Group Project

University trains its expertise on aging and its consequences
by Helene Ragovin

By the time you finish reading this sentence, you'll be about five seconds older.

In other words, there's no escaping the aging process. Tufts has turned that universal concern into a university-wide undertaking known as the Mathew and Brenda B. Ross Initiative on AgingÑa multidisciplinary approach to research on aging and its consequences.

Dr. Marshal Folstein, professor and chair of psychiatry at the School of Medicine, says aging isn't necessarily accompanied by a significant decline in cognition. © Mark Morelli

The goals of the Ross Initiative are to encourage synergy among faculty and researchers and provide educational outreach. According to the program's director, it's an effort that's certainly relevant.

"This is the right time for this type of initiative to be taking place at Tufts," Dr. Robert M. Russell, director of the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), said during the initiative's symposium in November. "The demographics are changing."

Currently, 13 percent of the U.S. population is over age 65, Russell said. In 30 years, that number will jump to 20 percent.

And that aging population will have "absolutely enormous consequences for us," said Tufts President Lawrence S. Bacow. Not only will the aging population present challenges for the medical, nutritional and scientific communities, but it will pose challenges on a social and economic scale, he said.

"As a society, how will we deal with the well-being of this aging population?" asked Bacow. This demographic shift will be evident almost everywhere, influencing areas as diverse as philanthropy, the financing of health care or the design and production of everyday products, he said.

"Clearly, this will have consequences for every facet of what this university does," Bacow said. "We've just begun to scratch the surface."

Seeds of interest
During the past year, the main activity of the Ross Initiative has been its small grants program, Russell said. The initiative is now accepting proposals for its latest set of seed grants. The deadline is December 15. See www.tufts.edu/provost/initiatives/aging for more information.

Research on aging is strong on the Boston campus, Russell said. The Ross program would like to plant the seeds of interest on the other campuses, particularly Medford/Somerville.

The fall symposium, held in the Coolidge Room of Ballou Hall on November 9, was titled "Aging and Cognition." The speakers were Dr. Marshal Folstein, professor and chair of psychiatry at the School of Medicine; Dr. Irwin H. Rosenberg, University Professor and dean of the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy; Dr. Antonio Martin, assistant professor at the Friedman School and a scientist at the HNRCA; Dr. David Thaler, co-director of Tufts' Comprehensive Stroke Center; and Van Toi Vo, associate professor of electrical engineering and computer science.

Quality of life
Understanding the many factors that influence cognitive skills in the elderlyÑand, more specifically, understanding what may contribute to their decline with ageÑis a prime concern, the researchers agreed.

"Cognition is important to the quality of life of aging people," said Rosenberg. "The most feared consequences of aging are usually put in terms of competence and cognition."

Yet, contrary to popular assumptions, aging is not necessarily linked with a significant decline in cognition, Folstein said.

"Never say people are impaired because they're old," Folstein said. Tests of cognitive skills in older individuals show that many diverse factorsÑincluding lifelong health, education and socioeconomic status, genetics, even childhood experiencesÑinfluence competency in later life.

When different age groups of similar education are studied, for example, "there's very little effect of so-called aging," Folstein said.

Olga Baloueff, associate professor of occupational therapy, listens to the speakers at the fall forum of the Mathew and Brenda B. Ross Initiative on Aging. © Mark Morelli

Medical and nutritional factors
Most of the symposium speakers focused on medical and nutritional developments.

• Rosenberg addressed the relationship among cognition, vascular disease and the B vitamins.

Usually, people associate declining cognition and dementia in older adults with the onset of Alzheimer's disease, but vascular changes in the brain also likely play a role in cognitive decline, he said.

High levels of the amino acid homocysteine have been linked to vascular disease. And, high levels of homocysteine also have been associated with low intake of two B vitaminsÑfolate and B6, Rosenberg said.

Of interest to researchers is a 1996 move by the FDA requiring enriched flour to be fortified with folic acid. The action was not motivated by the possible connection between folate and vascular disease. Rather, it was spurred by the link between low folate intake in pregnant women and neural tube defects, such as spina bifida, in newborns. But it will give nutrition researchers the opportunity to see whether higher levels of folate intake will influence homocysteine levels, and ultimately, cognitive decline.

• Antonio Martin addressed the issue of Alzheimer's disease and antioxidants such as vitamins E and C. During the progression of Alzheimer's, neurons in the brain are replaced by a sticky plaque. Antioxidants may play a role in preventing the breakdown of those neurons, Martin said.

• David Thaler discussed ischemic stroke, the leading cause of long-term disability in the United States. He described risk factor modification and treatment of stroke for the elderly, and ended his talk with what he called a "sobering thought." Some physicians, Thaler said, may not be as aggressive in treating elderly stroke patients as they could be.

Also, he said, some stroke patients do not adhere to their treatment plans for a variety of reasons. For example, they may stop taking their medicine because they don't like the side effects, because they forget, because the medicine is too expensive or because they have physical difficulty taking the pills.

• Vo demonstrated several ophthalmic devises for diagnosis and treatment of eye conditions such as glaucoma, ocular hypertension, digitalis intoxication, macular degeneration and dry eye.

One such item is a special set of eyeglasses through which a patient can administer eye drops at frequent intervals. Using a conventional eye drop dispenser can be difficult for older people, and this makes the task easier.