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Thursday, April 25, 2024
Dementia

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A study in mice suggests that the “glymphatic system,” which removes the brain’s toxic waste during sleep, may not operate efficiently in shift workers who sleep during the day. This may explain their increased risk of brain disorders, such as Alzheimer’s disease.

In 2012, researchers at the University of Rochester Medical Center (URMC), NY, discovered a previously unknown waste disposal system in the brain.

They dubbed it the glymphatic system because nerve cells called glial cells manage its operation, which fulfills a similar role for the brain that the lymphatic system does for the rest of the body.

The following year, the same team found that the glymphatic system is most active during sleep.

In their latest experiments, the researchers reveal that it is the body’s circadian rhythms, the “master clock” regulating the sleep-wake cycle of roughly 24 hours, that governs this system.

“These findings show that glymphatic system function is not solely based on sleep or wakefulness, but by the daily rhythms dictated by our biological clock,” says neuroscientist Dr. Maiken Nedergaard, co-director of the Center for Translational Neuromedicine at URMC and senior author of the study.

The findings appear in the journal Nature Communications.

Toxic waste products

One of the processes that occur during sleep is the clearance of toxic products of metabolism that accumulate in the brain during wakefulness. One such waste product is the protein beta-amyloid, which — if not removed — forms the plaques associated with Alzheimer’s disease.

An ongoing failure to remove waste products such as beta-amyloid may partly explain why chronic sleep disruption is an early sign of neurodegenerative disorders such as Alzheimer’s.

In their early work, Dr. Nedergaard and her colleagues showed that the glymphatic system is a network of channels adjoining blood vessels in the brain.

The channels comprise projections, or “endfeet,” from a type of glial cell known as astrocytes. The endfeet effectively enclose the blood vessels in a hollow sheath.

During sleep, the glymphatic system pumps cerebrospinal fluid around the brain in time with the pulsing of arteries. This liquid washes away soluble waste products before draining into the lymphatic system.

But the new research reveals the activity of the glymphatic system is governed by the body’s biological clock, rather than sleep.

In humans, circadian rhythm regulates our physiology cycle between wakefulness during the day and sleep at night.

“Because this timing also influences the glymphatic system, these findings suggest that people who rely on cat naps during the day to catch up on sleep, or work the night shift, may be at risk for developing neurological disorders,” says Lauren Hablitz, Ph.D., a research assistant professor in Nedergaard’s lab and the first author of the paper.

“In fact, clinical research shows that individuals who rely on sleeping during daytime hours are at much greater risk for Alzheimer’s and dementia, along with other health problems,” she adds.

Fluorescent tracer

The researchers made their discovery in mice, which are nocturnal — their sleep-wake cycle is the reverse of that characteristic in humans.

To monitor cerebrospinal fluid movement through the animals’ brains, they injected a fluorescent tracer that they could see through the animals’ skulls.

This revealed that the flow of fluid into the brain was around 53% higher during the day while the animals were asleep, compared with the night when they were active.

Crucially, this cycle of activity in their glymphatic system persisted even when the researchers anesthetized the mice throughout the day and night.

It also continued when they kept the rodents in constant light for 10 days.

This strongly suggests that circadian rhythms govern this system and therefore may not operate efficiently during daytime sleep in humans.

Finally, the researchers show that the circadian regulation of cerebrospinal fluid through the brain depends on a water channel called aquaporin-4 in the membrane of the endfeet.

In mice genetically engineered to lack this channel, the usual tidal flow of fluid across the day and night was completely absent.

Disrupted daily rhythms

The authors note that while much research is needed, their work suggests disrupting circadian rhythms may prevent the efficient removal of the brain’s toxic byproducts.

This may lead to the chronic inflammation that characterizes neurodegenerative disorders such as Alzheimer’s.

They conclude:

“Although glymphatic function has yet to be studied in models of circadian disruption, such as in shiftwork, it has been established that shift workers are at increased risk for neurodegenerative disorders […] Understanding how these rhythms, all with different timing and biological functions, interact to affect glymphatic function and lymphatic drainage may help prevent morbidity associated with circadian misalignment.”

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Welcome to the latest edition of our Medical Myths series. Today, to mark World Alzheimer’s Day, we will be tackling myths relating to both Alzheimer’s disease and dementia at large.

Today, an estimated 5.8 million people aged 65 years or older in the United States have dementia.

Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 million.

Figures of this stature spark justifiable fear, and, as we have found in previous Medical Myths articles, fear tends to breed misconceptions.

