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New research further confirms a link between higher lutein levels (as measured in the blood) and the preservation of "crystallized intelligence" in older adults.  Crystallized intelligence is the ability to use the skills and knowledge one has acquired over a lifetime. Lutein is in foods such as leafy green vegetables, cruciferous vegetables (broccoli, brussels sprouts, cauliflower, and cabbage) and egg yolks. Lutein is also found in small amounts in other fruits and vegetables. Bottom line: eat a variety of fresh fruits and vegetables daily. [Original study.]Medical Xpress:

Study links nutrition to brain health and intelligence in older adults

A study of older adults links consumption of a pigment found in leafy greens to the preservation of "crystallized intelligence," the ability to use the skills and knowledge one has acquired over a lifetime.

Lutein (LOO-teen) is one of several plant pigments that humans acquire through the diet, primarily by eating leafy green vegetables, cruciferous vegetables such as broccoli, or egg yolks, said University of Illinois graduate student Marta Zamroziewicz, who led the study with Illinois psychology professor Aron Barbey. Lutein accumulates in the brain, embedding in cell membranes, where it likely plays "a neuroprotective role," she said. "Previous studies have found that a person's lutein status is linked to cognitive performance across the lifespan," Zamroziewicz said. 

The study enrolled 122 healthy participants aged 65 to 75 who solved problems and answered questions on a standard test of crystallized intelligence. Researchers also collected blood samples to determine blood serum levels of lutein and imaged participants' brains using MRI to measure the volume of different brain structures. The team focused on parts of the temporal cortex, a brain region that other studies suggest plays a role in the preservation of crystallized intelligence.

The researchers found that participants with higher blood serum levels of lutein tended to do better on tests of crystallized intelligence. Serum lutein levels reflect only recent dietary intakes, Zamroziewicz said, but are associated with brain concentrations of lutein in older adults, which reflect long-term dietary intake. Those with higher serum lutein levels also tended to have thicker gray matter in the parahippocampal cortex, a brain region that, like crystallized intelligence, is preserved in healthy aging, the researchers report..... "Our findings do not demonstrate causality," Zamroziewicz said. "We did find that lutein is linked to crystallized intelligence through the parahippocampal cortex."

Tobacco use is a leading cause of cancer and early death in the U.S. and throughout the world. According to a new study looking at people 70 years old and older, the good news is that quitting smoking at any time in life (even as late as the 60s) is better for immediate health and also reduces the risk of death.

The study compared people who had never smoked to people currently smoking - and found that in the 6 year follow up period current smokers were more than three times more likely to die than people who had never smoked. Furthermore, quitting smoking at any age was associated with a lower risk of death. Former smokers who quit smoking earlier in life received the largest benefit from quitting smoking. But even people who quit during their 60s were at substantially decreased risk of death (when compared to people who continued to smoke). Bottom line: It's never too late to quit smoking. But best is to never even start smoking. From MedicalXpress:

Quitting smoking at any age reduces the risk of death after 70

Tobacco use continues to be a major cause of cancer and premature death. Most studies of cigarette smoking and mortality have focused on middle-aged populations, with fewer studies examining the impact of tobacco cessation on disease and mortality risk among the elderly. A new study published in the American Journal of Preventive Medicine, found that people aged 70 or older currently smoking were more than three times more likely to die than never-smokers, while former smokers were less likely to die the sooner they quit.

Investigators reviewed data for more than 160,000 individuals aged 70 and over who participated in the NIH-AARP Diet and Health Study. They completed a questionnaire in 2004-2005 detailing their smoking use, and reported deaths were tracked until the end of 2011....For this study, participants still smoking in their 70s were identified as current smokers, and former smokers were classified by the decade of life when quitting. At the beginning of the study (2004-2005), the median age of participants was 75 years. Almost 56% were former smokers and 6% were current smokers. Males were less likely (31% vs 48% of females) to be never-smokers. 

During an average follow-up of 6.4 years, almost 16% of the participants died. While 12.1% of the never smokers died, 16.2%, 19.7%, 23.9%, and 27.9% of former smokers who quit between ages 30-39, 40-49, 50-59, and 60-69 years died, respectively. Current smokers fared the worst, with 33.1% dying. Mortality rates for women were lower than men at each level of smoking use.

