HEALTH&CARE Journal 2025 Summer/Fall

Over 25% of Adults 60+ Have Heart Valve Disease

Women's Health Study Supports Hormone Replacement Therapy in Early Menopause

Dr. Brian Peterson, MD, FACS, FSVS Vascular Surgeon at St. Luke’s Heart & Vascular Institute

Publisher Editor

Todd Abrams Design Art Direction Production

Michael Kilfoy Studio X Printing

Walsworth Fulton Advisory Board

Dr. Donald Bassman

Dr. Joshua Cohen

Dr. Shaun Donegan

Katy Dowd

Robert Fruend

Joel Iskiwitch

Dr. James Jenkins

Dr. Steve Lauter

Catina O’Leary, PhD

Dr. Harvey Serota

Mark Tucker

Healthy Humor

Charles Barsotti

Welcome to the Summer/Fall 2025 Issue of HEALTH&CARE® Journal

Our mission is to provide information, understanding and confidence to help you make health decisions for yourself and your family.

Each issue has relevant, up-to-date articles about many important health discoveries from experts locally, nationally and internationally.

Some highlights in this issue include:

In The Patient’s Advocate on page 8 Jane Tucker talks about being inspired by and inspiring others on her health care journey.

In Cardiovascular Health beginning on page 12 you can read the cover story, “Pioneering Stroke Prevention Surgery Performed at St. Luke’s Hospital,” about Dr. Brian Peterson and his team. Also, articles about the risks to the heart from anger and fatty muscles.

In Cancer Treatment and Prevention, page 19 there are new discoveries for some unexpected ways to help reduce a variety of cancer risks.

You will also find interesting and useful news in the sections Better Breathing, Aches & Pains, Women’s Health, Aging & Caregiving, Mental Health and Kid & Teen Health. And a review of the new book Blind Spots by Dr. Marty Makary, as well as Healthy Humor on page 50.

Please page through this issue and help yourself to information that can enable you to realize better health for yourself and your loved ones.

Please leave this magazine for another reader! You can get your own free digital subscription at the links below. And let us know what you think about the magazine and other information that would be helpful. You can contact us at www.healthandcareSTL.com.

Todd Abrams Publisher toddabrams1@gmail.com

Summer/Fall 2025

6 Health Briefs

8 The Patient’s Advocate

Cardiovascular Health

10 Over a Quarter of ‘Healthy’ Folks Age 60+ Have Heart Valve Disease

12 COVER STORY: Pioneering Stroke Prevention Surgery Performed at St. Luke’s Hospital

14 How Anger Could Raise Your Heart Risks

15 Fatty Muscles and Heart Disease

16 Fainting: Simple Tips to Stay Safe

18 Everything You Need to Know About Stroke Symptoms

Cancer Prevention & Treatment

19 Why Does Cancer Spread to the Lungs So Often?

20 The Pill Protects Against Ovarian Cancer

21 Daily Aspirin Reduces Colon Cancer Risk

22 Diabetes Drug Protects Against Skin Cancer, New Research Says

23 Fitter Folks Have Better Odds Against Cancer

Better Breathing

24 Pollen Allergies: Understanding and Managing Seasonal Symptoms

28 The 2024-25 Flu Season Was the Worst in 15 Years Aches & Pains

30 Chronic Joint Pain Plus Depression Can Take Toll on the Brain

32 My Journey with Rheumatoid Arthritis by Bill Eastman

33 Best Foot Forward: Tips for Keeping Feet Healthy and Reducing Pain

Women’s Health

34 Major Study Supports Hormone Replacement Therapy in Early Menopause

36 Can You Rely on Your Mammogram to Identify Heart Disease Risk?

Aging & Caregiving

38 America’s Health System Isn’t Ready for the Surge of Seniors with Disabilities

40 Preparing to Hang Up the Car Keys as We Age

Mental Health

42 ‘News Addiction’ Is Common and Can Harm Your Mental Health

43 Nearly 1 in 3 U.S. Adolescents Are Getting Mental Health Treatment

44 Most U.S. Adults Want to Be Asked About Mental Health at Primary Care Visits

45 Wildfire Smoke Increases Risk of Mental Health Problems

HEALTH&CARE JOURNAL ® is published quarterly by Healthcom Network LLC and distributed to Missouri and Illinois healthcare locations in the St. Louis Metro area. Article topics are chosen to provide readers with helpful information about health and care topics of interest.

Opinions expressed in articles and editorials are those of the authors, and do not necessarily reflect the views of Healthcom Network. While every effort is made to assure accuracy, we are not responsible for how information found in HEALTH&CARE Journal is used. Readers are encouraged to consult with their healthcare providers for advice about their own health and care. We are very interested in hearing from readers about content in this magazine, and about topics they would like covered. Correspondence should be sent to the address below or to editor@healthandcarestl.com

Reproduction of content of this magazine without permission is prohibited. All submitted materials, including images, logos and text for advertising, articles and editorials are assumed to be the property of the contributor, and Healthcom Network does not take responsibility for unintentional copyright infringement. Healthcom Network has the right to refuse advertising and content not deemed appropriate for this publication.

Kid & Teen Health

46 Too Many After-School Programs Can Harm Teens’ Mental Health

47 Preschool BMI Can Predict Childhood Obesity Risk

48 Kids’ Fitness Also Improves Their Mental Health

49 Social Media Use Linked to Eating Disorders in Kids and Young Teens

50 Book Review

For information regarding advertising opportunities in HEALTH&CARE Journal, use the QR code at left.

Or call, write or email Todd Abrams, publisher: HealthCom Network

P.O. Box 411036

St. Louis, MO 63141

toddabrams1@gmail.com 314-443-3024

HEALTH&CARE is a registered trademark with the US Patent and Trademark Office

Association of Health Care Journalists

Health Briefs

U.S. adults give health care system a 'D' for handling mental health

Three-quarters of U.S. adults believe mental health issues are identified and treated worse than physical health issues, according to the results of a survey.

West Health and Gallup

30 minutes of aerobic exercise weekly cuts body fat in overweight or obese adults

A half-hour weekly session is associated with moderate reductions in body weight, waist circumference, and body fat measures, according to a review published online in December. Modestly increased physical and mental aspects of quality of life also were seen in association with aerobic exercise.

JAMA Network Open

Cutting screen time boosts mental health in children and teens

Short-term reduction in leisure-time screen media use within families positively affects psychological symptoms in children and adolescents, according to a study published last July.

JAMA Network Open

Making up for lost sleep on the weekend may lower your risk of heart disease

Inadequate shut-eye has been linked to conditions such as coronary artery disease, atrial fibrillation and stroke. If sleep is a luxury on busy weekdays, catching up on the weekend may be a lifesaver. A new study finds sleep-deprived adults who get the most catch-up sleep on the weekend are 20% less likely to develop heart disease.

Eating a hearty breakfast lowers depression risk in heart patients

The researchers say there’s growing evidence linking heart disease with depression and dietary factors have been shown to play an important role. The results showed people who consumed the most calories at breakfast (791 on average) were 30% less likely to develop depression compared to those ate the skimpiest morning meals (about 88 on average).

BMC Psychiatry

Risk for Head and Neck Cancer Lower for Coffee and Tea Drinkers

More than four cups of caffeinated coffee daily are inversely associated with HNC, oral cavity cancer, and oropharyngeal cancers. The odds ratios for HNC and its subsites were examined, adjusting for sociodemographic and lifestyle factors.

Being optimistic may help you save money

Looking on the bright side may do more than lift your mood. It could also help you save money, especially if you're on a tight budget. A study published recently found that people who are more optimistic tend to save more money over time, even after accounting for income, personality traits and financial literacy.

Journal of Personality and Social Psychology

Alcohol-associated liver disease up in older U.S. adults

Despite global decreases, the prevalence of and mortality from alcohol-associated liver disease (ALD) and alcohol use disorder (AUD) increased among older U.S. adults in the years 2010-2019. Nearly half of U.S. states showed a rise in mortality from alcohol-associated cirrhosis.

American Assn. for the Study of Liver Diseases

About half of all people with glaucoma don't even know they have it

If you get a glaucoma test and start treatment early, you may protect your eyes from serious vision loss. Medicare covers a glaucoma screening once every 12 months if you're at high risk for developing glaucoma.

Acta Ophthalmologica

On Your Healthcare Journey: Be Inspired by,

By Jane Tucker

OK… let’s be honest! How many times a year do you meet someone or go out for dinner with friends and bore the socks off everyone when you repeat the saga of your knee replacement or your list of meds or how many hours you were in the ER and the tests they ran on you until 3 am?

It’s still a new year and I’m suggesting you talk a little less and listen a lot more. Use the time in the hospital waiting room or doctor’s office normally spent on the phone and strike up a conversation with the person next to you. Everyone has a story.

I’m not suggesting you pry into diagnoses, prognosis or medical complications. Those are personal or confidential. But everyone has an interesting story about how they ended up here or who helped them along the way.

Ask the guy next to you how he broke his foot. Ask the nurse about how she handles the snowstorms and makes it into the office. Ask the technicians why they like their job and what’s the most remarkable thing they’ve learned from patients.

and

Inspire, Others

entertain friends at the next get-together. I think that if we all stop and pay attention to the people we meet, the rewards are numerous. You might learn of things that make your journey easier. Or you might hear something so inspirational it might have an impact on the rest of your life. Or it might simply affirm that what you’re feeling or fearing is common among all patients.

It might be a simple “what did you learn from having a heart attack” or a broken leg? Or…maybe it’s a question about what humorous event has happened during your treatment? Maybe your reward is good, practical knowledge you can use, or just a story that puts a smile on your face.

even though she thought she might be having a heart attack (she was). The patient next to me last week drives 3 hours each way twice a month for treatment. The guy across from me brings a fellow church member into town once a week for treatment, even though he hardly knows him. Oh… they have lunch at Cracker Barrel after each treatment.

My favorite story is about a farmer who has a thousand-acre farm 150 miles from our hospital. He needed to be in a study that would take so much time he’d have to abandon his farming for the harvest season. It was going to be a financial calamity for him, but one day, coming home from his three-hour drive after treatment he pulled into his drive and saw 15 tractors harvesting his crops. His neighbors, unbeknownst to him, had decided they were going to harvest his crops for him and save him financially. Talk about heroes!

This last snowstorm I found out that the woman that draws my blood slept at the hospital for three days so her patient could count on her. And a doctor who braved the snow and ice to see one patient. Heroes, yes…. you won’t know how many heroes are out there until you look around.

If the stranger next to you begins a conversation about their medical issues, how can you move it into something interesting? How can you dig deeper and find out if there’s a hero in their story? Who went beyond the call of duty to be of help? Who brings them to the doctor’s office four times a month? What remarkable talent does the doctor have? Do they have a favorite technician who always takes their blood? How did that person next to you handle Covid?

There are plenty of heroes out there. Look, I’m not suggesting you do this so you can

Let’s not overlook what your interest in someone’s experience means to them. Everyone wants to feel they have something to contribute. What better way to help someone feel good than by noticing them?

I’ve been a cancer patient going on 26 years. I have heard plenty of stories. If I had to pick one thing more impactful than treatment it would be the people that I’ve met along the way. From college students to grandparents, from scientists to the people that brought me snacks and the people that clean my room or take my blood. Listening rather than crying, smiling back rather that looking away has done more for me than anything. Here are a few….

