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Low oxygen during sleep and sleep apnea associated with epilepsy in older adults

Sleep apnea and low oxygen levels during sleep are linked to epilepsy that first manifests after the age of 60, termed late-onset epilepsy, according to a study supported by the National Institutes of Health (NIH) and featured in the journal Sleep. This connection remains significant even when accounting for other well-established risk factors for late-onset epilepsy and sleep apnea, such as hypertension and stroke. These insights could enhance our understanding of the relationship between sleep disorders and late-onset epilepsy and could highlight new avenues for therapeutic intervention.

Rebecca Gottesman, M.D., Ph.D., who is the chief of the Stroke Branch at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and also a contributor to the study, noted the growing body of evidence suggesting that late-onset epilepsy could signal underlying vascular or neurodegenerative disease, possibly serving as a preclinical indicator of such conditions. She highlighted that among various age groups, older adults display the highest rates of newly diagnosed epilepsy, with nearly half of these cases having no apparent cause. Although sleep apnea is prevalent among individuals with epilepsy, its precise role is not thoroughly understood.

The research team, headed by Christopher Carosella, M.D., an assistant professor of neurology at Johns Hopkins University in Baltimore, pinpointed cases of late-onset epilepsy using Medicare claims and examined sleep data from over 1,300 participants involved in a study focused on sleep-disordered breathing and cardiovascular health. They discovered that individuals experiencing nocturnal hypoxia, where oxygen saturation drops below 80% during sleep, were three times more likely to develop late-onset epilepsy compared to those without such severe drops in oxygen levels. Moreover, participants who reported having sleep apnea later in life were twice as likely to develop late-onset epilepsy as those without this sleep condition.

The researchers found that the severity of hypoxia during sleep was linked to an increased likelihood of developing late-onset epilepsy, independent of other concurrent medical conditions and demographic factors. Interestingly, the study did not find a correlation with the apnea-hypopnea index, a standard measure of sleep apnea severity.

The study highlights that sleep apnea is a known risk factor for various other aspects of poor brain health, including increased risks of stroke and dementia. However, its association with epilepsy had not been previously established. The findings suggest that chronic, repeated exposure to low oxygen levels overnight could induce brain changes that eventually escalate the risk of epilepsy. While the study does not confirm whether treating or preventing sleep apnea could reduce epilepsy risk, it implies that addressing sleep apnea might be a crucial strategy for mitigating the risk of late-onset epilepsy.

Dr. Carosella expressed optimism about the implications of their findings, stating that identifying a reversible cause for any idiopathic epilepsy is a long-standing ambition among epilepsy researchers and clinicians. He hopes this study represents an initial step towards this goal and encourages further evaluation and treatment of sleep disorders in epilepsy patients.

Given the broader implications of sleep apnea on cardiovascular and brain health, these findings could also help identify individuals at risk for these conditions, potentially opening doors to preventative treatments and interventions.

More information: Christopher M Carosella et al, Sleep apnea, hypoxia, and late-onset epilepsy: the Atherosclerosis Risk in Communities study, SLEEP. DOI: 10.1093/sleep/zsad233

Journal information: SLEEP Provided by NIH/National Institute of Neurological Disorders and Stroke

Perceived gender discrimination associated with a decrease in wellbeing among older women

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A research project involving over 3,000 middle-aged and later-aged women in England has uncovered that individuals who felt they had been subjected to gender discrimination were more prone to experiencing declines in their wellbeing over time. Ruth Hackett from King’s College London, UK, and her team shared these insights in the open-access journal PLOS ONE on March 20, 2024.

Previous studies have indicated that individuals who believe they have faced gender discrimination tend to report lower mental wellbeing. However, these studies often did not track wellbeing longitudinally or primarily focused on younger demographics.

To understand how this dynamic plays out among older women, Hackett and her colleagues examined data from 3,081 participants in the English Longitudinal Study of Ageing (ELSA), which tracks a broad demographic of people over 50.

During 2010 or 2011, each participant responded to queries regarding the frequency of their encounters with various forms of discrimination, such as harassment or receiving less respect or courtesy, and whether they attributed these experiences to their gender or another characteristic like race or age. They also completed standard questionnaires to assess mental wellbeing on two occasions, first in 2010 or 2011 and then in 2016 or 2017.

