Monthly Archives: November 2024

Medication and Cognitive Behavioural Therapy Can Alleviate Fatigue in Multiple Sclerosis Patients

A University of Michigan-led study has delved into the efficacy of standard treatments for individuals with multiple sclerosis, mainly focusing on the impact of medical and behavioural interventions on fatigue. This pervasive symptom significantly disrupts daily life. The study employed a randomised clinical trial framework to evaluate the effectiveness of modafinil — a medication that promotes wakefulness and is typically prescribed for sleep disorders — and cognitive behavioural therapy (CBT) in reducing fatigue among over 300 adults with multiple sclerosis whose daily activities were hampered by this condition.

The research revealed that modafinil and CBT, administered individually over the phone, significantly reduced fatigue over 12 weeks. Interestingly, while combining these treatments did not enhance the fatigue scores beyond the results of the singular interventions, it affirmed the effectiveness of each approach. These findings have been published in The Lancet Neurology, contributing valuable insights into the comparative benefits of medication and behavioural therapy in managing multiple sclerosis symptoms.

Tiffany J. Braley, M.D., M.S., the study’s first author and a prominent figure at the University of Michigan Health, highlighted the prevalent challenge of fatigue in multiple sclerosis management, noting the uncertainty surrounding the optimal use of available treatments. She pointed out that the study provides compelling evidence that both CBT and modafinil are comparably effective in addressing MS-related fatigue, potentially influencing future treatment protocols for one of the disease’s most debilitating symptoms.

The significance of fatigue in the lives of those with multiple sclerosis cannot be overstated, with up to 90% of the nearly 3 million people affected worldwide experiencing fatigue, and almost half of them citing it as their most disabling symptom. The research adopted a real-world approach that mirrors actual clinical practices more closely than traditional clinical trials, incorporating inputs from stakeholders with MS who participated in designing the study.

The effectiveness of the treatments was notable, with more than 60% of participants in each treatment group reporting a clinically meaningful improvement in fatigue, assessed using the Modified Fatigue Impact Scale. According to Anna L. Kratz, Ph. D., senior author and professor at the U-M Medical School, both standalone and combined treatments were recommended as viable options for managing chronic fatigue in multiple sclerosis patients.

The study also highlighted the role of patient-centric outcomes and the importance of shared decision-making in treatment selection, considering patient characteristics and broader treatment goals. Interestingly, trial participants who only received CBT reported lower fatigue scores even 12 weeks post-treatment, underscoring CBT’s long-term efficacy in fatigue management previously evidenced in other studies.

Kratz emphasised the potential of telehealth in extending the reach of behavioural health care like CBT to more patients, especially those with limited access to such services. The study confirmed that CBT is not only a feasible option but also imparts fatigue management skills that patients can continue to use indefinitely, offering lasting benefits beyond the treatment period.

However, the study also found that the participants’ sleep habits could influence the efficacy of the treatments. For instance, those with poor sleep hygiene experienced better outcomes with CBT, while those with good sleep hygiene benefitted more from modafinil. This suggests that while modafinil could worsen sleep quality in patients with behaviourally induced sleep issues, behavioural treatments incorporating sleep education are more suitable for individuals with poor sleep habits.

In sum, this comprehensive study not only reaffirms the efficacy of modafinil and CBT in treating fatigue in multiple sclerosis but also underscores the nuanced approach needed in selecting and applying these treatments, considering the individual’s specific circumstances and broader health objectives.

More information: Tiffany J Braley et al, Comparative effectiveness of cognitive behavioural therapy, modafinil, and their combination for treating fatigue in multiple sclerosis (COMBO-MS): a randomised, statistician-blinded, parallel-arm trial, The Lancet Neurology. DOI: 10.1016/S1474-4422(24)00354-5

Journal information: The Lancet Neurology Provided by Michigan Medicine – University of Michigan

Ozempic, a Diabetes Medication, Also Benefits Chronic Kidney Disease and Obesity

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This groundbreaking study, led by clinical pharmacologist Hiddo L. Heerspink from the University Medical Center Groningen in the Netherlands, revealed significant findings about the diabetes medication Ozempic, now recognized not only for its weight loss capabilities but also for its efficacy in treating chronic kidney disease. The results, published in Nature Medicine and presented at the American Society of Nephrology’s annual congress, mark a pioneering moment in the medical field. The idea for this study came to Heerspink during the early days of the coronavirus pandemic, inspired by previous discoveries that another class of Type 2 diabetes drugs, SGLT2 inhibitors, were beneficial for chronic kidney disease patients without diabetes. Motivated by this, Heerspink was eager to investigate whether semaglutide could similarly benefit those suffering from chronic kidney disease and obesity.

As semaglutide gained recognition for its weight loss effects, patient interest in participating in the study surged. The research began in the second half of 2022, when demand for semaglutide exceeded supply, making participation in the study highly attractive. Offering a 50% chance of receiving the drug, the study drew many eager participants, highlighting the widespread desire for new therapeutic options.

