Monthly Archives: April 2024

Recent research uncovers the molecular signature of biological ageing

The University of Pittsburgh, a renowned institution in the field of ageing research, has achieved a significant milestone. Their researchers have successfully identified blood markers that correspond with an individual’s health and ageing rate. This breakthrough allows for the estimation of a person’s biological age, a measure that reflects the ageing rate of their cells and organs, independent of their actual birthdate.

Published in the esteemed journal Aging Cell, this groundbreaking study sheds light on the biological pathways and compounds that influence ageing rates and paves the way for potential treatments. By understanding the diverse aging processes among individuals, this research proposes new avenues for interventions aimed at slowing down aging and improving the quality of life in old age.

Aditi Gurkar, Ph. D., the study’s lead author and an assistant professor of geriatric medicine at the University of Pittsburgh’s School of Medicine, emphasizes that age should be seen as more than just a number. She illustrates this by comparing two 65-year-olds, one physically active and the other struggling with basic mobility despite having the same chronological age. This disparity in ageing has been the driving force behind Gurkar’s research.

To investigate the variations in aging rates, the lead author, Aditi Gurkar, Ph.D., and her team conducted a comprehensive study. They examined 196 older adults, categorizing them as either healthy or rapid agers based on their performance in simple walking tasks. These tasks, which are indicative of overall health, encompass cardiovascular fitness, physical strength, and neurological condition. Importantly, the study focused on differentiating between biological and chronological aging by selecting rapid agers who were chronologically younger than the healthy agers.

Employing metabolomics, the analysis of metabolites produced by the body’s chemical reactions, the researchers could sketch a molecular blueprint of biological ageing from the participants’ blood samples. Unlike genetic studies, metabolomics offers a dynamic view of ageing since metabolites can change based on lifestyle, diet, and environmental factors, providing a real-time snapshot of one’s health.

The study identified a set of 25 metabolites, termed the Healthy Aging Metabolic (HAM) Index, which could effectively differentiate between healthy and rapid agers. This index proved more accurate than traditional ageing metrics in distinguishing between groups. To further validate their findings, the team applied the HAM Index to an independent group of older adults from Wisconsin, confirming its efficacy in predicting healthy ageing with a significant accuracy rate.

Moreover, the researchers utilized artificial intelligence to pinpoint three key metabolites likely to influence the ageing process significantly. Future studies will explore these metabolites and the molecular pathways they activate, seeking strategies to mitigate rapid ageing.

Gurkar is also planning further research to monitor how the metabolome evolves in younger individuals. The ultimate goal is to develop a blood test that could predict biological age in younger adults, potentially enabling early lifestyle interventions to reverse or slow the ageing process.

This research underscores a paradigm shift towards preventative medicine, focusing on early detection and personalized interventions to delay the onset of age-related diseases and extend the period of good health. Gurkar envisions a future where understanding an individual’s biological ageing process becomes a cornerstone of medical care, emphasizing the importance of prevention in managing the ageing process.

More information: Shruthi Hamsanathan et al, A molecular index for biological age identified from the metabolome and senescence-associated secretome in humans, Aging Cell. DOI: 10.1111/acel.14104

Journal information: Aging Cell Provided by University of Pittsburgh

Disparities in sleep health and insomnia can start early in life

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Most individuals have endured sleepless nights, restlessly trying to drift off or maintain sleep. However, for some, sleep disturbances are not merely sporadic events but persistent issues that can start as early as childhood.

Research spearheaded by a team from Penn State has revealed that children and adolescents from racial and ethnic minority groups are disproportionately plagued by enduring insomnia symptoms that initiate in childhood and persist into young adulthood. The study, in particular, highlighted that Black children are 2.6 times more likely to suffer from these prolonged sleep difficulties when compared to their white peers. Recently published in SLEEP, this research emphasizes the critical need for early detection and intervention of insomnia symptoms with treatments appropriate for different ages.

Julio Fernandez-Mendoza, a professor at the Penn State College of Medicine and the study’s senior author, remarked, “Insomnia is a public health issue.” He pointed out that the prevalence of childhood-onset insomnia, where symptoms begin in early years and continue into young adulthood, is more widespread than previously recognized. He emphasized that, unlike transient childhood sleep disturbances such as sleep terrors or sleepwalking, insomnia does not simply dissipate with puberty and maturation.

