Update on the 90+ Longevity Study by the University of California - Irvine

If you regularly watch the television show, "60 Minutes," you may have seen one of the stories they have shown about The 90+ Study, an ongoing project lead by Dr. Claudia Kawas, M.D., from the University of California in Irvine. The research was begun in 1981, long before Dr. Kawas was involved, but continues to be handled by her and other researchers at UCI.  Most of the people that were studied over the past 40+ years live in the retirement community of Laguna Woods Village, where the project is still going on today.  Such a long-term study has enabled them to get detailed information about the two separate issues of longevity and how to reduce your risk of dementia, since few people hope to live a long life while suffering from a disease like Alzheimer's. 

Recently, Dr. Claudia Kawas, the current lead researcher on the project, spoke at a Healthy Aging Forum in Laguna Woods Village to bring residents up-to-date on what the researchers have learned.  What she discovered has been fascinating.  As a resident of Laguna Woods, I attended this forum, took photos of her slides, and want to share a bit of her research with my readers.

Longevity Continues to Increase

According to Dr. Kawas, she estimates that one-half of all children born today in developed countries can expect to live to be 100 years old!  She acknowledged the fact that our nation's longevity has dipped the past couple of years because of Covid.  However, she believes that other medical advances will enable us to continue to expand our lifespans.

Who Did the UCI Researchers Study?

The study began in 1981 and between that year and 1985 they enrolled 13,978 senior citizens from the Laguna Woods Village Retirement Community, which was called Leisure World when they started.  Because of the makeup of the residents living in the community at the time, the people who enrolled in the program were primarily white, well-educated, had a median age of 73 at the time, and about two-thirds of them were women.

The researchers continued to follow up with the original enrollees in 1983, 1985, 1992, and 1998.  They have continued to enroll new subjects and study them since that time.  Dr. Kawas announced that 2022 is the last year she plans to enroll new subjects ... so she will eventually be able to retire!  Perhaps another researcher will pick up where she left off but, meanwhile, they have learned a lot about the two separate issues of longevity and dementia!

What Factors Are NOT Associated With Longevity?

The first issue they studied was longevity ... which qualities did or did not seem to help people live longer. 

They studied a number of factors which they thought MIGHT influence how long people would live.  Although these factors might benefit people in other ways, they did NOT help people live longer. Here is the list of factors they studied which did NOT seem to increase longevity:

Vitamin C - either from diet or supplements did not help them live longer

Vitamin A  - either from diet or supplements did not increase longevity

Vitamin E supplements - did not increase lifespan

Calcium consumption in the diet - did not help respondents live longer

Consumption of soft drinks by the elderly - did not affect longevity according to the researchers (which I thought was interesting).

Some of the above factors also surprised Dr. Kawas, because she had expected the vitamins and minerals mentioned above to have an effect on increasing longevity.  Although they might have other benefits, they did not seem to increase how long you would live.  (However, readers may have seen recent research which has shown that the simple act of taking a daily multi-vitamin can dramatically reduce dementia risk, which is discussed later in this post.)

What Factors WERE Associated With Longevity?

The factors below DID seem to increase how long a person would live, and some of these items also surprised Dr. Kawas.

Moderate caffeine consumption from coffee or tea did add to their lifespans.

Moderate alcohol consumption - one small drink a day for women and two for men increased longevity.  People who drank that amount lived longer than people who drank more, or who did not drink alcohol at all.  However, it is possible that the reasons many people do not drink alcohol is because they already have serious health problems or because they did significant damage to their bodies from alcohol abuse early in adulthood.  The researchers did discover that excessive drinking was associated with a shorter lifespan.

A Body Mass Index slightly ABOVE average seemed to improve longevity.  People who were very skinny or very obese did not live as long as people who were of average or slightly above average weight. (Yay for those of us who carry a little extra weight.)

Daily Exercise made a difference.  Those who exercised for 15 minutes a day did better than those who were sedentary.  Those who exercised for 30 minutes lived even longer.  Those who exercised for 45 minutes or more did the best.  However, there was no longevity benefit for those who exercised more than 45 minutes a day.  There is no need to run marathons, unless you simply want to. So take a nice, 45 minute walk every day, and you have a better chance of living to a ripe old age.