My mother-in-law went to pick up bagels

I once had to go to the ER because I dropped a bowl of hot soup down my shirt. My husband had to go to the ER because he sealed his arms while trying to seal the driveway. Different ERs, but the same levels of laughter.

So, here’s an assignment: start to gather stories of bravery, stories of gratefulness, stories of generosity, stories of loyalty, serious stories, humorous stories, stories that make you cry or laugh or feel pride. Maybe even stories about you. And the next time you have your bridge club, your pizza night with friends or go for coffee or dinner with friends, tell them these stories. You might get more interest and you, for sure, will feel better.

Over a Quarter of ‘Healthy’ Folks Over 60 Have Heart Valve Disease

Heart valve disease is much more common in aging adults that has been thought, a new study warns.

More than a quarter of healthy and symptom-free people aged 60 and older had previously undetected heart valve disease, researchers report.

“Our findings showed that more than 28% of these adults had some form of heart valve disease, although reassuringly it was only mild in the majority of the cases,” said lead researcher Vassilios Vassiliou, a clinical professor of cardiac medicine with the University of East Anglia’s Norwich Medical School in the U.K.

“The data also indicated that age was the main factor associated with these heart valve problems, meaning that the older a person is, the higher their chance of having a significant valve issue,” Vassiliou said in a university news release.

Blood is meant to flow through the heart in one direction. Valves inside the heart keep blood from flowing back between beats, ensuring optimal function.

The four heart valves

The tricuspid valve has three leaflets or cusps. It separates the top right chamber (atrium) from the bottom right chamber (ventricle). It opens to allow blood to flow from the right atrium to the right ventricle, and prevents the back flow of

blood from the right ventricle to the right atrium.

The pulmonary valve has three leaflets and separates the right ventricle from the pulmonary artery. It opens to allow blood to be pumped from the right ventricle to the lungs through the pulmonary artery, where it will receive oxygen. The pulmonary valve also prevents the back flow of blood from the pulmonary artery to the right ventricle.

The mitral valve has two leaflets and separates the top left chamber (atrium) from the bottom left chamber (ventricle). It opens to allow blood to flow from the left atrium to the left ventricle and prevents the back flow of blood from the left ventricle to the left atrium.

The aortic valve has three leaflets, unless it is abnormal from birth, such as a bicuspid aortic valve. It separates the left ventricle from the aorta, and opens to allow blood to leave the heart from the left ventricle through the aorta and into the body. It prevents the backflow of blood from the aorta to the left ventricle.

Heart valve disease

Heart valve disease occurs when one or more of the heart valves malfunctions, either by not opening fully to let enough blood through or by not closing properly, which allows blood to leak back in the wrong direction.

“These problems can put extra strain on the heart and make the heart work harder,” said co-lead researcher Michael Frenneaux, of the Royal Brompton Hospital in the U.K. “Over time, it can increase the risk of having a heart attack, stroke and other heart conditions.”

Symptoms of heart valve disease can include breathlessness, chest pain, weakness, dizziness, fatigue, swollen ankles and feet, or chest or neck palpitations, researchers said.

For the new study, researchers evaluated more than 4,200 UK residents aged 60 and older who had not been diagnosed with heart valve disease.

The participants filled out a health questionnaire, then underwent a clinical exam and an ultrasound reading of their hearts. Heart valve disease was found in 28% of them, although moderate to severe disease was found in only 2.4%, results show.

One in every 42 of those 60 and older had undiagnosed valve disease, researchers estimated. That goes up to one in 15 for those 75 and older.

Diagnosing heart valve disease

The diagnosis of valve disease relies heavily on heart ultrasound exams, but those are “normally only carried out if symptoms are reported or if an unusual murmur is heard during a physical examination,” Vassiliou said.

“This can be challenging in the elderly because mild symptoms may be masked by reduced physical activity and impaired mobility,” Vassiliou added.

“This study reveals that many older adults have heart valve issues, even if they don't show any symptoms, and we would suggest that if people do develop any new symptoms or signs that could indicate heart disease to discuss this with their doctor,” Vassiliou said.

Further studies are needed to figure out the exact prevalence of heart valve disease in the elderly, as well as better screening methods to accurately identify and manage the disease.

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Pioneering Stroke Prevention Surgery Performed at St. Luke’s Hospital

Strokes are the fifth leading cause of death in the US and a leading cause of disability. Most strokes are caused by blockage of a blood vessel in the brain. About 30% are blockages in the carotid artery that carries oxygenated blood to the head and neck.

The risks

Carotid artery stenosis or narrowing of the carotid artery due to the buildup of fatty deposits called plaque, puts a patient at risk of stroke due to the reduced blood flow. At highest risk of stroke are those with high blood pressure, high cholesterol, diabetes, cigarette smokers, or a family history of heart disease or peripheral artery disease.

The standard treatment since the 1950s has been carotid endarterectomy, open

surgery in which the patient is given blood thinners, the surgeon cuts into the artery, splays it open and scrapes and flushes out plaque.

An alternative, minimally invasive procedure is carotid artery stenting where a stent is placed in the carotid artery and a balloon opens it up to create a channel for improved blood flow, pushing plaque against the walls of the artery. It had been used primarily to treat high-risk patients, those with severe heart disease, lung disease or other conditions that make open surgery more difficult and riskier.

An added risk during the stenting procedure approached through the groin or wrist is pieces of plaque that can break off and flow up to the brain, which could cause a stroke during surgery.

The TCAR Enroute® Neuroprotection System

Trans Carotid Artery Revascularization (TCAR) is a distinct hybrid approach to carotid stenting that uses a small incision at the base of the neck. In addition to inserting a stent in the artery, TCAR Enroute® Neuroprotection System employs a tube to reverse blood flow during the ballooning and stenting procedure. Blood is drawn down through a loop out of the body, diverting any debris that breaks off during the procedure from traveling up to the brain. The blood is filtered before being returned through the groin. Once the stent is in place the tubes and filter are removed. During the procedure blood still reaches the brain through other blood vessels.

Expertise at St. Luke’s

Dr. Brian Peterson, MD, FACS, FSVS, a vascular surgeon at St. Luke’s Heart and Vascular Institute, is a world-wide leader in TCAR surgery, having performed over 550 of the procedures. In 2024 he performed the world’s first TCAR surgery using the Enroute® TCAR PLUS.

This next generation device from Silk Road Medical builds upon the prior TCAR Enroute System to deliver smoother arterial sheath insertion for delivery of the stent, greater blood flow precision, and a simplified prep experience for surgical teams, all while maintaining unparalleled neuroprotection with TCAR. The stent is

made from a metal called nitinol, an alloy of titanium and nickel, and is designed to last a lifetime.

Dr. Peterson and St. Luke’s were chosen by Silk Road to pioneer the Enroute TCAR PLUS because of the volume of TCAR procedures they have performed and their excellent outcomes. The dedicated team of vascular nurses and other support specialists have shown very low risk of strokes during the procedures.

The TCAR procedure was initially used just for the “sickest of the sick” high-risk patients who would not be able to tolerate carotid endarterectomy open surgery. But because it is less invasive, it has been found to be tolerated much better than open surgery.

There are some patients with anatomical features that make carotid endarterectomy open surgery necessary, such as those with excessive buildup of plaque at the point where the incision would need to be made for revascularization stenting.

Saving time and risk

The newest procedure takes about 45 minutes, vs. an hour and a half to two hours for open surgery. And the risk of a stroke during the procedure goes down from 2% to just 0.6%. These factors make TCAR less burdensome on the surgery workforce. The surgery is less invasive, so recovery is also much quicker. Dr. Peter-

son reports that well over 90% of patients go home the morning after surgery and return to their routine lives right away with very little pain. His team has not seen recurrence of restricted blood flow following the procedure.

These comparative results from TCAR in treating patients with carotid artery disease are so compelling that Medicare has now approved it for standard risk patients. Two-thirds of TCAR procedures at St. Luke’s are performed on patients with carotid artery disease and who have had symptoms such as mini-stroke or TIAs - transient ischemic attacks, short periods of symptoms similar to those of a stroke, typically caused by a brief blockage of blood flow to the brain. The balance of patients have carotid artery disease, but no symptoms.

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Dr. Peterson concludes, “Outcomes are so positive that TCAR will become the first line treatment for carotid artery disease. It’s hard to argue with success.”

Dr.

Brian Peterson, MD, FACS, FSVS

How Anger Could Raise Your Heart Risks

Feeling angry constricts blood vessels in unhealthy ways and could raise a person’s long-term odds for heart disease.

“If you’re a person who gets angry all the time, you’re having chronic injuries to your blood vessels,” said study leader Dr. Daichi Shimbo, a cardiologist at Columbia University Irving Medical Center in New York City. His team conducted experiments where the activity of blood vessels was monitored while people were in angry states versus states of anxiety, sadness or neutral emotions.

They found that an angry state of mind was tied to a temporary inability of the blood vessels to dilate (relax) as they should. These effects lasted up to 40 minutes after the angry outburst was over.

tions and Prevention Branch of the National Heart, Lung, and Blood Institute (NHLBI), which funded the study.

The research “also opens the door to promoting anger management interventions as a way to potentially help stave off heart disease, the leading cause of death in this country.”

“We’ve long suspected, based on observational studies, that anger can negatively affect the heart.”

– Laurie Friedman Donze

“We’ve long suspected, based on observational studies, that anger can negatively affect the heart. This study in healthy adults helps fill a real knowledge gap and shows how this might occur,” said Laurie Friedman Donze. She’s a psychologist and program officer in the Clinical Applica-

The study was published in mid-2024 in the Journal of the American Heart Association and involved 280 healthy adult New York City residents under the age of 74. The group skewed young – averaging 26 years of age

– and had no history of heart disease or major heart risk factors such as hypertension, high cholesterol or diabetes.

All of the participants were monitored for blood vessel changes in their dominant arms and then asked to engage in very personal eight-minute talks or readings that elicited various emotional states –

anger, sadness, anxiety or no heightened emotion at all (the control group).

Shimbo’s group found that healthy blood vessel dilation was inhibited when folks were angry. A brief provocation of anger has an adverse effect on the health of endothelial cells, the single layer of cells that lines the inner surface of blood and lymphatic vessels. These cells play a crucial role in maintaining blood vessel function, regulating blood flow, clotting and inflammation.

This effect wasn’t observed among people in states of either anxiety or sadness, the team noted.

The researchers noted this buildup impaired dilation is often a precursor to a dangerous buildup of fat on artery walls, known as atherosclerosis. That can raise the odds for heart attack and stroke.

“It’s these chronic [anger-linked] injuries over time that may eventually cause irreversible effects on vascular health and eventually increase your heart disease risk," Shimbo said in an NHLBI news release.

He said it's not yet clear how anger impairs blood vessel dilation. Perhaps it activates the autonomic nervous system, stress hormones or inflammation of the arteries, Shimbo said. Only further research can reveal exact mechanisms, he added.

"An implication of these findings is that the contribution of a biological mechanism that increases cardiovascular disease risk may differ across core negative emotions," the authors write. Could positive emotional states, like joy or laughter, counter the ill effects of anger on the heart? Further research could elucidate that question, as well.

In the meantime, anger management is always a good idea for mental and physical health, the team said. Exercise, yoga, deep breathing and cognitive behavioral therapy (CBT) are all potential pathways to a less rage-filled life, Donze said.

Source: National Heart, Lung, and Blood Institute

More information

Find out more about managing your anger at the American Psychological Association.

