Ageing does not have to bring poor health and frailty, say King’s College scientists

Researchers at King’s College London say the findings debunk the common assumption that ageing automatically makes people doddery and infirm .

Ageing does not have to bring poor health and frailty, scientists have claimed, after discovering that the most active people in their 70s are as fit as those in their 50s.

A study of older cyclists found that there was little physical difference between people aged 79 and those aged 55 if they maintained similar levels of exercise.

Exercise in sixties boosts healthy ageing

Regular exercise can have remarkable health benefits, even for those who do not take up physical activities until their sixties, a study suggests

Researchers at King’s College London say the findings debunk the common assumption that ageing automatically makes people doddery and infirm.

The team picked super-fit amateur cyclists between 55 and 79 and tested a wide range of physical functions commonly associated with ageing such as aerobic fitness, resting heart rate, skeletal mass, breathing ability and muscle density.

They were hoping to discover whether specific physiological markers could be used to determine age. But they found that it was difficult to tell who was older.

“If you couldn’t see these people many of these functions would point them to a much younger age,” said Professor Stephen Harridge, Director of the Centre of Human & Aerospace Physiological Sciences at Kings College.

“By exercising you do what your body wants it to do and are allowing to age optimally.

“So it is not ageing itself which brings about poor function and frailty, but the fact that people have stopped exercising and are no longer active.”

The 84 male and 41 female cyclists picked for the study had to be able to cycle 100km in under 6.5 hours and 60km in 5.5 hours, respectively, to be included in the study.

Smokers, heavy drinkers and those with high blood pressure or other health conditions were excluded.

The cyclists underwent two days of laboratory testing at King’s which measured cardiovascular, respiratory, neuromuscular, metabolic, endocrine and cognitive functions, bone strength, and health and well-being.

Volunteers’ reflexes, muscle strength, oxygen uptake during exercise and peak explosive cycling power were also measured.

The results of the study showed that in these individuals, the effects of ageing were far from obvious, with people of different ages having similar levels of function such as muscle strength, lung power and exercise capacity.

The maximum rate of oxygen consumption showed the closest association with age, but even this marker could not identify with any degree of accuracy the age of any given individual.

In a basic test which measured the time taken to stand from a chair, walk three metres, turn, and sit back down, even the oldest cyclists were well within the range of healthy young adults.

Although the researchers chose cyclists most other forms of aerobic activity would produce similar results.

Emeritus Professor Norman Lazarus, a member of the King’s team and also a cyclist, said: “Inevitably, our bodies will experience some decline with age, but staying physically active can buy you extra years of function compared to sedentary people.

“Cycling not only keeps you mentally alert, but requires the vigorous use of many of the body’s key systems, such as your muscles, heart and lungs which you need for maintaining health and for reducing the risks associated with numerous diseases.”

The new research was welcomed by charities who urged people to stay active.

Jane Tadman at medical research charity Arthritis Research UK said “The findings of this study back up our own research in the fact that many symptoms associated with ageing such as frailty are caused by being physical inactive. So many of our population are now living well into their 70s and 80s, and that should be a cause for celebration.

“But unless we can ensure that old age is spent in good health through remaining active, and this doesn’t necessarily meaning visiting the gym, it could be climbing the stairs on a regular basis, it will be a stage in life that is endured rather than enjoyed”.

New technology makes decayed teeth repair

Scientists have developed a technique that triggers the tooth’s natural repair process to reverse decay – and it could be available within three years.
The technique, developed at King’s College London, uses electrical currents to trigger minerals in the tooth to repair damage.
It’s called Electrically Accelerated and Enhanced Remineralisation, and the result is that a cavity is remineralised with calcium and phosphate painlessly – no drills, injections or fillings required.
“The way we treat teeth today is not ideal. When we repair a tooth by putting in a filling, that tooth enters a cycle of drilling and refilling as, ultimately, each ‘repair’ fails,” said professor Nigel Pitts of King’s College London Dental Institute in a press release.
“Not only is our device kinder to the patient and better for their teeth, but it’s expected to be at least as cost-effective as current dental treatments.”
Of course, the technique has its limits – it’s unlikely to work on decay and cavities that are too far along, and won’t be able to regrow teeth.
But according to the researchers, this technology, which should be available within three years, will effectively stimulate teeth to heal themselves and may also be able to whiten them

New Test Identifies Preeclampsia Requiring Delivery.

