Tag Archives: neurological disorders and injuries

Sports

Russell Gage taken to hospital after being injured during NFL Wild-Card playoff game, coach says

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CNN
 — 

Tampa Bay Buccaneers wide receiver Russell Gage was taken to a hospital with a concussion after an injury during a NFL Wild-Card playoff game against the Dallas Cowboys Monday, his coach said.

The game was paused with two minutes and 55 seconds left in the fourth quarter after Gage fell awkwardly after he was hit across his neck on a second down play at Tampa’s Raymond James Stadium.

Gage appeared to try to get up but couldn’t and was quickly swarmed my medical staff.

“They took him to the hospital right now, he has a concussion. They’ll also test him for potential neck injuries,” Buccaneers head coach Todd Bowles said in the postgame news conference following the team’s 31-14 loss to the Cowboys.

When asked if Gage had movement in his extremities, Bowles replied: “His fingers were moving when he was down there. I don’t know about the rest.”

After he was injured, trainers surrounded Gage and players from both teams knelt while he was receiving medical care. The broadcast showed Gage moving his legs while trainers were administering care. He was later immobilized and carted off the field.

Gage’s on-field injury came just two weeks after Buffalo Bills safety Damar Hamlin suffered cardiac arrest and collapsed after making a tackle during another Monday night game. A medical team resuscitated the 24-year-old before an ambulance carried him off the field in critical condition. He was discharged from the hospital last week.

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Health

Here’s how to eat to live longer, new study says

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CNN
 — 

You can reduce your risk of an early death for any reason by nearly 20%, just by eating more foods from your choice of four healthy eating patterns, according to a new study.

People who more carefully followed any of the healthy eating patterns — which all share a focus on consuming more whole grains, fruits, vegetables, nuts and legumes — were also less likely to die from cancer, cardiovascular illness, and respiratory and neurodegenerative disease.

The results of the study, published Monday in the journal JAMA Internal Medicine, show “there is more than one way to eat well and derive the attendant health benefits,” said Dr. David Katz, a lifestyle medicine specialist who was not involved in the study.

People often get bored with one way of eating, study coauthor Dr. Frank Hu said, “so this is good news. It means that we have a lot of flexibility in terms of creating our own healthy dietary patterns that can be tailored to individual food preferences, health conditions and cultures.

“For example, if you are eating healthy Mediterranean, and after a few months you want to try something different, you can switch to a DASH (Dietary Approaches to Stop Hypertension) diet or you can switch to a semi-vegetarian diet,” said Hu, a professor of nutrition and epidemiology and chair of the department of nutrition at the Harvard T.H. Chan School of Public Health. “Or you can follow US dietary guidelines and create your own healthy eating plate.”

The study followed the eating habits of 75,000 women participating in the Nurses’ Health Study and more than 44,000 men in the Health Professionals Follow-up Study over 36 years. None of the men and women had cardiovascular disease at the start of the study, and few were smokers. All filled out eating questionnaires every four years.

“This is one of the largest and longest-running cohort studies to examine recommended dietary patterns and the long-term risk of premature deaths and deaths from major diseases,” Hu said.

Hu and his team scored participants on how closely they followed four healthy eating styles that are in sync with current US dietary guidelines.

One is the Mediterranean diet, which stresses eating fruits, vegetables, whole grains, nuts, legumes, fish and a high amount of olive oil, Hu said. “This dietary pattern emphasizes healthy fats, especially monounsaturated fat, in addition to plant-based foods and moderate alcohol,” he said.

The next is called the healthful plant-based diet, which also focuses on eating more plant products but gives negative points for all animal products and any alcohol.

“It even discourages relatively healthy options, like fish or some dairy products,” Hu said, adding that the eating plan frowns on unhealthy plant-based foods such as potato products.

“So you can imagine that vegetarians are probably on the higher end of this diet score,” he said, “and people who eat a lot of animal products or highly processed carbohydrate foods would be at the lower end of this score.”

