Monthly Archives: May 2025

Vitamin D Supplements Linked to Delaying the Ageing Process

Recent findings from the VITAL randomised controlled trial have highlighted the significant role vitamin D supplementation might play in preserving telomeres, those protective caps at the ends of our chromosomes that naturally shorten as we age. Published in The American Journal of Clinical Nutrition, the study draws upon a sub-study of VITAL, carried out by researchers at Mass General Brigham and the Medical College of Georgia. This work offers promising insights into vitamin D’s potential to slow a crucial pathway of biological ageing, adding to an expanding body of evidence suggesting that vitamin D might exert protective effects at the cellular level.

JoAnn Manson, MD, the principal investigator of VITAL and chief of the Division of Preventive Medicine at Brigham and Women’s Hospital, emphasised the groundbreaking nature of the findings. “VITAL is the first large-scale and long-term randomised trial to demonstrate that vitamin D supplements help protect telomeres and preserve their length,” she explained. The significance of this result is underscored by earlier research from VITAL, which had already identified vitamin D’s capacity to reduce inflammation and lower the risk of some chronic diseases associated with ageing, such as advanced cancer and autoimmune disorders. These findings collectively strengthen the notion that vitamin D supplementation could have far-reaching implications for healthy ageing.

To understand the importance of these findings, it’s worth noting that telomeres consist of repeating DNA sequences that act as buffers to protect our chromosomes from deterioration or harmful fusions. With each cell division, telomeres gradually shorten, and this shortening process is considered a hallmark of cellular ageing. Shortened telomeres have been linked to an increased risk of various age-related conditions, making them a focal point for research on strategies to extend health span. Although there had been a handful of smaller, short-term studies hinting at vitamin D’s potential to maintain telomere length, their results were often inconclusive, leaving the field with many unanswered questions.

VITAL, which stands for VITamin D and OmegA-3 TriaL, was meticulously designed as a randomised, double-blind, placebo-controlled study. It examined the effects of daily supplementation with vitamin D3 at 2,000 IU and omega 3 fatty acids at 1 gram in a cohort of American adults—women aged 55 and older and men aged 50 and older—over a five-year period. The VITAL Telomere sub-study involved 1,054 participants from this larger group, with telomere length measurements in white blood cells taken at the study’s start, year two, and year four. These robust methods ensured the data’s reliability and the findings’ significance.

Remarkably, compared to placebo participants, who received vitamin D3 supplements experienced significantly less telomere shortening over the four-year span. This effect was akin to preventing nearly three years of biological ageing compared to those on placebo. However, omega 3 fatty acid supplementation did not significantly impact telomere length over the study period. These results suggest that vitamin D, rather than omega 3 fatty acids, could play a unique role in preserving the structural integrity of our chromosomes, with implications for slowing down cellular ageing.

Commenting on these findings, Haidong Zhu, PhD, first author of the report and a molecular geneticist at the Medical College of Georgia, noted, “Our results suggest that targeted vitamin D supplementation may offer a promising strategy for slowing a biological ageing process, although further research is certainly warranted.” This tempered enthusiasm highlights the need for additional studies to confirm these results and determine how they might translate into tangible benefits for human health. Nevertheless, this new evidence provides a significant step forward in understanding how targeted nutritional interventions, such as vitamin D supplementation, could influence the biological processes that drive ageing and disease.

More information: JoAnn Manson et al, Vitamin D3 and marine ω-3 fatty acids supplementation and leukocyte telomere length: 4-year findings from the VITamin D and OmegA-3 TriaL (VITAL) randomized controlled trial, American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2025.05.003

Journal information: American Journal of Clinical Nutrition Provided by Mass General Brigham

New Research Uncovers the Impact of Social Ties on Health in Older Adults

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A groundbreaking study has illuminated social networks’ profound and lasting impact on health in later life, revealing critical insights into how connections with others can shape ageing trajectories. The research, published in Innovation in Aging, followed over 1,500 older adults over ten years. Using three waves of data from the National Social Life, Health and Aging Project, the study offers a nuanced understanding of how different patterns of social interaction can influence well-being. Led by Professor Lissette Piedra from the University of Illinois Urbana-Champaign and James Iveniuk of the University of Chicago’s National Opinion Research Center, the research identified three distinct social network types: enriched, focused, and restricted, each reflecting varying degrees of social engagement and support.

The findings are stark in their implications. Individuals in enriched networks—those characterised by a broad and active range of social relationships—reported the highest self-rated health, a reliable indicator of overall well-being. In contrast, those in restricted networks, typically smaller, more isolated, and centred on family, exhibited significantly worse health. The focused group, occupying a middle ground, provided emotional support but lacked the broader variety of interactions seen in enriched networks. Over the decade, health disparities persisted between the groups, though the gap narrowed slightly, particularly as focused networks also began to show declining outcomes.

Professor Piedra emphasised the severe consequences of loneliness and social isolation for older adults. Factors such as declining health, the loss of loved ones, economic hardship, and systemic inequalities can all contribute to a shrinking social world. Older adults living in marginalised conditions—whether due to race, ethnicity, language, or geography—face even steeper challenges in maintaining social bonds. The study found that Black, Hispanic, and other minoritised individuals reported the highest levels of loneliness, underlining how structural and cultural barriers compound over time and increase vulnerability in later life.

