Monthly Archives: February 2024

Singapore’s anti-smoking legislation could have prevented 20,000 heart attacks among the older adults

The broadening of Singapore’s smoking prohibition in 2013 to include the shared spaces of residential areas and various outdoor locations might have prevented as many as 20,000 heart attacks in individuals aged 65 and above. This finding comes from a pioneering local study that explored the health outcomes of extending smoking restrictions to outdoor environments.

Published in BMJ Global Health, a peer-reviewed open-access journal, the research was spearheaded by experts from the Duke-NUS Medical School. They discovered that the augmentation of the smoking ban correlated with a reduction in the monthly incidence of heart attacks, mainly benefiting the elderly and male populations.

Globally, exposure to second-hand smoke is linked to approximately 1.3 million deaths annually, with a significant number of these deaths due to heart attacks. Despite this, the positive health impacts of comprehensive smoke-free laws—adopted by 67 countries since 2003—are predominantly documented for indoor smoking prohibitions, leaving a gap in understanding regarding bans in residential and outdoor areas.

Dr Joel Aik, an Adjunct Assistant Professor in the Health Services & Systems Research Programme at Duke-NUS and the study’s senior author, highlighted the importance of smoke-free zones in communal areas of housing estates, where residents often gather. He emphasized that such bans minimize residents’ exposure to tobacco smoke, thereby lowering their heart attack risk.

To protect its citizens, Singapore expanded its smoke-free laws in 2013 to include all communal spaces in residential buildings—home to 80% of the population—as well as outdoor areas like covered walkways, overhead bridges, and the vicinity of bus stops. This initiative was extended in subsequent years to encompass reservoirs, residential parks, educational institutions, and more types of public transportation.

The researchers evaluated the impact of these legislative measures on heart attack occurrences by analyzing monthly data from the Singapore Myocardial Infarction Registry between January 2010 and December 2019. Over this decade, 133,868 heart attacks were recorded, with a significant proportion occurring among men and older adults.

Before the 2013 law expansion, the heart attack rate for those aged 65 and above was significantly higher than for younger individuals, with men experiencing nearly double the rate of women. Following the implementation of the law, there was a notable decline in heart attack rates, particularly among seniors and men, suggesting that these groups benefited most from the smoking ban.

The study estimated that the legislation may have prevented approximately 19,591 heart attacks in older adults and 4,748 in men. However, the impact of further legislative extensions on heart attack rates in later years was less pronounced, possibly due to advancements in diagnostic technology. Despite this, the consistent reduction in heart attack rates across different demographics following the 2017 law expansion indicates potential benefits, although further research is needed for confirmation.

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, remarked on the study’s implications for policymakers, especially in Asia, where smoking remains a significant public health challenge. The research offers additional evidence to support the expansion of smoke-free laws as a means to mitigate the harmful effects of tobacco smoke exposure and reduce the burden of heart disease.

More information: Jamie S Y Ho et al, Association between the extension of smoke-free legislation and incident acute myocardial infarctions in Singapore from 2010 to 2019: an interrupted time-series analysis, BMJ Global Health. DOI: 10.1136/bmjgh-2023-012339

Journal information: BMJ Global Health Provided by Duke-NUS Medical School

Do Canada’s dietary recommendations offer sufficient advice for older adults?

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The most recent guidelines from Canada’s food guide are designed to minimise the risk of chronic diseases. Nevertheless, questions arise regarding how our national dietary guidance fulfils the nutritional needs of the entire Canadian populace.

Older adults must consume sufficient amounts of certain nutrients. However, until recent studies, there was a need for more knowledge on whether adherence to Canada’s food guide effectively meets the specific nutrient requirements for this demographic. Researchers at McGill University’s School of Human Nutrition analysed dietary data from the most recent national survey conducted in 2015 on Canadians aged 65 and above. They aimed to determine whether compliance with our nation’s nutritional guidelines correlates with an adequate nutrient intake critical for the health of older adults.

The findings were anticipated. The study showed that individuals who adhered to the guidelines of the food guide had higher intakes of nutrients such as fibre, magnesium, vitamin B6, and potassium. Despite these positive outcomes, the research also highlighted a significant shortfall; adherence to the guide did not ensure adequate intake of calcium, vitamin D, and folate, which are crucial for the well-being of older adults, according to Didier Brassard, a Postdoctoral Fellow at the School of Human Nutrition at McGill University who spearheaded the research. That reveals a gap in the dietary recommendations, indicating they need to be more comprehensive to guarantee the consumption of essential nutrients like calcium, vitamin D, and folate.

