Poor sleep linked to years of poor cardiovascular health

Quantifying the impact of sleepless nights and ongoing drowsiness

March 8, 2023

Science Daily/University of Sydney

Poor sleep could lead to between two and seven years worth of heightened heart disease risk and even premature death, according to a new study led by researchers at the University of Sydney in collaboration with Southern Denmark University.

The study analysed data from over 300,000 middle-aged adults from the UK Biobank and found that different disturbances to sleep are associated with different durations of compromised cardiovascular health later in life compared to healthy sleepers.

In particular, men with clinical sleep-related breathing disorders lost nearly seven years of cardiovascular disease-free life compared to those without these conditions, and women lost over seven years. Importantly, even general poor sleep, such as insufficient sleep, insomnia complaints, snoring, going to bed late, and daytime sleepiness is associated with a loss of around two years of normal heart health in men and women.

"Anyone who's had a few rough nights of sleep knows how it can lead to bad mood and not feeling one's best. Our research shows that, over time, regular poor sleep can lead to significantly compromised cardiovascular health in middle and old age, said Professor Emmanuel Stamatakis from the Charles Perkins Centre and Faculty of Medicine and Health, senior author of the paper in BMC Medicine.

"Sleep apnoea is well known to increase the risk of cardiovascular disease and other chronic conditions, but these findings are a wake-up call that poor sleep in general can pose significant risk to heart health."

How does snoring affect long term health?

The team used an established composite sleep score comprising self-reported sleep duration, insomnia complaints, snoring, daytime sleepiness and whether the person was a night owl or an early bird to come up with three sleep categories: poor, intermediate, and healthy at age 40, and compared this with their overall cardiovascular disease-free health expectancy.

By combining the study participants' self-reported data with clinical data from their doctors in the two years preceding the study, the researchers were able to compare health outcomes for self-reported sleep patterns and clinically diagnosed conditions such as sleep-related breathing disorders. The team categorised participants as poor, intermediate, and healthy sleepers at age 40, and compared their health outcomes at old age.

Women with poor sleep were likely to experience two years more of compromised cardiovascular health compared to healthy sleepers, while men experienced more than two years. Intermediate sleepers lost almost one year of heart disease-free life among women, and men lost slightly more.

This means that snoring and trouble falling asleep or staying asleep can be a warning sign of potential health issues in the future.

"While the average life expectancy of the UK study participants is around 80 years, people with clinically diagnosed sleep-related breathing disorders like sleep apnoea lost over seven years of cardiovascular-disease free life," said the study's lead author Dr Bo-Huei Huang, an epidemiologist recently graduating from the Charles Perkins Centre and Faculty of Medicine and Health.

A wake-up call for health and policy

Professor Peter Cistulli, the ResMed Chair of Sleep Medicine at the Charles Perkins Centre and Royal North Shore Hospital, said that these findings are significant because they extend the findings of previous studies linking poor sleep to important health outcomes.

"Sleep is a vital biological function that has been under-appreciated in public health policy to date. It's gratifying that these findings shine a light on the importance of sleep, and the need for it to be recognised as a pillar of good health, alongside physical activity and nutrition. The time is right to ensure that sleep is recognised in public health policy," said Professor Cistulli.

https://www.sciencedaily.com/releases/2023/03/230308084352.htm

How heavy alcohol consumption increases brain inflammation

March 7, 2023

Science Daily/Scripps Research Institute

For people with alcohol use disorder (AUD), there is a constant, vicious cycle between changes to the brain and changes to behavior. AUD can alter signaling pathways in the brain; in turn, those changes can exacerbate drinking.

Now, scientists at Scripps Research have uncovered new details about the immune system's role in this cycle. They reported in the journal Brain, Behavior and Immunity on Feb. 28, 2023, that the immune signaling molecule interleukin 1β (IL-1β) is present at higher levels in the brains of mice with alcohol dependence. In addition, the IL-1β pathway takes on a different role in these animals, causing inflammation in critical areas of the brain known to be involved in decision-making.

"These inflammatory changes to the brain could explain some of the risky decision-making and impulsivity we see in people with alcohol use disorder," says senior author Marisa Roberto, PhD, the Schimmel Family Chair of Molecular Medicine and a professor of neuroscience at Scripps Research. "In addition, our findings are incredibly exciting because they suggest a potential way to treat alcohol use disorder with existing anti-inflammatory drugs targeting the IL-1β pathway."

AUD is characterized by uncontrolled and compulsive drinking, and it encompasses a range of conditions including alcohol abuse, dependence and binge drinking. Researchers have previously discovered numerous links between the immune system and AUD -- many of them centered around IL-1β. People with certain mutations in the gene that codes for the IL-1β molecule, for instance, are more prone to developing AUD. In addition, autopsies of people who had AUD have found higher levels of IL-1β in the brain.

"We suspected that IL-1β was playing a role in AUD, but the exact mechanisms in the brain have been unclear," says first author Florence Varodayan, PhD, an assistant professor at Binghamton University and former postdoctoral fellow in the Roberto lab.

In the new study, Roberto, Varodayan and their colleagues compared alcohol-dependent mice with animals drinking moderate or no alcohol at all. They discovered that the alcohol-dependent group had about twice as much IL-1β in the medial prefrontal cortex (mPFC), a part of the brain that plays a role in regulating emotions and behaviors.

The team then went on to show that IL-1β signaling in the alcohol-dependent group was not only increased, but also fundamentally different. In mice that had not been exposed to alcohol, as well as in mice that had drunk moderate amounts of alcohol, IL-1β activated an anti-inflammatory signaling pathway. In turn, this lowered levels of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), a signaling molecule known to regulate neural activity in the brain.

However, in alcohol-dependent mice, IL-1β instead activated pro-inflammatory signaling and boosted levels of GABA, likely contributing to some of the changes in brain activity associated with AUD. Notably, these changes in IL-1β signaling in the alcohol-dependent mice persisted even during alcohol withdrawal.

Drugs that block the activity of IL-1β are already approved by the U.S. Food and Drug Administration to treat rheumatoid arthritis and other inflammatory conditions. More work is needed to determine whether these existing drugs could have utility in treating AUD.

"We plan to follow up on this study with more work on exactly how targeting specific components of the IL-1β pathway might be useful in treating alcohol use disorder," says Roberto.

https://www.sciencedaily.com/releases/2023/03/230307073219.htm

Age of first exposure to tackle football and years played associated with less white matter in brain

New finding suggests that future therapies should target white matter loss in former contact sport athletes

March 6, 2023

Science Daily/Boston University School of Medicine

Chronic traumatic encephalopathy (CTE) is not the only problem football players should be aware of. Long careers in American football are linked to less white matter in the brain and associated with problems with impulsive behavior and thinking according to a new study from the Boston University CTE Center. This finding is independent of whether football players had chronic traumatic encephalopathy (CTE).

CTE is a progressive neurodegenerative disease frequently found in contact sports athletes. However, many former contact sports athletes suffer from thinking problems and impulsive behavior in the absence of CTE, or with very mild CTE. This new study suggests that a separate type of brain damage, which can appear earlier than CTE, may underlie some of these symptoms.

"Damage to the white matter may help explain why football players appear more likely to develop cognitive and behavioral problems later in life, even in the absence of CTE," said corresponding author Thor Stein, MD, PhD, a neuropathologist at VA Boston Healthcare System and assistant professor of pathology and laboratory medicine at Boston University Chobanian & Avedisian School of Medicine.

The researchers studied the brains of 205 deceased American football players donated to the Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank and measured levels of myelin, a component of white matter that covers, protects and speeds up the connections in the brain. They then interviewed family members on measures of cognition and impulsivity and then compared how career length and age of beginning tackle football related to levels of myelin, and how myelin levels related to cognition and impulsivity. In addition to more years of football played, the researchers found that starting tackle football at a younger age was also related to more white matter loss, independent of career length.

"These results suggest that existing tests that measure white matter injury during life, including imaging and blood tests, may help to clarify potential causes of changes in behavior and cognition in former contact sport athletes. We can also use these tests to better understand how repeated hits to the head from football and other sports lead to long term injury to the white matter," said co-author Michael L. Alosco, PhD, associate professor of neurology.

The researchers hope these findings help reinforce the idea that more needs to be done to protect the brains of athletes, especially children, from repeated hits to the head.

These finding appear online in the journal Brain Communications.