Fernandez-Mendoza further explained that insomnia beginning in childhood poses a significant risk of health issues due to the extended period of sleep deprivation. This risk is notably higher among Black and Hispanic/Latino children, who experience disparities in sleep patterns from a young age.

The findings stem from an extensive review of Penn State Child Cohort data. This cohort study, initiated in 2000, initially recruited participants aged between 5 and 12 and followed them through adolescence into young adulthood, with evaluations conducted around the ages of 9, 16, and 24. These assessments, including parental reports during childhood and in-lab sleep studies similar to those used for diagnosing sleep apnea, provided a longitudinal view of sleep evolution across different developmental stages.

The study is pioneering in examining how childhood insomnia symptoms develop and vary among different racial and ethnic groups, addressing a significant research gap, according to Fernandez-Mendoza. Results showed that 23.3% of the participants experienced persistent insomnia symptoms across all three assessment points, and 16.8% developed symptoms during young adulthood. The racial and ethnic breakdown revealed that Black participants predominantly experienced persistent insomnia symptoms, followed by Hispanic/Latino youth.

The data indicated that Black participants were 2.6 times more likely than non-Hispanic white participants to have persistent insomnia symptoms into young adulthood. Moreover, Black children were 3.44 times more likely to see their insomnia symptoms continue rather than resolve after childhood compared to their white counterparts, suggesting that their symptoms were less likely to diminish as they transitioned to adulthood. Hispanic/Latino participants were 1.8 times more likely to experience persistent insomnia symptoms compared to white participants.

Fernandez-Mendoza stressed the importance of not waiting until adulthood to address sleep issues that have been present throughout a person’s life. He advocates for greater attention to insomnia symptoms in children and adolescents, underlining the necessity of proactive healthcare approaches to mitigate the long-term consequences of poor sleep from a young age.

More information: Rupsha Singh et al, Racial/ethnic disparities in the trajectories of insomnia symptoms from childhood to young adulthood, SLEEP. DOI: 10.1093/sleep/zsae021

Journal information: SLEEP Provided by Penn State

The approach of remote care enhanced therapy adherence and engagement among patients with type 2 diabetes

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A recent study by researchers from Mass General Brigham has shown that a remote team dedicated to identifying, educating, and prescribing therapy can significantly enhance adherence to guideline-directed medical therapy (GDMT) in patients with type 2 diabetes who are also at high risk for cardiovascular and kidney complications. The study found that patients who received education concurrently with medication management had a higher uptake of medications and started treatment earlier than those who were educated about two months before beginning medication management. These findings were presented at the 2024 American College of Cardiology’s Annual Scientific Session and published in Circulation.

Dr. Alexander J. Blood, MD, MSc, the corresponding author who presented these findings, emphasized the effectiveness of simultaneous education and treatment. Dr Blood, who is an attending physician in the Division of Cardiovascular Medicine and the Heart and Vascular Center at Brigham and Women’s Hospital—part of the founding network of the Mass General Brigham healthcare system—advocated for initiating treatment promptly when a patient shows readiness to invest in their health, suggesting that providers should capitalize on the patient’s immediate interest.

Type 2 diabetes is a prevalent condition in the United States that heightens the risk of severe cardiovascular and kidney events. Despite the potential benefits of medications like SGLT2 inhibitors and GLP-1 receptor agonists in improving outcomes for these patients, widespread adoption remains limited. Clinical trials and societal recommendations have not sufficiently translated into broad clinical practice.

The study involved a parallel, randomized, open-label clinical trial funded by the Novo Nordisk Foundation. It enrolled 200 adult patients with type 2 diabetes at elevated risk for cardiac and kidney issues at Mass General Brigham. Participants were randomly assigned to either an “education-first” group, which received two months of dedicated educational content through patient-centric videos on disease management and medication before starting treatment, or a “simultaneous” group, which received the same academic resources concurrently with treatment initiation.

