Friday, June 23, 2017

Frequent sexual activity can boost brain power in older adults

More frequent sexual activity has been linked to improved brain function in older adults, according to a study by the universities of Coventry and Oxford.

Researchers found that people who engaged in more regular sexual activity scored higher on tests that measured their verbal fluency and their ability to visually perceive objects and the spaces between them.

The study, published today in The Journals of Gerontology, Series B: Psychological and Social Sciences, involved 73 people aged between 50 and 83.

Participants filled in a questionnaire on how often, on average, they had engaged in sexual activity over the past 12 months -- whether that was never, monthly or weekly -- as well as answering questions about their general health and lifestyle.

The 28 men and 45 women also took part in a standardized test, which is typically used to measure different patterns of brain function in older adults, focusing on attention, memory, fluency, language and visuospatial ability.

This included verbal fluency tests in which participants had 60 seconds to name as many animals as possible, and then to say as many words beginning with F as they could -- tests which reflect higher cognitive abilities.

They also took part in tests to determine their visuospatial ability which included copying a complex design and drawing a clock face from memory.

It was these two sets of tests where participants who engaged in weekly sexual activity scored the most highly, with the verbal fluency tests showing the strongest effect.

The results suggested that frequency of sexual activity was not linked to attention, memory or language. In these tests, the participants performed just as well regardless of whether they reported weekly, monthly or no sexual activity.

This study expanded on previous research from 2016, which found that older adults who were sexually active scored higher on cognitive tests than those who were not sexually active.

But this time the research looked more specifically at the impact of the frequency of sexual activity (i.e. does it make a difference how often you engage in sexual activity) and also used a broader range of tests to investigate different areas of cognitive function.

The academics say further research could look at how biological elements, such as dopamine and oxytocin, could influence the relationship between sexual activity and brain function to give a fuller explanation of their findings.

Lead researcher Dr Hayley Wright, from Coventry University's Centre for Research in Psychology, Behaviour and Achievement, said:

"We can only speculate whether this is driven by social or physical elements -- but an area we would like to research further is the biological mechanisms that may influence this.

"Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are, and whether there is a 'cause and effect' relationship between sexual activity and cognitive function in older people.

"People don't like to think that older people have sex -- but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general wellbeing."

Thursday, June 22, 2017

Greater emphasis on preventing, treating heart disease in women needed

Women and physicians do not put enough emphasis on cardiovascular disease in women, and a social stigma regarding body weight may be a primary barrier to these important discussions, according to research publishing today in the Journal of the American College of Cardiology.

Cardiovascular disease is the number one cause of death in the United States, accounting for nearly 400,000 deaths and killing more women than all types of cancer combined. Although there has been a decline in overall mortality from heart disease, this decrease has been smaller for women compared to men and the death rate in women younger than 55 years old has increased.

"Increasing awareness of cardiovascular disease in women has stalled with no major progress in almost 10 years, and little progress has been made in the last decade in increasing physician awareness or use of evidence-based guidelines to care for female patients," said Bairey Merz, director of the Barbra Streisand Women's Heart Center in the Cedars-Sinai Heart Institute and the study's lead author.

For this study, researchers from the Women's Heart Alliance interviewed 1,011 U.S. women aged 25-60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists. The goal of the surveys was to determine knowledge, attitudes and beliefs regarding heart disease in women.

The researchers found that 45 percent of women were unaware that heart disease is the number one killer of women in the U.S. Awareness level was lower in women with lower levels of education and income and in ethnic minorities. Nearly 71 percent of women almost never brought up the issue of heart health with their physician, assuming their doctor would raise the issue if there was a problem. However, physicians were more likely to discuss cardiovascular health if prompted by the patient or due to the presence of a risk factor.

Physicians often did not discuss cardiovascular disease because the patient had a more immediate health issue or did not fully report their symptoms, indicating that prevention prior to symptoms was not a priority. Women who knew someone with heart disease were more likely to express concern and bring this issue up with their physician or to discuss heart disease with a friend thought to be at risk for having or developing heart disease.

While a majority of women reported having a routine physical or wellness exam in the past year, only 40 percent reported having a heart health assessment. While 74 percent reported having at least one risk factor for heart disease, just 16 percent were told by their doctor that they were at risk. Sixty-three percent of women admitted to putting off going to the doctor at least sometimes and 45 percent of women canceled or postponed an appointment until they lost weight. Many women reported being embarrassed or overwhelmed by their heart disease and many also cited difficulties in losing weight or finding time to exercise.

Only 22 percent of primary care physicians and 42 percent of cardiologists felt well prepared to assess cardiovascular risk in women. Additionally, only 16 percent of primary care physicians and 22 percent of cardiologists fully implemented guidelines for risk assessment.

