What We Can Learn From Supercentenarians About Our Own Aging

At the age of 102, Mollye Marcus would be the first family member up and out of her seat to wash dishes after the holiday dinner. When she was 104 years old, she knew exactly how much money her wallet held at any given time down to the penny. And two years later, Marcus canceled her medical alert system, insisting she had no need for such a thing.

According to her granddaughter, Debbie Tynan, she stayed incredibly sharp and quick-witted for most of her life. Marcus continued to date men even as she approached 100 — and would stretch the truth about her age.

“There are so many stories about my grandmother, like how she loved to tease and had a thing for good-looking men,” said Tynan. “When the paramedics came for her after being dehydrated, she started flirting with all these young EMS guys.”

While most of us hope to merely reach 90 years old, Marcus — who died at the remarkable age of 111 — belongs to a remarkable group of outliers called supercentenarians. While centenarians have attained a century in age, supercentenarians are those individuals who live to 110 or older.

While only three reported cases occurred before 1960 worldwide, their numbers have increased since. Today, 42 living supercentenarians (41 women and 1 man) live in countries like Japan, Italy, Jamaica, and the U.S., according to the Gerontology Research Group. One estimate states that seven in 1,000 people born at the turn of the last century lived to become centenarians, while one in 100,000 lived to be 110 or older.

Why does it happen?

Why do supercentenarians like Marcus win the longevity lottery? Scientists have begun to study individuals who reach what’s called “extreme old age” to discover what makes them unique — and possibly unlock secrets of long life in the process. Studies on supercentenarians have found that they not only live longer but also age more slowly. Age-related diseases like cancer, dementia, and stroke affect them much later in life. Other studies have found particular features in their genetic profiles.

“About 25 percent of how long a given person lives is due to genetic factors, and the rest is really luck and lifestyle,” said Stuart Kim, an aging researcher formerly at Stanford University who has spent time examining the genetic differences between supercentenarians, centenarians and regular people in hopes of better understanding what makes up the 25 percent.

Kim and his colleagues have sequenced the genomes of the oldest people in the world in order to tease out the genetic factors associated with extreme longevity. In a 2014 study, they performed whole-genome sequencing on 17 supercentenarians but failed to find a significant result due to small sample size. However, when interviewing the subjects and their family members, Kim noticed that many of them — including Marcus — remained cognitively and physically functional to a high degree well into old age.

“One way that a person could live to 100 is just luck — they didn’t have cancer, heart attack, or stroke. But if I look at that person, he’s going to look 100 years old,” said Kim. “The other potential is that a person might be aging slower, and after 100 years, this person only looks 70 years old, which is also the reason why he hasn’t had cancer, stroke, etc.”

One of Kim’s supercentenarians worked as a pediatrician until the age of 103, while another drove a car at 107 years old. Also, none of the 17 had cardiovascular disease, stroke, or diabetes at the time. These anecdotal findings are consistent with other studies that have shown a delay in onset of age-related diseases, physical and cognitive function impairment, and overall morbidity. Most supercentenarians maintained independence in daily life until 100 years old, only entering a nursing home or hospital around age 105.

In his latest study, Kim and his colleagues looked at 801 centenarians and 5,406 people over 90, finding five gene variants associated with age-related diseases that occurred less frequently in this long-living population. The findings suggest these variants may influence extreme longevity and a reduced rate of aging.

So aside from winning the genetic lottery, what can the average person do to not only live longer but also healthier? Peter Martin, a gerontology researcher at Iowa State University, has studied hundreds of centenarians over the years and learned about what contributes to successful aging.

“Other than some of the obvious characteristics, such as good physical health and high cognitive functioning, we also should consider social aspects such as good social relationships and social engagement, the personality of older adults, and the rich experiences that make up an important part of an individual,” said Martin.

The successful older adults in his studies also have aspects of their personality that promote longevity. They are resilient, outgoing, highly conscientious, and don’t worry easily. Staying active both physically and mentally can contribute to well-being later in life.

Have we hit our limit?

Tynan remembers her grandmother being an avid reader of Danielle Steele and maintaining a love for cooking and baking. She remained social for her entire life, playing cards with friends, staying in close contact with family, and involving herself in the local community.

“Family was the most important thing to her, and her world was her two daughters and grandchildren,” said Tynan. “She was sharp, loving, and very stubborn — but that also kept her going for so long.”