This work was supported by grant funding from: NIA (AG057902, AG06234, RF1AG054156), NINDS (U54NS115266, K23NS102399, RF1NS122854), National Institute of Aging Boston University AD Center (P30AG072978); the United States Department of Veterans Affairs, Veterans Health Administration, BLRD Merit Award (I01BX005161); the Nick and Lynn Buoniconti Foundation, and BU-CTSI Grant Number 1UL1TR001430. The views, opinions and/or findings contained in this article are those of the authors and should not be construed as an official Veterans Affairs or Department of Defense position, policy or decision, unless so designated by other official documentation. Funders did not have a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

https://www.sciencedaily.com/releases/2023/03/230306143450.htm

Trouble falling asleep at bedtime or in the middle of the night? It could impact your risk for developing dementia

March 6, 2023

Science Daily/Elsevier

Adding to the growing body of evidence on sleep disturbances and cognitive impairment, new research finds significant links between three measures of sleep disturbance and the risk for developing dementia over a 10-year period. The results, reported in the American Journal of Preventive Medicine, published by Elsevier, associate sleep-initiation insomnia (trouble falling asleep within 30 minutes) and sleep medication use with higher risk for developing dementia. The investigators also found that people who reported having sleep-maintenance insomnia (trouble falling back to sleep after waking) were less likely to develop dementia over the course of the study.

"We expected sleep-initiation insomnia and sleep medication usage to increase dementia risk, but we were surprised to find sleep-maintenance insomnia decreased dementia risk," explained lead investigator Roger Wong, PhD, MPH, MSW, an Assistant Professor in the Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA. "The motivation behind this research was prompted on a personal level. My father has been experiencing chronic sleep disturbances since the COVID-19 pandemic began, and I was concerned how this would affect his cognition in the future. After reading the existing literature, I was surprised to see mixed findings on the sleep-dementia relationship, so I decided to investigate this topic."

This research is novel because it is the first to examine how long-term sleep disturbance measures are associated with dementia risk using a nationally representative US older adult sample. Previous research has associated REM sleep behavior, sleep deprivation (less than five hours of sleep), and the use of short-acting benzodiazepines with cognitive decline. Their results for sleep-maintenance insomnia support other recent studies using smaller, separate data samples.

This study used 10 annual waves (2011?2020) of prospective data from the National Health and Aging Trends Study (NHATS), a longitudinal panel study that surveys a nationally representative sample of Medicare beneficiaries aged 65 years and older within the USA. This study included only people who were dementia-free at baseline in 2011.

There is no cure for dementia and recent pharmaceutical approaches to treat dementia have had limited success, pointing to the importance of preventive approaches to dementia. "By focusing on the variations in sleep disturbances, our findings can help to inform lifestyle changes that can reduce dementia risk," explained co-investigator Margaret Anne Lovier, MPH, Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

While the mechanism for decreased dementia risk among those with sleep-maintenance insomnia is still unknown, the investigators theorize that greater engagement in activities that preserve or increase cognitive reserve may thereby decrease dementia risk.

Recent evidence indicates there is a higher prevalence of sleep disturbances among older adults than among other age groups. This could be attributed to a variety of factors including anxiety about the COVID-19 pandemic or warmer nights as a consequence of climate change.

"Older adults are losing sleep over a wide variety of concerns. More research is needed to better understand its causes and manifestations and limit the long-term consequences," added Dr. Wong. "Our findings highlight the importance of considering sleep disturbance history when assessing the dementia risk profile for older adults. Future research is needed to examine other sleep disturbance measures using a national longitudinal sample, whether these sleep-dementia findings hold true for specific dementia subtypes, and how certain sociodemographic characteristics may interact with sleep disturbances to influence dementia risk."

https://www.sciencedaily.com/releases/2023/03/230306143443.htm

A good night's sleep may make it easier to stick to exercise and diet goals

March 3, 2023

Science Daily/American Heart Association

People who reported getting regular, uninterrupted sleep did a better job sticking to their exercise and diet plans while trying to lose weight, according to preliminary research presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023. The meeting will be held in Boston, February 28-March 3, 2023, and offers the latest science on population-based health and wellness and implications for lifestyle and cardiometabolic health.

"Focusing on obtaining good sleep -- seven to nine hours at night with a regular wake time along with waking refreshed and being alert throughout the day -- may be an important behavior that helps people stick with their physical activity and dietary modification goals," said Christopher E. Kline, Ph.D., an associate professor in the department of health and human development at the University of Pittsburgh. "A previous study of ours reported that better sleep health was associated with a significantly greater loss of body weight and fat among participants in a year-long, behavioral weight loss program."

The researchers examined whether good sleep health was related to how well people adhered to the various lifestyle modifications prescribed in a 12-month weight loss program. The weight-loss program included 125 adults (average age of 50 years, 91% female, 81% white) who met criteria for overweight or obesity (body mass index of 27-44) without any medical conditions requiring medical supervision of their diet or physical activity.

Sleep habits were measured at the beginning of the program, at 6 months and at 12 months, through patient questionnaires, a sleep diary and 7-day readings from a wrist-worn device that recorded sleep, waking activity and rest. These measures were used to score each participant as "good" or "poor" on six measures of sleep: regularity; satisfaction; alertness; timing; efficiency (the percentage of time spent in bed when actually asleep); and duration. A composite sleep health score of 0-6 was calculated for each participant, with one point for each "good" measure of sleep health, with higher scores indicating better levels of sleep health.

Adherence to the weight loss program was measured by percentage of group intervention sessions attended; percentage of days in which each participant ate between 85-115% of their recommended daily calories; and change in daily duration of moderate or vigorous physical activity. Participants had an average sleep health score of 4.5 out of 6 at the start of the study, at 6 months and at 12 months. Participants self-reported their caloric intake each day using a phone app and researchers measured participants' physical activity with an accelerometer worn at the waist for one week at a time at the start of the study, at 6 months and at 12 months.

After adjusting the sleep health scores for age, gender, race and whether or not there was a partner sharing the bed, the researchers found that better sleep health was associated with higher rates of attendance at group interval sessions, adherence to caloric intake goals and improvement in time spent performing moderate-vigorous physical activity. They found:

• Participants attended 79% of group sessions in the first six months and 62% of group sessions in the second six months.

• Participants met their daily caloric intake goals on 36% of days in the first six months and 21% in the second six months.

• Participants increased their total daily time spent in moderate-vigorous activity by 8.7 minutes in the first six months, however, their total time spent decreased by 3.7 minutes in the second six months.

The decrease in group session attendance, caloric intake and in time spent in moderate-vigorous activity in the second six months was expected, Kline said. "As one continues in a long-term behavioral weight loss intervention, it's normal for the adherence to weight loss behaviors to decrease," he said.

Additionally, while there was an association between better sleep health scores and an increase in physical activity, it was not strong enough to be statistically significant, meaning that researchers cannot rule out that the results were due to chance.

"We had hypothesized that sleep would be associated with lifestyle modification; however, we didn't expect to see an association between sleep health and all three of our measures of lifestyle modification," he said. "Although we did not intervene on sleep health in this study, these results suggest that optimizing sleep may lead to better lifestyle modification adherence. "

The study's limitations include that it did not incorporate any intervention to help participants improve their sleep, that the study sample was not recruited based upon participants' sleep health characteristics, and that the overall sample population had relatively good sleep health at baseline. The sample was also primarily white and female, so it is unclear whether these results are generalizable to more diverse populations.

"One question of interest for future research is whether we can increase adherence to lifestyle modifications -- and, ultimately, increase weight loss -- if we improve a person's sleep health," Kline said.

A second question for the researchers is how such an intervention would be timed to improve sleep.

"It remains unclear whether it would be best to optimize sleep prior to rather than during attempted weight loss. In other words, should clinicians tell their patients to focus on getting better and more regular sleep before they begin to attempt weight loss, or should they try to improve their sleep while at the same time modifying their diet and activity levels?" Kline said.

Improving one's sleep health is something everyone can do to improve their cardiovascular health and is a key component of the American Heart Association's Life's Essential 8. Sleep was added in 2022 as the eighth component of optimal cardiovascular health, which includes eating healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight and controlling cholesterol, blood sugar and blood pressure levels. Cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined, according to the 2023 Statistical Update from the American Heart Association.

