Category: Ageing

Improving Attitudes to Ageing Measurably Improves Health

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Helping people feel better about how they are ageing could result in real improvements in health and well-being later on, according to research from the University of British Columbia which was published in JAMA Network Open.

Over a four-year period, researchers tracked changes in how participants felt about their own ageing, then looked for measurable changes in health and well-being after another four years had passed. Those participants whose attitudes had improved over the first four years were more likely to have measurable health improvements in the next four years.

“Prior research has looked at how psychological risk factors like depression and stress might adversely influence health and well-being outcomes, but we are interested in factors that might positively influence health and well-being outcomes,” said Julia Nakamura, a graduate student in UBC’s department of psychology and first author of the study. “With further research, our findings suggest that interventions to increase aging satisfaction might improve the health and well-being of our rapidly growing older adult population.”

Health and well-being are gaining favor as indicators of societal progress, over pure economic indicators. Governments and intergovernmental organisations have recognised that using gross domestic product as the primary measure of success can lead to policies that devalue environmental, psychological and social health. Increasingly, they are looking for more holistic ways to measure societal well-being.

In this study, more than 13 000 adults over age 50 contributed data through the Health and Retirement Study in the U.S. between 2008 and 2018. The research team analysed participants’ data at three separate intervals, four years apart.

At the first interval, the researchers recorded initial measures of health and well-being. They also captured aging satisfaction through participants’ responses to statements such as:

  • Things keep getting worse as I get older.
  • I am as happy now as I was when I was younger.
  • The older I get, the more useless I feel.

At the second interval, they assessed ageing satisfaction again.

At the third and final interval, they measured how health and well-being measures had changed four years after the second measurement of aging satisfaction.

Of the 35 outcomes they measured, 27 had improved in association with improved aging satisfaction four years earlier. Decreases in ageing satisfaction from the first to second interval were associated with worsening health and well-being outcomes by the third interval.

The order in which these measurements were taken is important. People in better health could be expected to have more positive attitudes about ageing than those with health problems, but this analysis in fact showed that increases in ageing satisfaction clearly preceded improvements in health and well-being.

“Interventions that make people feel better about aging could potentially produce concrete benefits,” said Nakamura. “Those interventions could come at both the individual level and the broader, societal level. At the societal level, combating ageism and reducing harmful stereotypes about aging are potential paths to improving individual aging satisfaction. If a person thinks ageing is destined to be a negative experience, that might become a self-fulfilling prophecy.”

Source: University of British Columbia

Body Mass Index Impacts Pain in People with Hand Osteoarthritis

Source: Pixabay CC0

In a study published in Arthritis & Rheumatologypeople with hand osteoarthritis, higher body mass index was associated with greater pain severity in the hands, feet, knees, and hips.

Osteoarthritis is one of the most debilitating joint disorders worldwide, affecting up to 10% of men and 13% of women.  Osteoarthritis is characterised by a progressive onset of joint damage, commonly associated with pain. Joints commonly affected include the knee, hip and hand. Various stressors, risk factors and genetics may predispose an individual to developing osteoarthritis in a particular joint.

In a study of 281 patients, researchers noted that observed associations of body mass index with hand pain and total body joint pain seemed to involve certain inflammatory markers (leptin and high-sensitivity C-reactive protein, respectively).  

The researchers suggest that systemic effects of obesity, measured by leptin, could have a larger mediating role for pain in hands than in lower extremities. Low-grade inflammation, measured by hs-CRP, may contribute to generalised pain in overweight or obese individuals.

“Our results highlight the complexity of pain in hand osteoarthritis. Obesity is not only leading to pain through increased loading of joints in the lower extremities, but seems to have systemic effects leading to pain in the hands and overall body,” said lead author Marthe Gløersen, MD, of Diakonhjemmet Hospital, in Norway.

