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Aging

Aging, History, Medicine and Literature, Medicine and Society, Stanford News

Stanford humanities scholar examines “the youngest society on Earth”

Stanford humanities scholar examines "the youngest society on Earth"

Young and old faces Over the past decades, our society has undergone a process of “juvenescence” that, according to Stanford professor Robert Harrison, PhD, makes it the “youngest on Earth.” For the first time in human history, he says, “the young have become a model of emulation for the older population, rather than the other way around” (as quoted in Stanford Report). The post-war period “has unleashed extraordinary youthful energies in our species and represents one of the momentous revolutions in human cultural history.”

Harrison is a professor of Italian literature whose new book Juvenescence: A Cultural History of Our Age examines the cultural forces that have brought about this development. The term “juvenescence” draws on the biological concept of neoteny, or the retention of juvenile characteristics through adulthood. Harrison’s research spans literature, philosophy, and evolutionary science.

His basic argument is that “juvenescence” can refer to either a positive or a negative change, and it isn’t clear which more accurately describes our current situation. The positive sense is one of cultural rejuvenation, while the negative one denotes juvenilization. Harrison explains, citing examples from his book:

Rejuvenation is about recognizing heritage and legacy, and incorporating and re-appropriating historical perspective in the present – like the Founding Fathers did when they created a new nation by drawing on ancient models of republicanism and creatively retrieving many legacies of the past… Unlike rejuvenation, juvenilization is characterized by the loss of cultural memory and a shallowing of our historical age.

…I feel ambivalent about where we are culturally in this age of ours.  It is hard to say whether we are on the cusp of a wholesale rejuvenation of human culture or whether we are tumbling into a dangerous and irresponsible juvenility.

Several aspects of our society suggest juvenilization. Most citizens of the developed world today enjoy the luxury of remaining childishly innocent about what they operate, consume, and depend on in daily life, while “in terms of dress codes, mentality, lifestyles and marketing, the world that we live in is astonishingly youthful and in many respects infantile.” Our culture’s emphasis on innovation and change honors the youthful drive that brings renewal and progress, but, without firm roots in the stability and wisdom of older generations and longstanding institutions, this risks being a meaningless chase after novelty. Youth’s genius is a luxury that requires solid foundations.

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Aging, Chronic Disease, Pediatrics, Research

“The child is father of the man”: Exploring developmental origins of health and disease

"The child is father of the man": Exploring developmental origins of health and disease

3801281145_1f3fb2c8bf_z Among scientific communities, there is a small but growing segment of research concerned with “DOHaD” – the developmental origins of health and disease. The work usually focuses on how childhood, including birth, the fetal period, and sometimes even pre-conception events, affects a person’s lifelong health and well-being and is the topic of a recent article (subscription required) published in Pediatrics by researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The phrase “the child is father of the man” is a line from William Wordsworth’s “My Heart Leaps Up” and also the title of the article, whose authors added, commendably, “and the mother of the woman.”

DOHaD gained acceptance within the medical community starting with the “Barker Theory” in 1995, when David Barker, MD, showed that babies with low birth weights were at higher risk for coronary heart disease later in life. Prior to his work, the dominant model was that the health of those who survived childhood without major disease or disability was sort of “reset” in adulthood, to decline from then into old age. This is increasingly understood to be a simplistic model.

Resistance to the idea stems from the fact that links between child and adult health are associative and not proven to be causative; therefore, the article’s authors Alan E. Guttmacher, MD, and Tonse N.K. Raju, MD, call for scientists to do more mechanistic research investigating causation, and “more importantly, to devise treatments and preventions, for the many “adult-onset” conditions that actually are rooted in much earlier exposures and events.” Such research is difficult because of the incredible number of variables that occur over an entire lifespan, and even within the category “perinatal risk factors.”

In the piece, the authors describe the importance of DOHaD and how a better understanding of it could affect pediatrics and health care:

Arguably the most important advance in the health care of children, and in establishing pediatrics as a medical specialty, was the cultural awakening that children were not simply small adults. Ironically, DOHaD greatly expands the impact of pediatrics by reversing that shift and focusing on how children actually are smaller versions of the adults they will become.

Once the biological and behavioral pathways that underlie DOHaD are identified and understood, the role of pediatrics should expand in fundamental and powerful ways. Anticipatory guidance in the future will not be just about the next 6 weeks or 6 months or even 6 years of the child’s life, but the entire life span. The pediatrician and other children’s health care providers will inform parenting and behaviors, including diet and exercise, and even prescribe presymptomatic medication targeted to the individual child. The pediatrician will become the gatekeeper to lifelong health.

