Although caring for an elderly mother or father is one of the most difficult challenges a person can face, it can also deepen an adult child's respect for the parent and understanding for the role of caregiver. Gifts from the Heart: Meditations on Caring for Aging Parents is the caregiver's companion, a sympathetic guide to the spiritual aspects of an often demanding and exhausting situation. More than 200 meditations offer reflections on ways to embrace one's own growth while coping with the decline of an aging parent.

It is too early to conclude that vitamin E has all the beneficial effects attributed to it, but even if only 25% of current expectations were to be fulfilled, vitamin E would become an important weapon against a range of chronic diseases.

The book is not simply scientific and education but also a please to read.Dimitrios Trichopoulos, MDVincent L. Gregory Professor of Cancer Prevention and Professor of Epidemiology, Harvard School of Public Health

This anthology helps us to meet the challenge of understanding and adjusting to a new stage in life. Through essays, poetry, and short stories, over 50 contributors rabbis, authors, social workers, psychologists share their insights about aging, retiring, caring for their elderly parents, living, loving, learning, and dying.

An extensive resource section includes an annotated bibliography, a guide to services for the aged, and suggestions for ceremonies to mark milestones in the life of senior citizens.

Author: Susan Berrin
Paperback: 384 pages
Company: Jewish Lights Publishing (1999-02)
ISBN: 1580230512
List Price: $18.95
Amazon Price: $3.49
Used Price: $0.19

A step-by-step guide for the millions of baby boomers who want one simple practice for feeling and looking great—yoga!

One in five Americans is now moving toward the age bracket of "sixty and beyond," and while many are calling sixty the "new forty," this milestone is the perfect time to take stock in good health. One form of exercise that is proven to prevent or alleviate a host of physical and mental ailments for the last 5,000 years is yoga.

Now, under the guidance of a qualified and well-known Iyengar yoga teacher, who is also the author of The New Yoga for People Over 50, readers can reap the benefits of yoga with this gentle and clear guide written specifically with today’s baby boomers in mind. Filled with clear instructions, including the use of yoga props and modified poses, plus crisp follow-along photographs, The New Yoga for Healthy Aging takes readers step by step through the asanas (poses) that can prevent or lessen ailments such as osteoporosis, hip fractures, chronic pain, arthritis, Alzheimer’s and Parkinson’s disease. With heartfelt interviews and tips from some of America's most active yoga teachers and their older students—each sharing wisdom, insights and successes—readers will discover a source of inspiration that will help their practice evolve into more than just those moments they spend on the mat.

In this groundbreaking book, Dr. Kilmer S. McCully explains what is really behind the epidemic of heart disease. For many years, clogged arteries have been inaccurately viewed as the cause, rather than a symptom, of heart disease. Now, McCully shows you how to cut your risk of heart disease by controlling the real culprit, homocysteine. Considered one of the most significant medical breakthroughs in recent years, McCully's findings have been validated by numerous large-scale studies. The Heart Revolution:

Challenges the long-held assumption that lowering cholesterol is the key to preventing heart disease

Explains how eating vitamin B-rich food can control homocysteine levels

Lays out a plan with menus for putting more B vitamins in our diet

Discusses how food processing and additives compromise our health

Explains how costly cholesterol-lowering medicines can actually harm our health

Eat Your Way to a Healthy Heart

Pork Chops with Potatoes and Onions, Veal with Wine and Mushrooms, Guacamole, Omelettes. This is not your typical diet program. Dr. McCully offers real food choices with fresh ingredients available just about everywhere. The focus is on delicious foods that will leave you satisfied. The purpose is to make sure you're getting enough of the vitamins needed to prevent heart disease—B6, B12, and folic acid, as well as essential, phytochemicals, fat-soluble vitamins, minerals, antioxidants, and essential oils. It's easy to follow this plan as it relies on foods you want to eat with little preparation time and tons of variety.

More than one million Americans undergo heart bypass surgery and balloon angioplasty every year at a cost of fifty billion dollars. But there is a simple, nonsurgical method to open clogged arteries that is administered in the doctor's office. Chelation therapy works in all the arteries at once, it's much safer, and is much less expensive.