In this article, we aim to dispel 11 of these myths.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging.

According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S.

As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same thing

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on Aging define dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology.

Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link.

As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5% of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. FTD, which is much less common, has a stronger genetic link, but if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Today, FTD affects an estimated 15–22 in every 100,000 people. Of these individuals, 10–15% have a strong family history of the condition.

4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimate that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000, or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studies have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changes may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel,” explains Jeremy Hughes, former Chief Executive of the Alzheimer’s Society.

“[W]e want to reassure people that life doesn’t end when dementia begins.” – Jeremy Hughes

7. Memory loss always signifies dementia

Although memory loss can be an early symptom of dementia, it does not necessarily signify the start of this condition. Human memory can be unpredictable, and we all forget things occasionally. However, if memory loss is interfering with everyday life, it is best to speak with a doctor.

Although memory issues tend to be an early sign of Alzheimer’s disease, that is not the case for other forms of dementia. For instance, early signs and symptoms of FTD can include changes in mood and personality, language difficulties, and obsessive behavior.MEDICAL NEWS TODAY NEWSLETTERStay in the know. Get our free daily newsletter

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8. Dementia is always preventable

This, unfortunately, is untrue. Importantly, though, certain factors can either reduce the risk of certain types of dementia developing or delay their onset.

For instance, the Lancet Commission’s 2020 report on dementia prevention, intervention, and care lists 12 factors that increase the risk of dementia:

  • less education
  • hypertension
  • hearing impairment
  • smoking
  • obesity
  • depression
  • physical inactivity
  • diabetes
  • low levels of social contact
  • alcohol consumption
  • traumatic brain injury
  • air pollution

Some of these factors are more difficult to modify than others, but working on changing any of them might help reduce the risk of developing dementia. The authors of the report explain:

“Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed.”

However, as Dr. Nancy Sicotte, a neurologist at Cedars-Sinai hospital in Los Angeles, CA, explains, “Reducing your risk requires starting these lifestyle changes from the get-go, not waiting until you’re 70.”

9. Vitamins and supplements can prevent dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report “some general limitations of the evidence,” they conclude:

“We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions.”

10. All people with dementia become aggressive

In some cases, people with dementia might find it increasingly hard to make sense of the world around them. This confusion can be frustrating, and some individuals might respond to the emotions in an angry manner. However, this is not the case for everyone.

In a study involving 215 people with dementia, 41% of the participants developed aggression during the 2-year study. When they looked at factors that increased the risk of developing aggression, the researchers identified two of the primary factors as physical pain and a low quality relationship between the person and their caregiver.

11. Dementia is never fatal

Unfortunately, dementia can be fatal. According to a recent study, which appears in JAMA Neurology, dementia may be a more common cause of death than experts have traditionally thought it to be. The authors “found that approximately 13.6% of deaths were attributable to dementia over the period 2000–2009.”

Dementia worries people, especially as they age, and this is justifiable in many ways. However, it is important to counter misinformation that might enhance concerns and stigma.

For now, researchers are working tirelessly to develop better ways to treat and prevent dementia. In the future, hopefully, science will reduce the impact of dementia and, therefore, the fear associated with the condition.

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The authors of a recent study found that healthy older adults who took a daily, low dose of aspirin were at higher risk of receiving a diagnosis of advanced cancers and dying from cancer than those who took a placebo.

The findings raise the possibility that taking aspirin every day may make cancers worse once they have developed in this age group.

In recent years, there have been high hopes that taking a daily, low dose of aspirin might help protect older people from dementia, cognitive decline, and cancer.

Doctors widely prescribe daily aspirin to people at high risk of cardiovascular problems.

In addition, some clinical trials involving mostly middle-aged adults have found that aspirin may reduce the risk of developing cancer, especially colorectal cancer.

However, until recently, evidence for the drug’s use as a preventive treatment in otherwise healthy older people has been lacking.

A study originally published in March 2020 suggested that taking a daily low dose of aspirin did not protect older people from cognitive decline and dementia.

The latest study, which investigated the same cohort of individuals, reports that daily aspirin increases the risk of receiving a diagnosis of advanced cancers and cancer that has spread or metastasized.

The results found associations between daily aspirin and increased cancer mortality over the follow-up period.

The scientists published their findings in the Journal of the National Cancer Institute.

ASPREE trial

Researchers at Massachusetts General Hospital in Boston, the Berman Center in Minneapolis, MN, and Monash University in Melbourne, Australia, carried out the recent study.

