Newly discovered blood biomarkers may help detect cognitive impairment in people with Parkinson’s disease. In a study published in Brain, NIA researchers demonstrated the ability of extracellular vesicle biomarkers to identify whether an individual with Parkinson’s had a cognitive impairment.

Extracellular vesicles are tiny sacs released by cells in the body that transport “cargo molecules” between cells and communicate information. Extracellular vesicles originating from neurons have proteins such as alpha-synuclein, beta-amyloid, phosphorylated tau, and an insulin-signaling protein called Insulin Receptor Substrate 1 (IRS-1). These proteins are biomarkers, measurable indicators of body processes that can help doctors diagnose diseases. Alpha-synuclein buildup in the brain is a key pathological hallmark of Parkinson’s and may also contribute to dementia. Buildups of beta-amyloid and phosphorylated tau are typically associated with brain changes in Alzheimer’s disease but are also present in Parkinson’s. Additionally, insulin resistance — an impaired response to the hormone insulin, resulting in increased blood sugar — is associated with Parkinson’s. Extracellular vesicles and their cargo molecules can be isolated and measured in blood to identify potential Parkinson’s biomarkers.

NIA researchers collaborated with scientists in New Zealand and France to isolate neuronal extracellular vesicles in blood samples from more than 200 people. The samples came from participants in the New Zealand Parkinson’s Progression Programme who had Parkinson’s, either with normal cognition or with cognitive impairment (mild cognitive impairment or dementia, excluding Lewy body dementia), and 49 people without Parkinson’s. The researchers measured the levels of alpha-synuclein, beta-amyloid, phosphorylated tau, and active IRS-1 proteins in each sample.

Those with Parkinson’s had less alpha-synuclein and IRS-1 and more phosphorylated tau than healthy individuals. Among those with Parkinson’s, participants with normal cognition had more alpha-synuclein and IRS-1 and less phosphorylated tau than participants with cognitive impairment. However, beta-amyloid did not differ between groups. This indicates that alpha-synuclein, phosphorylated tau, and IRS-1 play a role in the progression of Parkinson’s with cognitive impairment. The results also seem to suggest that phosphorylated tau and alpha-synuclein are jointly involved in producing cognitive impairment in Parkinson’s.

Analyzing extracellular vesicles may be an effective way to find new biomarkers for neurodegenerative diseases such as Parkinson’s. Blood biomarkers that help detect cognitive impairment in Parkinson’s could improve timely diagnosis and treatment. Future studies may measure extracellular vesicle biomarkers over time to establish a timeline for biomarker changes in people with Parkinson’s.

A community-based support group focusing on sharing relevant information and education about all things Parkinson’s.

Meetings are held monthly on the third Tuesday, 10-11am, at Crosspointe Church (5415 Ralston Ave.). Next meeting: Tuesday, January 17, 2022

Ventura County Parkinson’s Support Group gets together every month with skilled, experienced professionals who present significant breakthroughs, strategies and related issues surrounding Parkinson’s. The group’s mission is for participants to better understand and talk about how this information impacts their own lives and affects immediate family members. In addition to those diagnosed with PD, caregivers, family members and friends are ALL welcome to attend FREE of charge.

More than just a meeting, all discussions/presentations offer interactive, 0-pcompassionate, relevant education on PD. Topics range from “How to get up off the floor when you’ve fallen,” to “Nutrition and Parkinson’s” to “The benefits of deep brain stimulation and assessing if you’re a good candidate for DBS.”

Jon Everhart, retired accountant, US Marine and regular group attendee said, “It’s nice comparing treatments, symptoms, and the challenges we all face living with Parkinson’s.” This caring group empowers people like Jon to be more proactive and to participate in deciding the direction of his treatment, complemented by his team of doctors’ suggestions.

This unique group gives everyone a great opportunity to learn more about current PD research, to gain more awareness about local help and resources, to share relevant experiences with others — and to have fun along the way.