Despite these concerning patterns, the study also uncovered promising signs of resilience. Some participants strengthened their social ties over time, particularly in the focused group. Although people in focused networks had relatively limited social circles, they often reported lower levels of loneliness than those in the restricted group. This suggests that the quality of social interactions can compensate for limited quantity. Indeed, the focused group showed the most significant mobility, with over 43% moving into enriched networks during the study period. However, the reverse was also true for a smaller portion, with 22% transitioning into more isolated restricted networks.

This dynamic contrasted sharply with the restricted group, which proved relatively static. More than 85% of those who began the study in restricted networks remained there, highlighting the persistence of social disadvantage and the difficulties in breaking out of isolation. Vulnerable populations—particularly older women and people of colour—were disproportionately likely to experience a decline in social connectivity. The reasons are complex but include widowhood, chronic illness, and systemic barriers such as lack of access to transportation, safe community spaces, or culturally appropriate activities that foster inclusion.

The study also revealed that women, Black participants, and the oldest individuals were more likely to transition from enriched to focused networks over time. These shifts reflect not just personal circumstances, such as the death of a spouse, but broader structural constraints. Piedra explained that when an older woman’s social world is intertwined mainly with her partner’s, his passing can cause her network’s abrupt and lasting collapse. Similarly, environmental factors—ranging from high-crime neighbourhoods to rural isolation and disability—further reduce opportunities for meaningful interaction, reinforcing the erosion of social support.

Nevertheless, the overarching message from the study is one of cautious optimism. Social networks are not inherently fixed or immutable. With thoughtful intervention and inclusive policy-making, it is possible to support older adults in cultivating richer, more fulfilling connections. Piedra underscored the need for public health strategies tailored to different populations’ unique challenges. “We saw movement into more robust networks across all groups,” she said. “That gives us reason to be hopeful. These findings make it clear that fostering social ties is not just a matter of emotional well-being—it is a vital component of health equity. If we want older adults to thrive, we must prioritise the creation of inclusive environments where relationships can flourish.”

More information: Lissette Piedra et al, Social Network Types and Self-Rated Health Among Diverse Older Adults: Stability, Transitions, and Implications for Health Equity, Innovation in Aging. DOI: 10.1093/geroni/igaf025

Journal information: Innovation in Aging Provided by University of Illinois at Urbana-Champaign, News Bureau

Treating Hearing Loss May Foster Social Connection Among Older Adults

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A recent study led by researchers at NYU Langone Health suggests that providing hearing aids and personalised guidance on their use may play a key role in maintaining social connections as people age. Published in JAMA Internal Medicine on May 12, the research forms part of the larger ACHIEVE clinical trial. It highlights the potential for hearing interventions to curb social isolation, a concern that disproportionately affects older adults. According to its authors, such measures could serve as a meaningful strategy to combat the so-called “loneliness epidemic” facing elderly Americans by preserving the interpersonal ties that often dwindle in later life.

The backdrop for the study is a growing recognition of social isolation as a serious public health challenge. The U.S. Centers for Disease Control and Prevention reports that over a quarter of seniors experience limited or no social contact, while a third identify as feeling lonely. Hearing loss, which impairs effective communication, has been increasingly implicated in these experiences of isolation. The 2023 U.S. Surgeon General’s Advisory elevated the issue to the same level of urgency as tackling tobacco use, obesity, and addiction, underscoring the societal impact of diminishing human connection.

In examining the effects of hearing care on social ties, researchers compared nearly 1,000 older adults with untreated hearing loss. Participants aged between 70 and 84 were recruited from Maryland, North Carolina, Minnesota, and Mississippi sites. Half the group received hearing aids, tailored counselling sessions, and support from audiologists, including technical training and assistive devices such as TV adapters. The control group received general health education focused on physical activity and effective communication with healthcare professionals. The results showed that those given hearing interventions preserved one more social connection on average than their counterparts over three years.

More than maintaining contacts, participants who received hearing care demonstrated richer, more diverse social networks—family, friends, and acquaintances—and reported higher-quality relationships. Their interactions were measured using a comprehensive range of indicators, including frequency of social encounters, network diversity, and emotional closeness. In terms of loneliness, both groups started at a similar baseline. Still, over time, those who received hearing aids exhibited slight improvements, whereas those without hearing intervention saw their loneliness scores worsen. These changes were tracked through periodic assessments over three years using a validated 20-item questionnaire measuring feelings of disconnect and solitude.

Lead author Nicholas Reed, AuD, PhD, a faculty member at NYU Grossman School of Medicine’s Optimal Aging Institute, noted that addressing hearing loss could significantly enhance mental and physical health by promoting social engagement. The study strengthens previous evidence linking hearing impairment and loneliness to more serious health outcomes such as depression, cardiovascular disease, and even premature death. Reed’s colleague and co-principal investigator Josef Coresh, MD, PhD, emphasised that these findings should prompt renewed efforts to integrate hearing aids into Medicare coverage, pointing out that the average cost of hearing care—around $4,700—is typically borne by patients themselves and remains a barrier to widespread adoption.

However, the authors caution that participants received unusually high care during the trial, including immediate hearing aid replacements and extended time with audiologists, which may not reflect the average public experience. The research team plans to expand the study over three years and include a more ethnically and socioeconomically diverse sample in future phases, as the current cohort was predominantly White. Still, the study underscores a critical message: hearing care restores sound and preserves the social fabric that sustains well-being in old age.