Both groups were managed using a research and clinical care management platform developed by the Accelerator for Clinical Transformation at Brigham and Women’s Hospital and Mass General Brigham. This platform supported coordinated care delivery involving patient navigators, pharmacists, nurse practitioners, and physicians, thus facilitating comprehensive patient engagement and streamlined communication. This system is integral to Mass General Brigham’s efforts to transform healthcare delivery. It allows patients to access services and monitor their health from home, which is particularly vital when hospitals are often over capacity.

Over a six-month follow-up period or one-month post-medication initiation, if longer, results showed notable benefits like weight loss and reduced blood glucose levels in both groups. However, the simultaneous education group demonstrated superior medication retention rates, with 60 per cent adherence compared to 44 per cent in the education-first group. Interestingly, the education-first group’s engagement with the educational platform was lower than initially expected.

The findings challenge the assumption that a pre-treatment education period alone can resolve medication adherence issues and highlight the potential of remote, team-based care delivery. This approach appears promising for facilitating the adoption of new therapies, reducing disparities in care quality, and improving health outcomes across diverse patient groups. The flexibility of remote treatment models can broaden access to care, particularly benefiting underserved communities and individuals with demanding schedules. Additionally, including a patient navigation team enhances ongoing communication between patients and providers, ensuring personalized support essential for sustained engagement in healthcare.

Dr. Benjamin M. Scirica, MD, MPH, the principal investigator of the DRIVE study and director of the Accelerator for Clinical Transformation, expressed strong belief in the impact of remote care programs that utilize non-licensed navigators, clinical pharmacists and team-based care in conjunction with a dedicated care delivery platform. He emphasized that such programs improve operational efficiencies and communication and significantly contribute to enhancing access, elevating patient outcomes, reducing physician burden, and promoting the appropriate use of guideline-recommended medications.

More information: Alexander J. Blood et al, Randomized Evaluation of a Remote Management Program to Improve Guideline-directed Medical Therapy: The Diabetes Remote Intervention to Improve Use of Evidence-based Medications (DRIVE) Trial, Circulation. DOI: 10.1161/CIRCULATIONAHA.124.069494

Journal information: Circulation Provided by Brigham and Women’s Hospital

The Mediterranean Diet: Beneficial for Your Well-being and Wallet

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The Mediterranean diet, renowned for its health benefits, is a dietary approach that has piqued the interest of many. However, the misconception of it being expensive often discourages budget-conscious individuals from considering it.

Research from the University of South Australia has uncovered a fascinating aspect of the Mediterranean diet: it promotes health and offers significant economic benefits. Compared to a typical Western diet, adopting the Mediterranean diet could potentially save a family of four an average of $28 per week, translating to a substantial $1456 annually.

This research evaluated the nutritional content and cost of three dietary models: the conventional Australian Western diet, the Mediterranean diet, and the dietary approach recommended by the Australian Guide to Healthy Eating (AGHE). The Mediterranean and AGHE diets satisfied the criteria for recommended food groups, macronutrient ratios, and essential micronutrients for maintaining good health. In contrast, the typical Australian diet lacked several nutrients such as fibre, zinc, potassium, calcium, magnesium, vitamin E, and vitamin B6. It exceeded the advisable salt intake by twofold.

The cost analysis revealed that the Mediterranean diet required an expenditure of $78 weekly for an individual, $135 for two, $211 for three, and $285 for a family of four.

Ella Bracci, a researcher and PhD candidate at UniSA, has drawn attention to the implications of the study. She has underscored the Mediterranean diet as a viable and healthful choice for households on a budget, emphasizing the role of diet as a modifiable risk factor for chronic diseases. Bracci has also highlighted the alarming prevalence of unhealthy eating habits in Australia, contributing to the rising rates of type 2 diabetes, cardiovascular diseases, obesity, and osteoporosis.

The challenge in Australia has been the perceived expense associated with adopting diets like the Mediterranean, which emphasizes fruits, vegetables, whole grains, nuts, extra virgin olive oil, seeds, and seafood. Bracci’s research counters this perception, demonstrating the Mediterranean diet as an economically viable means to prioritize health and financial well-being.

