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Published on Leave a comment on Low Vitamin D Levels Associated With Cognitive Decline Among Older Adults

New research has found that low vitamin D levels among older adults is associated with accelerated cognitive decline and impaired performance (particularly in areas of memory and executive function). The next research in this area will have to look at whether vitamin D supplementation will change (slow down) the decline. Please note that it is widely accepted that an average daily intake of 1000 IU  of D3 daily is safe. The best source of  vitamin D is sunlight. From Science Daily:

Low vitamin D among elderly associated with decline in cognition, dementia

Vitamin D insufficiency among the elderly is highly correlated with accelerated cognitive decline and impaired performance, particularly in domains such as memory loss that are associated with Alzheimer's disease and dementia, researchers with the UC Davis Alzheimer's Disease Center and Rutgers University have found. The effect is "substantial," with individuals with low vitamin D declining at a rate three times faster than those with adequate vitamin D levels. 

The researchers said their findings amplify the importance of identifying vitamin D insufficiency among the elderly, particularly high-risk groups such as African-Americans and Hispanics, who are less able to absorb the nutrient from its most plentiful source: sunshine. Among those groups and other darker-skinned individuals, low vitamin D should be considered a risk factor for dementia, they said. "Independent of race or ethnicity, baseline cognitive abilities and a host of other risk factors, vitamin D insufficiency was associated with significantly faster declines in both episodic memory and executive function performance," said Joshua Miller...

The large, longitudinal study was conducted in nearly 400 racially and ethnically diverse men and women in Northern California participating in longitudinal research at the Alzheimer's Disease Center in Sacramento, Calif. Fifty percent of participants were Caucasian and 50 percent were African-American or Hispanic. The participants had a mean age of 76 and were either cognitively normal, had mild cognitive impairment, or dementia.The participants' serum vitamin D status was measured at the beginning of the study.... Overall, 26 percent were deficient and 35 percent were insufficient. Among Caucasians, 54 percent had low vitamin D, compared with 70 percent of African-Americans and Hispanics.

Over five years of follow-up, vitamin D deficient individuals experienced cognitive declines that were two-to-three times faster than those with adequate serum vitamin D levels. In other words it took only two years for the deficient individuals to decline as much as their counterparts with adequate Vitamin D declined during the five-year follow-up period.

Exposing the skin to sunlight is the major source of vitamin D. Racial and some ethnic minorities are at greater risk of low vitamin D because the higher concentration of melanin that makes their skin darker -- and protects against skin cancer in sunny climates -- also inhibits synthesis of vitamin D. Diet is the other major source of vitamin D. Dietary vitamin D is obtained particularly through dairy consumption. The intake of dairy products is especially low among minority groups, with only 6.5 percent of African-Americans and 11 percent of Mexican-Americans nationwide consuming the recommended three daily servings of dairy products, the study says.

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Another study finds health benefits to eating a Mediterranean based diet (here combined with the DASH diet) - the MIND diet. The researchers found that the older adults who followed the diet best were about 7.5 years younger cognitively than those who followed it least, thus suggesting that it may slow the cognitive decline of aging. Earlier research had suggested that it may reduce a person's risk in developing Alzheimer's disease. Foods to eat: fruits, vegetables, berries, whole grains, legumes (beans), nuts, fish, a little wine, and some chicken. Foods to limit on this diet: butter, red meat, margarine, sweets and pastries, whole fat cheese, and fried or fast food. From Medical Xpress:

Eating away at cognitive decline: MIND diet may slow brain from aging by 7.5 years

While cognitive abilities naturally diminish as part of the normal aging process, it may be possible to take a bite out of this expected decline. Eating a group of specific foods known as the MIND diet may slow cognitive decline among aging adults, even when the person is not at risk of developing Alzheimer's disease, according to researchers at Rush University Medical Center. This finding is in addition to a previous study by the research team that found that the MIND diet may reduce a person's risk in developing Alzheimer's disease.

