New research suggests that psychological resilience, ie having attitudes and behaviours that help people bounce back after stressful challenges, may help older individuals with type 2 diabetes to experience fewer hospitalisations and have better physical functioning, lower disability, better mental quality of life, and a lower likelihood of becoming frail.
The study, published in published in theJournal of the American Geriatrics Society, recruited 3199 participants, average age 72.2 years, 61% female, 61% white, and followed them for 14 years. The association of resilience with some metrics (grip strength and self-reported disability) varied based on recent hospitalisation history, and results suggested that some associations may differ based on race/ethnicity.
“This study suggests that individuals who report being psychologically resilient also report fewer aging-related concerns,” said lead author KayLoni L. Olson, PhD, of the Warren Alpert Medical School of Brown University. “This study is preliminary but points to the potential role of psychological resilience in helping individuals feel better mentally and physically, which can ultimately enhance their later years of life.”
Scientists have developed a variety of games designed to boost older adults’ cognitive capacity. Co-creator Professor Adam Gazzaley, MD, PhD, said the games can be an “experiential medicine”. The games adapt to the players’ skill on the fly, and were shown to confer benefits on many important cognitive processes such as short-term memory, attention and long-term memory.
Each game uses adaptive closed-loop algorithms that Dr Gazzaley’s lab pioneered in the widely cited 2013 Neuroracer study published in Nature, which first demonstrated it was possible to restore diminished mental faculties in older people with just four weeks of training on a specially designed video game. The most recent game, which uses drumming, is described in in PNAS.
Watch a short video showing how the games Neuroracer and Body Brain Trainer, developed by the Neuroscape Center, improve cognitive function for multitasking and working memory, and can even be beneficial for conditions like ADHD, Parkinson’s, and multiple sclerosis.
These algorithms get better results than commercial games by automatically adjusting in difficulty according to the players’ skills. The games using these algorithms recreate common activities, such as driving, exercising and playing a drum, and use the skills each can engender to retrain cognitive processes that decline with age.
“All of these are taking experiences and delivering them in a very personalised, fun manner, and our brains respond through a process called plasticity,” said Prof Gazzaley at the UCSF Weill Institute for Neurosciences and who is founder and executive director of Neuroscape. “Experiences are a powerful way of changing our brain, and this form of experience allows us to deliver it in a manner that’s very accessible.”
The lab’s most recent invention is a musical rhythm game, developed in consultation with drummer Mickey Hart, that not only taught the 60 to 79-year-old participants how to drum, but also improved their ability to remember faces.
The eight-week program used visual cues to train people how to play a rhythm on an electronic tablet, with an algorithm matching difficulty to the player’s ability. The cues disappeared over time, forcing the players to memorise the rhythmic pattern.
When the participants were tested at the end to see how well they could recognise unfamiliar faces, electroencephalography (EEG) data showed increased activity in a part of the brain on the right side (the superior parietal lobule) that is involved both in sight reading music and in short-term visual memory for other tasks. The researchers said the data indicate that the training improved how people bring something into memory and then take it back out again when they need it.
A second game, the Body Brain Trainer, published recently in NPJ Aging, improved blood pressure, balance and attention in a group of healthy older adults with eight weeks of training, as well as a key signature of attention that declines with age. The game also included a feedback mechanism.
“We had people wearing a heart rate monitor, and we were getting that heart rate data and feeding it into the game,” said Joaquin A. Anguera, PhD, associate professor of neurology at UCSF and director of the Clinical Division at Neuroscape. “If they weren’t working hard enough, the game got harder.”
Neuroscape published the results of a third study last year in Scientific Reports on a virtual reality spatial navigation game called Labyrinth that improved long-term memory in older adults after four weeks of training.
“These are all targeting cognitive control, an ability that is deficient in older adults and that is critical for their quality of life,” Prof Gazzaley said. “These games all have the same underlying adaptive algorithms and approach, but they are using very, very different types of activity. And in all of them we show that you can improve cognitive abilities in this population.”
