“Aging is not inevitable; it is an opportunity. Not everyone has the chance to grow old,” said Robert Friedland, professor of neurology at the University of Louisville and an expert on aging. “How well we age depends on what we do.”

Inspired by his grandfather’s struggle with dementia, Friedland has spent nearly five decades as a neurologist and researcher, studying the causes of neurological diseases and seeking new ways to treat and prevent them. In addition to seeing patients with a focus on cognitive, behavioral and geriatric neurology, his ongoing research investigates the connection between microbes in the gut and mouth and the development of Alzheimer’s and Parkinson’s disease and other neurodegenerative conditions.

Based on this work, Friedland says it is possible for people to preserve health into later years by stockpiling reserves in cognitive, physical, psychological and social health.

Although Friedland admits that certain physical declines are inevitable with age and that genetics can predispose a person to certain diseases, he believes in many cases these reserves can prevent diseases or lessen their effects, delay age-related declines and allow an older person to recover from accidents and illness.

“Genetics do have a role in our health but they are not the whole story. Choices we make throughout life affect whether diseases develop and how much they reduce our health when they do,” Friedland said. “We can do things that delay or mitigate heart disease, diabetes and cognitive and neurological diseases and allow us to recover from life events that otherwise may cause permanent declines in health.”

Each of Friedland’s four factors, described below, is dependent on the others. Friedland provides tips on increasing reserves of each area. By developing habits that add to these reserves, you can maximize your opportunity to remain active and healthy as you get older.

Cognitive reserve – The ability of the brain to work effectively, solve problems and make decisions.

Since the brain controls every system in the body, it makes sense that a healthy brain will support other reserve factors (physical, psychological, social).

Keep the brain healthy by seeking opportunities to learn new things and challenge your ways of thinking throughout life. Learn a new language or a new skill, such as playing a musical instrument or crochet. Play chess or other games. Any activity that involves learning and strategy will strengthen your brain.

“Watching television is not a good activity since it is completely passive and does not require participation. Reading is a better choice as it demands involvement,” Friedland said. “Telling stories is good for your memory and attention skills.”

Physical reserve – The health of the body’s cardiovascular, neurological, musculoskeletal and other systems.

These reserves depend on eating the right food, engaging in physical activity every day and receiving regular health care.

A diverse diet of healthy foods supports both your body and your microbiota, the microorganisms that live in and on the body and are essential to your overall health. Friedland recommends a diet that is mostly plants, high in fiber and low in sugar, salt and saturated fat. When you improve your diet, you also can improve the health of your microbes which aids your own health.

“I call it gene therapy in the kitchen,” Friedland said. “By making the best choices in your food, you can alter the genetic makeup of your microbiota and improve your overall health in as little as two weeks.”

Exercising for 30 minutes each day, regardless of weather or circumstance, is enough to improve physical health, Friedland says. More is better, of course, and when you combine physical activity with social interactions and cognitive activity by playing a sport such as golf or tennis, the benefits multiply.

Taking steps to protect yourself from injury or illness also is important. Wear a helmet when you are riding a bike, wash your hands and avoid exposure to toxins.

It also is important to get enough quality sleep each night, practice good dental hygiene, avoid excess alcohol and have regular medical checkups.

Polypharmacy is another problem to avoid. Friedland said that as people age, they may accumulate prescriptions for multiple health concerns that can interact or alter the effectiveness of each other. If you are taking several prescriptions, regularly evaluate all of them with your health care provider.

Psychological reserve – A healthy mental state that is free of agitation, anxiety and depression.

Poor mental health can affect your ability to interact with others or maintain your physical health. Practice a positive mental attitude, engage in activities that are meaningful to you and manage stress with meditation or other measures.

“Depression is common in older people, and that can lead to memory problems,” Friedland said. “Physical factors can contribute to depression, such as poor sleep or vitamin deficiency. A lack of social interactions and physical activity also can cause or aggravate depression.”

Social reserve – Personal relationships and the ability to function in society.

The company of others can motivate people to take care of themselves and encourage them to maintain healthful behaviors. Positive relationships can be with a spouse, a group of friends or professional colleagues.

“Studies indicate that dementia is more common among people whose social activity declines later in life,” Friedland said. “Humans need relationships with others in order to maintain good health.”  

