Monthly Archives: September 2025

Simple blood test may speed up early Alzheimer’s diagnosis

In a landmark study focusing on Hispanic and Latino adults, researchers at the University of California, San Diego School of Medicine have uncovered a connection between self-reported cognitive decline and blood-based biomarkers. Their findings suggest the possibility of developing a simple blood test that could aid in diagnosing Alzheimer’s disease and related dementias. Such an approach holds the promise of being faster, less invasive, and more affordable than current screening methods. The results of this important work were recently published in JAMA Network Open.

According to the corresponding author, Freddie Márquez, PhD, a postdoctoral scholar in the Department of Neurosciences, there is an urgent need for tools that can identify underlying neurodegenerative conditions earlier in patients presenting with cognitive symptoms. Márquez emphasised that blood-based biomarkers may provide a more accessible and scalable option for understanding cognitive decline, particularly for communities that traditional diagnostic pathways have historically underserved.

Currently, only one blood test has been approved by the United States Food and Drug Administration for the diagnosis of Alzheimer’s disease. Known as the Lumipulse G pTau217/Aβ42 plasma ratio, this test can detect proteins associated with the disease, but it remains prohibitively expensive and limited to specialised care environments. Whether blood testing can be reliably used for large-scale early detection of Alzheimer’s remains an open question—one that the present study has sought to address.

To explore this possibility, the researchers turned to the Study of Latinos–Investigation of Neurocognitive Aging, a clinical sub-study within the larger Hispanic Community Health Study/Study of Latinos. This is the most extensive long-term study of Hispanic and Latino health in the United States, making it a rich resource for examining the links between biomarkers and cognition. The research team highlighted that Hispanic and Latino adults face a disproportionately high risk of Alzheimer’s disease and related dementias, and they are projected to experience the most significant increases in prevalence over the coming decades. Despite this, they remain markedly underrepresented in dementia research.

The team analysed blood samples from 5,712 Hispanic and Latino adults aged 50 to 86, looking for proteins such as amyloid beta and tau, both of which are typically present in the brains of individuals with Alzheimer’s disease. Alongside these biomarker assessments, participants were asked about their own perceptions of cognitive decline, a measure referred to as subjective cognitive decline. This approach provided insight not only into biological changes but also into how individuals experience shifts in memory, planning, and overall cognitive ability.

The findings were striking. Elevated blood levels of neurofilament light (NfL), a marker of nerve cell injury, and glial fibrillary acidic protein (GFAP), an indicator of brain inflammation, were associated with greater self-reported difficulties in thinking and planning. Increased levels of NfL and tau protein (ptau-181) correlated with declines in memory performance. Interestingly, amyloid-beta protein levels showed no relationship with subjective cognitive decline. Notably, associations between NfL and reported cognitive changes were observed even in individuals who were otherwise cognitively healthy, suggesting that NfL could signal early changes in brain function before clinical symptoms are evident.

While these findings provide compelling evidence for the potential of blood-based biomarkers in the early detection of Alzheimer’s disease, the researchers stress the need for caution. Márquez and colleagues argue that such tests should not replace existing diagnostic approaches, but rather complement them as part of a clinician’s broader toolkit. The inclusion of participants from underrepresented backgrounds is also a key strength of the study, as it allows for better consideration of social determinants of health and comorbidities that may affect cognitive outcomes. Still, the researchers underscore that further work is required before blood-based testing can be integrated into routine clinical practice, even as the results mark a promising step forward in the search for more equitable and accessible diagnostic strategies.

More information: Freddie Márquez et al, Alzheimer Disease Biomarkers and Subjective Cognitive Decline Among Hispanic and/or Latino Adults, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.31038

Journal information: JAMA Network Open Provided by University of California – San Diego

Scientists develop ‘metabolic clock’ to spot early indicators of disease and accelerated ageing

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A groundbreaking study published in npj Metabolic Health and Disease (Nature Portfolio) has introduced a new “metabolic clock” that can predict biological age, uncover disease-specific metabolic signatures, and support early detection of health risks. Unlike chronological age, which measures only the passage of years, this tool focuses on biological processes, offering a more accurate reflection of an individual’s actual health status.

The clock was developed from data provided by more than 13,500 participants in the AKRIBEA cohort, a large-scale health study conducted in the Basque Country in collaboration with the Mondragón Corporation. In total, the final dataset included around 20,000 people spanning a wide age range, making it one of the most comprehensive efforts to date. By building on this robust foundation, the research team has created a model with the power to transform how ageing and disease are understood.