Non-exercise activities or participating in hobbies also added to longevity.  The key, however, was that they had to ENJOY the activities. It doesn't help to just force yourself to do things you don't enjoy.

A Positive Attitude is important, too.  Being depressed shortens your lifespan, but being enthusiastic and positive can add to the length of your life.

Who Gets Dementia?

Next, the researchers went on to investigate whether or not their long-lived subjects developed dementia, what physical indications of dementia they could find in their brains, and what lifestyle factors seemed to make a difference in who did and did not develop dementia.

What Assessments Did They Perform on the Study Subjects?

The research they performed over the years on the people enrolled in the program far exceeded simple physical examinations and interviews.  Here are some of the ways the researchers evaluated the participants:

They studied their Medical History;

Performed Neuropsychological Tests on their memory, language ability, and executive function;

Completed both neurological and physical examinations;

Asked the participants to complete detailed questionnaires over the years, covering their diet, lifestyle, amount of exercise they get, activities they participate in, and other factors;

Did genetic studies, including looking at their DNA and cell lines;

Performed various types of brain imaging, including MRIs and PET scans.

In addition, they asked the participants to donate their brains to the researchers, so they could autopsy them and look for various types of pathologies, such as a build-up of amyloid plaques and tangles in the brain, or signs of microinfarcts, white matter disease, hippocampal sclerosis and a disease called LATE, which is when a protein called TDP-43 accumulates in brain cells. 

As you can see, the researchers were very thorough in researching not just how long the people lived, but also the incidence of dementia in this population.  They also learned what behaviors seemed to help prevent or postpone dementia as they aged.

Resilience is a Significant Factor in Preventing Dementia

Dr. Kawas particularly appreciated the people who donated their brains, because she was able to learn so much from them.  Some of the people who never appeared to have dementia while they were alive, had a number of troublesome pathologies in their brain that were only found after they died.  On the other hand, some people who had experienced dementia symptoms while they were alive seemed to have fairly healthy brains.  That was a surprise!

In other words, you do not always have to be a helpless victim of the plaques, tangles and other problems that may exist in your brain.  Some people seem to manage well in old-age, despite how their brain looked when it was autopsied.   Dr. Kawas called this protection against signs of dementia, even in the presence of serious pathologies, resilience.  People who have resilience seem to age better than people without it.

Another Surprising Finding!

Most of us assume that Alzheimer's Disease is the most common cause of dementia.  However, in her research Dr. Kawas discovered that it only accounts for about 25% of cases of dementia.  Vascular dementia is actually the most common cause, resulting in about 40% of dementia cases.  LATE (which stands for limbic-predominant age-related TDP-43 encephalopathy) accounts for around 19% of cases, Lewy Body dementia causes about 5% of cases, and all the other pathologies account for the remaining 11% of cases of dementia.

It is also interesting that people can have MORE than one cause of their dementia at the same time. For example, someone could have both Alzheimer's Disease and vascular dementia at the same time.  Obviously, the more pathologies you have, the more likely you are to have obvious symptoms of dementia while you are alive.

The concern that vascular problems lead to vascular dementia is also why researchers often tell people that activities which help your heart will also lower your dementia risk. If vascular dementia accounts for 40% of dementia cases, then any behaviors which hurt your heart will also increase your risk of developing vascular problems in other parts of your body, especially the brain.  Conversely, what is good for the heart is also good for the brain.  Living a heart healthy lifestyle can also improve your brain health. One excellent book you may want to read can be found here:  "Prevent and Reverse Heart Disease - The Revolutionary, Scientifically Proven, Research Based Cure"

While I encourage you to read the book, the bottom line is that getting exercise, eating healthy unprocessed foods, following the advice of your cardiologist or internist about taking statins and other heart medicines, getting adequate sleep, continuing to learn new things, AND taking a multi-vitamin can help you postpone or prevent vascular dementia, and may also reduce your risk of some other types of dementia, as well.   

You can also learn more about the 90+ Study at www.90study.org and can look for Dr. Claudia Kawas and the 90+ Study on YouTube.  Their research is fascinating.

