Image courtesy of cessable

For better quality of life as you age it’s important to keep the fire burning, according to a new study published in the Journal of the American Geriatric Society.

Researchers at the Stein Institute for Research on Aging at UC San Diego looked at data from 1,235 post-menopausal women participating in the Women’s Health Initiative (WHI) study. The women were asked questions about their health, both physical and mental, as well as sexual activity and functioning.

Though aging was associated with an expected decline in physical health and sexual frequency, overall sexual satisfaction did not decline with age. Additionally, having a satisfying sex life was also associated with indicators of successful aging and high quality of life.

“Feeling satisfied with your sex life—whatever you levels of sexual activity—is closely related to your perceived quality of life,” says Wesley K. Thompson, co-author of the study. “While we cannot assess cause and effect from this study, these results suggest that maintaining a high level of sexual satisfaction may positively reinforce other psychological aspects of successful aging.”

Is it time to start bringing home flowers and candles in addition to the extra calcium and fish oil supplements? Let’s hope so.

Meditation is associated with stronger connections between brain regions. Photo courtesy of R_x - renee barron.

Meditation is the practice of focusing your mind on a single thought or idea for an extended period of time in order to achieve some benefit. The goals of meditation can vary and include increased focus, increased awareness or “presence,” better memory, decreased stress and achieving a state of enlightenment. Physiological advantages have also been reported, such as decreased blood pressure and pain reduction.

Though meditation has been practiced all over the world for thousands of years, the mechanism by which it works is still largely unknown. A recent study published in the journal NeuroImage suggests that mediation may work by strengthening the connections between brain regions, thereby building more robust neural networks.

The study compared age and gender matched meditators with non-meditators. Researchers used a method called diffusion tensor imaging (DTI) that detects the size and direction of white matter tracts in the brain. White matter is made up of long neuronal processes called axons that transmit information from one area of the brain to another. DTI is used to measure the integrity of white matter tracts and is thought to indicate the strength of neural connections.

Meditators had stronger DTI measures than non-meditators, particularly in the corticospinal tract (axons from the brain to the rest of the body), the superior longitudinal fasciculus (connections between executive brain areas and sensory regions) and the uncinate fasciculus (connects executive brain areas to emotion and memory regions). Meditators also seemed to have less age-related degeneration.

Though this was not a randomized controlled trial and cannot determine if mediation was the cause of the structural changes, this study opens a new area of research for exploring the role of meditation and brain training in strengthening and preserving the neural connections necessary for memory and other important cognitive tasks.

Exercise prevents the shortening of telomeres caused by psychological stress. Image courtesy of mikebaird.

New research by Nobel Prize winning UCSF researcher, Elizabeth Blackburn, provides a possible mechanism by which exercise protects against stress-related chromosome aging.

The findings, presented this month at the American Association for Cancer Research 102nd Annual Meeting, were based on earlier research showing that stress accelerates telomere shortening. Telomeres are protective strands of DNA found on the end of chromosomes that protect them from degradation during cell division. Telomere length is associated with cellular health, and is a known marker of cell aging.

Shorter telomeres are associated with cell death and chromosome instability, which can lead to inflammation. In immune cells, short telomeres can predict poorer prognosis in patients with heart disease and cancer.

In a previous study by Blackburn, psychological stress was associated with shorter telomeres in the lymphocytes of caregivers of chronically ill children. This was the first demonstration that telomere length is correlated to perceived stress. In the current study, co-authored by biochemist Jue Lin, telomere length was again associated with stress levels, this time in primary caregivers looking after a family member with dementia. However when the researchers looked at the immune cells in those who exercised, there was no association between stress and telomere length.

Another study, led by Eli Puterman, examined the impact of exercise on the telomeres of healthy women who had been victims of child abuse. In this study those who exercised were protected against the effects of stress on telomere length.

“We saw a relationship between childhood trauma and short telomere length but the relationship seems to go away in people who exercise vigorously at least three times a week,” said Lin in a press release.

