One in 5 over-65s who drink alcohol do so at unsafe levels

August 23, 2015
Science Daily/King's College London
One in five older people who drink alcohol are consuming it at unsafe levels -- over 21 units of alcohol for men and 14 units for women each week -- according to a new study. The research found these unsafe older drinkers are more likely to be of higher socioeconomic status.

The researchers used anonymised electronic GP health records for 27,991 people aged 65 and over in the Borough of Lambeth in London. From these records, they identified 9,248 older people who had reported consuming alcohol and of these 1,980 people drank at unsafe levels.

They found unsafe drinkers were more likely to be male, younger and have higher socioeconomic status. Men were more likely to be unsafe drinkers than women -- 46% of people in the study were male, but they were 60% of the drinkers and 65% of the unsafe drinkers.

Dr Tony Rao, lead author from the Institute of Psychiatry, Psychology & Neuroscience at King's College London said: 'As the Baby Boomer generation become seniors, they represent an ever increasing population of older people drinking at levels that pose a risk to their health. This study shows the need for greater awareness of the potential for alcohol related harm in older people, particularly those of higher socio-economic status, who may suffer the consequences of ill health from alcohol at an earlier age than those in previous generations.'

The median alcohol consumption was 6 units per week for all over-65s who reported drinking. However, the top 5% of alcohol drinkers reported consuming more than 49 units per week for men and more than 23 units per week for women.

Dr Mark Ashworth, study author from the Division of Health and Social Care Research at King's College London said: 'This research highlights that as GPs we need be more aware of the risk of older people, especially men, drinking excessively. Reducing alcohol misuse is important to prevent premature death and serious negative health effects, such as alcoholic liver disease, which are big burden on our health system. Alcohol excess carries additional risks in the older population such as falls and confusion.'

Alcohol drinkers were also more likely to be ethnically White or Irish, while people from Caribbean, African or Asian ethnicities were less likely to drink. People of White ethnicity were 59% of the study population, but were 68% of those who reported drinking alcohol and 80% of the unsafe drinkers. People of Irish ethnicity were 5% of the study population, but were 6% of the alcohol drinkers and 8% of the unsafe drinkers.

Dr Ashworth added: 'Based on our findings, the elderly who were most at risk were those from the white British population rather than from an ethnic minority, and those who were wealthier and better educated rather than those from a more deprived background.'’

The authors caution that results from inner-city London may not apply to other areas of the UK with different demographics. They also note that while the study contains an almost complete sample of older people in the area, people may have under-reported their alcohol consumption to their GP.
Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/08/150823215345.htm

Men, people over 65 sleep better when they have access to nature

August 24, 2015
Science Daily/University of Illinois College of Agricultural, Consumer and Environmental Sciences
Men and persons age 65 and older who have access to natural surroundings, whether it's the green space of a nearby park or a sandy beach and an ocean view, report sleeping better.

"It's hard to overestimate the importance of high-quality sleep," said Diana Grigsby-Toussaint, a U of I professor of kinesiology and community health and a faculty member in the U of I's Division of Nutritional Sciences. "Studies show that inadequate sleep is associated with declines in mental and physical health, reduced cognitive function, and increased obesity. This new study shows that exposure to a natural environment may help people get the sleep they need."

In the study, Grigsby-Toussaint worked with both U of I researchers and scientists from the New York University School of Medicine. The team used data from the CDC's Behavioral Risk Factor Surveillance System, which surveyed 255,171 representative U.S. adults, to learn whether there was an association between self-reported days of insufficient sleep and access to green space. The team also used a USDA index that scores the country's geographical areas for their natural amenities, using hours of sunlight, which is important in regulating a person's circadian rhythm, and temperature.

In response to the survey question about sleep quality in the last month, the researchers found that the most common answer was that respondents had slept poorly for less than one week.
"Interestingly, though, across the entire sample, individuals reporting 21 to 29 days of insufficient sleep consistently had lower odds of access to green space and natural amenities compared to those reporting less than one week," she said.