They analyzed results from the Aspirin in Reducing Events in the Elderly (ASPREE) trial, which included 19,114 individuals living in Australia and the United States. None of the participants had cardiovascular disease, dementia, or physical disability at the start of the study.

Most participants were over 70 years of age, apart from African American and Hispanic participants in the U.S., who were over 65 years of age.

Researchers randomly assigned the participants to take either 100 milligrams of aspirin per day or a placebo.

An earlier analysis of outcomes in the two groups after a mean follow-up period of 4.7 years found a higher number of deaths from all causes in the aspirin group. Most of the excess deaths were due to cancer.

The latest study examined aspirin’s effect on cancer diagnoses and deaths as a result of cancer in greater detail.

Overall, 981 participants who were taking aspirin and 952 who were taking placebo developed cancer. This difference between the two groups was not statistically significant.

However, daily aspirin had associations with a 19% higher risk of metastatic cancer and a 22% higher risk of receiving a diagnosis of advanced cancer compared with a placebo.

The results also indicated that people in the aspirin group were at a higher risk of dying during follow-up due to advanced cancer.

“Deaths were particularly high among those on aspirin who were diagnosed with advanced solid cancers, suggesting a possible adverse effect of aspirin on the growth of cancers once they have already developed in older adults,” says senior author Dr. Andrew T. Chan of Massachusetts General Hospital and Harvard Medical School.

“Although these results suggest that we should be cautious about starting aspirin therapy in otherwise healthy older adults, this does not mean that individuals who are already taking aspirin — particularly if they began taking it at a younger age — should stop their aspirin regimen.” – Dr. Andrew T. Chan

In their paper, the researchers also point out that the increased cancer mortality risk associated with taking aspirin in their study equated to an extra 1.5 deaths per 1,000 person years. This is relatively small compared with the risk of mortality from other causes.

Blunted immune response?

Aspirin reduces inflammation in the body. The researchers write that one possible explanation for their finding may be that aspirin suppresses or “blunts” immune responses that are critical to controlling the growth and spread of cancer at later stages of its development.

They note that other research has found differences between the biology and behavior of tumors in older adults and younger individuals.

“These reports make it plausible that aspirin might also act differently, at the cellular or molecular level, in older individuals,” they write.

A meta-analysis of trials involving populations around 10 years younger than in ASPREE, published in 2019, found that taking daily low dose aspirin for around 5 years neither increased nor decreased cancer incidence or mortality.

Other research suggests that it may take at least 10 years of taking daily aspirin before there is a beneficial reduction in the incidence of colorectal cancer.

There may also be a delayed benefit in older people that only becomes apparent after a longer follow-up period. The authors of the current study write:

“Cancer molecular and genetic data give reason to suggest that the potential adverse impact of aspirin identified in ASPREE might be specific to this age group. The cohort continues to be followed to explore the possibility of a delayed reduction in cancer incidence and/or mortality that may emerge with longer-term observation.”

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Leptospirosis is a bacterial disease that affects humans and animals. Bacteria of the genus Leptospira cause it. In humans, it can cause a wide range of symptoms, some of which may be mistaken for other diseases. Some infected persons, however, may have no symptoms at all.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.
Infection

The bacteria that cause leptospirosis are spread through the urine of infected animals, which can get into water or soil and can survive there for weeks to months. Many different kinds of wild and domestic animals carry the bacterium.

These can include, but are not limited to: cattle, pigs, horses, dogs, rodents, and wild animals. When these animals are infected, they may have no symptoms of the disease.

Infected animals may continue to excrete the bacteria into the environment continuously or every once in a while for a few months up to several years. Humans can become infected through: contact with urine (or other body fluids, except saliva) from infected animals and contact with water, soil, or food contaminated with the urine of infected animals.

The bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth), especially if the skin is broken from a cut or scratch. Drinking contaminated water can also cause infection. Outbreaks of leptospirosis are usually caused by exposure to contaminated water, such as floodwaters. Person to person transmission is rare.
Sign and symptoms

In humans, Leptospirosis can cause a wide range of symptoms, including: high fever, headache, chills, muscle aches, vomiting, jaundice (yellow skin and eyes), red eyes, abdominal pain, diarrhea, and rash.

Many of these symptoms can be mistaken for other diseases. In addition, some infected persons may have no symptoms at all.The time between a person’s exposure to a contaminated source and becoming sick is two days to four weeks. Illness usually begins abruptly with fever and other symptoms. Leptospirosis may occur in two phases: after the first phase (with fever, chills, headache, muscle aches, vomiting, or diarrhea) the patient may recover for a time but become ill again; and if a second phase occurs, it is more severe; the person may have kidney or liver failure or meningitis.

