Forgot where you put your car keys? Having trouble recalling your colleague’s name? If so, this may be a symptom of subjective cognitive impairment (SCI), the earliest sign of cognitive decline marked by situations such as when a person recognizes they can’t remember a name like they used to or where they recently placed important objects the way they used to. Studies have shown that SCI is experienced by between one-quarter and one-half of the population over the age of 65. A new study, published in the January 11, 2010, issue of the journal Alzheimer’s & Dementia, finds that healthy older adults reporting SCI are 4.5 times more likely to progress to the more advanced memory-loss stages of mild cognitive impairment (MCI) or dementia than those free of SCI.

The long-term study completed by researchers at NYU Langone Medical Center tracked 213 adults with and without SCI over an average of seven years, with data collection taking nearly two decades. Further cognitive decline to MCI or dementia was observed in 54 percent of SCI persons, while only in 15 percent of persons free of SCI.

“This is the first study to use mild cognitive impairment as well as dementia as an outcome criterion to demonstrate the outcome of SCI as a possible forerunner of eventual Alzheimer’s disease,” said Barry Reisberg, MD, professor of psychiatry, director of the Fisher Alzheimer’s Disease Program and director, Clinical Core, NYU Alzheimer’s Disease Center at NYU Langone Medical Center. “The findings indicate that a significant percentage of people with early subjective symptoms may experience further cognitive decline, whereas few persons without these symptoms decline. If decline does occur in those without SCI symptoms, it takes considerably longer than for those with subjective cognitive symptoms.”

According to the authors, scientists and physicians can now target the prevention of eventual Alzheimer’s disease in the SCI stage, beginning more than 20 years before dementia becomes evident

“These intriguing results more fully describe the possible relationship between early signs of memory loss and development of more serious impairment. This is critical to know, as we look for ways to define who is at risk and for whom the earliest interventions might be successful,” said Neil Buckholtz, PhD, National Institute on Aging (NIA) which supported the research. “These findings also underscore the importance of clinicians’ asking about, and listening to, concerns regarding changes in cognition and memory among their aging patients.”

If you’re an aging baby boomer hoping for a buffer physique, there’s hope. A team of American scientists from Texas and Michigan have made a significant discovery about the cause of age-related muscle atrophy that could lead to new drugs to halt this natural process. This research, available online in the FASEB Journal, shows that free radicals, such as reactive oxygen species, damage mitochondria in muscle cells, leading to cell death and muscle atrophy. Now that scientists understand the cause of age-related muscle loss, they can begin to develop new drugs to halt the process.

“Age-related muscle atrophy in skeletal muscle is inevitable. However, we know it can be slowed down or delayed,” said Holly Van Remmen, Ph.D., co-author of the study, from the Sam and Ann Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center at San Antonio. “Our goal is to increase our understanding of the basic mechanisms underlying sarcopenia to gain insight that will help us to discover therapeutic interventions to slow or limit this process.”

To make this discovery, Van Remmen and colleagues used mice that were genetically manipulated to prevent them from having a protective antioxidant (CuZnSOD). As a result of not being able to produce this antioxidant, the mice had very high levels of free radicals (reactive oxygen species) and lost muscle mass and function at a much faster rate than normal mice. Additionally, the muscles of the genetically modified mice were much smaller and weaker than those of normal mice. Scientists believe that these findings mimic effects of the normal aging process in humans, but at an accelerated rate.

“I don’t expect to see baby boomers gracing the pages of body building magazines tomorrow. But this research is important because it identifies molecules responsible for the aging of our muscles: free radicals,” said Gerald Weissmann

A molecular receptor pivotal to the action of male hormones such as testosterone also plays a crucial role in the body’s ability to heal, report scientists in the December issue of the Journal of Clinical Investigation.

In studies in mice, scientists at the University of Rochester Medical Center found that this receptor – the androgen receptor – delays wound healing. When scientists used an experimental compound to block the receptor, wounds healed much more quickly.

Scientists say that while the results in mice offer new insights into a potential new way to help the body heal faster, they stress that more research must be done before considering whether to explore the treatment in people whose wounds are slow to heal.

“This is a very interesting observation,” said Edward Messing, M.D., a urologist and surgeon at the University of Rochester Medical Center who was not involved in the study. “For people at the marginal end of health – the elderly, or people who have impaired healing for other reasons, such as diabetes – maybe blocking the androgen receptor in certain cells could speed up wound healing and help prevent infections.”