The recent study shows that older adults who followed the MIND diet more rigorously showed an equivalent of being 7.5 years younger cognitively than those who followed the diet least. The results of the study recently were published online in the journal Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

The National Institute of Aging funded study evaluated cognitive change over a period of 4.7 years among 960 older adults who were free of dementia on enrollment. Averaging 81.4 years in age....residents of more than 40 retirement communities and senior public housing units in the Chicago area. .... Martha Clare Morris, ScD, a nutritional epidemiologist, and colleagues developed the diet, whose full name is the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay. As the name suggests, the MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both diets have been found to reduce the risk of cardiovascular conditions, like hypertension, heart attack and stroke.

"Everyone experiences decline with aging; and Alzheimer's disease is now the sixth leading cause of death in the U.S., which accounts for 60 to 80 percent of dementia cases. Therefore, prevention of cognitive decline, the defining feature of dementia, is now more important than ever," Morris says.

The MIND diet has 15 dietary components, including 10 "brain-healthy food groups" and five unhealthy groups - red meat, butter and stick margarine, cheese, pastries and sweets, and fried or fast food. To adhere to and benefit from the MIND diet, a person would need to eat at least three servings of whole grains, a green leafy vegetable and one other vegetable every day—along with a glass of wine—snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week. In addition, the study found that to have a real shot at avoiding the devastating effects of cognitive decline, he or she must limit intake of the designated unhealthy foods, especially butter (less than 1 tablespoon a day), sweets and pastries, whole fat cheese, and fried or fast food (less than a serving a week for any of the three).

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

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An observational study of older adults found that the Mediterranean diet may help preserve the connections between neurons in the brain, by preserving the microstructure in the white matter of the brain. This appeared to have a strong cognitive benefit - equal up to 10 years of delayed cognitive aging in those who adhered to the Mediterranean diet most closely. So if you haven't started already, try eating what the Mediterranean diet stresses: fruits, vegetables, whole grains, seeds, nuts, legumes, olive oil, some fish, and some wine. And cut back on highly processed foods, meat, and high fat foods. It's not one or two foods, but overall diet that is important. From Medscape:

Mediterranean Diet May Preserve Brain Structural Connectivity

The Mediterranean diet may help preserve structural connectivity in the brain in older adults, results of a French study hint. Greater adherence to the Mediterranean diet was associated with preserved microstructure in extensive areas of the white matter up to a decade later, the study team found. And this appeared to be related to strong cognitive benefit, equal to up to 10 years of delayed cognitive aging for those with the greatest adherence, they say....The study was published online July 16 in Alzheimer's & Dementia. The Mediterranean diet has been associated with a lower risk for Alzheimer's disease, but the underlying mechanisms have been unclear.

The new findings are based on 146 nondemented older adults in the Bordeaux Three-City study, a prospective cohort initiated in 1999-2000 to study vascular risk factors for dementia. Participants provided information on their diet in 2001-2002 (at a mean age of 73 years), underwent brain MRI an average of 9 years later (including diffusion tensor imaging)...On the basis of dietary assessment, 26% of participants had a low Mediterranean diet (MedDi) score of 0 to 3, indicating poor adherence to the diet; 47% had medium scores (4 or 5); and 27% had higher scores (6 to 8) representing the best adherence to the diet.

In adjusted analysis, there was no significant association between the MedDi score and grey matter or white matter volume. However, there was a strong association between the MedDi and diffusion tensor imaging patterns, suggesting that higher MeDi adherence was associated with a "general pattern of preserved WM [white matter] microstructure in multiple bundles," the researchers say. And preserved white matter microstructure with higher adherence to the MedDi "appeared to delay cognitive aging by up to 10 years."

"Our results suggest that the Mediterranean diet helps preserve the connections between neurons, which appear to be damaged with aging, vascular brain diseases and neurodegenerative diseases such as Alzheimer's dementia," Dr Samieri told Medscape Medical News. "In addition, the regions which appeared preserved with greater adherence to the Mediterranean diet were extended and were not specific to a particular disease, suggesting that the Mediterranean diet may have the potential to prevent not only stroke (as previously demonstrated with the PREDIMED [Prevención con Dieta Mediterránea] trial) but also multiple age-related brain pathologies," she added.