Overall, human life expectancy continues to rise, but one big question remains: As time goes by, will we keep getting older as a species? In other words, is there an upper limit to human lifespan? According to molecular geneticist Jan Vijg at the Albert Einstein College of Medicine, we’ve already hit a plateau when it comes to maximum lifespan.

During a recent lab meeting, Vijg and his colleagues discussed the unique case of supercentenarian Jeanne Calment. In 1997, she died at the extreme age of 122 years old and today is still considered the oldest person who ever lived. The researchers wondered why, after two whole decades, no one had broken Calment’s record or even come very close. (The second oldest person had been 119 when she died.)

“We thought, maybe we’ve hit the end of the human lifespan,” said Vijg. “Even with all the advances in medicine and technology, maybe we can’t do anything to extend human life past this point.”

Using global demographic data, their study found evidence that suggests human lifespan may indeed have hit its natural limit. In countries with the largest number of supercentenarians — France, Japan, the U.K., and the U.S. — the maximum reported age at death significantly increased from the early 1970s until the 1990s. But after 1995, the maximum age began to drop and remains on a downward trend ever since. In fact, the average age at death of supercentenarians hasn’t changed since 1968. While some scientists vehemently oppose the idea of a longevity limit, most agree with the study’s conclusion.

“There has been an enormous increase in the number of people over 100 years old, so why does lifespan hit against this ceiling of 115? We don’t know,” he said.  

Health24.com | The potential danger of catheters used in dialysis

Tubes called catheters that are used to draw and return blood to the body during dialysis appear to cause the majority of bloodstream infections in people receiving dialysis for kidney problems, a new study finds.

Three-quarters of bloodstream infections in dialysis patients were related to accessing their blood, the 2014 US Centers for Disease Control and Prevention data showed.

The information came from more than 6 000 outpatient dialysis centres in 2014. There were nearly 30 000 bloodstream infections reported, the study found.

The analysis also found that 63% of all bloodstream infections and 70% of access-related bloodstream infections occurred in patients with a central venous catheter – also called a central line. Other dialysis complication rates were also highest among patients using central venous catheters, the findings showed.

Staphylococcus aureus was the most common bacterial cause of bloodstream infections (31%). 40% of the S. aureus samples were resistant to the antibiotic methicillin (“MRSA”), the investigators found.

Dialysis not available for everyone

Dialysis is necessary in the case of end stage kidney failure when your own kidneys can no longer filter your blood, i.e. when you have lost more than around 85% of your kidney function.

Healthy kidneys filter out excess fluid and wastes. The kidneys also produce hormones that keep your bones strong, blood chemically balanced and stimulate your bone marrow to make red blood cells. These cells carry oxygen in your blood to your organs.

Since 2012 dialysis patients in South Africa are able to undergo dialysis at night. National Renal Care (NRC), South Africa’s largest private dialysis therapy provider and a joint venture between Netcare and Adcock Ingram Critical Care, has introduced a groundbreaking new nocturnal or overnight, dialysis programme.

It is estimated that in South Africa only about a third of those living with kidney conditions are receiving life-saving dialysis.

Other options available

Dialysis patients have an increased risk for infection due to the repeated need to access their blood, the study authors explained.

“Our findings emphasise the need for haemodialysis facilities to improve infection prevention and vascular access care practices,” study author Dr Duc Bui Nguyen, from the CDC, said in a news release from the American Society of Nephrology.

                                                                       

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The study authors said there are other options available for dialysis patients, such as an arteriovenous fistula. This is created by connecting a patient’s own vein and artery to form a long-lasting site through which blood can be removed and returned.

Another option is an arteriovenous graft, which is a plastic conduit between an artery and a vein, the researchers said.

Findings from the study were published in the Clinical Journal of the American Society of Nephrology.

In an editorial accompanying the study, Dr Dana Miskulin of Tufts University School of Medicine and Dr Ambreen Gul of Dialysis Clinic, Inc., explained that part of the problem may be that dialysis units have been placed on an “honour system” when it comes to reporting adverse events.

The editorialists “make a plea to the dialysis community to ‘clean up’ the data, so that the quality incentive programme is fairer for all, and to enable the full potential of these data… to be realised.”

Read more:

Kidney dialysis

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Health24.com | Is your child’s ‘penicillin allergy’ real?

