Amyloid PET Scan Useful in Memory Evaluation

MedicalResearch.com Interview with:
Arno de Wilde, MD / PhD candidate

Department of Neurology & Alzheimer Center
Amsterdam Neuroscience
VU University Medical Center
Amsterdam, the Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies assessing the clinical utility of amyloid imaging used very selected research populations, limiting the translatability to clinical practice. In contrast, we used an unselected memory clinic cohort, offering amyloid PET to ALL patients visiting our memory clinic, and for the purpose of this study, we implemented amyloid PET in our routine diagnostic work-up. Our results demonstrate that amyloid PET has important consequences, in terms of diagnosis and treatment changes, for a significant number of patients within a situation that closely resembles clinical practice. I think that these results are an important step in ‘bridging the gap’ between using amyloid PET in a research setting versus daily clinical practice.

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How To Prevent the Elderly From Falling?

MedicalResearch.com Interview with:

Dr. Alex Krist

Dr. Krist

Dr. Alex Krist, M.D., M.P.H.

Dr. Krist is is a professor of family medicine and population health at Virginia Commonwealth University and active clinician and teacher at the Fairfax Family Practice residency.

What is the background for these recommendation statements? What are the main findings?

Response: Falls are the leading cause of injuries in adults age 65 and older and can lead to serious disability and even death. Bone fractures—which may result from a fall—can also cause serious disability and death in older adults.

The U.S. Preventive Services Task Force looked into the most recent evidence on the best ways to prevent falls and fractures in older adults. We found that clinicians should recommend exercise or physical therapy to help prevent falls by older adults who live at home and are at higher risk for falling.

Additionally, we concluded that taking a low dose of vitamin D and calcium does not help prevent fractures due to osteoporosis, but we don’t know if taking a higher dose is effective or not, so we are calling for more research.

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For Older Men, Dairy Food Intake Linked To Better Bone Health

MedicalResearch.com Interview with:
“bought a passive-aggressive amount of milk” by Paul Downey is licensed under CC BY 2.0Shivani Sahni, PhD
Assistant Professor of Medicine, Harvard Medical School
Director, Nutrition Program
Associate Scientist, Musculoskeletal Research
Institute for Aging Research, Hebrew SeniorLife,
Boston  MA  02131-1097

MedicalResearch.com: What is the background for this study?

Response: Previous studies have shown that higher milk intake is associated with higher bone mineral density. In one of our previous studies, we reported that higher dairy food intake was protective against bone loss especially among older adults who used vitamin D supplements. Older adults are at high risk of vitamin D deficiency because recommended intakes are difficult to achieve without fortified foods (such as dairy) or supplements. Vitamin D stimulates calcium absorption, which is beneficial for building bones. However, it is unclear if the effect of vitamin D on calcium absorption is substantial enough to translate into beneficial effects on bone.

Therefore, the current study determined the association of dairy food intake with bone health. We further examined whether these associations would be modified by vitamin D status.

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Falls in Older Adults Cost US Over $50 Billion Dollars Annually

MedicalResearch.com Interview with:

Curtis Florence, PhD Division of Analysis, Research and Practice Integration  CDC’s Injury Center

Dr. Florence

Curtis Florence, PhD
Division of Analysis, Research and Practice Integration
CDC’s Injury Center

MedicalResearch.com: What is the background for this study?

Response: The estimates in this study provide a more robust indicator of the economic impact falls have on the U.S. economy.  Previous studies focused on Medicare spending. This study includes Medicare, Medicaid and out-of-pocket spending.

MedicalResearch.com: What are the main findings? 

Response: Our study found that older adult (65 years and over) falls impose a large economic burden on the U.S. healthcare system. In 2015, with a total medical cost $50 billion for non-fatal and fatal falls.  About three-quarters of the total cost was paid by government-funded programs.  Medicare paid nearly $29 billion for non-fatal falls, Medicaid $8.7 billion, and $12 billion was paid for by Private/Out-of-pocket expenses.  For fatal falls, $754 million was spent in 2015.

