Aging, Author Interviews, Disability Research, Lancet / 09.12.2015

MedicalResearch.com Interview with: Prof. Carol Jagger AXA Professor of Epidemiology of Ageing and Deputy Director of the Newcastle University Institute for Ageing (NUIA) Institute of Health & Society Campus for Ageing and Vitality Newcastle upon Tyne  Medical Research: What is the background for this study? Prof. Jagger: Although we know that life expectancy at older ages is increasing, there is still uncertainty about whether the extra years are healthy ones. Our results are based on data from the Cognitive Function and Ageing Studies (CFASI and II), two cohorts of people aged 65 years and over in three centres in England (Cambridgeshire, Newcastle and Nottingham) who were interviewed in 1991 and 2011. The participants, over 7000 people in each study, were recruited from general practices in the area and included those living in care homes to ensure our results reflect the total older population. Medical Research: What are the main findings? Prof. Jagger: We used three health measures to calculate the health expectancies at age 65: cognitive impairment, self-perceived health and disability (mild and moderate/severe). Over the 20 year period women’s life expectancy at age 65 increased by 3.6 years whilst they gained 4.4 years free of cognitive impairment, 3.1 years in good self-perceived health but only 0.5 years free of disability. Men on the other hand lived an extra 4.5 years in total with gains of 4.2 years free of disability, 3.8 years in good self-perceived health and 2.6 years free of disability. So all the extra years of life were free of cognitive impairment for women but most were spent with disability, although the gains were in mild rather than more severe disability. (more…)
Aging, Author Interviews, Depression, Geriatrics / 13.11.2015

MedicalResearch.com Interview with: Helena Chui, Ph.D. CPsychol Lecturer Division of Psychology University of Bradford Bradford England  Medical Research: What is the background for this study? What are the main findings? Dr. Chui: It is debatable whether psychological well-being improves or declines with age. Findings of the age-related changes in psychological well-being, life satisfaction, and depressive symptoms, are not unequivocal. Some studies have found that people stay pretty stable in terms psychological well-being until late life. Other studies have found otherwise. My recent publication reports the findings using a 15-year longitudinal study from Australia. Results showed that as people get older, depressive symptoms increase. Both men and women reported increasingly more depressive symptoms as they aged, with women initially starting with more depressive symptoms than men. However, men showed a faster rate of increase in symptoms so that the difference in the genders was reversed at around the age of 80. (more…)
Aging, Author Interviews, Cost of Health Care, Pharmacology / 26.10.2015

MedicalResearch.com Interview with: Sue Dong, DrPH Data Center Director CPWR-The Center for Construction Research and Training Silver Spring, MD, 20910 Medical Research: What is the background for this study? What are the main findings? Response: The Center for Construction Research and Training (CPWR) is a nonprofit organization funded by NIOSH and several other federal government agencies. The aging workforce study is part of our NIOSH projects. According to our surveillance data (using the Current Population Survey), more than 30% of US workers were baby boomers in 2014, and about 63% of those baby boomers were aged 55 and up. Overall, the baby boomer generation is composed of 75 million Americans who have reached or will soon reach their retirement years. Despite the impending magnitude of societal disruption, information on health status among baby boomers and the potential burden faced by this cohort is still scarce. We hope this study can provide some needed information on the aging population in the US. To address this concern, we used data from the Health and Retirement Study (HRS). HRS is a national longitudinal survey of Americans aged 50 and over, which started in 1992. The baby boomer cohort (including Early Baby Boomers and Mid Baby Boomers who were born between 1948 and 1959) was added to the survey in recent years. HRS collects information on demographics, employment, health, health expenditures, etc. The rich information and relatively consistent survey instruments used over time allowed us to conduct this study. Medical Research: What are the main findings? Response: We estimated medical conditions and expenditures among the baby boomer cohort and compared them with the original HRS cohort (born between 1931 and 1941). We found that the baby boomers were more likely to report chronic conditions than the previous generation (HRS cohort) at similar ages. For example, at age 51-61, about 70% of the baby boomer cohort had at least one chronic condition, while 60% of the HRS cohort had at least one chronic condition. By detailed condition, 42.2% of baby boomers had high blood pressure, compared to 32.1% of the HRS cohort; 14.4% of the baby boomers had diabetes, nearly twice the proportion for the HRS cohort (7.8%). Overall, baby boomers had higher prevalence of chronic conditions for the nine conditions we measured compared to the HRS cohort at the same age. We also found that the baby boomers were more likely to be overweight compared to the previous generation. The prevalence of obesity was 37% among baby boomers, but it was 21.9% among the HRS cohort when they were at similar ages In terms of medical expenditures, the average out-of-pocket expenditure (OOPE) for the past two years for those aged 51-61 was $2,156 for the HRS cohort, but $3,118 for the baby boomers. Dollar value was adjusted to 2012 dollars for even comparison. The findings will be presented at the recent APHA annual conference in Chicago. (more…)
Aging, Author Interviews, Mental Health Research, Neurology / 15.09.2015

