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Optimists Live Longer
Never underestimate the power of positive thinking.
Although research has identified many risk factors that increase the likelihood of diseases and premature death, much less is known about positive psychosocial factors that can promote healthy aging. But a new study based on decades of research indicates that optimism could boost our chances of living 85 years or more by over 50 percent.
Researchers from Boston University’s School of Medicine, the National Center for PTSD at VA Boston Healthcare System, and Harvard University’s T. H. Chan School of Public Health have found that hope really might spring eternal—individuals with greater optimism are more likely to live longer and to achieve “exceptional longevity”—that is, living to age 85 or older. Optimism refers to a general expectation that good things will happen, or believing that the future will be favorable because we can control important outcomes.
The study, published August 26, 2019, in Proceedings of the National Academy of Sciences, was based on survey data collected from 69,744 women and 1,429 men. Both groups completed survey questions to assess their level of optimism, as well as their overall health and habits, such as diet, smoking, and alcohol use. The women were followed for 10 years, the men for 30 years. When individuals were compared based on their initial levels of optimism, the researchers found that the most optimistic men and women demonstrated, on average, an 11 percent to 15 percent longer life span, and had 50 percent to 70 percent greater odds of reaching 85 years of age compared New study by BU, Harvard researchers indicates positive thinking can help us live past age 85
Whether we see this glass as half full or half empty may say something about our chances of living beyond the age of 85, according to a new study from BU and Harvard.
to the least optimistic groups. The results were maintained after accounting for age, demographic factors such as educational attainment, chronic diseases, and depression, and health behaviors, such as alcohol use, exercise, diet, and primary care visits.
“This study has strong public health relevance because it suggests that optimism is one such psychosocial asset that has the potential to extend the human life span. Interestingly, optimism may be modifiable using relatively simple techniques or therapies,” says the study’s first and corresponding author, Lewina Lee, a MED assistant professor of psychiatry and a clinical research psychologist at the National Center for PTSD at VA Boston.
Despite the good news, it’s still unclear how exactly optimism helps people attain longer life.
“Other research suggests that more optimistic people may be able to regulate emotions and behavior as well as bounce back from stressors and difficulties more effectively,” says study senior coauthor Laura Kubzansky of Harvard. The researchers also consider that more optimistic people tend to have healthier habits, such as being more likely to engage in more exercise and less likely to smoke, which could extend life span.
“Research on the reason why optimism matters so much remains to be done, but the link between optimism and health is becoming more evident,” says Francine Grodstein of Harvard and Brigham and Women’s Hospital, another study senior coauthor.
This study was supported by the National Institutes of Health, the Clinical Science Research and Development Service of the US Department of Veterans Affairs, and the Fonds de Recherche en Santé–Quebec. The VA Normative Aging Study is a research component of the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) and is supported by the VA Cooperative Studies Program/Epidemiological Research Centers. n
Why We Need a Contraception Revolution
Deborah Anderson wants a contraception revolution. In an editorial published in the New England Journal of Medicine, Dr. Anderson lays out the reasons why she believes it’s time to reignite research for developing new forms of birth control—and why we need better contraceptive options now more than ever before.
Dr. Anderson, BU School of Medicine professor of medicine, is an expert in the use of plant-grown antibodies, called “plantibodies,” to protect against HIV and herpes simplex virus. Now, her lab is developing new antibodies against sperm for contraception. The idea is to develop a topical film—similar to a Listerine strip—that can be applied vaginally as a contraceptive. Her lab at BU recently received a Contraception Research Center grant from the National Institutes of Health to develop new forms of birth control.
According to the United Nations predictions, human population will reach 9 billion by 2050, up from the current 7.7 billion people estimated to share the planet. That’s a lot of people. And the more people there are, the more resources and energy we need to support us all. As Dr. Anderson points out, although some estimates in the past have said that Earth could theoretically support a human population ranging from 1.5 to 100 billion, that’s only possible if the planet’s own health is stable. Once the Earth’s ecosystem health and rapidly declining biodiversity are factored into the equation, the number of humans that our planet BU microbiologist Deborah Anderson argues that new birth control approaches are needed to combat overpopulation, climate change
stably can support plummets drastically, ranging between 1.5 to 5 billion.