"These data show that age at smoking initiation and cessation, both key components of smoking duration, are important predictors of mortality in U.S. adults aged 70 years and older," commented Dr. Nash. "In the NIH-AARP study population, younger age at initiation was associated with increased risk of mortality, highlighting the importance of youth and early-adult smoking on lifetime mortality risk, even among people who live to age 70 years. In addition, former smokers were at substantially reduced risk of mortality after age 70 years relative to current smokers, even those who quit in their 60s. These findings show that smoking cessation should be emphasized to all smokers, regardless of age."

Interesting preliminary research that suggests that daily intake for 12 weeks of several beneficial bacteria species (Lactobacillus acidophilus, L. casei, L. fermentum, and Bifidobacterium bifidum) resulted in improved mental (cognitive) functioning in 52 people with Alzheimer's Disease. Could this be true - daily probiotics to improve mental functioning in those with Alzheimer's?

Many more studies need to be done, but this is definitely interesting. The nice thing in this study was that the patients were randomly assigned to the groups, and it was "double-blind" so no one knew who got just plain milk and who drank probiotic milk in the study (so no biases to distort results). There were also metabolic and inflammation improvements in those taking the probiotics. From Medical Xpress:

Probiotics improve cognition in Alzheimer's patients

For the first time, scientists have shown that probiotics—beneficial live bacteria and yeasts taken as dietary supplements—can improve cognitive function in humans. In a new clinical trial, scientists show that a daily dose of probiotic Lactobacillus and Bifidobacterium bacteria taken over a period of just 12 weeks is enough to yield a moderate but significant improvement in the score of elderly Alzheimer's patients on the Mini-Mental State Examination (MMSE) scale, a standard measure of cognitive impairment.

Probiotics are known to give partial protection against certain infectious diarrheas, irritable bowel syndrome, inflammatory bowel disease, eczema, allergies, colds, tooth decay, and periodontal disease. But scientists have long hypothesized that probiotics might also boost cognition, as there is continuous two-way communication between the intestinal microflora, the gastrointestinal tract, and the brain through the nervous system, the immune system, and hormones (along the so-called "microbiota-gut-brain axis"). In mice, probiotics have indeed been shown to improve learning and memory, and reduce anxiety and depression- and OCD-like symptoms. But prior to the present study there was very limited evidence of any cognitive benefits in humans.

Here, the researchers, from Kashan University of Medical Sciences, Kashan, and Islamic Azad University, Tehran, Iran, present results from a randomized, double-blind, controlled clinical trial on a total of 52 women and men with Alzheimer's between 60 and 95 years of age. Half of the patients daily received 200 ml milk enriched with four probiotic bacteria Lactobacillus acidophilus, L. casei, L. fermentum, and Bifidobacterium bifidum (approximately 400 billion bacteria per species), while the other half received untreated milk.

At the beginning and the end of the 12-week experimental period, the scientists took blood samples for biochemical analyses and tested the cognitive function of the subjects with the MMSE questionnaire, which includes tasks like giving the current date, counting backwards from 100 by sevens, naming objects, repeating a phrase, and copying a picture.

Over the course of the study, the average score on the MMSE questionnaire significantly increased (from 8.7 to 10.6, out of a maximum of 30) in the group receiving probiotics, but not in the control group (from 8.5 to 8.0). Even though this increase is moderate, and all patients remained severely cognitively impaired, these results are important because they are the first to show that probiotics can improve human cognition. Future research, on more patients and over longer time-scales, is necessary to test if the beneficial effects of probiotics become stronger after longer treatment.

Treatment with probiotics also resulted in lower levels of triglycerides, Very Low Density Lipoprotein (VLDL), high-sensitivity C-Reactive Protein (hs-CRP) in the blood of the Alzheimer patients, and likewise a reduction in two common measures (called "Homeostatic Model Assessment", HOMA-IR and HOMA-B) of insulin resistance and the activity of the insulin-producing cells in the pancreas. "These findings indicate that change in the metabolic adjustments might be a mechanism by which probiotics affect Alzheimer's and possibly other neurological disorders," says Salami. "We plan to look at these mechanisms in greater detail in our next study." [The original study.]

