Personality psychologists describe openness as one of five major personality traits. Studies suggest that the other four traits (agreeableness, conscientiousness, neuroticism and extraversion) operate independently of a person’s cognitive abilities. But openness – being flexible and creative, embracing new ideas and taking on challenging intellectual or cultural pursuits – does appear to be correlated with cognitive abilities.

The new study, published in the journal Psychology and Aging, gave older adults a series of pattern-recognition and problem-solving tasks and puzzles that they could perform at home. Participants ranged in age from 60 to 94 years and worked at their own pace, getting more challenging tasks each week when they came to the lab to return materials.

“We wanted participants to feel challenged but not overwhelmed,” said University of Illinois educational psychology and Beckman Institute professor Elizabeth Stine-Morrow, who led the research. “While we didn’t explicitly test this, we suspect that the training program – adapted in difficulty in sync with skill development – was important in leading to increased openness. Growing confidence in their reasoning abilities possibly enabled greater enjoyment of intellectually challenging and creative endeavors.”

Researchers tested the cognitive abilities and personality traits of 183 older adults, randomly assigned to either an experimental group who participated in a cognitive intervention or a control group who did not. They were tested a few weeks before the intervention and afterwards. At the end of the program, those who had engaged in the training and practice sessions saw improvement in their pattern-recognition and problem-solving skills, while those in the control group did not. And those who improved in these inductive reasoning skills also demonstrated a moderate but significant increase in openness.

This study challenges the assumption that personality doesn’t change once one reaches adulthood, said Illinois psychology professor and study co-author Brent Roberts.

“There are certain models that say, functionally, personality doesn’t change after age 20 or age 30. You reach adulthood and pretty much you are who you are,” he said. “There’s some truth to that at some level. But here you have a study that has successfully changed personality traits in a set of individuals who are (on average) 75. And that opens up a whole bunch of wonderful issues to think about.”

~Medical News Today Article

Researchers at the University of Pittsburgh selected the records of 260 participants in the Cardiovascular Health Study who were in their mid-70s and who had no problems with memory, thinking or reasoning. The researchers then looked at fish consumption and found that 163 of these men and women ate fish regularly, with the majority of them including it in their meals one to four times a week.

Ten years later, three-dimensional MRI brain scans were obtained for each participant. The researchers then did a brain mapping analysis on these scans that measured gray matter, which is crucial to brain health. “This is a mathematical way of understanding the influence of fish intake on the brain,” says Cyrus Raji, M.D., the lead author.

Taking into account factors such as age, sex, physical activity, obesity and education, the researchers determined that people who ate fish weekly had large amounts of gray matter in areas of the brain that are related to Alzheimer’s and mild cognitive impairment, a subtle but measurable memory disorder. Although previous studies have linked eating fish to brain health, the researchers say this is the first study to establish a direct relationship between fish consumption, brain structure and Alzheimer’s risk.

“Specific areas of gray matter in the brain are smaller in people with Alzheimer’s because the disease slices away at these regions cell by cell,” says neuropsychologist James Becker, a senior author of the study. If you start out with stronger, larger brain cells, however, it will take longer before the disease destroys so many cells that behavior and thinking start to change, Becker says.

Many people say that Alzheimer’s is genetic and there’s nothing you can do about your genes, notes Becker. “That’s true. But even if you’re destined to develop Alzheimer’s you can delay the point at which the disease shows its face,” he says. “Look at it this way. If you drive a four-cylinder car and one of the cylinders blows, you’re in a lot of trouble. But if you drive an eight-cylinder car and a cylinder blows, you may not be in good shape but you can still get to where you’re going. This is the biological equivalent of building in an extra four cylinders so that even if something goes wrong you’ve still got a lot of oomph left.”

The researchers noted that regular servings of baked or broiled fish promote stronger brain cells in gray matter by making them larger and healthier; greater volume could reduce the risk for a five-year decline in mental skills by almost fivefold.

Although the study didn’t identify the specific kinds of fish participants ate, past research ties fatty fish such as salmon, mackerel and herring, which are rich in omega-3 fatty acids, to brain health. Scientists already know that eating these fish can protect the heart. It turns out that they also protect the brain. Fried fish, on the other hand, provides no such benefits. “Frying changes the chemical composition of the omega-3 fatty acids, causing them to break down so there’s less available,” says Becker.