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Fatty Muscles Increase Heart Disease Risk

People with pockets of fat hidden within their muscles have a higher risk of dying from heart-related health problems, researchers reported in a study published this year in the European Heart Journal.

For every 1% increase in fatty deposits in muscle, there was a 7% increased risk of heart-related death, heart attack or heart failure, researchers found.

“Knowing that intermuscular fat raises the risk of heart disease gives us another way to identify people who are at high risk, regardless of their body mass index,” senior researcher Dr. Viviany Taqueti, director of the Cardiac Stress Laboratory at Brigham and Women’s Hospital in Boston, said in a news release.

For the study, researchers performed imaging scans on nearly 670 patients being evaluated for chest pain or shortness of breath. CT scans were used to assess how well the patients’ hearts were functioning, and also measured the amounts and location of fat and muscle in their torso.

“Intermuscular fat can be found in most muscles in the body, but the amount of fat can vary widely between different people,” Taqueti said.

The patients then were followed for about six years to see whether they died or were hospitalized for a heart attack or heart failure. It turned out that people with more fat in their muscles were more likely to suffer damage to the tiny blood vessels that serve the heart, a condition called coronary microvascular dysfunction (CMD).

People who had high levels of fatty muscle and evidence of CMD were at especially high risk of death, heart attack and heart failure. People with higher amounts of lean muscle had lower risk, and fat stored under the skin did not increase risk.

“Fat stored in muscles may be contributing to inflammation and altered glucose metabolism leading to insulin resistance and metabolic syndrome,” Taqueti said.

“In turn, these chronic insults can cause damage to blood vessels, including those that supply the heart, and the heart muscle itself,” Taqueti added.

Unfortunately, it’s not yet known how to lower heart risk for people with fatty muscle, Taqueti said. “For example, we don’t know how treatments such as new weight-loss therapies affect fat in the muscles relative to fat elsewhere in the body, lean tissue, and ultimately the heart,” Taqueti said.

Source: European Heart Journal, news release, 2025

Fainting: Simple Tips to Stay Safe

Fainting can be scary, but it's often harmless.

Known medically as syncope, fainting happens when there’s not enough blood flow to the brain, causing a brief loss of consciousness. But how do you know if it's just a simple faint or something more serious? Dr. Elijah Behr, a cardiologist at Mayo Clinic Healthcare in London, shares five key facts about fainting: what causes it, how to prevent it and when to see a doctor.

Most fainting is harmless, but not always

The most common type of fainting is vasovagal syncope, often triggered by emotional stress, pain, illness or dehydration.

“In some people, if they have a drop in blood pressure from emotional distress, pain, illness or dehydration, for example, or just generally have a low blood pressure, any provocation causes a reflex in the heart,” Dr. Behr explained in a news release.

“Rather than the heart speeding up and pumping more forcefully to maintain the blood pressure, it starts to slow down. The blood pressure drops, the heart rate slows further, and the heart can pause for many seconds; sometimes close to a minute for some people who have more severe fainting episodes.”

While simple fainting usually resolves quickly, cardiac syncope – caused by an underlying heart problem – can be more serious.

“This is usually a more abrupt loss and return of consciousness than in simple fainting. If you're older, you're more likely to have underlying heart disease that you may or may not be aware of. That's one of the reasons to be more concerned about loss of consciousness in older individuals,” Behr explained.

“Young people can also have heart diseases that can cause cardiac syncope that may be a warning sign of something more serious to come, so it is important to investigate it.”

Warning signs

Fainting often comes with early warning signs:

n Lightheadedness

n Nausea

n Buzzing in the ears

n Tunnel vision or temporary vision loss

n Sweating and clamminess

Some people get these warnings 30 minutes before fainting, while others have just 30 seconds to react, Behr added.

What to do if you feel faint

“If your blood pressure is getting low and you're getting those symptoms, it means the blood doesn't get into your brain, and if your heart is trying to push the blood to your brain against gravity, then it's struggling. You really need to get your head level or below your heart so the blood pressure gets back to the brain, and that will avert all the symptoms and the vicious cycle that ensues,” Behr explained.

“Get your head between your knees or lie down and put your head down and your feet up in the air, depending on where you are and what is feasible to do.”

Key steps if you or someone else faints:

n Check for breathing and a pulse. If absent, start CPR and call for help

n Lay the person flat and open the airway

n Rest after fainting and drink water, preferably with electrolytes if dehydrated

Getting up and walking around straight away is probably the worst thing to do, Behr warned.

When to see a doc

Most simple fainting doesn’t require emergency care.

“If somebody has had simple fainting with the clear precipitants that I described, it is best to have a chat with your GP (your primary care physician) to talk about it. Particularly if it's a first onset of symptoms, it's best not to ignore it,” Behr added.

“Often people go to the emergency department after a first faint, which I think is very fair to do and I would encourage.”

Seek medical help if:

n You faint while exercising

n You have heart palpitations

n There’s a family history of sudden death or heart problems

n You faint without warning or get injured during a fall

Can fainting be prevented?

“For general preventive measures, we advise most people who have fainted to drink more water and to sometimes add a bit of salt to their food, because generally they're running a low blood pressure,” Behr said.

“For those who faint at the sight of blood, cognitive behavioral therapy (CBT) may help overcome the reaction,” Behr also added.

If you faint often or without warning, talk to your doctor – it might signal a heart issue.

More information

The Cleveland Clinic has more on causes and first aid tips for fainting.

Source: Mayo Clinic, news release, Feb. 18, 2025

Everything You Need to Know About Stroke Symptoms

By Carolyn D. Brockington, MD

Astroke is an injury to the brain caused by an interruption in blood flow from a vessel blockage, blood clot or vessel rupture. There are two main types of strokes: ischemic stroke and hemorrhagic stroke.

Ischemic stroke

The most common type of stroke is called an ischemic stroke, or your doctor may say “ischemic infarct (stroke).” Ischemia means lack of blood supply, which may result in tissue damage because of the lack of oxygen and nutrients. Therefore, an ischemic stroke is caused by an interruption of blood flow to the brain from a blocked blood vessel due to plaque (buildup of fatty deposits) or a blood clot.

Once the blood vessel is blocked, it is like clogged plumbing. If blood cannot get to the brain for a period of time, that region of the brain becomes injured, resulting in a stroke that produces symptoms.

Hemorrhagic stroke

The other type of stroke is called a hemorrhagic stroke and accounts for approximately 10-15% of all strokes. Hemorrhage is defined as acute loss of blood from a damaged blood vessel. In this case, a blood vessel in the brain leaks or breaks open, spilling blood into the brain and resulting in injury and producing symptoms.

How can I recognize symptoms of a stroke?

The signs and symptoms of a stroke are related to how the brain is organized. Since the left side of the brain controls the right side of the body and the right brain controls the left side of the body, the symptoms occur suddenly and typically involve one side of the body. Because it is impossible to predict which part of the brain may be involved with a stroke, a range of symptoms are possible, including:

n Numbness or weakness of face, arm or leg, especially on one side of the body

n Confusion, trouble speaking or understanding speech

n Trouble seeing in one or both eyes

n Trouble walking, dizziness, loss of balance or coordination

n Severe headache with no known cause

It is extremely important to know the signs and symptoms of a stroke.

To help remember the symptoms of a stroke, it helps to know the acronym BE FAST.

B is for BALANCE. Sudden loss of balance or coordination.

about treatment: There is now effective treatment to try to reduce the risk of a significant stroke and permanent disability. Treatment opportunities are time-dependent though, so if anyone develops signs and symptoms of a stroke, 911 should be called immediately to ensure the person is taken to the closest emergency department for a rapid assessment and appropriate treatment.

What happens when you call 911 for stroke symptoms?

E is for EYES. Sudden blurred, double vision or loss of vision.

F is for FACE. Sudden face drooping or numbness.

A is for ARM. Sudden weakness or numbness of the arms or legs on one side of the body.

S is for SPEECH. Sudden slurred speech, inability to speak or difficulty to understand.

T is for TIME. A stroke is an emergency, so call 911 immediately.

Is a stroke an emergency?

Yes, a stroke is considered an emergency. The saying “time is brain” highlights the importance of a prompt assessment and treatment to try to prevent irreversible injury to the brain. As every minute goes by without the brain getting the appropriate blood, 1.9 million brain cells die, resulting in permanent injury and potential disability.

As the Director of the Stroke Center at Mount Sinai West and Mount Sinai Morningside, I can share some good news

When someone calls 911 and says, “I’m having a stroke,” the call is treated as an emergency, and the emergency medical service (EMS) team is mandated to take the person to the closest emergency department with a specialized team to care for stroke patients. In the emergency room, a series of tests and assessments need to be performed to determine whether a specific patient is eligible for acute stroke therapy. Depending on several factors—including the time the symptoms began, medical history and the results of testing—doctors may be able to administer certain therapies, including a powerful intravenous blood thinner to improve blood flow to the brain.

On some occasions, specialized physicians may determine it is necessary to go into the artery to remove the blockage and improve blood flow to the brain. The procedure is an endovascular intervention (in the blood vessels) and is performed using a cerebral (brain) angiogram.

An angiogram is a diagnostic procedure that allows the creation of images of the blood vessels (like a map) using X-rays. By using the map, a catheter can traverse the arteries to the point of the blockage with the goal of unblocking the clogged artery by pulling out the blood clot.

Successful treatment of stroke patients requires a multidisciplinary team with specialized skills to diagnose and treat patients rapidly to improve the chances of a good outcome.

Why Does Cancer Spread to the Lungs So Often?

Dennis Thompson

The lungs are a tempting place for cancer cells – so much so that more than half of people with advanced cancer elsewhere in their bodies wind up with lung tumors.

Researchers now think they know why.

Elevated levels of an amino acid called aspartate appear to allow cancer cells to grow more easily inside the lungs, researchers reported in a study published Jan. 1 in the journal Nature.

“We found high levels of aspartate in the lungs of mice and patients with breast cancer compared to mice and patients without cancer, which suggests that aspartate may be important for lung metastasis,” lead researcher Ginevra Doglioni, a doctoral student with the Flemish Institute for Biotechnology’s Center for Cancer Biology in Belgium, said in a news release from the college.

For the study, researchers examined the

genetic activity of tumor cells taken from aggressive lung cancers.

They found that aspartate – an amino acid used to make proteins in the body – appeared to trigger gene activity that results in higher cancer aggressiveness and more risk for lung tumors.

Essentially, aspartate activates a surface protein on cancer cells that results in a gene signaling cascade. This cascade of activity enhances the ability of cancer cells to alter their environment and make it more suitable for aggressive growth. These findings could help doctors keep the lungs cancer-free, even in advanced cases where cancer is spreading to other parts of the body, researchers explained.

The research team also noted that drugs are already on the market that target the processes which appear to make lungs more cancer-prone.

“There are drugs available to target the mechanism we identified and thus with further research a translation toward a clinical setting might be possible,” senior researcher Sarah-Maria Fendt, a principal investigator with the Flemish Institute for Biotechnology’s Center for Cancer Biology, said in a news release.

What This Means For You

Key Takeaways

n An amino acid appears to make the lungs more likely to have cancer spread to them from elsewhere in the body

n Aspartate triggers a genetic cascade that helps cancer grow aggressively

n Drugs that block this action could protect the lungs

Aspartate appears in very low levels in the bloodstream, but it showed up in very high concentrations in the lungs of mice with advanced breast cancer, results show. Researchers noted a similar process when examining human lung tumor samples, results show.

Drugs already on the market might be able to protect the lungs from developing tumors caused by cancers elsewhere in the body.

