LiveLongAgeWell

You may think that getting older means becoming less happy, but various studies, including this new one just released at the American Psychological Association (APA) meeting in Toronto, show just the opposite: most people actually become happier as they get older. Good news, especially as the fastest growing population segment—in the U.S. at least—is people over age 85.

This APA study from the University of California found two exceptions to the older=happier correlation. First are people dealing with dementia, and second are people stuck in a long-term stressful situation without escape, for example, a debilitating chronic disease.

Most of us, however, can look forward to greater happiness as we get older. The researchers felt that a main reason for that is that over time, we learn from experience what makes us stressed or unhappy, and we become better at avoiding or just ignoring those people or situations.

More from the APA Meeting

Two other interesting presentations at the APA …One a large Swedish study demonstrating that those adults who have a “strong social network” were 60% less likely to become demented over time.

The second one sounds obvious, yet is something frequently ignored—that many people who seem to be getting mentally slower are really not; it’s just that their hearing has slowly dropped, making them seem dim-witted. Be aware that many older folks are embarrassed to admit a hearing problem, so keep this in mind regarding your own family. If you notice someone losing sharpness over time, one of the first things to test is hearing.

“Sham” Vertebral Procedure and the Placebo Effect

The best possible research study is a “double-blind clinical trial”, and a typical trial like this involves splitting up a group of people into two equal groups, and giving one group an active drug, and the other group an inactive drug (placebo) and then comparing the outcome of the two groups over time. Unfortunately, since these studies are expensive and time-consuming, a majority of research studies are not true clinical trials, and surgical clinical trials involving placebo, or “sham” surgery, is exceedingly rare.

Sham surgery is complex in many ways; you can imagine trying to convince one half of a study group that they really had surgery, when in fact they had nothing more than an incision made, or an anesthetic shot given, rather than a full operation.

So I can’t recall the last time I read about a sham surgery clinical trial, but one was just completed by a team from Australia, Britain, and the U.S. The goal was to learn if vertebroplasty, a common back procedure (to decrease pain in vertebral fracture patients) was actually effective, or the improvement seen was just a placebo effect.

The researchers performed the full procedure on one half of the patients, involving an anesthetic shot and injecting bone cement into the fractured vertebra. The 50% of patients who had the sham procedure had the anesthetic shot but no cement was placed. To add realism to the sham group, the doctors had the cement in the room to give the same smell sensation as the real procedure.

The result was that the sham surgery group did just as well, with just as much improvement, as the ones who had the full procedure. For more details, look at this full summary in the New York Times. And if you have doubts about the efficacy of a procedure or operation your doctor suggests, you might ask “what clinical trials have been done, if any, to show this procedure is effective?” Your doc will be surprised, but should be able to answer.

Finally….it seems a number of research papers in the past decade have been “ghostwritten” by medical marketing companies rather than doctors. (This is probably no surprise to most doctors, but I suspect it might be for the general public.) In these cases the drug company hires a marketing company to write a paper with a positive spin on whatever they are selling or wanting to sell. Note that if the research did not turn out in their favor, they just wouldn’t publish it.

After the marketing writer finishes his favorable report, the doctor(s) may just look the paper over and make a few changes, but often the report is tailor-made to suit the drug company. Amazing how medicine has changed over the years, and how doctors can be bought off. Supposedly this practice, now exposed, will stop, but I doubt it.

Artificial Tanning Beds

Last month I covered sunscreens and sunless tanning lotions, and as a follow-up, there was a recent reclassification by the International Agency for Research on Cancer (IARC) that tanning beds should be raised to Group 1, that is, the highest risk level: “carcinogenic to humans”. While the artificial tanning bed industry has marketed their products as safer than the ultraviolet radiation from sunlight—and as not increasing the risk of melanoma (though they neglect to mention the increased risk of other forms of skin cancer)—the IARC reports a 75% greater risk of melanomas in people who start using tanning beds before the age of 30. Besides the cancer risks, while a tan might make you look better in the short run, in the long run you will end up more wrinkled. And though artificial tanning booths are dangerous, remember that sunless tanning lotions can be quite effective and safe.