For men, the relationship between sleep and exposure to green space was much stronger than for women. And males and females 65 and over found nature to be a potent sleep aid, she added.

Grigsby-Toussaint noted that living near green landscapes is associated with higher levels of physical activity and that exercise in turn predicts beneficial sleep patterns.

But men appeared to benefit much more from their natural surroundings. The researcher speculated that women may take less advantage of nearby natural settings out of concern for their safety, but she added that more research is needed.

The finding should be a boon for people who are having trouble sleeping as they age. "If there is a way for persons over 65 to spend time in nature, it would improve the quality of their sleep--and their quality of life--if they did so," Grigsby-Toussaint said.

The study points to the importance of conserving nature in general, she added.

"And, specifically, our results provide an incentive for nursing homes and communities with many retired residents to design buildings with more lighting, create nature trails and dedicated garden spaces, and provide safe outdoor areas that encourage outdoor activity for men and women," she said.
Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/08/150824130814.htm

Physical activity linked to greater mental flexibility in older adults

August 24, 2015
Science Daily/University of Illinois at Urbana-Champaign
One day soon, doctors may determine how physically active you are simply by imaging your brain. Physically fit people tend to have larger brain volumes and more intact white matter than their less-fit peers. Now a new study reveals that older adults who regularly engage in moderate to vigorous physical activity have more variable brain activity at rest than those who don't. This variability is associated with better cognitive performance, researchers say.

"We looked at 100 adults between the ages of 60 and 80, and we used accelerometers to objectively measure their physical activity over a week," said University of Illinois postdoctoral researcher Agnieszka Burzynska, who led the study with Beckman Institute for Advanced Science and Technology director Art Kramer.

The researchers also used functional MRI to observe how blood oxygen levels changed in the brain over time, reflecting each participant's brain activity at rest. And they evaluated the microscopic integrity of each person's white-matter fibers, which carry nerve impulses and interconnect the brain.

"We found that spontaneous brain activity showed more moment-to-moment fluctuations in the more-active adults," said Burzynska, who now is a professor at Colorado State University. "In a previous study, we showed that in some of the same regions of the brain, those people who have higher brain variability also performed better on complex cognitive tasks, especially on intelligence tasks and memory."

The researchers also found that, on average, older adults who were more active had better white-matter structure than their less-active peers.

"Our study, when viewed in the context of previous studies that have examined behavioral variability in cognitive tasks, suggests that more-fit older adults are more flexible, both cognitively and in terms of brain function, than their less-fit peers," Kramer said.

The new research highlights yet another way to assess brain health in aging, Burzynska said.

"We want to know how the brain relates to the body, and how physical health influences mental and brain health in aging," she said. "Here, instead of a structural measure, we are taking a functional measure of brain health. And we are finding that tracking changes in blood-oxygenation levels over time is useful for predicting cognitive functioning and physical health in aging."
Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/08/150824110531.htm

Older people getting smarter, but not fitter

August 31, 2015

Science Daily/International Institute for Applied Systems Analysis

Older populations are scoring better on cognitive tests than people of the same age did in the past -- a trend that could be linked to higher education rates and increased use of technology in our daily lives, say population researchers.

People over age 50 are scoring increasingly better on tests of cognitive function, according to a new study published in the journal PLOS ONE. At the same time, however, the study showed that average physical health of the older population has declined.

The study relied on representative survey data from Germany which measured cognitive processing speed, physical fitness, and mental health in 2006 and again in 2012. It found that cognitive test scores increased significantly within the 6-year period (for men and women and at all ages from 50 to 90 years), while physical functioning and mental health declined, especially for low-educated men aged 50-64. The survey data was representative of the non-institutionalized German population, mentally and physically able to participate in the tests.

In recent years, population experts at the International Institute for Applied Systems Analysis (IIASA) have been exploring new ways to measure age that focus on people's characteristics rather than the number of years they have lived. Cognition normally begins to decline with age, and is one key characteristic that demographers use to understand how different population groups age more successfully than others.

