Aging

Higher aerobic fitness levels linked to fewer word failures in older adults

  • A small study found that aerobic fitness was linked to the frequency of tip-of-the-tongue occurrences in older adults.

A small UK study involving 28 healthy older adults (20 women with average age 70; 8 men with average age 67), has found that those with higher levels of aerobic fitness experienced fewer language failures such as 'tip-of-the-tongue' states.

The association between the frequency of tip-of-the-tongue occurrences (TOTs) and aerobic fitness levels existed even when age and vocabulary size was accounted for. Education level didn't affect TOTs, but only a few of the participants hadn't gone to university, so the study wasn't really in a position to test this out.

However, the larger the vocabulary for older adults, the less likely they were to have TOTs. Older adults also had more TOTs over longer words.

The test involved a 'definition filling task', in which they were asked to name famous people, such as authors, politicians and actors, based on 20 questions about them. They were also given the definitions of 20 'low frequency' and 20 'easy' words and asked whether they knew the word relating to the definition.

Aerobic fitness was assessed by a static bike cycling test.

The study included 27 young adults as a control group, to provide a comparison with older adults' language abilities, confirming that older adults did indeed have more TOTs. The young adults' fitness was not tested. All participants were monolingual.

https://www.eurekalert.org/pub_releases/2018-04/uob-haf042618.php

Reference: 

Segaert et al (2018). Higher physical fitness levels are associated with less language decline in healthy ageing. Scientific Reports. https://www.nature.com/articles/s41598-018-24972-1

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Better physical fitness and lower aortic stiffness key to slower brain aging

  • A study found that physical fitness & arterial stiffness accounted for a third of the cognitive differences between older adults, completely erasing age as a factor.

An Australian study involving 102 older adults (60-90) has concluded that physical fitness and arterial stiffness account for a great deal of age-related memory decline.

The study that, while both physical fitness and aortic stiffness were associated with spatial working memory performance, the two factors affected cognition independently. More importantly, and surprisingly, statistical modelling found that, taking BMI and gender into account, fitness and aortic stiffness together explained a third (33%) of the individual differences in spatial working memory — with age no longer predicting any of the differences.

While physical fitness didn’t seem to affect central arterial stiffness, the researchers point out that only current fitness was assessed and long term fitness might be a better predictor of central arterial stiffness.

It's also worth noting that only one cognitive measure was used. However, this particular measure should be a good one for assessing cognition untainted by the benefits of experience — a purer measure of the ability to process information, as it were.

It would also be interesting to extend the comparison to younger adults. I hope future research will explore these aspects.

Nevertheless, the idea that age-related cognitive decline might be largely, or even entirely, accounted for by one's physical fitness and the state of one's arteries, is an immensely appealing one.

Fitness was assessed with the Six-Minute Walk test which involved participants walking back and forth between two markers placed 10 metres apart for six minutes. Only participants who completed the full six minutes were included in the analysis.

https://www.eurekalert.org/pub_releases/2018-06/ip-bpf061118.php

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Moving more in old age may protect brain from dementia

  • A long-running study found older adults who moved more were less likely to develop dementia, even when they had brain pathologies characteristic of dementia.

A long-running study involving 454 older adults who were given physical exams and cognitive tests every year for 20 years has found that those who moved more than average maintained more of their cognitive skills than people who were less active than average, even if they have brain lesions or biomarkers linked to dementia.

Participants wore an activity monitor for a week, an average of two years before death. The range of physical activity was extreme, with the average being 155,000 counts/day and the standard deviation being 116,000 counts. Daily physical activity was affected by age (unsurprisingly) and education.

For every increase in physical activity by one standard deviation, participants were 31% less likely to develop dementia. For every increase in motor ability by one standard deviation, participants were 55% less likely to develop dementia.

191 had dementia and 263 did not. The participants donated their brains for research upon their deaths. The average age at death was 91 years. Almost all (95.6%) showed at least one brain pathology, with 85% having at least two, and the average being three. Pathologies include Alzheimer's pathology, Lewy Bodies, nigral neuronal loss, TDP-43, hippocampal sclerosis, micro- and macro-infarcts, atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy.

https://www.eurekalert.org/pub_releases/2019-01/rumc-mmi011119.php

https://www.theguardian.com/science/2019/jan/16/activity-sharpens-even-dementia-affected-brains-report-suggests

Reference: 

Buchman, Aron S. et al. 2019. Physical activity, common brain pathologies, and cognition in community-dwelling older adults. Neurology, 92 (8), e811-e822; DOI: 10.1212/WNL.0000000000006954

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Physical activity linked to better brain health & cognition in older adults

  • A study found that older adults remembered names better after moderately intense exercise.
  • A large, long-running study found that each hour of light physical activity per week was linked to less brain atrophy.
  • Similarly, another long-running study reported that higher levels of lifestyle physical activity were associated with less brain atrophy.