Organic Food Not Worthwhile?

A headline from Reuters London caught my eye last week: “Organic food no healthier, study finds”. The author of the English study stated: “Our review indicates that there is currently no evidence to support the selection of organically over conventionally produced foods on the basis of nutritional superiority [italics mine].”  (Really, OK, maybe not proof, but no evidence at all?)

So a quick read might lead you to think it’s not worth the extra expense and trouble to seek out organic products. But this would be a false conclusion on at least two counts. First, the study only analyzed “nutritional content”; this is, what’s in the food, but most people choose organics because what’s NOT in them; i.e., pesticides and other organo-toxins (not addressed in this research). Second, if you look at what they consider “nutritional content”, you find they did not analyze antioxidant content, which is another reason to choose organic. While it’s true that there is not yet proof organics have a higher natural antioxidant content; for me, I’ll stick to organic products whenever I can. Unlikely any future research will find any health benefit whatsoever from eating foods with pesticides. It’s far more likely organic foods suffer less antioxidant loss during any processing, transport, and chemical additions.

Another Reason To Keep Your Cholesterol Below 200

If you know that your total cholesterol level is borderline or elevated, and you haven’t taken measures to change that, here’s another reason to take action. Published in the August Dementia and Geriatric Cognitive Disorders, researchers studied nearly 10,000 Northern California Kaiser Hospital members, and found that those who had total serum cholesterol levels over 200 mg/dL in their 40s, had a significantly great risk of dementia when they reached their 60s and 70s. The risk for either Alzheimer’s disease or vascular dementia was at least 50% percent greater in people with only mildly high levels—over 200. So take measures to keep your cholesterol in the normal range: whether it means a change in your diet and/or increased exercise, and if that doesn’t work, you should ask your doctor about possibly taking a “statin” drug to lower your lipid levels  (which—as logically follows from this study—have been shown may help prevent dementia.)

In my last post I gave a link to a scandalous blog written by two 80-something women, and if you haven’t looked at it, I suggest you do. For sure, these are some unusual women, but it shows what’s possible when a couple older people learn how to use a computer.

This recent New York Times article reveals how many oldsters have blossomed with a little social networking…it is happening! The benefits go beyond relieving isolation because—while the research proof is still not in—it’s likely that middle age and older adults who use online social networking have a significantly lower risk of becoming demented in later life. An older relative with dementia is no picnic for the sufferer nor for the spouse or children, so whatever can be done to lower that risk is well worthwhile for everyone.

This LLAW blog has a wide range of readers: subscribers range from age 23 to 94, but what is true for the youngest is true for the oldest—we all need a social network to live long and in good health, and the internet can be the vehicle that carries us there if our real-world network is insufficient.

Twenty- to 30somethings probably have a Facebook or MySpace (filled with ads now however) or Orkut page or at least MSN Messenger, so you know the potential of online connections. Now think about your older relatives or acquaintances who—for reasons of health or divorce or distant children, whatever—are more isolated. How about suggesting they consider online social networking, and then follow through to see that they really try it? There are new social networking sites for baby boomers and older, like eons.com. Many colleges have alumni networks, and Facebook’s growth is now greatest in the older crowd.

The big problem is getting some people to approach the computer, but you can start by pointing out that the computer is the most efficient and cheapest way to keep them up to date with family and friends. Mention that if they hope to see recent photos, those probably won’t arrive anymore in a photo album, and their only hope is to see them on the computer.

You can yourself tutor your computer-illiterate relative/friend, but this might be a big task, requiring lots of patience. Perhaps better if you research classes or tutors through the local “senior center” or community college (craigslist might be a little risky—you want these new, more vunerable users to be safe,  away from viruses, phishing, etc…).

While few 80somethings will end up online as wild and raw and funny as Margaret and Helen, you can still do a lot for others and yourself, fight the isolation that is too common in older folks, and along with that, cut the risk of a helpless, brain-weak relative in your future. Don’t wait.

My next blog will be about health and social networking on the internet, but today I suggest you check out this outrageously funny blog, (supposedly) written by two women in their 80s…it’s wild and raw and if you can imagine something written by the Golden Girls on steroids, this would be it.

