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US seniors ’smarter’ than English seniors

Researchers from the Peninsula Medical School, the University of Cambridge and the University of Michigan have carried out the first international comparison of cognitive function in nationally representative samples of older adults in the US and England and discovered that US seniors performed significantly better that their English counterparts.

The finding is surprising because older people in the US are known to suffer more from cardiovascular risk factors and diseases, which are generally associated with more cognitive decline and poorer mental function.

The study compared 8,299 Americans with 5,276 British seniors aged 65 and older. The same cognitive tests were administered to the two groups in the same year. The US advantage in ‘brain health’ was greatest for those aged 85 and older. On a population level, the overall difference in cognitive performance between the two countries was quite large and amounted to a decade of ageing – the cognitive performance of 75-year-olds in the US was as good, on average, as that of 65-year-olds in England.

Data from the US population came from the Health and Retirement Study, conducted by the University of Michigan Institute for Social Research and funded by the National Institute on Aging. Data on the UK study were from the English Longitudinal Study of Ageing. Both are nationally representative, population-based studies designed to facilitate direct comparisons of health, wealth and well-being among older men and women.

Participating individuals in both countries took tests of immediate and delayed recall of 10 common nouns including hotel, river, tree, skin, gold, village, baby and table. They heard the words spoken and were asked to repeat as many as possible immediately. Then they completed other survey questions and five minutes later, were asked to repeat as many of the words as possible. During the interview participants were also asked what day, date, month and year it was. Taken together, their answers (10 points for immediate recall, 10 for delayed recall and four for orientation) made up a 24-point scale of cognitive function.

The researchers compared scores stratified by age, gender, and education as well as country. The mean score for the combined cognitive scale was 12.5 (out of 24) for the youngest group of English adults (ages 65-74) and 8.3 for the oldest group (age 85 and older). The mean scores for the youngest and oldest groups in the U.S. were 13.8 and 10.1, respectively.

The research team also examined data on participant health conditions, risk factors, and treatments for stroke, diabetes, heart disease, hypertension, lung disease, and cancer. They also collected data on recent symptoms of depression, and on smoking status, alcohol consumption, and limitations in performing common activities of daily living, including dressing, bathing, taking medications, and managing money.

U.S. adults reported significantly lower levels of depressive symptoms than English adults, and this may have accounted for some of the U.S. advantage in ‘brain health’ since depression is linked with worse cognitive function. The research team also found significant differences in alcohol consumption between the U.S. and English seniors. More than 50 percent of U.S. seniors reported no alcohol use, compared to only 15.5 percent of English seniors. Previous research has shown that moderate alcohol consumption, compared to abstinence, is linked with better cognition among those aged 50 and over.

U.S. adults reported a higher prevalence of hypertension, yet they also were more likely to be taking medications to treat the condition. A number of studies have shown a link between untreated hypertension and an increased risk for cognitive impairment.

Two researchers from the Peninsula Medical School worked on the study, Dr Iain Lang and Dr David Llewellyn. Dr Iain Lang commented: “While we in England may not like the results of this study, there are important lessons to be gleaned regarding the differences in lifestyle and the treatment of cardiovascular diseases between the US and England. Given the good results achieved by the American oldest-old, we can hypothesise that the more aggressive diagnosis and treatment of hypertension and possibly other cardiovascular risks that occurs in the US, may lead to less cognitive decline. US citizens tend to retire later than those in England, and this too can have an effect on cognitive performance – there may be a connection between early retirement and the early onset of cognitive decline.”

Dr David Llewellyn added: “It is possible that the results of this study could lead to other research designed to improve cognitive performance for older people in England. Certainly, with the population of the world ageing at a rapid rate future cross-national studies regarding medical and social factors and ageing can only make significant contributions to the quality and delivery of public health – not least in providing possible savings for health and social care providers such as the NHS.”