One way I have learned to keep myself mentally sharp and resilient has been by learning new things, writing posts on my blog, setting up an Etsy store and designing products for it. I think that it is important that everyone over the age of 60 continues to have creative and mentally challenging activities in order to remain sharp.  I also take the advice of Dr. Kawas and other researchers by getting regular exercise, sleeping 7+ hours a night, eating healthy foods, taking my prescribed medications and recommended vitamins, and staying active.

You can find gifts for retirees and others at my Etsy Store, DeborahDianGifts.

  http://www.etsy.com/shop/DeborahDianGifts

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Photo credits: Dr. Claudia Kawas at UCI, Amazon book cover, and my Etsy Store

Dementia and Alzheimers Symptoms Vary Widely

Over the past year, my husband and I have spent time with two relatives who were deep in the depths of dementia.  In both cases, their situation was tragic, although their symptoms were very different.  As a result, I thought it would be helpful for my readers to know more about the different symptoms and stages of dementia so they can be more aware of the symptoms when they begin to see them in their loved ones.

Below are two personal examples of what can happen when people get dementia, followed by the Alzheimer's Association list of the symptoms of dementia at different stages.

The Alzheimer's Disease of My Mother

In the first case, my mother's late-stage dementia reached the point where she became very suspicious and uncomfortable around people she did not see on a daily basis.  Although my mother and father lived with my sister and her husband during the last three years of my mother's life, she tended to be very unhappy during much of that time, especially whenever my sister had friends visit. 

My mother is the woman in the photo above and seemed the happiest when she was only surrounded by family. She would tell other people she wanted them to leave and that she did not want them in "her" house.  In one case, she even hit a man in the face with her fist when he came to trim the hedges.  Fortunately, she was so frail that her punch was harmless, although unexpected.  Before dying from her dementia, combined with congestive heart failure, she had reached the point where she needed constant care, could no longer walk or eat on her own, and seemed unaware of her surroundings.

The Dementia of My Sister-in-Law

In the second case, my husband's older sister moved into an assisted living community a year ago when she became lost several times in the gated community where she had lived for 25 years.

We recently visited her for a few days at her new assisted living community. It was sad to realize she did not remember the names of her grandchildren and great-grandchildren.  She did not remember that she used to play golf with us or walk on the beach with her dog.  She did not remember trips she took or special events such as family weddings.  She no longer has any hobbies.  She rarely watches television, plays the piano, or participates in any activities at her assisted living community.

She was unaware of what was happening in the world outside her community. She could not name one thing she did during the day, although her physical health was good and she was able to walk around easily. Both days we visited her, she was wearing jeans and a heavy sweater, although the temperature was nearly 90 F.  However, she was friendly and gracious.  She genuinely seemed to enjoy our visit, although she probably did not remember it after we left.  She happily showed us around her community, although she got lost walking the 100 yards from her cottage to the swimming pool.  She was very cheerful, and did not seem at all fearful or distressed to be around other people.  She realized that her memory was not very good, but laughed it off.

After these two visits, I began to wonder about the different forms dementia could take.  The information I learned from the Alzheimer's Association is listed below.  It helped me understand that my mother and sister-in-law were in different stages of their dementia.  The symptoms listed below may help other people understand what is going on with their loved ones.

Diagnosing Dementia

One question people often have is the difference between dementia and Alzheimer's Disease.  Dementia describes a spectrum of illnesses which cause memory or thinking problems.  Alzheimer's is the most common and is thought to be responsible for approximately 70 percent of cases, but it is not the only cause of dementia.  For example, after a stroke, a patient may develop vascular dementia.  Dementia can also be a result of a variety of illnesses including Parkinson's disease, Huntington's Disease, Creutzfeldt-Jakob disease, Lewy Body, hydrocephalus, and combinations of different diseases.  It is possible for someone to have more than one type of dementia at the same time. 

In order for someone to be diagnosed with dementia, they must be impaired in at least two of the following areas, according to alz.org, the website for the Alzheimer's Association:

* Memory
* Communication and language
* Ability to focus and pay attention
* Reasoning and judgment
* Visual perception

The Alzheimer's Association website said they "may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood."

Those symptoms were certainly true for both my mother and sister-in-law.  While both had been very capable women throughout most of their lives, dementia caused them to lose the ability to handle their finances, safely drive a car, or take care of themselves, even before their memory loss became severe.

