Monthly Archives: March 2024

Research uncovers how the brain adapts to cognitive deterioration in older age

Researchers have discovered that alternative regions or networks within the brain can assume the responsibilities and functions of impaired areas to mitigate the effects of age-related cognitive decline. Recently published as a Reviewed Preprint in eLife, their findings have been hailed by the journal’s editors as a significant breakthrough in our comprehension of neural functional compensation, bolstered by persuasive evidence. This research provides methodologies for future investigations to measure compensation in studies focused on the neuroscience of healthy ageing.

The concept of functional compensation is well-established in neuroscience. The brains of older adults may engage in additional activity from an alternative brain region to offset diminished cognitive function. However, the actual impact of this compensation on cognitive performance enhancement remains a subject of debate.

Ethan Knights, a Research Associate at the Medical Research Council (MRC) Cognition and Brain Sciences Unit at the University of Cambridge, UK, emphasises the importance of understanding the neurophysiological alterations that sustain cognitive functionality in preventing cognitive decline in the elderly, a critical public health concern. “Fluid intelligence, which involves solving novel and abstract problems, significantly diminishes with age. It is known to activate a brain network called the multiple demand network (MDN), whose activation tends to wane as we age,” Knights explains.

In their exploration of functional compensation during tasks that require fluid intelligence, Knights and his team involved 223 adults aged between 19 and 87 years from the Cambridge Centre for Ageing and Neuroscience project’s Stage 3. They employed a modified version of the odd-one-out subtest from the standardised Cattell Culture Fair Intelligence Test. During the task, they monitored brain activity changes using functional magnetic resonance imaging (fMRI). Participants were challenged to identify the odd one from a row of display panels based on visual differences with varying difficulty levels.

The researchers observed, via fMRI scans, activation in brain regions typically associated with the MDN during these tasks. They sought regions showing positive effects of both age and performance, indicative of an age-related compensatory response, identifying two areas of interest: the cuneus, located at the rear of the brain and involved in processing visual information, and the bilateral frontal cortex, associated with decision-making, problem-solving, and social interactions.

The team confirmed these areas’ involvement in task-related functional compensation using multivariate Bayesian decoding. This neuroimaging analysis approach analyses activity patterns across several brain regions to infer data. Interestingly, while the informational content in the frontal cortex remained constant across ages, older adults showed increased information in the cuneus, suggesting its role in maintaining cognitive performance during fluid intelligence tasks, indicative of functional compensation.

eLife’s editorial team suggested that the study’s robustness could be enhanced by including more demographic details about the participants to ensure a sample truly representative of the general population.

In conclusion, senior author Kamen Tsvetanov, an Alzheimer’s Society Dementia Research Leader Fellow at the Department of Clinical Neurosciences, University of Cambridge, remarked, “Our findings provide the most convincing evidence to date of functional compensation in healthy aging. Given the cuneus’s established role in visual attention, its additional recruitment in older participants likely facilitated their ability to simultaneously process multiple visual panel features, accurately identifying the odd-one-out. Future research should aim to elucidate the specific role of the cuneus in such problem-solving tasks and how age, cuneus activation, and fluid intelligence interrelate, taking into account factors like education and lifestyle choices.”

More information: Ethan Knights et al, Neural Evidence of Functional Compensation for Fluid Intelligence in Healthy Ageing, eLife. DOI: 10.7554/eLife.93327.1

Journal information: eLife

Listening to calming words while you sleep can decelerate your heartbeat

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A study conducted by researchers at the GIGA – Center of Research Cyclotron at the University of Liège, in collaboration with the University of Fribourg, Switzerland, has unveiled that the human body continues to interact with the external environment even during sleep, thereby influencing sleep quality based on sensory inputs. This groundbreaking research delves into the body’s response to auditory stimuli during sleep, mainly focusing on the effect of different types of words on the heart rate. The findings indicate that hearing calming words while asleep can reduce heart rate, signifying a state of more profound relaxation as opposed to neutral words that do not trigger a similar slowing of cardiac activity. Published in the Journal of Sleep Research, this study illuminates the intricate brain-heart dynamics during sleep.

The research team, including Matthieu Koroma (a postdoctoral researcher funded by the Fund for Scientific Research – FNRS), Christina Schmidt and Athena Demertzi (both research associates at the Fund for Scientific Research – FNRS) at the GIGA Cyclotron Research Center, University of Liège, along with colleagues from the University of Fribourg, expanded on previous work which analyzed brain data (via electroencephalograms). This prior study showed that calming words extended the duration of deep sleep and enhanced overall sleep quality, suggesting the potential of auditory stimuli to modulate sleep beneficially. It was hypothesized that the brain remains receptive to sensory information during sleep, leading to a relaxation of the body upon hearing soothing words. This latest study further explored this hypothesis by examining changes in cardiac activity (via electrocardiograms) after introducing relaxing versus neutral words, confirming that only relaxing words effectively reduce heart rate.