At the heart of the innovation is nuclear magnetic resonance (NMR) metabolomics, a technology that examines small molecules circulating in the blood. Using machine-learning algorithms, the researchers developed a system capable of predicting biological age with striking accuracy. “Our goal was to obtain an independent measure of age, beyond the information on a passport,” explains Dr Óscar Millet, who led the work at CIC bioGUNE, part of the Basque Research and Technology Alliance (BRTA). “The significance of this lies in the ability to detect discrepancies between chronological and metabolic age, which may act as early indicators of disease.”

The researchers tested the clock by analysing samples from individuals with a variety of conditions. In men with prostate cancer, the average metabolic age was nearly five years older than their actual age, while in patients with fatty liver disease (MASLD), the difference rose to more than 14 years. These results suggest that “metabolic distortion” could serve as a valuable marker for identifying diseases at an early stage, potentially long before they are apparent through conventional diagnostic methods.

Beyond its predictive power, the platform is capable of estimating more than 25 standard clinical parameters from a single blood sample, including measures of inflammation and kidney function. This ability to provide a broader, more integrated picture of a person’s health could support clinicians in tailoring treatment strategies and monitoring patients more effectively. As Dr Millet notes, “It is remarkable how much information is already encoded within a serum NMR spectrum, waiting to be unlocked.”

By offering a reliable and non-invasive means of measuring biological age and disease risk, the metabolic clock paves the way for more personalised and preventative healthcare. It holds the promise not only of spotting illnesses earlier but also of helping individuals and doctors to monitor the pace of ageing, opening up new opportunities to maintain health and quality of life across the lifespan.

More information: José M. Mato et al, Metabolomic-based aging clocks, npj Metabolic Health and Disease. DOI: 10.1007/s00394-023-03123-x

Journal information: npj Metabolic Health and Disease Provided by CIC bioGUNE

New research reveals why influenza hits older adults harder

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Scientists have revealed why influenza infections are often more dangerous in older adults, and their discovery opens the door to new treatments that could reduce this heightened risk. The research, published in PNAS, identifies a key biological factor that makes elderly patients more vulnerable to severe outcomes when infected with the flu virus.

The study found that older people produce much higher levels of apolipoprotein D (ApoD), a glycosylated protein involved in lipid metabolism and inflammation. While ApoD is a natural part of cellular processes, in excess, it appears to weaken the body’s defences against viral infection. This overproduction reduces the ability of older patients to mount an effective immune response, making influenza both more severe and more damaging.

Researchers showed that increased ApoD in the lungs leads to extensive tissue injury during infection. This damage undermines the body’s antiviral type I interferon response, which usually helps to contain viruses. Without this protective response, influenza infection spreads more easily and becomes more destructive, particularly in the ageing lung.

An international team of scientists from the China Agricultural University, the University of Nottingham, the Institute of Microbiology at the Chinese Academy of Sciences, the National Institute for Viral Disease Control and Prevention at the Chinese Centre for Disease Control and Prevention, and the University of Edinburgh conducted the investigation. According to Professor Kin-Chow Chang, from the School of Veterinary Medicine and Science at the University of Nottingham, “Ageing is a leading risk factor in influenza-related deaths. With global populations ageing at an unprecedented pace, understanding why older patients experience worse outcomes is crucial for healthcare and the wider economy.”

Using an ageing mouse model alongside carefully selected human tissue samples, the team investigated the mechanisms driving this age-related vulnerability. They discovered that ApoD impairs the activation of the immune system by accelerating the breakdown of mitochondria, a process known as mitophagy. Since mitochondria are essential both for producing cellular energy and for triggering protective interferons, their loss allows the virus to replicate more freely, resulting in higher viral loads and greater lung damage.

These findings identify ApoD as a critical therapeutic target. By inhibiting its harmful effects, researchers hope to develop treatments that strengthen the immune response in older patients and prevent severe influenza outcomes. As Professor Chang explained, “There is now an exciting opportunity to improve outcomes for the elderly by targeting ApoD, potentially reducing morbidity and mortality linked to influenza worldwide.”

