Dementia isn't inevitable. Here's how to reduce your risk.
Your chance of developing dementia at some point is uncomfortably high. Forty-two percent of Americans older than 55 will develop the condition during their lifetime, a recent Nature Medicine study estimates. It's also on the rise: More than 500,000 had it in 2020; by 2060, that's expected to double.
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Gizmodo
18 minutes ago
- Gizmodo
Bats Have Cancer-Fighting ‘Superpowers'—Here's What That Means for Humans
When you think of longevity in animals, chances are that the Greenland shark will immediately come up. After all, researchers estimate that the enigmatic animal can live for at least 250 years. It turns out, however, that bats also hold their own when it comes to lifespan, with some species living up to 25 years—equivalent to 180 human years—and they tend to do it cancer-free. Researchers from the University of Rochester (UR) have investigated anti-cancer 'superpowers,' as described in a UR statement, in four bat species: the little brown bat, the big brown bat, the cave nectar bat, and the Jamaican fruit bat. The results of their investigation could have important implications for treating cancer in humans. 'Longer lifespans with more cell divisions, and longer exposure to exo- [external] and endogenous [internal] stressors increase cancer incidence,' the researchers wrote in a study published last month in the journal Nature Communications. 'However, despite their exceptional lifespans, few to no tumors have been reported in long-lived wild and captive populations of bats.' Led by biologists Vera Gorbunova and Andrei Seluanov from the UR Department of Biology and Wilmot Cancer Institute, the team identified a number of biological defenses that help bats avoid the disease. For example, bats have a tumor-suppressor gene, called p53. Specifically, little brown bats carry two copies of the gene, and have high p53 activity, which can get rid of cancer cells during apoptosis, a biological process that eliminates unwanted cells. 'We hypothesize that some bat species have evolved enhanced p53 activity as an additional anti-cancer strategy, similar to elephants,' the researchers explained. Too much p53, though, runs the risk of killing too many cells. Clearly, bats are able to find the right apoptosis balance. Humans also have p53, but mutations in the gene—which disrupt its anti-cancer properties—exist in around 50% of human cancers. The researchers also analyzed the enzyme telomerase. In bats, the telomerase expression allows bat cells to multiply endlessly. That means they don't undergo replicative senescence: a feature that restricts cell proliferation to a certain number of divisions. Since, according to the study, senescence 'promotes age-related inflammation contributing to the aging process,' bats' lack thereof would seem to promote longevity. And while indefinite cell proliferation might sound like the perfect cancer hotbed, bats' high p53 activity can kill off any cancer cells. Furthermore, 'bats have unique immune systems which allows them to survive a wide range of deadly viruses, and many unique immune adaptations have been described in bats,' the researchers wrote. 'Most knowledge of the bat immune systems comes from studies of bat tolerance to viral infections deadly to humans. However, these or similar immune adaptations may also recognize and eliminate tumors,' as well as 'temper inflammation, which may have an anticancer effect.' Cells have to go through several steps, or 'oncogenic hits,' to become harmful cancerous cells. Surprisingly, the researchers also found that it only takes two hits for normal bat cells to become malignant, meaning bats aren't naturally resistant to cancer—they just have 'robust tumor-suppressor mechanisms,' as described in the statement. The team's findings carry important implications for treating cancer. Specifically, the study confirms that increased p53 activity—which is already targeted by some anti-cancer drugs—can eliminate or slow cancer growth. More broadly, their research is yet another example of scientists turning to nature for solutions to human challenges on all scales. Though the study focuses on bats, the ultimate aim is, always, finding a cure for cancer in humans.
Medscape
28 minutes ago
- Medscape
IRONMAN: Can PSA Guide Metastatic Prostate Cancer Care?