In comparing cardiac and brain activity markers, the researchers aimed to elucidate the extent to which each contributes to sleep modulation through auditory information. While previous assumptions were that cardiac activity’s influence on perception was limited to wakefulness, these new findings reveal its significance during sleep, offering a fresh perspective on the role of bodily responses in our understanding of sleep, in addition to brain activity.

Dr Schmidt noted the rarity of sleep research addressing bodily activities and highlighted the brain’s and body’s interconnectedness during sleep. This suggests a holistic approach is necessary to understand how humans process and react to environmental stimuli. Dr Demertzi added that considering brain and body responses is crucial for comprehensively understanding human interaction with the environment, even during sleep.

Furthermore, Dr. Koroma emphasized the team’s commitment to Open Science principles by sharing their methodology openly, hoping to inspire further research into the cardiac role in sleep functions.

This pioneering study proposes a broader framework for exploring how sensory information, particularly auditory stimuli, modulates sleep functions. Future research could investigate the body’s role in how sounds affect the emotional processing of memories during sleep, highlighting the potential for a more integrated approach to understanding sleep and its functions.

More information: Matthieu Koroma et al, Probing the embodiment of sleep functions: Insights from cardiac responses to word-induced relaxation during sleep, Journal of Sleep Research. DOI: 10.1111/jsr.14160

Journal information: Journal of Sleep Research Provided by University of Liège

Physical activity during childhood is associated with cerebellar size in adolescence

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Research conducted by the University of Jyväskylä and the University of Eastern Finland reveals a significant correlation between sustained physical fitness from childhood and the volume of cerebellar grey matter in adolescents. The study highlights that adolescents with superior neuromuscular fitness, greater strength, speed, and agility possessed a larger volume of Crus I grey matter during their teenage years.

The cerebellum’s role in cognitive functions and learning is well-documented, yet the relationship between physical fitness and the cerebellum’s volume during adolescence has yet to be thoroughly understood. This investigation delves into how physical fitness correlates with the grey matter volume in specific cerebellar lobules implicated in adolescents’ cognitive processes, examining differences across genders.

Findings indicate that adolescents with higher levels of neuromuscular fitness since childhood exhibit a greater volume of Crus I grey matter. Conversely, those with better cardiorespiratory fitness showed a reduction in the total volume of cerebellar grey matter. Notably, male adolescents with enhanced neuromuscular fitness from childhood were found to have a reduced volume of Crus II grey matter.

Doctoral Researcher Petri Jalanko from the Faculty of Sport and Health Sciences at the University of Jyväskylä emphasised the significance of ongoing physical activity from childhood through adolescence. Such activity leads to improved physical fitness, which may be crucial for the cerebellum’s volumes integral to cognition and learning. However, Jalanko also acknowledged the paradoxical nature of some of the observed associations.

Jalanko further commented on the necessity of future research to elucidate the connections between physical fitness and cerebellar volume. He advocated for implementing randomised controlled trials that employ direct measurements of cardiorespiratory fitness and advanced brain imaging techniques. These studies should encompass a broader demographic and analyse the sexes separately to comprehend better adolescents’ links and causality between physical fitness and cerebellar volumes.

The insights are derived from the FitBrain study, part of an 8-year follow-up examination within the Physical Activity and Nutrition in Children (PANIC) study involving 40 participants. The cohort comprised 22 females and 18 males, with an average age of 17.9 years.

Cardiorespiratory fitness assessment involved a maximal ramp test using a cycle ergometer. Muscular strength was measured through the standing long jump, speed agility via the 10 x 5 m shuttle-run test, and coordination through the Box and Block Test. Neuromuscular fitness was quantified as a composite score based on the standing long jump, Box and Block Test, and shuttle-run test z-scores. Cerebellar volumes were determined through magnetic resonance imaging. These findings have been published in the esteemed Scandinavian Journal of Medicine and Science in Sports, marking a significant contribution to the field.