The Ventura County Parkinson’s Support Group was recently resurrected (post-Covid) by Dr. Vanessa White, owner of Ventura County Neurofitness (a local fitness program designed specifically for those with Parkinson’s and other neurological degenerative diseases). The impetus for her assuming this responsibility was after her mother-in-law, Toy White, was diagnosed several years ago with PD. This important, special group was born upon her passing.

Most people tend to focus on one type of exercise or activity and think they’re doing enough. Research has shown that it’s important to get all four types of exercise: endurance, strength, balance, and flexibility. Each one has different benefits. Doing one kind also can improve your ability to do the others, and variety helps reduce boredom and risk of injury. No matter your age, you can find activities that meet your fitness level and needs!

Endurance activities, often referred to as aerobic, increase your breathing and heart rates. These activities help keep you healthy, improve your fitness, and help you perform the tasks you need to do every day. Endurance exercises improve the health of your heart, lungs, and circulatory system. They also can delay or prevent many diseases that are common in older adults such as diabetes, colon and breast cancers, heart disease, and others. Physical activities that build endurance include:

Brisk walking or jogging
Yard work (mowing, raking)
Dancing
Swimming
Biking
Climbing stairs or hills
Playing tennis or basketball

Increase your endurance or “staying power” to help keep up with your grandchildren during a trip to the park, dance to your favorite songs at a family wedding, and rake the yard and bag up leaves. Build up to at least 150 minutes of activity a week that makes you breathe hard. Try to be active throughout your day to reach this goal and avoid sitting for long periods of time.

Your muscular strength can make a big difference. Strong muscles help you stay independent and make everyday activities feel easier, like getting up from a chair, climbing stairs, and carrying groceries. Keeping your muscles strong can help with your balance and prevent falls and fall-related injuries. You are less likely to fall when your leg and hip muscles are strong. Some people call using weight to improve your muscle strength “strength training” or “resistance training.”

Some people choose to use weights to help improve their strength. If you do, start by using light weights at first, then gradually add more. Other people use resistance bands, stretchy elastic bands that come in varying strengths. If you are a beginner, try exercising without the band or use a light band until you are comfortable. Add a band or move on to a stronger band (or more weight) when you can do two sets of 10 to 15 repetitions easily. Try to do strength exercises for all of your major muscle groups at least 2 days per week, but don’t exercise the same muscle group on any 2 days in a row.

Balance exercises help prevent falls, a common problem in older adults that can have serious consequences. Many lower-body strength exercises also will improve your balance.

Balance exercises include:

Tai Chi, a “moving meditation” that involves shifting the body slowly, gently, and precisely, while breathing deeply.
Standing on one foot.
The heel-to-toe walk.
The balance walk.
Standing from a seated position.

Flexibility exercises include:
The back stretch exercise
The inner thigh stretch
The ankle stretch
The back of leg stretch
Safety tips
Stretch when your muscles are warmed up.
Stretch after endurance or strength exercises.
Don’t stretch so far that it hurts.
Always remember to breathe normally while holding a stretch.
Talk with your doctor if you are unsure about a particular exercise.

Optimism is linked to a longer lifespan in women from diverse racial and ethnic groups, and to better emotional health in older men, according to two NIA-funded studies. One study showed that the previously established link between optimism and longevity applies to racially and ethnically diverse populations of women and that the link is only partially due to changes in health behaviors. The other study showed that more optimistic men have fewer negative emotions, due in part to reduced exposure to stressful situations. These findings suggest that increasing optimism may be a way to extend lifespan and improve well-being in older adults.

However, most of these studies were in non-Hispanic White populations. In a collaborative study published in the Journal of the American Geriatrics Society, researchers from Harvard University; Boston University School of Medicine; Kaiser Permanente; University of California, Davis; University of California, San Diego; and the Warren Alpert Medical School of Brown University explored the link between optimism and longevity in a racially diverse population of women.

