Cholesterol and our Aging Brains

Cholesterol is in every cell in our body and becomes concentrated in our brain. Our brain is 60% fat, with over 25% of that being cholesterol. Most of the cholesterol in the brain is produced in the hypothalamus itself, establishing cholesterol as an integral part of our brain.

One of the most dramatic difference between young and old brains is the reduced myelination—fat sheathing—around nerves, which might explain why aging brains shrink at 1% a year. Myelin is a sheet of lipid, or fat, with the highest cholesterol content of any brain tissue. Even neurotransmitters, the chemical words used in the language that the brain communicates in, are made of cholesterol. George Bartzokis, with UCLA, and his colleagues, found a correlation between diminishing speed of performing tasks and diminishing level of myelination. The older we get, the less myelination we have. And in older age we can destroy this protective layer much faster through excessive alcohol intake and some non-/prescription drugs.

Myelination seems to be important in how we learn. Although grey matter—on the outside of the cortex made up of neurons—carry messages and does the “thinking”—white matter—the myelinated part of the brain—controls the strength of signals. Myelination is how we learn, strengthening some signals above others. Myelination also occurs in at different ages. Starting from the back of the brain as children, and finishing off at the front of the brain in adulthood. This explains why certain tasks are easier when you are a child then at older ages (learning to speak without an accent.)

And the role of cholesterol seems crucial to this process of myelination. In 2008 Rebecca West and her colleagues from Mount Sinai School of Medicine, New York, unexpectedly found that among normal—no expression of dementia and not having the genes that predispose you to get dementia—older adults aged 85 years and older, high total cholesterol and high LDL (bad) cholesterol were associated with higher memory scores.

Other evidence is mounting. Elizabeth Johnson and Ernst Schaefer with Tufts University, Boston, MA conjectured that one commercially available fish oil capsule per week—180 mg dietary DHA/d—might reduce the risk of dementia by half.  On the negative side, two small trials published in 2000 and 2004 by Matthew Muldoon from the University of Pittsburgh, suggest that prescription medication we use to lower cholesterol—statins—might bring about cognitive decline. He reported that participants taking placebo pills improved on repeated tests of attention and reaction while those on statins did not.  This was further confirmed by anecdotal evidence published in an article in 2003 in Reviews of Therapeutics which reported  that among 60 statin users who had reported memory problems to MedWatch, when they stopped taking the medication more than half reported  improved memory.

Science is not truer than religion. Science is being able to challenge the accepted reality of today. Science is a method rather than a body of truths. The method is to question beliefs, to test expectations. The problem with science in large U.S. institutions is that it has become a religion.

© USA Copyrighted 2014 Mario D. Garrett

Leaving Behind the Victim of Dementia

Unfortunately, I come across many anecdotal stories of caregivers dying.  And as a result, leaving behind the person who depended upon them. Increasingly, those left behind are suffering from dementia.

This observation raises two questions. The obvious one, which is an emotional question; who will look after the care recipient now? But a second question has a more radical focus; why are these caregivers dying earlier?

What has been described as a ‘living bereavement’, caring for a loved one with dementia becomes increasingly difficult the further the disease progresses. Unlike most other caregiving, where the care, in most cases, becomes less stressful because the person improves (eg some stroke patients) or they grow up (eg children) or they die quickly (eg some cancer patients) , with dementia the diseases progressively incapacitates the victim. With further incapacity comes a greater burden on the caregiver. Caregivers of loved ones with dementia carry an extra burden that is reflected in more sever and negative effects.

Although David Roth and his colleagues, in their study of 3,503 family caregivers, reported that caregiving was not associated with increased risk of death, they failed to identify the specific type—and intensity—of care being provided. Not all caregiving is the same. And you learn that when you look after a victim of dementia.

As early as 1990, Janice Kiecolt-Glaser from Ohio State University and her colleagues measured the different impact caring for a patient with dementia had on their caregivers. They reported that caregivers of people with dementia had significantly more depression, reported less support and fewer important personal relationships, and experienced more days of illnesses from infections, when compared with caregivers of non-demented loved ones. What was convincing in their argument is that these caregivers had physical immunological deficiencies. They were sicker.