R. Scott Turner, MD, PhD Director of the Memory Disorders Program Georgetown University Medical CenterMedicalResearch.com Interview with: R. Scott Turner, MD, PhD Director of the Memory Disorders Program Georgetown University Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Turner: The resveratrol trial originated from the extensive scientific literature demonstrating that caloric restriction (consuming only 2/3 usual calories) prevents or delays diseases of aging - including Alzheimer's disease (AD) in laboratory animals. The molecular mechanism is thought to involve sirtuins - a group of genes/proteins that sense energy balance to regulate gene expression. Sirtuins are activated by caloric restriction (a mild stressor) to express genes that promote resilience of the organism. Resveratrol is a potent activator of sirtuins - thus bypassing the requirement for caloric restriction. On the opposite side of the coin - caloric excess, midlife obesity, and diabetes are strong risk factors for Alzheimer's disease. And we have long-known that resveratrol is found in red grapes, red wine, and other foods that promote general health. (more…)
Aging, Author Interviews, Genetic Research, Smoking, UCLA / 11.09.2015

Dr. Morgan Elyse Levine PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles MedicalResearch.com Interview with: Dr. Morgan Elyse Levine PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles Medical Research: What is the background for this study? What are the main findings? Dr. Levine: Studies using mice, worms, and flies have suggested that longevity may be linked to stress resistance. All of us are constantly encountering things that damage our cells and tissue and disrupt physiological functioning. Therefore, people who are genetically predisposed to better prevent or repair this damage may age slower. Smoking is one of the most damaging things someone can do to their health, yet some smokers are able to survive to extreme ages. This study looked at long-lived smokers to see if we could identify a "genetic signature". We generated a genetic risk score that was found to be associated with longevity both in smokers and non-smokers, and also appeared to be associated with cancer risk. (more…)
Aging, Author Interviews, Cognitive Issues, Exercise - Fitness / 22.08.2015

Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of CopenhagenMedicalResearch.com Interview with: Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of Copenhagen Medical Research: What is the background for this study? Response: A sufficient level of physical capability is a precondition for maintaining independence and quality of life. Physical capability can be assessed objectively by tests of physical performance, for instance handgrip strength, chair-rising and postural balance. Physical performance is associated with mortality and disability in late life, so gaining insights into the variance in physical performance is important to promote sustained physical capability and prevent disability. Research has previously found physical activity, health status and socioeconomic position to be associated with physical performance. In addition, early life factors, such as childhood SEP, have been found to be associated with measures of physical performance later in life. The objective of our study was to examine the association between intelligence in early adulthood and midlife physical performance in Danish men. If an association between intelligence in early life and midlife physical performance exists it may indicate that cognitive abilities and physical performance share some of the same neurodevelopmental processes, but may also indicate that intelligence has an independent effect on later physical performance through various pathways. Medical Research: What are the main findings? Response: In our study of more than 2800 Danish men, we found positive associations between intelligence in early adulthood and five objective measures of physical performance in midlife independent of other early life factors. A one standard deviation increase in intelligence score resulted in 1.1 more chair-rises in 30 seconds, a 1 cm higher jump, a 3.7% smaller balance area, a 0.7 kg increase in handgrip-strength, and a 0.5 kg increase in lower back force. (more…)
Aging, Author Interviews, BMJ, Exercise - Fitness / 05.08.2015

Dr David Hupin CHU Saint-Etienne, Hôpital Nord Service de Physiologie Clinique et de l'Exercice, Centre VISAS Cedex 2, FranceMedicalResearch.com Interview with: Dr David Hupin CHU Saint-Etienne, Hôpital Nord Service de Physiologie Clinique et de l'Exercice, Centre VISAS Cedex 2, France Medical Research: What is the background for this study? Dr. Hupin: Today, over 95% of the world’s population has health problems, according to the Global Burden of Disease Study published recently in The Lancet. The proportion of healthy years lost due to disease rapidly increased with age. There is no medical treatment that can influence as many diseases in a positive manner as can physical activity. It is well established that regular physical activity is an efficient strategy for successful aging. The 2008 Physical Activity guidelines for Americans recommend a minimum of 150 min of moderate-intensity (>3 MET) or 75 min of vigorous-intensity (≥6 MET) physical activity per week or an equivalent combination of moderate and vigorous physical activity (MVPA). A Metabolic Equivalent or MET is a unit useful for describing the energy expenditure of a specific physical activity. However, less than 50% of older adults are able to achieve the current recommendations of physical activity. Thus, the prescription of physical activity for older adults needs to be clarified, i.e., what "dose" of physical activity is required. Medical Research: What is the design of your study? Dr. Hupin: Within the dynamic Department of Clinical and Exercise Physiology of University Hospital of St-Etienne, we conducted a systematic review and meta-analysis. Out of at total of 835 relevant studies, nine were suitable for analysis. These involved a total of 122, 417 participants, monitored for an average of around 10 years, during which time 18,122 died. (more…)
Aging, Author Interviews, Cost of Health Care, Electronic Records, Geriatrics / 27.07.2015

MedicalResearch.com Interview with: Nisha C. Hazra MSc Department of Primary Care and Public Health Sciences, King's College London, London, UK Medical Research: What is the background for this study? What are the main findings? Response: Our study was motivated by limited evidence about the health status of very old people, the fastest growing group of the UK population with significant implications for future NHS health-care costs. Our findings indicated an increasing number of people reaching the age of 100 years, with the increase being higher among women comparing to men (a ratio of 4 to 1). Another interesting finding was that men reaching 100 years tended to be healthier than their female counterparts. In particular, women were more likely to present multiple chronic diseases compared to men and tended to be more frail, experiencing more falls, fractures, incontinence and hearing/visual impairments. (more…)
Aging, Author Interviews / 20.07.2015