More information: Petri Jalanko et al, Associations between physical fitness and cerebellar gray matter volume in adolescents, Scandinavian Journal of Medicine and Science in Sports. DOI: 10.1111/sms.14513

Journal information: Scandinavian Journal of Medicine and Science in Sports Provided by University of Eastern Finland

Video game enthusiasts across the globe could be jeopardizing their hearing permanently or facing the risk of tinnitus

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The researchers have found that the volume levels reported in investigations encompassing over 50,000 individuals often approach or surpass the thresholds considered safe, leading them to conclude that a tangible risk is associated with exposure to such sound levels. Given the widespread appeal of video gaming, they argue for heightened public health initiatives to alert the public about these potential dangers.

Traditionally, concerns about unsafe sound exposure have centred on headphones, earbuds, and music venues, with video games and e-sports receiving comparatively little scrutiny regarding their impact on auditory health. The researchers note that gamers frequently engage with their games at loud volumes for extended periods. With estimates suggesting over 3 billion gamers worldwide in 2022, the potential for widespread auditory damage is significant.

In their quest to establish a foundation of evidence, the researchers examined numerous studies and documents, including those found in the grey literature, across languages such as English, Spanish, and Chinese. Their review included 14 peer-reviewed studies from nine different countries across continents, including North America, Europe, Southeast Asia, Asia, and Australasia, encompassing 53,833 participants. These studies varied in focus, from the direct impact of computer and video games on hearing to the environments of gaming centres and personal computer rooms, particularly popular in Asia, and even included the use of mobile devices.

The studies revealed that sound levels could range significantly, from as low as 43.2 decibels (dB) with mobile devices to between 80-89 dB in gaming centres, with exposure time varying according to the gaming access frequency and mode. Notably, impulse sounds during gameplay, which are short bursts significantly louder than the ambient noise, were reported to reach levels as high as 119 dB, far exceeding the recommended exposure limits for both children and adults as defined by the International Telecommunication Union (ITU) in collaboration with the World Health Organization.

The review highlights the ITU’s guidelines on permissible sound exposure levels, illustrating how exposure limits decrease with each increase in decibel level. For instance, a permissible exposure of 80 dB for 40 hours a week would be halved to 20 hours at 83 dB, showcasing the severe restrictions necessary to maintain safe listening practices.

Furthermore, the study addresses the prevalence of video gaming among youth, the associations between gaming and reported hearing issues such as tinnitus and hearing loss, and gender differences in gaming habits. It suggests that boys are more likely to play video games more frequently, for longer durations, and at higher volumes than girls.

Despite some studies dating back to the early 1990s, the evidence indicates a concerning trend of gamers, especially those frequently engaging at or above the documented average sound levels, likely exceeding safe listening thresholds. This behaviour poses a significant risk for permanent auditory damage, including hearing loss and tinnitus.

The researchers underscore several critical gaps in the current understanding, such as the specific impacts of e-sports, geographical location, gender, and age on hearing loss, underscoring the necessity for further research. This future research is crucial for developing preventive measures and informing global policy initiatives to safeguard hearing health among the gaming community. They advocate for prioritizing educational and awareness campaigns that promote safe listening habits among gamers to mitigate these risks.

More information: Lauren K Dillard et al, Risk of sound-induced hearing loss from exposure to video gaming or esports: a systematic scoping review, BMJ Public Health. DOI: 10.1136/bmjph-2023-000253

Journal information: BMJ Public Health Provided by BMJ

Long-term survivors of childhood cancer are at an increased risk of mortality following cardiac complications; the threshold for addressing risk factors ought to be reduced

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Recent studies from the VCU Massey Comprehensive Cancer Center and VCU Health Pauley Heart Center have unveiled that individuals who have survived cancer during childhood face a substantially increased risk of death after experiencing major cardiovascular incidents such as heart failure, heart attacks, or strokes, compared to the general population.

Published in the Journal of the American College of Cardiology, these insights suggest a need for a fundamental change in the clinical approach to heart health, advocating for the consideration of cardiovascular risk factors at a younger age among childhood cancer survivors.

The research reveals a startling comparison: a 50-year-old from the general population faces a similar risk of death following a major cardiovascular event as a 30-year-old who had been treated for cancer in childhood. Wendy Bottinor, M.D., the lead author of the study and a cardio-oncologist at both Massey and the Pauley Heart Center, highlighted the amplified impact of untreated risk factors on the mortality risk after severe heart events in childhood cancer survivors compared to their counterparts in the general population. That challenges the assumption that youth automatically diminishes the need to treat risk factors such as high blood pressure or cholesterol.

Building on previous findings that childhood cancer survivors are at an increased risk of heart disease and cardiovascular mortality, this study delves deeper into how these early-life cancers affect survivors’ mortality risks from major cardiovascular events later in life, in contrast to individuals without a cancer history.

The researchers relied on comprehensive data from the Childhood Cancer Survivors Study, which comprises a cohort of 25,000 childhood cancer survivors and their siblings, and the CARDIA study, a diverse cardiology database focused on the development of heart disease in young adults. Their findings indicate that childhood cancer survivors experience higher mortality rates following heart failure, heart attack, or stroke than their siblings without a cancer history and that they are significantly younger than the general population when these events occur.

This phenomenon suggests an “accelerated ageing” effect in childhood cancer survivors, wherein their medical profiles resemble those of significantly older individuals. The study also explored potential interventions, identifying dyslipidemia—an imbalance of fats in the blood—as a condition that, when treated with statins, could lower the mortality risk post-cardiovascular event. Statins, which reduce cholesterol levels and inflammation, may offer protective benefits against heart disease and cancer.

Furthermore, the research underscores the heightened risk of heart-related deaths associated with hypertension among childhood cancer survivors. This finding calls for reevaluating current medical guidelines, often setting high thresholds for prescribing blood pressure medication, especially for younger patients.

Dr Bottinor advocates for a lower threshold for treating hypertension in childhood cancer survivors, given their elevated risk of heart disease. She emphasizes the necessity for further research to fully understand the impact of heart health risk factors in young adults treated for cancer, the potential benefits of modifying these risk factors, and the importance of raising awareness about the cardiovascular risks following cancer treatment in children and young adults.

Cardio-oncology development as a field aims to provide specialized, multidisciplinary heart care throughout the cancer treatment process to minimize cardiovascular health repercussions. The cardio-oncology program at Massey and the Pauley Heart Center stands out as the sole program in Virginia recognized as a Center of Excellence by the International Cardio-Oncology Society.

More information: Wendy Bottinor et al, Mortality After Major Cardiovascular Events in Survivors of Childhood Cancer, Journal of the American College of Cardiology. DOI: 10.1016/j.jacc.2023.12.022

Journal information: Journal of the American College of Cardiology Provided by Virginia Commonwealth University

New insights into the perplexing mystery of itching

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Researchers at Harvard Medical School have unveiled groundbreaking insights into how the commonly found skin bacterium, Staphylococcus aureus, can directly cause itching by interacting with nerve cells. This revelation, detailed in a study published on November 22 in the journal Cell, stems from experiments conducted on mice and human cells. It significantly advances our understanding of the mechanisms behind itch, particularly in the context of widespread skin conditions such as eczema and atopic dermatitis, notorious for their persistent itching sensation.

The study highlights a disruption in the balance of skin microorganisms, which typically maintain skin health, as a precursor for the overgrowth of S. aureus. The itching associated with conditions like eczema and atopic dermatitis was traditionally attributed to skin inflammation. However, this new research indicates that S. aureus alone can trigger itching by initiating a series of molecular interactions that ultimately provoke the desire to scratch.

Isaac Chiu, the study’s senior author and an associate professor of immunology at the Blavatnik Institute at HMS, emphasizes the novelty of their findings, pointing out the direct role of the Staph aureus bacterium in causing itch. The bacterium achieves this by releasing chemicals that stimulate a protein on nerve fibres, sending itch signals from the skin to the brain. An exciting aspect of their research showed that FDA-approved anti-clotting medication could block this protein’s activation, interrupting the itch-scratch cycle, alleviating symptoms, and reducing skin damage.

These discoveries open the door to developing new oral medications and topical creams designed to combat the persistent itch associated with various conditions linked to an imbalance in the skin’s microbial community, such as atopic dermatitis, prurigo nodularis, and psoriasis. Chronic scratching, a common symptom of these conditions, can lead to significant skin damage and increased inflammation.

Liwen Deng, the study’s first author and a postdoctoral research fellow in the Chiu Lab, underscores the debilitating nature of itch in patients with chronic skin conditions, many of whom harbour the microbe now identified as a direct cause. Through their research, scientists aimed to pinpoint the exact molecular “spark plug” that ignites the itch sensation. They discovered that exposure to S. aureus intensified itching in mice, leading to severe skin damage and a heightened sensitivity to otherwise non-irritating stimuli, a phenomenon known as alloknesis, commonly observed in chronic skin condition sufferers.

The team’s investigations revealed that a bacterial enzyme called protease V8 triggered an itch by activating a specific protein called PAR1 in skin neurons. This activation leads to the transmission of itch signals to the brain. Notably, traditional itch-inducing factors like immune cells and inflammatory chemicals were not implicated in the itch caused by bacterial exposure.

The research further explored the potential of anti-clotting drugs blocking PAR1 to mitigate itch. Such drugs, already approved for human use to prevent blood clots, showed promise in reducing itching and skin damage in treated mice, suggesting a viable path for developing new anti-itch treatments.

The researchers are curious whether other microbes can also trigger itch and the evolutionary advantages this might provide to the pathogens. Speculating on the broader implications of their findings, they consider the possibility that microbes might exploit itch and other neural reflexes to facilitate their spread, highlighting an intriguing area for future investigation. This research sheds light on the complex nature of itch. It poses fundamental questions about the interactions between pathogens and their hosts, paving the way for innovative treatments and a deeper understanding of microbial behaviour.

More information: Liwen Deng et al, S. aureus drives itch and scratch-induced skin damage through a V8 protease-PAR1 axis, Cell. DOI: 10.1016/j.cell.2023.10.019

Journal information: Cell Provided by Harvard Medical School

Can changes in health and lifestyle safeguard older adults from Alzheimer’s?

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As advancements continue in the development of medications for Alzheimer’s disease seeking federal approval, a groundbreaking study spearheaded by teams from UC San Francisco and Kaiser Permanente Washington reveals that tailored health and lifestyle modifications can stave off or even halt memory deterioration in older adults at elevated risk.

This investigation, which spanned two years, assessed cognitive performance, risk elements, and life quality across 172 subjects. Half of these individuals received bespoke guidance aimed at enhancing their health and lifestyle in aspects deemed to escalate Alzheimer’s risk, such as unchecked diabetes and lack of physical activity. These advised participants witnessed a modest elevation in cognitive test scores, registering a 74% enhancement compared to their counterparts who didn’t receive any intervention.

Further distinctions were observed in the analysis of risk factors and life quality between the groups, with improvements roughly amounting to 145% and 8%, respectively, as reported by the researchers. The findings were published in JAMA Internal Medicine on November 27, 2023.

A notable aspect of this study, dubbed SMARRT (systematic multi-domain Alzheimer’s risk reduction trial), is its departure from previous studies that have delivered mixed outcomes regarding health and lifestyle interventions. This study distinguished itself by offering personalized coaching tailored to each participant’s risk profile, preferences, and priorities.

Kristine Yaffe, MD, the study’s lead author and a prominent figure at UCSF, emphasized the uniqueness of this personalized intervention, which concentrates on diverse cognitive areas. According to Yaffe, unlike the generic one-size-fits-all strategies, this approach could significantly reduce risk factors and is among the few trials demonstrating cognitive benefits likely to lower dementia risk.

In collaboration with Eric B. Larson, MD, MPH, Yaffe highlighted the eagerness of older adults to understand their personal risk factors for Alzheimer’s and their readiness to adopt lifestyle changes to diminish dementia risk based on an earlier survey involving 600 participants.

Study participants and those from the earlier survey were recruited from Kaiser Permanente Washington, aged between 70 and 89, and exhibited at least two of eight identified dementia risk factors.

Those in the intervention group worked with a nurse and a health coach to pinpoint and tackle selected risk factors, receiving periodic coaching to evaluate their goals. These sessions initially took place in person but moved to phone calls due to the pandemic.

Contrastingly, the non-intervention group, matched in age, risk factors, and cognitive scores with the intervention cohort, was provided with educational materials on reducing dementia risk and mailed quarterly.

The study’s outcomes were notably positive and unaffected by the pandemic’s challenges, indicating that participants under the intervention protocol maintained better cognitive function and exhibited fewer risk factors during and after the trial despite the pandemic.

Yaffe, also affiliated with the San Francisco VA Health Care System and the UCSF Weill Institute for Neurosciences, pointed out that unlike costly anti-amyloid medications requiring stringent eligibility and extensive side-effect monitoring, risk-reduction programs offer a cost-effective, accessible alternative.

She expressed hope that future Alzheimer’s treatment would mirror the management of cardiovascular diseases, integrating both risk-reduction strategies and specific drugs targeting the disease mechanisms.

More information: Kristine Yaffe et al, Effect of Personalized Risk-Reduction Strategies on Cognition and Dementia Risk Profile Among Older Adults, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2023.6279

Journal information: JAMA Internal Medicine Provided by University of California, San Francisco

Exercise applications fail to address the requirements of older adults

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In an era where physical activity is increasingly recognized as a cornerstone of healthy ageing, a research team led by Luis Soto, a physiotherapist at the Parc Sanitari Pere Virgili health complex, in collaboration with digital health specialists from the Universitat Oberta de Catalunya (UOC), embarked on a comprehensive evaluation of exercise mobile applications available on prominent app stores. Their goal was to assess the app’s suitability for the online prescription of physical exercise and its alignment with the specific needs of older adults.

Soto emphasized the universal advice from the current scientific literature to enhance physical activity, incorporate strength training, and curtail sedentary habits. “While engaging in any form of exercise is preferable to inactivity, it is our duty as professionals to tailor our recommendations to each individual, adjusting the intensity, volume, frequency, and progression of activities accordingly,” he stated.

What sets this investigation apart, as highlighted by PhD Marco Inzitari, Director of Integrated Care and Research at Parc Sanitari Pere Virgili and a researcher at the UOC’s Faculty of Health Sciences and the eHealth Center, is its systematic approach. Published in the prestigious journal of the British Geriatrics Society, the study adheres to stringent app selection and analysis methods and ventures beyond traditional scientific databases to explore applications directly from consumer marketplaces. This approach offers insights into the apps that are readily accessible and widely used, shedding light on their practical application in everyday life.

The study critically assessed 15 out of more than 8,000 exercise apps available on Apple’s App Store and Google’s Play Store, selecting those with over 10,000 downloads, targeted at older audiences, updated within the last three years, available in English, and not confined to any single fitness discipline. The research team found these apps lacking in several areas, particularly in their adaptability to the needs of older individuals, both in terms of exercise prescription and user-friendliness, thus highlighting a significant gap in empowering this demographic.

A notable deficiency identified was the absence of apps catering to cognitive functions, underscoring the necessity for applications to be straightforward, user-friendly, and specifically designed with older adults in mind. The researchers advocate for involving potential users in the development process, especially older individuals from diverse backgrounds and with varying technological proficiency, to ensure the apps effectively meet their needs.

“Technology holds the potential to aid us significantly, yet its applications need to undergo thorough quantitative and qualitative evaluations. Our study aimed to provide a qualitative assessment of these apps, informed by scientific evidence, to aid professionals in prescribing physical exercise for older individuals,” Soto added.

Surprisingly, only one of the 15 apps evaluated was grounded in scientific evidence, as indicated by references in the PubMed scientific publication database. This study involved contributions from multiple institutions, including Parc Sanitari Pere Virgili, Universitat Oberta de Catalunya, the HiTT Foundation, Qida, and the Blanquerna School of Psychology, Education, and Sport Science at Ramon Llull University, highlighting the collaborative effort to improve digital health solutions for older adults.

More information: Luis Soto-Bagaria et al, Mobile applications to prescribe physical exercise in frail older adults: review of the available tools in app stores, Age and Ageing. DOI: 10.1093/ageing/afad227

Journal information: Age and Ageing Provided by Universitat Oberta de Catalunya (UOC)

A Mediterranean diet enhances not only overall health but also fertility

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The Mediterranean diet, renowned for its focus on fruits, vegetables, and legumes, has been widely celebrated for its extensive health benefits. Recent studies now indicate that this diet might play a crucial role in enhancing fertility, presenting a non-invasive and cost-effective approach for couples attempting to conceive.

This research, a collaborative effort by Monash University, the University of the Sunshine Coast, and the University of South Australia, reveals that the Mediterranean diet can boost fertility, increase the success rates of assisted reproductive technology (ART), and enhance sperm quality in males.

The study’s core finding is the diet’s anti-inflammatory effects, significantly boosting couples’ likelihood of conception.

Infertility represents a significant global health issue, impacting approximately 48 million couples and 186 million individuals across the globe.

Dr Evangeline Mantzioris, a researcher at UniSA, highlights the importance of preconception nutrition modification as a non-invasive and highly effective method to improve fertility outcomes. She points out the emotional strain couples face when conception does not happen as anticipated. The study explores how an anti-inflammatory diet, like the Mediterranean diet, could positively affect fertility outcomes by examining its influence on factors such as sperm quality, menstrual cycles, and implantation.

The findings reveal that a diet rich in polyunsaturated fats and flavonoids (like those found in leafy greens) and low in red and processed meats can significantly enhance fertility. The Mediterranean diet, predominantly plant-based, includes whole grains, extra virgin olive oil, fruits, vegetables, beans, legumes, nuts, herbs, and spices, as well as moderate amounts of yoghurt, cheese, and lean proteins like fish, chicken, or eggs, with minimal red and processed meat intake.

On the contrary, the Western diet, characterized by high saturated fats, refined carbohydrates, and animal proteins, lacks essential dietary fibre, vitamins, and minerals and is often linked with increased inflammation.

Simon Alesi, a researcher from Monash University, notes the potentially transformative impact understanding the link between anti-inflammatory diets, such as the Mediterranean diet, and fertility could have for individuals looking to start a family. He emphasizes the global recognition of the Mediterranean diet as one of the healthiest, with added benefits for conception and pregnancy being particularly promising.

Adopting a Mediterranean diet represents a non-invasive and economical option that could notably improve fertility issues. While further research is needed, transitioning to this diet enhances overall health. It potentially increases the likelihood of conception, offering hope for couples aspiring to expand their families.

More information: Simon Alesi et al, Anti-Inflammatory Diets in Fertility: An Evidence Review, Nutrients. DOI: 10.3390/nu14193914

Journal information: Nutrients Provided by University of South Australia

The ethical burden, limited resources, and ineffective management lead to the departure of home care workers from their positions

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Numerous wellbeing services counties recently established in Finland are contemplating reductions in expenditures on eldercare services, particularly affecting continuous care and home care. Concurrently, the industry is grappling with a pronounced workforce deficit, resulting in an increasing number of elderly individuals, many of whom require extensive support, having to fend for themselves in their homes without sufficient assistance. A novel investigation conducted by the University of Eastern Finland reveals that challenges in home care have been a longstanding issue, significantly impacting the well-being of home care workers.

Postdoctoral Researcher Marjo Ring from the University of Eastern Finland highlighted the findings from their study on why home care workers are choosing to leave their positions. They pinpointed four primary factors: a discrepancy between the needs of elderly clients and the available resources; the excessive time required by performance-driven practices and various digital systems; the demands placed on employees alongside the rigidity of their roles; and the ethical challenges faced.

The research advocates for the recognition of home care workers as professionals who are keen to assume responsibility for their roles and contribute to the advancement of their sector. These workers seek more personalized management and more significant consideration for their needs and clients. The study calls for a dialogue on the values underpinning their work, necessitating the creation of metrics for home care that go beyond mere procedural focus to cater to the needs of elderly individuals truly. Moreover, it emphasizes fostering interactions and encounters between clients and home care workers.

This research delves into the reasons behind the attrition of home care workers, considering the influence of public service reforms and eldercare policies shaped by New Public Management (NPM) in Finland. Since its prominence in the 1990s, NPM has aimed to streamline eldercare services through enhanced management practices and market-driven approaches.

Ring noted that New Public Management principles significantly resonate with home care workers’ experiences and reasons for leaving the profession. Decisions regarding eldercare at the national level and organizational solutions profoundly affect home care workers’ daily tasks, prompting their departure.

The study forms part of the SOLDEX project, focusing on old-age social exclusion primarily from the viewpoint of older home care recipients.

Associate Professor Elisa Tiilikainen of the University of Eastern Finland remarked on the precarious situation of many home care recipients, who often live alone or with an ageing spouse and require considerable support due to physical or cognitive impairments. She pointed out the heightened risk of social exclusion among older home care clients if home-based services fail to meet their needs, underscoring the critical nature of this issue for those reliant on home care.

This investigation received support from the Finnish Work Environment Fund and the Research Council of Finland.

More information: Marjo Ring et al, From Restricted Resources to Ethical Burden—Former Home Care Workers’ Reasons for Leaving Their Jobs, Journal of Applied Gerontology. DOI: 10.1177/07334648241231404

Journal information: Journal of Applied Gerontology Provided by University of Eastern Finland

Salt substitutes aid in sustaining healthy blood pressure levels in older adults

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Switching from regular salt to a salt substitute can lower the frequency of hypertension or elevated blood pressure in older adults without heightening the risk of episodes of low blood pressure, as revealed by a recent investigation published in the Journal of the American College of Cardiology. The study found that individuals using a salt substitute experienced a 40% reduction in the incidence and probability of developing hypertension compared to those who continued using regular salt.

The World Health Organization identifies hypertension as a primary risk factor for cardiovascular diseases and death globally, affecting more than 1.4 billion adults and causing approximately 10.8 million fatalities annually. One of the most productive methods to mitigate the risk of hypertension is lowering sodium consumption. The research examines salt substitutes as an improved approach for controlling and preserving optimal blood pressure levels over merely decreasing salt intake.

Yangfeng Wu, MD, PhD, the study’s lead researcher and the Executive Director of the Peking University Clinical Research Institute in Beijing, China, emphasized the importance of understanding the health implications of our dietary choices, particularly the excessive consumption of salt through processed foods that are both affordable and readily available. Wu highlighted the need for increasing awareness about low-sodium dietary options for better heart health.

This study assessed the effects of sodium reduction strategies on blood pressure among elderly individuals in Chinese care facilities. Despite previous research confirming that salt intake reduction can prevent or postpone the onset of hypertension, maintaining a long-term low-salt diet poses significant challenges.

