NewsMakers
Older people in good shape have fitter brains
Seventy- to eighty-year-olds who train for better fitness are better at solving cognitive tasks and are less likely to suffer cognitive impairment.

“Our findings suggest that being fit can protect against mild cognitive impairment in older people,” says Ekaterina Zotcheva.
Just before Christmas, Zotcheva defended her doctoral dissertation on exercise and brain health at the Norwegian University of Science and Technology, NTNU. The day before the defence, the last study for her doctoral degree was published in the highly regarded Sports Medicine journal.
The article is just one of three recent research articles from NTNU that show how important it is for the brain to stay in good physical shape as you get older. Common to all three articles is that they are based on data from the world’s largest training study for older adults, the Generation 100 study from the Cardiac Exercise Research Group.
Dementia risk
“The Generation 100 study has been going on for almost ten years now. After the study participants had been exercising for five years, we tested the cognitive function of almost 1000 of them.”
“The men and women who had maintained or increased their physical fitness during the study had better brain health than those whose fitness had declined over the five years,” says Zotcheva.
The cognitive test that the participants took is the same one that is often used to check whether people are at risk of developing dementia.
The test assesses short-term memory, execution function and the ability to orient oneself in time and space. Scoring below a certain number indicates a risk of mild cognitive impairment.
“We know that mild cognitive impairment can lead to dementia for some individuals. The greater the increase in a participant’s fitness level during the five years of the study, the lower their probability was of developing mild cognitive impairment,” says Zotcheva.
Better at problem solving
Good conditioning appears to be an important prerequisite for good brain function in the elderly in the other two research articles as well. In both of these studies, the researchers tested the brain health of more than 100 of the participants in the Generation 100 study at start-up and after one, three and five years of training.
“Participants who were in good shape, both when the study started and later in the study, had a faster reaction time. The ones who improved their fitness level gained a somewhat better working memory,” says NTNU professor Asta Håberg.
The ability to solve cognitive problems was tested using the web-based Memoro platform, which Håberg developed in collaboration with neuropsychologist Tor Ivar Hansen.
Less brain atrophy
Håberg has been involved in the work with all three recent research articles. In the third study, the researchers performed MRI scans of the participants’ brains to see how the brain volume and thickness of the cerebral cortex changed throughout the study. Here, too, the most energetic participants came out best.
“Participants who were in good shape when the study started had a thicker cerebral cortex after one, three and five years, as compared with those who had lower maximum oxygen uptake. But we didn’t find any effect from increasing fitness during the study,” says Håberg.
The cerebral cortex is the outermost layer of the brain and is important for several important brain functions, such as attention, ability to make choices, working memory, abstract thinking and memory. This part of the brain becomes thinner with age, and thinning of the cerebral cortex in different areas is linked to different types of dementia, such as Alzheimer’s disease and frontotemporal dementia.
Fitness more important than type of exercise
All 70- to 77-year-olds in Trondheim were invited to the Generation 100 study in 2012. Those who agreed to participate were randomly assigned to five years of exercise of various kinds. One group would primarily do high intensity intervals, a second group would mainly go for walks or do other exercise with moderate intensity, and the last group would try to follow the activity recommendations of the health authorities to be physically active for at least 150 minutes each week.
The first two groups were followed up most closely by the researchers, and were offered two organized training sessions each week. The NTNU researchers looked beyond the connection between fitness and brain health and also investigated whether the type of training follow-up that participants received made a difference.
“Our results show that organized training follow-up may have given older men, but not older women, better cognitive function and lowered the probability of mild cognitive impairments. But all in all, it seems that the most important thing is that you actually train in a way that increases your fitness, regardless of whether you get organized help to be physically active or not,” says Zotcheva.
Less brain atrophy than expected
“In the groups that received follow-up with high-intensity training and training with moderate intensity, respectively, we found somewhat greater loss of brain volume in deep areas of the brain than among those who trained themselves. But we have to emphasize that everyone in the Generation 100 study – regardless of the form of exercise they did – had less brain loss than expected for people in their 70s. The group that trained on their own without organized follow-up had the least shrinkage in the hippocampus and thalamus,” Håberg says.
The training follow-up in Generation 100 was not decisive for the participants’ ability to solve cognitive tasks.
“The groups that were able to attend organized training didn’t perform any better than the group that trained on their own on various tasks, such as remembering where an object is located, memorizing words, processing information quickly or planning,” says Håberg.
Maintained good cognitive function
“It’s still worth noting that the 70-77-year-old participants on average had the same cognitive abilities after five years as at start-up, and that during the study period they even improved on some of the tests. The results show that being in good shape like the Generation 100 participants were, is important for maintaining good brain function,” Håberg says.
The training effect thus seems to be greatest for people who enter retirement age in good shape, and exercise that improves fitness can provide further benefits. So how should the elderly train to get in better shape?
