Framingham Heart Study

Framingham, MA, United States

Framingham Heart Study

Framingham, MA, United States
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News Article | April 20, 2017
Site: www.eurekalert.org

Americans love sugar. Together we consumed nearly 11 million metric tons of it in 2016, according to the US Department of Agriculture, much of it in the form of sugar-sweetened beverages like sports drinks and soda. Now, new research suggests that excess sugar -- especially the fructose in sugary drinks--might damage your brain. Researchers using data from the Framingham Heart Study (FHS) found that people who drink sugary beverages frequently are more likely to have poorer memory, smaller overall brain volume, and a significantly smaller hippocampus -- an area of the brain important for learning and memory. But before you chuck your sweet tea and reach for a diet soda, there's more: a follow-up study found that people who drank diet soda daily were almost three times as likely to develop stroke and dementia when compared to those who did not. Researchers are quick to point out that these findings, which appear separately in the journals Alzheimer's & Dementia and Stroke, demonstrate correlation but not cause-and-effect. While researchers caution against over-consuming either diet soda or sugary drinks, more research is needed to determine how -- or if -- these drinks actually damage the brain, and how much damage may be caused by underlying vascular disease or diabetes. "These studies are not the be-all and end-all, but it's strong data and a very strong suggestion," says Sudha Seshadri, a professor of neurology at Boston University School of Medicine (MED) and a faculty member at BU's Alzheimer's Disease Center, who is senior author on both papers. "It looks like there is not very much of an upside to having sugary drinks, and substituting the sugar with artificial sweeteners doesn't seem to help." "Maybe good old-fashioned water is something we need to get used to," she adds. Matthew Pase, a fellow in the MED neurology department and an investigator at the FHS who is corresponding author on both papers, says that excess sugar has long been associated with cardiovascular and metabolic diseases like obesity, heart disease, and type 2 diabetes, but little is known about its long-term effects on the human brain. He chose to study sugary drinks as a way of examining overall sugar consumption. "It's difficult to measure overall sugar intake in the diet," he says, "so we used sugary beverages as a proxy." For the first study, published in Alzheimer's & Dementia on March 5, 2017, researchers examined data, including magnetic resonance imaging (MRI) scans and cognitive testing results, from about 4,000 people enrolled in the Framingham Heart Study's Offspring and Third-Generation cohorts. (These are the children and grandchildren of the original FHS volunteers enrolled in 1948.) The researchers looked at people who consumed more than two sugary drinks a day of any type -- soda, fruit juice, and other soft drinks -- or more than three per week of soda alone. Among that "high intake" group, they found multiple signs of accelerated brain aging, including smaller overall brain volume, poorer episodic memory, and a shrunken hippocampus, all risk factors for early-stage Alzheimer's disease. Researchers also found that higher intake of diet soda--at least one per day--was associated with smaller brain volume. In the second study, published in Stroke on April 20, 2017, the researchers, using data only from the older Offspring cohort, looked specifically at whether participants had suffered a stroke or been diagnosed with dementia due to Alzheimer's disease. After measuring volunteers' beverage intake at three points over seven years, the researchers then monitored the volunteers for 10 years, looking for evidence of stroke in 2,888 people over age 45, and dementia in 1,484 participants over age 60. Here they found, surprisingly, no correlation between sugary beverage intake and stroke or dementia. However, they found that people who drank at least one diet soda per day were almost three times as likely to develop stroke and dementia. Although the researchers took age, smoking, diet quality, and other factors into account, they could not completely control for preexisting conditions like diabetes, which may have developed over the course of the study and is a known risk factor for dementia. Diabetics, as a group, drink more diet soda on average, as a way to limit their sugar consumption, and some of the correlation between diet soda intake and dementia may be due to diabetes, as well as other vascular risk factors. However, such preexisting conditions cannot wholly explain the new findings. "It was somewhat surprising that diet soda consumption led to these outcomes," says Pase, noting that while prior studies have linked diet soda intake to stroke risk, the link with dementia was not previously known. He adds that the studies did not differentiate between types of artificial sweeteners and did not account for other possible sources of artificial sweeteners. He says that scientists have put forth various hypotheses about how artificial sweeteners may cause harm, from transforming gut bacteria to altering the brain's perception of "sweet," but "we need more work to figure out the underlying mechanisms." Founded in 1839, Boston University is an internationally recognized institution of higher education and research. With more than 33,000 students, it is the fourth-largest independent university in the United States. BU consists of 16 schools and colleges, along with a number of multi-disciplinary centers and institutes integral to the University's research and teaching mission. In 2012, BU joined the Association of American Universities (AAU), a consortium of 62 leading research universities in the United States and Canada.


