Tag Archives: medical fields and specialties

Health

When young children test positive for Covid-19 and another respiratory virus, their illness is much more severe, a new study suggests

Leave a comment



CNN
 — 

When Covid-19 patients younger than 5 also test positive for another respiratory virus, they tend to become sicker and develop more severe disease, a new study suggests.

Among hospitalized children younger than 5, testing positive for both Covid-19 and another respiratory virus at the same time is associated with about twice the odds of severe respiratory illness than those who tested negative for other viruses, according to the study published Wednesday in the journal Pediatrics.

The study comes amid a harsh season of respiratory viruses, including RSV, flu, Covid-19 and other viruses that overwhelmed children’s hospitals. The findings demonstrate the impact respiratory viruses have on pediatric hospitals and how “continued surveillance” of circulating Covid-19 and other illnesses can help predict future surges in hospitalizations, wrote the researchers, from the US Centers for Disease Control and Prevention and various universities and health departments across the United States.

Caring for young children with overlapping respiratory illnesses was something Jenevieve Silva has experienced firsthand throughout the Covid-19 pandemic.

“The height of the illnesses was from September through mid-November, when our household just could not catch a break,” she said.

The mother of eight, based in San Jose, California, said that her toddler-age twin boys “have been battered by viruses” since they started preschool in May 2021.

Last October, Silva’s twins tested positive for Covid-19 and then developed what their pediatrician suspected was another respiratory viral infection, possibly respiratory syncytial virus or RSV, around the same time.

“Based on what the pediatrician told us, she said ‘I highly believe that they had these overlapping viruses,’” Silva said, adding that the boys’ symptoms included shortness of breath, cough, fatigue, and fever, with one twin having a 105-degree fever for four days straight.

Warm baths and massaging Vicks VapoRub onto their backs and chest helped ease their pain, but watching her boys battle these respiratory illnesses was “brutal,” Silva said.

“They had just looked so frail – they looked sick, like something deeper than just back-to-back viruses,” she said. “It was hell. I mean, it was really bad.”

The boys have recovered and are currently “doing great” and have gained healthy weight, Silva said, but she worries that they developed asthma following their illnesses.

Ever since October, when they had the overlapping viruses, “the doctor has now said it seems like that might have triggered asthma in them. And so now, ever since then, when they get a cold, they have asthma symptoms – violent episodes of coughing, sometimes throwing up,” Silva said.

“I can’t be the only mom dealing with virus after virus,” she said, adding that for other parents out there, she has a message of hope: “Be patient. Listen to your doctor.”

The new study included data on 4,372 children who were hospitalized with Covid-19. Among those who were tested for other respiratory viruses, 21% had a codetection, meaning another respiratory virus was also detected in their test results. The data came from the US Centers for Disease Control and Prevention’s Covid-19 hospitalization surveillance network called COVID-NET, with data from across 14 states.

The researchers noted that they focused on codetection, not coinfection, since testing wouldn’t necessarily show that a child was actively infected with both viruses just because they test positive.

Overall, “this study found that respiratory virus codetections were rare in the first year of the pandemic, RSV and rhinovirus or enterovirus codetections increased during the Delta-predominant period and influenza codetections were infrequent throughout the first 2 years of the pandemic,” the researchers wrote in their study.

The data also showed that children with codetections were more likely to be younger than 5, receive increased oxygen support, and be admitted to the intensive care unit. No significant associations were seen among children 5 and older.

Specifically for children younger than 2, testing positive for respiratory syncytial virus or RSV while having Covid-19 was significantly associated with severe illness.

More research is needed on the precise impact that two respiratory viruses can simultaneously have on the body, said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases, who was not involved in the new study.

“But we do think that being attacked by two viruses, particularly if you are less than five years of age, it’s been clearly demonstrated by this study, it does tend to make your illness more severe, more likely to be prolonged in the hospital, more likely to be in the pediatric intensive care unit,” Schaffner said. “And so clearly, having your lungs and your throat and your body – generally your immune system – attacked by two viruses simultaneously, understandably might make some young children more severely ill.”

Dr. Asuncion Mejias, associate professor of pediatric infectious diseases at Nationwide Children’s Hospital, said hospitalized children she has treated for Covid-19 and codetections of other respiratory viruses often require increased oxygen support and treatment in the intensive care unit.

“Covid is a very proinflammatory virus, so it really weakens your immune response,” said Mejias. “And when you haven’t recovered yet, and you get a second hit, in this case, RSV or rhinovirus, you develop a more severe disease.”

Overall, Schaffner said that these new study findings are more reason why it remains important to make sure children are up to date on their Covid-19 vaccinations as well as vaccinated against the flu.

Mejias agreed, emphasizing the importance of safe practices to prevent the spread of viruses to children too young to be vaccinated.

“The pandemic taught us how contagious these viruses are,” Mejias said about respiratory pathogens.

“If somebody is sick, try to avoid contact,” she said. “These viruses are not only transmitted by saliva and secretions but by hands. It can survive in your hands for more than 30 minutes. So if you touch your mouth and then touch a little baby, the baby can self inoculate the virus and become infected. So washing hands and all these measures are very important.”

Read original article here

Health

Large new review underscores the risks of Covid-19 during pregnancy

Leave a comment



CNN
 — 

Pregnant women and their developing babies are at higher risk for severe outcomes if they get Covid-19, and now a large, international review is helping to underscore how devastating those risks can be.

The study draws on data from 12 studies from as many countries—including the United States. Altogether, the studies included more than 13,000 pregnant women—about 2,000 who had a confirmed or probable case of Covid-19. The health outcomes for these women and their babies were compared to about 11,000 pregnancies where the mother tested negative for Covid-19 or antibodies to it at the time of their deliveries.

Across the studies about 3% of pregnant women with Covid-19 needed intensive care, and about 4% needed any kind of critical care, but this was far higher than the numbers of pregnant women who needed that kind of care outside of a Covid-19 infection.