More information

The National Cancer Institute has more on advanced cancer.

Source: Flemish Institute for Biotechnology, news release, Jan. 2, 2025

The Pill Protects Against Ovarian Cancer

The Pill prevents pregnancy –and maybe ovarian cancer, too, a new study suggests.

Women who have ever used the contraceptive pill have a 26% lower risk of ovarian cancer, researchers say. Women who used the pill after age 45 benefit even more, with a 43% lower risk of ovarian cancer, according to findings published in the International Journal of Gynecological Cancer. The effect of ovulation

The hormones in the birth control pill work in part by stopping or reducing ovulation, the process by which eggs are released from the ovaries.

“This poses the question as to whether interventions that reduce the number of ovulations could be used as a potential target for prevention strategies for ovarian cancer,” investigator Amanda Lumsden, a research fellow with the University of South Australia, said in a news release. The findings are in line with a theory of ovarian cancer first floated in 1971 which argued that “incessant ovulation” might promote the growth of abnormal pre-cancerous cells, researchers noted.

Other mammals only ovulate during breeding seasons, and ovarian cancer is

rare among these species, the theory holds.

than 90% for ovarian cancers that are caught early,” she continued. “That’s why it’s so important to identify risk factors.”

For the study, researchers analyzed data on more than 221,000 women participating in the UK Biobank, a long-term health research project. During a follow-up of nearly 13 years, 1,441 women developed ovarian cancer. Researchers dug deep to figure out what aspects of their lives and health might have increased their cancer risk.

“We included information from almost 3,000 diverse characteristics related to health, medication use, diet and lifestyle, physical measures, metabolic, and hormonal factors, each measured at the start of the study,” lead investigator Iqbal Madakkatel, a research associate in machine learning at the University of South Australia, said in a news release.

The analysis also found that women who’d given birth to two or more children had a 39% lower risk of developing ovarian cancer, compared to those who had not had children.

Key Takeaways

n The Pill can help ward off ovarian cancer

“It is possible that by using the contraceptive pill to reduce ovulations or by reducing harmful adiposity (excess body fat), we may be able to lower to risk of ovarian cancer,” senior researcher Elina Hypponen, a professor of nutritional and genetic epidemiology with the University of South Australia, said in a news release. Using artificial intelligence to identify risk factors

n Women who have used the birth control pill at any time have a 26% lower risk of ovarian cancer

n Their risk is 45% lower if they used the pill after age 45

The discovery of the pill’s potential protective powers resulted from an effort to use AI to identify risk factors for ovarian cancer.

“Ovarian cancer is notoriously diagnosed at a late stage, with about 70% of cases only identified when they are significantly advanced,” Lumsden said. “Late detection contributes to a survival rate of less than 30% over five years, in comparison to more

Further, researchers discovered some characteristics of red blood cells and liver enzymes in the blood associated with ovarian cancer risk. “It was particularly interesting that some blood measures – which were measured on average 12.6 years before diagnoses – were predictive of ovarian cancer risk, because it suggests we may be able to develop tests to identify women at risk at a very early stage,” Madakkatel said.

The study also confirmed some risk factors already suspected for ovarian cancer, including excess weight and taller stature. “But more research is needed to establish the best approaches to prevention, as well as the ways in which we can identify women most at risk,” she concluded.

Source: University of South Australia, news release, Feb. 2, 2025

More information

Planned Parenthood has more on how the birth control pill works.

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Daily Aspirin Reduces Colon Cancer Risk

Daily low-dose aspirin can help prevent cancers from returning in about a third of colon cancer patients, a new study says.

Taking 160 milligrams of aspirin a day cuts the risk of cancer recurrence in half among colon cancer patients with a mutation in their PI3K genes, researchers reported at the 2025 American Society of Clinical Oncology Gastrointestinal Cancers Symposium in San Francisco. These PI3K mutations are found in about 30% of all colon cancers, researchers said in background notes. They can make cancers more aggressive and harder to treat.

Lower risk of recurrence

Patients taking daily aspirin had a 51% lower risk of cancer recurrence if they had a mutation in their PIK3CA mutation, compared to placebo, researchers found. Recurrence was 7.7% for people taking aspirin versus 14.1% for those on placebo.

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Likewise, patients with other PI3K mutations had a 58% lower risk of cancer recurrence if they took aspirin – 7.7% for those patients versus 16.8% for those given placebo tablets. Overall, patients who took aspirin were 55% less likely to have their cancer recur than those on placebo, researchers said.

For the study, researchers recruited more than 600 patients in Sweden, Denmark, Finland and Norway who had moderate to advanced colon cancer or rectal cancer. The patients were randomly assigned to take either daily aspirin or a placebo for three years.

In addition, side effects related to aspirin use were rare, researchers said. There was one case of severe gastrointestinal (GI) bleeding, one case of brain bleeding and one allergic reaction.

Potential to change treatment

The results of this study could immedi-

ately change treatment for those colon cancer patients, researchers said. “Aspirin has been shown to effectively reduce recurrence rates and improve disease-free survival in more than one-third of these patients,” lead researcher Dr. Anna Martling, a professor of surgery at the Karolinska Institute in Sweden, said in a news release.

“The old adage ‘take two aspirin and call me in the morning’ may now find a new meaning,” said Dr. Pamela Kunz, chief of GI medical oncology at the Yale School of Medicine, who was not involved in the study.

“A simple intervention of low-dose aspirin reduces the risk of colorectal cancer recurrence for patients with genetic changes in the PI3K signaling pathway, occurring in one-third of patients with colorectal cancer,” Kunz added in a news release.

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal. The conference took place Jan. 23-25.

You are cordially invited to the

2025 Annual Men’s Dinner

Thursday, November 20

Cocktails 5:45 Dinner 6:45

The Ritz-Carlton St. Louis

Featured Speaker:

Pre-eminent NFL studio personality and the first NFL player with a star on the Hollywood Walk of Fame

Terry Bradshaw

The Annual Men’s Dinner raises funds for cancer research, care and prevention for men and women, pediatric to geriatric.

Cost: $425 per person

Every man who attends will enjoy cocktails, sumptuous hors d’oeuvres and a dinner valued at $145 and a $150 gift certificate that can be used at one of 7 different stores.

Dress Code: jacket and tie

For more information about the St. Louis Men’s Group Against Cancer, visit or call www.mensgroupagainstcancer.org 314-786-5950

Invitations will be mailed the first week in October and will be available online.

Diabetes Drug Protects Against Skin Cancer A

popular diabetes drug can provide protection against skin cancers, a new study says.

Metformin significantly reduces people’s risk of developing basal cell cancers or squamous cell cancers, the two most common skin cancers, researchers found in a recent study published in the Journal of Drugs in Dermatology. This study strengthens the evidence supporting Metformin's potential as a protective agent against non-melanoma skin cancer,” concluded the research team led by senior researcher Dr. Tiffany Libby, an assistant professor of dermatology with Brown University.

Basal and squamous cell skin cancers

About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the U.S., according to the American Cancer Society. Of those, 8 out of 10 are basal cell cancers. Deaths from these skin cancers are not common. Only about 2,000 to 8,000 people a year die from skin cancers that aren’t melanoma, which is much more dangerous, the ACS says.

For this study, researchers compared a healthy control group against more than 8,000 people diagnosed with basal cell cancer and more than 4,100 patients with squamous cell cancer. Each person with skin cancer was matched with four other healthy people who shared their age, race, ethnicity and sex, researchers said. The patient data came from a diverse health database maintained by the National Institutes of Health.

Metformin

Metformin is now the most widely prescribed pill for type 2 diabetes, researchers said in background notes. Previous studies have suggested that metformin might lower a person’s risk of skin cancer.

Metformin might protect against skin cancer by regulating mechanisms that block cancer cells’ access to energy and nutrients, or by blocking the ability of cancer cells to grow and proliferate, researchers said.

Metformin also promotes the death of unhealthy cells, enhances the body’s immune response against cancer cells, reduces inflammation and inhibits the growth of new blood vessels to skin tumors.

Results showed that metformin users did indeed have a lower risk of skin cancers, especially after researchers adjusted for other medications that can increase risk of skin cancer. However, the drug did not protect Black patients against squamous cell cancers, researchers found.

“This discrepancy could stem from the fact that SCC in these patients often develops in sun-protected areas and is strongly linked to chronic scarring and inflammation, factors that may not be influenced by metformin use,” the research team wrote.

“In conclusion, our results suggest that further research may be warranted to consider metformin as a chemo-preventive agent,” the researchers concluded.

Fitter Folks Have Better Odds Against Cancer

Pumping iron and hitting the treadmill can improve your odds against cancer, a new evidence review says. People with more muscle strength and better cardio fitness are less likely to die from cancer, researchers reported recently in the British Journal of Sports Medicine. This survival benefit extends even to people with advanced-stage cancers.

Exercise Prior to Cancer Diagnosis

Exercising now can increase your chances of successfully fighting cancer in the future. Even low levels of exercise provided protection against cancer, a study published in the January British Journal of Sports Medicine shows.

People were 47% less likely to die from cancer if they’d been engaging in moderate to vigorous physical activity prior to their diagnosis, compared to people not exercising at all, researchers found. Likewise, those engaging in light exercise had a 33% lower risk of dying from cancer, the study says.

For the study, researchers tracked the health of more than 28,000 people diagnosed with early-stage cancers in South Africa between 2007 and 2022. Breast and prostate cancers were the most common, representing 44% of cases.

Researchers compared the patients’ levels of physical activity in the 12 months prior to their cancer diagnosis with how quickly their cancer progressed after diagnosis.

Moderate-intensity exercise includes walking briskly, bicycling slowly, taking active yoga, or doing yard work. Vigorous exercise includes running, swimming laps, bicycling fast or taking an aerobics class.

They found that moderate to high levels of exercise reduced the risk of cancer progressing to more dangerous stages by 27%, compared to no exercise. Light exercise reduced the risk of cancer progression by 16%.

Long-term benefits

What’s more, exercise prior to cancer was associated with lower risks of progres-

sion and death as far as five years out from diagnosis, researchers found. The researchers speculated that exercise might help prepare the body to fight cancer by strengthening natural immunity.

Exercise might also lower the progression risk of hormone-driven cancers like breast and prostate cancer by improving the body’s regulation of estrogen and testosterone.

“Public health guidelines should encourage individuals to engage in physical

gest “muscle-strengthening activities could be employed to increase life expectancy.”

“Muscle strength and cardiorespiratory fitness were significant predictors of allcause mortality, especially in patients with advanced cancer,” concluded the research team led by Robert Newton, a professor of exercise medicine at Edith Cowan University in Australia.

Exercise as part of cancer treatment

The results indicate that hitting the gym might deserve to be part of a person's cancer treatment, researchers added. “Implementing tailored exercise prescriptions to enhance these physical fitness components throughout the cancer continuum may contribute to reducing cancer-related mortality,” the researchers wrote.

activity to not only prevent cancer but to mitigate the risk of cancer progression,” the researchers concluded.

Improved Survival Among Cancer Patients

Muscle strength and cardiorespiratory fitness may be especially important for cancer patients. Another new study finds both of these fitness components – when strong – may significantly boost survival.

Researchers reviewed data from 42 published studies involving more than 47,000 patients with various types and stages of cancer. Those with high muscle strength and cardiorespiratory fitness were 31%46% less likely to die from any cause and the benefit remained strong even among patients with advanced cancer, according to the results.

