Researchers in the US found that people caring for a spouse with dementia were six times more likely to develop it themselves compared to similar older married adults whose spouse never develops it.

A paper on the study, led by Dr Maria Norton of Utah State University, is about to be published in a May issue of the Journal of the American Geriatrics Society, which is available online.

Norton and colleagues also found that husbands looking after wives with dementia were at higher risk of developing it themselves than wives looking after husbands with the condition.

The authors wrote that while many studies have shown dementia caregivers are at higher risk of poor physical and mental health, none has looked at the specific risk of dementia in caregivers.

Looking after someone with dementia is physically and mentally demanding, and caregivers in this situation tend to report more personal sacrifices and stress than those caring for physically impaired elderly people who do not have dementia.

For the study, Norton and colleagues recruited 2,442 participants (1,221 married couples) aged 65 and over living in Northern Utah. None of the participants had dementia at the start of the study, and they were followed for 12 years.

During follow up, 30 cases (60 individuals) of dementia were diagnosed in both spouses, plus 125 where only the husband developed it, and 70 where only the wife developed the condition.

After adjusting for socioeconomic status (a factor that is known to significantly affect dementia risk and other health outcomes), the researchers found that:

* Incident dementia was not only significantly linked to older age, but also to having a spouse with dementia.

* After adjusting for age, gender, genetic factors (APOE genotype), in addition to socioeconomic status, having a spouse with dementia was linked to a six times higher risk of developing dementia.

* For men caring for a spouse with dementia, the risk was 11.9 times higher, while for women it was 3.7 times.

Norton told the media that more research is needed to find out how much of this risk is due to caregiver stress and how much is due to a shared environment.

She also stressed that on the positive side, most of the participants whose spouses developed dementia did not themselves develop the condition, and therefore “more research is needed to explore which factors distinguish those who are more vulnerable”.

“Given the significant public health concern of Alzheimer’s disease and other dementias, and the upcoming shift in population age composition, continued research into the causes of dementia is urgent,” she added.

Despite the aches and pains that occur in old age, many older adults maintain a positive outlook, remembering the positive experiences from their past. A new study, reported in the April 2010 issue of Elsevier’s Cortex, reveals that older adults’ ability to remember the past through a positive lens is linked to the way in which the brain processes emotional content. In the older adult brain, there are strong connections between those regions that process emotions and those known to be important for successful formation of memories, particularly when processing positive information.

Dr Donna Rose Addis from the University of Auckland, together with a team of researchers supervised by Dr. Elizabeth A. Kensinger of Boston College (Chestnut Hill, MA), asked young adults (ages 19-31) and older adults (ages 61-80) to view a series of photographs with positive and negative themes, such as a victorious skier or a wounded soldier. While participants viewed these images, a functional magnetic resonance imaging (fMRI) scan recorded the brain activity across a number of different regions. When participants had completed the fMRI scan, they were asked to remember as many of the photographs as they could.

Analyses revealed that aging did not affect the connectivity among regions engaged during memory formation for negative photographs. However, age differences did arise during the creation of memories for positive photographs. In older adult brains, two regions that are linked to the processing of emotional content the ventromedial prefrontal cortex (a region located just behind the bridge of the nose) and the amygdala (a region embedded in the tissue between the ears) were strongly connected to regions that are linked to memory formation. In young adults, there was not a strong connection between the emotion-processing regions and the memory-creation regions.

These findings suggest that older adults remember the good times well, because the brain regions that control the processing of emotions act in concert with those that control the processing of memory, when older adults experience positive events. Young adults lack these strong connections, making it harder for them to remember positive experiences over the long term.

At age 55, men can expect another 15 years of sexual activity, but women that age should expect less than 11 years, according to a study by University of Chicago researchers published early online March 10 by the British Medical Journal. Men in good or excellent health at 55 can add 5 to 7 years to that number. Equally healthy women gain slightly less, 3 to 6 years.

One consolation for women is that many of them seem not to miss it. Men tend to marry younger women, die sooner and care more about sex, the study confirmed. Although 72 percent of men aged 75 to 85 have partners, fewer than 40 percent of women that age do. Only half of women 75-85 who remained sexually active rated their sex lives as “good,” and only 11 percent of all women that age report regularly thinking about or being interested in sex. Among those age 57 to 85 not living with a partner, 57 percent of men were interested in sex, compared to only 11 percent of women.