Social engagement can go hand in hand with the other types of activity by including friends in physical exercise, games, a craft or work. Involvement in community or religious activities also can increase a sense of belonging and a desire to stay active.

Ideally, you will begin developing habits that contribute to these reserves early in life, but Friedland says it is possible to add to reserves and improve your health at any age – even once you reach an age when you experience the effects of deficits.

“Aging is not inevitable,” Friedland said. “The chance to be alive should be recognized as an opportunity – an opportunity to manage our lifestyle factors to maximize survival, health, fitness and meaning as we age.”

More detailed advice from Friedland that may help people live longer, healthier lives and a deeper discussion of the reasons he makes these recommendations are available in his book, “.” Published in October by Cambridge University Press, the book was cited by the Wall Street Journal as one of the five best books on aging and retirement published in 2022.

• Shower doors made with “smart glass”
• Zero-waste systems for distilleries
• Systems to turn wastewater into purified water for brewing craft beer
• Methods to minimize plastic waste in the ocean
• Methods to prevent corrosion in concrete roads and bridges
• Products to keep children from being forgotten in hot cars

From solar batteries to building designs to a specialized Alexa product for Papa John’s franchisees, the projects and prototypes demonstrated at the first Engineering and Design Innovation Showcase showed the depth and breadth of UofL engineering students’ ingenuity and enthusiasm.

The event, held in the Student Activities Center April 18, featured teams of seniors — as well as a select group of first-years — demonstrating their capstone projects. Almost 90 teams totaling more than 350 students showed their posters and prototypes to representatives from the president’s office, members of the boards of trustees and overseers, faculty, industry professionals, administrators, fellow Speed students, K-12 students and even a few proud parents.

Fifty teams had company sponsors for a total of $168,000. Additionally, four companies sponsored coveted industry awards — DuPont, Papa John’s, Qk4 and TOPY America Inc.

One team, Saf-T Child, took home two of the four industry awards: DuPont’s Innovation to Thrive Award and the Papa John’s Most Innovative Award, each worth $1,000. The team designed a weight-sensing pad that alerts drivers if a child remains in the car after it is turned off. Team members were Clay Groeschen, Hadassah Lamppin, Michael York and Kendall Ogden.

The QK4 Engineering Award, worth $500, was given to the team Technology for People Living with Dementia, which came up with an affordable computer system that those with dementia can use when caregivers cannot help with tasks. Team members were Kody Arvin, Robert McKinney and Daniel Padgett.

The winner of the TOPY America Inc. Environmental Award, also worth $500, was Operation: Save the Turtles. The team’s goal was to protect ocean life by coming up with an alternative to recycling plastic that would convert plastic into useful products such as diesel fuel. Team members were Delaney Coovert, Allison Melvin, Miao Ting Li and Jianchao Zhao.

“I could feel the excitement and the interest of those who were attending,” said Speed School Dean Emmanuel Collins, who promised to make the showcase an annual event. 

Check out video from the event: 

These unique graphic characters may prove to be valuable tools in detecting signs of Alzheimer’s disease decades before symptoms become apparent.

In an article published online last week in , Emily Mason, PhD, a postdoctoral associate in the Department of Neurological Surgery at UofL, reported research showing that cognitively normal people who have a genetic predisposition for Alzheimer’s disease have more difficulty distinguishing among novel figures called Greebles than individuals without genetic predisposition.

Alzheimer’s disease is a progressive, irreversible neurodegenerative disease characterized by declining memory, cognition and behavior. AD is the most prevalent form of dementia, affecting an estimated 5.5 million individuals in the United States and accounting for 60 to 80 percent of dementia cases. The ability to detect the disease earlier may allow researchers to develop treatments to combat the disease.

“Right now, by the time we can detect the disease, it would be very difficult to restore function because so much damage has been done to the brain,” Mason said. “We want to be able to look at really early, really subtle changes that are going on in the brain. One way we can do that is with cognitive testing that is directed at a very specific area of the brain.”

AD is characterized by the presence of beta amyloid plaques and tau neurofibrillary tangles in the brain. Tau tangles predictably develop first in the perirhinal and entorhinal cortices of the brain, areas that play a role in visual recognition and memory. Mason and her colleagues developed cognitive tests designed to detect subtle deficiencies in these cognitive functions. They hoped to determine whether changes in these functions would indicate the presence of tau tangles before they could be detected through imaging or general cognitive testing.

