia. "It contributes to her emotional well-being, just knowing that she is safe. It's empowering. It's just a wonderful thing."

Provided by University of Alberta

Healthy eating, exercise, and brain-training

A comprehensive programme providing older people at risk of dementia with healthy eating guidance, exercise, brain training, and management of metabolic and vascular risk factors appears to slow down cognitive decline, according to the first ever randomised controlled trial of its kind, published in The Lancet.

12 mar 2015--In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, researchers led by Professor Miia Kivipelto from the Karolinska Institutet in Stockholm, Sweden, National Institute for Health and Welfare in Helsinki, and University of Eastern Finland, assessed the effects on brain function of a comprehensive intervention aimed at addressing some of the most important risk factors for age-related dementia, such as high body-mass index and heart health.

1260 people from across Finland, aged 60-77 years, were included in the study, with half randomly allocated to the intervention group, and half allocated to a control group, who received regular health advice only. All of the study participants were deemed to be at risk of dementia, based on standardised test scores.

The intensive intervention consisted of regular meetings over two years with physicians, nurses, and other health professionals, with participants given comprehensive advice on maintaining a healthy diet, exercise programmes including both muscle and cardiovascular training, brain training exercises, and management of metabolic and vascular risk factors through regular blood tests, and other means.

After two years, study participants' mental function was scored using a standard test, the Neuropsychological Test Battery (NTB), where a higher score corresponds to better mental functioning. Overall test scores in the intervention group were 25% higher than in the control group. For some parts of the test, the difference between groups was even more striking—for executive functioning (the brain's ability to organise and regulate thought processes) scores were 83% higher in theintervention group, and processing speed was 150% higher. Based on a pre-specified analysis, the intervention appeared to have no effect on patients' memory. However, based on post-hoc analyses, there was a difference in memory scores between the intervention and control groups.

According to Professor Kivipelto, "Much previous research has shown that there are links between cognitive decline in older people and factors such as diet, heart health, and fitness. However, our study is the first large randomised controlled trial to show that an intensive programme aimed at addressing these risk factors might be able to prevent cognitive decline in elderly people who are at risk of dementia."

The study participants will now be followed for at least seven years to determine whether the diminished cognitive decline seen in this trial is followed by reduced levels of dementia and Alzheimer's diagnoses. The researchers will also be investigating possible mechanisms whereby the intervention might affect brain function.

More information: The Lancet, www.thelancet.com/journals/lan… (15)60461-5/abstract

Provided by Lancet

Apple highlights Parkinson's app

A new iPhone mobile app which allows patients with Parkinson's disease to track their symptoms in real time and share this information with researchers was featured by Apple executives today during the company's semi-annual product launch event.

11 mar 2015--"There is unmet demand for tools by which individuals can measure the course of their disease and receive feedback on how they're doing," said University of Rochester neurologists Ray Dorsey, M.D., M.B.A. "To have a dedicated Parkinson's disease app backed by research that will allow patients to engage with their care and receive feedback on their condition is amazing. To make that data in the aggregate available for research is heartening. Five years ago this would have been inconceivable."

The app, dubbed Parkinson mPower (Mobile Parkinson Observatory for Worldwide, Evidenced-based Research), was developed by Sage Bionetworks, non-profit research organization based in Seattle, in partnership with Dorsey and Karl Kieburtz, M.D., M.P.H. from the University of Rochester, and Max Little, Ph.D., a mathematician and lecturer at Aston University in the United Kingdom. mPower is available to download immediately at the Apple App Store.

The mPower app will be used as a part of an observational study that collects data from Parkinson's patients in an effort to more fully understand the disease and how it impacts daily life. The study is being funded by the Robert Wood Johnson Foundation.

Parkinson's disease is a progressive neurological disorder that erodes an individual's control over their movements and speech. Over time, individuals with Parkinson's disease experience stiffness or rigidity of the arms and legs, slowness or lack of movement, and walking difficulties, in addition to tremors in their hands, arms, legs, jaw or face. An estimated half a million Americans live with the disease.

