Skip to content

Study after study has found negative health effects from frequent heavy drinking of alcohol, including a number of cancers. On the other hand, light to moderate drinking seems to have some health benefits (here and here). Recently a large study conducted in France found that chronic heavy drinking, which has resulted in alcohol use disorders (alcohol abuse, alcohol dependence, or alcoholism), is the biggest risk factor for developing dementia, especially early onset dementia. Only people with alcohol use disorders which resulted in them being hospitalized were included in the study.

But the surprising thing was that lower levels of "chronic heavy drinking" doesn't seem so much - it's daily consumption of more than 60 grams of pure alcohol  for men, and more than 40 grams of pure alcohol for women. In the United States, a standard drink contains about 14 grams of alcohol - which is a 12 ounce (350 ml) glass of beer, a 5 ounce (150 ml) glass of 12% wine, or a 1.5 ounce (44 ml) glass of spirits. In other words, drinking 3 glasses of wine daily (or more) is heavy drinking for a woman. (Note: The Centers for Disease Control (CDC) views moderate drinking as 1 glass of wine daily for women, and 2 glasses of wine daily for men).  ...continue reading "Heavy Drinking And Risk of Dementia"

A new observational study from Taiwan found that having one of eight chronic diseases, such as heart disease or diabetes, or their markers (e.g. high cholesterol levels as a marker for heart disease), also significantly raises the person's odds of developing cancer or dying from cancer. The study estimated that these diseases or markers accounted for about 20% of all new cancers and 39% of all cancer deaths. That's about the risk of 5 lifestyle factors combined (smoking, alcohol consumption, obesity, unhealthy diet, and lack of exercise) contributing to cancer development and death.

The eight chronic diseases and markers were: cardiovascular disease (markers for which include blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease (markers for which include proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis (for which uric acid is a marker). The higher the chronic disease and marker score, the higher the risk of developing cancer and cancer death (a dose-response). Chronic diseases and markers were associated with a shortened lifespan -  about 13.3 years in men and 15.9 years in women.

But the good news is that regular physical exercise lowers the risk of developing cancer by about 48% and the risk of cancer death by 27%. That's huge!  So physical exercise and activity could be viewed as "cancer prevention" strategies. The researchers pointed out that additional cancer prevention strategies are avoiding smoking (very important), avoiding excessive alcohol consumption, maintaining healthy weight, and a healthy diet. From Science Daily:

Substantial impact of chronic diseases on cancer risk

Several common chronic diseases together account for more than a fifth of new cancer cases and more than a third of cancer deaths, finds a study published by The BMJ today. The findings show that the cancer risks from common chronic diseases, such as heart disease and diabetes, are as important as those from five major lifestyle factors combined.

A team of researchers based in the US and Taiwan therefore set out to investigate the combined effect of eight common chronic diseases or disease markers (for example, high blood pressure as a marker of heart disease) on cancer risk compared with lifestyle factorsThey also explored whether physical activity could reduce the cancer risk associated with chronic diseases and disease markers. The study involved 405,878 men and women in Taiwan with no history of cancer .... underwent a series of medical tests between 1996 and 2007. .... Participants were followed for an average of 8.7 years.

The researchers found that cardiovascular disease markers, diabetes, chronic kidney disease markers, pulmonary disease, and gouty arthritis marker were individually associated with risk of developing cancer or cancer death. Higher chronic disease risk scores based on these diseases or markers were linked with an increased risk of developing cancer and cancer death, with the highest level associated with a more than twofold increase in risk of developing cancer and a fourfold increase in risk of cancer death.

High chronic disease risk scores were also associated with substantial reduction in life span. The highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. Together, these chronic diseases and markers accounted for more than one fifth of all new cancers and more than one third of all cancer deaths in this study population, which was similar to the contribution of five major lifestyle risk factors combined -- smoking, insufficient physical activity, insufficient fruit and vegetable intake, alcohol consumption, and obesity.

The researchers also found that physical activity was associated with a nearly 40% reduction in the excess risks of cancer and cancer death associated with chronic diseases and markers. [Original study.]

