TIME neuroscience

This Alzheimer’s Breakthrough Could Be a Game Changer

Scientists recreated what goes on in the brains of Alzheimer’s patients in a 3D culture dish that could speed development of new drugs for the disease

Researchers have overcome a major barrier in the study of Alzheimer’s that could pave the way for breakthroughs in our understanding of the disease, a new report shows—and that new understanding could, in turn, pave the way for drugs that treat or interrupt the progression of the neurodegenerative condition.

For decades, animals have been the stand-ins for studying human disease, and for good reason. Their shorter lifespans mean they can model human conditions in weeks or months, and their cells can be useful for testing promising new drug treatments.

But they haven’t been so helpful in studying Alzheimer’s disease. Two factors contribute to the neurodegenerative condition — the buildup of sticky plaques of the protein amyloid, and the toxic web of another protein, tau, which strangles healthy nerve cells and leaves behind a tangled mess of dead and dying neurons. Despite attempts by scientists to engineer mice who exhibit both factors, they haven’t been able to generate the tau tangles that contribute to the disease.

Now, Dr. Rudolph Tanzi and Dr. Doo Kim at the Mass General Institute for Neurodegenerative Diseases at Massachusetts General Hospital, have devised a work-around that doesn’t involve animals. They have developed a way to watch the disease progress in a lab dish.

“In this new system that we call ‘Alzheimer’s-in-a-dish,’ we’ve been able to show for the first time that amyloid deposition is sufficient to lead to tangles and subsequent cell death,” said Tanzi in a statement.

MORE: Blood Test for Alzheimer’s

While autopsies showed evidence of both amyloid and tau in the brain, Alzheimer’s experts have been debating for years which came first — do amyloid plaques trigger the formation of tau tangles, or does the presence of tau cause amyloid to get stickier and bunch together in the brain? Tanzi and his colleagues showed definitively for the first time that amyloid is the first step in the Alzheimer’s process, followed by tau tangles. When he blocked the formation of amyloid in the culture with a known amyloid inhibitor, tau tangles never formed.

The disease-in-a-dish model is an emerging way of understanding conditions that either can’t be recapitulated accurately in animals, or diseases that make it difficult to study and test in human patients. In recent years, for example, scientists have successfully recreated the process behind amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease, using stem cells from patients and allowing them to develop into the motor neurons that are affected by the disease. The technique led to a breakthrough in understanding that a certain population of nerve cells known as glial cells poison the motor neurons and impede their normal function. Now experts are focusing on finding ways to control the glial cell activity as possible treatment for ALS.

MORE: How Moodiness and Jealousy May Lead to Alzheimer’s

Tanzi and his team are hoping that something similar will come from their model of Alzheimer’s.

While the genes responsible for the inherited form of Alzheimer’s differ slightly from those involved in the more common form that affects people as they age, the end result — the build up of amyloid plaques and tau tangles — are the same. So now that they can see both the clumps of amyloid and the tau tangles, form, they can start to tease apart the processes that link the two processes together.

That will open the way toward finding drugs or other ways of interrupting the process more quickly than they could working with animals. It took six to eight weeks for the cells in the dish to form plaques and then tangles, compared to a year or so in mice. “We can now screen hundreds of thousands of drugs in this system that recapitulates both plaques and tangles…in a matter of months,” Tanzi said. “This was not possible in mouse models.” The system also makes it possible to test these drug compounds at one-tenth the cost of evaluating them in mice, he said. And that means that finding a way to prevent Alzheimer’s may come both faster and cheaper than scientists had expected.

MONEY Social Security

This Little-Known Social Security Strategy Can Boost Your Retirement Income

woman flicking light switch
JGI/Jamie Grill—Getty Images

For retirees who need added income temporarily, turning your Social Security benefit on and off can be a smart move. It may also help your family over the long term.

Welcome to the Social Security claiming world of start-stop-start, a sophisticated strategy that can add big bucks to some people’s lifetime benefits if properly used.