The study was conducted across four countries: Canada, Germany, Spain, and the Netherlands, involving 101 participants. Half received 24-week injections of semaglutide, while the others were given a placebo. The results were compelling: there was a 52% reduction in protein in the urine—a key indicator of kidney damage. Additionally, the study recorded a 30% reduction in kidney inflammation and blood pressure reductions comparable to those achieved with standard antihypertensive drugs. A 33% improvement was also observed in a critical metric of heart failure, and participants recorded about a 10% loss in body weight.

Heerspink expressed great enthusiasm about these outcomes, noting the drug’s comprehensive effects on kidney health. Semaglutide directly reduces inflammation and fatty tissue around the kidneys, lowering protein levels in the urine. Indirectly, it helps by reducing body weight and blood pressure, enhancing overall kidney function. Despite the short duration of the study, which limited assessments of quality of life or medium-term effects, dietary questionnaires showed participants felt less hungry, leading to less food intake, which indirectly supports the drug’s weight management claims.

The study’s success has paved the way for further research, with Heerspink keen to explore semaglutide’s potential in reducing the need for dialysis or kidney transplants. He is particularly interested in assessing the drug’s benefits for kidney disease patients without obesity. However, the overwhelming demand for semaglutide presents a challenge, making it difficult to procure enough of the drug for expansive studies.

These findings open new avenues for treating chronic kidney disease and highlight the multifaceted benefits of diabetes medications beyond their primary purpose. As research continues, the medical community remains optimistic about the potential of semaglutide and similar drugs to offer comprehensive benefits for complex health issues, underscoring the importance of innovative pharmaceutical research in chronic disease management.

More information: Ellen M. Apperloo et al, Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial, Nature Medicine. DOI: 10.1038/s41591-024-03327-6

Journal information: Nature Medicine Provided by Universitair Medisch Centrum Groningen

Exploring the Connection Between Food Waste, Climate Change, and an Ageing Population

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Food production is a cornerstone of human civilisation, fundamentally influencing the alterations humans have wrought upon the Earth’s landscapes. Cultivating food and delivering it to people’s dining tables involves energy and resource consumption. Regrettably, around one-third of all food produced worldwide goes uneaten and is discarded. Therefore, minimising food waste is crucial for cultivating sustainable societies.

According to government reports, in 2021, an alarming 2.47 megatons of food waste was generated in Japanese households, with a significant portion potentially still fit for consumption. This indicates considerable potential for Japan to reduce household food waste. However, a detailed understanding of which food types are most frequently wasted, their associated greenhouse gas emissions, and the demographics most inclined to waste food still needs to be improved.

To address this knowledge gap, a team led by Associate Professor Yosuke Shigetomi from the College of Science and Engineering at Ritsumeikan University, along with Ms. Asuka Ishigami from Nagasaki University, Associate Professor Andrew Chapman from Kyushu University, and Associate Professor Yin Long from The University of Tokyo, undertook an extensive study. Their research, published in Nature Communications on 21 October 2024, analysed food waste in Japanese households by incorporating demographic and dietary data, revealing significant correlations between food waste volumes, types, associated emissions, and the age of the individuals involved.

The team utilised data from existing surveys to calculate the ratio of the edible-to-inedible portion for over 2,000 food items. It measured the actual volume of food waste for different food categories. They integrated these findings with socio-economic data related to food, exploring the impact of age and other factors on the types and quantities of approximately 200 foods wasted.

Dr. Shigetomi particularly acknowledged Ms. Asuka Ishigami’s contribution to the research. “Ms. Asuka Ishigami, who I supervised at my previous institution, Nagasaki University, played a crucial role in gathering the foundational data and performing the initial analyses for this study during her undergraduate thesis project,” he stated.

A striking discovery from the study was that the quantity of food waste per capita in households tended to increase with the age of the household head. Elderly households, for instance, were found to produce nearly double the food waste of households led by individuals in their 30s. Vegetables emerged as the most frequently wasted food category, and the age of the household head also appeared to influence the greenhouse gas emissions linked to food waste, with vegetables, ready meals, and fish and seafood being significant contributors.

These findings underscore the direct relationship between an ageing population, food waste, and its associated emissions. Dr. Shigetomi emphasised the need to consider demographic factors when devising strategies to curb household-generated food waste. He also highlighted the necessity of focusing on dietary preferences and lifestyles across different generations, especially given the trend towards vegetarianism as a strategy to combat climate change.

Ultimately, the insights from this study are vital for formulating effective strategies to reduce food waste and enhance public awareness of its environmental risks. Educational initiatives could significantly aid in encouraging more mindful food consumption, cooking, storage practices, and waste reduction, thereby mitigating the environmental impact of discarded food.

