STRATEGY PROPOSED FOR PREVENTING DISEASES OF AGING
From the News Desk of Jeanne Hambleton Embargo expired: 23-Jul-2014 1:00 PM EDT
Source : Washington University in St. Louis Citations Nature, vol. 511 (7510), pp. 405-406
Newswise — Medicine focuses almost entirely on fighting chronic diseases in a piecemeal fashion as symptoms develop. Instead, more efforts should be directed to promoting interventions that have the potential to prevent multiple chronic diseases and extend healthy lifespans.
Researchers writing in the journal Nature say that by treating the metabolic and molecular causes of human aging, it may be possible to help people stay healthy into their 70s and 80s.
In a commentary published July 24 in Nature, a trio of aging experts calls for moving forward with preclinical and clinical strategies that have been shown to delay aging in animals. In addition to promoting a healthy diet and regular exercise, these strategies include slowing the metabolic and molecular causes of human aging, such as the incremental accumulation of cellular damage that occurs over time.
The researchers, at Washington University School of Medicine in St. Louis, Brescia University in Italy, the Buck Institute for Aging and Research and the Longevity Institute at the University of Southern California, write that economic incentives in biomedical research and health care reward treating disease more than promoting good health.
“You do not have to be a mathematician or an economist to understand that our current health care approach is not sustainable,” said first author Luigi Fontana, MD, PhD, professor of medicine and nutrition at Washington University and Brescia University.
“As targeting diseases has helped people live longer, they are spending more years being sick with multiple disorders related to aging, and that’ is expensive,” said
The diseases of old age — such as heart failure, diabetes, arthritis, cancer and Alzheimer’s disease — tend to come as a package, the researchers write. More than 70 percent of people over age 65 have two or more chronic diseases. But, they noted, studies of diet, genes and drugs indicate that interventions targeted to specific molecular pathways that delay one age-related disease often stave off others, too.
“Heart failure does not happen all at once,” Fontana said. “It takes 30 or 40 years of an unhealthy lifestyle and activation of aging-related pathways from metabolic abnormalities such as high blood pressure, high cholesterol and type 2 diabetes to give a person heart failure in his 60s. So we propose using lifestyle interventions — such as a personalized healthy diet and exercise program — to down-regulate aging pathways so the patient avoids heart failure in the first place.”
His own research has highlighted potential benefits from dietary restriction in extending healthy life span. He has found that people who eat significantly fewer calories, while still getting optimal nutrition, have “younger,” more flexible hearts. They also have significantly lower blood pressure, much less inflammation in their bodies and their skeletal muscles function in ways similar to muscles in people who are significantly younger.
Fontana and his co-authors also point out that several molecular pathways shown to increase longevity in animals also are affected by approved and experimental drugs, including rapamycin, an anticancer and organ-rejection drug, and metformin, a drug used to treat type 2 diabetes.
Numerous natural and synthetic molecules affect pathways shared by aging, diabetes and its related metabolic syndrome. Also, healthy diets and calorie restriction are known to help animals live up to 50 percent longer.
But it has been difficult to capitalize on research advances to stall aging in people. Fontana and his colleagues write that most clinicians do not realize how much already is understood about the molecular mechanisms of aging and their link to chronic diseases. And scientists do not understand precisely how the drugs that affect aging pathways work.
Fontana and his colleagues contend that the time is right for moving forward with preclinical and clinical trials of the most promising findings from animal studies. They also call for developing well-defined endpoints to determine whether work in animals will translate to humans. They are optimistic on that front because it appears that the nutrient-sensing and aging-related pathways in humans are very similar to those that have been targeted to help animals live longer and healthier lives.
But challenges abound. The most important change, they argue, is in mindset. Economic incentives in biomedical research and health care reward treating diseases more than promoting good health, they note.
“But public money must be invested in extending healthy lifespan by slowing aging. Otherwise, we will founder in a demographic crisis of increased disability and escalating health care costs,” they write in Nature.
“The combination of an aging population with an increased burden of chronic diseases and the epidemic of obesity and type 2 diabetes could soon make healthy care unaffordable for all but the richest people,” Fontana added.
Fontana, L. Kennedy BK, Longo V. Treat ageing: prepare for human testing. Nature, vol. 511 (7510), pp. 405-406. July 24, 2014
Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.
Aging experts urge more focus on disease prevention to promote a long and healthy lifespan. Strategies include a healthy diet, exercise and possibly manipulating molecular pathways that slow aging.
Washington University BioMed Radio
Some researchers are proposing that changing how medical care is delivered could help prevent multiple chronic diseases and extend healthy lifespan. The idea, they argue, would be to target the molecular pathways that slow aging as a way to prevent the diseases many of us develop later in life. Jim Dryden reports…
ALZHEIMER’S DETECTION, 20 YEARS IN ADVANCE
Noninvasive retinal imaging device detects Alzheimer’s 20 years in advance
From the FMS Global News Desk of Jeanne Hambleton Posted on July 22, 2014 Stone Hearth News
Device could be FDA-approved by 2015 and early signs of Alzheimer’s could be detected in a regular ophthalmologist exam
Cedars-SinaI Medical Center researchers have developed a noninvasive retinal imaging device that can provide early detection of changes indicating Alzheimer’s disease 15 to 20 years before clinical diagnosis.
“In preliminary results in 40 patients, the test could differentiate between Alzheimer’s disease and non-Alzheimer’s disease with 100 percent sensitivity and 80.6 percent specificity, meaning that all people with the disease tested positive and most of the people without the disease tested negative,” said Shaun Frost, a biomedical scientist and the study manager at the Commonwealth Scientific and Industrial Research Organisation (CSIRO), Australia’s national science agency.