And right now? “We’re making a mess of things,” says Dr. Anderson.
At our current consumption rates, we will need 1.75 Earths to meet humanity’s needs, according to the Global Footprint Network. That’s unfortunate, because we’ve got exactly 1.00 Earths to work with. Last year the Intergovernmental Panel on Climate Change (IPCC), the UN body dedicated to climate science, found that we have as little as 12 years until the world reaches 1.5 degrees of warming, which will escalate the life-threatening risks expected to be caused by a hotter climate. Much of the world is already experiencing the effects of climate change, with prolonged heat waves, droughts, and shrinking glaciers. Add in waste from cities, pollution from agriculture and livestock industries, depleting resources from forests and oceans, the mass extinction of species, and it’s no wonder Dr. Anderson believes it’s time to reinvent the ways we prevent unplanned pregnancies.
Out of the 210 million human pregnancies that occur each year worldwide, about 40 percent are unplanned.
“An unplanned pregnancy can ruin young women economically,” explains Dr. Anderson. “We want to develop products
We have already exceeded the Earth’s predicted carrying capacity—and climate change will make things worse.
that are more accessible to all women. Bringing the number of unplanned pregnancies down is an important step we can take to rebalance the planet.”
Despite the efforts of a “contraception revolution” during the 20th century, when several effective birth control methods were developed, a large contraception gap remains. As Dr. Anderson points out, a disproportionate number of unplanned pregnancies occur in young women who often lack access to comprehensive sex education and modern contraception methods. Effective, accessible contraception could be the key to reducing population growth and meeting global sustainable development goals, while ensuring
pregnancies are planned and wanted.
“There were so many great ideas that were tabled more than a decade ago, such as ideas for male contraceptives,” says Dr. Anderson. “This area of research needs to be reignited and needs more funding.” Over the past decade, the US spent upwards of $240 billion on health-related impacts of climate change, according to a 2017 report from the Universal Ecological Fund, and those costs are expected to increase in the next decade if drastic steps to mitigate the climate crisis—or protect the planet from the increasing burden of a growing human population—are not taken.
“Noncoercive human reproductive rights could be an important step toward rebalancing the planet and preserving its natural treasures for future generations,” Dr. Anderson wrote in her editorial. Similar to the framework laid out by reproductive justice advocates in the late 1990s, she is calling for contraception options, family planning, and sex education to be accessible to women and men around the world.
Given that the global health costs related
Your Race May Affect Where an Ambulance Takes You
Your race—not which hospital is nearest—may influence which emergency room you are transported to by emergency medical services (EMS).
National guidelines require EMS to transport patients to the nearest suitable hospital. But to what extent this occurs and whether this varies based on the race or ethnicity of patients has remained unknown. Until now, there has been scant research on the destination patterns of EMS-transported patients to hospitals. BU researchers also find that, regardless of race, 40 percent of patients transported by EMS are not brought to the nearest hospital
to climate change are projected to exceed $1 trillion per year by the end of the century, Dr. Anderson believes costs to support contraception innovation would be quickly offset by saving the cost of care that would otherwise be needed to treat even more people for diseases attributable to pollution and global warming.
“I’m a scientist and I’m an optimist, and I think if we can get more funding in this field we can make a difference. We can innovate to develop contraception approaches that we can’t even think of right now,” she says.
Dr. Anderson, whose research background is in microbiology and reproductive health, is currently working on a new approach, called multipurpose prevention technology (MPT), using plantibodies, or antibodies from plants. MPT is designed to simultaneously offer dual protection against unintended pregnancy and sexually transmitted infections.
After spending over a decade creating a plantibody-based microbicide that attacks different parts of the HIV virus and neutralizes herpes simplex virus, her lab is now working to incorporate other plantibodies that act as a powerful spermicide. These plantibodies attack sperm cells, causing them to bind together and become completely inactive in less than 30 seconds. Working with scientists in a San Diego–based biopharmaceutical company, Mapp Biopharma, Dr. Anderson envisions that her lab’s plantibody-based technology could someday be used in new STI and pregnancy prevention products that would be affordable and available without a prescription.