About 9.2 per cent of the participants reported experiencing gender discrimination, often in situations where they were treated with less respect or courtesy. Notably, those who perceived gender discrimination reported higher instances of depressive symptoms, increased loneliness, and a decline in both quality of life and life satisfaction. From one time point to the next, there was a tendency among these women to report worsened quality of life and life satisfaction, along with heightened feelings of loneliness. These observations remained significant even after adjusting for other factors related to wellbeing, such as age, wealth, and physical activity levels.

These outcomes point to a possible link between perceived gender discrimination and deteriorating mental wellbeing in women during middle age and beyond, leading the researchers to advocate for intensified efforts to combat gender discrimination. They also highlight the importance of further investigations to better understand this association’s underpinnings and overcome the study’s limitations, including its lack of diversity among participants.

The researchers concluded: “Our findings reveal that middle-aged and older women who experienced perceived sexism were more susceptible to depression and loneliness compared to those who did not perceive sexism. Additionally, these women indicated lower levels of life satisfaction and poor quality of life. The enduring negative impact of gender-based discrimination on mental health and wellbeing observed six years later raises significant concerns.”

More information: Ruth A. Hackett et al, The relationship between gender discrimination and wellbeing in middle-aged and older women, PLoS ONE. DOI: 10.1371/journal.pone.0299381

Journal information: PLoS ONE Provided by PLOS

A few cups of coffee daily may help prevent Parkinson’s disease in individuals at increased risk

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According to research by the National Neuroscience Institute, individuals with Asian gene variants associated with Parkinson’s disease (PD) who regularly consume tea or coffee have a substantially lower risk—four to eight times less—of developing the condition compared to those who do not consume caffeine but carry the PD genes. Caffeine consumers with the PD gene have a lower risk of developing PD than non-caffeine consumers without the gene.

Professor Tan Eng King, the study’s Principal Investigator, Deputy Chief Executive Officer (Academic Affairs), and Senior Consultant at the Department of Neurology, National Neuroscience Institute, emphasized that caffeine has a known potential protective effect against PD and other neurodegenerative conditions. The study highlights its significant impact in reducing PD risk, thus balancing the risk levels for Asians who are genetically predisposed to PD but are currently without symptoms.

Professor Tan announced these findings at the 10th Singapore International Parkinson Disease and Movement Disorders Symposium. He explained that caffeine is believed to reduce inflammation in brain neurons, which can prevent cell death. However, the specific interactions between caffeine and Asian PD gene variants remain unclear.

The research involved 4,488 participants and found that individuals with specific Asian genetic variants are 1.5 to 2 times more likely to develop PD. These variants are most prevalent among East Asians, with up to 10% of the Singapore population carrying one of these gene variants located in the coding region, which is crucial for protein synthesis.

Participants in the study completed a validated caffeine intake questionnaire. The average caffeine consumption was 448.3 mg among those diagnosed with PD and 473.0 mg among healthy controls. This is equivalent to 4 to 5 cups of Western-style Arabica coffee or 2 cups of traditional Singapore coffee made from Robusta beans, which are higher in caffeine content. The study also noted that higher doses of caffeine seemed to enhance protective benefits, though even those consuming less than 200 mg of caffeine daily saw a reduced risk of PD. Daily 400 mg of caffeine is generally considered safe for most healthy adults.

Parkinson’s disease is the fastest-growing neurodegenerative condition worldwide, with over 8,000 individuals living with PD in Singapore alone. This figure represents only a fraction of the potential cases, as a study by NNI indicated that 26% of the local elderly population show mild Parkinsonian signs. Professor Tan highlighted that these findings represent a significant advance in combatting this debilitating condition.

He stressed the broader implications of this research for PD prevention, particularly in regions like Singapore, where the relevant Asian gene variants are prevalent. In these communities, tea and coffee are widely available and culturally ingrained, offering a simple, enjoyable, and social means for individuals to decrease their PD risk.