These women—assuming it’s not a hoax blog, but I believe somehow two old ladies are writing—are definitely going to drop dead dancing in their 90s…at least dancing on their scooters (see their homepage). The best word I think to describe them—feisty; these are two feisty women, getting older and having a great time at it.

Warning: if you love Rush Limbaugh, Dick Cheney and/or don’t like to read strong language, probably best to avoid the blog, but otherwise, check it out:

http://margaretandhelen.wordpress.com/
I hope I’m not violating any copyright here, but here’s a sample of one of their posts, so you can see what I’m talking about:

Let me tell you a little story about my shit for brains nephew who actually does live in California. He was married ten years and had two children. Sadly, it didn’t work out. Honestly she was horrible, but you never really want to see a marriage end. So we were all a little sad when she left and he fell apart. Eventually he got his shit together, picked up the pieces and met another girl. I don’t like her much, but she makes him happy so what do I care if they want to get married? However, the Catholic church cared a great deal. You see, he was still married in the eyes of the church even though his moron of an ex-wife had been gone 4 years. And the new one is also divorced… and (oh my) a Baptist.

Problem? Not for long. Two annulments later and wallah – they were never married. Never mind the kids. Bastards all of them I guess. Funny but I didn’t know the Catholic church could annul a Baptist marriage, but you live and learn.

I’ve lived a long time and I have learned many things. For instance, I now know that even if the marriage is annulled, you don’t get your wedding gift back. I also learned that the previously married then divorced then never really married and now newly engaged couple can actually have the gall to print on their invitation where they are registered. As if that blender I purchased for the first wedding was annulled as well. But I digress…

Medical Bankruptcy

Health care costs have been one big reason we are in the Great Recession right now, and a majority of personal bankruptcies also have medical bills as a cause…. check out this New York Times blog post:

http://well.blogs.nytimes.com/2009/06/04/medical-bills-cause-most-bankruptcies/

Something seriously needs to be done to fix the medical care system. Usually I love Paul Krugman’s op-ed pieces in the Times, and today’s is about the insurance industry and health care reform:

http://www.nytimes.com/2009/06/05/opinion/05krugman.html?em

bottom line:

1) Don’t trust the insurance industry.

2) Don’t trust the insurance industry.

Finally, here is the single best article I have read that explains why the U.S. has been going bankrupt medically. (I am sure the same forces are taking shape in many other countries as well.) It’s long, but, in true New Yorker fashion, is a sample of writing perfection and well worth your time:

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

I will leave you with a quote from the article:

the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue….

Recently I’ve written about prescription drugs (like modafinil) that will likely improve your mental performance, but, like most drugs, there are possible side effects. Since these drugs are so new, there may be really serious ones that show up only after years of use. So today let’s talk briefly about something much milder—chewing gum—which might improve your mental performance, and certainly with much less risk.

I have been particularly interested in this subject because here in Brazil—and this is also true in many European and Asian countries—that the outcome of one big test, one written exam, will determine if someone gets into college or not. I have a friend here who is taking a written test that will determine if he gets an important job. There’s no interview, just this one test, so it’s lots of pressure.  I wanted to give him a little help, but didn’t want to suggest drugs such as modafinil. So I encouraged that he chew gum right before and during the test. There is research evidence that it could help him perform better, and you might consider this even if you don’t have to take tests anymore, but at times need a little mental boost.

Earlier in the decade there were studies that chewing gum improved performance on memory tests involving word lists, but the most recent study came from Baylor University in Houston. Researchers there looked at 108 students aged 13 to 16, and gave half of them sugar-free chewing gum to use in math class and while doing homework, and the other half went without gum. After fourteen weeks, they all took the Texas Assessment of Knowledge and Skills test, and the gum chewers slightly outperformed the non-chewers (by 3%, but they felt this was statistically significant).

Teachers noted also that the gum-chewers needed fewer breaks during class, seemed to pay better attention, and were quieter (they must have been careful and courteous chewers).