Photo by Brad Brundage

Aging, Podcasts

Healthy aging, made easy: A conversation

Healthy aging, made easy: A conversation

Gray hair is sign of wisdom in the Middle East, geriatrician Mehrdad Ayati, MD, writes in the new book “Paths to Healthy Aging,” which he penned with his wife, Azerou (Hope) Azarani, PhD. Born into a family of doctors in Iran, Ayati moved to the United States in his 30s and soon discovered his passion for caring for older folks. The book aims to provide a easily digestible guide to aging, with chapters on mental health, exercise and nutrition.

Ayati recently sat down with Paul Costello, chief communication officer for Stanford’s medical school, for a conversation captured in a 1:2:1 podcast. During the talk Ayati explained why he was motivate to write the book:

One of the major complaints is there’s a lack of valid and easy-to-understand information about aging. They’ve been complaining to me that they’ve being bombarded by a lot of contradictory claims and  a lot of instructions that are very difficult to follow.

Costello also asked Ayati about his transition from Iran to America — older people are treated very differently in those two cultures. Ayati responded:

In my culture, elderly people have a special status in their family, their community and their society. They are considered very sage. They are highly respected by other people… Since they are young, they have a dream to have this status someday in their life.

Ayati likened the Middle Eastern respect for the elderly to America’s love of babies. Both are vulnerable humans, and both need our love and support, Ayati said.

For more information on the book, which also includes a series of questionnaires for readers, visit Ayati’s blog.

Previously: Tick tock goes the clock — is aging the biggest illness of all?, Neighborhood’s “walkability” helps older adults maintain physical and cognitive health and Walking and aging: A historical perspective
Photo by Garry Knight

Aging, Genetics, In the News, Research, Stanford News

“A lot more data” needed to determine what makes supercentenarians live so long

"A lot more data" needed to determine what makes supercentenarians live so long

Scientists from Stanford and elsewhere have been hunting for a genetic explanation for extreme longevity for the past four years and are realizing that it is a more difficult proposition than they initially hoped.

Their research compared the genomes of 17 “supercentenarians” – those who have lived 110 years and beyond – with those of 4,300 “regular” people recorded earlier in a National Institutes of Health study. The study was geared toward finding a single gene or group of genes responsible for a particular trait – in this case longevity – similar to genes which have been found to cause disease or confer immunity. But they have had no luck. Stuart Kim, PhD, a Stanford geneticist and molecular biologist and founder of the Kim Lab for the study of aging, commented in a San Francisco Chronicle piece:

We were looking for a really simple explanation in a single gene, and we know now that it’s a lot more complicated, and it will take a lot more experiments and a lot more data from the genes of more supercentenarians to find out just what might account for their ages.

However, data about the oldest people in the world still suggests that the reason they can live so long has to do with their genes, and not with lifestyle choices. The supercentenarians have average rates of cancer, heart disease, and stroke, although they have escaped many age-related diseases, and their smoking, alcohol, exercise and diet appear no different than among ordinary people. Furthermore, as noted in the article, the parents, siblings and children of the centenarians have also lived well beyond average.

Previously: Unlocking the secrets to human longevity and California’s oldest person helping geneticists uncover key to aging

Aging, Neuroscience, Research

Being bilingual “provides the brain built-in exercise”

Being bilingual "provides the brain built-in exercise"

Spanish_booksWith less than two months left in 2014, many of us will soon begin the annual ritual of selecting our New Year’s resolutions. Those who are looking to boost their brain power may want to consider learning a second language in 2015: Research published today in the journal Brain and Language shows that being bilingual makes the brain more efficient at processing information.

In the study, researchers used functional magnetic resonance imaging (fMRI) technology to examine participants’ brains as they performed language comprehension tests. For example, researchers would say the word “cloud” to individuals while showing them four pictures, including one of a cloud and others of similar-sounding objects, like a clown. To complete the exercise, participants had to recognize the correct photo and ignore the irrelevant images. According to a release, study results showed:

The bilingual speakers were better at filtering out the competing words because their brains are used to controlling two languages and inhibiting the irrelevant words, the researchers found.

The fMRI scans showed that “monolinguals had more activation in the inhibitory control regions than bilinguals; they had to work much harder to perform the task,” [said lead author Viorica Marian, PhD.]

“Inhibitory control is a hallmark of cognition,” said Marian. “Whether we’re driving or performing surgery, it’s important to focus on what really matters and ignore what doesn’t.”

The fact that bilinguals are constantly practicing inhibitory control could also help explain why bilingualism appears to offer a protective advantage against Alzheimer’s and dementia, said Marian.

“That’s the exciting part,” she said. “Using another language provides the brain built-in exercise. You don’t have to go out of your way to do a puzzle because the brain is already constantly juggling two languages.”