More information: Yi-Lin Ong et al, Caffeine intake interacts with Asian gene variants in Parkinson’s disease: a study in 4488 subjects, The Lancet. DOI: 10.1016/j.lanwpc.2023.100877

Journal information: The Lancet Provided by SingHealth

Introducing spatial orientation tests would enhance safety assessments for older drivers

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New findings from the University of East Anglia (UEA) reveal that older drivers with diminished spatial orientation capabilities face more challenges while executing turns across oncoming traffic. Spatial orientation, a crucial skill set for drivers, involves mentally ascertaining one’s or one’s vehicle’s position relative to the surroundings.

Sol Morrissey, a doctoral student at UEA’s Norwich Medical School, underscores the profound implications of ageing on driving safety. As individuals age, a myriad of changes can impact driving behavior, yet the specific role of cerebral alterations in this behavior remains largely uncharted. Morrissey’s study illuminates that older adults with compromised spatial orientation tend to drive less frequently and report more difficulties while driving. A striking discovery is an association between poor spatial orientation and heightened challenges in navigating turns across oncoming traffic, a well-known precursor to serious road accidents. This revelation hints at the potential future integration of spatial orientation tests in driving safety assessments for the elderly, a measure that could significantly enhance road safety.

The study, conducted between February and August 2021, involved 804 participants, averaging 71. Criteria for inclusion were being 65 or older, holding a valid driving license, and driving at least once a week. Participants provided information through online surveys covering demographics, health, driving history and habits, and incidents, in addition to assessments of spatial memory and navigation skills. They also underwent neuropsychological tests to evaluate cognitive performance in various domains.

Results highlighted a direct link between spatial orientation deficits and driving difficulties among the elderly, reinforcing previous studies that identified processing speed as a crucial factor affecting driving in older adults. Spatial orientation emerged as the sole cognitive skill significantly impacting driving behaviour, underscoring its importance in safely navigating turns and judging vehicle positioning.

The overrepresentation of older adults in multi-vehicle intersection crashes points to spatial orientation deficits as a significant individual risk factor. The study’s findings further demonstrate that poor spatial orientation, reduced processing speed, and episodic memory are associated with increased driving difficulty and avoidance of challenging driving scenarios.

Professor Michael Hornberger of Norwich Medical School underscores the robustness of spatial orientation deficits as an indicator of driving performance in the elderly. He advocates for the consideration of these deficits in future driving assessments to bolster road safety among the ageing population. With the projected increase in the number of older drivers, comprehending and addressing the challenges posed by age-related physiological changes and health conditions become pivotal for maintaining both independence and safety. The study’s findings offer a beacon of hope, suggesting that incorporating spatial orientation tests in driving safety assessments can potentially mitigate the risks associated with ageing and driving.

Traditionally, research on the impact of ageing on driving has focused more on physical and sensory functions, with less attention given to cognitive changes despite their known significance. The UEA study contributes valuable normative data on cognitive functioning in healthy older adults, utilizing online cognitive assessments to offer a more convenient and efficient alternative to traditional in-person tests for monitoring changes in driving fitness over time.

The researchers also propose that spatial orientation’s role in driving difficulty could explain the reduced road safety observed in individuals with Mild Cognitive Impairment (MCI) and Alzheimer’s disease. However, they acknowledge limitations such as reliance on self-reported driving behaviours and their study’s lack of environmental context. Future research could include naturalistic driving measures and explore cognitive functioning trajectories to inform the frequency and fitness methods to drive assessments and monitoring.

More information: Sol Morrissey et al, The Impact of Spatial Orientation Changes on Driving Behavior in Healthy Aging, Journal of Gerontology. DOI: 10.1093/geronb/gbad188

Journal information: Journal of Gerontology Provided by University of East Anglia

Research indicates that ChatGPT could be an effective tool for managing medications, potentially enhancing healthcare for older adults

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Polypharmacy, which refers to the simultaneous use of five or more medications, is prevalent among older adults and elevates the risk of adverse drug interactions. Combatting this risk involves deprescribing unnecessary medications, an intricate process that demands considerable time. There is a growing need for robust tools to manage polypharmacy, primarily to assist the often overburdened primary care practitioners.

A recent study by the Mass General Brigham MESH Incubator highlighted the potential of ChatGPT, a generative artificial intelligence (AI) chatbot, as a valuable resource in managing polypharmacy and facilitating deprescription. The results of this pioneering study, disclosed on April 18th in the Journal of Medical Systems, mark a significant development in the use of AI models in medication management, keeping policymakers informed of the latest advancements.