According to a study which was published in The Journal of Neuroscience, neurons in the entorhinal cortex (a brain area responsible for memory) were significantly larger and healthier in 80+ year olds who have exceptional memory, also known as ‘SuperAgers’.
Their neurons were larger than those of cognitively average peers, individuals with early-stage Alzheimer’s disease and even those decades younger than SuperAgers. These neurons also did not harbour tau tangles, a hallmark of Alzheimer’s disease.
“The remarkable observation that SuperAgers showed larger neurons than their younger peers may imply that large cells were present from birth and are maintained structurally throughout their lives,” said lead author Tamar Gefen, an assistant professor at Northwestern University Feinberg School of Medicine. “We conclude that larger neurons are a biological signature of the SuperAging trajectory.”
The study of SuperAgers with exceptional memory was the first to show that these individuals carry a unique biological signature that comprises larger and healthier neurons in the entorhinal cortex that are relatively clear of tau tangles.
The Northwestern SuperAging Research Program studies unique individuals known as SuperAgers, 80+ year-olds who show exceptional memory at least as good as individuals 20 to 30 years their junior.
“To understand how and why people may be resistant to developing Alzheimer’s disease, it is important to closely investigate the postmortem brains of SuperAgers,” A/Prof Gefen said. “What makes SuperAgers’ brains unique? How can we harness their biologic traits to help elderly stave off Alzheimer’s disease?”
Scientists studied the entorhinal cortex of the brain because it controls memory and is one of the first locations targeted by Alzheimer’s disease. The entorhinal cortex comprises six layers of neurons. Layer II, in particular, receives information from other memory centres and is a very specific and crucial hub along the brain’s memory circuit.
In the study, scientists show that SuperAgers have large, healthier neurons in layer II of the entorhinal cortex compared to their same-aged peers, individuals with early stages of Alzheimer’s disease and even individuals 20 to 30 years younger. They also showed that these large layer II neurons were spared from the formation of tau tangles.
These findings together suggest that a neuron spared from tangle formation can maintain its structural integrity, and the inverse is true: Tau tangles can lead to neuronal shrinkage.
Participants in the SuperAger study donate their brains for research.
For the study, scientists examined the brains of six SuperAgers, seven cognitively average elderly individuals, six young individuals and five individuals with early stages of Alzheimer’s. Then they measured the size of neurons in layer II of the entorhinal cortex (compared to layers III and V). They also measured the presence of tau tangles in these cases.
For reasons that remain unknown, cell populations in the entorhinal cortex are selectively vulnerable to tau tangle formation during normal aging and in early stages of Alzheimer’s.
“In this study, we show that in Alzheimer’s, neuronal shrinkage (atrophy) in the entorhinal cortex appears to be a characteristic marker of the disease,” Gefen said.
“We suspect this process is a function of tau tangle formation in the affected cells leading to poor memory abilities in older age,” A/Prof Gefen said. “Identifying this contributing factor (and every contributing factor) is crucial to the early identification of Alzheimer’s, monitoring its course and guiding treatment.”
Future studies are needed to understand how and why neuronal integrity is preserved in SuperAgers. A/Prof Gefen wants to focus on probing the cellular environment.
“What are the chemical, metabolic or genetic features of these cells that render them resilient?” she asked. She also plans to investigate other hubs along the memory circuit of the brain to better understand the spread of or resistance to disease.
Only 48% of people age 50 to 80 taking blood pressure medications or have a health condition affected by hypertension regularly check their blood pressure at home or other places, found a new study published in JAMA Network Open.
A somewhat higher number (62%) say a health care provider encouraged them to perform such checks. Poll respondents whose providers had recommended they check their blood pressure at home were three and a half times more likely to do so than those who didn’t recall getting such a recommendation.
The findings underscore the importance of exploring the reasons why at-risk patients aren’t checking their blood pressure, and why providers aren’t recommending they check — as well as finding ways to prompt more people with these health conditions to check their blood pressure regularly. This could play an important role in helping patients live longer and maintain heart and brain health, the study’s authors say.
