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Can Exercise Prevent Dementia?

Market Watch’s recent article entitled “How exercise can help prevent dementia” points out that although there’s no cure for Alzheimer’s disease, and an estimated 3% of all cases are entirely genetic, recent research suggests that some lifestyle interventions could slow its progression.

Dr. Dean Sherzai, a clinical neurologist and co-director of the Brain Health and Alzheimer’s Prevention Program at Loma Linda University in California, has developed a five-component lifestyle intervention therapy he uses with patients.

“We have people coming to us with early signs, or so-called subjective impairment, and then we have people a little more advanced, classified as having mild cognitive impairment, or MCI,” Dr. Sherzai explained. “We give them interventions, give them advice on changes they can make to their lifestyle components and we look at what happens.”

Of the five components in Dr. Sherzai’s lifestyle intervention, exercise is the one he typically recommends starting first.

“Whenever we apply behavior change to a population, we’re looking to create sustainable habits with small successes people can see right away, and nothing is better than exercise. It’s easy to implement, measurable and precise, with a fast return,” Dr. Sherzai said.

After only a couple of weeks of regular exercise, Dr. Sherzai’s patients often feel better, get better sleep and their lipid and blood glucose profiles improve. He says that these are some of the indirect ways exercise reduces risk for Alzheimer’s, because each of those factors are associated with higher rates of the disease. The doctor also mentioned three direct links between exercise and improved brain health:

  1. Exercise increases blood flow to the brain, which delivers more oxygen and nutrients;
  2. Exercise simultaneously flushes inflammatory and oxidative elements out the brain faster; and
  3. An increase in a chemical called brain-derived neurotrophic factor (BDNF) which Sherzai says, “is almost like growth hormones for neurons, but specifically for the connections between neurons.” Maintaining these neuronal connections is a key in preventing Alzheimer’s disease.

Brain scientists agree that exercise is good for preventing cognitive decline but they don’t yet know if any one type is better than another. It is something that scientists are starting to research. For now, a number of studies have shown that both aerobic and resistance training have major cognitive benefits.

Sherzai recommends exercises involving the legs, whether that’s walking, running, cycling or weightlifting he says that’s because, “your legs — not the heart — are the largest pump in the body.”

Reference: Market Watch (Sep. 28, 2021) “How exercise can help prevent dementia”

Does My Brain Improve as I Age?

Money Talks News’ recent article entitled “2 Ways Your Aging Brain Actually Improves Over Time” explains that our ability to gather new information and to concentrate on the most important things in any given situation may get better with age, according to new research out of Georgetown University Medical Center. The findings were published in the journal Nature Human Behavior.

As part of the study, researchers examined three distinct components of attention and executive function in group of about 700 participants:

  • Alerting — a state of enhanced vigilance and preparedness in order to respond to incoming information;
  • Orienting — the shifting of brain resources to a particular location in space; and
  • Executive inhibition — in which we inhibit distracting or conflicting information, allowing us to focus on what is important.

Study co-author João Veríssimo, an assistant professor at the University of Lisbon, Portugal, explained:

“We use all three processes constantly. For example, when you are driving a car, alerting is your increased preparedness when you approach an intersection. Orienting occurs when you shift your attention to an unexpected movement, such as a pedestrian. And executive function allows you to inhibit distractions, such as birds or billboards, so you can stay focused on driving.”

They looked at individuals from 58 and 98, the ages when cognition tends to change the most during the aging process. The researchers found that while alerting abilities declined with age, the other two abilities improved. Those two abilities help us with several key parts of cognition, such as:

  • Memory
  • Decision-making
  • Self-control
  • Navigation
  • Math
  • Language
  • Reading

The researchers say orienting and inhibition appear to be skills that can get better over a lifetime the more they’re practiced. However, it appears that alerting — a basic state of vigilance and preparedness — can’t improve with practice.

Study co-author Michael T. Ullman, a professor in the Georgetown University Department of Neuroscience and director of Georgetown’s Brain and Language Lab, commented, “People have widely assumed that attention and executive functions decline with age, despite intriguing hints from some smaller-scale studies that raised questions about these assumptions. However, the results from our large study indicate that critical elements of these abilities actually improve during aging, likely because we simply practice these skills throughout our life.”