By now, anyone who regularly reads about Social Security likely knows that delaying benefits until age 70 allows them to reach their highest level.

They also probably know that beginning to collect retirement benefits as early as age 62 will reduce them by 25% from what they would have been at age 66 (and 76% from their level at age 70 if claiming is deferred).

But it’s a whole lot less likely that they know about being able to begin taking benefits early, stopping them at age 66, and enjoying the benefits of delayed retirement credits until age 70. This is a potentially great option that can boost lifetime benefits, as well as help people who may be in a temporary financial bind in their early 60s—perhaps they have to take early retirement, but later end up earning more money in a second career.

Larry Kotlikoff, an economics professor (and co-author of my upcoming book on Social Security claiming), provides a useful and detailed explanation of the start-stop-start strategy. His analysis includes extensive computer simulations to determine how best to take advantage of these rules.

How Start-Stop-Start Works

The flexibility to start and stop your benefit is yet another important aspect of the agency’s rules regarding what it calls Full Retirement Age (FRA). This is 66 for people born between 1943 and 1955. For people born later, it rises by two months a year before hitting 67 for anyone born in 1960 and later. (I wrote recently about how the FRA can affect claiming decisions.)

I recommend that people consider waiting until age 70 to begin Social Security. But there are lots of valid reasons to begin claiming as soon as 62, which normally is the soonest you can receive benefits (there are earlier claiming ages for people with disabilities and surviving spouses).

If you take reduced benefits early—with “early” meaning before your FRA—you generally are stuck at those reduced benefit levels until you reach your FRA. There is a provision that lets you withdraw your benefit decision within a year of making it, pay back everything you’ve received from Social Security (included Medicare premium payments, if applicable) and get a fresh start with your claiming record.

But most early claimers don’t do this. Once they file early, they are stuck with whatever reduced benefit they get until they hit their FRA. At that time, Social Security rules allow a person to suspend their benefits for as long as four years. This is the “stop” part of start-stop-start. And most people are not aware of this FRA-related rule.

During this “stop” period, their benefits will earn delayed retirement credits. If they suspend for the full four years before their second “start,” their benefit will be 32% higher than when they suspended it. That’s a real 32% gain, too, as the delayed credits include the program’s annual cost-of-living adjustments for inflation. Now, this person’s benefits at age 70 will still be less than if they had never claimed a reduced benefit. But they’ll still be much higher than if they had never suspended them at their FRA.

Here’s a simple example: Say you are due a $1,000 retirement benefit at your FRA of 66. It will rise 32% to $1,320 a month (in real, inflation-adjusted terms) if you wait to claim until you turn 70. It will be reduced 25% to $750 a month if you claim early at age 62. However, that $750 will rise by 32% to $990 a month if you suspend at age 66 (the “stop”) and resume (the second “start”) at age 70. That’s a lot more than $750, of course, but it’s still far short of the $1,320 you’d get if you never claimed benefits at all until you turned 70.

Who Benefits by Resetting Your Claim

Besides helping out those in a temporary financial bind, this strategy may also improve your spouse’s benefits. Under Social Security rules, one spouse has to first file for their retirement benefit before the second spouse can file for a spousal benefit. While filing for retirement early will reduce that filer’s benefits, it could increase your family’s overall income. That’s because your husband or wife can then collect spousal benefits, while his or her individual benefit will keep rising till age 70.

If there’s a big age difference between you and your spouse, or if your spouse has a work record to consider, it can make sense for one spouse to begin benefits early, then suspend them when the second spouse reaches an optimal claiming age. The benefits of start-stop-start can become particularly valuable in maximizing family benefits for a couple, especially if they have young children.

As you can see, calculations for how to maximize benefits using start-stop-start can be very complex. You will probably do best to get help from a financial adviser, or use a benefits claiming calculator (see some recommendations here and here), or both.

Philip Moeller is an expert on retirement, aging, and health. He is an award-winning business journalist and a research fellow at the Sloan Center on Aging & Work at Boston College. Reach him at moeller.philip@gmail.com or @PhilMoeller on Twitter.

