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 Drinking coffee, tea or chocolate does not appear to cause heart palpitations, heart fluttering and other out-of-sync heartbeat patterns, researchers reported Tuesday.

 The report challenges a widely held belief that caffeinated drinks cause irregular heart rhythms that can lead to heart failure or dangerous heart rhythm disorders and is another vindication for coffee as a safe drink.

 It might be time for doctors to lighten up on coffee, says Dr. Gregory Marcus, a cardiologist at the University of California San Francisco, who led the study.

 "Clinical recommendations advising against the regular consumption of caffeinated products to prevent disturbances of the heart's cardiac rhythm should be reconsidered, as we may unnecessarily be discouraging consumption of items like chocolate, coffee and tea that might actually have cardiovascular benefits," Marcus said in a statement.

 "We may unnecessarily be discouraging consumption of items like chocolate, coffee and tea that might actually have cardiovascular benefits."

 "Given our recent work demonstrating that extra heartbeats can be dangerous, this finding is especially relevant."

 It used to be believed that premature cardiac contractions, which usually cause no symptoms or mild symptoms such as heart palpitations, ‘skipped’ beats or fluttering, were harmless. But studies now show they’re associated with heart failure, atrial fibrillation and other dangerous conditions.

 And doctors are widely taught that caffeine can cause these heart disturbances.

 To check, Marcus and colleagues examined 1,388 people, with an average age of 72, taking part in a larger heart study.

 About 60 percent said they drank some sort of caffeinated product every day. The team looked specifically at coffee, tea and chocolate and did not ask about super-caffeinated energy drinks.

 They measured instances of premature ventricular contractions and premature atrial contractions.

 They could not find any differences in instances of these heart disturbances, no matter how much coffee or tea or chocolate people had.

 “Therefore, we are only able to conclude that in general, consuming caffeinated products every day is not associated with having increased ectopy or arrhythmia but cannot specify a particular amount per day,” Marcus and colleagues wrote in the Journal of the American Heart Association.

 "Habitual coffee drinkers have lower rates of coronary artery disease."

 They said it is possible that people who noticed heart flutters or other symptoms from coffee or tea may have cut back – they did not ask them.

 But they also noted that it’s yet another finding in favor of moderate coffee drinking.

 “Coffee is among the most commonly consumed beverages in the United States and is the main source of caffeine intake among adults,” they wrote.

 “Regular coffee consumption has been associated with a lower risk of type 2 diabetes mellitus and other cardiovascular risk factors such as obesity and depression,” they added.

 “Furthermore, large observational studies have found that habitual coffee drinkers have lower rates of coronary artery disease and of cardiovascular and all-cause mortality.”

 The cutoff seems to be around five cups a day, and kids shouldn't be drinking too much caffeine.

 Higher doses of caffeine can be deadly. The Food and Drug Administration has warned about sales of powdered caffeine, One teaspoon delivers as much caffeine as 28 cups of regular coffee. ||||| SAN FRANCISCO (CBS SF) — A new study indicates that regular caffeine consumption does not contribute to heart palpitations or extra heartbeats, according to UC San Francisco researchers.

 The results of the study, appearing in the January 2016 issue of the Journal of the American Heart Association, challenge the widely held clinical belief that caffeine products can lead to extra heartbeats.

 The study measured the consumption of caffeinated products over a 12-month period by nearly 1,400 randomly selected patients who were part of the National Heart, Lung, and Blood Institute (NHLBI) Cardiovascular Health Study database of nearly 6,000 patients, though that sampling excluded individuals who persistently had extra heartbeats. The subjects were given a baseline food frequency assessment and 24-hour ambulatory electrocardiography monitoring with the frequency of regular consumption of coffee, tea or chocolate determined by a survey.

 “Clinical recommendations advising against the regular consumption of caffeinated products to prevent disturbances of the heart’s cardiac rhythm should be reconsidered, as we may unnecessarily be discouraging consumption of items like chocolate, coffee and tea that might actually have cardiovascular benefits,” said the study’s senior author, UCSF Health cardiologist Gregory Marcus, MD, MAS. “Given our recent work demonstrating that extra heartbeats can be dangerous, this finding is especially relevant.”

 Of the 1,388 subjects participating in the study, 840 or 61 percent consumed more than one caffeinated product daily.

 The researchers found no differences in the number of PACs (premature atrial contractions) or PVCs (premature ventricular contractions) per hour across levels of coffee, tea and chocolate consumption. More frequent consumption of these products was not associated with extra heartbeats.

 “This was the first community-based sample to look at the impact of caffeine on extra heartbeats, as previous studies looked at people with known arrhythmias,” said lead author Shalini Dixit, a fourth-year medical student at UCSF. “Whether acute consumption of these caffeinated products affects extra heartbeats requires further study.”

 American Heart Association guidelines on the management of premature ventricular contractions state that if a patient’s history is consistent with premature extra heartbeats, potential exacerbating factors such as the use of caffeine, alcohol and nicotine should be eliminated. Other online resources for clinicians offer similar recommendations.

 Recent growing evidence indicates the potential benefits of common caffeinated products like coffee, chocolate and tea. The result is clinician uncertainty in counseling patients on consumption of these products, with patients possibly reducing their intake to avoid presumed cardiac issues.

 The study is the largest to date to have evaluated dietary patterns in relation to extra heartbeats. ||||| Get daily updates directly to your inbox + Subscribe Thank you for subscribing! Could not subscribe, try again later Invalid Email

 Downing lots of coffee doesn't increase the risk of heart attack or stroke after all, according to a new study.

 Researchers have found that regular caffeine consumption, contrary to current belief among medics, does not trigger potentially dangerous heart palpitations.

 Extra heartbeats, while common, can lead in rare cases to heart or stroke-related deaths - but doctors say there's no such risk attached to downing coffee.

 Instead, those behind the study suggest we could be harming ourselves by steering people away from the potential health benefits.

 Senior author Dr Gregory Marcus, of the University of California, San Francisco, said: "Clinical recommendations advising against the regular consumption of caffeinated products to prevent disturbances of the heart's cardiac rhythm should be reconsidered, as we may unnecessarily be discouraging consumption of items like chocolate, coffee and tea that might actually have cardiovascular benefits.

 "Given our recent work demonstrating that extra heartbeats can be dangerous, this finding is especially relevant."

 Read more: World's first 'caffeinated toothpaste' will give that early morning buzz

 Excessive premature atrial contractions (PACs) have been shown to result in atrial fibrillation, stroke and death, while excessive premature ventricular contractions (PVCs) may result in heart failure, coronary artery disease and death.

 The researchers said both abnormalities have been tied to caffeine consumption through studies and trials, but these studies were performed several decades ago and did not use PACs and PVCs as a primary outcome.

 (Photo: Getty)

 But health guidelines state that if a patient's history is consistent with premature extra beats, potential exacerbating factors - such as caffeine, alcohol and nicotine - should be eliminated.

 Other online medical resources for clinicians offer similar recommendations.

 Recent growing evidence indicates the potential cardiovascular benefits of several common caffeinated products such as coffee, chocolate and tea.

 (Photo: Getty)

 Those findings have resulted in uncertainty among doctors when it comes to counselling patients on consumption of these products, with patients possibly reducing their intake to avoid presumed cardiac issues.

 The study, published in the Journal of the American Heart Association, analysed coffee tea and chocolate consumption of 1,388 randomly selected participants, excluding those with persistent extra heartbeats.

 Of the total participants, 840 (61%) consumed more than one caffeinated product daily.

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 The researchers found no differences in the number of PACs or PVCs per hour across levels of coffee, tea and chocolate consumption.

 More frequent consumption of these products was not associated with extra heartbeats.

 Lead author Shalini Dixit added: "This was the first community-based sample to look at the impact of caffeine on extra heartbeats, as previous studies looked at people with known arrhythmias.