Reference: Money Talks News (Sep. 6, 2021) “2 Ways Your Aging Brain Actually Improves Over Time”

Will Congress Provide more Dollars for Elder Care?

For millions of Americans taking care of elderly or disabled loved ones, resources are very costly. Government assistance is provided through Medicaid, but it’s just for those with the lowest incomes. Many who qualify don’t get the help because many states restrict the number of eligible recipients, resulting in long waiting lists.

NBC News’ recent article entitled “Democrats want billions to pay for elder care. Republicans say the price tag is too high” reports that Democrats have earmarked roughly $300 billion to expand home-based care for seniors and the disabled in the $3.5 trillion spending bill dubbed the American Families Plan. The bill would offer states incentives to lift their income caps to 300 times the poverty level, or about $38,600 per person. Democrats say it would enable an additional 3.2 million people to be eligible for home-based assistance.

However, Republicans are launching an all-out messaging campaign that accuses Democrats of a “reckless tax and spending spree” and saying the American Families Plan would lead to higher inflation and a suffering economy. Democrats say they aren’t afraid of the cost or of Republican claims about inflation. Research shows that the elder care proposal is one of the most popular components of their agenda among likely Democratic voters. Two-thirds of voters said expanding access to home-based care for the elderly and the disabled was important, and 48% strongly favored the expansion.

Progressives have said $3.5 trillion is too little to transform the economy. Moderate Democrats point to the risk of inflation.

U.S. Rep. Katherine Clark (D-MA), who is a member of the House Women’s Caucus, cared for her dad, who suffered a stroke, her mom, who had Alzheimer’s and three young children when she was running for Congress. She said elder care is a priority.

“Even though I had resources and options, it was really, really challenging to me. That story plays out for parents and women across this country every day,” Clark said in an interview. “It is long past time that we recognize how fundamental the care agenda and the care economy is to our economy in general.”

Democrats also would like to pass provisions to guarantee that home health care workers make a living wage through reporting guidelines and by requiring a minimum wage, which would be set by region.

Reference: NBC News (Aug. 21, 2021) “Democrats want billions to pay for elder care. Republicans say the price tag is too high.”

What Is Science Doing About Hearing Loss?

Thanks to advances in technology and medicine like artificial intelligence and gene therapy, hearing research is producing significant innovations. AARP’s recent article entitled “Three Game-Changing Innovations for Those With Hearing Loss” looks at a couple of them, in various stages of development.

  1. Eyeglasses That Turn Speech into Subtitles. With these, you’ll be able to read what people are saying. An app on your smartphone would listen to a conversation and transcribe the speech into sentences in real time. The text would be sent instantaneously to your enhanced eyeglasses, which would create subtitles. Vuzix, a tech company, recently released smart glasses that work with transcription software. Automatic speech-to-text programs have proliferated in recent years, and live computer-generated captions are now available on most videoconferencing platforms. Smartphone apps can also generate real-time transcriptions for in-person conversations. However, the issue is that users have to be in front of a PC or looking at a phone, which detracts from full social engagement. However, companies are making subtitles more natural, by using “smart glasses” technology, which can project text to a user’s field of vision in a comfortable, nonintrusive way. We may see this in a few years.
  2. An App That Lets You Hear Someone in a Crowded Room. This technology can isolate a person’s speech in a noisy environment, which would solve what scientists call the “cocktail party problem.” An app would “listen” to the soundscape surrounding you and separate out different streams of sound, including voices, ambient music and other background noise. It would then isolate the sound you want to hear based on the direction you’re facing — and reduce everything else. The cleaned-up sound would then be delivered straight to your ear through your hearing aid, cochlear implant, or earbuds. Powerful de-noising programs look to be available on hearing technology within five years.
  3. Drug Therapy That Regrows Cells That Help Your Hearing. Your body would repair damage to your inner ear — like when a salamander regrows his tail. A drug delivered into your inner ear would turn on chemical switches to regrow the cells responsible for hearing and most hearing loss. Those born with hearing loss or those who lose hearing later in life would get injections to restore some or all of their hearing. This hair cell regeneration would be ideal for anyone who’s lost hearing because of missing or damaged hair cells. However, this isn’t anticipated to be available very soon. Some hair cell regrowth therapies using different methods are currently in human clinical trials. There are trials being conducted at Novartis, Eli Lilly, Frequency Therapeutics, and Pipeline Therapeutics. However, most of this work is still being tested in the lab.