Interesting new research found health benefits to the brain from daily low intake of alcohol (equivalent to about 2 1/2 drinks per day). The University of Rochester (in New York) researchers found that while low daily (chronic) levels of alcohol were beneficial to the brain's glymphatic system, higher daily levels or binge drinking was not. And the low daily levels of alcohol intake was also better for the glymphatic system than no alcohol at all (the control group). In 2015 this same research team described the glymphatic system as not just the brain’s “waste-clearance system,” but as potentially helping fuel the brain by transporting glucose, lipids, amino acids, and neurotransmitters.

I'm sure this study will be greeted by many as great news, but remember it was done with MICE, and not humans, so one should be cautious in generalizing the results. But the researchers think that it does apply to humans, and may explain why some studies find some health benefits to low levels of daily alcohol intake, even better than no alcohol, and many negative effects to higher levels of alcohol intake - thus the J-shaped curve of effects seen in studies. [NOTE: Studies also find that alcohol consumption can cause cancer, and this is dose related. Studies find the Mediterranean diet (which includes low to moderate levels of alcohol) beneficial for brain health.]

By the way - no, the mice didn't receive wine as the press release from the Univ. of Rochester says. The mice actually received "intraperitoneal injections of low, intermediate, and high doses of ethanol" or just plain saline (the control group). From Science Daily:

In wine, there's health: Low levels of alcohol good for the brain

While a couple of glasses of wine can help clear the mind after a busy day, new research shows that it may actually help clean the mind as well. The new study, which appears in the journal Scientific Reports, shows that low levels of alcohol consumption tamp down inflammation and helps the brain clear away toxins, including those associated with Alzheimer's disease.

"Prolonged intake of excessive amounts of ethanol is known to have adverse effects on the central nervous system," said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC) and lead author of the study. "However, in this study we have shown for the first time that low doses of alcohol are potentially beneficial to brain health, namely it improves the brain's ability to remove waste." The finding adds to a growing body of research that point to the health benefits of low doses of alcohol. While excessive consumption of alcohol is a well-documented health hazard, many studies have linked lower levels of drinking with a reduced risk of cardiovascular diseases as well as a number of cancers.

Nedergaard's research focuses on the glymphatic system, the brain's unique cleaning process that was first described by Nedergaard and her colleagues in 2012. They showed how cerebral spinal fluid (CSF) is pumped into brain tissue and flushes away waste, including the proteins beta amyloid and tau that are associated with Alzheimer's disease and other forms of dementia. Subsequent research has shown that the glymphatic system is more active while we sleep, can be damaged by stroke and trauma, and improves with exercise.

The new study, which was conducted in mice, looked at the impact of both acute and chronic alcohol exposure. When they studied the brains of animals exposed to high levels of alcohol over a long period of time, the researchers observed high levels of a molecular marker for inflammation, particularly in cells called astrocytes which are key regulators of the glymphatic system. They also noted impairment of the animal's cognitive abilities and motor skills.

Animals that were exposed to low levels of alcohol consumption, analogous to approximately 2 ½ drinks per day, actually showed less inflammation in the brain and their glymphatic system was more efficient in moving CSF through the brain and removing waste, compared to control mice who were not exposed to alcohol. The low dose animals' performance in the cognitive and motor tests was identical to the controls.

"The data on the effects of alcohol on the glymphatic system seemingly matches the J-shaped model relating to the dose effects of alcohol on general health and mortality, whereby low doses of alcohol are beneficial, while excessive consumption is detrimental to overall health" said Nedergaard. "Studies have shown that low-to-moderate alcohol intake is associated with a lesser risk of dementia, while heavy drinking for many years confers an increased risk of cognitive decline. This study may help explain why this occurs. Specifically, low doses of alcohol appear to improve overall brain health." [Original study. Especially interesting is the Introduction & Discussion sections.]

The spice turmeric is a very popular supplement nowadays, believed to have all sorts of health benefits due to the curcumin in it (e.g. that it is anticancer, anti-Alzheimer's, anti inflammatory). And yes, studies in the lab (in vitro and in vivo) look very promising. However, a large 2017 review of existing studies also found evidence that "curcumin is unstable under physiological conditions and not readily absorbed by the body, properties that make it a poor therapeutic candidate". In other words, the hype for curcumin supplements is not matching the reality, especially or probably because it is so poorly absorbed by humans. But researchers keep trying. And keep in mind that turmeric has other compounds in it also - it is not just curcumin and nothing else.

