Presidential Healthcare center

We provide the same Preventive Executive Physical Program as received by the President of the United States.


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Body Composition May Hasten Hip Osteoarthritis

osteoHigher fat mass and increased body mass index (BMI) adversely affected hip cartilage in women, while increases in fat-free mass were associated with beneficial cartilage changes at the hip for women and men, according to an Australian community-based study.

After adjusting for age and femoral head bone area, for every 1-unit increase in BMI, there was an associated 26 mm3 reduction in femoral head cartilage volume in women, although no such link was seen in men for BMI and femoral head cartilage volume, reported Flavia M. Cicuttini, MD, of Monash University in Melbourne, in colleagues.

The results “likely represent very early structural joint damage” given that the study population had no clinical hip disease, the investigators osteo 2wrote in Arthritis Research and Therapy.  However, they added that “the mechanisms by which an increased BMI and fat mass adversely affects hip cartilage is unknown. It is possible that deleterious structural changes may in part be due to excessive loading of the hip joint caused by increased body mass. For instance, through altered joint biomechanics, obesity may remodel hip bone. In turn, abnormal bone geometry could act as an intermediary between obesity and cartilage damage.”

Source: Medpage Today


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Air Pollution Tied to Brain Aging

air pollution 3Air pollution is known to increase the risk for stroke and other cerebrovascular disorders. But now researchers have found it is also linked to premature aging of the brain.

The study, in the May issue of Stroke, used data on 943 men and women over 60 who were participants in a larger health study. Researchers did M.R.I. examinations and gathered data on how close the people lived to major highways. They also used satellite data to measure particulate matter smaller than 2.5 micrometers, or PM 2.5, a form of pollution that easily enters the lungs and bloodstream.air pollution 1

After controlling for health, lifestyle and socioeconomic factors, they found that compared with people exposed to the lowest levels of PM 2.5, those with the highest exposure had a 46 percent increased risk for covert brain infarcts, the brain damage commonly called “silent strokes.”

They also found that each additional two micrograms per cubic meter increase in PM 2.5 was linked to a decrease in cerebral brain volume equivalent to air pollution 2about one year of natural aging.

“We’re seeing an association between air pollution and potentially harmful attacks on the brain,” said the lead author, Elissa H. Wilker, a researcher at Beth Israel Deaconess Medical Center. “This helps us to better understand the mechanisms related to air pollution and clinically observed outcomes.”

Source: New York Times


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Mediterranean Diet Has Marked Impact On Aging

M Diet 2The Mediterranean diet consistently has been linked with an array of health benefits, including decreased risk of chronic disease and cancer. Until now, however, no studies had associated the diet with longer telomeres, one of the biomarkers of aging.

In a study published Tuesday online in The BMJ, researchers at Harvard-affiliated Brigham and Women’s Hospital (BWH) found that greater adherence to the Mediterranean diet correlated with longer telomeres.

Telomeres are repetitive DNA sequences at the ends of chromosomes that get shorter every time a cell divides. Shorter telomeres have been associated with decreased life expectancy and increased risk of aging-related disease, while longer telomeres have been linked to longevity. Telomere shortening is accelerated by stress and inflammation, and scientists have speculated that adherence to the Mediterranean diet may help protect against that effect.M diet 3

“To our knowledge this is the largest population-based study specifically addressing the association between Mediterranean diet adherence and telomere length in healthy, middle-aged women,” explained Immaculata De Vivo, an associate professor in the Channing Division of Network Medicine at BWH and the Harvard T.H. Chan School of Public Health, the senior author of this study. “Our results further support the benefits of adherence to this diet to promote health and longevity.”

The researchers analyzed 4,676 disease-free women from the Nurses’ Health Study who had completed the food-frequency questionnaire and whose telomere lengths had been measured. They found that a greater adherence to the Mediterranean diet was associated with longer telomeres, and that even small changes in diet made a difference.

“Our findings showed that healthy eating, overall, was associated with longer telomeres. However, the strongest association M Dietwas observed among women who adhered to the Mediterranean diet,” explained Marta Crous Bou, a postdoctoral fellow in the Channing Division of Network Medicine and the first author of the study.

De Vivo notes that future research should be aimed at determining which components of the Mediterranean diet drive this association. This would allow researchers to gain insight into the biological mechanism, as well as provide a basis for increased public education for informed lifestyle choices.

Source: Harvard Gazette

“The Presidential Healthcare Center Provides Nutritional Assessments.”  


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Researchers say Vitamin D deficiency raises Alzheimer’s risk

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People with moderate-to-severe vitamin D deficiencies are significantly more likely to develop Alzheimer’s disease or other forms of dementia than those who have an adequate supply of the vitamin in their body, a new study has found.