Previous studies have found elderly people to be in increasingly good health--"younger" in many ways than previous generations at the same chronological age--with physical and cognitive measures all showing improvement over time. The new study is the first to show divergent trends over time between cognitive and physical function.

"We think that these divergent results can be explained by changing lifestyles," says IIASA World Population Program researcher Nadia Steiber, author of the PLOS ONE study. "Life has become cognitively more demanding, with increasing use of communication and information technology also by older people, and people working longer in intellectually demanding jobs. At the same time, we are seeing a decline in physical activity and rising levels of obesity."

A second study from IIASA population researchers, published last week in the journal Intelligence found similar results suggesting that older people have become smarter also in England.

"On average, test scores of people aged 50+ today correspond to test scores from people 4-8 years younger and tested 6 years earlier," says Valeria Bordone, a researcher at IIASA and the affiliated Wittgenstein Centre for Demography and Global Human Capital.

The studies both provide confirmation of the "Flynn effect" -- a trend in rising performance in standard IQ tests from generation to generation. The studies show that changes in education levels in the population can explain part, but not all of the effect.

Bordone says, "We show for the first time that although compositional changes of the older population in terms of education partly explain the Flynn effect, the increasing use of modern technology such as computers and mobile phones in the first decade of the 2000s also contributes considerably to its explanation."

The researchers note that the findings apply to Germany and England, and future research may provide evidence on other countries.

Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/08/150831144100.htm

Active body, active mind: The secret to a younger brain may lie in exercising your body

October 23, 2015

Science Daily/University of Tsukuba

It is widely recognized that our physical fitness is reflected in our mental fitness, especially as we get older. How does being physically fit affect our aging brains? Neuroimaging studies, in which the activity of different parts of the brain can be visualized, have provided some clues. Until now, however, no study has directly linked brain activation with both mental and physical performance.

http://images.sciencedaily.com/2015/10/151023084456_1_540x360.jpg

Stroop-interference-related cortical activation patterns.

Credit: Image courtesy of University of Tsukuba

As reported in the latest volume of the journal NeuroImage, an exciting new study led by Dr Hideaki Soya from the University of Tsukuba in Japan and his colleagues show, for the first time, the direct relationship between brain activity, brain function and physical fitness in a group of older Japanese men. They found that the fitter men performed better mentally than the less fit men, by using parts of their brains in the same way as in their youth.

As we age, we use different parts of our brain compared to our younger selves. For example, when young, we mainly use the left side of our prefrontal cortex (PFC) for mental tasks involving short term memory, understanding the meaning of words and the ability to recognize previously encountered events, objects, or people. When older, we tend to use the equivalent parts of our PFC on the right side of the brain for these tasks. The PFC is located in the very front of the brain, just behind the forehead. It has roles in executive function, memory, intelligence, language and vision.

With tasks involving the temporary storage and manipulation of memory, long term memories and inhibitory control, young adults favor the right side of the PFC, while older adults engage both the right and left PFC. In fact, with aging, we tend to use both sides of the PFC during mental tasks, rather than just one. This phenomenon has been coined HAROLD (hemispheric asymmetry reduction in older adults) and reflects the reorganisation of the brain as compensation for reduced brain capacity and efficiency due to age-related structural and physiological decline.

In the NeuroImage study, 60 older men (aged 64-75 years) underwent an exercise test to measure their aerobic fitness. The men, whose physical fitness was found to vary widely, then performed a test to measure their selective attention, executive function and reaction time. This well-known 'color-word matching Stroop test' involved showing the men words meaning color, such as blue, green, red, but asking them to name the color of the letters rather than read the word itself. This is harder than it sounds. When the color of the letters does not match the word -- blue, red, green -- it takes the brain longer to react. This reaction time is used as a measurement of brain function. Activity in the PFC region of the mens' brains was measured throughout the test using a unique neuroimaging technique called functional near infrared spectroscopy or fNIRS. This technique provides a measure of blood oxygen concentration in surface blood vessels, indicative of activity in the brain's outer layers, using a set of wearable probes in a cap that is placed on the head. Active brain cells require fresh oxygenated blood which dislodges the deoxygenated blood from that region. fNIRS measures the changes in color between oxygenated red blood and blue deoxygenated blood and thus indirectly measures brain activity.