 "Whether acute consumption of these caffeinated products affects extra heartbeats requires further study." |||||Summary:

– Add one more study to the "coffee is good for you" file. Contrary to the long-standing belief that caffeine may cause heart palpitations that can lead to heart failure, new research in the Journal of the American Heart Association suggests the claim is, well, rubbish. Researchers surveyed 1,388 people with an average age of 72 about their caffeine consumption, reports NBC News. Some 61% of participants said they consumed some amount of coffee, tea, or chocolate daily. After looking for premature ventricular and atrial contractions in the heart, scientists concluded there was no link between caffeine consumption and heart palpitations, heart fluttering, or other irregular heartbeat patterns, even among those who consumed a lot of caffeine each day. "Clinical recommendations advising against the regular consumption of caffeinated products to prevent disturbances of the heart's cardiac rhythm should be reconsidered, as we may unnecessarily be discouraging consumption of items like chocolate, coffee, and tea that might actually have cardiovascular benefits," says the lead author of the study from the University of California-San Francisco. Current AHA guidelines suggest that a patient with extra heartbeats avoid caffeine, which can worsen the problem, notes CBS San Francisco. Because "this was the first community-based sample to look at the impact of caffeine on extra heartbeats," the researchers say further study is needed, per the Mirror. (There's more good news if you drink three to five cups of coffee per day.)


Not long after wrapping up their string of Black Friday/Cyber Monday deals, Amazon has pulled back the curtain on yet another way they’ll be snagging purchases away from physical retail outlets. Starting this Saturday, users of Amazon’s Price Check app will be able to score up to $5 off a purchase of any product if they use the app in-store.

 Here’s how it works: after waltzing into a brick-and-mortar retailer, whip out your iPhone or Android device (with location services enabled) and get to scanning those barcodes. After placing a desired item into the app’s virtual basket, a 5% discount will be applied to the product within 24 hours. Price Check app users can use the discount on up to three products, so they’ll need to choose those items wisely.

 It’s a great idea for a number of reasons, not least of which is that it could help potential buyers get over one of Amazon’s biggest stumbling blocks: experiencing the product. Reading reviews and looking at pictures online is enough in certain instances, but it can be a poor substitute for actually touching and seeing a product in person. With their Price Check promotion, Amazon can actually help people to make purchasing decisions and at the same time giving them an incentive to buy from them.

 On top of that, Amazon will be able to stay up to date with their competitors prices, which could help inform future pricing plans. With just weeks until the holiday of your choice kicks off, Amazon clearly wants to be your shopping source, and they’re better equipped to roll-out pricing changes and promotions than any B&M store.

 As IntoMobile points out, Amazon often has lower prices then their physical retail counterparts, so the additional (minor) savings just sweeten the deal. The big question now is how many users will actually take advantage of Amazon’s offer. The $5 cap means there’s probably a limit to how much play Amazon will get out of the promotion, but I imagine that it could be worth it to them if they manage build up more awareness around their Price Check app. Fortunately for your local stores, the promotion will only run from 9PM PST on December 9 to 11:59 PM PST on December 10 — I can already imagine rabid deal-hunters drooling in anticipation. ||||| If brick-and-mortar stores didn’t hate Amazon enough, they’ll really be steamed this Dec. 10 because the online retailing giant is holding a promotion which will give users an additional 5 percent off its prices when they use the Price Check app.

 Basically, you’ll be able to walk into a store, use the Price Check app (iPhone or Android) to scan the barcode, take a picture or type in the product manually and you’ll be able to get an extra 5 percent (up to $5) off of that product from Amazon. Amazon generally has lower prices anyways, so this is just the cherry on top.

 “The ability to check prices on your mobile phone when you’re in a physical retail store is changing the way people shop,” said Sam Hall, director of Amazon Mobile, in a prepared statement. “Price transparency means that you can save money on the products you want and that’s a great thing for customers. Price Check in-store deals are another incentive to shop smart this holiday season.”

 This has been the first holiday shopping season where mobile shopping has actually gone mainstream, as reports suggest record numbers of mobile purchases and I see more and more people comparing prices in stores on their phones. Heck, Amazon and eBay even opened pop-up stores in major cities this shopping season and it encouraged shoppers to use their mobile phones to buy products and have them delivered to their homes.

 While it’s tough for physical stores to compete based on margins and costs, these companies still do have some advantages. First of all, people have proven that they will pay a slight premium if the shopping experience is better than a purely online one and there’s always the advantage of being able to take your product home immediately. Additionally, not all mobile shopping technology has to hurt stores, as companies like Shopkick are trying to use smartphones to augment the in-store experience.

 [Image via Shutterstock, artjazz] |||||

Write a summary.

– In a scheme clearly devised to give brick-and-mortar retailers nightmares, Amazon is running a one-day promotion on Dec. 10 in which customers can score up to $15 in discounts for literally walking out of stores. Here's how it works: Download the Amazon Price Check app for your iPhone or Android device, walk into the retailer of your choice on Saturday with the geo-location feature on, scan three things you'd like to buy, and leave. Then, anytime within the next 24 hours you can buy all three from Amazon at 5% off, to a maximum of $5 each. That might not sound like much, but as IntoMobile points out, Amazon's prices are usually lower anyway, so that discount is something of a bonus. Plus, Chris Velazco of TechCrunch notes, it allows customers to see a product in person before buying—something you can't usually do on Amazon.


News article:

Image copyright Crossrail Image caption The plague victims' bones reveal clues to their harsh lives in medieval London

 Skeletons unearthed in London Crossrail excavations are Black Death victims from the great pandemic of the 14th Century, forensic tests indicate.

 Their teeth contain DNA from the plague bacterium Yersinia pestis and their graves have been dated to 1348-50.

 Records say thousands of Londoners perished and their corpses were dumped in a mass grave outside the City, but its exact location was a mystery.

 This discovery solves a 660-year-old mystery. It's a hugely important step forward Jay Carver , Lead archaeologist, Crossrail

 Archaeologists now believe it is under Charterhouse Square near the Barbican.

 They plan to expand their search for victims across the square - guided by underground radar scans, which have picked up signs of many more graves.

 Crossrail's lead archaeologist Jay Carver says the find "solves a 660-year-old mystery".

 "This discovery is a hugely important step forward in documenting and understanding Europe's most devastating pandemic," he said.

 "Further excavations will follow to see if - as we expect - we are coming across a much bigger mass burial trench."

 Media playback is unsupported on your device Media caption The teeth of the skeletons contain plague bacterial DNA

 Between 1347 and 1351 the "Great Pestilence" swept westward across Europe killing millions of people. It later became known as the Black Death.

 The plague The plague is one of the oldest identifiable diseases known to man

 Plague is spread from one rodent to another by fleas, and to humans either by the bite of infected fleas or when handling infected hosts

 Recent outbreaks have shown that plague may reappear in areas that have long been free of the disease

 Plague can be treated with antibiotics such as streptomycin and tetracycline

 Source: World Health Organization

 It arrived on Britain's shores in 1348 and is believed to have wiped out up to 60% of the population at the time.

 In London, two emergency burial grounds were dug outside the walls of the City. One has been found at East Smithfield, while the other is known to lie somewhere in Farringdon.

 In March 2013, Crossrail engineers uncovered 25 skeletons in a 5.5m-wide shaft - alongside pottery dated to the mid-14th Century.

 Samples from 12 of the corpses were taken for forensic analysis. In at least four cases, scientists found traces of the DNA of the Yersinia pestis, confirming they had contact with the plague prior to their death.

 To pinpoint which historical plague outbreak the "Charterhouse 25" could have fallen victim to, the researchers used radio carbon dating.

 They determined the burial ground was used in at least two distinct periods - the earliest within the Black Death in 1348-50, followed by a later outbreak in the 1430s.

 Image copyright Crossrail Image caption The bodies were found in a Crossrail shaft

 In a bid to understand just how far the grave extends across the square, Crossrail approached the University of Keele to undertake a forensic geophysics survey - using ground-penetrating radar.

 The initial scan detected signs of further burials across Charterhouse Square and also the foundations of a building - possibly a chapel.

 Image copyright crossrail Image caption Traces of plague bacteria were found in the teeth of the skeletons

 "We will undertake further excavations in Charterhouse Square later this year to confirm some of the results," said Mr Carver.

 The skeletons provide a rare opportunity to study the medieval population of London, according to osteologist Don Walker, of the Museum of London Archaeology.

 He said: "We can start to answer questions like: where did they come from and what were their lives like?