The added finding that none of the individual components of the Mediterranean diet was strongly associated with imaging results "supports our hypothesis that overall diet quality may be more important to preserve brain structure than any single food," they write.

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Finding an increased risk of dementia and Alzheimer's with so many common over-the-counter medications such as Benadryl and  Chlortrimeton (the first generation allergy drug that so many people took for years) was an unpleasant surprise. Note: they found the link with high doses or heavy use (3 or more years). Some examples of common anticholinergics (from Wikipedia) are: atropine, benztropine (Cogentin), chlorpheniramine (Chlor-Trimeton), dimenhydrinate (Dramamine), diphenhydramine (Benadryl, Sominex, Advil PM, etc.), doxylamine (Unisom), hydroxyzine (Atarax, Vistaril), ipratropium (Atrovent), oxybutynin (Ditropan, Driptane, Lyrinel XL), tolterodine (Detrol, Detrusitol), tiotropium (Spiriva), and bupropion (Zyban, Wellbutrin). The message here: only take medications when absolutely needed and for as little a time as necessary. The study was done on older adults, so now the question is: what about children or young adults who take these drugs for years? Is there a similar increased risk later in life? From Medical Daily:

Common Over-The-Counter Anticholinergic Drugs Like Benadryl May Increase Your Risk Of Alzheimer's

Anticholinergic medications span a range of common drugs and include antihistamines, sleep aids, antidepressants, cardiovascular meds, gastrointestinal drugs (for diarrhea, incontinence, diverticulitis, and ulcers), and muscle relaxants. Now, a new study confirms the link between these everyday medications and dementia. Taking anticholinergic drugs at high doses or for a long time may significantly increase your risk for developing Alzheimer's disease and other dementias, say researchers from University of Washington School of Pharmacy.

“If providers need to prescribe a medication with anticholinergic effects because it is the best therapy for their patient, they should use the lowest effective dose, monitor the therapy regularly to ensure it's working, and stop the therapy if it's ineffective,” Dr. Shelly Gray, a professor and director of the geriatric pharmacy program at the UW School of Pharmacy said in a release.

On average, older people take four or five prescription drugs and two over-the-counter drugs each day. Clearly, drugs are an important part of medical care for older people; however, older people are more sensitive to the effects of many pills, including anticholinergics, which block the neurotransmitter acetylcholine and so effect the nervous system. While the drugs are too numerous to mention, those with anticholinergic effects — and these effects are sometimes dependent on the dose — include Benadryl, Sominex, Xanax, Ativan, Valium, Luminal, Skelaxin, Limbitrol, and Tavist.

For the current study, the researchers investigated a previously reported link between anticholinergics, both prescription strength and over-the-counter, and dementia by employing more rigorous methods than in the past. Specifically, the researchers conducted a longer follow-up of more than seven years and more accurate use assessment via pharmacy records, which included nonprescription choices. The team tracked nearly 3,500 seniors participating in a long-running study, the Adult Changes in Thought (ACT), a joint project of UW and the National Institute on Aging.

The most commonly used medications in the study, the researchers discovered, were tricyclic antidepressants like doxepin (Sinequan), antihistamines like chlorpheniramine (Chlor-Trimeton), and antimuscarinics for bladder control like oxybutynin (Ditropan). People taking at least 10 mg/day of doxepin, 4 mg/day of diphenhydramine, or 5 mg/day of oxybutynin for more than three years, the researchers estimated, would be at greater risk for developing dementia. Importantly, substitutes are available for some of these drugs.  

While this study is the first to show a dose response — meaning, the more you use anticholinergic medications the greater your risk of developing Alzheimer’s — it also is the first to suggest this higher risk may persist, and may not be reversible, even years after you stop taking these drugs. 

