Daily Archives: 6 March 2024

Higher dementia diagnosis rates linked to benzodiazepine use in anxious older adults

Leave a Reply

Research conducted at the Saint Louis University School of Medicine has unveiled significant findings regarding old adults, anxiety, dementia, and the role of benzodiazepines. The study, entitled “Anxiety Disorders, Benzodiazepine Prescription and Incident Dementia,” published in the Journal of the American Geriatrics Society, reveals a nuanced relationship between these elements. Patients aged 65 and older diagnosed with anxiety were found to have a notably higher likelihood of developing dementia. Moreover, exposure to benzodiazepines was linked to a 28% elevation in dementia risk. However, for those receiving benzodiazepines for an anxiety disorder, no significant correlation with dementia was observed, suggesting a complex interplay between anxiety management and dementia risk.

Jay A. Brieler, M.D., an associate professor of family and community medicine at SLU, spearheaded the research as the primary author, with Jeffrey Scherrer, PhD, a professor in the same department and a member of the AHEAD Institute, serving as the senior author. Their investigation aimed to discern the contributions of anxiety and benzodiazepine use to dementia risk amidst concerns over benzodiazepine-related dementia implications. The study’s conclusions indicate that both anxiety and benzodiazepine use independently are associated with increased dementia risk. Yet, when benzodiazepines are prescribed for anxiety disorders, this risk does not significantly change.

This retrospective cohort study meticulously analyzed electronic health records from 72,496 patients spanning 2014 to 2021, utilizing data from the Saint Louis University-SSM Healthcare System’s Virtual Data Warehouse (VDW). This resource, developed by the Advanced HEAlth Data (AHEAD) Research Institute at Saint Louis University, encompasses a vast array of clinical encounters and has been instrumental in facilitating research that would otherwise be challenging due to the logistical and financial constraints of longitudinal studies.

The findings underscore the complexity of treating late-life anxiety, particularly with benzodiazepines, which have been the subject of debate due to their association with cognitive impairment, falls, and fractures in the short term. The study highlights the critical need for careful consideration in the prescription of benzodiazepines to older adults, given their potential implications for dementia risk. Anxiety in older adults, associated with a spectrum of adverse health outcomes such as cardiovascular disease, depression, and chronic disease burden, presents a significant public health challenge, particularly as the population ages.

The study’s insights are particularly timely, given the projected increase in Alzheimer’s and related dementia diagnoses, which is expected to double by 2060. These findings advocate for a nuanced approach to managing anxiety in older adults, emphasizing the importance of further research to explore alternative anxiety treatments and their impacts on dementia risk. The authors call for additional studies to ascertain whether the association with incident dementia varies with the use of other anxiety medications, underscoring the ongoing quest for optimal strategies to mitigate dementia risk while effectively managing anxiety in the ageing population.

This research not only contributes to our understanding of the interrelations between anxiety, benzodiazepine use, and dementia risk but also exemplifies the value of leveraging real-world clinical data to address complex health questions. The support of the Saint Louis University Research Institute and the collaboration among a diverse team of researchers underscore the collective effort to improve the care and outcomes of older adults facing the dual challenges of anxiety and the risk of dementia.

More information: Jay A. Brieler et al, Anxiety disorders, benzodiazepine prescription, and incident dementia, Journal of the American Geriatrics Society. DOI: 10.1111/jgs.18515

Journal information: Journal of the American Geriatrics Society Provided by Saint Louis University

Scientists chart the progression of the measles virus through the human brain

Leave a Reply

Researchers from the Mayo Clinic have meticulously traced the mutation and proliferation patterns of the measles virus in the brain of an individual who died from a rare and fatal brain condition. This disease is an uncommon complication arising from measles infection, and its occurrence might increase as measles becomes more prevalent among unvaccinated populations, according to the researchers.

Leveraging advanced genetic sequencing technologies, the Mayo Clinic team recreated the process by which a variety of viral genomes took hold within a human brain. These genomes underwent specific mutations facilitating the virus’s expansion from the frontal cortex to other areas.

Roberto Cattaneo, Ph.D., a leading virologist at Mayo Clinic and co-author of the study published in PLOS Pathogens, emphasized the significance of their findings. He stated that their research offers critical insights into how the viral RNA mutates and disseminates within a major human organ—specifically, the brain. These insights are pivotal for understanding the persistence and adaptation of other viruses within the human brain, potentially leading to disease. Furthermore, this knowledge could aid in the development of potent antiviral medications.

Measles is known for its high contagion levels. It initially infects the upper respiratory system and utilizes the trachea as a launch pad, spreading through droplets emitted during coughs or sneezes by infected individuals.

Dr. Cattaneo has been at the forefront of research on the systemic spread of the measles virus. His fascination with measles began approximately 40 years ago, particularly with subacute sclerosing panencephalitis (SSPE), a lethal brain disease that emerges in roughly 1 out of every 10,000 measles cases. SSPE manifests years after the initial measles infection, leading to severe neurological symptoms such as memory loss, seizures, and paralysis. Dr. Cattaneo dedicated many years to studying SSPE until the disease became rare, thanks to widespread measles vaccination.

However, the resurgence of measles, driven by vaccine scepticism and missed vaccinations, especially during the COVID-19 pandemic, has led to a significant rise in measles cases and deaths globally. The decline in vaccination rates has resulted in an estimated 18% increase in measles cases and a 43% surge in measles-related deaths in 2021 compared to the previous year, as the Centers for Disease Control and Prevention (CDC) reported.

The research team, including Dr. Cattaneo and Iris Yousaf, a Ph.D. candidate at the Mayo Clinic Graduate School of Biomedical Sciences, utilized a unique opportunity to study SSPE through a collaboration with the CDC. They analyzed brain samples from an individual who contracted measles in childhood and later succumbed to SSPE. By conducting genetic sequencing on various brain regions, they pieced together how the measles virus evolved and increased within the brain.

They found that the virus’s genome began mutating in detrimental ways upon entering the brain, creating a diverse population of viral genomes. Two specific genomes possessed characteristics that significantly enhanced the virus’s ability to spread from the frontal cortex, effectively colonizing the entire brain.

The research team plans to explore further how particular mutations facilitate the virus’s spread in the brain. These investigations will involve studies on brain cell cultures and brain-like organoids. The aim is to uncover potential antiviral treatments to prevent virus proliferation within the brain. Despite the challenges in treating advanced stages of diseases like SSPE, vaccination against measles remains the most effective prevention strategy.

More information: Iris Yousaf et al, Brain tropism acquisition: the spatial dynamics and evolution of a measles virus collective infectious unit that drove lethal subacute sclerosing panencephalitis, PLoS Pathogens. DOI: 10.1371/journal.ppat.1011817

Journal information: PLoS Pathogens Provided by Mayo Clinic