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February 18, 2023

How eye tests could help detect diabetes, MS, and dementia

The eyes have long been called the “windows to the soul,” and increasingly, evidence is suggesting that they might be also windows to both the brain and body. Several health conditions can be detected by examination of the eyes, among them diabetes, multiple sclerosis, and even Alzheimer’s disease. Medical News Today spoke to experts in the field to discover how the eye can reveal the body’s secrets.

Asian woman with blonde highlights sporting sunglasses, a bright blue sky behind her — How much could our eyes reveal about our health? Image credit: A.J. Schokora/Stocksy.

Most of us have our eyes tested regularly, but few may be aware that an eye test is not just for checking vision and correcting sight problems.

Because it has a “window” at the front, the eye is the only part of the body where doctors can, non-invasively, examine the inside of an organ. At the back of the eye is the retina, where blood vessels and the optic nerve can be clearly seen.

Thanks to this, optometrists and ophthalmologists could diagnose not only disorders of the eye, but also systemic diseases — those that affect other organs in the body or the whole body.

If a routine eye test raises concerns, the optometrist can refer a person to a medical ophthalmologist who will investigate by carrying out further eye examinations. If their investigations reveal a systemic disease, they can then refer the person to the relevant specialist.

Dr. Hagar Ibrahim, senior specialist trainee (ST6) in medical ophthalmology at St. Paul’s Eye Unit, Liverpool University Hospitals NHS Trust, in the United Kingdom, told Medical News Today that “a routine eye examination in which the pupils are dilated using eye drops can provide a full and clear view of the optic nerve, which connects to the brain, the retina, […] and all the blood vessels supplying the retina.”

“Therefore, pathology in the eye can be clearly seen during [an] eye examination, both in localized eye conditions and in systemic disease, truly making the eye a window into the rest of the body,” she added.

“People are often surprised when an eye doctor diagnoses them with a systemic illness but they shouldn’t be. Many people with systemic illnesses are first diagnosed by their eye doctor, which is just one reason why all adults should have regular eye examinations at least every 2 years.”

– Dr. Philip Storey, a board-certified ophthalmologist and fellowship-trained retina specialist at Austin Retina Health

As well as identifying problems with vision, such as nearsightedness, farsightedness, and astigmatism, a routine eye test will detect other eye disorders, such as glaucoma, and age-related macular degeneration.

By examining the blood vessels in the retina and the optic nerve, the optometrist can also discover a lot about a person’s general health.

This non-invasive process can detect many other health conditions that may seem unconnected to the eyes, among them hypertension, diabetes, thyroid disorders, and neurodegenerative diseases such as Alzheimer’s disease, and multiple sclerosis (MS).

“Ocular inflammation can affect many parts of the eye, and can often be the first sign of a systemic disease. The key to diagnosing the cause is in focused history taking followed by [a] guided investigation of the relevant body systems, including blood tests,” explained Dr. Ibrahim.

Changes in the blood vessels in the retina can be early indicators of both diabetes and hypertension.

Dr. Storey told MNT that “[d]iabetes is the most commonly diagnosed disease given the frequency of the illness as well as the classic findings on retina exam, which can include bleeding, leakage of fluid, and areas of poor blood flow.”

Although a firm diagnosis of diabetes can only be made with a blood glucose test, changes in the blood vessels of the retina can give a strong indication that a person may have diabetes. They can then be referred for further testing.

According to the American Academy of Ophthalmology, the signs of diabetic retinopathy can sometimes be detected by eye examination even before a person suspects they may have diabetes.

Once diagnosed, provided the diabetes is well controlled, the person can then minimize the risk of further eye damage, as Dr. Ibrahim explained: “In addition to localized eye therapies such as laser treatment or intravitreal eye injections, improving blood sugar levels by sticking to the proper pharmacological treatment, restricting sugar intake and making necessary lifestyle changes, can result in regression of diabetic retinopathy.”

However, for those with diabetes, the most important eye tests take place after diagnosis, to monitor changes in the eyes and take steps to prevent further damage, as Dr. Howard R. Krauss, surgical neuro-ophthalmologist and director of Pacific Neuroscience Institute’s Eye, Ear & Skull Base Center at Providence Saint John’s Health Center in Santa Monica, CA, noted:

“In most cases, diabetes is diagnosed before changes become evident in the retina, but the retinal examination is a vital part of routine diabetic evaluations, so as to aid in the management of the disease, and to intervene when indicated, with any of a variety of treatments to reduce the risk of blindness from diabetic retinopathy.”

Studies have shown that signs of hypertension, or high blood pressure, are found in the eyes of around 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the adult, diabetes-free population.

On examination, an eye doctor might see traces of narrowing of arterioles in the retina, arteriovenous nicking, retinal hemorrhages, and, as in diabetic retinopathy, microaneurysms. All these are indicators of hypertensive retinopathy.

“Hypertension also presents with classic signs within the eye. The earliest signs of hypertension are narrowing of the vessels, often referred to as ‘silver wiring’ because of their appearance.”

– Dr. Philip Storey

The good news is that if the hypertension is controlled, the damage can be halted, as Dr. Ibrahim explained.

“Early detection means that appropriate precautions are taken and necessary lifestyle changes are made, such as eating a healthy diet and exercising regularly, in addition to starting the proper medical treatment thereby reducing the risk of heart disease,” she told us.

During a routine eye test, the eye doctor will also examine the optic nerve to look for any abnormalities or changes.

