LiveLongAgeWell

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

A LLAW reader several days ago mentioned that it sounded like I advocated use of “mind drugs” to enhance mental performance (post: the new drug war…move over marijuana). I told her that I didn’t either advocate or vilify their use, but the subject deserves our consideration. All of us interested in potential advances in better aging will be increasingly exposed to—perhaps seduced by—the possibility that a prescription drug might boost mental performance and diminish the need or desire to sleep. Some have exclaimed: welcome…the age of cosmetic neurology is almost here!

In a recent journal Nature, seven prominent scientists argued that these drugs should be legal and more available for otherwise normal, healthy people who simply want a mental boost (“cognitive enhancement”). They stated

cognitive enhancement has much to offer individuals and society, and a proper societal response will involve making enhancements available while managing their risks.

Among those in-the-know, the main player in this field of pharmaceutical grade cognitive enhancements is modafinil (trade name Provigil). I haven’t taken it so I can’t speak from experience, but My Experience With Smart Drugs is a London journalist’s story about his use of the medication over several weeks. His report is glowingly positive. He wrote that he accomplished significantly more focused work while taking modafinil, and seemingly without side effects. He only stopped the drug after he became concerned about potential long-term brain damage.

Until recently, most user reports about modafinil have been positive, or at least neutral, with no significant side effects noted. Lately though, there has been somewhat of a backlash against the drug, and a National Institute on Drug Abuse study published in the March 18 Journal of the American Medical Association demonstrated, by using PET brain tomography scans, that modafinil increased brain dopamine levels. The conclusion was the drug carries a significant addiction risk, similar to cocaine. The authors noted, however “reports of modafinil abuse are rare and much less frequent than those for stimulant drugs” [such as Ritalin]. They also mentioned a significant blood pressure and heart rate increase with the drug.

But the big fear with modafinil is what was voiced by the London journalist: are there long-term deleterious brain effects? No one knows, especially since researchers are uncertain how the drug actually works, making the whole adventure rather more scary. Might it increase the risk of dementia and, by making thinking “easier” in the short term, thereby making the brain lazy and less creative?  (Brain function, similar to that for muscles, improves through synapse creation which is stimulated by mental effort.)

And indeed, could use prove to be physically or psychologically addicting?  From experience with other drugs, often serious side effects, such as addiction, only show up years later. Valium, for example—passed out almost indiscriminately during the 60s—only years later was discovered to be addictive, leaving a wake of angry patients who, after years of free use, were forced (to try) to wean off.

Next post…brief wrap-up on cognitive enhancement drugs.

I am trying to drink at least two cups of coffee these days. It helps wake me up and gives me a boost in the afternoon. Plus I enjoy it as a health drink—it’s full of antioxidants. Still, I find many people still carry (unnecessary) guilt about drinking coffee, so as new research about health and coffee comes forward, I will present it in this LLAW blog, be it positive or negative. The news, though, has been overwhelmingly favorable.

Here’s another report—this from the latest Journal of Alzheimer’s Disease—that should make coffee drinkers feel good, and if you don’t drink, you might consider it because this research is more confirmation that coffee seems to help keep your brain functioning well.

How does coffee help the brain? We don’t know but here are three theories: coffee decreases the risk of developing diabetes, which has been associated with dementia. Second, Alzheimer’s disease is marked by a build-up of “amyloid” plaques—basically sticky brain “junk” that blocks function—and caffeine apparently decreases the formation of these plaques. Finally, coffee’s antioxidant effect might be brain protective.

This Scandinavian study—part of the Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Study—followed 1,400 men and women for more than 21 years, a very long time as research goes, and the result was that those who drank three to five cups per day were 65% less likely to develop dementia than those who didn’t drink coffee or drank less than two cups. The researchers tried to ensure that this difference between coffee drinkers and non-drinkers wasn’t the result of some other factor, for example, that the coffee drinker group had lower blood pressure or cholesterol than the non-drinking group.

Still, since this wasn’t a prospective clinical trial, the researchers can’t be certain that they looked at all factors involved. So there could be something else besides coffee that improved brain function. As a hypothetical example, maybe the coffee drinkers were a more sociable group, and they got out and mixed with more people and that’s what preserved their brains, not the coffee.

But this CAIDE study is one of several that have suggested drinking coffee is a very good way to preserve brain function, and for me, I’m sticking to my two or three cups of caffeinated coffee per day.