The results from these tests were combined and extensively statistically analysed to explore the associations between aerobic fitness, Stroop reaction time and brain activity during the Stroop test. As predicted for older adults, during the Stroop test both sides of the PFC are active, with no difference between right and left, verifying the HAROLD phenomenon amongst this group of men. Previous studies have shown that young adults favour the left side of the PFC for this task.

Analysis of the relationship between brain activity and Stroop reaction time revealed that those men that favored the left side of the PFC while performing the Stroop test had faster reaction times. This indicates that older adults who use the more youth-like, task-related side of the brain perform better in this test.

Next, the association between aerobic fitness and Stroop reaction time was analysed. Fitter men had shorter reaction times.

Based on these findings, the researchers correctly predicted that higher aerobic fitness would be associated with higher left-PFC activity. In other words, fitter men tend to use the more youth-like side of their brains, at least while performing the Stroop test.

Previous studies have not examined the interaction between the three factors under investigation in this study -- aerobic fitness, mental performance and brain activation. Using clever statistical tests called mediation analyses to look at these interactions, the researchers found that aerobically fitter older men can perform better mentally than less fit older men by using the more important brain regions when needed. In fact, the fitter older men are using parts of their brains in the same way as when they were younger.

How do they do this? Professor Soya says "one possible explanation suggested by the research is that the volume and integrity of the white matter in the part of brain that links the two sides declines with age. There is some evidence to support the theory that fitter adults are able to better maintain this white matter than less fit adults, but further study is needed to confirm this theory."

If you are an aging woman, you will be wondering if these results can be applied to your female brain. Both aging sexes might also wonder whether increasing aerobic fitness later in life can increase mental fitness. The results aren't in, but I'm heading off for a brisk walk just in case.

Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/10/151023084456.htm

Long-term aerobic exercise prevents age-related brain changes

October 29, 2015

Science Daily/PLOS

A study of the brains of mice shows that structural deterioration associated with old age can be prevented by long-term aerobic exercise starting in mid-life, according to new research. Structural changes that make the blood-brain barrier leaky and result in inflammation of brain tissues in old mice can be mitigated by allowing the animals to run regularly, providing a potential explanation for the beneficial effects of exercise on dementia in humans.

Old age is the major risk factor for Alzheimer's disease, like many other diseases. Age-related cognitive deficits are due partly to changes in neuronal function, but also correlate with deficiencies in the blood supply to the brain and with low-level inflammation. In this study, the authors set out to investigate the changes in the brains of normal young and aged laboratory mice by comparing by their gene expression profiles using a technique called RNA sequencing, and by comparing their structures at high-resolution by using fluorescence microscopy and electron microscopy. The gene expression analysis indicated age-related changes in the expression of genes relevant to vascular function (including focal adhesion, vascular smooth muscle and ECM-receptor interactions), and inflammation (especially related to the complement system, which clears foreign particles) in the brain cortex. These changes were accompanied by a decline in the function of astrocytes (key support cells in brain) and loss of pericytes (the contractile cells that surround small capillaries and venules and maintain the blood-brain barrier) and of major components of the basement membrane, which forms an integral part of the blood-brain barrier, as well as an increase in the density and functional activation of the immune cells known as microglia/monocytes, which scavenge the brain for infectious agents and damaged cells. Dr. Soto, lead author on the study, says: "Collectively, our data suggests that normal aging causes significant dysfunction to the cortical neurovascular unit, including basement membrane reduction and pericyte loss. These changes correlate strongly with an increase in microglia/monocytes in the aged cortex,"