Richard Schulz and his colleagues from the University of Pittsburgh in 1999 showed how even after adjusting for a variety of factors, caregivers who are experiencing strain had mortality risks that were 63% higher than non-caregiving controls. The beneficial spiritual and physical effects of caregiving do not override the negative effects of caring for someone with dementia.

One indicator of sickness, which also reduces your lifespan—is the size of your telomeres. These DNA blocks at the end of each of our 46 chromosomes have been likened to an aglet—the plastic at the end of shoelaces. The size of these telomeres determine how many times each cell can replicate—the longer the telomeres, the more your cell can replicate, the longer they live, the longer you live. There are numerous studies being published showing how stress and trauma reduces telomeres. With varying intensities of care there are reduction in these telomeres. Dementia caregivers not only have vastly shortened telomeres, but this change is permanent even after their loved one dies. Despite most caregivers of dementing illness being older and frailer than other caregivers, most choose to look after their loved ones. The decision, of whether providing this care accelerates your mortality faster than the mortality of your care recipient, is not an easy one to make.

© USA Copyrighted 2014 Mario D. Garrett

Older Adults' Fascination with Obituaries

The fascination of reading the obituaries forms a purely older adult phenomenon. And it is not a morbid fascination with death, but a testament that the reader is still alive. Longevity is related to being happy with your lot. Even if you could change events, you wouldn’t--that kind of happiness. Because the only anti-aging that nature knows is death, nature rewards those who accept aging and the losses we experience on the way.

How older adults deal with loss points to effective strategies that they have learned to use in maintaining an optimistic perspective. These are patterns of coping that start early in life. These coping strategies result in less damage to the body and result in greater longevity. One theory popular in the 1980s is now known as the Baltes’s Selective Optimization with Compensation—SOC—theory. Here Baltes describes strategies of how we address physical and mental losses as we age in order to minimize their effect.

Let's take for example that you are becoming deaf. The theory predicts three main strategies that older adults follow. First you become selective. You will increasingly choose quieter social settings without conflicting noises. You stop going to loud parties. Then you will optimize those situations that you choose to participate in.  You will choose to be with people that you can hear better, sitting closer, giving them your best ear, you optimize what hearing you do have. This optimizes your remaining ability to listen. Lastly, you will start to compensate. You might start going to the cinema or theatre more where you do not have to converse with anyone. You might do more activities where you do not have to talk (running, swimming, hiking.) You might also compensate by learning to use hearing aides. These three SOC strategies allow you to participate without drastically changing your lifestyle. SOC is a strategy for accepting your losses. To focus on what you can do rather than what you cannot do. This strategy, learned earlier on, gets more useful with increasing age as we experience more deficits.

One of the uniquely frequent experiences in older age is the death of a close friend. Although death never becomes easier to accept--it is so final--there is a greater appreciation of acceptance. In 2001 Christopher Davis from St. Francis Xavier University and Susan Nolen-Hoeksema from the University of Michigan reported that older adults who have lost a loved one often try to extract some meaning of their loss. Even if meaning cannot be found the authors report that older adults search for some benefit in the loss. This is different from grief of younger adults or children. The belief that there is meaning or some benefit even in anguish of loss suggest a positive strategy. Again, the strategy of SOC is to accept the reality and to try and compensate the loss by finding some hidden meaning or benefit.

The philosophy is “it could be worse.” Which brings us back to the fascination older adults have with the obituaries. You are always better than those who are dead.

© USA Copyrighted 2014 Mario D. Garrett

The Death Experience.

