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Health See other Health Articles Title: Ninety-Year-Olds Becoming Mentally Sharper, More Functional Medscape: A study that includes 2 cohorts of nonagenarians born 10 years apart suggests cognitive ability and daily function in the oldest old may be improving. Investigators at the University of Southern Denmark in Odense found that the younger cohort born in 1915 performed better than their older counterparts born in 1905 on tests of cognitive ability and activities of daily living. In addition, those born in 1915 were nearly a third (32%) more likely to reach the age of 95 than those in the 1905 cohort. "The study challenges speculations that the improving longevity is the result of the survival of very frail and disabled elderly people," lead author Kaare Christensen, MD, PhD, said in a statement. "With the rapidly growing populations of very elderly people in high-income countries, surveillance of changes in functioning within and between birth cohorts of people in this age group will be of fundamental importance in the planning of health care, both for individual families and for society," the authors write. The study is published online July 11 in The Lancet. The 1905 cohort was surveyed in 1998, and the 1915 group was surveyed 12 years later. The current study included 2262 persons from the 1905 cohort (mean age, 93.1 years) and 1584 from the 1915 cohort (mean age, 95.3 years). The 2 studies used the same design and survey instrument. The rates of nonresponse, proportion of proxy respondents, and reasons for nonresponse and for use of proxy were similar. In both cases, it was the first time that subjects participated in the survey and so there was no opportunity for a practice effect on cognitive tests. The assessment consisted of an interview, physical and cognitive tests, and the collection of biological material. The investigators found that cognitive function was better in the 1915 group than in the 1905 cohort (mean cognitive composite score of attention, verbal memory, and word fluency, 0.49 vs 0.01; P = .0003) and that the proportion of those with maximum Mini-Mental State Evaluation (MMSE) scores (28 to 30 points) was substantially greater in the 1915 group (23% vs 13%.) This was especially evident among men, in whom 16% of the 1905 cohort and 32% of the 1915 cohort attained maximum scores. No Reduction in Depression The 1915 group had better scores on activities of daily living (mean score, 2.0 vs 1.8; P < .0001) but physical functioning as tested by grip strength, gait speed, and ability to rise from a chair was similar between the groups. "This finding suggests that the basis for the improved activities of daily living score in the later cohort is improved cognitive functioning and living conditions in elderly people, as well as better aids to support mobility and independence (eg, walking aids, sophisticated grab bars, threshold ramps, swivel seats). Together these factors enable improved functioning with the same physical resources," the authors write. Educational attainment was slightly higher in the 1915 cohort, but the difference was significant only in women who had very low educational attainment in both cohorts. The 1915 group still had higher MMSE and cognitive composite scores after adjusting for this improvement in education. This finding, the authors note, "suggests that changes in other factors such as nutrition, burden of infectious disease, work environment, intellectual stimulation, and general living conditions also play an important part in the improvement of cognitive functioning." The fact that the physical performance tests did not improve might suggest that changes in the intellectual environment rather than in the physical environment are the basis for the improvement, they add. Unexpectedly, the improved cognitive functioning did not translate into a reduction in depression symptoms in either women or men. The findings are limited to Denmark, and don't necessarily apply to other regions that have varying profiles of health and disease and different survival probabilities, the authors note. The number of people aged 90 and over in the United States is growing. In 1980, it was about 720,000; in 2010, it had grown to about 1.5 million. Robust Findings In an accompanying editorial, Marcel Olde Rikkert, PhD, and Rene Melis from Radboud University Medical Center in Nijmegen, the Netherlands, praised the high quality of the demographic data used in the study. The findings are "robust" and are not only "good news" for very elderly people in Denmark but also have wider implications, they write. "This methodological quality resulted in highly valid data in what could prove to be a landmark study in gerontological research," the editorialists add. The finding of improved cognitive function in the later cohort "might even suggest the possibility of lowering the incidence or delaying the onset of dementia" and seems to substantiate the important plateau in dementia incidence after age 90 years. Further, the findings "should stimulate further research to investigate the goal of increased longevity with improved functioning." The authors and editorialists have disclosed no relevant financial relationships. Lancet. Published online July 11, 2013. Poster Comment: Seems to be contradicted by current dementia epidemic. Post Comment Private Reply Ignore Thread Top • Page Up • Full Thread • Page Down • Bottom/Latest
#1. To: Tatarewicz (#0)
(Edited)
One reason for this phenomenon is simply that people in their 90s now (in the 21st century) have more to keep their minds active than people who were in their 90s back before, say, 1980. In the old days we'd plunk oldsters in front of the video all day everyday and they'd get what little stimulation comes from worrying about whether Gilligan and his friends are ever going to get off that effing island. Nowadays we have (1) much better and wider selections of what to watch on TV - complete with closed captions for those whose hearing has deteriorated, (2) computers and the internet, and (3) various tools to enable people to keep up with their favorite hobbies even when they have developed some physical limitations. Also, (4) some medical advances enable oldsters to avoid being bedridden longer. In other words, a whole lot more ways elderly people can keep their minds and bodies active.
When I was at Truman Healthcare here recovering from meningitis, they had the Alzheimers unit where they kept those people locked up so they could not wander off or hurt themselves. Alzheimers has nothing to do with dementia, however. ;) "When bad men combine, the good must associate; else they will fall, one by one." Edmund Burke
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