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Category: healthy aging

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From Medical Xpress:

Obesity may shorten life expectancy up to eight years

'Tis the season to indulge. However, restraint may be best according to a new study led by investigators at the Research Institute of the McGill University Health Centre (RI-MUHC) and McGill University. The researchers examined the relationship between body weight and life expectancy. Their findings show that overweight and obese individuals have the potential to decrease life expectancy by up to 8 years. The study, published in the current issue of The Lancet Diabetes and Endocrinology, further demonstrates that when one considers that these individuals may also develop diabetes or cardiovascular disease earlier in life, this excess weight can rob them of nearly two decades of healthy life.

Dr. Grover and his colleagues used data from the National Health and Nutrition Examination Survey (from years 2003 to 2010) to develop a model that estimates the annual risk of diabetes and cardiovascular disease in adults with different body weights. This data from almost 4,000 individuals was also used to analyze the contribution of excess body weight to years of life lost and healthy years of life lost.

Their findings estimated that individuals who were very obese could lose up to 8 years of life, obese individuals could lose up to 6 years, and those who were overweight could lose up to three years. In addition, healthy life-years lost were two to four times higher for overweight and obese individuals compared to those who had a healthy weight, defined as 18.5-25 body mass index (BMI). The age at which the excess weight accumulated was an important factor and the worst outcomes were in those who gained their weight at earlier ages.

"The pattern is clear - the more an individual weighs and the younger their age, the greater the effect on their health," Dr. Grover adds. "In terms of life-expectancy, we feel being overweight is as bad as cigarette smoking."

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That's right - when thinking about having children, don't just focus on the women's age. Think about sperm quality also. From Science Daily:

Men's sperm quality declines with age, review of 90 studies confirms

Conflicting evidence about the extent to which men's semen quality declines with age -- likely lowering their fertility -- is being cleared up by new research that has collated and reviewed data from 90 previous studies from around the world.

After conducting a systematic review and meta-analysis of the studies' data, researchers from the University's Departments of Zoology and Anatomy found consistent age-related declines in semen volume and sperm performance and increases in malformed and DNA-damaged sperm. Semen quality is regarded as a proxy for how fertile a male is.

"The effects of declining semen traits with increasing male age have largely been ignored due to inconsistencies in the literature, but our work now suggests that male age affects a variety of traits. It is well recognised that reduced sperm performance can affect pregnancy success, but it is less well known that the quality of the sperm, particularly DNA quality, could affect the development and health of the offspring," Dr Johnson says.

"Our study made no attempt to estimate the rate of decline, but some well-controlled clinic-based studies have observed consistent declines with increasing age, whereas others project declines after age 35 for some traits and after age 40 for others" she says.

"Older males contribute to increased risk of obstetric complications, miscarriage, and offspring disorders such as autism, Down syndrome, epilepsy, and schizophrenia. In addition, increasing male age may be an overlooked component of couple infertility, leading to our increased use and dependency on fertility treatments, such as IVF."

The authors suggest that clinical analysis of the percentage of DNA-fragmented sperm cells and a greater focus on how well sperm swim may lead to better patient outcomes during fertility treatments of aging couples."These are likely more accurate and consistent predictors of a man's fertility status than commonly clinically measured traits such as semen volume, sperm concentration and total sperm count," Dr Johnson says.

Sperm under microscope. Credit: Fertility Associates Ltd. NZ

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Based on the study results, the researchers suggest that even older couples in bad marriages could benefit from marriage counseling.From Science Daily:

Bad marriage, broken heart?

Older couples in a bad marriage -- particularly female spouses -- have a higher risk for heart disease than those in a good marriage, finds the first nationally representative study of its kind.

Liu analyzed five years of data from about 1,200 married men and women who participated the National Social Life, Health and Aging Project. Respondents were aged 57-85 at the beginning of the study...Liu set out to learn how marital quality is related to risk of heart disease over time, and whether this relationship varies by gender and/or age. Among her findings:

Negative martial quality (e.g., spouse criticizes, spouse is demanding) has a bigger effect on heart health than positive marital quality (e.g., spousal support). In other words, a bad marriage is more harmful to your heart health than a good marriage is beneficial.

The effect of marital quality on cardiovascular risk becomes much stronger at older ages. Over time, the stress from a bad marriage may stimulate more, and more intense, cardiovascular responses because of the declining immune function and increasing frailty that typically develop in old age, Liu said.

Marital quality has a bigger effect on women's heart health than it does on men's, possibly because women tend to internalize negative feelings and thus are more likely to feel depressed and develop cardiovascular problems, Liu said.