  Eating lots of fruits and vegetables (more than 10 servings a day!)  is linked to better cognitive functioning in both normal weight and overweight adults (both young and older adults), and may delay the onset of cognitive decline that occurs with aging and also dementia. Overweight and obese older adults with a daily fruit and vegetable consumption of less than 5 servings generally had worse cognitive functioning. Higher levels of physical activity and higher daily fruit and vegetable consumption were both associated with better cognitive functioning. Cognitive functioning generally refers to a person’s ability to reason and think, the mental processes needed to gather and process information, and all aspects of language and memory.

The York University researchers found that fruit and vegetable consumptionphysical activity, and BMI or body mass index (normal, overweight, obese) all appear to interact in how a person mentally functions (cognitive functioning), especially as they age. The ideal goal as one ages is to preserve the mind. It appears that eating lots of fruits and vegetables daily (10 or more servings), being physically active (this includes daily walks), and being a healthy weight help with this goal. It helps to also be highly educated (or read books?) so that the brain has a "cognitive reserve",

Why is daily fruit and vegetable consumption (FVC) good for cognitive functioning and the brain? Studies find that daily consumption of fruits and vegetables is strongly associated with a reduced risk of cardiovascular disease, cancer, diabetes and age-related declines. They appear to be "protective" against cognitive decline. The study researchers point out that fruits and vegetables contain high quantities of vitamin C and E, fiber, micronutrients, flavonoids, beta-carotenes and other classes of phytochemicals. These are important in various ways: "they modulate detoxifying enzymes, stimulate the immune system, modulate cholesterol synthesis, and act as antibacterial, antioxidant or neuroprotective agents." NOTE: A serving of fruit is generally 1 medium fruit or 1/2 cup of fruit. A serving of vegetables is 1 cup of raw leafy greens or 1/2 cup of other vegetables. From Medical Xpress:

Healthy living linked to higher brain function, delay of dementia

It's tempting to dip into the leftover Halloween treats, but new research out of York University has found eating plenty of fruits and vegetables, combined with regular exercise, leads to better cognitive functioning for younger and older adults, and may delay the onset of dementia. York U post-doctoral fellow Alina Cohen and her team, including Professors Chris I. Ardern and Joseph Baker, looked at cross-sectional data of 45,522 participants, age 30 to 80+, from the 2012 annual component of the Canadian Community Health Survey.

What they found was that for those who are normal weight or overweight, but not obese, eating more than 10 servings of fruit and vegetable daily was linked to better cognitive functioning. When moderate exercise was added, those eating less than five servings, reported better cognitive functioning. Higher levels of physical activity were linked to the relationship between higher daily fruit and vegetable consumption and better cognitive performance. Those with higher body mass indexes, low activity levels and fruit and vegetable consumption were associated with poorer cognitive functioning.

More details from the original study in the Journal of Public Health: Physical activity mediates the relationship between fruit and vegetable consumption and cognitive functioning: a cross-sectional analysis

Results: Higher BMIs, lower PA [physical activity] and FVC [fruit and vegetable consumption] were associated with poorer cognitive functioning. Additionally, PA statistically mediated the relationship between FVC and cognitive function (Sobel test: t = −3.15; P < 0.002); and higher education levels and daily FVC were associated with better cognitive function (P < 0.001). Conclusion: Higher PA levels were associated with better cognitive functioning in younger and older adults. Also, higher daily FVC and education levels were associated with better cognitive scores.

Individuals who were normal weight or overweight and reported a FVC of >10 servings per day reported better cognitive functioning scores than those who reported <10 servings, as well as those individuals with obesity . As well, both active and inactive individuals who reported a FVC of >10 servings per day had better cognitive scores than those who consumed fewer servings. However, in those who were moderately active, individuals with a daily FVC of <5 or 5–10 servings reported better cognitive functioning than those with a daily FVC of 10 or more servings; this may have resulted because of underestimations of the number of servings of fruits and vegetables actually consumed... Thus, increasing FVC and PA levels as well as having a healthy BMI may aid in the delay of cognitive decline.