Stéphanie Chevalier, a McGill’s School of Human Nutrition professor, emphasises the need for additional, tailored dietary recommendations for older adults that focus on increasing intake of foods rich in calcium, vitamin D, and folate. The existing food guide offers broad suggestions suitable for the general population. Yet, more detailed guidance specifying the types and quantities of food and consumption frequency is required for specific groups, notably older adults, to ensure they meet their unique nutritional needs.

The research team plans to extend their work by exploring the impact of following the current dietary guidelines on health outcomes such as physical function, mobility, and cognitive abilities in older adults. This next phase will also investigate potential modifications to the procedures to enhance these health outcomes, highlighting the ongoing need for dietary guidance that addresses the specific needs of different population segments, including older adults.

More information: Didier Brassard et al, Relationship between Adherence to the 2019 Canada’s Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults, Journal of Nutrition. DOI: 10.1016/j.tjnut.2023.07.005

Journal information: Journal of Nutrition Provided by McGill University

Adult ADHD and its association with dementia risk

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Dementia is a condition marked by significant cognitive decline that disrupts daily functioning. It is a major contributor to disability and death worldwide. As of 2022, it was estimated that 6.5 million Americans aged 65 and older were living with dementia, a number projected to more than double to 13.8 million by 2060. Consequently, pinpointing risk factors and preventive measures for dementia has become a global health imperative.

In this comprehensive study involving 109,218 participants observed over up to 17.2 years, and after adjusting for 18 possible confounding factors, the primary analysis revealed that a diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD) was linked to an almost threefold increase in the risk of developing dementia. Further analyses supported the main finding, suggesting it remains robust under various analytical conditions. This discovery underscores the importance for policymakers, caregivers, patients, and healthcare providers to consider ADHD as a significant concern in older populations, advocating for diligent monitoring and management strategies to address this risk.

More information: Stephen Z. Levine et al, Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2023.38088

Journal information: JAMA Network Open Provided by JAMA Network

Engaging in physical fitness during adolescence is associated with reduced atherosclerosis in middle adulthood

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Men who maintained high levels of physical fitness in their youth had a significantly reduced risk of developing atherosclerosis nearly four decades later, according to research conducted by a team from Linköping University in Sweden. This study, published in the British Journal of Sports Medicine, highlights the role of atherosclerosis as a key factor in the relationship between physical fitness and the risk of cardiovascular diseases.

Pontus Henriksson, the senior associate professor at the Department of Health, Medicine and Caring Sciences at Linköping University and a leading figure in the study, emphasized the lasting impact of physical fitness on health outcomes well into later life. He expressed concern over current trends indicating a decline in the physical fitness of today’s youth compared to the levels observed in the 1970s and 80s, which makes these findings particularly significant for the current generation.

While it is acknowledged that a lack of physical fitness in early life is associated with an increased risk of cardiovascular diseases later on, the specific mechanisms underlying this association have remained unclear. Given that atherosclerosis, characterized by plaque buildup within the arteries, is a known risk factor for future cardiovascular issues, the research team aimed to explore the potential link between physical fitness during adolescence and atherosclerosis in later life. This connection would help clarify atherosclerosis as a plausible mechanism linking physical fitness to cardiovascular disease.

Leveraging data from the Swedish Military Conscription Register and the Swedish Cardiopulmonary Bioimage Study (SCAPIS), the researchers examined nearly 9,000 men aged between 50 and 64 years, for whom fitness data from their conscription at age 18 (between 1972 and 1987) were available. The long-term follow-up of these men, averaging 38 years, and the general population basis of the study are among its strengths.

For the first time, the study employed coronary CT angiography (CCTA) to assess the presence of plaques in the coronary arteries, vital for supplying blood to the heart, concerning physical fitness in youth. This advanced imaging technique allowed the researchers to evaluate calcified plaques, which are more straightforward to measure and have been a traditional focus of study, and examine non-calcified plaques. These latter plaques are deemed more dangerous as they are more prone to rupture, leading to heart attacks, and generally have a worse prognosis.

The findings revealed that both cardiorespiratory fitness and muscle strength in youth are associated with a lower risk of developing atherosclerosis in the coronary arteries nearly four decades later. The research also extended to examining atherosclerosis in the major arteries leading from the heart to the brain using ultrasound technology.