In their assessment, researchers provided ChatGPT with various clinical scenarios, each depicting an elderly patient on multiple medications but differing in their cardiovascular disease history (CVD) and levels of daily living activities impairment (ADL). ChatGPT was then posed with decision-making questions requiring yes or no answers concerning reducing prescribed medications. The AI tended to recommend deprescribing in cases without CVD history but showed more restraint where CVD was a factor, generally advising to maintain the existing medication regimes. Notably, the severity of ADL impairment did not influence the AI’s decisions.

Interestingly, the study observed that ChatGPT often overlooked pain issues, showing a preference for reducing pain medications rather than other types, such as statins or antihypertensives. The researchers also pointed out that the AI’s responses could vary even when presented with identical scenarios in different sessions, which they attributed to potential inconsistencies in the deprescribing trends on which the AI was trained.

With over 40 per cent of older adults falling into the category of polypharmacy and an increasing number of specialists being involved in their care, primary care providers are often left with the critical task of managing medications. The study suggested that deploying an effective AI tool like ChatGPT could significantly support these efforts.

Dr. Marc Succi, MD, Associate Chair of Innovation and Commercialization at Mass General Brigham Radiology and Executive Director of the MESH Incubator, emphasized the study’s importance. He stated, “Our study provides the first use case of ChatGPT as a clinical support tool for medication management. While enhancing the accuracy of such models is important, AI-assisted polypharmacy management could help alleviate the growing pressure on general practitioners. Continued research with specifically trained AI tools could greatly improve the care provided to elderly patients.”

Arya Rao, the lead author, a researcher at MESH, and a medical student at Harvard, remarked, “Our findings suggest that AI-based tools can play a crucial role in ensuring safe medication practices for older adults; it is vital that we keep refining these tools to better handle the complexities involved in medical decision-making.”

More information: Arya Rao et al, Proactive Polypharmacy Management Using Large Language Models: Opportunities to Enhance Geriatric Care, Journal of Medical Systems. DOI: 10.1007/s10916-024-02058-y

Journal information: Journal of Medical Systems Provided by Mass General Brigham

Older adults are eager to communicate using emojis; they simply struggle with understanding their usage

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A recent study conducted by the University of Ottawa sheds light on how emojis are interpreted across different age groups. It revealed that while older adults comprehend the meanings of emojis, they often need to learn to use them more frequently than their younger counterparts. This hesitation stems from a need for more confidence in using technology for communication, challenging the stereotype that older generations are resistant or incapable of adopting modern digital language such as emojis.

The research led by Isabelle Boutet, an Associate Professor at the School of Psychology within the University’s Faculty of Social Sciences, emphasizes that the reluctance among older adults to use emojis does not arise from an inability to understand them. Instead, it points to a lower tendency to employ emojis, a limited variety in their emoji use, and discomfort in interpreting the symbols. Contrary to the assumption that older individuals cannot accurately interpret emojis, the study found that confidence in using emojis and technology primarily affects their usage patterns.

This comprehensive examination of emoji use across generations, including participants over 60, aimed to document how age and generational differences impact emojis. To investigate how age influences these factors, it assessed several aspects of emoji adoption, such as usage frequency, diversity, ease of interpretation, and accuracy in understanding emojis. Among the findings, the emoji for surprise—a face with wide eyes and raised eyebrows—was identified as particularly challenging for older adults to interpret, followed by emojis representing happiness.

The study observed that as age increases, individuals tend to find emojis more challenging to use, display less confidence in their emoji usage capabilities, and are generally less engaged with technology where emojis are prevalent. This trend led the researchers to conclude that older adults are motivated and able to use emojis but need more confidence and technological expertise.

Recognizing the potential benefits of emojis in enhancing communication, fostering intergenerational connections, combating loneliness, and helping individuals achieve social and emotional objectives, Boutet advocates for initiatives to encourage emoji use among older adults. The importance of these initiatives is underscored by the need to bridge the gap between different generations, fostering understanding and connection in an increasingly digital world.