“Interest in sex, participation in sex and even the quality of sexual activity were higher for men than women, and this gender gap widened with age,” said lead author Stacy Tessler Lindau, MD, associate professor of obstetrics and gynecology at the University of Chicago. But the study also “affirms a positive association between later-life health, sexual partnership and sexual activity,” she said.

Lindau and co-author Natalia Gavrilova focused on two large surveys, the National Survey of Midlife Development, involving about 3,000 adults aged 25 to 74 and completed in 1996, and the National Social Life Health and Aging Project, involving another 3,000 adults aged 57 to 85, completed in 2006. Participants provided information about their relationship status and rated the quality of their sex lives and how often they had sex. They also rated the level of their general health as poor, fair, good, very good or excellent.

The results showed that men are more likely to be sexually active, report a good sex life and be interested in sex than women. This difference was most stark among the 75 to 85-year-old group, where almost 40 percent of men, compared to 17 percent of women, were sexually active.

The study also introduced a new health measure, “sexually active life expectancy,” or SALE, the average remaining years of sexually active life. For men, SALE was about ten years lower than total life expectance. For women it was 20 years lower.

Men at the age of 30, for example, have a sexually active life expectancy of nearly 35 years, but they can, on average, expect to remain alive for 45 years, including a sexless final decade. For 30-year-old women, SALE is almost 31 years but total life expectancy is more than 50. So men that age can anticipate remaining sexually active for 78 percent of their remaining lifespan, while women at 30 can expect to remain sexually active for only 61 percent of the remaining years.

The authors conclude that “sexually active life expectancy estimation is a new life expectancy tool than can be used for projecting public health and patient needs in the arena of sexual health,” and that “projecting the population patterns of later life sexual activity is useful for anticipating need for public health resources, expertise and medical services.”

In an accompanying editorial, Professor Patricia Goodson from Texas University says Lindau and Gavrilova’s research is both refreshing and hopeful. She says: “the study bears good news in the form of hope … the news that adults in the US can enjoy many years of sexual activity beyond age 55 is promising.”

Goodson adds that many unanswered questions remain in the field of older people and sexuality, such as problems with measurement and silence regarding the sexual health of ageing homosexual, bisexual or intersexed people. “They stand as dim reminders of the limitations inherent in applying science to the study of complex human realities, and the cultural values shaping the topics we choose to study,” she concludes.

people who are in good health are just about twice as likely to be interested in sex compared to those in poor health.

Sexual activity is recognized as having several health benefits. In addition, it is linked to living longer. In this case, the study investigates how general health impacts on the quality of sex.

Furthermore, this research estimates how many remaining sexually active years healthy men and women have left.

Findings indicate that at the age of 30, sexually active life expectancy is:

• For men: nearly 35 years
• For women: almost 31 years

At the age of 55, this figure changes to:

• For men: almost 15 remaining years
• For women: 10 remaining years

This gender difference diminishes for people with a spouse or intimate partner.

Sexually active life expectancy was longer for men. However, they lost more years of this activity due to poor health than women.

Authors, Stacy Tessler Lindau and Natalia Gavrilova from the University of Chicago, used data from two representative research groups in the US. One group consisted of over 3,000 men and women between the ages of 25 and 74. The other group included over 3,000 men and women between 57 and 85 years of age.

Participants were asked to provide information about their relationship status. They rated the quality of their sex lives and how often they had sex. They also rated the level of their general health between poor and excellent.

The results disclose that men are more likely to be sexually active, report a good sex life and be interested in sex than women. This dissimilarity was most considerable among the 75 to 85 year old group, where almost four out of ten (40 percent) males compared to less than two out of ten (17 percent) women were sexually active.

The authors write in conclusion:”sexually active life expectancy estimation is a new life expectancy tool than can be used for projecting public health and patient needs in the arena of sexual health” and that “projecting the population patterns of later life sexual activity is useful for anticipating need for public health resources, expertise and medical services.”

In an associated editorial, Professor Patricia Goodson from Texas University says Lindau and Gavrilova’s research is both interesting and encouraging. She writes: “the study bears good news in the form of hope … the news that adults in the US can enjoy many years of sexual activity beyond age 55 is promising.”