Results also indicated that higher education levels along with a daily FVC of five or more servings were associated with better cognitive functioning. Education may be assisting in the process of delaying cognitive decline by increasing cognitive reserve, the ability of the human brain to cope with damage by using different brain processes to retain the ability to function well. Cognitive reserve is developed through intellectual stimulation and translates into a higher volume of connections between neurons and stronger rates of cerebral blood flow.

One of the dreaded afflictions of getting older is age-related macular degeneration (AMD), which is a leading cause of vision loss in Americans 60 years and older. It has no cure. Thus this study finding that eating a Mediterranean diet, and especially lots of fruit, was associated with a lower risk of macular degeneration was welcome news. They also found a protective effect from drinking caffeinated beverages - about 78 mg of caffeine per day (about one cup of coffee or one shot of espresso). A Mediterranean diet stresses eating fruits, vegetables, nuts, whole grains, legumes, fish, seeds, and olive oil. From Science Daily:

Fruit-rich Mediterranean diet with antioxidants may cut age-related macular degeneration risk by more than a third

People who closely follow the Mediterranean diet -- especially by eating fruit -- may be more than a third less likely to develop age-related macular degeneration, a leading cause of blindness, according to a study presented at AAO 2016, the 120th annual meeting of the American Academy of Ophthalmology. The study is the first to identify that caffeine may be especially protective against AMD.

Many studies have confirmed the health benefits of the Mediterranean diet, which emphasizes eating fruits, vegetables, whole grains, legumes, nuts, healthy fats and fish, and limiting red meat and butter. The diet has been shown to improve heart health and reduced risk of cancer, but there has been little research on whether its benefits can extend to eye disease. To determine this, researchers studied a Portuguese population to see whether adherence to the diet impacted people's risk of AMD. Their findings revealed a significant reduction in risk in those who ate a Mediterranean diet most frequently, and particularly among those who consumed more fruit and caffeine.

Researchers at the University of Coimbra in Portugal studied 883 people age 55 or older in the central region of the country between 2013 and 2015. Of those, 449 had AMD in its early stages before vision loss, and 434 did not have AMD. Researchers assessed their diets based on a questionnaire asking how often they ate foods associated with the Mediterranean diet. The more they ate foods associated with the diet, the higher the score, from 0-9. Those who closely followed the diet scored a 6 or greater. Their findings were as follows:

Higher diet adherence scores meant lower AMD risk Of those who did not closely follow the diet (scored below a 6), 50 percent had AMD. Of those who did closely follow the diet (scored 6 or above), only 39 percent had AMD. This represents a 35 percent lower risk compared to those who did not adhere to the diet.

Fruits were especially beneficial Researchers analyzed consumption of foods and found that people who consumed higher levels of fruit were significantly less likely to have AMD. Of those who consumed 150 grams (about five ounces) or more of fruit a day: 54.5 percent did not have AMD and 45.5 percent had AMD. Overall, people who ate that much fruit or more each day were almost 15 percent less likely to have AMD, based on an odds ratio calculation.

Caffeine and antioxidants also were protective Researchers used a computer program to analyze the participants' consumption of micronutrients, according to their answers on the questionnaire. They found higher consumption of antioxidants such as caffeine, beta-carotene and vitamins C and E was protective against AMD. Of those who consumed high levels of caffeine (about 78 mg a day, or the equivalent of one shot of espresso): 54.4 percent did not have AMD and 45.1 percent had AMD....The researchers opted to look at caffeine because it is a powerful antioxidant that is known to be protective against other conditions, such as Alzheimer's disease.