The Healthy Eating Index tracks whether people follow basic US nutritional guidelines, which stress healthy, plant-based foods, frown on red and processed meat, and discourage eating added sugar, unhealthy fats and alcohol, Hu said.

The Alternate Healthy Eating Index was developed at Harvard, Hu said, and uses the “best available evidence” to include foods and nutrients most strongly associated with a lower risk of chronic disease.

“We explicitly included nuts, seeds, whole grains and lower consumption of red and processed meats and sugar-sweetened beverages,” he added. “A moderate consumption of alcohol is allowed.”

After each person’s eating pattern was scored, the participants were divided into five groups, or quintiles, from highest to lowest adherence to one or more of the eating patterns.

“The highest quintile of diet quality as compared to the lowest was associated with a roughly 20% reduction in all-cause mortality,” said Katz, president and founder of the nonprofit True Health Initiative, a global coalition of experts dedicated to evidence-based lifestyle medicine.

The study also found reductions in risk of death from certain chronic diseases if people improved their diet over time, Hu said.

Participants who improved the health of their diet by 25% could reduce their risk of dying from cardiovascular disease by a range of 6% to 13% and dying from cancer by 7% to 18%, he said. There was up to a 7% reduction in risk of death by neurodegenerative disease, such as dementia.

“Respiratory disease mortality reduction was actually much greater, reducing risk by 35% to 46%,” Hu said.

The study relied on participants’ self-reports of food preferences and therefore only showed an association, not a direct cause and effect, between eating habits and health outcomes. Still, the fact that the study asked about diets every four years over such a long time frame added weight to the findings, Hu said.

What is the takeaway of this large, long-term study?

“It’s never too late to adopt healthy eating patterns, and the benefits of eating a healthy diet can be substantial in terms of reducing total premature deaths and different causes of premature death,” Hu said.

“People also have a lot of flexibility in terms of creating their own healthy dietary pattern. But the common principles — eating more-plant based foods and fewer servings of red meat, processed meats, added sugar and sodium — should be there, no matter what kind of diet that you want to create.”

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Business

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

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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.”

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Health

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

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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!

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Health

Dolphins show hallmarks of Alzheimer’s, study suggests

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London
CNN
 — 

The brains of three species of dolphin found stranded along the Scottish coast have shown the hallmarks of Alzheimer’s disease, according to new research, providing greater insight into the disease in species other than humans.

The findings may also provide a possible answer to unexplained strandings of dolphins along the coast, researchers said.

Alzheimer’s disease is a common neurodegenerative disorder that mostly affects older humans, with symptoms such as memory loss, forgetfulness and confusion.

According to a study published December 13 in the European Journal of Neuroscience, researchers in Scotland conducted postmortem studies on the brains of 22 odontocetes, or toothed whales, making their findings more detailed compared with others, the authors said.

“It’s more in depth and breadth as it looks at larger numbers of animals from several different species of cetaceans known to be aged for the species (older in age),” Mark Dagleish, coauthor and a senior clinician in anatomic pathology from the University of Glasgow, told CNN on Tuesday.

The study looked at specimens from five species: Risso’s dolphins, long-finned pilot whales, white-beaked dolphins, harbour porpoises and bottlenose dolphins. Of the 22 studied, 18 were aged specimens.

“Critically, (it) examined the whole brains to provide lesion (abnormality) profiles using more markers of Alzheimer’s disease,” Dagleish added, with the same techniques used for human tissues.

Findings showed that three aged dolphins — a long-finned pilot whale, a white-beaked dolphin and a bottlenose dolphin — presented brain changes, or lesions, associated with Alzheimer’s disease in humans.

Tara Spires-Jones, another study coauthor, said in a statement this week that researchers “were fascinated to see brain changes in aged dolphins similar to those in human (aging) and Alzheimer’s disease.”

“Whether these pathological changes contribute to these animals stranding is an interesting and important question for future work,” said Spires-Jones, the personal chair of neurodegeneration at the University of Edinburgh’s Deanery of Biomedical Sciences.