Compared to pregnant individuals who weren’t infected, those who got Covid-19 were nearly 4 times more likely to be admitted to an intensive care unit. They were 15 times more likely to be ventilated and were 7 times more likely to die. They also had higher risks for pre-eclampisa, blood clots, and problems caused by high blood pressure. Babies born to moms who had Covid-19 were at higher risk for preterm birth and low birth weights.

Previous studies have suggested that Covid-19 may increase the risk of stillbirth, but this study didn’t find that same link.

Still, the findings paint a clear picture that shows the risks of pregnancy are amplified by Covid-19 infections.

“It’s very clear and even it’s consistent, you know, whether we’re talking about Sweden where we have really generally great pregnancy outcomes to other countries that you know, have bigger problems with maternal morbidity and mortality, that having COVID and pregnancy increases risk for both mom and baby,” said lead study author Emily Smith, who is an assistant professor of global health at George Washington University.

The study has some caveats that may limit how applicable the findings are to pregnant individuals in the Omicron era.

First, the studies were conducted relatively early in the pandemic, at a time when most people were still unvaccinated and uninfected. That means people in the study were likely at higher risk not just because they were pregnant, but also because they were immunologically naïve to the virus—they didn’t have any pre-existing immunity to help them fight off their infections.

Since then, many pregnant individuals have gotten vaccinated, or had Covid-19 or both. As of the first week of January, about 72% of pregnant people in the U.S. have had their primary series of Covid-19 vaccines, and about 95% of Americans are estimated to have had Covid-19 at least once, or been vaccinated against it, according to data from the Centers for Disease Control and Prevention. That means it’s likely they have some immune memory against the virus that may help protect against severe outcomes.

That immune memory appears to fade over time, however. CDC data show just 19% of pregnant women have had an updated booster, meaning many people may not have as much protection against the virus as they think they do.

Lead study author Emily Smith, who is an assistant professor of global health at George Washington University, says the study results reflect the risk of Covid-19 and pregnancy in unvaccinated people.

Unfortunately, Smith says, many countries still don’t have clear guidelines advising vaccination during pregnancy. And there are some parts of the world, such as China, that still have substantial proportions of their population who’ve never been been infected.

For people who are trying to weigh the risks and benefits of Covid-19 vaccination during pregnancy, Smith says this study helps tip the scales firmly on the side of vaccination.

“It’s worth it to protect yourself in pregnancy,” Smith said.

She says this study didn’t look at the benefits of vaccination in pregnancy, but other studies have, showing big decreases in the risk of stillbirth, preterm birth and severe disease or death for mom.

“And so that’s kind of the complementary story,” said Smith.

Dr. Justin Lappen, division director of Maternal Fetal Medicine at the Cleveland Clinic, praised the study and said its findings reinforce and advance previous research, which has found that Covid-19 markedly increases the risk of severe outcomes for mom and baby. He wasn’t involved in the study.

He says the findings highlight the importance of preventing and treating Covid-19 in pregnant women.

Therapies that are indicated or otherwise recommended should not be withheld specifically due to pregnancy or breastfeeding, Lappen wrote in an email to CNN.

The study is published in the journal BMJ Global Health.

Read original article here

Health

Focused ultrasounds: How the noninvasive brain surgery works

Leave a comment



CNN
 — 

Undergoing clinical trials around the world is a brain surgery that doesn’t need an incision or produce any blood yet drastically improves the lives of people with essential tremor, depression and more. The procedure, known as a focused ultrasound, aims sound waves at parts of the brain to disrupt faulty brain circuits causing symptoms.

“Focused ultrasound is a noninvasive therapeutic technology,” said Dr. Neal Kassell, founder and chairman of the Focused Ultrasound Foundation. “We’ve said that focused ultrasound is the most powerful sound you will never hear, but sound that someday could save your life.”

Kassell describes the way it works as “analogous to using a magnifying glass to focus beams of light on a point and burn a hole in a leaf.”

“With focused ultrasound, instead of using an optical lens to focus beams of light,” he added, “an acoustic lens is used to focus multiple beams of ultrasound energy on targets deep in the body with a high degree of precision and accuracy, sparing the adjacent normal tissue.”

The procedure has been significantly beneficial for people with essential tremor, a neurological disorder that causes involuntary and rhythmic shaking. The disorder can affect almost any body part, but the tremors typically occur in hands — even during simple tasks such as eating, drinking or writing.

Essential tremor is usually more prominent on one side of the body and can worsen with movement. It’s most common in people 40 and older, and it affects nearly 25 million worldwide, according to a 2021 study.

Such was the case with Brenda Hric, 80, who recently underwent focused ultrasound at the University of Virginia, a pioneering institution of the procedure.

Hric’s tremors made her uncomfortable in social situations because she was afraid of spilling or knocking something over, she told CNN.

But just 44 seconds of focused ultrasound waves got rid of her tremor.

“I looked at my hand, and I could see that it was not moving, and that was the first time I had been able to see my fingers still in about 20 years,” Hric said. “I think it’s definitely a miracle, and I thank the Lord for it.”

Focused ultrasound is a form of functional neurosurgery, the targeting of precise structures deep in the brain to change it, to restore function or, in this case, to stop a tumor. It’s an alternative treatment for those who, like Hric, don’t respond to or stop being affected by conventional medication treatment, experts said.

“In a simplistic sense, you can imagine that there’s a bunch of abnormal neurons in this one target that are firing away uncontrollably, causing the tremor, the shaking,” Kassell said.

Focused ultrasound technology uses a transducer to force beams of sound waves to converge at one point to raise the temperature and destroy tissue.

Before receiving high-intensity focused ultrasound, the one necessary for treating essential tremor, patients need to have their heads shaved since air can sometimes get trapped in hair follicles.

The patient then undergoes MRI and CT scans so doctors can use the resulting images to map the structure of the brain and the target.

The Insightec Exablate Neuro, a focused ultrasound platform, instructs how many beams should be used to do the treatment, then neurosurgeons might do what Dr. Jeff Elias calls “test shots, just to make sure we’re focused right at the bull’s-eye.”