“There’s a growing awareness that what we eat can affect our brain,” says Scott Small, M.D., a Columbia University neurologist who was not involved in the research. “This interesting paper is a critical first step in pointing out a link between eating fish and reducing the risk of cognitive decline.”

By: Nissa Simon  From: AARP Bulletin

“She couldn’t remember names, where she’d been or what she’d done that day,” Ms. Atkins recalled in an interview. “Initially, I was not too worried. I thought it was part of normal aging. But over time, the confusion and memory problems became more severe and more frequent.”

Her mother couldn’t remember the names of close relatives or what day it was. She thought she was going to work or needed to go downtown, which she never did. And she was often agitated.

A workup at a memory clinic resulted in a diagnosis of early Alzheimer’s disease, and Ms. Katz was prescribed Aricept, which Ms. Atkins said seemed to make matters worse. But the clinic also tested Ms. Katz’s blood level of vitamin B12. It was well below normal, and her doctor thought that could be contributing to her symptoms.

Weekly B12 injections were begun. “Soon afterward, she became less agitated, less confused and her memory was much better,” said Ms. Atkins. “I felt I had my mother back, and she feels a lot better, too.”

Now 87, Ms. Katz still lives alone in Manhattan and feels well enough to refuse outside assistance.

Still, her daughter wondered, “Why aren’t B12 levels checked routinely, particularly in older people?”

It is an important question. As we age, our ability to absorb B12 from food declines, and often so does our consumption of foods rich in this vitamin. A B12 deficiency can creep up without warning and cause a host of confusing symptoms that are likely to be misdiagnosed or ascribed to aging.

A Vital Nutrient

B12 is an essential vitamin with roles throughout the body. It is needed for the development and maintenance of a healthy nervous system, the production of DNA and formation of red blood cells.

A severe B12 deficiency results in anemia, which can be picked up by an ordinary blood test. But the less dramatic symptoms of a B12 deficiency may include muscle weakness, fatigue, shakiness, unsteady gait, incontinence, low blood pressure, depression and other mood disorders, and cognitive problems like poor memory.

Labs differ in what they consider normal, but most authorities say a deficiency occurs when B12 levels in adults fall below 250 picograms per milliliter of blood serum. Like all B vitamins, B12 is water-soluble, but the body stores extra B12 in the liver and other tissues. Even if dietary sources are inadequate for some time, a serum deficiency may not show up for years.

If the amount of B12 in storage is low to begin with, a deficiency can develop within a year, even more quickly in infants.

Recommended dietary amounts of B12 vary: 2.4 micrograms daily for those age 14 and older, 2.6 micrograms for pregnant women and 2.8 micrograms for nursing women. Barring circumstances that impair B12 absorption, these are levels easily obtained from a well-balanced diet containing animal protein.

In its natural form, B12 is present in significant amounts only in animal foods, most prominently in liver (83 micrograms in a 3.5-ounce serving). Good food sources include other red meats, turkey, fish and shellfish. Lesser amounts of the vitamin are present in dairy products, eggs and chicken.

Those at Risk

Natural plant sources are meager at best in B12, and the vitamin is poorly absorbed from them. Many strict vegetarians and all vegans, as well as infants they breast-feed, must consume supplements or fortified breakfast cereals to get adequate amounts.

Certain organisms, like the bacterium Spirulina and some algae, contain a pseudo-B12 that the body cannot use but may result in a false reading of a normal B12 level on a blood test. Despite claims to the contrary, laver, a seaweed, and barley grass are not reliable sources of B12.

In animal foods, B12 is combined with protein and must be released by stomach acid and an enzyme to be absorbed. Thus, chronic users of acid-suppressing drugs like Prilosec, Prevacid and Nexium, as well as ulcer medications like Pepcid and Tagamet, are at risk of developing a B12 deficiency and often require a daily B12 supplement.

Stomach acid levels decline with age. As many as 30 percent of older people may lack sufficient stomach acid to absorb adequate amounts of B12 from natural sources. Therefore, regular consumption of fortified foods or supplementation with 25 to 100 micrograms of B12 daily is recommended for people over 50.