Dr. Ibrahim explained why: “The optic nerve connects the eye to the brain and is therefore an extension of the central nervous system. It is the only part of the brain that can be clearly visualized by examining the back of the eye.”

“Optic nerve swelling or inflammation can be detrimental to vision and color vision, and can diagnose MS, [which is] an autoimmune demyelinating disease of the brain and spinal cord, [as well as] neuroinflammatory disorders such as neuromyelitis optica or brain tumor,” she added.

Vision problems in MS, which tend to flare up then resolve within a few weeks, are usually a result of optic neuritis, an acute inflammatory demyelinating disorder of the optic nerve.

Optic neuritis is the first symptom in up to 20{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people who are subsequently diagnosed with MS, although it can indicate other disorders, or even be the result of a viral infection or vitamin deficiency.

If an optometrist suspects optic neuritis in a routine eye examination, they will refer a person for further testing to confirm the diagnosis and identify the cause.

“Retinal screening of Alzheimer’s disease is an exciting prospect at the forefront of current medical research. The retina […] is made up of multiple layers of specialized neural cells and there is strong evidence that the same changes in the brain can occur in the retina, potentially allowing screening patients for early signs of Alzheimer’s disease.”

– Dr. Hagar Ibrahim

Current methods of diagnosing Alzheimer’s are often lengthy, invasive and expensive, so being able to diagnose the condition from the retina would be a huge advance.

Although this is not yet a disease that can be diagnosed from a routine eye examination, recent research has suggested that doctors could, in the future, diagnose Alzheimer’s through retinal scans.

The new technique, so far tested only in mice, combines the results of two scans to assess the condition of the retina. Those with Alzheimer’s disease have a much rougher retinal surface than those without.

Other research has identified beta-amyloid plaques on the retina as an indication of Alzheimer’s disease, and also in the lens of the eye, both of which can be detected by non-invasive methods.

Dr. Ibrahim explained some of the new developments:

“There are several areas under research. Firstly, looking for the presence of beta-amyloid fragments in the retina, which may be detected by specialist retinal imaging modalities, before symptom onset. […] Secondly, looking at biomarkers detectable on retinal OCT-A images in the form of differences of retinal microvasculature in patients with Alzheimer’s disease and mild cognitive impairment compared to healthy controls.”

Perhaps these findings may lead to easier, earlier diagnosis of Alzheimer’s disease enabling treatment to begin before symptoms become severe.

As well as allowing an optometrist to detect diseases elsewhere in the body, changes in the eyes can tell a physician how a systemic disease is progressing.

So regular eye tests are important, particularly as we get older, as Dr. Benjamin Bert, an ophthalmologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, told MNT:

“While eye exams are mostly to check the health of the eyes, they do help to screen for systemic diseases. For adults, if you don’t have any need for glasses or contact lenses, it is still recommended to get an annual exam at least once in your 20s, twice in your 30s, and more regularly after 40. After 40 is when eye-specific ailments can start to become more common — including presbyopia, glaucoma, cataract, and changes to the retina from diabetes or high blood pressure.”

Dr. Krauss reiterated the same advice.

But it is also important to remember that eye examinations are only one tool in monitoring health conditions.

“An examination of the retina often reflects the severity of a disease throughout the body. […] However, patients should not rely on an eye examination to assess how well their systemic disease is controlled,” Dr. Storey cautioned.

“The damage that we see in the eye can take years to occur. Even when a patient’s eye examination is normal, their systemic disease — hypertension or diabetes for example — could be poorly controlled,” he explained.

So, make sure a regular eye test is part of your overall health care, particularly as you get older — it may just detect a condition that you were unaware of, helping you to take control of your health.

December 23, 2022

Dementia, stem cell, and mental health research

2022 has been an eventful year when it comes to medical research, but what are some of the most intriguing findings and trends? Our editors, Maria Cohut, Yasemin Nicola Sakay, and James McIntosh reflect on this year’s highlights in our December “In Conversation” episode.

While 2020 and 2021 may have stuck in the collective memory as two intense pandemic years, 2022 has also been an eventful one.

Google’s Year in Search report pinpoints some of people’s most pressing concerns at a global scale throughout 2022. One of these is the monkeypox epidemic, which the World Health Organization (WHO) declared a “public health emergency of international concern” in August.

The death of Queen Elizabeth II of Great Britain in September, after a record 70-year reign, garnered global interest, as did the impact of the ongoing conflict in Ukraine.

And the overturning of Roe v. Wade in the United States sparked concern among medical communities worldwide.

But 2022 has also seen a wealth of advances in medical research, from a new way of assessing potential dementia symptoms that may help to diagnose it up to 9 years sooner than the current standard to the discovery of an insulin-mimicking molecule that may, in the future, help treat diabetes.

This December, three of our editors — myself, the Feature Editor, Yasemin Nicola Sakay, the Global News Editor, and Managing Editor James McIntosh — joined the “In Conversation” podcast to talk about some of 2022’s research highlights.

These include the twists and turns dementia research has taken this year, why scientists are increasingly interested in the potential of psychedelics in mental health treatments, and how stem cell research is advancing at a steady pace.

Listen to this month’s installment of our podcast below, or on your preferred streaming platform.

This year has been a very charged one for dementia research. As many as 55 million people around the world live with a form of dementia, the most common form of which is Alzheimer’s disease.