CHICAGO — Prostate-specific antigen (PSA) levels could help guide treatment decisions for patients with metastatic hormone-sensitive prostate cancer, according to real-world findings from the IRONMAN study. Specifically, an undetectable PSA nadir — defined as PSA level < 0.2 ng/mL — predicted a good prognosis and a PSA level ≥ 0.2 ng/mL predicted poor prognosis among patients receiving androgen deprivation therapy (ADT) or androgen receptor pathway inhibitor (ARPI) therapy for 6-12 months, according to Michael Ong, MD, who presented the findings at the 2025 American Society of Clinical Oncology annual meeting. In other words, this real-world study found that absolute PSA at 6 and 12 months is prognostic in this patient population, said Ong, a medical oncologist at Ottawa Hospital Research Institute, Canada. Patients with a poor prognosis could then be considered for clinical trials offering therapy escalation, whereas those with a better prognosis — particularly those with PSA < 0.1 ng/mL — could be considered for de-escalation, said Ong. Ong explained that prior phase 3 studies have demonstrated that PSA > 0.2 ng/mL is associated with poor prognosis in patients receiving ADT and ARPI. However, data in real-world settings remain limited. Some patients with rapid PSA decline never progress, whereas others develop early resistance despite intensive therapy, he explained. The IRONMAN study set out to answer two main questions: When should PSA cutoffs be interpreted for prognostic significance? And how may PSA cutoffs differ in real-world patients? To this end, Ong and his colleagues included 1219 patients from the prospective IRONMAN cohort with metastatic hormone-sensitive prostate cancer who had received ADT and ARPI therapy, with or without docetaxel, and had PSA data available. PSA was stratified into three groups: ≥ 0.2 ng/mL, 0.10-0.19 ng/mL, and < 0.10 ng/mL. The research team constructed a 12-month landmark population to assess conditional overall survival (OS) and progression-free survival (PFS) at 6 and 12 months across each PSA level. The 12-month analysis was the primary study outcome. Patients were a median age of 70 years, 58% had Gleason score of 8-10, and 75% had de novo metastatic disease. Overall, most (74%) were White and just over half were enrolled from centers outside US or Canada. ARPI agents included abiraterone acetate (44%), apalutamide (21%), enzalutamide (22%), or darolutamide (13%), and 12% of patients received docetaxel in addition to doublet therapy with ADT plus ARPI. PSA levels shifted across the two time points. At 6 months, 52% of patients had a PSA < 0.2 ng/mL, whereas 48% had a PSA level ≥ 0.2 ng/mL. At 12 months, 68% had PSA levels < 0.2 ng/mL and 32% had levels ≥ 0.2 ng/mL. Both the 6- and 12-month landmark analyses showed that PSA ≥ 0.2 ng/mL was associated with worse conditional OS and PFS compared with PSA < 0.2 ng/mL. Ong broke down conditional OS and PFS at 12 months — the primary study outcome —by absolute PSA levels. Absolute PSA 3-year overall survival 3-year progression-free survival OS mortality risk (adjusted hazard ratio) ≥ 0.2 ng/mL 45% 41% 4.85 (3.36-7.01) 0.10-0.19 ng/mL 79% 62% 1.34 (0.82-2.20) < 0.1 ng/mL 84% 80% Reference After adjustment for confounders, PSA ≥ 0.2 ng/mL was associated with an almost fivefold higher risk for death at 12 months (adjusted hazard ratio, 4.85). Ong noted that PSA was prognostic of overall survival regardless of ARPI class or whether patients received doublet or triplet therapy with docetaxel. Invited discussant Rahul Aggarwal, MD, agreed that a PSA nadir between 6 and 12 months 'is strongly prognostic for progression-free and overall survival.' However, Aggarwal cautioned, although 'it is tempting to use PSA nadir to guide treatment decisions in clinical practice,' the approach has not been validated. Plus, other factors and biomarkers may play a role in treatment decisions and help optimize outcomes, including quality of life, treatment and financial toxicity, and the role of the tumor suppressor gene PTEN , added Aggarwal, of the University of California, San Francisco. 'We await randomized trial data to know, in fact, whether we should use this to guide treatment decision-making,' said Aggarwal. Such trials are underway. Ong is co-chair of a phase 3 study assessing survival after treatment escalation for patients with PSA ≥ 0.2 ng/mL after 6-12 months of ADT and ARPI therapy. Another phase 3 study will assess treatment de-escalation in those with PSA ≤ 0.2 ng/mL at 6-12 months after treatment initiation. This study's principal funder was the Movember Foundation; the Prostate Cancer Clinical Trials Consortium was a trial sponsor, plus Amgen, Astellas, AstraZeneca, Bayer, Janssen, Merck, Novartis and Sanofi provided funding support. Ong disclosed relationships with AstraZeneca, Bayer, Bristol-Myers Squibb, EMD Serono, Janssen, Merck, Novartis/AAA, Pfizer, Sanofi, and Ipsen. Aggarwal disclosed relationships with Alessa Therapeutics, Amgen, AstraZeneca, Bayer, BioXcel Therapeutics, Boxer Capital, Curio Science, and others.
