Tag Archives: Aging

RESEARCH: ‘THE SCIENCE OF HEALTHY AGING’ (SCRIPPS)

Although growing older comes with a number of major life changes, science can help inform the things we do in the here in and now to forestall the most serious features of the aging self, promoting healthspan and not just lifespan.

Summer 2021
  • Build Muscle – Muscle mass is one the best predictors of health and longevity. Muscle tissue is known to release its own chemicals called myokines, which can have benefits that span cognition, immunity and anti-cancer activity. By performing regular, resistance-based exercise that prioritizes strength, we can delay the loss of bone density and risk of physical injuries.
  • Vitamin D – Commonly known as the sunshine vitamin, vitamin D is in fact a critical hormone that helps maintain healthy bones, boost our immune system and improve our cardiovascular function. With age, the production of vitamin D in the skin can become less efficient, so if we don’t spend enough time outdoors, our risk of vitamin D deficiency may increase.
  • Neurodegenerative Diseases – One of the most unsettling aspects of aging is the potential for neurodegenerative disease. These conditions are increasingly prevalent in those with diabetes, suggesting that the brain’s blood flow and energy supply may be compromised. Research indicates that regular physical exercise, a healthy whole foods diet and staying intellectually active could at least slow the rate of decline.
  • Mindfulness – As we get older, major arteries can become thicker and less flexible, leading to increased blood pressure and undue strain on the heart. A regular mindfulness practice such as yoga or meditation has been shown to stem the release of stress hormones like cortisol and adrenaline. By freeing us from this “fight-or-flight” state, this habit can improve blood flow and reduce the risk of heart attack and stroke.
  • Stay Social – As social animals, maintaining a strong sense of community and close personal relationships into old age are underestimated contributors to longevity. While social isolation in seniors can result in significant physical and mental decline, research suggests that close loved ones offer important emotional support and behavioral modifications that can overcome periods of high stress.
  • Metabolism – “My metabolism is slowing down!” That’s what we often hear, as the aging body becomes less effective at using energy, placing us at risk of obesity and type 2 diabetes. By maintaining our muscle mass and reducing sugar consumption, we can support hormonal health, preserve our metabolism and keep our vitality into those advanced years. As scientists continue to find ways to extend our lives, paying attention to these keys to healthy aging can help increase the quality of those extra years.

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Cancer: Aging & Tumor Microenvironments

Professor Ashani Weeraratna has been studying the cancer microenvironment in her lab for the past 17 years. Taking into account that the tissues in our bodies change as we age is important when researching cancer biology. She hopes that gaining a better understanding of how the growth of cancer cells is affected by their direct cellular ‘neighbourhood’, especially when we age, could be key to developing better treatments for patients with cancer. Read more in

Doctor’s Journal: ‘Alcohol And Health’

Alcohol has been used by mankind since before recorded history. It causes a pleasant slowdown of the nervous system, Lessening inhibition  and loosening the tongue, making it the perfect lubricant for social interaction. Unfortunately, it is a metabolic poison.

Excess alcohol use is common enough to have resulted in its prohibition in the United States in the 20s. The side effects of this prohibition proved worse than its benefits, and alcohol currently enjoys the status of one of the few legally permitted Psychoactive drugs.

After diligently searching for beneficial effects of alcohol, society discovered that mild drinking promotes longevity. It is difficult to drink just the right amount of alcohol, and  There is little doubt that excessive drinking is deleterious to the body.

The liver is the organ responsible for getting rid of alcohol. Unfortunately, liver function gradually declines with age, so that the older you get the less alcohol you can tolerate. 14 drinks a week is the suggested upper limits for alcohol’s benefit, and this number shrinks as you get older.

I became interested in alcohol in the elderly because of a friend whose doctor discovered that his red blood cells were enlarged. This can be due to alcohol in at least two different ways. If you drink too much alcohol, you need less calories, and often have a poor diet as a result. B12 (and folic acid) deficiency can result and may cause large red blood cells.