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As We Age, Our Circadian Clock Becomes Less Sensitive To Light, Leading To Sleep Problems

MedicalResearch.com Interview with:
“Woman sleeping” by Timothy Krause is licensed under CC BY 2.0Dr Gurprit S. Lall BSc, MSc, PhD, PGCHE, FHEA

Medway School of Pharmacy
Interim Deputy Head of School
Senior Lecturer in Pharmacology
Director of Graduate Studies (Research),
University of Kent at Medway
Chatham Maritime, Chatham, Kent

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Medical advancement in prevention and diagnosis of disease has increased life expectancy significantly, thus generating an ageing population far greater than previously seen.  Because of this, it is essential that we begin to understand the ageing process, together with the health implications associated with senescence.  Recent research has found that changes in the circadian clock, located in the brain, play a contributing role in the decline of many physiological and behavioural traits observed through the ageing process.  One example of this, which is commonly seen in the elderly is a decline in sleep-wake cycle regulation; typically presenting as disrupted sleeping patterns.

The circadian clock, in mammals, possesses the ability to integrate our social lifestyle choices with the environmental day-night cycle to generate a 24-hour rhythm to which our physiological functions are synchronised.  It is this synchronisation that plays a vital role in regulating many of our behavioural outputs, such as sleeping-wake patterns.  This clock takes its strongest timing cue from the natural day night cycle governed by the duration of daily sunlight.

Our study investigated the changes in the interpretation of this light signal by the circadian clock as we age and its impact on function.  We found that the clock became less responsive to light stimuli at both the level of clock cells and at driving behavioural activity.  We were able to narrow this down to changes in the proteins within cells that relay light information to the molecular time setting machinery.  In detail, light signals are relayed to the clock through an excitatory neurotransmitter called glutamate and this signal is predominantly relayed through NMDA receptors located on the surface of clock cells.  It is the configuration of the NMDA receptor that alters as we age and this leads to the clock becoming less responsive to light.

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Alcohol Accelerates Aging of Brain’s Frontal Cortex

MedicalResearch.com Interview with:
alcohol-cdc-image
Edith V. Sullivan, Ph.D.
Professor
Department of Psychiatry & Behavioral Sciences
Stanford University School of Medicine
Stanford, CA 94305-5723 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Alcohol misuse is a major public health problem worldwide with profound health consequences on the body, brain, and function. Our research group has conducted naturalistic yet controlled studies of alcohol dependence for several decades to further our understanding of when and how alcohol misuse affects specific parts of the brain.  In addition, we wanted to know how alcohol misuse interacts with the typical changes in the brain as we grow older.  The studies are controlled in that we recruit healthy, non-alcohol dependence men and women from the community to undergo the same screening and neuroimaging procedures as our alcoholic recruits.  The studies are quantitative because we use neuroimaging methods (Magnetic Resonance Imaging) that enable us to measure specific regions of brain structural volumes.  Consistent collection of such data over the years positioned us to ask whether age and alcohol dependence interact to produce regional brain volume loss beyond the loss that occurs in normal aging.

A number of cross-sectional studies pointed to the likelihood that the effects of alcohol dependence on brain structure would be exacerbated by normal aging, which we do know from longitudinal neuroimaging studies results in shrinkage of cortical gray matter volume and thinning of the cortex. What was particularly striking about our longitudinal study of men and women with alcohol dependence was the acceleration of the aging of brain structure that was especially prominent in the frontal cortex.  Critically, even those who initiated dependent drinking at an older age showed accelerated loss.

Because our study sample was large enough, we could also test whether our findings were attributable to conditions that commonly co-occur with alcohol dependence, namely, illicit drug use and hepatitis C.  Although both drug use and hepatitis C infection may have exacerbated brain volume loss, these factors did not fully account for the alcoholism-aging interaction we identified.