More information: Nicholas Reed et al, Hearing Intervention, Social Isolation, and Loneliness
A Secondary Analysis of the ACHIEVE Randomized Clinical Trial, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2025.1140

Journal information: JAMA Internal Medicine Provided by NYU Langone Health / NYU Grossman School of Medicine

Resilience in a Pandemic: How Japan’s Older Adults Adapted to COVID-19 Healthcare Challenges

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Public health emergencies, particularly pandemics such as COVID-19, exert severe pressure on healthcare systems, often leading to long-term structural and operational disruptions. These disruptions are especially consequential for older adults, who are more susceptible to chronic diseases and are particularly vulnerable when routine medical services are interrupted. As the COVID-19 virus emerged in December 2019 and rapidly escalated into a global crisis, it triggered a cascade of emergency responses intended to limit transmission. However, while crucial for infection control, these measures inevitably created barriers to healthcare access for the ageing population, a demographic already facing challenges in navigating healthcare services even in stable times.

In Japan, which has one of the most aged populations globally, the early phase of the pandemic saw the swift adoption of stringent measures, including enforced social distancing, mandatory mask-wearing, and government-mandated lockdowns. These were accompanied by repeated declarations of a state of emergency (SoE). While these interventions were essential in curbing viral spread, they unintentionally discouraged many older adults from seeking medical attention due to the dual pressures of fear and logistical difficulty. As a result, necessary care was often deferred or avoided, exacerbating the health risks faced by this vulnerable group. Although many studies have explored these early responses and their immediate impacts, there remains a notable lack of research examining how older adults engaged with the healthcare system during the prolonged, later stages of the pandemic, particularly as less virulent strains emerged and containment measures were gradually lifted.

To address this knowledge gap, a team of researchers from Waseda University undertook a comprehensive study to assess healthcare utilisation patterns among Japan’s older adult population during the extended pandemic phase, specifically between November 2021 and September 2022. The research was conducted by a multidisciplinary team including Associate Professor Rong Fu, Assistant Professor Masato Oikawa, Professors Haruko Noguchi and Akira Kawamura, and master’s student Sizhe Liu. Their study is especially significant given Japan’s unique context: a super-aged society with a universal healthcare system, where the balance between public health interventions and uninterrupted access to care becomes complex and essential.

The research team drew on a vast dataset comprising nearly 190 million medical claims, all linked to income tax data from Japan’s long-term care insurance system. This approach enabled them to track trends in healthcare access and service usage among individuals aged 75 and older. By comparing this data with indicators of crisis severity, regional public health policies, and socioeconomic stratification, the study aimed to understand whether access changed and how those changes were distributed across the population. Lead researcher Rong Fu emphasised the broader implications of the work, noting that as global populations continue to age, ensuring equitable healthcare access during emergencies is a pressing international concern.

Their analysis revealed a nuanced picture. Implementing precautionary health measures was associated with a moderate reduction in medical visits and outpatient appointments. However, despite the decline in patient volumes, healthcare costs and the overall provision of services remained broadly stable. This suggests that fewer people were visiting healthcare facilities, the intensity or complexity of care per visit may have increased, or systems adapted to deliver essential services more efficiently. Interestingly, the study found no significant disparities in general healthcare access across different income levels, with one notable exception: dental services. Lower-income older adults were significantly less likely to access dental care, underscoring the persistence of inequality in certain types of healthcare even under a universal system.

Ultimately, the study illustrates that health systems can adapt to protect older populations during extended crises. Still, gaps remain, particularly in areas like preventive dental care, where socioeconomic factors play a larger role. The authors propose that more robust systems—such as integrated early warning mechanisms, mobile or telehealth service delivery models, and targeted safety protocols—can help safeguard access to care in future emergencies. Fu and colleagues stress the need for policymakers to design interventions that mitigate inequality and ensure continuity of care, even during protracted public health disruptions. Their findings, published in Scientific Reports by Nature Research in April 2025, offer crucial insights for governments and healthcare providers as they prepare for future challenges in a world increasingly shaped by ageing populations and potential health crises.

More information: Rong Fu et al, Healthcare utilization among Japanese older adults during later stage of prolonged pandemic, Scientific Reports. DOI: 10.1038/s41598-025-98908-x

Journal information: Scientific Reports Provided by Waseda University

Preliminary research links prolonged work hours to changes in brain structure

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Preliminary research published in Occupational & Environmental Medicine suggests that long working hours may physically alter the brain’s structure, particularly in regions responsible for emotional regulation and executive functions such as working memory and problem-solving. The study, which utilised advanced neuroimaging techniques, observed notable differences in the brain anatomy of individuals routinely working 52 hours or more per week compared to those working standard hours. According to the researchers, these structural changes may reflect the brain’s neuroadaptive response to chronic occupational stress, potentially influencing cognitive and emotional health over time.

The consequences of overwork have long been associated with a heightened risk of cardiovascular disease, metabolic disorders, and a spectrum of mental health issues. Data from the International Labour Organisation estimates that excessive working hours contribute to more than 800,000 deaths globally each year. While overwork’s psychological and behavioural implications are well-documented, its neurological and anatomical impact remains an underexplored frontier. To address this knowledge gap, researchers analysed structural brain volume in a cohort of South Korean healthcare workers using MRI data collected as part of the Gachon Regional Occupational Cohort Study (GROCS).