The illness lasts from a few days to three weeks or longer. Without treatment, recovery may take several months.
Prevention

The risk of acquiring leptospirosis can be greatly reduced by not swimming or wading in water that might be contaminated with animal urine, or eliminating contact with potentially infected animals. Protective clothing or footwear should be worn by those exposed to contaminated water or soil because of their job or recreational activities.
Prevention

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. Intravenous antibiotics may be required for persons with more severe symptoms. Persons with symptoms suggestive of leptospirosis should contact a health care provider.

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Researchers in Italy found that a continued lack of sleep for 5 consecutive nights predisposes people to see pleasant and neutral images adversely, indicating that poor sleep may generate a negative emotional bias.

The feeling of having a sleepless night is a familiar one to many people. Lack of sleep can affect a person’s performance at work, as well as their emotional state.

People are more likely to be irritable and frustrated when they have not slept properly the night before.

The influence of limited sleep on emotional well-being is of growing interest as a lack of sleep is widespread in modern society. The Centers for Disease Control and Prevention (CDC) report that about 35% of adults in the United States sleep less than 7 hours per night.

Although several reports suggest that lack of sleep influences our emotional state, a new study published in the Journal of Sleep Research has formalized this.

In the study, participants looked at “pleasant and neutral images” after 5 nights of normal sleep and 5 nights of restricted sleep. The results showed that the participants were more likely to have negative responses to these images after the periods of disturbed sleep than after normal sleep.

The authors conclude that lack of sleep imposes a negative emotional bias on people and has important implications for daily life, as well as in clinic settings.

Continued sleep restriction

Numerous studies have investigated the behavioral effects of lack of sleep. However, most have looked at the impact of a total lack of sleep, rather than slightly reduced sleep over a more extended period.

To test the impact of partial sleep deprivation on emotional reactions, the researchers behind this study asked 42 people to change their sleep patterns for 2 weeks.

During the 2-weeks, participants had 5 consecutive nights of normal sleep followed by 5 consecutive nights of restricted sleep in which they could sleep no more than 5 hours per night. In the sleep-restricted phase, participants went to bed at approximately 2 am and woke up at about 7 am.

The researchers switched the order of the sleep patterns between the participants, with a two-day ‘wash out’ period in-between to allow people to reset before the next period.

The morning after each 5-day period, the researchers asked the participants to rate images on a nine-item scale of emotions.

The researchers took the images from the International Affective Picture System (IAPS), a database of pictures that psychologists use to study emotion and attention. The database contains a vast, wide-ranging selection of images that depict pleasant, neutral, and unpleasant events.

The researchers randomized the order of the pictures and assessed the emotion the image evoked, as well as the intensity of the emotion.

Impact on emotional outlook

The researchers found that participants rated pleasant and neutral images more negatively after having 5 nights of restricted sleep than when they had slept normally.

Even when the researchers took account of mood changes, they continued to find that people viewed images more negatively under restricted sleep conditions.

“Insufficient sleep may impose a negative emotional bias, leading to an increased tendency to evaluate emotional stimuli as negative.” – Daniela Tempesta, Ph.D., of the University of L’Aquila in Italy

This suggests that sleep-deprived people are likely to perceive emotional stimuli — such as events or personal interactions in their daily life — as worse than they really are.

The researchers did not find any significant difference in how people rated the unpleasant pictures under different sleep conditions.

Sleep and mood disorders

These findings suggest that lack of sleep may cause significant changes in emotional reactions, perhaps leading to an overall more negative outlook. Given how commonplace lack of sleep is in today’s society, these results will be relevant to many.

“Considering the pervasiveness of insufficient sleep in modern society, our results have potential implications for daily life, as well as in clinical settings,” says lead author Dr. Daniela Tempesta.

Although each person requires a different amount of sleep, the authors also say that future studies should investigate exactly how sleep loss leads to emotional changes.

Understanding how continued lack of sleep affects the brain could improve clinical outcomes for people with sleep disorders, as evidence suggests that disturbed sleep may be involved in mood disorders and post-traumatic stress disorder.

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An analysis of pooled data from 15 population studies around the world suggests that higher levels of trace lithium — a metal used in some psychiatric medicines — in public drinking water is associated with lower rates of suicide.