News Article | April 21, 2017
Site: www.futurity.org

New research suggests that excess sugar—especially the fructose in sugary drinks—might damage your brain. Researchers using data from the Framingham Heart Study (FHS) found that people who drink sugary beverages frequently are more likely to have poorer memory, smaller overall brain volume, and a significantly smaller hippocampus—an area of the brain important for learning and memory. But before you chuck your sweet tea and reach for a diet soda, there’s more: a follow-up study found that people who drank diet soda daily were almost three times as likely to develop stroke and dementia when compared to those who did not. Researchers are quick to point out that these findings, which appear separately in the journals Alzheimer’s & Dementia and Stroke, demonstrate correlation but not cause-and-effect. While researchers caution against over-consuming either diet soda or sugary drinks, more research is needed to determine how—or if—these drinks actually damage the brain, and how much damage may be caused by underlying vascular disease or diabetes. “These studies are not the be-all and end-all, but it’s strong data and a very strong suggestion,” says Sudha Seshadri, a professor of neurology at Boston University School of Medicine and a faculty member at the university’s Alzheimer’s Disease Center. “It looks like there is not very much of an upside to having sugary drinks, and substituting the sugar with artificial sweeteners doesn’t seem to help.” “Maybe good old-fashioned water is something we need to get used to,” adds Seshadri, who is senior author of both papers. Excess sugar has long been associated with cardiovascular and metabolic diseases like obesity, heart disease, and type 2 diabetes, but little is known about its long-term effects on the human brain, says Matthew Pase, a fellow in the university’s neurology department, an investigator at the FHS, and lead author of both papers. He chose to study sugary drinks as a way of examining overall sugar consumption. “It’s difficult to measure overall sugar intake in the diet,” he says, “so we used sugary beverages as a proxy.” For the first study, researchers examined data, including magnetic resonance imaging (MRI) scans and cognitive testing results, from about 4,000 people enrolled in the Framingham Heart Study’s Offspring and Third-Generation cohorts. (These are the children and grandchildren of the original FHS volunteers enrolled in 1948.) The researchers looked at people who consumed more than two sugary drinks a day of any type—soda, fruit juice, and other soft drinks—or more than three per week of soda alone. Among that “high intake” group, they found multiple signs of accelerated brain aging, including smaller overall brain volume, poorer episodic memory, and a shrunken hippocampus, all risk factors for early-stage Alzheimer’s disease. Researchers also found that higher intake of diet soda—at least one per day—was associated with smaller brain volume. In the second study, the researchers, using data only from the older Offspring cohort, looked specifically at whether participants had suffered a stroke or been diagnosed with dementia due to Alzheimer’s disease. After measuring volunteers’ beverage intake at three points over seven years, the researchers then monitored the volunteers for 10 years, looking for evidence of stroke in 2,888 people over age 45, and dementia in 1,484 participants over age 60. Here they found, surprisingly, no correlation between sugary beverage intake and stroke or dementia. However, they found that people who drank at least one diet soda per day were almost three times as likely to develop stroke and dementia. Although the researchers took age, smoking, diet quality, and other factors into account, they could not completely control for preexisting conditions like diabetes, which may have developed over the course of the study and is a known risk factor for dementia. Diabetics, as a group, drink more diet soda on average, as a way to limit their sugar consumption, and some of the correlation between diet soda intake and dementia may be due to diabetes, as well as other vascular risk factors. However, such preexisting conditions cannot wholly explain the new findings. “It was somewhat surprising that diet soda consumption led to these outcomes,” says Pase, noting that while prior studies have linked diet soda intake to stroke risk, the link with dementia was not previously known. He adds that the studies did not differentiate between types of artificial sweeteners and did not account for other possible sources of artificial sweeteners. Pase says that scientists have put forth various hypotheses about how artificial sweeteners may cause harm, from transforming gut bacteria to altering the brain’s perception of sweet, but “we need more work to figure out the underlying mechanisms.”