“Several paths can lead to that goal, and the most important factor is to find an activity you enjoy and can continue with over time. In order to maintain or increase your fitness, you should in any case exercise regularly in a way that gets you out of breath and sweaty,” says Zotcheva.
NewsMakers
All work and no play will really make a dull life – research
‘Achievement’ and ‘conformity’ values had no impact on happiness whatsoever. However, the researchers believe achievement could impact on happiness when linked to job satisfaction or the amount of days worked.

A study across three countries led by the Department of Psychology’s Dr Paul Hanel discovered people who prioritised achievement over enjoyment were less happy on the next day. Whereas those who aimed for freedom said they had a 13% increase in well-being, recording better sleep quality and life satisfaction. And participants who tried to relax and follow their hobbies recorded an average well-being boost of 8% and a 10% drop in stress and anxiety.
Dr Hanel worked with colleagues at the University of Bath on the Journal of Personality-published study. For the first time, it explored how following various values impacts our happiness.
Dr Hanel said: “We all know the old saying ‘All work and no play makes Jack a dull boy’ and this study shows it might actually be true. There is no benefit to well-being in prioritising achievement over fun and autonomy. This research shows that there are real benefits to having a balanced life and taking time to focus on enjoying ourselves and following individual goals. Ironically by doing this, people could in fact be more successful as they will be more relaxed, happier and satisfied.”
The study –Value Fulfilment and Well-being: Clarifying Directions Over Time – examined more than 180 people in India, Turkey and the UK. They filled in a diary across nine days and recorded how following different values affected them.
Interestingly all nationalities reported the same results with the following of ‘hedonism’ and ‘self-direction’ values leading to increased happiness. ‘Achievement’ and ‘conformity’ values had no impact on happiness whatsoever. However, the researchers believe achievement could impact on happiness when linked to job satisfaction or the amount of days worked.
Professor Greg Maio, University of Bath, said: “This multination project was an exciting foray into questions about how values affect well-being in day-to-day life. People often spend most of their days working hard for their daily income, studies, and careers. Against this backdrop, where achievement-oriented values have ring-fenced a great portion of our time, we found that it helps to value freedom and other values just enough to bring in balance and recovery.”
In the future, it will be interesting to consider how this pattern interacts with relevant traits, such as conscientiousness, and situational contexts, such as type of employment, Maio added.
It is hoped the research will now influence mental health provision and influence therapeutic give to clients.
Dr Hanel added: “Our research further shows that it might be more important to focus on increasing happiness rather than reducing anxiety and stress, which is of course also important, just not as much.”
The study was published in collaboration with Hamdullah Tunç, Divija Bhasin, and Dr Lukas Litzellachner.
NewsMakers
Why breast cancer survivors don’t take their medication, and what can be done
For roughly 80% of breast cancer survivors, treatment doesn’t end with surgery, radiation and chemotherapy. Instead, for the next five to 10 years, doctors recommend that they take medication to block sex hormones, which can fuel tumor growth and spark recurrence.

For roughly 80% of breast cancer survivors, treatment doesn’t end with surgery, radiation and chemotherapy. Instead, for the next five to 10 years, doctors recommend that they take medication to block sex hormones, which can fuel tumor growth and spark recurrence.
The drugs are life-saving: They’ve been shown to cut risk of cancer recurrence by as much as half in patients with hormone receptor-positive tumors (HR+)—the most common form of breast cancer. Yet despite their promised benefits, 40% of patients stop taking them early and a third take them less frequently than directed.
New CU Boulder research, published this month in the Journal of Clinical Oncology, sheds light on why that is and what doctors and the health care system can do about it.
It found that, overall, interventions can increase medication adherence by nearly 1.5 times. But some strategies work better than others.
“Our bottom-line finding is that there are strategies that do work in supporting women to take these life-extending medications, and that we as a cancer care community need to do better,” said senior author Joanna Arch, a professor in the Department of Psychology and Neuroscience and member of the CU Cancer Center on the Anschutz Medical Campus.
Arch noted these so-called “adjuvant endocrine therapies,” like the estrogen-blockers Tamoxifen and aromatase inhibitors, can be costly and come with a host of side effects, including weight gain, sexual side effects, joint pain, depression and sleeplessness.
“Imagine going from your normal estrogen activity to little or no estrogen within days. That’s what these medications do,” she said. “But the women who take them as prescribed also have lower recurrence rates and live longer. It’s a dilemma.”
As more next-generation cancer drugs, including chemotherapy agents, shift from infusions provided in a clinic to oral therapies taken at home, the medical community has grown increasingly interested in developing ways to make sure patients take their pills.
In a sweeping meta-analysis, Arch and her colleagues analyzed 25 studies representing about 368,000 women to gain insight into what works and what doesn’t.