There have been other studies, using “functional MRI” scans, suggesting that gum chewing temporarily stimulates mental activity. These studies suggested that the mechanism is increased blood flow to the areas of the brain having to do with memory and focus such as the hippocampus and pre-frontal cortex. Other researchers have suggested that chewing temporarily lowers anxiety by releasing nervous tension, allowing one to perform better. This makes sense, and likely it is a combination of factors that allow students to perform better.

So while the mental boosting effect is not great, chewing gum might give you a little boost when you need it. Try it and see if it works for you; there’s not much to lose. But beyond possible mental benefits, gum chewing can be good for you in other ways, and we will cover that in the next post.  Have a great weekend!

Here are several excellent articles that may interest you… The first two cover recent LLAW topics (red meat and mind drugs), and these links will give you a totally different slant on each subject. The third article, and the shortest,  regards a totally different subject: creativity.

From The New Yorker, titled Brain Gain, is a long piece that first describes how college students are taking advantage of mind drugs (easily found on-campus) to ultra-perform. Then, in true New Yorker style, the author dives into several people at the forefront of cosmetic neurology, and the “transhumanist” movement (who believe we humans have the potential to live a very long time).

And if you are looking for even more motivation to cut down on your red and processed meat consumption, I suggest this relatively short article in the New York Times: Paying a Price for Loving Red Meat by Jane Brody.

I subscribe to an American Medical Association news feeder that every day sends me a digest of the latest medical news, and I have noticed for the last few months, the news is dominated by public health policy and health care economic reform in the United States.

So let me suggest a topic far away from those subjects… from a founder of the company IDEO, which helped design the Apple Computer.

Getting older is much more fun if you constantly keep your “creative juices” flowing, no matter your age; believe me, you will help keep your brain in good form, and this brief and entertaining piece from the IDEO group gives six hints to help us achieve that! Love it!

You probably have a friend, or perhaps a boss, like Bristol (name changed)….let me summarize Bristol—she’s very bright, but she consistently has a negative, pessimistic reaction to, well, seems like everything. I really like Bristol, but I’m constantly amazed: how can someone find something bad in almost every bit of news I give her? Now maybe I have an answer.

In the most recent issue of Veja (no link since it’s by subscription; only in Portuguese…most similar to Time magazine in the U.S.), there was an article of a British/Brazilian university study which identified a gene that appears to control optimism and pessimism. Several hundred people were put through DNA analysis along with a battery of psychological testing, and the results were clear: if a person has two “long” versions of this particular gene, they are prone to optimism, if they have the “short” gene version, they are much more likely to look at the world in a negative way, pessimistically.

This gene in question helps control transport of the neurotransmitter serotonin from nerve cell to nerve cell, and speaking generally, the more serotonin that travels the gap from nerve cell to nerve cell, the happier a person tends to be. It’s the basis for the most popular form of anti-depressants, SSRIs, otherwise known as “selective serotonin reuptake inhibitors”, which increase the amount of serotonin in that nerve gap, the synapse. So the people with the two long form genes have more serotonin available to bridge those nerve gaps, and probably look at the world in a more positive way.

With this gene information, I will try to be even more understanding with Bristol, or perhaps mention to her again the idea of seeing a physican to at least consider “up-regulating” her serotonin levels with medication. Of course, medication and the issue of behavior being genetic or environmental…all of these are hot and controversial topics. As science identifies more genes influencing more behavior types, I suspect the controversy will become even more intense, more polarized, as people debate how responsible individuals are for their own behaviors, and if  “problem” behaviors should be “fixed” with medication. What do you think?

Last Friday’s post was somewhat directed towards dense research (aging theory, anti-inflammatories, vitamin D, avoiding diabetes) so today, let’s go lighter, simpler, and to a topic that probably is more important than the heavy science issues, at least concerning your mind and memory.

I have a theory that much unnecessary (I might say, premature) aging occurs just because you think you should age in a certain way, at a certain rate. Maybe you observed such aging changes in your parents or contemporaneous friends, and now you feel this is how it should be for you too. But it doesn’t have to be. In many areas, if you really believe that you can maintain your abilities as you get older, you can. I’ve seen it many times. Certainly not in all aspects of aging, but it’s true in many: your mindset is most important. It’s not so complicated.