Due to the historical context in which only men were required to perform military service in Sweden, the study’s insights are confined to men. Consequently, it is impossible to extend these conclusions to women based on this research alone.

The study received funding from several sources, including the Heart-Lung Foundation, the prominent financier of SCAPIS, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, Vinnova, and the Joanna Cocozza Foundation for Children’s Medical Research. The research also benefited from the contributions of other scholars from Linköping University, including Karin Rådholm, Carl Johan Östgren, Kristofer Hedman, and Sara Higueras-Fresnillo. This collaborative effort underscores the importance of physical fitness in youth as a determinant of cardiovascular health later in life, highlighting the need for strategies to improve physical fitness among the younger population to mitigate future health risks.

More information: Ángel Herraiz-Adillo et al, Physical fitness in male adolescents and atherosclerosis in middle age: a population-based cohort study, British Journal of Sports Medicine. DOI: 10.1136/bjsports-2023-107663

Journal information: British Journal of Sports Medicine Provided by Linköping University

Research indicates that a reduction in serotonin levels could play a role in the cognitive deterioration observed during the initial phases of Alzheimer’s disease

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In a comprehensive study involving over 90 adults, both with and without mild cognitive impairment (MCI), researchers from Johns Hopkins Medicine have observed that individuals with MCI exhibit notably lower serotonin levels — a neurotransmitter often linked to feelings of well-being and happiness — in certain brain regions. This decrease in serotonin levels could potentially contribute to the memory challenges commonly associated with Alzheimer’s disease. Published online on September 13 in the Journal of Alzheimer’s Disease, these findings add to the accumulating evidence that significant changes in brain function may occur early in individuals experiencing mild memory issues, well before an Alzheimer’s diagnosis is confirmed. This research underscores the potential for identifying new therapeutic targets to decelerate or halt the disease’s progression.

The study highlights the early loss of serotonin transporters in individuals with MCI. This condition marks a transitional phase between the expected cognitive decline associated with ageing and the onset of Alzheimer’s disease. Symptoms of MCI include frequent forgetfulness, trouble finding words, and a diminished sense of smell. While some individuals with MCI may not progress beyond this stage, others may develop more severe cognitive impairments, emphasizing the importance of identifying markers that could predict disease progression and potentially guide early intervention strategies.

Gwenn Smith, PhD, a professor of psychiatry and behavioural sciences at the Johns Hopkins University School of Medicine, explains that the research demonstrates a correlation between diminished serotonin transporter levels and memory issues in MCI patients. This correlation persists even when accounting for MRI-detected neurodegeneration and PET-detected amyloid protein levels, both of which are markers associated with Alzheimer’s disease. However, the study’s design does not establish causation or definitively outline serotonin’s role in the transition from MCI to Alzheimer’s disease, signalling the need for further longitudinal studies to explore this relationship.

The research team recruited 49 volunteers with MCI and 45 healthy adults over 55 for the study, which spanned from 2009 to 2022. Participants underwent MRI scans to detect changes in brain structure and two PET scans to examine serotonin transporter levels and the distribution of amyloid-beta (Aβ) protein in the brain. Aβ protein accumulation is a hallmark of Alzheimer’s disease pathology. Previous studies conducted by Johns Hopkins on mice have shown that serotonin degradation precedes the widespread accumulation of beta-amyloid deposits in the brain, linking serotonin loss to depression, anxiety, and other psychological disorders.

The study found that MCI patients had both lower serotonin transporter levels and higher Aβ levels than healthy controls, with up to a 25% reduction in serotonin transporter levels in the cortical and limbic regions of the brain, which are crucial for executive function, emotion, and memory. Smith emphasizes the significance of the correlation between reduced serotonin transporters and memory challenges in MCI, suggesting that targeting this brain chemical could improve cognitive deficits and depressive symptoms. If future research establishes a direct link between serotonin loss and the progression from MCI to Alzheimer’s disease, it could open the door to using newly developed antidepressants as a means to enhance memory and potentially slow the disease’s progression.

Looking ahead, the researchers plan to conduct longitudinal studies to investigate the relationship between serotonin degradation further, increases in Aβ levels, and the accumulation of Tau protein, another Alzheimer’s disease marker, compared to healthy controls. They are also exploring the effectiveness of multi-modal antidepressant drugs in treating depression and memory deficits, with the hope of mitigating and halting the symptoms of Alzheimer’s disease. This collaborative effort involves scientists from the Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health, highlighting the interdisciplinary approach to understanding and combating Alzheimer’s disease.