The work was led by Chawnshang Chang, Ph.D., director of the George Whipple Laboratory for Cancer Research and a widely recognized expert on the androgen receptor. The first author is former graduate student Jiann-Jyh Lai, Ph.D., who is now a researcher at the University of Massachusetts.

The work thrusts a sex hormone front and center into one of the most important and pervasive processes of the body. Inflammation is crucial for allowing the body to heal from wounds and to fight off invaders. But when our inflammatory response goes beyond what’s necessary, or if it occurs in the wrong time or place, it hurts our health and can be deadly.

By identifying the androgen receptor as a key player in at least one form of inflammation, the work opens a new window for scientists investigating differences between the genders when it comes to autoimmune or inflammatory diseases.

“Many inflammatory diseases, such as atherosclerosis and asthma, manifest themselves differently in the genders, indicating that sexual hormones could be involved. We’ve found that the androgen receptor plays a role regulating the inflammatory response in wound healing. It will be very interesting to see if the receptor plays a similar role in other diseases,” said Lai.

To block the receptor and speed healing, the team used ASC-J9, a synthetic chemical compound loosely based on a compound found in curry that can shut down the receptor selectively. ASC-J9 is being tested in Phase II trials as a treatment for severe acne by San Diego-based AndroScience Corp., a biotech company founded by Chang and colleagues. Both Chang and the University of Rochester own a stake in the company, which has licensed several of Chang’s research findings.

Chang’s current study delves in a detailed way into the molecular underpinnings of wound healing. When the body is injured, myriad cells rush to the scene, a bit like emergency responders hustling to a disaster. Some cells issue cries for help by sending out certain chemical messengers; other cells act as dispatchers to recruit more responders to the scene. It can seem like a great deal of chaos zeroed in on a small patch of skin. Usually, the body gets the job done, drawing upon dozens of molecular actors to heal the wound efficiently and quickly; sometimes, though, the inflammation can be detrimental.

For the current study funded by the National Cancer Institute, Chang and colleagues studied several different types of cells involved in wound healing. The team created different types of mice, turning off the androgen receptor in certain cell types while leaving it functional in other cells. Then scientists applied ASC-J9 to block the activity of the androgen receptor and studied the effects.

The team found that the androgen receptor spurs white blood cells known as macrophages to produce a chemical messenger called TNF-alpha, which in turn stimulates the body’s inflammatory response. The receptor also plays a role recruiting macrophages to the site of injury. When the team blocked the receptor, there were fewer macrophages and less TNF-alpha at the wound site, and the wound healed much more quickly.

“It is a surprise that the androgen receptor is involved in wound healing in so many ways,” said Chang, who is a faculty member in the departments of Pathology and Urology and the James P. Wilmot Cancer Center. “People have suspected that the receptor plays a role in wound healing, but it’s new that it plays a direct role guiding circulating macrophages to the area.”

Shutting off the interaction between the androgen receptor and androgen hormones like testosterone is a goal in several areas of medicine. The action is taken by doctors most commonly to treat patients with advanced prostate cancer. For some patients, doctors prescribe “chemical castration” and shut down the body’s supply of hormones like testosterone. This causes severe, systemic side effects that can include impotence, loss of libido, osteoporosis, and fatigue.

Scientists like Chang are exploring another way to prevent that same interaction, by shutting down the androgen receptor itself in select tissues but keeping the flow of hormones intact.

Messing, a surgeon who regularly treats men with prostate cancer, says that the ability to turn off the effects of androgens in just the tissues necessary is a challenge but holds great promise.

“Currently there is no way of preventing androgens in your body from reaching just one particular wound or one specific part of the body,” said Messing. “To stop them anywhere, you need to turn off androgens throughout the body, which has severe and unpleasant side effects, particularly in men. Turning off the androgen receptor only where you want to, and nowhere else, could lead to new treatments for diseases like prostate cancer and for speeding wound healing.”

US researchers found that even after the age of 80, smoking increased a person’s risk of developing AMD, age-related macular degeneration, the leading cause of blindness among Americans aged 65 and over, suggesting it is never too late to give up the habit.

The study was the work of lead author Dr Anne Coleman, professor of ophthalmology at the Jules Stein Eye Institute at University of California, Los Angeles (UCLA), and colleagues, and is published in the January issue of the American Journal of Ophthalmology.