Source: Gray S, Crane P, Dublin S, et al. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia. JAMA Internal Medicine. 2015.

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Great news for coffee lovers, especially for those drinking 3 to 5 cups daily! From Medical Daily:

Drinking Coffee Can Lower Alzheimer's Risk By 20%, All It Takes Is 3 Cups A Day

As if you weren’t already drinking a lot of coffee, a review of several studies has found drinking three to five cups a day could reduce risk of Alzheimer’s disease by 20 percent.

The research was presented at the 2014 Alzheimer Europe Annual Congress, and found that people who drank coffee regularly — all you lifers out there — were less likely to develop the debilitating disease. Alzheimer’s, perhaps the worst type of dementia, is a progressive disease that works slowly, first making it difficult to remember newly learned things, and later on making it difficult to remember early memories and family member’s faces, while also causing hallucinations. The biggest risk factor for the disease is being over 65 years old.

Roughly 83 percent of American adults drink coffee, according to the National Coffee Association. What many of these Americans don’t know, however, is that inside that cup of Joe is a wealth of polyphenols, which you probably know as antioxidants. These antioxidants — researchers said they’re the same ones found in the Mediterranean diet — prevent the formation of a hallmark of Alzheimer’s disease known as amyloid plaques and neurofibrillary tangles, the study found. They also reduce inflammation and deterioration of brain cells, particularly in the areas of the brain (the hippocampus and cortex) responsible for memory.

Along with prevention of Alzheimer’s, coffee has been linked to a reduced risk of liver cancer and other liver conditions, a lower risk of type 2 diabetes; it prevents eye damage and Parkinson’s disease; and even boosts endurance. But even then, drinking too much isn’t good, either. As the researchers noted, three to five cups is optimal; anything over that, and you might find yourself with some problems.

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An assortment of vitamin and health articles from the past year. (Note: Some other major Vitamin D study results were posted earlier this year, as well as today - search Vitamin D). Whether one should take vitamins is still being debated, with the most support being for supplementation with Vitamin D (specifically D3).The first summary is from pubmed.gov:

Taking vitamin D with the largest meal improves absorptioncally D3) and results in higher serum levels of 25-hydroxyvitamin D.

Many patients treated for vitamin D deficiency fail to achieve an adequate serum level of 25-hydroxyvitamin D [25(OH)D] despite high doses of ergo- or cholecalciferol. The objective of this study was to determine whether administration of vitamin D supplement with the largest meal of the day would improve absorption and increase serum levels of 25(OH)D.... it is concluded that taking vitamin D with the largest meal improves absorption and results in about a 50% increase in serum levels of 25(OH)D levels achieved. Similar increases were observed in a wide range of vitamin D doses taken for a variety of medical conditions.

 The following are all from Science Daily:

Long-term daily multivitamin supplement use decreases cataract risk in men, study finds

Long-term daily multivitamin supplement use may lower cataract risk in men, according to a study of nearly 15,000 male physicians. Half took a common daily multivitamin, as well as vitamin C, vitamin E and beta carotene supplements. The other half took a placebo. The researchers followed the participants to identify how many participants in each group developed new cases of two common eye diseases: cataract and age-related macular degeneration. Results showed a 9 percent decrease in risk for those that took the supplements.

Taking B vitamins won't prevent Alzheimer's disease, researchers conclude

Taking B vitamins doesn't slow mental decline as we age, nor is it likely to prevent Alzheimer's disease, conclude researchers who have assembled all the best clinical trial data involving 22,000 people to offer a final answer on this debate. When looking at measures of global cognitive function -- or scores for specific mental processes such as memory, speed or executive function -- there was no difference between those on B vitamins and those receiving placebo to a high degree of accuracy.

Children who drink non-cow's milk are twice as likely to have low vitamin D

Children who drink non-cow's milk such as rice, almond, soy or goat's milk, have lower levels of vitamin D in their blood than those who drink cow's milk, according to a new study. In North America, every 100 millilitres of cow's milk is required to be fortified with 40 units of vitamin D. Adding vitamin D to non-cow's milk, however, is voluntary.