News Article | April 21, 2017
Site: www.chromatographytechniques.com

Drinking at least one artificially sweetened beverage daily was associated with almost three times the risk of developing stroke or dementia compared to those who drank artificially-sweetened beverages less than once a week, according to new research in the American Heart Association’s journal Stroke. The authors caution that the long-term observational study was not designed or able to prove cause and effect, and only shows a trend among one group of people. “Our study shows a need to put more research into this area given how often people drink artificially-sweetened beverages,” said Matthew Pase, a senior fellow in the department of neurology at Boston University School of Medicine, Swinburne University of Technology in Melbourne, Australia, and the Framingham Heart Study. “Although we did not find an association between stroke or dementia and the consumption of sugary drinks, this certainly does not mean they are a healthy option. We recommend that people drink water on a regular basis instead of sugary or artificially sweetened beverages.” The researchers analyzed the Framingham Heart Study Offspring Cohort of 2,888 people, primarily Caucasian, over the age of 45 for the stroke study and 1,484 people over the age of 60 for the dementia arm of the study. Over a period of seven years, the researchers reviewed what people were drinking at three different points in time. Participants reported their eating and drinking habits by responding to food frequency questionnaires. The researchers then followed up with the study subjects for the next 10 years to determine who developed stroke or dementia, then compared the dietary information to the risk of developing stroke and dementia over the course of the study. The data collected did not distinguish between the types of artificial sweeteners used in the beverages. At the end of the 10-year follow-up period, the researchers noted 97 cases (three percent) of stroke, 82 of which were ischemic (caused by blockage of blood vessels), and 81 (five percent) cases of dementia, 63 of which were diagnosed as Alzheimer’s disease. The researchers used statistical models, adjusted for various risk factors such as age, sex, caloric intake, education, diabetes mellitus and the presence of a variant of the Alzheimer’s risk gene apolipoprotein E, to determine potential links between artificially-sweetened drink consumption and the risk of stroke or dementia. They found that people who drank at least one artificially-sweetened beverage a day were three times as likely to develop ischemic stroke and 2.9 times as likely to develop Alzheimer's disease dementia. Although the prospective nature of the study design increases the reliability of its findings, there are limitations. The participants were overwhelmingly white, and it is possible that ethnic preferences may influence how often people select sugary or artificially sweetened drinks, Pase said. People did not drink sugary sodas as often as diet sodas, which Pase said could be one reason the researchers did not see an association with regular soda since the participants may have been health conscious and just not consuming them as frequently. The main limitation, Pase said, is the important point that an observational study like this cannot prove that drinking artificially-sweetened drinks is linked to strokes or dementia, but it does identify an intriguing trend that will need to be explored in other studies. “Even if someone is three times as likely to develop stroke or dementia, it is by no means a certain fate,” Pase said. “In our study, three percent of the people had a new stroke and five percent developed dementia, so we're still talking about a small number of people developing either stroke or dementia.” According to an accompanying editorial, the current body of scientific research is inconclusive regarding whether or not drinking artificially sweetened beverages can actually lead to stroke, dementia or other cardiovascular conditions. However, there are a growing number of population based studies, such as this study by Pase, et.al, that show associations between frequent consumption of artificially sweetened beverages and undesirable effects on blood vessels throughout the body. This suggests that it may not be advisable to substitute or promote artificially sweetened drinks as healthier alternatives to sugar-sweetened drinks. “Both sugar and artificially sweetened soft drinks may be hard on the brain,” said senior editorial author Ralph Sacco M.D., a former president of the American Heart Association and the chairman of the Department of Neurology at the Miller School of Medicine at University of Miami in Florida. “We know that limiting added sugars is an important strategy to support good nutrition and healthy body weights, and until we know more, people should use artificially sweetened drinks cautiously. They may have a role for people with diabetes and in weight loss, but we encourage people to drink water, low-fat milk or other beverages without added sweeteners,” said Rachel K. Johnson, past chair of the American Heart Association’s Nutrition Committee and professor of nutrition at the University of Vermont.