The findings add to the growing body of scientific evidence showing that being bilingual can have profound impacts on your brain.

Previously: Study shows bilingualism may enhance attention and working memory and ¿Habla Español? How bilingualism may delay the onset of Alzheimer’s symptoms
Photo by Megan Morris

Aging, NIH, Public Health, Research, Science, Stanford News

Tick tock goes the clock – is aging the biggest illness of all?

Tick tock goes the clock - is aging the biggest illness of all?

3821120232_d1452b4109_zIt’s an uncomfortable truth that aging is the single biggest risk factor for many chronic diseases. It’s also completely out of our control. (The alternative is, well, not so fun to contemplate.) But although we all think we’d like to live longer, longevity in and of itself is not necessarily a good thing. Living longer rapidly loses its appeal if you’re too sick or feeble to really enjoy your extra “golden” years.

But researchers from many scientific disciplines are now working to understand how and why our bodies tend to break down as time passes. The Trans-NIH Geroscience Interest Group (a group of researchers from numerous NIH institutes) interested in aging held a summit in 2013 to explore mechanisms of aging and identify common themes that could serve as research targets. The thought is that understanding, and slowing, aging may be an efficient way to tackle many chronic diseases simultaneously.

Now the group, which includes Stanford geneticist Anne Brunet, PhD; neurologist Tony Wyss-Coray, PhD; and Thomas Rando, MD, PhD, has released the conclusions of the summit and outlined a plan for the work that lies ahead. (Rando is the director of the Glenn Center for the Biology of Aging at Stanford.) Many of the findings focus  on a concept called “healthspan,” which designates the portion of a person’s lifespan in which he or she is relatively healthy and fully functional. From the Cell article:

While life expectancy continues to rise, healthspan is not keeping pace because current disease treatment often decreases mortality without preventing or reversing the decline in overall health.  Elders are sick longer, often coping with multiple chronic diseases simultaneously.  Thus, there is an urgent need to extend healthspan.

The researchers identified seven intertwined “pillars of aging” for targeted research, including adaptation to stress, stem cells and regeneration, metabolism, macromolecular damage, inflammation, epigenetics and a concept called proteostasis, which describes the intricate dance in which proteins are made, transported and degraded within a cell. They suggest the creation of an Aging Research Initiative that works to merge the emerging field of geroscience with research on chronic disease and to search for therapeutic interventions that could extend both lifespan and healthspan.

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Aging, Health and Fitness, Neuroscience, Public Health, Research

Neighborhood’s “walkability” helps older adults maintain physical and cognitive health

Neighborhood’s “walkability” helps older adults maintain physical and cognitive health

3275748024_c4914d4ae0_zLiving in a walkable neighborhood could be an important factor in helping older adults maintain their physical and cognitive health, according to new research from the University of Kansas.

In the small study, researchers monitored a group of adults diagnosed with mild Alzheimer’s disease and compared them to those without any cognitive impairment. Over a two-year period, individuals completed cognitive tests designed to measure attention, verbal memory and mental status. The ”walkability” of participants’ neighborhoods was determined using geographic information systems (GIS). Medical News Today reports:

Results from the study suggest that communities that are easier to walk in are linked to better physical health outcomes – such as lower body mass and blood pressure – and cognition – including better memory.

[Researchers] believe their findings could benefit older adults, health care professionals, caregivers and even architects and urban planners.

Finding also showed that environments with more complex layouts appeared to aid residents in staying mentally sharp, rather than confusing them. Researchers presented their findings over the weekend at the Gerontological Society of America’s annual meeting in Washington, DC.

Previously: Walking and aging: A historical perspective, Even old brains can stay healthy, says Stanford neurologist,  Exercise and your brain: Stanford research highlighted on NIH Director’s blog , Moderate exercise program for older adults reduces mobility disability, study shows and Creating safer neighborhoods for healthier lifestyles
Photo by Ed Yourdon

Aging, Men's Health, Research, Science, Stanford News, Stem Cells

Viva la hedgehog! Signaling protein also shown to be important in prostate growth

Viva la hedgehog! Signaling protein also shown to be important in prostate growth

6111053153_5b14f4570d_zOk, so it may *appear* that this post is just an excuse to post a cute hedgehog picture. After all, who could resist that little face? But this is really meant to be a quick shout-out to Stanford developmental biologist Philip Beachy, PhD, who has shown yet again that the signalling protein called hedgehog is critically important during many aspects of development.

In Beachy’s latest work, published earlier this week in Nature Cell Biology, he and his colleagues show that the precise control of when and where the hedgehog protein is made dictates the branching of tubules in the adult prostate (you may remember other recent work from Beachy’s lab about the role that hedgehog plays in bladder cancer, and what that could mean for patients). The findings of the current research suggest that aberrant hedgehog signalling could play a role in the prostatic hyperplasia, or non-cancerous enlargement of the prostate, which often happens as men age.