True penicillin allergy is rare with the estimated frequency of anaphylaxis at only 1–5 per 10 000 cases of penicillin therapy. Hypersensitivity reactions are in fact the major problem in the use of penicillin.

Some children may be having a true allergic reaction, but it could be caused by something else instead of the inexpensive, first-line antibiotic penicillin, new research indicates.

The findings – which echo similar research earlier this year in adults – mean many patients are instead prescribed more expensive broad-spectrum antibiotics, experts said. These alternatives can come with greater side effects and contribute to a rise in antibiotic-resistant infections.

According to a previous report in the Current Allergy & Clinical Immunology, many children with the label of penicillin allergy can safely take the drug without fear of an allergic reaction.

The study was published online in the journal Pediatrics.

Unnecessary use of less effective antibiotics 

“It’s important to question this because it leads to a substantial increase in costs, for both families and the health care system, when we have to switch to a more broad-spectrum antibiotic,” said study author Dr David Vyles. He’s an attending paediatric emergency medicine physician at Medical College of Wisconsin in Milwaukee.

“We think many cases aren’t a true allergic reaction,” he added. “It substantially limits the type of antibiotics that can be prescribed.”

More than 266 million courses of antibiotics were dispensed to outpatients in US pharmacies in 2014, according to the US Centers for Disease Control and Prevention. This equates to more than five prescriptions written each year for every six people.

Statistics reflecting the number of antibiotic courses dispensed in South Africa are not available.

Vyles and his team analysed questionnaires from nearly 600 parents of children aged four to 18 that described their child’s reported allergy symptoms. The families came to an urban paediatric emergency department over a span of 19 months.

Not a new concept

Health24 reported that viral infections could also be misdiagnosed and in some cases, patients simply don’t remember their experience correctly.

Just over 300 of the children had previously experienced low-risk symptoms for penicillin allergy, including rash, vomiting or diarrhoea, according to parents.

Of those, 100 children were tested for penicillin allergy using a standard, three-part testing process. This includes a skin test; an injection with a tiny amount of penicillin; and an “oral challenge” in which the child swallows a dose of penicillin under close medical supervision.

All 100 children tested were found not to be allergic to penicillin and had the designation removed from their medical record, the researchers said.

“During my paediatric residency and fellowship, we constantly saw families reporting a penicillin allergy and were questioning the validity” of the claim, Vyles said. Two of his three young children have also been wrongly identified as allergic to the drug, he noted.

Why the confusion?

Vyles and another expert said many parents notice that their children have a rash around the same time they’re prescribed penicillin. But the rash is likely due to an infection, not the drug.

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“Many infections are associated with a rash, and if a child is given an antibiotic for this illness or some other reason, the rash can be falsely attributed to a penicillin allergy,” explained Dr Stephen Eppes. He’s vice chair of paediatrics and director of paediatric infectious diseases at Christiana Care Health System in Wilmington, Delaware.

Eppes, who wasn’t involved in the new research, said up to 10% of people are either told or believe they’re allergic to penicillin. But when they’re tested for the allergy, more than 90% of them are not actually allergic to the drug.

Misdiagnosis of allergy

“Either the diagnosis of penicillin allergy was inaccurate to start with, or they had a hypersensitivity to it that went away over time,” he said. “I think the former is more common – meaning people think they had a reaction that’s not truly an allergy.”

Another misconception is that penicillin allergy is hereditary, Eppes noted, so some parents who are allergic to the drug assume their children are as well.

And since the three-pronged standard testing for penicillin allergy takes about three hours to complete, many are unwilling to go through with it, the doctors said.

In a continued study based on the new findings, Vyles said he plans to proceed directly to the “oral challenge” in children identified as low risk for penicillin allergy while still being treated in the hospital emergency department.

Read more:

Think you’re allergic to penicillin? Maybe not

Be allergy alert

20% of parents do not check kids’ allergy meds expiration date

Health24.com | 10 weird names for sports injuries

There are many injuries that can occur while playing sport – or during everyday activities for that matter.

Most of these injuries, whether mild or severe, rare or frequent, sound familiar to our ears. A few, however, have really unusual or exotic names. 

Here are 10 sports injuries with odd names:

Read more:

Common sports injuries

Treating sports injuries

Preventing sports injuries