Alphabet’s Google division is, fundamentally, in the business of selling data. That is a useful thing to keep in mind when Alphabet’s Verily comes calling for your medical data. But Google is also inarguably useful; this is why, despite knowing that my every move is being tracked by the company, I still make use of Google search, Gmail, and Google Docs, among its other myriad services. Verily’s Project Baseline is, in some sense, the health equivalent of those kinds of services — it has the potential to greatly expand our knowledge about what human health looks like. Not incidentally, the project will be of service to Verily as well. Researchers will collect genetic data, blood samples, medical images, and other information. In 2014, Verily — then a division of Google X — announced the Baseline Project, a collaboration with Duke University and Stanford University to try to get a sense of what a “normal” human looks like. Today, the group announced it will begin enrolling 10,000 healthy people, following a pilot in about 200 people that began in 2014. Over the course of four years, researchers will collect genetic data, blood samples, medical images, and other information from the study participants. That “other information” might include environmental data, as well as responses to phone surveys, and data from sensors in the Study Watch, a sensor-packed smartwatch announced last week. The studies are starting in the San Francisco Bay Area and North Carolina, though the scientists behind the effort hope to expand the areas surveyed. And because the program is meant to be nationally-representative, recruitment may be a little slow. When it’s over, there will be a database of anonymized data that plenty of researchers — including those from the pharmaceutical industry — will have access to. This style of study isn’t unprecedented; in fact, it’s been a feature of medical discovery for quite some time. The most famous example is the Framingham Heart Study, which began in 1948 with about 5,000 patients. At the time, doctors didn’t know much about heart attack and stroke, except that they were common and often deadly. So the Framingham study was devised in order to follow people ages 30 to 62 from the town of Framingham, Massachusetts for years and see if there were clues to those ailments. In 1948, and every two years afterwards, the study participants checked in. A second generation was added in 1971, and a third in 2002. Framingham has provided clues to most major cardiovascular risk factors Over the course of decades, Framingham has provided clues to most major cardiovascular risk factors: high blood pressure, high cholesterol, smoking, obesity, diabetes, and a sedentary lifestyle, among others. Framingham alone wasn’t enough to identify all these contributors, of course — but it told other scientists where to look. Something like 1,200 articles have been published in academic health journals over the last 50 years on Framingham alone. Project Baseline is twice the size of the original Framingham study population and is attempting more comprehensive measurement. And unlike Framingham, which was funded primarily by the National Heart, Lung and Blood Institute, this study is funded by Verily. Government spending on science has stagnated over the last decade, and Framingham has been among its casualties; the study lost 40 percent of its funding in 2013 as a result of the budget sequester. In fact, it would be a lot harder to get a publicly-funded study like Framingham off the ground today — both because it’s expensive and because it’s hard to predict what studies like this will find. Verily’s Project Baseline, then, is a mightily ambitious piece of basic science, and one that could prove useful. Advisory board member Adrian Hernandez, a cardiologist and professor of medicine at Duke, says the Project Baseline group is “aiming to build an early discovery platform.” It’s possible subtle changes occur in some areas — biomarkers, behavior, anything really — before a disease takes hold, Hernandez notes. Discovering what those changes are may lead to earlier and better treatment. Beyond those broad brushstrokes, it’s a bit difficult to say what a study like this is for until well after the fact, points out Stanford’s Sam Gambhir, who also sits on the advisory board. With a cohort study like this one — or like Framingham — it’s impossible to know the medical impact until well afterward. It is, however, possible to take an educated guess at what Verily gains by running the study. The point of a publicly-traded company is to make money for its shareholders, and Verily is owned by Alphabet, which is a publicly-traded company. So Verily stands to make money — the question is how. Verily, according to Alphabet’s investor documents, sells R&D services and licenses. This is worth keeping in mind; the data generated by Project Baseline will be shared with “qualified researchers.” Duke and Stanford are the two obvious places where the data will be shared, and the researchers there are likely to use Project Baseline data just as they’d use other data. When I asked about the possibility for pharmaceutical companies to access this data, Jessica Mega, the chief research officer at Verily, got squirrely. Here’s her initial reply: “There's a scientific executive committee that will review every request and the composition includes individuals with a leadership from Duke and Stanford, so it would need to be in line with the overall mission of the study.” Many companies sell their large databases of customer information I asked again, if someone who worked at a company like Pfizer would be able to gain access to the data, and Mega said, “Yes, as long as the intent is try to improve medical discovery.” Verily doesn’t yet figured out what “access” to the data will look like, I was told, but “the philosophy of the study is to make this information broadly available to qualified researchers.” Verily declined to comment on the possibility of fees for accessing its data. Many companies sell their large databases of customers’ information for discovery research. 23andMe, for instance, sells de-identified data from its genetic tests to researchers (such as Stanford), drug companies (Genentech, a subsidiary of Roche), and other entities (including the Michael J Fox Foundation, which does Parkinson’s research). In fact, the data is 23andMe’s moneymaker, not the tests it sells. Ancestry LLC, which also sells genetic test kits, does the same. It stands to reason Project Baseline could create similar revenue opportunities for Verily. There is also the matter of the Study Watch, which provides Verily with a number of opportunities. The most obvious is a consumer version of the Study Watch, though Mega says the company doesn’t currently plan to make the watch commercially available. The watch could also be used as a platform other researchers license in order to gather fairly continuous data. As it happens, the Study Watch is being used in the Personalized Parkinson’s Project — another Verily study, taking place in the Netherlands. That trial and Project Baseline may serve as trial runs for future research uses. Those two studies may also provide some sense of how reliable the data from the watch is, as well. (The Study Watch wasn’t used in the Project Baseline initial pilot run of about 200 patients.) Most wearables don’t require FDA approval, as long as they are marketed as “wellness devices.” But any kind of specific medical claim would probably require the regulators’ sign-off. Verily declined to comment on any regulatory plans for the watch. At this stage, it’s too early to speculate about what public good might come from Project Baseline, though it does seem likely there will be advantages to the work. It’s even possible that Project Baseline will be as useful to research as Framingham was 50 years ago. It may provide — as Framingham did before it — clues to the roots of common ailments. There may even be new drugs developed out of it. One thing is nearly certain, though: Project Baseline is meant to benefit Verily, too.