"[This book] has been honed into an elegant compendium. This outstanding work should be widely read -- it is perhaps the best example of an integrative approach to gerontology." Score: 94, 4 stars

--Doody's

This book serves as an authoritative textbook and guide to the physical changes and common pathologies associated with the aging process, with special emphasis on the psychological and social implications of these changes in the lives of older adults. This fifth edition presents the newly available research findings that differentiate "normal" aging from actual pathology.

The authors provide a thoroughly updated and expanded review of important topics in aging, including death and grieving, complementary and alternative therapies, nutrition, exercise, and much more. The book also demonstrates how the elderly population can gain greater personal control over aging through lifestyle modifications and preventive health strategies.

Key topics introduced and discussed: Psychosocial theories of aging Changes and disorders in the skeletal, nervous, cardiovascular, and respiratory systems Dementia, delirium, and mild cognitive impairment Aging in persons with lifelong disabilities

This volume serves as a comprehensive textbook for students studying to become health care professionals, and is also a fundamental resource for gerontologists, nurses, social workers, psychologists, rehabilitation specialists, clergy, and counselors.

Author: Sue V. Saxon PhD, Mary Jean Etten EdD GNP FT , Dr. Elizabeth A. Perkins PhD (c) RNMH
Paperback: 512 pages
Company: Springer Publishing Company (2009-11-09)
ISBN: 082610441X
List Price: $55.00
Amazon Price: $40.49
Used Price: $30.22

In this guide, Stephen Sinatra, M.D., reveals how an explosive combination of the nutrients coenzyme Q10 and L-carnitine--the twin pillars of healing--can have an exciting, positive impact on the cardiovascular system.

Based on exciting new scientific findings from leading institutions, Stop Aging Now! reveals the stunning truth: Much of what we call aging is not inevitable, but is needless and can be prevented and reversed to a startling degree by supplements and foods. Indeed, aging is often due to unsuspected deficiencies that can be readily corrected, and even people in their sixties, seventies and eighties can turn back the clock and recover their youth.

Leading scientists have found that:

Vitamins can prevent and reverse memory loss and other signs of aging.

Vitamins and minerals can rejuvenate immune functions, restoring youthful resistance to infections and cancer.

Antioxidants in foods and supplements can help prevent clogged arteries, heart attacks and general bodily deterioration.

Many unfamiliar but readily available food chemicals can prolong life and preserve your vitality.

Clin Auton Res. 2012 Feb 8;
Kang P, Kloke J, Jain S

OBJECTIVE: Olfactory impairment occurs early in Parkinson's disease (PD), as may dysautonomia. We investigated the relationship between olfaction and dysautonomia as well as other non-motor manifestations of PD. METHODS: Olfaction [University of Pennsylvania Smell Identification Test (UPSIT)], autonomic function in the pupillary (constriction and redilation velocity) and cardiac systems (resting low- and high-frequency heart rate variability (LF and HF HRV), positional changes in systolic blood pressure), neuropsychiatric function [Mini-mental Status Exam (MMSE)], Hamilton Depression Scale, activities of daily living [(ADLs), Schwab and England ADLs scale], quality of life [Short Form-36 health survey, PD Questionnaire 39 (PDQ-39)], and other non-motor symptoms [Non-motor Symptoms Scale (NMSS)] were simultaneously assessed in 33 participants (15 PD, 18 controls). Group comparisons, Spearman's coefficients and non-parametric rank-based regression were employed to characterize relationships between olfaction and non-motor features. RESULTS: Smell scores were lower in the PD group and correlated positively with pupil constriction velocity and HF HRV. Smell scores were correlated negatively with PDQ-39 and gastrointestinal items of the NMSS and positively with MMSE and Schwab and England ADLs. These correlated measures were not significant terms in regression models of smell scores in which age and PD diagnosis were significant and accounted for over half of the variability (R-squared 0.52-0.58). INTERPRETATION: This study suggests olfactory involvement occurs with parasympathetic dysautonomia in the pupillary and cardiovascular systems, involving both age-related and PD-related processes. Other non-motor features are concurrently involved, supporting the notion that aging and PD have widespread effects involving discrete portions of the autonomic and olfactory systems.