Source: Wiley

Reduced Heart Failure Risk in Postmenopausal Women Who Walk Faster

Photo by Teona Swift from Pexels

A study of postmenopausal women, published in the Journal of the American Geriatrics Society, found that those who reported a faster walking pace had a lower risk of developing heart failure

Among 25 183 women aged 50 to 79 years, there were 1455 cases of hospitalisation for heart failure during a median follow-up of 16.9 years. Compared with women who walked at a casual pace, those who walked at an average pace or fast pace had 27% and 34% lower risks of heart failure, respectively.

Fast walking for less than 1 hour per week was associated with the same risk reduction of heart failure as average or casual walking for more than 2 hours per week.

“This study confirms other studies demonstrating the importance of walking speed on mortality and other cardiovascular outcomes,” said senior author Charles B. Eaton, MD, MS, of the Warren Alpert Medical School of Brown University. “Given that limited time for exercise is frequently given as a barrier to regular physical activity, walking faster but for less time might provide similar health benefits as the recommended 150 minutes per week of moderate physical activity.”

Further study is warranted to determine whether interventions to increase the walking pace in older adults will reduce heart failure risk and whether fast pace will compensate for the short duration of walking.

Source: Wiley

Two Key Proteins with a Major Role in Ageing

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In the largest genetic study of ageing to date, two key proteins have been identified that play a significant role in the ageing process. Developing drugs that target these proteins could be one way of slowing down ageing.

Genetics, lifestyle, environment and chance influence ageing. The study sheds light on the part proteins play in this process. Some people have higher or lower levels of certain proteins according to their individual DNA, which in turn affect a person’s health.

In a study published in Nature Aging, researchers from the University of Edinburgh combined the results of six large genetic studies into human ageing – each containing genetic information on hundreds of thousands of people.

Among 857 proteins studied, researchers identified two that had significant negative effects across various ageing measures.

People who inherited DNA that causes raised levels of these proteins were frailer, had poorer self-rated health and were less likely to live an exceptionally long life than those who did not.

The first protein, apolipoprotein(a) (LPA), is made in the liver and thought to play a role in clotting. High levels of LPA can increase the risk of atherosclerosis – a condition in which arteries become clogged with fatty substances. Heart disease and stroke is a possible outcome.

The second protein, vascular cell adhesion molecule 1 (VCAM1), is primarily found on the surfaces of endothelial cells lining blood vessels. The protein controls the vessels’ expansion and retraction – and have a function in blood clotting and the immune response.

Levels of VCAM1 increase in response to signals indicating an infection, and the protein then allows immune cells to cross the endothelial layer.

The researchers say that drugs used to treat diseases by reducing levels of LPA and VCAM1 could have the added benefit of improving quality and length of life.  

One such example is a clinical trial that is testing a drug to lower LPA as a way of reducing the risk of heart disease. No clinical trials with VCAM1 are underway, but studies in mice have shown how antibodies lowering this protein’s level improved cognition during old age.

The identification of these two key proteins could help extend the healthy years of life. Drugs that reduce these protein levels in the blood could allow the average person to live as healthy and as long as individuals who have won the genetic lottery and are born with genetically low LPA and VCAM1 levels.

Source: University of Edinburgh

Muscles may Stay Younger at an Epigenetic Level through Exercise

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While the benefits of exercise in ageing have been well established, such as lowering risk of cardiovascular disease, a new study that used mice demonstrated that exercise in aged individuals could help muscles stay younger at an epigenetic level.

Despite generating a wealth of data, the study, which was published in Aging Cell, made use of a relatively straightforward experiment. Lab mice nearing the end of their natural lifespan, at 22 months, were allowed access to a weighted exercise wheel. Mice generally run voluntarily, without any coercion. Older mice will run anywhere from six to eight kilometres a day, mostly in spurts, while younger mice may run up to 10 to 12 kilometres. The weighted wheel ensured they built muscle. While there isn’t a direct analogue to most human exercise routines, first author Kevin Murach, assistant professor at the University of Arkansas, likened it to “a soldier carrying a heavy backpack many miles.”

When the mice were examined after two months of progressive weighted wheel running, it was determined that they were the epigenetic age of mice eight weeks younger than sedentary mice of the same age – 24 months. Murach noted that while the specific strain of mice and their housing conditions can impact lifespans, “historically, they start dropping off after 24 months at a significant rate.” Needless to say, when your lifespan is measured in months, an extra eight weeks – roughly 10 percent of that lifespan – is a noteworthy gain.