In addition, increases in cardiorespiratory fitness alone were associated with a reduced risk of cancer-specific mortality. The authors say assessing physical fitness, especially muscle strength and cardiorespiratory fitness, is crucial for predicting cancer mortality, and these findings sug-

Previous studies have linked better physical fitness to an overall lower risk of early death, as well as a lower risk of death by heart or lung disease, researchers said in background notes. But this is the first time a review has attempted to see whether fitness can ward off death from cancer, researchers said.

What’s more, their risk of death fell as their muscle strength and fitness increased, researchers said. Each unit increase in muscle strength lowered cancer patients' risk of death from any cause by another 11%. Likewise, each unit increase in fitness level lowered risk of cancer-related death by 18%.

Benefits also extended to patients with advanced cancer, whose risk of early death was 8% to 46% lower if their muscle strength and cardio fitness were high. Strength and fitness specifically lowered risk of death 19% to 41% among people with lung or GI cancers, researchers found.

“Our findings highlight that muscle strength could potentially be used in clinical practice to determine mortality risk in cancer patients in advanced stages and, therefore, muscle strengthening activities could be employed to increase life expectancy,” researchers wrote.

Source: British Journal of Sports Medicine, news release, Jan. 21, 2025

Pollen Allergies: Understanding and Managing Seasonal Symptoms

By: Todd A. Mahr, MD, Executive Medical Director American College of Allergy, Asthma and Immunology

Do you find yourself sneezing, itching or battling watery eyes as the seasons change? If so, you may have a pollen allergy—one of the most common types of seasonal allergies.

A confirmed diagnosis from a board-certified allergist is the first step to helping you enjoy the outdoors again. While there isn’t a cure for pollen allergies, the American College of Allergy, Asthma and Immunology (ACAAI) explains several treatments and lifestyle modifications to help ease your symptoms.

What is a pollen allergy?

A pollen allergy occurs when your immune system mistakenly identifies pollen—tiny particles from trees, grasses and weeds—as a threat. In response, the immune system releases histamine and other chemicals, triggering symptoms like sneezing, runny nose, itchy eyes and congestion. The pollen responsible for these symptoms often comes from trees in the spring, grasses in the summer and weeds like ragweed in the fall.

n Grasses: Timothy, Johnson, Kentucky bluegrass, Bermuda, orchard, sweet vernal and red top

n Weeds: Ragweed, sagebrush, pigweed, tumbleweed, Russian thistle and cockle weed

Pollen season varies by location, but climate change is causing both earlier and longer pollen seasons, in addition to higher pollen concentrations.

Recognizing pollen allergy symptoms

People with pollen allergies may experience a variety of symptoms, including:

n Sneezing

n Runny or stuffy nose

Common causes of pollen allergies

Trees, grasses and weeds release pollen to fertilize other plants. Unlike the heavy, sticky pollen of flowering plants like roses—which are pollinated by insects— allergy-triggering pollen is small, light and airborne, making it able to travel long distances.

Common pollen allergy triggers include:

n Trees: Oak, birch, cedar, elm, ash, hickory, poplar, sycamore, maple, cypress, walnut, catalpa, olive and pecan

n Itchy, watery eyes

n Scratchy throat

n Sinus pressure

Combined, these symptoms may disrupt sleep, concentration and overall quality of life.

If you have asthma, pollen may also cause increased coughing and wheezing—potentially triggering an asthma attack. In fact, pollen allergy is believed to be one of the main reasons for the “September Asthma Peak,” which is when asthma-related hospitalizations and ER visits tend to spike.

Treatment options for pollen allergies

Skin testing or blood tests by a board-certified allergist can confirm which types of pollen trigger your symptoms. An allergist can also help you find relief by determining which medications will work best for your set of triggers.

n Over-the-counter medications: Antihistamines like cetirizine, also known by the brand name Zyrtec, and loratadine (Claritin) may help reduce itching and sneezing, while nasal corticosteroids like fluticasone (Flonase) may relieve inflammation and congestion.

n Immunotherapy: Allergy shots, or under-the-tongue tablets for grass and ragweed allergies, may help reduce sensitivity to pollen over time.

n Biologics: For severe cases, biologics target the source of symptoms and may benefit those with allergic rhinitis who have nasal polyps or asthma.

Most allergy treatments work best when started at least two weeks before pollen season begins. This allows the treatments to prevent your body from releasing histamine and other chemicals that cause your symptoms.

Tips for managing pollen allergies

In addition to medications, there are steps you may take to reduce exposure to pollen and manage your symptoms:

n Check daily pollen forecasts and stay indoors on high-pollen days.

n Keep windows closed and use high-efficiency filters in your home’s heating, ventilation and air conditioning (HVAC) system to filter pollen out of your home.

n Wash your clothing frequently and try to bathe pets weekly.

n Shower and change clothes after being outdoors.

n Clean your home regularly by vacuuming and dusting.

n Use a saline nasal wash—rinse your sinuses with a saline solution (saltwater) to flush out allergens and mucus.

Living with pollen allergies doesn’t have to mean constant discomfort. With the right knowledge and support from your allergist, you can find relief.

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Linda is a youthful 68 and has always put her emphasis on helping others. She raised her five children as a single mother, working full time as a government lawyer. In her mid60s, a series of family crises put her through extraordinary stress. She knew that she needed to get herself in better shape to be able to visualize and move forward into a better future.

Taking the first step required a leap of faith, provided by an article Linda

read in Summer of 2023 about Sharon, a client who lost 50 lbs in one year of working out with me. Linda had never taken on a serious workout regimen, but communicated that she was committed to giving her body the respect it deserved, by engaging in a conscientious, individually-tailored workout plan.

Relatable inspiration

Linda feels that people in their 60s and beyond are often stereo-

A Regular Can Help Person A Success Story

typed and not seen as the multi-faceted individuals they are. These misperceptions often hamper their ability to reinvent themselves mentally, physically and spiritually. At our initial interview I asked questions that seemed to get at the heart of what her goals were, and I made sure that she felt understood.

I try to never be dismissive or to assume that I know what a person’s needs are. I always want to meet prospective clients where they are and understand what they are trying to achieve. We then design a holistic program to help them get there.

Getting healthy to reinvent herself

Linda was at a turning point. She had a strong feeling that once her body felt better, she would be able to access dormant dreams and yearnings from the past, and to self-actualize what had been impossible to undertake or achieve in the past. This was the time to “reinvent” herself, to bounce back from all she’d been through, get back in shape, lose weight and gain the strength to assure that she could continue to live life to the fullest.

Linda lost 40 pounds and gained a new sense of optimism.

Regular Exercise Program Help You Become the

You Want to Be Story from Bret Kliethermes, Owner of Strong Human Fitness

Her newfound physical resilience has brought her many psychological benefits - the most profound of which is the belief that anything she can visualize in her life is possible, including the inner yearnings of her heart and mind.

I like to take a comprehensive approach in helping my clients achieve their goals. In addition to our focused exercise sessions, this includes providing guidance on diet, sleep and daily activity. Linda is conscious of what she eats and enjoys daily walks. She says that after just two weeks exercising with me, she noticed a change in her mental outlook. At 12 weeks she felt her body change. Now after 20 months she has lost 40 pounds, looks great, has lots more energy and has gained a new sense of optimism.

Value yourself – don’t give up

Linda feels that our exercise sessions are the most valuable thing she does for herself, and she has really come to enjoy them. She feels that our small gym has not only provided her with camaraderie and friendship, but also a community of wise and supportive people, where all encourage and applaud the triumphs of each other.

Linda offers this advice to others who find themselves in a similar situation: It starts with the willingness to value yourself. Never give up on yourself. Take the spark of belief in your intrinsic value and use it to become the greatest project you will ever undertake. You have the power to shape your own destiny through dedication, effort and the willingness to start again when necessary. The results are life-affirming in every way.

2024-25 Flu Season Was the Worst in 15 Years

In the 2024-25 flu season there have been at least 47 million illnesses and 610,000 hospitalizations related to influenza, or the flu – the most since the 2010-2011 season, according to the U.S. Centers for Disease Control and Prevention. There have also been 27,000 deaths caused by the flu, the CDC says.

“For the first time this year, flu deaths have surpassed COVID deaths,” Dr. Lauren Siewny, medical director of the Duke University Emergency Department in Durham, N.C., told HealthDay TV.

Reasons for the increase

There are a few reasons for why this season has been so bad, she said. “Some of it may be some lingering effects from the COVID pandemic– that we were just starting to see folks out and about more and spreading communicable disease,” Siewny said.

“I think some of it is just that it peaked late this year, and so it's really feeling like it's dragging out that winter season,” she added. “Everyone that I know feels like they've had some sort of viral illness in the last months.”

“It looks like the peak was around the first week of February,” Siewny said. “Again, that's a little later than last year. Last year was more around the holidays time.”

How bad the season has been varies, depending on where you live, Siewny added.

“Actually, compared to last year, we have had fewer hospitalizations,” Siewny said of her region, in central North Carolina. “Some of it is how you define how busy the flu season is. If you look at hospitalizations, those are a little bit down from last year. But if you look at overall emergency department visits, those have been high.”

CDC recommends

When the new flu vaccine becomes available this fall, the CDC recommends that everyone 6 months and older get a flu vaccine, with rare exceptions. Flu vaccines help to reduce the burden of flu illnesses, hospitalizations and deaths on the health care system each year. Flu vaccination also has been shown to reduce the severity of illness in people who get vaccinated but still get sick.

People at higher risk of serious flu complications include young children, pregnant women, people with certain chronic

health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older.

Vaccination also is important for health care workers and other people who live with or care for people at higher risk of serious flu illness to keep from spreading flu to them. This is especially true for people who work in long-term care facilities, which are home to many of the people most vulnerable to flu. Children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated. People who care for infants should be vaccinated instead.

While the ideal time is by the end of October, getting vaccinated later in the season is still beneficial and provides protection as long as influenza viruses are circulating. Siewny said, “The flu vaccine is the best protection we have, particularly at preventing those hospitalizations in the folks who are more susceptible to influenza complications, such as the elderly, the immunocompromised and very young children.”

Treatment for the flu

She also recommends that people get prompt treatment for the flu, which now can include antiviral drugs that are likely to shorten a person’s illness.

“There's absolutely a window,” Siewny said. “If you think you have the flu, if you test positive for the flu, and you're in one of those conditions that would be potentially susceptible to severe disease, we really want to get that medication started within the first 48 hours.”

Likewise, people should head to the ER if they develop severe symptoms, she added.

“The things that we really want to see in the emergency department are shortness of breath – that is going to be the number one for us every time – confusion, severe dehydration, chest pain,” Siewny said. “Those are the things that I would kind of bypass urgent care and come to the emergency department for evaluation.”

SOURCES: Dr. Lauren Siewny, medical director, Duke University Emergency Department, Durham, N.C.; U.S. Centers for Disease Control and Prevention

More information

The U.S. Centers for Disease Control and Prevention has more about influenza.

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Compound Effect of Chronic Joint Pain Plus Depression Can Take Toll on the Brain

Having achy, painful joints isn't just a physical woe: Coupled with depression, it could also degrade an older person's brain function over time.

That's the conclusion of a study of almost 5,000 older Britons tracked for 12 years. People who had both chronic joint pain and depression tended to perform worse on cognitive tests, especially tests focused on memory skills.