A UVA Health neurosurgeon who treated Hric, Elias is a pioneer of treating essential tremors using ultrasound waves. In 2011, he led the clinical trials critical for gaining regulatory approval of this procedure in the United States.

“These (test shots) are really low energy, but we want to see if our treatment is exactly where we want it,” he said. “This is our chance to kind of sight the rifle.”

Four 11-second treatment doses significantly improved Hric’s tremor. The entire procedure lasted less than two hours, with most of it spent mapping the brain and testing the target.

Beforehand, Hric had trouble drawing inside the lines of circles. Focused ultrasound helped her color inside the lines.

Generally, anyone with an essential tremor diagnosis not responding to medications would be eligible for focused ultrasound treatment, said Dr. Nir Lipsman, a scientist at Sunnybrook Health Sciences Centre in Toronto and director of Sunnybrook’s Harquail Centre for Neuromodulation.

People who can’t undergo MRI scans due to claustrophobia or having metal inside their body aren’t eligible for focused ultrasound, said Dr. Noah Philip, a professor of psychiatry and human behavior at Brown University’s Alpert Medical School. Philip is also lead for mental health research at the VA RR&D Center for Neurorestoration and Neurotechnology.

Ideally, the benefits of focused ultrasound are permanent, Lipsman said. “If you’re able to destroy the part of the brain responsible for the tremor, it should be a permanent effect,” he said. “At one year, however, some of these patients will have a rebound or recurrence of their tremor, and we don’t know why that is.”

Such a return can happen with medication treatment, too, though — which is why some essential tremor patients turn to focused ultrasound in the first place.

But some patients have experienced the benefits five years after undergoing focused ultrasound, according to a 2022 study by Elias.

Potential side effects of focused ultrasound are why the mapping and testing parts of the procedure are so important. If the wrong area is targeted or treated excessively, a patient’s balance and stability can be harmed long term.

“The most common risks that we encounter in patients is a temporary numbness or tingling that can sometimes happen in the treated arm or in the lip area,” Lipsman said. “The vast majority of the time that goes away with time.”

Other common, but usually temporary, risks include slight unsteadiness on one’s feet after the procedure. But doctors don’t use a general anesthetic or hospitalize patients for this procedure, he added.

Today, focused ultrasound technology is used globally in various stages, including clinical trials and approved regulatory use. There are more than 170 clinical uses — including for neurodegenerative disorders and tumors of the brain, breast, lung, prostate and more — and the field is growing, Kassell said.

“You can watch the effect of the ultrasound treatment in real time while the treatment’s being administered, whereas with radiation, the effect of the treatment is invisible while it’s being administered,” Kassell said. “And it takes weeks or months for the effect of radiation to become apparent.”

Use for depression and obsessive-compulsive disorder is on the table, according to a small 2020 study by Lipsman and a team of researchers. They found focused ultrasound was safe and effective in improving symptoms for people with major depression and OCD. But further studies are needed.

One limitation of focused ultrasound is that not every person’s skull is made equal, Lipsman said.

“The density of the skull has a major impact on the ability of ultrasound to travel through it,” he added. “It’s rare, but there are some patients that, try as we might, we cannot make an effective lesion in the brain. The skull does not allow the passage of ultrasound. So that’s a technical limitation of the technology, something that we’re actively working on.”

Focused ultrasound isn’t available for every condition, but experts said they are hopeful that “medicine’s best-kept secret” will one day become a standard treatment.

“My belief is that in 10 years,” Kassell said, “focused ultrasound will be a mainstream therapy that is affecting millions of patients every year around the world. It’ll be widely accepted.”

Read original article here

Health

Aging can be reversed in mice. Are people next?

Leave a comment



CNN
 — 

In Boston labs, old, blind mice have regained their eyesight, developed smarter, younger brains and built healthier muscle and kidney tissue. On the flip side, young mice have prematurely aged, with devastating results to nearly every tissue in their bodies.

The experiments show aging is a reversible process, capable of being driven “forwards and backwards at will,” said anti-aging expert David Sinclair, a professor of genetics in the Blavatnik Institute at Harvard Medical School and codirector of the Paul F. Glenn Center for Biology of Aging Research.

Our bodies hold a backup copy of our youth that can be triggered to regenerate, said Sinclair, the senior author of a new paper showcasing the work of his lab and international scientists.

The combined experiments, published for the first time Thursday in the journal Cell, challenge the scientific belief aging is the result of genetic mutations that undermine our DNA, creating a junkyard of damaged cellular tissue that can lead to deterioration, disease and death.

“It’s not junk, it’s not damage that causes us to get old,” said Sinclair, who described the work last year at Life Itself, a health and wellness event presented in partnership with CNN.

“We believe it’s a loss of information — a loss in the cell’s ability to read its original DNA so it forgets how to function — in much the same way an old computer may develop corrupted software. I call it the information theory of aging.”

Jae-Hyun Yang, a genetics research fellow in the Sinclair Lab who coauthored the paper, said he expects the findings “will transform the way we view the process of aging and the way we approach the treatment of diseases associated with aging.”

While DNA can be viewed as the body’s hardware, the epigenome is the software. Epigenes are proteins and chemicals that sit like freckles on each gene, waiting to tell the gene “what to do, where to do it, and when to do it,” according to the National Human Genome Research Institute.

The epigenome literally turns genes on and off. That process can be triggered by pollution, environmental toxins and human behaviors such as smoking, eating an inflammatory diet or suffering a chronic lack of sleep. And just like a computer, the cellular process becomes corrupted as more DNA is broken or damaged, Sinclair said.

“The cell panics, and proteins that normally would control the genes get distracted by having to go and repair the DNA,” he explained. “Then they don’t all find their way back to where they started, so over time it’s like a Ping-Pong match, where the balls end up all over the floor.”

In other words, the cellular pieces lose their way home, much like a person with Alzheimer’s.

“The astonishing finding is that there’s a backup copy of the software in the body that you can reset,” Sinclair said. “We’re showing why that software gets corrupted and how we can reboot the system by tapping into a reset switch that restores the cell’s ability to read the genome correctly again, as if it was young.”

