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SYDNEY, March 28 AAP - One in four elderly people with mild cognitive impairment naturally reverts to normal, according to research that shows regular mental and physical exertion are important factors in \"ageing well\". \"While it is not always possible to predict who will get better, there are some indicators,\" says University of NSW (UNSW) neuropsychiatrist Professor Perminder Sachdev, the lead author of the research. \"It seems both enriching mental activity and physical exercise may be very important factors,\" says Prof Sachdev, a co-director of UNSW's Centre for Healthy Brain Ageing.

\"We've gone from the third leading cause of death, to the second leading cause of death in a year, that's a massive increase,\" Ms [Carol Bennett] said. \"We certainly can't afford to rest on our laurels when it comes to the increasing rate of dementia in this country,\" she said. \"But that shouldn't make us very pessimistic because I think we are finding there are a number of things one could do to possibly prevent dementia.\"

Prof [Perminder Sachdev] said most people were affected to some extent by the age of 65, but more younger people were now showing signs of premature brain \"ageing\" and unhealthy lifestyles could be to blame.

TWINS SYDNEY, Aug 29 AAP - An Australian study involving 300 sets of older twins is expected to reveal new genes which control how humans age. University of NSW researchers are enlisting 150 sets of identical twins and a similar number of non-identical twins aged over 65 to take part in the large-scale brain study. The four-year project, which will also involve the twins' siblings, has the potential to discover new genes involved in cognitive decline or resilience.

Professor Perminder Sachdev, a University of New South Wales (UNSW) neuropsychiatrist, said a study using magnetic resonance imaging (MRI) on the brains of people in their 40s had shown the development of lesions. Prof Sachdev said today most people were affected to some extent by the age of 65, but more younger people were now showing signs of premature brain \"ageing\" and unhealthy lifestyles could be to blame. \"We've just done a study of people aged 44 to 48 and although we haven't fully analysed the data, the scans show many of them have these lesions in the early stages,\" Prof Sachdev said.

Prof Perminder Sachdev, a University of New South Wales neuropsychiatrist, said a study using magnetic resonance imaging on the brains of people in their 40s had shown the development of lesions. Prof Sachdev said today most people were affected to some extent by the age of 65, but more younger people were now showing signs of premature brain \"ageing\" and unhealthy lifestyles could be to blame. \"We've just done a study of people aged 44 to 48 and, although we haven't fully analysed the data, the scans show many of them have these lesions in the early stages,\" Prof Sachdev said.

Professor Perminder Sachdev, a University of New South Wales (UNSW) neuropsychiatrist, said a study using magnetic resonance imaging (MRI) on the brains of people in their 40s had shown the development of lesions. Professor Sachdev said yesterday most people were affected to some extent by the age of 65, but more younger people were now showing signs of premature brain `ageing' and unhealthy lifestyles could be to blame.

Professor Perminder Sachdev, a University of New South Wales neuropsychiatrist, said a study using magnetic resonance imaging on the brains of people in their 40s had shown the development of lesions.

According to the Australian Bureau of Statistics, dementia deaths are rising and it's now the nation's second biggest killer after heart disease. The most common type of dementia is the debilitating Alzheimer's disease - and the biggest risk factor for Alzheimer's is old age. That doesn't, shouldn't make us very pessimistic because I think we are increasingly finding that there are a number of things one could do to possibly prevent dementia - and if not prevent, to at least postpone the development of dementia.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.