The study involved 110 participants, most of whom were clinicians. They were divided into two groups based on working hours: 32 individuals were classified as working excessive hours, while 78 fell within the standard work range. Interestingly, those in the overworked category were generally younger, had fewer years of professional experience, and possessed higher levels of education. This demographic distinction, however, did not account for the neuroanatomical differences observed, suggesting that the prolonged duration of work itself may play a significant role in shaping brain structure.

To assess these differences, the researchers employed voxel-based morphometry (VBM) and atlas-based analysis—two sophisticated neuroimaging methods that precisely compare grey matter volume and identify anatomical regions. Their analysis revealed that individuals working longer hours significantly increased brain volume in areas associated with executive control and emotional processing. Notably, a 19% increase in the volume of the middle frontal gyrus was identified, a region involved in attention regulation, working memory, and higher-order cognitive functions. Additional increases were noted in the superior frontal gyrus, which governs planning and decision-making, and the insula, which integrates sensory and emotional input and is central to self-awareness.

While the researchers acknowledge the limitations of their study—chief among them its small sample size and observational design—they argue that these findings present a meaningful foundation for further inquiry. Without long-term data, whether the observed brain changes directly result from overwork or represent pre-existing anatomical differences predisposing specific individuals to tolerate or seek out longer hours remains unclear. The increased brain volumes could indicate a form of adaptation to chronic stress, although the mechanisms underlying this remain largely speculative.

The authors conclude by underscoring the broader implications of their findings. These changes in brain structure could provide a biological explanation for the cognitive and emotional difficulties frequently reported by individuals subjected to prolonged occupational stress. They call for expanded research efforts, particularly longitudinal and multi-modal neuroimaging studies, to validate these initial observations and delve deeper into the causal relationships. Most importantly, they emphasise the urgent need to treat overwork as a significant occupational health issue, advocating for workplace policies that actively discourage excessive working hours and prioritise employees’ mental and neurological well-being.

More information: Wonpil Jang et al, Overwork and changes in brain structure: a pilot study, Occupational and Environmental Medicine. DOI: 10.1136/oemed-2025-110057

Journal information: Occupational and Environmental Medicine Provided by BMJ Group

Groundbreaking Study Identifies Sedentary Lifestyle as a Standalone Risk Factor for Alzheimer’s Disease

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More than six million Americans are currently living with Alzheimer’s disease, a figure that continues to grow as the population ages. While much of the focus in Alzheimer’s research has traditionally centred on genetic predispositions and pharmacological treatments, scientists are increasingly turning their attention to modifiable lifestyle factors that may influence the likelihood of developing the disease. Researchers from Vanderbilt University Medical Center and the University of Pittsburgh have recently published compelling evidence pointing to sedentary behaviour as a significant and independent risk factor. Their findings, featured in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, highlight how extended periods of sitting or lying down may negatively affect brain health in older adults, even when they engage in regular physical exercise.

This groundbreaking study was spearheaded by Dr Marissa Gogniat, assistant professor of Neurology at the University of Pittsburgh and a former postdoctoral fellow at the Vanderbilt Memory and Alzheimer’s Center. She collaborated closely with Dr Angela Jefferson, professor of Neurology and founding director of the exact centre at Vanderbilt University Medical Center. Together, they led a detailed investigation into the long-term effects of sedentary behaviour on brain function and structure. Their research examined 404 adults aged 50 and above who were asked to wear wrist-worn activity monitors continuously for one week. These devices recorded their daily movement patterns, allowing researchers to quantify participants’ time in sedentary states.

What set this study apart was its long-term follow-up and its integration of both cognitive assessments and neuroimaging data. Over seven years, participants underwent regular cognitive testing and brain scans. The results were stark: individuals who spent more time being sedentary were more likely to experience declines in cognitive function and to exhibit brain shrinkage in regions associated with the development of Alzheimer’s disease. Importantly, these associations persisted regardless of how much physical exercise participants reported, suggesting that sedentary behaviour—independent of overall physical activity—poses a unique threat to brain health.

A particularly striking aspect of the study was the role of genetics, specifically the presence of the APOE-e4 allele. This well-known genetic variant significantly increases the risk of developing Alzheimer’s. For those carrying this allele, the detrimental effects of prolonged sedentary time were even more pronounced. This finding suggests that reducing sedentary behaviour may be especially crucial for individuals with a genetic vulnerability, providing a behavioural target that could offset some of their inherent risk. It also implies that public health strategies aimed at Alzheimer’s prevention should be more nuanced, accounting for encouraging exercise and curbing extended periods of inactivity.

Dr Gogniat underscored this message in her commentary on the findings, noting, “Reducing your risk for Alzheimer’s disease is not just about working out once a day. Minimising the time spent sitting, even if you exercise daily, reduces the likelihood of developing Alzheimer’s disease.” Her statement challenges the belief that daily exercise alone is sufficient to maintain cognitive health in later life. Instead, the study advocates for a more dynamic and continuous approach to movement throughout the day—suggesting that frequent interruptions of sedentary periods may be just as vital as scheduled workouts.

Dr Jefferson expanded on these implications, stressing the importance of understanding how everyday choices affect long-term brain health. “Our study showed that reducing sitting time could be a promising strategy for preventing neurodegeneration and subsequent cognitive decline,” she stated. “This research highlights the importance of reducing sitting time, particularly among ageing adults at increased genetic risk for Alzheimer’s disease. It is critical to our brain health to take breaks from sitting throughout the day and move around to increase our active time.” As researchers continue to unravel the complex interplay between genetics, lifestyle, and neurodegeneration, this study reinforces a simple yet powerful message: to protect our brains as we age, we must move more and sit less.