It doesn’t matter if the body is 50 or 75, healthy or wracked with disease, Sinclair said. Once that process has been triggered, “the body will then remember how to regenerate and will be young again, even if you’re already old and have an illness. Now, what that software is, we don’t know yet. At this point, we just know that we can flip the switch.”

The hunt for the switch began when Sinclair was a graduate student, part of a team at the Massachusetts Institute of Technology that discovered the existence of genes to control aging in yeast. That gene exists in all creatures, so there should be a way to do the same in people, he surmised.

To test the theory, he began trying to fast-forward aging in mice without causing mutations or cancer.

“We started making that mouse when I was 39 years old. I’m now 53, and we’ve been studying that mouse ever since,” he said. “If the theory of information aging was wrong, then we would get either a dead mouse, a normal mouse, an aging mouse or a mouse that had cancer. We got aging.”

With the help of other scientists, Sinclair and his Harvard team have been able to age tissues in the brain, eyes, muscle, skin and kidneys of mice.

To do this, Sinclair’s team developed ICE, short for inducible changes to the epigenome. Instead of altering the coding sections of the mice’s DNA that can trigger mutations, ICE alters the way DNA is folded. The temporary, fast-healing cuts made by ICE mimic the daily damage from chemicals, sunlight and the like that contribute to aging.

ICE mice at one year looked and acted twice their age.

Now it was time to reverse the process. Sinclair Lab geneticist Yuancheng Lu created a mixture of three of four “Yamanaka factors,” human adult skin cells that have been reprogrammed to behave like embryonic or pluripotent stem cells, capable of developing into any cell in the body.

The cocktail was injected into damaged retinal ganglion cells at the back of the eyes of blind mice and switched on by feeding mice antibiotics.

“The antibiotic is just a tool. It could be any chemical really, just a way to be sure the three genes are switched on,” Sinclair told CNN previously. “Normally they are only on in very young, developing embryos and then turn off as we age.”

The mice regained most of their eyesight.

Next, the team tackled brain, muscle and kidney cells, and restored those to much younger levels, according to the study.

“One of our breakthroughs was to realize that if you use this particular set of three pluripotent stem cells, the mice don’t go back to age zero, which would cause cancer or worse,” Sinclair said. “Instead, the cells go back to between 50% and 75% of the original age, and they stop and don’t get any younger, which is lucky. How the cells know to do that, we don’t yet understand.”

Today, Sinclair’s team is trying to find a way to deliver the genetic switch evenly to each cell, thus rejuvenating the entire mouse at once.

“Delivery is a technical hurdle, but other groups seem to have done well,” Sinclair said, pointing to two unpublished studies that appear to have overcome the problem.

“One uses the same system we developed to treat very old mice, the equivalent of an 80-year-old human. And they still got the mice to live longer, which is remarkable. So they’ve kind of beaten us to the punch in that experiment,” he said.

“But that says to me the rejuvenation is not just affecting a few organs, it’s able to rejuvenate the whole mouse because they’re living longer,” he added. “The results are a gift and confirmation of what our paper is saying.”

What’s next? Billions of dollars are being poured into anti-aging, funding all sorts of methods to turn back the clock.

In his lab, Sinclair said his team has reset the cells in mice multiple times, showing that aging can be reversed more than once, and he is currently testing the genetic reset in primates. But decades could pass before any anti-aging clinical trials in humans begin, get analyzed and, if safe and successful, scaled to the mass needed for federal approval.

But just as damaging factors can disrupt the epigenome, healthy behaviors can repair it, Sinclair said.

“We know this is probably true because people who have lived a healthy lifestyle have less biological age than those who have done the opposite,” he said.

His top tips? Focus on plants for food, eat less often, get sufficient sleep, lose your breath for 10 minutes three times a week by exercising to maintain your muscle mass, don’t sweat the small stuff and have a good social group.

“The message is every day counts,” Sinclair said. “How you live your life even when you’re in your teens and 20s really matters, even decades later, because every day your clock is ticking.”

Read original article here

Health

US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

Leave a comment



CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

Read original article here

Health

Updated childhood obesity treatment guidelines include medications, surgery for some young people

Leave a comment



CNN
 — 

Updated American Academy of Pediatrics guidelines for treatment of obesity urge prompt use of behavior therapy and lifestyle changes, and say surgery and medications should be used for some young people.

The guidelines, published Monday in the journal Pediatrics, are the first comprehensive update to the academy’s obesity treatment guidelines in 15 years. They provide guidance for treatment of children as young as 2 and through the teen years.

The guidelines acknowledge that obesity is complex, and tied to access to nutritious foods and health care, among other factors.

Treatment for younger children should focus on behavior and lifestyle treatment for the entire family, including nutrition support and increased physical activity. For children 12 and older, use of weight loss medications is appropriate, in addition to health behavior therapy and lifestyle treatment, AAP says. Teens 13 and older with severe obesity should be evaluated for surgery, according to the guidelines.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” Dr. Sandra Hassink, an author of the guideline and vice chair of AAP’s Clinical Practice Guideline Subcommittee on Obesity, said in a statement. “The goal is to help patients make changes in lifestyle, behaviors or environment in a way that is sustainable and involves families in decision-making at every step of the way.”

For children and teens, overweight is defined as a body mass index at or above the 85th percentile and below the 95th percentile; obesity is defined as a BMI at or above the 95th percentile.

Myles Faith, a psychologist at the State University of New York at Buffalo who studies childhood eating behaviors and obesity, praised the new report both for acknowledging that the causes of childhood obesity are complex and that its treatments must be a team effort.

“It’s not one cause for all kids,” he says. “There’s not been this kind of report to say that there are more options and that we shouldn’t automatically discount the possibility of medication, that we shouldn’t discount the role of surgery. For some families, it might be something to consider,” said Faith, who was not involved in the creation of the guidelines.

The new guidelines do not discuss obesity prevention; it will be addressed in another AAP policy statement to come, it says.