Goodson remarks that in the field of older people and sexuality, many questions remain unanswered, such as problems with measurement and silence regarding the sexual health of ageing homosexual, bisexual or intersexed people. “They stand as dim reminders of the limitations inherent in applying science to the study of complex human realities, and the cultural values shaping the topics we choose to study, she concludes.”

“Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of aging”

Some anti-depressant drugs are associated with an increased chance of developing cataracts, according to a new statistical study by researchers at the University of British Columbia, Vancouver Coastal Health Research Institute and McGill University.

The study, based on a database of more than 200,000 Quebec residents aged 65 and older, showed statistical relationships between a diagnosis of cataracts or cataract surgery and the class of drugs called selective serotonin reuptake inhibitors (SSRIs), as well as between cataracts and specific drugs within that class.

Published online in the journal Ophthalmology, the study does not prove causation but only reveals an association between the use of SSRIs and the development of cataracts. The study could not account for the possibility of smoking – which is a risk factor for cataracts – and additional population-based studies are needed to confirm these findings, the researchers say.

This study of statistical relationships is the first to establish a link between this class of drugs and cataracts in humans. Previous studies in animal models had demonstrated that SSRIs could increase the likelihood of developing the condition.

“When you look at the trade-offs of these drugs, the benefits of treating depression – which can be life-threatening – still outweigh the risk of developing cataracts, which are treatable and relatively benign,” says Dr. Mahyar Etminan, lead author of the article, a scientist and clinical pharmacist at the Centre for Clinical Epidemiology at Vancouver Coastal Health Research Institute and an assistant professor in the Dept. of Medicine at UBC.

Researchers found patients taking SSRIs were overall 15 per cent more likely to be diagnosed with cataracts or to have cataract surgery.

The degree of risk among specific and different types of SSRIs varied considerably. Taking fluvoxamine (Luvox) led to a 51 per cent higher chance of having cataract surgery, and venlafaxine (Effexor) carried a 34 per cent higher risk. No connection could be made between fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft) and having cataract surgery.

Co-author Dr. Frederick S. Mikelberg, professor and head of the Dept. of Ophthalmology and Visual Sciences at UBC and head of the Dept. of Ophthalmology at Vancouver General Hospital, notes that the average time to develop cataracts while taking SSRIs was almost two years.

“While these results are surprising, and might inform the choices of psychiatrists when prescribing SSRIs for their patients, they should not be cause for alarm among people taking these medications,” Mikelberg says.

UC Irvine neurobiologists are providing the first visual evidence that learning promotes brain health – and, therefore, that mental stimulation could limit the debilitating effects of aging on memory and the mind.

Using a novel visualization technique they devised to study memory, a research team led by Lulu Chen and Christine Gall found that everyday forms of learning animate neuron receptors that help keep brain cells functioning at optimum levels.

These receptors are activated by a protein called brain-derived neurotrophic factor, which facilitates the growth and differentiation of the connections, or synapses, responsible for communication among neurons. BDNF is key in the formation of memories.

“The findings confirm a critical relationship between learning and brain growth and point to ways we can amplify that relationship through possible future treatments,” says Chen, a graduate researcher in anatomy & neurobiology.

Study results appear in the early online edition of the Proceedings of the National Academy of Sciences for the week of March 1.

In addition to discovering that brain activity sets off BDNF signaling at the sites where neurons develop synapses, researchers determined that this process is linked to learning-related brain rhythms, called theta rhythms, vital to the encoding of new memories.

Theta rhythms occurring in the hippocampus involve numerous neurons firing synchronously at a rate of three to eight times per second. These rhythms have been associated with long-term potentiation, a cellular mechanism underlying learning and memory.

In rodent studies, the team found that both unsupervised learning and artificial application of theta rhythms triggered BDNF signaling at synapse creation sites.

“This relationship has implications for maintaining good brain health,” says Gall, a professor of anatomy & neurobiology. “There is evidence that theta rhythms weaken as we age, and our discoveries suggest that this can result in memory impairment. On the other hand, they suggest that staying mentally active as we age can keep neuronal BDNF signaling at a constant rate, which may limit memory and cognitive decline.”

A study in the March 1 issue of the journal Sleep shows that frequent napping is associated with an elevated prevalence of type 2 diabetes and impaired fasting glucose in an older Chinese population.