The researchers found that the specimens had accumulated phospho-tau proteins and glial cells, and had formed amyloid-beta plaques, the clumping of a protein found in brains of people with Alzheimer’s disease. The distribution of these lesions was comparable to the brain regions in humans with Alzheimer’s, according to the research paper.

Dagleish said the findings are “the closest anyone has been able to show that any animals develop the Alzheimer’s disease-associated lesions spontaneously,” which had been thought only to develop in humans.

Odontocetes are regularly stranded on UK coasts in groups, which the study authors said may support the “sick-leader” theory of when the group follows an aged leader into shallow waters, potentially as a result of the leader’s confusion.

The similar neuropathology of the aged dolphins and humans with Alzheimer’s suggests that the marine mammals have a susceptibility to the disease, but Dagleish said that a diagnosis can only be made if there are cognitive deficits. These are typically found using cognitive impairment assessments — impossible with postmortem studies.

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Health

Hearing aids may lower your risk for cognitive decline and dementia, study finds

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CNN
 — 

Hearing aids might be an important tool in the effort to prevent cognitive decline and dementia, according to a new study.

Research has established that hearing loss in an important risk factor in developing dementia, but whether intervening with the hearing loss will also treat the progression of cognitive decline has been less clear, said senior study author Woei Shyang Loh, Head of Otolaryngology at the National University Hospital and National University of Singapore.

The new study published Monday in JAMA Neurology offers evidence that managing hearing loss may potentially help reduce or delay cognitive decline, Loh said.

A metanalysis of 3,243 studies, both observational and trials, the research looked at the association between hearing loss and cognitive decline over a range of durations, from two to 25 years. The review found that people with hearing loss who wore devices to help performed 3% better on cognitive scores in the short term, according to the study.

The use of hearing aids was associated with a 19% reduction in long-term cognitive decline, the study found. When it comes to cognitive decline, preventing progression is important, the study authors noted.

“Dementia is far easier to prevent than treat, and exceedingly difficult to reverse,” said senior study author Dr. Benjamin Tan, Dean’s Fellow at the Yong Loo Lin School of Medicine, National University of Singapore.

Hearing loss, while a big risk factor for cognitive decline, is fairly easy to correct in developed countries, said Dr. Thomas Holland, physician scientist of the Rush Institute for Health Aging. Holland was not involved in the research.

“Get screened for hearing loss, and if you do have hearing loss, speak with your audiologist or physician ENT to ensure appropriate and optimal correction to help stave off the potential dementia risk and cognitive decline,” Holland said.

The researchers said the next question that needs to be examined is whether the severity of hearing loss changes the effectiveness of interventions when it comes to preventing cognitive decline.

But in the meantime, people with hearing loss should talk with their doctor about whether it is appropriate to use hearing aids, Tan said.

And it is never too early to intervene, he added, saying that the new study shows that benefits accrue over time.

“Therefore, affected patients should begin treatment now, if they want to see the benefits in a few years,” Tan said.

But the use of these devices can even benefit those who have begun to show a decline in cognition, and according to the new research, patients can still see benefit even if they did not add in hearing aids early, he added.

“Encouragingly, even patients who already started with mild cognitive impairment (“early dementia”) in our pooled analysis also benefitted from the use of hearing aids, as they also had approximately 20% lower risk of progressing to dementia,” said Tan via email. “This means that it is never too late to start using hearing aids, but early treatment may help to preserve the most cognition.”

Hearing aids aren’t the only way to prevent cognitive decline, however, and a well-rounded, preventive approach is important, Holland said.

“Along with getting your hearing screened by an audiologist or physician, work toward implementing healthy lifestyle modifications that have been shown to slow or reduce your risk of Alzheimer’s dementia,” he said.

Those include a healthy diet pattern like the MIND diet, which aims at preventing Alzheimer’s, or the Mediterranean diet, Holland said. Also included are moderate to vigorous physical activity, an active social life, good sleep, and stress reduction.