Educational pamphlets are not enough
The study found that cost-cutting policy changes, such as providing generic alternatives or requiring insurance companies to cover pills at the same level as infusions, consistently worked. Such “oral parity laws” have been passed in 43 states in recent years.
In one study, participants were asked to create stickers to put on their pill boxes.
Mobile apps and texts to remind patients to take their medication and psychological/coping strategies also yielded modest improvements.
The study’s findings around managing side effects were complicated: Simply educating women on side effects, via pamphlets or verbal explanations, generally failed to increase the likelihood that women took their medication as directed.
But things such as physical therapy, exercise and behavioral counseling aimed at alleviating or managing side effects often worked.
“Education in and of itself is not enough. That is a clear finding,” said Arch, suggesting that doctors write referrals to practitioners who specialize in side effects and follow up with appointment reminders. “Most oncologists, I believe, don’t realize how low adherence is for these women. They assume that if they write the prescription, it’s being taken.”
Addressing mental health is key
One study included in the meta-analysis was Arch’s own.
In it, women were asked to identify their primary motivation for taking their medication—whether it was living to see their child or grandchild grow up, pursuing their art or running a marathon someday. Via an online program, they created a sticker with a photo representing that goal, and the words “I take this for…” below it. Then, they stuck it on their pill box.
Participants were more likely to take their pills, at least for the first month, than those who didn’t.
“Even just a tiny thing like this can help,” said Arch.
Notably, very few studies looked at whether treating depression can help. Arch, aiming to fill this gap, recently launched her own pilot trial.
“One of the most consistent predictors of not adhering to any medication is depression,” she said. “Depression taps motivation.”
The new Journal of Clinical Oncology study is the first meta-analysis to show that interventions can be helpful, and that’s important, said Arch, because insurance companies need data to make decisions about what to cover.
But the study also showed that the effects are relatively modest and that there is room for improvement.
Arch said she hopes the study will spark more research into novel ways to support survivors:
“We have a lot of work to do.”
NewsMakers
Children with higher BMI at increased risk of developing depression
Associations between a higher BMI and depression were weaker between ages 16 and 21 indicating ages 12-16 is a sensitive point where preventative methods could be beneficial.

Children between ages 12 and 16 with a higher body mass index (BMI) are at an increased risk of developing depression symptoms, new research has found.
Associations between a higher BMI and depression were weaker between ages 16 and 21 indicating ages 12-16 is a sensitive point where preventative methods could be beneficial.
The study, published in Psychological Medicine by researchers from King’s College London, analysed data from more than 10,000 twins in the Twins Early Development Study (TEDS) and UK Adult Twin Registry (TwinsUK).
In the TEDS depressive symptoms, such as low mood, loneliness and exhaustion, were self-reported in twins born between 1994 and 1996. Researchers looked at the relationship between BMI and depression at ages 12, 16 and 21.
They found that children between ages 12-16 with a higher BMI were at an increased risk of developing depression than between ages 16-21. Researchers also found that there was a stronger association for children with a higher BMI at an early age to develop depression at a later age, than children with depression first to have a higher BMI later in childhood.
First author Dr Ellen Thompson, from King’s College London, said: “Understanding the relationship between mental ill-health and weight in adolescence is vital to provide timely support where needed. This study shows a stronger association between having a higher BMI at age 12 years and subsequent depression symptoms at age 16 years than the reverse.”
Using data from TEDS, the study also shows that the covariation between BMI and depression within each age was mostly explained by environmental factors.
Dr Thompson added: “This indicates that this relationship is environmentally mediated and could be due to several factors that adolescents may experience. Our study did not ask questions around the reasons why this effect was seen, but previous research has suggested body dissatisfaction and weight related stigma from external sources could be a factor. This study identifies a crucial point where intervention might be beneficial.”
Previous research found poverty may be a risk factor, however this study adjusted for socio-economic status and found the relationship between depression symptoms and weight to be unaffected.
This means that ages 12-16 is a sensitive and potentially detrimental time for young children and preventative measures would be beneficial. Support structures and positive body image messages could be taught in PHSE to counteract depressive symptoms.
Co-senior author Professor Thalia Eley, Professor of Developmental Behavioural Genetics from King’s College London, said: “Our findings suggest that the experience of having higher BMI is associated with later depression. This study shows that early adolescence is a critical point for developing depressive symptoms associated with weight gain. Mental ill-health and obesity are growing concerns for Britain’s young people and this study shows how both are intertwined. Working with young teens to support them to have a positive body image using strategies such as focusing on health and wellbeing rather than weight may be useful in preventing subsequent depression.”
Co-senior author Professor Claire Steves, Professor of Ageing and Health at King’s College London, added: “Using the TwinsUK cohort, which focuses on older adult twins, our study showed that the relationship between BMI and depression was much weaker in later life. The exact reasons for these changes over the life course need further investigation.”
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