More information: Isabelle Boutet et al, Are older adults adapting to new forms of communication? A study on emoji adoption across the adult lifespan, Computers in Human Behavior Reports. DOI: 10.1016/j.chbr.2024.100379

Journal information: Computers in Human Behavior Reports Provided by University of Ottawa

Hybrid insulin pumps are highly effective in adults with type 1 diabetes

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New advanced insulin pumps are transforming the management of type 1 diabetes by continuously monitoring blood sugar levels and using specific algorithms to administer insulin doses automatically, maintaining stable glucose levels. This cutting-edge technology, Advanced Hybrid Closed Loop (AHCL), features a pump that continuously delivers insulin through a tube connected to a thin cannula placed in the subcutaneous fatty tissue. In recent years, these pumps have become available in Sweden to treat type 1 diabetes.

Blood sugar control has been a primary focus of a study conducted in collaboration with Sahlgrenska University Hospital Östra, with the findings published in the Journal of Diabetes Science and Technology. The study included 142 randomly selected adults with type 1 diabetes treated with one of two AHCL pumps at six different diabetes clinics across Sweden. The average age of the participants was 42 years, and they had been using their AHCL pump for just over one and a half years.

The results showed a notable improvement in blood sugar control among patients using the hybrid pumps. Insulin therapy aims to maintain blood sugar levels within a specific range, between 3.9 and 10 mmol/L. The study found that the time patients spent within this target range increased by approximately three and a half hours daily. Before starting pump therapy, patients’ blood sugar levels were within this range 57% of the time, on average. With the hybrid insulin pumps, this average increased to 71.5%.

Additionally, the risk of organ damage was reduced, as indicated by Dr. Ramanjit Singh, a Resident Physician affiliated with research at the University of Gothenburg and the study’s lead author. Dr Singh highlighted the significance of the improvement, noting that even an additional hour within the target range is crucial for reducing the risk of organ damage. The new treatment also reduced the time patients spent with dangerously low blood sugar levels, from 0.7% to 0.3% during the day, without increasing the occurrence of severe sugar dips.

Participants also reported high satisfaction levels with the advanced insulin pump compared to their previous diabetes treatments. In a research survey, they rated their experience on a scale from minus 18 (worst) to plus 18 (best), with an average score of plus 14.8.

Despite the treatment’s effectiveness, the researchers noted the potential for further improvement. Approximately one-third of the patients experienced skin reactions to the adhesive in the infusion sets or sensors.

Professor Marcus Lind, a leading figure in diabetology at the Sahlgrenska Academy and head of the diabetes research unit at Sahlgrenska University Hospital Östra, emphasized the potential for even more significant improvements in blood sugar levels as more patients receive the new treatment. This could further reduce organ damage and improve overall prognosis. He also highlighted the importance of developing products that are more skin-friendly and conducting more extensive studies to assess the safety of the treatment.

The insulin pumps used in the study, MiniMed™ 780 G and Tandem® t:slim X2™ with Control IQ™, represent significant advancements in the field. The study was an academic research project conducted independently of the companies responsible for these pumps, underscoring its objectivity and the significance of the findings in advancing diabetes treatment.

More information: Ramanjit Singh et al, Effects, safety, and treatment experience of advanced hybrid closed loop systems in clinical practice among adults living with type 1 diabetes, Journal of Diabetes Science and Technology. DOI: 10.1177/19322968241242386

Journal information: Journal of Diabetes Science and Technology Provided by University of Gothenburg

BNP peptide implicated in eczema

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The groundbreaking research conducted at North Carolina State University has unveiled the pivotal role of a specific peptide in the onset of atopic dermatitis, commonly known as eczema. This discovery holds immense potential in revolutionizing the treatment landscape for this condition, offering more precise and potent therapeutic interventions.

Atopic dermatitis (AD) manifests as itchy, irritated, and thickened skin at affected sites. A particular peptide, the brain natriuretic peptide (BNP), is elevated in individuals suffering from AD. According to Santosh Mishra, an associate professor of molecular biomedical sciences at NC State and the study’s corresponding author, BNP is produced in sensory neurons—cells responsible for transmitting sensations to the brain through the spinal cord. Previous studies have established BNP’s role in conveying the itch sensation from the skin to the brain. This research aimed to explore BNP’s involvement in activating AD.

The team made a striking observation through a meticulously designed chemically induced mouse model of AD. Mice that lacked BNP did not exhibit the typical signs of AD, such as thickened or irritated skin, and their itching was significantly reduced compared to the control group with BNP. This rigorous approach to the study instils confidence in the validity of our findings.