Exercise is known to beneficially impact immune function and several other aspects of health. This new research illuminates on one possible mechanism by which physical activity exerts its helpful effects.

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Another promising dietary supplement fails to deliver protection against a target disease, this time Alzheimer's. Image courtesy of outcast104.

Another promising dietary supplement fails to deliver protection against a target disease, this time Alzheimer's.

DHA (or docosahexaenoic acid for the geekier among you) is an omega-3 fatty acid that is abundant in the brain. Epidemiological studies have suggested that people who consume more DHA from fish have a lower incidence of Alzheimer's disease. Further, DHA supplementation has improved markers of cognitive impairment in mouse models of Alzheimer's disease.

Scientists speculated that DHA supplementation may be beneficial in treating cognitive decline because previous research has suggested that among all omega-3 fatty acids, DHA was the only one associated with a reduced incidence of impairment. Also, the other major omega-3 fatty acid found in fish, eicosapentaenoic acid (EPA), is not present in the human brain, whereas DHA is abundant.

The study, published in JAMA, was a collaborative effort by scientists from the Oregon Health and Science University, UC San Diego, Yale, UC San Francisco, NYU and others. It was a randomized, double-blind, placebo-controlled trial of DHA supplementation in patients with mild to moderate Alzheimer's disease.

The researchers found no benefit of 2 g/day DHA supplementation on cognitive performance on the Alzheimer's Disease Assessment Scale (ADAS) or Clinical Dementia Rating (CDR) compared to placebo. There was also no measurable benefit of DHA on brain volume, which typically declines with Alzheimer's progression.

Though this research does not rule out a benefit of DHA on cognitive health, it does not bode well for regular supplementation. The treatment lasted for 18 months and cognitive changes were detected in both groups. So if DHA had any effect on the rate of cognitive decline it should have been apparent.

It is possible that beginning DHA treatment after early signs of Alzheimer's have already been detected is too late for any meaningful protection offered by DHA. Maybe some benefit would have been found if the treatment began in healthy adults before symptoms of cognitive decline developed.

It may also be that DHA is beneficial, but is not effective in supplement form. DHA is very vulnerable to oxidative damage, and some research has shown that it provides more cognitive benefit when co-administered with an antioxidant (lutein) to protect it. DHA ingested in the form of food (fish) would not be subject to the same level of oxidative degradation, which may explain the results seen in epidemiological data.

It is not uncommon for supplements to fail to replicate epidemiological benefits seem from foods, and more careful studies are needed to determine the nutritional benefit, if any, of DHA on cognitive aging.

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"There's a long list of concerns that people have raised about the effects of chronic HIV infection on different health outcomes," says Dr. Paul Volberding, who as a co-chair of San Francisco's Center for AIDS Research is bringing together this group of scientists. UCSF/San Francisco General Hospital cardiologist Priscilla Hsue, for example, has found that HIV-positive patients (the patients she sees in San Francisco are mostly men) have heart attacks when they're around 50 years old. That's 10 years earlier than when your average, uninfected, man has a heart attack.

Other researchers have found that HIV-infected patients develop dementia younger and kidney failure at a faster rate than their uninfected peers. Volberding says that these patients are also showing accelerated bone loss and accelerated loss of their kidney function. These are all ways in which our bodies normally decline as we age. But in patients with HIV, the decline seems to be faster.

At the beginning, researchers believed that anti-retroviral drugs were causing the aging, but as research has progressed, the thinking has shifted. "The more nuanced recognition now is that maybe some of that was from the drugs," says Volberding, "but maybe some of it was because the drugs were working and patients were living longer and allowing us to see these other effects of chronic viral infection." Even though anti-retroviral drugs can bring the amount of virus in the body down to almost undetectable levels, there is always a tiny amount of HIV replicating inside a patient's body. And Volberding and others believe that this virus could be responsible for the sped-up aging.