Researchers analyzed data from over 150,000 women ages 50–79, collected as a part of the Women’s Health Initiative (WHI). The WHI included non-Hispanic White, Black, Hispanic/Latina, and Asian women. Each participant in the study completed a validated optimism test and provided demographic and health information. When scientists analyzed the data, they found that the most optimistic women lived, on average, 5.4% longer (approximately 4.4 years) than the least optimistic women. The most optimistic women were also more likely to achieve exceptional longevity, defined as living over 90 years. These trends were consistent across all racial and ethnic groups.

Scientists also tested the hypothesis that optimistic women live longer because they have healthier lifestyles. Previous studies showed that optimistic people are likelier to engage in behaviors that promote health and longer lifespan. Given this, the authors used statistical methods to determine whether lifestyle factors could explain the link between optimism and lifespan. Specifically, the study collected information on exercise, diet, body mass index, smoking history, and alcohol consumption. The researchers found that these factors only accounted for 25% of the link between optimism and longevity. These results suggest that the link between optimism and lifespan may be partly due to healthier behaviors, but that other pathways and factors are also likely to be involved.

Another NIA-funded study, published in The Journals of Gerontology, explored the idea that reductions in stressful experiences could be one of the factors that explain the link between optimism and better health. Prior studies from other research groups established that stress exposure is linked to worse health and a shorter lifespan. In this study, a group of scientists from the VA Boston Healthcare System, Boston University, Harvard T.H. Chan School of Public Health, Rush Medical College, and Northwestern University analyzed the relationship between optimism, stress, and emotional well-being in older men.

Researchers found that more optimistic men experienced fewer negative emotions. More than 50% of this link could be explained by reduced exposure to daily stressors. These results suggest that optimism may cause older adults to avoid, direct their attention away from, or change how they think about stressful situations. The authors note that their study is limited in that participants were all male, primarily White, and had a higher socioeconomic status than the general population. To determine whether the results apply to everyone, the study should be repeated in more diverse populations.

Results from these two studies provide important insights into how optimism may improve health and longevity. Findings from the first study show that optimism is linked to a longer lifespan across racial and ethnic groups. Although differences in healthy behaviors can explain a modest portion of this link, that is only part of the story. The second study suggests that optimism may benefit health and well-being because it is linked to reduced exposure to stress.

Because optimism is a modifiable characteristic that can be changed with interventions like writing exercises and therapy, improving optimism may be an effective strategy to improve health and extend lifespan across racial and ethnic groups.

This research was supported in part by NIA grants R01AG053273, K08AG048221, and R01-AG018436.

Many older adults worry about their memory and other thinking abilities. For example, they might be concerned about taking longer than before to learn new things, or they may sometimes forget to pay a bill. These changes are usually signs of mild forgetfulness — often a normal part of aging — not serious memory problems.

What’s the difference between normal, age-related forgetfulness and a serious memory problem? It’s normal to forget things occasionally as we age, but serious memory problems make it hard to do everyday things like driving, using the phone, and finding your way home.

Talk with your doctor to determine whether memory and other cognitive problems, such as the ability to clearly think and learn, are normal and what may be causing them.

Signs that it might be time to talk to a doctor include:

Asking the same questions over and over again
Getting lost in places a person knows well
Having trouble following recipes or directions
Becoming more confused about time, people, and places
Not taking care of oneself —eating poorly, not bathing, or behaving unsafely

Tips for dealing with forgetfulness
People with some forgetfulness can use a variety of techniques that may help them stay healthy and deal with changes in their memory and mental skills. Here are some tips:

Learn a new skill.
Follow a daily routine.
Plan tasks, make to-do lists, and use memory tools such as calendars and notes.
Put your wallet or purse, keys, phone, and glasses in the same place each day.
Stay involved in activities that can help both the mind and body.
Volunteer in your community, at a school, or at your place of worship.
Spend time with friends and family.
Get enough sleep, generally seven to eight hours each night.
Exercise and eat well.
Prevent or control high blood pressure.
Don’t drink a lot of alcohol.
Get help if you feel depressed for weeks at a time.