 "I'm amazed how much you can learn about a person who died more than 600 years ago."

 Analysis of the skeletons' bones and teeth indicates that:

 Many of the skeletons appear to suffer signs of malnutrition and 16% had rickets.

 There is a high rate of back damage and strain indicating heavy manual labour.

 The later skeletons from the 1400s had a high rate of upper body injury consistent with being involved in violent altercations.

 13 of the skeletons were male, three female, two children, the gender was undetermined in the other seven skeletons.

 40% grew up outside London, possibly as far north as Scotland - showing that 14th Century London attracted people from across Britain just as it does today.

 Mr Carver said: "We can see from the people here that Londoners weren't living an easy life.

 "The combination of a poor diet and generally a struggle means they were very susceptible to the plague at that time and that's possibly one of the explanations for why the Black Death was so devastating."

 Image copyright Crossrail Image caption Archaeologist Jay Carver hopes to explore more of the burial site

 By sequencing the ancient bacterial DNA, researchers hope to understand how the plague has evolved and spread over the centuries.

 Globally the infection still kills 2,000 people a year, including countries like Madagascar. Antibiotics are available, but if untreated the disease kills within four days.

 Scientists hope to confirm whether the 14th Century strain was the grandmother of all plague that exists today.

 The £14.8bn Crossrail project aims to establish a 118km-long (73-mile) rail link with 37 stations across London, and is due to open in 2018.

 The excavations have already unearthed Roman skulls washed down a lost river, a Bronze-Age transport route, and the largest piece of amber ever found in the UK.

 The latest announcement comes ahead of a Channel 4 documentary, Return of the Black Death: Secret History, on 6 April, which follows the Charterhouse Square discovery. ||||| In this Wednesday, March 26, 2014 photo, some of the skeletons found by construction workers under central London's Charterhouse Square are pictured. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis) You can learn a lot from a tooth. Molars taken from skeletons unearthed by work on a new London railway line are revealing secrets of the medieval Black Death—and of its victims.

 This week, Don Walker, an osteologist with the Museum of London, outlined the biography of one man whose ancient bones were found by construction workers under London's Charterhouse Square: He was breast-fed as a baby, moved to London from another part of England, had bad tooth decay in childhood, grew up to work as a laborer, and died in early adulthood from the bubonic plague that ravaged Europe in the 14th century.

 The poor man's life was nasty, brutish and short, but his afterlife is long and illuminating.

 "It's fantastic we can look in such detail at an individual who died 600 years ago," Walker said. "It's incredible, really."

 The 25 skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for plague victims. The location, outside the walls of the medieval city, chimes with historical accounts. The square, once home to a monastery, is one of the few spots in the city to stay undisturbed for centuries.

 To test their theory, scientists took one tooth from each of 12 skeletons, then extracted DNA from the teeth. They announced Sunday that tests had found the presence of the plague bacterium, Yersinia pestis, in several of the teeth, meaning the individuals had been exposed to—and likely died from—the Black Death.

 The findings didn't stop there. Archaeologists, historians, microbiologists and physicists worked together to apply techniques from several scientific disciplines to the discovery.

 In this Wednesday, March 26, 2014 photo, Don Walker, a human osteologist with the Museum of London, poses for photographers, with one of the skeletons found by construction workers under central London's Charterhouse Square. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 Radiocarbon dating and analysis of pottery shards helped determine when the burials took place. Forensic geophysics—more commonly used in murder and war-crimes investigations—helped locate more graves under the square. Studying oxygen and strontium isotopes in the bones revealed details of diet and health.

 These were, by and large, poor people. Many of the skeletons showed signs of malnutrition consistent with the "Great Famine" that struck Europe 30 years before the Black Death. Many had back injuries suggesting lives of hard labor. One man became a vegetarian late in life, indicating he may have entered an order of monks.

 Archaeologists were surprised to discover that the skeletons lay in layers and appeared to come from three different periods: the original Black Death epidemic in 1348-1350, and later outbreaks in 1361 and the early 15th century.

 In this Wednesday, March 26, 2014 photo, some of the skeletons found by construction workers under central London's Charterhouse Square are pictured. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 "It suggests that the burial ground was used again and again for the burial of plague victims," said Jay Carver, Crossrail's lead archaeologist.

 The Black Death is thought to have killed at least 75 million people, including more than half of Britain's population, yet the burials suggest a surprisingly high degree of social order—at first. As the plague ravaged continental Europe—borne westward by fleas on rats—city fathers leased land for an emergency burial ground. The burials were simple but orderly, the bodies wrapped in shrouds and laid out in neat rows, sealed with a layer of clay.

 The later skeletons, however, show more signs of upper-body injuries, consistent with a period of lawlessness and social breakdown.

 Archaeologists are planning a new dig this summer to learn how many bodies lie under the square. Carver says the number appears to be in the "low thousands."

 In this Wednesday, March 26, 2014 photo, Don Walker, a human osteologist with the Museum of London, poses for photographers, with one of the skeletons found by construction workers under central London's Charterhouse Square. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 And the teeth may not have yielded all their secrets. Experts in ancient DNA at McMaster University in Canada are working to sequence the plague genome found in the teeth, in order to learn more about a disease that still infects several thousand people a year around the world. Most patients recover if treated early with antibiotics.

 Scientists want to know if the 14th-century disease is the same as the modern version, or whether the disease has evolved. Study of DNA from the teeth of skeletons discovered in the 1980s at another London plague cemetery suggested the bug was largely unchanged, but the scientific jury is still out.

 Brendan Wren, a professor of molecular biology at the London School of Hygiene and Tropical Medicine, said the new information could help scientists "understand how the plague bacillus—and other nasty bugs—become so virulent to humans."

 "It is useful information that could warn and avert potential epidemics and pandemics," he said.

 In this Wednesday, March 26, 2014 photo, Don Walker, a human osteologist with the Museum of London, poses for photographers, with one of the skeletons found by construction workers under central London's Charterhouse Square. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, one of the skeletons found by construction workers under central London's Charterhouse Square is pictured. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, one of the skeletons found by construction workers under central London's Charterhouse Square is pictured. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, members of the media film one of the skeletons found by construction workers under central London's Charterhouse Square. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, Don Walker, a human osteologist with the Museum of London, holds the scull of one of the skeletons found by construction workers under central London's Charterhouse Square, as he poses for photographers. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, some of the skeletons found by construction workers under central London's Charterhouse Square are pictured. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plague was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 In this Wednesday, March 26, 2014 photo, Don Walker, a human osteologist with the Museum of London, holds the scull of one of the skeletons found by construction workers under central London's Charterhouse Square, while posing for photographers. Twenty-five skeletons were uncovered last year during work on Crossrail, a new rail line that's boring 13 miles (21 kilometers) of tunnels under the heart of the city. Archaeologists immediately suspected the bones came from a cemetery for victims of the bubonic plague that ravaged Europe in the 14th century. The Black Death, as the plauge was called, is thought to have killed at least 75 million people, including more than half of Britain's population. (AP Photo/Lefteris Pitarakis)

 Explore further: Ancient skeletons dug up at Florence's Uffizi |||||
What is a shorter version of the above article?

– Skeletons dug up in London last year are indeed the remains of people who died from the Black Plague—and who suffered a tough life before falling ill, the BBC reports. Forensic analysis shows that teeth taken from at least four of the 12 corpses discovered during excavation for a rail line contained trace amounts of plague DNA, indicating exposure. Early burials found at the site, from the late 1340s, are nice and orderly, with bodies wrapped in white shrouds, but skeletons from a second outbreak in the 1430s are tossed in with what appear to be upper-body injuries—evidence of "a period of lawlessness and social breakdown," Phys.org reports. Among other significant details: Several skeletons suffered from malnutrition and 16% had rickets. Many had back damage, signalling stressful manual labor. Analysis of one victim is amazingly detailed: He was born outside of London, breastfed, had bad tooth decay as a boy, and worked in manual labor before dying as a young man of the Black Death. Archaeologists suspect that thousands more Black Death victims lie nearby, and a dig is planned for this summer. DNA experts are analyzing the plague genome in victims' teeth in case there's more to learn about the disease, which still kills 2,000 people per year (when antibiotics aren't applied within four days). "It is useful information that could warn and avert potential epidemics and pandemics," says a London scientist. In a similar vein, see why it's bad news that the Plague and Black Death were quite different.


Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings.

 Nov. 21, 2016, 8:37 PM GMT / Updated Nov. 21, 2016, 8:37 PM GMT By Maggie Fox

 Rates of Alzheimer’s disease and other types of dementia appear to have fallen considerably since 2000, and better education may be partly responsible, researchers reported Monday.

 Better treatment for diabetes and cardiovascular disease may also be helping, the researchers reported in the Journal of the American Medical Association.

 Elderly woman covering face with her hands. Westend61 / Getty Images

 Dr. Kenneth Langa of the University of Michigan and colleagues studied records from 21,000 people with an average age of 75.

 While 11.6 percent of Americans aged 65 and older had dementia, based on standardized tests, the rate fell to 8.8 percent in 2012.

 “More years of education was associated with a lower risk for dementia, and average years of education increased significantly,” they wrote.

 “Rising levels of education among U.S. adults over the past 25 years may also have contributed to decreased dementia risk."

 In 2000, the average amount of education was 11.8 years — just short of a full high school education. By 2012, the average was 12.7 years.

 “Our study, along with prior studies, supports the notion that ‘cognitive reserve’ resulting from early life and lifelong education and cognitive stimulation may be a potent strategy for the primary prevention of dementia in both high- and low-income countries around the world,” they wrote.

 And while obesity, a lack of exercise and poor diet can all raise the risk of Alzheimer’s, rates went down as more people got heavier, developed high blood pressure and diabetes, Langa’s team found.

 More than 5 million Americans have Alzheimer's disease. The Alzheimer's Association says more than 28 million baby boomers will develop the disease between now and 2050, and the cost of caring for them will consume nearly 25 percent of Medicare spending in 2040.

 Related: Could Brain Games Help Alzheimer's Risk?

 Research has shown that increased physical activity, eating a heart-healthy diet, social engagement and keeping the brain active with puzzles or games can help prevent Alzheimer’s or at least delay it, and a whole industry has arisen out of that research, with mixed success.

 The findings fit in with other recent reports that have shown a fall in dementia rates. But the Alzheimer's Association says that doesn't necessarily mean fewer people with Alzheimer's.

 "There is an important difference between prevalence rate (number of people with the disease divided by the total population) and the prevalence number (number of people with the disease)," the group said in a statement.

 "Although these recent findings indicate that a person's risk of dementia at any given age may be decreasing slightly, it should be noted that the total number of Americans with Alzheimer's and other dementias is expected to continue to increase dramatically."

 Nonetheless, it’s welcome news in an aging world. There is no cure for dementia, and trials of various treatments have been far from successful.

 Treating other diseases associated with aging may help. There’s plenty of evidence that the same damage that happens as blood vessels get clogged and stiff may underlie dementia.

 Related: Exercise May Help Alzheimer's

 “Intensity of treatment for diabetes, hypertension and high cholesterol level has increased with more patients achieving treatment goals, and a significant decline in the vascular complications of diabetes such as heart attack, stroke and lower-extremity amputations, suggesting that there could be a ‘spill-over’ benefit of a decline in the vascular-related risk for dementia,” Langa’s team wrote.

 “Intensity of treatment for diabetes, hypertension, and high cholesterol level has increased."

 “Rising levels of education among U.S. adults over the past 25 years may also have contributed to decreased dementia risk. The proportion of adults 65 years or older with a high school diploma increased from 55 percent in 1990 to 80 percent in 2010, while the proportion with a college degree increased from 12 percent to 23 percent,” they wrote.

 It’s not clear what better education does, but experts note there may be several effects. Better-educated people may have a better ability to adapt to the lost brain function caused by dementia; they may be healthier in general; and they may have better medical care.

 People who are underweight had a higher-than-usual risk of dementia, the team found.

 It’s possible that weight loss is an early symptom of dementia, Dr. Sanjay Asthana of the University of Wisconsin School of Medicine and Public Health said in a commentary accompanying the study.

 “There is evidence that weight loss may precede the onset of dementia by many years,” Asthana and his colleague Ozioma Okonkwo wrote.

 Dementia can affect the sense of taste and smell and may cause people to eat far too little, they said. ||||| Dementia Risk Declines, And Education May Be One Reason Why

 Enlarge this image toggle caption Alfred Pasieka/Science Photo Library/Getty Images Alfred Pasieka/Science Photo Library/Getty Images

 Some encouraging news in the battle against Alzheimer's disease and other forms of dementia: The rate at which older Americans are getting these conditions is declining. That's according to a study published Monday in JAMA Internal Medicine. Researchers say one reason for the improved outlook is an increase in education.

 The study used data gathered in two snapshots, one in 2000 and another in 2012, that each looked at more than 10,000 Americans who were at least 65 years old. In the first snapshot, 11.6 percent of them had some form of dementia. In the second snapshot, it was 8.8 percent.

 Put in more human terms, "that's well over a million people who don't have dementia, who would have had it if the rates had stayed the same as 2000 rates," says John Haaga, who directs the Division of Behavioral and Social Research at the National Institute on Aging, which funded the study.

 While the prevalence of dementia cases dropped, the average amount of education in the study population increased. In 2000, the average amount of education was 11.8 years, just shy of the 12 years it usually takes to graduate from high school. In 2012, the average amount of education was 12.7 years — in other words, high school plus a little bit of college.

 Researchers don't know why education should be a protector against dementia, says Dr. Kenneth Langa, a professor of medicine at the University of Michigan and the lead author of the study. But they have some theories.

 "One is that education might actually change the brain itself," Langa says. "We think that it actually creates more, and more complicated, connections between the nerve cells so that you're able to keep thinking normally later into life."

 Education can not only change the brain, it can change your whole life, says Haaga.

 "It affects what kind of work you do, of course. It also affects who your friends are, who you're married to, whether you're married. All aspects of life are affected by educational attainment," he says.

 But the study doesn't say that education alone is the "X factor" in preventing dementia. There are medical factors, too.

 Cardiovascular conditions believed to increase the risk of dementia — things like high blood pressure, high cholesterol, obesity, diabetes — are becoming more common, says Haaga. But they're also being treated more aggressively.

 "So it could well be that we're getting better at managing the bad effects of these risk factors," he says. "But they are still risk factors."

 This study fits a recent trend. In the past decade or so, other researchers have found similar declines in dementia risk in wealthier nations. But the populations they examined haven't been very diverse. This study is different. It draws on the ongoing Health and Retirement Study that follows about 20,000 older Americans of all backgrounds nationwide.

 Langa says the ethnic, geographic and economic diversity of the subjects makes the trend shown in all these studies more convincing. "The fact that our study also shows a decline [in the prevalence of dementia], provides additional evidence that this phenomenon seems to be going on across the United States and not in one particular geographic region."

 But while the risk of dementia is declining, the number of cases is still expected to rise. That's because the population of older adults in this country is increasing. The number of people 65 and older is expected to nearly double by 2050. ||||| Key Points

 Question Has the prevalence of dementia among older adults in the United States changed between 2000 and 2012?

 Findings In this observational cohort study of more than 21 000 US adults 65 years or older from the nationally representative Health and Retirement Study, dementia prevalence declined significantly, from 11.6% in 2000 to 8.8% in 2012.

 Meaning Population brain health seemed to improve between 2000 and 2012; increasing educational attainment and better control of cardiovascular risk factors may have contributed to the improvement, but the full set of social, behavioral, and medical factors contributing to the improvement is still uncertain.

 Abstract

 Importance The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs.

 Objective To compare the prevalence of dementia in the United States in 2000 and 2012.

 Design, Setting, and Participants We used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS.

 Main Outcomes and Measures Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012.

 Results The study cohorts had an average age of 75.0 years (95% CI, 74.8-75.2 years) in 2000 and 74.8 years (95% CI, 74.5-75.1 years) in 2012 (P = .24); 58.4% (95% CI, 57.3%-59.4%) of the 2000 cohort was female compared with 56.3% (95% CI, 55.5%-57.0%) of the 2012 cohort (P < .001). Dementia prevalence among those 65 years or older decreased from 11.6% (95% CI, 10.7%-12.7%) in 2000 to 8.8% (95% CI, 8.2%-9.4%) (8.6% with age- and sex-standardization) in 2012 (P < .001). More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years [95% CI, 11.6-11.9 years] to 12.7 years [95% CI, 12.6-12.9 years]; P < .001) between 2000 and 2012. The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults.

