FRIDAY, May 9 (HealthDay News) -- Having an intellectually demanding job that nurtures thinking abilities may result in better cognitive abilities during retirement, regardless of intelligence, education level or age, a Duke University Medical Center study suggests.

"Our society is expected to live and work longer than previous generations, so we sought to understand how an individual's occupation affected cognition later in life," study author Guy Potter, an assistant professor of psychiatry, said in a prepared statement.

The study included 1,036 male twins who were given a test to determine their general learning abilities when they joined the U.S. military in the early 1940s. The participants had follow-up assessments of their cognitive status every three or four years after they were in their 60s.

The Duke researchers found that cognitive benefits associated with intellectually demanding jobs were greatest among people who had lower scores on intelligence tests in their youth, while physically demanding work was associated with a decrease in cognitive performance later in life.

The study was published in the May issue of Neurology.

"Although the intellectual and physical demands of an individual's job are not the largest factors influencing cognitive performance as we age, this study illustrates how a number of smaller influences like these can accumulate over the life span to have a positive or negative effect on brain health in later life," Potter said. "Unlike age or intellect, job demands are something that an individual can potentially modify to optimize their cognitive reserve."

"Most of us spend a significant portion of our adult life at work, and we may actually be benefiting from the intellectual demands placed upon us," he added.

Potter and his colleagues made special mention about the finding that manual labor may be associated with poorer cognitive performance later in life.

"Physical exertion has health benefits in its own right. It is important for people to find a place for both mental and physical activity in their lives, and for researchers to offer insights about how this can best be achieved," Potter said.

More information

The AGS Foundation for Health in Aging offers cognitive vitality tips for older adults  .

WEDNESDAY, May 7 (HealthDay News) -- Older adults following a medication regimen are less likely to miss doses when reminded by an electronic pillbox that both beeps at the appointed drug-taking time and announces the number of pills to take and how to take them, new research reveals.

The study, which was funded by the National Institute on Aging, was presented recently at the American Geriatric Society meeting in Washington, D.C., by co-authors Vesta Brue, founder and chairman of Lifetechniques Inc., of San Antonio, and P. Ryder, of the University of Maryland School of Pharmacy and Pharmaceutical Health Services Research division. Lifetechniques is the manufacturer of the particular electronic pillbox that was the focus of the research.

The interactive pillbox was given to a group of patients between the ages of 65 and 84 who were each following a prescription regimen of a least four medications.

All the patients were self-sufficient with respect to their ability to take their own medications and to move about freely. About one-third of the patients were men. About 38 percent were white, 40 percent were black, and 22 percent were Hispanic.

After three weeks to monitor natural pill-taking patterns, patients were tracked for three more weeks using "MedSignals" -- an electronic pillbox that is already commercially available.

The pillbox holds up to a month's supply of medications, with separate compartments for up to four drugs. As programmed, the box beeps at pill-taking times, indicates the appropriate compartment, and displays the number of pills to take on a screen. As well, when the compartment lid is lifted a programmed audio message announces the number of pills to take, along with specific information about how to ingest the particular medication.

All the boxes were rigged to record, time-stamp and transmit via phone lines all lid openings, which the researchers equated with the taking of an actual medication. The researchers noted that the pillbox comes with such a phone-monitoring system, for patients and their caregivers to use as desired.

The researchers found that electronic pillboxes boosted drug adherence. With the boxes, patients prescribed more than a single dose per day of any particular drug took one pill more per day on average, the authors found. As well, the number of days when patients accidentally skipped their drug regimen altogether dropped to just 6 percent when using an electronic pillbox -- from 12 percent without the box.

In addition, the proportion of doses taken within 15 percent of the time they should be taken went up with the electronic pillbox.

Dr. David Flockhart, director of the division of clinical pharmacology at Indiana University's School of Medicine in Indianapolis, said the notion of an electronic pillbox draws critical attention to a major public health concern.

"Compliance with medications is a huge problem in general, and in particular among the elderly," he observed. "And it is even more problematic among those who take a lot of medication, which is a lot of people, given that the majority of seniors who take medications take more than five prescriptions a day. So the value of something like this is potentially very large."

"However," he added, "the question always come up as to whether these kinds of benefits seen in a clinical trial would really translate to the real world. Because the patients in a study like this know that they're being monitored, so they might be remembering to do something when the box beeps that they might not actually remember in real life. So I would encourage the investigators to follow up this finding with a strictly observational study, rather than a clinical trial, to see how this will work in a natural setting."

To take control of their prescription medication regimen, the U.S. Food and Drug Administration recommends that senior citizens use a calendar or a pillbox to help adhere to drug routines. They point out that pillboxes with multiple compartments are particularly helpful for older patients dealing with complex multi-pill regimens, as well as for those who have difficulty opening safety sealed drug containers.

The FDA also encourages seniors to undergo a yearly "Medicine Check-Up," as an opportunity to both toss out expired medicines and to discuss possible drug side effects and interactions with a pharmacist and/or doctor.

On that score, a second study also presented at the meeting by Yale University School of Medicine researchers indicated that more than 90 percent of senior citizens taking five or more medications experience one or more "mildly bothersome" side effects. And one-third attributed such mood change, insomnia, impaired balance, fatigue, and/or dizziness problems to one of their medications.

More information

For more advice on safe prescription medication use for senior citizens, visit the U.S. Food and Drug Administration.

SATURDAY, May 3 (HealthDay News) -- Two new studies show that anticholinergics, a commonly prescribed group of drugs, may cause elderly people to "slow down" in their daily physical activities.

The two reports from researchers at Wake Forest University School of Medicine support findings released a few weeks ago that anticholinergic drugs -- which treat a variety of diseases and conditions, including acid reflux, Parkinson's disease and urinary incontinence -- may cause older people to lose their thinking skills more quickly than those who don't take the medicines.

Anticholinergic drugs work by stopping acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.

In the first Wake Forest study, older adults taking anticholinergics became more likely to walk more slowly and to need help in other daily activities.

"These results were true even in older adults who have normal memory and thinking abilities," study author Dr. Kaycee M. Sink said in a prepared statement. "For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older."

Common anticholinergic medicines cited in the study included the blood pressure medication nifedipine (Adalat or Procardia), the stomach antacid ranitidine (Zantac) and the incontinence medication tolterodine (Detrol).

The findings, which involved more than 3,000 people, average age 78, were scheduled to be presented Saturday at the American Geriatrics Society annual meeting, in Washington, D.C.

In a separate Wake Forest study, published online in April in the Journal of the American Geriatrics Society, Sink found that older nursing home residents who took medicines for dementia along with anticholingerics for incontinence declined in function 50 percent faster than those only treated only for dementia.

"Over a year's time, the decline we observed would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity," said Sink, an assistant professor of internal medicine-gerontology at Wake Forest.

The seniors in the second study had completed at least two consecutive prescriptions for cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine. These include donepezil (brand name Aricept), galantamine (Razadyne), rivastigmine (Exelon) and tacrine (Cognex).

About 10 percent of those studied were also taking either oxybutynin or tolterodine, the two most commonly prescribed drugs for urinary incontinence.

"The two drugs are pharmacological opposites, which led us to hypothesize that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drugs, Sink said.

As an estimated 33 percent of people with dementia also take a medicine to control incontinence, this finding is especially alarming.

The two studies suggest that physicians should carefully consider the implications when prescribing anticholingeric medications to older adults.

More information

The U.S. National Institute on Aging has more about older adults and medications  .