More great news about drinking coffee daily - for women. Older women (between ages of 65 to 80 at the start of the study) reporting drinking higher amounts of caffeinated beverages (about 261 mg which is about 2 to 3 cups of coffee per day) had a lower incidence of dementia and cognitive impairment over a 10 year period (as compared to the low caffeine group). The low caffeine group averaged 64 mg of caffeine per day.  Other studies also found a reduction in "cognitive decline" in older people with coffee consumption. This study, among others, is more evidence of caffeine being "neuroprotective". NOTE: an 8-ounce cup of brewed coffee contains about 95 mg of caffeine, 8-ounces of brewed black tea contains about 47 mg, a 12-ounce can of carbonated cola contains 33 mg, and 8-ounces of decaffeinated coffee has about 5 mg of caffeine. Science Daily:

For women, caffeine could be ally in warding off dementia

Among a group of older women, self-reported caffeine consumption of more than 261 mg per day was associated with a 36 percent reduction in the risk of incident dementia over 10 years of follow-up. This level is equivalent to two to three 8-oz cups of coffee per day, five to six 8-oz cups of black tea, or seven to eight 12-ounce cans of cola.

"The mounting evidence of caffeine consumption as a potentially protective factor against cognitive impairment is exciting given that caffeine is also an easily modifiable dietary factor with very few contraindications," said Ira Driscoll, PhD, the study's lead author and a professor of psychology at the University of Wisconsin-Milwaukee. "What is unique about this study is that we had an unprecedented opportunity to examine the relationships between caffeine intake and dementia incidence in a large and well-defined, prospectively-studied cohort of women."

The findings come from participants in the Women's Health Initiative Memory Study, which is funded by the National Heart, Lung, and Blood Institute. Driscoll and her research colleagues used data from 6,467 community-dwelling, postmenopausal women aged 65 and older who reported some level of caffeine consumption. Intake was estimated from questions about coffee, tea, and cola beverage intake, including frequency and serving size.

In 10 years or less of follow-up with annual assessments of cognitive function, 388 of these women received a diagnosis of probable dementia or some form of global cognitive impairment. Those who consumed above the median amount of caffeine for this group (with an average intake of 261 mg per day) were diagnosed at a lower rate than those who fell below the median (with an average intake of 64 mg per day). The researchers adjusted for risk factors such as hormone therapy, age, race, education, body mass index, sleep quality, depression, hypertension, prior cardiovascular disease, diabetes, smoking, and alcohol consumption. (The original study in the Journal of Gerontology.)

 Image result for books wikipedia There are some things we can do that are linked to living longer, such as not smoking and exercising regularly, but could reading books also have such an effect? A study published in the journal Social Science and Medicine concludes that those who regularly read books add several years to their lives. They found this effect in both men and women, found that reading books are "protective regardless of gender, wealth, education", but the effect holds only for books and not magazines and newspapers. Since surveys show that 87% of book readers read fiction, then it is likely that most of the book readers were reading fiction.

In the long-term (12 years) study of 3,635 people, the researchers found that those that read books for more than 3.5 hours per week lived on average two years longer than non-readers, and that there was a dose-response effect (the more one reads, the better). This appeared to be linked to cognitive enhancement rather than any other associated factor, such as age, sex, education, race, health, wealth, etc. The research team from the Yale University School of Public Health divided their subjects into three groups: those who didn’t read at all, those who read for 3.5 hours per week or less, and those who read for more than 3.5 hours per week. They found that the occasional readers were 17 percent less likely to die during the follow-up period than those who did not. This beneficial effect of reading was only linked to books, and not other forms of reading material such as magazines or newspapers. From the journal Social Science and Medicine:

A chapter a day: Association of book reading with longevity

This study examined whether those who read books have a survival advantage over those who do not read books and over those who read other types of materials, and if so, whether cognition mediates this book reading effect. The cohort consisted of 3635 participants in the nationally representative Health and Retirement Study who provided information about their reading patterns at baseline.....based on survival information up to 12 years after baseline. A dose-response survival advantage was found for book reading by tertile.....Book reading contributed to a survival advantage that was significantly greater than that observed for reading newspapers or magazines. Compared to non-book readers, book readers had a 23-month survival advantage at the point of 80% survival in the unadjusted model. A survival advantage persisted after adjustment for all covariates (HR = .80, p < .01), indicating book readers experienced a 20% reduction in risk of mortality over the 12 years of follow up compared to non-book readers. Cognition mediated the book reading-survival advantage. These findings suggest that the benefits of reading books include a longer life in which to read them.