Holland recommends going to your primary care physician once a year for medical evaluations to appropriately control blood sugars and blood pressure, which are important for brain health.

And cognitively stimulating activities, like visiting museums, reading books or starting new hobbies, are also important to work into your life, Holland said.

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Health

Ultraprocessed food may contribute to dementia, study says

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CNN
 — 

We all eat them — ultraprocessed foods such as frozen pizza and ready-to-eat meals make our busy lives much easier. Besides, they are just darn tasty — who isn’t susceptible to hot dogs, sausages, burgers, french fries, sodas, cookies, cakes, candy, doughnuts and ice cream, to name just a few?

If more than 20% of your daily calorie intake is ultraprocessed foods, however, you may be raising your risk for cognitive decline, a new study found.

That amount would equal about 400 calories a day in a 2,000-calories-a-day diet. For comparison, a small order of fries and regular cheeseburger from McDonald’s contains a total of 530 calories.

The part of the brain involved in executive functioning — the ability to process information and make decisions — is especially hard hit, according to the study published Monday in JAMA Neurology.

Men and women in the study who ate the most ultraprocessed foods had a 25% faster rate of executive function decline and a 28% faster rate of overall cognitive impairment compared with those who ate the least amount of overly processed food.

“While this is a study of association, not designed to prove cause and effect, there are a number or elements to fortify the proposition that some acceleration in cognitive decay may be attributed to ultraprocessed foods,” said Dr. David Katz, a specialist in preventive and lifestyle medicine and nutrition, who was not involved in the study.

“The sample size is substantial, and the follow-up extensive. While short of proof, this is robust enough that we should conclude ultraprocessed foods are probably bad for our brains.”

There was an interesting twist, however. If the quality of the overall diet was high — meaning the person also ate a lot of unprocessed, whole fruits and veggies, whole grains and healthy sources of protein — the association between ultraprocessed foods and cognitive decline disappeared, Katz said.

“Ultraprocessed foods drag diet quality down, and thus their concentration in the diet is an indicator of poor diet quality in most cases,” Katz said. “Atypical as it seems, apparently some of the participants managed it. And when diet quality was high, the observed association between ultraprocessed foods and brain function abated.”

The study followed over 10,000 Brazilians for up to 10 years. Just over half of the study participants were women, White or college educated, while the average age was 51.

Cognitive testing, which included immediate and delayed word recall, word recognition and verbal fluency, was performed at the beginning and end of the study, and participants were asked about their diet.

“In Brazil, ultraprocessed foods make up 25% to 30% of total calorie intake. We have McDonald’s, Burger King, and we eat a lot of chocolate and white bread. It’s not very different, unfortunately, from many other Western countries,” coauthor Dr. Claudia Suemoto, an assistant professor in the division of geriatrics at the University of São Paulo Medical School, told CNN when the study abstract was released in August.

“Fifty-eight percent of the calories consumed by United States citizens, 56.8% of the calories consumed by British citizens, and 48% of the calories consumed by Canadians come from ultraprocessed foods,” Suemoto said.

Ultraprocessed foods are defined as “industrial formulations of food substances (oils, fats, sugars, starch, and protein isolates) that contain little or no whole foods and typically include flavorings, colorings, emulsifiers, and other cosmetic additives,” according to the study.

Those in the study who ate the most ultraprocessed foods were “more likely to be younger, women, White, had higher education and income, and were more likely to have never smoked, and less likely to be current alcohol consumers,” the study found.

In addition to the impact on cognition, ultraprocessed foods are already known to raise the risk of obesity, heart and circulation problems, diabetes, cancer and a shorter life span.

“Ultraprocessed foods in general are bad for every part of us,” said Katz, president and founder of the nonprofit True Health Initiative, a global coalition of experts dedicated to evidence-based lifestyle medicine.