Vitamin E intake critical during 'the first 1,000 days'

Amid conflicting reports about the need for vitamin E and how much is enough, a new analysis published today suggests that adequate levels of this essential micronutrient are especially critical for the very young, the elderly, and women who are or may become pregnant... "It's important all of your life, but the most compelling evidence about vitamin E is about a 1000-day window that begins at conception," Traber said. "Vitamin E is critical to neurologic and brain development that can only happen during that period. It's not something you can make up for later." Some of the best dietary sources of vitamin E -- nuts, seeds, spinach, wheat germ and sunflower oil -- don't generally make the highlight list of an average American diet. 

Vitamin D deficiency linked to higher risk of cardiovascular, cancer death

Analysis of pooled data showed a strong association between low vitamin D levels and risk of death in general death from cardiovascular diseases, death in from cancer, at least in older people with a history of cancer. "Going into our study, the effect of vitamin D supplementation on risk of death was not clear," said the lead investigator. "Our analysis confirms the protective nature of this substance especially in elderly patients."

High-dose vitamin D for ICU patients who are vitamin D deficient does not improve outcomes

Administration of high-dose vitamin D3 compared with placebo did not reduce hospital length of stay, intensive care unit length of stay, hospital mortality, or the risk of death at 6 months among patients with vitamin D deficiency who were critically ill, according to a study.

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To celebrate National Nut Day, two articles about health benefits of nuts. From Medical Daily:

National Nut Day 2014: Peanuts, Tree Nuts, And How Each Helps Your Health

“For people who already eat plenty of meat and dairy products…nuts and ‘nutty’ legumes, like Brazil nuts, cashews, peanuts and walnuts, are a good nutritional alternative to meat,” Dr. Donal Murphy-Bokern, independent agri-environmental scientist and author of several studies on food system impacts, said in a statement. Heeding this advice means people can reap the benefits that come with eating nuts — Protein! Fiber! Omega-3 fatty acids! 

Nuts fall into two categories: peanuts (which are really legumes) and tree nuts. The latter includes Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, walnuts and America’s beloved almonds. ...” And existing research generalizes that eating nuts does everything from reduce risk for a slew of diseases, maintains weight, boosts gastrointestinal and bone health, even adds years to a person’s life.

As previously mentioned, nuts are pretty much equal in terms of calories. There are, however, some nuts that have more heart-healthy nutrients and fats than others. See: pistachios. This particular tree nut is high in healthy fats called monounsaturated fats (MUFA). MUFAs are often associated with belly fat.

One study published in the journal Nutrition found that when middle-aged adults at risk for heart disease and diabetes incorporated more pistachios into their diet, they weighed less and lessened their cholesterol and blood sugar levels after just six months. And a separate study from UCLA found people who regularly ate pistachios lost an average of 10 to 12 pounds. Almonds and cashews are additional nuts high in MUFAs. 

The Harvard School of Public Health reported, “several of the largest cohort studies, including the Adventist Study, the Iowa Women’s Health Study, the Nurses’ Health Study, and the Physicians’ Health Study have shown a consistent 30 percent to 50 percent lower risk of myocardial infarction, sudden cardiac death, or cardiovascular disease associated with eating nuts several times a week.”

Though almonds tend to be associated most with heart health, it’s actually walnuts that take the number one spot. ...Health reported a 2006 Spanish study, which “suggested that walnuts were as effective as olive oil at reducing inflammation and oxidation in the arteries after eating a fatty meal.”

Folate, as defined by Harvard Medical School, is “the naturally occurring form of the vitamin that is in foods or in the blood.” It’s also the vitamin that staves off brain atrophy, or the progressive loss of brain cells over time... A study published in the American Journal of Psychiatry found folate may ward off depression, too. And which nut is super rich in folate? Unsalted peanuts...peanuts are also high in vitamin E and niacin, both of which boost brain health. Hazelnuts and almonds are known to have concentrated amounts of E, too, so either nut is bound to help your noggin.

