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

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

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

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

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

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

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

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

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

Journal information: Johns Hopkins Medicine

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Journal information: BMJ Open

Mushrooms increase memory capacity by enhancing nerve growth

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

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

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

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

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

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

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

Journal information: Journal of Neurochemistry Provided by University of Queensland

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

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

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

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

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

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

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

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

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

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

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

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

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

Singapore’s anti-smoking legislation could have prevented 20,000 heart attacks among the older adults

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The broadening of Singapore’s smoking prohibition in 2013 to include the shared spaces of residential areas and various outdoor locations might have prevented as many as 20,000 heart attacks in individuals aged 65 and above. This finding comes from a pioneering local study that explored the health outcomes of extending smoking restrictions to outdoor environments.

Published in BMJ Global Health, a peer-reviewed open-access journal, the research was spearheaded by experts from the Duke-NUS Medical School. They discovered that the augmentation of the smoking ban correlated with a reduction in the monthly incidence of heart attacks, mainly benefiting the elderly and male populations.

Globally, exposure to second-hand smoke is linked to approximately 1.3 million deaths annually, with a significant number of these deaths due to heart attacks. Despite this, the positive health impacts of comprehensive smoke-free laws—adopted by 67 countries since 2003—are predominantly documented for indoor smoking prohibitions, leaving a gap in understanding regarding bans in residential and outdoor areas.

Dr Joel Aik, an Adjunct Assistant Professor in the Health Services & Systems Research Programme at Duke-NUS and the study’s senior author, highlighted the importance of smoke-free zones in communal areas of housing estates, where residents often gather. He emphasized that such bans minimize residents’ exposure to tobacco smoke, thereby lowering their heart attack risk.

To protect its citizens, Singapore expanded its smoke-free laws in 2013 to include all communal spaces in residential buildings—home to 80% of the population—as well as outdoor areas like covered walkways, overhead bridges, and the vicinity of bus stops. This initiative was extended in subsequent years to encompass reservoirs, residential parks, educational institutions, and more types of public transportation.

The researchers evaluated the impact of these legislative measures on heart attack occurrences by analyzing monthly data from the Singapore Myocardial Infarction Registry between January 2010 and December 2019. Over this decade, 133,868 heart attacks were recorded, with a significant proportion occurring among men and older adults.

Before the 2013 law expansion, the heart attack rate for those aged 65 and above was significantly higher than for younger individuals, with men experiencing nearly double the rate of women. Following the implementation of the law, there was a notable decline in heart attack rates, particularly among seniors and men, suggesting that these groups benefited most from the smoking ban.

The study estimated that the legislation may have prevented approximately 19,591 heart attacks in older adults and 4,748 in men. However, the impact of further legislative extensions on heart attack rates in later years was less pronounced, possibly due to advancements in diagnostic technology. Despite this, the consistent reduction in heart attack rates across different demographics following the 2017 law expansion indicates potential benefits, although further research is needed for confirmation.

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, remarked on the study’s implications for policymakers, especially in Asia, where smoking remains a significant public health challenge. The research offers additional evidence to support the expansion of smoke-free laws as a means to mitigate the harmful effects of tobacco smoke exposure and reduce the burden of heart disease.

More information: Jamie S Y Ho et al, Association between the extension of smoke-free legislation and incident acute myocardial infarctions in Singapore from 2010 to 2019: an interrupted time-series analysis, BMJ Global Health. DOI: 10.1136/bmjgh-2023-012339

Journal information: BMJ Global Health Provided by Duke-NUS Medical School

Do Canada’s dietary recommendations offer sufficient advice for older adults?

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The most recent guidelines from Canada’s food guide are designed to minimise the risk of chronic diseases. Nevertheless, questions arise regarding how our national dietary guidance fulfils the nutritional needs of the entire Canadian populace.