The Australian Guide to Healthy Eating outlines a balanced diet encompassing five food groups. Despite these guidelines, only 8% of Australians meet the recommended vegetable intake, with many consuming a significant portion of their daily calories from high-salt, high-sugar, and high-fat foods.

Associate Professor Karen Murphy from UniSA remarked on the affordability of healthy eating, suggesting that maintaining a balanced diet could be more cost-effective than some might think, contrary to the financial toll unhealthy eating can have on the body. She advocated for the Australian Healthy Eating Guidelines and the Mediterranean diet, noting the latter’s lower cost.

Murphy provided practical advice on reducing grocery expenses, such as taking advantage of sales, buying seasonal produce, and opting for generic brands. She highlighted the significant cumulative savings – nearly $1500 annually – that can be achieved by choosing the Mediterranean diet, underscoring the potential impact on households’ budgets during challenging financial times.

More information: Ella L. Bracci et al, Developing a Mediterranean Healthy Food Basket and an Updated Australian Healthy Food Basket Modelled on the Australian Guide to Healthy Eating, Nutrients. DOI: 10.3390/nu15071692

Journal information: Nutrients Provided by University of South Australia

Global team investigates the potential of selenium in combating ovarian cancer

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Selenium, a critical micronutrient for human health, exhibits toxic properties at elevated concentrations. Nonetheless, recent advancements in biomedical research have highlighted its potential anti-cancer benefits when administered in high dosages.

Under the leadership of renowned experts, Professor Steve Conlan from Swansea University and Professor Laurent Charlet at Université Grenoble Alpes, a team embarked on exploring the feasibility of developing selenium nanoparticles as a viable cancer treatment option, addressing the challenge posed by selenium’s toxicity.

Their research, conducted in a unique 3D environment that closely mimics the natural tumour setting, showcased the efficacy of selenium nanoparticles in eradicating ovarian cancer cells.

A groundbreaking discovery emerged from their investigation, revealing a novel biological process through which selenium likely exerts its anti-cancer effects. The team identified that selenium alters the activity of histone methyltransferases, enzymes pivotal in regulating epigenetic modifications—changes influenced by environmental factors that affect gene expression without altering the DNA sequence. These reversible epigenetic modifications affect how DNA sequences are interpreted rather than their composition.

Dr Benoit Toubans conducted this study as part of his joint PhD project under the auspices of the strategic partnership between Swansea and Grenoble and Dr Noor Al Kafri, a CARA fellow in Professor Conlan’s lab. They collaborated with specialists at the synchrotron facility in Grenoble and the University of Stuttgart.

The findings of their research were published in the esteemed journal Redox Biology.

Professor Conlan, who leads the Reproductive Biology and Gynaecological Oncology group at Swansea University Medical School, lauded the project as an exceptional scientific endeavour.

He remarked on the significance of the discovery and praised Noor and Benoit’s remarkable talent and commitment, which were instrumental in achieving this breakthrough. Professor Conlan also emphasized how the Swansea-Grenoble partnership exemplifies the impact of international and interdisciplinary collaborations in pioneering scientific discoveries.

The discovery of selenium nanoparticles’ mode of action opens new avenues in understanding their potential. It underscores the importance of considering both their antioxidant properties and novel impacts on histone methylation in the development of cancer therapies.

More information: Benoit Toubhans et al, Selenium nanoparticles modulate histone methylation via lysine methyltransferase activity and S-adenosylhomocysteine depletion, Redox Biology. DOI: 10.1016/j.redox.2023.102641

Journal information: Redox Biology Provided by Swansea University

How does climate change impact eczema?

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In a comprehensive analysis of all pertinent studies that examined the relationship between atopic dermatitis (also known as eczema) and climate-related hazards stemming from greenhouse gas emissions, researchers identified both direct and indirect impacts on the condition. Direct effects, such as inflammation triggered by particulate matter from wildfires, and indirect effects, including stress from drought-induced food shortages, were noted.

The findings, published in the journal Allergy, included maps crafted by the researchers depicting the historical, current, and predicted future burdens of eczema related to climate-related hazards. The study highlighted a significant shortage of data, particularly from areas expected to face increased frequency of these events due to climate change.

