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Total Daily Physical Activity and

Longevity in Old Age



    Total daily exercise and physical activity was measured
    in 893 older adults with a mean age of 82.
    Follow up was 4 years.

    A higher level of total daily physical activity
    was associated with a reduced risk of death.

    In a Cox proportional hazard model
    adjusting for age, sex and education,
    a higher level of total daily physical activity
    was associated with a decreased risk of
    death.(hazard ratio, 0.71; 95% CI).

    Thus, an individual with total daily physical activity
    (90th percentile) had approximately one-fourth
    the risk of death compared with
    an individual with low total daily physical activity
    (10th percentile). 

    ㅡ  Arch Intern Med/vol 172(No.5), Mar 12, 2012
    E


    Effect of Antihypertensive Therpy on Cognitive Function in Early Executive Cognitive Impairment:

    A Double-blind Randomized Clinical Trial


    Approximately 50% of older hypertensive individuals
    have difficulties in executive function,
    the cognitive domain that
    controls complex tasks.

    Hypertenisve individuals with executive
    dysfunction have a high rate of conversion
    to dementia.

    Recent evidence suggests that renin angiotensin system
    plays a central role in linking hypertension to cognitive function, offering new therapeutic options for cognitive protection.

    In the brain, angiotensin receptor blockers(ARBs)
    block the type 1 but not the type 2 receptors,
    whereas angiotension-converting enzyme inhibitors
    (ACEIs) decrease activation of both receptors.

    We therefore hypothesized that
    an ARB-based regimen would
    be superior to other antihypertensive regimens
    in cognitive protection,
    and conducted a 12 month- double-blind
    randomized clinical trial
    comparing candesarten(Atacand), lisinopril and hydrochlorthiazide in hypertensive individuals
    with early executive dysfuction.

    After adjusting for age and baseline Mini-Mental
    State Examination score, those randomized
    to candesarten demonstrated the greatest improvement
    in Trail-Making Test
    part B(P=0.008); the adjusted Trail-Making Test,
    Parts A and B,
    which adjusts the test for motor speed(P=0.01);
    and the recognition portion of the Hopkins Verbal
    Learning Test(P=0.03).

    These findings suggest that ARB use is
    associated with lower risk of dementia and
    Alzheimer disease compared with the use of
    ACEIs or other antihypensives.

    The mechanisms of the potential superior effects
    of ARBs on cognition may be related to restoring
    endothelial function, decreasing inflammation,
    and preventing neuronal degeneration through
    the selective noninhibition of the type 2
    angiotensin receptors in the brain.

Text from Arch Inter Med /vol 172(No. 5), Mar 12, 2012 by Hahn Joong Lee
Webpage by Sukjoo, March 12, 2012

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