Past research has shown that regular home monitoring can help with blood pressure control, and that better control can mean reduced risk of death; of cardiovascular events including strokes and heart attacks; and of cognitive impairment and dementia.
A team from Michigan Medicine, the University of Michigan’s academic medical centre, conducted the research. The data come from the National Poll on Healthy Aging and build on a report issued last year.
The poll, based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine and AARP, asked adults aged 50 to 80 about their chronic health conditions, blood pressure monitoring outside of clinic settings, and interactions with health providers about blood pressure. Study authors Mellanie V. Springer, M.D., M.S., of the Michigan Medicine Department of Neurology, and Deborah Levine, M.D., M.P.H., of the Department of Internal Medicine, worked with the NPHA team to develop the poll questions and analyze the findings.
The data in the new paper come from the 1,247 respondents who said they were either taking a medication to control their blood pressure or had a chronic health condition that requires blood pressure control — specifically, a history of stroke, coronary heart disease, congestive heart failure, diabetes, chronic kidney disease or hypertension.
Of them, 55% said they own a blood pressure monitor, though some said they don’t ever use it. Among those who do use it, there was wide variation in how often they checked their pressure — and only about half said they share their readings with a health provider. But those who own a monitor were more than 10 times more likely to check their blood pressure outside of health care settings than those who don’t own one.
The authors note that blood pressure monitoring is associated with lower blood pressure and is cost-effective. They say that the results suggest that protocols should be developed to educate patients about the importance of self blood pressure monitoring and sharing readings with clinicians.
Researchers in Japan have found that older participants have longer reaction times, slower decision times, and greater brain activation in the parts of the brain involved with inhibition and switching tasks. These findings, published in the journal Brain Behavioural Research, illuminate the causes of accidents involving elderly drivers who press the brake instead of the accelerator.
With one of the oldest populations in the world, Japan is concerned about cognitive decline in drivers resulting in accidents. The police require drivers over 75 to take periodic cognitive tests. However, few studies have investigated executive functions and brain activity among older adults in terms of foot responses during braking and accelerating.
To address this gap, a group led by Professor Nobuyuki Kawai of the Graduate School of Informatics at Nagoya University in Japan scanned the brains of elderly people and students while performing pedal-pressing simulations. The researchers were particularly interested in the left dorsolateral prefrontal cortex, the part of the brain associated with inhibition and switching responses.
To simulate the response of a person’s feet and hands when driving a car, they created a new task in the laboratory called the bimanual and bipedal response selection and response-position compatibility task. During this task, a signal directed participants to press the left or right button with their left or right foot, or their left or right hand. Sometimes participants pressed the pedal in front of them, whereas at other times they had to press it diagonally. This was done to allow the researchers to assess how the participants responded in situations where the cognitive load was higher. Administering this task to both university students and elderly participants, the researchers then monitored blood flow in their brains. The results were published in Behavioural Brain Research.
They found that older participants had longer reaction times, slower decision times, and greater brain activation than younger people. Furthermore, pressing the diagonal pedal required longer reaction times and greater brain activation than pressing directly ahead in the left dorsolateral prefrontal cortex. Interestingly, this was only found when people were asked to use their feet but not their hands. In short, older people had to do more active thinking than younger people when deciding which ‘pedal’ to press with their feet.
“This indicates that the cognitive load is higher when pushing the pedal diagonally with the foot, such as when pressing the brake,” explains Professor Kawai. “When you push a diagonal pedal with your foot, you are using the frontal lobe more than when you push the pedal straight in front. In particular, the left dorsolateral frontal lobe, which is important for response switching, is more active when the foot is pressed at an angle than when the pedal is pressed straight. In these tasks, older adults have higher neural activity throughout the frontal lobe than college students.”