Altern Ther Health Med. 2011 Jul-Aug; 17(4): 8-14
Lu WA, Chen GY, Kuo CD

Objective Complementary and alternative medicine (CAM) has long been used by people to postpone the aging process and to reverse disease progression. Reflexology is a CAM method that involves massage to reflex areas in the feet and hands. This study investigated the effect of foot reflexology (FR) on the autonomic nervous modulation in patients with coronary artery disease (CAD) by using heart rate variability analysis. Study Methods Seventeen people with angiographically patent coronary arteries and 20 patients with CAD scheduled for coronary artery bypass graft surgery were recruited as the control and CAD groups, respectively. The normalized high-frequency power (nHFP) was used as the index of vagal modulation and the normalized very low-frequency power (nVLFP) as the index of vagal withdrawal and renin-angiotensin modulation. Results In both control and CAD groups, the nHFP was increased significantly whereas the nVLFP was decreased significantly 30 and 60 minutes after FR, as compared with those before FR. The systolic, diastolic, mean arterial, and pulse pressures were significantly decreased after FR in both groups of participants. In the CAD group, the percentage change in heart rate 30 and 60 minutes after FR was smaller than that in the control, and the percentage change in nVLFP 60 minutes after FR was smaller than that in the control. In conclusion, a higher vagal modulation, lower sympathetic modulation, and lower blood pressure can be observed following 60 minutes of FR in both controls and CAD patients. The magnitude of change in the autonomic nervous modulation in CAD patients was slightly smaller than that in the controls. Conclusion FR may be used as an efficient adjunct to the therapeutic regimen to increase the vagal modulation and decrease blood pressure in both healthy people and CAD patients.

Popul Health Manag. 2012 Feb 7;
Priest J, Buikema A, Engel-Nitz NM, Cook CL, Cantrell CR

Abstract The objective of this cross-sectional, retrospective, claims-based analysis was to evaluate disease-specific quality measures, use of acceptable therapies, and health care cost and utilization among Medicare Advantage Part D (MAPD) enrollees overall and by income/subsidy eligibility status. Individuals aged ≥65 years with evidence of ≥1 of 8 common conditions and continuously enrolled in a MAPD plan throughout 2007 were assigned to low-income/dually eligible (LI/DE) or non-LI/DE cohorts. Quality of care metrics were calculated for asthma, chronic obstructive pulmonary disease (COPD), diabetes, and new episode depression. Persistence (proportion with percentage of days covered ≥80%), compliance (proportion with medication possession ratio ≥80%), health care costs, and utilization metrics were assessed by condition. All measures were evaluated for calendar year 2007. Bivariate comparisons were made between all LI/DE and non-LI/DE subgroups. A total of 183,213 patients were included. Metrics showed deficiencies in quality of care overall but generally favored non-LI/DE patients. The proportion of patients filling acceptable medication was suboptimal for most conditions, ranging from 40% to 96% across conditions and cohorts, with COPD the lowest and heart failure (HF) the highest. LI/DE patients were significantly more likely than non-LI/DE patients to fill acceptable therapy in each disease group (P

Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2012 Feb; 29(1): 38-42
Kang Y, Lao H, Yu X, Chen J, Zhong S

Coronary heart disease is one of the most important causes of death in human, and consumes vast medical resources. Percutaneous coronary intervention (PCI) has been a significant breakthrough for its treatment. However, clinical application has been hampered by in-stent restenosis (ISR). Although drug eluting stent (DES) has reduced the occurrence of restenosis, incidence of ISR is still about 5% to 10%. The main reasons for restenosis after PCI are hyperplasia of vascular endothelial cells and smooth muscle cell migration. The exact mechanism of personalized differences in restenosis is not clear yet, but there may be a variety of risk factors. In addition to aging, smoking and diabetes, an increasing number of studies have found that genetic and epigenetic factors play an important role in ISR. In this article, authors have reviewed genetic and epigenetic factors on the progression of ISR, which may help to determine the genetic risk factors in patients with ISR after PCI.