TIME Aging

Quiz: How Long Will You Live?

baby
Getty Images

8 questions that help determine your life span

Americans can now expect to live longer than ever, a new government report finds. That’s largely because death rates are declining for the leading causes of death, like heart disease, cancer and stroke.

How long will you live? These eight basic questions, calculated by two researchers from the University of Pennsylvania, are some of the most predictive of American life expectancy. “Those are the most important risk factors that we have solid evidence for,” Lyle Ungar, professor of computer and information science at the University of Pennsylvania, tells TIME.

The one missing factor? “If you’re in a happy marriage, you will tend to live longer,” he says. “That’s perhaps as important as not smoking, which is to say: huge.” So feel free to give yourself a little bump if you’ve got a happy relationship.

Find out yours in the quiz below (and if you’re on your phone, turn your device sideways):

via Life Expectancy Calculator from Lyle Ungar and Dean Foster

Read next: Eat More Mediterranean Foods Now: Your Later Self Will Thank You

TIME Aging

Men’s Bone Health Is Largely Ignored

skeleton xray bones
Getty Images

Why men need to start saving their skeletons

A third of all hip fractures happen in men, and in the year after a fracture, men are twice as likely to die as women. That’s due, in part, to the fact that men don’t get treated as often as women do for osteoporosis, a new report from the International Osteoporosis Foundation says.

In fact, men’s bone health is largely ignored, and one study showed that men are half as likely as women to get treatment. About 20% of men over 50 have osteoporosis fractures, a number set to rise with the aging population, the report says. From 2010-2030, the number of hip fractures in American men is set to rise 52%, while the number among women is expected to drop by nearly 4% (likely because women are routinely screened for bone loss and are treated preventively).

The lifetime risk of a bone fracture for men is now higher than the risk for getting prostate cancer, and those who smoke, drink heavily, or have vitamin D, testosterone or calcium deficiencies are especially at risk. “People should not have to live with the pain and suffering caused by osteoporosis as we can help prevent and control the disease,” says Professor John A. Kanis, president of the International Osteoporosis Foundation, in a statement.

One of the best lifestyles switches men can make for their bones is to exercise more. Men lose muscle as they age, which makes bones much more vulnerable. Weight-bearing exercise protects against bone loss and falls, and these 6 best anti-aging exercises for men are proven to make aging men stronger.

MONEY

Here’s the Only State Where Retirees Have Enough Income

Just one state plus the District of Columbia have typical retirees with more than 70% of pre-retirement income. Traditional pensions and low cost of living make a difference.

The problems retirees encounter trying to secure lifetime income know no bounds: In 49 states those past the age of 65, on average, fall short of a widely accepted benchmark for minimum income in retirement, new research shows.

Financial advisers generally agree you need at least 70% of pre-retirement income to maintain your lifestyle after calling it quits. Many say 80% to 85% is a more appropriate target.

But even using the lower bar, Nevada is the only state where the typical retiree has sufficient income to live comfortably in retirement, according to a study from Interest.com, a division of Bankrate, a financial information provider. The District of Columbia also makes the cut. But every other jurisdiction in the nation falls short, underscoring the scope of the retirement income crisis in America.

Nationally, the median income for those who are 65 and older equals just 60% of the median income for those aged 45 to 64, the study found. In Nevada, median income for those past 65 is 71%. In Washington D.C., the figure is 74%. States that get close to the minimum retirement income level are Hawaii (69%), Arizona (68%) and Mississippi (68%). At the bottom are Massachusetts (49%) and North Dakota (49%).

The national rate represents a jump of 10 percentage points over the past decade. But that is not as encouraging as it may appear, reflecting trends where older Americans stay on the job longer and young workers fail to see significant wage gains. The share of Americans working past 65 has been increasing for 20 years and reached 18.9% this May, one of the highest levels in the last half century.