The mPower study will gather real time data from volunteers who download the app and agree to participate in the study. The app will measure dexterity, balance and gait, voice, and memory at multiple times each day. For example, patients will use the app to record their voice. Subtle changes to the voice, including tremor and reduced amplitude have been shown to be an accurate way to measure the severity of symptoms. The app will can also measure dexterity by tracking how fast a person can tap the screen on their iPhone. The device's GPS and accelerometer can measure mobility and balance.

The data collected during the study will allow researchers to learn about the variations of Parkinson's disease and enable patients to measure how their symptoms change over time and in response to exercise and medication. The data will help researchers learn more about the natural history of the disease and what factors influence its effects. The app will also include a dashboard that allows patients to track their progress.

The approach will enable researchers to collect information on scale – both in terms of data points and number of participants – that has previously been unachievable, thereby providing them greater insight on the disease.

"Researchers who have made the effort to work together in the kinds of communities enabled by Sage's platforms are becoming massively more productive," said Stephen Friend, MD, PhD, president of Sage Bionetworks and mPower principal investigator. "But we need more data. In a traditional clinical study, you'd be thrilled to find 500 research 'subjects.' But imagine what is possible when you can quickly and reliably activate 20,000 research 'partners.' Similarly, gathering data a few times per year is the traditional gold standard, so imagine the possibilities when we are able to gather data continuously, all the time."

Sage Bionetworks has announced plans to collaborate with the Michael J. Fox Foundation to expand awareness of the study within the Parkinson's community and use the application to contribute to the Foundation's own efforts – called Fox Insight – to collect data and provide researchers with a more holistic view of the lived experience of people with Parkinson's disease.

Ultimately, the approach used by the mPower app – harnessing mobile technologies and monitoring systems to track disease progression – could eventually be used to transform patient care. Currently, people with Parkinson's tend to interact specialists in a very episodic manner – usually in the context of a semi-annual appointment – and physicians rely on subjective self-reporting to determine how the disease is progressing, how patients are responding to medications, and their quality of life.

"We know that Parkinson's disease symptoms fluctuate over the course of a day, or a week, but that has never been measured objectively," said Dorsey. "The mPower study will enable us to learn from patients, and we'll be able to give information back to patients so they can manage their conditions regardless of distance or disability."

mPower was one of a suite of disease-specific apps launched today that will help researchers better understand a number of conditions, including cardiovascular disease, breast cancer, diabetes, and asthma. The apps were unveiled during Apple's "Spring Forward" product launch event in San Francisco, which was followed live by a global audience.

mPower and the other apps were developed using ResearchKit, a software development framework designed by Apple that enables researchers to gather data more frequently and more accurately from study participants and allows volunteers to play a greater role in shaping research directions and outcomes.

Provided by University of Rochester Medical Center

Boosting older adults' vision through training

Just a weeks' worth of training can improve vision in older adults, according to new research in Psychological Science, a journal of the Association for Psychological Science. The findings show that training boosted older adults' sensitivity to contrast and also their ability to see things clearly at close distances.

10 mar 2015--"Our research indicates that the visual system of older adults maintains a high degree of plasticity and demonstrates that training methods can be used to improve visual function," explains psychological scientist G. John Andersen of the University of California, Riverside who co-authored the study with graduate student Denton DeLoss and colleague Takeo Watanabe of Brown University.

Age-related declines in vision and visual processing are common and they can have serious negative consequences for the health and well-being of older adults. Older adults are particularly likely to show declines in their ability to process low-contrast visual stimuli - for example, images that are grainy or not clearly defined. This decline hampers their ability to see visual detail, and can hinder their ability to process information that is important for both balance and driving.

While some age-related declines in vision can be traced to the eye itself, research suggests that decline in other aspects of vision are the result of changes in brain function, and DeLoss and colleagues wondered whether a training program that involved repeated exposure to specific stimuli might counteract these changes in brain function.

The researchers recruited 16 young adults (on average, about 22 years old) and 16 older adults (on average, about 71 years old) to participate in the study, all of whom were screened to ensure that they didn't show signs of cognitive decline or eye disease.