“These are the most comprehensive, patient-centered guidelines we have had that address overweight and obesity within childhood,” Dr. Rebecca Carter, pediatrician at the University of Maryland Children’s Hospital and assistant professor at the University of Maryland School of Medicine, said in an email Monday.

“New to these recommendations are several new medication management strategies that have proven very successful in the treatment of obesity as a chronic disease for adults, and are now being recommended for use in children and adolescents,” Carter said. “This is a major step in allowing overweight and obesity to be considered as the chronic diseases that they are.”

She added that the recommendations also are a “major step forward” in helping both parents and medical teams “take ownership” over a child’s long-term health risks related to overweight and obesity.

“They give a variety of tools to help families feel empowered that there are ways to treat these medical conditions, and that there are nuanced causes for these conditions that go beyond easy solutions and certainly take our focus away from outdated or unhealthy dieting strategies,” Carter said.

The new guidelines are designed for health care providers, but Carter said parents should talk with their children’s doctor if there are concerns about weight, and discuss strategies to optimize health and monitor changes.

“It is also appropriate to do this in a child-focused manner, taking care not to stigmatize them or make them feel bad about their body, while empowering the child to feel they have the tools needed to keep their body healthy over time.”

The new guidelines are a “much-needed advancement” to align holistic care with current science, Dr. Jennifer Woo Baidal, assistant professor of pediatrics and director of the Pediatric Obesity Initiative at Columbia University in New York City, said in a separate email Monday.

“Uptake of the new guidelines will help reverse the epidemic of childhood obesity,” she said. “More work at policy levels will be needed to mitigate policies and practices that propagate racial, ethnic, and socioeconomic disparities in obesity starting in early life. Although the guidelines support advocacy efforts of pediatricians, we as a society need to voice our support for healthful environments for the nation’s children.”

AAP says more than 14.4 million children and teens live with obesity. Children with overweight or obesity are at higher risk for asthma, sleep apnea, bone and joint problems, type 2 diabetes and heart disease, according to the US Centers for Disease Control and Prevention.

Separate research, published last month in the American Diabetes Association journal Diabetes Care, suggests that the number of young people under age 20 with type 2 diabetes in the United States may increase nearly 675% by 2060 if current trends continue.

Last month, the CDC released updated growth charts that can be used to track children and teens with severe obesity.

Growth charts are standardized tools used by health care providers to track growth from infancy through adolescence. But as obesity and severe obesity became more prevalent in the last 40 years – more than 4.5 million children and teens had severe obesity in 2017-2018, the agency says – the charts hadn’t kept up.

The growth chart in use since 2000 is based on data from 1963 to 1980 and did not extend beyond the 97th percentile, the agency said. The newly extended percentiles incorporate more recent data and provide a way to monitor and visualize very high body mass index values.

The existing growth charts for children and adolescents without obesity will not change, the CDC said, while the extended growth chart will be useful for health care providers treating patients with severe childhood obesity.

“Prior to today’s release, the growth charts did not extend high enough to plot BMI for the increasing number of children with severe obesity. The new growth charts coupled with high-quality treatment can help optimize care for children with severe obesity,” Dr. Karen Hacker, director CDC’s National Center for Chronic Disease Prevention and Health Promotion, said in a statement. “Providers can work with families on a comprehensive care plan to address childhood obesity.

Read original article here

Business

Alzheimer’s drug lecanemab receives accelerated FDA approval amid safety concerns

Leave a comment



CNN
 — 

The US Food and Drug Administration granted accelerated approval Friday for the Alzheimer’s disease drug lecanemab, one of the first experimental dementia drugs to appear to slow the progression of cognitive decline.

“Alzheimer’s disease immeasurably incapacitates the lives of those who suffer from it and has devastating effects on their loved ones,” Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research, said in a statement. “This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease.”

Lecanemab will be marketed as Leqembi, the FDA statement said. It has shown “potential” as an Alzheimer’s disease treatment by appearing to slow progression, according to Phase 3 trial results, but it has raised safety concerns due to its association with certain serious adverse events, including brain swelling and bleeding.

In July, the FDA accepted Eisai’s Biologics License Application for lecanemab under the accelerated approval pathway and granted the drug priority review, according to the company. The accelerated approval program allows for earlier approval of medications that treat serious conditions and “fill an unmet medical need” while the drugs continue to be studied in larger and longer trials.

If those trials confirm that the drug provides a clinical benefit, the FDA could grant traditional approval. But if the confirmatory trial does not show benefit, the FDA has the regulatory procedures that could lead to taking the drug off the market.

Lecanemab, a monoclonal antibody, is not a cure but works by binding to amyloid beta, a hallmark of Alzheimer’s disease. In late November, results from an 18-month Phase 3 clinical trial published in The New England Journal of Medicine showed that lecanemab “reduced markers of amyloid in early Alzheimer’s disease and resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events.”

The results also showed that about 6.9% of the trial participants given lecanemab, as an intravenous infusion, discontinued the trial due to adverse events, compared with 2.9% of those given a placebo. Overall, there were serious adverse events in 14% of the lecanemab group and 11.3% of the placebo group.

The most common adverse events in the lecanemab group were reactions to the intravenous infusions and abnormalities on their MRIs, such as brain swelling and bleeding called amyloid-related imaging abnormalities, or ARIA, which can become life-threatening.

Some people who get ARIA may not have symptoms, but it can occasionally lead to hospitalization or lasting impairment. And the frequency of ARIA appeared to be higher in people who had a gene called APOE4, which can raise the risk of Alzheimer’s disease or other dementias. ARIA “were numerically less common” among APOE4 noncarriers, the study showed.

The drug’s prescribing information carries a warning about ARIA, the FDA says.

The trial results also showed that about 0.7% of participants in the lecanemab group and 0.8% of those in the placebo group died, corresponding to six deaths in the lecanemab group and seven in the placebo group.

The Alzheimer’s Association welcomed Friday’s decision.