UCSF molecular biologist Elizabeth Blackburn, another member of this new group, has spent her life studying the tips of our chromosomes, called our telomeres (pronounced TEAL-oh-meres), and the role they play in aging. Blackburn has found that as we age, our telomeres wear away and shorten. She has studied the telomeres in patients with heart disease and cancer, and now she wants to look at HIV patients' telomeres.

Listen to the Graying of HIV radio report online.

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This is the second of two stories born out of an afternoon at UCSF's Memory and Aging Center, where a team of scientists, led by Dr. Bruce Miller, is trying to tease out the differences between as many as 200 dementias that affect aging brains.

The two stories have a lot in common: Both introduce us to people who have lived with extremely difficult degenerative diseases: ALS in "Decoding the Emotional Brain," and frontotemporal dementia in this week's story. Both open up provocative questions about human nature. And neither would have happened without the generosity of a Northern California family – in this case, Cassandra Shafer, who drove down from Forestville with her daughter, Columbia, to tell me about Cassandra's husband and Columbia's father, Keith Jordan.

In these video clips, you meet Keith Jordan in the second half of his disease, after doctors at UC Davis and UCSF diagnosed him with frontotemporal dementia. The videos were taken at UCSF over the course of many hours doctors spent studying Keith and his symptoms. In them, we glimpse of two of Keith's FTD-caused obsessions: joke telling and music. (We also see one of the first symptoms to have emerged: his Jerry Garcia hairdo.)

At first glance, Keith's behavior might strike you as more eccentric than brain-damaged, which is precisely why FTD can take so long to diagnose. If you're a doctor with a 15-minute appointment slot, frontotemporal dementia might just look like a midlife crisis. What we don't see in the video clips are the five heartbreaking years that Cassandra spent trying to figure out what was happening to her husband – a search that included marriage and career counseling, the full gamut of conventional western specialists, yoga, meditation, chelation therapy, replacing every household cleaning product, every pot and pan, all the way to shamanic soul retrieval and exorcism – all while his behavior grew more erratic and difficult to be around. It's impossible to overstate the drain – both emotional and financial — that this search brought on Keith's family.

Keith died in May and Cassandra is still, she says, "inching her way" out of the "foreign land" that FTD plunged her into. As unlikely as it sounds, I think she takes some comfort in the fact that Keith's illness also gave doctors a chance to explore profound questions about human nature and the extent to which the structure of our brains determines who we are.

FTD can turn Democrats into Republicans, and vice versa. People with no interest in art begin to paint obsessively. As the neurons in Keith's right frontotemporal lobe (just behind the right eyebrow) died, his taste in music, his sense of humor, his relationships with his family members and friends changed completely. Our self, in other words, may owe much more to the way our brains are built than we'd care to acknowledge.

And what to make of the fact that this same part of the brain that shapes personality is also responsible for reading other people's reactions? People with some forms of FTD can't empathize with others (hear more about this in our slide show about FTD and art) or read the emotion on another person's face. Not only do they experience radical personality changes, but they lose the ability to sense others' reactions to them. In other words, how we define ourselves – whether we consider ourselves funny, smart, ambitious — seems to have everything to do with how others define us. We are all, in other words, people people.

Which begs the question: What about people raised in isolation, without the critical feedback loop of social interaction? What does FTD tell us, for example, about children who have been deeply neglected in orphanages? Or – taking another angle entirely — autistic people, who have trouble empathizing with others? What does self-perception look like in those who can’t perceive those around them?

If all this is giving you a headache, you might spend some time exploring the web extras we've produced for these two stories. Here, Bruce Miller explains why frontotemporal dementia can bring with it an artistic renaissance. And here, we introduce you to Matt Cheney and find out what his compulsive laughing and crying jags might reveal about emotion and the human brain.

Then use our blog, below, to let us know what you think.

Listen to the Beyond Alzheimer's radio report online, and watch our Web Extra: Dementia and Artistic Renaissance slideshow.

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