Washington D.C. tops the retirement income list in large measure because of its huge population of retired federal employees, many of who have generous traditional pension plans. Nevada (along with Arizona and Mississippi) benefits from a low cost of living; the costs of food, housing, utilities, transportation and medical care in Reno, Nev., are just 67% of such costs in Washington D.C.

Hawaii is one of the most expensive places on Earth to retire. But it measures up well in this study because the state has a strong traditional pension culture. It may also help that wealthy people choose it as their retirement destination. At the bottom, Massachusetts (like much of the Northeast) has long suffered from a high cost of living while North Dakota recently has seen its cost of living soar amid an oil boom in that state.

MONEY retirement age

How to Know When It’s Time to Retire

Birthday candles
Fuse—Getty Images

I’ve long argued that one’s quality of life should be a principal factor in deciding when to retire. At the same time, however, financial considerations can’t be ignored. With this in mind, here are three rules of thumb to help you decide whether you’ve reached the perfect age to retire.

1. Have you saved enough money?

The “multiply by-25″ rule is a popular tool that retirement experts encourage people to use to estimate whether they’ve saved enough money to stop working and, at least hopefully, begin a life of leisure.

Here’s how it works: Multiply your desired annual income in retirement, less projected annual Social Security benefits, by 25. If your savings are greater than that, then you’re in good shape. If not, then you may not be financially ready to retire.

For example, let’s say that Bob and Mary Jane estimate they’ll spend $40,000 a year in retirement. Using the rule of 25, they’ll need savings of $1 million.

A slightly different iteration of this is the “multiply by-300″ rule. This is the same thing, but it focuses on months instead of years — that is, take your average monthly expenditures, minus your monthly Social Security check, and multiply that by 300.

If your savings are greater than that, then you’re all set. If not, then you might want to continue working for a few more years.

2. Will you have enough income?

This question is related to the first one, but it attacks the issue from a slightly different angle. As such, it also has its own rule of thumb: the 4% rule.

This rule holds that you can safely withdraw 4% from your portfolio every year and still be confident it will last through retirement. Thus, to determine if you’ll have enough income in retirement, multiply your portfolio by 4% and then add in your projected annual Social Security benefits — to learn one potential problem with this rule, click here.

If the sum of these two numbers is enough to cover your expenses, then you’re ready to retire. If not, then it may behoove you to put off retirement for a while longer, as doing so should allow your portfolio to continue growing. It will also give your Social Security benefits time to accrue delayed retirement credits.

3. Is your portfolio properly allocated?

Finally, determining if you’re ready to retire isn’t just about how much you’ve saved, it’s also about how your savings are allocated into various asset classes — namely, stocks and bonds.

To be ready for retirement, you want to make sure that your assets are invested in as safe of a way as possible. To do so, it’s smart to steer your portfolio increasingly toward fixed-income investments like bonds as you approach your desired retirement age.

Experts use the following rule to determine the proper allocation: “The percentage of your portfolio invested in bonds should equal your age.” Thus, if you’re 60 years old, then 60% of your portfolio should be in bonds and 40% in stocks. If you’re 55, then the split is 55% to 45%, respectively.

While this may seem like it has less to do with the timing of retirement than the former two rules, the reality is that it’s of equal importance. As my colleague Morgan Housel has discussed in the past, one of investors’ biggest mistakes is to underestimate the volatility in the stock market. According to Morgan’s research, stocks fall by an average of 10% once every 11 months.

Suffice it to say, a drop of this magnitude would have a material impact on both of the preceding rules, as a 10% decline in your stock holdings would equate to a much smaller income under the 4% rule and, as a corollary, it would call for a delayed retirement date under the multiply by-25 rule.

And the impact of this would be even more exaggerated if the lions’ share of your assets were still in stocks as opposed to bonds. Consequently, the culmination of your strategy to bring your portfolio into accord with this final rule is a key step in determining the perfect age at which you’re ready to pull the trigger and actually retire.