June 27th, 2009 | Posted in AntiAging Medicine, Neurologic Disease | No Comments

Ginger Capsules Help Chemo Nausea

Ginger capsules can be an inexpensive, natural way to fight nausea. Chemo induced nausea is more than just a quality-of-life issue, doctors say. Many cancer patients avoid chemotherapy treatment and some refuse chemo altogether because of nausea, hurting their chances of beating the disease.

Many medicines do a good job of curbing vomiting, but nearly three-fourths of chemo patients still suffer the sensation of nausea, which may be be worse, Ryan said.

Ginger has long been touted for stomach upsets, ranging from motion sickness to morning sickness during pregnancy. Studies have had mixed results.

The new one used a specially formulated gelcap containing concentrated, purified ginger root extract made by Aphios Corp. of Woburn, Mass.

The study involved 644 patients from cancer treatment programs around the U.S. who had suffered nausea in a previous round of chemotherapy. Two-thirds had breast cancer and the rest, other forms of the disease. They were placed in four groups and given one of three doses of ginger (the equivalent of one-half, 1 or 1 1/2 grams of ginger per day) or dummy capsules in addition to standard anti-sickness medicines.

All of the ginger doses significantly reduced nausea, and the middle and lowest doses gave the best results.

May 16th, 2009 | Posted in Cancer | No Comments

A Stem Cell Cure for Common Cause of Vision Loss

Scientists have created the first stem cell therapy to cure the most common cause of blindness. Surgeons predict it will become a routine, one-hour procedure that will be widely available in six or seven years.

The breakthrough treatment involves replacing a layer of degenerated cells with new ones created from embryonic stem cells. It was pioneered by scientists and surgeons from the Institute of Ophthalmology at University College London and Moorfields eye hospital.

This week Pfizer, the world’s largest pharmaceutical research company, will announce its financial backing to bring the therapy to patients.

The treatment will tackle age-related macular degeneration (AMD), the most common cause of blindness. It affects millions of people worldwide and the number is forecast to increase significantly as people live longer. The disease involves the loss of eye cells.

Embryonic stem cells have the ability to develop into all types of body tissue. Their use is controversial, however, because it involves the destruction of human embryos.

Laboratory trials completed by the British team have demonstrated that stem cells can prevent blindness in rats with a similar disease to AMD. They have also successfully tested elements of the technology in pigs.

The team is led by Professor Pete Coffey, director of the London Project to Cure Blindness, working alongside Lyndon da Cruz, a surgeon at Moorfields.

Coffey said the treatment would take “less than an hour, so it really could be considered as an outpatient procedure. We are trying to get it out as a common therapy”.

April 19th, 2009 | Posted in Age Related Macular Degeneration, Eye Health, Ophthalmology | No Comments

Fluorescent Chemical Dye Brain Surgeons Remove Gliomas

Gliomas are malignant brain tumors that arise from glial (supporting) cells of the brain. Gliomas are frequently resistant to chemotherapy drugs. These glioma tumors develop thin extensions that infiltrate normal brain tissue and, in addition, individual tumor cells may produce extensions or “satellites” in surrounding tissue. Therefore, it has been almost impossible to remove the tumor tissue completely by surgery.

A complete or “radical” surgical removal of the tumor would significantly improve the prognosis of glioma patients. Surgeons face the difficulty of distinguishing between glioma tumor tissue and normal healthy brain tissue during brain surgery. Dr. Eva Frei of DKFZ, collaborating with doctors and researchers of the Medical Faculty of Heidelberg University, has now developed a method to improve neurosurgery.

The scientists utilized the fact that glioma tumors have high energy needs and take up large amounts of the blood protein albumin to meet the high energy needs. The researchers attached a fluorescent compound (5-aminofluorescein) to albumin, which is then injected into the bloodstream and eventually accumulates in the brain tumor. Laser light causes the substance to glow and makes the fine extensions of the tumor visible.

