seniors

Slower walking speeds linked to dementia risk

  • A large, long-running study has found older adults with a slower walking speed were more likely to develop dementia in the next decade.
  • Another long-running study has found that slowing over 14 years was linked to brain atrophy in the hippocampus, and cognitive impairment.

Data from the English Longitudinal Study of Aging, in which nearly 4,000 older adults (60+) had their walking speed assessed on two occasions in 2002-2003 and in 2004-2005, those with a slower walking speed were more likely to develop dementia in the next 10 years. Those who experienced a faster decline in walking speed over the two-year period were also more likely to develop dementia.

https://www.eurekalert.org/pub_releases/2018-03/ags-oaw032318.php

A long-running study involving 175 older adults (70-79) found that slowing in walking speed over a 14-year period was associated with cognitive impairment, and with shrinkage of the right hippocampus specifically.

Gait slowing over an extended period of time was a stronger predictor of cognitive decline than slowing at a single time point. All the participants slowed over time, but those who slowed by 0.1 seconds more per year than their peers were 47% more likely to develop cognitive impairment.

The finding held even when the researchers took into account slowing due to muscle weakness, knee pain and diseases, including diabetes, heart disease, and hypertension.

Typically, a slowing gait is seen as a physical issue, but doctors should consider that there may be a brain pathology driving it.

http://www.futurity.org/gait-hippocampus-brains-dementia-1472892/

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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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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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Is there really a level at which alcohol benefits cognition?

  • A very large study of adults aged 40-73 found evidence that alcohol's suggested benefit for cognition applies to a much lower level of alcohol consumption than previously claimed — only one drink a day.
  • Another longitudinal study that also removed the bias that's thought to come from including non-drinkers in the analysis, found no evidence for any cognitive benefits at any level of alcohol consumption.

Large study shows level of beneficial alcohol consumption much lower than thought

A UK study using data from 13,342 middle-aged and older adults (40-73) has found that having up to one standard unit of alcohol a day improved reaction time, but more than that amount harmed cognitive performance. The effect was more pronounced in older adults.

While several studies have suggested a U-shaped relationship between alcohol and cognition, with light to moderate consumption being beneficial to older adults, this has been quite controversial, with little consensus on how much is too much.

This study uses data from the over half a million people who participated in the UK Biobank prospective cohort study. Of these, 20,346 undertook a repeat assessment 5 years after the initial assessment. The study excluded any who disclosed a history of neurological disorder, and then included only those who consumed alcohol at least once a week. Weekly drinkers had lower levels of socioeconomic deprivation, were more likely to hold a university degree, and to be male.

Cognitive performance was assessed very simply, using a 'stop-go' reaction time task. RT decreased as alcohol consumption increased up to 10g/day, and then increased after that point. This harmful effect became stronger as people got older.

This level of 10 g/day is markedly lower than that suggested by other studies, which have variously argued for: up to 40g for women and 80g for men; up to 34g for middle-aged adults; no more than 16g.

The study omitted people who didn't drink at all, because of the 'sick quitter' effect — it's been argued that the apparent connection between moderate alcohol consumption and better health and cognition is due to bias in the control group, with many people abstaining or quitting due to health issues, and this has been supported by some recent studies. For example, a 2016 review and meta-analysis found no significant difference in mortality for low-volume drinkers once abstainer biases were adjusted for.

The main takeaway from this study — which seems quite robust given the scale of the study — is that the level of 'positive' alcohol consumption is much lower than previously claimed.

The study is open access, and can be read in its entirety at https://academic.oup.com/jpubhealth/article/40/2/304/4793394

Study shows no benefits from alcohol consumption once abstainer bias accounted for

Another longitudinal study, using a subset of participants in the Swedish Twin Registry, found no evidence for any cognitive benefits at any level of alcohol consumption.

Participants were those 486 individuals who had been surveyed on their alcohol intake in their midlife (in 1967), and also taken part in cognitive assessments 25 years later. Cognitive tests occurred at 2-year intervals for the next 10 years.

The study found a significant negative dose-response association between alcohol intake in midlife and performance on the MMSE and tests of episodic memory. There was no significant association with semantic memory and spatial ability.