The participants came to the lab for 1.5-hour sessions over the course of 7 days. In general, each trial of the experiment involved looking at a striped visual stimulus and determining whether it was rotated clockwise or counterclockwise from its original orientation. The researchers varied the contrast of the stimulus across trials, altering how grainy or clear the image was.

Each day, the contrast threshold of the trials was calibrated to the participants' previous performance so that they were training near the limit of what they could reliably detect. Participants were exposed to 750 trials on each training day, for a total of 3,750 training trials over the course of the study.

The data showed that visual training effectively eliminated the age deficit in contrast sensitivity. At the beginning of the experiment, younger adults outperformed older adults on the task; but the older adults improved with training, showing performance similar to that of their younger peers by the end of the 7 days.

Further analyses confirmed that these improvements stemmed from changes in visual processing in the brain and not changes in the eye.

"We found that the training effect was not due to factors such as dilating the pupils to let in more light to the retina," explains Andersen.

Even more remarkable, both younger and older adults showed improvements in visual acuity when they were tested using an eye chart similar to the one at your doctor's office. At the end of training, older adults showed improvement in near acuity, or the ability to see things clearly when they are near; younger adults, on the other hand, showed improved ability to see things clearly when they are far.

"Given the short training period, the degree of improvement is quite impressive, particularly in the cases of near and far acuity, in which subjects were able to read an average of two to three additional letters on acuity charts after training," the researchers write.

It's important to note that these findings don't shed light on visual function among adults suffering from age-related eye diseases, such as glaucoma or macular degeneration. Nonetheless, the findings could have broad relevance for the many millions of adults who experience age-related decline in visual processing.

The researchers hope to further explore the mechanisms involved in perceptual learning and whether the effects of visual training carry over to real-world tasks, such as driving.

More information: Psychological Science, pss.sagepub.com/content/early/… 97614567510.abstract

Provided by Association for Psychological Science

Male smokers at higher risk than females for osteoporosis, fractures

In a large study of middle-aged to elderly smokers, men were more likely than women to have osteoporosis and fractures of their vertebrae. Smoking history and chronic obstructive pulmonary disease (COPD) were independent risk factors for low bone density among both men and women in the study, which has been published online in the Annals of the American Thoracic Society.

09 mar 2015--Current guidelines do not recommend osteoporosis screening for men. While current smoking is a recognized risk factor for osteoporosis, neither smoking history nor COPD are among criteria for bone-density screening.

"Our findings suggest that current and past smokers of both genders should be screened for osteoporosis," said Elizabeth Regan, MD, assistant professor of medicine at National Jewish Health. "Expanding screening to include men with a smoking history and starting treatment in those with bone disease may prevent fractures, improve quality of life and reduce health care costs."

The researchers, from National Jewish Health and other institutions, evaluated 3,321 current and ex-smokers ages 45 to 80, with a minimum of 10 pack-years of smoking history using quantitative CT to assess bone density. Overall, 11 percent of the study participants had normal bone density, 31 percent had intermediate bone density, and 58 percent had low bone density. Thirty-seven percent of the participants had one or more fractures of their vertebrae.

Men accounted for 55 percent of the smokers with low bone density and 60 percent of those with vertebral fractures.

Low-bone density increased in prevalence with worsening COPD, rising to 84 percent among severe COPD patients of both genders. COPD is the third leading cause of death in the United States and up to 49 percent of the population over 45 is a current or ex-smoker.

Each additional pack-year of smoking raised the odds of having low bone density by 0.4 percent. The participants with normal bone density had an average of 36.6 pack-year of smoking, while those with low bone density had an average of 46.9 pack-years of smoking history.

"The growing use of CT scans to screen heavy smokers for lung cancer may provide an opportunity to use the same scans for bone density screening in this high-risk population," said Dr. Regan.

Provided by National Jewish Health

Study shows poor heart function could be major risk for Alzheimer's disease

Heart diagram. Credit: Wikipedia

A healthier heart could prevent Alzheimer's disease, according to new research at Vanderbilt University Medical Center.

08 mar 2015--The study, published online Feb. 19 in Circulation, associates heart function with the development of dementia and Alzheimer's disease. Participants with decreased heart function, measured by cardiac index, were two to three times more likely to develop significant memory loss over the follow-up period.