TIME Aging

Americans Can Now Expect to Live Longer Than Ever

A three-day old baby girl at Shady Grove Adventist Hospital, in Rockville, Maryland, Sept. 5, 2014.
A three-day old baby girl at Shady Grove Adventist Hospital, in Rockville, Maryland, Sept. 5, 2014. Evelyn Hockstein—The Washington Post/Getty Images

Americans can expect to live longer as the leading causes of death—heart disease and cancer—become a little less deadly

A child born in America today will live longer than at any other time in history, according to a new government report that forecasts average life expectancy for the U.S. population at 78.8 years.

Life expectancy for people born in 2012—the latest year researched by the Centers for Disease Control and Prevention—was 0.1 years longer than it was in 2011. Women can expect to live to 81.2 years, while men can expect to live to 76.4 years.

The infant mortality rate decreased 1.5% in 2012 to a historic low of 597.8 infant deaths per 100,000 live births, the CDC said.

Eight of the 10 leading causes of death in the U.S. became less deadly in 2012, with death rates for heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, influenza and kidney disease all reduced between 2011 and 2012. Suicide rates, however, did climb significantly.

“Much of the recent improvement in death rates and life expectancy for population groups examined can be attributed to reductions in death rates from major causes of death, such as heart disease, cancer, stroke, and chronic lower respiratory diseases,” the CDC said.

MONEY retirement planning

Why I Want a Real Retirement, And You Should Too

Senior on sailboat
Monika Lewandowska—Getty Images

Working longer may improve your finances. But that doesn't mean it will make you happier.

Looking forward to retirement seems irrational these days. Rising life expectancies and the increasing funding problems for Social Security and private pension plans have led to the recommendation that we defer retirement past the traditional age of 65—perhaps into our 70s and beyond. It’s getting to the point where many in my generation have started to assume that they might never retire at all.

It’s true that delaying retirement into your 70s will likely improve your financial situation. Yet in an age when work has come to permeate most of our waking hours, it seems even more important to delineate at least a decade when you’re still healthy enough to both reap the benefits of that hard work and devote your time to other pursuits. And yet the concept of a real retirement has come to symbolize financial irresponsibility or laziness or both.

This was not always the case. Over the last century, the retirement age has gone through enormous fluctuations, mostly dictated by public and corporate policy, not personal preference. In the period of 1950 to 1955, the median age of retirement was 66.9 for men and 67.7 for women, according to the U.S. Bureau of Labor Statistics. But changes in defined benefit plans increasingly encouraged early retirement as a way to cut the work force, and by 1990-1995 the median retirement age had dropped to about 62 for both men and women.

But as defined contribution plans such as 401(k)s have overtaken traditional pension plans, employers no longer have as much sway over the timing of their workers’ retirements. Instead, that decision is more often dictated by savings rates and the financial markets that drive investment performance. Once again employment rates for Americans ages 65 to 69 and 70 to 74 have begun to rise, a trend only accelerated by the Great Recession. As of September, 60% of workers age 65 or older had full-time jobs, up from about 55% in 2007.

Meanwhile, for anyone born after 1960, the “full retirement age” (meaning the age you get full Social Security benefits) is now 67, and there are strong incentives to delay benefits until 70.

The consequences of working longer on our health and well-being are largely unknown, but researchers at the University of Southern California have recently examined data from 12 countries, including the U.S., and their preliminary results are telling. Contrary to conventional wisdom that working longer provides a buffer for mental health, retirement actually reduces depression, their analysis shows. What does increase the probability of depression, and reduces life satisfaction, is not being bored by not working, but health conditions that impact the ability to go about your daily activities. While household wealth, being married and one’s level of education are all positively related to life satisfaction, income alone does not seem to have a significant effect on depression or life satisfaction.

Granted, many of us still won’t have a choice about when we retire. We may not be able to afford to stop working when we want to, or we may get forced into early retirement by the loss of a job. But we may also want to take a look at whether the work-until-you-drop ethos has become more of a cultural commandment then a financial imperative—“I’d get bored if I didn’t work” is the new corollary to the often-uttered “I’m crazy busy.” It’s as if retirement has become so elusive that we’ve decided to tarnish the whole concept. But there is nothing wrong with looking forward to retirement if one has done a decent amount of saving and planning.

