Posted on Patient Talk

Poor Vascular Health Speeds Up Brain Ageing

Researchers at Karolinska Institutet have used an AI tool to analyze brain images from 70-year-olds, revealing that poor vascular health can make the brain appear older. Factors like inflammation and high blood sugar levels are linked to older-looking brains, while healthy lifestyles are associated with younger-looking brains. These findings were published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Every year, over 20,000 people in Sweden are diagnosed with dementia, with Alzheimer’s disease making up about two-thirds of these cases. Various risk and health factors influence the speed of brain ageing.

“New Alzheimer’s drugs won’t work for everyone with dementia, so we’re studying ways to boost the brain’s resilience against ageing,” says Anna Marseglia, the study’s lead author and researcher at Karolinska Institutet.

AI-Derived Brain Age

The study involved 739 cognitively healthy 70-year-olds from Gothenburg’s H70 cohort in Sweden. Using MRI scans and an AI-based algorithm, the researchers estimated the biological age of their brains.

“The algorithm is accurate, robust, and easy to use,” says Eric Westman, principal investigator and professor of Neurogeriatrics. “It needs further evaluation but may eventually be useful in clinical settings, such as dementia investigations.”

Factors Influencing Brain Age

The study collected blood samples alongside brain scans to measure lipids, glucose, and inflammation. Participants also completed cognitive tests and provided data on lifestyle factors like exercise and medical conditions.

The AI tool estimated the average brain age to be 71 years. By comparing participants’ biological brain age to their actual age, researchers found that diabetes, stroke, small vessel disease in the brain, and inflammation were linked to older-looking brains. In contrast, a healthy lifestyle with regular exercise was linked to younger-looking brains.

“Keeping your blood vessels healthy is important for protecting your brain. For example, maintaining stable blood glucose levels can help prevent your brain from ageing prematurely,” says Anna Marseglia.

Future Research on Sex Differences

The study also found differences between men and women in terms of factors linked to brain age. Researchers plan to investigate how social health, including social engagement, connectedness, and support, along with sleep and stress, influence brain resilience, particularly focusing on women’s health factors.

“Next year, we’ll start a study to understand the impact of social health on brain resilience, especially in middle and older age,” adds Marseglia.

Posted on Exercise

More dense, populated neighborhoods inspire people to walk more

Adding strong evidence in support of “walkable” neighbourhoods, a large national study found that the built environment can increase how much people walk.

The study showed a strong connection between place and activity by studying about 11,000 twins, which helps control for family influences and genetic factors. The researchers found that each 1% increase in an area’s “walkability” resulted in a 0.42% increase in neighbourhood walking. When scaled up, that means a 55% increase in the walkability of the surrounding neighbourhood would result in about 23% more walking—or about 19 minutes a week for every resident living in that area.

In terms of public health, that can add up to a big difference for the highly sedentary U.S. populace, according to study lead author Glen Duncan, a Washington State University nutrition and exercise physiology professor.

“We have so many people in the U.S. population who don’t get sufficient activity. If we could shift the percentage of the population that just took on more plain old walking, we would see real health benefits,” said Duncan, the director of the Washington State Twin Registry.

For the study, neighbourhoods were deemed walkable based on an index that assesses the density of people, roads and desirable places to walk to, such as stores, parks, restaurants and coffee shops. The twin pairs in the study lived in all parts of the U.S., but the more walkable neighbourhoods were typically found in urban areas.

Duncan said Seattle’s Capitol Hill area is a good example of a walkable neighbourhood, given its profusion of shops and restaurants and access to public transportation such as buses and a light rail station. Conversely, more suburban or rural areas tend to be less walkable as they require driving to access things like grocery stores or other amenities.

The study analyzed data from surveys of 5,477 pairs of twins from 2009 to 2020. It included information about where they lived and how many minutes they walked in a typical week, whether for recreation, exercise, or to get from one place to another. The analysis revealed that those who lived in areas considered more walkable did walk more.

The researchers also examined whether an area’s walkability increased transit use, but few study participants used public transit. However, living in a walkable neighbourhood reduced the chance of having no transit use by 32%.

Living in a walkable area didn’t appear to affect more vigorous exercise. Still, the authors note that this kind of exercise, which includes running and lifting weights, isn’t limited to the neighbourhood environment. For example, a person could go for a vigorous bike ride that would take them well outside the boundaries of their neighbourhood.

Regardless, Duncan emphasized that walking is a great and easy way to improve health. It also counts toward the widely recommended 150 minutes a week of physical activity.     

“You don’t have to spend much on fitness clothing and the best gear. Walking is a very natural thing. You lace on some shoes and head out the door,” he said.