Study done in mice, but shows benefits of walnuts to brain. From Science Daily:

Fight against Alzheimer's disease: New research on walnuts

A new animal study published in the Journal of Alzheimer's Disease indicates that a diet including walnuts may have a beneficial effect in reducing the risk, delaying the onset, slowing the progression of, or preventing Alzheimer's disease. Research led by Abha Chauhan, PhD, head of the Developmental Neuroscience Laboratory at the New York State Institute for Basic Research in Developmental Disabilities (IBR), found significant improvement in learning skills, memory, reducing anxiety, and motor development in mice fed a walnut-enriched diet.

The researchers suggest that the high antioxidant content of walnuts (3.7 mmol/ounce) may have been a contributing factor in protecting the mouse brain from the degeneration typically seen in Alzheimer's disease. Oxidative stress and inflammation are prominent features in this disease, which affects more than five million Americans.

Walnuts have other nutritional benefits as they contain numerous vitamins and minerals and are the only nut that contains a significant source of alpha-linolenic acid (ALA) (2.5 grams per ounce), an omega-3 fatty acid with heart and brain-health benefits. The researchers also suggest that ALA may have played a role in improving the behavioral symptoms seen in the study.

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Yes, going out in the sunshine for a while is a good way to get vitamin D. From Science Daily:

Link between vitamin D, dementia risk confirmed

Vitamin D deficiency is associated with a substantially increased risk of dementia and Alzheimer's disease in older people, according to the most robust study of its kind ever conducted. An international team found that study participants who were severely vitamin D deficient were more than twice as likely to develop dementia and Alzheimer's disease.

The team studied elderly Americans who took part in the Cardiovascular Health Study. They discovered that adults in the study who were moderately deficient in vitamin D had a 53 per cent increased risk of developing dementia of any kind, and the risk increased to 125 per cent in those who were severely deficient.

Similar results were recorded for Alzheimer's disease, with the moderately deficient group 69 per cent more likely to develop this type of dementia, jumping to a 122 per cent increased risk for those severely deficient.

The study was part-funded by the Alzheimer's Association, and is published in Neurology, the medical journal of the American Academy of Neurology. It looked at 1,658 adults aged 65 and over, who were able to walk unaided and were free from dementia, cardiovascular disease and stroke at the start of the study. The participants were then followed for six years to investigate who went on to develop Alzheimer's disease and other forms of dementia.... Previous research established that people with low vitamin D levels are more likely to go on to experience cognitive problems, but this study confirms that this translates into a substantial increase in the risk of Alzheimer's disease and dementia.

Vitamin D comes from three main sources -- exposure of skin to sunlight, foods such as oily fish, and supplements. Older people's skin can be less efficient at converting sunlight into virVitamin D, making them more likely to be deficient and reliant on other sources. In many countries the amount of UVB radiation in winter is too low to allow vitamin D production.

The study also found evidence that there is a threshold level of Vitamin D circulating in the bloodstream below which the risk of developing dementia and Alzheimer's disease increases. The team had previously hypothesized that this might lie in the region of 25-50 nmol/L, and their new findings confirm that vitamin D levels above 50 nmol/L are most strongly associated with good brain health....During this hottest of summers, hitting the beach for just 15 minutes of sunshine is enough to boost your vitamin D levels. 

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More long-term benefits from breastfeeding. The first study finds that long-term it's as good or better than statins! From Science Daily:

Birthweight and breastfeeding have implications for children's health decades later

Young adults who were breastfed for three months or more as babies have a significantly lower risk of chronic inflammation associated with cardiovascular and metabolic diseases, according to research from the Brown School at Washington University in St. Louis.

"This study shows that birthweight and breastfeeding both have implications for children's health decades later," said Molly W. Metzger, PhD, assistant professor at the Brown School and a co-author of the study with Thomas W. McDade, PhD, of Northwestern University.