Yahoo
34 minutes ago
- Yahoo
Weight-loss drugs were said to be a game changer. Turns out the benefit might be thinner than thought
Common GLP-1 weight loss drugs - including Wegovy and Ozempic - may not work for everyone in a 'real-world' setting, Cleveland Clinic researchers said Tuesday. The reason is that patients may take lower dosages or discontinue their treatment, negatively impacting the ability to control blood sugar levels in those who are pre-diabetic. The findings may have implications for people considering using the drugs, that are taken by more than eight million Americans every year. They've offered an alternative to traditional and taxing weight loss methods, such as diets and fitness. 'Our study shows that patients treated for obesity with semaglutide or trizepatide lost less weight on average in a regular clinical setting compared to what is observed in randomized clinical trials,' Dr. Hamlet Gasoyan, a researcher with Cleveland Clinic, said in a statement. 'According to our data, this could be explained by higher rates of discontinuation and lower maintenance dosages used in clinical practice, compared to randomized clinical trial settings.' Gasoyan was the lead author of the study published on Tuesday in the Obesity Journal. 'Semaglutide has been extensively examined in robust clinical development programs, large real-world-evidence studies and has cumulatively over 33 million patient years of exposure,' a Novo Nordisk spokesperson told The Independent. 'Semaglutide's efficacy and safety have been extensively demonstrated in people with obesity/overweight with robust evidence for improving health outcomes. Semaglutide has demonstrated improvements in cardiovascular death, stroke, and myocardial infarction.' A request for comment from Eli Lilly was not immediately returned to The Independent. The study focuses on drugs with the active ingredients semaglutide and tirzepatide; they include the U.S. Food and Drug-administration approved type 2 diabetes medications Zepbound and Mounjaro. The authors studied their effects on weight loss and blood sugar regulation in a real-world setting. They noted that previous randomized clinical trials have shown the efficacy of those medications. The authors monitored the health of nearly 7,900 adults who were severely obese. Of those, more than 1,300 had pre-diabetes at the study's start and were at a higher risk for developing type 2 diabetes: a chronic condition that affects a person's ability to use insulin and keep blood sugar at normal levels. Participants took the shots between 2021 and 2023. The researchers sorted patients who discontinued their obesity medications into two groups: those who did it within just three months and by three months to a year. The study's follow-up period ended last December. The most common reasoning for discontinuation of treatment in the real-world setting was due to the steep cost of the drugs and insurance, side effects and shortages. Notably, since the study's, prices have started to fall. Of the participants, more than 20 percent discontinued their medications early and 32 percent discontinued their medications late. Furthermore, the authors noted than more than 80 percent had been on the lower dosages needed to sustain a therapeutic effect. For semaglutide, that's equal to or less than 1 milligram and equal to or less than 7.5 milligrams for tirzepatide. Following a year of treatment, the average weight reduction was 3.6 percent among participants who discontinued their treatment early, compared to 6.8 percent for those who discontinued their treatment late. But, those who did not discontinue treatment and were on the highest dosages necessary lost the most weight, at up to 13.7 percent with semaglutide and 18 percent with tirzepatide. Participants had higher odds of achieving 10 percent or greater weight reduction after one year of treatment if they did not discontinue their medications or did so late, were on the highest dosages needed for a therapeutic effect, received tirzepatide, and were women. Tracking the maintenance of blood sugar levels in those with pre-diabetes, the researchers said just a third of those who discontinued their treatment early experienced normal blood sugar levels compared to 41 percent who discontinued their treatment late and 67.9 percent who did not discontinue treatment. Lastly, the researchers observed that while patients who discontinued obesity medications lost significantly less weight compared to those who did not, their weight trajectories remained relatively stable. They said that would be the subject of additional research. 'Our findings about the real-world use patterns of these medications and associated clinical outcomes could inform the decisions of healthcare providers and their patients on the role of treatment discontinuation and maintenance dosage in achieving clinically meaningful weight reductions,' explained Gasoyan.