Reference: AARP (August 2, 2021) “Three Game-Changing Innovations for Those With Hearing Loss”

This Breathing Trick may Make You More Heart-Healthy

An easy technique, called high-resistance inspiratory muscle strength training (IMST) is when a person inhales deeply through a hand-held device that provides resistance. Doctors say that to get an idea of how it works, think of “sucking hard through a tube that sucks back.”

Money Talks News’ recent article entitled “This 5-Minute Trick Could Help Your Heart More Than Exercise” reports that, as part of the study, 36 adults ages 50 to 79 with above-normal systolic blood pressure readings (120 or higher) were divided into two groups. Half of them performed high-resistance IMST for six weeks; and the other half did a placebo protocol, which involved much less resistance. (Systolic blood pressure refers to the first or top number in a blood pressure reading. For example, if your reading is 120/80, your systolic blood pressure is 120.)

After six weeks, the systolic blood pressure of the IMST group went down an average of nine points. That reduction is better than what’s normally achieved by walking 30 minutes a day, five days a week. It is also equal to the effects of some drugs that work to lower blood pressure. Moreover, those in the IMST group saw a 45% improvement in vascular endothelial function. That’s the ability of arteries to expand upon stimulation. Levels of nitric oxide — a molecule that dilates arteries and prevents plaque buildup — also increased. Lastly, markers of inflammation and oxidative stress fell drastically. Higher levels of these markers are linked to increased heart attack risk. These findings were published recently in the Journal of the American Heart Association.

IMST has been used for years to help patients with respiratory disease to strengthen their diaphragm and other breathing muscles. Researchers now say that more widespread use of IMST might help aging adults lower their risk of cardiovascular disease, the No. 1 cause of death in America.

In a press release, Daniel Craighead, lead author of the study and an assistant research professor in UC Boulder’s Department of Integrative Physiology, noted, “There are a lot of lifestyle strategies we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access. IMST can be done in five minutes in your own home while you watch TV.”

The researchers say that 65% of U.S. adults over age 50 have above-normal blood pressure—this raises their risk of heart attack or stroke.

It’s usually suggested that those performing IMST engage in a 30-minute-per-day regimen at low resistance. However, Craighead and others have found that a reduced regimen of 30 inhalations per day at high resistance, six days per week also offers cardiovascular, cognitive, and sports performance benefits. The researchers noted that the IMST regimen may be of particular benefit to postmenopausal women. Earlier research has found that postmenopausal women who aren’t taking supplemental estrogen don’t see as much benefit to vascular endothelial function from exercise as men do.

But IMST looks to boost vascular endothelial function in women just as much as men. Craighead says, “If aerobic exercise won’t improve this key measure of cardiovascular health for postmenopausal women, they need another lifestyle intervention that will. This could be it.”

The breathing-muscle training device used in the study is called a POWERbreathe K3, manufactured by a company in England. It costs a few hundred dollars. However, the researchers say they’re developing a smartphone app that will enable people to do the same IMST regimen at home with other devices.

Reference: Money Talks News (July 15, 2021) “This 5-Minute Trick Could Help Your Heart More Than Exercise”

Should I Stay Fit after 50?

Being physically fit after 50 will help improve your health as you age, but it can also benefit your body, mind and wallet in ways you might not realize. Money Talks News’ recent article entitled “7 Surprising Benefits of Staying Fit in Retirement” says that maintaining muscle health can also help improve energy levels, decrease the risk of fractures and speed up recovery from illnesses.

Her are some big potential benefits of staying in shape in your 50s (and well beyond that) you might not have considered. But visit your doctor for a checkup before beginning a fitness program and work your way into any exercise routine to avoid injuries.