Ultaprocessed foods are usually high in sugar, salt and fat, all of which promote inflammation throughout the body, which is “perhaps the most major threat to healthy aging in the body and brain,” said Dr. Rudy Tanzi, professor of neurology at Harvard Medical School and director of the genetics and aging research unit at Massachusetts General Hospital in Boston. He was not involved in the study.

“Meanwhile, since they are convenient as a quick meal, they also replace eating food that is high in plant fiber that is important for maintaining the health and balance of the trillions of bacteria in your gut microbiome,” Tanzi added, “which is particularly important for brain health and reducing risk of age-related brain diseases like Alzheimer’s disease.”

How can you keep this from happening to you? If you include ultraprocessed foods in your diet, try to counter these by also eating high-quality, whole foods such as fruits, vegetables and whole grains.

“The conclusion suggested here is that ultraprocessed foods are, indeed, an important ‘ingredient,’ but the exposure that should be the focus of public health efforts is overall diet quality,” Katz said.

One easy way to ensure diet quality is to cook and prepare your food from scratch, Suemoto said.

“We say we don’t have time, but it really doesn’t take that much time,” Suemoto said.

“And it’s worth it because you’re going to protect your heart and guard your brain from dementia or Alzheimer’s disease. That’s the take-home message: Stop buying things that are superprocessed.”

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Health

Improve memory as you age by eating more flavonols, study says

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CNN
 — 

Eating more flavonols, antioxidants found in many vegetables, fruits, tea and wine, may slow your rate of memory loss, a new study finds.

The cognitive score of people in the study who ate the most flavonols declined 0.4 units per decade more slowly than those who ate the fewest flavonols. The results held even after adjusting for other factors that can affect memory, such as age, sex and smoking, according to the study recently published in Neurology, the medical journal of the American Academy of Neurology.

“It’s exciting that our study shows making specific diet choices may lead to a slower rate of cognitive decline,” said study author Dr. Thomas Holland, an instructor in the department of internal medicine at Rush University Medical Center in Chicago, in a statement.

“Something as simple as eating more fruits and vegetables and drinking more tea is an easy way for people to take an active role in maintaining their brain health.”

Flavonols are cytoprotective, meaning they protect cells, including neurons, so it’s plausible there could be a direct impact on cognition, said Dr. David Katz, a specialist in preventive and lifestyle medicine and nutrition who was not involved in the study.

“But they are also a marker of higher intake of fruits and vegetables — which is good for the brain because it is good for every vital organ, and the organism as a whole,” Katz said in an email.

“They may also be a marker of better overall diet quality, or even greater health consciousness. People who are more health conscious may do things to preserve their cognition, or maybe being more health conscious is a by-product of better cognition.”

Plants contain over 5,000 flavonoid compounds, which play roles in producing cell growth, fighting environmental stress and attracting insects for pollination.

Flavonols, a type of flavonoid, have been shown in animal and some human studies to reduce inflammation, a major trigger for chronic disease, and are rich sources of antioxidants. Antioxidants combat free radicals, “highly unstable molecules that are naturally formed when you exercise and when your body converts food into energy,” according to the National Center for Complementary and Integrative Health, part of the National Institutes of Health.

One of the most common flavonols, quercetin, has shown promise in reducing the onset of colorectal cancer and other cancers, according to studies. Onions contain the highest levels — lower levels can be found in broccoli, blueberries, cauliflower, curly kale, leeks, spinach and strawberries.

Another common flavonol, kaempferol, appears to inhibit the growth of cancer cells while preserving and protecting normal cells. Good sources of kaempferol are onions, asparagus and berries, but the richest plant sources are spinach, kale and other green leafy vegetables, as well as herbs such as chives, dill and tarragon.

A third major player is myricetin, which has been studied in rodents for blood sugar control and the reduction of tau, a protein that causes the hallmark tangles of Alzheimer’s and other dementia. Spinach and strawberries contain high levels of myricetin, but honey, black currants, grapes and other fruits, berries, vegetables, nuts and tea are also good sources.