Chin J Integr Med. 2012 Feb; 18(2): 83-7
Liu Y, Chen KJ

With the arrival of the era of global population aging, we strive for healthy aging and a healthy senior life rather than simple prolongation of the physical age. For the past 50 years, cardiovascular diseases (CVD) have been the most common cause of death among the elderly people globally. In China, there has been an exponential increase in the incidence of heart disease and stroke in the elderly population. Atherosclerosis is the pathological change in the coronary artery disease, stroke, and peripheral vascular disease. Despite the signifificant benefifit demonstrated, control of classic risk factors alone, such as lifestyle change or drug therapy, was shown to have limitations in reducing the incidence of cardiovascular events. Vascular aging has been shown to be an important independent predictor of CVD events. Interventions targeting vascular aging have emerged as a new paradigm in conjunction with control of risk factors for the prevention of CVD. Vascular aging and atherosclerosis are two distinct pathological changes and diffificult to distinguish clinically. Recent research with Chinese medicine (CM) has shown encouraging observations, linking the clinical benefit of delaying vascular aging and treating atherosclerosis. These results demonstrate great potential of CM in the prevention and treatment of CVD.

Am J Physiol Heart Circ Physiol. 2012 Feb 3;
Cooper LL, Odening KE, Hwang MS, Chaves L, Schofield L, Taylor CA, Gemignani AS, Mitchell GF, Forder JR, Choi BR, Koren G

Aging increases the risk for arrhythmias and sudden cardiac death (SCD). We aimed at elucidating aging-related electrical, functional, and structural changes in the heart and vasculature that account for this heightened arrhythmogenic risk. Young (5 - 9 months) and old (3.5 - 6 years) female NZW rabbits were subjected to in vivo hemodynamic, electrophysiologic, and echocardiographic studies as well as ex vivo optical mapping, high-field magnetic resonance imaging (MRI), and histochemical experiments. Aging increased aortic stiffness (baseline PWV: young, 3.54 ± 0.36 vs. old, 4.35 ± 0.28 m/s, p

Cell. 2012 Feb 3; 148(3): 421-33
Park SJ, Ahmad F, Philp A, Baar K, Williams T, Luo H, Ke H, Rehmann H, Taussig R, Brown AL, Kim MK, Beaven MA, Burgin AB, Manganiello V, Chung JH

Resveratrol, a polyphenol in red wine, has been reported as a calorie restriction mimetic with potential antiaging and antidiabetogenic properties. It is widely consumed as a nutritional supplement, but its mechanism of action remains a mystery. Here, we report that the metabolic effects of resveratrol result from competitive inhibition of cAMP-degrading phosphodiesterases, leading to elevated cAMP levels. The resulting activation of Epac1, a cAMP effector protein, increases intracellular Ca(2+) levels and activates the CamKKβ-AMPK pathway via phospholipase C and the ryanodine receptor Ca(2+)-release channel. As a consequence, resveratrol increases NAD(+) and the activity of Sirt1. Inhibiting PDE4 with rolipram reproduces all of the metabolic benefits of resveratrol, including prevention of diet-induced obesity and an increase in mitochondrial function, physical stamina, and glucose tolerance in mice. Therefore, administration of PDE4 inhibitors may also protect against and ameliorate the symptoms of metabolic diseases associated with aging.

J Cell Mol Med. 2012 Feb 4;
Diop SB, Bodmer R

Obesity and cardiovascular disease are among the world's leading causes of death, especially in Western countries where consumption of high caloric food is commonly accompanied by low physical activity. This lifestyle often leads to energy imbalance, obesity, diabetes, and their associated metabolic disorders, including cardiovascular diseases. It has become increasingly recognized that obesity and cardiovascular disease are metabolically linked, and a better understanding of this relationship requires that we uncover the fundamental genetic mechanisms controlling obesity-related heart dysfunction, a goal that has been difficult to achieve in higher organisms with intricate metabolic complexity. However, the high degree of evolutionary conservation of genes and signaling pathways allows researchers to use lower animal models such as Drosophila, which is the simplest genetic model with a heart, to uncover the mechanistic basis of obesity-related heart disease and its likely relevance to humans. Here we discuss recent advances made by using the power of the Drosophila as a powerful model to investigate the genetic pathways by which a high fat diet may lead to heart dysfunction. © 2012 The Authors Journal of Cellular and Molecular Medicine © 2012 Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd.