Preeclampsia complicates up to 8% of pregnancies and has been difficult to accurately diagnose with traditional markers.

Now, British researchers report that a new test (Triage, Alere, San Diego, CA) that measures the level of placental growth factor (PlGF) in the blood can help doctors determine with a high degree of accuracy if a woman will develop preeclampsia during her pregnancy[1].

In a prospective multicenter study of 625 pregnant women presenting before 35 weeks’ gestation with suspected preeclampsia, low plasma PlGF (lower than the fifth centile for gestation) had very high sensitivity and very low negative predictive value for pinpointing those women who actually had the disorder and would need delivery within 14 days.

The study is published online November 4, 2013 in Circulation.

“For many years we’ve tried to work out which women have preeclampsia and need delivery, and we relied on high blood pressure and protein in the urine to tell us that,” lead author Dr Lucy Chappell (King’s College, London, UK) told heartwire .

And for the first time, we have a highly accurate blood test that we think will change antenatal care practice because it tells you with 96% certainty that a woman has preeclampsia, which is going to require delivery within 14 days. And that’s important for the woman, it’s important for the doctor, and it’s important for the health service,” Chappell said.

Placental growth factor increases during pregnancy and can rise as high as 3000 pg/mL. A sign of a healthy, growing placenta, PlGF peaks at around 30 weeks’ gestation and then starts to decline. Any value above 100 pg/mL is considered normal.

A great deal of time and effort is spent trying to pick out the women who are at highest risk for preeclampsia. The real importance of the test is to flag the women who need greater surveillance, Chappell said.

“All obstetricians and family physicians see a considerable proportion of the women under their care come through with suspected preeclampsia, with readings of high blood pressure or a bit of protein in their urine or headache, and it’s very difficult out of those women to tell who is going to need more monitoring and who could continue on with usual levels of monitoring. A lot of time and effort is spent trying to pick the women at highest risk, and that is exactly what this blood test does,” she said.

“It’s got such high accuracy for determining the women who are going to get preeclampsia and require urgent delivery. It doesn’t tell you to deliver the baby, it tells you whom you should be shining your spotlight on and whom you can leave alone.”

In addition to determining the accuracy of low plasma PlGF (defined as being below the fifth centile for gestational age) in predicting the need to deliver within 14 days in women before 35 weeks’ gestation, the researchers also looked at its accuracy at 35 to 36 weeks’ and at 37 or more weeks’ gestation.

They also looked at the accuracy of the test when using a lower threshold (<12 pg/mL) of PlGF.

Of the 625 women who took part in the study, 346 (55%) developed confirmed preeclampsia.

Overall, 287 women were enrolled at 20 to 24 weeks’ gestation, 137 women at 35 to 36 weeks’ gestation, and 201 between 37 and 40 weeks’ gestation.

The researchers found that the test was most accurate in the earlier stages of pregnancy. Between 20 and 34 weeks, the sensitivity of the assay in predicting the need for delivery within 14 days was 0.96 (95% CI 0.89–0.99) and its negative predictive value was 0.98 (95% CI 0.93–0.995).

Between 35 and 36 weeks’ gestation, the sensitivity of low PlGF in predicting the need for delivery within 14 days was 0.70 (95% CI 0.58–0.81) and its negative predictive value was 0.69 (95% CI 0.57–0.80).

At 37 weeks or more, the test’s sensitivity was 0.57 (95% CI 0.46–0.68) and its negative predictive value was 0.70 (95% CI 0.62–0.78).

The researchers also found that a PlGF less than 100 pg/mL was just as good as a PlGF <5% at predicting preeclampsia requiring delivery within 14 days, with the same sensitivity and negative predictive value between 20 and 34 weeks’ gestation and a sensitivity of 0.95 (95% CI 0.83–0.99) and negative predictive value of 0.94 (95% CI 0.80–0.99) at 35 to 36 weeks’ gestation.

“This is of great importance to clinicians,” Chappell said. “The doctor can do this test in the office; anything less than 100 pg/mL would mean increased, careful surveillance. In our study, levels under 100 pg/mL indicated an average time to delivery of 23 days.”

Very low levels of PlGF (<12 pg/mL) indicated an average time to delivery of only nine days.

The PlGF test was significantly better than all other commonly used tests, such as systolic and diastolic blood pressure, uric acid, alanine transaminase, and proteinuria, in determining preeclampsia requiring delivery within 14 days, when used alone or in combination (p<0.001 for all comparisons).