News Article | May 23, 2017
Site: www.futurity.org

For people over the age of 65, getting more than nine hours of sleep on a regular basis may be an early sign of the onset of dementia or Alzheimer’s disease, a new study suggests. To reach their conclusions, a team of researchers analyzed data from the Framingham Heart Study, the nation’s longest-running epidemiological study, which began in 1948. The researchers found that people over age 65 who consistently sleep more than nine hours every night had twice the risk of developing dementia and Alzheimer’s disease within the next 10 years when compared to those who slept less than nine hours a night. Sudha Seshadri, professor of neurology at Boston University School of Medicine and leader of the research team, says longer periods of sleep can also be a sign of depression. Researchers analyzed data from 2,457 Framingham study participants who responded to questions about their sleep patterns as part of their regular medical exams. Over a 10-year period of follow-up exams, 234 of these participants received a dementia diagnosis. By reviewing the responses related to their sleep patterns, the researchers found a statistically significant correlation among those who reported increasing their sleep to more than nine hours a night. The results of the study, published in the journal Neurology, suggest that longer sleep sessions may be a symptom rather than a cause of the brain changes that occur with dementia. It does not mean that family members should intervene by waking up older loved ones, Seshadri says. Earlier detection, however, can help patients and their families plan and obtain services and support. “One of the concerning things can be that before there is a formal diagnosis of dementia, people can sometimes fall victim to scams,” says Seshadri. “They can end up in an unsafe situation, because it’s not recognized that they may be able to drive a car; they may be able to live alone at home, but not respond to something unexpected,” Seshadri adds. “Recognizing the signs earlier can provide access to services, can enable people to get the admittedly limited, but valuable treatment options that are available, and could help protect them from potentially dangerous situations.: The researchers also found that a person’s education level correlated with outcomes. People over 65 without a high school degree who slept more than nine hours nightly had a 600 percent greater risk of later receiving a dementia diagnosis than people with a high school degree. “There’s a widely accepted understanding that education may be of some benefit in delaying the onset of clinical dementia,” Seshadri says, but it remains unclear whether the difference in risk is because education is associated with a person’s economic status or because brains build more synapses as they are educated. It’s also unclear how sleep may impact Alzheimer’s risk. She says researchers suspect that the longer sleeping time may be activating certain biological processes that could remove amyloid proteins from the brain, or for some other reason. Seshadri says she hopes that the study will improve our understanding of the role of sleep in preventing dementia. The researchers are now preparing another study for publication, which looks at the sleep cycles of a subgroup of Framingham Heart Study participants. “The question is, what is the pattern of sleep that is associated with increased risk of dementia?” Seshadri says. “We know it is more hours, but what is happening in the extra hours? Are they in stage 1 sleep, rapid eye movement (REM) sleep, slow-wave sleep? Details like that can help us understand the precise biology.” Additional questions researchers hope to pursue focus on the biology of the brain. The researchers hypothesize that elongated sleep patterns could be what Seshadri calls “a compensatory mechanism for the brain to clear extra amyloid,” or protein fragments. “It could also just be a marker of early disease,” she says. The National Institute on Aging; the National Institute of Neurological Disorders and Stroke; and the National Heart, Lung, and Blood Institute funded the the study.