 Conclusions and Relevance The prevalence of dementia in the United States declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.

 Introduction

 Dementia, a decline in memory and other cognitive functions that leads to a loss of independent function, is a common and feared geriatric syndrome that affects an estimated 4 to 5 million older adults in the United States1 and has a large social and economic impact on patients, families, and government programs.2 Although the number of older adults with dementia in the United States and around the world is expected to grow up to 3-fold by 2050 owing to the large increase in the size of the elderly population,3 recent studies suggest that the age-specific risk of dementia may have actually declined in some high-income countries over the past 25 years, perhaps owing to increasing levels of education and better control of key cardiovascular risk factors, such as hypertension, diabetes, and hypercholesterolemia.4-6 For instance, the incidence of dementia among older participants in the Framingham Heart Study declined by about 20% per decade between 1977 and 2008, and the decline in risk was seen only among those with at least a high school education.7

 If confirmed in representative populations, a decline in age-specific risk for dementia would have important implications for public health and public policy. For instance, a recent population-based study8 of dementia in England found a 24% decline in the expected number of cases of dementia between 1991 and 2011 (a 6.5% prevalence among older adults in 2011, compared with 8.3% in 1991; P = .003), which translates to more than 200 000 fewer cases of dementia.

 Quiz Ref IDThere have been changes over the past 2 to 3 decades in both the prevalence and treatment of cardiovascular risk factors that also influence the risk for dementia. For instance, 23% of US adults were obese in 1990 compared with 35% in 20129,10; among adults 65 years or older, the prevalence of diabetes increased from 9% to 21%.10 However, intensity of treatment for diabetes, hypertension, and high cholesterol level has increased with more patients achieving treatment goals, and a significant decline in the vascular complications of diabetes such as heart attack, stroke, and lower-extremity amputations,11 suggesting that there could be a “spill-over” benefit of a decline in the vascular-related risk for dementia.4,7

 Rising levels of education among US adults over the past 25 years may also have contributed to decreased dementia risk. The proportion of adults 65 years or older with a high school diploma increased from 55% in 1990 to 80% in 2010, while the proportion with a college degree increased from 12% to 23%.12 More years of formal education is associated with a reduced risk of dementia, likely through multiple causal pathways, including a direct effect on brain development and function (ie, the building of “cognitive reserve”), health behaviors, as well as the general health advantages of having more wealth and opportunities.13-15

 To further address these questions, we used the Health and Retirement Study16 (HRS), a large nationally representative prospective cohort study of US adults, to test whether the age-specific prevalence of dementia declined in the United States between 2000 and 2012. Since most prior studies of dementia trends have used samples from geographically restricted regions and with limited representation of minority populations, we could determine if those studies’ findings were replicated in a sample representative of the US population.

 Methods

 Data and Study Sample

 We used data from the 2000 and 2012 waves of the HRS. The HRS is a biennial survey of US adults that started in 1992 and collects a wide-range of data on health, cognition, family, employment, and wealth.16 The HRS follows respondents longitudinally until death, and new cohorts have been enrolled at different times since the 1992 baseline interviews in order to maintain population representativeness as the study sample has aged.16 As a result, 4008 individuals in our analysis were included in both the 2000 and 2012 cohorts, while 6538 were included only in 2000 and 6503 only in 2012.

 Our study sample of 21 057 included all HRS participants aged 65 or older, living in the community or in nursing homes in 2000 and 2012. There were 10 546 respondents in 2000 and 10 516 respondents in 2012, after excluding 165 (1.5%) and 218 (2.0%) respondents from the 2000 and 2012 samples, respectively, owing to missing data for 1 or more covariates used in the analysis. If a respondent is unable or unwilling to participate in the survey, the HRS attempts to identify a proxy respondent (usually a spouse or adult child) to complete the survey for them. There were 1317 (12.5% unweighted) respondents represented by a proxy in 2000 and 860 (8.2% unweighted) in 2012. The response rate for the full HRS sample was 88% in 2000 and 89% in 2012.17

 Verbal informed consent to participate in the HRS is obtained from all respondents, and they are provided about $80 in compensation for their participation. The HRS has been approved by the Health Sciences and Behavioral Sciences institutional review board at the University of Michigan.

 Measurement of Cognitive Function and Cognitive Category Definitions

 The HRS assesses cognitive function in self-respondents with a range of tests adapted from the Telephone Interview for Cognitive Status (TICS). Based on our prior work,18 we used a 27-point cognitive scale that included an immediate and delayed 10-noun free recall test, a serial 7 subtraction test, and a backward count from 20 test. Cutpoints for normal, cognitive impairment—no dementia (CIND), and dementia were validated against the prevalence of CIND and dementia in the Aging, Demographics, and Memory Study (ADAMS), an HRS substudy of Alzheimer disease and dementia that uses a 3-to 4-hour in-home neuropsychological and clinical assessment as well as expert clinician adjudication to obtain a gold-standard diagnosis of CIND or dementia.18,19 Respondents who scored from 0 to 6 on the 27-point scale were classified as having dementia, 7 to 11 as having CIND, and 12 to 27 as normal.

 For respondents represented by a proxy, an 11-point scale was developed using the proxy’s assessment of the respondent’s memory ranging from excellent to poor (score, 0-4), the proxy’s assessment of whether the respondent had limitations in 5 instrumental activities of daily living (IADLs) (managing money, taking medication, preparing hot meals, using phones, and shopping for groceries; score, 0-5), and the survey interviewer’s assessment of whether the respondent had difficulty completing the interview because of a cognitive limitation (a score of 0-2 indicating, none, some, and prevents completion). Using this information, respondents with high scores (6-11) were classified as having dementia, and those with mid-range scores (3-5) as having CIND.18

 Using the ADAMS dementia diagnosis as the gold standard, this categorization method correctly classifies 78% of HRS respondents as having dementia or not (76% of self-respondents and 84% of those represented by a proxy).18 More details on the HRS self-report and proxy cognition measures are available at the HRS web site.20

 Independent Variables Used as Covariates

 The following sociodemographic measures were included in the regression analyses as independent variables: age, self-reported race/ethnicity (white, black, Hispanic, other), sex, education (<12 years, 12 years, 13-15 years, and ≥16 years), and net worth (quartiles in year-2000 dollars). The self-reported chronic medical conditions and cardiovascular risk factors included were stroke, diabetes, heart disease, hypertension, and body-mass index (BMI) (derived from self-reported height and weight). All of these sociodemographic and health measures were selected for inclusion in the regression analyses a priori, based on prior studies suggesting that they are associated with dementia risk.

 Analytic Framework

 For descriptive analyses (Tables 1, 2, and 3), the 2012 sample was age- and sex-standardized to the 2000 population using direct standardization. For multivariable analyses (Table 4), we pooled data from 2000 and 2012 and estimated logistic regression models with a dichotomous dependent variable indicating whether an individual had dementia (the reference group included those with normal cognition or CIND). A linear trend variable that took the value of 0 in 2000 and 1 in 2012 was included in the regression models. An odds ratio (OR) of less than 1 for this trend variable would indicate a decrease in the prevalence of dementia (ie, a decrease in the overall odds of dementia among those ≥65 years) between 2000 and 2012. We estimated 4 separate logistic models with different sets of independent variables added sequentially (eg, trend variable only, an age- and sex-adjusted model, and then subsequent models that included sociodemographic variables and then health variables) to better assess which variables were associated with a change in the prevalence of dementia between 2000 and 2012. We tested for interactions between each independent variable and the year of observation.

 Statistical analyses were performed using STATA software (release 13.1, Stata Corp). We used HRS sampling weights to adjust for nonresponse and the complex sampling design of the HRS survey.