A "double-blind, placebo-controlled clinical trial" is the best evidence for something being effective. That means a study where people are randomly assigned to groups, no one actually knows who is getting what, and there is a placebo group that is getting a "sham" treatment. A recent study did exactly that in testing a new formulation of curcumin (Theracurmin) that was easily absorbed (bioavailable) by the persons participating in the study.

And yes - they found health benefits, specifically improvements in memory and attention in those persons taking the curcumin supplements over a 18 month period (as compared to those taking a placebo and whose memory and attention deteriorated over that time). The subjects (who were between 50 and 90 years of age) did not have dementia at the start of the study, but were showing signs of "normal aging" or had mild neurocognitive disorder. Brain scans (before and after treatment) suggested that the behavioral and cognitive benefits from curcumin were associated with "decreases in plaque and tangle accumulation in brain regions moduating mood and memory" - so it had anti-inflammatory and/or anti-amyloid brain effects.

So...  Stay tuned. Meanwhile, perhaps frequent eating of foods containing turmeric may also have beneficial effects, as some studies suggest. From Science Daily:

Curcumin improves memory and mood

Lovers of Indian food, give yourselves a second helping: Daily consumption of a certain form of curcumin -- the substance that gives Indian curry its bright color -- improved memory and mood in people with mild, age-related memory loss, according to the results of a study conducted by UCLA researchers. .... Found in turmeric, curcumin has previously been shown to have anti-inflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India, where curcumin is a dietary staple, have a lower prevalence of Alzheimer's disease and better cognitive performance.

The double-blind, placebo-controlled study involved 40 adults between the ages of 50 and 90 years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or 90 milligrams of curcumin twice daily for 18 months. All 40 subjects received standardized cognitive assessments at the start of the study and at six-month intervals, and monitoring of curcumin levels in their blood at the start of the study and after 18 months. Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months.

The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not, Small said. In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos. The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions. [Original study.]

Many people look forward to retirement, thinking of all the wonderful things they will finally be able to do.  However, what no one expects is that retirement can have a negative effect on their cognitive functioning. This is what a long-term study carried out by the University of London in the United Kingdom found. The study tracked 3,433 civil servants for the 14 years before retirement, and then another 14 years afterward. The participants were given periodic examinations to assess their cognitive functioning (verbal memory, abstract reasoning, etc.).

The researchers found that when people did eventually retire, they experienced decline in their verbal memory 38 percent faster than before they stopped working. They concluded that the act of retirement significantly accelerates verbal memory decline. They also found that a higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline after retirement across the different employment grades.

The researchers pointed out that the adverse effect of retirement on verbal memory is consistent with the results of other studies. That's why they stress how important it is to continue undertaking mentally stimulating activities after retirement in order to prevent this decline. The researchers felt that the study results supported the ‘use it or lose it’ hypothesis regarding verbal memory function. But the good news was that retirement seemed to have little impact on other domains of cognitive functions, such as abstract reasoning and verbal fluency. They just showed normal age-related declines over time.

From European Journal of Epidemiology: Effect of retirement on cognitive function: the Whitehall II cohort study

According to the ‘use it or lose it’ hypothesis, a lack of mentally challenging activities might exacerbate the loss of cognitive function. On this basis, retirement has been suggested to increase the risk of cognitive decline, but evidence from studies with long follow-up is lacking. We tested this hypothesis in a cohort of 3433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement.

We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. In analyses stratified by employment grade, higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains. In conclusion, these findings are consistent with the hypothesis that retirement accelerates the decline in verbal memory function. This study points to the benefits of cognitively stimulating activities associated with employment that could benefit older people’s memory.

A recent study's results give hope to those who haven't really exercised or been physically active as they've gone through middle-age (it's viewed as "sedentary aging") and wonder if this dooms them in some way. Is it too late to get benefits from starting to exercise now? Studies show that being sedentary (that is, not being physically active or exercising weekly) and in "poor physical fitness" in middle-age is a risk factor for later heart failure. This is because a consequence of "sedentary aging" is stiffness of the heart, specifically the left ventricle (thus a loss of "cardiac plasticity").