This study’s findings suggest that to compensate for the decline in cognitive functions, greater brain activation may be necessary in elderly people. Older people may struggle in situations with a high cognitive load, such as parking a vehicle in a narrow space. “This study suggests that the performance of older adults is vulnerable in these situations,” Professor Kawai explains. “Elderly drivers should not be overconfident that their driving is fine. Even elderly people who are normally able to drive without any problems, when a cognitive load is applied, such as when switching from one parking space to another or when talking to a passenger, things may be different and there is a chance of pressing the wrong pedal. We believe that it is important to educate elderly drivers about this fact.”
In new research published in the Journal of Bone and Mineral Research, elevated blood levels of a certain chemokine, or small signalling protein, that promotes osteoclast formation were linked with a higher risk of hip fracture in men.
To maintain bone health, a balanced activity of various bone cell types including bone-forming osteoblasts and bone-resorbing osteoclasts has to take place. When osteoclasts dominate without adequate bone formation to compensate, osteoporosis results.
The study included 55 men and 119 women who had experienced a hip fracture an average of 6.3 years after their blood was collected. The participants were matched individually to controls who did not develop hip fractures.
The researchers found higher levels of the chemokine CXCL9 in the pre-fracture blood samples of men with subsequent hip fractures compared with their non-fracture controls. In women, the researchers saw no such.
“The unexpected difference in the results between men and women in our study may be explained by how changes in sex hormone levels during aging could influence the level and effects of CXCL9 differently in older men and women,” explained corresponding author Woon-Puay Koh, MBBS, PhD, from the National University of Singapore (NUS).
“Our findings open the exciting possibility that early interventions targeting CXCL9 or CXCL9-CXCR3 signalling could be beneficial in preventing hip fractures in older men,” added co-corresponding author Christoph Winkler, PhD, also from NUS.
Although low physical activity and greater time spent sitting are well known to be linked to a higher risk of death, a study published in Journal of Aging and Physical Activity showed that a genetic predisposition to longevity was not a substitute for sitting less and greater physical activity, which can benefit even those not gifted with such genes.
“The goal of this research was to understand whether associations between physical activity and sedentary time with death varied based on different levels of genetic predisposition for longevity,” said doctoral student Alexander Posis, lead author of the study.
In 2012, as part of the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health study (OPACH), researchers began measuring the physical activity of 5446 women aged 63 and older, following them through 2020 to determine mortality. Participants wore a research-grade accelerometer for up to seven days to measure how much time they spent moving, the intensity of physical activity, and sedentary time.
Higher levels of light physical activity and moderate-to-vigorous physical activity were found to be associated with lower risk of death. Higher sedentary time was associated with higher risk of mortality. These associations were consistent among women who had different levels of genetic predisposition for longevity.
“Our study showed that, even if you aren’t likely to live long based on your genes, you can still extend your lifespan by engaging in positive lifestyle behaviours such as regular exercise and sitting less,” said Assistant Professor Aladdin H. Shadyab, PhD, senior author. “Conversely, even if your genes predispose you to a long life, remaining physically active is still important to achieve longevity.”
Given the ageing adult population in the United States, and longer time spent engaging in lower intensity activities, the study findings support recommendations that older women should participate in physical activity of any intensity to reduce the risk of disease and premature death, wrote the authors.
At 100, Dr Howard Tucker holds the Guinness world record for being the world’s oldest practising doctor. Though he has only just stopped seeing patients, he still teaches medical residents at St. Vincent Charity Medical Center in Ohio, USA.
Having practised medicine for 75 years, the secret is to keep going, he said. “I look upon retirement as the enemy of longevity,” Dr Tucker told TODAY over a video call. He has a computer and smartphone, and is determined to keep up with technology.
“I think that to retire, one can face potential shrivelling up and ending in a nursing home. It’s fun staying alive and working… It’s delightful work. Every day I learn something new.”
Born on July 10, 1922 and graduating from medical school in 1947, Dr Tucker got the “gift of COVID” from one of his relatives at his 100th birthday last month, but recovered quickly and felt fine. He even broke is neck while skiing in the late 1980s, though he “came out of it totally intact”.