"These findings suggest a need to destigmatize cardiovascular disease for women and counteract stereotypes with increased objective risk factor evaluation education to improve treatment by physicians," Bairey Merz said. "National action campaigns should work to make cardiovascular disease 'real' to American women and destigmatize the disease by promoting the use of cardiovascular risk assessment to counter stereotypes with facts and valid assessments."

In an editorial comment published with the paper, Jennifer G. Robinson, MD, MPH, from the College of Public Health at the University of Iowa discusses the importance of developing healthy lifestyle habits early in life to reduce the risk for cardiovascular disease.

"Helping women overcome barriers to increasing physical activity and healthier eating habits may help to avoid the stigma of focusing on weight loss," she said. "Women are often the gate-keepers for family meals, activities and health care, and a focus on healthy lifestyle habits may also encourage early prevention in the family as a whole."

Accentuate the positive to reduce risk of chronic disease

People who experience not just positive emotions but a diversity of positive emotions appear to have lower levels of systemic inflammation, which may reduce their risk for chronic diseases such as diabetes and heart disease, according to research published by the American Psychological Association.

"There is growing evidence that inflammatory responses may help explain how emotions get under the skin, so to speak, and contribute to disease susceptibility," said lead author Anthony Ong, PhD, of Cornell University and Weill Cornell Medical College. "Our findings suggest that having a rich and diverse positive emotional life may benefit health by lower circulating levels of inflammation."

The research was published in the APA journal Emotion.

Ong and his colleagues sought to build upon previous research suggesting that people who experience more positive emotions tend to have better health outcomes over time. They specifically sought to determine whether range and variety of emotions that individuals experience--what they dubbed "emodiversity"--would be related to an objective biological indicator -- namely, inflammation. High levels of systemic inflammation have been associated with chronic disease (e.g., atherosclerosis, Type 2 diabetes, osteoporosis) and increased risk of premature death, according to Ong.

The researchers followed 175 participants, ages 40 to 65, from the Phoenix metropolitan area for 30 days. During that period, participants used a tablet computer given to them for the study to keep a daily record of their emotional experiences. Six months later, blood samples were taken and tested for markers of inflammation (i.e., IL-6, CRP, fibrinogen).

"Greater diversity in day-to-day positive emotions was related to lower systemic inflammation," said Ong. "This association remained significant after accounting for average levels of positive or negative emotions, differences in demographic characteristics, body mass index, personality, medication use and medical conditions."

It is important to note that this effect was only found for diversity of positive emotions, according to Ong, a finding that was surprising to the researchers because they had expected to find similar associations for negative and overall emotional diversity as well.

To determine positive emotional diversity, the researchers had participants indicate their experience of 16 different positive emotions (enthusiastic, interested, determined, excited, amused, inspired, alert, active, strong, proud, attentive, happy, relaxed, cheerful, at ease, calm) across the 30-day period. Diversity was measured not only by the number of discrete emotions experienced but by overall distribution and the number of times each emotion was experienced.

"Specifically, low emodiversity is characterized by emotional experiences that are relatively homogeneous and concentrated in a few emotion categories, whereas high emodiversity reflects emotional experiences that are relatively diverse and distributed more evenly across categories," said Ong.

While previous studies have looked at the independent role of positive and negative emotions on inflammation, Ong believes this may be the first to look at the role of the diversity of emotion as well. He warns, though, that the findings, which specifically focus on middle-aged individuals from a single geographic area, need to be replicated in larger, more culturally diverse samples.

The link between job stress, junk food and sleep

Stress during the workday can lead to overeating and unhealthy food choices at dinnertime, but there could be a buffer to this harmful pattern.

A good night's sleep can serve as a protecting factor between job stress and unhealthy eating in the evening, indicates a new study co-authored by a Michigan State University scholar.

The study, published online in the Journal of Applied Psychology, is one of the first to investigate how psychological experiences at work shape eating behaviors.

"We found that employees who have a stressful workday tend to bring their negative feelings from the workplace to the dinner table, as manifested in eating more than usual and opting for more junk food instead of healthy food," said Chu-Hsiang "Daisy" Chang, MSU associate professor of psychology and study co-author.

"However, another key finding showed how sleep helped people deal with their stressful eating after work," she added. "When workers slept better the night before, they tended to eat better when they experienced stress the next day."

The research involved two studies of 235 total workers in China. One study dealt with information-technology employees who regularly experienced high workload and felt there was never enough time in the workday. The second study involved call-center workers who often got stressed from having to deal with rude and demanding customers.