And this recent simple research from North Carolina State University, published in Experimental Aging Research, is directed towards that theory. Basically, two groups of older individuals were given memory tests to see how well their minds were functioning. Before and during the tests, half of them were essentially told (or in subtle ways reminded): “you are old”, and the other half were not biased with that rubbish at all…they just were allowed to do the memory tests.

The study found that those older people who were subtly told: “we are young researchers doing memory tests on you old people” did much worse on the tests than the older people who just took the test without any such biased and unnecessary comments. So as you, and we, all get older, we will be subjected to such biases and comments (be ready so you can reject them), and if you just believe in yourself, you’ll do much better…

I could only find a short abstract of the study (I couldn’t get access to the full report), so I suggest you read the following press release from North Carolina State University, which sums up the details of the study very nicely:

Thinking your memory will get worse as you get older may actually be a self-fulfilling prophecy. Researchers at North Carolina State University have found that senior citizens who think older people should perform poorly on tests of memory actually score much worse than seniors who do not buy in to negative stereotypes about aging and memory loss.

In a study published earlier this month, psychology professor Dr. Tom Hess and a team of researchers from NC State show that older adults’ ability to remember suffers when negative stereotypes are “activated” in a given situation. “For example, older adults will perform more poorly on a memory test if they are told that older folks do poorly on that particular type of memory test,” Hess says. Memory also suffers if senior citizens believe they are being “stigmatized,” meaning that others are looking down on them because of their age.

“Such situations may be a part of older adults’ everyday experience,” Hess says, “such as being concerned about what others think of them at work having a negative effect on their performance – and thus potentially reinforcing the negative stereotypes.” However, Hess adds, “The positive flip side of this is that those who do not feel stigmatized, or those in situations where more positive views of aging are activated, exhibit significantly higher levels of memory performance.” In other words, if you are confident that aging will not ravage your memory, you are more likely to perform well on memory-related tasks.

The study also found a couple of factors that influenced the extent to which negative stereotypes influence older adults. For example, the researchers found that adults between the ages of 60 and 70 suffered more when these negative stereotypes were activated than seniors who were between the ages of 71 and 82. However, the 71-82 age group performed worse when they felt stigmatized.

Finally, the study found that negative effects were strongest for those older adults with the highest levels of education. “We interpret this as being consistent with the idea that those who value their ability to remember things most are the most likely to be sensitive to the negative implications of stereotypes, and thus are most likely to exhibit the problems associated with the stereotype.”

One of the hottest topics in medical research regarding aging is that many problems—from some cancers to atherosclerosis to Alzheimer’s disease and even some aspects of aging itself—can be in part caused by inflammation, which we might describe as a low-grade infection in the body over many years. This chronic irritation gradually results in damage to various organs such as the brain and the lining of our blood vessels, and might be one of the major factors in determining who among us will lose our mental capacity as we get older…the more the chronic inflammation, the greater the long-term damage, the higher the risk for dementia.

So for the past several years at least, the conventional wisdom has been that drugs that decrease inflammation also lower the risk of dementia, and much hope has been directed towards the non-steroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen and naproxen (U.S. trade names like Aleve, Advil, Motrin).

Indeed, it was almost exactly one year ago that the esteemed journal Neurology published a huge study of veterans (about 250,000 people) over the age of 55, and found that during a five-year period, NSAID use appeared to lower the risk of developing Alzheimer’s by 24-40%. Considering the grand theory of inflammation, this all made sense. But now a University of Washington study, spanning 12 years, showed the opposite result—those who used NSAIDs most heavily (which, we would think, should markedly cut the inflammatory effect), had a 66% higher risk of developing Alzheimer’s than those who didn’t use NSAIDs.

The authors of this new study suspect the reason for this contradiction is that the earlier research studied younger people, and the latest study looked at people over 75. So perhaps NSAIDs only have the protective effect for younger people, and if you are above 75, NSAIDs markedly raise your risk? Is it perhaps that NSAID use by younger people delays the onset of Alzheimer’s, but ultimately raises the risk? This is still a very messy and complex topic, which won’t be resolved soon. What is certain is that much new research will come out over the next decade, and maybe by then the issue will be resolved.