Circulation. 2012 Feb 1;
Kim JK

Insulin resistance is a major characteristic of type 2 diabetes and develops in multiple organs including skeletal muscle, liver, adipose tissue, and heart(1). Insulin resistance is caused by obesity and therefore establishes an important causal relationship between obesity and type 2 diabetes(2). Insulin resistance also develops in aging, but this process is less well understood. Obesity is a complex physiological state with alterations in lipid metabolism, dysregulated production of hormones, ectopic accumulation of fat, mitochondrial dysfunction, and chronic low-grade inflammation(3,4). All of these abnormalities may independently cause insulin resistance and affect glucose homeostasis, which make insulin resistance as equally complex as obesity itself. (SELECT FULL TEXT TO CONTINUE).

Cardiol J. 2012; 19(1): 45-52
Jeevanantham V, Chughtai H, Little WC, Morgan T, Kitzman DW, Hamilton CA, Hundley WG

Background: During adrenergic stress, the influence of age on left atrial (LA) function is unknown. We hypothesized that aging decreases LA total emptying fraction (LAEF) during maximal adrenergic stress. The aim of the study was to determine the influence of aging on LA function during adrenergic stress in middle aged and older patients. Methods: We enrolled 167 middle aged and elderly participants, and measured LA and left ventricular (LV) volumes using a multi-slice three-dimensional cine white blood cardiovascular magnetic resonance (CMR) technique before and during intravenous dobutamine infused to achieve 80% of the maximum heart rate response for age. Paired sample t-test was used to detect differences in LA and LV volumes between baseline and peak dose stage of dobutamine stress CMR, and multivariable linear regression was used to identify predictors of LA function. Results: Participants averaged 68 ± 8 years in age, 53% were men, 25% exhibited coronary artery disease, 35% had diabetes, 9% had a remote history of atrial fibrillation, 90% had hypertension, and 11% had inducible LV wall motion abnormalities indicative of ischemia during dobutamine CMR. Increasing age correlated with LA volumes (maximal and minimal) and inversely correlated with LAEF at rest and after peak adrenergic stress. Age was an independent predictor of LAEF during adrenergic stress, even after accounting for gender, LV volumes, and other co-morbidities including inducible ischemia. Conclusions: Age is associated with a decrease in LA function during adrenergic stress even after adjusting for co-morbidities associated with cardiovascular disease and LV function. (Cardiol J 2012; 19, 1: 45-52).

Indian J Public Health. 2011 Oct-Dec; 55(4): 247-51
, Laskar AR

With changing demographic profile India has more older women than men as life expectancy for women is 67.57 as against 65.46 for men. Gender differences in the aging process reflect biological, economic, and social differences. Both social and health needs of the older women are unique and distinctive as they are vulnerable. The social problems revolve around widowhood, dependency, illiteracy and lack of awareness about the policies and programmes from which they can benefit. Among the medical problems, vision (cataract) and degenerative joint disease top the list, followed by neurological problems. Lifestyle diseases form another single-most important group of health problems in the elderly women. The risk of cardiovascular disease doubles with the outcome being poorer than men. The most common causes of death among women above the age of 60 years are stroke, ischemic heart disease and COPD. Hypertensive heart disease and lower respiratory tract infections contribute to mortality in these women. Common malignancies viz. Cervical, breast and uterus in women are specific to them and account for a sizeable morbidity and mortality. In a study done at Lady Hardinge medical college in Delhi, Hypertension (39.6%) and obesity (12-46.8%) were very common in postmenopausal women. Half or more women had high salt and fat intake, low fruit and vegetable intake and stress. There is a need to recognize the special health needs of the women beyond the reproductive age, to be met through strengthening and reorienting the public health services at all levels starting from primary health care to secondary till tertiary care level with adequate referral linkages. All policies and programs need to have a gender perspective. At present there is lack of sensitization and appropriate training of the health personnel in dealing with the needs of elderly. Women too need to be aware to adopt healthy lifestyle and seek timely care.