Older Adults do not fear death they fear dying. Specifically, we fear a prolonged process of dying—the agonal image of death. This is not a new observation.
Lora-Jean Collett and David Lester made this distinction in 1969 and devised a scale to distinguish between the fear of death from the fear of the process of dying.  Some older adults are better at confronting death than others. In an interesting study, James Griffith from Shippensburg University, Pennsylvania and his colleagues examined attitudes toward dying and death among older men who had different experiences with danger. The group of men included skydivers (high death risk), nursing home residents (high death exposure), volunteer firefighters (high death risk and high death exposure), and a control group. Their analyses identified that accepting death by risking death, reduces the fear of death.  High death riskers are better at accepting death. It seems that the fear of death can be minimized, perhaps not only by risking death.
Studies with nurses have reported that working with dying patients diminished their fear of death. This acceptance of death occurred while in nurse training as well. As always, the fear is brought on more by the unknown. And this fear determines how we behave.  Balfour Mount, a palliative care specialist suggested that deep-rooted existential fear of death prevents healthcare professionals from providing good and compassionate care for the dying.
Maturity involves an appreciation that dying is itself a process. A process which, at the very end, we seem to share with other people across many cultures.
Raymond Moody coined the term “Near Death Experience”—NDE. As early 1975 Moody described survivors who ‘let go’ and accepted their death, but when they survived, reported experiences of great joy. Although there are exceptions—especially with the use of medications at the end-of-life—Moody describes how after travelling through darkness they came against a bright light, accompanying “beings of light” that helped them to review their life. Such experiences have been shown to be experienced across many cultures. And the interesting outcome after these NDEs is that these individuals report having a diminished fear of death.
It was up to a chemistry professor with West Texas A&M to find some of the physiology reasons for NDEs.  James E. Whinnery studied fighter pilots subjected to extreme gravitational forces in a giant centrifuge. What he found is that under extreme g-forces, fighter pilots experience gravitationally-induced loss of consciousness—G-LOC—similar to NDEs in many of its characteristics, including the tunnel experience and the bright lights. Only when Whinnery went beyond the pilots losing consciousness, to the brink of near death, did the fighter pilots have a near death experience.
We are conscious of our death and we have developed an evolutionary positive method of dealing with it. Death, as defined by our evolution, is a positive experience. Death might be detrimental to the individual, but it is imperative for the specie to survive. It is appropriate that evolution honors this. The way to reduce our fear of death is to confront it, dying itself is a positive experience.

© USA Copyrighted 2013 Mario D. Garrett

Cougar Sex

David M Buss has been writing about older women’s sexual adventures for some time. He notes in “Why Women Have Sex” that women use sex as a defensive tactic against a mate’s infidelity (protection), as a ploy to boost self-confidence (status), as a barter for gifts or household chores (resource acquisition), or as a cure for a migraine headache (medication). Like most of men's evaluation of women’s sexuality, pleasure is not one of the reasons explored.

Using Craigslist to enlist three quarters of their volunteers Buss and his colleagues found that women aged 27 through 45 years of age report having more sexual fantasies, more intensely and engaging in more sexual encounters than their younger cohorts. The impact of marriage and having children was not found to be as important as age . Only age had a strong positive effect on women's reported sexual interest and behavior. Women’s sexual awakening seems to be formidable.

Women’s sexual interest was believed to peak and then fall precipitously after menopause. But this drop might be a misinterpretation by some researchers.

Susan E. Trompeter, and her colleagues from the University of California San Diego looked at women 25 years after their menopause. Half (49.8%) reported sexual activity within the past month with or without a partner. Sexual activity included arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time. Only a third reported low, very low, or no sexual desire. Although frequency of sexual activity decreased with age, they all reported increased satisfaction when they did have an orgasm.

Having the brain as one of the largest sex organ—together with the skin—determines that emotional closeness is associated with more frequent arousal, lubrication, and orgasm during sex. Overall, two thirds of sexually active women were moderately or very satisfied with their sex life. With such statistics, the idea of peaking only before menopause seems a myth. For some women they keep on going.

Little is written about late life sexual activity except for educational purpose. What has been written is about marriage from public records. In a recent article in an unlikely journal of Review of Economics and Statistics, Hani Mansour and Terra McKinnish from the University of Colorado reported that couples with big age differences are typically less attractive, less educated and make less money than couples of similar ages. The more pronounced the age difference the less positive attributes they had.

Interestingly, they make a class issue (using education as a proxy for class.) More educated people tend to interact more with people their own age while those with lower formal education and who work in low-skill jobs are more likely to socialize with people of a wide range of ages. Poorer people have networks that are more age diverse. But this might be about marriage, a social contract.

Pleasure comes in many forms and sexual gratification is one of them. Marriage is not an indication of pleasure, but age is. Maurice Chevalier’s "never date anyone under half your age plus seven" might be appropriate for most people but it might not apply to some older women. Sexual arousal for older women matches those of younger men.

© USA Copyrighted 2013 Mario D. Garrett

Children Killing Their Parents

As upsetting as it is, there are numerous blogs on how to kill your parents. Unlike elder abuse, killing younger parents seems to be voyeuristic entertainment. This surprising revelation is worrisome

The animosity children feel towards their parents provides a necessary feeling of detachment, augurs for a healthy separation process from their parents. It is how they differentiate themselves from their primary influences in life in order for them to become whole persons. Such feelings are nothing new. The surprise being websites devoted to killing one’s parents, with instructions. Then the second surprise was the statistics.