The science behind this hinges largely on DNA methylation, where methyl groups attach to DNA, altering their function. As the body ages, there tends to be increased DNA methylation, or even hypermethylation, at promoter sites on genes in muscle. “DNA methylation changes in a lifespan tend to happen in a somewhat systematic fashion,” Murach explained, “to the point you can look at someone’s DNA from a given tissue sample and with a fair degree of accuracy predict their chronological age.” Due to this, researchers can use one of a number of “methylation clocks” to determine the age of a DNA sample.

While the paper strengthens the case for exercise, much work remains to be done. Though there is a clear connection between methylation and ageing, the relationship between methylation and muscle function is less clear. Murach is not yet prepared to say that the reversal of methylation with exercise causes improved muscle health. “That’s not what the study was set up to do,” he explained. However, he intends to pursue future studies to determine if “changes in methylation result in altered muscle function.”

Source: University of Arkansas

How Many Intervention Sessions to Prevent Cognitive Decline?

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Physical activity, diet and cognitive stimulation are all known to be good interventions for the prevention of Alzheimer’s disease and dementia. Now an international team of researchers has determined that only about a dozen intervention sessions are all that were needed to observe an improvement in cognition.

Until now, the number of sessions or “doses” needed for optimal effect has been unknown. Published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the study led by Université de Montréal psychology professor Sylvie Belleville showed that between 12 and 14 sessions were all that were needed to boost cognitive ability, though the gain observed levelled off with more sessions.

“In pharmacological studies, every effort is made to define an optimal treatment dose needed to observe the expected effects, “ said Prof Belleville,  a neuropsychologist and researcher at the research centre of the UdeM-affiliated Institut universitaire de gériatrie de Montréal. “This is rarely done in non-pharmacological studies, especially those on the prevention of cognitive decline, where little information is available to identify this dose.

“Defining an optimal number of treatment sessions is therefore crucial.,” she continued. “Indeed, proposing too few sessions will produce no noticeable improvement effects, but too many sessions is also undesirable as these interventions are costly. They are costly both for the individual who follows the treatments, in terms of time and involvement, and for the organisation offering these treatments.”

The study is based on a secondary analysis of data from the three-year Multidomain Alzheimer Preventive Trial (MAPT) and examined 749 participants who received a range of interventions aimed at preventing cognitive decline. These interventions included dietary advice, physical activity and cognitive stimulation.

In their research, Prof Belleville’s team noted that people’s individuality should be considered when determining the optimal treatment dose.

In their study, the researchers gauged the effects of the sessions in terms of each participant’s age, gender, education level, and cognitive and physical condition. The relationship between the “dose” each received and their cognitive improvement was then analysed.

The findings revealed an increase with dose followed by a plateau effect after 12 to 14 sessions. However, participants with lower levels of education or more risk factors for frailty did benefit from more sessions.

The researchers concluded that it’s important to pinpoint an optimal dose and to customise the treatment for each individual. Not only is “dosage” an important component of behavioural interventions, it can also provide valuable information in resource-constrained settings, helping public-health agencies develop effective prevention programs and offer guidance to older adults and clinicians.

Source: University of Montreal

Exercise Protects Ageing Synapses

Photo by Barbara Olsen from Pexels

When elderly people stay active, their brains have more proteins that enhance the connections between neurons to maintain healthy cognition, according to a study published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

This protective impact was found even in people whose brains at autopsy were riddled with amyloid and tau proteins, associated with Alzheimer’s and other neurodegenerative diseases.

“Our work is the first that uses human data to show that synaptic protein regulation is related to physical activity and may drive the beneficial cognitive outcomes we see,” said lead author Kaitlin Casaletto, PhD.

The beneficial effects of physical activity on cognition have been shown in mice but have been much harder to demonstrate in people.