Heart disease leads to a decline in marital quality for women, but not for men. This is consistent with the longstanding observation that wives are more likely to provide support and care to sick husbands, while husbands are less likely to take care of sick wives.

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Jogging? Now retirees planning to relax and putter around instead have to jog for health? From Science Daily:

Jogging keeps you young: Seniors who run regularly can walk as efficiently as 20-somethings

A new study by researchers at Humboldt State University and the University of Colorado, Boulder is shedding light on an unexpected benefit of jogging in older adults. The study looked at adults over the age of 65 -- some of whom walk for exercise and some who run for exercise. The researchers found that those who run at least 30 minutes, three times a week were less likely to experience age-related physical decline in walking efficiency than those who simply walked.

In fact, the older runners were 7-10 percent more efficient at walking than those who didn't jog. "What we found is that older adults who regularly participate in high aerobic activities -- running in particular -- have what we call a lower metabolic cost of walking than older, sedentary adults. In fact, their metabolic cost of walking is similar to young adults in their 20s," said Justus Ortega, a Kinesiology Professor at Humboldt State and director of HSU's Biomechanics Lab.

Metabolic cost is the amount of energy needed to move and naturally increases as we age. High metabolic cost contributes to making walking more difficult and tiring. Decline in walking ability is a key predictor of morbidity in older adults.

In the study, researchers looked at self-reported older joggers over the age of 65 -- those who ran at least 30 minutes a day, three times a week -- and self-reported walkers, those who walked three times a week for 30 minutes. Participants were asked to walk on a treadmill at three speeds (1.6, 2.8 and 3.9 miles per hour) as researchers measured their oxygen consumption and carbon dioxide production. Overall, older joggers were 7-10 percent more efficient at walking than older adults who just walked for exercise. Their metabolic cost was similar to young people in their 20s.

Researchers aren't yet sure what makes joggers more efficient than walkers but they believe it may have something to do with the mitochondria found in cells. Evidence suggests that people who exercise vigorously have healthier mitochondria in their muscles.

 And a related concern: what about my knees? From  Science Daily:

Running does not lead to knee osteoarthritis, may protect people from developing disease, experts say

Running as a habitual exercise at any stage in life not only does not increase a person’s risk of developing knee osteoarthritis and may even help protect a person from developing the painful disease, according to new research findings."This {research} does not address the question of whether or not running is harmful to people who have pre-existing knee OA," said Dr. Lo. "However, in people who do not have knee OA, there is no reason to restrict participation in habitual running at any time in life from the perspective that it does not appear to be harmful to the knee joint."

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Big question: will vitamin D supplementation prevent cognitive decline? And what should be a daily supplement dose for adults? An earlier post cited a Medscape article suggesting that taking 1000 IU of vitamin D3 daily would be a good daily level of supplementation. From Medscape:

Vitamin D Deficiency Predicts Cognitive Decline

A new study supports a link between low levels of vitamin D and increased risk for cognitive decline, prompting calls for clinical trials to test whether vitamin D supplementation may delay or prevent dementia. In a group of cognitively intact older adults, serum 25-hydroxyvitamin D (25OHD) levels below 75 nmol/L at the outset predicted cognitive decline over roughly the next 4 years, independent of other factors.

For this analysis, the researchers looked at data on 1927 community-dwelling elderly individuals (mean age, 73.9 years) participating in the Italian population-based cohort study, Progetto Veneto Anziani (Pro.V.A.).

Dr Toffanello and colleagues say studies are needed to evaluate whether vitamin D supplementation might help to delay the cognitive decline, especially in patients who already have cognitive impairment.

David J. Llewellyn, PhD, from the University of Exeter Medical School in the United Kingdom, who has studied vitamin D and cognitive function but wasn't involved in this study, agrees. He told Medscape Medical News that this new study "effectively replicates" a 2010 study by his group showing a link between low vitamin D levels and an increased risk for cognitive decline. He said the Pro.V.A . study results are also consistent with a study his group published just this year inNeurology. That study suggested older patients with vitamin D levels below 50 nmol/L have about a 122% increased risk for dementia compared with those with higher levels.

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The message here is: find a passion or purpose to your life. From Science Daily:

Sense of meaning and purpose in life linked to longer lifespan

A study of 9,050 English people with an average age of 65 found that the people with the greatest well-being were 30 percent less likely to die during the average eight and a half year follow-up period than those with the least well-being.