Jessica Finlay M.A. Department of Geography, Environment and Society University of Minnesota MNMedicalResearch.com Interview with: Jessica Finlay M.A. Department of Geography, Environment and Society University of Minnesota MN Medical Research: What is the background for this study? What are the main findings? Response: Natural environments are known to promote physical, mental, and spiritual healing. People can attain health benefits by spending time outside, often in remote places to "get away from it all." Now research conducted by a University of Minnesota graduate student with a team in Vancouver, B.C., shows that green and "blue" spaces (environments with running or still water) are especially beneficial for healthy aging in seniors. The research team interviewed older adults aged 65 - 86 years who lived in Vancouver, B.C., Canada. All study participants were low-income, represented 8 different self-identified racial and ethnic groups, and experienced a range of chronic conditions and health status. Published in the journal Health and Place, the study - "Therapeutic landscapes and wellbeing in later life: Impacts of blue and green spaces for older adults" - demonstrates that by incorporating smaller features, such as a koi pond or a bench with a view of flowers, public health and urban development strategies can optimize nature as a health resource for older adults. Throughout the research, green and blue spaces promoted feelings of renewal, restoration, and spiritual connectedness. They also provided places for multi-generational social interactions and engagement, including planned activities with friends and families, and impromptu gatherings with neighbors.  (more…)
Aging, Author Interviews, Sexual Health / 20.07.2015

Dr. Alan J. Gow PhD, CPsychol, CSci, AFBPsS, FHEA Associate Professor in Psychology School of Life Sciences Heriot-Watt University EdinburghMedicalResearch.com Interview with: Dr. Alan J. Gow PhD, CPsychol, CSci, AFBPsS, FHEA Associate Professor in Psychology School of Life Sciences Heriot-Watt University Edinburgh Taylor-Jane Flynn, who conducted the research is a recent graduate in psychology from Heriot-Watt, and is about to commence postgraduate training in Counseling Psychology at Glasgow Caledonian University Medical Research: What is the background for this study? What are the main findings? Dr. Gow: We were interested in exploring how sexual behaviours might be associated with quality of life in older adults. Ms. Taylor-Jane Flynn, who led on the research, noted "There is an abundance of research identifying factors that predict better health and well-being in later life, but sex is one that is under researched." We asked our participants to report the frequency with which they engaged in six sexual behaviours from touching or holding hands to sexual intercourse, and then to also rate how important the behaviours were to them. Our results suggested that how often older adults engaged in sexual behaviours was positively associated with the quality of their social relationships. Interestingly, the importance of these sexual behaviours was found to be positively associated with their psychological quality of life. Our recently published research on how sexual behaviours are associated with quality of life in older adults grew from Taylor-Jane’s work with older adults. She reflected "I found my inspiration for this study while working as a Health Care Assistant caring for older adults. In recent years, many of those who opened up to me on a personal level expressed their need and want to have intimacy and companionship in their lives. However, sex has generally been seen as a taboo subject, especially among older adults. Despite this, older adults shared in our conversations that they miss and want to engage in sexual behaviours, whether that be a kiss to intercourse, and for many these behaviours remained an important element in their life." We were therefore keen to use these anecdotal accounts as a foundation for studying sexual behaviours as one of the many and varied determinants of wellbeing. (more…)
Aging, Author Interviews, Exercise - Fitness / 30.06.2015

MedicalResearch.com Interview with: Andreas Vigelsø PhD, research assistant University of Copenhagen Faculty of Health Sciences Center for Healthy Aging Dept. of Biomedical Sciences Copenhagen Denmark Medical Research: What is the background for this study? Response: According to the UN, the number of individuals more than 60 years old is expected to more than double, from 841 million worldwide today to more than 2 billion in 2050. Furthermore, the aging process is associated with a reduction in muscle mass, strength and fitness level. Collectively, this may contribute to frailty and may limit independent living. In addition, disease or injuries that can cause short-term immobilization are a further threat to independent living for older individuals. Despite its clinical importance for an increasing population of older individuals, few studies have examined older individuals after immobilization. Thus, our aim was to determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, and leg muscle mass in young and older men. Medical Research: What are the main findings? Response: Interestingly, our study reveals that inactivity affects the muscular strength in young and older men equally. Having had one leg immobilized for two weeks, young people lose up to a third of their muscular strength, while older people lose approx. one fourth. A young man who is immobilized for two weeks loses muscular strength in his leg equivalent to ageing by 40 or 50 years. Moreover, short-term leg immobilization had marked effects on leg strength, and work capacity and 6 weeks’ retraining was sufficient to increase, but not completely rehabilitate, muscle strength, and to rehabilitate aerobic work capacity and leg muscle mass. (more…)
Abuse and Neglect, Aging, Weight Research / 21.06.2015