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Gene Changes During Aging Predispose To Cancer Formation

MedicalResearch.com Interview with:

Hariharan Easwaran, PhD Assistant Professor of Oncology The Sidney Kimmel Comprehensive Cancer Center The Johns Hopkins University School of Medicine Bunting/Blaustein Cancer Research Building 1 Baltimore, MD 21287

Dr. Easwaran

Hariharan Easwaran, PhD
Assistant Professor of Oncology
The Sidney Kimmel Comprehensive Cancer Center
The Johns Hopkins University School of Medicine
Bunting/Blaustein Cancer Research Building 1
Baltimore, MD 21287

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The interpretation of the information encoded in our DNA by the various cells in our body is mediated by a plethora of modifications of DNA and proteins that complex with DNA. DNA methylation is one such important modification, which is normally established in a very orchestrated fashion during development. All normal cells have a defined pattern of DNA methylation, which may vary by tissue type, but is consistent within tissues. This normal pattern is disrupted in all known cancers, and is considered a hallmark of cancers.

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How Old is Old?

MedicalResearch.com Interview with:
“Im Spiegel / In the mirror” by njs-photographie is licensed under CC BY-NC-ND 3.0William Chopik PhD
Department of Psychology
Michigan State University
East Lansing, MI 

MedicalResearch.com: What is the background for this study?

Response: The motivation for the study was that we saw a lot of differences in the way people defined “old age”. We also noticed that there is a stigma that goes along with being old. So we had a natural curiosity to see how these perceptions my change as people age.

As people aged, the tended to report feeling younger and consider an older adult as “always in the future”–never quite where they are now.

We found that our results confirmed a lot of existing theories about how our attitudes toward aging change as we age ourselves.

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Activation of Telomerase Will Not Cure Aging

MedicalResearch.com Interview with:

Douglas P. Kiel, MD, MPH Professor of Medicine Harvard Medical School Director Musculoskeletal Research Center Institute for Aging Research, Hebrew SeniorLife Associate Member Broad Institute of Harvard and MIT

Dr. Kiel

Douglas P. Kiel, MD, MPH
Professor of Medicine
Harvard Medical School
Director Musculoskeletal Research Center
Institute for Aging Research, Hebrew SeniorLife
Associate Member Broad Institute of Harvard and MIT 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Why we age? and how we age?, are perennial questions that are of interest to all. The research described in this publication brings together two major and different concepts of aging – epigenetic aging, which is manifested by modifications on DNA and telomere-related aging, which is manifested by shortening of chromosome ends (telomeres).  In our search for genes that could potentially affect epigenetic aging, we detected  a variant of the TERT gene (whose encoded protein, telomerase maintains telomere length) to be associated with accelerated epigenetic aging. TERT is a subunit of the enzyme telomerase which is a widely known enzyme for the following reasons:

1)    Telomerase has been touted as an anti-aging enzyme. It has been called a modern fountain of youth. However, some scientists have pointed out that it is unlikely to become a source of anti-aging therapies (see the review article by de Magalhães JP1, Toussaint in Rejuvenation Research (2004) .https://www.ncbi.nlm.nih.gov/pubmed/15312299)   Our new results gained by the epigenetic clock also indicate that telomerase will not halt organismal aging.

2)    The book “The Telomere Effect” by Nobel prize winner Elizabeth Blackburn and Elissa Epel was on the New York Times best seller list and received substantial news coverage:https://www.cbsnews.com/news/telomere-effect-book-living-younger-healthier-longer/

Our data provides a much needed  understanding of the molecular drivers of the epigenetic clock and reveal a unexpected and paradoxical connection between two seemingly distinct aging clocks: the telomere clock and the epigenetic clock.

Our main finding was that variants in the human telomerase reverse transcriptase gene (TERT) were associated with increased “intrinsic epigenetic aging.” 