For more than two decades, Kathleen Heide from the University of South Florida has been conducting analysis of homicides where children kill their parents. In the USA about five parents a week are killed by their biological children. Matricide—where the mother is murdered--and patricide—where the father is murdered—are both very rare events and constitute about 1 percent of all homicides in the United States—but we have a lot of homicides in the US.

In a 2011 report from the Department of Justice, Alexia Cooper and Erica L. Smith reported a change in trend of family homicide. The most common were homicide by a spouse or ex-spouse, which is declining from 52% of all family homicides in 1980 to 37% in 2008. Children killed by their parents were the second most frequent type of family homicide. This is seeing an increase, from 15% in 1980 to 25% in 2008. But the fastest growing homicide is the last category where parents are killed by one of their children. This type of homicide has been increasing steadily from 9.7% of all family homicides in 1980 to 13% in 2008. Children killing their parents is the fastest growing type of family homicide. In the latest federal statistics both matricide and patricide is committed primarily by sons between 16-19 years and then declines rapidly at older ages.

In 1993 Clifford J. Linedecker wrote a book on “Killer Kids” where he reports that there were over a million assaults in the USA by children on their parents, some were fatal. He documents some of the most horrific cases. Most use their parents’ guns, others use knives, axes and any available weapon. The younger killers are more likely to use their parents’ gun.

Since patricide is most frequent (nearly twice as likely as matricide) and  increasing, there might be a number of reasons for this. With increasing breakdown of family structure in the USA--with one in two marriages ending up in divorce--there is a risk of one parent alienating their children against the second parent. Parental alienation is on the increase as are children killing their fathers. Very often the father (rather than the mother) becomes portrayed as the reason for all the negative emotions. Parental alienation does not start or end with divorce. But there are reasons for this behavior. We just need to find that reasoning, however repugnant and irrational.

© USA Copyrighted 2013 Mario D. Garrett

Dying to Be Born

Mekayla Storer, and her colleagues in Barcelona, and Daniel Muñoz-Espín, and his colleagues in Madrid, just published interesting findings about death. When a cell dies, it was always assumed that it is in response to age, stress or trauma. In fact, the anti-aging industry is built upon the foundation of stopping cell death with the hope of making us immortal.  But these Spanish researchers have shown that cell death is a necessary process for development. That in order for other cells to grow they need some of the cells to die first and create a pattern. What is unique in these studies is that the information comes not from older adults but from studies on the embryo.

For the first time, there is evidence showing that cell death is programmed in order for specific organs to be able to develop. Cell death is not only a part of development but is a required part it. They are like the advance party that charts out a territory and then die, sending out directions for the main party. In the embryo, when a cell dies, its death instructs new tissue growth. The necessity of cell death has been shown to help control normal limb formation, nervous system development, development of kidneys and ear formation.

These studies are showing that cell death is a necessary part of development of normal organs. This is new. Such studies are a death knoll to the anti-aging industry, since such knowledge destroys the concept of eradicating cell death in order to gain immortality. Cell death is a necessary process in order to pave the way for other cells to grow and to enable the growth of different parts of our bodies.

The process is determined by how the dead cells are cleaned by specialized cells that leave behind them a pattern that is followed by the new cells. When cells do not die, then there are problems with development. It is no wonder that birth defects are in parts of the embryos where these dead cells occur. The death of cells and how they are cleaned up is instrumental for the normal growth of cells.

This is important for older adults because dying cells and how they are cleaned up have complementary functions in cancer. We do not know the exact relationship (whether one encourages the other or not) but we know that they are related because we can listen to them communicating. Cells communicate in short distances—known as paracrine—and long distances—through hormones and endocrine system. This language could be what differentiates good dying cells from bad dying cells—cancer. Good dying cells have a different short distance message from cancer cells. Good dying cells might call out to the cleaner cells while cancer cells give short messages that keep the cleaner cells away. How these two different types of dying cells work in aging is still unknown, but we now know that cell death communicate with those living cells. Can you hear me now?

© USA Copyrighted 2013 Mario D. Garrett