While there are some treatments that target symptoms of dementia, such as memory loss and anxiety, there is currently no cure for Alzheimer’s disease and related neurodegenerative conditions.

One thing that would help researchers find better treatments to prevent or slow down the progression of dementia symptoms would be finding out its true cause and the mechanisms that drive it.

The ‘amyloid hypothesis’ controversy

In 2006, a study that appeared in the journal Nature lent credibility to what is now known as the “amyloid hypothesis,” which holds that an overaccumulation of beta-amyloid protein in the brain — forming sticky amyloid plaques — disrupts the communication between neurons, thus being largely responsible for the main symptoms of dementia, such as memory and thinking problems.

Since its publication, the Nature paper has been cited in over 2,200 other studies, and the amyloid hypothesis has informed the vast majority of the dementia research conducted until now.

Yet in July 2022, an assistant professor of neurology at Vanderbilt University called into question claimed that some of the images in the seminal study had been manipulated, which may affect the credibility of the amyloid theory.

While the 2006 Nature paper has not, at the time of writing, been retracted, the recent claims of scientific misconduct have caused an uproar among dementia experts, and given rise to many questions.

One question is: If the paper truly does build on inaccuracies, will this invalidate some of the findings in dementia research reported until now? Not so, some experts say.

Speaking to Medical News Today, Dr. Sara Imarisio, head of research at Alzheimer’s Research UK, explained that “the findings from the [Nature] paper were very specific and, contrary to some reports, have not significantly affected the progress or direction of research into Alzheimer’s.”

“Even for research groups who work in this particular area, findings that can’t be reproduced will be identified as controversial and lose credibility, while genuine findings will come to predominate and guide the direction of future studies.”

– Dr. Sara Imarisio

Indeed, some findings about amyloid plaques seem to hold true, as a recently developed drug, lecanemab, which attacks the accumulation of beta-amyloid in the brain, has shown clear promise in recent clinical trials, and its developers hope that the drug will be approved for use in people aged 65 years and older in the U.S. as soon as next year.

New research avenues

But scientists were already aware that beta-amyloid plaques are not the be-all and end-all of dementia research. How so? In our June 2022 podcast, we spoke with Dr. Kamar Ameen-Ali, a lecturer in biomedical science at Teesside University in the United Kingdom.

Dr. Ameen-Ali explained that the crux of the matter is this: Beta-amyloid accumulates in the brains of healthy people just as it does in those of people with dementia symptoms. What makes this protein disruptive in some cases but not others remains unclear.

This is one of the reasons why dementia research does not, and has never stopped at the amyloid hypothesis, influential as it may be.

The controversy has also meant that more and more researchers are looking into alternative or additional pathologies in Alzheimer’s disease and other forms of dementia, including the role of tau, another protein implicated in dementia, which, some experts say, may be a better indicator of Alzheimer’s disease progression.

In September, an animal study whose results appeared in PLOS Biology suggested that brain inflammation caused by a dysfunction in the blood-brain barrier may be a likely cause of Alzheimer’s disease.

“These findings may have a significant global impact on the millions of people living with Alzheimer’s disease,” Prof. Warren Harding, chair of Alzheimer’s WA, told MNT about the study.

And in November 2022, a study published in Nature argued that disruptive swelling along axons, which form the link between neurons, may be the true cause of Alzheimer’s symptoms.

One emerging treatment for dementia is stem cell therapy, thanks to the potential of stem cells — which are a kind of “blank slate” cells — to differentiate and “specialize” into cells with different functions, thus providing healthy cells to replace those that have experienced some degree of “damage.”

Stem cell research has made great strides this year, with scientists looking at the potential of stem cell treatment in many incurable or difficult-to-treat diseases.

In April 2022, for instance, a study whose findings appeared in npj Regenerative Medicine showed how implanting induced pluripotent stem cells in rats with Parkinson’s disease-like motor symptoms helped reverse those symptoms by replacing damaged neurons.

Speaking to MNT about the study results, Dr. Jeffrey Kordower, director of the ASU-Banner Neurodegenerative Disease Research Center at Arizona State University, said that they gave him “great confidence” about the treatment’s applicability in human patients in the future.

Another stem cell therapy highlight made the press in summer 2022, when the fourth, and oldest patient yet with HIV and leukemia achieved remission after receiving a stem cell transplant.

The patient, a 66-year-old man, achieved long-term remission of HIV 3 years after receiving a stem cell transplant for leukemia, which is a blood and bone marrow cancer.

“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence. I never thought I would live to see the day that I no longer have HIV,” the patient declares in a statement for the press.

Creating embryo and brain models from stem cells

Stem cell research has also reached other intriguing and much-debated heights this year. In August 2022, two different research teams reported having successfully created embryo models in the laboratory, using not sperm and egg cells, but stem cells to do so.

The embryo models managed to develop rudimentary structures, including a beating heart, blood stem cell circulation, a head region with folds, and the beginnings of a gut tube.

They are also viable enough to allow researchers to delve deeper into the study of embryonic development. Models like these can also help researchers steer free of experiments with potential ethical implications.

Other researchers managed to create brain organoids — models of brain tissue — from stem cells in the lab. Such models can help scientists learn more about rare neurological conditions, such as microcephaly, where the size of the brain is reduced compared to that of a healthy brain.

More widely, researchers could use models of brain tissue to better understand the way in which viruses, such as SARS-CoV-2, might attack and affect the brain, and to further dementia research.