MedicalResearch.com Interview with: Dr. Min Du Ph.D Department of Animal Sciences Washington Center for Muscle Biology Washington State University Pullman, WA Medical Research: What is the background for this study? What are the main findings? Response: The beige fat is only recently identified and is highly inducible. we observed that polyphenolic compounds including resveratrol enhances AMPK activity, and hypothesized that resveratrol might enhance the formation of beige fat through activation of AMPK. Therefore, we used resveratrol, a very well characterized polyphenolic compound as a representative of polyphenolic compounds in fruits, to check its effects on the formation of beige fat. We found that resveratrol induced the formation of beige adipocytes both in vitro and in vivo. We further found that the lipid oxidation rate was enhanced due to the formation of beige fat, which is correlated with the anti-obesity effect of resveratrol. (more…)
Aging, Author Interviews / 19.06.2015

MedicalResearch.com Interview with: Arlene Ash Ph.D., Professor David Hoaglin Ph.D., Professor and Aimee R. Kroll-Desrosiers, MS Department of Quantitative Health Sciences University of Massachusetts Medical School Worcester, MA Medical Research: What is the background for this study? What are the main findings? Response: The Long Life Family Study (LLFS) is an international collaborative investigation of the genetics and familial components of exceptional survival, longevity, and healthy aging. It has enrolled members of long-lived sibships, their offspring, and spouses of either group.  Medicare claims data is a unique, nationally representative source of data on all treated diseases for most Americans over the age of 65. Our main question was: Does membership in a long-lived family protect against disease? For each American LLFS participant who was at least age 65 in 2008 and alive in 2009, we selected four persons from the general Medicare population who matched the participant on age, sex, and ZIP code of residence. We then used 2008–2010 Beneficiary Annual Summary Files from the Centers for Medicare & Medicaid Services (CMS) to compare the prevalence of 17 conditions among 781 LLFS participants in Medicare with those of 3,227 non-LLFS matches.* Analyses accounted for nesting within LLFS families and adjusted for age, sex, race, and year. Among LLFS participants identified as members of a long-lived sibship, 7 of the 17 conditions were significantly less common than for similarly aged controls (Alzheimer’s, hip fracture, diabetes, depression, prostate cancer, heart failure and chronic kidney disease); in contrast, 4 (arthritis, cataract, osteoporosis and glaucoma) were significantly more common. Spouses, offspring and offspring spouses of these long-lived siblings share in significantly lower risk for Alzheimer’s, diabetes and heart failure. Several additional analyses found suggestive (although not statistically significant) evidence of lower disease prevalence in both genetically and maritally-related LLFS cohort members. (more…)
Aging, Author Interviews, BMJ, Disability Research, End of Life Care, Geriatrics, Yale / 21.05.2015

Thomas M. Gill, M.D Humana Foundation Professor of Medicine (Geriatrics) Professor of Epidemiology (Chronic Diseases) and of Investigative Medicine Director Yale Program on Aging and Yale Center for Disability and Disabling Disorders Director, Yale Training Program in Geriatric Clinical Epidemiology and Aging-Related ResearchMedicalResearch.com Interview with: Thomas M. Gill, M.D Humana Foundation Professor of Medicine (Geriatrics) Professor of Epidemiology  and of Investigative Medicine Director Yale Program on Aging and Yale Center for Disability and Disabling Disorders Director, Yale Training Program in Geriatric Clinical Epidemiology and Aging-Related Research Medical Research: What is the background for this study? What are the main findings?h Response: Understanding the disabling process at the end of life is essential for informed decision-making among older persons, their families, and their physicians. We know from prior research that the course of disability at the end of life does not follow a predictable pattern for most older persons.  This raises the question about what is driving the development and progression of disability at the end of life. We identified six distinct trajectories of disability in the last year of life, ranging from the least disabled to most disabled.  We found that the course of disability in the last year of life closely tracked the monthly prevalence of hospitalization for each of the six trajectories. (more…)
Aging, Author Interviews, JAMA, Metabolic Syndrome / 20.05.2015

Robert Wong, M.D., M.S. Attending Physician, Gastroenterology & Hepatology Director, GI Research Highland Hospital I A member of Alameda Health System Oakland, CA 94602MedicalResearch.com Interview with: Robert Wong, M.D., M.S. Attending Physician, Gastroenterology & Hepatology Director, GI Research Highland Hospital   I A member of Alameda Health System Oakland, CA 94602 Medical Research: What is the background for this study? What are the main findings? Dr. Wong: The main findings are that despite the stabilizing prevalence of metabolic syndrome, a large proportion of U.S. adults affected with metabolic still raises concern, especially given the significant health consequences associated with this syndrome.  In additional to cardiovascular disease, metabolic syndrome also increases the risk of concurrent nonalcoholic fatty liver disease, often considered the hepatic manifestation of metabolic syndrome.  Many studies, including work that our group has completed suggests that nonalcoholic fatty liver disease will soon become the leading etiology of chronic liver disease in the U.S.  Furthermore, our finding that metabolic syndrome increases with increasing age, reflects the increased risk for metabolic syndrome associated diseases such as hypertension, diabetes, and dyslipidemia with older age.  This is important to recognize given the aging population of the U.S. (more…)
Aging, Author Interviews, Nature / 03.05.2015

Juan Carlos Izpisua Belmonte PhD Professor, Gene Expression Laboratory Roger Guillemin Chair Salk Institute For Biological ScienceMedicalResearch.com Interview with: Juan Carlos Izpisua Belmonte PhD Professor, Gene Expression Laboratory Roger Guillemin Chair Salk Institute For Biological Science MedicalResearch: What is the background for this study? What are the main findings? Response: Werner protein (WRN) plays roles in DNA replication, transcription, repair as well as telomere maintenance. Mutations in WRN are associated with Werner syndrome. In the current study we discovered that WRN was interacting with proteins implicated in heterochromatin maintenance. We observed that mutations in the WRN protein led to alterations in heterochromatin and those alterations are drivers of the aging process. (more…)
Aging, Author Interviews, Exercise - Fitness, Geriatrics, Lifestyle & Health, Nutrition / 01.05.2015

Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South KoreaMedicalResearch.com Interview with: Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South Korea Dr. Lee wishes to acknowledge Jinhee Kim, PhD, the lead author of the study. Medical Research: What is the background for this study? Dr. Lee: We have known for some time that there is a progressive loss of muscle mass with aging, where older people lose on average about 1% of their skeletal muscle mass per year. A decline in muscle mass is serious in that it increases the person’s risk of falls, frailty, disability, and death. Because there is currently no “cure” for muscle mass loss, prevention is the best strategy. Over the years, researchers have studied various lifestyle factors to identify potentially modifiable behaviors that may prevent or slow the loss of muscle mass. The majority of prior research so far have found that diet, in the form of protein supplementation, and exercise, especially resistance exercise, may confer some benefits. More recently, the scientific community have begun to pay attention to the positive role of vegetables and fruits intake on the muscle. The role of aerobic exercise on muscle mass is, however, less clear. Also, because people tend to adopt various lifestyles, we were interested in finding out whether those engaging in healthier patterns of diet and exercise retained higher muscle mass. This is why bodybuilders pay such close attention to their diet and make sure their muscle mass is at it's peak. They can also take supplements like SARMs (see SARMS.io for more information about that) to improve muscle mass but their diet has a massive effect on it too. This is where some of the inspiration for this research came from as we knew what an effect food had on bodybuilders so we wondered how it could effect the elderly. Using data from a nationally representative sample of older adults, we investigated whether those who had healthier diet and participated in regular exercise, individually and in combination, maintained higher muscle mass. We looked at five healthy lifestyle factors that included dietary intake of three food groups (meat, fish, eggs, legumes; vegetables; and fruits) and participation in two types of exercise (aerobic and resistance). (more…)
Aging, Author Interviews, Case Western, Nursing / 17.04.2015

kathy-wrightMedicalResearch.com Interview with: Kathy Wright, PhD, RN, GCNS-BC, PMHCNS-BC KL2 Postdoc, Clinical Instructor 2011-13 SAMHSA Scholar 2010-12 National Hartford Center of Gerontological Nursing Excellence Patricia G. Archbold Scholar Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland, Ohio MedicalResearch: What is the background for this study? Dr. Wright: This study was a secondary analysis of baseline data from the After Discharge Care Management of Low Income Frail Elderly (Agency for Healthcare Research and Quality grant #1 R01 HS014539-01A1). The participants were aged 65 and older enrolled during an acute care hospitalization. Each participant had at least one deficit in activities of daily living (e.g., bathing, dressing) or two deficits in instrumental activities of daily living (e.g., transportation, paying bills). The purpose of the study was to test House’s Conceptual Framework for Understanding Social Inequalities in Health and Aging in Medicare-Medicaid enrollees in a group of low-income older adults to determine the relationships between socio-demographic factors (i.e., race, education, age, gender, income, and neighborhood poverty), health behaviors, and physical function and emotional well-being. As a part of the health behavior component, participants were interviewed and asked questions regarding the amount of physical activity they engaged in during the week. (more…)
Aging, Author Interviews, Heart Disease / 12.04.2015

MedicalResearch.com Interview with: Salah Altarabsheh, MD,MRCSI Cardiac Surgery Senior Specialist Queen Alia Heart Institute Amman, Jordan Coronary artery bypass grafting is the most common surgical procedure performed by cardiac surgeons worldwide. With the increased life expectancy for the general population, and the added comorbidities among elderly population, we are seeing a good number of elderly populations who are referred for coronary artery bypass surgery. There are few reports which compare off-pump versus on-pump methods of revascularization among this subset of elderly people. We choose octogenarians in our meta-analysis to see whether off-pump revascularization method could be of benefit since there is increased chance to have ascending aortic calcifications among these patients, and off-pump coronary artery bypass in which there is lesser chance for aortic manipulations, can be beneficial. (more…)
Aging, Author Interviews, Genetic Research / 28.03.2015