In both cases, workday stress was linked to employees' negative mood while on the job, which in turn was linked to unhealthy eating in the evening, said Yihao Liu, co-author and assistant professor at the University of Illinois.

The study proposed two potential explanations, Liu said.

"First, eating is sometimes used as an activity to relieve and regulate one's negative mood, because individuals instinctually avoid aversive feelings and approach desire feelings," he said. "Second, unhealthy eating can also be a consequence of diminished self-control. When feeling stressed out by work, individuals usually experience inadequacy in exerting effective control over their cognitions and behaviors to be aligned with personal goals and social norms."

Chang said the finding that sleep protects against unhealthy eating following workday stress shows how the health behaviors are related.

"A good night's sleep can make workers replenished and feel vigorous again, which may make them better able to deal with stress at work the next day and less vulnerable to unhealthy eating," she said.

To address the problem, companies should emphasize the importance of health management for their employees and consider sleep-awareness training and flexible scheduling.

Companies should also reconsider the value of food-related job perks, which have become very common.

"Food-related perks may only serve as temporary mood-altering remedies for stressed employees," Chang said, "and failure to address the sources of the work stress may have potential long-term detrimental effects on employee health."

Engaging in moderate physical activity may slow progression of Alzheimer's

People at risk for Alzheimer's disease who do more moderate-intensity physical activity, but not  are more likely to have healthy patterns of glucose metabolism in their brain, according to a new UW-Madison study. Light-intensity physical activity did no thave a similar effect.

Results of the research were published today online in Journal of Alzheimer's Disease. Researchers used accelerometers to measure the daily physical activity of participants, all of whom are in late middle-age and at high genetic risk for Alzheimer's disease, but presently show no cognitive impairment.

Activity levels were measured for one week, quantified, and analyzed. This approach allowed scientists to determine the amount of time each subject spent engaged in light, moderate, and vigorous levels of physical activity. Light physical activity is equivalent to walking slowly, while moderate is equivalent to a brisk walk and vigorous a strenuous run. Data on the intensities of physical activity were then statistically analyzed to determine how they corresponded with glucose metabolism--a measure of neuronal health and activity--in areas of the brain known to have depressed glucose metabolism in people with Alzheimer's disease. To measure brain glucose metabolism, researchers used a specialized imaging technique called 18F-fluorodeoxyglucose positron emission tomography (FDG-PET).

Moderate physical activity was associated with healthier (greater levels of) glucose metabolism in all brain regions analyzed. Researchers noted a step-wise benefit: subjects who spent at least 68 minutes per day engaged in moderate physical activity showed better glucose metabolism profiles than those who spent less time.

"This study has implications for guiding exercise 'prescriptions' that could help protect the brain from Alzheimer's disease," said Dougherty. "While many people become discouraged about Alzheimer's disease because they feel there's little they can do to protect against it, these results suggest that engaging in moderate physical activity may slow down the progression of the disease."

"Seeing a quantifiable connection between moderate physical activity and brain health is an exciting first step," said Okonkwo. He explained that ongoing research is focusing on better elucidating the neuroprotective effect of exercise against Alzheimer's disease. To investigate this further, the team is recruiting individuals with concerns about their memory for a national clinical trial called EXERT to test whether physical exercise can slow the progression of early memory problems caused by Alzheimer's disease.

Encouraging, but inconclusive evidence on interventions to prevent cognitive decline, dementia

The public is enormously concerned about dementia and cognitive impairment, and a wide range of programs and products, such as diets, exercise regimens, games, and supplements, purport to keep these conditions at bay. It is difficult for individuals, health care providers and policy makers to ascertain what has been demonstrated to prevent or reduce risk.

To help sort through the data and to understand the quality and weight of current evidence for possible interventions, the National Institute on Aging (NIA) at the National Institutes of Health, commissioned experts for an extensive scientific review and to provide recommendations for public health messaging and future research priorities. In response to that request, a National Academies of Sciences, Engineering and Medicine (NASEM) committee has concluded that current evidence does not support a mass public education campaign to encourage people to adopt specific interventions to prevent cognitive decline or dementia.

Importantly, the committee also cited “encouraging although inconclusive” evidence for three specific types of interventions — cognitive training, blood pressure control for people with hypertension, and increased physical activity. Based on that evidence, the committee recommended providing the public with accurate information about their potential positive impacts for some conditions while more definitive research on these and other approaches moves forward. The committee suggested that health care providers might include mention of the potential cognitive benefits of these interventions when promoting their adoption for the prevention or control of other diseases and conditions.

The full NASEM report, “Preventing Cognitive Decline and Dementia: A Way Forward,” can be viewed at (link is external).