The last group of flavonols, isorhamnetin, may protect against cardiovascular and neurovascular disease in addition to anti-tumor and anti-inflammatory benefits. Good sources of isorhamnetin are pears, olive oil, wine and tomato sauce.

You can find a full list of the flavonoid content of various fruits and vegetables here.

The new study asked 961 people with an average age of 81 and no signs of dementia to fill out a food questionnaire each year for seven years. In addition, the participants underwent annual cognitive and memory tests and were quizzed on their time spent being physically and mentally active.

People were divided into groups based on their daily intake of flavonols. The lowest intake was about 5 milligrams a day; the highest 15 milligrams a day — equal to about a cup of dark leafy greens, the study noted. (For comparison, the average flavonol intake in US adults is about 16 to 20 milligrams per day, according to the study.)

The study looked at the impact of the four major flavonols — kaempferol, quercetin, myricetin and isorhamnetin — on the rate of cognitive decline over the seven years.

The greatest impact was found with kaempferol: People who ate the highest amounts of foods with kaempferol showed a 0.4 units per decade slower rate of cognitive decline compared with those who ate the fewest, according to the study.

Myricetin was next: People who ate the most foods with myricetin had a 0.3 units per decade slower rate of cognitive decline compared with the lowest consuming group. People who ate the most foods with quercetin showed a 0.2 units per decade slower rate of cognitive decline.

Dietary isorhamnetin had no impact, the study found.

Despite the apparent positives, studies on the impact of flavonols on human health have been inconclusive -— mainly because many are observational and cannot show a direct cause and effect. That applies to the Neurology study as well, according to its authors.

A few randomized controlled trials — the scientific gold standard — have shown benefits associated with flavonols for controlling blood sugar in type 2 diabetes and improving cardiovascular health, according to the Linus Pauling Institute, home to the Micronutrient Information Center, an online database for nutrition information.

It’s not known whether these benefits are long term, the institute said, and no clear impact has been shown for cancer prevention or cognitive protection.

“There are other bioactives that may contribute to the observed outcomes,” Katz said. “Supplemental studies are required to isolate flavonoid effects fully.”

There’s also a downside to assuming a health impact without the necessary studies to back it up, said Dr. Christopher Gardner, a research professor of medicine and director of the Nutrition Studies Research Group at Stanford University.

“You can count on Americans wanting the benefits of plants but not wanting to eat them,” he said in an email.

“(What) if people read the headline and rush out and buy bottled (extracted) flavonols instead of eating whole plant foods, and it turns out it wasn’t just the flavonols, but the package deal of everything in those plants (instead).”

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Health

Secrets of ‘SuperAgers’ with superior memories into their 80s

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CNN
 — 

Despite volunteering and working out at the gym several days each week, socializing frequently with friends and family, reading all manner of books and doing daily crossword puzzles, 85-year-old Carol Siegler is restless.

“I’m bored. I feel like a Corvette being used as a grocery cart,” said Siegler, who lives in the Chicago suburb of Palatine.

Siegler is a cognitive “SuperAger,” possessing a brain as sharp as people 20 to 30 years younger. She is part of an elite group enrolled in the Northwestern SuperAging Research Program, which has been studying the elderly with superior memories for 14 years. The program is part of the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease at Northwestern University Feinberg School of Medicine in Chicago.

“I’ve auditioned twice for ‘Jeopardy!’ and did well enough on it to be invited to the live auditions. Then Covid hit,” said Siegler.

“Who knows how well I would have done,” she added with a chuckle. “What I have told my children and anybody else who asked me: ‘I may know an awful lot about Beethoven and Liszt, but I know very little about Beyoncé and Lizzo.’”

To be a SuperAger, a term coined by the Northwestern researchers, a person must be over 80 and undergo extensive cognitive testing. Acceptance in the study only occurs if the person’s memory is as good or better than cognitively normal people in their 50s and 60s.