Older adults must consume sufficient amounts of certain nutrients. However, until recent studies, there was a need for more knowledge on whether adherence to Canada’s food guide effectively meets the specific nutrient requirements for this demographic. Researchers at McGill University’s School of Human Nutrition analysed dietary data from the most recent national survey conducted in 2015 on Canadians aged 65 and above. They aimed to determine whether compliance with our nation’s nutritional guidelines correlates with an adequate nutrient intake critical for the health of older adults.

The findings were anticipated. The study showed that individuals who adhered to the guidelines of the food guide had higher intakes of nutrients such as fibre, magnesium, vitamin B6, and potassium. Despite these positive outcomes, the research also highlighted a significant shortfall; adherence to the guide did not ensure adequate intake of calcium, vitamin D, and folate, which are crucial for the well-being of older adults, according to Didier Brassard, a Postdoctoral Fellow at the School of Human Nutrition at McGill University who spearheaded the research. That reveals a gap in the dietary recommendations, indicating they need to be more comprehensive to guarantee the consumption of essential nutrients like calcium, vitamin D, and folate.

Stéphanie Chevalier, a McGill’s School of Human Nutrition professor, emphasises the need for additional, tailored dietary recommendations for older adults that focus on increasing intake of foods rich in calcium, vitamin D, and folate. The existing food guide offers broad suggestions suitable for the general population. Yet, more detailed guidance specifying the types and quantities of food and consumption frequency is required for specific groups, notably older adults, to ensure they meet their unique nutritional needs.

The research team plans to extend their work by exploring the impact of following the current dietary guidelines on health outcomes such as physical function, mobility, and cognitive abilities in older adults. This next phase will also investigate potential modifications to the procedures to enhance these health outcomes, highlighting the ongoing need for dietary guidance that addresses the specific needs of different population segments, including older adults.

More information: Didier Brassard et al, Relationship between Adherence to the 2019 Canada’s Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults, Journal of Nutrition. DOI: 10.1016/j.tjnut.2023.07.005

Journal information: Journal of Nutrition Provided by McGill University

Adult ADHD and its association with dementia risk

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Dementia is a condition marked by significant cognitive decline that disrupts daily functioning. It is a major contributor to disability and death worldwide. As of 2022, it was estimated that 6.5 million Americans aged 65 and older were living with dementia, a number projected to more than double to 13.8 million by 2060. Consequently, pinpointing risk factors and preventive measures for dementia has become a global health imperative.

In this comprehensive study involving 109,218 participants observed over up to 17.2 years, and after adjusting for 18 possible confounding factors, the primary analysis revealed that a diagnosis of adult Attention Deficit Hyperactivity Disorder (ADHD) was linked to an almost threefold increase in the risk of developing dementia. Further analyses supported the main finding, suggesting it remains robust under various analytical conditions. This discovery underscores the importance for policymakers, caregivers, patients, and healthcare providers to consider ADHD as a significant concern in older populations, advocating for diligent monitoring and management strategies to address this risk.

More information: Stephen Z. Levine et al, Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2023.38088

Journal information: JAMA Network Open Provided by JAMA Network

Engaging in physical fitness during adolescence is associated with reduced atherosclerosis in middle adulthood

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Men who maintained high levels of physical fitness in their youth had a significantly reduced risk of developing atherosclerosis nearly four decades later, according to research conducted by a team from Linköping University in Sweden. This study, published in the British Journal of Sports Medicine, highlights the role of atherosclerosis as a key factor in the relationship between physical fitness and the risk of cardiovascular diseases.

Pontus Henriksson, the senior associate professor at the Department of Health, Medicine and Caring Sciences at Linköping University and a leading figure in the study, emphasized the lasting impact of physical fitness on health outcomes well into later life. He expressed concern over current trends indicating a decline in the physical fitness of today’s youth compared to the levels observed in the 1970s and 80s, which makes these findings particularly significant for the current generation.