“This information is quite useful for an obstetrician, because if the women’s levels were very low, then you would want to step up your surveillance. In the UK, we would certainly be admitting those women and monitoring them carefully. So this blood test can really discriminate between those who don’t have a problem and those who need stepped-up surveillance,” she said.

Levels 100 pg/mL and above are reassuring and would mean that the time to delivery is 62 days or nine weeks, Chappell added.

The ability to home in on at-risk women more accurately will result in improved outcomes for mother and baby, at least that is the hope for this test, she said.

“It might help to reduce the number of women who are delivered too soon, because if we target our care correctly, we can reduce unnecessary harm as well,” she said.

Blood test ‘detects sepsis in hours’

Sepsis kills more people than breast and bowel cancer combined
Sepsis kills more people than breast and bowel cancer combined

A rapid blood test to diagnose blood poisoning, or sepsis, at the hospital bedside could potentially save thousands of lives, say researchers.

Early studies at King’s College London suggest the condition can be diagnosed in two hours using a simple blood test.

Current diagnostic methods take up to two days, which may delay treatment with life-saving antibiotics.

The condition – caused when the body’s immune system overreacts to infection – causes 37,000 UK deaths each year.

In the study, published in the journal PLOS ONE, researchers identified a biomarker for diagnosing sepsis rapidly in blood samples.

It is based on detecting nucleotides specific to sepsis to rule out similar conditions that can mimic its symptoms.

A small study at a London hospital and a larger study in Sweden demonstrated that sepsis could be diagnosed within two hours, with an accuracy of 86%.

Facts about sepsis

  • Sepsis is a more common reason for hospital admission than heart attack – and has a higher mortality.
  • The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
  • The most common signs of sepsis are a high fever, violent shivering, fainting, cold and pale hands, rapid breathing, confusion or delirium.
  • In the UK, 37,000 people are estimated to die of sepsis each year.
  • From the time sepsis first takes hold, healthcare workers have just hours to deliver the right care.

Lead researcher Prof Graham Lord, director of the NIHR biomedical research centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, told BBC News: “If our early phase result holds up in a large trial, it could have significant effects in saving thousands of lives and reducing the use of unnecessary antibiotics.

“If we can prove its value in prospective trials, we can quite rapidly translate it into NHS clinical care.”

He said more research was needed to be done, but if successful, the test could be available for use in the NHS in about two years.

UK Sepsis Trust chairman Dr Ron Daniels said the work paved the way for earlier detection of sepsis.

“If we had a simple test that would reliably detect sepsis – particularly in vulnerable groups – it would significantly improve the reliability of the delivery of care,” he said.

He added: “We still need the suspicion of sepsis to be present for someone to give the test.”

In September, a report from the health service ombudsman found significant failings in treatment of sepsis and said more had to be done to save the lives of patients.

The National Institute for Health and Care Excellence will produce guidance for GPs and clinicians to help them recognise sepsis at an early stage.

Depression risk ‘starts in the womb’

Children whose mothers are depressed during pregnancy have a small increased risk of depression in adulthood, according to a UK study.

Medical treatment during pregnancy could lower the risk of future mental health problems in the child, say researchers at Bristol University.

Pregnant woman

The study followed the offspring of more than 8,000 mothers who had postnatal or antenatal depression.

The risk is around 1.3 times higher than normal at age 18, it found.

The study is published in JAMA Psychiatry. Lead researcher Dr Rebecca Pearson told the BBC: “Depression in pregnancy should be taken seriously and treated in pregnancy. It looks like there is a long-term risk to the child, although it is small.”

She said it was an association, not a causal link, and needed further investigation.

Prof Carmine Pariante of King’s College London‘s Institute of Psychiatry said the development of an individual’s mental health did not start at birth but in the uterus.

“The message is clear – helping women who are depressed in pregnancy will not only alleviate their suffering but also the suffering of the next generation.”

Prof Celso Arango of Gregorio Maranon General University Hospital, Madrid, said stress hormones may affect the child’s development in the womb.

“Women with depression would ideally be treated before getting pregnant, but if they are already pregnant when diagnosed with depression it is even more important that they are treated as it will impact on the mother and child.”

The researchers think different factors may be involved in antenatal and postnatal depression, with environmental factors such as social support having a bigger impact in postnatal depression.

The data comes from the Avon Longitudinal Study of Parents and Children – a long-term health research project, also known as Children of the 90s.