Posted on Multiple Sclerosis

Good News for People with MS: COVID-19 Doesn’t Worsen Symptoms

Leading health organizations are urging people to get a flu shot if they haven’t already done so. Compared to last year’s mild flu season,[1] the U.S. has already seen more than three times the number of flu-related deaths.[2] While seasonal influenza activity shows a declining trend,[3] flu season is expected to continue well into spring. The American Heart Association®, the American Lung Association® and the American Diabetes Association® are teaming up to send a message to people who have not yet received this season’s flu vaccine: It’s not too late to protect yourself and others, some of whom are more vulnerable to the dangers of the flu, by getting your flu shot. While no one wants to experience the misery of the flu, for many people with chronic conditions, the flu causes serious complications, leading to hospitalization or in some instances death. According to the Centers for Disease Control and Prevention, in recent years, about 9 out of every 10 people who were in the hospital due to the flu had at least one underlying medical condition.[4] The underlying health conditions that commonly put adults at higher risk of complications from the flu include heart disease, history of stroke, type 1 or type 2 diabetes, obesity and chronic lung disease such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).[5] “Adults who have cardiovascular disease face a significant risk of complications if they contract the flu,” said Eduardo Sanchez, M.D., M.P.H., FAHA, the American Heart Association’s chief medical officer for prevention. “For example, if you have heart disease and you’re not vaccinated against the flu, you are six times more likely to have a heart attack within a week of infection. The flu vaccine can be doubly protective—from bad flu and from its complications. While earlier in the season is ideal, we have a lot of flu season left, and it’s better to get one now than not at all.” With the U.S. flu season typically peaking mid-to late winter, between December and February,[6] experts say those who haven’t gotten the flu shot yet should do so as soon as possible. By getting vaccinated, individuals are not only protecting themselves but those around them who may not be able to get vaccinated or who have a weakened immune response to vaccines. “Even a minor respiratory virus can be hard on someone with lung disease, and the flu is especially challenging,” said Dr. Albert Rizzo, M.D., chief medical officer for the American Lung Association. “We want to reiterate that not only should people with any chronic illness get a flu shot, but their loved ones and friends should also protect them by getting the flu vaccine. It’s imperative that we slow the spread of the flu this year as much as possible to continue to decrease the number of cases and hospitalizations, and to protect our most vulnerable loved ones.” Many of these same chronic conditions also put individuals at higher risk of complications from COVID-19, so it is important to also stay up to date on the COVID vaccine. Health professionals recommend the flu shot for anyone 6 months of age and older, and say it is safe to get a flu vaccine along with a COVID-19 booster. They also urge those 65 and older to ask about the flu vaccines recommended for their age and get the best one that’s available at that location at that time. “In recent years, almost a third of the people hospitalized due to the flu had diabetes,”[7] said Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association. “The impact from any illness can pose a threat to someone with diabetes, especially considering many people who live with diabetes have other complications like heart disease and kidney disease. Staying up to date on all annual vaccines and the COVID-19 vaccine is recommended for everyone who is eligible, especially those living with diabetes and other chronic illness.”

A recent study brings good news for people with multiple sclerosis (MS): having a COVID-19 infection does not make MS symptoms or disability worse.

“Infections can sometimes lead to more disability in people with MS,” said Dr. Amber Salter from UT Southwestern Medical Center in Dallas. “However, our study found this is not the case with COVID-19. People with MS don’t need to worry about long-term worsening of their symptoms after a COVID-19 infection.”

The study followed 2,132 adults with MS, with an average age of 65, over 18 months. Participants reported whether they had ever had a COVID-19 infection, which was confirmed by a test. Among them, 796 had COVID-19, while 1,336 did not.

Participants also rated the severity of their MS symptoms, including walking, hand function, pain, fatigue, and memory, at least six times during the study. They scored their disability based on daily activities like walking or standing.

After accounting for factors like age, race, and gender, researchers found that MS symptoms increased very slightly over time—by just 0.02 points per month—regardless of whether participants had COVID-19. There was no difference in MS symptom severity between those who had COVID-19 and those who didn’t. The same was valid for disability levels.

“Our study shows that COVID-19 infection did not lead to immediate changes in symptom severity or disability. It also did not alter the MS symptoms or disability trajectory for more than a year and a half after the infection,” said Salter. “While our study mainly looked at older people, these findings help us better understand how COVID-19 affects people with MS.”

One limitation of the study is that COVID-19 tests can sometimes give incorrect results, and some people may have had COVID-19 without knowing it.

This research offers reassurance to people with MS and highlights the resilience of their health in the face of COVID-19.

Posted on Autism

Lithium as a Potential Therapy for Autism

Scientists have discovered that lithium, a drug traditionally used to treat bipolar disorder and depression, could potentially be used to treat autism. Research conducted by the Institute for Basic Science (IBS) reveals that lithium can improve brain function and alleviate behavioural symptoms in animal models of autism caused by mutations in the Dyrk1a gene.

Autism is a developmental condition affecting 2.8% of the global population. Social challenges, repetitive behaviours, and intellectual difficulties characterize it. The significant impact on individuals and their families makes it crucial to find new treatment methods. Despite its prevalence, there are no definitive treatments for autism.

One crucial genetic factor associated with autism is mutations in the Dyrk1a gene, which can lead to symptoms such as small head size (microcephaly), language problems, and social disabilities. In mice with this mutation, researchers found that lithium could normalize brain size, improve neuron structure and function, and significantly enhance behaviours related to anxiety and social interaction. Remarkably, these positive effects lasted into adulthood, suggesting long-term benefits.

By analyzing proteins and their activities, researchers discovered that lithium’s therapeutic effects involve a molecule called Kalirin-7, which is essential for proper brain function. This breakthrough suggests that lithium helps restore balance in the brain’s communication networks, addressing core issues associated with autism.

Dr. Roh Junyeop, a senior researcher, likened the effects of lithium to clearing a traffic jam in the brain, allowing neurons to communicate smoothly. Director Kim Eunjoon emphasized that early intervention is crucial and that lithium’s effects highlight its potential as a treatment for autism.

Published in Molecular Psychiatry on December 5, this study offers hope for new therapeutic approaches, underscoring the importance of early diagnosis and intervention. It provides a promising outlook for families and individuals affected by autism.