“Our findings suggest that BNP likely plays a key role in the activation of itch,” Mishra noted. The study then explored the connection between BNP and periostin, aiming to understand the mechanism behind this activation process.

Periostin, a protein that interacts with sensory neurons in the skin to trigger the itch response, is produced in skin cells known as keratinocytes and fibroblasts. Keratinocytes possess receptors for BNP, known as NPR1 receptors. Activation of these receptors by BNP leads to the production of periostin, which activates the itch sensation.

“The intriguing aspect of our findings is that sensory neurons initiate the activation process,” explained Mishra. The neuron releases BNP, which then activates keratinocytes with NPR1 receptors, releasing periostin.

This research not only sheds light on the role of peripheral neurons, but also initiates a cascade of responses in the development of AD. It all starts in the sensory neurons, triggering a series of events. This significant finding not only deepens our understanding of AD, but also opens up a new realm of therapeutic possibilities. For instance, the potential to inhibit BNP’s interaction with NPR1 receptors in the skin could herald a new era in the treatment of AD, instilling hope in the scientific community.

More information: Joshua J. Wheeler et al, Brain Natriuretic Peptide Exerts Inflammation and Peripheral Itch in a Mouse Model of Atopic Dermatitis, Journal of Investigative Dermatology. DOI: 10.1016/j.jid.2023.09.273

Journal information: Journal of Investigative Dermatology Provided by North Carolina State University

Engaging in intellectually stimulating occupations could potentially offer protection against the onset of dementia in later stages of life

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A recent groundbreaking study, conducted by researchers from Columbia University Mailman School of Public Health, the Columbia Aging Center, and the Norwegian Institute of Public Health, illuminates the potential protective effects of engaging in intellectually stimulating occupations against the development of dementia later in life. Published in Neurology, this study delves into the relationship between occupational cognitive demands and the risk of mild cognitive impairment (MCI) and dementia in individuals aged 70 and above, providing a wealth of new insights.

The findings reveal that individuals who had been involved in cognitively stimulating occupations during their 30s, 40s, 50s, and 60s exhibited a reduced risk of developing MCI and dementia after reaching the age of 70. This underscores the significance of maintaining cognitive stimulation throughout midlife to preserve cognitive function in old age. Notably, this study distinguishes itself by employing objective assessments rather than relying on subjective evaluations, marking a significant advancement in understanding this association.

Dr Vegard Skirbekk, a professor of Epidemiology at Columbia Mailman School of Public Health and Columbia Aging Center, who spearheaded the project, emphasises the importance of mentally challenging job tasks in sustaining cognitive functioning as individuals age. Similarly, Trine Holt Edwin, the first author of the study from Oslo University Hospital, underscores the vital role of education and intellectually stimulating work environments in promoting cognitive health during older age.

The researchers used information from the Norwegian administrative registry to gather data for their analysis. They paired it with occupational attributes obtained from the Occupational Information Network (O*NET) U.S. Department of Labor, Employment & Training Administration database. They computed a Routine Task Intensity (RTI) index to gauge the cognitive demands of various occupations, with lower RTI values indicating higher cognitive demands. This approach is built upon previous research on occupational physical activity trajectories.

Using group-based trajectory modelling, the researchers identified four distinct groups with varying occupational cognitive demands across life stages. They then examined the association between these trajectory groups and the incidence of clinically diagnosed MCI and dementia in participants aged 70 and above while also accounting for key dementia risk factors such as age, gender, education, income, overall health, and lifestyle habits.

After adjusting for age, sex, and education, the study revealed that individuals in occupations with low cognitive demands (high RTI group) faced a 37 per cent higher risk of dementia compared to those in occupations with high cognitive demands. Trine Holt Edwin notes that while education played a significant role in this association, it did not entirely explain the relationship between occupational cognitive demands and the risk of MCI and dementia, suggesting that both factors independently influence mental health outcomes.

The study represents a significant advancement in the field by moving beyond retrospective, subjective evaluations of occupational cognitive demands and instead utilising registry data on occupational histories for a more robust analysis. Yaakov Stern, a Principal Investigator of the project at Columbia University, highlights the importance of this approach in strengthening existing evidence.