Katrina Abuabara, MD, MA, MSCE, from the University of California, San Francisco, the study’s corresponding author, commented on the sensitivity of atopic dermatitis to climatic factors such as air pollution. She noted that until now, the impacts of more frequent climate-related hazards such as warming, heatwaves, drought, wildfires, and floods were less understood. “Our findings suggest that most climatic hazards negatively affect atopic dermatitis,” Abuabara stated. “Future research needs to incorporate data on how various climate factors cumulatively affect the incidence, prevalence, and long-term activity of atopic dermatitis in a broader range of environments to fill these gaps in research.”

More information: Sheng-Pei Wang et al, Impact of climate change on atopic dermatitis: A review by the International Eczema Council, Allergy. DOI: 10.1111/all.16007

Journal information: Allergy Provided by Wiley

Experts develop a blueprint to assist elderly individuals at risk of storm floods

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Recent research findings suggest that emergency planners in Shanghai and New York City are under increasing scrutiny to safeguard elderly residents from the severe consequences of coastal flooding precipitated by storms and cyclones.

Both metropolises are acutely vulnerable to the ravages of storm-induced flooding, and a comparative analysis of their emergency management systems reveals marked disparities in their approaches to evacuating elderly individuals to safety.

Through an in-depth examination of emergency protocols within these cities, specialists have formulated a strategy for efficient evacuation that could potentially apply to other cities globally threatened by similar flood risks, including Mumbai, Bangkok, Jakarta, Ho Chi Minh City, Miami, and Tokyo.

This innovative research, featuring contributions from the University of Birmingham, was published in Nature Water. The authors urge emergency planning bodies to establish additional local shelters to expedite the safe evacuation of those in flood-prone areas.

The study points out the discrepancy in evacuation travel times, noting that trips to evacuation sites in New York City generally take less than 20 minutes. This starkly contrasts with Shanghai, where evacuating flood-threatened areas can extend up to 3 to 4 hours due to a scarcity of accessible shelters in vulnerable communities.

Professor Nigel Wright of the University of Birmingham remarked on the vulnerability of peripheral neighbourhoods in coastal cities to storm-induced flooding, highlighting that despite these areas’ lower population densities, they often house groups with special needs, including older adults.

The contrast in evacuation strategies for older adults in Shanghai and New York City underscores the importance of strategic, risk-informed evacuation planning against storm flooding. The study offers valuable insights into making operational emergency evacuation decisions and suggests a template for crafting flood management policies for major coastal cities worldwide.

The researchers also identified potential challenges in evacuating people from offshore islands, such as Shanghai’s Chongming Island, where emergency responders face difficulties promptly reaching evacuees. The centralisation of shelters and uneven distribution of vulnerable populations leave such high-risk neighbourhoods inadequately served during extreme flood events.

Amid the backdrop of increasing coastal population sensitivity to flood disasters, China and the United States are enhancing their emergency management strategies through better organisation and evacuation planning. The evolving nature of coastal flood risk necessitates further research into evacuation strategies, factoring in climate change, coastal urbanisation, and adaptation strategies.

The phenomenon of coastal flooding, exacerbated by storm surges, is a global issue. Incidents are becoming more frequent and severe due to factors such as climate-induced sea-level rise, changes in storm patterns, and human activities. Notable flood disasters in cities like Shanghai, New Orleans, New York City, and Macau highlight the acute vulnerability of coastal cities to such events.

Projections for the 136 largest coastal cities indicate a more than threefold increase in the population exposed to centennial coastal floods from 38.5 million in 2005 to 150 million by the 2070s, with potential economic damages escalating to more than ten times the current figures by 2050.

In Europe, without mitigative action, the expected annual exposure of individuals to coastal flooding could surge from 10,200 to 3.65 million by 2100, primarily affecting major urban areas due to rising sea levels and ongoing socioeconomic development.

