Category Archives: Aging

Cognition & Brain Studies: Apathy, Not Depression, Associated With Dementia

‘Journal of Neurology, Neurosurgery & Psychiatry” (July 10, 2020):

jnnp-2020-July-91-7-677-F1.mediumWe tested the hypothesis that apathy, but not depression, is associated with dementia in patients with SVD. We found that higher baseline apathy, as well as increasing apathy over time, were associated with an increased dementia risk. In contrast, neither baseline depression or change in depression was associated with dementia. The relationship between apathy and dementia remained after controlling for other well-established risk factors including age, education and cognition. Finally, adding apathy to models predicting dementia improved model fit. These results suggest that apathy may be a prodromal symptom of dementia in patients with SVD.

Cerebral small vessel disease (SVD) is the leading vascular cause of dementia and plays a major role in cognitive decline and mortality.1 2 SVD affects the small vessels of the brain, leading to damage in the subcortical grey and white matter.1 The resulting clinical presentation includes cognitive and neuropsychiatric symptoms.1

Apathy is a reduction in goal-directed behaviour, which is a common neuropsychiatric symptom in SVD.3 Importantly, apathy is dissociable from depression,3 4 another symptom in SVD for which low mood is a predominant manifestation.5 Although there is some symptomatic overlap between the two,6 research using diffusion imaging reported that apathy, but not depression, was associated with white matter network damage in SVD.3 Many of the white matter pathways underlying apathy overlap with those related to cognitive impairment, and accordingly apathy, rather than depression, has been associated with cognitive deficits in SVD.7 These results suggest that apathy and cognitive impairment are symptomatic of prodromal dementia in SVD.

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Future Of Medicine: “The Rise Of Teledermatology”

From AMA.org (June 12, 2020):

Teledermatology“There’s an aging population, and there’s a lot of skin out there,” said Dr. Isaacs. “One in five people in the country develop skin cancer, but there is a plethora of benign skin conditions that also require the expertise of the dermatologist. So, you have increasing demand and a limited supply of dermatologists.”

A basic example of how the TPMG teledermatology program works involves a patient who is concerned about a suspicious lesion or mole on their body. The patient can take a picture of the location in question and send it to their primary care physician for review. The physician can request the patient come in for a more thorough evaluation, or if the physician determines that a dermatologist should be involved, they can send the photo to an on-call dermatologist to review.

If the patient does an in-person evaluation, the physician can also take a higher-quality image and forward that to a dermatologist. The dermatologist can then decide whether there is a problem, if a prescription is needed, or if there should be an in-person evaluation and potential biopsy.

A study in the Journal of the American Academy of Dermatology in 2019 found that when TPMG dermatologists had the chance to look at well-photographed skin lesions, they were able to identify nearly 10% more cancers with almost 40% fewer referrals to the dermatology department.

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Podcast: “MedDiet” Alters Gut Micriobiome In Older People, Improves Frailty, Cognition, Inflammation

We observed that increased adherence to the MedDiet modulates specific components of the gut microbiota that were associated with a reduction in risk of frailty, improved cognitive function and reduced inflammatory status. 

Dr Philip Smith, Digital and Education Editor of Gut and Consultant Gastroenterologist at the Royal Liverpool Hospital interviews Professor Paul O’Toole; who is Professor of Microbial Genomics, Head of School of Microbiology and Principal Investigator in APC Microbiome Ireland, an SFI funded centre at University College Cork, Ireland, on “Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across 5 European countries” published in paper copy in Gut in July 2020.

Read article in BMJ Journal “Gut”

Brain Health Studies: Blueberries, Flavonoid-Rich Foods Lower Risks Of Alzheimer’s And Dementia

From the American Journal of Clinical Nutrition (April 22, 2020):

FlavonoidsOur findings imply that higher long-term dietary intakes of flavonoids are associated with lower risks of ADRD and AD in US adults.

Our findings provide new evidence that diets higher in flavonols, anthocyanins, and flavonoid polymers are associated with a lower risk of developing ADRD. These associations were sustained after accounting for a variety of potential confounders including key nutrients related to ADRD risk and overall diet quality. Similar findings were seen with AD risk for flavonols and anthocyanins but the association with flavonoid polymers was no longer statistically significant.

Along with improvements in healthcare and medical technology, the aging of the baby boom generation will result in an unprecedented rise in the number of older Americans (12). Currently, there are >50 million Americans aged ≥65 y, and that is projected to more than double by 2060 (3). A consequence of this increase in older adults is the escalation of age-related diseases (45). Alzheimer disease (AD) and related dementias (ADRD), a group of symptoms in which there is progressive deterioration in cognitive function severe enough to interfere with a person’s daily living activities, are regarded as among the most significant public health challenges largely affecting adults aged >65 y (6). AD is the most common form of dementia, making up ∼60–80% of dementia cases. Currently, 5.8 million Americans are living with AD, and by 2050 that is projected to escalate to 14 million (7).