"There are over 100 studies linking sleep to weight gain and obesity, but this was a great example showing how sleep isn't just tied to weight itself, it's tied to the things we're doing to help manage our own weight. This could be because sleep impacts the things that drive hunger and cravings, your metabolism and your ability to regulate metabolism and the ability to make healthy choices in general," said Michael A. Grandner, Ph.D., MTR. Grandner is director of the Sleep and Heath Research Program at the University of Arizona, director of the Behavioral Sleep Medicine Clinic at the Banner-University Medical Center in Tucson, Arizona, and was a co-author of the Association's Life's Essential 8 cardiovascular health score. "Studies like this really go to show that all of these things are connected, and sometimes sleep is the thing that we can start taking control over that can help open doors to other avenues of health."

https://www.sciencedaily.com/releases/2023/03/230303175844.htm

For older adults, every 500 additional steps taken daily associated with lower heart risk

American Heart Association Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023, Presentation 360

March 3, 2023

Science Daily/American Heart Association

A new study found that walking an additional 500 steps, or about one-quarter of a mile, per day was associated with a 14% lower risk of heart disease, stroke or heart failure, according to preliminary research to be presented at the American Heart Association's Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Scientific Sessions 2023. The meeting will be held in Boston, February 28-March 3, 2023, and offers the latest science on population-based health and wellness and implications for lifestyle and cardiometabolic health.

"Steps are an easy way to measure physical activity, and more daily steps were associated with a lower risk of having a cardiovascular disease-related event in older adults," said Erin E. Dooley, Ph.D., an assistant professor of epidemiology at the University of Alabama at Birmingham School of Public Health and lead researcher of the study. "However, most studies have focused on early-to-midlife adults with daily goals of 10,000 or more steps, which may not be attainable for older individuals."

Participants in the current analysis were part of a larger study group of 15,792 adults originally recruited for the ongoing Atherosclerosis Risk in Communities (ARIC) study. The present study evaluated health data collected from ARIC study visit 6 (2016-17) to evaluate the potential association between daily step counts and cardiovascular disease.

Researchers analyzed health data for 452 participants who used an accelerometer device similar to a pedometer, worn at the hip, that measured their daily steps. Participants were an average age of 78 years old; 59% were women; and 20% of participants self-identified as Black adults (70% of whom were women, and 30% of whom were men).

The devices were worn for three or more days, for ten or more hours, and the average step count was about 3,500 steps per day. Over the 3.5-year follow-up period, 7.5% of the participants experienced a cardiovascular disease event, such as coronary heart disease, stroke or heart failure.

The analysis found:

• Compared to adults who took less than 2,000 steps per day, adults who took approximately 4,500 steps per day had a 77% lower observed risk of experiencing a cardiovascular event.

• Nearly 12% of older adults with less than 2,000 steps per day had a cardiovascular event, compared to 3.5% of the participants who walked about 4,500 steps per day.

• Every additional 500 steps taken per day was incrementally associated with a 14% lower risk of cardiovascular disease.

"It's important to maintain physical activity as we age, however, daily step goals should also be attainable. We were surprised to find that every additional quarter of a mile, or 500 steps, of walking had such a strong benefit to heart health," Dooley said. "While we do not want to diminish the importance of higher intensity physical activity, encouraging small increases in the number of daily steps also has significant cardiovascular benefits. If you are an older adult over the age of 70, start with trying to get 500 more steps per day."

Additional research is needed to determine if meeting a higher daily count of steps prevents or delays cardiovascular disease, or if lower step counts may be an indicator of underlying disease.

Everyone can improve their cardiovascular health by following the American Heart Association's Life's Essential 8: eating healthy food, being physically active, not smoking, getting enough sleep, maintaining a healthy weight, and controlling cholesterol, blood sugar and blood pressure levels. Cardiovascular disease claims more lives each year in the U.S. than all forms of cancer and chronic lower respiratory disease combined, according to the American Heart Association.

The study had limitations. Participants had to enroll in the accelerometer device study, and hip-worn accelerometers are limited in capturing other activity behaviors that may also be important to heart health, such as bicycling and swimming. Study participants were more likely to have had at least some college or above education compared to the overall ARIC sample, and primarily self-identified as white and female, which may limit the study's generalizability. Additionally, steps were only measured at one single point in time, and the researchers were unable to examine if changes in steps over time impacted CVD event risk.

https://www.sciencedaily.com/releases/2023/03/230303105410.htm

High blood pressure during pregnancy linked to thinking problems later

Study finds even greater risk in those with preeclampsia, eclampsia

March 1, 2023

Science Daily/American Academy of Neurology

High blood pressure disorders during pregnancy are associated with an increased risk of thinking problems later in life, according to a study published in the March 1, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers found that those with these disorders had a higher risk of cognitive problems in later life than those who did not have high blood pressure during pregnancy. They also found that those with preeclampsia, which is high blood pressure that develops halfway through pregnancy and usually involves the kidneys and other organs, may have an even greater risk of cognitive decline later in life, compared to those with gestational high blood pressure, a condition with high blood pressure in pregnancy but without affecting the kidneys or other organs.

"While high blood pressure during pregnancy, including preeclampsia, is recognized as a risk factor for heart disease and stroke, our study suggests that it may also be a risk factor for cognitive decline in later life," said study author Michelle M. Mielke, PhD, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, and a member of the American Academy of Neurology.

The study involved 2,239 female participants with an average age of 73. Researchers looked at medical records for information about previous pregnancies.

Of the participants, 1,854 people or 83% had at least one pregnancy, and 385 people or 17% never had a pregnancy or had a pregnancy of less than 20 weeks. Of those with pregnancies longer than 20 weeks, 100 had gestational high blood pressure, 147 had preeclampsia or eclampsia and 1,607 had normal blood pressure. Preeclampsia is when there is excess protein in the urine during pregnancy. Eclampsia is when high blood pressure during pregnancy causes one or more seizures, sometimes followed by a coma.

For the study, participants took nine memory and thinking tests every 15 months over an average of five years. The tests measured thinking and memory skills including global cognition, processing speed, executive function, language and visual perception.

Overall, researchers found that those with high blood pressure during pregnancy had a greater decline than those without high blood pressure during pregnancy and those who had not given birth on tests of global cognition, attention, executive function and language.

After adjusting for age and education, the average composite score of all memory and thinking tests of participants with any type of high blood pressure disorder had a decline of 0.3 points compared to those who did not have high blood pressure during pregnancy with a decline of 0.05 points. When looking at different types of high blood pressure disorders, those with preeclampsia had a decline of 0.04 points compared to those with other blood pressure disorders and those with no blood pressure disorders, which both had a decline of 0.05.

After adjusting for age and education, those with high blood pressure in pregnancy declined 0.4 standard deviation over five years on tests of executive function and attention, compared to those who had normal blood pressure for all pregnancies and declined only 0.1 standard deviation. These results were more pronounced for those who had preeclampsia, with a 0.5 standard deviation decrease on tests of executive function and attention compared to a 0.1 decrease for those who had normal blood pressure for all pregnancies.

"More research is needed to confirm our findings. However, these results suggest that managing and monitoring blood pressure during and after pregnancy is an important factor for brain health later in life," Mielke said.

A limitation of the study is that most of the participants were white, so results may not be generalizable to more diverse populations that have higher rates of high blood pressure in pregnancy.

https://www.sciencedaily.com/releases/2023/03/230301162703.htm

Taking vitamin D could help prevent dementia

Taking vitamin D supplements may help ward off dementia, according to a new, large-scale study.

March 1, 2023

Science Daily/University of Exeter

Taking vitamin D supplements may help ward off dementia, according to a new, large-scale study.

Researchers at the University of Calgary's Hotchkiss Brain Institute in Canada and the University of Exeter in the UK explored the relationship between vitamin D supplementation and dementia in more than 12,388 participants of the US National Alzheimer's Coordinating Center, who had a mean age of 71 and were dementia-free when they signed up. Of the group, 37 per cent (4,637) took vitamin D supplements.

In the study, published in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, the team found that taking vitamin D was associated with living dementia-free for longer, and they also found 40 per cent fewer dementia diagnoses in the group who took supplements.

Across the entire sample, 2,696 participants progressed to dementia over ten years; amongst them, 2,017 (75%) had no exposure to vitamin D throughout all visits prior to dementia diagnosis, and 679 (25%) had baseline exposure.