The importance of stem cell donation

Our own Managing Editor, James McIntosh, donated stem cells earlier this year to help further research on better treatments for people with blood cancers and blood disorders. James talks about his experience at length in a “Through My Eyes” personal perspective article.

When a person donates blood, they can also choose to donate stem cells, which are separated through a process called “apheresis.” It may seem like an unsettling experience, but, James wrote, it was nowhere near as scary as a first-time stem cell donor might think.

In his article, he explains how apheresis works:

“All the heavy lifting was going to be done by a cell-separating machine. The nurse inserted a needle into a vein in my left arm from which my blood was drawn into the machine. The machine then separated the blood into its separate components: red blood cells, white blood cells, plasma, and platelets. Once the blood was separated, the parts containing my precious stem cells were taken away, leaving the rest of the blood to return to me. The nurse inserted another needle into a vein in my right arm, and the blood was able to rejoin my bloodstream here from the machine.”

James encourages everyone who can to donate stem cells for treatment and research: “Stem cells are a vital part of treatment for several serious conditions while also showing a lot of potential in the development of new therapies for currently untreatable diseases. As a result, it is very important for there to be people willing to donate their stem cells. Many will be able to save lives by joining a donation register.”

Our January 2022 podcast on blood donations and transfusions further explains how blood donation works, how to prepare, what the different types of blood donation are, and why this is such a vital part of medical treatment and research.

Another research avenue that has been gaining ground in 2022 is the use of psychedelics in the treatment of anxiety and depression.

Around the world, hundreds of millions of people live with anxiety or depression, which can severely affect their quality of life.

The standard treatments for these mental health conditions include psychotherapy and cognitive behavioral therapy (CBT), as well as medications such as serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — also known as “antidepressants” — which are meant to help rebalance the levels of key chemicals in the brain.

However, according to some estimates, up to 30{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of adults living with major depressive disorder have treatment-resistant depression, which does not respond to standard lines of treatment.

And around 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of adults with generalized anxiety disorder do not respond to first-line treatments, such as antidepressants.

In a bid to find more effective ways of addressing the symptoms of hard-to-treat depression and anxiety, researchers have turned to a sometimes-controversial line of inquiry, namely psychedelics, particularly ketamine, LSD, and psilocybin, the psychoactive compound in magic mushrooms.

What do psychedelics do?

These drugs are, for the most part, illegal in the U.S. and elsewhere, at least for personal use, but researchers can study their effects in humans under closely supervised, clinical trial conditions, and the results of some of these studies have been intriguing.

In our May 2022 podcast, we spoke to Dr. Adrian Jacques Ambrose, medical director of the Columbia Psychiatry Practice Office.

“For anxiety disorder, as well as panic disorder, there’s hyperactivation of what we call the fear network. [By this] I mean specific parts of the brain that includes the thalamus, the amygdala, the hippocampus, and the striatum,” Dr. Ambrose explained.

And since the human brain has a negativity bias — meaning it tends to hold onto negative memories and emotions — this may exacerbate the negative thinking that occurs in anxiety and depression.

Dr. Ambrose believes that standard treatments such as antidepressants may not always work “because of their lack of specificity.” In contrast, psychopharmacological treatments may be able to “rewire” the parts of the brain involved in this vicious cycle of negative thoughts.

Indeed, a study whose results appeared in JAMA Psychiatry in October 2022 concluded that ketamine can ease depression symptoms in as little as 4 hours by “updating” negative beliefs that people with severe depression hold about themselves and the future.

“We observed each patient before and after ketamine and found an early cognitive effect on beliefs about the future. Notably, patients started to show an optimism bias in belief updating 4 hours after [the] first, single infusion. At one week of treatment, the optimist bias in belief updating correlated to the clinical antidepressant effect,” says study author Dr. Liane Schmidt.

And in November, a study from NEJM found that a single, 25-milligram dose of a synthesized formulation of psilocybin also relieved the symptoms of treatment-resistant depression, although the exact way in which psilocybin acts on the brain remains unclear.

The catch

While studies such as the ones mentioned above seem to indicate that psychedelics may indeed be the way to go when it comes to severe anxiety and depression, they all come with a series of caveats.

In the JAMA Psychiatry study, the participants received ketamine infusions, which is a very specific method of administration. They also received their regular antidepressant treatment throughout the study period.

Speaking to MNT, Dr. Guochuan Emil Tsai, neuropsychiatry expert and CEO of the company SyneuRx, not involved in the study, pointed out that:

“Ketamine infusion is available but not commonly used. It’s usually reserved only for treatment-resistant depression and can only be done in facilities that offer IV infusion and can monitor patients. It would be similar to a dialysis center. Ketamine is also a Schedule III controlled substance with inherent risks.”

The NEJM study came with an even greater caveat: Although psylocibin did help reduce depression symptoms in most of the participants, about a week after the treatment, the most commonly reported side effects were suicidal ideation and intentional self-injury.

“It’s not a recreational process — it”s not like do-it-yourself self-help,” Dr. David A. Merrill, psychiatrist, and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA, not involved in the study, told MNT in an interview.

“It really needs to be done with professionally trained, licensed, or certified practitioners who understand the power of these drugs to create a mind-altered state. Dissociation, even at times hallucinations, [are] part of the journey of psychedelics to open the mind to new possibilities, but that journey needs to be supported with professional help,” stressed Dr. Merrill.