More information: Yosuke Shigetomi et al, Curbing household food waste and associated climate change impacts in an ageing society, Nature Communications. DOI: 10.1038/s41467-024-51553-w

Journal information: Nature Communications Provided by Ritsumeikan University

Broader Access to Weight-Loss Medications May Save Thousands of Lives Annually

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The new study, led by researchers from Yale School of Public Health and the University of Florida, presents compelling evidence that increasing access to innovative and highly effective weight-loss medications could potentially prevent over 40,000 deaths annually in the United States. This research underscores the urgent need to dismantle the current barriers that restrict people’s access to these crucial treatments, thereby hampering public health initiatives aimed at tackling the obesity epidemic in the nation. According to statistics from the U.S. Centers for Disease Control and Prevention, approximately 74% of the American population is overweight, with about 43% falling into the obese category.

Obesity is well-known for its detrimental effects on health, significantly worsening conditions such as type 2 diabetes, cardiovascular disease, and certain forms of cancer. Despite the grave consequences associated with obesity, the development and implementation of effective obesity treatments have not kept pace with the scale of the problem. However, recent breakthroughs in pharmaceuticals, particularly with the advent of drugs like glucagon-like peptide-1 (GLP-1) receptor agonists such as Ozempic and Wegovy, as well as the dual gastric inhibitory polypeptide and GLP-1 receptor agonists like tirzepatide, have proven highly effective in facilitating weight loss. These medications have performed well in clinical trials and are increasingly being prescribed for weight management.

This research aimed to estimate the mortality reduction that could be achieved by making these weight-loss drugs more accessible. The researchers combined data concerning mortality risks associated with different body mass index (BMI) levels, the prevalence of obesity, and the existing limitations on accessing these drugs, which include high costs and insurance coverage restrictions. The study revealed that if these new medications were made available to all qualifying individuals, it could result in up to 42,027 fewer deaths each year in the U.S. This figure includes around 11,769 deaths among individuals with type 2 diabetes. This group is particularly susceptible to the harmful effects of obesity. Even with the current restricted access, the study estimates that approximately 8,592 lives are saved annually, primarily among those with private health insurance.

The researchers pointed out a significant disparity in access to these drugs, primarily due to their high cost, which can exceed $1,000 per month for those without insurance. Notably, Medicare, a primary insurance provider for older adults, does not cover these medications for weight loss, significantly impacting those who stand to benefit. Medicaid coverage varies considerably across states, and private insurers often require high deductibles and co-pays, further limiting access.

Alison P. Galvani, the study’s corresponding author and the Burnett and Stender Families Professor of Epidemiology (Microbial Diseases) at Yale, emphasized that enhancing access to these medications is not merely about improving treatment options; it is a critical public health measure. The findings strongly suggest that substantial reductions in mortality could be achieved by overcoming financial and coverage obstacles.

The research also examined how broadening access to these drugs could differentially impact various regions and socioeconomic groups within the U.S. States with higher rates of obesity and diabetes, such as West Virginia, Mississippi, and Oklahoma, would likely see the most significant reductions in mortality per capita. However, the authors caution that despite the potential benefits, several significant challenges remain. The high cost of these medications poses a significant barrier, and there are concerns about pharmaceutical companies’ profit margins. Additionally, supply constraints and limitations in production capacity continue to restrict widespread availability.

Dr. Burton H. Singer, another corresponding author of the study and adjunct professor of mathematics at the Emerging Pathogens Institute at the University of Florida, highlighted that addressing these challenges necessitates a comprehensive strategy. This would involve ensuring that drug prices reflect the actual costs of manufacturing and expanding production capacity to meet demand. Concurrently, issues related to insurance coverage and accessibility must be addressed to enable more individuals to access the treatment they require.

The researchers also considered the influence of socioeconomic factors on the effectiveness of expanded access to these medications. After adjusting their estimates for income disparities, they found that the potential for saving lives remains significant. The results indicate that improving access to these drugs could reduce healthcare costs associated with obesity-related conditions and enhance many Americans’ overall quality of life.

More information: Abhishek Pandey et al, Estimating the lives that could be saved by expanded access to weight-loss drugs, Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.2412872121

Journal information: Proceedings of the National Academy of Sciences Provided by Yale University

Can Occupational Stress Affect Cardiovascular Health?

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In an expansive and meticulous study involving a large, multi-ethnic cohort of adults in the United States who were initially free from cardiovascular disease, it was found that individuals experiencing work-related stress were significantly more likely to exhibit poorer measures of cardiovascular health. These enlightening findings have been thoroughly documented and recently published in the Journal of the American Heart Association, highlighting a crucial public health issue linked to the workplace.

The research analysed data meticulously collected between 2000 and 2002 from 3,579 community-dwelling adults aged between 45 and 84 years. These participants were all part of the Multi-Ethnic Study of Atherosclerosis, a detailed project designed to investigate the factors affecting cardiovascular health across different ethnic groups. To assess the state of each participant’s cardiovascular health, researchers used a composite score derived from seven critical health metrics: smoking status, level of physical activity, body mass index (BMI), dietary quality, total cholesterol levels, blood pressure, and blood glucose levels. Each metric contributed to a cumulative score ranging from 0 to 14 points, with zero points indicating poor health, one point for intermediate health, and two points for ideal health across each metric.

The findings revealed that 20% of the study participants reported experiencing work-related stress, as determined by their responses to a detailed questionnaire. When the data was adjusted for various confounding factors such as age, gender, ethnicity, and socio-economic status, it became evident that individuals with work-related stress had 25% and 27% lower odds of achieving average (9–10 points) and optimal (11–14 points) cardiovascular health scores, respectively. This was in stark contrast to their peers who did not report such stress, pointing to a significant association between occupational stress and diminished cardiovascular wellness.

The implications of these findings are substantial, prompting calls from the study’s authors for a deeper investigation into this phenomenon. First author Dr Oluseye Ogunmoroti, MD, MPH, from Emory University, alongside senior author Dr Erin Michos, MD, MHS, from Johns Hopkins University, emphasised the urgency of addressing work-related stress as a significant factor in public health strategies. They suggested that future research should focus on longitudinal studies to trace the mechanisms that underlie the relationship between work-related stress and cardiovascular health over time. Understanding these pathways is critical to developing targeted interventions.

Moreover, the authors advocated for implementing thorough intervention studies within workplace environments. These studies are crucial to developing, testing, and refining effective stress management strategies. By improving these strategies, it is possible to enhance employees’ well-being and significantly uplift their cardiovascular health profiles. The potential benefits of such initiatives extend beyond individual health improvements, proposing a model for healthier working environments that could inspire similar efforts globally. This research underscores the need for a holistic approach to employee health, where mental and physical health are equally prioritised to foster a healthier society.

More information: Oluseye Ogunmoroti et al, Work‐Related Stress Is Associated With Unfavorable Cardiovascular Health: The Multi‐Ethnic Study of Atherosclerosis, Journal of the American Heart Association. DOI: 10.1161/JAHA.124.035824

Journal information: Journal of the American Heart Association Provided by Wiley

People with Schizophrenia Face Over Four Times Higher Risk of Sudden Cardiac Death

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The lifetime risk of experiencing a sudden and unexpected death from a cardiovascular cause, known as sudden cardiac death, is more than four times greater in individuals with schizophrenia compared to the general population, as highlighted by recent Danish research published in the journal Heart.

This elevated risk persists, albeit at a reduced ratio of approximately two times higher, for those suffering from other forms of mental ill health, such as depression, regardless of age. The study findings reveal a concerning expectation that 18-year-olds with mental health issues may live around 10 years less than their peers without such conditions.

The focus of the research was to evaluate whether the heightened risk of sudden cardiac death among young individuals with psychiatric illnesses extends across their entire lifespan and if certain mental health disorders pose a greater risk than others. To this end, researchers conducted a systematic review of all deaths from sudden cardiac causes among Danish residents aged 18 to 90 in 2010, using data extracted from death certificates and autopsy reports.

Mental health conditions within the decade leading up to the study were identified either through the International Classification of Diseases criteria or via prescriptions for psychotropic drugs issued within the year prior.

In 2010 alone, out of 45,703 deaths among individuals aged between 18 and 90, 6002 were determined to be sudden cardiac deaths. Of these, 2319 occurred in individuals with a diagnosed mental illness, compared to 3683 in the general population. Those with mental health disorders often presented multiple risk factors, such as older age, female gender, and co-existing medical conditions like cardiovascular disease, heart failure, arrhythmias, and diabetes.

The incidence of sudden cardiac death was notably higher—up to 6.5 times—in those with mental health disorders across all age groups, although the disparity lessened in older demographics. Even after adjusting for factors like age, sex, and pre-existing health conditions, mental ill health remained independently linked to a doubled risk of sudden cardiac death. Specifically, the risk was doubled for those with depression, tripled for people living with bipolar disorder, and increased 4.5 times for those with schizophrenia.

Furthermore, mental health disorders are significantly correlated with deaths from other causes, nearly tripling the risk and contributing to a shortened overall lifespan. Based on their findings, the researchers estimated that an 18-year-old with a psychiatric disorder might expect a life expectancy reduced by about ten years — 68 years compared to 78 for someone without such conditions. Similarly, a 70-year-old might anticipate living another 10 years versus 14 more years for someone in the general population.

Interestingly, sudden cardiac death accounted for approximately 13% of the disparity in reduced lifespan up to the age of about 40. While the observational nature of this study prevents definitive conclusions about causality, the researchers suggest that factors such as an unhealthy lifestyle and side effects from psychiatric medications, like weight gain, may predispose individuals to conditions like high blood pressure and heart disease.

Despite adjustments for these risk factors, the persistent association between mental health disorders and sudden cardiac death indicates that comorbidities such as cardiovascular disease are not the sole contributors to this increased risk, as stated in the research.

In an associated editorial, Drs. Aapo Aro and Jarkko Karvonen of Helsinki University Hospital commend the study for significantly enhancing our understanding of the risk of sudden cardiac death within this vulnerable population. However, they note that the study’s design means the underlying mechanisms behind sudden cardiac death remain primarily speculative.

The editorial also highlights that sudden cardiac death is often preceded by symptoms in about half of the affected individuals. Prompt recognition and action upon these symptoms can lead to a fivefold increase in survival rates following a cardiac arrest. This recognition and response might be even more challenging among the mentally ill. Still, future advancements in technology, such as AI and wearable electronic devices, may soon offer new ways to identify those at the highest risk and potentially save lives.

More information: Jasmin Mujkanovic et al, Nationwide burden of sudden cardiac death among patients with a psychiatric disorder, Heart. DOI: 10.1136/heartjnl-2024-324092

Journal information: Heart Provided by BMJ Group

Prompts Help Combat Age-Related Memory Deterioration

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A recent study from the University of Texas at Arlington reveals the significant role reminders play in mitigating age-related memory decline. This breakthrough is pivotal in tackling the cognitive hurdles the elderly face, focusing on prospective memory, which is crucial for remembering to take medications or attend meetings.

Prospective memory is fundamental to daily life and sustaining autonomy, mainly as individuals grow older, according to Hunter Ball, an associate professor of psychology at UTA and the study’s principal investigator. He notes that forgetting to perform future-oriented tasks can have severe repercussions, with earlier studies showing a tendency for this memory to deteriorate with age.

The research, conducted in collaboration with psychologists from UTA and Arizona State University, comprised two experiments that evaluated prospective memory in younger and older adults under various conditions, both with and without reminders. Participants were tasked with remembering specific actions while engaged in other activities, with their performance measured under both high-load (more items to remember) and low-load (fewer items to remember) scenarios.

In the first experiment, participants had to recall specific tasks like reacting to particular words, with some receiving on-screen reminders. The findings indicated no notable age-related decline in prospective memory without reminders in low-load situations; however, in high-load scenarios, reminders proved beneficial for both age groups, suggesting that they help lessen cognitive burden by reducing reliance on internal memory processes.

The second experiment introduced more complex, general tasks requiring participants to identify categories like animals or fruits rather than specific words. Here, older adults found it more challenging to recall these broader tasks under a high memory load without reminders. However, when reminders were available, these age-related performance disparities were eradicated, underscoring the potential of reminders to counteract the deficits linked with more cognitively demanding tasks that typically challenge older adults’ memory.

Ball and his team suggest that the effectiveness of reminders for older individuals could be attributed to their propensity to check these cues more frequently under high cognitive demands. This compensatory behaviour likely aids them in managing tasks that would be too taxing on their internal memory resources.

The implications of this study go beyond the confines of the laboratory, as prospective memory plays a vital role in real-life settings. With the ageing population, finding practical solutions to memory issues is increasingly crucial. The researchers emphasise that digital tools such as smartphone apps, personal assistants like Amazon Alexa, or even straightforward reminder notes can be invaluable in helping older adults manage their daily routines effectively and maintain their independence.

Ball highlights that cognitive offloading, mainly through tools like cell phone calendars, can significantly alleviate declines in prospective memory. While the study was performed in a controlled environment, these findings are readily applicable in everyday contexts, offering a simple and effective method to ease the challenges of prospective memory in older adults.

More information: Hunter Ball et al, Reminders eliminate age-related declines in prospective memory, Psychology and Aging. DOI: 10.1037/pag0000844

Journal information: Psychology and Aging Provided by University of Texas at Arlington

Thrive and Reflect: Studies Link Healthy Practices to Enhanced Cognitive Well-being

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A study published on October 23, 2024, in the online edition of Neurology®, a journal of the American Academy of Neurology, suggests that middle-aged individuals with poorly controlled risk factors such as blood pressure, blood sugar, and cholesterol, combined with a lack of adherence to healthy practices including exercise, diet, and adequate sleep, may face an increased risk of stroke, dementia, or depression later in life. However, it is crucial to note that the study does not establish a causal relationship but merely indicates an association between these factors.

The research highlights the American Heart Association’s Life’s Essential 8, which comprises critical cardiovascular and brain health factors: physical activity, healthy eating, maintaining an average weight, abstaining from smoking, keeping blood pressure at healthy levels, ensuring adequate sleep, and managing cholesterol and blood sugar. Dr. Santiago Clocchiatti-Tuozzo, MD, MHS, from Yale University and a member of the American Academy of Neurology, emphasised the importance of brain health for overall well-being and optimal functioning. He noted that adopting these healthy lifestyle choices in middle age could significantly benefit brain health in later years.