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Seniors Entering Old Age Will Increasingly Have Multiple Complicated Health Conditions

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

Prof. Jagger

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 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As part of a larger study (MODEM – modelling outcome and cost impacts of interventions for dementia) we have developed a microsimulation model called PACSim which forecasts the number of older people aged 65 years and over along with their health and lifestyle factors as they age over the next 20 years. Crucially these are the first projections that include the health and lifestyle profiles of younger people as they age into to older population, rather than just assuming they have the same health profiles as existing young-old.

Other studies have already reported that the proportion of older people with multimorbidity (two or more concurrent diseases) has increased. Our study shows that not only will this continue but that the largest increase over the next 20 years will be for complex multimorbidity (four or more diseases). Much of the gain in life expectancy over the next 20 year for a 65 year old will be years spent with complex multimorbidity. And more importantly the future cohorts of young-old entering the older population will have successively more multimorbidity. Continue reading

Good Relationship With Grandparents Mitigates Feelings Of Ageism

MedicalResearch.com Interview with:
“Grandparents” by Tim Wilson is licensed under CC BY 2.0Allison Flamion, Doctorante

Unité de Psychologie de la Sénescence
Département Psychologies et cliniques des systèmes humains
Université de Liège
LIEGE Belgique

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Ageism—stereotypes that lead to prejudice and discrimination against older people— occurs frequently in young adults and can even be seen in children as young as 3.

Ageism has deleterious consequences on older people in our aging Western societies. However, the factors influencing this phenomenon in the young are not well known.

To answer this question, we have asked 1151 Belgian children and adolescents to provide their views of the elderly, using especially designed questionnaires and open questions. We found four main influences on their views of the elderly: gender and age of the child, quality of contact with grandparents, and grandparents’ health. Girls had slightly more positive views than boys. Ageist stereotypes fluctuated with age, with 7- to 9-year-olds expressing the most prejudice and 10- to 12-year-olds expressing the least. This finding mirrors other forms of discrimination (e.g., those related to ethnicity or gender) and is in line with cognitive-developmental theories. For example, acquiring perspective-taking skills around age 10 reduces previous stereotypes. With regard to ageism, prejudice seemed to reappear when the participants in this study reached their teen years: 13- to 16-year-olds had higher levels of ageism compared with younger children. Moreover, youths who described their contact with grandparents as good or very good had more favorable feelings toward the elderly than those who described the contact less positively.

Finally, children and adolescents with grandparents in poor health were more likely to hold ageist views than youths with grandparents in better health.

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Early Studies Suggest Blood Pressure Medication Hydralazine May Slow Aging and Neurodegeneration

CrawlingCelegans Wikipedia

Crawling C. elegans
Wikipedia image

MedicalResearch.com Interview with:
Hamid Mirzaei, Ph.D.
Assistant Professor of Biochemistry
University of Texas Southwestern
Department of Biochemistry
Dallas, TX 75390

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Aging is a complex process at the cellular level with distinct organismal phenotypes. Despite millennia-old obsession with aging and relentless pursuits for ways to stop and reverse it, such elixir has not been found due to the complexity of the involved mechanisms and our limited understanding of the processes that lead to aging. Although progress has been made in recent years in slowing down the aging process in model organisms and human cells.

In this study, we report that and FDA approved antihypertensive drug, hydralazine, decelerates aging in C. elegans by mechanisms that seem to resemble dietary restriction. We show that hydralazine increases the median lifespan of the C. elegans by 25% which is comparable to or better than other known antiaging compounds.

We demonstrate that not only hydralazine-treated worms live longer, they appear to be healthier in general. Because aging is directly linked to neurodegenerative diseases, we tested our drug on both in vitro and in vivo models of neurodegenerative diseases using chemical and biological stressors (rotenone and tau fibrils) and show that hydralazine has neuroprotective properties as well.