How pain and depression affect the brain

“Both pain and symptoms of depression act on areas of the brain (mainly the hippocampus) associated with cognitive processing," explained Brazilian gerontology researcher and study lead author Patrícia Silva Tofani, of the Federal University of Sergipe. She has a theory as to how joint pain and depression might pose a double whammy to brain health.

"There’s an overlap of information, causing the brain to become ‘congested’ and to have to delegate some functions to process the pain response and the symptoms of depression," she said in a university news release. "This would interfere with formation of memory and global cognitive performance. In the study, we saw that over the years, this overload leads to faster cognitive decline.”

The study

The findings were published recently in the journal Aging & Mental Health. The study was based on data from the English Longitudinal Study of Aging and looked at data on 4,718 Britons aged 50 or older whose health was tracked for a dozen years. Among other things, they were queried as to their levels of any kind of joint pain (for example, of the knee or hip), and any level of depression.

Tofani's group also tracked levels of

Importance of the findings

“This is important, because memory and executive function are the two most important domains for autonomy, in other words, for older people to live alone, for example,” Tofani noted. The findings highlight that treating both arthritis and depression – two conditions common among the elderly – may be crucial to keeping them independent and cognitively healthy.

cognition and memory decline over the study period. They looked at six cognitive domains: executive function (making decisions and planning and carrying out actions), language, attention, memory, perceptomotor (movement in response to sensory stimuli), and social cognition (the ability to understand one’s own emotions and those of other people, and to interpret the behavior of others).

The findings

Her team found that people who had a combination of chronic joint pain and depression showed significantly faster decline in memory and global cognition compared to people who only had joint pain or were only depressed.

"We didn’t expect that only the first group (pain + depression) would show faster memory impairment," added study co-author Tiago da Silva Alexandre, a professor of gerontology at the university. "Following the evolution of this issue for 12 years has allowed us to see that the problem lies in the combination of the two conditions."

Interestingly, folks with joint pain plus depression exhibited no faster decline in their executive function, according to the study.

“It’s relatively common for people to mistakenly attribute symptoms of depression and pain as normal factors of aging. And they’re not," said Alexandre. "This belief leads professionals who are not specialists in gerontology and geriatrics to minimize the complaints of older people in primary care and to fail to diagnose and treat modifiable conditions. But in our study, we showed that when this is not valued in the consultation, it not only damages mood and mobility (in the case of pain) but also the individual’s cognitive issues."

The combination of pain and depression is common and can create a cycle where one condition worsens the other. Depression can cause pain, and pain can lead to depression. This co-occurrence, known as comorbidity, can be challenging to treat, as it may require addressing both conditions separately or with treatments that target both.

Some individuals with depression experience unexplained physical symptoms like back pain or headaches, which may be the first or only sign of depression. Chronic pain, in particular, can disrupt sleep, increase stress, lower self-esteem, and cause significant distress, all of which can contribute to depression. Pain can worsen depressive symptoms, and depression can intensify pain perception, creating a feedback loop.

Source: Fundação de Amparo à Pesquisa do Estado de São Paulo.

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HEALTH&CARE Journal features informative articles about preventing, treating and caregiving for important health conditions. It also features sections including Women’s Health, Mental Health, Aging & Caregiving and Aches & Pains. Our goal is to enhance patients’ health literacy, to help them seek and comply with professional health care.

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My Journey with Rheumatoid Arthritis

By Bill Eastman

I’ve had rheumatoid arthritis (RA) for the last 45 years. Sometimes our medical issues are all people want to talk about. Seniors like me especially. I’ve been reluctant to talk about RA, even to write this article, because I believe there’s more to me than RA. I’m a husband, father, tutor for young people, good cook, gardener, and a dog and kid magnet. I want to talk/listen/learn about everyone and everything… except my latest replacement surgery. I've had 40.

So why put my struggle ‘out there’ so publicly in a magazine? Because there are many people who have serious health issues…many much worse than mine… who may be inspired by my story … or tell their own story.… or try one of the strategies I use to fight RA. Telling my story is worth it even if just one person is helped by my words.

Early diagnosis and treatments

I was diagnosed with RA in my early 30’s. I knew something was wrong, continually complaining of fatigue and joint pain. RA is an inflammatory, auto-immune disease which in my case destroyed tissues, bones and joints. All of them. No drug/infusion/treatment was effective for long, side effects often were worse than the disease.

Because of RA, I’ve had replacement/ fusion surgeries and many more ‘procedures’ such as infusions, nerve ablations, drainage of inflammation, injections, open wounds that would not close, casts. The only joint that is still ‘original’ is my left hip. All other joints have been replaced or fused, some three times, all because RA prevented necessary bone growth and fusion. Neck, shoulders, knees, hip, feet, spine from top to bottom. Hospital stays, appointments with doctors, physical therapists, pain management experts, and even Mayo Clinic visits are so many I’ve stopped counting.

Many people to thank

The skill of my surgeons and countless other doctors, nurses and physical therapists has been without equal. They have done amazing work so that if you saw me now at 75 you would not believe me. I walk, swim, tutor kids, cook, garden, recently traveled to France with family, have a strenuous regimen of daily exercises and live a very active life. I also heal very fast. And both our sons will marry beautiful, talented women this year! I am so fortunate.

My wife, sons and friends have nursed me back to health, driven me to appointments and everywhere, fed me, cried with me when an operation failed and another was needed, were woken by cries of pain in my sleep. I could not be on this journey without them.

Perseverance, staying in shape and “work arounds”

A major reason for my success is perseverance. I don’t know who penned the following, but it means a great deal to me… ’Success is never final… failure is rarely fatal. It’s the will to continue that counts.’

Sure, I’ve had plenty of setbacks, too many failed surgeries where bones did not fuse, metal plates or screws broke after surgery, and replacements over replacements. And many very dark days. But I’ve never stopped battling this disease or trying new strategies. I think that’s my secret weapon. One strategy that works for me is to stay in good physical condition. I’ve learned to prepare for each of my surgeries by being in the best shape possible because, once on the operating table, I knew I was about to reduce my physical health by at least 30%.

I’m always finding ‘work arounds’ for those things difficult to do for a person like me…. strategically placed ‘grab bars’, ‘reachers’ and ‘sock aids’ so I can dress myself and pick up what I dropped…plus canes, crutches, wheelchairs, etc.

I changed my diet and don’t eat processed food, no sugar, eat meat rarely, lost weight, and exercise every day. I’m also beginning to talk about my struggle …. this article is an example …. and it feels really good. I’ve been able to talk with others who share my experience, learned so much and, I hope, have given back even more.

Learning to live with limitations

Constant physical therapy has helped me to learn how to live a life with limitations and still thrive. I believe that if I had my current therapist years ago, many of my surgeries would not have been necessary. My journey, like that of so many others, has been tough and included many dark days. I urge others who suffer to try new strategies that hold promise for better days. I’ve listed some of mine. There are so many others.

“Pain in life is inevitable…. suffering is optional” is an AA maxim I live by. RA has knocked me down so many times. But never for long.

Best Foot Forward: Tips for Keeping Feet Healthy and Reducing Pain

Most people spend a lot of time on their feet, so it’s good to take care of them. You can minimize the stress on your feet when holding you up and getting you around, an expert says.

“Common problems that people face include hammertoes, blisters, plantar fasciitis and bunions. Some of these are easily solvable, but others may need the involvement of a specialist,” said Dr. Ronald Lepow, assistant professor of orthopedic surgery at Baylor College of Medicine in Houston.

Foot issues and pain are most often caused by friction and pressure. Choosing the correct shoe for daily activities can help. Your shoes should have a toe box that is wide and deep so that your toes can move freely. They should be breathable for sweat and odor control. Avoid high heels.

Bunions can form at the big toe, causing the toe to turn inward. Some bunions are hereditary, others from arthritis.

“X-rays of the foot reveal what kind of foot arch you have and the structure of the foot,” Lepow said. “If you are experiencing pain, knowing these two things will help dictate a care plan. You may need surgery if the pain continues,” he added. Some people will also develop hammertoes, when a tendon in the toe contracts and bends at the first joint, causing the toes to overlap and rub against each other. Hammertoes can lead to corns, blisters or calluses. Toe spacers or toe straighteners can help alleviate this problem, but they’re not a cure.

Older adults may be at higher risk of foot issues. Osteoarthritis, common with age, can cause deformations of the joints. This allows bone spurs to form in the heel or other parts of the foot. Shoe inserts or alterations, cortisone injections, physical therapy and custom-made orthotics may help.

“If you’re experiencing foot pain, visit a specialist to examine the pathology of your foot,” Lepow said in a Baylor news release. “This gives us a bigger picture of what issues you face and how we can best help you.”

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Major Women’s Health Study Supports Hormone Replacement Therapy in Early Menopause

Hormone replacement therapy can safely ease middle-aged women’s symptoms during early menopause, data from a major women’s health study show.

Women younger than 60 can use hormone replacement to treat symptoms like hot flashes and night sweats without significantly increasing their risk of breast cancer or other health problems, according to long-term results from the Women’s Health Initiative (WHI).

“The WHI findings should never be used as a reason to deny hormone therapy to women in early menopause with bothersome menopausal symptoms,” said lead researcher Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston.

“Many women are good candidates for treatment and, in shared decision-making with their clinicians, should be able to receive appropriate and personalized healthcare for their needs,” Manson added in a hospital news release.

The WHI involved more than 160,000 postmenopausal women ages 50 to 79. The study tracked their rates of heart disease, cancer and hip fractures, and also included randomized clinical trials of more than 68,000 women to test potential aging treatments like hormone therapy or calcium and vitamin D supplementation. Prior to the WHI, studies had reported that older women who took hormone therapy had lower risks of heart disease, stroke, dementia, chronic disease and death, researchers said in background notes.

Correcting earlier findings

A WHI clinical trial had slammed the brakes on hormone replacement therapy

in 2002, reporting that women taking combination (estrogen and progestin) hormone therapy had an increased risk for breast cancer, heart disease, stroke and blood clots.

But as women participating in the WHI have been followed over two more decades, a more nuanced picture of hormone therapy’s risks and benefits has emerged. Findings continue to show that hormone therapy does nothing to decrease women’s risk for health problems related to aging like heart disease or hip fractures, counter to pre-WHI studies.

However, hormone therapy has been shown to not be as risky for middle-aged women nearing menopause, and helpful in dealing with symptoms related to that change in life.

“Women also have more options for treatment now, including estrogen in lower doses and delivered through the skin as a patch or gel, which may further reduce risks,” Manson said. “Non-hormonal treatments are also available.”

Diet and supplements

This WHI update, which was published in May of 2024 in the Journal of the American Medical Association, also includes fresh information on the value of low-fat diets and calcium and vitamin D supplementation.

Although calcium and vitamin D supplements don’t reduce risk of hip fracture in aging women, researchers noted that these supplements can help fill nutrient gaps among those not eating a balanced diet.

Meanwhile, low-fat diets now are associated with a reduced risk of death from breast cancer, researchers report. Earlier WHI findings had found that low-fat diets did not reduce risk of breast or colorectal cancer.

Researchers recommend that women talk

with their doctors about whether a low-fat diet or calcium and vitamin D supplements would be good for them.

Hormone replacement therapy and depression

Another study from 2024 found that hormone replacement therapy might help women avoid depression as they go through menopause. Women treated with hormone therapy at a menopause clinic in Ontario, Canada, experienced a reduction in their symptoms of depression, researchers reported in February in the journal Menopause.