More than 14,000 mothers enrolled during pregnancy in 1991 and 1992, and the health and development of their children has been followed in detail since then.

Toddler brain scan language insight.

Regions of the brain that show leftward asymmetry of myelin
The left hand side of the brain has more myelin

The brain has a critical window for language development between the ages of two and four, brain scans suggest.

Environmental influences have their biggest impact before the age of four, as the brain’s wiring develops to process new words, say UK and US scientists.

The research in The Journal of Neuroscience suggests disorders causing language delay should be tackled early.

It also explains why young children are good at learning two languages.

The scientists, based at King’s College London, and Brown University, Rhode Island, studied 108 children with normal brain development between the ages of one and six.

“Start Quote

Our work seems to indicate that brain circuits associated with language are more flexible before the age of 4, early intervention for children with delayed language attainment should be initiated before this critical age”

Dr Jonathan O’Muircheartaigh King’s College London

They used brain scans to look at myelin – the insulation that develops from birth within the circuitry of the brain.

To their surprise, they found the distribution of myelin is fixed from the age of four, suggesting the brain is most plastic in very early life.

Any environmental influences on brain development will be strongest in infanthood, they predict.

This explains why immersing children in a bilingual environment before the age of four gives them the best chance of becoming fluent in both languages, the research suggests.

It also suggests that there is a critical time during development when environmental influence on cognitive skills may be greatest.

Dr Jonathan O’Muircheartaigh, from King’s College London, led the study.

He told the BBC: “Since our work seems to indicate that brain circuits associated with language are more flexible before the age of four, early intervention for children with delayed language attainment should be initiated before this critical age.

“This may be relevant to many developmental disorders, such as autism, since delayed language is a common early trait.”

Growing vocabulary

Early childhood is a time when language skills develop very rapidly.

Babies have a vocabulary of up to 50 words at 12 months but by the age of six this has expanded to about 5,000 words.

Language skills are localised in the frontal areas of the left-hand side of the brain.

The researchers therefore expected more myelin to develop in the left-hand side of the brain, as the children learned more language.

In fact, they found it remained constant, but had a stronger influence on language ability before the age of four, suggesting there is a crucial window for interventions in developmental disorders.

“This work is important as it is the first to investigate the relationship between brain structure and language across early childhood and demonstrate how this relationship changes with age,” said Dr Sean Deoni from Brown University, a co-researcher on the study.

“This is important since language is commonly altered or delayed in many developmental disorders, such as autism.”

Commenting on the study, Prof Dorothy Bishop of the department of Developmental Neuropsychology at the University of Oxford said the research added important new information about early development of connections in brain regions important for cognitive functions.

“There is suggestive evidence of links with language development but it is too early to be confident about functional implications of the findings,” she said.

“Ideally we would need a longitudinal study following children over time to track how structural brain changes relate to language function.”

The study was funded by the National Institutes for Mental Health (US) and the Wellcome Trust (UK).

Kinesio tape: fad, fashion accessory, placebo?

Kinesio tape. It was first brought to my attention during Euro 2012, with Italian players such as Buffon and Balotelli strapping this bright blue tape on the bodies. And since the Olympics has kicked off, I’ve seen it a lot more.

According to Kinesio it is adhesive strapping designed to provide muscle and joint support without restricting movement. However, it can only be applied by skilled practioners who have been on a course on how to apply it. Apparently, more than 4,000 people now know this technique and I should imagine many of the Olympic team doctors. However, there appears to be fairly minimal evidence that it can relieve pain or improve muscle strength.

From Reuters:

Kevin Anderson, managing director of Kinesio UK has said “There’s nothing magical in the tape, it certainly can’t improve your performance or make you into Superman, but the way people use the tape is to lift the skin, reduce the pressure and that helps relieve pain and swelling.”

Steve Harridge, a professor of human and applied physiology at King’s College London, said many athletes appeared to be wearing tape even when they had no injury, possible hoping for some preventative or enhancing effect.

“It may be a fashion accessory, and it may be just one of those fads that come along from time to time, but to my knowledge there’s no firm scientific evidence to suggest it will enhance muscle performance,” he told Reuters.

Both scientists agreed, however, that there may be a benefit, in the form of the placebo effect.


Have you noticed the increasing use of this tape? Can it really prevent injuries? Who is being trained in how to use it? Are athletes just using it as a fashion statement? Is it part of sporting superstitions?

Source: BJM/doc2doc