More information: Marissa Gogniat et al, Increased sedentary behavior is associated with neurodegeneration and worse cognition in older adults over a 7-year period despite high levels of physical activity, Alzheimer’s & Dementia. DOI: 10.1002/alz.70157

Journal information: Alzheimer’s & Dementia Provided by Vanderbilt University Medical Center

Excessive Sleep May Impair Cognitive Function, Particularly in Depressed Individuals, UT Health San Antonio Study Reveals

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A recent study conducted by researchers at The University of Texas Health Science Center at San Antonio (UT Health San Antonio) revealed that sleeping nine or more hours per night is linked to reduced cognitive performance. This effect is most pronounced among individuals experiencing symptoms of depression, indicating a potential interaction between sleep duration and mental health that may accelerate cognitive decline. The research underscores the increasingly recognised importance of sleep as a modifiable factor influencing brain function and overall neurological health.

The study analysed data from 1,853 individuals participating in the Framingham Heart Study, an ongoing, community-based cohort study supported by the U.S. National Heart, Lung, and Blood Institute. Participants were aged between 27 and 85, with an average age of 49.8 years, and were free from both dementia and a history of stroke. The Framingham study is renowned for its longitudinal cardiovascular and neurological health insights. It offers a robust platform for exploring the complex interplay between sleep, cognition, and psychiatric conditions such as depression.

Vanessa Young, MS, the study’s lead author and a clinical research project manager at UT Health San Antonio’s Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, highlighted a key observation: individuals who regularly slept for nine or more hours were more likely to report symptoms of depression. Young, who is also pursuing a PhD in Translational Science, suggested that sleep might represent a modifiable risk factor for cognitive decline, particularly in people grappling with depression. This insight could pave the way for more targeted interventions to preserve mental health through improved sleep regulation.

Published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association on 21 April, the study included collaborators from several international institutions, including Arizona State University, the University of Montreal, Hôpital du Sacré-Coeur de Montréal, Boston University, Monash University in Australia, and the Framingham Heart Study. The wide-ranging collaboration lends further credence to the study’s implications, suggesting a consensus across disciplines regarding the significant impact of sleep habits on cognitive outcomes.

Senior author Dr Sudha Seshadri, founding director of the Biggs Institute, noted that extended sleep durations were explicitly associated with poorer performance in various cognitive domains, including global cognition, memory, visuospatial abilities, and executive function. Importantly, these associations were strongest among those experiencing depressive symptoms, regardless of whether they were taking antidepressants. The findings add depth to existing literature, showing mixed results regarding the effects of long versus short sleep on mental performance. This study offers a more nuanced picture by integrating mental health status into the analysis.

Sleep has long been acknowledged as essential for brain health, yet the mechanisms by which its duration and quality influence cognitive ageing remain under active investigation. The current study adds to a body of research suggesting that deviations from the recommended 7 to 8 hours of nightly sleep may be detrimental, especially when accompanied by psychological stressors like depression. Sleep disturbances and depression frequently co-occur, with nearly 90% of those diagnosed with depression also reporting sleep-related difficulties. These co-morbidities may compound cognitive vulnerability, particularly during middle age and later life.

The researchers concluded that the relationship between prolonged sleep and cognitive deficits is amplified in individuals showing signs of depression, regardless of whether they are on antidepressant treatment. In contrast, those without depressive symptoms exhibited weaker associations, and no significant cognitive effects of sleep duration were found in participants using antidepressants but not experiencing depressive symptoms. The authors suggest that further large-scale, longitudinal studies are needed to untangle the directionality and causality of these associations. Nonetheless, their findings make a strong case for considering sleep habits — particularly in individuals with mood disorders — as a key component of strategies to preserve cognitive function and prevent age-related decline.

More information: Vanessa Young et al, Long sleep duration, cognitive performance, and the moderating role of depression: A cross-sectional analysis in the Framingham Heart Study, Alzheimer’s & Dementia. DOI: 10.1002/alz.70160

Journal information: Alzheimer’s & Dementia Provided by University of Texas Health Science Center at San Antonio

Guided Physical Therapy Enhances Recovery from Hip Fractures in Elderly Women

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Findings from the STEP-HI (Starting a Testosterone and Exercise Programme after Hip Injury) trial have provided new insight into the role of testosterone therapy in older women recovering from hip fractures. This multi-centre, randomised, double-blind controlled trial, published on 15 May in JAMA Network Open, aimed to assess whether adding low-dose testosterone gel to an exercise rehabilitation programme could enhance recovery, particularly regarding long-distance mobility. The study enrolled 129 community-dwelling women aged 65 or older who had recently undergone surgical repair for a hip fracture and exhibited impaired mobility. Participants were recruited from eight sites across the United States over five years, from 2018 to 2023, and were followed through a 24-week regimen of supervised exercise with or without testosterone therapy.