At age 67 he passed the Ohio Bar Exam because he was interested in law.
Tucker shared some of his longevity advice with TODAY:
“Heredity and family history of longevity is a healthy start. However, it must be supported by moderation of nutrition, alcohol, and happiness,” Dr Tucker explained in his Guinness World Records entry.
Longevity runs in his family: his mother lived to 84 and his father to 96, and he has avoided the diseases of ageing such as heart disease and dementia. In addition, Dr Tucker never smokes but drinks alcohol occasionally, and eats in moderation. He has exercised his entire life – though he is now banned from skiing. The day after his 100th birthday, he threw the opening pitch for a baseball game.
His advice is to not retire , and stay active. Though there are jobs which people can’t or don’t wat to do anymore as they age, people should at least take up a hobby or do communal work to provide a daily stimulus for the brain.
The other challenge is to keep learning. As well as earning his law degree, he stayed current with technology, for which he credits his grandson, Austin, who is also making a documentary about the centenarian’s life. He also keeps up with his field of neurology, which he follows with excitement.
Finally, Dr Tucker said that you have to cultivate happiness. “You have to be happy in your job and in your domestic life,” he said.
Chinese traditional medicine based on combinations of typically 5 to ten plants, usually boiled and administered as a decoction or tea, has long been used to treat rheumatoid arthritis (RA), but few clinical trials have tested its potential. A review in the Journal of Internal Medicine outlines a strategy to analyse the ability of different mixtures of plants used in Chinese medicine to combat RA.
One fundamental of traditional medicine is to prevent disease. RA is an autoimmune, inflammatory and chronic disease that primarily affects the joints of 0.5%–1% of the population. In two out of three of the cases, the patients are characterised by the presence of autoantibodies such as the rheumatoid factor and the more disease-specific autoantibody against citrullinated proteins, so-called ‘ACPA’ (anticitrullinated protein/peptide antibodies). ACPA positivity is also strongly associated with specific variations in the HLA-DRB1 gene, the shared epitope alleles. Together with smoking, these factors account for the major risks of developing RA.
The researchers’ strategy involves isolating the active components of individual plants and testing them alone or in combinations against key pathways of disease pathology, followed by experiments conducted in animal models of RA.
“A substantial number of our current drugs are natural products or derivatives thereof, and without doubt nature will continue to be a source of future discoveries,” the authors wrote. “Therefore continuous research based on the traditional use of plants is highly motivated. In our opinion, the strategy of starting from knowledge in traditional medicine, followed by the combination of in vivo evidence of efficacy and bioassay-guided isolation to understand the chemistry and pathways involved, is one effective way forward.”
In a study of 210 community-dwelling older adults who had surgery following hip fracture, participants who reported feeling high levels of psychological resilience were later able to walk faster and longer than those feeling less resilient. The results, published in the Journal of the American Geriatrics Society, will help the development of interventions such as targeted exercise programmes.
Walking capacity is a critically important outcome following hip fracture, in that it serves both as a surrogate measure of functional ability and physical health more globally, as well as a predictor of future survival, institutionalisation, social interaction and community engagement. Moreover, poor recovery after hip fracture causes considerable suffering for patients and imposes a financial burden on the social and health care sector. In 29%–50% of cases, older adults with hip fracture do not reach their pre-fracture levels of functioning a year after the fracture. Poorer pre-fracture function, greater cognitive impairment, greater co-morbidity burden, poorer social support, and poorer nutrition, have been identified as predictors for diminished post-fracture recovery.
Psychological resilience was measured through a questionnaire provided at the start of the study, and they assessed walking capacity at the start as well as 16 weeks later.
“We believe these results support opportunities to improve walking capacity following hip fracture in older adults by devising multicomponent interventions combining targeted exercise with psychological resilience-enhancing programmes,” said corresponding author Richard H. Fortinsky, PhD, of the University of Connecticut School of Medicine and the UConn Center of Aging.