Researchers, led by David J. Llewellyn at the University of Exeter Medical School, found that adults who suffered from a moderate deficiency of vitamin D had a 53 percent higher risk of some form of dementia, while the risk increased 125 percent in those with severe deficiencies. People moderately deficient in vitamin D were 69 percent more likely to develop Alzheimer’s-caused dementia, while those severely deficient raised the risk to 122 percent.

The team discovered what appear to be clear threshold levels for brain health using standard medical measurements of concentration in the blood. The risk of dementia appears to rise for people with vitamin D blood levels below 25 nanomoles per liter, while vitamin D levels above 50 nanomoles appear to be good levels for brain health.

The researchers acknowledged the possibility of reverse causation — that is, that having dementia might alter a person’s behavior or diet in such a way as to contribute to vitamin D deficiency — but suggested that the makeup of the study made that unlikely.

Llewellyn said that although the international team of researchers expected to find a link between vitamin D deficiency and dementia, the strong correlation between the two was surprising. He said further study was necessary to determine whether consuming oily fish or vitamin D supplements might prevent Alzheimer’s disease.

 “We thought it was important for bone health. But there’s this recent revelation that it might be playing an important role throughout the body,” Llewellyn said. He said more recent research suggests that vitamin D may act as a buffer regulating calcium levels in brain cells.
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Alzheimer’s disease is the leading form of dementia, affecting more than 5 million people in the United States. That number is expected to reach 16 million by 2050 as the population ages.

Vitamin D, which helps the body use calcium, is created when skin is exposed to sunshine. Milk is often fortified with the vitamin, and it is also found in fatty fish and other foods.

Researchers in the Exeter study noted that laboratory experiments have shown that vitamin D may play a role in ridding cells of beta-amyloid plaques, an abnormality that distinguishes Alzheimer’s.

“It seems to be that vitamin D was actually helping to break down and take away those protein abnormalities,” Llewellyn said Wednesday in an interview.

Knowing that previous studies have also linked vitamin D deficiency to heightened risk of cognitive decline in older people, the multinational team of researchers studied vitamin D blood levels in 1,658 people age 65 and older who were able to walk, free of dementia, and without a history of cardiovascular disease or stroke. Medical personnel tracked the subjects over six years, using brain scans, cognitive tests, medical records and other diagnostic tools, to see how many developed Alzheimer’s disease or other forms of dementia.

The study, funded in part by the Alzheimer’s Association, appeared Wednesday in Neurology, the medical journal of the American Academy of Neurology.

Source: Washington Post


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Life Expectancy Gains Threatened As More Older Americans Suffer From Multiple Medical Conditions

dr-oldldayWith nearly four in five older Americans living with multiple chronic medical conditions, a new study by researchers at Johns Hopkins Bloomberg School of Public Health finds that the more ailments you have after retirement age, the shorter your life expectancy. The analysis, one of the first to examine the burden of multiple chronic conditions on life expectancy among the elderly, may help explain why increases in life expectancy among older Americans are slowing.

A report on the findings, based on an analysis of 1.4 million Medicare enrollees, appears in the August issue of the journal Medical Care.

“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” says Eva H. DuGoff, a recent PhD recipient at the Johns Hopkins Bloomberg School of Public Health and lead author of the report. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”

For their analysis, researchers used the Medicare 5% sample, a nationally representative sample of Medicare beneficiaries, enrolled as of January 1, 2008, which included 21 defined chronic conditions and the records of nearly 1.4 million people 67 and older.

Life expectancy in the U.S. is rising more slowly than in other parts of the developed world and many blame the obesity epidemic and its related health conditions for the worsening health of the American population.

The analysis found that, on average, a 75-year-old American woman with no chronic conditions will live 17.3 additional years (that’s to more than 92 years old). But a 75-year-old woman with five chronic conditions will only live, on average, to the age of 87, and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men, while white people live longer than black people.

It’s not just how many diseases you have, but also what disease that matters. At 67, an individual with heart disease is estimated to live an additional 21.2 years on average, while someone diagnosed with Alzheimer’s disease is only expected to live 12 additional years.

On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up.

“We tend to think about diseases in isolation. You have diabetes or you have heart failure. But many people have both, and then some,” says senior author Gerard F. Anderson, PhD, a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “The balancing act needed to care for all of those conditions is complicated, more organ systems become involved as do more physicians prescribing more medications. Our system is not set up to care for people with so many different illnesses. Each one adds up and makes the burden of disease greater than the sum of its parts.”