Dr Casaletto collaborated with William Honer, MD, a professor of psychiatry at the University of British Columbia and senior author of the study, to leverage data from the Memory and Aging Project at Rush University in Chicago. The project tracked the late-life physical activity of elderly participants, who also agreed to donate their brains upon death.

“Maintaining the integrity of these connections between neurons may be vital to fending off dementia, since the synapse is really the site where cognition happens,” Dr Casaletto said. “Physical activity – a readily available tool – may help boost this synaptic functioning.”

The researchers found that elderly people who remained active had higher levels of proteins that facilitate the exchange of information between neurons. This result dovetailed with Prof Honer’s earlier finding that people who had more of these proteins in their brains when they died were better able to maintain their cognition late in life.

Surprisingly, the effects ranged beyond the hippocampus to include other brain regions associated with cognitive function.

“It may be that physical activity exerts a global sustaining effect, supporting and stimulating healthy function of proteins that facilitate synaptic transmission throughout the brain,” Prof Honer said.

The brains of most older adults accumulate amyloid and tau proteins that are the hallmarks of Alzheimer’s disease pathology. Many scientists believe amyloid accumulates first, then tau, causing synapses and neurons to fall apart.

Dr Casaletto previously found that synaptic integrity, whether measured in the spinal fluid of living adults or the brain tissue of autopsied adults, appeared to dampen the relationship between amyloid and tau, and between tau and neurodegeneration.

“In older adults with higher levels of the proteins associated with synaptic integrity, this cascade of neurotoxicity that leads to Alzheimer’s disease appears to be attenuated,” she said. “Taken together, these two studies show the potential importance of maintaining synaptic health to support the brain against Alzheimer’s disease.”

Source: University of California in San Francisco

Consumption of Olive Oil Reduces Risk of Premature Death

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A new study has found that people who consume higher amounts of olive oil may lower their risk of premature death overall and from specific causes including cardiovascular disease, cancer, and neurodegenerative disease, compared to people who never or almost never consume olive oil. People who consumed olive oil instead of animal fat were also found to have a lower risk of total and cause-specific mortality.

“Olive oil consumption has been linked to lower cardiovascular disease risk, but its association with premature death was unclear,” said Marta Guasch-Ferré, a senior research scientist in the Department of Nutrition at Harvard Chan School. “Our findings confirm current dietary recommendations to replace animal fats with plant oils for the prevention of chronic diseases and premature death.”

The researchers used health data collected between 1990 and 2018 for 60 582 women participating in the Nurses’ Health Study and 31 801 men in the Health Professionals Follow-up Study. All participants were free of cardiovascular disease or cancer at the study start.

Participants were asked how often they used olive oil in salad dressings, added to food or bread, or in baking or frying. According to the findings, people in the highest category of olive oil consumption (> 7g/day) had 19% lower risk of total and cardiovascular disease mortality, 17% lower risk of cancer mortality, 29% lower risk of neurodegenerative mortality, and 18% lower risk of respiratory mortality, compared with those who never or rarely consumed olive oil. Compared to margarine, butter, mayonnaise, or dairy fat, olive oil usage was correlated with reduced risk of total and cause-specific mortality. However no significant risk reduction was seen compared to use of other vegetable oils.

“Clinicians should be counselling patients to replace certain fats, such as margarine and butter, with olive oil to improve their health,” advised Guasch-Ferré. “Our study helps make specific recommendations that will be easy for patients to understand and hopefully implement into their diets.”

The findings were published in the Journal of the American College of Cardiology.

Source: Harvard University

Grip Strength is an Important Health Marker in Older Women

Source: CDC

Researchers have found that greater grip strength in older women reduces mortality risk, regardless of weight change, suggesting that mobility and strength support should have more focus than weight loss in this group.

Grip strength and short physical performance battery (SPPB) are measures of physical functioning. Grip strength assesses strength of grip alone, whereas SPPB is a cumulative score considering three components: balance test, timed walk, and chair stands. 

Previous studies have shown a link between increased grip strength and lower all-cause mortality. SPPB considers timed walk, balance test, and chair stands, and is associated with CVD risk in older women. However, studies of the effects of weight loss on grip strength which evaluated participants before and after weight loss interventions have shown inconsistent results.