Professor Zahinoor Ismail, of the University of Calgary and University of Exeter, who led the research, said: "We know that vitamin D has some effects in the brain that could have implications for reducing dementia, however so far, research has yielded conflicting results. Our findings give key insights into groups who might be specifically targeted for vitamin D supplementation. Overall, we found evidence to suggest that earlier supplementation might be particularly beneficial, before the onset of cognitive decline."

While Vitamin D was effective in all groups, the team found that effects were significantly greater in females, compared to males. Similarly, effects were greater in people with normal cognition, compared to those who reported signs of mild cognitive impairment -- changes to cognition which have been linked to a higher risk of dementia.

The effects of vitamin D were also significantly greater in people who did not carry the APOEe4 gene, known to present a higher risk for Alzheimer's dementia, compared to non-carriers. The authors suggest that people who carry the APOEe4 gene absorb vitamin D better from their intestine, which might reduce the vitamin D supplementation effect. However, no blood levels were drawn to test this hypothesis.

Previous research has found that low levels of vitamin D are linked to higher dementia risk. Vitamin D is involved in the clearance of amyloid in the brain, the accumulation of which is one of the hallmarks of Alzheimer's disease. Studies have also found that vitamin D may provide help to protect the brain against build-up of tau, another protein involved in the development of dementia.

Co-author Dr Byron Creese, at the University of Exeter, said: "Preventing dementia or even delaying its onset is vitally important given the growing numbers of people affected. The link with vitamin D in this study suggests that taking vitamin D supplements may be beneficial in preventing or delaying dementia, but we now need clinical trials to confirm whether this is really the case. The ongoing VitaMIND study at the University of Exeter is exploring this issue further by randomly assigning participants to either take vitamin D or placebo and examining changes in memory and thinking tests over time."

The VitaMIND study is run via PROTECT, an online study open to people aged 40 and over. In PROTECT annual questionnaires on detailed lifestyle factors combine with cognitive testing, to determine what keeps the brain sharp in later life. To find out more or to sign up, visit their website. In Canada, CAN-PROTECT, is a linked online study on aging, in people aged 40 and over, with an additional focus on caregiving in dementia.

https://www.sciencedaily.com/releases/2023/03/230301101511.htm

Lending a paw for defense veterans: 'Clear evidence' that assistance dogs help improve mental health

March 1, 2023

Science Daily/University of South Australia

A new Australian study focused on defence veterans' mental health has found strong evidence that assistance dogs used in conjunction with traditional therapies provide the most effective treatment outcomes.

Almost 90 per cent of veterans reported improvements in their post-traumatic stress, depression and anxiety 12 months after being matched to an assistance dog, according to researchers from the University of South Australia (UniSA), University of Adelaide, and Military and Emergency Services Health Australia (MESHA).

Of the 16 returned veterans who took part in the study, 63 per cent reported "significant clinical improvements" to their mental health thanks to an assistance dog provided by the Operation K9 Program run by See Differently with the Royal Society for the Blind.

The study, funded by The Hospital Research Foundation Group, is the first in Australia to use self-reported measures, clinical assessments, and face-to-face interviews with veterans to investigate the value of an assistance dog over time.

It is published in the International Journal of Environmental Research and Public Health.

UniSA Master of Clinical Psychology student Melissa Sherman, who analysed the data, says the findings are relevant to policymakers and demonstrate the power of human-animal relationships.

"Previous studies have shown that existing treatments for post-traumatic stress among returned veterans are not ideal, with high dropout rates and poor adherence," Sherman says.

"This study provides clear evidence that assistance dogs can play a key role in a veteran's recovery from post-traumatic stress and other mental health conditions, supporting existing treatments."

Of the 5000 ADF members who transition from the forces to civilian life every year, 46 per cent experience mental health issues, including suicidal thoughts, anxiety, and depression. Almost a quarter of them are diagnosed with post-traumatic stress in their lifetime.

"This is an important issue that needs addressing," according to MESHA Executive Director Miranda Van Hooff, an Adjunct Associate Professor at both UniSA and the University of Adelaide.

Three major themes emerged from the study: that assistance dogs were a "life changer," a constant companion, and helped returned veterans to increase their social interactions.

"For many veterans, an assistance dog gave them a sense of purpose and a reason to live," Assoc Prof Van Hooff says.

Veterans reported their dog helped them "reclaim their life," giving them independence and a way to manage their mental health issues and fluctuating emotions, including hypervigilance.

Some participants described their dog as "a comfort or security blanket," with one veteran saying he was a recluse for many years until being matched with an assistance dog: 'Now, every day is an adventure, giving me something to look forward to'.

The study showed a slight drop in participants still reporting suicidal feelings after 12 months, but the reduction was not significant. The main benefits were a large reduction in depression, anxiety, and post-traumatic stress symptoms.

Researchers say the study was limited by the lack of a control group of veterans with post-traumatic stress not receiving an assistance dog, and the small number of study participants due to the cost of breeding, training, and matching dogs to veterans.

https://www.sciencedaily.com/releases/2023/03/230301101544.htm

Daily 11 minute brisk walk enough to reduce risk of early death

February 28, 2023

Science Daily/University of Cambridge

One in ten early deaths could be prevented if everyone managed at least half the recommended level of physical activity, say a team led by researchers at the University of Cambridge.

In a study published today in the British Journal of Sports Medicine, the researchers say that 11 minutes a day (75 minutes a week) of moderate-intensity physical activity -- such as a brisk walk -- would be sufficient to lower the risk of diseases such as heart disease, stroke and a number of cancers.

Cardiovascular diseases -- such as heart disease and stroke -- are the leading cause of death globally, responsible for 17.9 million deaths per year in 2019, while cancers were responsible for 9.6 million deaths in 2017. Physical activity -- particularly when it is moderate-intensity -- is known to reduce the risk of cardiovascular disease and cancer, and the NHS recommends that adults do at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity a week.

To explore the amount of physical activity necessary to have a beneficial impact on several chronic diseases and premature death, researchers from the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge carried out a systematic review and meta-analysis, pooling and analysing cohort data from all of the published evidence. This approach allowed them to bring together studies that on their own did not provide sufficient evidence and sometimes disagreed with each other to provide more robust conclusions.

In total, they looked at results reported in 196 peer-reviewed articles, covering more than 30 million participants from 94 large study cohorts, to produce the largest analysis to date of the association between physical activity levels and risk of heart disease, cancer, and early death.

The researchers found that, outside of work-related physical activity, two out of three people reported activity levels below 150 min per week of moderate-intensity activity and fewer than one in ten managed more than 300 min per week.

Broadly speaking, they found that beyond 150 min per week of moderate-intensity activity, the additional benefits in terms of reduced risk of disease or early death were marginal. But even half this amount came with significant benefits: accumulating 75 min per week of moderate-intensity activity brought with it a 23% lower risk of early death.

Dr Soren Brage from the MRC Epidemiology Unit said: "If you are someone who finds the idea of 150 minutes of moderate-intensity physical activity a week a bit daunting, then our findings should be good news. Doing some physical activity is better than doing none. This is also a good starting position -- if you find that 75 minutes a week is manageable, then you could try stepping it up gradually to the full recommended amount."

Seventy-five minutes per week of moderate activity was also enough to reduce the risk of developing cardiovascular disease by 17% and cancer by 7%. For some specific cancers, the reduction in risk was greater -- head and neck, myeloid leukaemia, myeloma, and gastric cardia cancers were between 14-26% lower risk. For other cancers, such as lung, liver, endometrial, colon, and breast cancer, a 3-11% lower risk was observed.

Professor James Woodcock from the MRC Epidemiology Unit said: "We know that physical activity, such as walking or cycling, is good for you, especially if you feel it raises your heart rate. But what we've found is there are substantial benefits to heart health and reducing your risk of cancer even if you can only manage 10 minutes every day."

The researchers calculated that if everyone in the studies had done the equivalent of at least 150 min per week of moderate-intensity activity, around one in six (16%) early deaths would be prevented. One in nine (11%) cases of cardiovascular disease and one in 20 (5%) cases of cancer would be prevented.

However, even if everyone managed at least 75 min per week of moderate-intensity physical activity, around one in ten (10%) early deaths would be prevented. One in twenty (5%) cases of cardiovascular disease and nearly one in thirty (3%) cases of cancer would be prevented.

Dr Leandro Garcia from Queen's University Belfast said: "Moderate activity doesn't have to involve what we normally think of exercise, such as sports or running. Sometimes, replacing some habits is all that is needed. For example, try to walk or cycle to your work or study place instead of using a car, or engage in active play with your kids or grand kids. Doing activities that you enjoy and that are easy to include in your weekly routine is an excellent way to become more active."