She is also optimistic about other emerging birth control options, including male hormonal birth control pills and gels. Leadership and funding for research, education, and family planning services will be critical for a full-fledged contraception revolution, she says, and, ultimately, we can only save the planet if we all work together.
“Everyone has to do what they can. I’m using contraception as my tool because that’s what I know, but a lot of people have other special interests and talents to be applied,” says Dr. Anderson. “The contraception revolution is just one piece of the solution.” n
Researchers at Boston University School of Medicine have discovered large differences between the emergency department and hospital destinations of black and Hispanic patients transported by EMS in comparison with their white counterparts.
In a first-of-its-kind study, BUSM researchers showed large differences between the EMS-transport destinations of black and Hispanic patients in comparison with their white counterparts. They also found that 40 percent of patients overall, regardless of race, were not taken to the nearest hospital. According to the researchers, these findings, published online in JAMA Network, suggest that the difference in these transportation destinations may be motivated by factors other than proximity or time. Using national Medicare claims data, the study divided patients based on the zip code they lived in, and compared which emergency departments and hospitals nonHispanic white, black, and Hispanic patients were brought to within the same zip code. The study also looked at how often black and Hispanic patients were transported to the destinations most frequently used for white patients.
The results of the study showed sizable differences by race and ethnicity in which medical center patients were brought to by
”—James Feldman
EMS. The widest disparities were seen in larger urban areas with multiple hospitals and emergency departments within the vicinity. The study also found that black and Hispanic patients were more likely to be transported to a “safety net” hospital—
CTE Risk More Than Doubles after Just Three Years of Playing Football
BU researchers discover a strong link between time of football play and rising chance of getting the disease F or every year of absorbing the pounding and repeated head collisions that come with playing American tackle a type of medical center that by legal obligation or mission provides healthcare for individuals regardless of their insurance status—compared with their white counterparts living in the same zip code.
“This is not a causal study, so we really don’t know why we are seeing this pattern,” says study corresponding author Amresh Hanchate, PhD, associate professor of medicine and a health economist at VA Boston Healthcare System. “It could be a benign phenomenon where people are being brought to the place that they’ve asked to go, because that’s where their regular doctor or cardiologist is located.”
EMS currently doesn’t keep track of the details that determine which hospital a patient is brought to. Dr. Hanchate hopes that this study may change that, and that EMS providers may document whether a patient requests to be brought to a specific medical center.
“This study raises interesting questions,” Dr. Hanchate says. “What are the potential issues with patients not being brought to the nearest place? Let’s say they go to the medical center where their doctors, their patient records are—we know that continuity of care is important. But at what point is the extra loss of time it takes to get there worthwhile or not worthwhile? We need more research to understand the role that patient choice, usual source of care, and clinical condition play in guiding EMS transportation decisions in diverse systems across the United States.”
“I think [our findings are] unlikely to represent racism or intrinsic bias because one of the important observations we’ve made is that the pattern could be related to favorable reasons for someone wanting to be taken to a usual site of care,” says coauthor James Feldman, MD, MPH, professor of emergency medicine and vice chair of research in Boston Medical Center’s department of emergency medicine.
It’s also likely that ambulance diversion— a controversial practice where a hospital goes on “diversion” status, meaning its ER is at full capacity and patients must be routed to other medical centers—is impacting the data. Ambulance diversion has been banned in Massachusetts since 2009.
“Massachusetts was the first and remains the only state that has blocked ambulance diversion. [It] is unfortunately a practice that remains common throughout the country,” says Dr. Feldman. “This research is a necessary first step to examine the effects ambulance diversion has on patient care and understanding the relationship between emergency utilization and healthcare disparities.”