The news about vitamin D just keeps getting better and better. In fact, it’s hard to find much news that is negative about this vitamin. The latest work comes from studying Costa Rican children with asthma, and those with the lowest vitamin D levels had a much higher risk of severe asthma.

Want to avoid diabetes? (who doesn’t?)  It seems likely that most cases of diabetes in people 65 or older are preventable… it’s not just fate, or family history. Nine out of ten cases can be avoided if you “live right”. According to a recent report in The Annals of Internal Medicine, people who follow some basic health principles regarding diet and exercise have a 89% lower risk of developing diabetes.

Here’s how to do it…see the details in MedPageToday, and of course, consult your physician for your specific situation:

1. above average physical activity
2. healthy diet regarding fat and fiber intake
3. don’t smoke, or have quit 20 or more years ago
4. light to moderate alcohol use, vs. not drinking at all
5. avoiding obesity
6. keeping your waist under 34.6 inches (88cm) for women, and under 36.2 inches (92 cm.) for men

For a long time scientists have suspected that the progressive, degenerative neurological disease Parkinson’s can be triggered by exposure to pesticides. Animal studies have shown exposure to the common pesticides paraquat and maneb will damage the brain’s dopamine producing neurons, and a lack of dopamine in the brain can lead to the rigidity and tremors seen human Parkinson’s disease.

A recent report from UCLA studied people in California’s agricultural Central Valley who lived close to crops exposed to the pesticides paraquat and maneb (and a matched “control group” who lived far away from the treated crop fields) and found that the people living close by had a 75% increased risk of developing Parkinson’s. Those pesticides are commonly used on a number of vegetables including soybeans, potatoes, lettuce, and corn. This is another reason to seriously consider buying organic when you can. Especially if you have a worrisome family history for any neurological problems, the cost difference should be well worthwhile. On the positive side, keep in mind, as mentioned in a previous post, that caffeinated coffee seems to markedly decrease the risk of Parkinson’s disease.

And, while the UCLA study was only directed at the association between pesticides and Parkinson’s disease, I suspect further research will show an association between chronic pesticide exposure and other neurologic disorders….it seems logical that if pesticides cause damage in the dopamine-producing neurons, that they also cause damage elsewhere in the nervous system, and increase the risk of other degenerative neural disorders. Maybe dementia, or the tremor commonly seen in many (not all) older people…for example the little shake when some grab a cup of coffee…that is harmless but serves as one marker indicating that yes, this person seems to be getting “old”.

OK, now here comes a link that will make the cost of your subscription to LLAW worthwhile (hehe…drDave just wanted a little chuckle to himself there)—it’s my favorite list of veggies and fruits with the highest pesticide content, with lower pesticide alternatives (if you don’t or can’t buy organic)…print and consult this list.  You just might live longer and better!

http://www.organicconsumers.org/organic/pesticide-residues.cfm

To finish the week…vitamin D and the racial health gap

You probably know that in the U.S. at least, African-American individuals suffer from a greater incidence of many health disorders, and at an earlier age, such as colon and breast cancer, and more aggressive forms of prostate cancer, and there are various theories why. Now it’s been found that darker-skinned individuals have lower levels of vitamin D, and perhaps that’s  one of the major reasons for the health gap.

Darker-skinned people, and people who live farther from the equator—especially during the winter—can easily suffer from low vitamin D levels, and more and more data is showing how important vitamin D is for our health (click on the “Pick A Topic” cloud on the LLAW right sidebar, and you’ll find a number of posts about vitamin D). While the current recommendation for D is from 200 to 600 units a day, most likely in a year or so these will be raised, maybe to 1000 units per day. Check out and click on Pick A Topic to see more about the vitamin that probably deserves so much praise. Keep posted here for the latest updates. Have a great weekend!

p.s. If you want to read even more about vitamin D this weekend (or whenever), check out this non-profit source:

http://www.vitamindsociety.org/about.php