MedicalResearch.com Interview with: Thomas Perls, MD, MPH Professor Boston University School of MedicineMedicalResearch.com Interview with: Thomas Perls, MD, MPH Professor Boston University School of Medicine Medical Research: What is the background for this study? Dr. Perls:   For years now, Gerontology scholars continue to state that 25% of what they interchangeably call aging, longevity, life expectancy and life span is genetic and 75% is due to the environment and health-related behaviors. This assertion is based on Scandinavian twins reared apart, but the oldest participants in those studies lived to their 70s and 80s. Part of the problem here is the lack of consistency in what people mean by the terms Aging, Life Span and Longevity. In fact, the Seventh Day Adventists, who generally have a high prevalence of healthy behaviors (vegetarian, daily exercise, eat in moderation, abstain from tobacco and alcohol, and activities that help manage stress well) have an average live expectancy of approximately 88 years. Yet, 7th Day Adventists are ethnically and racially heterogeneous and thus it appears that those healthy behaviors explain the vast majority of the variation in how old these people live to be. This finding is consistent with the optimistic view of the twin studies, that much of living to one's 80's is in our hands. Living to only our 50s-70's is also in our hands (e.g. 75% behaviors) if we choose to smoke, eat red meat frequently, be obese, not exercise, be exposed to gun violence, have unsafe sex, do IV drugs, etc. So it is safe to say, in my opinion, that 75% of the variation in how old we live to be, is on average due to our behavior and exposure choices. The empowering and important point is that if we all lived like the Seventh Day Adventists, average life expectancy would increase almost 8 years and health costs would markedly decline because we would be getting to these older ages because we are healthier not because we are pouring more resources into more effectively treating diseases. The New England Centenarian Study, which I direct, and a number of other studies of nonagenarians (people in their 90s) have demonstrated via direct genetic studies as well as studies of family trees where at least some family members get to these very old ages, that with older and older ages of survival beyond age ~95 years, variations in genetic profiles explain a greater and greater proportion of the variation in how old people live to be at these ages. So much so that I believe the findings to date are consistent with the roles of genes and environment being reversed for survival to age 106+ years, that is, 75% genetics and 25% environment/behaviors. This supposition is based upon several observations: (1) as people reach the age of 105+ years, they become more and more alike in terms of what age-related diseases they get and when they get them. Consistent with Jim Fries; "Compression of Morbidity" hypothesis, people who survive to ages 110+ (called supercentenarians) and who therefore approximate the limit of human lifespan are on average disease and disability-free up until the last 5 or so years of their lives. This increasing homogeneity, especially compared to the increasing heterogeneity in the rates of aging and incidences of age-related diseases at younger percentiles or ages of survival, suggests underlying genetic similarities (similar genetic profiles) amongst groups of these supercentenarians; and (2) the New England Centenarian Study previously discovered genetic signatures (made up of longevity-associated variations of about 130 genes) that were associated with surviving to age 106+ years with 80% accuracy, but with only 60% accuracy for accurately picking out people living to ~100 years. This increasing accuracy with older and older ages also suggests a stronger and stronger genetic influence upon survival to these rarest percentiles of survival. With the above background, we set out in this study and subsequent paper, to (1) assess sibling relative risk using the largest-ever collection of validated pedigrees of centenarians, (2) to assess the risk of a sibling achieving the same age as their very old sibling (e.g. ages 95, 100, or 105+ years) relative to average people born around the same time, and (3) to look at how when a person was born (eg before or after 1890) made a difference in these relative risks. (more…)
Aging, Author Interviews, Exercise - Fitness, Frailty, JAMA, Vitamin D / 23.03.2015

MedicalResearch.com Interview with: Kirsti Uusi-Rasi, PhD, Adjunct Professor Senior Researcher UKK Institute for Health Promotion Research Tampere Finland Medical Research: What is the background for this study? What are the main findings? Dr. Kirsti Uusi-Rasi: Falls are the leading cause of unintentional injuries and fractures in older adults, head injuries and fractures being the most severe consequences. Therefore, falls prevention is important when trying to prevent injuries. There is strong high-quality evidence from previous studies that exercise that includes strength and balance training can reduce the risk of falling in older adults. However, there are also studies that have reported no benefit in reducing the actual incidence of falls. Effects of vitamin D have also been studied widely, and vitamin D is known to be vital for bone metabolism and health. However, results regarding effects on falls and fractures are inconsistent. Furthermore, persons with low vitamin D levels (serum 25OHD) have been associated with lower physical performance and greater decline in physical functioning, but clinical trials exploring the role of vitamin D in reducing falls and fractures and in improving physical functioning are inconclusive. Because there is hardly any evidence about exercise and vitamin D together, we investigated the separate and combined effects of multimodal exercise training and vitamin D supplementation in reducing falls and injurious falls among older women at risk for falling. We assigned 409 participants randomly to one of four groups with: 1)vitamin D 800 IU/day and exercise 2) placebo and exercise 3) vitamin D 800 IU/day without exercise 4) placebo without exercise. Exercise consisted of strength, balance, mobility and agility group training. At the end of two years, exercise seemed to be more effective in reducing injurious falls in this age group, with or without vitamin D. Exercise also improved physical functioning (strength, balance and mobility). In general, the training program was well tolerated with no severe adverse effects or injuries. Vitamin D helped maintain femoral neck BMD and increased trabecular bone density at the tibia. Our study also suggests that the current vitamin D recommendation (800 IU/d for older people) is adequate. (more…)
Aging, Author Interviews, Education, NYU, Surgical Research / 21.03.2015

Uzma Samadani, MD, PhD Chief of Neurosurgery, New York Harbor Health Care System Assistant Professor, Departments of Neurosurgery, Psychiatry, Neuroscience and Physiology Co-Director, Steven and Alexandra Cohen Veterans Center NYU Langone Medical CenterMedicalResearch.com Interview with: Uzma Samadani, MD, PhD Chief of Neurosurgery, New York Harbor Health Care System Assistant Professor, Departments of Neurosurgery, Psychiatry, Neuroscience and Physiology Co-Director, Steven and Alexandra Cohen Veterans Center NYU Langone Medical Center Medical Research: What is the background for this study? What are the main findings? Response: The purpose of this study was to determine the current and future incidence of chronic subdural hemorrhage in the United States civilian and Veterans' Administration populations.  It's main findings are that, as the population ages, the incidence of subdural hemorrhage is increasing. (more…)
Aging, Author Interviews / 20.03.2015