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Hearing Loss Associated With Higher Risk of Cognitive Decline and Dementia

MedicalResearch.com Interview with:
“Hear” by Jaya Ramchandani is licensed under CC BY 2.0David G. Loughrey, BA(Hons)

NEIL (Neuro Enhancement for Independent Lives) Programme
Trinity College Institute of Neuroscience, School of Medicine
Trinity College Dublin, Dublin, Ireland

MedicalResearch.com: What is the background for this study?

Response: Age-related hearing loss, a common chronic condition among older adults, has emerged in the literature as a potential modifiable risk factor for dementia. This is of interest as current pharmacological therapies for dementias such as Alzheimer’s disease only offer symptom-modifying effects. Treatment of risk factors such as hearing loss may help delay the onset of dementia and may provide an alternate therapeutic strategy. However, there is variance in the research on hearing loss and cognition with some studies reporting a small or non-significant association. In this meta-analysis, we investigated this association and we only included observational studies that used standard assessments of cognitive function and pure-tone audiometry (the clinical standard).

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Doing Something Is Better Than Nothing: Even Light Physical Activity Improves Health

MedicalResearch.com Interview with:

Michael J. LaMonte, PhD, MPH Research Associate Professor Department of Epidemiology and Environmental Health Co-Director, MPH Program (epidemiology) School of Public Health and Health Professions Women’s Health Initiative Clinic University at Buffalo – SUNY 

Dr. LaMonte

Michael J. LaMonte, PhD, MPH
Research Associate Professor
Department of Epidemiology and Environmental Health
Co-Director, MPH Program (epidemiology)
School of Public Health and Health Professions
Women’s Health Initiative Clinic
University at Buffalo – SUNY 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Current national public health guidelines recommend 150 minutes of moderate to vigorous physical activity a week for adults. The guidelines recommend persons 65 and older follow the adult guidelines to the degree their abilities and conditions allow. Some people, because of age or illness or deconditioning, are not able to do more strenuous activity. Current guidelines do not specifically encourage light activity because the evidence base to support such a recommendation has been lacking.

Results from the Objective Physical Activity and Cardiovascular Health (OPACH) Study, an ancillary study to the U.S. Women’s Health Initiative, recently published in the Journal of the American Geriatrics Society showed women ages 65-99 who engaged in regular light intensity physical activities had a reduction in the risk of mortality. The 6,000 women in the OPACH study wore an activity-measuring device called an accelerometer on their hip for seven days while going about their daily activities and were then followed for up to four and a half years.  Results showed that just 30 additional minutes of light physical activity per day lowered mortality risk by 12 percent while 30 additional minutes of moderate activity, such as brisk walking or bicycling at a leisurely pace, exhibited a 39 percent lower risk. 

The finding for lower mortality risk associated with light intensity activity truly is remarkable. We anticipated seeing mortality benefit associated with regular moderate-to-vigorous intensity activity, as supported by current public health guidelines. But, observing significantly lower mortality among women who were active at levels only slightly higher than what defines being sedentary was such a novel finding with important relevance to population health.

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Aging Population, Socio-Economic Disparities Linked To Increase in Heart Failure Incidence

MedicalResearch.com Interview with:

Prof Kazem Rahimi FRCP The George Institute for Global Health Oxford Martin School University of Oxford, Oxford

Prof. Rahimi

Prof Kazem Rahimi FRCP
The George Institute for Global Health
Oxford Martin School
University of Oxford, Oxford

MedicalResearch.com: What is the background for this study?

Response: We decided to investigate this topic because disease incidence data is very important for public health bodies; for example, for the allocation of healthcare resources or for the design and assessment of disease prevention measures.

When we reviewed the literature, we found that estimates of heart failure incidence, temporal trends, and association by patient features were scarce. Studies often referred to restricted populations (such as relatively small cohorts that may or may not be representative of the general population), or limited data sources (for example, only including patients hospitalized for their heart failure and not considering those diagnosed by clinicians outside of hospitals). Few studies reported comparable, age-standardized rates, with the result that the rates reported varied considerably across the literature.

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