More information: Kin-Chow Chang et al, ApoD mediates age-associated increase in vulnerability to influenza virus infection, Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.2423973122

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

Hitting 100 grows less likely as longevity improvements lose steam

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A new study co-authored by a University of Wisconsin–Madison professor has found that the extraordinary life expectancy gains made by high-income countries in the first half of the 20th century have slowed dramatically. The researchers conclude that no generation born after 1939 will achieve an average lifespan of 100 years, marking a significant shift in expectations about longevity.

The study, published in the Proceedings of the National Academy of Sciences, was carried out by Héctor Pifarré i Arolas of the La Follette School of Public Affairs, José Manuel Aburto Andrade of the Max Planck Institute for Demographic Research, and Carlo Giovanni Camarda of the Institut national d’études démographiques. Using data from the Human Mortality Database, the team examined life expectancy trends in 23 high-income, low-mortality countries, applying six different statistical models to forecast how future lifespans might unfold.

According to Pifarré i Arolas, the steep rise in life expectancy achieved in the early 20th century was “unprecedented” and unlikely to be repeated. Even if survival among adults were to improve at twice the currently expected rate, the overall gains would not match the rapid increases of that earlier era. The analysis highlights the unique impact of that historical moment, when medical breakthroughs, better public health, and improved living conditions drastically reduced the risk of dying young.

Between 1900 and 1938, life expectancy in high-income countries rose by roughly five and a half months with each new generation. A child born in 1900 could expect to live to 62, while someone born in 1938 had a projected lifespan of 80. After 1939, however, the pace of improvement slowed to just two and a half to three and a half months per generation, depending on the forecasting method used. This decline reflects the diminishing influence of infant and child survival on overall longevity.

As Andrade explained, the dramatic gains of the past were fuelled mainly by falling child mortality, whereas future progress now depends almost entirely on extending survival at older ages. With infant and child mortality already at very low levels in high-income countries, advances in longevity are harder to achieve. The researchers forecast that those born in 1980, for example, will not reach 100 years of age on average, nor will any subsequent cohort included in their analysis.

While no projection can fully account for the possibility of unexpected developments such as pandemics, medical innovations, or societal upheavals, the study provides important insights for policymakers. Slower growth in life expectancy has profound implications for healthcare systems, pension schemes, and social planning, while also shaping individual choices about savings, retirement, and long-term care. In short, both governments and citizens need to recalibrate their expectations of human longevity in the 21st century.

More information: Héctor Pifarré i Arolas et al, Cohort mortality forecasts indicate signs of deceleration in life expectancy gains, Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.2519179122

Journal information: Proceedings of the National Academy of Sciences Provided by University of Wisconsin-Madison

Weight variation as a potential contributor to cognitive decline in later life

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Adults aged 65 and older who lose more than five per cent of their body weight, or whose weight fluctuates by this amount over time, may face an accelerated risk of cognitive decline. This conclusion comes from a study led by researchers in the Department of Nutritional Sciences at Penn State, whose findings were recently published in Obesity.

“We examined over a decade of information on weight, body mass index, and waist circumference,” explained Muzi Na, associate professor of nutritional sciences and senior author of the study. “Using three different analytic approaches, the pattern was unmistakable: the greater the year-to-year variation in a person’s weight, the faster they experienced cognitive decline.”

The research team drew on data from 4,304 older adults who took part in the National Health and Aging Trends Study between 2011 and 2021. In addition to weight-related measures, the dataset included annual assessments of memory, orientation, and executive function. These variables were combined into a composite index of cognitive ability, allowing the team to track trajectories of decline. Apart from minor adaptations necessitated by the COVID-19 pandemic, the data were gathered consistently each year.

As Na observed, it is natural for cognitive ability to diminish gradually with age, and the study confirmed this trend across the sample. However, participants whose weight varied most dramatically displayed markedly faster declines. When grouped according to weight stability, those with the least variation experienced the slowest decline. In contrast, those with the most significant variation suffered two to four times the rate of cognitive deterioration. The association remained significant when examining fluctuations in waist circumference and body mass index.

Further analyses revealed that both a weight loss of at least five per cent and repeated cycles of losing and regaining this amount were strongly associated with steeper cognitive decline. These findings, Na noted, highlight the potential dangers of unstable weight in later life. Interestingly, participants who gained weight over time showed similar levels of cognitive decline to those whose weight remained stable. However, Na emphasised that this should not be interpreted as a recommendation for older adults to gain weight.