The findings of this study carry significant implications for our understanding of cognitive health in old age. They underscore the importance of engaging in intellectually stimulating occupations to reduce the risk of MCI and dementia in later life. Dr. Skirbekk stresses that while education and occupational cognitive demands play pivotal roles in mitigating cognitive decline, this research empowers us to make informed choices about our careers and lifestyles to protect our cognitive health.

It is important to note that this study, while providing valuable insights, establishes associations rather than direct causation between occupational cognitive demands and dementia risk. It did not differentiate between varying cognitive requirements within the same occupational category or consider the evolution of job responsibilities over time. These aspects indicate potential avenues for future research and refinement of these findings, sparking curiosity and interest in the future of cognitive health studies.

More information: Trine H. Edwin et al, Trajectories of Occupational Cognitive Demands and Risk of Mild Cognitive Impairment and Dementia in Later Life, Neurology. DOI: 10.1212/WNL.0000000000209353

Journal information: Neurology Provided by Columbia University Mailman School of Public Health

A study focusing on middle-aged and older adults, which took into account lifestyle and demographic factors, found that a higher Body Mass Index (BMI) is closely linked to poorer mental health, with this association being particularly notable in women

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Obesity and mental health issues stand as substantial challenges to global health. Studies have established a connection between higher levels of body fat and the occurrence of depression and general well-being. Nonetheless, documentation of such evidence remains scarce in Ireland. Additionally, research points to the potential influence of lifestyle choices and health conditions on mental health, which could alter the impact of body fat on depression and overall well-being.

The research involved a cross-sectional analysis of 1,821 individuals, both men and women, aged between 46 and 73 years. These participants were randomly selected from a comprehensive primary care centre. The assessment of depression and well-being was carried out using the 20-item Centre for Epidemiologic Studies Depression Scale (CES-D) and the World Health Organization-Five (WHO-5) Well-Being Index, respectively. Through linear regression analyses, the study examined the relationship between mental health outcomes (as the dependent variable) and levels of adiposity (as the independent variable), as indicated by body mass index (BMI) and waist-height ratio. This examination examined various demographic characteristics, lifestyle factors, and health conditions.

The results of this study indicate a significant link between higher adiposity and diminished mental health, even when controlling for lifestyle choices and health conditions. These findings underscore the importance of incorporating strategies for weight management at the population level into interventions aimed at reducing depression.

More information: Caoimhe Lonergan et al, Associations between adiposity measures and depression and well-being scores: A cross-sectional analysis of middle- to older-aged adults, PLoS ONE. DOI: 10.1371/journal.pone.0299029

Journal information: PLoS ONE Provided by PLOS

Cardiovascular fitness reduces mortality and the incidence of diseases by nearly 20%

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New groundbreaking research from the University of South Australia highlights the profound impact of regular exercise, such as running, cycling, or swimming, on extending one’s lifespan and promoting overall health. The study reveals that maintaining a higher level of cardio fitness can lead to a remarkable 11-17% reduction in mortality risk from any cause.

Published in the British Journal of Sports Medicine (BJSM), this comprehensive study analysed data from 26 systematic reviews with meta-analysis, encompassing over 20.9 million observations from 199 unique cohort studies. It represents the most extensive compilation of scientific evidence on the prospective relationship between cardiorespiratory fitness (CRF) and health outcomes in adults.

The research, led by Senior Author Professor Grant Tomkinson from UniSA, underscores the pivotal role of cardiorespiratory fitness in maintaining good health. CRF, defined as the ability to sustain physical activity over an extended period, correlates strongly and consistently with various health outcomes, including heart disease, depression, diabetes, dementia, and cancer.

The findings reveal a direct association between CRF levels and the risk of premature death and chronic conditions, such as heart failure. For every 1-MET increase in CRF, equivalent to the energy expended during quiet sitting, the risk of early mortality and heart failure decreases by 11-17% and 18%, respectively.

Professor Tomkinson emphasises that regular aerobic exercise, such as running, cycling, or swimming, can effectively boost CRF levels and mitigate the risk of adverse health outcomes. The study’s message is clear: vigorous physical activity significantly reduces the likelihood of premature death and the development of chronic diseases.