"Heart function could prove to be a major risk factor for dementia and Alzheimer's disease," said Angela Jefferson, Ph.D., director of the Vanderbilt Memory & Alzheimer's Center, and principal investigator of the study.

"A very encouraging aspect of our findings is that heart health is a modifiable risk. You may not be able to change your genetics or family history, but you can engage in a heart healthy lifestyle through diet and exercise at any point in your lifetime."

The research used data from the Framingham Heart Study, an effort that began in 1948 to identify risk factors for heart disease. 1,039 participants from Framingham's Offspring Cohort were followed for up to 11 years to compare cardiac index to the development of dementia.

"Cardiac index is a measure of heart health. It reflects cardiac output or the amount of blood that leaves the heart and is pumped through the body taking into consideration a person's body size. A low cardiac index value means there is less blood leaving the heart," Jefferson said.

Over the study period, 32 participants developed dementia, including 26 cases of Alzheimer's disease. Compared to normal cardiac index, individuals with clinically low cardiac index had a higher relative risk of dementia.

"We thought heart disease might be driving the increased risk of dementia and Alzheimer's disease. When we excluded participants with heart disease and other heart conditions, we were surprised that the risk of dementia and Alzheimer's disease got even worse," Jefferson said.

Jefferson said the research community has long associated heart health with brain health, but cardiac index has not been previously recognized as a risk factor for significant memory loss or dementia.

"For the average adult, the brain accounts for 2 percent of overall body weight but receives as much as 15 percent of blood leaving the heart. If there are changes in the heart's ability to pump blood, the brain is resilient and does a great job at regulating blood flow to maintain a consistent level to support brain tissue and activity. But as we age, our vessels tend to be less healthy. They become less adaptable to blood flow changes, and those changes may affect brain health and function," she said.

"The risk we found between lower cardiac index and the development of dementia may reflect a subtle but protracted process that occurs over decades —essentially a lifetime burden of subtle reductions in oxygen and nutrient delivery to the brain. That possibility is concerning given the observation that one in three participants in our study met the medical definition for low cardiac index."

Jefferson emphasizes that this research points only to a risk factor.

"At present, there is no proven method for preventing dementia or Alzheimer's disease. But leading a heart healthy lifestyle could help. When 30 percent of the population is exposed to a potential risk factor, like low cardiac index, that suggests it may be of significant public health concern."

Provided by Vanderbilt University Medical Center

Time to 'just say no' to behavior-calming drugs for Alzheimer patients? Experts say yes

Various pills. Credit: Wikipedia

Doctors write millions of prescriptions a year for drugs to calm the behavior of people with Alzheimer's disease and other types of dementia. But non-drug approaches actually work better, and carry far fewer risks, experts conclude in a new report.

07 mar 2015--In fact, non-drug approaches should be the first choice for treating dementia patients' common symptoms such as irritability, agitation, depression, anxiety, sleep problems, aggression, apathy and delusions, say the researchers in a paper just published by the British Medical Journal.

The best evidence among non-drug approaches is for those that focus on training caregivers—whether they are spouses, adult children or staff in nursing homes and assisted living facilities—to make behavioral and environmental interventions.

The researchers, from the University of Michigan Medical School and Johns Hopkins University, reviewed two decades' worth of research to reach their conclusions about drugs like antipsychotics and antidepressants, and non-drug approaches that help caregivers address behavioral issues in dementia patients.

They lay out their findings along with a framework that doctors and caregivers can use to make the most of what's already known. Called DICE for Describe, Investigate, Evaluate, and Create, the framework tailors approaches to each person with dementia, and as symptoms change.

"The evidence for non-pharmaceutical approaches to the behavior problems often seen in dementia is better than the evidence for antipsychotics, and far better than for other classes of medication," says first author Helen C. Kales, M.D., head of the U-M Program for Positive Aging at the University of Michigan Health System and investigator at the VA Center for Clinical Management Research. "The issue and the challenge is that our health care system has not incentivized training in alternatives to drug use, and there is little to no reimbursement for caregiver-based methods."