“Obesity during mid-life is a well-established risk factor for cognitive decline in later years,” Na explained. “Yet there is also an ‘obesity paradox’ in which late-life obesity has been linked with healthier cognitive trajectories. The interplay of age-related muscle loss and fat gain is highly complex, and our study does not imply that gaining weight is beneficial for older adults.”

The findings suggest that tracking weight stability could be an important tool in safeguarding cognitive health. Still, Na warned against relying solely on occasional doctor’s appointments for monitoring. “Weight can be measured inconsistently in clinical settings,” she said. “Clothing, footwear, and other factors can skew results. Older adults should aim for consistent at-home tracking, such as weighing themselves at the same time each morning after waking, before breakfast, and after using the bathroom, while wearing the same type of clothing. This approach offers more reliable information, and if changes appear, they should be shared with physicians.”

More information: Muzi Na et al, Variability in body weight and body composition and cognitive trajectories in older adults in the United States, Obesity. DOI: 10.1002/oby.24309

Journal information: Obesity Provided by Penn State

Biological ageing speed shown to predict cognitive deterioration in older adults

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A new study published in Aging (Aging-US), Volume 17, Issue 7, on 21 July 2025, is titled “Association of DNA methylation age acceleration with digital clock drawing test performance: the Framingham Heart Study.” The research team was led by first author Zexu Li of the Department of Anatomy and Neurobiology at Boston University’s Chobanian and Avedisian School of Medicine, with corresponding author Chunyu Liu, who also holds appointments at the Boston University School of Public Health. Their investigation sheds light on the relationship between biological ageing at the molecular level and long-term cognitive performance.

The researchers found that individuals who exhibited signs of faster biological ageing tended to perform less well on a digital cognitive test administered seven years later. This suggests that the rate at which DNA undergoes age-related molecular changes may influence how the brain functions as people grow older. The findings emphasise that biological, rather than simply chronological, age might provide a more accurate measure of an individual’s vulnerability to cognitive decline.

The analysis drew on data from 1,789 participants in the Framingham Heart Study, a long-running cohort that has provided extensive insights into health and ageing. To estimate biological age, the team examined DNA methylation (DNAm) patterns—chemical modifications to DNA known to accumulate over time and commonly referred to as “epigenetic ageing.” Cognitive function was measured using the digital Clock Drawing Test (dCDT), a computerised version of the traditional assessment tool. The dCDT evaluates memory, processing speed, motor control, and spatial reasoning, producing both overall and domain-specific scores.

Results showed that greater epigenetic age acceleration was significantly associated with lower cognitive scores, particularly among participants over 65 years of age. Among the different epigenetic ageing metrics, the DunedinPACE measure showed the strongest correlation with poorer cognitive function across age groups. Other indices, such as Horvath and PhenoAge, were linked to lower performance only in the older participants. Declines were most pronounced in areas related to motor ability and spatial reasoning, both essential for everyday functioning.

The study also investigated proteins included in the GrimAge epigenetic clock, a blood-based biomarker of ageing. Two proteins in particular—plasminogen activator inhibitor-1 (PAI1) and adrenomedullin (ADM)—were closely associated with poorer cognitive performance, again with the most potent effects seen in older individuals. These findings point to a broader connection between systemic ageing processes in the body and mental as well as motor decline in the brain, highlighting the intertwined nature of ageing across multiple biological systems.

Taken together, the results provide compelling evidence that accelerated biological ageing is linked to declines in memory, thinking speed, and motor control. The authors argue that epigenetic age is likely a better predictor of cognitive decline than chronological age. Because the dCDT is automated, precise, and easy to administer, it could become a valuable tool for early detection of brain ageing when combined with DNA methylation measures. Ultimately, this research opens new possibilities for identifying individuals at risk of cognitive impairment and developing more targeted approaches to support healthy ageing in older populations.

More information: Zexu Li et al, Association of DNA methylation age acceleration with digital clock drawing test performance: the Framingham Heart Study, Aging-US. DOI: 10.18632/aging.206285

Journal information: Aging-US Provided by Impact Journals LLC

The hidden costs of early puberty and young motherhood

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The age at which women reach puberty or give birth may have profound consequences for their long-term health. New research published in eLife by investigators at the Buck Institute shows that girls who experience puberty (marked by the onset of menstruation) before age 11 or women who have their first child before age 21 face significantly elevated health risks. Specifically, these women are twice as likely to develop type 2 diabetes, obesity, and heart failure, and four times more likely to suffer from severe metabolic disorders later in life. Conversely, later puberty and childbirth were genetically linked to longer lifespan, reduced frailty, slower epigenetic ageing, and a lower risk of age-related conditions such as diabetes and Alzheimer’s disease.