The study involved analysing data from 316,127 individuals with an average age of 56 who were monitored over five years. The participants’ adherence to Life’s Essential 8 was assessed, and they were categorised into three groups based on their scores: optimal, intermediate, and poor. Out of the total participants, 64,474 had optimal scores, 190,919 had intermediate scores, and 60,734 were categorised as having poor scores.

The follow-up involved reviewing health records to identify the onset of neurological conditions such as stroke, dementia, or late-life depression. The definition of poor brain health was the development of any of these conditions during the study period. Results showed that 1.2% of the participants were categorised as having poor brain health, with 3,753 individuals diagnosed with one of the conditions. The incidence of poor brain health was significantly lower among those with optimal scores at 0.7%, compared to 1.2% for those with intermediate scores and 1.8% for those with poor scores.

Further analysis, adjusted for variables such as age, sex, race, and ethnicity, indicated that individuals with poor scores on the lifestyle factors were more than twice as likely to develop one of the neurological conditions compared to those with optimal scores. Those with intermediate scores had a 37% higher risk than those with optimal scores.

Dr Clocchiatti-Tuozzo pointed out that the elastic nature of the risk factors underscores the potential brain health benefits of adopting Life’s Essential 8 as a guide for healthy lifestyle choices. He also stressed the need for further research to explore the link between lifestyle habits and brain health and to understand how social factors like race and ethnicity might influence this relationship.

To validate their findings, the researchers conducted a repeat study with 68,407 participants over five years, which confirmed the initial results. One limitation noted was that the participants’ scores were measured only once at the beginning of the study, not accounting for any lifestyle changes that might have occurred during the five years. This highlights the importance of continuous monitoring and intervention to maximise the potential health benefits.

More information: Santiago Clocchiatti-Tuozzo et al, Life’s Essential 8 and Poor Brain Health Outcomes in Middle-Aged Adults, Neurology. DOI: 10.1212/WNL.0000000000209990

Journal information: Neurology Provided by American Academy of Neurology

The Link Between Vitamin D Deficiency and the Development of Autoimmune Disorders

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As Canadians prepare for the “vitamin D winter” — when the sun is too low on the horizon to stimulate vitamin D synthesis in the skin — a study from McGill University elucidates the correlation between early-life vitamin D deficiency and an increased risk of autoimmune diseases.

In our developmental years, the thymus plays a crucial role in training immune cells to differentiate between the body’s cells and foreign invaders. The study found that a lack of vitamin D during this critical phase accelerates the ageing process of the thymus. According to John White, Professor and Chair of the Department of Physiology at McGill and the study’s lead author, this accelerated ageing of the thymus can compromise its ability to effectively filter out immune cells that might erroneously target the body’s tissues, thus heightening the risk of autoimmune diseases such as Type 1 diabetes.

Professor White also pointed out that while it has long been understood that vitamin D is essential for calcium absorption and the maintenance of strong bones, recent research has shed light on its pivotal role in immune regulation. “Our research offers a clearer understanding of this link and may pave the way for new preventative strategies against autoimmune diseases,” he remarked.

Although the research primarily involved mice, the findings are deemed applicable to humans due to both species’ similar functionality of the thymus. Published in the journal Science Advances, the study underscores the significance of ensuring sufficient vitamin D intake, particularly for children. Professor White emphasised the necessity of vitamin D supplementation in regions like Montreal, where natural vitamin D production is halted from late fall to early spring. He advised that parents consult healthcare providers to ensure their children receive adequate vitamin D.

This new study builds on earlier research, notably a 2001 Finnish study that tracked over 10,000 children. It revealed that those who received vitamin D supplements early in life were up to five times less likely to develop Type 1 diabetes in later years. Finland’s extended periods of low sunlight exposure make it an exemplary model for studying the broader impacts of vitamin D.

In their methods, the McGill researchers utilised mice genetically modified to be unable to produce vitamin D. They conducted cellular analyses and gene sequencing to investigate the effects of vitamin D deficiency on the thymus, which may have broader implications for the immune system.

Looking ahead, Professor White is keen to explore further the effects of vitamin D on the human thymus, an area yet to be thoroughly examined in scientific research. This ongoing investigation into vitamin D’s roles and mechanisms offers promising insights into its critical functions in human health.

More information: Patricio Artusa et al, Skewed epithelial cell differentiation and premature ageing of the thymus in the absence of vitamin D signaling, Science Advances. DOI: 10.1126/sciadv.adm9582

Journal information: Science Advances Provided by McGill University

Recent research reveals a connection between a partner’s joy and reduced stress hormone levels in ageing couples

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According to recent findings from the University of California, Davis, having a happy, intimate partner may elevate our spirits and aid in managing stress, particularly in our later years.

The study delved into the relationship between individuals’ self-reported emotional states and satisfaction within relationships and how these correlate with their cortisol levels — a hormone closely linked with stress. Researchers found that older couples exhibited lower cortisol levels when their partners experienced positive emotions. This effect was notably pronounced among those who expressed greater satisfaction in their relationships. The findings were detailed in the journal Psychoneuroendocrinology in September.

Tomiko Yoneda, an assistant professor of psychology at the College of Letters and Science and the study’s lead author, described the experience of sharing positive emotions with a partner as akin to having a social resource. She explained that these emotions could serve as a buffer against the production of cortisol, thereby playing a crucial role in managing stress responses, especially pertinent as one age.

Cortisol is integral to our body’s stress response and overall functioning. Typically, it surges upon waking and decreases throughout the day. However, during acute stress, there is a significant spike in cortisol, which prepares the body for immediate action by increasing glucose production and metabolism. The study suggests that our emotional state throughout the day significantly influences cortisol production. Negative emotions are associated with higher cortisol levels, which, if consistently elevated, can detrimentally affect overall health.

The relationship between emotions and cortisol production is robust for older individuals. Older adults often exhibit more pronounced physiological responses to stress, yet their bodies struggle to modulate cortisol production effectively. Thus, as noted by the researchers, the quality of intimate relationships may play a pivotal role in cortisol management for older couples.

Yoneda and her team conducted a comprehensive analysis of data from 321 adults aged between 56 and 87, collected through three intensive studies carried out in Canada and Germany from 2012 to 2018. The studies involved multiple daily measurements of emotional states and cortisol levels collected via saliva samples over a week. The findings revealed that individuals’ cortisol levels were lower when their partners reported higher-than-usual positive emotions. This impact was even more substantial than the effects of the individuals’ positive emotions. It was most pronounced among older participants and those with higher relationship satisfaction.

Interestingly, the study did not find a correlation between individuals’ cortisol levels and their partners’ negative emotions. Yoneda remarked that this lack of physiological response to a partner’s negative emotions aligns with previous research, which suggests that older adults might protect their partners from experiencing physiological responses to negative emotions.

Yoneda also highlighted that these results support the psychological theory that positive emotions enhance our capacity to act fluidly in the moment, creating a positive feedback loop that strengthens this capacity over time. She emphasized that relationships, particularly high-quality ones, offer crucial support, a factor that gains even more importance as people age.

In conclusion, the study underscores the significant role that positive emotional exchanges within relationships play in health and well-being, particularly among older adults. This interplay between emotions and physiological responses highlights the importance of nurturing positive relationships and points to the potential health benefits they can bring, enhancing happiness and health throughout life.

More information: Tomiko Yoneda et al, “What’s yours is mine”: Partners’ everyday emotional experiences and cortisol in older adult couples, Psychoneuroendocrinology. DOI: 10.1016/j.psyneuen.2024.107118

Journal information: Psychoneuroendocrinology Provided by University of California – Davis

Signs of Vaping’s Detrimental Impact on Blood Vessels and the Heart’s Left Ventricle

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A recent investigation conducted by academics from the USC Viterbi School of Engineering, in partnership with the Keck School of Medicine of USC, the Huntington Medical Research Institutes (HMRI), and UC Irvine, sheds light on the detrimental effects of both electronic and traditional cigarettes on cardiovascular health. The study found that electronic cigarettes compromise the health of blood vessels, whereas traditional cigarettes detrimentally affect the heart.

The research, published in the Journal of the American Heart Association (JAHA), was spearheaded by Rashid Alavi while he was a mechanical engineering PhD student. Alavi worked in Niema Pahlevan’s laboratory, holds the Gordon S. Marshall Early Career Chair in Engineering at USC and is a Fellow of the American Heart Association (FAHA). Pahlevan is a renowned expert in flow physics, particularly in its application to medical diagnostics and treatments, and has pioneered non-invasive methods to monitor heart health.

The study, entitled “Adverse Cardiovascular Effects of Nicotine Delivered by Chronic Electronic Cigarettes or Standard Cigarettes Captured by Cardiovascular Intrinsic Frequencies,” employs a novel analysis technique based on fluid dynamics to evaluate the impact of nicotine delivered through both e-cigarette vapour and smoke from traditional cigarettes. Although initially conducted on animal models, the methodology applies to human subjects, as demonstrated in other medical scenarios such as heart failure. In human applications, a simple smartphone camera can detect anomalies in cardiovascular functioning.

Pahlevan elucidates the technique, stating that a smartphone camera captures images of the neck skin. The images are then analysed by an algorithm that extracts vessel wall dilation from the recorded skin vibrations. This dilation waveform reflects the pressure waveform in major arteries, such as the carotid artery, which exhibits minimal viscoelasticity of the wall.

The results of the study indicate that electronic cigarettes containing nicotine adversely affect vascular function and the coupling between the left ventricle and arteries. Similarly, traditional cigarettes have been shown to impair the contractile function of the left ventricle significantly. These outcomes highlight the potential long-term risks associated with nicotine consumption and its implications for cardiovascular health.

Pahlevan points out the accelerated ageing of the vascular system induced by vaping with nicotine, emphasising the severity of its effects. Despite the growing popularity of electronic cigarettes as a potential cessation aid for smokers, their impact on cardiovascular health has been largely underexplored until this study.

Pahlevan stresses the need for careful consideration when opting for electronic cigarettes, as their adverse effects are significant. The objective of the study, according to Alavi, is to increase awareness regarding the long-term effects of vaping on the cardiovascular system. He remarks on the eventual detrimental impact on the heart when blood vessels are compromised, underscoring the importance of making informed decisions about substance use. Alavi’s doctoral thesis on this subject was recognised among the top four in the USC Viterbi Best PhD Dissertation Award, and he is currently the James Boswell Postdoctoral Fellow at Caltech and HMRI.

Alavi also notes that the intrinsic frequency method, a cutting-edge fluid dynamics-based analysis technique, is susceptible to detecting abnormalities in the cardiovascular system, surpassing some traditional hemodynamic measures. This technique holds promise for cellphone applications aimed at assessing heart function, adding a layer of accessibility and cost-effectiveness to cardiovascular monitoring.

The study lays the groundwork for further human clinical trials by developing an innovative, cost-effective method to detect cardiovascular damage using simple measurements of carotid pressure waveforms. This approach could lead to quicker, easier, and more widespread cardiovascular health assessments, making significant strides in medical diagnostics and public health awareness.

More information: Rashid Alavi et al, Adverse Cardiovascular Effects of Nicotine Delivered by Chronic Electronic Cigarettes or Standard Cigarettes Captured by Cardiovascular Intrinsic Frequencies, Journal of the American Heart Association. DOI: 10.1161/JAHA.124.035462

Journal information: Journal of the American Heart Association Provided by University of Southern California

Dementia Diagnostic Indicators Vary According to Time of Day

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New research led by the University of Surrey has revealed that the timing of blood sample collection can significantly influence the outcomes of diagnostic tests for dementia. This study underscores the critical impact of the time of day on the accuracy of dementia diagnostics, particularly in identifying biomarkers linked to Alzheimer’s disease, including a marker promising for early detection.

The research team observed that levels of these biomarkers shift throughout the day, with the lowest levels recorded in the morning upon waking and the highest in the evening. The study specifically highlighted the p-tau217 biomarker, known for its potential in the early diagnosis of dementia, which exhibited substantial variations between morning and evening. These fluctuations were comparable to the progression of mild memory issues worsening over a year.

Dr Ciro della Monica, a research fellow at the Surrey Sleep Research Centre, part of the University of Surrey, and lead author of the study, stressed the importance of time-of-day consideration in clinical diagnostics. He advocated for standardising sample collection times to enhance the precision of dementia diagnoses and the monitoring of disease progression.

The investigation involved 38 participants, including individuals with mild Alzheimer’s, their caregivers, and healthy controls, all residing at the Surrey Sleep Research Centre, which forms part of the UK Dementia Research Institute’s (UK DRI) Care Research & Technology Centre. In a departure from typical clinical practice, where only a single blood sample is usually taken, this study required participants to provide blood samples every three hours over 24 hours.

The findings showed that four of the five biomarkers tested—p-tau217, Aβ40, Aβ42, and NfL—demonstrated significant daily fluctuations. Only one biomarker, GFAP, did not exhibit noticeable variations. The exact causes of these time-of-day differences remain unclear. Still, they may be associated with sleep patterns, meal times, physical posture, activity levels, or other circadian rhythms.

Despite the uncertainty about the underlying mechanisms, the research clearly indicates that the timing of sample collection is a crucial factor in implementing and interpreting plasma biomarkers for dementia. The results advocate for standardising or at least consistent recording of the sampling time to ensure reliability in dementia research and patient care.

Professor Derk-Jan Dijk, Director of the Surrey Sleep Research Centre, UK DRI Group Leader, and senior author of the publication, commented on the implications of the findings. He pointed out that circadian rhythm studies have consistently shown that nearly all aspects of physiology and brain function are subject to diurnal variations. He concluded that applying this fundamental knowledge to dementia research is very promising and could lead to enhanced understanding, improved diagnoses, and better treatment strategies for Alzheimer’s disease.

More information: Ciro della Monica et al, P-tau217 and other blood biomarkers of dementia: variation with time of day, Translational Psychiatry. DOI: 10.1038/s41398-024-03084-7

Journal information: Translational Psychiatry Provided by University of Surrey