The researchers say their findings could be useful to Social Security and Medicare planners as they make population and cost predictions for the future. Policymakers are facing a different landscape as so many more people are living with multiple chronic conditions than before: 60 percent of those 67 and older in the U.S. have three or more of these diseases, the researchers found. Eventually, there may be a tipping point, when the medical advances that have boosted life expectancy for so long can no longer keep pace with the many illnesses people are collecting as they age.

“We already knew that living with multiple chronic conditions affects an individual’s quality of life, now we know the impact on quantity of life,” DuGoff says. “The growing burden of chronic disease could erase decades of progress. We don’t want to turn around and see that life expectancy gains have stopped or reversed.”

“Multiple Chronic Conditions and Life Expectancy, A Life Table Analysis” was written by Eva H. DuGoff, PhD; Vladimir Canudas-Romo, PhD; Christine Buttorff; Bruce Leff, MD; and Gerard F. Anderson, PhD. The study was supported by the American Insurance Group.

Source: Johns Hopkins


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Active Mind and Body Fend Off Alzheimer’s, Study Says

Sleep disturbances such as apnea may increase the risk of Alzheimer’s disease, while moderate exercise in middle age and mentally stimulating games, such as crossword puzzles, may prevent the onset of the dementia-causing disease, according to research to be presented Monday.

oldpeopleThe findings — which are to be introduced during the six-day Alzheimer’s Association International Conference in Copenhagen — bolster previous studies that suggest sleep plays a critical role in the aging brain’s health, perhaps by allowing the body to cleanse itself of Alzheimer’s-related compounds during downtime. The studies also add to a growing body of literature that suggests keeping the brain busy keeps it healthy.

The battle against Alzheimer’s disease has become more urgent for the United States and other developing nations as their populations turn increasingly gray. The disease is the leading cause of dementia in older people and afflicts more than 5 million Americans. At its current pace, the number is expected to soar to 16 million people by 2050.

In 2012, the United States adopted a national plan to combat the disease and the Group of Eight nations last year adopted a goal of providing better treatment and prevention by 2025.

Erin Heintz, a spokeswoman for the Alzheimer’s Association, said U.S. government funding to combat the disease now stands at about $500 million a year. To reach its 2025 goal, th e United States should be spending $2 billion a year, she said.

The sleep study, conducted by University of California at San Francisco researchers on a large sample of veterans, found that those with diagnosed sleep disorders such as apnea or insomnia were 30 percent more likely to suffer dementia than veterans without such problems. Veterans who suffered from sleep problems and post-traumatic stress disorder (PTSD) had an 80 percent greater risk.

“I would say that this is another important study showing this link between sleep and subsequent diagnosis of dementia,” Kristine Yaffe, a psychiatry professor at UCSF who heads its Dementia Epidemiology Research Group, said in a telephone interview. She said her study’s findings benefited from having such a large sample of participants: Researchers used eight years of records on 200,000 veterans, most of whom were male and 55 or older.

It is well known that people afflicted with Alzheimer’s suffer from sleep disorders, Yaffe said, but further research is necessary to determine whether sleep disturbance heightens the risk of getting dementia or is a symptom.

In a separate study, researchers at the Wisconsin Alzheimer’s Institute and the Wisconsin Alzheimer’s Disease Research Center wanted to find out whether middle-aged people who engage in mentally stimulating activities might reduce their risk of cognitive impairment and dementia. Forty percent of the subject group carried the gene linked to Alzheimer’s and 74 percent had a parent with the illness, two factors known to increase the risk of getting the disease.

The researchers studied 329 participants — 69 percent of whom were women, whose mean age was about 60 — to find out how often the participants read books, visited museums, played games such as checkers or worked on puzzles.

The subjects also underwent a battery of tests, including MRI brain scans to measure the volume of those regions commonly afflicted by Alzheimer’s.

For purposes of the study, researchers focused on the group’s game-playing habits to see if the frequency of playing games was related to better brain and cognitive health.

Stephanie Schultz, lead author of the study, said that although more research is necessary to know for sure, the findings suggest that stimulating the brain with ordinary diversions such as crossword puzzles may help some people preserve brain tissue and cognitive functions that are vulnerable to dementia. Those who reported a higher frequency of playing games also had greater brain volume in regions affected by Alzheimer’s, such as the hippocampus.

“The more they play these types of games, the better it is for … brain health,” she said.

One reason could be that game-playing involves more complicated processes across multiple regions of the brain, compared with more passive forms of mental engagement, the researchers said.

“It’s very clear it’s a different quality of mental engagement when you’re playing games of skill than when you’re reading a book,” said Ozioma Okonkwo, an assistant professor of medicine at the University of Wisconsin School of Medicine and senior author of the study. “To win a card game, you have to judge, you have to plan, you have to do something, you have to remember what the last player played.”