Buck professor Dr Pankaj Kapahi, senior author of the study, underscores the public health importance of these findings. “Although menstrual and childbirth history is routinely recorded during medical care, it is rarely considered outside of gynaecological contexts,” he explains. “Our research shows that these factors, whether beneficial or harmful, have a powerful influence on ageing and the development of disease. They need to be incorporated into the broader framework of women’s healthcare.”

The study represents one of the most comprehensive analyses of reproductive timing to date. Drawing on regression analyses of nearly 200,000 women enrolled in the UK Biobank, the team identified 126 genetic markers that connect early reproductive events with accelerated ageing. “Many of these markers lie within well-known longevity pathways, including IGF-1, growth hormone, AMPK, and mTOR signalling,” notes Dr Yifan Xiang, a postdoctoral fellow who led the research. These pathways regulate metabolism and ageing, making them central to understanding how early puberty and childbirth set the stage for long-term health risks.

The findings provide compelling evidence for the evolutionary concept of antagonistic pleiotropy—the idea that genetic traits advantageous early in life can have damaging consequences later on. “Our results show that genetic factors promoting early reproduction carry a substantial cost for women as they age,” Kapahi says. “From an evolutionary perspective, it makes sense: traits that enhance the survival of offspring may simultaneously increase disease risk and accelerate ageing in the mother.”

Body Mass Index (BMI) emerged as a key mechanism in this process. The study demonstrated that women who undergo early reproductive events tend to have higher BMI, which in turn increases their risk for metabolic diseases. Kapahi elaborates: “Enhanced nutrient absorption would be advantageous in the context of supporting offspring survival, but in today’s world of abundant calories, this same mechanism contributes to obesity and diabetes.”

From a public health standpoint, the implications are far-reaching. Kapahi argues that integrating reproductive timing into healthcare strategies could improve health outcomes across the lifespan. Personalised approaches—including lifestyle interventions, routine metabolic screenings, and targeted nutritional guidance—may help offset the risks linked to early puberty and early childbirth. The issue is especially timely, as recent research shows that the age of menarche in the United States has steadily declined by about three months per decade since the 1970s. While the underlying causes remain uncertain, rising rates of childhood obesity appear to play a role.

Finally, the study challenges long-standing practices in basic science research. Most preclinical studies on ageing use virgin female mice, which may not adequately represent the health trajectories of women who reproduce early. Kapahi suggests this oversight limits the translational value of such research. “If evolution has prioritised early reproduction at the expense of healthy ageing, then we need to ask how this knowledge can be applied in modern society,” he reflects. “We cannot alter our genetic inheritance, but we can use these insights to shape lifestyle, healthcare, and even medical interventions aimed at extending women’s healthspan.” The identification of genetic pathways associated with reproductive timing, he adds, also opens avenues for future therapies that could benefit both mothers and their children.

More information: Yifan Xiang et al, Early menarche and childbirth accelerate aging-related outcomes and age-related diseases: Evidence for antagonistic pleiotropy in humans, eLife. DOI: 10.7554/eLife.102447.4

Journal information: eLife Provided by Buck Institute for Research on Aging

Consistent sleep patterns linked to better recovery outcomes in heart failure, researchers report

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People recovering from heart failure may significantly improve their chances of avoiding further complications by maintaining a regular sleep routine, according to a new study led by Oregon Health & Science University (OHSU). Published in JACC Advances, the research highlights the risks associated with irregular sleep schedules, showing that even moderate inconsistency can double the likelihood of a serious medical event within six months. Such events could range from emergency room visits and hospital readmissions to fatalities.

The investigation was conducted by a team of OHSU researchers, led by Brooke Shafer, Ph.D., a research assistant professor in the Sleep, Chronobiology and Health Laboratory within the OHSU School of Nursing. Shafer underscored the broader health implications of sleep consistency, but stressed its particular importance for those already managing heart failure. “Going to bed and waking up at consistent times is important for overall health,” she explained. “Our study suggests that consistency in sleep timing may be essential for adults with heart failure.”