Funding for this study was provided by the National Institutes of Health (NIH) National Heart, Lung, and Blood Institute, and the NIH National Institute on Minority Health and Health Disparities. n
football, a person’s risk of developing chronic traumatic encephalopathy (CTE), a devastating neurodegenerative disease, increases by 30 percent. And for every 2.6 years of play, the risk of developing CTE doubles. These new findings from an analysis of 266 deceased former amateur and professional football players—reported in Annals of Neurology by a team of researchers from the Boston University CTE Center—are the first to quantify the strength of the link between playing tackle football and developing CTE.
In a critical distinction between many previous CTE studies, the analysis included dozens of brains of former football players who did not have CTE. That sizable control group provided enough data for the researchers to be confident in their discovery that there is a strong relationship between CTE risk and the number of years a person plays football. “This study is a testament to the hundreds of families who have donated their loved one’s brain. . . . It is only because of this support that we can confidently estimate the strength of the relationship between duration of [football] play and risk of CTE,” says the study’s corresponding author Ann McKee, MD, a William Fairfield Warren Distinguished Professor of neurology and pathology at BU, director of the BU CTE Center, and chief of neuropathology at the VA Boston Healthcare System.
The large number of brain donations has provided the researchers with a big enough sample size (the CTE Center has amassed about 700 brains in total), that they can draw statistically relevant conclusions from their analyses.
“While we don’t yet know the absolute risk of developing CTE among American football players, we now can quantify
that each year of play increases the odds of developing CTE by 30 percent,” says lead author Jesse Mez, MD, MS, assistant professor of neurology, director of BU’s Alzheimer’s Disease Center Clinical Core, and a CTE Center researcher. “We hope that these findings will guide players, family members, and physicians in making informed decisions regarding play.”
As part of their analysis, the researchers also looked at other potential variables, including the total number of concussions, football positions played, a person’s age at first exposure to tackle football, their participation in other contact sports, their race, and the presence of other diseases, to see whether those factors had any influence on a person’s CTE risk, or if they were diagnosed with CTE, the severity of their CTE symptoms. They found no associations between these other variables and CTE risk or severity.
But the researchers did find that among players with a CTE diagnosis, their odds of developing severe symptoms of the disease doubled for every additional 5.3 years of football played. Those who played tackle football fewer than 4.5 years were 10 times less likely to develop CTE than those who played longer, although several men who played four years or fewer were diagnosed with CTE, including three whose only contact sport was football. Those who sustained the longest careers, playing more than 14.5 years, were 10 times more likely to develop CTE than those who played fewer years. But the researchers “ This study is a testament to the hundreds of families who have donated their loved one’s brain. . . . It is only because of this support that we can confidently estimate the strength of the relationship between duration of [football] play and risk of CTE.
”—Ann McKee
noted that several players with football careers longer than 15 years did not have evidence of CTE.
The average length of players’ careers in the National Football League is 3.3 years. But the premature and sudden retirements of a number of stars in the league, including Indianapolis Colts quarterback Andrew Luck, Detroit Lions receiver Calvin Johnson, and New England Patriots tight end Rob Gronkowski, have put renewed attention on the toll the game takes on players’ bodies. The BU team drew their findings from analyzing the brains of 223 football players with CTE, and 43 without, from the brain banks at the Veterans AffairsBoston University-Concussion Legacy Foundation and the Framingham Heart Study, both of which are directed by Dr. McKee. Family members of the deceased provided information about the amount of time that the brain donors spent playing football or other contact sports while they were alive. For former professional players, an online database also was consulted. All of the brains underwent a complete neuropathological evaluation—the
researchers were not made aware of the clinical history of any of the donors before examination—and CTE diagnoses were made using well-established criteria.
A major concern of doing CTE research utilizing brain banks is that brain donors— who may pledge their brain tissue based on neurological symptoms they’ve experienced during life—may not be representative of the general population. These factors may bias the relationships being investigated by researchers. But Drs. McKee, Mez, and their collaborators show in this latest study that the strength of the relationship between CTE and years of football played remained consistent even after they factored in these potentially biasing factors.
Although CTE currently can only be diagnosed after death, Dr. Mez says, “these findings move us closer to diagnosing CTE in life, which is critical for testing potential therapies and for guiding clinical care.”