AMD causes a darkening and/or blurring of central vision, and prevents you from being able to read, drive and recognize people you know. It is a progressive degeneration of the macula, the centre of the retina, the part of the membrane inside the back of the eye that allows us to see fine details.

Advanced AMD with loss of vision affects about 1.75 million Americans: this figure is expected to rise to just under 3 million by 2020.

Smoking is the second most common risk factor for AMD: age is the first. Coleman and colleagues wanted to find out whether age was linked to the effect of smoking on AMD risk.

Coleman told the press that age was the strongest predictor for AMD, yet most of the research done on the disease only looked at people aged 75 and under.

“Our population was considerably older than those previously studied,” said Coleman.

“This research provides the first accurate snapshot of how smoking affects AMD risk later in life,” she added.

For the study, Coleman and her team compared the retinal photographs of nearly 2,000 women taken at age 78 and 83, looked for signs of AMD and then did logistical regression statistical tests to find out whether smoking affected the women’s risk of developing the disease.

The women were already taking part in a study called the Study of Osteoporotic Fractures, where 45 degree stereoscopic fundus retinal photographs were part of the observations taken at clinic follow ups in year 10 and 15 of the study.

They found that:

* Overall, the smokers had 11 per cent higher rates of AMD than the non-smokers of the same age.

* But among the over 80s, the smokers were 5.5 times more likely to develop AMD than the non-smokers.

The authors concluded that:

“The magnitude of the greater-than-additive effect of smoking on the age-adjusted risk of AMD reinforces recommendations to quit smoking even for older individuals.”

“The take-home message is that it’s never too late to quit smoking,” said Coleman.

“We found that even older people’s eyes will benefit from kicking the habit,” she added.

Speculating on the underlying biological reasons for this link, the authors said there is a theory that smoking increases AMD risk by reducing levels of antioxidants in the blood, changing the blood flow to the eyes and reducing the amount of pigmentation in the retina.

Dr Paul Sieving, director of the National Eye Institute, which funded the research with the National Institute on Aging, said this study gives:

“Yet another compelling reason to stop smoking and suggests that it is never too late to quit.”

Researchers and the general public have a new resource for information on the health and intimate relationships of older people, thanks to a new supplemental issue of The Journals of Gerontology Series B: Psychological and Social Sciences (Volume 64B, Supplement 1).

Based on the groundbreaking National Social Life, Health, and Aging Project (NSHAP), the supplement’s 14 articles focus on demographic characteristics; social networks; social and cultural activity; physical and mental health, including cognition, well-being, illness, medications, and alternative therapies; history of sexual and intimate partnerships; and patient-physician communication.

“The NSHAP represents an extraordinary contribution to the study of aging, and published findings from it have already shed new light on critical issues in social gerontology – from abuse to sexuality, said Journal of Gerontology: Social Sciences Editor Kenneth F. Ferraro, PhD, of Purdue University. “A truly distinctive feature of the study is the collection of several biomeasures on a national sample.”

The NSHAP is a unique, interdisciplinary effort to collect social data alongside biological indicators in a population-based sample of older adults. The study collected 13 biomeasures, including the assessment of respondents’ weight, waist circumference, height, blood pressure, distance vision, smell, touch, and mobility. NSHAP also collected blood spots, saliva, oral fluid for HIV testing, and, from female respondents, a self-administered vaginal swab.

Sexuality among older adults tended to vary with age and gender. At all ages in the study, men were more likely than women to have a partner, more likely to be sexually active with that partner, and tend to have more positive and permissive attitudes toward sex.

Similarly, men were more likely than women to report alcohol use, potential problem drinking, and ever having smoked. Alcohol use and smoking were also lower among older age groups.

This information can provide physicians and public health policy makers with a scientific base of knowledge for advising older people about positive social and intimate relationships, as well as designing health programs to capitalize on and promote these relationships.

As the classic saying goes, “You can never be too rich or too thin.” However, it seems American women would rather look younger than be rich or thin. A recent poll commissioned by ZO Skin Health and reveals that on average, women would be willing to spend more on a facial care system that would make them look 10 years younger than they would on a diet program that would make them lose 10 pounds.