Kamen Tsvetanov, PhD Centre for Speech, Language and the Brain Department of Psychology University of Cambridge Downing Street Cambridge, United KingdomMedicalResearch.com Interview with: Kamen Tsvetanov, PhD Centre for Speech, Language and the Brain Department of Psychology University of Cambridge Downing Street Cambridge, United Kingdom   Medical Research: What is the background for this study? What are the main findings? Dr. Tsvetanov: Older brains may be more similar to younger brains than previously thought! In our study we have shown that changes in the aging brain previously observed using functional magnetic resonance imaging (fMRI) – one of the standard ways of measuring brain activity – may be due to changes in our blood vessels, rather than changes in the activity of our nerve cells, our neurons. Given the large number of fMRI studies used to assess the aging brain, this has important consequences for understanding how the brain changes with age and it challenges current theories of ageing. (more…)
Aging, Author Interviews, Hearing Loss, JAMA / 13.03.2015

MedicalResearch.com Interview with: Isabelle Mosnier, MD, Praticien Hospitalier ORL Otologie, Implants Auditifs et Chirurgie de la Base du Crâne Centre Référent Implant Cochléaire Adulte d'Ile de France Centre Maladies Rares Surdité Génétique de l'adulte et Neurofibromatose de type 2 Groupe Hospitalier de la PITIE-SALPETRIERE Paris MedicalResearch: What is the background for this study? What are the main findings? Dr. Mosnier: Association between hearing impairment and cognitive decline has been established; however, the impact on cognition through cochlear implantation in profoundly deaf elderly patients is not known. The focus was to determine the impact of hearing rehabilitation including cochlear implant on cognitive functions, in addition to the influence of cognitive factors on cochlear implant outcomes over time. (more…)
Aging, Author Interviews, Geriatrics, Social Issues / 01.03.2015

Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MOMedicalResearch.com Interview with: Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MO MedicalResearch: What is the background for this study? What are the main findings? Dr. Curl: Often people think of stopping driving as just effecting one person: the person who stops driving. In reality, for married couples driving cessation affects both spouses. Using longitudinal data (1998-2010) from 1,457 married couples participating in the Health and Retirement Study, we found that husbands and wives who are no longer able to drive are less likely to work, and less likely to engage in formal volunteering (for charitable organizations) and informal volunteering (helping friends and neighbors not-for-pay). Having a spouse in the household who is still able to drive does reduce these negative consequences a little, but not entirely. Furthermore, the spouse who continues to drive is also less likely to continue working or volunteering following the driving cessation of their partner, presumably because he/she is providing transportation or social support to the non-driver. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Nutrition, Weight Research / 28.02.2015

William Mair, Ph.D Assistant Professor Department of Genetics and Complex Diseases Harvard T. H Chan School of Public Health Boston, MA 02115MedicalResearch.com Interview with: William Mair, Ph.D Assistant Professor Department of Genetics and Complex Diseases Harvard T. H Chan School of Public Health Boston, MA 02115 MedicalResearch: What is the background for this study? What are the main findings? Dr. Mair: Dietary restriction, the reduction of food intake without malnutrition has been known for 80 years to prolong lifespan in organisms ranging from single celled yeast to non human primates, and early signs suggest improvement of metabolic parameters in patients undergoing clinical trials. However, negative side effects associated with low calorie intake remain, and compliance and lifestyle factors make it an unappealing therapeutic. Since calorie restriction (CR) can have remarkable protective effects against multiple age onset diseases in mouse models - ranging from cancer to neurodegeneration to metabolic disease - finding molecular mechanisms though which calorie restriction functions might provide novel therapeutic targets that promote healthy aging. Using a model system, the nematode worm C. elegans, we show that perception of energy intake in the nervous system may be as critical for the effects of low energy on aging as actual calorie intake itself. Animals expressing an active form of a protein called AMPK, which is a cellular energy sensor, were long lived despite eating normally but this longevity could be turned off or on by changes to a neurotransmitter in just a few neurons. This suggests that therapeutic targets that modulate the perception of energy status in the nervous system might provide novel ways to gain the benefit of calorie restriction and promote healthy aging. (more…)
Aging, AHA Journals, Author Interviews, Exercise - Fitness / 20.02.2015

Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on AgingMedicalResearch.com Interview with: Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on Aging Medical Research: What is the background for this study? What are the main findings? Dr. Buford: This study was a cross-sectional analysis of data collected from over 1000 older adults upon their entry into the Lifestyle Interventions and Independence for Elders (LIFE) study. Briefly, participants were recruited into the LIFE Study who were over 70 years of age, sedentary, and had mobility limitations. The objective of this study was to examine, at baseline prior to their participation in the study interventions, the association between daily physical activity habits and risk of major cardiovascular events (i.e. heart attack and coronary-related death). The study utilized accelerometers, devices designed to identify and quantify human movement, to measure participant’s daily activity. Predicted risk of cardiovascular events was determined using a risk score established in the Framingham Heart Study. As identified by accelerometry measures, participants spent on average 70% of their waking hours being sedentary. The major finding of the study, however, was that even extremely low-level activity was associated with an improved cardiovascular risk profile. For every 25-30 minutes a participant was sedentary per day, predicted risk was 1 percent higher. Conversely, But activity identified as slightly above sedentary — which could be light housework or slow walking — was associated with higher levels of the more beneficial kind of cholesterol, HDL, in people with no history of heart disease. (more…)
Aging, Author Interviews, Inflammation / 15.02.2015