Working in her previous position at Vanderbilt University, Mason identified test subjects age 40 to 60 who were considered at-risk for AD due to having at least one biological parent diagnosed with the disease. She also tested a control group of individuals in the same age range whose immediate family history did not include AD.

The subjects completed a series of “odd-man-out” tasks in which they were shown sets of four images depicting real-world objects, human faces, scenes and Greebles in which one image was slightly different than the other three. The subjects were asked to identify the image that was different.

The at-risk and control groups performed at similar levels for the objects, faces and scenes. For the Greebles, however, the at-risk group scored lower in their ability to identify differences in the images. Individuals in the at-risk group correctly identified the distinct Greeble 78 percent of the time, whereas the control group correctly identified the odd Greeble 87 percent of the time.

“Most people have never seen a Greeble and Greebles are highly similar, so they are by far the toughest objects to differentiate,” Mason said. “What we found is that using this task, we were able to find a significant difference between the at-risk group and the control group. Both groups did get better with practice, but the at-risk group lagged behind the control group throughout the process.”

Mason would like to see further research to determine whether the individuals who performed poorly on the test actually developed AD in the future.

“The best thing we could do is have people take this test in their 40s and 50s, and track them for the next 10 or 20 years to see who eventually develops the disease and who doesn’t,” Mason said.

In recent years, a great deal of research has focused on identifying early biomarkers of Alzheimer’s disease. However, not everyone who has an individual biomarker ultimately develops the disease. Brandon Ally, PhD, assistant professor of neurological surgery at UofL and senior author of the publication, said the tests with Greebles can provide a cost-effective way to identify individuals who may be in the early stages of AD, as well as a tool for following those individuals over time.

“We are not proposing that the identification of novel objects such as Greebles is a definitive marker of the disease, but when paired with some of the novel biomarkers and a solid clinical history, it may improve our diagnostic acumen in early high-risk individuals,” Ally said. “As prevention methods, vaccines or disease modifying drugs become available, markers like novel object detection may help to identify the high priority candidates.”

professor and Mason and Mary Rudd Endowed Chair in Neurology at UofL, has studied clinical and biological issues in Alzheimer’s disease and related disorders for 35 years. He believes that early detection will enhance the ability of patients and physicians to employ lifestyle and therapeutic interventions.

“This work shows that the effects of Alzheimer’s disease on cognition can be measured decades before the onset of dementia,” Friedland said. “The fact that the disease takes so long to develop provides us with an opportunity to slow its progression through attention to the many factors that are linked to the disease, such as a sedentary lifestyle, a high fat diet, obesity, head injury, smoking, and a lack of mental and social engagement.”

The article, “,” will appear in the Journal of Alzheimer’s Disease, Volume 57, Issue 2.

ANSWER: Greeble No. 4 is different.

The number of individuals with AD and related disorders in the region is rising due to the rapidly aging population and public health systems have not kept pace with recent developments in treatment.

“There is little awareness of dementia in the region because of prevailing biases about the loss of function in healthy aging,” Friedland said. “People in the Middle East need to know that it is never normal for a person at any age to be demented.”

Friedland, the Mason and Mary Rudd Endowed Chair in Neurology at UofL and an organizer for the previous six ICAD-ME meetings, will discuss his research into the relationship between gut microbiota and neurodegeneration, and provide information on potential preventative measures to delay the onset of AD. In addition, he hopes to learn about special features and needs of the region’s population.

The conference will cover topics including the history of Alzheimer’s disease and its basic pathophysiology, pharmacological and non-pharmacological therapies, ethical and legal issues, and aging as it is addressed in the Koran and the Bible.

The event, sponsored by the United States National Institutes of Health/National Institute on Aging and Biogen, is Feb. 23-25, 2017 in Abu Dhabi, United Arab Emirates. Additional organizers are Changiz Geula, PhD, professor at Northwestern University, Marwan Sabbagh, MD, professor at Barrow Neurological Institute of Phoenix, and Abdu Adem, PhD, professor at United Arab Emirates University.