Lithium is primarily prescribed by doctors to help stabilize the moods of people with bipolar disorder and to reduce their risk of suicide.

Most rocks contain trace amounts of the element. Weathering washes it into groundwater and standing water, which is how the chemical finds its way into the public water supply.

Several studies over the years have found associations between relatively high amounts of lithium in drinking water and lower rates of suicide across various populations.

Recently, researchers at Brighton and Sussex Medical School and King’s College London, both in the United Kingdom, have now pooled data from 15 of these studies in a meta-analysis.

The studies included had been conducted in the United States, Austria, Greece, Italy, Lithuania, the U.K., and Japan, encompassing a total of 1,286 regions, counties, and cities.

The new meta-analysis suggests a clear relationship between higher levels of lithium in public drinking water and lower rates of suicide among these populations.

The research has been published in The British Journal of Psychiatry.

Individuals who take lithium as a mood stabilizer are monitored to prevent excess amounts from building up in the blood, which can have toxic effects. However, the amounts of lithium in drinking water are hundreds of times lower than those in medications.

“The levels of lithium in drinking water are far lower than those recommended when lithium is used as medicine, although the duration of exposure may be far longer, potentially starting at conception,” says Prof. Allan Young, the senior author of the new analysis and director of Centre for Affective Disorders at King’s College London.

Possibilities and ethical implications

Suicide is a major cause of preventable death around the world, and public health experts are searching for new ways to reduce the toll and address the underlying suffering of individuals and their loved ones.

The National Institute of Mental Health estimate that, in 2017, more than 47,000 people in the U.S. died by suicide. Among people ages 10–34 years old, suicide was the second leading cause of death after “unintentional injury.”

The World Health Organization (WHO) report that globally there are around 800,000 deaths by suicide every year, which is equivalent to one such death every 40 seconds.

“In these unprecedented times of the COVID-19 pandemic and the consequent increase in the incidence of mental health conditions, accessing ways to improve community mental health and reduce the incidence of anxiety, depression, and suicide is ever more important.” – Lead author Prof. Anjum Memon

The study authors say that the next step may be to investigate the effects of adding lithium in trace amounts to the water supplies of particular communities.

They suggest that the research could focus on communities or areas with a high risk of suicide and high prevalences of mental health problems, chronic substance abuse, and violent criminal behavior.

While this may seem like a promising way of controlling suicide rates at a community level, the notion is highly controversial from an ethical point of view.

In a study paper published in Public Health Ethics in 2019, Dr. Jared Ng, Dr. Manne Sjöstrand, and Prof. Nir Eyal discuss the idea of adding higher levels of lithium to the water sources serving allegedly at-risk communities and critique its ethical implications.

They discuss the potential harms and benefits and focus particularly on the ways in which it would bypass individual autonomy.

“Whether and how we should administer trace amounts of lithium depends in part on what future empirical evidence reveals,” they argue.

‘Grounds for further investigations’?

Commenting on the findings of the current study, Prof. Carmine Pariante, from the Royal College of Psychiatrists, in the U.K., who was not involved in the research, suggests that “This study shows that the boundaries between medication and nutritional interventions are not as rigid as we used to think, opening up the possibility of new treatments that span both domains.”

Speaking to the Science Media Centre, in London, Prof. Keith Hawton, director of the Centre for Suicide Research, at the University of Oxford, observes:

“Whether the results of this review truly indicate a potentially useful element for suicide prevention policy remains unclear. Nevertheless, there would appear to be grounds for further investigating whether supplementing lithium levels in domestic water supplies could help to prevent some deaths, especially in countries with higher suicide rates.”

While the idea of adding a mood-altering chemical to drinking water is controversial, there may be another argument in its favor: There is some evidence that microdoses of lithium may also help reduce the risk of Alzheimer’s disease.

Research in rat models of the disease suggests that lithium could stop the progression of the disease.

Clinical trials investigating the effects of lithium microdoses on the risk of dementia in people, however, have yet to be performed.

Still, an epidemiological study in Denmark found an association between higher levels of lithium consumed by populations in their drinking water and a lower risk of dementia.

Overall, the current findings contribute to an ongoing discussion about the merits and risks of lithium microdoses on mental and neurological health.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.

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Mature businessman examining documents at desk in office

A study suggests a sedentary job may provide better cognitive protection than a more physically active role.

Experts have long warned about the potential dangers of a sedentary lifestyle. Many studies suggest that being physically inactive increases the risk of health issues.