  1. Thinking More Clearly. In addition to building muscles, exercise can help with brain function. Exercise can improve mood and sleep and decrease stress and anxiety. These can indirectly help with overall cognitive function.
  2. Spending Less On Medical Care. The average retiree household spends $6,800 a year on health care. However, with a regular exercise regimen, you can improve your health. That means you may be able to spend less time and money at the doctor’s office. The Mayo Clinic says regular exercise helps prevent or manage a wide range of health problems, such as stroke, high blood pressure, depression and cancer.
  3. Save On Life Insurance. If you stay fit, you may save money on life insurance because underwriters generally base policy costs on your risk of death. Overweight seniors will pay higher rates but maintaining a healthy weight and strong vital signs could reduce your premiums.
  4. Feel Happier. There’s a strong link between physical fitness and happiness. In addition to boosting your energy, exercise can elevate your mood. Physical activity stimulates brain chemicals that can make you feel more relaxed and less anxious. You may also feel better about your appearance, which can raise your self-esteem.
  5. Decrease Muscle And Bone Mass Loss. Regular strength training can help women to reduce the loss of bone and muscle mass that happens as they get older. This condition is more pronounced in women than men, since menopause accelerates this decline. Weight-based exercises are intended to thwart these conditions, which can impact a woman’s ability to perform daily activities.
  6. Keep Your Independence. According to the National Council on Aging, regular exercise can help older adults stay independent. Certain types of exercise, such as tai chi, can even reduce your risk of falls, which are the top cause of fatal and non-fatal injuries among seniors.
  7. Live longer. Aerobic fitness is a dynamic indicator of long-term mortality, and the more aerobic exercise you do, the greater the benefit. Three hours a week of regular exercise may potentially extend life by as much as five years. However, not exercising creates a risk of premature death that is equal to or worse than cardiovascular disease, diabetes or smoking, according to a large study published in 2018 in JAMA Network Open.

Reference: Money Talks News (December 25, 2020) “7 Surprising Benefits of Staying Fit in Retirement”

What’s the Criticism of the New Alzheimer’s Drug?

Three members of the FDA panel overseeing research have resigned since the approval this week, including Dr. Aaron Kesselheim, a professor of medicine at Harvard Medical School, who said in a letter the agency’s decision on Biogen “was probably the worst drug approval decision in recent U.S. history.”

CNBC’s article entitled “Biogen Alzheimer’s drug and the battle over dementia treatment of the future” reports that last November, in an 8-1 vote, that panel said Biogen’s late-stage study didn’t provide “strong evidence” showing that aducanumab effectively treated Alzheimer’s; two other panelists said that the data was “uncertain.”

While some experts see Aduhelm an “effective treatment” for a disease that affects millions of Americans, others have concerns about the FDA ruling’s implications for the panoply of other potential treatment options that are in late-stage development.

An immediate challenge facing other researchers working on a wider Alzheimer’s drug pipeline will be to keep participants in ongoing trials. In most cases, many Alzheimer’s sufferers will quit other drug studies to pursue treatment with the newly approved Aduhelm. This will make the trial data for those alternative drugs less useful, even though the drugs in question might one day prove safer, more effective, or more appropriate for different stages of the disease’s progression. Nonetheless, Aduhelm’s approval is seen by many as a big boost towards those efforts.

Some major drug companies stopped efforts to research brain diseases, including Pfizer and Boehringer Ingelheim in 2018. Biogen had given up on Aduhelm at one time in the clinical trials in 2019 before reversing its decision. This was after decades of failure in search of a breakthrough.

The National Institutes of Health spent two to three times more on heart disease and cancer research than on dementia in recent years, while a lack of qualified participants for clinical trials also slowed progress.

Aduhelm’s clinical trial data demonstrated that the drug successfully targets and clears out clusters of a specific type of protein that are thought to be responsible for Alzheimer’s. However, it gave insufficient evidence to prove the drug provides patients with cognitive benefits. Known among scientists as aducanumab, it works by offering an array of identical antibodies that are cloned from white blood cells. These antibodies are chosen for their targeting abilities, since they can identify specific proteins, called beta amyloids, that have constructed particular formations in the body. There’s extensive evidence suggesting that these beta amyloid formations, also known as “pathological aggregates” or “plaques,” are a major driver of Alzheimer’s disease, though the exact causal mechanisms are still not fully understood.

“What we’re going to find out from the use of this drug one way or the other, is whether or not the amyloid clearing hypothesis is correct,” says USC health economist Darius Lakdawalla, who argues the continued trialing of Biogen’s drug will prove useful to that confirmatory effort.

“If it is correct, then I think it opens the door for a lot of innovation, a lot of drug candidates that are going to try to clear amyloid in the future pursuit of that hypothesis.”

Reference: CNBC (June 12, 2021) “Biogen Alzheimer’s drug and the battle over dementia treatment of the future”