"Specifically, we are looking at the effects of these early factors on later levels of C-reactive protein (CRP), a biomarker associated with risk for cardiovascular and metabolic disease," Metzger said. "Comparing the long-term effects of breastfeeding to the effects of clinical trials of statin therapy, we find breastfeeding to exert effects that are as large or larger."

The researchers used data from the U.S. National Longitudinal Study of Adolescent Health, including parent surveys, and blood samples providing measurements of CRP. These findings held up in a series of sibling models, in which one sibling was breastfed and the other was not. Such models provide improved confidence in the results by implicitly controlling for genetic factors for elevated CRP.

This study was published a year ago (Aug. 2013) and shows a long-term benefit to the mother (reduced Alzheimer's risk) of breastfeeding. From Science Daily:

Breastfeeding may reduce Alzheimer's risk

Mothers who breastfeed their children may have a lower risk of developing Alzheimer's Disease, with longer periods of breastfeeding also lowering the overall risk, a new study suggests.

The report, newly published in the Journal of Alzheimer's Disease, suggests that the link may be to do with certain biological effects of breastfeeding. For example, breastfeeding restores insulin tolerance which is significantly reduced during pregnancy, and Alzheimer's is characterised by insulin resistance in the brain.

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This is Part 3 on how lifestyle influences aging. Many recent research reports tell of a link between our lifestyle and how we'll age - whether we'll be active and healthy well into our 80s or in terrible shape and dying young. Mind you, these are not "definites" because nothing can give you a guarantee, but they are ways we can improve our odds in living a long and healthy life. From Medical Xpress:

Having a sense of purpose may add years to your life, study finds

Feeling that you have a sense of purpose in life may help you live longer, no matter what your age, according to new research. The research has clear implications for promoting positive aging and adult development, says the lead researcher.

The researchers looked at data from over 6000 participants, focusing on their self-reported purpose in life (e.g., "Some people wander aimlessly through life, but I am not one of them") and other psychosocial variables that gauged their positive relations with others and their experience of positive and negative emotions.

Greater purpose in life consistently predicted lower  across the lifespan, showing the same benefit for younger, middle-aged, and older participants across the follow-up period. "To show that purpose predicts longer lives for younger and older adults alike is pretty interesting, and underscores the power of the construct," he explains.

From Science Daily:

Education boosts brain function long after school, study shows

Education significantly improves mental functioning in seniors even four decades after finishing school, shows a new study. The study shows that people who attended school for longer periods performed better in terms of cognitive functioning than those who did not. Using data from individuals aged around 60, the researchers found a positive impact of schooling on memory scores. The fact that young people or their parents did not choose whether to go longer to school strongly suggests that schooling is the cause rather than personal characteristics that would affect this choice and could also explain the differences in cognitive function.

From Medscape:

Lifetime of Intellectual Enrichment Keeps Aging Brain Sharp

A lifetime of intellectual enrichment helps delay onset of cognitive decline in older individuals, new data from the Mayo Clinic Study on Aging show.

In this longitudinal study, researchers found ties between higher levels of education and working in mentally stimulating jobs in early- to mid-life, as well as higher levels of mid- to late-life cognitive activity, such as using a computer, reading, and participating in social activities, and better cognition with age..."We also found that an individual with low education/occupation benefited more by engaging in high mid-/late-life cognitive activity than an individual with high education/occupation," Dr. Vemuri noted.

A number of research results were reported at the Alzheimer's Association International Conference 2014.  From Science Daily:

Potential Alzheimer's disease risk factor and risk reduction strategies become clearer

Participation in activities that promote mental activity, and moderate physical activity in middle age, may help protect against the development of Alzheimer's disease and dementia in later life, according to new research.

From Science Daily:

Physical activity is beneficial for late-life cognition

Physical activity in midlife seems to protect from dementia in old age, according to a study. Those who engaged in physical activity at least twice a week had a lower risk of dementia than those who were less active. The protective effects were particularly strong among overweight individuals. In addition, the results showed that becoming more physically active after midlife may also contribute to lowering dementia risk.