The research was funded by the Medical Research Council and the European Research Council.

What counts as moderate-intensity physical activity?

Moderate-intensity physical activity raises your heart rate and makes you breathe faster, but you would still be able to speak during the activity. Examples include:

• Brisk walking

• Dancing

• Riding a bike

• Playing tennis

• Hiking

https://www.sciencedaily.com/releases/2023/02/230228205249.htm

Time in nature may help older adults with improved health, purpose in life

February 24, 2023

Science Daily/Penn State

Over time, research has demonstrated that spending time in nature confers psychological, emotional and physical benefits. To maximize benefits of spending time in nature for people over the age of 65, researchers from Penn State; National Open University, Taiwan; and Lunghwa University of Science and Technology, Taiwan, studied the attitudes, beliefs and actions of a group of elders -- people over the age of 65 -- who regularly spent time in a natural area. The researchers found that fostering social connections around nature-based activities may be connected to improved health and quality of life for elders.

In Japan, the term shinrin-yoku, or "forest bathing," was developed to refer to spending time in nature while engaging all of one's senses: tasting the air, smelling a forest, listening to a stream, and being present with whatever you experience.

For elders who encounter challenges when attempting to hike quickly over difficult trails, forest bathing may present an enjoyable and safe way to spend time in nature. According to the researchers, forest bathing is popular among older adults in Japan, China and Taiwan, where the practice originated, and it is becoming increasingly popular in the United States.

The researchers studied older visitors to the Xitou Education Area, a natural preserve in Taiwan. Between April and June of 2022, the researchers surveyed 292 visitors to the preserve who were at least 65 years old and who visited the park at least once a week. Participants were asked a range of questions, from whether they felt supported by others, to how much they thought about their futures, to how much purpose they felt that their lives had.

The results of the study were published in the journal Leisure Sciences. The researchers found that people who discussed their experiences in nature with others tended to have a greater sense of attachment to forest bathing and a stronger sense of purpose in life.

Prior research supports the conclusion that these factors are related to better physical and mental health and higher quality of life. This finding can guide leisure-service providers working in various settings including community recreation departments and retirement villages on how to facilitate leisure for elders, according to John Dattilo, professor of recreation, park and tourism management at Penn State and co-author of this research.

"Elders can access community and state parks where it is safe for them to spend time in nature: places with walkable paths and convenient, accessible parking, are helpful," Dattilo explained." Agencies can publicize these opportunities and help identify the value they offer to elders and others.

"Better yet, leisure-service providers could arrange transportation and then afterwards facilitate social interactions among participants," Dattilo continued. "Enabling people to get out into nature to experience their surroundings is one aspect of forest bathing. Part of what we found is the linkage between positive social relationships and spending time in nature. So, if leisure-service providers create opportunities for elders to return from an experience, meet over a warm beverage and talk about their experiences, there will be value in these connections for people's sense of purpose."

An improved sense of purpose is related to better physical functioning, higher quality of life, and lower fear of death, according to Liang-Chih Chang, professor of living sciences at National Open University in New Taipei City, Taiwan. Forest bathing matters, he continued, because it might be able to help people foster that sense of purpose.

"Forest bathing seems to connect people to the moment and the world," Chang said. "When elders use that same experience to develop social connections and support, they may experience a broad range of benefits associated with physiological functioning as well as cognitive health. These are associations, not cause and effect, but the potential consequences are exciting to consider."

The study continues Dattilo's research on the value of the leisure experience for elders that he has explored with his collaborators in Taiwan as well as locally with colleagues from Penn State's Center for Healthy Aging.

"We have conducted research on square dancing and karaoke, both of which are common activities for elders in Asia," Dattilo said. "Forest bathing, is unique in that it is closely tied to hiking, strolling or sitting in nature in which many elders engage across the globe. If leisure-service providers facilitate exposure to nature and help participants build a sense of community around those experiences, then elders could live, not only healthier, but richer and more meaningful lives."

https://www.sciencedaily.com/releases/2023/02/230224135027.htm

Getting good sleep could add years to your life

Having five low-risk sleep habits may have long-term benefits

February 24, 2023

Science Daily/American College of Cardiology

Getting good sleep can play a role in supporting your heart and overall health -- and maybe even how long you live -- according to new research being presented at the American College of Cardiology's Annual Scientific Session Together With the World Congress of Cardiology. The study found that young people who have more beneficial sleep habits are incrementally less likely to die early. Moreover, the data suggest that about 8% of deaths from any cause could be attributed to poor sleep patterns.

"We saw a clear dose-response relationship, so the more beneficial factors someone has in terms of having higher quality of sleep, they also have a stepwise lowering of all cause and cardiovascular mortality," said Frank Qian, MD, an internal medicine resident physician at Beth Israel Deaconess

Medical Center, clinical fellow in medicine at Harvard Medical School and co-author of the study. "I think these findings emphasize that just getting enough hours of sleep isn't sufficient. You really have to have restful sleep and not have much trouble falling and staying asleep."

For their analysis, Qian and team included data from 172,321 people (average age 50 and 54% women) who participated in the National Health Interview Survey between 2013 and 2018. This survey is fielded each year by the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics to help gauge the health of the U.S. population and includes questions about sleep and sleep habits. Qian said this is the first study to his knowledge to use a nationally representative population to look at how several sleep behaviors, and not just sleep duration, might influence life expectancy.

About two-thirds of study participants self-reported as being White, 14.5% Hispanic, 12.6% Black and 5.5% Asian. Because researchers were able to link participants to the National Death Index records (through December 31, 2019), they could examine the association between individual and combined sleep factors and all-cause and cause-specific mortality. Participants were followed for a median of 4.3 years during which time 8,681 individuals died. Of these deaths, 2,610 deaths (30%) were from cardiovascular disease, 2,052 (24%) were from cancer and 4,019 (46%) were due to other causes.

Researchers assessed ?ve different factors of quality sleep using a low-risk sleep score they created based on answers collected as part of the survey. Factors included: 1) ideal sleep duration of seven to eight hours a night; 2) difficulty falling asleep no more than two times a week; 3) trouble staying asleep no more than two times a week; 4) not using any sleep medication; and 5) feeling well rested after waking up at least five days a week. Each factor was assigned zero or one point for each, for a maximum of five points, which indicated the highest quality sleep.

"If people have all these ideal sleep behaviors, they are more likely to live longer," Qian said. "So, if we can improve sleep overall, and identifying sleep disorders is especially important, we may be able to prevent some of this premature mortality."

For the analysis, researchers controlled for other factors that may have heightened the risk of dying, including lower socioeconomic status, smoking and alcohol consumption and other medical conditions. Compared to individuals who had zero to one favorable sleep factors, those who had all five were 30% less likely to die for any reason, 21% less likely to die from cardiovascular disease, 19% less likely to die from cancer, and 40% less likely to die of causes other than heart disease or cancer. Qian said these other deaths are likely due to accidents, infections or neurodegenerative diseases, such as dementia and Parkinson's disease, but more research is needed.

Among men and women who reported having all five quality sleep measures (a score of five), life expectancy was 4.7 years greater for men and 2.4 years greater for women compared with those who had none or only one of the five favorable elements of low-risk sleep. More research is needed to determine why men with all five low-risk sleep factors had double the increase in life expectancy compared with women who had the same quality sleep.

"Even from a young age, if people can develop these good sleep habits of getting enough sleep, making sure they are sleeping without too many distractions and have good sleep hygiene overall, it can greatly benefit their overall long-term health," Qian said, adding that for the present analysis they estimated gains in life expectancy starting at age 30, but the model can be used to predict gains at older ages too. "It's important for younger people to understand that a lot of health behaviors are cumulative over time. Just like we like to say, 'it's never too late to exercise or stop smoking,' it's also never too early. And we should be talking about and assessing sleep more often."

These sleep habits can be easily asked about during clinical encounters, and the researchers hope patients and clinicians will start talking about sleep as part of their overall health assessment and disease management planning.

One limitation of the study is that sleep habits were self-reported and not objectively measured or verified. In addition, no information was available about the types of sleep aid or medicine used or how often or long participants used them. Future research is needed to understand how these gains in life expectancy might continue as people age, as well as further explore the sex differences that were observed.