Dr. Jeremy Van Raamsdonk Laboratory of Aging and Neurodegenerative Disease (LAND), Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, Michigan, Department of Translational Science and Molecular Medicine, Department of Genetics, Michigan State University, East Lansing, Michigan, Department of Biology, McGill University, Montreal, Quebec, CanadaMedicalResearch.com Interview with: Dr. Jeremy Van Raamsdon PhD Laboratory of Aging and Neurodk egenerative Disease (LAND), Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, Michigan, Deptment of Translational Science and Molecular Medicine, Department of Genetics, Michigan State University, East Lansing, Michigan,Dep. of Biology, McGill University, Montreal, Quebec, Canada Medical Research: What is the background for this study? What are the main findings? Dr. Van Raamsdonk : The free radical theory of aging is one of the most widely accepted theories of aging. This theory suggests that reactive oxygen species (ROS), which are also known as free radicals, cause a type of damage, called oxidative damage, that accumulates over time to cause the functional decline associated with aging. ROS have also been proposed to play a role in many diseases including neurodegenerative disorders such as Parkinson’s disease and Huntington’s disease. However, recent work has demonstrated that ROS are not necessarily detrimental. ROS perform functional roles in the body and thus it is possible to have too little ROS. We previously showed that increasing ROS by decreasing the levels of an antioxidant enzyme called superoxide dismutase (SOD) does not decrease lifespan even when all of the SOD genes are removed. We also showed that in some cases treatment with an antioxidant, such as Vitamin C, can lead to decreased lifespan. This finding is consistent with human clinical trials in which it has not been possible to show a beneficial effect of antioxidants on longevity. In this paper we further examine the relationship between ROS and aging. We use a simple genetic model organism, the worm Caenorhabditis elegans, which has been used extensively in aging research, to determine how location impacts the effect of ROS on lifespan. We used a genetic approach to increase the levels of ROS in different parts of a cell and found that location is crucial in determining the effect of ROS on lifespan. Mildly increasing the levels of ROS in the mitochondria increases lifespan, while increasing ROS in the cytoplasm has the opposite effect of decreasing lifespan. (more…)
Aging, Author Interviews, Memory, Nature, Nutrition / 09.02.2015

Ashok K. Shetty, Ph.D. Professor and Director of Neurosciences Institute for Regenerative Medicine and Department of Molecular and Cellular Medicine
Texas A&M Health Science Center College of Medicine, Temple, TX
Research Career Scientist, Central Texas Veterans Health Care System (CTVHCS), Temple, TXMedicalResearch.com Interview with: Ashok K. Shetty, Ph.D. Professor and Director of Neurosciences Institute for Regenerative Medicine and Department of Molecular and Cellular Medicine
Texas A&M Health Science Center College of Medicine, Temple, TX
Research Career Scientist, Central Texas Veterans Health Care System (CTVHCS), Temple, TX Medical Research: What is the background for this study? Prof. Shetty: Hippocampus is a region in the brain important for maintaining functions such as learning, memory and mood. However, this region is highly vulnerable to aging and brain insults. Previous research has shown that diminished function in the dentate gyrus region of the hippocampus is one of the key reasons for memory impairments seen in old age. Dentate gyrus is also one of the few regions in the brain where neural stem cells generate new neurons on a daily basis, also referred to as "adult neurogenesis". Studies have suggested that a significant fraction of newly born neurons mature, get incorporated into the existing hippocampus circuitry and contribute to learning, formation of new memories, and normal mood. However, with aging, the dentate gyrus shows decreased function with some conspicuous structural changes, which include reduced production of new neurons, diminished microvasculature implying reduced blood flow, and occurrence of hypertrophy of astrocytes and activated microglia, signs of chronic low-level inflammation. Because alterations such as reduced neurogenesis, decreased blood flow and brain inflammation can contribute to memory and mood impairments, the idea that drugs that are efficacious for mitigating these changes may preserve memory and mood function in old age has emerged. Such drugs may be prescribed to the aging population if they are efficacious for maintaining normal cognitive and mood function in old age with no or minimal side effects. Medical Research: What is the rationale for choosing resveratrol for preventing age-related memory dysfunction in this study? Prof. Shetty:  Administration of resveratrol, a naturally occurring polyphenol found in the skin of red grapes, red wine, peanuts and some berries, appeared suitable for counteracting age-related detrimental changes in the hippocampus. This is because, previous studies have shown that resveratrol has ability to promote the formation of new capillaries (through pro-angiogenic effects) and to suppress oxidative stress and inflammation (via antioxidant and antiinflammatory effects) with no adverse side effects. Other studies have also reported that resveratrol can mediate extension of the life span and delayed onset of age related diseases. More importantly, a recent human study suggested that a reasonably lower dose of resveratrol intake for 26 weeks is good enough to improve memory performance as well as hippocampus functional connectivity in 23 healthy overweight older individuals (Witte et al., J. Neurosci., 34: 7862-7870, 2014). (more…)