While most sedentary behaviors are well-established risk factors for mortality in older individuals (Wullems et al., 2016; de Rezenade et al., 2014, Katzmaryk & Lee, 2012; Muennig, Rosen, & Johnson, 2013), previous studies of a behavior which is often sedentary, reading, have had mixed outcomes....We speculated that books engage readers’ minds more than newspapers and magazines, leading to cognitive benefits that drive the effect of reading on longevity

Reading books tends to involve two cognitive processes that could create a survival advantage. First, it promotes "deep reading,” which is a slow, immersive process; this cognitive engagement occurs as the reader draws connections to other parts of the material, finds applications to the outside world, and asks questions about the content presented (Wolf, Barzillai, & Dunne, 2009). Cognitive engagement may explain why vocabulary, reasoning, concentration, and critical thinking skills are improved by exposure to books (Stanovich, West, & Harrison, 1995; Stanovich & Cunningham, 1998; Wolf, Barzillai, & Dunne, 2009). Second, books can promote empathy, social perception, and emotional intelligence, which are cognitive processes that can lead to greater survival (Bassuk, Wypij, & Berkmann, 2000; Djikic, Oatley, & Moldoveanu 2013; Kidd & Castano 2013; Shipley, Der, Taylor, & Deary 2008; Olsen, Olsen, Gunner-Svensson, & Waldstrom, 1991).

The final sample consisted of 3635 individuals that were followed over 34,496 person years, with 27.4% of the sample dying during an average 9.49 years of follow-up. Consistent with the older population, the sample was predominantly (62%) female.....The average time spent reading per week was 3.92 hours for books and 6.10 hours for periodicals. The two types of reading were not strongly correlated, and 38% of the sample (n=1390) read only books or only periodicals; this allowed them to be treated as separate constructs.....Cognitive engagement was assessed with total cognitive score (available in the supplemental Imputation of Cognitive Function Measures) which is a summary variable based on 8 items, including immediate recall, delayed recall, serial 7s, backwards count from 20, object naming, President naming, Vice President naming, and date naming.

A 20% reduction in mortality was observed for those who read books, compared to those who did not read books. Further, our analyses demonstrated that any level of book reading gave a significantly stronger survival advantage than reading periodicals.....The mediation analyses showed for the first time that the survival advantage was due to the effect that book reading had on cognition....This finding suggests that reading books provide a survival advantage due to the immersive nature that helps maintain cognitive status.

A new study conducted in China found an association between low vitamin D levels and future cognitive decline in older adults. The lower the vitamin D levels at the initial screening (the baseline), the more people with cognitive decline at a 2 year follow-up. There were were no gender differences. (Another study with similar results.) Vitamin D is produced naturally in the skin when exposed to sunlight, and also found in smaller amounts in food such as fish (e.g. salmon) and eggs. Vitamin D helps maintain healthy bones and muscles, but it also plays a key part in brain function and is viewed as neuroprotective. Low levels are associated with greater risk of cardiovascular and neurodegenerative diseases.

The 1,202 participants (60 years or older) in China had their baseline vitamin D levels measured at the start of the study, and their cognitive abilities assessed over two years. What I found interesting in this study was that the vitamin D levels in the people was in general pretty low - this was without any supplementation, thus from sunlight. The researchers specified vitamin D levels (25-Cholecalciferol) in nmol/l, but in the United States values are generally specified in ng/ml. In the study the median level of vitamin D levels in the lowest quartile converted to ng/ml was 10.0 ng/ml, and in the highest quartile the median level was 26.4 ng/ml. With those low numbers, all 4 groups in the United States would be advised to supplement daily with vitamin D (specifically vitamin D3). From Journals of Gerontology: Medical Sciences:

Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey

Vitamin D has a neuroprotective function, potentially important for the prevention of cognitive decline. Prospective studies from Western countries support an association between lower vitamin D level and future cognitive decline in elderly people.