 Results

 Characteristics of the Study Sample

 Table 1 shows the characteristics of the 21 057 individuals in the 2000 and 2012 study cohorts (with age- and sex-standardization to the 2000 cohort). Quiz Ref IDCompared with the 2000 cohort, the 2012 cohort had a significantly larger proportion of those who were 85 years or older, but the average age for the full cohort was similar across the 2 years. The 2012 cohort had significantly more years of education; individuals with fewer than 12 years of education comprised 32.6% (95% CI, 30.8%-34.4%) of the sample in 2000 but only 20.6% (95% CI, 18.8%-22.6%) in 2012 (P < .001). On average, individuals in the 2012 cohort had nearly 1 more year of education compared with those in the 2000 cohort (12.7 years [95% CI, 12.6-12.9 years] vs 11.8 years [95% CI, 11.6-11.9 years]; P < .001). There was a greater disparity in household net worth in 2012 (in constant year-2000 dollars), with a greater proportion of the 2012 cohort in both the lowest and highest wealth quartiles (P = .02).

 The 2012 cohort had significantly higher rates of self-reported cardiovascular risk factors, including obesity (29.2% [95% CI, 27.9%-30.4%] in 2012 vs 18.3% [95% CI, 17.2%-19.4%] in 2000; P < .001), diabetes (24.7% [95% CI, 23.5%-26.0%] vs 16.4% [95% CI, 15.5%-17.3%]; P < .001), and hypertension (67.6% [95% CI, 66.2%-68.7%] vs 54.6% [95% CI, 53.7%-55.5%]; P < .001). The prevalence of heart disease increased from 29.1% (95% CI, 28.1%-30.1%) to 31.8% (95% CI, 30.8%-33.1%) between 2000 and 2012 (P < .001), but the prevalence of stroke did not change significantly. There was a small decline between 2000 and 2012 in the proportion of individuals with 1 or more IADL limitations, but this change was not significant (P = .14). The proportion of the sample living in a nursing home at the time of their HRS interview declined from 4.4% (95% CI, 4.0%-4.8%) in 2000 to 2.8% (95% CI, 2.5%-3.2%) in 2012 (P < .001), and the weighted and standardized proportion of the HRS sample represented by a proxy respondent declined from 12.1% (95% CI, 11.%-13.1%) in 2000 to 6.6% (95% CI, 6.2%-7.3%) in 2012 (P < .001).

 Trend in Prevalence and Adjusted Odds of Dementia

 Table 2 displays the weighted percentage of individuals in each cognitive function category in 2000 and 2012, and shows a significant decrease in the proportion of individuals 65 years or older with dementia between 2000 and 2012 (11.6% [95% CI, 10.7%-12.7%] in 2000 compared with 8.8% [95% CI, 8.2%-9.4%] in 2012; P < .001). The prevalence of CIND also decreased significantly across the 2 cohorts from 21.2% [95% CI, 20.1%-22.3%] to 18.8% [95% CI, 17.8%-19.9%] (P < .001). After age- and sex-standardizing the 2012 cohort to the 2000 cohort, the decline in dementia prevalence was slightly greater (8.6% in 2012) because of the greater proportion of those who were 85 years or older in 2012. Table 3 provides results stratified by age groups (65-74 years, 75-84 years, and ≥85 years).

 Table 4 reports the results of 4 different logistic regression models with the presence of dementia as the outcome variable, using pooled 2000 and 2012 data. The trend variable in the first row of the table represents the OR of dementia in 2012 compared with 2000. Model 1 shows the significant decline (OR, 0.73; 95% CI, 0.67-0.82) in unadjusted dementia prevalence already noted in Table 2, and model 2 shows the OR after adjusting for differences across the cohorts in age and sex (OR, 0.69; 95% CI, 0.62-0.77). Controlling for education, net worth, and race (model 3) explained 9 percentage points of the decrease in age- and sex-standardized odds of dementia between 2000 and 2012 (OR, 0.78; 95% CI, 0.70-0.88), while the addition of cardiovascular risk factors and BMI (model 4) accounted for 4 additional percentage points of the decline in prevalence (OR, 0.82; 95% CI, 0.73-0.92). Quiz Ref IDIn the fully adjusted model (model 4), more years of education and higher net worth were associated with a significantly lower odds of dementia, while older age, being African American or Hispanic, and having a history of stroke or diabetes were all associated with increased odds.Quiz Ref ID Being underweight was also associated with higher odds of dementia, while being overweight or obese was associated with lower odds of dementia, compared with those at normal BMI.

 When testing for an interaction effect between each independent variable and year, controlling for the main effects of all other variables, heart disease had a significantly lower OR for dementia in 2012 compared with 2000 (P < .001). No other interactions were significant at the P < .05 level.

 Discussion

 In a large nationally representative survey of older Americans we found that, among those 65 years or older, the prevalence of dementia decreased from 11.6% to 8.8% between 2000 and 2012, representing an absolute decrease of 2.8 percentage points, and a relative decrease of about 24%. Educational attainment increased significantly, with those 65 years or older in 2012 having nearly 1 additional year of education compared with the 2000 cohort. After controlling for the socioeconomic factors of education, wealth, and race/ethnicity, controlling for changes in the prevalence of cardiovascular risk factors did not explain much of the additional difference in dementia risk across the two cohorts.

 Our study, along with prior studies, supports the notion that “cognitive reserve” resulting from early-life and lifelong education and cognitive stimulation may be a potent strategy for the primary prevention of dementia in both high- and low-income countries around the world.21 However, it should be noted that the relationships among education, brain biology, and cognitive function are complex and likely multidirectional; for instance, a number of recent population-based studies have shown genetic links with level of educational attainment,22,23 and with the risk for cognitive decline in later life.24 Higher levels of educational attainment are also associated with health behaviors (eg, physical activity, diet, and smoking), more cognitively-complex occupations, and better access to health care, all of which may play a role in decreasing lifetime dementia risk.

 The prevalence of obesity and diabetes among those 65 years or older increased significantly between 2000 and 2012, and diabetes was associated with 39% higher odds of dementia, after controlling for all other factors. As in prior studies among older adults, we found that obesity was associated with a decreased risk of dementia, consistent with the hypothesis that, while obesity in mid-life may increase risk for later-life cognitive decline and dementia, obesity at older ages may be associated with cognitive and other health advantages.25-27 The trend toward a declining risk for dementia in the face of a large increase in the prevalence of diabetes suggests that improvements in treatments between 2000 and 2012 may have decreased dementia risk, along with the documented declines in the incidence of common diabetes-related complications, such as heart attack, stroke, and amputations.11 Our finding of a significant decline between 2000 and 2012 of the heart disease-related OR for dementia would also be consistent with improved cardiovascular treatments leading to a decline in dementia risk. To explore this hypothesis further, we used additional HRS data on self-reported treatments for diabetes (either oral medications or insulin). The proportion of adults with diabetes reporting either oral medication or insulin use increased from 86% in 2000 to 90% in 2012 (P < .01). Furthermore, the interaction of diabetes treatment by survey year in our regression model was statistically significant (P < .01), suggesting that diabetes treatment in 2012 was associated with a significantly lower OR of dementia compared with 2000.

 Our findings are consistent with those of a number of recent studies that also found declines in dementia incidence or prevalence in high-income countries around the world6-8,28-31 and also suggest that the trend toward a declining prevalence of cognitive impairment or dementia in the United States that we found between 1993 and 2002 using earlier waves of the HRS data13 has continued through 2012, even with significant increases in the prevalence of cardiovascular risk factors that may increase dementia risk. Our findings are consistent with the declining incidence of dementia found over the past 4 decades in the Framingham Heart Study,7 as well as the decline in dementia prevalence between 1991 and 2011 in the Cognitive Function and Aging Study (CFAS) in England.8 Both the Framingham and CFAS studies also pointed to increases in education and better control of cardiovascular risk factors as likely contributors to declining dementia risk.7,8

 Limitations

 Our study has several limitations. Our dementia diagnosis is based on a limited set of cognitive tests, although prior validation studies show a 78% concordance for dementia diagnosis when using these tests compared with the detailed ADAMS clinical evaluation.18 The recent Framingham7 and CFAS8 studies both used more extensive cognitive testing and clinical information when making a dementia diagnosis in their studies, so likely have less diagnostic misclassification. In addition, although we used a validated method to define diagnostic categories for both self-respondents and respondents represented by a proxy, the proportion of the HRS sample represented by a proxy declined significantly between 2000 and 2012 (from 12.5% to 8.2% unweighted), likely due in part to a change in HRS field procedures between these 2 waves. In 2006, the HRS purposefully increased the proportion of interviews administered face-to-face in respondents’ homes and decreased the proportion administered by phone. Since 2006, about one-half of HRS interviews at each wave have been administered face-to-face, while prior to 2006 only about 20% were face-to-face. This shift in survey mode likely encouraged an increase in self-interviews that in prior waves would have been completed by proxy, possibly leading to a change in the calibration of the self- and proxy-cognitive measures to dementia status. Quiz Ref IDAnother potential limitation is that changes in diagnostic thresholds and in the frequency of diagnostic testing between 2000 and 2012 may have affected the self-reported prevalence of cardiovascular risk factors, and the relationship of treatments to both cardiovascular and cognitive outcomes. Finally, the accuracy of self-report of cardiovascular risk factors may be less reliable for those with cognitive impairment or dementia.