The committee’s recommendations are based in large part on an NIA-requested and supported systematic evidence review by the Agency for Healthcare Research and Quality’s (AHRQ) Evidence-based Practice Center (EPC). The Minnesota EPC categorized hundreds of studies by strength and quality for the AHRQ part of the project.

“We’re all urgently seeking ways to prevent dementia and cognitive decline with age,” said NIA Director Richard J. Hodes, M.D. “But we must consider the strength of evidence -- or lack thereof -- in making decisions about personal and public investments in prevention. I am grateful for the National Academies’ and AHRQ’s careful reviews, which recognize the progress research has made in beginning to answer such questions, while pointing the way for additional studies. This report will be very instructive for what we can tell the public now, as critical research continues.”

The committee noted potential effects, as well as limitations of the evidence, for:

Cognitive training 

Interventions aimed at enhancing reasoning, memory, and speed of processing, to delay or slow age-related cognitive decline were found promising, based primarily on conclusions from the NIA-funded Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial and bolstered by additional data from prospective observational studies on the benefits of cognitively stimulating activities.

The committee cautioned, however, that it could not draw conclusions about the relative effectiveness of different cognitive training approaches or techniques. It also noted that there was no evidence to support the notion that beneficial long-term cognitive effects suggested by the ACTIVE trial could be applied to computer based brain training applications being offered commercially, as the suite of cognitive interventions in the ACTIVE trial were substantially different.

The committee found no evidence to suggest that cognitive training might prevent, delay or slow development of Mild Cognitive Impairment (MCI) or Alzheimer’s, however.

Blood pressure management for people with hypertension 

Encouraging but inconclusive evidence suggests that blood pressure management, particularly in midlife, might prevent, delay or slow clinical Alzheimer’s-type dementia, according to the committee. While clinical trials in this area do not offer strong support for blood pressure management against Alzheimer’s, prospective population studies and what we have learned about the natural history and biology of the disease make it plausible, then, that blood pressure management for people with hypertension would also reduce their risk of dementia and cognitive decline, the report said.

The committee pointed out the known cardiovascular benefits from well-managed blood pressure, which would be experienced while Alzheimer’s prevention is potentially addressed.

Increased physical activity 

Citing the many known health benefits of physical activity, the committee pointed to growing evidence that among these is the possible reduced risk of age-related cognitive decline. Here, too, the experts turned to what they called encouraging but inconclusive evidence, noting that clinical trials results in this area suggest effectiveness, taken together with observational studies and knowledge of neurobiological processes. There was not sufficient evidence to support increased physical activity as a preventive intervention for MCI or Alzheimer’s disease, however. Further, the committee could not find sufficient evidence to help determine which specific types of physical activity might be particularly effective for preventing cognitive decline and dementia.

In communicating with the public, the committee said, the NIH, the Centers for Disease Control and Prevention and other organizations should present potential benefits of the three interventions as they apply to cognitive decline, MCI, and Alzheimer’s dementia, while pointing out the limitations of the evidence. There are considerable challenges in presenting such nuanced messages, it added, as the public likely will not draw fine distinctions among the three conditions or about levels of evidence.

The committee expressed optimism for the future of research to provide answers that the public and providers are seeking. Substantial knowledge has been gained since the last comprehensive evidence review in 2010, and this complex and exciting area of discovery will continue to grow with investments in research. In addition to encouraging ongoing research in the three areas for which it found evidence most developed, the committee recommended as priority areas for further study: new anti-dementia treatments; treatments for diabetes and depression; dietary interventions; lipid-lowering treatments; sleep quality interventions; social engagement, and vitamin B12 plus folic acid supplementation.

For its evidence review, the AHRQ’s EPC examined the scientific literature on 13 classes of interventions associated with preventing, slowing, or delaying the onset of clinical Alzheimer’s-type dementia and MCI. The AHRQ report, issued in March 2017, found that most approaches showed no evidence of benefit to delay or prevent age-related cognitive decline, MCI, or Alzheimer’s dementia. It concluded that, at present, there is not sufficient strength of evidence to justify large-scale investing in public health activities aimed at preventing dementia; some results may be viewed as potential added benefits to already identified public health interventions.

Wednesday, June 21, 2017

Eating fish may reduce arthritis symptoms

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In the study of 176 patients, frequency of fish consumption was assessed by a food frequency questionnaire assessing usual diet in the past year.

"If our finding holds up in other studies, it suggests that fish consumption may lower inflammation related to rheumatoid arthritis disease activity," said Dr. Sara Tedeschi, lead author of the Arthritis Care & Research study. "Fish consumption has been noted to have many beneficial health effects, and our findings may give patients with rheumatoid arthritis a strong reason to increase fish consumption."