Coincidentally, a new U.S. Government Accountability Office published the same day as the BMJ paper addresses the issue of overuse of antipsychotic medication for the behavior problems often seen in dementia. It finds that one-third of older adults with dementia who had long-term nursing home stays in 2012 were prescribed an antipsychotic medication—and that about 14 percent of those outside nursing homes were prescribed an antipsychotic that same year.

The GAO calls on the federal government to work to reduce use of these drugs further than it's already doing, by addressing use in dementia patients outside nursing homes.

Kales, however, cautions that penalizing doctors for prescribing antipsychotic drugs to these patients could backfire, if caregiver-based non-drug approaches aren't encouraged.

She and her colleagues from Johns Hopkins, Laura N. Gitlin PhD and Constantine Lyketsos MD, note in their paper that "there needs to be a shift of resources from paying for psychoactive drugs and emergency room and hospital stays to adopting a more proactive approach."

But they also write, "drugs still have their place, especially for the management of acute situations where the safety of the person with dementia or family caregiver may be at risk." For instance, antidepressants make sense for dementia patients with severe depression, and antipsychotic drugs should be used when patients have psychosis or aggression that could lead them to harm themselves or others. But these uses should be closely monitored and ended as soon as possible.

The authors lay out five non-pharmacologic categories to start with based on their review of the medical evidence. These approaches have been shown to help reduce behavior issues:

• Providing education for the caregiver
• Enhancing effective communication between the caregiver and the person with dementia
• Creating meaningful activities for the person with dementia
• Simplifying tasks and establishing structured routines
• Ensuring safety and simplifying and enhancing the environment around the patient, whether in the home or the nursing/assisted living setting

They also note that many "hidden" medical issues in dementia patients - such as urinary tract infection and other infections, constipation, dehydration and pain - can lead to behavioral issues, as can drug interactions. So physicians should look to assess and address these wherever possible.

Kales, Gitlin and Lyketsos are working with the U-M Center for Health Communications Research to launch a National Institute of Nursing Research-sponsored clinical trial this spring that will test the DICE approach through a computer based tool for caregivers called the WeCareAdvisor. The tool will help families identify tips and resources in a single computer interface to address behavioral symptoms. The tips are designed to prevent or mitigate possible triggers for common behavioral symptoms such as pacing, repetitive questioning, restlessness, or shadowing.

For instance, de-cluttering the environment, using music or simple activities that help to engage a person with dementia , or using a calm voice instead of being confrontational, could help greatly to reduce behavioral symptoms, Kales says. And making sure that caregivers get breaks from their responsibilities and take care of themselves, especially in the home, can help them avoid burnout and taking their frustration out on patients.

"Behavior-based strategies may take longer than prescriptions," acknowledges Kales, a member of the U-M Institute for Healthcare Policy and Innovation. "But if you teach people the principles behind DICE, the approach becomes more natural and part of one's routine. It can be very empowering for caregivers or nursing home staff."

More research on both new drug options and the best ways to assess and address behavioral symptoms is needed, the authors conclude. But in the meantime, the evidence to date comes down in favor of non-drug approaches in most cases.

More information: BMJ 2015; 350 doi: dx.doi.org/10.1136/bmj.h369 (Published 02 March 2015)

Provided by University of Michigan Health System

Better midlife fitness may slow brain aging

People with poor physical fitness in their 40s may have lower brain volumes by the time they hit 60, an indicator of accelerated brain aging, according to new research presented at the American Heart Association EPI/Lifestyle 2015 meeting.

06 mar 2015--"Many people don't start worrying about their brain health until later in life, but this study provides more evidence that certain behaviors and risk factors in midlife may have consequences for brain aging later on," said Nicole L. Spartano, Ph.D., lead author and a postdoctoral fellow at the Boston University School of Medicine.

A subset of 1,271 participants from the Framingham Offspring Study participated in exercise treadmill testing in the 1970s, when their average age was 41. Starting in 1999, when their average age was 60, they underwent magnetic resonance imaging (MRI) of their brains as well as cognitive tests. The participants did not have heart disease or cognitive problems at the beginning of the study, and none were taking medication that alters heart rate.

In individuals with low fitness levels, the blood pressure and heart rate responses to low levels of exercise are often much higher than in individuals with better fitness.