But the study found that after 2 years of an exercise program in (formerly) sedentary middle-aged adults, they improved their maximal oxygen uptake, decreased the heart's stiffness, and improved overall fitness. All good, even though it was a small study (only 53 people completed the study). So the bottom line is: No, it's not too late to start exercising. The heart has elasticity and can remodel itself if the exercise is started before age 65 and is done 4 to 5 times a week. The adults studied were both male and female, between the ages of 45 and 64,  and exercised or were physically active for a total of 150 to 180 minutes a week, which meant at least 30 minutes 4 or 5 times a week.

Looking at the study's exercise regimen, it's clear that a variety of exercises or physical activities (low, moderate, and high intensity) is necessary. Some of the time one should be active or exercise to a point of breaking a sweat and feeling the heart pump. This meant that over time the participants increased their exercise frequency, duration, and intensity. Think about it - as you get more fit, it takes more to get your heart pumping and to break a sweat, and you can handle more exercise. 

Unfortunately the "control group", who did a combination of yoga, balance, and strength training 3 times a week for 2 years did not show improvements in heart plasticity, maximal oxygen uptake, or in overall fitness.Yikes. Sooo...the study clearly shows it is worth getting off your butt and making the effort to exercise. Perhaps view it as brushing your teeth - a daily nuisance, but necessary for health. The researchers themselves stated "Exercise is medicine." From Science Daily:

Proper exercise can reverse damage from heart aging

Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure -- if it's enough exercise, and if it's begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit, the exercise regimen should begin by late middle age (before age 65), when the heart apparently retains some plasticity and ability to remodel itself, according to the findings by researchers at the Institute for Exercise and Environmental Medicine (IEEM), which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas.

And the exercise needs to be performed four to five times a week. Two to three times a week was not enough, the researchers found in an earlier study..... The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down: One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 percent of peak rate for 4 minutes, with 3 minutes of recovery, repeated four times (a so-called "4 x 4"). Each interval session was followed by a recovery session performed at relatively low intensity. One day's session lasted an hour and was of moderate intensity. (As a "prescription for life," Levine said this longer session could be a fun activity such as tennis, aerobic dancing, walking, or biking.) One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation -- the "talk test.".... One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.

The more than 50 participants in the study were divided into two groups, one of which received two years of supervised exercise training and the other group, a control group, which participated in yoga and balance training.A t the end of the two-year study, those who had exercised showed an 18 percent improvement in their maximum oxygen intake during exercise and a more than 25 percent improvement in compliance, or elasticity, of the left ventricular muscle of the heart, Dr. Levine noted. He compared the change in the heart to a stretchy, new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the heart's left ventricle, the chamber that pumps oxygen-rich blood back out to the body, he explained.

"When the muscle stiffens, you get high pressure and the heart chamber doesn't fill as well with blood. In its most severe form, blood can back up into the lungs. That's when heart failure develops," said Dr. Levine, who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who don't exercise and aren't fit, leaving them with small, stiff chambers that can't pump blood as well[Original study.]

For those who need convincing that lifestyle can contribute to development of cancer or its prevention, new medical research has once again supported the importance of lifestyle choices. A report from Australian researchers (with similar findings as a study in the US) stated: an estimated 38% of cancer deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices.

And what were the lifestyle choices that are linked to cancer?  The researchers list 20 separate things (in 8 broad groups) that are known to cause or are linked to cancer. They are: tobacco smoke (smoking or second-hand smoke), dietary factors (low-intake of fruit, non-starchy vegetables, and dietary fiber; and high intake of red and processed meat), overweight/obesity, alcohol, physical inactivity, solar ultraviolet radiation, certain infections (they list 7 infections, such as human papillomavirus, hepatitis B, hepatitis C), and reproductive factors (lack of breastfeeding, menopausal hormone therapy use, combined oral contraceptive use). Note that they found that the #1 most important lifestyle factor is tobacco smoke - and it accounted for about 23% of all preventable cancer deaths in Australia. From Medscape:

One Third of Cancer Deaths Could Be Prevented by Lifestyle

As we head into the festive season, many are looking forward to the tradition of "Eat, drink, and be merry." But as another research paper shows that more than a third of cancer deaths could be prevented by lifestyle, maybe a qualifier should be added:"celebration in moderation." The latest statistics come from Australia, where researchers note that 44,004 cancer deaths occurred in 2013. But an estimated 38% of these deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices, says a research team led by Louise Wilson, MEpi, at the QIMR Berghofer Medical Research Institute and the University of Queensland, Brisbane.