News Article | May 23, 2017
Site: www.eurekalert.org

Findings from 2 long-term studies in line with other associated health benefits of fiber A fibre-rich diet is linked to a lowered risk of painful knee osteoarthritis, finds the first study of its kind, published online in the Annals of the Rheumatic Diseases. The findings, which draw on two different long term studies, are broadly in line with the other reported health benefits of a fibre-rich diet. These include reductions in blood pressure, weight, and systemic inflammation, and improved blood glucose control. The researchers mined data from two US studies in a bid to find out if dietary fibre might have any bearing on the risks of x-ray evidence of knee osteoarthritis, symptomatic knee osteoarthritis (x-ray evidence and symptoms, such as pain and stiffness), and worsening knee pain. The first of these studies was the Osteoarthritis Initiative (OAI). This has been tracking the health of nearly 5000 US men and women with, or at risk of, osteoarthritis since 2004-6 (average age 61), to pinpoint potential risk factors for the condition. The second was part of the Framingham Offspring cohort study, which has been tracking the health of more than 1200 adult children of the original Framingham Heart Study and their partners since 1971. For the current study, results are based on data first taken between 1993-4, when participants were 54, on average, up to 2002-5. For both studies, dietary fibre intake was measured using Food Frequency Questionnaire responses. It averaged out at around 15 g daily in the OAI, and 19 g daily in the Framingham Offspring, study. Information on symptoms and x-ray evidence were collected every year for four years in the OAI and assessed after 9 years in the Framingham Offspring study. Data were also gathered on potentially influential factors, such as knee injury/surgery, medication, and lifestyle, including tobacco and alcohol use and physical exercise. At the end of 4 years, among the 4051 participants in the OAI with complete data on dietary fibre intake, 869 knees were symptomatic; 152 displayed x-ray evidence of osteoarthritis; and pain had worsened in 1964. After an average of 9 years, among 971 participants in the Framingham Offspring study with complete dietary fibre data, 143 knees were symptomatic and 175 displayed x-ray evidence of osteoarthritis. Analysis of the data showed that eating more fibre was associated with a lower risk of painful knee osteoarthritis. Compared with the lowest intake (bottom 25 per cent of participants), the highest intake (top 25 per cent) was associated with a 30 per cent lower risk in the OAI and a 61 per cent lower risk in the Framingham study. But it was not associated with x-ray evidence of knee osteoarthritis. Additionally, among the OAI participants, eating more fibre in general, and a high cereal fibre intake, were associated with a significantly lower risk of worsening knee pain. These findings held true, regardless of other potentially influential factors. This is an observational study, so no firm conclusions can be drawn about cause and effect. Nevertheless, the researchers say: "These data demonstrate a consistent protective association between total fibre intake and symptom-related knee [osteoarthritis] in two study populations with careful adjustment for potential confounders." And they point to other evidence suggesting that a fibre-rich diet is associated with several health benefits, many of which are relevant to osteoarthritis.