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Podcast Interviews: “Exercise Is Medicine” Author Judy Foreman

Science Talk logoHealth journalist Judy Foreman talks about her new book Exercise Is Medicine: How Physical Activity Boosts Health and Slows Aging

downloadThis is Scientific American’s Science Talk, posted on April 24th, 2020. I’m Steve Mirsky. And under our current, often locked-down situation, it’s still really important to try to get some exercise. Judy Foreman is the author of the new book Exercise is Medicine: How Physical Activity Boosts Health and Slows Aging. She’s a former nationally syndicated health columnist for the Boston Globe, LA times, Baltimore Sun and other places, and an author for the Oxford University Press.

Judy Foreman is the author of “A Nation in Pain” (2014), “The Global Pain Crisis” (2017), and “Exercise is Medicine,” (2020), all published by Oxford University Press, and was a staff writer at The Boston Globe for 22 years and the health columnist for many of these years. Her column was syndicated in national and international outlets including the Los Angeles TimesDallas Morning NewsBaltimore Sun and others.

She graduated Phi Beta Kappa from Wellesley College and has a Master’s from the Harvard Graduate School of Education. She was a Lecturer on Medicine at Harvard Medical School, a Fellow in Medical Ethics at Harvard Medical School and a Knight Science Journalism Fellow at the Massachusetts Institute of Technology. She spent six months as a guest reporter for The Times of London. She was also a Senior Fellow at the Schuster Institute for Investigative Journalism at Brandeis University. She was also host of a live, weekly call-in radio show on Healthtalk.com.

Judy has won more than 50 journalism awards, including a 1998 George Foster Peabody award for co-writing a video documentary about a young woman dying of breast cancer and the 2015 Science in Society award from the National Association of Science Writers.

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The Elderly & Dementia: “Managing Daily Activities & Fall Prevention” (UCSF)

Presented by Sarah Dulaney, RN, CNS, a nurse at the UCSF Memory and Aging Center, and Helen Medsger, a family caregiver and LBD support group leader, as part of the Lewy Body Dementia Caregiver Webinar Series supported by the UCSF Memory and Aging Center and the Administration for Community Living.

Health Study: Older Adults With High Glucose Levels (A1C) Have Greater Cognitive Decline

From a MedPage Today online article (April 2, 2020):

Endocrine Society NewsThis relationship between higher glucose levels and poorer cognitive functioning extended beyond just CASI z-score, as well, Cukierman-Yaffe noted. Higher HbA1c levels were also tied to significantly poorer performance in other psychological tests, including the clock making test of executive functioning, test of discriminative ability, and for the test of verbal fluency.

Poorer glycemic control was tied to cognitive decline following a lacunar stroke in a prospective cohort study.

Among 942 individuals with type 2 diabetes who had a lacunar stroke, every 1% higher HbA1c was tied to a 0.06 drop in cognitive function at baseline measured by Cognitive Assessment Screening Instrument (CASI) z-score (95% CI -0.101 to -0.018), reported Tali Cukierman-Yaffe, MD, MSc, of Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Israel.

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Health Podcast: “Aging And The Immune System” (Mayo Clinic Radio)

On the Mayo Clinic Q&A podcast, Dr. Jessica Lancaster, a Mayo Clinic immunologist, discusses aging and the immune system. Some people are at higher risk of getting very sick from COVID-19 because of their age or underlying health conditions, according to the Centers for Disease Control and Prevention (CDC).

Adults 60 and older and those with an underlying health condition or a compromised immune system appear to develop serious illness more often than others. This interview was recorded March 19, 2020.

Learn more about immune system research at Mayo Clinic: https://www.mayo.edu/research/centers…

Exercise: “Shelter In Place” Home Circuit Workouts For Older Adults (WSJ)

From a Wall Street Journal article (March 21, 2020):

As we age, our balance declines, says Dani Johnson, a physical therapist with the Mayo Clinic’s Healthy Living Program in Rochester, Minn. Implementing balance exercises as simple as standing on one leg as you brush your teeth can help prevent falls. Getting a daily dose of cardio can boost the immune system.

This at-home circuit routine will get your heart rate up while also challenging strength and balance. Perform the circuit three times. Walk up and down steps or march in place for two to three minutes between sets. To up the effort, she suggests adding dumbbells or improvising with cans or tube socks filled with coins or rice.

Chair squats

Stand in front of a chair with your feet shoulder-width apart. Bend your knees, lowering your hips back, keeping weight in your heels and your chest upright. Start by sitting into the chair and standing back up 10 to 12 times. If this is easy, hover above the chair then return to standing.

 

 

Counter push-ups

Image result for incline push up at home gif animationPlace your hands on the edge of a counter, just beyond shoulder-width apart. Lower into a push-up then press back up. Repeat 10 to 12 times. For more of a challenge, walk your feet farther away from the counter.

Chair triceps dips

Sit upright in a chair with your hands on the armrests, elbows bent at 90 degrees. Straighten your arms, lifting your body off the chair. Hold briefly. Then lower yourself down. Use your legs to balance. Repeat 10 to 12 times.

Calf raises

Begin in a standing position. Rise up onto your toes, hold briefly, then lower back down. Repeat 10 to 12 times. Place one or both hands on a table or chair for more support. For an added challenge, perform on one leg at a time.

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