These cancer diagnoses and deaths were seen in Australians of all ages and are directly attributable to 20 known modifiable risk factors within eight categories that are established causes of cancer, the study authors say. The report is published in the February 2018 issue of the International Journal of Cancer.

Smoking was the leading cause of preventable cancer death in Australia in 2013 and accounted for 23% of all cancer deaths. ...Three other categories of modifiable risk factors — poor diet, overweight/obesity, and infections — accounted for 5% of cancer deaths each. In a fifth category, alcohol-related cancer accounted for 2.4% of deaths. Physical inactivity factors were responsible for 0.8% of cancer deaths, overexposure to ultraviolet radiation for 3.2% of cancer deaths, and, in the eighth category, reproductive or hormonal factors were linked to 0.4% of cancer deaths.

In the diet category, risk factors include low intake of fruit, nonstarchy vegetables, and dietary fiber and high intake of red and processed meat. In the infection category, seven cancer-causing agents, including human papillomavirus (associated with cancer of the vulva, vagina, penis, anus, oral cavity, and oropharynx) and Helicobacter pylori (noncardia stomach cancer), are included. Lack of breastfeeding, use of menopausal hormone therapy, and use of combined oral contraceptive use (breast and cervical cancer) are listed as preventable risk factors in the reproductive category.

These findings are in keeping with other research on the role of modifiable lifestyle-related risk factors in cancer prevention. As previously reported by Medscape Medical News, results from a large cohort study in the United States led researchers to conclude that 20% to 40% of cancer cases and related mortality could be prevented by not smoking, maintaining a healthy weight, and exercising regularly. In another report, results from a national online survey undertaken by the American Society of Clinical Oncology showed that, like their Australian counterparts, most US adults don't know alcohol and obesity are major risk factors for cancer[Original study.]

A dividing lung cancer cell. Lung cancer is associated with smoking. Credit: National Institute of Health (NIH). 


The message is clear from a recent study: older adults should get out and move, move , move (brisk walking is fine) - to lower the risk of early death. The older women engaging in the most moderate to vigorous activity had a 65% lower risk of early death during an average follow-up period of 2.3 years (when compared to the women with the least exercise).

How much exercise did the groups get? The least active had 6.8 minutes per day of moderate to vigorous exercise, and the most active had about 68 minutes/day of moderate to vigorous physical activity. The women wore a Fitbit type of device (an accelerometer) that measured their movements. Moderate to vigorous exercise was any movement that got the heart rate up a bit, made them sweat a little - and which could be brisk walking.

The study was done with older women (in their 70s), but one would think it also applies to men. Note: all-cause mortality means death from any cause (death in general). From Medscape:

Intense Exercise Tied to 65% Lower Death Risk in Older Women

Older women who engaged in the greatest amount of moderate to vigorous physical activity, such as brisk walking, were found to have a 65% lower risk of all-cause mortality compared with women who performed the least amount of such exercise, a new study reports. The researchers examined women in their early 70s in the Women's Health Study (WHS) who wore a triaxial accelerometer for 7 days to measure physical activity. The findings, by Dr I-Min Lee (Brigham and Women's Hospital, Boston, MA) and colleagues, were published November 6, 2017 in Circulation.

It's been known for a long time that physical activity is associated with lower mortality rates, Dr Lee told | Medscape Cardiology.... Now that physical activity can be better measured using a research-grade triaxial accelerometer, the magnitude of the reduced risk of short-term death with recommended amounts of moderate to vigorous physical activity can be seen to be as strong as not smoking, Lee said. ... This study "reinforces the message that adults should strive to meet physical activity guidelines of 150 minutes of moderate or 75 minutes of vigorous exercise per week," Dr Alpa Patel (American Cancer Society, Atlanta, Georgia) who recently published a related article that showed benefits from walking told | Medscape Cardiology.

From 2011 to 2015, 18,289 of 29,494 living women (63%) in the Women's Health Study agreed to participate in the current study.... The remaining 17,708 women were mailed a research-grade triaxial accelerometer (ActiGraph GT3X+, ActiGraph Corp) and asked to wear it on their hips for 7 days (but to take it off when sleeping or swimming) and then mail it back. 