This improvement occurred whether or not antidepressants were also prescribed, results showed. “This study showed a beneficial effect of hormone therapy on mood symptoms during menopause when used alone and a synergistic effect when used in combination with antidepressants,” said Dr. Stephanie Faubion, medical director for The Menopause Society.

“It also highlights the high prevalence of mood symptoms during this transition and the need to address women's symptoms holistically rather than having a singular focus on hot flash management," Faubion added in a society news release. Hormone therapy has been shown to effectively manage hot flashes, but its ability to address mood-related symptoms is less established, researchers said in background notes. Hormones influence the brain pathways that regulate mood during and after menopause and are thought to play a role in depressive symptoms, the researchers said.

The toll of all the physical symptoms that accompany menopause also could dampen women’s moods, they added.

Women who went through natural menopause experienced significant improvement in their symptoms of depression, researchers found. However, women who went through menopause due to cancer treatment or surgery did not have similar improvements, results showed.

More information

Johns Hopkins Medicine has more on menopausal hormone therapy. The Women’s Health Initiative has more information on its landmark findings.

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Can You Rely on Your Mammogram to Identify Heart Disease Risk?

KFF Health News

When people check in for their annual mammogram these days, some may face a surprising question: In addition to reviewing the mammogram for breast cancer, would the patient like the radiologist to examine the images for heart disease risk?

That’s what happened recently when a colleague visited Washington Radiology, a practice with more than a dozen locations in Washington, D.C., Maryland, and Virginia.

For $119, she was told, the practice would use artificial intelligence software to analyze her mammogram for calcification in the arteries of her breasts, which could indicate she’s at risk for cardiovascular disease.

What to know about the screening

Washington Radiology is one of a number of practices nationwide offering this type of screening. Here’s what to know about the screening and whether research

supports it.

Although breast X-rays are typically used to detect and diagnose breast cancer, the pictures also indicate whether the arteries in the breast have calcifications, which show up as parallel white lines on the film.

Calcifications, which are considered “incidental” findings unrelated to breast cancer, may be associated with someone’s heart disease risk. They’ve been visible on images for decades, and some radiologists have routinely noted them in their reports. But the information hasn’t typically been passed on to patients.

Now some practices make the results available to patients — sometimes for a fee.

Washington Radiology didn’t respond to interview requests, but in a video on its website describing the practice’s “Mammo+Heart” AI screening, Islamiat Ego-Osuala, a breast imaging radiologist there, said, “If the past few decades have taught us anything about the field of radiology, it is that the sky’s the limit. The possibilities are endless.”

Some imaging experts question that rosy assessment as it relates to screening for breast arterial calcification to gauge heart disease risk.

Calcifications are different

“What we’re seeing on the mammogram is calcification in the breast artery, but that’s not the same as the calcification in the coronary artery,” said Greg Sorensen, chief science officer at RadNet, which has nearly 400 imaging centers in eight states. RadNet doesn’t offer breast arterial calcification screening and has no plans to. “It doesn’t feel like it’s delivering value today,” Sorensen said.

Associations, but questions remain

Coronary artery calcification is recognized as a strong marker of heart disease risk. But while studies have shown an association between breast arterial calcification and the risk of cardiovascular disease, questions remain.

For one thing, even women who don’t have breast arterial calcification might still be at risk of heart disease, heart attack, or stroke. In a study of postmenopausal women, 26% had breast arterial calcification, and over a 6½-year study period it was associated with a 23% increased risk of heart disease of any kind and a 51% increase in risk of heart attack or stroke. However, most cardiovascular events happened to women who did not have breast arterial calcification.

“I wouldn’t feel comfortable telling people they have a higher or lower risk of heart disease based on their breast arterial calcification,” said Sadiya Khan, a preventive cardiologist at Northwestern Medicine in Chicago who co-authored a medical journal editorial commenting on the study. “I think this is an exciting area, but we need to move cautiously.”

It’s understandable that women’s health clinicians would be eager to embrace the idea of using the annual breast cancer screening that millions of women get every year to screen for heart disease risk as well.

Heart disease risk and recommendations

Heart disease is the No. 1 killer in the United States. It was responsible for more than 300,000 — or roughly 1 in 5 — women’s deaths in 2021. Many women don’t recognize their heart disease risk or the many factors that increase it, such as high blood pressure, diabetes, high cholesterol, smoking, drinking too much alcohol, and being overweight.

Online calculators can help people assess their risk of cardiovascular disease. For those whose 10-year risk is 7.5% or higher, clinicians may recommend lifestyle changes and/or prescribe a statin to lower blood cholesterol. Laura Heacock, a radiologist who specializes in breast imaging at NYU Langone Health in New York City, pointed out that patients already can get much of the information resulting from breast arterial calcification scoring from their physicians and use of those risk calculators. The key is that breast arterial calcification screening provides another chance to talk about heart disease risk.

One study found that 57% of women who were informed that they had breast arterial calcification after a mammogram reported they had discussed their results with their primary care physician or a cardiologist.

More studies are needed

Heacock said she’d like to see more studies showing that reporting breast arterial calcification leads to changes in patient care and fewer heart attacks and strokes.

Every woman who visits the Lynn Women’s Health and Wellness Institute in Boca Raton, Florida, for a mammogram is screened for breast arterial calcification. Patients at the Boca Raton institute aren’t charged for the screening. It’s been a standard service since 2020, said Heather Johnson, a preventive cardiologist at the center. If calcification is found, the woman is referred to a cardiologist or other health care practitioner at the center to discuss the findings and get more information about heart disease risk.

Johnson acknowledged that more studies are needed to understand the connection between calcification in breast arteries and heart disease. Still, she said, the screening “allows a communication pathway.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF— an independent source of health policy research, polling, and journalism.

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America’s Health System Isn’t Ready for the Surge of Seniors with Disabilities

By Judith Graham For Kaiser Family Foundation

The number of older adults with disabilities — difficulty with walking, seeing, hearing, memory, cognition, or performing daily tasks such as bathing or using the bathroom — will soar in the decades ahead, as baby boomers enter their 70s, 80s, and 90s.

But the health care system isn’t ready to address their needs.

That became painfully obvious during the covid-19 pandemic, when older adults with disabilities had trouble getting treatments and hundreds of thousands died.

The Department of Health and Human Services and the National Institutes of Health have been targeting some failures that led to those problems.

One initiative strengthens access to medical treatments, equipment, and web-based programs for people with disabilities. The

other recognizes that people with disabilities, including older adults, are a separate population with special health concerns that need more research and attention.

Lisa Iezzoni, 69, a professor at Harvard Medical School who has lived with multiple sclerosis since her early 20s and is widely considered the godmother of research on disability, called the developments “an important attempt to make health care more equitable for people with disabilities.”

“For too long, medical providers have failed to address change in society, changes in technology, and changes in the kind of assistance that people need,” she said.

Among Iezzoni’s notable findings published in recent years:

Most doctors are biased. In survey results published in 2021, 82% of physicians admitted they believed people with significant disabilities have a worse quality of life than those without impairments. Only 57% said they welcomed disabled patients.

“It’s shocking that so many physicians say they don’t want to care for these patients,” said Eric Campbell, a co-author of the study and professor of medicine at the University of Colorado.

While the findings apply to disabled people of all ages, a larger proportion of older adults live with disabilities than younger age groups. About one-third of people 65 and older — nearly 19 million seniors — have a disability, according to the Institute on Disability at the University of New Hampshire.

Doctors don’t understand their responsibilities. In 2022, Iezzoni, Campbell, and colleagues reported that 36% of physicians had little to no knowledge of their responsibilities under the 1990 Americans with Disabilities Act, indicating a concerning lack of training. The ADA requires medical practices to provide equal access to people with disabilities and accommodate disability-related needs.

Among the practical consequences: Few clinics have height-adjustable tables or mechanical lifts that enable people who are frail or use wheelchairs to receive thorough medical examinations. Only a small number have scales to weigh patients in wheelchairs. And most diagnostic imaging

equipment can’t be used by people with serious mobility limitations.

Iezzoni has experienced these issues directly. She relies on a wheelchair and can’t transfer to a fixed-height exam table. She told me she hasn’t been weighed in years.

Among the medical consequences: People with disabilities receive less preventive care and suffer from poorer health than other people, as well as more coexisting medical conditions. Physicians too often rely on incomplete information in making recommendations. There are more barriers to treatment and patients are less satisfied with the care they do get.

Egregiously, during the pandemic, when crisis standards of care were developed, people with disabilities and older adults were deemed low priorities. These standards were meant to ration care, when necessary, given shortages of respirators and other potentially lifesaving interventions.

There’s no starker example of the deleterious confluence of bias against seniors and people with disabilities. Unfortunately, older adults with disabilities routinely encounter these twinned types of discrimination when seeking medical care.

Such discrimination would be explicitly banned under a rule proposed by HHS in September. For the first time in 50 years, it would update Section 504 of the Rehabilitation Act of 1973, a landmark statute that helped establish civil rights for people with disabilities.

The new rule sets specific, enforceable standards for accessible equipment, including exam tables, scales, and diagnostic equipment. And it requires that electronic medical records, medical apps, and websites be made usable for people with various impairments and prohibits treatment policies based on stereotypes about people with disabilities, such as covid-era crisis standards of care.

“This will make a really big difference to disabled people of all ages, especially older adults,” said Alison Barkoff, who heads the HHS Administration for Community Living. She expects the rule to be finalized this year, with provisions related to medical equipment going into effect in 2026. Medical providers will bear extra costs associated with compliance.

Also in September, NIH designated people with disabilities as a population with health disparities that deserves further attention. This makes a new funding stream available and “should spur data collection that allows us to look with greater precision at the barriers and structural issues that have held people with disabilities back,” said Bonnielin Swenor, director of the Johns Hopkins University Disability Health Research Center.

One important barrier for older adults: Unlike younger adults with disabilities, many seniors with impairments don’t identify themselves as disabled.

“Before my mom died in October 2019, she became blind from macular degeneration and deaf from hereditary hearing loss. But she would never say she was disabled,” Iezzoni said. Similarly, older adults who can’t walk after a stroke or because of severe osteoarthritis generally think of themselves as having a medical condition, not a disability.

Meanwhile, seniors haven’t been well integrated into the disability rights movement, which has been led by young and middle-aged adults. They typically don’t join disability-oriented communities that offer support from people with similar experiences. And they don’t ask for accommodations they might be entitled to under the ADA or the 1973 Rehabilitation Act.

Many seniors don’t even realize they have rights under these laws, Swenor said. “We need to think more inclusively about people with disabilities and ensure that older adults are fully included at this really important moment of change.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.

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Preparing to Hang Up the Car Keys as We Age

By Judith Graham For Kaiser Family Foundation

Lewis Morgenstern has made up his mind. When he turns 65 in four years, he’s going to sign an advance directive for driving.

The directive will say that when his children want him to stop getting behind the wheel, Morgenstern will follow their advice.

“I recognize that I might not be able to make the best decision about driving at a certain point, and I want to make it clear I trust my children to take over that responsibility,” said Morgenstern, a professor of neurology, neurosurgery, and emergency medicine at the University of Michigan.

His wife, 59, intends to sign a similar document at 65.

Morgenstern has given a lot of thought to the often-divisive issue of when to stop

driving. He co-authored a recent article in the Journal of the American Geriatrics Society that found 61% of older adults with cognitive impairment continued to drive even though 36% of their caregivers were concerned about their performance. Many of these seniors probably adapted by exercising caution and drawing on extensive experience behind the wheel, Morgenstern said. But, he noted, “there is undoubtedly a group of people who are driving and shouldn’t be because they’re a risk to themselves and to others.”