Keith Black, MD, professor and chair of Cedars-Sinai’s Department of Neurosurgery and director of the Maxine Dunitz Neurosurgical Institute and the Ruth and Lawrence Harvey Chair in Neuroscience, said the accumulation of beta-amyloid plaque in the brain is a hallmark sign of Alzheimer’s, but current tests detect changes only after the disease has advanced to late stages.
Researchers believe that as treatment options improve, early detection will be critical, but existing diagnostic methods are inconvenient, costly and impractical for routine screening.
“PET scans require the use of radioactive tracers, and cerebrospinal fluid analysis requires that patients undergo invasive and often painful lumbar punctures, but neither approach is quite feasible, especially for patients in the earlier stages of disease,” he said. Positron emission tomography, or PET, is the current diagnostic standard.
“A few years ago, we discovered at Cedars-Sinai that the plaques associated with Alzheimer’s disease occur not only in the brain but also in the retina.”
Common curcumin spice marks plaque in the retina
“By ‘staining’ the plaque with curcumin, a component of the common spice turmeric, we could detect it in the retina even before it began to accumulate in the brain. The device we developed enables us to look through the eye — just as an ophthalmologist looks through the eye to diagnose retinal disease — and see these changes.”
This clinical trial was designed to enable researchers to correlate retinal plaque detected by optical imaging with brain plaque detected by PET scans. Studies involved three groups: patients diagnosed with Alzheimer’s, a group with mild cognitive impairment, and a group of people with no evidence of brain abnormality.
“This large double-blind clinical trial appears to validate our novel human retinal amyloid imaging approach using curcumin labeling. It further demonstrates significant correlation with brain amyloid burden, thereby predicting accumulation of plaques in the brain through the retina,” said Koronyo-Hamaoui, a faculty principal investigator and head of the Neuroimmunology and Retinal Imaging Laboratory at Cedars-Sinai.
FDA approval in 2015 sought
One goal of the research is to “detect the changes of Alzheimer’s disease as early as possible so that as treatment approaches improve we will be able to provide interventions before cognitive deficits appear — in other words, before too much irreversible damage has been done,” Black explained to KurzweilAI in an email interview.
“A second goal is to develop a method for monitoring the effectiveness of treatments. We believe retinal imaging may make both of these goals possible. The retina is actually part of the central nervous system, and we have shown that Alzheimer’s-associated amyloid accumulates in the retina even before it affects the brain. This appears to give us a way to predict Alzheimer’s changes in the brain before they occur, and it may give us a simple and cost-effective way to gauge disease progression and treatment benefit.
“We are aiming for FDA approval in 2015.”
The optical-imaging technology has been licensed by Cedars-Sinai to NeuroVision Imaging LLC for further development. “Potentially, this could be a 20-minute test which you could get when you go to your ophthalmologist for your regular eye screening,” Black, who is chairman of the company, said in the video.
The retinal imaging study is being conducted as part of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging, often referred to as AIBL, a longitudinal research cohort with more than 1,300 subjects. It is a collaborative effort of Austin Health, the CSIRO, Edith Cowan University, the Florey Institute of Neuroscience and Mental Health and the National Aging Research Institute, with NeuroVision Imaging LLC providing image processing, and data collection and analysis support for the retinal imaging substudy.
The researchers presented their findings July 15 at the Alzheimer’s Association International Conference 2014 in Copenhagen.
5 THINGS TO KNOW ABOUT COMPLEMENTARY HEALTH PRACTICES FOR COGNITIVE FUNCTION, DEMENTIA, AND ALZHEIMER’S DISEASE
From the FMS Global News Desk of Jeanne Hambleton
National Center for Complementary and Alternative Medicine (NCCA)
Many people, particularly older individuals, worry about forgetfulness and whether it is the first sign of dementia or Alzheimer’s disease. In fact, forgetfulness has many causes. It can also be a normal part of aging, or related to various treatable health issues or to emotional problems, such as stress, anxiety, or depression. The National Institute on Aging has a lot of information on the aging brain as well as cognitive function, dementia, and Alzheimer’s disease. Although no treatment is proven to stop dementia or Alzheimer’s disease, some conventional drugs may limit worsening of symptoms for a period of time in the early stages of the disease.
Many dietary supplements are marketed with claims that they enhance memory or improve brain function and health. To date, research has yielded no convincing evidence that any dietary supplement can reverse or slow the progression of dementia or Alzheimer’s disease. Additional research on dietary supplements, as well as several mind and body practices such as music therapy and mental imagery, which have shown promise in basic research or preliminary clinical studies, is underway.
Here are 5 things to know about current research on complementary health approaches for cognitive function, dementia, and Alzheimer’s disease.
- To date there is no convincing evidence from a large body of research that any dietary supplement can prevent worsening of cognitive impairment associated with dementia or Alzheimer’s disease. This includes studies of ginkgo, omega-3 fatty acids/fish oil, vitamins B and E, Asian ginseng, grape seed extract, and curcumin. Additional research on some of these supplements is underway.
- Preliminary studies of some mind and body practices such as music therapy suggest they may be helpful for some of the symptoms related to dementia, such as agitation and depression. Several studies on music therapy in people with Alzheimer’s disease have shown improvement in agitation, depression, and quality of life.
- Mindfulness-based stress reduction programs may be helpful in reducing stress among caregivers of patients with dementia. To reduce caregiver stress, studies suggest that a mindfulness-based stress reduction program is more helpful for improving mental health than attending an education and support program or just taking time off from providing care.
- Do not use complementary health approaches as a reason to postpone seeing a health care provider about memory loss. Treatable conditions, such as depression, bad reactions to medications, or thyroid, liver, or kidney problems, can impair memory.
- Some complementary health approaches interact with medications and can have serious side effects. If you are considering replacing conventional medications with other approaches, talk to your health care provider.
Take care. Back tomorow Jeanne