Dementia is not a normal part of aging. It includes the loss of cognitive functioning — thinking, remembering, learning, and reasoning — and behavioral abilities to the extent that it interferes with a person’s quality of life and activities. Memory loss, though common, is not the only sign of dementia. People with dementia may also have problems with language skills, visual perception, or paying attention. Some people have personality changes.

While there are different forms of dementia, Alzheimer’s disease is the most common form in people over age 65. The chart below explains some differences between normal signs of aging and Alzheimer’s.

If you, a family member, or friend has problems remembering recent events or thinking clearly, talk with a doctor. He or she may suggest a thorough checkup to see what might be causing the symptoms. You may also wish to talk with your doctor about opportunities to participate in research on cognitive health and aging.

At your doctor visit, he or she can perform tests and assessments, which may include a brain scan, to help determine the source of memory problems. Your doctor may also recommend you see a neurologist, a doctor who specializes in treating diseases of the brain and nervous system.

Memory and other thinking problems have many possible causes, including depression, an infection, or medication side effects. Sometimes, the problem can be treated, and cognition improves. Other times, the problem is a brain disorder, such as Alzheimer’s disease, which cannot be reversed.

Finding the cause of the problems is important for determining the best course of action. Once you know the cause, you can make the right treatment plan. People with memory problems should make a follow-up appointment to check their memory every six to 12 months. They can ask a family member, friend, or the doctor’s office to remind them if they’re worried they’ll forget.

by Alzheimer’s Association California Central Coast Chapter

Alzheimer’s disease is the third leading cause of death within Ventura County, behind disease of the heart and all cancers, according to the 2022 Needs Assessment report recently released by Ventura County Community Health Improvement Collaborative.

While disease of the heart and all cancers rank the same when compared to the state and the nation, Alzheimer’s holds a notably higher ranking for leading cause of death in Ventura County compared to that of California and the United States, which ranks fifth and seventh respectively.

It is unclear why this disease is a more common cause of death in this county than other areas.

However, research does show that Alzheimer’s and other dementias are more prevalent amongst Latino populations; Latinos are about one-and-a-half times as likely as older whites to have the disease.

Ventura County has a large Hispanic/Latino population, making up 44.66% of residents.

Maintaining good heart health through diet and exercise can lessen your risk for developing Alzheimer’s or vascular dementia earlier on in life. The risk appears to increase from many conditions that damage the heart and blood vessels, including heart disease, diabetes, stroke, high blood pressure and high cholesterol.

Primary data shared within the report reflect that Alzheimer’s and other dementia are part of a significant health need; though less than half (41%) of general respondents chose aging complications—including dementia, falls and social isolation—as an important community health problem.

For the many families who have been affected by dementia, they know firsthand the complications and turmoil that can come with navigating this disease.

And according to the Alzheimer’s Association, the numbers of those who are living with Alzheimer’s will only continue to grow, estimated to reach 840,000 in California by 2025. Currently, there are over 1.2 million Californians providing unpaid care for someone living with the disease.

“While it is an exciting time for research and treatment, the reality is that there is no cure for this disease that impacts so many people, so it is extremely important to keep Alzheimer’s at the forefront of our efforts as a community,” said Janelle Boesch, communications manager at the Alzheimer’s Association California Central Coast Chapter.

The Association calls all Ventura County residents to become educated about Alzheimer’s risk reduction and early detection, as well as best methods for providing care for a loved one living with the disease.

Free support services, including care consultations, support groups and education classes, can be accessed through the Alzheimer’s Association. Their Ventura office is located at 2580 E Main Street #201, and their 24/7 Helpline is 800.272.3900 for around-the-clock support and information in English and Spanish. Visit them online at alz.org/cacentral.

A new measurement system based on phenotypic (observable) data can identify individuals at risk for adverse health outcomes based on their computed “aging score.” After collecting these data from nearly 1,000 people aged 24 to 93, NIA-funded researchers found that individuals with higher biological aging scores exhibited faster physical and cognitive decline, developed multiple health conditions, and had shorter lifespans. The approach may be a better predictor of health outcomes over time than the traditional focus on a person’s chronological age, which is based on birthdate. Findings from the study were published in Nature Aging.