The motivation behind the study stems from the persistent difficulties many older women face following hip fractures. Despite improvements in surgical techniques and standard rehabilitation protocols, a significant proportion—nearly three out of four—do not recover their pre-fracture levels of mobility and independence. Hip fractures are not only physically debilitating but also increase vulnerability to further injury and death. Thus, researchers were keen to explore whether hormonal supplementation, specifically testosterone, might augment muscle strength and enhance the effects of physical therapy. Testosterone, while typically associated with male physiology, is also present in women, although levels decline with age. Its known anabolic properties led to the hypothesis that it might provide functional benefits when administered alongside strength training.

The study’s primary endpoint focused on long-distance mobility, assessed through the Six Minute Walk Distance—a standardised measure that evaluates endurance and the capacity to walk continuously. Results showed that while all participants improved with supervised exercise, those who received additional testosterone therapy did not demonstrate significantly greater improvements in long-distance mobility than those who exercised alone. This finding suggests that testosterone, at least in the dosage and duration tested, does not enhance endurance-related outcomes beyond what exercise can achieve. Therefore, structured exercise remains the cornerstone of effective rehabilitation for older women seeking to improve stamina and walking distance post-surgery.

However, the researchers noted secondary findings that warrant further investigation. Women in the testosterone group showed improved short-distance mobility and balance and were less reliant on assistive devices such as canes and walkers by the end of the study. While not the primary focus of the research, these effects point to the potential benefits of testosterone in specific functional domains. Dr George Kuchel, director of the UConn Center on Ageing and co-author of the study, highlighted that among women who used mobility aids at baseline, those receiving testosterone were likelier to walk unaided six months later than those receiving exercise alone or usual care. Although these results were not statistically conclusive, they suggest a promising area for further research into the nuanced effects of hormonal therapy.

Another notable outcome of the STEP-HI trial was the evident success of progressive resistance training among participants. Many older women, initially apprehensive about engaging in strength-based exercise, demonstrated remarkable gains in physical performance over the study period. Dr Jenna Bartley, principal investigator at the UConn site, reported that by the end of the study, some participants could leg press over 100 pounds—an outcome that underscores the resilience of older women and the powerful benefits of resistance training. These observations challenge commonly held assumptions about ageing and physical limitations, showing that even those who are frail or recently injured can make significant functional progress with the proper support and regimen.

In summary, the STEP-HI trial contributes meaningful knowledge to geriatric rehabilitation. While it did not confirm the anticipated benefit of testosterone on long-distance mobility, it reaffirmed the critical value of structured, supervised exercise for older women recovering from hip fractures. The study also opened new avenues for inquiry into how testosterone might influence other aspects of recovery, such as balance and short-distance mobility. Overall, the findings support a more refined and individualised approach to post-fracture care that emphasises physical training as a primary intervention while cautiously exploring the supplemental role of hormonal treatments.

More information: Jenna M. Bartley et al, Combining Exercise Training and Testosterone Therapy in Older Women After Hip Fracture, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.10512

Journal information: JAMA Network Open Provided by University of Connecticut

Memory-Related Brain Changes Associated with REM Sleep Apnoea

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Obstructive sleep apnoea (OSA), a condition marked by repeated interruptions in breathing during sleep, has been linked to changes in brain regions responsible for memory, according to a study published on 7 May 2025 in Neurology®, the medical journal of the American Academy of Neurology. The research suggests that the drops in oxygen levels caused by OSA—particularly during rapid eye movement (REM) sleep—may lead to the degeneration of memory-related brain structures through damage to the brain’s small blood vessels. Notably, the study reveals a strong association rather than a direct causal relationship, indicating that more investigation is needed to determine whether OSA actively causes these neurological changes.

OSA typically occurs when the muscles in the throat relax during sleep, temporarily blocking the upper airway. This disruption often causes individuals to wake repeatedly to resume breathing. Such fragmented sleep results in lowered blood oxygen levels, and over time, these episodes of hypoxia can harm the delicate microvascular structures in the brain. Damage to these small blood vessels is known to impair white matter integrity and may initiate or exacerbate cognitive decline. While sleep apnoea is known to increase in prevalence with age, its potential role in accelerating neurodegeneration has become a growing focus of research.

REM sleep is especially significant in this context, as it is the stage of sleep most closely associated with dreaming, emotional processing, and memory consolidation. According to Dr Bryce A. Mander of the University of California, Irvine, who led the study, the findings suggest that low oxygen levels during REM sleep may be particularly harmful in cognitive decline. By examining the relationship between oxygen saturation and brain health, the research contributes to a deeper understanding of how OSA might impair neural function—particularly in brain areas vital for memory, such as the hippocampus and the entorhinal cortex.

The study involved 37 older adults, with an average age of 73, none of whom had been diagnosed with cognitive impairment or were using sleep medications. Each participant underwent overnight polysomnography, a comprehensive sleep study that measured various physiological parameters, including blood oxygen levels throughout different stages of sleep. Brain imaging was also conducted using high-resolution scans to assess white and grey matter structures. Of the participants, 24 were diagnosed with obstructive sleep apnoea, allowing researchers to compare brain changes between those with and without the condition.

One of the study’s key findings was the association between oxygen desaturation during REM sleep and increased volumes of white matter hyperintensities—lesions that appear as bright spots on MRI scans and are considered markers of small vessel disease. The researchers also found that the lowest oxygen saturation levels and time spent below 90% blood oxygen saturation during sleep predicted the extent of white matter hyperintensities. Further analysis revealed that these lesions were linked to a reduced hippocampus volume and a thinner entorhinal cortex. These structural changes, in turn, were associated with poorer performance on memory tasks, suggesting a possible pathway from sleep-related hypoxia to cognitive impairment.