I also learned that alcohol can directly caused large red blood cells because of the toxic effects on the bone marrow, where Red blood cells are made. The very young also have more difficulty with alcohol. Early in my career I discovered 2 young infants who had convulsions after getting into their parents wine closets. These convulsions turned out to be caused by a low blood sugar which developed because glucose, the common blood sugar, is consumed in the process of burning, or metabolizing, alcohol.

My own use of alcohol has been progressively declining with age. I feel good with less alcohol for a shorter time the older I get.

—Dr. C.

INFOGRAPHIC: ENHANCING BRAIN HEALTH ACROSS AN INDIVIDUAL’S LIFESPAN

Opportunities for enhancing brain health across the lifespan

Published online by Cambridge University Press:  22 March 2021

Summary

As we age, there are characteristic changes in our thinking, reasoning and memory skills (referred to as cognitive ageing). However, variation between people in the timing and degree of change experienced suggests that a range of factors determine individual cognitive ageing trajectories. This narrative review considers some of the lifestyle factors that might promote (or harm) cognitive health. The focus on lifestyle factors is because these are potentially modifiable by individuals or may be the targets of behavioural or societal interventions. To support that, the review briefly considers people’s beliefs and attitudes about cognitive ageing; the nature and timing of cognitive changes across the lifespan; and the genetic contributions to cognitive ability level and change. In introducing potentially modifiable determinants, a framing that draws evidence derived from epidemiological studies of dementia is provided, before an overview of lifestyle and behavioural predictors of cognitive health, including education and occupation, diet and activity.

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Telehealth: Older Adults increase Use Of Virtual Visits from 4% To 26% (2020)

From 2019 to 2020, there was a substantial increase in the proportion of older adults who reported that their health care providers offered telehealth visits. In May 2019, 14% of older adults said that their health care providers offered telehealth visits, compared to 62% in June 2020.

Similarly, the percentage of older adults who had ever participated in a telehealth visit rose sharply from 4% in May 2019 to 30% in June 2020. Of those surveyed in 2020, 6% reported having a telehealth visit prior to March 2020, while 26% reported having a telehealth visit in the period from March to June 2020.

Over the past year, some concerns about telehealth visits decreased among adults age 50–80 whether or not they had a telehealth visit. Older adults’ concerns about privacy in telehealth visits decreased from 49% in May 2019 to 24% in June 2020, and concerns about having difficulty seeing or hearing health care providers in telehealth visits decreased from 39% in May 2019 to 25% in June 2020. Concerns about not feeling personally connected to the health care provider decreased slightly (49% to 45%).

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TOP NEW BOOKS ON AGING: “EXERCISED” BY DANIEL E. LIEBERMAN – “EXTENDING LONGEVITY” (HARVARD)

HARVARD MAGAZINE (SEPT – OCT 2020): From the book EXERCISED: Why Something We Never Evolved to Do Is Healthy and Rewarding by Daniel E. Lieberman, to be published on September 8, 2020 by Pantheon Books:

‘….many of the mechanisms that slow aging and extend life are turned on by physical activity, especially as we get older. Human health and longevity are thus extended both by and for physical activity.’

What Happens When We Exercise?
The graph breaks total energy expenditure (TEE) into two parts: active energy expenditure, and resting metabolism. Resting metabolism remains elevated for hours even after exercise ceases, burning additional calories in a phase known as excess post-exercise oxygen consumption (EPOC).

Exercise is like scrubbing the kitchen floor so well after a spill that the whole floor ends up being cleaner. The modest stresses caused by exercise trigger a reparative response yielding a general benefit.

In order to elucidate the links between exercise and aging, I propose a corollary to the Grandmother Hypothesis, which I call the Active Grandparent Hypothesis. According to this idea, human longevity was not only selected for but was also made possible by having to work hard during old age to help as many children, grandchildren, and other younger relatives as possible survive and thrive. That is, while there may have been selection for genes (as yet unidentified) that help humans live past the age of 50, there was also selection for genes that repair and maintain our bodies when we are physically active.