News Article | May 25, 2017
Site: www.sciencedaily.com

A fibre-rich diet is linked to a lowered risk of painful knee osteoarthritis, finds the first study of its kind, published online in the Annals of the Rheumatic Diseases. The findings, which draw on two different long term studies, are broadly in line with the other reported health benefits of a fibre-rich diet. These include reductions in blood pressure, weight, and systemic inflammation, and improved blood glucose control. The researchers mined data from two US studies in a bid to find out if dietary fibre might have any bearing on the risks of x-ray evidence of knee osteoarthritis, symptomatic knee osteoarthritis (x-ray evidence and symptoms, such as pain and stiffness), and worsening knee pain. The first of these studies was the Osteoarthritis Initiative (OAI). This has been tracking the health of nearly 5000 US men and women with, or at risk of, osteoarthritis since 2004-6 (average age 61), to pinpoint potential risk factors for the condition. The second was part of the Framingham Offspring cohort study, which has been tracking the health of more than 1200 adult children of the original Framingham Heart Study and their partners since 1971. For the current study, results are based on data first taken between 1993-4, when participants were 54, on average, up to 2002-5. For both studies, dietary fibre intake was measured using Food Frequency Questionnaire responses. It averaged out at around 15 g daily in the OAI, and 19 g daily in the Framingham Offspring, study. Information on symptoms and x-ray evidence were collected every year for four years in the OAI and assessed after 9 years in the Framingham Offspring study. Data were also gathered on potentially influential factors, such as knee injury/surgery, medication, and lifestyle, including tobacco and alcohol use and physical exercise. At the end of 4 years, among the 4051 participants in the OAI with complete data on dietary fibre intake, 869 knees were symptomatic; 152 displayed x-ray evidence of osteoarthritis; and pain had worsened in 1964. After an average of 9 years, among 971 participants in the Framingham Offspring study with complete dietary fibre data, 143 knees were symptomatic and 175 displayed x-ray evidence of osteoarthritis. Analysis of the data showed that eating more fibre was associated with a lower risk of painful knee osteoarthritis. Compared with the lowest intake (bottom 25 per cent of participants), the highest intake (top 25 per cent) was associated with a 30 per cent lower risk in the OAI and a 61 per cent lower risk in the Framingham study. But it was not associated with x-ray evidence of knee osteoarthritis. Additionally, among the OAI participants, eating more fibre in general, and a high cereal fibre intake, were associated with a significantly lower risk of worsening knee pain. These findings held true, regardless of other potentially influential factors. This is an observational study, so no firm conclusions can be drawn about cause and effect. Nevertheless, the researchers say: "These data demonstrate a consistent protective association between total fibre intake and symptom-related knee [osteoarthritis] in two study populations with careful adjustment for potential confounders." And they point to other evidence suggesting that a fibre-rich diet is associated with several health benefits, many of which are relevant to osteoarthritis.


News Article | May 24, 2017
Site: www.chromatographytechniques.com

If senior citizens you know are sleeping more than nine hours every night, it could be time to suggest checking for early signs of dementia or Alzheimer’s disease. A team of researchers led by Sudha Seshadri, a Boston University School of Medicine (MED) professor of neurology, analyzed data from the Framingham Heart Study, the nation’s longest-running epidemiological study. Begun in 1948 and supported by the National Heart, Lung, and Blood Institute (NHLBI), it has been run by BU since 1971. The researchers found that people over age 65 who consistently sleep more than nine hours every night had twice the risk of developing dementia and Alzheimer’s disease within the next 10 years when compared to those who slept less than nine hours a night. Seshadri says longer periods of sleep can also be a sign of depression. MED researchers analyzed data from 2,457 Framingham study participants who responded to questions about their sleep patterns as part of their regular medical exams. Over a 10-year period of follow-up exams, 234 of these participants received a dementia diagnosis. By reviewing the responses related to their sleep patterns, the researchers found a statistically significant correlation among those who reported increasing their sleep to more than nine hours a night. Findings from the study, which received funding from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the NHLBI, were published in the journal Neurology. The results suggest that longer sleep sessions may be a symptom rather than a cause of the brain changes that occur with dementia. It does not mean that family members should intervene by waking up older loved ones, Seshadri says. Earlier detection, however, can help patients and their families plan and obtain services and support. “One of the concerning things can be that before there is a formal diagnosis of dementia, people can sometimes fall victim to scams,” says Seshadri. “They can end up in an unsafe situation, because it’s not recognized that they may be able to drive a car; they may be able to live alone at home, but not respond to something unexpected. Recognizing the signs earlier can provide access to services, can enable people to get the admittedly limited, but valuable treatment options that are available, and could help protect them from potentially dangerous situations.” The researchers also found that a person’s education level correlated with outcomes. People over 65 without a high school degree who slept more than nine hours nightly had a 600 percent greater risk of later receiving a dementia diagnosis than people with a high school degree. “There’s a widely accepted understanding that education may be of some benefit in delaying the onset of clinical dementia,” Seshadri says, but it remains unclear whether the difference in risk is because education is associated with a person’s economic status or because brains build more synapses as they are educated. It’s also unclear how sleep may impact Alzheimer’s risk. She says researchers suspect that the longer sleeping time may be activating certain biological processes that could remove amyloid proteins from the brain, or for some other reason. Seshadri says she hopes that the study will improve our understanding of the role of sleep in preventing dementia. The researchers are now preparing for publication another study, which looks at the sleep cycles of a subgroup of Framingham Heart Study participants. “The question is, what is the pattern of sleep that is associated with increased risk of dementia?” Seshadri says. “We know it is more hours, but what is happening in the extra hours? Are they in stage 1 sleep, rapid eye movement (REM) sleep, slow-wave sleep? Details like that can help us understand the precise biology.” Additional questions researchers hope to pursue focus on the biology of the brain. The researchers hypothesize that elongated sleep patterns could be what Seshadri calls “a compensatory mechanism for the brain to clear extra amyloid,” or protein fragments. “It could also just be a marker of early disease,” she says.