Previous studies have shown that getting too little or too much sleep can negatively affect the heart. It's also been widely reported that sleep apnea, a sleep disorder that causes someone to pause or stop breathing while asleep, can lead to a number of heart conditions, including high blood pressure, atrial fibrillation and heart attacks.

https://www.sciencedaily.com/releases/2023/02/230224135111.htm

Exercise more effective than medicines to manage mental health

February 23, 2023

Science Daily/University of South Australia

University of South Australia researchers are calling for exercise to be a mainstay approach for managing depression as a new study shows that physical activity is 1.5 times more effective than counselling or the leading medications.

Published in the British Journal of Sports Medicine, the review is the most comprehensive to date, encompassing 97 reviews, 1039 trials and 128,119 participants. It shows that physical activity is extremely beneficial for improving symptoms of depression, anxiety, and distress.

Specifically, the review showed that exercise interventions that were 12 weeks or shorter were most the effective at reducing mental health symptoms, highlighting the speed at which physical activity can make a change.

The largest benefits were seen among people with depression, pregnant and postpartum women, healthy individuals, and people diagnosed with HIV or kidney disease.

According to the World Health Organization, one in every eight people worldwide (970 million people) live with a mental disorder. Poor mental health costs the world economy approximately $2.5 trillion each year, a cost projected to rise to $6 trillion by 2030. In Australia, an estimated one in five people (aged 16-85) have experienced a mental disorder in the past 12 months.

Lead UniSA researcher, Dr Ben Singh, says physical activity must be prioritised to better manage the growing cases of mental health conditions.

"Physical activity is known to help improve mental health. Yet despite the evidence, it has not been widely adopted as a first-choice treatment," Dr Singh says.

"Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations, with some groups showing even greater signs of improvement.

"Higher intensity exercise had greater improvements for depression and anxiety, while longer durations had smaller effects when compared to short and mid-duration bursts.

"We also found that all types of physical activity and exercise were beneficial, including aerobic exercise such as walking, resistance training, Pilates, and yoga.

"Importantly, the research shows that it doesn't take much for exercise to make a positive change to your mental health."

Senior researcher, UniSA's Prof Carol Maher, says the study is the first to evaluate the effects of all types of physical activity on depression, anxiety, and psychological distress in all adult populations.

"Examining these studies as a whole is an effective way to for clinicians to easily understand the body of evidence that supports physical activity in managing mental health disorders.

"We hope this review will underscore the need for physical activity, including structured exercise interventions, as a mainstay approach for managing depression and anxiety."

https://www.sciencedaily.com/releases/2023/02/230223193417.htm

Air pollution speeds bone loss from osteoporosis

February 21, 2023

Science Daily/Columbia University's Mailman School of Public Health

Elevated levels of air pollutants are associated with bone damage among postmenopausal women, according to new research led by scientists at Columbia University Mailman School of Public Health. The effects were most evident on the lumbar spine, with nitrous oxides twice as damaging to the area than seen with normal aging.

The research findings appear in the peer-reviewed journal eClinicalMedicine, part of The Lancet Discovery Science suite of open-access journals.

Previous studies on individual pollutants have suggested adverse effects on bone mineral density, osteoporosis risk, and fractures in older individuals. The new study is the first to explore the connection between air pollution and bone mineral density specifically in postmenopausal women, and the first to explore the effects of air pollution mixtures on bone outcomes.

The researchers analyzed data collected through the Women's Health Initiative study, an ethnically diverse cohort of 161,808 postmenopausal women. They estimated air pollution (PM10, NO, NO2, and SO2) exposures based on participants' home addresses. They measured bone mineral density (BMD; whole-body, total hip, femoral neck, and lumbar spine) at enrollment at follow-up at year one, year three, and year six using dual-energy X-ray absorptiometry.

The magnitude of the effects of nitrogen oxides on lumbar spine BMD would amount to 1.22 percent annual reductions -- nearly double the annual effects of age on any of the anatomical sites evaluated. These effects are believed to happen through bone cell death by way of oxidative damage and other mechanisms.

"Our findings confirm that poor air quality may be a risk factor for bone loss, independent of socioeconomic or demographic factors. For the first time, we have evidence that nitrogen oxides, in particular, are a major contributor to bone damage and that the lumbar spine is one of the most susceptible sites of this damage," says study first author Diddier Prada, MD, PhD, associate research scientist in the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

"Improvements in air pollution exposure, particularly nitrogen oxides, will reduce bone damage in postmenopausal women, prevent bone fractures, and reduce the health cost burden associated with osteoporosis among postmenopausal women. Further efforts should focus on detecting those at higher risk of air pollution-related bone damage," says lead author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences at Columbia Mailman School of Public Health.

Car and truck exhaust is a major source of nitrous oxides, as are the emissions from electrical power generation plants.

Approximately 2.1 million osteoporosis-related bone fractures occur annually, resulting in up to $20.3 billion in annual direct health costs. Osteoporosis impacts women more than men, with 80 percent of the estimated 10 million Americans with osteoporosis being women. Postmenopausal women are at higher risk, with one in two women over 50 experiencing a bone fracture because of osteoporosis.

Previously, Columbia researchers showed that long-term air pollution exposure reduces BMD and increases bone fracture risk in later life. Subsequently, these findings have been confirmed in multiple human studies.

https://www.sciencedaily.com/releases/2023/02/230221132129.htm

Working a four-day week boosts employee wellbeing while preserving productivity, major six-month trial finds

February 21, 2023

Science Daily/University of Cambridge

Sixty-one organisations in the UK committed to a 20% reduction in working hours for all staff, with no fall in wages, for a six-month period starting in June 2022. The vast majority of companies also retained full-time productivity targets.

Now, results from the world's largest trial of a four-day working week reveal significantly reduced rates of stress and illness in the workforce -- with 71% of employees self-reporting lower levels of "burnout," and 39% saying they were less stressed, compared to the start of the trial.

There was a 65% reduction in sick days, and a 57% fall in the number of staff leaving participating companies, compared to the same period the previous year. Company revenue barely changed during the trial period -- even increasing marginally by 1.4% on average.

In a report of the findings presented to UK lawmakers, some 92% of companies that took part in the UK pilot programme (56 out of 61) say they intend to continue with the four-day working week, with 18 companies confirming the change as permanent.

Research for the UK trials was conducted by a team of social scientists from the University of Cambridge, working with academics from Boston College in the US and the think tank Autonomy. The trial was organised by 4 Day Week Global in conjunction with the UK's 4 Day Week Campaign.

Companies from across the UK took part, with around 2,900 employees dropping a day of work. Organisations involved in the trial ranged from online retailers and financial service providers to animation studios and a local fish-and-chip shop.

Other industries represented include consultancy, housing, IT, skincare, recruitment, hospitality, marketing, and healthcare.

Researchers surveyed employees throughout the trial to gauge the effects of having an extra day of free time. Self-reported levels of anxiety and fatigue decreased across workforces, while mental and physical health improved.

Many survey respondents said they found it easier to balance work with both family and social commitments: 60% of employees found an increased ability to combine paid work with care responsibilities, and 62% reported it easier to combine work with social life.

"Before the trial, many questioned whether we would see an increase in productivity to offset the reduction in working time -- but this is exactly what we found," said sociologist Prof Brendan Burchell, who led the University of Cambridge side of the research.

"Many employees were very keen to find efficiency gains themselves. Long meetings with too many people were cut short or ditched completely. Workers were much less inclined to kill time, and actively sought out technologies that improved their productivity."

Dr David Frayne, a Research Associate at the University of Cambridge, said: "We feel really encouraged by the results, which showed the many ways companies were turning the four-day week from a dream into realistic policy, with multiple benefits."

Joe Ryle, Director of the 4 Day Week Campaign, calls the results a "major breakthrough moment" for the idea of shorter working weeks. "Across a wide variety of different sectors of the economy, these incredible results show that the four-day week actually works."

In addition to the survey work, designed in collaboration with colleagues including Prof Juliet Schor from Boston College, the Cambridge team conducted a large number of extensive interviews with employees and company CEOs before, during and after the six-month trial.

Other pilots run by 4 Day Week Global in the US and Ireland -- with research conducted by many of the same academics -- have already reported their findings. However, the UK trial is not only the largest to date but also the first to include in-depth interview research.

"The method of this pilot allowed our researchers to go beyond surveys and look in detail at how the companies were making it work on the ground," said Frayne, from Cambridge's Department of Sociology.