Synthetic B12, found in supplements and fortified foods, does not depend on stomach acid to be absorbed. But whether natural or synthetic, only some of the B12 consumed gets into the body. Treatment to correct a B12 deficiency typically involves much larger doses than the body actually requires.

Free B12 from both natural and synthetic sources must be combined with a substance in the stomach called intrinsic factor to be absorbed through the gut. This factor is lacking in people with an autoimmune disorder called pernicious anemia; the resulting vitamin deficiency is commonly treated with injections of B12.

Although most doctors are quick to recommend injections to correct a B12 deficiency, considerable evidence indicates that, in large enough doses, sublingual (under-the-tongue) tablets or skin patches of B12 may work as well as injections for people with absorption problems, even for those with pernicious anemia.

Most often, a daily supplement of 2,000 micrograms is recommended for about a month, then lowered to 1,000 micrograms daily for another month, then lowered again to 1,000 micrograms weekly. Sublingual B12 or B12 patches, or even B12 lollipops, can be helpful for people who require a supplement but cannot swallow pills.

Others at risk of developing a B12 deficiency include heavy drinkers (alcohol diminishes B12 absorption), those who have had stomach surgery for weight loss or ulcers, and people who take aminosalicylic acid (for inflammatory bowel disease or tuberculosis) or the diabetes drug metformin (sold as Glucophage and other brands). Patients who take the anticonvulsants phenytoin, phenobarbital or primidone are also at risk.

Large doses of folic acid can mask a B12 deficiency and cause permanent neurological damage if normal levels of B12 are not maintained. Supplements of potassium impair B12 absorption in some people.

Although a B12 deficiency can raise blood levels of the amino acid homocysteine, a risk factor for heart disease and stroke, supplements of B12 have not reduced cardiovascular risk.

And while high homocysteine levels are linked to Alzheimer’s disease and dementia, lowering them with B12 supplements has not been shown to improve cognitive function. However, in one study, among women with a poor dietary intake of B12, supplements of the vitamin significantly slowed the rate of cognitive decline.

By Jane Brody

Could there be measurable benefits to your health, and to your brain in particular, from being a caregiver?

It’s practically become an article of faith that the reverse is true, that caring for an elderly relative is so stressful, relentless and draining that it takes a toll on your well-being. Some studies have shown that it can increase your risk of depression and heart disease, impair your immune system, even contribute to death.

That caregiving could actually provide some health advantage is so counter intuitive that when Lisa Fredman, a Boston University epidemiologist, first saw such results emerging from her study of elderly women, “I thought, what on earth is going on here?” she recalled. “I blamed myself. I thought something was wrong with my data.”

But over several years of studying the differences between caregivers and non-caregivers in four locations (Baltimore, Pittsburgh, Minneapolis and Portland, Ore.), Dr. Fredman and her colleagues found that while caregivers were indeed more stressed, they still had lower mortality rates than non-caregivers over eight years of follow-up.

In another study of about 900 women drawn from the same four-site sample, even those classified as high-intensity caregivers — because they performed more functions for their dependent relatives — maintained stronger physical performance than non-caregivers. On tests like walking pace, grip strength and the speed with which they could rise from a chair, the high-intensity group declined less than lower-intensity caregivers or non-caregivers over two years.

“That was a shocker,” Dr. Fredman said.

Now Dr. Fredman and her co-author Rosanna Bertrand, a health policy associate at Abt Associates in Cambridge, Mass., have gone back to this pool of women to look at their cognitive functioning. Here, again, caregivers did significantly better on memory tests than did non-caregivers followed over two years. Though the groups were about the same average age, in their early to mid-80s, caregivers scored at the level of people who were 10 years younger.

Along with what’s called “caregiver burden,” gerontologists and psychologists use the phrase “caregiver gain” to reflect the fact that this role, which often exacts such high costs, can bring rewards. But they’ve typically described those rewards in psychological, emotional and even spiritual terms: growing confidence in one’s abilities, feelings of personal satisfaction, increased family closeness. That caregivers can walk faster or recall more words on a memory test — that’s news.

Dr. Fredman has begun referring to this notion that caregivers are not invariably beaten down by their responsibilities as the “healthy caregiver hypothesis.” Taken together, her studies provide some evidence that caregivers, however stressed, may be stronger and stay stronger than women of the same ages who don’t undertake those tasks. The interesting question is why.

You can’t randomize studies like this, assigning some old women to serve as caregivers but not others. So it’s likely that a big part of the differences, Dr. Fredman said, stemmed from self-selection: Women become caregivers because they are healthy enough to shoulder that responsibility. “If you’re not healthy,” she said, “it goes to your daughter or daughter-in-law.” It’s not surprising, therefore, that even high-intensity caregivers have and maintain more physical strength.

It’s also true that Dr. Fredman’s definition of a caregiver sets a fairly low bar, including anyone who performs even one “instrumental activity of daily living,” such as helping someone with bill-paying or phone use. Hands-on help with bathing or toilet use is clearly more stressful, physically and emotionally; caring for someone with dementia can be particularly arduous.

But caregiving itself may provide real benefits. “Most caregiving activities require you to move around a lot,” Dr. Fredman pointed out. “It keeps people on their feet, up and going.” And exercise is known to improve physical health and cognition.

Moreover, Dr. Bertrand added: “Caregiving often requires complex thought. Caregivers monitor medications, they juggle schedules, they may take over financial responsibilities.” That, too, can ward off cognitive decline.

Plus there’s the whole matter of people benefiting from having a purpose. It’s hard to quantify, but it’s real.

So it’s fair to say that the question of how caregiving impacts the caregiver is more complicated and individual than we think. Both could be true, the burdens and the benefits, depending on how demanding the job is and a host of other factors.

That caregiving is a very tough job is beyond debate. “We don’t want to overstate this and say it’s good for caregivers and have governors across the country rush to cut support programs that help families,” said Steven Zarit, a Penn State gerontologist who has studied caregiving. (Of course, governors seem all too eager to do that anyway.)

Still, “it may not be as predictive of their demise as previously thought,” Dr. Bertrand said of elder care and caregivers. “There are potentially some positive aspects.”

By Paula Span

By Paula Span

Medical researchers are usually so cautious about characterizing results that when sober cardiologists use phrases like “very excited” and “a home run” and even “a new era,” you pay attention.

What’s causing this ripple is the emergence of new anticoagulant drugs, or blood thinners. Dabigatran (brand name Pradaxa) has already won Food and Drug Administration approval; rivaroxaban (Xarelto) has been endorsed by an F.D.A. advisory panel and awaits a final decision in November. A third drug, apixaban (Eliquis), exceeded investigators’ expectations in global clinical trials, according to findings just reported in The New England Journal of Medicine, and the manufacturer will seek F.D.A. approval by year’s end.

“The results are clear, so we’d expect the review process to be fairly rapid,” said Dr. Christopher Granger, the Duke University cardiologist who led the trials. A fourth new anticoagulant, edoxaban, is in advanced clinical trials.

As these medications hit the market, assuming most will, they’re likely to begin edging out warfarin, for 50 years the standard drug used to prevent strokes in people with atrial fibrillation. That’s what’s causing the cheers, though there are also some less-than-cheerful prospects.

A brief primer: Atrial fibrillation, a heart arrhythmia that can create blood clots, is thought to cause about one in five strokes in the United States. The condition increases steadily with age, so the number of people coping with it will rise along with the sheer numbers of older Americans.

Warfarin (Coumadin) reduces stroke risk from atrial fibrillation by about 60 percent, by thinning the blood so it’s less likely to clot. Along with blood pressure drugs, warfarin is one of the reasons that stroke deaths have declined sharply in recent decades.

But “the saying is that warfarin is the drug people love to hate,” said Dr. Jessica Mega, a cardiologist at Brigham and Women’s Hospital in Boston and author of an editorial in The New England Journal of Medicine hailing “a new era”. “It’s very unpopular.”

That’s because it affects individuals so differently that patients require careful monitoring; they typically have blood drawn each month to be sure the blood remains the proper consistency. “You want it thin enough that the drug is effective — you won’t form clots — but not so thin you’re going to bleed if you bump your head on the kitchen cabinet,” Dr. Mega said. If a doctor finds the monthly results unsatisfactory and adjusts the warfarin dose, the patient has to return for still another test.

“It’s a very labor-intensive medication,” Dr. Mega said. “People get fatigued, and they don’t want to do it anymore.”

Moreover, warfarin doesn’t play well with other drugs, from antibiotics to some blood pressure meds. Users even have to be mindful of what they eat (no bingeing on kale). And while some bleeding caused by warfarin — bruising, say, or nosebleeds –- is simply problematic and unpleasant, doctors particularly worry about bleeding into the brain. An intracranial hemorrhage can be fatal or disabling, as bad as the problems that warfarin was supposed to prevent.

That happens very rarely, it should be said. “It’s a low-frequency event, but it’s devastating,” Dr. Mega said.

So the goal in evaluating the new drugs has been to ascertain “noninferiority.” They didn’t have to be more effective than warfarin, which works quite well; they just have to be easier to take and no more likely to cause bleeding. That is benefit enough to seek F.D.A. approval.

Apixaban did well by those measures, the researchers found. In a randomized study of more than 18,000 people (median age: 70) with atrial fibrillation and at least one other risk factor for stroke, major bleeding occurred in 2.13 percent of patients in the apixaban group per year, significantly less than the 3.09 percent in the warfarin group. Apixaban significantly reduced bleeding in general, and brain bleeds in particular, compared with warfarin. And patients were able to skip the monthly monitoring. (Bristol-Myers Squibb and Pfizer, which hope to market apixaban, financed the study.)

But what caused excitement at the recent meeting of the European Society of Cardiology in Paris was that apixaban, a twice-daily pill, went beyond noninferiority. It prevented 21 percent more strokes than warfarin over the 1.8 years of the study and reduced deaths from any cause by 11 percent, in addition to reducing major bleeding incidents by nearly a third. “That’s a home run,” said Dr. Mega.

The other new drugs had similar benefits, she added: “Across all these trials, they make a whopping reduction in the risk of hemorrhagic stroke.” They have fewer dangerous interactions with other drugs as well. And although some drugs are less effective in the elderly, “one sees very clear findings of lower rates of stroke and bleeding among the elderly” in the apixaban study, Dr. Granger said.

The less-than-cheerful news is how much more the new meds cost than warfarin. Coumadin retails for about $1.50 a day, depending on dose. The generic goes for less than $10 a month at some big chains. By contrast, apixaban is expected to sell for $7 a day, a stiff price for patients on fixed incomes, even if they have Medicare Part D. “They fall into the doughnut hole fairly quickly,” Dr. Granger said.

Perhaps analysts will determine that cost savings of the new anticoagulants — at least a dozen monthly tests people no longer have to undergo, plus fewer strokes — will compensate for the higher costs.

Or maybe the competitive market will work the way it’s supposed to, with several new drugs entering the market in a short time creating downward pressure on costs. “We may be able to persuade pharmaceutical companies that it’s better to have broader use at lower prices than less use at higher prices,” Dr. Granger said.

What’s causing this ripple is the emergence of new anticoagulant drugs, or blood thinners. Dabigatran (brand name Pradaxa) has already won Food and Drug Administration approval; rivaroxaban (Xarelto) has been endorsed by an F.D.A. advisory panel and awaits a final decision in November. A third drug, apixaban (Eliquis), exceeded investigators’ expectations in global clinical trials, according to findings just reported in The New England Journal of Medicine, and the manufacturer will seek F.D.A. approval by year’s end.

“The results are clear, so we’d expect the review process to be fairly rapid,” said Dr. Christopher Granger, the Duke University cardiologist who led the trials. A fourth new anticoagulant, edoxaban, is in advanced clinical trials.

As these medications hit the market, assuming most will, they’re likely to begin edging out warfarin, for 50 years the standard drug used to prevent strokes in people with atrial fibrillation. That’s what’s causing the cheers, though there are also some less-than-cheerful prospects.

A brief primer: Atrial fibrillation, a heart arrhythmia that can create blood clots, is thought to cause about one in five strokes in the United States. The condition increases steadily with age, so the number of people coping with it will rise along with the sheer numbers of older Americans.

Warfarin (Coumadin) reduces stroke risk from atrial fibrillation by about 60 percent, by thinning the blood so it’s less likely to clot. Along with blood pressure drugs, warfarin is one of the reasons that stroke deaths have declined sharply in recent decades.