“SuperAgers are required to have outstanding episodic memory — the ability to recall everyday events and past personal experiences — but then SuperAgers just need to have at least average performance on the other cognitive tests,” said cognitive neuroscientist Emily Rogalski, a professor of psychiatry and behavioral sciences at Feinberg School of Medicine.

Only about 10% of people who apply to the program meet those criteria, said Rogalski, who developed the SuperAger project.

“It’s important to point out when we compare the SuperAgers to the average agers, they have similar levels of IQ, so the differences we’re seeing are not just due to intelligence,” she said.

Once accepted, colorful 3D scans are taken of the brain and cognitive testing and brain scans are repeated every year or so. Analysis of the data over the years have yielded fascinating results.

Most people’s brains shrink as they grow older. In SuperAgers, however, studies have shown the cortex, responsible for thinking, decision-making and memory, remains much thicker and shrinks more slowly than those of people in their 50s and 60s.

A SuperAger’s brain, usually donated to the research program by participants after death, also has bigger, healthier cells in the entorhinal cortex. It’s “one of the first areas of the brain to get ‘hit’ by Alzheimer’s disease,” said Tamar Gefen, an assistant professor of psychiatry and behavioral sciences at Northwestern, in an email.

The entorhinal cortex has direct connections to another key memory center, the hippocampus, and “is essential for memory and learning,” said Gefen, the lead author of a November study comparing the brains of deceased SuperAgers with those of older and younger cognitively normal people and people diagnosed with early Alzheimer’s.

SuperAger brains had three times fewer tau tangles, or abnormal formations of protein within nerve cells, than the brains of cognitively healthy controls, the study also found. Tau tangles are a hallmark sign of Alzheimer’s and other dementias.

“We believe that larger neurons in the entorhinal cortex suggest that they are more ‘structurally sound’ and can perhaps withstand neurofibrillary tau tangle formation,” Gefen said.

Gefen also found the brains of SuperAgers had many more von economo neurons, a rare type of brain cell, which so far has been found in humans, great apes, elephants, whales, dolphins and songbirds. The corkscrew-like von economo neurons are thought to allow rapid communication across the brain. Another theory is that the neurons give humans and great apes an intuitive advantage in social situations.

The von economo neurons were found in the anterior cingulate cortex, which forms a collar in the front of the brain linking the cognitive, reasoning side with the emotional, feeling side. The anterior cingulate is thought to be important for regulating emotions and paying attention — another key to good memory.

Taken together, these discoveries appear to point to a genetic link to becoming a SuperAger, Gefen said. However, she added: “The only way to confirm whether SuperAgers are born with larger entorhinal neurons would be to measure these neurons from birth until death. That obviously isn’t possible.”

SuperAgers share similar traits, said Rogalski, who is also the associate director of the Mesulam Center for Cognitive Neurology and Alzheimer Disease at Feinberg. These folks stay active physically. They tend to be positive. They challenge their brain every day, reading or learning something new — many continue to work into their 80s. SuperAgers are also social butterflies, surrounded by family and friends, and can often be found volunteering in the community.

“When we compare SuperAgers to normal agers we see that they tend to endorse more positive relations with others,” Rogalski said.

“This social connectedness may be a feature of SuperAgers that distinguishes them from those who are still doing well but who are what we would call an average or normal ager,” she said.

Looking back at her life, Carol Siegler recognizes many SuperAger traits. As a young child during the Great Depression, she taught herself to spell and play piano. She learned to read Hebrew at her grandfather’s knee, poring over his weekly Yiddish newspaper.

“I have a great memory. I’ve always had it,” Siegler said. “I was always the kid that you could say, ‘Hey, what’s Sofia’s phone number?’ and I would just know it off the top of my head.”

She graduated from high school at 16 and immediately went to college. Siegler got her pilot’s license at age 23 and later started a family business in her basement that grew to have 100 employees. At 82, she won the American Crossword Puzzle Tournament for her age group, which she said she entered “as a gag.”

