Health
A good night's sleep can increase the benefit of exercise, healthy diet, moderate alcohol consumption and non-smoking in their protection against cardiovascular disease (CVD), according to results of a large population followup study.
Results showed that the combination of the four traditional healthy lifestyle habits was associated with a 57 percent lower risk of cardiovascular disease (fatal and non-fatal) and a 67 percent lower risk of fatal events.
But, when “sufficient sleep” (defined as seven or more hours a night) was added to the other four lifestyle factors, the overall protective benefit was even further increased – and resulted in a 65 percent lower risk of composite CVD and an 83 percent lower risk of fatal events.
“If all participants adhered to all five healthy lifestyle factors, 36 percent of composite CVD and 57 percent of fatal CVD could theoretically be prevented or postponed,” the authors report. “The public health impact of sufficient sleep duration, in addition to the traditional healthy lifestyle factors, could be substantial.”
The study is published today in the European Journal of Preventive Cardiology, and is the first to investigate whether the addition of sleep duration to the four traditional healthy lifestyle factors contributes to an association with CVD.
The Monitoring Project on Risk Factors for Chronic Diseases (MORGEN) is a prospective cohort study in the Netherlands from which 6672 men and 7967 women aged 20 years and free of CVD at baseline were followed up for a mean time of 12 years.
Details of physical activity, diet, alcohol consumption, smoking and sleep duration were recorded between 1993 and 1997, and the subjects followed-up through a cross-link to national hospital and mortality registers.
As expected, results showed that adherence to each of the four traditional lifestyle factors alone reduced the risk of CVD.
Those at baseline who recorded sufficient physical activity, a healthy diet and moderate alcohol consumption reduced their risk of composite CVD from 12 percent for a healthy diet to 43 percent for not smoking; and risk reduction in fatal CVD ranged from 26 percent for being physically active to 43 percent for not smoking.
However, sufficient sleep duration alone also reduced the risk of composite CVD by about 22 percent (HR 0.78) and of fatal CVD by about 43 percent (HR 0.57) when compared with those having insufficient sleep. Thus, nonsmoking and sufficient sleep duration were both strongly and similarly inversely associated with fatal CVD.
These benefits were even greater when all five lifestyle factors were observed, resulting in a 65 percent lower risk of composite CVD and an 83 percent lower risk of fatal CVD.
As background to the study, the investigators note that poor sleep duration has been proposed as an independent risk factor for CVD in two other (non-European) studies, but without adding the effect of sleep to other healthy lifestyle benefits.
This study – in a large population – now suggests that sufficient sleep and adherence to all four traditional healthy lifestyle factors are associated with a lower CVD risk. When sufficient sleep duration is added to the traditional lifestyle factors, the risk of CVD is even further reduced.
As an explanation for the results, the investigators note that short sleep duration has been associated with a higher incidence of overweight, obesity and hypertension and with higher levels of blood pressure, total cholesterol, haemoglobin A, and triglycerides, effects which are “consistent with the hypothesis that short sleep duration is directly associated with CVD risk.”
The study's principal investigator, Dr Monique Verschuren from the National Institute for Public Health and the Environment in the Netherlands, said that the importance of sufficient sleep “should now be mentioned as an additional way to reduce the risk of cardiovascular disease.”
“It is always important to confirm results,” she added, “but the evidence is certainly growing that sleep should be added to our list of CVD risk factors.”
Dr. Verschuren noted that seven hours is the average sleeping time that “is likely to be sufficient for most people.”
An earlier study from her group in the Netherlands, which included information on sleep quality, found that those who slept less than seven hours and got up each morning not fully rested had a 63 percent higher risk of CVD than those sleeping sufficiently – although those who woke rested, even from less than seven hours' sleep, did not have the increased risk.
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Of the many negative stereotypes that exist about older adults, the most common is that they are forgetful, senile and prone to so-called “senior moments.”
In fact, while cognitive processes do decline with age, simply reminding older adults about ageist ideas actually exacerbates their memory problems, reveals important new research from the USC Davis School of Gerontology.
The study, forthcoming in the journal Psychological Science, is an extension of the idea of “stereotype threat” – that when people are confronted with negative stereotypes about a group with which they identify, they tend to self-handicap and underperform compared to their potential. In doing so, they inadvertantly confirm the negative stereotypes they were worried about in the first place.
The results highlight just how crucial it is for older adults, as well clinicians, to be aware of how ageist beliefs about older adults can affect older adults' real memory test performance.
“Older adults should be careful not to buy into negative stereotypes about aging – attributing every forgetful moment to getting older can actually worsen memory problems.” said Sarah Barber, a postdoctoral researcher at the USC Davis School and lead author of the study.
However, there is a way to eliminate the problem, the study reveals: “No one had yet examined the intriguing possibility that the mechanisms of stereotype threat vary according to age,” Barber said.
Barber and her co-author Mara Mather, professor of gerontology and psychology at USC, conducted two experiments in which adults from the ages of 59 to 79 completed a memory test.
Some participants were first asked to read fake news articles about memory loss in older adults, and others did not.
Notably, the researchers structured the test so that half of the participants earned a monetary reward for each word they remembered; the other half lost money for each word they forgot.
In past tests, 70 percent of older adults met diagnostic criteria for dementia when examined under stereotype threat, compared to approximately 14 percent when not assessed under threat.
But the latest research shows that stereotype threat can actually improve older adults' performance on memory tests, under certain conditions.
For participants who had something to gain, being confronted with age stereotypes meant poorer performance on memory tests. They scored about 20 percent worse than people who were not exposed to the stereotype.
But when the test was framed in terms of preventing losses due to forgetting, the results flipped: participants reminded of the stereotypes about aging and memory loss actually scored better than those who were under no stereotype threat.
“Stereotype threat is generally thought to be a bad thing, and it is well established that it can impair older adults' memory performance. However, our experiments demonstrate that stereotype threat can actually enhance older adults' memory if the task involves avoiding losses,” Barber said.
Older adults, it seems, respond to stereotype threat by changing their motivational priorities and focusing more on avoiding mistakes.
The study is part of a critical body of work on risk taking and decision making among older adults from the USC Davis School of Gerontology, named for AARP founder Leonard Davis and the leading research center in the world on aging and its biological, psychological, political and economic dimensions.
“Our experiments suggest an easy intervention to eliminate the negative effects of stereotype threat on older adults – clinicians should simply change the test instructions to emphasize the importance of not making mistakes,” Barber said.
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