As with the other study, in order to remove abstainer bias, non-drinkers were excluded from the analysis. There were 181 non-drinkers, and this group were more likely to be women, to have less education, lower socioeconomic status, higher BMI, and were more likely to have diabetes and hypertension. They did indeed perform worse on all cognitive tests, but as you can see, most of the characteristics of this group do lend themselves to such a result.

Midlife alcohol consumption was used because it was assumed that this would give a better reflection of lifetime habits than that reported in old age. As it happened, there were no heavy drinkers in the cohort — the highest consumption was 15 units/week. In this study, 1 unit corresponded to 12g.

The study is open access, and can be read in its entirety at https://www.frontiersin.org/articles/10.3389/fnagi.2018.00081/full

Reference: 

Giovanni Piumatti, Simon C Moore, Damon M Berridge, Chinmoy Sarkar, John Gallacher, The relationship between alcohol use and long-term cognitive decline in middle and late life: a longitudinal analysis using UK Biobank, Journal of Public Health, Volume 40, Issue 2, June 2018, Pages 304–311, https://doi.org/10.1093/pubmed/fdx186

Hassing, L. B. (2018). Light Alcohol Consumption Does Not Protect Cognitive Function: A Longitudinal Prospective Study. Frontiers in Aging Neuroscience, 10. https://doi.org/10.3389/fnagi.2018.00081

 

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Belly fat in older adults linked with cognitive impairment

  • A large Irish study found that belly fat was linked to poorer cognition in older adults, while BMI was not, probably because it doesn't distinguish between muscle and fat.

Data from over 5,000 individuals found that a measure of belly fat (waist:hip ratio) was associated with reduced cognitive function in older Irish adults (60+). Body mass index (BMI), however, was found to protect cognitive function.

BMI is a crude measure of body fat and cannot differentiate between fat and muscle — the muscle component is likely to be the protective factor.

Research indicates that as we age, our fat becomes less efficient at producing a hormone that helps support the growth and survival of neurons and helps regulate their activity.

That hormone is adiponectin, which is made by fat cells, circulates in our blood and enters our brain. Inside fat cells, its production is regulated by PPAR-γ (peroxisome proliferator-activated receptor gamma).

Adiponectin is anti-inflammatory and can help regulate neuronal activity, including turning activity of some neurons up and others down. However, adiponectin is reduced in Alzheimer’s patients. Delivering adiponectin to the brain has been shown to improve cognition in mice.

Chronic stress can also decrease fat's production of PPAR-γ and adiponectin.

Fat cells become less efficient at making adiponectin in obesity, and with age. One theory is that fat cells start making inflammation-promoting signals called cytokines and this inflammation then inhibits adiponectin production.

The shift from beneficial subcutaneous fat to unhealthy fat that piles up on our bellies and around the organs inside our abdominal cavity is one that naturally occurs with age, but it is of course worse if you have a lot of excess weight around your abdomen.

Genetic variations in PPAR-γ and adiponectin as well as low blood levels of adiponectin are associated with an increased Alzheimer's risk.

https://www.eurekalert.org/pub_releases/2018-08/tcd-mob080118.php

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Nutrients linked to better brain connectivity, cognition in older adults

  • A study found that higher levels of several key nutrients were associated with more efficient brain connectivity and better cognitive performance in older adults.

A study involving 116 healthy older adults (65-75) has found that higher levels of several key nutrients in the blood were associated with more efficient brain connectivity and better cognitive performance. In fact, the findings suggest that the level of nutrients governs the strength of the association between functional brain network efficiency and cognitive performance.

The study looked at 32 key nutrients in the Mediterranean diet. The effective nutrients, which appeared to work synergistically, included omega-3 and omega-6 fatty acids, carotenoids, lycopene, riboflavin, folate, vitamin B12 and vitamin D.

A pattern of omega-3s, omega-6s and carotene was linked to better functional brain network efficiency.

Omega-3 fatty acids are abundant in fish, walnuts and Brussels sprouts; omega-6 fatty acids are found in flaxseed, pumpkin seeds, pine nuts and pistachios; lycopene is the vivid red pigment in tomatoes, watermelon and a few other fruits and vegetables; alpha- and beta-carotenoids give sweet potatoes and carrots their characteristic orange color.

https://www.eurekalert.org/pub_releases/2018-12/uoia-sln121918.php

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