After seeing an advertisement for the SuperAger program on television, Siegler thought it too sounded like fun. Being chosen as a SuperAger was a thrill, Siegler said, but she is aware she was born lucky.

“Somebody with the same abilities or talents as a SuperAger who lived in a place where there was very little way to express them, might never know that he or she had them,” she said. “And that is a true shame.”

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Entertainment

Chris Hemsworth receives ‘strong indication’ of a genetic predisposition to Alzheimer’s disease while filming new show

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CNN
 — 

Chris Hemsworth embarked on a personal and physically demanding journey for his new series “Limitless” that ultimately led to a sobering discovery.

The “Thor” actor, 39, learns in one episode of the limited Disney+/National Geographic series – which shows him exploring ways to enhance his longevity and combat aging – that he has two copies of the APOE4 gene, one from each of his parents, meaning he has a heightened predisposition for developing Alzheimer’s disease.

“They took all my bloodwork and did a bunch of tests and the plan was to on-camera tell me all the results and then talk about how you can improve this and that,” Hemsworth shared with Vanity Fair in an article published on Thursday. “And Peter Attia, who is the longevity doctor in that episode, and overseeing a lot of the show, called [“Limitless” creator] Darren [Aronofsky] and said, ‘I don’t want to tell him this on camera. We need to have an off-side conversation and see if he even wants this to be in the show.’ It was pretty shocking because he called me up and he told me.”

Upon learning the news, Hemsworth said he “had a bunch of questions,” later adding that he “didn’t really know what to think. I was like, ‘Am I supposed to be worried? Is this concerning?’”

He also said that the show then “became even more relevant and important for me, even more poignant than I ever thought it would be,” adding that APOE4 is “not a pre-deterministic gene, but it is a strong indication. Ten years ago, I think it was more thought of as determinant.”

The new information, which Hemsworth said makes him “eight to 10 times more likely” to eventually develop Alzheimer’s disease, naturally caused him to reflect on death and his own mortality.

“There was an intensity to navigating it. Most of us, we like to avoid speaking about death in the hope that we’ll somehow avoid it,” he told Vanity Fair. “We all have this belief that we’ll figure it out. Then to all of a sudden be told some big indicators are actually pointing to this as the route which is going to happen, the reality of it sinks in.”

“Limitless,” which shows the Marvel star engaging in various stunts and practices to prolong and enhance his life, in fact deals with facing death in the final episode.

“I think that’s my favorite episode. That’s where I worked with the death doula and people who worked in palliative care and end of life care and then spoke to a number of people who were at the end of their days or coming upon them – even younger people that were diagnosed with cancer and didn’t have long to live,” he shared.

“Doing an episode on death and facing your own mortality made me go, ‘Oh God, I’m not ready to go yet,’” he later added. “I want to sit and be in this space with a greater sense of stillness and gratitude. And then you start talking about kids and family and going, ‘Oh my God, they’re getting older, they’re growing up and I keep slapping another movie on top of another movie.’ Before you know it, they’re 18 and they’ve moved out of house, and I missed the window.”

In preparing the show for air, Hemsworth also mentioned that he was “offered a version of the episode where we didn’t talk about [his discovered genetic predisposition to Alzheimer’s],” but that the prospect of helping others helped him to get over any hesitation.

“I thought, ‘No, look, if this is a motivator for people to take better care of themselves and also understand that there are steps you can take – then fantastic.’ My concern was I just didn’t want to manipulate it and overdramatize it, and make it into some sort of hokey grab at empathy or whatever for entertainment.”

Hemsworth, who most recently appeared as the MCU’s God of Thunder in his fourth solo outing in this summer’s “Thor: Love and Thunder,” is next set to appear in another sequel, next year’s “Extraction 2.” He is also wrapping up a yet-to-be-revealed role in 2024’s “Furiosa,” costarring Anya Taylor-Joy, set in the universe of “Mad Max.”

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