Exercise activates brain networks in older adults

A study involving healthy older adults (55-85) found that recall was better after a session of moderately intense exercise, and several crucial brain regions showed greater activation.

The recall task involved identifying famous names and non famous ones. The test occurred 30 minutes after the exercise session (using an exercise bike) and on a separate day after a period of rest.

Brain activation while correctly remembering names was significantly greater in the hippocampus, middle frontal gyrus, inferior temporal gryus, middle temporal gyrus, and fusiform gyrus.

https://www.eurekalert.org/pub_releases/2019-04/uom-eam042419.php

Light, physical activity reduces brain aging

Data from the Framingham Heart Study has found that each additional hour spent in light-intensity physical activity was associated with higher brain volumes, equivalent to approximately 1.1 years less brain aging.

https://www.eurekalert.org/pub_releases/2019-04/buso-lpa041719.php

https://www.theguardian.com/science/2019/apr/19/household-chores-keep-brain-young-research-suggests

Everyday physical activities linked to more gray matter in brains of older adults

Data from 262 older adults (mean age 81) in the long-running Rush's Memory and Aging Project, found that higher levels of lifestyle physical activity (e.g., house cleaning, dog-walking, gardening, as well as exercise) are associated with more gray matter.

Participants wore an accelerometer continuously for seven to ten days, in order to accurately measure the frequency, duration and intensity of a participant's activities.

The association between physical activity and gray matter volumes remained after further controlling for age, gender, education levels, body mass index and symptoms of depression.

https://www.eurekalert.org/pub_releases/2018-02/rumc-eaa021318.php

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Higher blood pressure linked to greater brain damage in older adults

  • A clinical trial found that hypertensive older adults who took medication to keep their systolic blood pressure around 130 showed markedly fewer white matter lesions than those maintaining a level of 145.
  • A large, long-running study found that higher blood pressiure was linked to more brain lesions and more tau tangles.
  • A long-running study found that both higher amyloid-beta levels and higher vascular risk were linked to faster cognitive decline, with the factors interacting to be worse than additive.

Lowering blood pressure prevents worsening brain damage in elderly

A clinical trial involving 199 hypertensive older adults (average age 81) found that those who took medicine to keep their 24-hour systolic blood pressure around 130 mm Hg for three years showed 40% less accumulation of white matter lesions compared with those taking medicine to maintain a systolic blood pressure around 145 mm Hg.

60% of the patients maintained their target blood pressure throughout the full three years, and data from these alone showed an even bigger difference in number of brain lesions.

The study used around-the-clock ambulatory blood pressure monitors, which measured participants' blood pressure during all activities of daily living.

Participants had an average systolic blood pressure around 150 mm Hg at the beginning of the trial.

The research was presented at the American College of Cardiology's 68th Annual Scientific Session.

https://www.eurekalert.org/pub_releases/2019-03/acoc-lbp031819.php

Brain lesions linked to higher blood pressure in older adults

A long-running study tracking 1,288 older adults (65+) until their deaths found that the risk and number of brain lesions increased with higher blood pressure. High blood pressure was also linked to increased risk of protein tangles in the brain.

Two-thirds of the subjects had high blood pressure, while about half had one or more brain infarcts. Those with an upper blood pressure of 147 had a 46% higher chance of having one or more lesions.

https://www.the-scientist.com/news-opinion/higher-blood-pressure-has-links-to-brain-lesions-in-older-adults-64495

Vascular risk interacts with amyloid levels to increase age-related cognitive decline

Data from 223 participants in the Harvard Aging Brain Study found that both elevated brain amyloid levels and higher vascular risk were associated with more rapid cognitive decline, with the most rapid changes seen in those with both factors. The interaction between the two factors appears to be synergistic rather than simply additive — that is, the interaction between vascular factors and amyloid burden produces more risk than would be predicted from simply adding the two together.

https://www.eurekalert.org/pub_releases/2018-05/mgh-vri052118.php

Reference: 

Arvanitakis, Z., Capuano, A. W., Lamar, M., Shah, R. C., Barnes, L. L., Bennett, D. A., & Schneider, J. A. (2018). Late-life blood pressure association with cerebrovascular and Alzheimer disease pathology. Neurology, 91(6), e517. https://doi.org/10.1212/WNL.0000000000005951

[4499] Rabin, J. S., Schultz A. P., Hedden T., Viswanathan A., Marshall G. A., Kilpatrick E., et al.
(2018).  Interactive Associations of Vascular Risk and β-Amyloid Burden With Cognitive Decline in Clinically Normal Elderly Individuals: Findings From the Harvard Aging Brain Study.
JAMA Neurology. 75(9), 1124 - 1131.

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Lymphatic vessels critical to a healthy brain

  • Lymphatic vessels surround the brain and are vital to its ability to manage waste.
  • A mouse study has found that improvements to the flow of waste from brain to lymph nodes dramatically improved their cognition, while obstructing the lymphatic vessels increased the level of amyloid-beta plaques.

