Journal of internal medicine
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The current increase in lifespan without an equivalent increase in healthspan poses a grave challenge to the healthcare system and a severe burden on society. However, some individuals seem to be able to live a long and healthy life without the occurrence of major debilitating chronic diseases, and part of this trait seems to be hidden in their genome. ⋯ By combining the results from studies using these different approaches, we conclude that only five main pathways have been consistently linked to longevity, namely (1) insulin/insulin-like growth factor 1 signalling, (2) DNA-damage response and repair, (3) immune function, (4) cholesterol metabolism and (5) telomere maintenance. As our current approaches to study the relevance of these pathways in humans are limited, we suggest that future studies on the genetics of human longevity should focus on the identification and functional characterization of rare genetic variants in genes involved in these pathways.
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Demographers have studied the Japanese mortality pattern since Japan became the most longevous population worldwide, half a century ago. Nutrition and lifestyle were considered by epidemiologists, gerontologists and other scientists as the most important reasons explaining the Japanese superiority. In Okinawa, the mortality pattern is even more exceptional, but few demographers have pointed out this exception. ⋯ The older generations clearly experience a highly favourable mortality pattern, whereas the younger generations show mortality levels that are definitively higher compared to mainland Japan. This contribution considers which factors may explain such a situation, including the plausible invalidation of the age of some oldest in the population. We plea for in-depth demographic age validation that will enhance all scientific findings so far and boost the exceptional longevity in Okinawa.
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Randomized Controlled Trial
Orthostatic blood pressure changes do not influence cognitive outcomes following intensive blood pressure control.
Effects of intensive blood pressure (BP) control on cognitive outcomes in patients with excess orthostatic BP changes are unclear. We aimed to evaluate whether orthostatic BP changes modified the effects of BP intervention on cognitive impairment. ⋯ Intensive BP control did not have a deteriorating effect on cognitive outcomes among hypertensive patients experiencing significant postural BP changes.