Ask elderly people what they fear most and the commonest answer is losing their mind. Many people believe that this is inevitable, particularly the older you get.

Good news, though. That isn’t true, as a recent study* has shown.

Danish researchers compared the data for two groups of older people. One group, all people born in 1915, were studied when they were 95 years old. The second group – of people born in 1905 – had been studied previously when they were 93 years old. The findings were fascinating.

The two groups were similar in physical tests such as hand-grip, standing and walking speed, although the 1915 group were better in tests related to the activities of daily living.

The researchers then used standard methods to assess ‘cognition’ – the brain-based skills everyone uses to deal with everything from the simplest to the most complex processes. The group born in 1915 scored significantly better – even though they were older at the time of assessment. These 95-year-olds had clearer minds than the 93-year-olds born ten years earlier.

The researchers concluded that that more people are living to older ages with better overall functioning.

Incidentally, they also found that those born in 1915 had a 32% greater chance of living longer than those who were born in 1905.

 

*Link to the study abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60777-1/abstract

 

One of the most significant studies in health has just celebrated 65 years since it started, and it’s still going strong.

Over those 65 years, residents of the small town of Framingham in Massachusetts, USA, have been participating in long-term studies looking at heart disease and its causes.

By the mid-1950s, the number of middle-aged men succumbing to coronary heart disease was causing serious concern – not least when several world leaders developed it. The disease had been on the rise since the start of the 20th century and the Framingham Heart Study set out in 1958 to establish what was behind this.

The study initially recruited more than 5,000 men and women, nearly a fifth of the whole population of Framingham. The researchers collected data about each of the participants every two years using interviews, clinical examinations and laboratory tests. The data covered participants’ lifestyle and environment as well as looking at their health and genetic profiles. This helped to show the importance of not smoking, taking enough physical activity, treating high blood pressure, avoiding obesity and the importance of blood fats in preventing coronary heart disease.

By 1971 the study had recruited a second generation of participants and in 1994 it extended its recruitment to reflect the changing population resulting from an influx of South Americans. 2002 saw the recruitment of a third generation. Over time, the study was widened to include other diseases, notably type 2 diabetes and dementia.

There were similar studies going on elsewhere but none was quite so comprehensive or prolonged. The Framingham study resulted in many papers published in leading scientific journals, and the work was widely discussed in scientific societies worldwide, greatly influencing research, debate and health policy.

Indeed, the findings in this and the other studies changed the way doctors looked at illness. Previously, most doctors thought of an illness as being caused by germs. If the germs could be killed or prevented from spreading, the illness would be eliminated. The Framingham discoveries required a rethink. This resulted in the concept of ‘non-communicable disease’ to explain much of modern illness and highlighted the importance of what we as individuals could do to prevent these diseases, as well as transforming the public health agenda.

There are questions over the future of this study, and whether it will continue to bring sufficient returns on the cost now that its primary objectives have been achieved. The US government has cut substantially its share of the funding.

But the fact remains that this study generated a novel way of looking at all disease and increased phenomenally our understanding of coronary heart disease.

About the study:  http://www.framinghamheartstudy.org/about/

 

Dementia is a frightening condition. It’s not surprising that many elderly people express concern about it – particularly if they find themselves becoming forgetful. But how worried should they be?

The first thing to keep in mind is that most people – of all ages – are forgetful at times. Think how often parents have to remind their children to take all the kit they need to school. And memory declines as we get older, simply as part of the ageing process. Memory loss certainly isn’t the same as dementia, although it is one of the symptoms.

Indeed, there’s a lot of confusion about what dementia actually is. For a start it’s not due to a single disease as many people think. Alzheimer’s disease is the best known, but it is only one of the causes. Unfortunately, we still don’t have an easy way to diagnose dementia as a whole, let alone the different variants.

What sets dementia apart from normal ageing is the loss to a greater or lesser extent of a range of ‘cognitive skills’, such as reasoning ability and use of words. Memory loss is often the symptom that is spotted first, partly because it interferes with social functioning and partly because this is the symptom most easily noticed by the sufferers themselves, as well as their friends and family.

So how can you tell whether memory loss is simply part of a decline with age or a sign that someone is already marked out for dementia?

Unfortunately, it seems we can’t. One recent study suggested that memory generally does not decline much before the age of 60. Memory loss before this age might therefore have been a useful marker for dementia. However, this has been questioned by the results of an extensive long-term UK study* that showed a general decline in memory and other cognitive skills even at the age of 45.

In the United States, a long-term study** carried out by phone survey – the Behavioral Risk Factor Surveillance System – has shown the scale of the issue. The results suggest that 1 in 8 people aged over 60 living at home have experienced confusion or memory loss in the previous 12 months to the extent that one third of them sought help from friends and relatives. Few, though, had sought professional advice.

These results highlight the need to find ways to differentiate those with memory loss who go on to develop dementia from those others where it is simply an inevitable result of ageing. This is important for those individuals, and also for society more widely in planning potentially expensive treatment and social needs.

We now have a significant population of people over 65, with their number increasing rapidly. All forms of dementia increase with age, especially in those over the age of 80 years. Differentiating people with normal ageing from those who are developing dementia is going to become increasingly important.

Until reliable diagnosis and effective treatments are available, the best bet is to take steps known to avoid dementia or delay its onset such as regular physical activity (especially during middle life), maintaining a lively mind, continuing manual and mental skills into older life, and keeping an active social life.

 

*Link to study:  http://www.bmj.com/content/344/bmj.d7622

**Link to study: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6218a1.htm?s_cid=mm6218a1_w

 

 

These days, when you have a book to sell you need a website. But when we were building our site, we realised it could be much more than a boring old marketing tool.

So what we’ve done is put together a site full of information we hope will be of value to everyone, whether or not you buy our book How to Live to 110. It outlines what to do now to keep yourself healthy, so you live longer and end up in great shape throughout your later years.

We’ve given an overview of all the main diseases covered in the book – heart disease, cancer, high blood pressure, diabetes, lung disease, infections, dementia and so on – and suggested some of the steps you can take to avoid these. We also give advice and suggestions on physical activity, burning calories, foods that help protect you from disease, avoiding hunger, losing weight permanently and giving up smoking.

People are living longer these days. Everyone really should be taking steps to make sure their old age is rewarding and healthy rather than years of illness and frailty. The website can’t go into depth on this, like our book does, but we hope it will still prove helpful. And, unlike some websites, all the suggestions we make are based on scientific studies

Of course, we’d love it if people buy our book. After all, we spent two hard years researching and putting it together, and we’re really proud of how it turned out! But if our website gets some people thinking about their future health – and perhaps contributes to a reduction in the diseases caused by modern living – then that’s great too.

(Our website is www.how-to-live-to-110.com – or click on the tab at the top of the blog.)

 

Professor Brian Kirby, author of How to Live to 110: Your comprehensive guide to a healthy life.

 

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