More information: Jie Yin et al, Strategic storm flood evacuation planning for large coastal cities enables more effective transfer of elderly populations, Nature Water. DOI: 10.1038/s44221-024-00210-z

Journal information: Nature Water Provided by University of Birmingham

Patient-centered cardiovascular care is crucial for enhancing equity and outcomes

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According to a new American Heart Association Scientific Statement published today in Circulation, adult cardiovascular care focusing on the patient can enhance individual experiences and medical outcomes.

Patient-centred care revolves around recognizing the patient as an individual and respecting their beliefs, preferences, and values. It merges the healthcare professional’s expertise with the patient’s health priorities, empowering patients through informed decision-making by providing clear information and fostering an active partnership among the patient, their family, and the healthcare team. Michael J. Goldfarb, M.D., M.Sc., chair of the scientific statement writing committee and associate professor of cardiology at the Jewish General Hospital and McGill University in Montreal, Quebec, emphasized that patient-centred care involves informed choices rather than allowing patients unrestricted freedom in their healthcare decisions.

Dr Goldfarb also highlighted the necessity for healthcare professionals managing adults with heart disease to acquire guidance and practical tools for integrating a person-centred approach into regular clinical practice. The statement outlines several critical components of patient-centred care, including shared decision-making, medication management, and focusing on patient-oriented outcomes.

Shared decision-making is characterized by a collaborative relationship based on trust, mutual respect, and open communication between patients, families, and healthcare professionals. Health professionals must accommodate their patients’ health literacy levels and provide transparent, straightforward information about risks, current health conditions, and the potential outcomes of different screening and treatment options, encouraging patients to engage in discussions about their health.

Although the effectiveness of medications in preventing and treating heart disease is well-documented, adherence issues are significant, with many patients not consistently taking their medications as prescribed. This can be due to various factors, including the complexity of medication regimes and the cost of drugs. Engaging patients in discussions about their medication can help improve adherence, reduce costs, and minimize side effects, possibly through the use of combination pills or substituting expensive medications with cheaper but equally effective alternatives.

The statement further stresses the importance of incorporating the patient’s physical, emotional, and social well-being assessments into managing their heart disease. This holistic view allows healthcare professionals to understand better the patient’s condition and the effects of treatments, recognizing changes that might not be apparent through standard medical examinations alone.

Dr. Goldfarb also pointed out that care outcomes significant to health professionals and health systems might only sometimes align with what is important to patients. For instance, while the length of hospital stay is a standard metric for care quality, patients might prioritize their overall quality of life and functional ability post-treatment more highly.

The statement also addresses the need to overcome barriers to implementing patient-centred care, particularly for populations burdened disproportionately by cardiovascular disease. This includes deploying culturally and linguistically appropriate services and considering social determinants of health such as economic stability and access to quality healthcare. Special attention is given to different demographics, such as older adults, women, individuals with behavioural and mental health issues, adults with congenital heart disease, and those with physical disabilities, emphasizing tailored approaches that consider their unique health needs and circumstances.

Moreover, the statement acknowledges the obstacles to patient-centred care stemming from patient, clinician, and health system-related factors. These include patients’ distrust or limited access to healthcare, clinicians’ time constraints and documentation demands, and health systems that may need more resources for team-based care.

In conclusion, while there are challenges to genuinely patient-centred care, the statement underscores that it is achievable and already practised to some extent. As highlighted by Dr Goldfarb, the ongoing development and incorporation of patient-centred outcome measures are vital for optimizing care for patients, their families, and caregivers.

More information: Michael J. Goldfarb et al, Patient-Centered Adult Cardiovascular Care: A Scientific Statement From the American Heart Association, Circulation. DOI: 10.1161/CIR.0000000000001233

Journal information: Circulation Provided by American Heart Association

Can skin moisturisers aid in preventing eczema in infants?

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Atopic dermatitis (AD), alternatively known as atopic eczema, ranks as the most prevalent chronic, recurrent, inflammatory skin condition, impacting between 5% and 30% of children globally. An examination published in the Journal of the European Academy of Dermatology & Venereology, which reviewed relevant studies, concluded that early emollients, or moisturisers, represent a productive approach to preventing AD in high-risk infants.