More information: Smith, Gwenn S. et al, Serotonin Degeneration and Amyloid-β Deposition in Mild Cognitive Impairment: Relationship to Cognitive Deficits, Journal of Alzheimer’s Disease. DOI: 10.3233/JAD-230570

Journal information: Journal of Alzheimer’s Disease Provided by Johns Hopkins Medicine

Golf, walking, and Nordic walking could improve cognitive abilities in elderly individuals

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A recent study published in BMJ Open Sport & Exercise Medicine reveals that engaging in a single 18-hole game of golf or walking 6 km, whether through Nordic walking or traditional walking, can significantly enhance immediate cognitive performance in older adults. This research was conducted collaboratively by the University of Eastern Finland, the University of Edinburgh, and ETH Zürich to investigate the immediate impact of three types of cognitively stimulating aerobic exercises on cognitive function and biological markers in healthy older adults.

The research included 25 healthy older adults who were regular golfers, all aged 65 or older. These participants participated in three physical activity sessions: playing an 18-hole round of golf, engaging in a 6 km Nordic walk, and undertaking a 6 km traditional walk. These activities were performed in natural settings, with the participants walking at their usual brisk pace.

The study utilized the Trail-Making Test (TMT) Parts A and B. TMT-A focuses on evaluating basic cognitive abilities such as attention and processing speed. In contrast, TMT-B aims to assess more complex executive functions, including the ability to switch tasks efficiently. In addition, blood samples were taken to measure levels of brain-derived neurotrophic factor (BDNF) and cathepsin B (CTSB), which are considered indicators of the positive effects of physical activity on brain health. Participants also used fitness trackers to log data specific to each exercise, such as distance covered, total duration, pace, calories burned, and step count. Heart rates were monitored using an ECG sensor attached to a chest strap.

The findings indicated that a single exercise session, regardless of the type, improved the more straightforward cognitive functions measured by the TMT-A test in the older participants. However, the study did not find significant changes in BDNF and CTSB levels. As evaluated by the TMT-B test, both Nordic and regular walking showed positive associations with improvements in the more complex executive functions.

This research aligns with prior studies that have suggested the cognitive benefits of short-term aerobic exercises, noting that the exercise’s intensity, duration, and nature can influence the degree of cognitive enhancement.

Julia Kettinen, the study’s lead author and a doctoral researcher in Sports and Exercise Medicine at the University of Eastern Finland’s Institute of Biomedicine, emphasized the importance of suitable aerobic exercises, like golf, Nordic walking, and regular walking, for preserving and improving cognitive abilities in older adults. She noted that, consistent with previous findings, physical activity supports cognitive health in ageing and offers potential benefits for individuals experiencing cognitive decline.

More information: Julia Kettinen et al, Cognitive and biomarker responses in healthy older adults to a 18-hole golf round and different walking types: a randomised cross-over study, BMJ Open Sport & Exercise Medicine. DOI: 10.1136/bmjsem-2023-001629

Journal information: BMJ Open Sport & Exercise Medicine Provided by University of Eastern Finland

Strategies for Maintaining Brain Health

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The human brain is an extraordinary organ, boasting around 100 billion nerve cells that collaborate seamlessly to enhance your cognitive agility and speed. However, like other parts of your body, the brain’s efficiency might diminish with age. You might start relying more on notes, miss appointments, or need more effort to keep up with conversations or television programs.

Fortunately, the potential exists to train your brain just as you would your muscles.

Hermundur Sigmundsson, a professor in the Department of Psychology at the Norwegian University of Science and Technology (NTNU), highlights the significance of grey and white matter in our nervous system. Grey matter comprises neurons and dendrites, whereas white matter facilitates communication between these neurons (via myelinated axons), playing a crucial role in the speed and distribution of neural signals.

A comprehensive review in the Brain Sciences journal synthesizes existing research on brain health, emphasizing the importance of maintaining the condition of our grey and white matter. The study provides extensive theoretical analysis and references 101 articles, identifying three critical factors for optimal brain function: physical activity, social engagement, and pursuing passions or interests, including learning new things and embracing challenges.

Physical activity emerges as a significant challenge for many. A sedentary lifestyle not only affects the body but the brain as well. Sigmundsson and his colleagues argue that an active lifestyle is crucial for developing the central nervous system and mitigating brain ageing. Thus, it’s essential to incorporate physical movement into your daily routine, especially if your job or lifestyle involves prolonged periods of sitting.

Social interactions also play a vital role in brain health. Despite some individuals preferring solitude or minimal social contact, engaging with others is beneficial. Interactions can stimulate complex biological processes that help prevent cognitive decline. Socializing, whether through conversation or physical contact, supports robust brain functioning.

Passion, or having a strong interest in something, can significantly influence learning and the development and maintenance of neural networks. Staying curious and open to new experiences is crucial, regardless of age. For instance, learning to play a new musical instrument could be rewarding and stimulates your brain.

Sigmundsson, master’s student Benjamin H. Dybendal and associate professor Simone Grassini from the University of Stavanger advocate for the “use it or lose it” approach to brain health. Their research parallels the necessity of physical exercise for the body with the need for mental stimulation to prevent cognitive decay. They stress that lifestyle choices, including physical exercise, social interactions, and engaging in passionate pursuits, are instrumental in developing and maintaining the brain’s structural integrity as we age.

These three elements — physical activity, social engagement, and passion — contribute to sustaining brain health and enhancing overall quality of life, giving a foundation for ageing gracefully.

More information: Hermundur Sigmundsson, Benjamin H Dybendal and Simone Grassini. Motion, Relation, and Passion in Brain Physiological and Cognitive Aging, Brain Sciences. DOI: 10.3390/brainsci12091122

Journal information: Brain Sciences Provided by Norwegian University of Science and Technology

Proper Hydration Connected to Healthy Ageing

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Adults maintaining adequate hydration levels exhibit healthier profiles, face a reduced incidence of chronic ailments such as heart and lung disease, and generally enjoy a longer lifespan than those who might not consume enough fluids. This conclusion stems from a study by the National Institutes of Health published in eBioMedicine, which scrutinized health information from 11,255 adults over three decades. The research examined the relationship between serum sodium levels—which rise with decreased fluid consumption—and various health metrics. It was discovered that adults at the upper spectrum of the normal serum sodium range were at a higher risk of developing chronic diseases and showed more pronounced signs of biological ageing than their counterparts with serum sodium levels in the mid-range. Furthermore, those with elevated levels faced an increased likelihood of earlier mortality.

Natalia Dmitrieva, PhD, a principal investigator in this study and a researcher at the National Heart, Lung, and Blood Institute (NHLBI), part of the NIH, suggested that staying adequately hydrated might decelerate the ageing process and extend life free from disease. This analysis builds upon findings published in March 2022, which identified a correlation between higher normal ranges of serum sodium and a heightened risk of heart failure. Both insights originate from the Atherosclerosis Risk in Communities (ARIC) study, which has been instrumental in understanding heart disease risk factors and influencing clinical protocols for its management and prevention.

For this study, researchers delved into data from five medical check-ups of study participants, initially in their 50s and later between 70 and 90 years old. To ensure a reliable comparison of hydration’s impact on health outcomes, individuals with high baseline serum sodium levels or pre-existing conditions affecting serum sodium, like obesity, were excluded. The study assessed serum sodium’s correlation with biological ageing through 15 health markers, such as blood pressure, cholesterol, and blood sugar levels, offering insights into the functionality of cardiovascular, respiratory, metabolic, renal, and immune systems. Adjustments were made for demographic and health-related variables, including age, race, sex, smoking status, and hypertension presence.

Findings indicated that adults within the higher spectrum of normal serum sodium levels (135-146 milliequivalents per litre) exhibited accelerated biological ageing. Indicators pointed to deteriorated metabolic and cardiovascular health, impaired lung function, and increased inflammation. Specifically, serum sodium levels above 142 mEq/L were associated with a 10-15% higher likelihood of advanced biological age compared to levels between 137-142 mEq/L, and levels above 144 mEq/L corresponded with a 50% increase. Additionally, serum sodium levels ranging from 144.5 to 146 mEq/L were linked with a 21% heightened risk of premature death relative to the 137-142 mEq/L range.

Moreover, individuals with serum sodium levels above 142 mEq/L were found to have up to a 64% greater risk of developing chronic conditions such as heart failure, stroke, atrial fibrillation, peripheral artery disease, chronic lung disease, diabetes, and dementia. On the contrary, those with serum sodium levels between 138-140 mEq/L demonstrated the lowest risk of chronic disease development.

While these findings do not establish a direct cause-and-effect relationship, they underscore the necessity for further research through randomized, controlled trials to ascertain whether optimal hydration can foster healthy ageing, avert disease, and extend lifespan. Nonetheless, the associations observed can guide clinical practices and inform personal health decisions.

Dmitrieva emphasized the importance of evaluating fluid intake for individuals with serum sodium of 142 mEq/L or higher. Increasing fluid intake to meet recommended levels through water, juices, or high-water-content fruits and vegetables is feasible and safe for most. The National Academies of Medicine advises that most women consume about 6-9 cups (1.5-2.2 litres) of fluids daily, while men should aim for 8-12 cups (2-3 litres). Specific individuals may require medical advice due to underlying health conditions. Ensuring adequate fluid intake while considering factors like medication-induced fluid loss is crucial, especially for patients with specific treatment plans, such as those limiting fluid intake for heart failure management.

This research highlights a global concern: approximately half of the world’s population needs to meet daily water intake recommendations, typically starting at 6 cups (1.5 litres). The pervasive issue of inadequate hydration, which leads to increased serum sodium levels, underscores the potential of proper hydration in slowing the ageing process and preventing or delaying the onset of chronic diseases. This study, supported by the Division of Intramural Research at NHLBI and the ARIC study funded by NHLBI, NIH, and the Department of Health and Human Services, contributes significantly to our understanding of hydration’s role in promoting health and longevity.

More information: Dmitrieva NI, Gagarin A, Liu D, et al, Middle-age high normal serum sodium as a risk factor for accelerated biological aging, chronic diseases, and premature mortality, EBioMedicine. DOI: 10.1016/j.ebiom.2022.104404

Journal information: EBioMedicine Provided by National Heart, Lung, and Blood Institute

How can we create societies that serve the needs of both the elderly and the youth?

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The advancements in extending the human lifespan are steering nations toward becoming ageing societies, where the demographic of those aged 65 and over is on par with the population aged 15 and below. Experts in ageing caution that such a shift might spark opposition to funding for extending healthy lives. The apprehension lies in the fear that prioritizing older adults could burden societies, fuel age discrimination, and create societal rifts.

The United States National Academy of Medicine has taken a pioneering step to tackle this issue by launching its inaugural Grand Challenge, culminating in the publication of the Global Roadmap for Healthy Longevity in June 2022. This roadmap was crafted by a globally diverse, independent commission by Linda P. Fried, MD, MPH, from Columbia University’s Mailman School of Public Health, and John Eu-Li Wong from the National University of Singapore. A December 2, 2022, commentary in Nature Aging by Dr. Fried, Dr. Wong, and Victor J. Dzau, MD, president of the National Academy of Medicine, deliberates on the roadmap’s insights and propositions.

Dr Fried, also the director of the Robert N. Butler Columbia Aging Center, emphasizes the critical juncture at which society stands: the choice between succumbing to pessimistic views on ageing or embracing a future characterized by healthful longevity, reduced disability, and fewer social hurdles. Given the projection that most countries will be ageing societies by 2050, the window to prepare is rapidly closing.

Dr Wong, a senior advisor at the National University Health System, points out the invaluable nature of a population’s health, highlighting how societies enriched with health are better equipped to tackle crises, including extreme weather events and pandemics. Encouraging the active participation of older individuals in society can leverage the investments made in human capital throughout their lives, thereby unlocking the social and economic potential of older adults in unprecedented ways.

Victor J. Dzau, President of the National Academy of Medicine, notes the global benefits of investing in the health and well-being of older adults. Such investments serve the individuals directly and enrich society by fostering productivity, community contribution, social and economic growth, and personal fulfilment.

The Global Roadmap offers several key insights and recommendations:

1. Longevity, if coupled with health, can turn older adults into unparalleled assets, yielding benefits across all ages—a phenomenon described as the “longevity dividend.”

2. Failing to invest in healthful longevity carries severe consequences, including the grim prospect of future generations ageing in poor health.

3. The roadmap outlines a vision (Vision 2050) for a future where individuals can enjoy long, healthy lives, older populations are valued, and people of all ages engage in meaningful activities, fostering intergenerational well-being and unity.

4. Realizing this vision requires a concerted effort from all societal sectors, led by government initiatives, to transform societal structures and policies.

5. The transition towards healthful longevity necessitates social unity and the creation of environments that cater to user needs.

6. The anticipated returns on this investment are significant, encompassing gains in human, social, and financial capital and improved well-being across generations.

Dr. Fried advocates for government collaboration with the business sector and civil society to cultivate the benefits of healthy longevity. That involves enacting policies and systems that support the employment desires of older adults, enhancing broadband access to bridge the digital divide, and promoting lifelong learning. She emphasizes the unique opportunity to foster a society that enjoys extensive social and economic advantages across all ages, cautioning against the dire consequences of neglecting to address the growing prevalence of ill health and disparities.

More information: L. P. Fried et al, A global roadmap to seize the opportunities of healthy longevity, Nature Aging. DOI: 10.1038/s43587-022-00332-7

Journal information: Nature Aging Provided by Columbia University Mailman School of Public Health

Individuals in their nineties who have a fear of falling participate in less physical activity, as reflected by activity tracker data that averages about 3,000 steps daily

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This study focused on how very old adults, specifically those in their nineties (nonagenarians), move and spend their time actively or inactively. Researchers wanted to understand how much these older adults move and how their movements relate to their own reports of activity, their body measurements, their social and health status, and how they think and remember things.

A small group of 38 people, averaging 91 years old, wore special watches (accelerometers) that tracked their movements for a week. They also answered questions about their health and did some thinking and memory tests over the phone. The researchers used statistical methods to see how the watches’ data matched what the participants reported about their own activity levels and other personal characteristics.

On average, these older adults took about 2,931 steps daily, spent 11 minutes in activities that got their heart rate up (like brisk walking), and mostly sat or lying down for about 13.6 hours daily. The most common pattern was to have short bursts of activity lasting less than 3 minutes and periods of sitting or being inactive lasting between 20 to 60 minutes. Interestingly, whether someone was a man or a woman didn’t make a difference in these patterns.

The researchers found a good match between what the activity watches recorded and what the participants said about their activity levels. According to the watch data, they also noticed that those with less education, those who felt dizzy, and those who were afraid of falling tended to be less active. Specifically, fear of falling was strongly linked to being less active and spending more time sitting or lying down.

In summary, while most people in their nineties didn’t move around much and spent a lot of time sitting, there was a wide range of activity levels among them. The consistency between what the watches measured and what people reported about their activity was high. According to the watch data, factors like education level, experiencing dizziness, and fear of falling significantly affected how active they were.

More information: Sari Aaltonen et al, Accelerometer-measured physical activity and sedentary behavior in nonagenarians: Associations with self-reported physical activity, anthropometric, sociodemographic, health and cognitive characteristics, PLoS ONE. DOI: 10.1371/journal.pone.0294817

Journal information: PLoS ONE

What causes the decline in spatial memory among some older adults?

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Ageing manifests in various forms, notably through alterations in memory functions. Interestingly, the rate of memory decline isn’t uniform across all older individuals, with some experiencing a more rapid deterioration than others.

A team of psychologists from the University of Arizona embarked on a research project to understand the factors behind this variability. Their goal was to explore the circumstances that might cause memory to fade in some elderly individuals. The study paid close attention to factors that change with age and those that do not, affecting memory in both the young and the old.

Central to their findings is the role of the hippocampus, a brain area pivotal for memory and spatial navigation. The research suggests that difficulties some older adults face with learning new places and environments could be traced back to how neural representations are formed in the hippocampus. Li Zheng, the lead author and a research scientist in the Psychology Department, pointed out that these neural patterns might be why specific individuals struggle to recall locations.

Zheng highlighted the significance of these insights, especially for predicting memory decline in the initial stages of dementia. The study, now published in the Proceedings of the National Academy of Sciences, draws inspiration from a related investigation into rats by Carol Barnes, a distinguished professor with expertise in psychology, neurology, and neuroscience. Barnes’ research focused on “place cells” in the hippocampus, neurons that activate in specific locations, aiding in the mental mapping of spaces. This process, known as “remapping,” was less effective in older rats, indicating diminished spatial memory capabilities.

Building upon Barnes’ work, Zheng’s team experimented with 25 young and 22 older adults, all in good health. Participants engaged in a virtual reality task where they had to memorize the layouts of shops in two simulated towns. As they undertook this spatial memory test, their brain activity was monitored using functional magnetic resonance imaging, specifically looking at the hippocampus.

The findings confirmed that older adults generally showed less distinct neural representations of different environments than younger adults. However, the study also unveiled an age-independent factor influencing memory retention. According to Zheng, certain neurons in the hippocampus are specialized, with some responding to environmental shapes and others to colours or features. These neurons work together to form a complete ecological representation.

If neurons overlap in function, it might lead to inaccurate environmental representations, thereby lowering the fidelity of neural signals, explained Arne Ekstrom, a cognition and neural systems professor at the University of Arizona and a senior author of the study. The cause of these low-fidelity signals remains uncertain, but they are present in individuals with poor memory performance regardless of age.

The research also identified an age-dependent factor affecting memory: the quality of neural signals entering the hippocampus from other brain areas. The study observed that even high-performing older adults showed reduced quality in these incoming signals, which could be linked to changes in the brain’s plasticity as it ages. This decline in signal quality correlates with diminished spatial memory in older individuals.

These insights, particularly regarding the remapping index and signal fidelity, could be crucial in predicting the extent of memory decline in those with dementia. The research team is now looking to further this study through immersive virtual reality experiments, aiming to incorporate more naturalistic navigation cues and enhance our understanding of memory decline mechanisms in ageing populations.

More information: Li Zheng et al, Hippocampal contributions to novel spatial learning are both age-related and age-invariant, Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.2307884120

Journal information: Proceedings of the National Academy of Sciences Provided by University of Arizona

Hopes and fears for the future significantly impact the quality of aging, finds OSU study

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According to recent findings from Oregon State University, believing in your potential to age into a healthy, active individual significantly shapes the likelihood of that becoming a reality. Shelbie Turner, a doctoral candidate at OSU’s College of Public Health and Human Sciences and a co-author of the study, emphasizes the strong correlation between our perceptions of our future selves and the eventual reality of our old age.

Historically, research into ageing has demonstrated that individuals’ self-perceptions at 50 can forecast many health outcomes decades later, including cardiovascular health, memory, balance, the desire to continue living, the frequency of hospital visits, and even death rates.

“Studies have indicated that those who maintain a positive outlook on ageing at 50 tend to outlive their less optimistic counterparts by an average of 7.5 years,” noted Karen Hooker, who also contributed to the study and held the Jo Anne Leonard Petersen Endowed Chair in Gerontology and Family Studies at OSU.

Hooker and Turner’s research delved into what shapes these critical self-perceptions of ageing, focusing on two key elements: the belief in one’s capacity to achieve their desired future self (self-efficacy) and a generally optimistic personality trait.

The study analyzed responses from older adults on their agreement with various statements about ageing and optimism. Additionally, the participants listed two “hoped-for” and two “feared” selves, evaluating their confidence in achieving or avoiding these potential futures.

The “hoped-for” selves often encompassed aspirations like maintaining a vibrant social life and staying physically healthy, while “feared” selves included scenarios such as chronic illness, dependence on others, or becoming irritable and isolated.

The findings confirmed the hypothesis that a higher level of optimism correlates with a more positive self-view of ageing. Moreover, both the efficacy in achieving “hoped-for” selves and avoiding “feared” selves played a significant role in shaping these perceptions, independently of innate optimism.

A critical aspect of how individuals perceive their ageing process is the internalization of ageist stereotypes, which range from beliefs about older adults’ driving capabilities to cognitive and physical limitations. These stereotypes start influencing perceptions as early as childhood and, if unchallenged, may negatively impact individuals’ health behaviours and attitudes towards ageing.

The study suggests combating ageist stereotypes through fostering intergenerational relationships, allowing younger generations to witness the fulfilling lives many older adults lead. This exposure can help dismantle negative stereotypes and encourage a more optimistic view of ageing, highlighting the abilities and contributions of older adults rather than focusing solely on potential declines. By promoting these positive interactions, society can work towards a more nuanced and hopeful perspective on ageing, benefiting individuals across all age groups.

More information: Shelbie G. Turner et al, Are Thoughts About the Future Associated With Perceptions in the Present?: Optimism, Possible Selves, and Self-Perceptions of Aging, The International Journal of Aging and Human Development. DOI: 10.1177/0091415020981883

Journal information: The International Journal of Aging and Human Development Provided by Oregon State University