Making it past 90 ... in style

My Mom is an extremely active 92 with signs only of normal aging.  She recently had me watch an episode of 60 Minutes from 2014 about a study of the "oldest of the old," those over 90.  I watched it and found it had a lot to say.  There wasn't much new for me, and some of it seemed to conflict a little with some newer studies.  But it had a number of good takeaways.

The study was conducted at UC Irvine, with Dr. Claudia Kawas as principal investigator.  Most of the story was based on an interview with her.  Her study was called the 90+ Study.  (Their page did not display well in Firefox, but did in Safari.  I don't know about Windows browsers.)

The study keyed off of a 1981 study of residents of a retirement community in California called Leisure World, now called Laguna Woods.  The earlier study compiled questionnaire responses from 14,000 people in their mid-late 50s.  At the time of the 90+ Study, those still living were in their 90s.  The researchers attempted to track down all of the 14,000 to learn what had become of them and learn about those still living.  About 1,600 of these were enrolled in the new study.  The researchers studied their lives, gave them cognitive tests, and studied their brains with fMRIs and in autopsy.  (We discussed fMRIs, functional magnetic resonance imaging, here.) 

The 60 Minutes story was an engaging look into the lives of some study participants with insights on how well and how poorly some of them were doing.  

I couldn't find a copy of the study outside of the paywall, but here are the main conclusions Dr. Kawas stated in the video:

• Taking vitamins had no effect on longevity or preservation of cognition.  (This is consistent with other research we've discussed.)
• People who drank alcohol moderately lived longer than those who drank immoderately or who did not drink alcohol at all.  It didn't matter what you drank, so, in their study, there was no special advantage in red wine.
• People who drank 1-3 cups of coffee per day lived longer than those who drank more or less.
• It's never good to be obese, but people who lived longer tended to be normal or somewhat overweight in their later years.  However, people who were overweight when they were younger did not do well. 
  
• Making it to 90 without dementia does not mean you won't still develop it.  After age 65, the probability you will develop dementia doubles every five years, and that continues in your 90s.
• The fMRIs found that 40% of those found to have dementia did not have the plaques and tangles we associate with Alzheimer's disease.  However, they found a strong presence of evidence for vascular dementia.
• As in the Nun Study which we discussed in the second edition of Beating the Dementia Monster, the brains of some test subjects showed evidence of Alzheimer's disease (plaques and tangles in both autopsy and fMRI) but did not show evidence of cognitive decline.  Essentially half of the people who died without evidence of dementia still had plaques and tangles in their brains at autopsy.  The big question is "why not?"
• Low blood pressure, at least later in life, correlated with a shorter life span.  Most current research correlates low blood pressure with less risk of dementia and lower risk of early death from cardiovascular disease.  But, perhaps, if you get to an older age with higher blood pressure, it's somehow protective?  I haven't seen an explanation for that one, but who knows.

This study was focused on what prolongs life, not so much on Alzheimer's disease or other dementias.  However, at the end, Dr. Kawas discussed Alzheimer's disease, saying that we may be misguided in seeking a simple answer.  We want one thing to explain Alzheimer's disease, but it may be too complex for that.  In the six years since they made this video, research has continued to confirm the confounding complexity of the disease.