"Small blood vessels in the brain are vulnerable to changes in blood pressure and can be damaged by these fluctuations," Spartano said. "Vascular damage in the brain can contribute to structural changes in the brain and cognitive losses. In our investigation we wanted to determine whether exaggerated blood pressure fluctuations during exercise were related to later structural changes in the brain."

The researchers found:

• People who had a lower fitness level or greater increase in diastolic blood pressure (bottom number) or heart rate a few minutes into the low-intensity treadmill test (2.5 miles an hour) had smaller brain tissue volume later in life.
• People who had a larger increase in diastolic blood pressure during low-intensity exercise also performed more poorly on a cognitive test for decision-making function later in life.

Poor physical fitness could be associated with accelerated brain aging.

"For every 3.4 units lower exercise capacity, every 7.1 mm Hg higher exercise diastolic blood pressure, and for every 8.3 beats/minute higher exercise heart rate in midlife, these effects are approximately equivalent to an additional 0.5 years ofbrain aging," Spartano said.

Apart from the exercise tests, a higher resting systolic blood pressure (top number) at age 40 was associated with a smaller frontal lobe volume and a greater volume of white matter hyperintensity (an indicator of loss of blood flow with aging) on the later brain MRIs.

Promotion of midlife physical fitness may be an important step towards ensuring healthy aging of the brain in the population, researchers said.

"It will be interesting to follow up with these participants in another 10 years to determine how many developed dementia, and if that may be related to their fitness or exercise blood pressure or exercise heart rate in midlife," Spartano said.

Provided by American Heart Association

Anticholinergic drugs linked to risk for pneumonia in elderly

Taking commonly used medications with anticholinergic effects is associated with a significantly higher risk for developing pneumonia in a study of more than 3,000 older Group Health patients living in the community—not in nursing homes. "Anticholinergic Medications and Risk of Community-Acquired Pneumonia in Elderly Adults: A Population-Based Case-Control Study" is in the Journal of the American Geriatrics Society.

05 mar 2015--"Our study is the first to address whether oral anticholinergic medications affect the risk of pneumonia in older people," said senior author Sascha Dublin, MD, PhD, a Group Health physician and Group Health Research Institute (GHRI) associate investigator. "This is important because so many older people use these medications, and pneumonia is such a common cause of illness and death in this age group." Dr. Dublin is also an affiliate associate professor of epidemiology at the UW School of Public Health.

A recent University of Washington (UW)-Group Health study linked cumulative use of anticholinergic medications to a higher risk for dementia. Dr. Dublin was a coauthor of that study of a different group of Group Health patients. Anticholinergic medications block the neurotransmitter called acetylcholine in the brain and body, and that can cause many side effects, including sedation, confusion, constipation, vision changes, retaining urine, and dry mouth and eyes.

Strengths

In the new study, more than 1,000 Group Health patients aged 65 to 94 years who developed pneumonia were compared with a control group of more than 2,000 patients who were matched to the first group by age, sex, and year and didn't get the disease.

"We found a link between both acute and chronic use of anticholinergic medications and a much higher risk for developing pneumonia," said first author Kathleen J. Paul, MD, MPH, a third-year resident in family medicine at Group Health. Acute use meant filling at least one prescription within 90 days before the pneumonia diagnosis; and chronic use was filling at least three prescriptions in the prior year. One of the study's strengths is that it used Group Health's pharmacy records (which include substantial over-the-counter use) to determine that the patients actually filled their prescriptions.

Prior reports about these same patients linked a higher risk for pneumonia to use of opioids—but not benzodiazepines, statins, proton pump inhibitors, histamine blockers, or angiotensin-converting enzyme inhibitors.

"Many older individuals are taking several medications, and our work confirms that clinicians should review them regularly to identify potential risks," Dr. Dublin said. "It's especially important for patients to tell their doctors about any over-the-counter medications that they are taking. Patients often assume over-the-counter medicines must be safe for them, but this isn't always true. No one should stop taking a medication without consulting their health care provider. But together, patients and providers can weigh the pros and cons—and discuss alternatives, making decisions in a shared way."