Okonkwo said the results were exciting particularly because they held true for people with a family history of Alzheimer’s and a genetic disposition to the disease.

“These individuals already have two strikes against them,” he said.

Similarly, a three-year study of people with mild cognitive impairment by researchers at the Mayo Clinic Study of Aging suggests that moderate physical exercise in middle age could decrease the risk that their cognitive deficits progress to dementia. The study looked at the timing of regular exercise — undertaken either in midlife between the ages of 50 and 65, or later in life, from age 70 and up — and its relationship to the onset of dementia in a group of 280 elderly people. Their median age was 81.

Oddly, however, the association did not hold for people who engaged in light or vigorous exercise in middle age or for any level of physical activity later in life.

On a similarly counterintuitive note, another study suggested that high blood pressure among people at least 90 years old — “the oldest old” — may protect against cognitive impairment. Researchers at the University of California at Irvine said that although hypertension is believed to increase the risk of Alzheimer’s and dementia for middle-aged people, the risk may shift with time.

Their study, which examined 625 people who are 90 or older, found that people who were diagnosed with high blood pressure between the ages of 80 and 89 had a significantly lower risk of dementia. People with hypertension after the age of 90 had an even lower risk, the researchers said.

(Source: Washington Post)


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90-year-old ex-president makes parachute jump

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Former President George H.W. Bush celebrated his 90th birthday on Thursday by making a tandem parachute jump near his summer home in coastal Maine, fulfilling a goal he made five years ago after a similar jump even though he can no longer use his legs.

The nation’s 41st president jumped from a helicopter at about 6,000 feet while harnessed to retired Sgt. 1st Class Mike Elliott, a former member of the Golden Knights, the Army’s parachute team. Elliott guided Bush to a safe landing on his 85th birthday.

“That’s what he wanted for his 90th birthday and that’s what he got,” Elliott said. “It’s a very good feeling to be involved and be able to turn back time.”

The helicopter picked up Bush outside his Kennebunkport home. His family transported him from his wheelchair to the chopper, singing “Happy Birthday” before it took off.

Bush floated to the ground under a red, white and blue parachute and landed on the lawn of St. Ann’s Episcopal Church, where several hundred friends and family had gathered. Elliott said Bush’s foot got tangled up underneath him during the landing, causing him to tumble forward onto the ground. A spokesman later said the former president was feeling “fine.”

“He had a big smile for the crowd. You could tell he was exhilarated,” said Diana Untermeyer, a family friend from Houston. “He’s an amazing man. This is just another sign of that. I think that like most of America, our family loves him to pieces. It was just a real thrill to do this again.”

Bush was greeted with a kiss from his wife, Barbara, and a hug from his son, former President George W. Bush. The family left without talking to reporters.

Outside the grounds, several hundred people gathered on the rocky shore to get a glimpse of the jump.

“He has a lot of courage. We need more like him,” said David Morris, 79, of Melrose, Massachusetts.

Said Carol Schierl, 75, of Green Bay, Wisconsin: “I think it’s wonderful. I hope I can jump out of a plane at 90.”

The jump was kept secret until Thursday morning–partly to give Bush the option of bagging it because of less-than-ideal weather, including a low ceiling of clouds.

“It’s vintage George Bush,” spokesman Jim McGrath said. “It’s that passion for life. It’s wanting to set a goal, wanting to achieve it. I’m sure part of it is sending a message to others that even in your retirement years you can still find challenges.”

Bush had to overcome the objections of his doctor, Barbara and the rest of the family before making the latest jump, Elliott said. Eventually, he won them over.

“He’s smiling like a kid in kindergarten,” Elliott said following the jump.

Bush’s jump was indicative of a trend among people of advanced age, said Lenard Kaye, director of the Maine Center on Aging at the University of Maine. More and more seniors are participating in extreme physical activities deep into their golden years, a trend that will pick up steam as more baby boomers retire, he said.

Such “extreme acts of adventure” are becoming a part of many seniors’ lives but they need to be mindful that their bones are more fragile than when they were younger, he said.

The first time Bush jumped from an airplane was when his plane was shot down in World War II over the Pacific. He marked his 75th, 80th and 85th birthdays by skydiving. Thursday was his eighth jump.

Other birthday festivities included a private dinner with more than 200 relatives and friends, including some from his White House days: press secretary Marlin Fitzwater, White House counsel Boyden Gray and political director Ron Kaufman, McGrath said. His children, including George W. Bush and former Florida Gov. Jeb Bush, will be there, McGrath said.

Kennebunkport is a special place for the president. As a boy, he visited the family home at Walker’s Point every summer, except during World War II. The retreat was later dubbed his “summer White House.”

Article via Washington Post