Results show that the prevalence of type 2 diabetes was 36 percent higher (adjusted odds ratio = 1.36) in participants who reported napping four to six times a week and 28 percent higher (OR = 1.28) in those who napped daily. Similar associations were found between napping and impaired fasting glucose. The observed associations were unaltered in statistical analyses that removed participants with potential ill health and daytime sleepiness, suggesting it is less likely that diabetes leads to daytime sleepiness and raising the possibility that napping may increase the risk of diabetes.

According to the authors, napping in China is a social norm, which is practiced by all ages primarily as a habit started in childhood. In Western countries, napping is less common and is often unplanned and prompted by sleepiness likely caused by aging, deteriorating health status or nighttime complaints.
Lead author Neil Thomas, PhD, reader in epidemiology at the University of Birmingham, U.K., said that additional research is needed to determine if napping itself plays a causative role in the development of type 2 diabetes, or if other factors are involved.

“In many non-Mediterranean, Western countries a large proportion of those that nap are generally older or have other conditions that cause tiredness and create an urge to nap,” said Thomas. “The napping can therefore be a marker of disease.”

This cross-sectional study analyzed baseline data from the Guangzhou Biobank Cohort Study, a collaboration between the Guangzhou Number 12 People’s Hospital and the Universities of Birmingham and Hong Kong. The community-based study took place in Guangzhou, China, where 19,567 participants between the ages of 50 and 93 years were recruited from 2003 to 2004 and 2005 to 2006. The sample comprised 13,972 women with a mean age of 61.4 years and 5,595 men with an average age of 64.2 years.

Participants underwent a half-day assessment, which included a structured interview on lifestyle and medical history, and a physical examination. Self-reported frequency of napping was obtained by questionnaire, and type 2 diabetes was assessed by a fasting blood glucose sample and/or self-reports of physician diagnosis or treatment. Participants were asked to describe their napping habits and daytime sleepiness.

Type 2 diabetes was identified in 13.5 percent of the sample and was more prevalent in people who reported napping daily (15.1 percent) and in those who napped four to six times per week (14.7 percent). Logistic regression models were constructed to assess the relationship between napping and diabetes and impaired fasting glucose, adjusting for demographics, lifestyle, sleep habits, health status, body fat and metabolic markers.

At least one nap per week was reported by 67.2 percent of participants, more commonly in males (76.4 percent) than in females (63.6 percent). About 59.4 percent of these people reported napping daily. Total sleep duration was longer and daytime sleepiness was reported less often in more frequent nappers than in people who never napped.

In a sub-sample of 3,822 participants who were re-contacted for additional information about sleep habits, there was a statistically significant trend of increasing risk of diabetes with longer nap duration. Compared with people who never took naps, the risk of diabetes was 41 percent higher (OR = 1.41) for people who took naps that lasted longer than 30 minutes and 35 percent higher (OR = 1.35) for people whose naps lasted 30 minutes or less.

The authors noted that the association between napping and diabetes was observed despite the fact that nappers had higher levels of physical activity, which has been shown to reduce the risk of diabetes. This suggests that the relationship between napping and diabetes might have been stronger had it not been offset by the protective effects of physical activity. The authors added that there will be profound public health implications in China if the relationship between napping and increased risk of type 2 diabetes is confirmed in longitudinal studies, as the nation is currently affected by an emerging diabetes epidemic.

A recent study, published in the January issue of Mayo Clinic Proceedings , demonstrates that in elderly patients undergoing hip fracture repair under spinal anesthesia with propofol sedation, the prevalence of delirium can be decreased by 50 percent with light sedation, compared to deep sedation.

“These data show that, for every 3.5 to 4.7 patients treated in this manner, one incident of delirium will be prevented,” says Frederick Sieber, M.D., primary investigator of the study from the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine in Baltimore. “Therefore, interventions capable of reducing the occurrence of postoperative delirium would be important from a public health perspective.”

Several demographic and perioperative variables are associated with postoperative delirium in elderly patients after hip fracture repair. The most important is preoperative dementia. Other risk factors for postoperative delirium include age, systemic disease and functionality. Inhalational and intravenous anesthetics, opioids, benzodiazepines and anticholinergic drugs are all known or suspected risk factors for postoperative delirium.