While the results provide compelling evidence for an association between sleep apnoea and neurodegeneration, the authors caution that the study has limitations. Chief among them is the relatively small sample size and the lack of ethnic diversity, as most participants were either white or Asian. This limits the ability to generalise the findings across broader populations. Nonetheless, the study contributes to a growing body of literature that connects untreated sleep apnoea with age-related cognitive decline and diseases such as Alzheimer’s. The findings underscore the importance of early diagnosis and management of sleep apnoea to improve sleep quality and potentially protect long-term brain health.

More information: Bryce A. Mander et al, Association of Hypoxemia Due to Obstructive Sleep Apnea With White Matter Hyperintensities and Temporal Lobe Changes in Older Adults, Neurology. DOI: 10.1212/WNL.0000000000213639

Journal information: Neurology Provided by American Academy of Neurology

Dementia on the Rise in China at an Unusual Pace

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A newly published study in the open-access journal PLOS One (7 May 2025) highlights a significant and accelerating rise in Alzheimer’s disease and other dementias (ADD) in China, outpacing the global average. Conducted by researchers Siyu Liu and Daoying Geng of Fudan University, the study draws attention to the disproportionate burden that dementia is placing on China, a country already grappling with the health implications of a rapidly ageing population. Despite the growing prevalence of these conditions worldwide, China stands out due to the sheer scale and speed of increase in cases, which the researchers argue warrants urgent public health attention.

ADD, comprising both Alzheimer’s disease and other related forms of cognitive decline, has become an increasingly serious global health issue, with incidence rates climbing steadily over the past several decades. However, the burden in China is particularly acute. Although the nation is home to one of the largest ageing populations in the world, there has been a notable lack of focused research into the specific causes, risk factors, and social impacts of dementia within the Chinese context. This lack of tailored understanding has hindered effective national planning and resource allocation to combat the disease.

To fill this knowledge gap, Liu and Geng utilised over thirty years of data from the Global Burden of Disease (GBD) project—a collaborative initiative involving the World Bank, the World Health Organisation, and several academic institutions. Their analysis found that between 1990 and 2021, cases of ADD in China more than tripled, while globally, cases merely doubled. This stark contrast highlights the unique demographic and epidemiological pressures facing China. Interestingly, while women in China carry a higher overall burden of the disease, likely due to their longer lifespans, men were found to have slightly higher death rates from dementia-related causes, suggesting a complex interplay of biological, behavioural, and social factors.

The study also projected future trends using advanced statistical models, anticipating that dementia cases in China will continue to rise significantly over the next 15 years. These projections suggest that unless robust and targeted interventions are implemented soon, the country may face an overwhelming increase in dementia-related healthcare demands. The anticipated rise is closely tied to population ageing and increased life expectancy, but it is not solely the result of demographic shifts. The researchers argue that several modifiable risk factors are contributing to the acceleration of dementia in the Chinese population and could serve as leverage points for public health action.

Among these modifiable factors, high blood sugar, often stemming from diabetes, has now overtaken other conditions as the leading preventable risk factor for dementia, both globally and within China. The study underscores that hyperglycaemia, once primarily associated with cardiovascular and metabolic diseases, is now emerging as a key contributor to cognitive decline. Smoking and high body weight were also identified as significant risk factors, particularly among men, suggesting that behavioural health interventions could yield substantial benefits in reducing the incidence of dementia. Public health campaigns targeting diet, physical activity, and tobacco cessation may therefore serve as critical tools in addressing this emerging crisis.

In their conclusion, Liu and Geng emphasise that while the demographic realities of China’s ageing population cannot be easily altered, the risk landscape for dementia can be. They call for a comprehensive, evidence-based strategy focused on prevention, early detection, and public education to slow the upward trajectory of ADD cases. “Alzheimer’s disease and related dementias represent one of the heaviest disease burdens globally,” they write, “and in China, this burden has increased year by year from 1990 to 2021.” Their findings serve as a stark reminder of the looming public health challenge that dementia poses, not just for China but for ageing societies around the world.

More information: Siyu Liu et al, A systematic analysis for disease burden, risk factors, and trend projection of Alzheimer’s disease and other dementias in China and globally, PLOS One. DOI: 10.1371/journal.pone.0322574

Journal information: PLOS One Provided by PLOS

Scientists uncover heart rate indicator linked to accelerated cognitive decline in ageing adults

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A healthy heart is not only defined by its strength or regularity, but also by its capacity to adapt. This adaptability manifests in the subtle complexity of each heartbeat, which responds dynamically to internal physiological demands and shifts in the external environment. Researchers at Mass General Brigham have introduced a novel technique for measuring this complexity in pulse rates, using data collected through wearable pulse oximetry technology. Their innovative method, detailed in the Journal of the American Heart Association, offers a more nuanced view of cardiac health than traditional heart rate variability metrics. Intriguingly, the study also establishes a connection between reduced pulse rate complexity and an increased risk of cognitive decline in older adults.

“Heart rate complexity is a hallmark of healthy physiology,” explained Dr Peng Li, senior author of the study and a researcher in the Department of Anaesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital (MGH). He also holds a position in the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital (BWH), both founding institutions of the Mass General Brigham healthcare network. “Our hearts must maintain a delicate balance between responsiveness and stability, dynamically adjusting to both internal signals and external stressors,” underscoring the physiological significance of heartbeat complexity as a biomarker for overall health.