This thorough examination delved into 11 randomised controlled trials involving a substantial number of infants. It found that three types of emollients—cream, emulsion (a mixture of two liquids that usually do not combine), and mixed types—were all effective in preventing AD. However, a closer look at the data suggests that the emollient emulsion might be the superior choice, instilling confidence in its effectiveness.

The systematic review and network meta-analysis authors noted, “The outcomes of this study indicate that the early application of skin emollients can successfully prevent the onset of AD in infants. Furthermore, among the three types of emollients available, the emollient emulsion is likely the best choice during infancy for more effectively preventing the development of AD.”

More information: Junqin Liang et al, Systematic review and network meta-analysis of different types of emollient for the prevention of atopic dermatitis in infants, Journal of the European Academy of Dermatology and Venereology. DOI: 10.1111/jdv.18688

Journal information: Journal of the European Academy of Dermatology and Venereology Provided by Wiley

Mental health inequalities increasing among transgender adults

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In the United States, transgender and gender non-conforming (TGNC) individuals form a historically marginalised group within society. They frequently encounter poorer outcomes in both physical and mental health realms when compared to their cisgender peers. Despite progress in enhancing both psychological and physical healthcare provisions for TGNC individuals over recent years, significant obstacles remain that impede access to essential services. These barriers include, but are not limited to, extended waiting periods, burdensome travel demands, and insufficient insurance coverage.

A recent study highlighted in the May 2024 edition of the American Journal of Public Health delves into shifts in self-reported mental health from 2014 to 2021 within a nationally representative sample of U.S. adults. Utilising data from the U.S. Behavioral Risk Factor Surveillance System Survey, researchers Donn Feir from the University of Victoria and Samuel Mann from the RAND Corporation observed that mental health distress has risen disproportionately among TGNC adults compared to cisgender individuals over this timeframe.

The frequency of self-reported “poor mental health days” per month is used as a critical gauge of mental health, and it aligns with other psychological and physical health markers. Although TGNC individuals recorded a higher number of poor mental health days in 2014, the disparity has notably widened over the subsequent seven years.

“In 2014, cisgender individuals reported an average of 3.68 poor mental health days, while transgender respondents reported an average of 5.42 poor mental health days. The size of this disparity, adjusted for differences in observable characteristics, expanded by 2.75 days throughout the sample period,” Mann clarified.

The researchers also revealed a disproportionate escalation in the frequency of mental health distress reported by TGNC individuals during the seven-year study span. “In 2014, 11.4% of cisgender adults reported frequent mental distress, in contrast to 18.9% of transgender adults. By 2021, these figures had risen to 14.6% of cisgender adults and 32.9% of transgender adults reporting frequent mental distress,” Feir noted.

The observed trend of rapidly increasing mental distress among TGNC adults suggests a potential exacerbation of socioeconomic and other disparities, as well as an augmentation in the barriers preventing access to necessary support services. This uptick in mental distress within the TGNC community might also be attributed to factors such as societal discrimination or restricted access to gender-affirming and mental health care resources.

The worrying increase in the frequency of self-reported mental distress among transgender individuals underscores an urgent need to re-evaluate nationwide initiatives that support TGNC individuals throughout the U.S. Allocating resources that improve access to gender-affirming and mental health services could play a vital role in reducing the mental health disparities existing between TGNC and cisgender individuals.

In conclusion, policy shifts that foster overall well-being and inclusivity for TGNC individuals could significantly enhance mental health outcomes for this underrepresented community in the long term. “Policies are needed to address the deteriorating mental health of transgender and gender-nonconforming people in the United States,” Mann emphasised.

More information: Donn Feir et al, Temporal Trends in Mental Health in the United States by Gender Identity, 2014–2021, American Journal of Public Health. DOI: 10.2105/AJPH.2024.307603

Journal information: American Journal of Public Health Provided by American Public Health Association

Biomarkers in the middle-aged brain can forecast cognitive health in later years

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Researchers have suggested that the brain in middle age could offer insights into one’s cognitive health in later life, according to a review published on March 19 in the journal Trends in Neurosciences. The study delves into both human and animal research to argue that the middle years—broadly defined as between 40 and 65 years of age—signify a pivotal stage in the brain’s ageing process. This stage is of utmost importance and deserves more attention in our research, highlighting the urgency and significance of the topic.