However, the connection between being physically active and maintaining cognitive health has been less clear. Now, a new study from the University of Cambridge in the United Kingdom further emphasizes this uncertainty.

The research has found that people with desk jobs are far less likely to experience cognitive decline than those with physically active roles.

“The often-used mantra ‘what is good for the heart, is good for the brain’ makes complete sense, but the evidence on what we need to do as individuals can be confusing,” says lead author Shabina Hayat.

“With our large cohort of volunteers, we were able to explore the relationship between different types of physical activity in a variety of settings,” she adds.

The research appears in the International Journal of Epidemiology.

Cognitive benefits of a desk job

The study is based on data from the Epic-Norfolk Cohort, a long-term project involving some 30,000 participants aged 40 to 79. It aims to investigate links between daily activities, diet, and cancer.

Across an average of 12 years, investigators assessed participants’ cognition, including attention, memory, and visual processing speed. Researchers also administered a reading-ability test that roughly captured each individual’s IQ.

Among the data collected was information regarding levels of physical activity during work hours and leisure time. Measurements of an individual’s physical activity in the Cambridge study combined the two.

A total of 8,585 individuals from the Epic-Norfolk study served as the cohort for the new Cambridge study.

The study reports that those with desk jobs — which are typically sedentary roles — have a lower risk of cognitive decline. Moreover, people with lifelong desk-based careers were most likely to be among the study’s top 10% of cognitive performers.

Conversely, people whose jobs involve manual work have nearly three times the risk of developing poor cognition.

Hayat proposes that it may be the job itself that provides the benefit. “Because desk jobs tend to be more mentally challenging than manual occupations, they may offer protection against cognitive decline,” Hayat says.

“Our analysis shows that the relationship between physical activity and cognitive [function] is not straightforward,” Hayat admits.

“While regular physical activity has considerable benefits for protection against many chronic diseases, other factors may influence future poor cognition.”

Seeking other connections

The researchers also looked at the potential impact of education level on cognition, but found little evidence that it was relevant. Hayat says that “people who have less active jobs — typically office-based, desk jobs — performed better at cognitive tests regardless of their education.”

The team also looked into the relationship between leisure physical activity and cognition. They were unable to draw any strong associations, at least partially, because such activities were “confounded by education, social class, and occupation.”

Confusingly, the data also suggest that leisure physical activity may offer some cognitive protection, though this seems to contradict the study’s main finding that work-related physical activity does not.

The data “reveals a differential in the association between cognition and inactivity during work and leisure,” says the study. Though exactly what that is remains unclear, particularly in light of the lower leisure-time activity levels reported by those with physical jobs.

People who were physically active during work were less likely to be similarly active during their time off.

The study concludes with an argument for additional research:

“Further studies are needed, in particular, on inequalities across socio-economic groups and the impact of lower education, poor-quality work (shortage of beneficial physical and mental stimulation), particularly for manual labor, and the lack of opportunity and space to be physically active for leisure. All these are key drivers that provide fewer opportunities to build cognitive reserve to protect for cognitive impairment and dementia in later life.”

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A new study has found that genetics and cardiovascular health can combine to increase the risk of developing dementia. Based on this, the authors suggest that people can mitigate some of the effects of their genes by improving their cardiovascular health.

New research has found that cardiovascular health and genetics can jointly increase the risk of dementia.

The research, published in the journal Neurology, suggests that even if someone is genetically predisposed to develop dementia, maintaining good cardiovascular health can help reduce this risk.

According to the National Institute on Aging (NIA), dementia describes a person’s loss of cognitive functioning, which affects their ability to think, remember, and reason. Various issues can cause this, the most common of which is Alzheimer’s disease.

Mild dementia may present as increasing forgetfulness or momentary confusion, accompanied by at least one other area of poor functioning, such as losing your way home (visuospatial problems) or not knowing how to pay a bill (executive function).

As it becomes moderate or severe, it can result in changes in personality, a failure to recognize family or friends, and an almost complete dependence on others for basic life activities.

Dementia occurs when a significant number of neurons — key cells in the brain — no longer function properly and ultimately die.

According to the NIA, this can happen in Alzheimer’s disease due to a combination of genetic, environmental, and lifestyle factors.

There is currently no cure for dementia. So understanding how these factors interrelate is the best way to help clinicians advise patients on what they can do to minimize their chances of developing this condition.

Genetics vs. cardiovascular health

In the present research, the researchers drew on data from the Framingham Heart Study (FHS) — a long-term study organized by the National Heart, Lung, and Blood Institute — to look at the relationship between genetics, cardiovascular health, and dementia.