I love working, but two decades from now I think I would prefer to downsize rather than stay in the workforce an extra five or 10 years in order to maintain my standard of living in retirement. (From a purely balance sheet perspective, if continuing to work has adverse effects on well-being, then the fiscal savings from delayed retirement may be offset by increased health expenditures.) Medicine may be prolonging our life, but that doesn’t necessarily mean that it’s improved the quality of the later stages of that life. I want to make sure that I have not just the time also but the ability to enjoy more than just a few years when work is no longer the priority.

Konigsberg is the author of The Truth About Grief, a contributor to the anthology Money Changes Everything, and a director at Arden Asset Management. The views expressed are solely her own.

TIME Aging

How Moodiness and Jealousy May Lead to Alzheimer’s

Researchers say certain personality traits, like jealousy, worry, anxiety and anger, can double a woman’s chances of developing Alzheimer’s

We’re familiar with many of the brain-related factors that can contribute to Alzheimer’s disease—letting thinking networks go inactive, putting off exercise and healthy eating, having few social connections, enduring head injuries and genetic factors. But what about personality? Can the way you look at the world affect your risk of developing the neurodegenerative disorder?

Dr. Ingmar Skoog, professor of psychiatry and director of the research center on health and aging at the University of Gothenburg believes the answer is yes. In a paper published in the journal Neurology, he and his colleagues show that women with certain personality characteristics in middle age were twice as likely to have Alzheimer’s nearly 40 years later.

MORE: New Research on Understanding Alzheimer’s

“Getting Alzheimer’s disease is some sort of sum of a lot of different damages to the brain, and different things happening to the brain,” he says. “[Personality] is one of them.”

Specifically, a suite of features linked to what mental health experts call neuroticism showed the strongest connection to Alzheimer’s. Skoog and his colleagues tapped into a database of health information involving 800 women who were 38 years to 54 years old in 1968, when they filled in personality questionnaires and agreed to come in periodically to evaluate their cognitive functions. The personality evaluation placed women on a spectrum of neuroticism and extraversion; those showing more neuroticism included women who reacted more emotionally to events and experiences, worried more, showed lower self esteem and were more likely to express jealousy, guilt and anger. Those who were more extroverted showed high levels of trust, gregariousness and fewer emotional peaks and valleys.

MORE: New Insight On Alzheimer’s: What Increases Your Risk

At each of the four follow ups over the next 38 years, the women reported their stress levels—and women with higher neuroticism scores consistently showed higher levels of stress than those with lower scores.

Skoog believes that stress is the linchpin between the personality traits and Alzheimer’s dementia; previous studies have connected stress to dementia, and he says that the neuroticism characteristics are highly correlated to stress. “It seems like the personality factor makes people more easily stressed, and if people are more easily stressed, then they have an increased risk of dementia,” he says.

What’s more, when he controlled for the effect of stress, the association between neuroticism and Alzheimer’s disappeared, strengthening the idea that personality may lay a foundation for being more vulnerable to the effects of stress. Higher stress, particularly if it’s persistent as it is with certain personalities, can bathe the brain in hormones like cortisol. Those can damage blood vessels and cells in the brain that can then make Alzheimer’s more likely.

MORE: Scientists Are Getting Closer to a Blood Test for Alzheimer’s

The results hint that people can lower their risk of Alzheimer’s not just by keeping the brain active and improving social connections, as earlier work suggests, but by addressing stress-related personality factors as well. That, however, may require being aware of your later Alzheimer’s risk as early as during childhood, when personalities are forming. “Personality is something that occurs early in life, but you may be able to do something about it,” says Skoog. Especially when it comes to stress and how people respond to stress, interventions such as psychotherapy, for example, can help people to cope in healthier and less harmful ways.