NIA’s Baltimore Longitudinal Study of Aging (BLSA), the United States’ longest-running scientific study of human aging, has shown that the manifestations of aging are highly variable across individuals. Because people age differently, chronological age alone does not provide a complete picture of the influences on and the effects of aging. Phenotypes, which are observable traits based on genes and the environment’s impact on those genes, may provide insight into biological aging. Phenotypes could reveal biological aging at the cellular and molecular level, and indicate how fast health changes will occur, such as the progression of chronic disease and decline in physical and cognitive function.

For this phenotypic study, researchers from NIA, Johns Hopkins Bloomberg School of Public Health, Yale School of Medicine, and the University of Maryland School of Medicine used data from 968 BLSA participants. The researchers organized the phenotypic data into four groups: body composition such as waist size, energetics such as oxygen consumption, homeostatic mechanisms such as blood pressure, and neuroplasticity/neurodegeneration such as brain volume and nerve firing.

For each phenotype, the researchers measured the difference between an individual’s changes over time and the sex- and age-specific average changes over time in the study population. Notably, by using these changes over time as a reference, the resulting phenotypic scores accounted for nonlinear rates of change. These nonlinear rates are important because certain measures of aging, such as fitness, do not change in a linear way over time. The study also included changes in mobility and cognitive testing, the number of medical conditions reported by participants, and participants’ lifespan.

The researchers averaged individual phenotypic scores within each phenotype group, then averaged the four group scores to find a participant’s longitudinal (over time) phenotypic-aging score. Those with higher scores, representing a faster rate of phenotypic aging than the general population, had a more rapid decline in functional aging, a speedier increase in their number of medical conditions, and a shorter lifespan. This longitudinal approach showed stronger associations with changes in physical and cognitive functions than aging measurements that use data from a single point in time. Next research steps could include linking the phenotypic-aging score with cellular and molecular measurements to enhance understanding of the biology of aging.

by National Institute on Aging

Vitamins and minerals are two of the main types of nutrients that your body needs to survive and stay healthy. Find information on some of the essential vitamins recommended for older adults and how to get the recommended amount within your diet.

Vitamins help your body grow and work the way it should. There are 13 essential vitamins — vitamins A, C, D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, B6, B12, and folate).

Vitamins have different jobs to help keep the body working properly. Some vitamins help you resist infections and keep your nerves healthy, while others may help your body get energy from food or help your blood clot properly. By following the Dietary Guidelines, you will get enough of most of these vitamins from food.

Like vitamins, minerals also help your body function. Minerals are elements that our bodies need to function that can be found on the earth and in foods. Some minerals, like iodine and fluoride, are only needed in very small quantities. Others, such as calcium, magnesium, and potassium, are needed in larger amounts. As with vitamins, if you eat a varied diet, you will probably get enough of most minerals.

It is usually better to get the nutrients you need from food, rather than a pill. That’s because nutrient-dense foods contain other things that are good for you, like fiber.

Most older adults can get all the nutrients they need from foods. But if you aren’t sure, always talk with your doctor or a registered dietitian to find out if you are missing any important vitamins or minerals. Your doctor or dietitian may recommend a vitamin or dietary supplement.

It’s important to be aware that some supplements can have side effects, such as increasing the risk of bleeding after an injury or changing your response to anesthesia during surgery. Supplements can also interact with some medicines in ways that might cause problems. For example, vitamin K can reduce the ability of the common blood thinner warfarin to prevent blood from clotting. If you do need to supplement your diet, your doctor or pharmacist can tell you what supplements and doses are safe for you.

When looking for supplements to buy, you may feel overwhelmed by the number of choices at the pharmacy or grocery store. Look for a supplement that contains the vitamin or mineral you need without a lot of other unnecessary ingredients. Read the label to make sure the dose is not too large. Avoid supplements with megadoses. Too much of some vitamins and minerals can be harmful, and you might be paying for supplements you don’t need. Your doctor or pharmacist can recommend brands that fit your needs.