So in the course of studying psychopharmacological treatments, a few questions remain: What are the safest doses and delivery methods? Do the benefits outweigh the risks? And who would most benefit from these interventions?

Our editorial team hopes that, in 2023, we may be one step closer to finding the answers to these and other questions that could transform healthcare practices for the better, and that our audience will continue to join us in our exploration of medical innovations.

March 31, 2022

Dementia risk linked to blood sugar, cholesterol levels at 35

A person tests blood sugar levels using a device — A new analyze suggests cholesterol and blood sugar at age 35 support predict Alzheimer’s illness, which is just one of the main leads to of demise amongst Us residents 65 and more mature. Dani Ferrasanjose/Getty Images

Scientists not too long ago investigated the website link involving cardiovascular steps and Alzheimer’s ailment.
They observed that small superior-density lipoprotein (HDL or “good” cholesterol), significant triglycerides, and blood glucose amounts from age 35 are associated with elevated Alzheimer’s possibility.
The authors conclude that early intervention to keep healthful HDL, triglyceride, and glucose degrees could reduced Alzheimer’s danger.

Alzheimer’s sickness (Advertisement) is the fifth foremost induce of demise among the Individuals age 65 and older. There are no proven techniques to prevent or slow cognitive decrease brought about by Advert.

Experiments display that when vascular risk stress from age 55 predicts Advertisement, regardless of whether or not this hyperlink is present in younger individuals is unfamiliar.

Realizing how early this website link commences could support scientists understand additional about Advert as a life-training course disorder.

Lately, scientists from Boston College investigated the partnership amongst Ad and vascular measures utilizing longitudinal data.

They found that lower HDL cholesterol, higher triglyceride levels, and significant glucose amounts in the blood from age 35 are linked to Advertisement afterwards in lifetime.

The study seems in the journal Alzheimer’s and Dementia.

“Many people today know superior cholesterol is a danger component for heart disease and other health disorders, but they really don’t notice it’s a possibility factor for dementia also,” Dr. Katy Bray, community engagement manager at Alzheimer’s Investigation United kingdom, who was not concerned in the study, instructed Health care Information These days.

“To continue to keep the mind healthful as we age, the greatest proof is to try to eat a well balanced diet plan, not smoke, drink in suggested suggestions, exercise often, and hold blood pressure and cholesterol in look at.”

For the review, the researchers integrated knowledge from 4,932 folks who ended up a aspect of the Framingham Coronary heart Review. Participants experienced an typical age of 37 upon enrollment and underwent nine examinations just about every 4 yrs till the age of 70.

At every single examination, scientists calculated participants’:

HDL and lower-density lipoprotein (LDL or “good”)cholesterol

blood glucose ranges

system mass index (BMI)

systolic and diastolic blood pressure

amount of cigarettes smoked for each day

From the next evaluation onward, the contributors also underwent cognitive assessments to keep track of the development of cognitive decrease.

Following examining the information, the researchers uncovered an inverse partnership in between Advert and HDL measured at the initially, next, sixth, and seventh exams.

The study also inbound links Advertisement to increased triglyceride stages at the first, next, fifth, sixth, and seventh examinations, independent of medicine.

In the meantime, higher blood glucose was significantly connected to the development of Advert at each examination.

The researchers also found no affiliation between Ad and LDL, BMI, cigarette smoking, or blood pressure at any examination.

MNT also spoke with Dr. Allison B. Reiss, an affiliate professor of drugs at NYU Very long Island University of Drugs and a member of the Alzheimer’s Foundation of America’s Clinical, Scientific, and Memory Screening Advisory Board. Dr. Reiss was not concerned in this investigation.

“The mind is whole of cholesterol and wants cholesterol to create and make nerve cells,” she spelled out.

“The stability and transport of cholesterol inside of the mind are meticulously controlled, and lipids are quite critical in mind function. Most prominent of the lipid-connected proteins in the mind is ApoE, a protein that transports lipids in the brain and elsewhere.”

“Some HDL particles consist of ApoE (apoE-loaded HDL), and this sort of apoE-loaded HDL is most concentrated in the mind. The high quality and amount of apoE-wealthy HDL may well partly reveal the Alzheimer’s ailment-HDL connection,” she ongoing.

Xiaoling Zhang, Ph.D., assistant professor of medicine and biostatistics at Boston College College of Medicine, one of the study’s authors, explained to MNT that improved blood flow in the brain could possibly also make clear some of their conclusions.

She described that HDL could improve transportation and hence decrease the accumulation of amyloid-beta plaques, which are protein develop-ups attribute of Advertisement.

When asked about the website link concerning Advert and glucose levels, Dr. Zhang explained that higher glucose stages in the blood are joined to larger mind glucose concentrations and much more severe plaques in Advertisement brains.

“We know that the brain relies on glucose for electricity, but excessive glucose in the brain can endure chemical reactions that make it damaging and swelling-inducing. When glucose stages are higher over prolonged periods, long-term neuroinflammation may well consequence.”

– Dr. Reiss

“Another dilemma with large glucose is that it prompts the release of insulin to lower the glucose, and this can direct to wildly fluctuating sugar stages in the brain, which is really poor for nerve cells,” she discussed.

The scientists conclude that early intervention to keep wholesome HDL, triglyceride, and glucose stages may perhaps reduced Advert threat.

On the other hand, they also take note a number of limits to their get the job done. As their cohort was white, they say their results may perhaps not translate to other demographics.