 Conclusions

 Using nationally representative data, we found a significant decline in dementia prevalence among older US adults between 2000 and 2012, using the same cognitive measures and the same diagnostic classification strategy in both years. Increases in the level of education among the later-born cohort accounted for some of the decreased dementia risk, and there was some evidence that improvements in treatments for cardiovascular risk factors (eg, diabetes) may also have played a role. However, the full set of social, behavioral, and medical factors contributing to the decline in dementia prevalence is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead, as well as for clarifying potential protective and risk factors for cognitive decline.

 Back to top Article Information

 Corresponding Author: Kenneth M. Langa, MD, PhD, Division of General Medicine, University of Michigan, 2800 Plymouth Rd, Building 16, Room 430W, Ann Arbor, MI 48109-2800 (klanga@umich.edu).

 Accepted for Publication: September 6, 2016.

 Published Online: November 21, 2016. doi:10.1001/jamainternmed.2016.6807

 Author Contributions: Dr Langa and Mr Kabeto had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

 Concept and design: Langa, Larson, Faul, Levine, Kabeto, Weir.

 Acquisition, analysis, or interpretation of data: Langa, Larson, Crimmins, Faul, Kabeto, Weir.

 Drafting of the manuscript: Langa, Kabeto.

 Critical revision of the manuscript for important intellectual content: All authors.

 Statistical analysis: Langa, Crimmins, Faul, Kabeto, Weir.

 Administrative, technical, or material support: Larson, Faul, Levine, Weir.

 Study supervision: Langa, Faul.

 Conflict of Interest Disclosures: None reported.

 Funding/Support: This work was supported by cooperative agreement U01 AG009740 (Dr Weir) from the National Institute on Aging (NIA), National Institutes of Health. Additional support was provided by grants K23 AG040278 (Dr Levine), P30 AG053760 (Dr Langa), and P30 AG024824 (Dr Langa) from the NIA. The Health and Retirement Study is performed at the Institute for Social Research, University of Michigan, Ann Arbor.

 Role of the Funder/Sponsor: Representatives of the NIA reviewed the manuscript but were not directly involved in the collection, management, analysis, or interpretation of the data, or the decision to submit the manuscript for publication.

 Disclaimer: The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA or the Department of Veterans Affairs. |||||
What is a one-paragraph summary of the above article?

– Good news for older Americans: A new study suggests that their odds of getting dementia are shrinking despite predictions to the contrary. While standardized tests showed 11.6% of Americans 65 and older had dementia in 2000, only 8.8% did in 2012, reports NBC News. What's more, people are getting dementia later, with the average age at diagnosis increasing from 80.7 to 82.4 over the same period, reports the New York Times. One possible factor: A person's average education increased during that period from 11.8 years to 12.7 years, say University of Michigan researchers. "Education might actually change the brain itself," lead author Kenneth Langa tells NPR. "We think that it actually creates more, and more complicated, connections between the nerve cells so that you're able to keep thinking normally later into life." Another potential factor: While health ailments linked to dementia such as diabetes, high blood pressure, and high cholesterol increased, people were treating them with better medications. The study draws on long-range data about 20,000 Americans from all kinds of backgrounds, and Langa says it suggests that dire predictions about the nation's dementia problem might have been been overstated. The Alzheimer's Association isn't so sure: Though dementia rates may be falling, "the total number of Americans with Alzheimer's and other dementias is expected to continue to increase dramatically" as the number of older adults climbs," it says. In the US, the number of people 65 and older is projected to double by 2050, notes NPR. (A game could reduce your dementia risk.)


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For Ganley, the current model of how airwaves are allocated to mobile carriers is broken. At the moment, telecoms firms in the U.S. will bid for so-called spectrum through an auction process held by the Federal Communications Commission (FCC). In other countries, the appropriate regulator will control spectrum auctions. This often leads to dominance from the larger players who have more money to spend.

 The CEO said that this has killed innovation, particularly among European firms that led the previous generations of mobile technology.

 "Because of the way spectrum was allocated, we adopted the top-down model in a way we haven't done since feudalism. We recreated a top-down structure now that has become an absolutely critical part of our economy," Ganley said.

 He added that this model suits the Chinese because of the top-down nature of the world's second-largest economy. In the auction model, U.S. firms are competing heavily against each other to win customers. This hits their profits and therefore their ability to invest in innovation. In China, however, where there are only two or three major state-run networks dominating the market, this model is very fitting. They can continue to operate and invest because of backing by the Chinese government. This could allow them to get ahead of the U.S. telecoms companies which may struggle to compete when it comes to rolling out 5G.

 Ganley said that while many European and U.S. telecoms companies could die, China could prop their domestic players up for several years. That's why he, and his company Rivada Networks, advocate a wholesale model for allocating spectrum, similar to how the electricity market works.

 The model would theoretically allow more players to bid for spectrum as and when it is needed to meet demand and this would lead to more dynamic pricing.

 "What we need to do is completely flip the table," Ganley said, adding that this would allow the U.S. to get ahead of China in 5G.

 Interestingly, the Trump administration has hinted toward such a policy. Kelsey Guyselman, policy advisor at the White House Office of Science and Technology Policy, said at a recent event that the government recognizes that "sharing" spectrum could be a way to roll-out the next generation of mobile network, hinting toward a wholesale model.

 And it's clear that the upper echelons of the Trump administration are thinking about a wholesale market model for 5G. Brad Parscale, Trump's 2020 campaign manager, tweeted last month that he thinks this is the way forward.

 Ganley said that the race for 5G is moving quickly and the U.S. needs to introduce a wholesale model or risk losing to the Chinese.

 "We are 13 months away from really failing," Ganley told CNBC.

 Not all experts are convinced however that a wholesale spectrum model could live up to the hype.

 "I think while it’s a good idea the jury is still out on whether it will achieve the goals that have been articulated and some of that is routed in the idea that many of the major players involved in 5G are still seeking out those really lucrative 5G business cases," Shaun Collins, CEO of technology, media and telecoms analyst firm CCS Insight, told CNBC by phone earlier this week. ||||| LISTEN TO ARTICLE 1:29 SHARE THIS ARTICLE Share Tweet Post Email

 A ship laden with U.S. soybeans that was steaming toward northern China looks to have lost its race to arrive before import duties are imposed.

 Retaliatory tariffs on U.S. goods have now taken effect after the U.S. implemented a raft of duties earlier in the day, China’s foreign ministry said at a press conference in Beijing on Friday afternoon. The Chinese government had previously said it will impose a 25 percent levy on shipments on soybeans among other U.S. agricultural produce and goods including automobiles.

 The bulk carrier Peak Pegasus, which had been accelerating earlier in the day as it raced to the port of Dalian, was about 25 miles away from its destination as of 4:25 p.m. local time and slowing down, according to ship-tracking data. It’s scheduled to arrive at about 5 p.m., the data show.

 Peak Pegasus is still heading toward Dalian as China announces its tariffs are now in effect.

 Click to track the path of the Pegasus.