Alternatives

"Sometimes providers have to prescribe a medication with anticholinergic effects because it is best for their patient," Dr. Paul said. But she gave these examples of possible alternatives for anticholinergic drugs for:

• Insomnia: consider trying melatonin or behavior change strategies (such as exercising more or avoiding caffeine) instead of benzodiazepines or antihistamines
• Depression: Instead of tricyclic antidepressants like doxepin (Sinequan), a provider might suggest a selective serotonin re-uptake inhibitor (SSRI) like citalopram (Celexa) or sertraline (Zoloft) with fewer anticholinergic effects. Counseling can also help treat depression.
• Allergies: Instead of first-generation antihistamines like diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton), consider a second-generation antihistamine like loratadine (Claritin).
• Urinary incontinence: It's harder to find alternative medications to antimuscarinics for bladder control like oxybutynin (Ditropan); but behavior change strategies can be more effective. For instance, it can help to set an alarm as a reminder to urinate every hour or two.

"It isn't clear why anticholinergic medications might raise pneumonia risk, but one possibility is that by causing sedation and altered mental status, they raise the risk for breathing problems—and lung infections," Dr. Paul said. "But more research is needed."

Provided by Group Health Research Institute

Neuropsychological, neuropsychiatric and functional assessments help follow the course of Alzheimer's disease

The cognitive performance of persons with Alzheimer's disease and behavioural and psychological problems are linked to their performance of activities of daily living, according to a recent study completed at the University of Eastern Finland. However, difficulties in cognitive performance were not linked to behavioural and psychological problems, although both deteriorated as the disease progressed. Some persons may have significant problems in memory and other cognitive performance without the presence of behavioural and psychological problems, while others experience behavioural and psychological problems already at the early phase of the disease.

04 mar 2015--Diseases causing dementia are becoming increasingly common as the population ages and life expectancy increases. Alzheimer's disease (AD) is the most common cause of dementia, leading to progressing problems in memory and other cognitive performance. AD is also associated with deteriorated performance of activities of daily living, and increased need for assistance. Furthermore, AD is often associated with behavioural and psychological problems. Information on the progression of the disease and its evaluation methods is needed for treatment planning and for the evaluation of treatment outcomes..

The PhD thesis of Ilona Hallikainen focuses on the progression of Alzheimer's symptoms after diagnosis, and sheds new light on the usability of the CERAD neuropsychological test battery in the monitoring of the progression of the disease. The study was a three-year follow-up of 236 persons with Alzheimer's disease and their caregivers from three Finnish hospital districts. The study constituted part of the multidisciplinary ALSOVA study coordinated by the Institute of Clinical Medicine (Neurology) at the University of Eastern Finland.

During the follow-up, difficulties in cognitive performance and activities of daily living as well as behavioural and psychological problems and the severity of the disease increased; however, approximately 50% of the study participants were diagnosed with a mild form of Alzheimer's disease after the three-year study period. An interesting observation was that persons who at the onset of the study were diagnosed with a very mild form of Alzheimer's disease and whose treatment had begun at the early phase experienced a slower decline in the performance of activities of daily living and less frequent presence of behavioural problems. The study sheds new light on how the disease progresses in persons under current treatment.

The CERAD neuropsychological test battery is widely used in the early detection of Alzheimer's disease. The study discovered that the test battery's total score was a well-functioning measure in follow-up use. In clinical use, however, the use of the CERAD test battery for the monitoring of AD-related symptoms may be limited due to it requiring plenty of time. In the test battery, tasks assessing global cognition, language, visual perception and executive function were found to be very useful in follow-up use. Although memory problems are first signs of the disease, the role of other cognitive deficits increases as the disease progresses. The results open up new possibilities for the monitoring of the disease both in research and in clinical settings.

Provided by University of Eastern Finland

Vitamin D and depression links debunked

The link between vitamin D and depression in older men has been analysed by UWA researcher

Vitamin D deficiency does not cause depression in later life but may be a marker for depression, a local study suggests.

02 mar 2015--Professor Osvaldo Almeida from the School of Psychiatry and Clinical Neurosciences at the University of Western Australia says there has, to date, been evidence suggesting vitamin D deficiency has some part in the causation of depression.