The researchers employed data from 503 elderly participants (average age 82, 76% of whom were women) enrolled in the Rush Memory and Aging Project, a long-standing and well-regarded cohort study. They analysed pulse rate data recorded overnight using the Itamar WatchPAT 300—a fingertip-worn oximetry device—alongside comprehensive cognitive assessments conducted contemporaneously and during follow-up visits up to 4.5 years. This longitudinal design allowed the researchers to track cognitive trajectories regarding baseline heart function over time.

Their findings were striking. Participants who exhibited greater baseline complexity in their pulse rates tended to experience slower cognitive decline over the ensuing years. This relationship held even when conventional markers of heart rate variability failed to predict similar outcomes, suggesting that the newly developed metric is more sensitive in capturing aspects of cardiac function relevant to brain health. These results indicate a potential shift in how cardiovascular indicators assess neurological risk, particularly in ageing populations.

Looking ahead, the research team intends to investigate whether this pulse rate complexity measure can be an early predictor of dementia. Should such a link be confirmed, the technique could prove invaluable in identifying individuals at heightened risk during preclinical stages of cognitive impairment, when therapeutic intervention might be most effective. This could represent a significant advance in preventive strategies aimed at delaying or mitigating the progression of neurodegenerative conditions such as Alzheimer’s disease.

“Our findings highlight the value of this new approach as a non-invasive indicator of how flexibly the heart responds to input from the nervous system,” said Dr Chenlu Gao, lead author of the study and fellow researcher at MGH. “Its utility extends beyond mere cardiac assessment—it opens a window into understanding the complex interplay between heart health and cognitive ageing.” The development of such metrics could pave the way for a more integrated view of physiological wellbeing in later life, recognising the interdependence of cardiovascular and neurological systems in maintaining quality of life across the ageing process.

More information: Chenlu Gao et al, Reduced Complexity of Pulse Rate Is Associated With Faster Cognitive Decline in Older Adults, Journal of the American Heart Association. DOI: 10.1161/JAHA.125.041448

Journal information: Journal of the American Heart Association Provided by Mass General Brigham

Study Uncovers Wide Life Expectancy Variations Across U.S. States

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A major new study led by researchers at the Yale School of Public Health (YSPH) has revealed striking disparities in life expectancy across U.S. states and Washington, D.C., spanning more than a century. This comprehensive research, published in JAMA Network Open, highlights how regional public health policies, social conditions, and environmental factors have profoundly shaped life outcomes. The study analysed over 179 million deaths from 1969 to 2020, focusing on birth cohort trends rather than the more conventional year-by-year mortality rates. This approach provides a clearer view of how entire generations have experienced health over time, capturing the long-term effects of policies and living conditions.

One of the key findings is the significant variation in life expectancy gains between different regions. States in the Northeast, the West, and Washington, D.C. have generally experienced the most important improvements. For example, the nation’s capital, which had the lowest life expectancy for the 1900 birth cohort, saw remarkable gains, with life expectancy for women increasing by 30 years and for men by 38 years by 2000. In stark contrast, several Southern states, including Mississippi, Alabama, and Kentucky, reported minimal improvements over the same period, particularly for women. This divergence highlights the long-term impact of local health policies, economic conditions, and social environments.

Lead author Theodore R. Holford, the Susan Dwight Bliss Professor Emeritus of Biostatistics at YSPH, emphasised the value of using a birth cohort approach, which captures the cumulative effects of policies and social conditions that might otherwise be masked in traditional year-by-year mortality data. “Looking at mortality trends by cohort gives us a more accurate reflection of the lived experiences of populations,” Holford said. This method allows researchers to consider how early-life exposures, such as access to clean water, sanitation, vaccinations, and tobacco use, influence long-term health outcomes. It also accounts for the lasting impacts of historical events like economic recessions, public health campaigns, and environmental regulations.

The study’s findings also underscore the role of state-level health policies in shaping life expectancy. For instance, California’s early adoption of smoke-free workplace laws in 1995 led to substantial public health gains, significantly reducing smoking-related mortality over time. In contrast, states like Kentucky, which have been slower to implement similar tobacco controls, continue to face higher smoking rates and associated health problems. This contrast highlights how proactive public health measures can transform population health outcomes, reducing the long-term burden of chronic diseases.

Moreover, the researchers examined the rate at which mortality increased after age 35, using a measure known as doubling time — the period it takes for an individual’s risk of death to double. They found that states like New York and Florida, which have implemented more comprehensive public health initiatives, exhibited slower mortality escalations, reflecting healthier ageing. In comparison, states like Oklahoma and Iowa experienced much faster mortality increases, emphasising the importance of sustained health investments over the life course.

Ultimately, the authors hope their findings inspire policymakers to address the deeply entrenched health disparities that still divide the United States. They argue that without conscious efforts to expand healthcare access, strengthen public health systems, and reduce economic inequality, these gaps in life expectancy will persist or even widen. Holford pointed out, “Where you are born shouldn’t determine how long you live. But in America, it still does.” This research offers a powerful reminder that the health of future generations depends on the choices made today.

More information: Theodore R. Holford et al, All-Cause Mortality and Life Expectancy by Birth Cohort Across US States, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.7695

Journal information: JAMA Network Open Provided by Yale University