While it is acknowledged that a lack of physical fitness in early life is associated with an increased risk of cardiovascular diseases later on, the specific mechanisms underlying this association have remained unclear. Given that atherosclerosis, characterized by plaque buildup within the arteries, is a known risk factor for future cardiovascular issues, the research team aimed to explore the potential link between physical fitness during adolescence and atherosclerosis in later life. This connection would help clarify atherosclerosis as a plausible mechanism linking physical fitness to cardiovascular disease.

Leveraging data from the Swedish Military Conscription Register and the Swedish Cardiopulmonary Bioimage Study (SCAPIS), the researchers examined nearly 9,000 men aged between 50 and 64 years, for whom fitness data from their conscription at age 18 (between 1972 and 1987) were available. The long-term follow-up of these men, averaging 38 years, and the general population basis of the study are among its strengths.

For the first time, the study employed coronary CT angiography (CCTA) to assess the presence of plaques in the coronary arteries, vital for supplying blood to the heart, concerning physical fitness in youth. This advanced imaging technique allowed the researchers to evaluate calcified plaques, which are more straightforward to measure and have been a traditional focus of study, and examine non-calcified plaques. These latter plaques are deemed more dangerous as they are more prone to rupture, leading to heart attacks, and generally have a worse prognosis.

The findings revealed that both cardiorespiratory fitness and muscle strength in youth are associated with a lower risk of developing atherosclerosis in the coronary arteries nearly four decades later. The research also extended to examining atherosclerosis in the major arteries leading from the heart to the brain using ultrasound technology.

Due to the historical context in which only men were required to perform military service in Sweden, the study’s insights are confined to men. Consequently, it is impossible to extend these conclusions to women based on this research alone.

The study received funding from several sources, including the Heart-Lung Foundation, the prominent financier of SCAPIS, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, Vinnova, and the Joanna Cocozza Foundation for Children’s Medical Research. The research also benefited from the contributions of other scholars from Linköping University, including Karin Rådholm, Carl Johan Östgren, Kristofer Hedman, and Sara Higueras-Fresnillo. This collaborative effort underscores the importance of physical fitness in youth as a determinant of cardiovascular health later in life, highlighting the need for strategies to improve physical fitness among the younger population to mitigate future health risks.

More information: Ángel Herraiz-Adillo et al, Physical fitness in male adolescents and atherosclerosis in middle age: a population-based cohort study, British Journal of Sports Medicine. DOI: 10.1136/bjsports-2023-107663

Journal information: British Journal of Sports Medicine Provided by Linköping University

Research indicates that a reduction in serotonin levels could play a role in the cognitive deterioration observed during the initial phases of Alzheimer’s disease

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In a comprehensive study involving over 90 adults, both with and without mild cognitive impairment (MCI), researchers from Johns Hopkins Medicine have observed that individuals with MCI exhibit notably lower serotonin levels — a neurotransmitter often linked to feelings of well-being and happiness — in certain brain regions. This decrease in serotonin levels could potentially contribute to the memory challenges commonly associated with Alzheimer’s disease. Published online on September 13 in the Journal of Alzheimer’s Disease, these findings add to the accumulating evidence that significant changes in brain function may occur early in individuals experiencing mild memory issues, well before an Alzheimer’s diagnosis is confirmed. This research underscores the potential for identifying new therapeutic targets to decelerate or halt the disease’s progression.

The study highlights the early loss of serotonin transporters in individuals with MCI. This condition marks a transitional phase between the expected cognitive decline associated with ageing and the onset of Alzheimer’s disease. Symptoms of MCI include frequent forgetfulness, trouble finding words, and a diminished sense of smell. While some individuals with MCI may not progress beyond this stage, others may develop more severe cognitive impairments, emphasizing the importance of identifying markers that could predict disease progression and potentially guide early intervention strategies.

Gwenn Smith, PhD, a professor of psychiatry and behavioural sciences at the Johns Hopkins University School of Medicine, explains that the research demonstrates a correlation between diminished serotonin transporter levels and memory issues in MCI patients. This correlation persists even when accounting for MRI-detected neurodegeneration and PET-detected amyloid protein levels, both of which are markers associated with Alzheimer’s disease. However, the study’s design does not establish causation or definitively outline serotonin’s role in the transition from MCI to Alzheimer’s disease, signalling the need for further longitudinal studies to explore this relationship.