Respir Physiol Neurobiol. 2012 Jan 18;
McDonough P, Padilla DJ, Kano Y, Musch TI, Poole DC, Behnke BJ

Aging, heart failure and diabetes each compromise the matching of O(2) delivery (Q˙O(2))-to-metabolic requirements (O(2) uptake, V˙O(2)) in skeletal muscle such that the O(2) pressure driving blood-myocyte O(2) flux (microvascular PO(2), PmvO(2)) is reduced and contractile function impaired. In contrast, β-guanidinopropionic acid (β-GPA) treatment improves muscle contractile function, primarily in fast-twitch muscle (Moerland and Kushmerick, 1994). We tested the hypothesis that β-GPA (2% wt/BW in rat chow, 8 weeks; n=14) would improve Q˙O(2)-to-V˙O(2) matching (elevated PmvO(2)) during contractions (4.5V @ 1Hz) in mixed (MG) and white (WG) portions of the gastrocnemius, both predominantly fast-twitch). Compared with control (CON), during contractions PmvO(2) fell less following β-GPA (MG -54%, WG -26%, P

J Am Geriatr Soc. 2012 Jan 27;
Snih SA, Peek KM, Sawyer P, Markides KS, Allman RM, Ottenbacher KJ

OBJECTIVES: To examine the factors associated with life-space mobility in older Mexican Americans. DESIGN: Cross-sectional study involving a population-based survey. SETTING: Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California). PARTICIPANTS: Seven hundred twenty-eight Mexican-American men and women aged 75 and older. MEASUREMENTS: Sociodemographic factors, self-reported physician diagnoses of medical conditions (arthritis, diabetes mellitus, heart attack, stroke, hip fracture, and cancer), depressive symptoms, cognitive function, body mass index (BMI), upper and lower extremity muscle strength, Short Physical Performance Battery (SPPB), activities of daily living (ADLs), and the life-space assessment (LSA) were assessed in in-home interviews. RESULTS: The mean age of participants was 84.2 ± 4.2. Sixty-five percent were female. Mean LSA score was 41.7 ± 20.9. Multiple regression analysis showed that older age, being female, limitation in ADLs, stroke, high depressive symptoms, and a BMI index of 35 kg/m(2) and greater were significantly associated with lower LSA scores. Education and better lower extremity function and muscle strength were factors significantly associated with higher LSA scores. CONCLUSION: Older Mexican Americans had restricted life-space, with approximately 80% limited to their home or neighborhood. Older age, female sex, stroke, high depressive symptoms, BMI of 35 kg/m(2) or greater, and ADL disability were related to less life-space. Future studies are needed to examine the association between life-space and health outcomes and to characterize the trajectory of life-space over time in this population.

J Am Geriatr Soc. 2012 Jan 27;
Pietrzak RH, Goldstein RB, Southwick SM, Grant BF

OBJECTIVES: To present findings on past-year medical conditions associated with lifetime trauma exposure and full and partial posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. older adults. DESIGN: Face-to-face diagnostic interviews. SETTING: Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PARTICIPANTS: Nine thousand four hundred sixty-three adults aged 60 and older. MEASUREMENTS: Logistic regression analyses adjusting for sociodemographic characteristics and psychiatric comorbidity were used to evaluate associations between PTSD status and past-year medical disorders; linear regression models evaluated associations with past-month physical functioning. RESULTS: After adjustment for sociodemographic characteristics and comorbid lifetime mood, anxiety, substance use, attention-deficit/hyperactivity, and personality disorders, respondents with lifetime PTSD were more likely than respondents who reported experiencing one or more traumatic life events but who did not meet lifetime criteria for full or partial PTSD (trauma controls) to report being diagnosed with hypertension, angina pectoris, tachycardia, other heart disease, stomach ulcer, gastritis, and arthritis (odds ratios (ORs) = 1.3-1.8) by a healthcare professional; they also scored lower on a measure of physical functioning than controls and respondents with partial PTSD. Respondents with lifetime partial PTSD were more likely than controls to report past-year diagnoses of gastritis (OR = 1.7), angina pectoris (OR = 1.5), and arthritis (OR = 1.4) and reported worse physical functioning. Number of lifetime traumatic event types was associated with most of the medical conditions assessed; adjustment for these events reduced the magnitudes of and rendered nonsignificant most associations between PTSD status and medical conditions. CONCLUSION: Older adults with lifetime PTSD have high rates of several physical health conditions, many of which are chronic disorders of aging, and poorer physical functioning. Older adults with lifetime partial PTSD have higher rates of gastritis, angina pectoris, and arthritis and poorer physical functioning.