Although postoperative delirium usually resolves within 48 hours of onset, delirium can persist and is associated with poor functional recovery, increased length of stay in hospitals, higher costs, and greater likelihood of placement in an assisted-living facility after surgery.

In addition to decreasing the prevalence of delirium, lighter sedation in this group of elderly surgical patients was associated with a reduction in delirium that averaged almost one day for each patient in the light sedation group. The effects of lighter sedation were observed in patients with or without preoperative cognitive dysfunction.

Limiting depth of sedation during spinal anesthesia is a simple, safe and cost-effective intervention for preventing postoperative delirium in elderly patients that could be widely and readily adopted, say Dr. Sieber.

Older people who have “mental lapses,” or times when their thinking seems disorganized or illogical or when they stare into space, may be more likely to have Alzheimer’s disease than people who do not have these lapses, according to a study published in the January 19, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.

These mental lapses, also called cognitive fluctuations, are common in a type of dementia called dementia with Lewy bodies, but researchers previously did not know how frequently they occurred in people with Alzheimer’s disease and, equally important, what effect fluctuations might have on their thinking abilities or assessment scores.

The study involved 511 people with an average age of 78. Researchers interviewed the participant and a family member, evaluated the participants for dementia and tested their memory and thinking skills.

People with three or four of the following symptoms met the criteria for having mental lapses:

– Feeling drowsy or lethargic all the time or several times per day despite getting enough sleep the night before

– Sleeping two or more hours before 7 p.m.

– Having times when the person’s flow of ideas seems disorganized, unclear, or not logical — Staring into space for long periods

A total of 12 percent of the people with dementia in the study had mental lapses. Of 216 people with very mild or mild dementia, 25 had mental lapses. Of the 295 people with no dementia, only two had mental lapses.

Those with mental lapses were 4.6 times more likely to have dementia than those without mental lapses. People with mental lapses also tended to have more severe Alzheimer’s symptoms and perform worse on tests of memory and thinking skills than people who did not have lapses.

“When older people are evaluated for problems with their thinking and memory, doctors should consider also assessing them for these mental lapses,” said senior study author James E. Galvin.

Research published today on bmj.com reports that angiotensin receptor blockers are associated with a reduced risk of Alzheimer’s disease and dementia. These drugs are normally used to treat high blood pressure and heart disease.

In addition, the study concludes that angiotensin receptor blockers appear to offer greater protection against Alzheimer’s disease and dementia than other high blood pressure and heart disease medication.

A growing number of people are threatened by dementia (including Alzheimer’s disease) as they get older. This has important economic implications since individuals who suffer from either disease can spend long periods of time in nursing homes.

Dementia and Alzheimer’s disease are complex diseases. There is increasing evidence of three main risk factors:

• age
• genetics
• heart disease

Mid-life diseases particularly like diabetes and high blood pressure seem to be associated with a higher chance of developing dementia.

Researchers explain that this is the first large scale study to investigate whether angiotensin receptor blockers reduce the risk of developing dementia and Alzheimer’s disease.

Professor Benjamin Wolozin from Boston University School of Medicine led the team of researchers. They investigated the incidence of dementia in over 800,000 individuals in the US from 2002 to 2006. They were mostly (98 percent) male subjects. The participants had cardiovascular disease and were 65 years of age or older.

The research subjects were divided in three groups: one using angiotensin receptor blockers, another the blood pressure lowering drug lisinopril and the third using other comparative drugs used for heart disease.

The findings indicate that the group on angiotensin receptor blockers was significantly less likely to develop Alzheimer’s disease or dementia. In addition, they reveal that angiotensin receptor blockers have an additive effect when used in combination with another type of high blood pressure drug (ACE inhibitors). In fact, individuals with existing Alzheimer’s disease or dementia who took both medicines were less likely to die early or be admitted to nursing homes.

In conclusion, Wolozin comments that the research is significant because it is the “first to compare both risk of dementia and progression of dementia in users of angiotensin receptor blockers compared with users of a drug from the same class (lisinopril) or users of other drugs prescribed for cardiovascular disease.”

In an associated editorial, two senior doctors from the University of Calgary highlight that the public health implications of finding an effective way of preventing dementia are immense. They say in closing that however, further work is needed to verify the usefulness of antihypertensives in general and angiotensin receptor blockers in particular.

“Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis”