Monthly Archives: March 2024

Higher levels of thyroid hormone linked to increased risk of cognitive disorders in older adults

A recent study conducted by Johns Hopkins Medicine has established a correlation between elevated levels of thyroid hormone, known as thyrotoxicosis, and a heightened risk of cognitive disorders in older adults. The study delineates two sources of thyrotoxicosis: exogenous, resulting from the intake of thyroid medication, and endogenous, stemming from thyroid ailments such as hyperthyroidism and Graves’ disease, both of which have been identified as contributing factors to an increased likelihood of cognitive impairment. This research was made available online on October 23 by JAMA Internal Medicine.

Roy Adams, PhD, M.S., the study’s lead author and an assistant professor of psychiatry and behavioural sciences at the Johns Hopkins University School of Medicine, pointed out that while previous research hinted at a possible link between thyrotoxicosis and cognitive disorders, the findings were inconsistent, and studies often excluded cases of exogenous thyrotoxicosis. He highlighted the significance of understanding the impact of thyroid hormone levels on cognitive health, especially given that thyroid hormone prescriptions are among the most common in the United States. A prior investigation by Johns Hopkins Medicine revealed that as many as 20% of individuals taking thyroid hormone medication might be receiving doses too high, exposing them to the risk of exogenous thyrotoxicosis.

The aim of the study, as Adams explained, was to explore whether the aggressive treatment approaches that lead to exogenous thyrotoxicosis could also be causing cognitive damage. The importance of recognizing the adverse effects of overtreatment lies in guiding medical professionals in their prescription of thyroid hormone therapies more cautiously.

For their research, the team utilized a database of electronic health records from Johns Hopkins Medicine, selecting a cohort of 65,931 individuals aged 65 and above who had been under primary care within the Johns Hopkins Health System from January 1, 2014, to May 6, 2023. The initial primary care visit recorded for these participants showed an average age of 71, with each individual having attended at least two appointments spaced by a minimum of 30 days.

The findings revealed a 39% increase in the diagnosis of cognitive disorders among patients experiencing any form of thyrotoxicosis—whether endogenous or exogenous—across different age brackets. Specifically, by the age of 75, 11% of patients who had undergone thyrotoxicosis received a diagnosis of cognitive disorder, compared to 6.4% who hadn’t experienced thyrotoxicosis. This risk escalated with age; by 85, the figures rose to 34% for those with thyrotoxicosis versus 26% for those without. Even after adjusting for potential biases and alternative explanations through statistical models, the increased risk linked to thyrotoxicosis persisted.

Moreover, the study established a correlation between the severity of thyroid hormone excess and the risk of developing cognitive disorders. Patients with severe excess were found to have a 65% increased risk, whereas those with a moderate excess faced a 23% increased risk.

Jennifer Mammen, M.D., Ph.D., the senior author of the study and an assistant professor of medicine at the Johns Hopkins University School of Medicine, underscored the implication of their findings: an increased risk of cognitive disorders could be a consequence of excess thyroid hormone, a frequent outcome of thyroid hormone treatment. She advised clinicians to employ age-appropriate treatment strategies to mitigate the risk of cognitive disorders in older adults by preventing overtreatment.

More information: Roy Adams et al, Endogenous and Exogenous Thyrotoxicosis and Risk of Incident Cognitive Disorders in Older Adults, Johns Hopkins Medicine. DOI: 10.1001/jamainternmed.2023.5619

Journal information: Johns Hopkins Medicine

For a longer independent living experience, explore cost-effective home improvements

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The COVID-19 pandemic has shed light on the vulnerabilities within nursing homes, prompting numerous families to reconsider the option of caring for their ageing relatives at home. A study by the University of California, San Francisco (UCSF) has highlighted a significant gap in the availability of essential self-care equipment for elderly Americans, which could otherwise facilitate their ability to live independently for a longer duration, thus delaying their transition into residential care facilities.

This study focused on three cost-effective and straightforward assistive devices: grab bars installed around the toilet and within the shower or tub area; seats for showers or tubs; and elevated toilet seats or adaptations to increase existing toilets. Researchers sampled around 2,600 seniors, representative of Medicare beneficiaries across the nation, from the National Health and Aging Trends study. These individuals were living at home yet faced mobility challenges, including significant difficulties with bathing, toileting, maintaining balance, and moving from sitting to standing.

A startling finding from the study was that 42 per cent of these seniors had an “unmet need” due to the absence of either bathroom aids or toilet adaptations. When extrapolated to the entire U.S. population, this group represents about 5 million Americans. The researchers described this situation as a “missed opportunity” to support these individuals in living more independently and safely. These findings were published in the Journal of the American Medical Association (JAMA) Internal Medicine on March 22, 2021.

Kenneth Lam, MD, the study’s lead author from the UCSF Division of Geriatrics, commented on these devices’ simplicity yet profound impact. Despite their mundane nature compared to high-tech medical treatments like engineered T-cells and stem cell therapies, these low-tech solutions can significantly reduce injuries, foster independence, uphold dignity, and enhance the quality of life for older adults with disabilities arising from complex, multifactorial reasons. Each device costs about $50, yet Medicare does not cover them.

Lam also reflected on the cultural perspective towards ageing, noting a general preference for reversing the ageing process rather than adapting to it. He argued that This mindset could exacerbate ageing challenges by resisting adjustments to accommodate an ageing body.

The study also revealed that younger seniors, mainly those aged 65 to 74, were more likely to have unmet needs than those 85 and older, with half of the younger group lacking the necessary equipment. This disparity could be partly attributed to the stigma associated with using such devices, which are often perceived as markers of vulnerability and old age. Interestingly, individuals who already owned a walker were more likely to have the other necessary equipment, possibly because they had already overcome the stigma associated with using assistive devices.

Another significant finding was the racial disparity in equipment availability, with nonwhite participants more likely to lack the necessary devices. This discrepancy points to broader access issues and possibly reflects the tendency of minority populations to rely more on familial caregiving rather than equipment.

The study also emphasised the importance of physicians inquiring about their patients’ home environments and recommending suitable assistive devices, a practice not commonly included in medical training. This oversight is critical as many emergency room admissions among older adults are due to accidents at home, such as falls on the way to the bathroom.

For seniors with cognitive impairments, such as probable or possible dementia, the study suggested additional home modifications that could enhance safety and ease caregiver burdens, including medication reminder pill boxes, electronic locks, and safety stoves. Other aids like music, activity blankets, and dolls could also help manage restless behaviours.

While these modifications and devices may not be sufficient to enable all seniors to remain at home, they represent valuable tools that could reduce the caregiving load and delay the need for nursing home care for many individuals. This study underscores the importance of addressing the practical needs of the elderly living at home and calls for systemic changes to support their independence and safety.

More information: Kenneth Lam et al, Unmet Need for Equipment to Help With Bathing and Toileting Among Older US Adults, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2021.0204

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

Consumption of energy beverages associated with diminished sleep quality and the onset of insomnia in university students

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A comprehensive study from Norway, published in BMJ Open, an open-access journal, reveals a correlation between the consumption of energy drinks and reduced sleep quality and insomnia among college students. This large-scale investigation underscores that the more frequently students consume these beverages, the less sleep they get each night. Interestingly, even infrequent consumption, defined as 1-3 times per month, is associated with an increased risk of sleep disturbances.

Energy drinks, known for their high caffeine content, averaging 150 mg per litre, also contain various amounts of sugar, vitamins, minerals, and amino acids. They are marketed as boosts for mental and physical energy and are particularly popular among college students and young adults. Although some evidence points to the negative impact of these drinks on sleep quality, it remains unclear which aspects of sleep are most affected and whether the effects differ between genders.

To delve deeper into these questions, researchers analyzed data from 53,266 participants aged between eighteen and thirty-five from the Students’ Health and Well-being Study (SHOT22), representing the latest wave of a significant national survey targeting college and university students in Norway. The survey inquired about the frequency of energy drink consumption and detailed sleep patterns, including bedtime routines, sleep latency, and incidents of wakefulness after falling asleep. From this, sleep efficiency was calculated, comparing total sleep hours to the time spent in bed.

The study defined insomnia as difficulty falling or staying asleep, or waking up early, on at least three nights a week, coupled with daytime sleepiness or fatigue for at least three days a week, lasting a minimum of three months. Responses highlighted gender differences in energy drink consumption, with a notable percentage of women reporting they never or seldom consumed these drinks compared to men.

Despite these differences, a clear pattern emerged. Both men and women who consumed energy drinks daily reported sleeping approximately thirty minutes less than those who consumed them occasionally or not at all. This association extended to increased wakefulness after sleep onset and longer sleep latency, indicating a dose-response relationship between energy drink intake and reduced sleep efficiency.

Furthermore, insomnia was significantly more prevalent among daily consumers of energy drinks than among occasional or non-consumers, with marked disparities between genders in the prevalence of the condition. The study found a progressive increase in sleep-related problems with higher consumption levels, particularly about short sleep duration.

The researchers observed that compared to those with no or occasional energy drink consumption, men reporting daily intake were over twice as likely to sleep under six hours per night. At the same time, women had an 87% higher likelihood of experiencing the same issue. Even those who consumed energy drinks just 1-3 times a month faced an elevated risk of sleep disturbances.

It’s important to note that this study is observational and cannot definitively establish causality. The possibility of reverse causality, where poor sleep might lead to increased consumption of energy drinks rather than the reverse, cannot be discounted. Additionally, the study did not account for the timing of consumption or the precise quantities consumed and relied on self-reported data rather than objective measures.

Despite these limitations, the researchers emphasize the vital link between energy drink consumption frequency and various sleep parameters. Identifying modifiable risk factors for sleep issues in college and university students is crucial, and the findings suggest targeting the frequency of energy drink consumption as a potential intervention point.

More information: Siri Kaldenbach et al, Energy drink consumption and sleep parameters in college and university students: a national cross-sectional study, BMJ Open. DOI: 10.1136/bmjopen-2023-072951

Journal information: BMJ Open

Mushrooms increase memory capacity by enhancing nerve growth

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Scientists at The University of Queensland have unveiled a breakthrough finding from an edible mushroom known for its capacity to enhance nerve growth and improve memory. Led by Professor Frederic Meunier of the Queensland Brain Institute, the research team pinpointed novel active compounds within the Hericium erinaceus mushroom, commonly referred to as lion’s mane mushroom. This mushroom has been recognized for its brain cell growth and memory enhancement capabilities in pre-clinical evaluations, as reported by the university.

Professor Meunier explained that lion’s mane mushrooms, long utilized in traditional Asian medicine, were studied to scientifically verify their effects on brain cells. The pre-clinical experiments demonstrated that these mushrooms notably boost brain cell growth and memory enhancement. Through laboratory examinations, the team observed that the isolated compounds from Hericium erinaceus significantly encourage the formation of neuron projections, which play a critical role in neuron connectivity and communication.

Employing advanced super-resolution microscopy techniques, the researchers discovered that extracts from the mushroom, along with its active components, substantially enlarged growth cones. These growth cones are essential for brain cells to navigate their surroundings and connect with other brain neurons, facilitating cognitive functions and memory.

Dr Ramon Martinez-Marmol, a study co-author from UQ, highlighted the potential of this discovery in treating and safeguarding against neurodegenerative cognitive conditions, including Alzheimer’s disease. The team’s objective was to find naturally occurring bioactive compounds capable of crossing the blood-brain barrier to stimulate neuron growth and enhance memory formation.