The DECIDE-Salt study involved 611 participants aged 55 and over from 48 care facilities, divided into two groups: one with 313 participants replacing their usual salt with a salt substitute and another with 298 participants continuing with their regular salt consumption. All participants had a baseline blood pressure of 140/90mmHg and were not on medication for hypertension. The primary focus was on participants who developed hypertension, began hypertension medication, or encountered significant cardiovascular events during the study.

After two years, the rate of hypertension was 11.7 per 100 person-years among those using the salt substitute, compared to 24.3 per 100 person-years among those using regular salt, indicating a 40% lesser likelihood of developing hypertension with the salt substitute. Additionally, the salt substitute did not lead to hypotension, a concern for older adults.

Wu expressed enthusiasm about the findings, suggesting they significantly advance blood pressure management. This approach protects individuals’ health and reduces cardiovascular risk while enjoying flavorful meals. Given its effectiveness in lowering blood pressure demonstrated in previous studies, the salt substitute benefits both hypertensive and normotensive individuals, making it a desirable strategy for preventing and controlling hypertension and cardiovascular disease.

However, the study has limitations, including its nature as a post-hoc analysis, the need for pre-specified study outcomes, and many participants were lost to follow-up. Despite these challenges, analyses suggested the missing data were random, and multiple sensitivity analyses supported the robustness of the findings.

In an editorial comment accompanying the study, Rik Olde Engberink, MD, PhD, is a researcher, nephrologist, and clinical pharmacologist at Amsterdam University Medical Center’s Department of Internal Medicine. He praised the study for offering an appealing alternative to the global challenge of reducing salt intake. However, he noted that further questions and efforts are necessary. He highlighted the study’s approach of providing salt substitutes to kitchen staff and restricting external food sources. He suggested that adopting salt substitutes early in the food production chain could significantly impact blood pressure outcomes by improving the sodium-potassium ratio in processed foods.

More information: Yangfeng Wu et al, Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults, Journal of the American College of Cardiology. DOI: 10.1016/j.jacc.2023.12.013

Journal information: Journal of the American College of Cardiology Provided by American College of Cardiology

Does having shingles elevate the risk of developing dementia in an individual?

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Shingles, a painful condition triggered by the reactivation of the chickenpox virus, manifests as a blistering rash on one side of the body or face due to nerve inflammation. Scientists have theorized that this inflammation could potentially heighten the risk of dementia in individuals. Nevertheless, a recent study has revealed that there is no link between shingles and an elevated risk of developing dementia. This study was published in the online edition of Neurology®, the official journal of the American Academy of Neurology, on June 8, 2022.

The increase in dementia risk with age is well-documented, highlighting the necessity to explore factors that may influence this risk, explained Sigrun Alba Johannesdottir Schmidt, MD, PhD, from Aarhus University Hospital in Denmark. Given that shingles predominantly affect individuals over 50, it is reassuring from our research that it does not seem to amplify the risk for dementia.

In conducting this study, Danish medical registries were scrutinized over two decades to identify 247,305 individuals who had either been hospitalized for shingles or had received antiviral treatment for the condition, alongside 1,235,890 individuals who had not been diagnosed with shingles, matched for age and sex. The mean age among these individuals was 64 years.

The research aimed to track the development of dementia in these participants up to 21 years following a diagnosis of shingles. Among those who had experienced shingles, 9.7% went on to develop dementia, compared to 10.3% among those who had not had shingles.

Even after accounting for other health issues such as diabetes, cancer, and head injuries, the findings indicated that individuals with shingles had a 7% lower risk of developing dementia compared to those without the condition.

“These findings were unexpected,” Schmidt remarked, noting the unclear reasons behind the reduced risk. One possible explanation might be the underdiagnosis of shingles in individuals with undiagnosed dementia. Although the shingles vaccine is recommended for the older adults to prevent disease complications, this study suggests it may not influence dementia risk.

The research did, however, uncover that individuals who experienced shingles spreading to the central nervous system were nearly twice as likely to develop dementia, though Schmidt pointed out that such cases are sporadic, affecting less than 0.1% of those with shingles.

A noted limitation of the study was its reliance on hospital records and antiviral prescriptions to identify participants. It may not fully represent individuals with less severe shingles or those who do not seek treatment.

More information: Sigrun Alba Johannesdottir Schmidt et al, Incident Herpes Zoster and Risk of Dementia A Population-Based Danish Cohort Study, Neurology. DOI: 10.1212/WNL.0000000000200709

Journal information: Neurology Provided by American Academy of Neurology