But “the saying is that warfarin is the drug people love to hate,” said Dr. Jessica Mega, a cardiologist at Brigham and Women’s Hospital in Boston and author of an editorial in The New England Journal of Medicine hailing “a new era”. “It’s very unpopular.”

That’s because it affects individuals so differently that patients require careful monitoring; they typically have blood drawn each month to be sure the blood remains the proper consistency. “You want it thin enough that the drug is effective — you won’t form clots — but not so thin you’re going to bleed if you bump your head on the kitchen cabinet,” Dr. Mega said. If a doctor finds the monthly results unsatisfactory and adjusts the warfarin dose, the patient has to return for still another test.

“It’s a very labor-intensive medication,” Dr. Mega said. “People get fatigued, and they don’t want to do it anymore.”

Moreover, warfarin doesn’t play well with other drugs, from antibiotics to some blood pressure meds. Users even have to be mindful of what they eat (no bingeing on kale). And while some bleeding caused by warfarin — bruising, say, or nosebleeds –- is simply problematic and unpleasant, doctors particularly worry about bleeding into the brain. An intracranial hemorrhage can be fatal or disabling, as bad as the problems that warfarin was supposed to prevent.

That happens very rarely, it should be said. “It’s a low-frequency event, but it’s devastating,” Dr. Mega said.

So the goal in evaluating the new drugs has been to ascertain “noninferiority.” They didn’t have to be more effective than warfarin, which works quite well; they just have to be easier to take and no more likely to cause bleeding. That is benefit enough to seek F.D.A. approval.

Apixaban did well by those measures, the researchers found. In a randomized study of more than 18,000 people (median age: 70) with atrial fibrillation and at least one other risk factor for stroke, major bleeding occurred in 2.13 percent of patients in the apixaban group per year, significantly less than the 3.09 percent in the warfarin group. Apixaban significantly reduced bleeding in general, and brain bleeds in particular, compared with warfarin. And patients were able to skip the monthly monitoring. (Bristol-Myers Squibb and Pfizer, which hope to market apixaban, financed the study.)

But what caused excitement at the recent meeting of the European Society of Cardiology in Paris was that apixaban, a twice-daily pill, went beyond noninferiority. It prevented 21 percent more strokes than warfarin over the 1.8 years of the study and reduced deaths from any cause by 11 percent, in addition to reducing major bleeding incidents by nearly a third. “That’s a home run,” said Dr. Mega.

The other new drugs had similar benefits, she added: “Across all these trials, they make a whopping reduction in the risk of hemorrhagic stroke.” They have fewer dangerous interactions with other drugs as well. And although some drugs are less effective in the elderly, “one sees very clear findings of lower rates of stroke and bleeding among the elderly” in the apixaban study, Dr. Granger said.

The less-than-cheerful news is how much more the new meds cost than warfarin. Coumadin retails for about $1.50 a day, depending on dose. The generic goes for less than $10 a month at some big chains. By contrast, apixaban is expected to sell for $7 a day, a stiff price for patients on fixed incomes, even if they have Medicare Part D. “They fall into the doughnut hole fairly quickly,” Dr. Granger said.

Perhaps analysts will determine that cost savings of the new anticoagulants — at least a dozen monthly tests people no longer have to undergo, plus fewer strokes — will compensate for the higher costs.

Or maybe the competitive market will work the way it’s supposed to, with several new drugs entering the market in a short time creating downward pressure on costs. “We may be able to persuade pharmaceutical companies that it’s better to have broader use at lower prices than less use at higher prices,” Dr. Granger said.

By PAULA SPAN

The costs of not participating in electronic communications are growing. Government and the private sector are shifting to online tools as their dominant form of public communication. It saves time and money, and provides more responsive public services. But surveys of Internet and technology use show that many, if not most, older consumers are bypassed with online communication.

Earlier this year, for example, the U.S. Social Security Administration said it would stop sending paper statements to Americans explaining their Social Security benefits. Instead, such statements would be available online. As part of a broader government policy, Social Security will also be ending paper-based benefit checks by May 2013.