Although first reported in 1816, the fact that the brain is surrounded by lymphatic vessels, which connect the brain and the immune system, was only rediscovered in 2015.

Lymphatic vessels are part of the body's circulatory system. In most of the body they run alongside blood vessels. They transport lymph, a colorless fluid containing immune cells and waste, to the lymph nodes. Blood vessels deliver white blood cells to an organ and the lymphatic system removes the cells and recirculates them through the body. The process helps the immune system detect whether an organ is under attack from bacteria or viruses or has been injured.

Since then, brain scans have indicated that our brains drain some waste out through lymphatic vessels, and could act as a pipeline between the brain and the immune system.

More recent research suggests the vessels are vital to the brain's ability to cleanse itself. When a compound was used to improve the flow of waste from the brain to the lymph nodes in the neck of aged mice, their ability to learn and remember improved dramatically.

Moreover, obstructing the vessels in mice worsened the accumulation of harmful amyloid plaques in the brain.

https://www.eurekalert.org/pub_releases/2018-07/uovh-bdc072518.php

https://www.eurekalert.org/pub_releases/2017-10/nion-nru100317.php

Reference: 

[4498] Da Mesquita, S., Louveau A., Vaccari A., Smirnov I., R. Cornelison C., Kingsmore K. M., et al.
(2018).  Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease.
Nature. 560(7717), 185 - 191.

Absinta, Ha et al. Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI, October 3, 2017, eLife: 10.7554/eLife.29738

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Absentmindedness can be an early warning sign of silent strokes

  • A small study found that older adults with white matter damage caused by silent strokes noticed poorer attention and distractability.

A study involving 54 older adults (55-80), who possessed at least one risk factor for a stroke, found that those with white matter damage caused by silent strokes reported poor attentiveness and being distracted more frequently on day-to-day tasks. Despite these complaints, about half of these people scored within the normal range on tests of attention and executive function.

It’s suggested that adults who notice that they frequently lose their train of thought or often become sidetracked may in fact be displaying early symptoms of cerebral small vessel disease.

"Silent" strokes are so-called because they don’t have obvious effects as seen with an overt stroke. Typically, they’re not diagnosed until the damage has accumulated to such an extent that effects are seen, or by chance through MRI scans.

https://www.eurekalert.org/pub_releases/2019-02/bcfg-apt020419.php

Reference: 

Dey, A. K., Stamenova, V., Bacopulos, A., Jeyakumar, N., Turner, G. R., Black, S. E., & Levine, B. (2019). Cognitive heterogeneity among community-dwelling older adults with cerebral small vessel disease. Neurobiology of Aging, 77, 183–193. https://doi.org/10.1016/j.neurobiolaging.2018.12.011

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Perivascular space size linked to cognitive impairment in older adults

  • Enlarged perivascular spaces have been linked to poorer processing speed and executive functioning in older adults.

Perivascular spaces are fluid-filled spaces around the cerebral small vessels, commonly seen on brain scans in older adults. They have been thought to be harmless, but a new study challenges this belief.

The study, which looked at older adults who have not yet developed dementia, showed that different markers of small vessel disease reflect distinct pathways of injury. Well-studied markers of small vessel disease include white matter hyperintensities, infarcts and microbleeds, and the most frequent associations in the study unsurprisingly linked white matter hyperintensities and cognition, including language, information processing speed, executive functioning and visuospatial skills.

Much more surprisingly, though, the next most frequent links were between enlarged perivascular spaces and information processing speed and executive functioning.

https://www.eurekalert.org/pub_releases/2019-03/vumc-sv032019.php

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Major heart surgery not much worse for cognition than other heart treatments

  • A large study found that older adults experiencing heart surgery showed more long-term cognitive decline than those having a less invasive treatment, but not a great deal more.

Data from 3,105 older adults (65+) who had either heart surgery or cardiac catheterization has found that those who had heart surgery didn’t experience much greater cognitive decline compared with those who had the much less invasive, catheter-based procedure.

Two years after the surgery, surgery participants showed a greater amount of decline equal to only 4.6 months of cognitive aging compared with those undergoing catheterization.

https://www.eurekalert.org/pub_releases/2018-12/e-bhn121818.php

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Multimorbidity score linked to cognitive decline

  • A very large study found that older adults with multiple health conditions showed much greater cognitive decline than those with fewer chronic conditions, even when the conditions weren't directly related to brain health.

Data from more than 14,265 people older adults (51+) multiple times over a decade or more through the University of Michigan Health and Retirement Study has found that people with higher “multimorbidity scores” showed much faster cognitive decline than those with lower scores, even though most of the chronic conditions included in the index had no direct relationship with brain health. The higher the score, the faster the decline.

The multimorbidity index was calculated using three long-term studies of more than 250,000 health professionals, and takes into account the different ways different conditions affect people and how they interact.

The tool is free and available at the ePrognosis website for clinicians.

https://www.futurity.org/multimorbidity-score-chronic-conditions-death-2089922-2/

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