“Other contrast agents often fade,” says Dr. Eva Frei, “for tumor resection can take five to six hours.” The fluorescence marker attached to albumin, however, is visible during the entire operation.

The scientists tested the albumin method in thirteen patients with malignant gliomas. In nine cases it was possible to remove the fluorescent tumor tissue completely thanks to the intensive yellow-green light signal. The researchers calculated that the probability of the glowing tissue being tumor cells is 97 percent.

The scientists will conduct a long-term study to see if the prognosis of patients will improve with the new method.

April 13th, 2009 | Posted in Cancer, Neurologic Disease, News | No Comments

New TB Vaccine in Development

Two billion people, one third of the Earth’s population—have been exposed to the tuberculosis pathogen. Each year, 8 million people become ill with tuberculosis, and 2 million people die from the disease worldwide.

An urgently needed new tuberculosis vaccine has completed a vital step in testing, an important advance at time when a third of the world’s population is believed to be have latent tuberculosis infection (LTBI), which, when re-activated, can cause full-blown disease.

The results of the Phase I trial of a leading new TB vaccine, MVA85A, appeared in the April 15th issue of the American Journal of Respiratory and Critical Care Medicine. MVA85A is scientific shorthand for Recombinant Modified Vaccinia Ankara expressing Antigen 85A.

“A more effective vaccine regimen than the currently available bacillus Calmette-Guérin (BCG) would have a major impact on the global TB burden, and ultimately, will be the most efficient way to control this pandemic,” wrote principal investigator, Helen McShane, M.D., Ph.D., reader in vaccinology and Wellcome senior fellow at the University of Oxford’s Jenner Institute in England.

One-third of the world’s population is latently infected with M. tuberculosis. Any new TB vaccine must be developed with this huge reservoir of infection in mind, as latent infection may decrease the therapeutic value of new vaccines or worsen vaccine-related adverse events. With this in mind, Dr. McShane and fellow researchers investigated the effects of MVA85A specifically in individuals who had LTBI.

“While BCG gives good protection against severe forms of TB…it does not provide adequate protection against adult pulmonary TB,” noted Hazel Dockrell, Ph.D., and Ying Zhang, Ph.D.

The investigators found the vaccine was safe and did not induce any immunopathology in this group, and also that the vaccine was as immunogenic in this group, as in the BCG-vaccinated individuals. Dr. McShane calls these results “very important in the further development of this vaccine.”

April 13th, 2009 | Posted in News, TB | No Comments

Lipoic Acid Helps in Lowering Triglycerides

Lipoic acid is a natural compound found at low levels in some foods, including red meat and green leafy vegetables. A powerful antioxidant, it’s been of considerable research interest in recent years for its apparent ability to reduce mitochondrial decay in cells and perhaps slow the process of aging.

Studies done on laboratory rats suggest that diets with lipoic acid had a significant effect in lowering triglycerides, which along with cholesterol levels and blood pressure are one of the key risk factors in cardiovascular disease.

In the lab animals, supplements of lipoic acid lowered triglyceride levels up to 60 percent. If the effect were the same in humans - which is not yet clear - that would be a greater impact than found with other dietary supplements, and similar to the effects of some prescription drugs.

The results were just published in the Archives of Biochemistry and Biophysics, a professional journal.

“The extent of triglyceride reduction was really dramatic, we didn’t expect it to be this profound,” said Regis Moreau, an assistant professor with the Linus Pauling Institute at Oregon State University. “The potential is good that this could become another way to lower blood triglycerides and help reduce the risk of atherosclerosis. It’s pretty exciting.”

In this research, it was found that supplements of lipoic acid appeared to affect triglyceride levels through two pathways. After eating, lipoic acid supplementation increased the rate of disappearance of triglycerides in the bloodstream. And supplements also reduced the genetic expression of enzymes in the liver that synthesize triglycerides.