The survey, which was conducted among 1,131 U.S. adult women by Harris Interactive, reported how much women care about the overall health and condition of their skin, particularly their face.

Even in a time when many women have cut back on discretionary spending, they are willing to spend on a facial care system that they believe will be effective at making their skin look younger and healthier.

“Results, results, results. At the end of the day, that’s all that matters. Women are fed up with products that don’t work, that make empty promises and bogus claims. What counts are the active ingredients and their concentrations,” says Dr. Zein Obagi, board-certified dermatologist and creator of ZO Skin Health.

Some of the products and services-like peels, injections, lasers, creams and machines–can be pricey, so overall spending has shifted away from procedures that are new and trendy, in favor of products that are proven effective.

The ZO Skin Health survey also revealed that women think about the health and condition of their skin more often than they think about their love life. About two in five women (43%) think about the health of their skin always or often, which is more often than they think about their relationship status (39%) or cardiovascular health (33%).

This is not surprising to skincare maverick Dr. Zein Obagi, who has been championing the importance of healthy skin throughout his 25-plus year career. Even in a recessionary economy, lipstick and cosmetics sell very well — presumably because women still like to look good, and they spend on affordable luxuries. “You can’t solve all of the world’s problems, but you can take care of yourself,” he said.

Best known for his original anti-aging skin care line available only through physicians, Dr. Obagi has now developed a skin care line that features products with high concentrations of active ingredients and time-released retinol, which has been proven to be the only topical skin care ingredient proven to reduce the signs of skin aging.

Midlife weight gain could mean midlife crisis. A study at Harvard School of Public Health says that women who are overweight do not live as long as women who are healthy and fit.

The study also suggests that women who are obese in middle age not only have a shorter life span but almost 80 percent more likely to have multiple health problems by the time they reach age 70.

The study appears to be the first to look at the effect of putting on weight during one’s life on the chances of healthy survival into old age. It looks at two growing trends in the US: longevity and weight.

For every one-point increase in their Body Mass Index, women had a 12 percent lower chance of surviving to age 70 in good health when compared to thin women. Researchers defined “healthy survival” as not only being free of chronic disease, but having enough mental and physical capability to perform daily tasks.

Researchers analyzed data for more than 17,000 women collected through the ongoing Nurses’ Health Study, which started in 1976. Just under 10 percent of the women in the study who had lived to age 70 or beyond (their mean age was 50 when the Nurses’ Health Study began) reported being free of the 11 major chronic diseases the researchers tracked, maintaining good mental health and cognitive and physical function.

“If you are on the obesity track early in life, it could get very dangerous by the time you are middle-aged,” said Stephan Rossner, an obesity expert at Karolinska University Hospital in Stockholm. He said it was uncertain if people could regain the health benefits of being thin if they lost weight later in life.

Overweight woman face health issues and shorter life span but Researcher Qi Sun, MD says, “The key message from our paper is that to enjoy a healthy yet long life, women need to maintain a healthy body weight throughout adulthood,” “Meanwhile, I believe it is never too late to take initiatives to lose weight in a safe and healthy way to maximize the probability to achieve healthy survival.” Sun points out that being physically active, at any weight, is a healthy habit.

People over 80 years are being treated too aggressively for high blood pressure, warns an expert in an editorial in BMJ Clinical Evidence this week.

According to Dr James Wright, the latest evidence suggests that less aggressive drug therapy may be more effective at reducing mortality in this age group. Based on this evidence, he suggests clinicians change what they are presently doing and move towards a more conservative approach for people aged over 80.

Despite limited evidence about high blood pressure (hypertension) treatment in the over 80s, UK and US guidelines recommend that people over 80 should receive the same treatment as people of any other age. This means using combinations of drugs to reach a target blood pressure of 140/90 mmHg.

But could this be doing more harm than good, asks Wright?

He points to the results of a recently updated Cochrane review which suggest that our present approach may be “excessively aggressive.”

This review includes data from two new trials which looked specifically at the effect of antihypertensive drugs in people over the age of 80. Interestingly, the only trial that found a significant reduction in mortality was the most conservative in terms of number of drugs and dose of drugs allowed. The treatment regime involved three easy steps, with a target blood pressure of 150/80 mmHg.

Using this approach would require little adjustment of drug doses and would markedly simplify and reduce the cost of managing these patients, says Wright.