"We now know that the brain has numerous receptors for vitamin D, which would suggest that it does play a role in modulating some aspect of brain function," Professor Almeida says.

"So, the possibility that low vitamin D could cause depression seems biologically plausible.

"However, our findings indicate that this association is most likely due to reverse causality, meaning that a low concentration of vitamin D is a consequence of depression because people with depression move less and are less exposed to sun light."

Consistent with this hypothesis, Professor Almeida and his colleagues found that a low concentration of vitamin D was associated with current depression, but not with past or future depression.

"These results suggest that the low concentration of vitamin D in older people with depression is simply a marker of depressive state, not the cause of it," Professor Almeida says,

Researchers analysed the plasma concentration of vitamin D in 3105 men aged 71 to 88 years from the Perth metropolitan area. All had a history of depression or were currently experiencing depression.

They questioned the men and used administrative health data to identify past depression. A Geriatric Depression Scale score established the presence of current depression.

The study reported retrospective, cross-sectional and prospective associations between vitamin D concentration and depressed mood in this sample.

Professor Almeida says their results suggest health practitioners should refrain from prescribing vitamin D supplementation for the treatment of depression.

"Vitamin D is often prescribed for people with osteoporosis, those who are at risk of falls and for people who have concentrations under 50 nmol/L," Professor Almeida says.

"Health practitioners need to be cautious because there is evidence that excess vitamin D may cause more harm than good.

"For example, a large Australian trial showed that its use increases the risk of falls and fractures."

Researchers did not dismiss the possibility that vitamin D can have a very small antidepressant effect, but suggest large randomised placebo-controlled trials be conducted to dismiss or establish with certainty a causal link.

More information: "Vitamin D concentration and its association with past, current and future depression in older men: The Health In Men Study" DOI:dx.doi.org/10.1016/j.maturitas.2015.01.016

Provided by Science Network WA

Altering perception of feeding state may promote healthy aging

Targeting mechanisms in the central nervous system that sense energy generated by nutrients might yield the beneficial effects of low-calorie diets on healthy aging without the need to alter food intake, suggests new research from Harvard T.H. Chan School of Public Health.

01 mar 2015--The study appears online February 26, 2015 in the journal Cell. Senior author was William Mair, assistant professor of genetics and complex diseases; lead author was Kristopher Burkewitz, a researcher in Mair's lab.

The researchers wanted to learn more about energy sensing processes in organisms—in this case using the model organism C. elegans—because previous studies in species ranging from nematode worms like C. elegans to primates have shown that limiting food intake, known as caloric restriction, can improve metabolic dysfunction and promote healthy aging.

The new study shows that there may be therapeutic alternatives to caloric restriction that produce similar benefits while avoiding some of the negative side effects, which in humans can include decreased fertility and immunity.

The study focused on a molecule called "AMP-activated protein kinase," or AMPK, which acts as a molecular fuel gauge to detect energy levels. It's been known that AMPK plays important roles in all cell types, but researchers didn't understand which of these activities were most critical to regulating longevity.

The researchers found that AMPK inhibited the activity of a protein called CRTC-1 in neurons. This process, in turn, controlled the behavior of mitochondria—the primary energy-producing organelles in cells—throughout the organism, by altering production of a neurotransmitter. The researchers were struck by the fact that altering the AMPK pathway in just a limited set of neurons was sufficient to override its effects on metabolism and longevity in other tissues. Aging was influenced more by what the animals perceived they were eating than what they actually ate.

The study suggests that manipulating this energy-sensing pathway can cause organisms to perceive their cells to be in a low-energy state, even if they are eating normally and energy levels are high. Drugs targeting the cells' energy-sensors in this way could potentially address age-related diseases, including cancer and neurodegeneration, and may offer an alternative to caloric restriction.

The new finding could have significant public health implications, given that aging is the central risk factor for the majority of complex diseases, and the disease burden of the elderly is one of the key challenges to public health in the 21st century.

More information: Cell, online February 26, 2015, DOI: 10.1016/j.cell.2015.02.004

Provided by Harvard School of Public Health