Between September 2022 and October 2023, the team enrolled 32 patients who had been admitted to OHSU Hospital and Hillsboro Medical Centre for acutely decompensated heart failure. After discharge, participants kept detailed sleep diaries for one week, recording when they went to sleep, woke up, and whether they took naps during the day. This data enabled the researchers to categorise individuals as either “regular” or “moderately irregular” sleepers, depending on the stability of their patterns.

The results were striking. Over the following six months, 21 participants experienced another clinical event. Among them, 13 were classified as moderately irregular sleepers, while only eight were identified as having regular sleep habits. Statistically, the irregular group faced more than double the risk of recurrence compared with their counterparts who maintained consistency. Importantly, this elevated risk persisted even after researchers adjusted for potential confounders such as other sleep disorders and chronic health conditions.

According to the authors, this is one of the first studies to specifically assess the impact of sleep regularity on heart failure outcomes. The findings contribute to a growing body of research suggesting that the timing of sleep—alongside its quality and duration—plays a key role in cardiovascular health. The team concluded that encouraging patients to stabilise their sleep schedules could provide a low-cost, non-invasive way to reduce the likelihood of repeat medical crises among those recovering from heart failure.

Shafer added that the physiological mechanisms behind this link may involve the cardiovascular system’s natural rhythm. “When we’re asleep and in a resting state, our blood pressure and heart rate decrease compared with daytime levels,” she said. “But variability in sleep timing may disrupt mechanisms involved in the regulation of the cardiovascular system. Irregular sleep may contribute to adverse outcomes, especially for people already affected by heart failure.” Moving forward, the researchers plan to scale up their study with a larger cohort to explore whether interventions that directly improve sleep regularity can further reduce risks in this vulnerable population.

More information: Brooke Shafer et al, Effect of Posthospitalization Sleep Regularity on Clinical Events in Adults With Heart Failure, JACC Advances. DOI: 10.1016/j.jacadv.2025.102109

Journal information: JACC Advances Provided by Oregon Health & Science University

Innovative drug could help patients with stubborn blood pressure

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A major international study has shown that a new tablet treatment can substantially reduce blood pressure in patients whose levels remain dangerously high despite taking several existing medicines. The findings come from a Phase III clinical trial led by Professor Bryan Williams of UCL’s Institute of Cardiovascular Science, and they point to a potentially transformative option for people living with resistant hypertension. Globally, high blood pressure affects around 1.3 billion people, with almost half of cases either uncontrolled or resistant to treatment. In the UK alone, around 14 million people are affected, leaving millions at heightened risk of heart attack, stroke, kidney disease, and premature death.

The BaxHTN trial, sponsored by AstraZeneca and supported by the NIHR Biomedical Research Centre at UCLH, tested the drug baxdrostat in nearly 800 patients across 214 clinics worldwide. After 12 weeks, those receiving baxdrostat at doses of 1 mg or 2 mg once daily experienced an average fall in blood pressure of 9–10 mmHg more than patients taking a placebo. This reduction was not only statistically significant but also clinically meaningful, since even modest reductions in systolic blood pressure are known to lower cardiovascular risk substantially. Remarkably, about four in ten patients taking baxdrostat achieved healthy blood pressure targets, compared with fewer than two in ten in the placebo group.

Professor Williams, who is presenting the findings at the European Society of Cardiology (ESC) Congress 2025 in Madrid and in the New England Journal of Medicine, described the results as “exciting.” He emphasised that a near 10 mmHg drop in systolic blood pressure represents a significant advance, directly translating into fewer heart attacks, strokes, episodes of heart failure, and cases of kidney disease. Moreover, the treatment proved durable, with clinically meaningful blood pressure reductions sustained for up to 32 weeks and no unanticipated safety concerns observed in the study population.

Baxdrostat is the latest innovation in a long research effort to tackle one of the most difficult drivers of hypertension: excess aldosterone. This hormone regulates salt and water balance in the body. When overproduced, it forces the kidneys to retain salt and water, pushing up blood pressure and making it stubbornly resistant to control. For decades, scientists have sought practical ways to target aldosterone overproduction, with limited success. Baxdrostat works by directly blocking aldosterone production, offering a precise way to address this underlying cause in people with difficult-to-treat hypertension.