J Am Geriatr Soc. 2012 Jan 27;
Akushevich I, Kravchenko J, Ukraintseva S, Arbeev K, Yashin AI

OBJECTIVES: To use the Medicare Files of Service Use (MFSU) to evaluate patterns in the incidence of aging-related diseases in the U.S. elderly population. DESIGN: Age-specific incidence rates of 19 aging-related diseases were evaluated using the National Long Term Care Survey (NLTCS) and the Surveillance, Epidemiology, and End Results (SEER) Registry data, both linked to MFSU (NLTCS-M and SEER-M, respectively), using an algorithm developed for individual date at onset evaluation. SETTING: A random sample from the entire U.S. elderly population (Medicare beneficiaries) was used in NLTCS, and the SEER Registry data covers 26% of the U.S. population. PARTICIPANTS: Thirty-four thousand seventy-seven individuals from NLTCS-M and 2,154,598 from SEER-M. MEASUREMENTS: Individual medical histories were reconstructed using information on diagnoses coded in MFSU, dates of medical services and procedures, and Medicare enrollment and disenrollment. RESULTS: The majority of diseases (e.g., prostate cancer, asthma, and diabetes mellitus) had a monotonic decline (or decline after a short period of increase) in incidence with age. A monotonic increase in incidence with age with a subsequent leveling off and decline was observed for myocardial infarction, stroke, heart failure, ulcer, and Alzheimer's disease. An inverted U-shaped age pattern was detected for lung and colon carcinomas, Parkinson's disease, and renal failure. The results obtained from the NLTCS-M and SEER-M were in agreement (excluding an excess for circulatory diseases in the NLTCS-M). A sensitivity analysis proved the stability of the incidence rates evaluated. CONCLUSION: The developed computational approaches applied to the nationally representative Medicare-based data sets allow reconstruction of age patterns of disease incidence in the U.S. elderly population at the national level with unprecedented statistical accuracy and stability with respect to systematic biases.

Age (Dordr). 2012 Jan 27;
Kulminski AM, Culminskaya I, Yashin AI

Studies focusing on unraveling the genetic origin of health span in humans assume that polygenic, aging-related phenotypes are inherited through Mendelian mechanisms of inheritance of individual genes. We use the Framingham Heart Study (FHS) data to examine whether non-Mendelian mechanisms of inheritance can drive linkage of loci on non-homologous chromosomes and whether such mechanisms can be relevant to longevity-related phenotypes. We report on genome-wide inter-chromosomal linkage disequilibrium (LD) and on chromosome-wide intra-chromosomal LD and show that these are real phenomena in the FHS data. Genetic analysis of inheritance in families based on Mendelian segregation reveals that the alleles of single nucleotide polymorphisms (SNPs) in LD at loci on non-homologous chromosomes are inherited as a complex resembling haplotypes of a genetic unit. This result implies that the inter-chromosomal LD is likely caused by non-random assortment of non-homologous chromosomes during meiosis. The risk allele haplotypes can be subject to dominant-negative selection primary through the mechanisms of non-Mendelian inheritance. They can go to extinction within two human generations. The set of SNPs in inter-chromosomal LD (N = 68) is nearly threefold enriched, with high significance (p = 1.6 × 10(-9)), on non-synonymous coding variants (N = 28) compared to the entire qualified set of the studied SNPs. Genes for the tightly linked SNPs are involved in fundamental biological processes in an organism. Survival analyses show that the revealed non-genetic linkage is associated with heritable complex phenotype of premature death. Our results suggest the presence of inter-chromosomal level of functional organization in the human genome and highlight a challenging problem of genomics of human health and aging.

J Am Coll Cardiol. 2012 Jan 31; 59(5): 475-83
Cecelja M, Jiang B, Spector TD, Chowienczyk P

The goal of this study was to examine the progression of central arterial pulse pressure (cPP) in women and the degree to which this can be reversed by nitrovasodilation.cPP can be partitioned into height of the first systolic shoulder (P1), generated by a forward pressure wave and related to arterial stiffness, and augmentation pressure (AP), thought to be influenced by pressure wave reflection from muscular arteries and/or aortic reservoir.Using a longitudinal cohort design, cPP, P1, and AP were estimated (using the SphygmoCor System [AtCor Medical Pty Ltd., West Ryde, Australia]) in 411 female twins over a mean follow-up of 10.8 years. In a subsample (n = 42), cPP, arterial stiffness (using pulse wave velocity [PWV]) and arterial diameters (using ultrasonography) were measured before and after nitroglycerin administration (400 μg s/l).cPP increased more than peripheral pulse pressure (10.3 and 9.2 mm Hg, respectively; p < 0.0001). In women