The research team recruited 49 volunteers with MCI and 45 healthy adults over 55 for the study, which spanned from 2009 to 2022. Participants underwent MRI scans to detect changes in brain structure and two PET scans to examine serotonin transporter levels and the distribution of amyloid-beta (Aβ) protein in the brain. Aβ protein accumulation is a hallmark of Alzheimer’s disease pathology. Previous studies conducted by Johns Hopkins on mice have shown that serotonin degradation precedes the widespread accumulation of beta-amyloid deposits in the brain, linking serotonin loss to depression, anxiety, and other psychological disorders.

The study found that MCI patients had both lower serotonin transporter levels and higher Aβ levels than healthy controls, with up to a 25% reduction in serotonin transporter levels in the cortical and limbic regions of the brain, which are crucial for executive function, emotion, and memory. Smith emphasizes the significance of the correlation between reduced serotonin transporters and memory challenges in MCI, suggesting that targeting this brain chemical could improve cognitive deficits and depressive symptoms. If future research establishes a direct link between serotonin loss and the progression from MCI to Alzheimer’s disease, it could open the door to using newly developed antidepressants as a means to enhance memory and potentially slow the disease’s progression.

Looking ahead, the researchers plan to conduct longitudinal studies to investigate the relationship between serotonin degradation further, increases in Aβ levels, and the accumulation of Tau protein, another Alzheimer’s disease marker, compared to healthy controls. They are also exploring the effectiveness of multi-modal antidepressant drugs in treating depression and memory deficits, with the hope of mitigating and halting the symptoms of Alzheimer’s disease. This collaborative effort involves scientists from the Johns Hopkins University School of Medicine and the Johns Hopkins Bloomberg School of Public Health, highlighting the interdisciplinary approach to understanding and combating Alzheimer’s disease.

More information: Smith, Gwenn S. et al, Serotonin Degeneration and Amyloid-β Deposition in Mild Cognitive Impairment: Relationship to Cognitive Deficits, Journal of Alzheimer’s Disease. DOI: 10.3233/JAD-230570

Journal information: Journal of Alzheimer’s Disease Provided by Johns Hopkins Medicine

Golf, walking, and Nordic walking could improve cognitive abilities in elderly individuals

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A recent study published in BMJ Open Sport & Exercise Medicine reveals that engaging in a single 18-hole game of golf or walking 6 km, whether through Nordic walking or traditional walking, can significantly enhance immediate cognitive performance in older adults. This research was conducted collaboratively by the University of Eastern Finland, the University of Edinburgh, and ETH Zürich to investigate the immediate impact of three types of cognitively stimulating aerobic exercises on cognitive function and biological markers in healthy older adults.

The research included 25 healthy older adults who were regular golfers, all aged 65 or older. These participants participated in three physical activity sessions: playing an 18-hole round of golf, engaging in a 6 km Nordic walk, and undertaking a 6 km traditional walk. These activities were performed in natural settings, with the participants walking at their usual brisk pace.

The study utilized the Trail-Making Test (TMT) Parts A and B. TMT-A focuses on evaluating basic cognitive abilities such as attention and processing speed. In contrast, TMT-B aims to assess more complex executive functions, including the ability to switch tasks efficiently. In addition, blood samples were taken to measure levels of brain-derived neurotrophic factor (BDNF) and cathepsin B (CTSB), which are considered indicators of the positive effects of physical activity on brain health. Participants also used fitness trackers to log data specific to each exercise, such as distance covered, total duration, pace, calories burned, and step count. Heart rates were monitored using an ECG sensor attached to a chest strap.