Daniel E. Lieberman is a paleoanthropologist at Harvard University, where he is the Edwin M Lerner II Professor of Biological Sciences, and Professor in the Department of Human Evolutionary Biology. He is best known for his research on the evolution of the human head and the evolution of the human body.

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COMMENTARY

Daniel Lieberman, a Cultural Anthropologist from Harvard, makes the case that paleolithic hunter-gatherers Grandparents were helpful, in fact necessary to their families, and evolved to be active into old age. They did not evolve to sit in front of the TV, and modern men pay a penalty if they do.

INACTIVITY at ANY AGE is bad. If you put 20 year olds to bed, both weight and blood pressure go up. The book addresses a conundrum. Free radicals are bad. Exercise runs O2 through the mitochondria, which produces free radicals.

But EXERCISE REDUCES FREE RADICALS. A metaphor is introduced: you spill some tomato juice on the floor. But you clean it up, and the floor becomes cleaner than it was before. You exercise, the muscles suffer some microtears and injury. The REPAIR RESTORES the muscles to better than before, maybe with some extra mitochondria.

The Bodies MECHANISMS are MEANT TO BE USED. DIET is meant to supply the body energy and units for repair, EXERCISE is meant to use that energy, and keep the mechanism lubricated, and SLEEP is meant to allow for time to accomplish repair.

Sleep, Diet and Exercise can all be reconciled by recourse to Paleolithic man, whose activities imprinted our modern bodies.

–Dr. C.

TELEMEDICINE: THE RISE OF TELEDERMATOLOGY (AMA)

From AMA.org (June 12, 2020):

Teledermatology

“There’s an aging population, and there’s a lot of skin out there,” said Dr. Isaacs. “One in five people in the country develop skin cancer, but there is a plethora of benign skin conditions that also require the expertise of the dermatologist. So, you have increasing demand and a limited supply of dermatologists.”

A basic example of how the TPMG teledermatology program works involves a patient who is concerned about a suspicious lesion or mole on their body. The patient can take a picture of the location in question and send it to their primary care physician for review. The physician can request the patient come in for a more thorough evaluation, or if the physician determines that a dermatologist should be involved, they can send the photo to an on-call dermatologist to review.

If the patient does an in-person evaluation, the physician can also take a higher-quality image and forward that to a dermatologist. The dermatologist can then decide whether there is a problem, if a prescription is needed, or if there should be an in-person evaluation and potential biopsy.

A study in the Journal of the American Academy of Dermatology in 2019 found that when TPMG dermatologists had the chance to look at well-photographed skin lesions, they were able to identify nearly 10% more cancers with almost 40% fewer referrals to the dermatology department.

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COMMENTARY

A high quality I-phone picture of a skin lesion can provide the dermatologist with 90% of the information needed for a diagnosis.

Melanoma diagnosis depends even more on the visual. In fact, Artificial  Intelligence evaluation of Melanoma may be  overtaking dermatologist expertise.

Size can be indicated by including a dime in the photo.

It is true that the roughness, softness or hardness may be important in diagnosis, but perhaps these characteristics could be described by the Patient.

This week, I started worrying about an itchy, rapidly growing lesion on my back. I sent a picture of this to my dermatologist, hoping he would call it a wart and reassure me. It was very regular, soft, and had a rough surface like warts I have had in the past.

However, he saw some redness and had me come in for removal. We will see what the pathology shows.

Dermatologists are in short supply, and making more efficient use of their expertise attractive.

Calling the Doctor’s office, arranging for e-mail Photo transmission, and a talk with the Doctor on the phone could save a visit. The Primary Doctor could send you directly to the dermatologist, or might be comfortable with watching and waiting.

Dermatology is indeed a field ripe for Telemedicine.

—Dr. C.