He doesn’t believe that addressing stress and traits like jealousy and worry alone will protect a person from developing Alzheimer’s, but, he says, “it’s important to try to find as many factors as you can that contribute to common disorders. The more factors we can do something about, the more we can reduce risk quite substantially.”

TIME Aging

Norway Is the Best Place to Grow Old

163252583
Westend61—Getty Images/Brand X

But a third of countries are not meeting the needs of their growing aging populations

Growing old is a pleasure—if you’re in Norway, that is. A new report looking at the social and economic wellbeing of older people in 96 countries reveals that Norway is the happiest place to age, followed by Sweden, Switzerland, and Canada.

It’s not as much fun elsewhere. The report, called the Global AgeWatch Index, found that a third of countries are ill equipped to deal with increasingly large aging populations. The report says that in low and middle income countries, only a quarter of people over age 65 receive a pension. Countries on the low-end of the list lacked programs for free health care and chronic disease treatment, community centers and subsidized transport.

The report by HelpAge International and the University of Southampton shows that by 2050, 21% of the global population will be over age 60. While more people are living longer, if people are also living sicker or without support, that takes a serious economic toll. In the U.S. alone, 2012 data noted that Social Security, Medicare and Medicaid eat up about 40% of all federal spending and 10% of the nation’s gross domestic product.

The authors note that Norway claimed the top spot because it has well-developed organizations for the elderly, a long history of state welfare and strong social media campaigns that create public awareness of age-related issues. The worst country for the elderly is Afghanistan, according to the report, and the United States ranked seventh overall.

Here’s the entire Global AgeWatch ranking:

  • Norway (1)
  • Sweden (2)
  • Switzerland (3)
  • Canada (4)
  • Germany (5)
  • Netherlands (6)
  • Iceland (7)
  • United States (8)
  • Japan (9)
  • New Zealand (10)
  • United Kingdom (11)
  • Denmark (12)
  • Australia (13)
  • Austria (14)
  • Finland (15)
  • France (16)
  • Ireland (17)
  • Israel (18)
  • Luxembourg (19)
  • Estonia (20)
  • Spain (21)
  • Chile (22)
  • Uruguay (23)
  • Panama (24)
  • Czech Republic (25)
  • Costa Rica (26)
  • Belgium (27)
  • Georgia (28)
  • Slovenia (29)
  • Mexico (30)
  • Argentina (31)
  • Poland (32)
  • Ecuador (33)
  • Cyprus (34)
  • Latvia (35)
  • Thailand (36)
  • Portugal (37)
  • Mauritius (38)
  • Italy (39)
  • Armenia (40)
  • Romania (41)
  • Peru (42)
  • Sri Lanka (43)
  • Philippines (44)
  • Viet Nam (45)
  • Hungary (46)
  • Slovakia (47)
  • China (48)
  • Kyrgyzstan (49)
  • South Korea (50)
  • Bolivia (51)
  • Columbia (52)
  • Albania (53)
  • Nicaragua (54)
  • Malta (55)
  • Bulgaria (56)
  • El Salvador (57)
  • Brazil (58)
  • Bangladesh (59)
  • Lithuania (60)
  • Tajikistan (61)
  • Dominican Republic (62)
  • Guatemala (63)
  • Belarus (64)
  • Russian (65)
  • Paraguay (66)
  • Croatia (67)
  • Montenegro (68)
  • India (69)
  • Nepal (70)
  • Indonesia (71)
  • Mongolia (72)
  • Greece (73)
  • Moldova (74)
  • Honduras (75)
  • Venezuela (76)
  • Turkey (77)
  • Serbia (78)
  • Cambodia (79)
  • South Africa (80)
  • Ghana (81)
  • Ukraine (82)
  • Morocco (83)
  • Lao PDR (84)
  • Nigeria (85)
  • Rwanda (86)
  • Iraq (87)
  • Zambia (88)
  • Uganda (89)
  • Jordan (90)
  • Pakistan (91)
  • Tanzania (92)
  • Malawi (93)
  • West Bank and Gaza (94)
  • Mozambique (95)
  • Afghanistan (96)

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