 The U.S. fired the first shot in the deepening trade war, imposing tariffs on $34 billion of Chinese imports from 12:01 a.m. Friday in Washington, just after midday in China. Soybeans have been a key battleground in escalating trade tensions between the two countries as China is the world’s biggest importer and America’s largest customer in trade worth $14 billion last year.

 The Asian country is expected to cancel or re-sell U.S. soybeans due to the additional duties and purchased 19 cargoes from Brazil last week. China typically imports from Brazil at this time of year before switching to the U.S., spurring concerns about a deficit in the fourth quarter.

 — With assistance by Shuping Niu ||||| Soybean prices in the U.S. and Brazil, the nations that account for roughly 80% of global exports, have taken drastically different paths thanks to Donald Trump’s trade war.

 In the U.S., average cash prices fell to about $7.87 a bushel this week, the lowest in almost a decade, according to an index compiled by the Minneapolis Grain Exchange. That comes as China gears up to enact retaliatory tariffs against American farm goods in response to President Trump’s pledge to slap fees on some products from the Asian country.

 Meanwhile in Brazil, exporters have been handed high times. Soybeans to be loaded in August at the nation’s Paranagua port fetched $2.21 a bushel more than Chicago futures on Thursday, the widest gap since data starts in 2014. The premium has more than tripled since the end of May, according to data from Commodity 3.

 “Premiums reflect the rising possibility of China being more dependent on Brazil’s soybeans,” Luis Fernando Roque, an analyst at consultancy firm Safras & Mercado, said in a telephone interview from Porto Alegre.

 The rally means the added premium for Brazil supplies are equal to about two-thirds the cost of the tariffs China is planning to levy on U.S. shipments, according to a report from INTL FCStone (intl).

 So far, good crushing margins are helping to keep Chinese demand robust for Brazilian supplies, even with surging premiums. China bought about 1.1 million metric tons of soybeans from Brazil last week, while no purchases from the U.S. were reported, according to the China National Grain and Oils Information Center.

 That’s an unusual move for this time of the year, when China usually starts booking U.S. supply in the months before the North American harvest starts. Supplies in Brazil begin to fall after shipments peak for the season in May. |||||

– Trade disputes generally don't lend themselves to exciting visuals, but the new one between the US and China might be an exception. As the deadline neared for new penalties to take effect, a ship laden with US soybeans raced toward the Chinese port of Dalian, capturing the attention of users on the Chinese social media site Weibo, reports Reuters. "You are no ordinary soybean!" one user wrote in regard to the ship Peak Pegasus, which set out from Seattle last month. "Good luck bro!" wrote another. However, Reuters reports that the Pegasus arrived just a smidge late to beat the deadline, and Bloomberg also reports that the ship "looks to have lost its race"—unless perhaps Chinese officials were feeling generous. Related coverage: Soybeans? They just happen to be the top American agricultural export to China, as an interactive graphic at Reuters reveals. China took in about $12 billion worth last year. US farmers' pain will be Brazilian farmers' gain, reports Fortune. One huge factor: CNBC reports that a major issue behind this trade war is 5G—and whether the US or China will be the nation to dominate the next generation of the mobile internet. This is about far more than faster download times, however. "It is being touted as a technology that could support the next generation of infrastructure, from the billions of internet-connected devices expected to come online in the next few years, to smart cities and driverless cars."


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Larimer County has seen 77 suicides this year, including three involving children under 18

 Two middle school students in Fort Collins have killed themselves this month, part of an increase in suicides that puts Larimer County on pace to surpass last year's total.

 The first student, a girl, died Nov. 16, according to the Larimer County coroner's office. The second, a boy, died Saturday. Both students were 11, the coroner's office said.

 The office has not released the students' names. An obituary for a girl who appears to be the female victim says she was a sixth-grader at Lincoln Middle School. The boy attended Blevins Middle School, according to the Fort Collins Coloradoan, which first reported the deaths.

 Their deaths put the total number of suicides in Larimer County at 77 this year, according to the coroner's office. Three of those deaths, including the most recent two, involved children under the age of 18.

 Last year, Larimer County saw 83 suicides, including two by children under 18. That tally was a 25 percent increase over 2013's total and the most the county had seen in at least 10 years. December was the deadliest month in 2014, with 11 suicides, according to the coroner's office.

 The Poudre School District has provided extra counseling services at the two students' schools, the district said in a statement Monday. Over the past five years, the district has boosted efforts to support student mental health, including providing students and staff with suicide-prevention training, according to the statement.

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 In the girl's obituary, her family asks that donations be made to groups that work to stop bullying in schools. Authorities have not publicly confirmed that bullying was involved in either death.

 "We must validate each other's feelings during this tragedy," the girl's family wrote in her obituary, "and help one another know that we're not alone in this world." ||||| Please enable Javascript to watch this video

 FORT COLLINS, Colo. — An unthinkable tragedy in Fort Collins is bringing the community together after two children took their own lives in the past week.

 The family of one of the victims said bullying took their young daughter’s life. They hope her story will help end bullying.

 Children in an east Fort Collins neighborhood spent their Sunday evening holding a candlelight vigil and balloon launch in memory of classmate Ariana Cordova. The 11-year-old Lincoln Middle School student committed suicide last week.

 “She started being bullied when she was in second grade,” her older sister Isabella Cordova said. “It wasn’t until she came home with a broken arm that we had to figure out what happened.”

 The girl’s family said she showed signs of bullying and depression in the past. She was put through counseling and programs. Her sister said Ariana was not showing any signs of suicide before her death.

 “There are people on her bus that said she was counting down days but she never let any of us know. She acted like everything was fine,” Isabella said.

 Cordova is not the only one. A second Fort Collins middle school student also took his own life during the weekend. The11-year-old Blevins Middle School student died Saturday night. His family has asked to keep his identity private.

 The two deaths are raising new questions about the way schools handle bullying.

 Cordova’s family said Lincoln Middle School was very good at handling situations where Ariana did not feel comfortable, including allowing her to take a course online. Isabella said more still needs to be done though.

 “I feel like it’s really bad, but it kind of goes unnoticed because there are all these signs and slogans saying no bullying, this is a no bully school, but overall nothing has changed. Everybody says what they want to say and do what they want to do without getting in trouble for it,” she said.

 She does not think more punishment for bullies is necessarily the answer though.

 “Those people are always going to have to live with that guilt on top of them and have the burden of what they said and what they did and I don’t think the best way to get that across is to make them feel that same way too because it’s just this endless cycle that needs to stop,” Isabella said.

 Ariana’s family now hopes their story will be a wake-up call for schools to implement real changes and serve as a message to other kids that asking for help is always the right answer.

 “If they’re not going to listen to me then imagine my little sister dancing in the sky wherever she is looking down on you saying that it’s going to be OK. You can make it through this,” she said.

 There will be a candlelight vigil for both young people Tuesday from 6:30 p.m. to 8 p.m. outside Colorado State University’s B.W. Pickett Equine Center in Fort Collins.

 The families are raising money to cover unexpected medical and funeral costs:

 Suicide and bullying resources |||||

– These are troubling times for parents in Fort Collins, Colo., where two 11-year-old children took their own lives within days of each other. The suicide of a girl in sixth grade at Lincoln Middle School last Monday was followed by the Saturday night suicide of a boy who attended Blevins Middle School. Both schools are in the Poudre School District, and authorities are investigating whether the two deaths are linked, reports the Coloradoan. The girl's family says she suffered from bullying and depression, but one of the boy's friends tells the Coloradoan that he was a well-liked prankster; the classmate doesn't believe the boy was bullied. A police spokeswoman tells the Coloradoan that they have "not received any information that bullying was a contributing factor in either incident." But the girl's older sister tells KDVR that the 11-year-old had been bullied since the second grade and the family didn't discover it until she came home with a broken arm. She says the family wants the death to bring about changes in how schools deal with bullying—and to send the message to bullied children that they should always ask for help. "If they're not going to listen to me, then imagine my little sister dancing in the sky wherever she is looking down on you saying that it's going to be OK. You can make it through this," she says. The Denver Post reports that Larimer County has logged 77 suicides year-to-date, including these two and one more of a child under age 18. The year prior, there were two under-18 suicides in the county. (Read about how a mother survived her son's high-profile suicide.)