They further more say that thanks to restrictions in their research design and style, their benefits might not accurately mirror age-certain tendencies. Considering the fact that the researchers did not acquire fasting blood samples at the very first two examinations, their final results could be a little skewed.

When requested about the major realistic takeaways from the analyze, Dr. Reiss said: “Eating fewer sugar and processed foodstuff and training regularly are excellent for each and every organ and primarily the mind and coronary heart. Checking blood glucose and the lipid profile and looking at HDL are excellent preventative measures.”

“We do not have prescription drugs that elevate HDL without creating a large amount of aspect results and, if the HDL is not of good good quality, raising it is pointless. For now, the finest way to aid HDL degrees is via exercising and actual physical action,” she concluded.

Posted on March 28, 2022
Lithium may reduce dementia risk

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According to a modern research, lithium could guard towards establishing dementia later on in life. Jasmin Merdan/Getty Images

A new examine concludes that lithium exposure could lessen the risk of dementia in people today over the age of 50.

Preceding reports have demonstrated that lithium disrupts the generation of proteins in the mind that are connected with Alzheimer’s illness.

The retrospective cohort examine also shown that men and women with mental health and fitness disorders who were being approved lithium had a reduce threat of building dementia.

According to the Globe Wellness Firm (WHO), conditions of dementia have been raising by 10 million every single year, globally. This is thanks in component to an getting older populace for the reason that the risk of producing dementia increases with age.

With this maximize comes a substantial well being and social treatment price tag. In simple fact, researchers believe that that delaying dementia onset by just 5 a long time could lessen its prevalence and financial influence by as considerably as 40{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

The leads to of dementia are both environmental and genetic and there are a variety of things that can increase the threat of establishing dementia.

Even though some investigate has proven that folks with bipolar affective dysfunction have a greater threat of producing dementia, a recent research gives an appealing new viewpoint.

The retrospective cohort examine identified that people who experienced been uncovered to lithium — a drug that is sometimes prescribed to persons with bipolar affective ailment and major depressive problem — were being considerably less most likely to create dementia.

The results of the investigate seem in the journal PLOS Drugs.

Dr. Christopher Weber director of world-wide science initiatives at the Alzheimer’s Affiliation, who was not involved in the research, informed Medical Information Today:

“[O]verall, when I seemed at the paper, I was quite interested and fired up about it because we’re hunting at new ways to have an understanding of and potentially handle, slow, and avoid dementia. And this is just another avenue that scientists are on the lookout at […] to decrease your threat for dementia.”

To investigate, researchers from the College of Cambridge in the United Kingdom accessed electronic medical information. They received these from secondary mental overall health products and services in Cambridge and Peterborough National Health Provider (NHS) Basis Have faith in.

They in comparison the information of 548 people today who experienced been approved lithium with 29,070 men and women who experienced not taken the treatment.

None of the contributors experienced dementia at baseline and all ended up aged 50 many years or more mature. Their signify age was 73.9 decades.

The medical information offered details about participants’ body weight, BMI, ethnicity, diabetes, cardiovascular disorder, smoking cigarettes, marital position, and other components that could impact the investigation.

Practically a few-quarters of folks prescribed lithium experienced bipolar affective ailment.

The members who experienced taken lithium had been followed for a suggest of 4.8 many years (1–14.9 yrs) and 9.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the individuals were identified with dementia throughout this time. This included 6.8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} with Alzheimer’s sickness and 2.6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} with vascular dementia.

Those who had not taken lithium ended up adopted for an normal of 4.3 yrs (1–14.9 yrs). In this group, 11.2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} made dementia, which include 8.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} with Alzheimer’s sickness and 2.6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} with vascular dementia.

Despite the fact that the examine was smaller, even following accounting for other components, the protective impact of lithium remained statistically major.

The result was most pronounced in people today who experienced taken lithium for much less than 1 12 months or far more than 5 decades.

MNT spoke with Prof. Rob Howard, a professor of outdated age psychiatry at College Higher education London who was not associated in the investigate. He reported:

“There’s an enzyme identified as glycogen synthase kinase, or GSK3, which is associated in the abnormal phosphorylation of tau protein, which makes tangles in Alzheimer’s illness. And lithium is a strong inhibitor of that enzyme. [..] This is not the first review to have shown the url involving lithium use and decreased prospective chance.”

The authors warn that, when the outcomes had been astonishing, they are not necessarily generalizable to the broader population. The key rationale for this is the fairly little variety of men and women who were having lithium.

They simply call for experts to conduct similar studies in bigger extra numerous populations.

New diagnostic techniques could aid determine persons in the very early levels of dementia said Prof. Howard. This could be utilized to discover individuals for long run trials investigating whether lithium could hold off the onset of dementia.

He believes that the next methods really should include “a trial in quite early, incredibly moderate Alzheimer’s sickness, just to see if you can display some impact of slowing the development of the condition around a few of decades.”

Posted on March 22, 2022April 30, 2022
Dementia and folate: Is there a link?

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Asparagus is made up of especially high amounts of folate. Jos_ Gouveia/EyeEm/Getty Visuals,Image,Getty

Blood folate ranges diminish with age, Movie News.

Folate deficiency impairs cognitive purpose and nerve signaling in the brain, potentially elevating threats of dementia and loss of life.

Researchers uncovered that lower serum folate amounts could maximize the danger of dementia by 68{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

They also observed that older adults with folate deficiency facial area nearly three times the hazard of dying from any bring about.