Professor Williams, Chair of Medicine at UCL, highlighted the broader significance of these findings, noting that up to half of patients on treatment may still have uncontrolled blood pressure—a figure likely higher when considering the stricter targets now set for optimal control. By effectively reducing blood pressure in resistant cases, baxdrostat provides crucial new evidence that aldosterone dysregulation is central to the condition in millions of people. Importantly, it offers hope that future care for hypertension could be much more effective, moving beyond simply adding more and more drugs to a patient’s regimen.

The global implications are profound. While hypertension was once more prevalent in higher-income Western nations, the burden has shifted dramatically to Eastern and lower-income countries as diets and lifestyles have changed. Today, more than half of all people with high blood pressure live in Asia, including 226 million in China and 199 million in India. Professor Williams concluded that the results suggest baxdrostat could help up to half a billion people worldwide—and as many as 10 million in the UK—at a time when achieving lower and healthier blood pressure targets has never been more urgent.

More information: Bryan Williams et al, Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension, New England Journal of Medicine. DOI: 10.1056/NEJMoa2507109

Journal information: New England Journal of Medicine Provided by University College London

Can eye tests uncover the earliest clues of Alzheimer’s disease?

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Within the next few years, a simple eye examination could offer doctors a new way of detecting Alzheimer’s disease and other dementias long before the first memory lapses appear. A study recently published in Alzheimer’s & Dementia suggests that routine eye checks may reveal subtle warning signs in the retina, potentially opening the door to earlier diagnosis and treatment.

The research, carried out at The Jackson Laboratory (JAX), focused on the tiny blood vessels that run through the retina. Scientists found that mice carrying a common genetic mutation linked to Alzheimer’s risk, known as MTHFR677C>T, displayed twisted vessels, narrowed arteries, and fewer vascular branches in their retinas as early as six months of age. These abnormalities are strikingly similar to changes seen in the brain, suggesting that the retina may serve as a powerful biomarker for neurodegenerative disease.

According to neuroscientist Alaina Reagan, who led the study with colleague Gareth Howell, the findings highlight the close relationship between the eye and the brain. “Your retina is essentially your brain, but it’s much more accessible because your pupil is just a hole,” Reagan explained. The retina, like the brain, is part of the central nervous system, and its neurons, immune cells, and supporting structures often respond to disease in the same way. This makes it uniquely suited for non-invasive monitoring of brain health.

Beyond structural changes, the researchers also observed molecular disruptions in both the brain and retina of the mutant mice. These included problems with energy production, removal of damaged proteins, and maintenance of blood vessel integrity—processes vital for healthy function. Such findings add weight to a growing theory that vascular health is central to the development of Alzheimer’s and related conditions. The study also noted that female mice fared worse than males, echoing epidemiological data showing that women are more likely than men to develop dementia.

The implications for clinical care are potentially far-reaching. Because eye tests are already part of routine health care—particularly for people over the age of fifty—optometrists and ophthalmologists may one day be able to flag early vascular changes that point to dementia risk. Reagan and her colleagues are now working with clinicians and dementia specialists at Northern Light Acadia Hospital in Maine to determine whether similar retinal patterns can be detected in humans and used to guide preventative strategies.

If successful, this approach could shift the timeline for Alzheimer’s detection forward by decades. “Are patients more at risk if they have these vascular changes, and is that a point when doctors could start mitigating brain changes?” Reagan asked. “That could be twenty years before cognitive decline becomes obvious to patients and their families.” For now, the research offers fresh hope that the eye may hold vital clues to one of the most challenging health problems of our time.

More information: Alaina Reagan et al, Retinal vascular dysfunction in the Mthfr677C>T mouse model of cerebrovascular disease, Alzheimer’s & Dementia. DOI: 10.1002/alz.70501

Journal information: Alzheimer’s & Dementia Provided by Jackson Laboratory

Fall Prevention in Aged Care: What Works Best

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An international review led by Flinders University has found that supervised exercise programs, vitamin D supplementation, and improved nutrition are among the most effective ways to prevent falls in aged care homes. Published by the Cochrane Collaboration, the study analysed data from 104 clinical trials involving nearly 69,000 residents across 25 countries, making it the most comprehensive investigation of its kind.

Lead author Dr Suzanne Dyer, from the Flinders Health and Medical Research Institute (FHMRI), says the findings provide vital guidance for care providers, policymakers, and families. “Falls are one of the most serious health risks facing older Australians, often leading to broken bones, hospital admissions, and loss of independence,” she explains. The evidence, she adds, shows that interventions must be carefully tailored rather than applied as a one-size-fits-all solution.