Common Symptoms of Dementia

Early Stage:

Difficulty remembering names of new people
Trying to remember the right word
Forgetting what you have just read
Losing important items
Disorganization
Difficulty with common tasks

(Many people may identify with some or all of these symptoms, which is one reason why it is so difficult to diagnose dementia in its early stages.  Someone with early stage dementia or mild cognitive impairment may never get worse, or they could be at the beginning of more severe dementia.  It is difficult to predict.)

Moderate Stage:

Forgetting your own past history, address, or phone number
Becoming moody, withdrawn or frustrated
Dressing incorrectly for the season or situation
Trouble controlling bladder and/or bowels
Changing sleep patterns
Wandering and becoming lost
Personality changes such as becoming suspicious, having delusions, or exhibiting compulsive behaviors

(During this stage, my mother became suspicious and moody; my sister-in-law dressed incorrectly for the weather. Both forgot large pieces of their personal history, and became lost easily.)

Late Stage:

The need for constant personal care
Loss of awareness of surroundings and experiences
Diminished physical abilities such as walking, sitting or even swallowing
Difficulty communicating
Lower immunity to infections such as pneumonia

(My mother was in this stage during the few months before she died. During the last few days, she could no longer swallow or communicate. My sister-in-law has not yet reached this stage, but ultimately she probably will.)

Dementia is a frightening illness and a slow, tragic way for your life to end ... unable to remember your own past or your connection to loved ones.  However, research is ongoing and there are medications which can sometimes slow down the symptoms.  If you suspect that you or a loved one could be showing signs of dementia, talk to a doctor right away.

For more information about common medical issues as we age, financial planning, where to retire, Social Security, Medicare and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

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Stanford Research on Alzheimers

Many experts believe that if someone lives long enough, it is virtually inevitable they will develop some type of dementia, most likely Alzheimer's.  While many of us express the desire to live a long, healthy, active life, very few of us like the idea that Alzheimer's will be a part of that scenario.

The University of California - Irvine has been studying people who are 90+ or the "oldest of the old" for over 30 years, and the results of their research has been included in this blog.  Meanwhile, Stanford University and several other well-known research universities have been doing their own research on Alzheimer's and dementia.

Dr. Frank Longo, chairman of the Department of Neurology and Neurological Sciences at Stanford University, heads up their research into treatments for Alzheimer's.  So far, although over 200 Alzheimer's drugs have been developed and tested in the U.S. since 2000, none of them have proven successful at stopping or reversing this disease. In a few cases, some of the drugs have shown a little promise in relieving the worst problems related to memory loss and confusion.  However, much more needs to be done.

Dr. Longo is frustrated by their limited success.  He reports, "My biggest frustration is that we've cured Alzheimer's in mice many times.  Why can't we move that success to people?"

Longo is now studying a drug known as LM11A-31 (or C31) that shows promise.  Rather than trying to erase the plaques of amyloid that seems to be present in most cases of Alzheimer's, this drug attempts to keep brain cells strong enough that, hopefully, they will be protected against neurological onslaughts, whether they are caused by amyloids or other factors.  This is a new, but important approach, because about 30 percent of people over 70 have amyloid in their brains but no signs of dementia.  In addition to amyloids, another Alzheimer's related protein is called tau.  Tau usually appears in the late stages when memory, organized thinking, and language have already begun to decline.

Approximately 1/3 of Americans over the age of 85 already are afflicted with Alzheimer's.  Around the world, 50 million people are living with some form of dementia.  Within 20 years, that number is expected to double.  Within three years, the global cost of caring for people with dementia could reach over $1 trillion.

Doctors are now able to do brain scans that can identify whether or not someone has amyloid deposits or tau in the brain.  However, they do not have a way to remove either problem, even if they see it in the scan.  That is why Longo's drug, C31, could be game changing.  If this drug is able to successfully slow down or stop the deterioration of nerve cells, it could enable doctors to prevent some of the damage caused by the amyloid in the brain. In mice, this drug has even been able to reverse some of the damage that has already been done ... although researchers are not sure if it can restore lost memory.