J Am Soc Echocardiogr. 2012 Jan 25;
Al-Mohaissen MA, Chan KL

Endocardial lead-induced tricuspid regurgitation has not been well recognized, either clinically or echocardiographically, and yet it is likely a preventable iatrogenic disease. In severe cases, it can lead to right ventricular failure and require tricuspid valve surgery. This complication will become increasingly important, because the numbers of permanent pacemakers and implantable cardioverter-defibrillators are expected to increase because of the aging population and the expanding capabilities of these devices. Published studies are largely retrospective, and serial studies to assess the time course of the development of tricuspid regurgitation are lacking. The mechanisms and severity of tricuspid regurgitation may not be well evaluated by two-dimensional echocardiography. Real-time three-dimensional echocardiography appears to be a promising technique to evaluate the mechanism of tricuspid regurgitation and may allow the early detection of patients who will develop severe lead-induced tricuspid regurgitation. A better understanding of the mechanism of lead-induced tricuspid regurgitation will be essential to the development of preventive strategies, which can then be tested in future clinical trials.

Curr Pharm Biotechnol. 2012 Jan 20;
Papp Z, Czuriga D, Balogh L, Balogh A, Borbély A

Naturally occurring decline in cardiovascular reserve with age associates with a combination of the reduction in cardiomyocyte number and altered cardiomyocyte function. Recent investigations suggested that about half of the cardiomyocytes is the same as at birth, while the other half of the cardiomyocytes is the result of cardiomyocyte renewal in the senescent heart. In addition, the total number of cardiomyocytes is estimated to be less by one third in the old heart than the number of cardiomyocytes at birth. Thus, the reduction in cardiomyocyte number of the aging heart cannot be fully compensated by cardiomyocyte renewal. Aging of long-lived differentiated myocardial cells, as well as of cardiac progenitor stem cells may contribute to an increased rate of apoptosis, and decreased capacity of cell duplication and/or differentiation. In addition, differentiated cardiomyocytes are prone for accumulating biological by-products of cellular metabolism and of incompletely processed oxidative insults. In this context, interactions between lysosomes and mitochondria may provide a mechanistic background for the age-dependent alterations in cardiac macromolecules. This reasoning postulates a direct relationship between the number of pro-oxidative, ill-functioning mitochondria and the amount of ballast-overloaded lysosomes in long-lived cardiomyocytes. Accumulation of biological garbage and telomere shortening might be considered as hallmarks of cardiomyocyte aging with implications for depressed cardiac function and cardiomyocyte renewal. Changes in protein expression together with posttranslational modifications of myocardial proteins affect excitation-contraction coupling and explain the declining mechanical function of the cardiomyocytes. Altogether, these changes represent a significant part of the reduced cardiovascular reserve in aged individuals.

Curr Pharm Biotechnol. 2012 Jan 20;
Gavina C, Falcão-Pires I, Rocha-Gonçalves F, Leite-Moreira A

Aortic stenosis is the most common type of valvular heart disease and its recent increase is related to aging. The decreased aortic valve area imposes a chronic systolic pressure overload to the left ventricle. In response, the ventricle hypertrophies in an attempt to normalize the increased wall stress, but this response is not uniform in patients with similar degrees of stenosis and its regression after surgical correction is variable, suggesting that several factors, other than load, can explain these differences. These findings are particularly important since the presence of left ventricular hypertrophy after aortic valve replacement is an independent predictor of worse outcome, probably because it indicates irreversible remodeling. Age, gender, hypertension, patient-prosthesis mismatch and interstitial remodeling also play an important role in this setting, raising the possibility of intervention beyond valve replacement. The possibility of combining estrogen treatment, antihypertensive agents, antioxidants and modulators of the renin-angiotensin-aldosterone system with surgical treatment to promote reverse remodeling is very appealing. On the other hand, a preventive strategy to intervene earlier in patients with significant left ventricular mass and avoid patient-prosthesis mismatch, especially in the younger and those with systolic dysfunction, can have a significant impact on prognosis. Further evidence, with well designed clinical trials, is needed but the spotlight must be in the ventricle, not the valve.