Serum folate concentrations might be a practical biomarker for dementia and mortality, but experts are unable to rule out reverse causality.

A considerable proportion of more mature grown ups could be suffering from folate, or vitamin B9, deficiency.

In accordance to the authors of the newest research, “Evidence suggests that serum folate deficiency improves the chance of deficits in cognitive overall performance and neurological performing, Movie News.”

It may perhaps follow that folate deficiency may possibly influence dementia possibility. Having said that, to date, observational reports looking for a likely partnership have created conflicting effects.

Just lately, researchers from the United States and Israel coordinated a substantial cohort review to look into further more.

They discovered that serum folate deficiency does correlate with each dementia risk and all-lead to mortality.

The conclusions look in the journal Proof-Primarily based Mental Wellbeing.

The scientists analyzed the health-related documents of 27,188 folks ages 60–75 several years. These individuals experienced no preexisting dementia for at least 10 a long time in advance of possessing their blood folate degrees checked.

The scientists monitored records for a dementia prognosis or loss of life. All over 13{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the contributors — or 3,418 — experienced serum folate concentrations down below 4.4 nanograms for each milliliter, which indicates folate deficiency.

Amongst the people today with inadequate amounts of folate, the rates of dementia have been 3.4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}. The premiums of dying from any cause came in just beneath 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

The contributors with out the deficiency professional costs of dementia of 3.2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, and the all-lead to death prices amounted to practically 4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, Movie News.

Following factoring in co-developing conditions, this kind of as diabetes, vitamin B12 deficiency, cognitive decline, and melancholy, the scientists associated folate deficiency with a 68{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} larger possibility of a dementia prognosis.

The individuals with folate deficiency experienced a few moments the risk of dying from any cause.

Anat Rotstein, Ph.D., a postdoctoral scholar in the Division of Psychiatry at the Icahn University of Drugs at Mount Sinai in New York, was the study’s guide creator.

In an job interview with Clinical News Today, Dr. Rotstein mentioned the significance of this operate:

“This research is essential for the reason that it critically characterizes the affiliation among a commonly made use of and uncomplicated-to-evaluate biomarker serum folate (vitamin B9 in the blood) and the pitfalls of dementia and all-induce mortality.”

“It is the 1st review of serum folate and the chance of dementia to contemplate two key methodological artifacts: mortality precludes dementia, and reverse causation,” she ongoing.

“Hence, our examine presents the finest evidence to day relating to the affiliation concerning serum folate deficiency and all-trigger mortality.”

David A. Merrill, M.D., Ph.D., is an grownup and geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health and fitness Centre at Providence Saint John’s Wellness Center in Santa Monica, CA.

In an interview with MNT, Dr. Merrill described this research as “newsworthy,” since the job of folate in cognitive health is not perfectly established.

He also famous that testing for folate amounts “could be useful […] more as a screening tool” because “deficiencies are associated with indicators.”

Dr. Rotstein and her crew also investigated the risk that reduced folate concentrations could come up from, not right before, preclinical dementia. This is difficult to rule out owing to the time it normally takes for cognitive decrease to manifest.

When the researchers categorized their info by the length of the checking period of time, they could not eliminate the possible function of reverse causation.

Dr. Rotstein informed MNT, “Our results demonstrate moderate evidence for reverse causation in dementia, suggesting that serum folate deficiency may perhaps be a consequence of the onset of dementia instead than its cause (not so with all-lead to mortality).”

If dementia is responsible for the fall in serum folate, it could be a practical marker to assistance medical practitioners determine people today with an amplified hazard of dementia.

The scientists acknowledge that their review has a number of limits.

First of all, it only incorporated individuals ages 60–75 yrs who had been selected to endure screening for serum folate concentrations. A random sample may possibly have manufactured much more correct estimates for a broader inhabitants.

Because of to the observational study style, the authors could not confirm that small folate levels induce dementia or early death.

Further more, serum folate concentrations might not replicate extended-time period folate levels, mainly because they modify with metabolic rate and foods ingestion.

Also, the examine did not account for feasible undetected genetic risk aspects.

The study’s authors conclude that health care industry experts really should “treat deficiency for [preventive] actions and/or as portion of applied therapeutic tactics although on a regular basis reviewing patients’ scientific results.”

Dr. Rotstein was hesitant to advise normal testing for folks outside of the study’s age variety of 60–75 years.

Even so, Dr. Merrill felt that annually or biannual screening could be useful for men and women with a spouse and children heritage of dementia or approaching middle and later lifestyle.

The price-efficiency of tests is questionable, while, as Dr. Merrill remarked: “You would get arguments on both facet. You would say, ‘Oh, properly, […] someone has no signs and symptoms, and it is a waste of sources.’ [But] you are going to by no means know except if you check, and then, often, if you hold out until finally you have a dilemma, it’s too late.”

Dr. Merrill suggested that fascinated men and women verify folate with vitamin B12, because the nutrients get the job done alongside one another in numerous metabolic processes. The geriatrician observed that many client laboratories are now checking these degrees in extensive blood exams as a preventive instrument.

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Posted on February 27, 2022
Do mental health conditions increase dementia risk?

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A new review investigates inbound links amongst psychological overall health and dementia. Rob and Julia Campbell/Stocksy

A substantial new research finds an association among psychological well being situations and dementia later on in life.