Dr. Dae Hee Lee of CNGBio Co, a collaborator and supporter of the research project, emphasized the historical use of lion’s mane mushrooms in traditional Chinese medicine for healing and health maintenance. The research sheds light on the molecular mechanisms behind the cognitive benefits of lion’s mane mushroom compounds, particularly in memory enhancement.

The findings were published in the Journal of Neurochemistry, acknowledging the joint efforts with researchers from South Korea’s Gachon University and Chungbuk National University. This study reaffirms the medicinal value of lion’s mane mushrooms and opens new avenues for developing treatments for cognitive disorders.

More information: Ramón Martínez-Mármol et al, Hericerin derivatives activates a pan-neurotrophic pathway in central hippocampal neurons converging to ERK1/2 signaling enhancing spatial memory, Journal of Neurochemistry. DOI: 10.1111/jnc.15767

Journal information: Journal of Neurochemistry Provided by University of Queensland

Can we have a quick chat? Studies have found that speaking at a faster rate is linked to superior brain health in older age

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As we age, it’s common to notice a slower retrieval of words, which often raises fears about cognitive decline and the potential onset of dementia.

However, recent research conducted by Baycrest and the University of Toronto introduces a novel perspective, emphasising the pace of speech as a more critical marker of brain health than the occasional struggle to find the right words, a phenomenon typically considered a regular aspect of ageing. This study is pioneering in examining the correlation between natural variations in speech patterns and overall brain health in healthy individuals.

Dr. Jed Meltzer of Baycrest, holding the Canada Research Chair in Interventional Cognitive Neuroscience and serving as the principal investigator for this study, shared, “Our findings suggest that alterations in the overall speed of speech could mirror changes in the brain. This highlights the importance of including speech speed assessments in routine cognitive evaluations to aid clinicians in detecting cognitive decline more promptly, thereby supporting older individuals in maintaining their brain health as they advance in age.”

In this research, 125 volunteers between 18 and 90 underwent three distinct evaluations. The initial test involved a picture-naming task that required participants to identify and name images while ignoring unrelated auditory distractions. This setup aimed to assess the subjects’ recognition and naming abilities.

Subsequently, the study involved participants describing complex images for one minute each, with their responses being analysed for speech pace and frequency of pauses through AI-based tools developed in collaboration with Winterlight Labs.

Lastly, the participants took standardised cognitive tests to measure mental functions that deteriorate with age, such as executive function, which encompasses the ability to process conflicting information, concentrate, and resist distractions.

Contrary to expectations, while many cognitive abilities diminished with age, including the speed of word retrieval, this decline was not directly correlated with a reduction in other mental capacities. Interestingly, the study found that participants’ frequency and duration of pauses when searching for words did not significantly relate to brain health indicators. Instead, the ability to quickly name pictures, which corresponded to their overall speech speed, was associated with executive function. That implies that not the hesitancy in finding words but rather the general speed of speech, including during pauses, is a more telling indicator of brain health.

These findings suggest that while many older adults worry about their pauses during speech as a sign of cognitive decline, such pauses are a normal aspect of ageing. More critical, however, is the observation that a slowdown in regular speech pace better reflects underlying changes in brain health.

Looking ahead, the research team plans to replicate this study over several years with the same group of participants to determine if speech speed indeed predicts brain health as individuals age. That could pave the way for developing early detection tools for cognitive decline, enabling healthcare professionals to recommend interventions to preserve or enhance brain health in older adults.

This study received financial support from the Natural Sciences and Engineering Research Council of Canada (NSERC) through a Discovery Grant, an Internship Grant from the Mitacs Accelerate Program, and a Connaught Innovation Award.

More information: Hsi T. Wei et al, Cognitive components of aging-related increase in word-finding difficulty, Aging Neuropsychology and Cognition. DOI: 10.1080/13825585.2024.2315774

Journal information: Aging Neuropsychology and Cognition Provided by Baycrest Centre for Geriatric Care