The investigators assessed the data of 1,211 participants from the FHS, analyzing their relative cardiovascular health and genetic risk score for dementia.

The researchers found that participants with high genetic risk scores were 2.6 times more likely to develop dementia than those with low-risk scores.

They also found that good cardiovascular health can reduce a person’s chances of developing dementia by 55% across the follow-up period, an average of 8.4 years. Having relatively poor cardiovascular health increased a person’s risk of developing dementia.

Finally, the study made it clear that genetic predisposition and poor cardiovascular health can jointly increase a person’s risk of developing dementia.

According to Dr. Sudha Seshadri, of The University of Texas Health Science Center at San Antonio and a co-author of the research, “[t]he connection between heart health and brain health becomes clearer with each finding.”

“We hope that the results of this study will send the public a message, and that message is to exercise, reduce stress, and eat a healthy diet. Then, regardless of your genes, you have the potential to lower your risk of dementia.” – Dr. Sudha Seshadri

Adding to this, co-author Dr. Claudia Satizabal noted, “[i]t is imperative to start today. [F]rom our findings, having favorable cardiovascular health mitigates the risk of dementia in persons with high genetic risk.”

While there are many unknowns around dementia, the study contributes to a growing body of research demonstrating that staying physically active and eating well can make a meaningful difference to cognitive health issues.

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A new study shows that a compound in pickled capers activates channels that are important for the activity of the heart and brain. The findings could potentially lead to the design of new drugs for epilepsy and arrhythmia.

People have practiced traditional or folk medicine — which the Western world generally considers alternative medicine — for centuries, and it remains the mainstay of healthcare in many countries.

Much traditional medicine relies on the use of plants, which have been the basis of medical treatments for thousands of years. Sometimes, researchers examine this traditional knowledge, interpret it in modern scientific terms, and then translate it into Western medicine.

Aspirin, for example, comes from willow plants and has played a role in medicine since ancient Egyptian times, long before people understood its mechanism of action.

A new study from the University of California, Irvine School of Medicine shows a similar story for capers, which people around the world consume and also use in traditional medicine.

The study, which appears in Communications Biology, finds that a compound in pickled capers activates potassium channels that regulate the activity of the heart and brain.

The researchers say that their findings could aid the design of new drugs for epilepsy and arrhythmia (abnormal heart rhythms).

A food with ancient origins

The authors of the study note that humans have been eating capers for more than 10,000 years. Findings in soil deposits in Syria and late Stone Age cave dwellings in modern day Greece and Israel have shown this to be true.

The ancient Roman cookbook “Apicius” also mentions capers. People continue to use them in traditional medicine for their antihelminthic, anticancer, antidiabetic, and anti-inflammatory properties and their possible circulatory and gastrointestinal benefits.

The research team behind the current study has now shown how capers act on the body, which includes activating a potassium channel important for heart and brain activity.

The researchers started looking at capers based on the results from a screen of plant extracts. They screened a range of extracts for activity on a family of potassium channels called KCNQ channels.

The KCNQ family of potassium channels plays several important roles in the body, including regulating the heartbeat, the contraction of muscles, and the function of the gastrointestinal tract. Their dysfunction is associated with certain diseases, including diabetes, arrhythmia, and epilepsy.

The importance of pickling

The researchers used an extract from pickled capers, the most common form in the United States, and found that a 1% extract was able to activate the channels.

The pickling process causes the formation of quercetin, which is the compound that activates KCNQ channels.

Further experiments with quercetin found that it binds to a part of the channels responsible for sensing electrical activity. This binding causes the channels to open when they would otherwise be closed, which may underlie the medicinal properties of capers.

Although capers are the richest natural source of quercetin, the authors note that other plant-derived compounds, such as E-2-dodecenal (present in cilantro), are more potent activators of KCNQ channels.

However, the authors also found that these compounds can work together. So, while eating capers alone may not have a significant effect, eating them together with other specific foods, such as cilantro, could increase their benefits.

Quercetin is also very common in food, being present in apples, berries, celery, chili peppers, and onions, as well as green tea and red wine. The compound may, therefore, accumulate in the body over time to provide benefits. Research has also shown that adding quercetin to food is safe, although this practice does not currently exist in the U.S.

Drugs to treat epilepsy and arrhythmia

Outside of food, the researchers say that their findings could help medicinal chemists design new drugs.