The findings indicated that a single exercise session, regardless of the type, improved the more straightforward cognitive functions measured by the TMT-A test in the older participants. However, the study did not find significant changes in BDNF and CTSB levels. As evaluated by the TMT-B test, both Nordic and regular walking showed positive associations with improvements in the more complex executive functions.

This research aligns with prior studies that have suggested the cognitive benefits of short-term aerobic exercises, noting that the exercise’s intensity, duration, and nature can influence the degree of cognitive enhancement.

Julia Kettinen, the study’s lead author and a doctoral researcher in Sports and Exercise Medicine at the University of Eastern Finland’s Institute of Biomedicine, emphasized the importance of suitable aerobic exercises, like golf, Nordic walking, and regular walking, for preserving and improving cognitive abilities in older adults. She noted that, consistent with previous findings, physical activity supports cognitive health in ageing and offers potential benefits for individuals experiencing cognitive decline.

More information: Julia Kettinen et al, Cognitive and biomarker responses in healthy older adults to a 18-hole golf round and different walking types: a randomised cross-over study, BMJ Open Sport & Exercise Medicine. DOI: 10.1136/bmjsem-2023-001629

Journal information: BMJ Open Sport & Exercise Medicine Provided by University of Eastern Finland

Strategies for Maintaining Brain Health

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The human brain is an extraordinary organ, boasting around 100 billion nerve cells that collaborate seamlessly to enhance your cognitive agility and speed. However, like other parts of your body, the brain’s efficiency might diminish with age. You might start relying more on notes, miss appointments, or need more effort to keep up with conversations or television programs.

Fortunately, the potential exists to train your brain just as you would your muscles.

Hermundur Sigmundsson, a professor in the Department of Psychology at the Norwegian University of Science and Technology (NTNU), highlights the significance of grey and white matter in our nervous system. Grey matter comprises neurons and dendrites, whereas white matter facilitates communication between these neurons (via myelinated axons), playing a crucial role in the speed and distribution of neural signals.

A comprehensive review in the Brain Sciences journal synthesizes existing research on brain health, emphasizing the importance of maintaining the condition of our grey and white matter. The study provides extensive theoretical analysis and references 101 articles, identifying three critical factors for optimal brain function: physical activity, social engagement, and pursuing passions or interests, including learning new things and embracing challenges.

Physical activity emerges as a significant challenge for many. A sedentary lifestyle not only affects the body but the brain as well. Sigmundsson and his colleagues argue that an active lifestyle is crucial for developing the central nervous system and mitigating brain ageing. Thus, it’s essential to incorporate physical movement into your daily routine, especially if your job or lifestyle involves prolonged periods of sitting.

Social interactions also play a vital role in brain health. Despite some individuals preferring solitude or minimal social contact, engaging with others is beneficial. Interactions can stimulate complex biological processes that help prevent cognitive decline. Socializing, whether through conversation or physical contact, supports robust brain functioning.

Passion, or having a strong interest in something, can significantly influence learning and the development and maintenance of neural networks. Staying curious and open to new experiences is crucial, regardless of age. For instance, learning to play a new musical instrument could be rewarding and stimulates your brain.

Sigmundsson, master’s student Benjamin H. Dybendal and associate professor Simone Grassini from the University of Stavanger advocate for the “use it or lose it” approach to brain health. Their research parallels the necessity of physical exercise for the body with the need for mental stimulation to prevent cognitive decay. They stress that lifestyle choices, including physical exercise, social interactions, and engaging in passionate pursuits, are instrumental in developing and maintaining the brain’s structural integrity as we age.

These three elements — physical activity, social engagement, and passion — contribute to sustaining brain health and enhancing overall quality of life, giving a foundation for ageing gracefully.

More information: Hermundur Sigmundsson, Benjamin H Dybendal and Simone Grassini. Motion, Relation, and Passion in Brain Physiological and Cognitive Aging, Brain Sciences. DOI: 10.3390/brainsci12091122

Journal information: Brain Sciences Provided by Norwegian University of Science and Technology