They highlight that middle age comes with certain risk factors that are both specific and modifiable, potentially influencing the risk of future dementia. This stage, they contend, deserves more attention than it has historically received. The rationale behind their argument is that most research traditionally zeroes in on the older population, so preventive or mitigating treatments might be less effective. However, by identifying risks of cognitive decline earlier, treatments could commence at a stage when they prove more beneficial, instilling a sense of hope and optimism in our research.

The authors note that the brain experiences considerable changes during middle age at the molecular, cellular, and structural levels, which have been associated with cognitive decline. This decline accelerates during these years. They point out that during middle age, the brain undergoes notable structural and functional changes that affect mental functioning. These variations could explain why cognitive ageing differs so widely among individuals.

Significant structural changes during middle age include alterations in the volume of various brain structures, a reduction in the size of the hippocampus (vital for memory and learning), and diminished connectivity among different brain regions. The researchers describe the fourth and fifth decades of life as crucial for reorganising brain networks, marked by peak efficiency and connectivity, followed by a swift deterioration.

Changes are not limited to the brain structure alone but include gene expression variations within the brain and other body parts. In particular, there’s an increase in the expression of genes related to the immune system and a decrease in those associated with synaptic function in the brain. The study also suggests systemic changes, evidenced by the secretion of proteins by various organs, could indicate brain health and function during middle age.

The potential role of exercise in promoting healthy cognitive ageing is mentioned, with the authors calling for further research to explore this avenue. Investigating how ageing and exercise influence molecular processes could uncover new therapeutic opportunities. The need for more research into the observed differences in brain ageing between sexes, particularly given the higher dementia rates among women, is also highlighted. Future studies should differentiate between processes contributing to declining brain health and those merely biomarkers of compensatory mechanisms.

In conclusion, the authors advocate for the application of recent advancements in ageing research to the middle-aged population. This approach could identify new biomarkers and interventions to address cognitive decline and significantly impact your work, helping to tackle the challenges posed by an ageing global population. This should make you feel more engaged and motivated in your research.

More information: Sebastian Dohm-Hansen et al, The ‘middle-aging’ brain, Trends in Neurosciences. DOI: 10.1016/j.tins.2024.02.001

Journal information: Trends in Neurosciences Provided by Cell Press

Grasping self-inflicted ageism

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“Older individuals often encounter ageism, which manifests as negative perceptions about their value, capabilities, or level of comprehension, alongside humour that targets their age,” Professor Henry explained.

He continued, “As individuals age, they increasingly depend on previous knowledge and environmental signals to shape their emotions, thoughts, and actions.

“In a society that undervalues ageing, these cognitive shifts can complicate the ability of the elderly to contest ageist prejudices they’ve internalized, often referred to as self-directed ageism.”

Self-directed ageism might manifest as doubts about one’s abilities, such as thinking, ‘I’m too old to learn this new technology’ or ‘I’m too old to form new friendships.’ It also appears as negative self-perceptions related to ageing, like believing, ‘I’m not as good at this as I once was.’

Furthermore, it may surface as worries about being judged based on age-related stereotypes, for instance, ‘If I forget this, they will assume it’s because I’m old.’

Professor Henry noted that when ageism becomes a personal belief, it is associated with reduced life expectancy, deteriorating physical and mental health, slower recovery from illness, and cognitive decline.

“It’s also detrimental when older adults let their adverse views on ageing impede their confidence to embrace new or challenging experiences and opportunities,” he added.

Interventions like fostering more positive interactions between younger and older people are essential to counteract these negative attitudes towards ageing.

“Our studies suggest that older adults would significantly benefit from a decrease in ageism cues within our broader social environment,” he stated.

“Reducing the number of ageist cues that capture the attention of older individuals could lower the chances of self-directed ageism occurring.”

More information: Julie D. Henry et al, The cognitive tenacity of self-directed ageism, Trends in Cognitive Sciences. DOI: 10.1016/j.tics.2023.03.010

Journal information: Trends in Cognitive Sciences Provided by The University of Queensland