Among the most effective measures were structured, supervised exercise programs, particularly when carried out regularly in groups or for more than an hour each week. These benefits extended even to residents living with dementia and other cognitive impairments, provided the exercise was delivered consistently and with staff support.

The study also found that vitamin D supplements reduced falls by improving muscle strength, while nutrition made a significant difference through diets rich in calcium and protein. Increasing dairy servings—such as milk, cheese, and yoghurt—strengthened bones and lowered both falls and fracture rates. Dr Dyer emphasises that “by adding more calcium and protein-rich foods, aged care homes were able to improve residents’ bone health and stability.”

The review further showed that combining personalised exercise plans with medication reviews and environmental assessments, supported by strong staff involvement, achieved the best results. In contrast, programs focused solely on medication management, staff training, or changes to care models did not consistently reduce falls. “We now have strong evidence about what works best,” says Dr Dyer, “and this offers aged care providers a clear roadmap for improving resident safety.”

More information: Suzanne Dyer et al, Interventions for preventing falls in older people in care facilities, Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD016064

Journal information: Cochrane Database of Systematic Reviews Provided by Flinders University

Study highlights deteriorating heart function in ageing adults with cardiac illness

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New research published in the Journal of the American Heart Association has revealed that U.S. adults aged 65 and older with high blood pressure, stroke, or heart failure are experiencing marked declines in cardiovascular health. The study analysed cardiovascular health scores derived from the American Heart Association’s “Life’s Essential 8” framework, which measures eight behaviours and health factors considered critical to heart and brain health: diet, physical activity, smoking, sleep, body mass index, cholesterol, blood sugar, and blood pressure. The results suggest that older adults with pre-existing cardiovascular disease consistently fared worse in maintaining optimal scores compared with their peers without such conditions.

The analysis was based on data collected from 2013 to 2018 through the U.S. National Health and Nutrition Examination Survey (NHANES), representing a sample of 3,050 adults that equated to population-level estimates for nearly 38 million older Americans. Researchers found that people with no history of cardiovascular disease had an average cardiovascular health score of 68 out of 100. In contrast, individuals who reported one or more cardiovascular conditions averaged scores below 60, with health further declining as the number of conditions increased. By condition, scores dropped by 4.1% for those with high blood pressure, 11.5% for those with a history of stroke, and 15.2% for those living with heart failure over the study period.

One of the most striking findings was the disparity in physical activity and blood pressure measures. According to lead author James M. Walker, a fourth-year M.D./M.B.A. student at Northwestern University, participants with cardiovascular disease typically had significantly lower scores in these categories. On average, adults with at least one cardiovascular disease had Life’s Essential 8 scores nine points lower than those without, underscoring the disproportionate challenges older adults face in maintaining activity levels and healthy blood pressure as their conditions progress.

The researchers emphasised that these results establish a crucial baseline for understanding cardiovascular health in older adults before the COVID-19 pandemic, a period when disparities became even more evident. As Walker explained, the study was designed to highlight cardiovascular health trends before 2020 to assess subsequent shifts caused by the pandemic. The findings provide insight into the urgent need for tailored interventions, suggesting that earlier and more comprehensive support is essential to preserve health in ageing populations, especially those already diagnosed with heart disease.

Experts who were not directly involved in the study, such as Dr. Stacey E. Rosen of Northwell Health, underscored the broader implications of these findings. With the U.S. population rapidly ageing and the last of the Baby Boom generation entering retirement age within five years, the burden of cardiovascular disease is expected to grow. Rosen noted that while medical advances have enabled more people to live longer even after serious cardiovascular events, strategies to promote healthier lifestyles at every stage of life are essential. The American Heart Association continues to urge individuals to adopt Life’s Essential 8 behaviours early, ideally starting in childhood, to mitigate risks later in life.

While the study provides compelling insights, the authors caution that it has limitations. Because the analysis was cross-sectional, it cannot establish causality, and it only included six primary cardiovascular conditions, potentially excluding less common diagnoses. Nevertheless, the results strongly reinforce the importance of early, sustained lifestyle interventions, as well as continued research to monitor and support cardiovascular health in the rapidly growing population of older adults.

More information: James M. Walker et al, Comparing the “Life’s Essential 8” Scores of Older Adults Living With Cardiovascular Diseases: NHANES, 2013 to 2018, Journal of the American Heart Association. DOI: 10.1161/JAHA.124.039659

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