The study, published in The Lancet as part of a special series on ageing, was conducted by researchers from UCL, Princeton University and Stony Brook University. It used questionnaire answers to measure a type of wellbeing called 'eudemonic wellbeing', which relates to your sense of control, feeling that what you do is worthwhile, and your sense of purpose in life. People were divided into four categories based on their answers, ranked from highest wellbeing to lowest wellbeing.

The results were adjusted for age, sex, socio-economic status, physical health, depression, smoking, physical activity and alcohol intake, to rule out as many factors as possible that could influence both health and wellbeing. For example, terminal illnesses could reduce both wellbeing and life expectancy.

Over the next eight and a half years, 9% of people in the highest wellbeing category had died, compared with 29% in the lowest category. Once all the other factors had been taken into account, people with the highest wellbeing were 30% less likely to die over the study period, living on average two years longer than those in the lowest wellbeing group.

"We have previously found that happiness is associated with a lower risk of death," says Professor Andrew Steptoe, Director of the UCL Institute of Epidemiology and Health Care, who led the study. "These analyses show that the meaningfulness and sense of purpose that older people have in their lives are also related to survival. We cannot be sure that higher wellbeing necessarily causes lower risk of death, since the relationship may not be causal. But the findings raise the intriguing possibility that increasing wellbeing could help to improve physical health. 

As part of the Lancet paper, the researchers also examined data on 'evaluative wellbeing', a measure of life satisfaction, and 'hedonic wellbeing', related to feelings of happiness, sadness, anger, stress and pain. International data from the Gallup World Poll confirmed that in high-income English speaking countries, life satisfaction dips around middle age and rises in older age, but the pattern varied across the world.

In the former Soviet Union and Eastern European countries, older residents reported very low rankings of life satisfaction compared with younger residents in those regions. This same pattern is seen in Latin America and Caribbean countries, though life satisfaction does not decrease as sharply as in the Eastern European countries. And in sub-Saharan Africa, life satisfaction is very low at all ages.

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Lasting benefits from lifestyle changes (Mediterranean diet and exercise). From Science Daily:

Mediterranean diets have lasting health benefits

The health benefits of switching to a Mediterranean style diet and upping the amount of time spent exercising for a period of just eight weeks can still be seen a year after stopping the regime, a new study has shown.

The research by Sheffield Hallam University and the University of Lincoln in the UK revealed that the diet and exercise combination leads to improved blood flow in cells in the inner lining of the blood vessels -- called the endothelial cells -- a full 12 months after completing participation in the intervention programme.

Endothelial cells line the interior of the entire vascular system of the human body -- from the large arteries to the smallest capillaries -- and improvements in their function could reduce the risk of people developing cardiovascular disease, the study said.

Researchers believe the long-term health benefits observed after such a short intervention could be due to molecular changes associated with the Mediterranean diet. Traditional Mediterranean cuisine is based on olive oil, fruit, vegetables and salad, fish, legumes, whole grain foods, wine and limited consumption of red meat.

The study focused on healthy people over the age of 50. Participants were originally assessed over an eight-week period.One group was encouraged to eat more vegetables, fruit, olive oil, tree nuts and fresh oily fish, as well as take up a moderate exercise regime, while the other just took up exercise alone.

The results showed more health improvements in the Mediterranean diet group than the exercise only group, which one year later, were still evident despite the lifestyle changes implemented during the study no longer being carefully followed.

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Think lifestyle changes, not medications. From Medical Daily:

Mild Hypertension Should Be Treated With Advice On Lifestyle Changes, Not Medication

In 2013, Dr. Iona Heath, a retired general practitioner published an article in the Journal of  the American Medical Association, in which she spoke about the side effects of overtreatment and overdiagnosis of mild hypertension. Now, in a new study, researchers revisit this idea, saying that unnecessary treatment of mild hypertension in low-risk patients is harming them and putting a burden on health care resources. They also argue that there's a need to reexamine criteria for diagnosing hypertension and treating blood pressure. 

About 40 percent of the world’s population, including 67 million American adults, have hypertension. Over half are classified as having mild hypertension. 

More than half of people with mild hypertension are treated with drugs, but there has been no evidence to suggest that blood pressure-lowering drugs prevent heart attacks. Instead of prescribing drugs to control mild hypertension, the authors urge clinicians to recommend healthier lifestyles to patients, which include exercising, quitting smoking, and decreased alcohol consumption. They also urge clinics to improve the accuracy of blood pressure-measuring instruments and to inform patients about measuring blood pressure at home. 