April 6th, 2009 | Posted in Coronary Artery Disease, Heart Disease, Uncategorized, genetics | No Comments

Newsflash–Sleep is Good for Your Brain According to New Research

A new study published in the April 3 edition of the Journal Science has found new molecular and structural evidence of that sleepy feeling - specific proteins were identified that build up in the brains of sleep-deprived fruit flies and then drop to lower levels in the brains of the well-rested. The proteins are located in the synapses, those specialized connections between neurons that allow brain cells to communicate with other neurons.

Sleep researchers at the University of Wisconsin-Madison School of Medicine and Public Health believe it is more evidence for their theory of “synaptic homeostasis.” This is the idea that synapses grow stronger when we’re awake as we learn and adapt to an ever-changing the environment, that sleep refreshes the brain by bringing synapses back to a lower level of strength. This is important because larger synapses consume a lot of energy, occupy more space and require more supplies, including the proteins examined in this study.

Sleep - lowers synaptic activity - saves energy, space and material, and clears away unnecessary “noise” from the previous day, the researchers believe. The fresh brain is then ready to learn again in the morning.

The researchers - Giorgio Gilestro, Giulio Tononi and Chiara Cirelli, of the Center for Sleep and Consciousness - found that levels of proteins that carry messages in the synapses (or junctions) between neurons drop by 30 to 40 percent during sleep.

In the Science paper, three-dimensional photos using confocal microscopy show the brains of sleep-deprived flies filled with a synaptic protein called Bruchpilot (BRP), a component of the machinery that allows communication among neurons. In well-rested flies, levels of BRP and four other synaptic proteins drop back to low levels, providing evidence that sleep resets the brain to allow more growth and learning the next day.

April 6th, 2009 | Posted in Sleep Disorders, Uncategorized | No Comments

Caffeine is Useful for Athletes

Competitive athletes can consume caffeine and expect to see a reduction in post workout pain–caffeine affects the adenosine system in the brain and spinal cord, and this system is involved in pain sensation.

University of Illinois kinesiology and community health professor Robert Motl’s latest published study on the effects of caffeine on pain during exercise is published in the April 2009 edition of the International Journal of Sport Nutrition and Exercise Metabolism.

“This study looks at the effects of caffeine on muscle pain during high-intensity exercise as a function of habitual caffeine use,” he said. “No one has examined that before.

“What we saw is something we didn’t expect: caffeine-naïve individuals and habitual users have the same amount of reduction in pain during exercise after caffeine (consumption).”

The study’s 25 participants were fit, college-aged males divided into two distinct groups: subjects whose everyday caffeine consumption was extremely low to non-existent, and those with an average caffeine intake of about 400 milligrams a day, the equivalent of three to four cups of coffee.

After completing an initial exercise test in the lab on an ergometer, or stationary cycle, for determination of maximal oxygen consumption or aerobic power, subjects returned for two monitored high-intensity, 30-minute exercise sessions.

An hour prior to each session, cyclists - who had been instructed not to consume caffeine during the prior 24-hour period - were given a pill. On one occasion, it contained a dose of caffeine measuring 5 milligrams per kilogram of body weight (equivalent to two to three cups of coffee); the other time, they received a placebo.

During both exercise periods, subjects’ perceptions of quadriceps muscle pain was recorded at regular intervals, along with data on oxygen consumption, heart rate and work rate.

“What’s interesting,” Motl said, “is that when we found that caffeine tolerance doesn’t matter, we were perplexed at first. Then we looked at reviews of the literature relative to caffeine and tolerance effects across a variety of other stimuli. Sometimes you see them, sometimes you don’t. That is, sometimes regular caffeine use is associated with a smaller response, whereas, other times, it’s not.”

April 6th, 2009 | Posted in AntiAging Medicine, Diet, Fitness | No Comments

PSA Test For Prostate May Not Be as Helpful as Doctors Had Hoped

The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found.

The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date.

The PSA test, which measures a protein released by prostate cells, does what it is supposed to do — indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late.