This community-based cohort study of elderly people in China follows 1,202 cognitively intact adults aged ≥60 years for a mean duration of 2 years. Plasma vitamin D level was measured at the baseline. Cognitive state of participants was assessed using the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score <18. Cognitive decline was defined as ≥3 points decline from baseline....Participants with low vitamin D level had an increased risk of cognitive decline. This first follow-up study of elderly people, including the oldest-old, in Asia shows that low vitamin D levels were associated with increased risk of subsequent cognitive decline and impairment.

Vitamin D is a secosteroid hormone necessary for maintaining good musculoskeletal health; its deficiency is associated with increased risks of cardiovascular and neurodegenerative diseases. Vitamin D is primarily synthesized in the skin upon exposure to sunlight; smaller amounts are obtained through dietary intake. More recently, enzymes responsible for the synthesis of its active form have been found to be distributed throughout the human brain.... This growing body of evidence suggests that vitamin D has a neuroprotective function that is potentially important for the prevention of cognitive decline. Although the importance of vitamin D cannot be disregarded, there is still no consensus on its optimal level. This is especially pertinent in the elderly people, the oldest-old in particular, as cutaneous synthesis of vitamin D decreases with age. Moreover, their impaired mobility and limited outdoor activities can further exacerbate vitamin D deficiency.

Cross-sectional studies have generally found a positive association between vitamin D status and cognitive performance in older adults. Recent prospective studies from United States and Europe support an association between diminished vitamin D status and future cognitive decline. Since cutaneous synthesis is the main source of vitamin D, there exists great variability in vitamin D levels across populations due to differences in latitude, seasons, and race/ethnicity, such as level of skin pigmentation.

Our findings were consistent with previous cohort studies showing that vitamin D status predicts cognitive decline....A notable observation in the present study is that the association of vitamin D status and cognitive decline were similar in both oldest-old and less elderly people. In this study, there was a clear association between lower 25(OH)D3 level and cognitive impairment in subjects aged ≥80....An additional difference from previous studies is that the current study indicates that the association between vitamin D and cognitive impairment is not gender specific.

The observation of temporal association between 25(OH)D3 levels and subsequent cognitive function supports the notion that vitamin D has a clinically important neuroprotective effect. A wide variety of mechanisms for this effect has been proposed and is supported by animal studies. Vitamin D has been found to modulate neuronal calcium homeostasis, cerebral process of detoxification, immunomodulation, and beta-amyloid clearance.....Further, it was unlikely that vitamin D supplementation would explain the association in this study, as 87% of the participants reported no use of vitamin supplements....In conclusion, our longitudinal study indicates that low 25(OH) D3 levels are associated with subsequent cognitive decline and cognitive impairment

What happens to your brain when you stop exercising? The results of this Univ. of Maryland study should be a wake up call for those who are not quite convinced of exercise's health benefits to the brain. The researchers examined cerebral blood flow in athletes (ages 50-80 years, who were recruited from running clubs) before and after a 10-day period during which they stopped all exercise. Using MRI brain imaging techniques, they found a significant decrease in blood flow to several brain regions important for cognitive health, including the hippocampus, after they stopped their exercise routines.

As the researchers pointed out: "...the take home message is simple -- if you do stop exercising for 10 days, just as you will quickly lose your cardiovascular fitness, you will also experience a decrease in blood brain flow." The only good news was that there were no differences on cognitive measures both before and after stopping exercise for 10 days. From Science Daily:

Use it or lose it: Stopping exercise decreases brain blood flow

We all know that we can quickly lose cardiovascular endurance if we stop exercising for a few weeks, but what impact does the cessation of exercise have on our brains? New research led by University of Maryland School of Public Health researchers examined cerebral blood flow in healthy, physically fit older adults (ages 50-80 years) before and after a 10-day period during which they stopped all exercise. Using MRI brain imaging techniques, they found a significant decrease in blood flow to several brain regions, including the hippocampus, after they stopped their exercise routines.