In a study published in the Journal of the American Geriatrics Society, researchers followed 5039 older women for an average of 5.4 years. They found that loss of 5% or more body weight was associated with a 66% higher risk of dying. However, there was no association of weight gain with mortality.

The researchers also found that higher grip strength and better lower extremity functioning were associated with lower risks of death during follow-up, regardless of weight change.

“Our findings support increasing efforts to improve mobility and muscle strength in older women and less focus on long-term weight loss in this population,” said lead author Lisa Underland, DO, of Children’s Hospital at Montefiore. 

Source: Wiley

Most Superheroes Will Age Healthily, Researchers Conclude

Spider-Man has a healthy outlook, so long as he doesn’t binge drink or smoke like his mentor, Iron Man. Source: Pixabay

Australian researchers in the Christmas edition of the British Medical Journal took a whimsical look at the ageing trajectories of Marvel superheroes based on their attributes and behaviours as seen in the films, finding them to be largely well-adjusted and likely to age healthily. 

Positive behaviours and health assets
Marvel superheroes are physically active, socially engaged, and optimistic, with high educational attainment and (with one notable exception) healthy weight, all of which have been associated with a positive ageing trajectory.

The review found that superheroes regularly engage in physical activity and exercise, both associated with healthy ageing. They often undertake high intensity interval training (HIIT), associated with improved health status in ageing men.

Even during discussions about how to stop aliens from enslaving humanity, superheroes stand regularly and pace, increasing their step count and further improving their healthy outlook.

In terms of social engagement, superheroes exhibit a high degree of social cohesion and connectedness, both linked to reduced dementia risk. People with strong social ties tend to live longer than isolated people, regardless of other risk factors such as smoking, alcohol consumption, and physical activity.

The superheroes show a positive or optimistic mindset on several occasions, as well as psychological resilience and a sense of purpose, all of which have been associated with healthy ageing.  Some have traumatic backgrounds, including Spider-Man who was orphaned, which increases his risk of substance abuse and mental health problems. However, his supportive social contacts, including positive male role models help mitigate this.

Most of the superheroes did not drink or smoke excessively, save for Iron Man and Thor, which is associated with longevity and healthy ageing. However, Thor is already thousands of years old and the researchers could not assume that modifiable personal traits would affect his life trajectory.

Negative behaviours and risk factors
Superheroes are exposed to loud noises, air pollution, and receive multiple head injuries precipitated by high risk physical activities.

Superheroes are repeatedly exposed to loud noises such as explosions, which is linked to hearing loss, which in turn is associated with an increased risk of cognitive impairment and dementia. Some of the superheroes, such as Hulk and Thor, have booming voices, potentially indicative of early sensorineural hearing loss.

During their activities, superheroes sustain multiple major head injuries, increasing their dementia risk. Involvement in high risk activities, which could increase their likelihood for life changing physical injury and disability.

Of the individual cases presented, Black Panther has probably the best health outlook, as he is extremely wealthy and intelligent, health assets that he shares in common with Iron Man. However, unlike Iron Man, he does not drink or smoke excessively, and is a vegetarian, which has well-studied benefits in healthy ageing.

On the other end of the spectrum, the Hulk was noted to have serious health concerns. Bruce Banner transforms to the Hulk when he experiences tachycardia—specifically, a heart rate of 200 beats per minute. The frequency of this occurrence suggests a predisposition to cardiac arrhythmias, possibly indicating underlying cardiac disease.

Hulk’s body mass index (BMI) is about 120 (calculated from height 213cm–243cm and weight 471kg–635kg). Although being in the overweight category might be protective, obesity is associated with a higher death rate as well as dementia, and several chronic health conditions and frailty. Hulk’s BMI also raises pragmatic concerns around future access to appropriate healthcare. Hulk’s almost constant anger (“That’s my secret Captain. I’m always angry”) might lead to increased inflammation and comorbidity in advanced old age.

Source: The British Medical Journal