In terms of motivations, several senior managers told researchers they saw the four-day week as a rational response to the pandemic -- and believed it would give them an edge when it came to attracting talent in the post-Covid job market.

Some saw it as an appealing alternative to unlimited home working, which they felt risked company culture. Others had seen staff suffer through health problems and bereavement during the pandemic, and felt an increased "moral responsibility" towards employees.

"I hated the pandemic, but it's made us see each other much more in the round, and it's made us all realise the importance of having a healthy head, and that family matters," said the CEO of a non-profit organisation that took part in the trial.

However, many said shorter hours were being discussed long before Covid as a response to demanding or emotionally draining work. The CEO of a video game studio pointed to high-profile examples of "crunch and burnout" in their industry as a reason for involvement in the trial.

Perhaps surprisingly, however, no organisation interviewed was taking part in the trials simply because technology had reduced their need for human labour.

Some companies stopped work completely for a three-day weekend, while others staggered a reduced workforce over a week. One restaurant calculated their 32-hour week over an entire year to have long opening times in the summer, but much shorter in winter.

A few companies in the trial attached strings to the reduced hours, including fewer holiday days, agreement that staff could be called in at short notice, or a "conditional" four-day week: one that only continued while performance targets were met.

Interviews documented how companies reduced working hours without compromising on targets. Common methods included shorter meetings with clearer agendas; introduction of interruption-free 'focus periods'; reforming email etiquette to reduce long chains and inbox churn; new analyses of production processes; end-of-day task lists for effective handovers or next-day head starts.

When employees were asked how they used additional time off, by far the most popular response was "life admin": tasks such as shopping and household chores. Many explained how this allowed them a proper break for leisure activities on Saturday and Sunday.

"It was common for employees to describe a significant reduction in stress," said researcher and Cambridge PhD candidate Niamh Bridson Hubbard. "Many described being able to switch off or breathe more easily at home. One person told us how their 'Sunday dread' had disappeared."

For some parents of young children, a midweek day off meant savings on childcare expenses. For those with older children, it meant some welcome 'me time'. All reported doing more of the activities they already enjoy -- from sport to cooking, music making to volunteering. Some developed new interests, while others used the time to get professional qualifications.

"When you realise that day has allowed you to be relaxed and rested, and ready to absolutely go for it on those other four days, you start to realise that to go back to working on a Friday would feel really wrong -- stupid actually," said the CEO of a consultancy organisation involved in the trial.

When it came to working culture, employees were generally positive, feeling more valued by their employer and describing a shared sense of purpose arising from efforts to make the four-day week a success.

However, several staff at one large company had concerns about intensifying workloads, while some at creative companies expressed disquiet over reduced worktime conviviality due to 'focus time', and argued that unstructured chat often generates new ideas.

By the end of the six-month trial, many of the managers said they could not imagine returning to a five-day week. "Almost everyone we interviewed described being overwhelmed with questions from other organisations in their industry that are interested in following suit," said Burchell.

"When we ask employers, a lot of them are convinced the four-day week is going to happen. It has been uplifting for me personally, just talking to so many upbeat people over the last six months. A four-day week means a better working life and family life for so many people."

https://www.sciencedaily.com/releases/2023/02/230221113132.htm

Psychological stress impedes performance, even for Olympic athletes

February 16, 2023

Science Daily/Association for Psychological Science

The 2020 Tokyo Olympics were unique not just for taking place during the COVID-19 pandemic but for being the first athletic event to measure and broadcast competitors' heart rates as world-class archers took a shot at Olympic gold. Analysis of these biometric data by Yunfeng Lu (Nanjing University) and Songfa Zhong (National University of Singapore, New York University Abu Dhabi) in Psychological Science provides empirical support for something sports fans have long suspected: When athletes feel the pressure, their performance suffers.

"We found that high contactless real-time heart rate is associated with poor performance," said Lu and Zhong in an interview. "This suggests that even the best professional athletes are negatively influenced by psychological stress, even though they are generally well trained to cope with pressure."

Olympic archery includes several types of individual and team-based competitions, but for this study, Lu and Zhong focused on within-gender individual competitions for which heart-rate data were available. During these competitions, the heart rates of 122 male and female archers were broadcast as they took 2,247 shots. The World Archery Federation, in collaboration with Panasonic, measured athletes' heart rates using high-frame-rate cameras that are designed to detect skin reflectance and can determine a person's heart rate 96% as accurately as a pulse oximeter or electrocardiogram.

During each match, individual archers shot a set number of arrows at a target, with a 20-s time limit for each shot. Archers could earn a maximum of 10 points for a perfect bulls-eye shot, with points decreasing the farther an arrow landed from the center of the target.

Lu and Zhong found that athletes whose heart rates were higher before taking a shot consistently scored lower on those shots. While archers' age and gender were not found to significantly influence the relationship between stress and performance, a number of factors related to the nature of the competition did.

Increased heart rate was more likely to reduce the performance of lower-ranking archers and of all archers who shot second in a match or who had a lower score than their opponent at that point in the match. There was also a stronger relationship between stress and performance closer to the end of each match, possibly due to the increase in pressure as athletes progressed in the competition, the authors wrote.

"Elite athletes usually receive training to manage psychological stress, but our results suggest that they continue to be subject to the influence of psychological stress," wrote Lu and Zhong.

In addition to offering evidence for the link between stress and performance in a real-life setting, this research demonstrates that heart rate captured by high-frame-rate cameras can serve as a reliable source of biometric data, according to Lu and Zhong, particularly in situations like the COVID-19 pandemic in which researchers and participants may be unable to meet in person.

"This method could become increasingly important in diverse settings, ranging from sports and business to mental health and medicine," the researchers wrote. "In this regard, our study can be viewed as a proof of concept by showing that contactless real-time heart rates captured psychological stress."

In future work, this technology could be used to observe how psychological stress influences athletic performance across different sports, Lu and Zhong said. The researchers would also like to further investigate how contactless real-time heart rate can be incorporated into behavioral studies in laboratory and field settings.

https://www.sciencedaily.com/releases/2023/02/230216083952.htm

Chronically disrupted sleep may increase the risk for heart disease

February 15, 2023

Science Daily/Vanderbilt University Medical Center

Sleep irregularity — chronically disrupted sleep and highly variable sleep durations night after night — may increase the risk for atherosclerosis, according to a study led by Kelsie Full, PhD, MPH, of Vanderbilt University Medical Center.

The multicenter study, reported Feb. 15 in the Journal of the American Heart Association, followed 2,032 older, racially and ethnically diverse participants from six communities around the United States.

When monitored over a seven-day period, participants with greater irregularity in their sleep duration were more likely to have a higher burden of coronary artery calcium, more plaque in their carotid arteries, and greater systemic atherosclerosis and stiffness in their blood vessels, commonly referred to as “hardening of the arteries.”

“These results suggest that maintaining regular or habitual sleep durations, or sleeping close to the same total amount of time each night, may play an important role in preventing cardiovascular disease,” said Full, a former postdoctoral fellow at the University of Minnesota who joined the Vanderbilt faculty last year as assistant professor of Medicine in the Division of Epidemiology.

The Multi?Ethnic Study of Atherosclerosis (MESA) Sleep Ancillary Study included participants from St. Paul, Minnesota; Baltimore; Chicago; Forsyth County, North Carolina; Los Angeles County, California; and northern Manhattan and the Bronx, New York.

The study excluded shift workers, who are likely to have irregular sleep patterns, and those with existing heart disease and obstructive sleep apnea, a known risk factor for coronary artery disease.

Among the study’s participants, those with more irregular sleep durations were more likely to have atherosclerosis in the coronary arteries and peripheral arteries. These findings suggest that doctors who encourage their patients to maintain regular sleep patterns can help them reduce their risk of cardiovascular disease, Full said.

Full’s coauthors were from Brigham and Women’s Hospital and Harvard Medical School in Boston, the Icahn School of Medicine at Mount Sinai, New York, the University of California, San Diego, and Johns Hopkins School of Medicine in Baltimore.

Disruption of the body’s circadian rhythm may be the link between disrupted sleep and cardiovascular disease. “Almost all major cardiovascular functions, including heart rate, blood pressure, vascular tone, and endothelial functions, are regulated by circadian clock genes,” the researchers reported. 