Other avenues of research are also being pursued.  For example, researchers at the Rush Alzheimer's Disease Center have discovered that people who have higher levels of a nerve-growth factor called BDNF tend to retain their cognitive functions longer, even when amyloid builds up.  Those who have the most BDNF saw a 50 percent slower rate of cognitive decline.  So far, there are no drugs that will boost a person's BDNF levels, although that is another avenue of exploration.

While more research needs to be done, these studies at Stanford and other locations are encouraging.

You may also want to read more about the University of California at Irvine's 90+ Study on the Oldest of the Old.

Source:

"Alzheimer's From a New Angle," Time Magazine, Feb. 29, 2016.

Interested in more information about aging, health, where to retire or financial planning?  Use the tabs or pull down menu at the top of this article to find links to hundreds of additional helpful articles related to retirement and aging.

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Is It Alzheimers or a Treatable Disease?

One of the biggest fears most of us will have as we get older is that we may develop Alzheimer's Disease or another form of dementia.  Every time we lose our keys, forget a friend's name, or can't remember why we entered a room, we worry that this could be the beginning of our mental decline.

Baby Boomers take vitamins, get exercise, work crossword puzzles and play video games, all in an attempt to do everything they can to ward off dementia.  The good news is that these efforts can sometimes be successful at slowing down our mental decline. 

However, did it ever occur to you that your forgetfulness, brain fog and periodic bouts of confusion may actually be caused by a treatable disease? The problem comes in determining which cases can be treated and which cases cannot.


While we all dread receiving a diagnosis of Alzheimer's or dementia, sometimes our memory loss and mental confusion is actually caused by a treatable illness and none of us would want our doctors to overlook this possibility!

According to the April, 2014 AARP Bulletin, in an article entitled "Am I Losing My Mind?" there are at least eight health issues that can "masquerade as dementia."  If you suspect that one of these problems could be causing your memory loss, you will want to have your doctor test you for them.

Eight Treatable Causes of Memory Loss and Confusion

Normal Pressure Hydrocephalus (NPH) - Fluids are putting pressure on your brain.  This problem may be corrected with a shunt.

Medications - If you become forgetful, especially after taking a new medicine, tell your doctor about all your medications and supplements; you may be having a reaction and a simple adjustment could restore clear thinking.

Depression or other mental health problems - Depression, anxiety, bi-polar disorder and similar mental illnesses can cause us to lose focus and have trouble thinking clearly.  Medications, exercise and/or cognitive therapy may be able to  resolve the issue.

Urinary Tract Infection (UTI) This one was a surprise!  However, infections of any kind, including UTI's may be asymptomic.  This means you may not realize you have an infection. However, once discovered, it can be treated with antibiotics and lifestyle adjustments.  Infections, especially UTI's, are a common cause of foggy thinking.

Thyroid disease - Although it can be detected with an easy blood test, many people go years without having their thyroid disease detected.  Once discovered, it can be treated with medication or, in some cases, surgery.  Symptoms include depression, foggy thinking, weight gain and feeling cold.  If you are experiencing these problems, be sure to have your thyroid checked.

B-12 deficiency - This is a type of anemia that cannot be treated with iron; however, injections of B-12 about once a month can make a tremendous difference in helping you to think more clearly and have more energy.

Diabetes - This is a very serious disease which, if left untreated, can even result in death.  It is important to catch and treat this disease early in order to reduce its affect on the brain

Alcohol abuse - It is amazing how many physicians do not consider the possibility of alcohol and drug abuse when they are attempting to diagnose the cause of dementia.  While the dementia can sometimes be resolved by simply abstaining from alcohol, in some cases it may be necessary to reverse the brain damage by using thiamine replacement therapy or similar treatments.  It is encouraging, however, to know that there are treatments that may make a significant difference in how clearly you think, even after years of alcohol abuse.

If you suspect that one of these issues could be causing memory loss for you or someone you love, make sure that you or your loved one receives all the possible tests and treatments.  Do not assume that dementia cannot be reversed and do not give up your quest for an alternate diagnosis too soon.  None of us want to suffer for years from a problem that could have been easily treated if it had been caught earlier.

Sources:

"Am I Losing My Mind?" AARP Bulletin, April 2014, pgs. 18-20

http://video.aarp.org/video/Treatable-Causes-of-Memory-Loss

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