Previously: Drug may prevent bladder cancer progression, say Stanford researchers, Cellular culprit identified for invasive bladder cancer, according to Stanford study and Bladder infections – How does your body repair the damage?
Photo by Tiffany Bailey

Aging, Imaging, Ophthalmology, Patient Care, Research, Stanford News

New way to predict advance of age-related macular degeneration

New way to predict advance of age-related macular degeneration

eyeballAge-related macular degeneration, in which the macula – the key area of the retina responsible for vision – begins to degenerate, is the leading cause of blindness and central vision loss among adults older than 65. Some 10-15 million Americans suffer from the disease.

If those numbers don’t scare you, try these: “It affects 14%-24% of the U.S. population aged 65-74 years and 35 -40% of people aged 74 years or more have the disease.” Yow!

Most cases of AMD don’t lead to blindness. But if the disorder progresses to an advanced stage where abnormal blood vessels accumulate underneath the macula and leak blood and fluid, irreversible damage to the macula can quickly ensue if treatment doesn’t arrive right on time.

Timing that treatment just right is a real issue. As I wrote in my recent release about a promising development in this field:

[U]ntil now, there has been no effective way to tell which individuals with AMD are likely to progress to the wet stage. Current treatments are costly and invasive – they typically involve injections of medicines directly into the eyeball – making the notion of treating people with early or intermediate stages of AMD a non-starter. Doctors and patients have to hope the next office visit will be early enough to catch wet AMD at its onset, before it takes too great a toll.

Here’s the good news: A team led by Stanford radiologist and biomedical informatician Daniel Rubin, MD, has found a new way to forecast which patients with age-related macular degeneration are likely to progress to the most debilitating form of the disease – and when.

The advance, chronicled in a study in Investigative Ophthalmology & Visual Science, is a formula – derived from extensive computer analysis of thousands of retinal scans of hundreds of patients’ eyes – that recommends, on a personalized basis,  when to schedule an individual patient’s next office visit in order to optimize the prospect of catching AMD progression before it causes blindness.

The formula predicts, with high accuracy, whether and when a patient with mild or intermediate AMD will progress to the dangerous advanced stage. And it does so simply by crunching imaging data that is already commonly collected in eye doctors’ offices anyway.

“Our technique involves no new procedures in the doctor’s office – patients get the same care they’ve been getting anyway,” Rubin told me. His team just tacked on a sophisticated, computerized image-processing step.

Previously: Treating common forms of blindness using tissue generated with ink-jet printing technology, To maintain good eyesight, make healthy vision a priority and Stanford researchers develop web-based tool to streamline interpretation of medical images
Image courtesy of Daniel Rubin

Aging, In the News, Mental Health, Women's Health

Love your body, love yourself

Love your body, love yourself

10227014165_7e464321d2_zAs someone with not much regard for my body, I can hear my nutritionist cackling with glee at the thought of this post. She’s spent months trying to brainwash me into liking it anyway. I fight back, chafing at the idea.

Now along comes Martha C. Nussbaum, PhD, a leading ethical thinker based at the University of Chicago, saying we should not just like our bodies or merely tolerate our young bodies in their prime. No, she writes in a recent New Republic essay, we should consider our bodies as “dynamic, marvelous, and, more important, just (as) us ourselves.” We should celebrate our bodies with the spirit captured by the 1970s movement Our Bodies, Ourselves, sparked by the book-turned-organization. The alternative is ugly:  Prejudice, bigotry and other social ills will surge when fueled by self-dislike.

Nussbaum mourns the loss of body-embracing spirit: “I fear that my generation is letting disgust and shame sweep over us again, as a new set of bodily challenges beckons.”

Flaccid muscles, graying hair, foreheads creasing with wrinkles. Not yuck, not gross, do not withdraw, do not hide in shame, she writes:

[The poet Walt] Whitman knew that we will not be able to love one another unless we first stop hiding from ourselves—meaning our bodies…

As we age, we are yielding to all the forces we tried, back then, to combat: not only the forces of external medical control, but the more insidious force of self-loathing. Whitman knew that disgust was a social poison. Psychologists studying the emotion today confirm his intuitions about its link with prejudice and exclusion.

If you don’t like yourself, your body, then what must you think of others, Nussbaum questions. Worth pondering, I’ll concede.

Previously: Ask Stanford Med: Director of Female Sexual Medicine Program responds to questions on sexual health, Blogging may boost teens’ self-esteem and Tai chi linked to mental-health boost, but more study is needed
Photo by Jennifer Morrow

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