Physical activity is already known to ameliorate the cognitive decline and sensorimotor deficits seen in old age in humans as well as in mice. To investigate the impact of long-term physical exercise on the brain changes seen in the aging mice, the researchers provided the animals with a running wheel from 12 months old (equivalent to middle aged in humans) and assessed their brains at 18 months (equivalent to ~60yrs old in humans, when the risk of Alzheimer's disease is greatly increased). Young and old mice alike ran about two miles per night, and this physical activity improved the ability and motivation of the old mice to engage in the typical spontaneous behaviors that seem to be affected by aging. This exercise significantly reduced age-related pericyte loss in the brain cortex and improved other indicators of dysfunction of the vascular system and blood-brain barrier. Exercise also decreased the numbers of microglia/monocytes expressing a crucial initiating component of the complement pathway that others have shown previously to play are role in age-related cognitive decline. Interestingly, these beneficial effects of exercise were not seen in mice deficient in a gene called Apoe, variants of which are a major genetic risk factor for Alzheimer's disease. The authors also report that Apoe expression in the brain cortex declines in aged mice and this decline can also be prevented by exercise.

Numerous studies have correlated the development of Alzheimer's disease with vascular dysfunction during aging. This study suggests that this dysfunction might be driven by astrocyte dysfunction and/or pericyte loss leading to a breakdown of the blood-brain barrier. But further work will be required to establish the mechanism(s): what is the role of the complement-producing microglia/macrophages, how does Apoe decline contribute to age-related neurovascular decline, does the leaky blood-brain barrier allow the passage of damaging factors from the circulation into the brain?

Previous studies showing that exercise is beneficial for the human brain suggest the effects on mice are relevant for human health. The authors conclude that, "Our data, supported by data from human studies, point towards focusing efforts on understanding the impact of aging and lifestyle choices on neurovascular unit decline and neuroinflammation, particularly astrocyte and pericyte dysfunction. Dr. Howell believes as a society we need to work hard to ensure we maintain an active lifestyle wherever possible. "In this day and age, with so many distractions and conveniences, it is easy to fall into a lifestyle that does not include enough exercise. With an aging population, I hope our study helps in encouraging a healthy lifestyle that includes exercise." He goes on to say that: "For those that are unfortunately unable to exercise, our study provides insight into a possible mechanism by which exercise may benefit the aging brain and may one day lead to improved treatments for age-related cognitive decline, Alzheimer's disease and other neurodegenerative disorders."

Science Daily/SOURCE http://www.sciencedaily.com/releases/2015/10/151029150301.htm

Strength of brain connectivity varies with fitness level in older adults

November 5, 2015

Science Daily/University of Illinois at Urbana-Champaign

A new study shows that age-related differences in brain health -- specifically the strength of connections between different regions of the brain -- vary with fitness level in older adults.

Michelle Voss led the study while a postdoctoral researcher at the University of Illinois with Beckman Institute director Arthur Kramer and kinesiology and community health professor Edward McAuley. Voss now is an assistant professor at the University of Iowa.

"Our study provides the strongest evidence to date that fitness in an older adult population can have substantial benefits to brain health in terms of the functional connections of different regions of the brain," Kramer said.

There are many ways to measure brain health across the lifespan. One popular technique measures the strength of connections between different parts of the brain while the person is completing a task or during wakeful rest. The latter is known as resting-state functional connectivity. Research has shown that some of these connections weaken with increasing age and indicate deteriorating brain health.

Using functional magnetic resonance imaging, Voss and colleagues measured the strength of these connections throughout the brain in younger and older adults at rest. As expected, the team confirmed that most connections were weaker for older adults when compared with younger adults.

Building on these findings, the researchers examined the role of cardiorespiratory fitness on resting-brain connectivity in older adults. Fitness is determined by how efficiently someone uses oxygen during physical activity such as running on a treadmill. Other factors aside from habitual physical activity may alter how fitness affects brain health. For example, a person's genetic makeup can influence his or her fitness and general brain health.