Different foods in each food group have different nutrients. Picking an assortment within every food group throughout the week will help you get many nutrients. For example, choose seafood instead of meat twice a week. The variety of foods will make your meals more interesting, too.

Sodium is another important mineral. In most Americans’ diets, sodium primarily comes from salt (sodium chloride). Whenever you add salt to your food, you’re adding sodium. But the Dietary Guidelines shows that most of the sodium we eat doesn’t come from our saltshakers — it’s added to many foods during processing or preparation. We all need some sodium, but too much over time can lead to high blood pressure, which can raise your risk of having a heart attack or stroke.

How much sodium is okay? People 51 and older should reduce their sodium intake to 2,300 mg each day. That is about one teaspoon of salt and includes sodium added during manufacturing or cooking as well as at the table when eating. If you have high blood pressure or prehypertension, limiting sodium intake to 1,500 mg per day, about 2/3 teaspoon of salt, may be helpful. Preparing your own meals at home without using a lot of processed foods or salt will allow you to control how much sodium you get. Try using less salt when cooking, and don’t add salt before you take the first bite. If you make this change slowly, you will get used to the difference in taste. Also look for grocery products marked “low sodium,” “unsalted,” “no salt added,” “sodium free,” or “salt free.” Also check the Nutrition Facts Label to see how much sodium is in a serving.

Eating more fresh vegetables and fruit also helps — they are naturally low in sodium and provide more potassium. Get your sauce and dressing on the side and use only as much as you need for taste.

From NIH Research Matters

Alzheimer’s disease, which can destroy the ability to think, learn, and remember, is more common in women than men. The reasons for this disparity between the sexes are not well understood.

Women are known to have greater levels of tau protein abnormally build up in brain cells over their lives. The structures that form, called tau tangles, are one of the hallmarks of Alzheimer’s disease.

An NIH-funded research team led by Drs. David Kang and Jung-A “Alexa” Woo from Case Western Reserve University has been searching for molecules in the brain that may be driving tau accumulation in women. Their new study was published on Oct. 13, 2022, inCell.

Tau is needed for the normal functioning of brain cells called neurons. In healthy neurons, old, damaged, or unneeded tau molecules are tagged for recycling and removal by the brain’s waste system. Enzymes called ubiquitinases place these tags. Other enzymes called deubiquitinases can remove these tags. Together, they help regulate when molecules are disposed of.

The team screened for deubiquitinases in the brain that might be stopping tau recycling. When they blocked one such enzyme called USP11, levels of tau in cells, including the type that can tangle, dropped substantially.

Further experiments confirmed that USP11 was removing the recycling tags from tau. When this happened, other enzymes added different molecular tags called acetyl groups, which are known to trigger the tangling process. The researchers found almost 10 times as much USP11 in tissue samples taken from people with Alzheimer’s disease as in those taken from people without the condition.

The gene that encodes USP11 is found on the X chromosome. Women have two copies of this chromosome, while men only have one. While one X chromosome is usually inactive in cells, some genes, such as the one for USP11, stay active on both. The researchers found that high USP11 levels were more strongly associated with tau tangles in samples taken from female brains than from male brains.

The team saw similar results in samples taken from the brains of female and male mice. Mice engineered to lack the gene that produces the mouse version of USP11, called usp11, had substantially less tau tagged with acetyl groups for it to tangle. As seen in the human samples, this improvement was far more substantial in female mice.

Compared to female mice that could produce usp11, those engineered to lack usp11 had far better performance on tests of memory and learning as they aged. Male mice that lacked usp11 only showed a small improvement. These findings show how USP11 can affect the development of Alzheimer’s disease differently in men and women.

“In terms of implications, the good news is that USP11 is an enzyme, and enzymes can traditionally be inhibited [with drugs],” Kang says. “Our hope is to develop a medicine that works in this way, in order to protect women from the higher risk of developing Alzheimer’s disease.”

— by Sharon Reynolds

This research was supported in part by NIA grant R01AG059721.