“By slowing progression of the disease when taken in the early stages of Alzheimer’s, individuals will have more time to participate in daily life and live independently,” President and CEO Joanne Pike said. “This could mean more months of recognizing their spouse, children and grandchildren. This could also mean more time for a person to drive safely, accurately and promptly take care of family finances, and participate fully in hobbies and interests.”

More than 6.5 million people in the United States live with Alzheimer’s disease, according to the Alzheimer’s Association, and that number is expected to grow to 13.8 million by 2060.

Lecanemab will carry a wholesale price of $26,500 per patient per year, the drug’s manufacturers announced Friday.

Biogen and Eisai have listed the drug slightly below the reduced price of the Alzheimer’s medication Aduhelm, which now costs an average patient about $28,200. The companies had to lower the cost of Aduhelm – originally set at $56,000 per patient per year – after insurers balked at covering it.

In justifying the cost of Leqembi, the companies said in a news release that based on the estimated quality of life gained by people who take it, the value of the medication to society is around $37,000 a year, but they chose to go lower “aiming to promote broader patient access, reduce overall financial burden, and support health system sustainability.”

The wholesale cost of a drug is akin to a car’s sticker price. It isn’t necessarily what patients will pay after insurance or other discounts are factored in.

Insurance coverage for this medication is not a given, however. Medicare restricted its coverage of lecanemab’s sister drug, Aduhelm, after clinical trials showed questionable benefits to patients. The agency agreed to cover the drug only for people enrolled in registered clinical trials, which limited access to the medication.

Center for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said after the FDA’s decision Friday that her office would quickly review Leqembi, but for now, because of its accelerated approval, it will be covered the same way Aduhelm is covered.

“At CMS, we will continue to expeditiously review the data on these products as they become available and are committed to timely access to treatments, including drugs, that improve clinically meaningful outcomes,” Brooks-LaSure said in a statement.

Last month, the Alzheimer’s Association filed a formal request asking CMS to provide “full and unrestricted coverage” Alzheimer’s treatments approved by the FDA.

“What the FDA did today in granting accelerated approval to Leqembi was the right decision. But what CMS is doing by severely restricting coverage for approved treatments is unprecedented and wrong,” Pike said in a statement Friday.

“The FDA carefully reviewed the evidence for Leqembi before granting approval. CMS, in sharp contrast, denied coverage for Leqembi months ago before it had even reviewed this drug’s evidence. CMS has never done this before for any drug, and it is clearly harmful and unfair to those with Alzheimer’s. Without access to and coverage of this treatment and others in its class, people are losing days, weeks, months – memories, skills and independence. They’re losing time.”

CMS told CNN that it will review and respond to the association’s request. The agency also noted that it continues to stay informed about ongoing clinical trials, including the most recent lecanemab results published in the New England Journal of Medicine. Also, it has met with drugmakers to learn about their efforts since CMS’s coverage decision was announced.

The FDA approved Aduhelm for early phases of Alzheimer’s disease in 2021 – but that decision has been shrouded in controversy as a congressional investigation found last week that the FDA’s “atypical collaboration” to approve the high-priced drug was “rife with irregularities.”

Before Aduhelm, the FDA had not approved a novel therapy for the condition since 2003.

Aduhelm’s FDA approval and initial hefty price tag hit Medicare’s Part B premiums, driving up the 2022 standard monthly payments by 14.5% to $170.10.

About $10 of the premium spike – or just under half the amount – was due to Aduhelm, a CMS official told CNN in late 2021.

The premium increase was set before Medicare announced its limited coverage of the drug, but its actuaries had to make sure that the program had sufficient funding in case Aduhelm was covered.

Medicare’s decision, as well as Biogen’s slashing of the drug’s cost, prompted a decline in monthly premiums for 2023 to $164.90.

The FDA’s accelerated approval of lecanemab was expected, said Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic in the Center for Brain Health at Florida Atlantic University’s Schmidt College of Medicine.

Isaacson said lecanemab can be “another tool” in his toolbox to fight Alzheimer’s disease.

“I will prescribe this drug in the right person, at the right dose and in a very carefully monitored way, but this drug is not for everyone,” he said.

“I would do genetic testing for APOE4 first. I would have a frank discussion with my patients,” he said. “If someone is having side effects, if someone is on a blood-thinning medication, if someone has a problem, they need to discuss this with the treating physician, and they need to seek medical attention immediately.”

Read original article here

US

Idaho murders: Suspect in student killings was seen multiple times wearing gloves, also placing garbage bags outside Pennsylvania home, source says

Leave a comment



CNN
 — 

The man accused of murdering four University of Idaho students in November had thoroughly cleaned the interior and exterior of his car and was also seen wearing surgical gloves multiple times before being apprehended, a law enforcement source tells CNN.

Bryan Kohberger, 28, is currently the sole suspect in the gruesome stabbings of students Kaylee Goncalves, 21; Madison Mogen, 21; Xana Kernodle, 20; and Ethan Chapin, 20, who were found dead inside their off-campus house in Moscow, Idaho, on November 13.

Kohberger, who was pursuing a PhD in criminal justice at Washington State University at the time of the killings, “cleaned his car, inside and outside, not missing an inch,” according to the law enforcement source.

The source, who spoke on the condition of anonymity, was briefed on observations made by investigators during four days of surveillance leading up to Kohberger’s arrest at his family’s Pennsylvania home on December 30.

As Kohberger now remains behind bars in Idaho awaiting his January 12 status hearing, new details have emerged elucidating some of the suspect’s movements in the days leading up to his arrest.

A surveillance team assigned to Kohberger was tasked with two missions, according to multiple law enforcement sources: keep eyes on Kohberger so they could arrest him as soon as a warrant was issued, and try to obtain an object that would yield a DNA sample from Kohberger, which could then be compared to DNA evidence found at the crime scene.

Kohberger was seen multiple times outside the Pennsylvania home wearing surgical gloves, according to the law enforcement source.