The researchers found a relationship between fitness and the strength of the connections between certain brain regions in older adults at rest that was independent of their level of physical activity.

"An encouraging pattern in the data from our study and others is that the benefits of fitness seem to occur within the low-to-moderate range of endurance, suggesting that the benefits of fitness for the brain may not depend on being extremely fit," Voss said.

The study concludes that there is a positive role of cardiorespiratory fitness, beyond habitual physical activity, on brain health as people age.

"The idea that fitness could be related to brain health regardless of one's physical activity levels is intriguing because it suggests there could be clues in how the body adapts for some people more than others from regular activity. This will help our understanding of how fitness protects against age-related cognitive decline and dementia," Voss said

Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/11/151105121735.htm

Not so happy old age?

Depressive symptoms increase with age

November 13, 2015

Science Daily/University of Bradford

The notion that older people are happier than younger people is being challenged following a recent study. In fact it suggests that people get more depressed from age 65 onwards

In fact it suggests that people get more depressed from age 65 onwards.

The study, led by psychology lecturer Dr Helena Chui and recently published in the international journal Psychology and Aging, builds on a 15-year project observing over 2,000 older Australians living in the Adelaide area.

Previous studies have shown an increase in depressive symptoms with age but only until the age of 85. This is the first study to examine the issue beyond that age.

Both men and women taking part in the study reported increasingly more depressive symptoms as they aged, with women initially starting with more depressive symptoms than men. However, men showed a faster rate of increase in symptoms so that the difference in the genders was reversed at around the age of 80.

Key factors in these increases include levels of physical impairment, the onset of medical conditions, particularly chronic ones, and the approach of death. Half of those in the study suffered with arthritis and both men and women with the chronic condition reported more depressive symptoms than those without.

Dr Chui said: "These findings are very significant and have implications for how we deal with old age. It's the first study to tell us depressive symptoms continue to increase throughout old age. We are in a period of unprecedented success in terms of people living longer than ever and in greater numbers and we should be celebrating this but it seems that we are finding it hard to cope.

"It seems that we need to look carefully at the provision of adequate services to match these needs, particularly in the area of mental health support and pain management. Social policies and aging-friendly support structures, such as the provision of public transport and access to health care services are needed to target the 'oldest-old' adults as a whole."

Science Daily/SOURCE :http://www.sciencedaily.com/releases/2015/11/151113115607.htm

Negative beliefs about aging predict Alzheimer's disease in study

December 7, 2015

Science Daily/Yale University

Individuals who hold negative beliefs about aging are more likely to have brain changes associated with Alzheimer's disease, newly published research demonstrates.

https://images.sciencedaily.com/2015/12/151207145906_1_540x360.jpg

The study suggests that combatting negative beliefs about aging, such as elderly people are decrepit, could potentially offer a way to reduce the rapidly rising rate of Alzheimer's disease, a devastating neurodegenerative disorder that causes dementia in more than 5 million Americans.

Credit: © Ivelin Radkov / Fotolia

The study suggests that combatting negative beliefs about aging, such as elderly people are decrepit, could potentially offer a way to reduce the rapidly rising rate of Alzheimer's disease, a devastating neurodegenerative disorder that causes dementia in more than 5 million Americans.

The study led by Becca Levy, associate professor of public health and of psychology, is the first to link the brain changes related to Alzheimer's disease to a cultural-based psychosocial risk factor. The findings were published online Dec. 7 in the journal Psychology and Aging.

"We believe it is the stress generated by the negative beliefs about aging that individuals sometimes internalize from society that can result in pathological brain changes," said Levy. "Although the findings are concerning, it is encouraging to realize that these negative beliefs about aging can be mitigated and positive beliefs about aging can be reinforced, so that the adverse impact is not inevitable."

Study authors examined healthy, dementia-free subjects from the Baltimore Longitudinal Study of Aging, the nation's longest-running scientific study of aging. Based on MRIs, the researchers found that participants who held more negative beliefs about aging showed a greater decline in the volume of the hippocampus, a part of the brain crucial to memory. Reduced hippocampus volume is an indicator of Alzheimer's disease.