“Increasing the activity of KCNQ channels in different parts of the body is potentially highly beneficial. Synthetic drugs that do this have been used to treat epilepsy and show promise in preventing abnormal heart rhythms.” – corresponding author Geoffrey Abbott, Ph.D.

Researchers are also investigating capers for their potential benefits against cancer, diabetes, and various inflammatory, circulatory, and gastrointestinal diseases. Understanding how capers act on the body on a molecular level could, therefore, lead to a wide range of new treatments.

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A study looks at the impact of having both hearing and vision impairment on the chances of developing dementia.

Researchers have linked hearing impairment and vision impairment individually to an increased chance of developing dementia. However, a new study finds that an individual’s chances of developing dementia are significantly higher when they have both conditions.

The risk of developing dementia increases by 86% for individuals who have both hearing and visual impairment.

“Evaluation of vision and hearing in older adults may predict who will develop dementia and Alzheimer’s. This has important implications for identifying potential participants in prevention trials for Alzheimer’s disease, as well as whether treatments for vision and hearing loss can modify risk for dementia.” – Study lead author Phillip H. Hwang, University of Washington

Re-purposing a previous study’s data

The research, “Dual sensory impairment in older adults and risk of dementia from the GEM Study,” appears in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring.

According to the study, some 33% of people aged 70 and older experience hearing loss, and vision loss affects about 18% of people in this age group. Since these conditions worsen with age, researchers think that a correlation exists between the advance of these conditions and the loss of a person’s functionality and mortality.

Previous research found a less obvious connection between hearing or visual loss and the onset of dementia.

The two leading theories indicate that either these specific impairments result from similar physical processes that cause dementia, or that hearing and visual loss lead to an increasing sense of social isolation, depression, and physical inactivity, each of which may lead to dementia.

The new study looks at the impact of having both conditions together. It refers to this combination as “dual sensory impairment.” According to the study:

“Although most prior studies have focused on impairments in hearing and vision individually, the impact of having combined hearing and visual impairment, or dual sensory impairment (DSI), on dementia risk is unclear.”

To investigate the impact of DSI on developing dementia, the researchers analyzed data collected by the Gingko Evaluation of Memory (GEM) study, a double‐blind randomized‐controlled trial investigating the value of Ginkgo biloba for preventing dementia in older people.

The GEM study involved adults aged 75 or older who, at the outset of the study, had normal cognitive function, or at most, mild dementia. The researchers studied the participants for 8 years.

In addition to collecting self-reported data regarding the individuals’ hearing and vision, follow-up examinations of participants assessed the development of dementia.

DSI and the risk of dementia

The final data set that Hwang and his colleagues studied consisted of 2,051 individuals. Of these, 1,480 people had neither hearing nor visual loss. 14.9% reported visual impairment, and 7.8% reported hearing loss. Just 5.1%, or 104 individuals, had DSI.

Compared to participants who did not have hearing or visual loss, those reporting DSI were more likely to be male, have other comorbidities, and describe themselves as smokers and drinkers.

The GEM study’s follow-up examinations revealed the following likelihoods of developing dementia:

  • 14.3% of those without any reported hearing or vision loss developed dementia.
  • 16.9% of those reporting a single impairment developed dementia.
  • 28.8% of those with DSI developed dementia.

People with both hearing and visual loss were nearly twice as likely to develop dementia as those without such impairments.

However, according to the results, the increased risk of dementia for an individual with DSI is only somewhat related to the severity of hearing and visual impairment.

While those classified as having a high level of DSI are at the greatest risk of developing dementia, those with lower DSI levels also have a significantly higher risk of dementia.

Risk for different forms of dementia

The researchers analyzed the link between DSI and three types of dementia: all-cause dementia, Alzheimer’s-related dementia, and vascular dementia.

The chances of acquiring Alzheimer’s’-related dementia are even higher. The study indicated that people with DSI are 112% more likely to develop Alzheimer’s than those without any impairment.

Hwang and his colleagues found no association between DSI and vascular dementia.

The implications of this research

The study’s conclusions suggest that doing more to mitigate hearing and visual loss in older people may be a way to hold off or thwart the onset of dementia.

The authors conclude, “Further research is needed to characterize the exact role of sensory impairments and whether treatments that improve sensory function, such as surgery or sensory aids, devices, and prostheses, can modify this risk.”

The study’s authors add that shifts toward an older general population make addressing the prevalence of dementia in the elderly more urgent.

They write: “Because the public health burden of dementia will increase over the next three decades, evaluation of vision and hearing function in older adults may help identify patients at elevated risk of developing dementia.”

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