In one instance prior to Kohberger’s arrest, authorities observed him leaving his family home around 4 a.m. and putting trash bags in the neighbors’ garbage bins, according to the source. At that point, agents recovered garbage from the Kohberger family’s trash bins and what was observed being placed into the neighbors’ bins, the source said.

The recovered items were sent to the Idaho State Lab, per the source.

Last Friday, a Pennsylvania State Police SWAT team then moved in on the Kohberger family home, breaking down the door and windows in what is known as a “dynamic entry” – a tactic used in rare cases to arrest “high risk” suspects, the source added.

On Thursday, Kohberger had his initial court appearance in Idaho after he was booked into the Latah County jail Wednesday night following his extradition from Pennsylvania.

Kohberger is charged with four counts of first-degree murder and one count of burglary. He did not enter a plea at the hearing.

Authorities spent nearly two months investigating before they were able to name publicly a suspect, a task that grabbed national attention and rattled the victims’ loved ones as well as the community – which had not recorded a murder in years.

Still, the public’s view of the case remains mired with questions. As of late Thursday, it remains unclear what motivated the killings. It’s also unclear how the suspect entered the house after authorities said there was no sign of forced entry or why two roommates who were inside the residence at the time of the killings survived the attacks.

Here’s how investigators narrowed the search to Kohberger:

  • DNA: Trash recovered from Kohberger’s family home revealed that the “DNA profile obtained from the trash” matched a tan leather knife sheath found “laying on the bed” of one of the victims, according to a probable cause affidavit released Thursday. The DNA recovered from the trash “identified a male as not being excluded as the biological father” of the suspect whose DNA was found on the sheath. “At least 99.9998% of the male population would be expected to be excluded from the possibility of being the suspect’s biological father,” the affidavit said.
  • Phone records: Authorities found the suspect’s phone was near the victims’ Moscow, Idaho, home at least a dozen times between June 2022 to the present day, according to the affidavit. The records also reveal Kohberger’s phone was near the crime scene hours after the murders that morning between 9:12 a.m. and 9:21 a.m, the document says. The killings were not reported to authorities until just before noon.
  • A white sedan: A Hyundai Elantra was seen near the victims’ home around the time of their killings. Officers at Washington State University identified a white Elantra and later learned it was registered to Kohberger. The same car was also found at the suspect’s Pennsylvania family home when he was arrested last Friday. The suspect’s university is about a 10-minute drive from the Idaho crime scene.

One of two roommates who were not harmed in the attacks said she saw a masked man dressed in black inside the house on the morning of the killings, according to the probable cause affidavit.

Identified as D.M. in the court document, the roommate said she “heard crying” in the house that morning and also heard a man’s voice say, ‘It’s OK, I’m going to help you.’” D.M. said she then saw a “figure clad in black clothing and a mask that covered the person’s mouth and nose walking towards her,” the affidavit continued.

“D.M. described the figure as 5’ 10” or taller, male, not very muscular, but athletically built with bushy eyebrows,” the affidavit says. “The male walked past D.M. as she stood in a ‘frozen shock phase.’

“The male walked towards the back sliding glass door. D.M. locked herself in her room after seeing the male,” the document says, adding the roommate did not recognize the male.

Read original article here

Entertainment

Sharon Osbourne reveals daughter Kelly has welcomed her first child

Leave a comment



CNN
 — 

Sharon Osbourne revealed that her daughter Kelly Osbourne has quietly welcomed a baby, her first, with her boyfriend, Sid Wilson.

Osbourne and the Slipknot DJ are new parents to a baby boy named Sidney, her mom announced during an appearance on Britain’s “The Talk” on Tuesday.

“So great, so great. She won’t let a picture go out of him, and I’m so proud of her,” Osbourne said of her daughter.

Kelly Osbourne first shared publicly she was pregnant last May with a sonogram pic on Instagram.

“I know that I have been very quiet these past few months so I thought I would share with you all as to why,” she wrote at the time. “I am over the moon to announce that I am going to be a Mumma.”

In November, she said on her Instagram Stories, “Okay, here we go,” with no other information.

The new baby makes five grandchildren for Ozzy Osbourne and Sharon.



Read original article here

Health

Dr. Sanjay Gupta: 6 keys to keeping sharp in 2023

Leave a comment

Editor’s Note: CNN Chief Medical Correspondent Dr. Sanjay Gupta is a practicing neurosurgeon and the author of the new book, “12 Weeks to a Sharper You: A Guided Program.”



CNN
 — 

At least once a year, we read a sparkling headline about some promising new drug that might help patients with Alzheimer’s disease. And at least once a year, we also hear about failed drug trials and reversals of promises that a cure-all is in sight. I wrote a book about how to keep your brain sharp that came out two years ago. Since then, not much has changed in our understanding of how we can preserve our memories, and the lessons remain as relevant as ever. But one thing has become abundantly clearer: Preventing and even treating forms of dementia are largely driven by lifestyle and the choices we make daily. You are not necessarily doomed to whatever fate you think sits stuck in your genes. If there’s one fact that’s increasingly apparent in scientific circles, it’s that our lifestyle choices contribute mightily to our aging process and risk for disease, likely as much – or perhaps even more – than our genetics.

Indeed, your everyday experiences – including what you eat, how much you move, with whom you socialize, what challenges you face, what gives you a sense of purpose, how well you sleep, and what you do to reduce stress – factor much more into your brain health and overall wellness than you might imagine. We may never have a drug that everyone can take to avoid, let alone cure, dementia and other neurodegenerative diseases. But we all can access the same toolkit proven to help stack the deck in our favor for a sharp brain for life. The program I outline in my book, and which informed the interactive workbook I have coming out this week – “12 Weeks to a Sharper You: A Guided Program” – features all the practical tools you need to implement in your life today. They can help stave off brain decline, and also help you feel less anxious, sleep better, improve energy, think more clearly, make better decisions, become more resilient to daily stress, and even lose weight and boost immunity – all resolutions most of us aim to make at the transition to a new year filled with hope and high expectations. We all know that change is a challenge, and changing long-established habits takes effort. But it doesn’t have to be tortuous, and it is really not that hard to do. Let me give you six things that will help you in 2023 – your keys to the kingdom of mental sharpness.