Though study has not established a causal website link, psychological wellness difficulties continue being a predictor of dementia.

Effectively addressing psychological wellbeing situations may help cut down the likelihood of dementia for older grown ups.

As of 2020, there ended up in excess of 55 million people today all over the world residing with dementia, with an estimated 10 million new scenarios just about every calendar year. Industry experts estimate that an individual develops the problem each 3 seconds.

For decades, scientists have suspected a relationship amongst mental overall health ailments previously in lifestyle and dementia afterwards on, although the outcomes of this kind of investigations have been inconsistent.

Now, scientists from the College of Michigan in Ann Arbor, Duke College in Durham, NC, and the University of Auckland in New Zealand have posted a extensive-phrase examine of 1.7 million individuals from New Zealand aged 21–60 many years.

The integrative character of the country’s national overall health program allowed the study’s authors to follow individuals throughout 30 a long time — from 1988 to 2018 — linking hospital information and inhabitants databases.

The study finds that psychological health and fitness disorders are strongly involved with dementia later in everyday living.

The research appears in JAMA Psychiatry.

Though the review reveals a sturdy statistical association concerning mental wellbeing problems and dementia, a longitudinal review these as this simply cannot demonstrate that previously psychological health problems bring about dementia.

The study’s direct author is Dr. Leah Richmond-Rakerd, an assistant professor in the Division of Psychology at the College of Michigan. She advised to Medical News Right now a few causes why such a robust affiliation may possibly exist:

“There could be shared danger things for the two psychological [health conditions] and dementia, this sort of as shared genetics. It may also be that people working experience a brain vulnerability that displays up as mental wellness problems previously in existence, and demonstrates up as dementia later in lifestyle.”

Dr. Archana Singh-Manoux, who was not associated in this review, advised MNT that she agrees that this rationalization is attainable.

Nonetheless, “it is a lot more possible that [having a mental health condition] early in lifestyle [may set] you on pathways that direct to adverse well being outcomes. This may well include things like harmful behaviors, [difficulties with managing] self-wellbeing treatment, noncompliance to therapy, poverty, side effects of medication, and many others.”

Dr. Singh-Manoux is a principal investigator of the epidemiology of growing old and neurodegenerative conditions at the Université de Paris in France.

“It’s essential to notice, though,” claimed Dr. Richmond-Rakerd, “that even if psychological wellbeing conditions are not a causal hazard factor for dementia, the existence of a mental health problem is even now an crucial indicator of danger.”

“The mental [health conditions] thought of in the examine,” stated Dr. Singh-Manoux, “were: material use, psychotic, temper, neurotic (i.e., anxiousness), physiological disturbance, temperament, developmental, behavioral, and unspecified diseases.”

As the lead author of a preceding analyze checking out a website link amongst melancholy and dementia, Dr. Singh-Manoux noted:

“It is significant to individual these findings from experiments that look at the association in between depressive signs and dementia, specifically experiments based on older grown ups. This is because depressive symptoms are prevalent in the preclinical section of dementia, and any affiliation is possible to be due to ‘reverse causation.’”

In other phrases, despair in more mature grown ups may possibly be an early indication of dementia, fairly than evidence that depressive signs are a hazard aspect for dementia.

The research observed that psychological overall health disorders were related with subsequent Alzheimer’s and non-Alzheimer’s dementias, as perfectly as other early- and late-onset dementias.

Of the total group researched, researchers recognized 3.8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} (64,857) of individuals as getting a psychological wellbeing affliction, even though 2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} (34,029) experienced a analysis of dementia.

Just about 6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people today with mental wellness situations made dementia in the course of the observation period of time. Between individuals with no mental health and fitness disorders, only 1.8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} produced dementia.

The affiliation persisted throughout all genders and age teams.

The scientists also determined that socioeconomic deprivation or earlier persistent actual physical health conditions ended up not considerable elements.

“We were being stunned to uncover that mental well being problems had been a a great deal stronger predictor of dementia than persistent bodily diseases,” reported Dr. Richmond-Rakerd.

“This reinforces the need to have,” stated Dr. Richmond-Rakerd, “to imagine about dementia prevention earlier in the daily life program for the reason that mental health conditions have a tendency to peak in young adulthood, although persistent physical illnesses do not ordinarily arise until eventually later on in lifetime. Supporting youthful people’s mental overall health could be a window of opportunity to support lessen the burden of dementia in older grown ups.”

MNT asked Dr. Richmond-Rakerd what kind of study she would like to see that could build or refute a causal connection among mental health conditions and dementia. She replied:

“One insightful approach would be to detect effective randomized scientific trials of psychiatric interventions and follow up the participants who obtained the intervention to see if in afterwards existence they are faring greater in conditions of their cognitive health and are protected against dementia. This would provide evidence that psychological overall health problems are a causal hazard issue.”

On the other hand, stated Dr. Singh-Manoux, “Establishing causality wherever dementia is worried is challenging thanks to the extensive interval more than which dementia develops — probably as lengthy as 15–20 decades. [Randomized controlled trials], the gold normal method to establish causality, are clearly not beneficial.”

This still left Dr. Singh-Manoux with much more faith in longitudinal scientific studies like Dr. Richmond-Rakerd’s:

“Thus, well-performed longitudinal reports, with a very long adhere to-up, are critical.” She extra, “Another technique is Mendelian randomization, the place genes are used as instruments to check causality in the affiliation among an exposure and an consequence.”

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