“Disruption or misalignment of circadian rhythms,” they wrote, “can interrupt these important cardiovascular functions, resulting in the promotion of chronic inflammation, alterations in glucose metabolism, heightened sympathetic nervous system activation, and increases in arterial pressures, all predisposing to the risk of atherosclerosis progression.”

https://www.sciencedaily.com/releases/2023/02/230215100414.htm

Nightly sleep is key to student success

A new study shows the impact of nightly sleep on a student's academic performance

February 13, 2023

Science Daily/Carnegie Mellon University

College is a time of transition for young adults. It may be the first time students have the freedom to determine how to spend their time, but this freedom comes with competing interests from academics, social events and even sleep.

A multi-institutional team of researchers conducted the first study to evaluate how the duration of nightly sleep early in the semester affects first year college students end-of-semester grade point average (GPA). Using Fitbit sleep trackers, they found that students on average sleep 6.5 hours a night, but negative outcomes accumulate when students received less than six hours of sleep a night. The results are available in the Feb. 13 issue of the Proceedings of the National Academy of Sciences.

Previous studies have shown that total sleep is an important predictor for a broad range of health and performance outcomes. Sleep guidelines recommend teenagers get 8 to 10 hours of sleep every night. Many college students experience irregular and insufficient sleep.

David Creswell, the William S. Dietrich II Professor in Psychology and Neuroscience at the Dietrich College of Humanities and Social Sciences, led a team of researchers to evaluate the relationship between sleep and GPA. College students often push themselves to achieve, and GPA is the important marker of academic success.

"Animal studies have shown how critical sleep is for learning and memory," said Creswell. Here we show how this work translates to humans. The less nightly sleep a first year college student gets at the beginning of the school term predicts lower GPA at the end of the term, some five to nine weeks later. Lack of sleep may be hurting students' ability to learn in their college classrooms."

Past work with animals has shown that memories that form during the day are consolidated during sleep. When normal sleep patterns are interrupted, the content learned during the day is lost. Extending this logic to students, the researchers were curious if interrupted or inadequate sleep could impair their academic learning and if this would be apparent by academic achievement.

The study evaluated more than 600 first-year students across five studies at three universities. The students wore wrist Fitbit devices to monitor and record their sleep patterns. The researchers found that students in the study sleep on average 6.5 hours a night.

More surprising, the researchers found that students who receive less than six hours of sleep experienced a pronounced decline in academic performance. In addition, each hour of sleep lost corresponded to a 0.07 decrease in end-of-term GPA.

"Once you start dipping below six hours, you are starting to accumulate massive sleep debt that can impair a student's health and study habits, compromising the whole system," said Creswell. "Most surprising to me was that no matter what we did to make the effect go away, it persisted."

The study controlled for past academic performance, daytime napping, race, gender and first-generation status. Several of the studies also controlled for total academic course load. None of these factors affected the overall impact of nightly sleep on GPA.

"A popular belief among college students is value studying more or partying more over nightly sleep," said Creswell. Our work here suggests that there are potentially real costs to reducing your nightly sleep on your ability to learn and achieve in college. There's real value in budgeting for the importance of nightly sleep."

This works suggests the importance of building structured programs and interventions at institutions of learning that encourage undergraduate students to focus on their sleep.

https://www.sciencedaily.com/releases/2023/02/230213201029.htm

Fructose could drive Alzheimer's disease

An evolutionary foraging instinct that relied on the sugar fructose, may now be fueling the formation of Alzheimer's disease

February 13, 2023

Science Daily/University of Colorado Anschutz Medical Campus

An ancient human foraging instinct, fueled by fructose production in the brain, may hold clues to the development and possible treatment of Alzheimer's disease (AD), according to researchers at the University of Colorado Anschutz Medical Campus.

The study, published recently in The American Journal of Clinical Nutrition, offers a new way of looking at a fatal disease characterized by abnormal accumulations of proteins in the brain that slowly erode memory and cognition.

"We make the case that Alzheimer's disease is driven by diet," said the study's lead author Richard Johnson, MD, professor at the University of Colorado School of Medicine specializing in renal disease and hypertension. The study co-authors include Maria Nagel, MD, research professor of neurology at the CU School of Medicine.

Johnson and his team suggest that AD is a harmful adaptation of an evolutionary survival pathway used in animals and our distant ancestors during times of scarcity.

"A basic tenet of life is to assure enough food, water and oxygen for survival," the study said. "Much attention has focused on the acute survival responses to hypoxia and starvation. However, nature has developed a clever way to protect animals before the crisis actually occurs."

When threatened with the possibility of starvation, early humans developed a survival response which sent them foraging for food. Yet foraging is only effective if metabolism is inhibited in various parts of the brain. Foraging requires focus, rapid assessment, impulsivity, exploratory behavior and risk taking. It is enhanced by blocking whatever gets in the way, like recent memories and attention to time. Fructose, a kind of sugar, helps damp down these centers, allowing more focus on food gathering.

In fact, the researchers found the entire foraging response was set in motion by the metabolism of fructose whether it was eaten or produced in the body. Metabolizing fructose and its byproduct, intracellular uric acid, was critical to the survival of both humans and animals.

The researchers noted that fructose reduces blood flow to the brain's cerebral cortex involved in self-control, as well as the hippocampus and thalamus. Meanwhile, blood flow increased around the visual cortex associated with food reward. All of this stimulated the foraging response.

"We believe that initially the fructose-dependent reduction in cerebral metabolism in these regions was reversible and meant to be beneficial," Johnson said. "But chronic and persistent reduction in cerebral metabolism driven by recurrent fructose metabolism leads to progressive brain atrophy and neuron loss with all of the features of AD."

Johnson suspects the survival response, what he calls the `survival switch,' that helped ancient humans get through periods of scarcity, is now stuck in the `on' position in a time of relative abundance. This leads to the overeating of high fat, sugary and salty food prompting excess fructose production.

Fructose produced in the brain can lead to inflammation and ultimately Alzheimer's disease, the study said. Animals given fructose show memory lapses, a loss in the ability to navigate a maze and inflammation of the neurons.

"A study found that if you keep laboratory rats on fructose long enough they get tau and amyloid beta proteins in the brain, the same proteins seen in Alzheimer's disease," Johnson said. "You can find high fructose levels in the brains of people with Alzheimer's as well."

Johnson suspects that the tendency of some AD patients to wander off might be a vestige of the ancient foraging response.

The study said more research is needed on the role of fructose and uric acid metabolism in AD.

"We suggest that both dietary and pharmacologic trials to reduce fructose exposure or block fructose metabolism should be performed to determine if there is potential benefit in the prevention, management or treatment of this disease," Johnson said.

https://www.sciencedaily.com/releases/2023/02/230213113345.htm

Mushrooms magnify memory by boosting nerve growth

February 10, 2023

Science Daily/University of Queensland

Researchers from The University of Queensland have discovered the active compound from an edible mushroom that boosts nerve growth and enhances memory.

Professor Frederic Meunier from the Queensland Brain Institute said the team had identified new active compounds from the mushroom, Hericium erinaceus.

Researchers have discovered lion's mane mushrooms improve brain cell growth and memory in pre-clinical trials. 

"Extracts from these so-called 'lion's mane' mushrooms have been used in traditional medicine in Asian countries for centuries, but we wanted to scientifically determine their potential effect on brain cells," Professor Meunier said.

"Pre-clinical testing found the lion's mane mushroom had a significant impact on the growth of brain cells and improving memory.

"Laboratory tests measured the neurotrophic effects of compounds isolated from Hericium erinaceus on cultured brain cells, and surprisingly we found that the active compounds promote neuron projections, extending and connecting to other neurons.

"Using super-resolution microscopy, we found the mushroom extract and its active components largely increase the size of growth cones, which are particularly important for brain cells to sense their environment and establish new connections with other neurons in the brain."

Co-author, UQ's Dr Ramon Martinez-Marmol said the discovery had applications that could treat and protect against neurodegenerative cognitive disorders such as Alzheimer's disease.

"Our idea was to identify bioactive compounds from natural sources that could reach the brain and regulate the growth of neurons, resulting in improved memory formation," Dr Martinez-Marmol said.

Dr Dae Hee Lee from CNGBio Co, which has supported and collaborated on the research project, said the properties of lion's mane mushrooms had been used to treat ailments and maintain health in traditional Chinese medicine since antiquity.

"This important research is unravelling the molecular mechanism of lion's mane mushroom compounds and their effects on brain function, particularly memory," Dr Lee said.

https://www.sciencedaily.com/releases/2023/02/230210115544.htm