Then researchers used brain autopsies to examine two other indicators of Alzheimer's disease: amyloid plaques, which are protein clusters that build up between brain cells; and neurofibrillary tangles, which are twisted strands of protein that build up within brain cells. Participants holding more negative beliefs about aging had a significantly greater number of plaques and tangles. The age stereotypes were measured an average of 28 years before the plaques and tangles.

In both stages of the study, Levy and her colleagues adjusted for other known risk factors for Alzheimer's disease, including health and age.

http://www.sciencedaily.com/releases/2015/12/151207145906.htm

Two studies from England, 20 years apart, show increase in healthy aging

December 8, 2015

Science Daily/The Lancet

Two studies conducted 20 years apart in England reveal an apparent increase in healthy aging, or years lived healthily, reflecting less cognitive impairment; and an increase in the proportion of life lived healthily, through a larger proportion of years lived with disability but less rather than more severe disability.

Whether rises in life expectancy result in increases in good quality years of life is of profound importance worldwide, with population ageing occurring in many countries. Jagger and colleagues investigated how expectancies in various domains of health have changed in England between 1991 and 2011, with identical study design and methods in each decade.

The research used baseline data from the Cognitive Function and Ageing Studies (study I in 1991 and II in 2011) which were led by the University of Cambridge, and which interviewed people aged 65 years or older in three geographically defined centres in England (Cambridgeshire, Newcastle, and Nottingham). Prevalence estimates for three health measures: self-perceived health (defined as excellent-good, fair, or poor); cognitive impairment (defined as moderate-severe, mild, or none, as assessed by Mini-Mental State Examination score); and disability in activities of daily living (defined as none, mild, or moderate-severe) were combined with mortality data to produce health expectancies for the three regions together.

Between 1991 and 2011, gains in life expectancy at age 65 years (4·5 years for men and 3·6 years for women) were accompanied by equivalent gains in years free of any cognitive impairment (4·2 years for men and 4·4 years for women) and decreased numbers of years with mild or moderate-severe cognitive impairment. Gains were also identified in years in excellent or good self-perceived health (3·8 years for men and 3·1 years for women).

Gains in disability-free years were much smaller than gains in excellent-good self-perceived health or in years free from cognitive impairment, especially for women (0·5 years compared with 2·6 years for men), mostly because of increased mild disability.

Further analysis showed that, despite a 20% lower prevalence of ill health in each age group in 2011, the overall prevalence in 2011 (9·7%) was higher than that in 1991 (9·3%), and, because of the increased numbers of people at the greatest risk, the absolute number of unhealthy individuals was larger.

The authors say: "During the past two decades in England, we report an absolute compression (meaning reduction) of cognitive impairment, an increase in the proportion of years of life spent in good health, and changes to the pattern of disability -- less severe disability is increasing but more severe disability is not. Reasons for these patterns are unknown but might include increasing obesity during previous decades. Our findings have wide-ranging implications for health services and for extension of working life."

They add: "Our findings of increases in the proportion of life spent healthily from age 65 years are in line with others across Europe. Evidence of expansion of mild disability has been reported in Spain and France, although some countries like Norway and the United States have experienced compression of disability."

Discussing the better medical management for various conditions such as heart disease and stroke over the past two decades, they say: "We need to quantify whether our findings are due to diseases and disorders becoming less disabling during the past two decades."

In a linked Comment, Dr Kenneth Rockwood, Dalhousie University, Halifax, NS, Canada, and Institute of Brain, Behaviour and Mental Health, University of Manchester, UK, says: "Even if the "problems of old age come as a package," quantification of the package in which those problems come is a challenge for ageing research...Policy makers must consider how health expectancy as, for example, disability prevalence, plays out against a background of an increasing number of older adults."

http://www.sciencedaily.com/releases/2015/12/151208204244.htm