News Article | May 9, 2017
Site: www.eurekalert.org

BOSTON -- Researchers from Hebrew Senior Life's Institute for Aging Research have discovered that foot pain - particularly severe foot pain - correlates to a higher incidence of recurrent falls. This finding also extends to those diagnosed with planus foot posture (flat feet), indicating that both foot pain and foot posture may play a role in falls among older adults. Using data from the Framingham Foot study, researchers found that foot pain and foot posture were not associated with any one fall; however, in the case of multiple falls, foot pain and foot posture were often a factor. These findings were published today in the journal Gerontology. "We know that having more than one fall can be of concern. Many don't think of feet as the culprit. However, higher odds of recurrent falls were seen for those with foot pain, especially severe foot pain, as well as those with planus foot posture, indicating that both foot pain and foot posture may play a role in falls," said Marian Hannan, Co -Director of the Musculoskeletal Research Center at the Institute for Aging Research and Associate Professor of Public Health, Harvard School of Public Health. "This is important because falls are a serious problem for older adults. They are a leading cause of hospitalization and often lead to a loss of independence, a decrease in quality of life, and sometimes death. With this new knowledge we hope to find more solutions to lessen the risk of falls in older adults," said Lead author Arunima Awale, Research Associate at Hebrew Senior Life's Institute for Aging Research. More than 30 percent of individuals over the age of 65 fall at least once a year. This figure increases to over 40% for persons aged 75 years or older. As a result of this study, scientists are hopeful that by lessening the instance of foot pain in older adults they can significantly reduce hospitalizations and loss of independence for American seniors. This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Disease and National Institute of Aging (grant number AR047853); and the National Heart, Lung and Blood Institute's Framingham Heart Study N01-HC-25195). About the Institute for Aging Research Scientists at the Institute for Aging Research seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity and productivity into advanced age. The Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment and cure of disease; advance the standard of care for older people; and inform public decision-making. The Aging Brain Center within IFAR studies cognitive aging and conditions affecting brain health. Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching and redefining the possibilities of aging. Founded in Boston in 1903, the nonprofit, non-sectarian organization today provides communities and health care for seniors, research into aging, and education for geriatric care providers. For more information about Hebrew SeniorLife, visit http://www. , follow us on Twitter @H_SeniorLife, like us on Facebook or read our blog.


Xanthakis V.,Framingham Heart Study
Journal of the American Heart Association | Year: 2013

Currently available screening tools for left ventricular (LV) hypertrophy (LVH) and systolic dysfunction (LVSD) are either expensive (echocardiography) or perform suboptimally (B-type natriuretic peptide [BNP]). It is unknown whether newer biomarkers are associated with LVH and LVSD and can serve as screening tools. We studied 2460 Framingham Study participants (mean age 58 years, 57% women) with measurements of biomarkers mirroring cardiac biomechanical stress (soluble ST-2 [ST2], growth differentiation factor-15 [GDF-15] and high-sensitivity troponin I [hsTnI]) and BNP. We defined LVH as LV mass/height(2) ≥the sex-specific 80th percentile and LVSD as mild/greater impairment of LV ejection fraction (LVEF) or a fractional shortening <0.29. Adjusting for standard risk factors in logistic models, BNP, GDF-15, and hsTnI were associated with the composite echocardiographic outcome (LVH or LVSD), odds ratios (OR) per SD increment in log-biomarker 1.29, 1.14, and 1.18 (95% CI: 1.15 to 1.44, 1.004 to 1.28, and 1.06 to 1.31), respectively. The C-statistic for the composite outcome increased from 0.765 with risk factors to 0.770 adding BNP, to 0.774 adding novel biomarkers. The continuous Net Reclassification Improvement was 0.212 (95% CI: 0.119 to 0.305, P<0.0001) after adding the novel biomarkers to risk factors plus BNP. BNP was associated with LVH and LVSD in multivariable models, whereas GDF-15 was associated with LVSD (OR 1.41, 95% CI: 1.16 to 1.70), and hsTnI with LVH (OR 1.22, 95% CI: 1.09 to 1.36). ST2 was not significantly associated with any outcome. Our community-based investigation suggests that cardiac stress biomarkers are associated with LVH and LVSD but may have limited clinical utility as screening tools.

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