Skip the crash diet and simply work on following the S.H.A.R.P. protocol: Slash the sugar and salt; Hydrate smartly; Add more omega-3 fatty acids from dietary sources; Reduce portions; and Plan ahead. The S.H.A.R.P. protocol is the easiest way to gravitate toward healthier foods in general and minimize the amount of processed, brain-busting junk. And if you need just one single thing to focus on here, start with the sugar. The average American consumes nearly 20 teaspoons of added sugar daily, most of that in the highly processed form of fructose, derived from high-fructose corn syrup. My guess is that a lot of this sugar intake comes in the form of a liquid – soda, energy drinks, juices and flavored teas. Swap sugar-laden drinks with water and you’ll take on two steps. That’s how to hydrate smartly.

Physical exertion is the only thing we’ve scientifically documented to improve brain health and function, and it may even slow memory loss. It’s the brain’s only superfood. And it needn’t be formal or require equipment. Walk more, take the stairs, and get up for light activity for two minutes every hour. According to the US Centers for Disease Control and Prevention, cognitive decline is almost twice as common among adults who are inactive compared to those are active. In 2022, a large international study that tracked the health of more than half a million people showed that the simple act of performing household chores like cooking, cleaning and washing the dishes can cut the risk of dementia by a stunning 21%. That put chores as the second biggest protective activity behind more obvious things such as riding a bike. In this same study, regular movement was shown to reduce risk of dementia by 35%, followed by meeting up with friends and family (a 15% lower risk). Again, simple things with huge payoffs.

On a scale of 1 to 10, with 10 being the most extreme, how would you rate your stress level? What if I told you that stress is now considered a trigger for silent neurodegeneration, which occurs years before symptoms develop? Scores of well-designed studies routinely show that chronic stress can impair your ability to learn and adapt to new situations, and subtly erode your cognition. More specifically, stress destroys cells in the hippocampus, the brain site responsible for memory storage and retrieval. So, by reducing stress, you not only help preserve cells vital to memory but you also improve focus, concentration and productivity. Don’t let toxic stress get in the way of keeping sharp. Take breaks during the day to engage in an activity that’s peaceful, meditative and stress-reducing. It can be as easy as walking in nature, journal writing, spending time with a pet, or even daydreaming. Download an app today that will give you a guided tour through a deep breathing exercise you can practice daily. I have a trusty meditative routine that calms me down in 90 seconds or less. I simply close my eyes, pay close attention to my breath, and picture my worries in clear bubbles directly in front of me that float weightlessly up and away.

Find what works for you and make it a part of your day – every day.

Are you getting restorative sleep? Contrary to popular belief, sleep is not a state of neural idleness. It is a critical phase during which the body replenishes itself in a variety of ways that ultimately affect every system, from the brain to the heart, the immune system, and all the inner workings of our metabolism. You can think of sleep as your brain’s rinse cycle for clearing out junk that could contribute to decline and disease. Prioritize sleep as you would anything else important. And start with your bedtime routine. Stop looking at screens a full hour before bed – your smartphone included – and prepare for a good night’s sleep. I bumped my pre-sleep prep time from 30 minutes to an hour and it has made all the difference in my energy and productivity the next day.

Are you learning something new every day that’s cognitively stimulating? Staying mentally challenged is vital, so much so that studies show that someone who retires at age 65 has about a 15% lower risk of developing dementia compared with someone retiring at 60, even after other factors are taken into account. Retire late, or never at all. Choose different routes to familiar destinations. Brush your teeth with the non-dominant hand. Skip the solitary games and crossword puzzles and pick up a new hobby that involves other people. Which brings me to the final key …

We are social creatures who need social connection to thrive, especially when it comes to brain health. Call a friend today. Invite a neighbor over for dinner. Go for a walk with a buddy and talk about your problems. Cherish those relationships. The strength of our connections with others can predict the health of both our bodies and our brains as we go through life. Good relationships protect us. They are a secret sauce to a long, sharp life.

As of 2022, scientists have documented a total of about 75 genes connected to the development of Alzheimer’s disease, but carrying these genes is not a one-way ticket to decline. How those genes express themselves and behave may depend largely on your daily habits. Remember that a disease like Alzheimer’s is multifactorial, made up of different pathological features. Which is why prevention and treatments are increasingly becoming personalized – individualized to a person’s biochemistry, from basic parameters like cholesterol levels, blood pressure and blood sugar balance, to the state of one’s oral health and gut microbiome, relics of past infections, and even how well you can see and hear. To that end, it helps to keep your numbers in check. Fon’t let your cholesterol or blood pressure, for instance, run amok. Same goes for your vision and hearing. In recent years, hearing and vision impairment have been added to the list of modifiable risk factors for cognitive decline.

Your DNA provides your body’s core language, but how that DNA behaves tells the story. In the future, interventional therapies that include a combination of lifestyle habits and drugs may help those stories end well. You’ll also track your risk for cognitive decline over time in the future using a simple app on your smartphone that can help you evaluate your physiology (and your memory) in real time and make suggestions tailored for you. Until we all have that technology at our fingertips, the six keys above afford you a great start and will give you a strong foundation.

The ultimate goal is to build what’s called cognitive reserve, which is what scientists call “brain resiliency.” With more cognitive reserve, you support cognitive function and can lower your risk of neurodegenerative issues. It’s like having a backup set of networks in your brain when one fails or, worse, dies and is no longer functional. In many aspects of life, the more backup plans we have, the more chances for success, right? Well, the same is true for our brain’s hard- and soft-wiring. And perhaps the most important key to establishing that reserve is to do so over time – years or even decades – before your risk for decline increases with advanced age.

Always remember this: Cognitive decline is not necessarily inevitable. Research suggests healthy habits you can incorporate into your daily life can help protect your brain health for the long term. Think of health as a “top-down” project. Focus on your brain and everything else will follow. Happy New Year!

Read original article here