The Social Security Administration says growing use of the Internet will allow it to save money on paper-based statements and still meet public needs. However, while the agency has stopped mailing out its annual statement of benefits, it has yet to begin offering this information online. And an agency spokesman says privacy rules prevent the agency from even measuring how many people visit its website. The agency knows that total page views on the site are rising, the spokesman said, but it is not allowed to collect specifics on how many beneficiaries are actually using the site.

The most probable answer, however, is “not many.” According to the Pew Research Center’s Internet & American Life Project, only 42 percent of Americans age 65 and older go online at all. Of these, even smaller percentages use the Internet to research information on specific topics. These numbers are rising, but still are roughly half the level of younger Americans. The Social Security Administration does say it plans to provide paper-based statements to older people, but has not yet spelled out the timing of this effort.

Laurie Orlov is a former Forrester Research analyst who started her own company, Aging in Place Technology Watch, to research and provide consulting advice about seniors and technology. While there have been some gains in technology use by older consumers, price and complexity are barriers to larger gains, as is seniors’ comfort with familiar ways of doing things.

“People are pretty inflexible” about technology use, she says, “so there’s a chance those numbers won’t improve much.” Is it fair to describe seniors as the lost generation in terms of technology? “I think they are,” she says.

Orlov can rattle off an impressive list of the costs to seniors of not being online, from paying extra for airline tickets by using a reservations agent, to missing out on online coupons and other digital bargains, to becoming isolated from grandchildren and other family members who increasingly rely on digital devices to communicate.

Baby boomers, by contrast, are using new technology at rates nearly equal to younger consumers. They are likely to continue such habits as they join the ranks of senior citizens, and it will be this trend that will firmly establish electronic communication and commerce as a senior activity.

For now, Orlov says, she’s extremely optimistic that computers and hand-held tablets and other devices will become easier to use and more friendly to inexperienced and older consumers alike.

Ingenious “apps” and uses for smartphones and other mobile communications devices are driving broad gains in consumer adoption. Orlov thinks the improvements in user interfaces and ease-of-use gains in these mass markets will help all consumers, including seniors. “I think technology is becoming multi-age friendly,” she says.

“We’re at the beginning of a remarkable time,” she says. “It’s going to get better because it can. That’s the nature of technology.”

By Phil Moeller

“The effects seems to be additive,” said Caitlin Mason, Ph.D., lead study author.

“The women who did both diet and exercise together had the greatest weight loss and greatest improvement in insulin and blood sugar control.”

In light of the additional benefits of exercise, such as preserving muscle mass during weight loss, “a combined program is the way to go,” said Mason, a postdoctoral fellow in public health sciences at the Fred Hutchinson Cancer Research Center.

For the study, which appears online and in the October issue of the American Journal of Preventive Medicine, 439 inactive, overweight postmenopausal women were randomly assigned to participate in a dietary weight loss program, an aerobic exercise program, or a program that included diet and exercise, or were told not to change their eating or exercise patterns.

Participants received diet and exercise counseling in groups of eight to 15 women, rather than individually.

The researchers estimated the women’s insulin resistance – which reflects how well or poorly the body metabolizes sugar – and their fasting blood sugar, when the study began and after 12 months. Increased insulin resistance and elevated blood sugar are signs that the risk of diabetes is high.

Insulin resistance improved significantly with diet and a bit more in the diet-plus-exercise group, but not with exercise alone, compared to women who made no changes. Exercise alone did improve fasting glucose, but only when it was elevated to begin with.

Women in the diet group lost an average of 8.5 percent of their initial body weight, while those who had diet plus exercise lost more than 10 percent. Improvement in insulin resistance was proportional to the amount of weight lost.

Jill Crandall, M.D., director of the Diabetes Clinical Trials Unit at the Albert Einstein College of Medicine, said she was “most impressed” by the magnitude of weight loss achieved in the study, “but the effect this will have on glucose metabolism or diabetes risk in the long run is a little hard to say from this paper.”

One of the most useful things the study did was to show that “a group-based program could be very effective for weight loss,” added Crandall, who has no affiliation with the study. From a public health perspective, she said, “anything done in the group setting is more feasible.”

She noted that strengthening exercise appears to have greater benefits for insulin resistance than aerobic exercise, and suggested that its inclusion in future studies might be “a desirable feature.”

By Carl Sherman, Health Behavior News Service