This study was funded by the National Institutes of Health, the Department of Defense, the Department of Veterans Affairs, the Alzheimer’s Association, the National Operating Committee on Standards for Athletic Equipment, the Nick & Lynn Buoniconti CTE Research Fund, the Concussion Legacy Foundation, the Andlinger Family Foundation, WWE, and the National Football League. n
RESEARCH AWARDS
■ Lewina Lee Awarded NIH Grant to Study Adverse Childhood Experiences, Later-Life Health Outcomes Lewina Lee, PhD, assistant professor of psychiatry and clinical research psychologist at the National Center for Post-Traumatic Stress Disorder at VA Boston, has received a five-year, $3.5 million, R01 grant from the National Institutes of Health’s (NIH) National Institute on Aging to establish the Boston Early Adversity and Mortality Study (BEAMS).
Dr. Lee, along with co-principal investigator Daniel Mroczek, PhD, professor of medical social sciences and director of the Lifespan Personality and Health lab at Northwestern University’s Feinberg School of Medicine, will build a unique, “cradle-to-grave” data set that tracks the life span of three Boston-based cohorts of men who have been followed by researchers for over half a century, and augment it with information on their siblings. Using this rich data set, the study team will evaluate whether and how childhood adversity in the socioeconomic, environmental, and psychosocial domains bring about Alzheimer’s disease and related dementias, cardiometabolic disease, and premature death in later life.
“Scientists have been unable to fully understand the effects of early adversity on later-life health in large part because there is inadequate ‘life span data’ collected from birth to death to help map the sequelae of early adversity over age,” Dr. Lee explains. Bringing together three of the longest-running studies of adult lives, BEAMS will further enrich these studies with prospective information on early-life circumstances and later-life health through linkages to multiple administrative databases, such as Decennial Census, hospital birth records, and military records. “Given the wealth of midand later-life data we have already collected on these cohorts over decades, the cradle-to-grave data set created in BEAMS will afford rare opportunities to test exceptionally long-term, explanatory pathways from early adversity to later-life health,” Dr. Mroczek says.
Dr. Lee received her PhD in clinical psychology (aging) from the University of Southern California. She completed a clinical psychology internship at VA Palo Alto, followed by a postdoctoral research fellowship on stress, health, and aging at the Boston University School of Public Health and VA Boston. Her research addresses biological, psychosocial, and behavioral pathways that transmit the effects of psychosocial stress exposure onto physical and mental health. She also studies factors that mitigate or exacerbate the effects of stress on health and well-being across the life span.
The researchers hope that BEAMS will create a valuable resource for researchers interested in studying developmental processes, and inform intervention efforts aimed at mitigating the harmful health consequences of early adversity across the life span.
The Research Project Grant (R01) is the original and historically oldest grant mechanism used by the NIH.
■ David Felson Receives NIH Award to Study Osteoarthritis, Musculoskeletal Pain David Felson, MD, MPH, professor of medicine and epidemiology at BU Schools of Medicine and Public Health, has received a five-year, $3.6M National Institutes of Health (NIH) P30 Center Grant.
The award will allow for further clinical research in rheumatology at the Boston University Core Center for Clinical Research, and will provide broad clinical research expertise to a large multidisciplinary group of investigators whose research focuses on osteoarthritis and gout with a secondary emphasis on scleroderma, spondyloarthritis, osteoporosis, and musculoskeletal pain.
The center includes researchers from BU, Boston Children’s Hospital, Beth Israel Deaconess Hospital, Massachusetts Institute of Technology, Northeastern University, and different sections at Harvard University. This group comprises individuals with backgrounds in rheumatology, physical therapy, engineering, epidemiology, biostatistics, genetics, evolutionary biology, and behavioral science, who critically review projects, provide methodologic guidance to research, and create new multidisciplinary collaborations.
P30 Center Grants support shared resources and facilities for categorical research by a number of investigators from different disciplines who provide a multidisciplinary approach to a joint research effort. n