Chronic health conditions pose a significant public health challenge, contributing to a substantial burden of disease and disability. In Australia alone, an estimated 11.6 million individuals, representing 47% of the population, grapple with chronic and debilitating health conditions, underscoring the urgency of preventive measures.

Lead author Dr Justin Lang, from the Public Health Agency of Canada and UniSA, underscores the importance of cardiorespiratory fitness as a critical indicator of health status. The study serves as a compelling reminder for individuals to prioritise physical activity and movement to enhance their fitness levels and improve overall health outcomes.

Dr Lang advocates for additional moderate physical activity, such as brisk walking for at least 150 minutes per week, to bolster cardiorespiratory fitness and reduce mortality and disease risk. Moreover, he stresses the importance of routine assessment by clinicians and exercise professionals to identify individuals at higher risk and implement tailored exercise programmes to enhance CRF through regular physical activity.

More information: Justin J Lang et al, Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies, British Journal of Sports Medicine. DOI: 10.1136/bjsports-2023-107849

Journal information: British Journal of Sports Medicine Provided by University of South Australia

Research review indicates the gut-skin axis as a crucial element in the development of atopic dermatitis

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Atopic dermatitis (AD), a long-term inflammatory condition of the skin, is characterized by symptoms including redness, swelling, and itching rashes. Its prevalence is notably higher among individuals with genetic predispositions. The onset and severity of symptoms are influenced by a combination of factors involving the immune system, environmental influences, and the gut microbiota. Despite ongoing research efforts, the intricacies of this condition remain partially understood. However, recent studies have begun to shed light on significant aspects; for instance, changes in the gut microbiota have been linked to the disease’s severity. Environmental triggers like allergens and pollution can exacerbate symptoms, while genetic predispositions increase susceptibility. Moreover, dietary interventions and faecal transplantation have emerged as potential therapeutic strategies.

A more profound comprehension of the interplay among these variables is crucial for advancing our understanding of atopic dermatitis and developing new treatments. This perspective is not only crucial but also significantly advanced by a review article in the International Journal of Molecular Sciences, a testament to the invaluable contributions of researchers from the University of São Paulo (USP) and the Federal University of São Paulo (UNIFESP) in Brazil.

Referred to also as atopic eczema, AD impacts 7%-10% of adults and 20%-25% of children globally. The demographic most affected, in terms of gender, remains unclear. The 21st century has seen a marked increase in AD cases attributed to a range of factors, including genetics, immune system issues, viral infections, and changes in lifestyle and diet, among others. A notable hypothesis for the spike in cases, particularly in developing countries, suggests that reduced exposure to beneficial bacteria might hinder the immune system’s development.

Central to recent research is the gut microbiota’s role in immune regulation, skin barrier function, and overall health. Sabri Saeed Sanabani, a researcher at the Institute of Tropical Medicine (IMT-USP) and the article’s last author, emphasizes the gut microbiota’s critical role in immune system regulation, skin integrity, and the gut-skin axis. Alterations in the gut microbiome, including imbalances in specific bacterial populations, have been implicated in AD’s development. For example, patients with AD show differences in their gut microbiome composition compared to healthy individuals, with variations in bacteria that could contribute to inflammation and disease pathogenesis.

Genetic research, particularly genome-wide association studies (GWAS), has identified genetic markers associated with AD susceptibility and progression. One of the most significant findings relates to mutations in the filaggrin gene, which plays a vital role in skin health. The connection between genetic factors and changes in the gut microbiome remains an area of active investigation.

Though not fully understood, environmental influences on AD are acknowledged to affect skin barrier function and the balance of the gut microbiome. The review highlights emerging treatments targeting these areas, including epigenetic interventions and strategies to alter gut microbiome composition through diet, probiotics, prebiotics, and faecal transplants.

Sanabani notes that the review aims to synthesize current research findings and identify gaps in knowledge, setting a direction for future investigations into atopic dermatitis.

More information: Rodrigo Pessôa et al, The Interaction between the Host Genome, Epigenome, and the Gut–Skin Axis Microbiome in Atopic Dermatitis, International Journal of Molecular Sciences. DOI: 10.3390/ijms241814322

Journal information: International Journal of Molecular Sciences Provided by Fundação de Amparo à Pesquisa do Estado de São Paulo