The women spent a median of 8.4, 5.8, and 0.5 hours/day being sedentary, doing light physical activity, and doing moderate to vigorous physical activity, respectively. "The least active quartile were doing 8 minutes a day of moderate to vigorous . . . physical activity," Lee said, which was typically "brisk walking, anything that gets your heart rate up a little bit, gets you to sweat a little bit." The most active quartile did about 68 minutes/day of moderate to vigorous physical activity. During an average follow-up of 2.3 years, 207 women died. The total amount of physical activity was inversely related to the risk of all-cause mortality during follow-up, after adjustment for age and time spent wearing the device. 

What does it take to live to 100 in relatively good health? Are there common psychological traits? A study looked at 29 rural Italians aged 90 to 101 and their 51 younger family members to try to answer that question. They found that the elderly  participants had worse physical health but better mental well-being than their younger family members.

The older adults had a positive attitude or positivity (resilience and optimism), they worked hard, and had strong bonds with family and religion. They also had a strong need for control (family members called them "domineering") and a love of the land. The researchers summarized: "Exceptional longevity was characterized by a balance between acceptance of and grit to overcome adversities along with a positive attitude and close ties to family, religion, and land, providing purpose in life." From Science Daily:

Common psychological traits in group of Italians aged 90 to 101

In remote Italian villages nestled between the Mediterranean Sea and mountains lives a group of several hundred citizens over the age of 90. Researchers at the University of Rome La Sapienza and University of California San Diego School of Medicine have identified common psychological traits in members of this group. The study, publishing in International Psychogeriatrics, found participants who were 90 to 101 years old had worse physical health, but better mental well-being than their younger family members ages 51 to 75.

"The main themes that emerged from our study, and appear to be the unique features associated with better mental health of this rural population, were positivity, work ethic, stubbornness and a strong bond with family, religion and land." There were 29 study participants from nine villages in the Cilento region of southern Italy. 

"The group's love of their land is a common theme and gives them a purpose in life. Most of them are still working in their homes and on the land. They think, 'This is my life and I'm not going to give it up,'" said Anna Scelzo, first author of the study with the Department of Mental Health and Substance Abuse in Chiavarese, Italy. Interview responses also suggested that the participants had considerable self-confidence and decision-making skills. "This paradox of aging supports the notion that well-being and wisdom increase with aging even though physical health is failing," said Jeste, also the Estelle and Edgar Levi Chair in Aging and director of the Sam and Rose Stein Institute for Research on Aging at UC San Diego.

"We also found that this group tended to be domineering, stubborn and needed a sense of control, which can be a desirable trait as they are true to their convictions and care less about what others think," said Scelzo. "This tendency to control the environment suggests notable grit that is balanced by a need to adapt to changing circumstances." [Original study.

Rural village in the region of Cilento,  Italy. Credit: Wikipedia.

This is interesting, that blood pressure naturally starts lowering in the 14 to 18 years prior to death in people 60 years or older - whether they are healthy, have hypertension, have heart disease, take hypertension medicines or not.

The researchers analyzed 20 years of medical data for patients in the United Kingdom, and while everyone's blood pressure dropped for more than a decade before death, the decreases were "steepest in patients with hypertension, dementia, heart failure, and late-life weight loss". From Science Daily:

Blood pressure declines 14 to 18 years before death

Blood pressure in the elderly gradually begins to decrease about 14 or so years before death, according to a new study published today in the Journal of the American Medical Association Internal Medicine. Researchers from UConn Health and the University of Exeter Medical School in the U.K. looked at the electronic medical records of 46,634 British citizens who had died at age 60 or older. The large sample size included people who were healthy as well as those who had conditions such as heart disease or dementia.

They found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with. But long-term declines also occurred without the presence of any of these diagnoses.

Doctors have long known that in the average person, blood pressure rises from childhood to middle age. .... Some studies have indicated that blood pressure might drop in older patients and treatment for hypertension has been hypothesized as explaining late-life lower blood pressures. But this study found blood pressure declines were also present in those without hypertension diagnoses or anti-hypertension medication prescriptions. Further, the evidence was clear that the declines were not due simply to the early deaths of people with high blood pressure. [Original study.]