From Medical Xpress:

Experts raise concern over unnecessary treatment of mild hypertension in low risk people

Lowering the drug threshold for high blood pressure has exposed millions of low-risk people around the world to drug treatment of uncertain benefit at huge cost to health systems, warn US experts in BMJ today. Dr Stephen Martin and colleagues argue that this strategy is failing patients and wasting healthcare resources.

Over half of people with mild hypertension are treated with medication. Yet treating low risk mildly hypertensive patients with drugs has not been proven to reduce cardiovascular disease or death. The authors argue that overemphasis on drug treatment "risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level."

And for those over 65 the levels can be even higher. From Science News:

'Mild' control of systolic blood pressure in older adults is adequate: 150 is good enough

A broad review of the use of medications to reduce blood pressure has confirmed that "mild" control of systolic pressure is adequate for adults age 65 or older -- in the elderly, there's no clear benefit to more aggressive use of medications to achieve a lower pressure. Historically, most medical practitioners tried to achieve control of systolic pressure -- the higher of the two blood pressure readings -- to 140 or less. Recently changed guidelines now suggest that for adults over 60, keeping the systolic pressure at 150 or less is adequate, and this extensive analysis confirms that.

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Again,the same message: get moving for health, including cognitive function. From Science Daily:

To reap the brain benefits of physical activity, just get moving

Everyone knows that exercise makes you feel more mentally alert at any age. But do you need to follow a specific training program to improve your cognitive function? Science has shown that the important thing is to just get moving. It's that simple.

The study compared the effects of different training methods on the cognitive functions of people aged 62 to 84 years. Two groups were assigned a high-intensity aerobic and strength-training program, whereas the third group performed tasks that targeted gross motor activities (coordination, balance, ball games, locomotive tasks, and flexibility). While the aerobics and strength-training were the only exercises that led to physical fitness improvements after 10 weeks (in terms of body composition, VO2 max, and maximum strength), all three groups showed equivalent improvement in cognitive performance.

The subjects in the third group performed activities that can easily be done at home, which is excellent news for sedentary people who can't see themselves suddenly going to a gym to work out. To improve your cognitive health, you can simply start by doing any activity you like. 

"Our study targeted executive functions, or the functions that allow us to continue reacting effectively to a changing environment. We use these functions to plan, organize, develop strategies, pay attention to and remember details, and manage time and space," explained Dr. Louis Bherer, PhD.

"For a long time, it was believed that only aerobic exercise could improve executive functions. More recently, science has shown that strength-training also leads to positive results. Our new findings suggest that structured activities that aim to improve gross motor skills can also improve executive functions, which decline as we age. I would like seniors to remember that they have the power to improve their physical and cognitive health at any age and that they have many avenues to reach this goal," concluded Dr. Nicolas Berryman, PhD.

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Chocolate lovers are rejoicing! From the NY Times:

To Improve a Memory, Consider Chocolate

Science edged closer on Sunday to showing that an antioxidant in chocolate appears to improve some memory skills that people lose with age. In a small study in the journal Nature Neuroscience, healthy people, ages 50 to 69, who drank a mixture high in antioxidants called cocoa flavanols for three months performed better on a memory test than people who drank a low-flavanol mixture.

On average, the improvement of high-flavanol drinkers meant they performed like people two to three decades younger on the study’s memory task, said Dr. Scott A. Small,a neurologist at Columbia University Medical Center and the study’s senior author. They performed about 25 percent better than the low-flavanol group.

The findings support recent research linking flavanols, especially epicatechin, to improved blood circulation, heart health and memory in mice, snails and humans. But experts said the new study, although involving only 37 participants and partly funded by Mars Inc.,the chocolate company, goes further and was a well-controlled, randomized trial led by experienced researchers.

Besides improvements on the memory test — a pattern recognition test involving the kind of skill used in remembering where you parked the car or recalling the face of someone you just met — researchers found increased function in an area of the brain’s hippocampus called the dentate gyrus, which has been linked to this type of memory.

To consume the high-flavanol group’s daily dose of epicatechin, 138 milligrams, would take eating at least 300 grams of dark chocolate a day — about seven average-sized bars. Or possibly about 100 grams of baking chocolate or unsweetened cocoa powder, but concentrations vary widely depending on the processing. Milk chocolate has most epicatechin processed out of it.

More extensive research is planned. As for why flavanols would help memory, one theory is that they improve brain blood flow; another, favored by Dr. Small, is that they cause dendrites, message-receiving branches of neurons, to grow.