However, he points out that only half of the people on this regimen would achieve a target blood pressure of 150/80 mmHg. This is below recommendations set out for UK GPs in the Quality and Outcomes Framework (QOF), which suggest that 70% of all patients should meet treatment targets.

Trials are now needed to compare this conservative approach with the more aggressive treatment strategies in common use today, he writes. In the meantime, clinicians should change what they are presently doing and move towards a more conservative approach for people aged over 80.

Smoking, being heavier, not using sunscreen and having had skin cancer appear to be associated with sun damage and aging of skin on the face, according to report based on a study of twins in the December issue of Archives of Dermatology, one of the JAMA/Archives journals.

Long-term exposure to the sun causes physical and structural changes to the skin, resulting in photodamage, according to background information in the article. Unlike typical skin aging, which is characterized by the development of fine wrinkles and skin growths, photodamage includes characteristics such as coarsely wrinkled skin, spots of extra pigment or lost pigment and dilated blood vessels on the face. Sun damage also has been associated with the development of cancerous growths. Up to 40 percent of aging-related changes are due to non-genetic factors.

To identify some of these environmental factors, Kathryn J. Martires, B.A., of Case Western Reserve School of Medicine, Cleveland, and colleagues studied 65 pairs of twins attending the 2002 annual Twin Days Festival in Twinsburg, Ohio. A total of 130 individuals completed surveys collecting information about skin type, history of skin cancer, smoking and drinking habits and weight. Clinicians assigned each participant a photodamage score, graded by such characteristics as wrinkling and change in pigmentation.

Photodamage scores were highly correlated among both monozygotic (identical) and dizygotic (fraternal) twins. Other factors associated with higher levels of photodamage included a history of skin cancer, heavier weight and smoking, whereas alcohol consumption was associated with lower photodamage scores.

“The Twins Days Festival provides a rare opportunity to study a large number of twin pairs to control for genetic susceptibility. Among the most important results is that a history of skin cancer and photodamage are highly associated in a population that shares genetic commonalities,” the authors conclude. “The relationships found between smoking, weight, sunscreen use, skin cancer and photodamage in these twin pairs may help to motivate the reduction of risky behaviors.”

There may be a new effective way to prevent and treat Alzheimer’s disease on the horizon, through raising levels of the hormone leptin. Alzheimer’s is the most common cause of a declining mental state that affects how well someone can speak, process thoughts and carry out their daily activities. Researchers continue to search for the right treatment and prevention for the disease.

The new discovery is connected to the energy regulating hormone leptin, which was discovered in the 1990s. Leptin is produced by fat cells and is thought to play a key role in controlling hunger and weight. There is now growing evidence linking leptin to brain development and memory. The new study evaluating leptin levels and its effects on Alzheimer’s disease, recently released in the Journal of the American Medical Association and conducted at Boston University Medical Center, involved patients that began in 1948 with the Framington Heart Study, and included 785 elderly volunteers originally. Between 1990 and 1994 levels of blood leptin levels were checked in the volunteers, and around eight years later there were regular brain scans conducted on 198 older volunteers that had not developed dementia, to check how their brains had aged.

Through the study there is evidence showing those with higher levels of leptin had four times better odds of not developing Alzheimer’s disease than those with much lower levels of the hormone. Patients beginning the study with higher leptin levels were rewarded with healthier brains and fewer signs of aging. A fourth of those with the lower levels of leptin eventually developed Alzheimer’s disease compared to only 6 percent of the participants that reported the highest leptin levels.

The newly released study was an additional step to study the effects of leptin in Alzheimer’s patients since there have been evidence linking leptin levels to brain plaques in patients with Alzheimer’s. There is more research in regards to leptin on the way. A small pilot study, being funded by a $3 million award from the National Institutes of Health, to study leptin replacement therapy’s affects on Alzheimer’s patients, will be recruiting 45 patients soon.

The researchers of the newly released study said, “If our findings are confirmed by others, leptin levels in older adults may serve as one of several possible biomarkers for healthy brain aging and, more importantly, may open new pathways for possible preventative and therapeutic interventions.” Studies involving animals and leptin treatment have shown memory performance improvements even after signs of Alzheimer’s have began. However, lead researcher Sudha Seshadri, M.D., of Boston University School of Medicine says it remains to be seen if leptin replacement therapy will benefit Alzheimer’s patients or help to prevent the onset of the disease.