The studies — one in Europe and the other in the United States — are “some of the most important studies in the history of men’s health,” said Dr. Otis Brawley, the chief medical officer of the American Cancer Society.

In the European study, 48 men were told they had prostate cancer and needlessly treated for it for every man whose death was prevented within a decade after having had a PSA test.

Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life.

Prostate cancer treatment can result in impotence and incontinence when surgery is used to destroy the prostate, and, at times, painful defecation or chronic diarrhea when the treatment is radiation.

As soon as the PSA test was introduced in 1987, it became a routine part of preventive health care for many men age 40 and older. Experts debated its value, but their views were largely based on less compelling data that often involved statistical modeling and inferences. Now, with the new data, cancer experts said men should carefully consider the possible risks and benefits of treatment before deciding to be screened. Some may decide not to be screened at all.

For years, the cancer society has urged men to be informed before deciding to have a PSA test. “Now we actually have something to inform them with,” Dr. Brawley said. “We’ve got numbers.”

The publication of data from the two new studies should change the discussion, said Dr. David F. Ransohoff, an internist and cancer epidemiologist at the University of North Carolina. “This is not relying on modeling anymore,” he said. “This is not some abstract, pointy-headed exercise. This is the real world, and this is real data.”

Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who studies cancer screening, also welcomed the new data. “We’ve been waiting years for this,” he said. “It’s a shame we didn’t have it 20 years ago.”

Read New England Journal Abstract HERE (US Study)

and HERE (NEJM European Study)

and HERE

March 22nd, 2009 | Posted in Cancer, Mens' Health, News, Prostate Cancer | No Comments

Brain Injury Patients May Seem OK , Then Get Sicker

Trauma surgeons and neurosurgeons weighing in on the Natasha Richardson tragedy have stated that she might have survived if she had had surgery shortly after the injury occurred.

At first, Natasha Richardson said she felt fine after she fell on a Canadian ski trip. But that’s not unusual for people who suffer traumatic head injuries like the one that killed the actress.

Surgeons say sometimes patients with serious head injuries have what is called a “lucid interval” where appear normal for an hour or more as the brain slowly, silently swells or bleeds. Later, back at her hotel, Richardson fell ill, complained of a headache, and was taken to a hospital. She died Wednesday in New York.

An autopsy Thursday revealed that the 45 year old actress injured her head, which led to bleeding between the skull and the brain’s covering, resulting in what is known as an epidural hematoma. This injury is usually caused by a skull fracture.

Because of the “lucid interval”, doctors always tell patients who seem to be OK after a head injury to have someone keep a close watch on them, in case symptoms develop.

The important symptoms are: headache; a loss of consciousness; vomiting; problems with vision, speaking or moving; confusion; drainage of a clear fluid from the nose or mouth. These symptoms appear after enough pressure builds in the skull. By then it’s an emergency.

“Once you have more swelling, it causes more trauma which causes more swelling,” said Dr. Edward Aulisi, neurosurgery chief at Washington Hospital Center in the nation’s capital. “It’s a vicious cycle because everything’s inside a closed space.”

Pressure from bleeding or swelling can force the brain downward to press on the brain stem that controls breathing and other vital functions, causing coma or death. Emergency treatment involves opening a portion of the skull to give the brain room to swell without pressing on the brainstem. They also drain the blood and remove clots that are present from the bleeding.

“This is a very treatable condition if you’re aware of what the problem is and the patient is quickly transferred to a hospital,” said Dr. Keith Siller of New York University Langone Medical Center. “But there is very little time to correct this.”

Details of Richardson’s case have not been made public.

A CT scan can identify bleeding, bruising or the beginning of swelling after an injury. Patients may not know when to seek emergency treatment if the injury seems mild.

“If there’s any question in your mind whatsoever, you get a head CT,” Aulisi advised. “It’s the best 20 seconds you ever spent in your life.”

March 22nd, 2009 | Posted in Neurologic Disease, News, Trauma | No Comments