The 8 determinants of life expectancy and health span

 There is a recent report on the American Heart Association (AHA) Life's Essential 8 metric and its association with both life expectancy and health span or life expectancy free of chronic diseases such as cardiovascular disease (CVD), cancer, diabetes, and dementia.

A new Harvard study leveraged the UK Biobank and included more than 135,000 UK adults with a mean age of 55. The AHA metric was defined as including the following lifestyle behavioral factors:

• Not smoking;
• Regular physical activity;
• Healthy weight;
• Healthy diet;
• Healthy sleep (defined as an average of 7-9 hours nightly);
• Blood pressure in a healthy range:
• Blood glucose in a healthy range; and
• Non-HDL cholesterol in a healthy range.

This study was just published in JAMA Internal Medicine.

"Overall, the findings make a compelling case for the importance of lifestyle factors in extending health span and years free of chronic disease. It can be motivating to tell our patients that a healthy lifestyle not only extends life expectancy but also extends years of health free of chronic disease."

Says Dr. JoAnn Manson one of the articles authors. Really?

To be brutally honest none of this is news to anyone, but it doesn't become fact until it is published in JAMA so there you have it, breaking news!

So while we are at it the JAMA neurology journal just published an article about hormone replacement and dementia, more breaking news!

Alzheimer's disease is caused by the deposition of certain proteins in the brain known as tau and amyloid. This study which was funded by the NIH imaged the brains of women who did and did not take hormone replacement.

Early menopause and delayed initiation of hormone therapy (HT) have been linked to an increase in Alzheimer's disease (AD) pathology in women, this new imaging study shows.

Investigators found elevated levels of tau protein in the brains of women who initiated HT more than 5 years after menopause onset, while those who started the therapy earlier had normal levels.

Tau levels were also higher in women who started menopause before age 45, either naturally or following surgery, but only in those who already had high levels of beta-amyloid.

The findings were published online April 3 in JAMA Neurology.

Here is the link to an abstract of the article

https://jamanetwork.com/journals/jamaneurology/article-abstract/2802791

Most of my patients know that I believe hormone replacement to be another critical component of aging well, especially in people over 50. Make that determinant of health number 9. In women, estrogen is critical in the prevention of heart disease, osteoporosis and dementia. Hopefully Harvard and JAMA will come around to doing a study on it and when they produce an article in a decade then it will be considered fact AKA breaking news!!