"We know that the hippocampus plays an important role in learning and memory and is one of the first brain regions to shrink in people with Alzheimer's disease," says Dr. J. Carson Smith, associate professor of kinesiology and lead author of the study, which is published in Frontiers in Aging Neuroscience in August 2016. "In rodents, the hippocampus responds to exercise training by increasing the growth of new blood vessels and new neurons, and in older people, exercise can help protect the hippocampus from shrinking. So, it is significant that people who stopped exercising for only 10 days showed a decrease in brain blood flow in brain regions that are important for maintaining brain health."

The study participants were all "master athletes," defined as people between the ages of 50 and 80 (average age was 61) who have at least 15 years history of participating in endurance exercise and who have recently competed in an endurance event. Their exercise regimens must have entailed at least four hours of high intensity endurance training each week. On average, they were running 36 miles (59 km) each week or the equivalent of a 10K run a day! Not surprisingly, this group had a V02 max (maximum volume of oxygen) above 90% for their age. This is a measure of the maximal rate of oxygen consumption of an individual and reflects their aerobic physical fitness.

Dr. Smith and colleagues measured the velocity of blood flow in brain with an MRI scan while they were still following their regular training routine (at peak fitness) and again after 10 days of no exercise. They found that resting cerebral blood flow significantly decreased in eight brain regions, including the areas of the left and right hippocampus and several regions known to be part of the brain's "default mode network" -- a neural network known to deteriorate quickly with a diagnosis of Alzheimer's disease. This information adds to the growing scientific understanding of the impact of physical activity on cognitive health.

 Eating several servings of seafood (especially fish) weekly has beneficial health effects throughout life, and now research finds another benefit in older adults. Seafood contains both EPA and DHA, which are two types of omega-3 fatty acids. DHA or docosahexanoic acid has "neuroprotective qualities" and is found in both the gray and white matter of the brain. Higher DHA levels (measured in the blood) was associated with better memory, less brain atrophy (better brain volume), and fewer amyloid plaques (which are associated with Alzheimer's) in cognitively healthy older adults. From Medscape:

Higher Serum DHA Linked to Less Amyloid, Better Memory

New research supports neuroprotectant effects of docosahexaenoic acid (DHA) in the aging brain. In a small cross-sectional study of cognitively healthy older adults, higher serum DHA levels were associated with less cerebral amyloidosis, better memory scores, and less regional brain atrophy.

"The interesting finding was the association of low serum DHA levels with cerebral amyloidosis (amyloid plaques) in older adults without evidence of dementia," Hussein N. Yassine, MD, Department of Medicine, University of Southern California, Los Angeles, told Medscape Medical News. "This association was predominantly driven by persons at the lowest quartile of serum DHA levels who likely have limited intake of seafood." "This study adds to the existing evidence on the benefit of seafood consumption on [Alzheimer's disease] AD risk factors," Dr Yassine added.

The study was published online August 8 in JAMA Neurology. In a linked editorial, Joseph F. Quinn, MD, Department of Neurology, Oregon Health and Science University, Portland, notes that DHA is "the most abundant polyunsaturated fatty acid in the brain, playing an important structural role in synapses while also modulating a number of signaling pathways. "Brain DHA levels are also modulated by dietary intake, so it is plausible for dietary DHA to alter brain concentrations and affect downstream targets including brain pathology and function."

Dr Yassine and colleagues assessed serum DHA levels, measures of amyloid burden based on positron emission tomography with Pittsburgh compound B, brain volume, and neuropsychological test scores in 61 adults without dementia in the Aging Brain Study.

They found that serum DHA levels (percentage of total fatty acids) were 23% lower in those with cerebral amyloidosis relative to those without. Serum DHA levels were inversely correlated with brain amyloid load, independent of age, sex, years of education, and apolipoprotein E genotype. They also noted a positive correlation between serum DHA levels and brain volume in several subregions affected by AD, in particular the left subiculum and the left entorhinal volumes.

Clinically, there was a significant association between serum DHA levels and nonverbal memory. This association persisted after adjustment for age but not after adjustment for apolipoprotein E genotype. Serum DHA levels were not associated with measures of global cognition, executive function, or verbal memory scores.