A growing concern

Relatively few studies have looked at how many older adults with mild cognitive impairment or dementia continue to drive, and there aren’t any national standards on when people should hand over the car keys. But the issue is a growing concern as

the ranks of seniors in their 70s, 80s, and 90s — the age group most likely to have cognitive impairment — expand.

Nearly 50 million people 65 and older held driver’s licenses in 2021, a 38% increase from 2012, according to data compiled by the American Automobile Association. Almost 19 million were 75 or older, a rise of 31%. During this period, motor vehicle deaths for people 65 and older increased 34%, reaching 7,489 in 2021. The number of seniors injured in vehicle crashes that year exceeded 266,000.

Older drivers are safe drivers

For the most part, older adults drive safely. They use seat belts more often, are intoxicated less often, and are less likely to speed than younger adults. Compared with younger and middle-aged adults, they’re involved in fewer fatal car crashes each year. And they’re more likely to restrict where and when they drive — following familiar routes, avoiding heavily trafficked streets, and not driving at night.

Risks for older drivers

Still, risks for older drivers rise with advancing age and the onset of medical conditions such as arthritis, glaucoma, and Parkinson’s disease. And when crashes occur, seniors are more likely to be severely injured or die because they’re

more vulnerable physically.

Cognitive impairment and dementia pose especially worrisome challenges because decision-making, attention, judgment, and risk assessment are compromised in people with these conditions.

“This is a big challenge when it comes to driving, because people don’t react appropriately and self-regulate,” said Emmy Betz, a professor of emergency medicine at the University of Colorado School of Medicine who has studied advance driving directives.

This was the case for Morgenstern’s beloved father-in-law, who developed moderate Alzheimer’s disease in his 70s but remained convinced he was fit to drive. After he got badly lost one day, Morgenstern’s mother-in-law took away the car keys, and “he didn’t understand why. He was very unhappy,” Morgenstern said.

Advance directives for driving

Morgenstern’s interest in advance directives for driving, an option he recommends in his paper, springs from this experience.

Several types of directives exist. One asks a person to name a family member or friend who will talk to them about whether it’s safe to continue driving. AAA and the American Occupational Therapy Association have endorsed a directive of this kind, which is not legally binding.

Obligations also run in the other direction, with family members agreeing to help the person explore ways to keep driving, if possible. If not, family members agree to help the person find other ways to get out and about by offering rides and helping them use public transportation, carpooling services, or volunteer-driver programs. Uber and Lyft, which have created programs for seniors, are newer options frequently used.

Cognitive impairment and assessment

Another nonbinding directive, endorsed by the Alzheimer’s Association, recognizes that people with dementia will not be able to drive as their illness progresses. It, too, names people who should raise concerns about driving when it becomes important. But it goes further by stating: “I understand that I may forget that I cannot drive anymore and may try to con-

tinue driving. If this happens, please know that I support all actions taken, including removing or disabling my car, to help ensure my safety and the safety of others.”

At the University of South Florida Health, Lori Dee Grismore, an occupational therapist and certified driving rehabilitation specialist, said up to 75% of the seniors she evaluates have some type of cognitive impairment.

This becomes evident during the first part of Grismore’s comprehensive evaluation: an interview about the person’s driving habits and recent problems; a review of their medical history; a vision exam; a physical assessment; and a battery of six cognitive tests. “If someone doesn’t have insight, which is common, they don’t understand why these tests have anything to do with driving,” she told me. If she thinks it’s safe, Grismore then takes older adults out on the road, checking their ability to follow directions, make turns, stay in their lanes, maintain appropriate speeds, and interpret signs, among other performance measures.

ing transportation needs in our 70s, 80s, and 90s,” she said. “The hard part is that driving is associated with independence, and this is such an emotional issue. But the more people look ahead, the more choice and control they can have.”

Many people with cognitive impairment continue to drive and don’t want to stop. There are no standards for when they should give up their car keys, but planning ahead is recommended. Here are some resources that offer guidance.

Resources

While most older adults with mild cognitive impairment pass these tests, Grismore usually recommends retesting at regular intervals and imposing restrictions such as driving only close to home and staying off highways. But she acknowledged there’s no guarantee seniors will remember these restrictions.

Grismore’s three-hour assessment costs $420. Medicare doesn’t pay — a barrier to seniors with low or fixed incomes. Older adults and families interested in finding a driving rehab provider can consult an American Occupational Therapy Association directory at myaota.aota.org/ driver_search/.

Elin Schold Davis, who coordinates the Older Driver Initiative at the occupational therapy association, recommends getting an evaluation of this kind when someone is diagnosed with cognitive impairment or when family members begin to notice problems.

“We should all be planning for our chang-

For basic information: Alzheimer’s Association: “Dementia and Driving” National Highway Traffic Safety Administration: “Driving and Alzheimer’s Disease”

Hitting the milestone: Healthwise: “Is It Time to Stop Driving?”

A conversation guide: The Hartford Center for Mature Market Excellence: “At the Crossroads: Family Conversations About Alzheimer’s Disease, Dementia and Driving.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.

‘News Addiction’ Is Common and Can Harm Your Mental Health

From the COVID-19 pandemic to the Russian invasion of Ukraine, school shootings, polarized politics and devastating wildfires, there's been no lack of doom and gloom lately, and many folks are glued to the news.

Compulsive news watching

For more than 16% of people, however, compulsive news watching can be seriously problematic and is linked to a host of physical and mental health woes, a recent study showed.

"For individuals who find themselves constantly thinking about and checking the news, news consumption may be having a more negative impact on their well-being than they realize," said study author Bryan McLaughlin, associate professor of advertising at Texas Tech University College of Media & Communication, in Lubbock.

People who report high levels of problematic news-watching experience great stress over prolonged periods. "If this leads to consistently high levels of inflammation, it may have adverse effects on an individual's physical health," McLaughlin said.

And things have likely gone from bad to worse with the torrent of distressing news in recent years, as well as all the political

conflict and divisiveness, he said. "The more things there are to be concerned about, the more likely people probably are to get deeply drawn into the news."

The study

McLaughlin's team surveyed 1,100 U.S. adults in August of 2021. People were asked if they agreed with statements such as, "I become so absorbed in the news that I forget the world around me," "my mind is frequently occupied with thoughts about the news," "I find it difficult to stop reading or watching the news," and "I often do not pay attention at school or work because I am reading or watching the news."

Folks were also asked if, and how often, they experienced stress and anxiety, as well as fatigue, pain, poor concentration and digestive issues.

People who reported problematic news consumption were more likely to experience mental and physical symptoms than those less invested in the news. Specifically, 61% of people with severe levels of problematic news-watching reported that they feel sickly "quite a bit" or "very much," compared with 6% of other people.

The report was published in the journal Health Communication.

The findings mirror what clinical psychologist Amanda Spray has been seeing in her practice recently. "This is likely due to the multiple health and social crises of the last several years in combination with the increased access to news 24/7 from a variety of outlets," said Spray, director of the Steven A. Cohen Military Family Center at NYU Langone Health in New York City.

"Problematic news consumption can significantly contribute to feelings of depression and anxiety, which in turn can have deleterious effects on our physical health," said Spray, who reviewed the study findings.

But going cold turkey isn't necessarily the answer, she said.

What to do about it

There are benefits to staying informed about current events, McLaughlin said, but if the news is causing duress, cut back and pay attention to your feelings.

"If someone notices they are feeling more depressed and anxious, having trouble pulling themselves away from the news for long periods, or it is causing them to be less engaged in other areas of their lives, they may want to examine how much news they are consuming," Spray suggested.

This starts with writing down how much time is spent watching the news.

"After monitoring use to get a clear idea of where their current usage is, one can identify how much news media they would ideally be consuming and gradually reduce their usage to a level that causes less interference, but still allows them to remain engaged with their community," she said.

Dr. Ami Baxi, a psychiatrist at Lenox Hill Hospital in New York City, added, "Frequent or continuous exposure to problematic news can impact some people's mental and physical health in detrimental ways, especially those with underlying mental or physical problems," said Baxi, who has no ties to the research. "It can trigger PTSD symptoms or keep patients in states of elevated anxiety, and it can also increase substance use."

More information

The Anxiety and Depression Association of America offers tips on staying informed without making anxiety worse.

Dr. Jennifer Ritchie Psy.D. Psychologist/Executive Director

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Nearly 1 in 3 U.S. Adolescents Are Getting Mental Health Treatment

Anew poll shows that nearly a third of American adolescents and teens received some sort of mental health treatment in 2023, suggesting more young Americans struggling with mental health issues are getting the help they need.

That translates to over eight million young people between the ages of 12 and 17 getting counseling, medication or another treatment, the survey from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) found.

Mental health is being destigmatized

“We’re pleased to see that more people received mental health treatment in 2023 than the previous year,” SAMHSA Administrator Miriam Delphin-Rittmon said in an agency news release announcing the survey.

Among adolescents, the biggest increase from 2022 was in the number of those getting mental health medications: Nearly 14% of those age 12 to 17 received such a prescription in 2023, up from 12.8% the year before.

SAMHSA officials said they saw the increase shows that mental health treatment is finally being destigmatized.

Rates of adolescents getting mental health treatment has increased virtually every year since 2009, though the agency noted that changes in how the survey was done were introduced in 2021.

In 2022, the survey estimated that 7.7 million youths ages 12 to 17 had received mental health treatment of some kind. The increase in 2023 amounts to more than 500,000 more young people getting treatment, SAMHSA noted.

Adolescent depression, substance abuse

Meanwhile, the rate of adolescents

reporting a major depressive episode has remained roughly flat since 2021, at just over 18% of those ages 12 to 17, the survey found.

Psychiatrists classify a major depressive episode as a period of feeling depressed for at least two weeks.

“The report shows us that we must remain steadfast in our efforts to address the mental health and substance use crises,” Delphin-Rittmon said during a media briefing, CBS News reported.

While trends in substance abuse did not see major shifts in the 2023 survey, alcohol use did see a statistically significant drop. In 2023, 47.5% of adults and adolescents – about 134.7 million Americans – reported drinking alcohol in the past month, down from 48.7% in 2022.

But rates of problem drinking were largely unchanged in 2023, with 21.7% reporting binge drinking and 5.8% reporting “heavy alcohol use.” And around 10.2% of adolescents and adults reported drinking to the point where they met the criteria of alcohol use disorder.

Most U.S. Adults Want to Be Asked About Mental Health at Primary Care Visits

Majority report that screening for depression and anxiety is very important

Mental health screenings are increasingly integrated into primary care visits as a proactive approach to identify and address mental health conditions early. These screenings help detect potential issues that might otherwise be missed.

Patients approve

Patients greatly approve of this practice. Seven in 10 U.S. adults would prefer to be asked about both their physical and mental health during medical appointments with primary care providers (PCPs), ac-

cording to the results of a survey released by West Health and Gallup.

Majorities among both men (65 percent) and women (76 percent) reported being eager to discuss both their mental and physical health with their PCPs. Most U.S. adults reported being either "very comfortable" (41 percent) or "somewhat comfortable" (33 percent) discussing mental health with their PCP.

The need for mental health treatment

If a mental health condition is diagnosed, more than half of adults (57 percent) say it is very important for the doctor to either address it themselves or provide a referral. The survey also revealed that about half of U.S. adults (51 percent) think it is very

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important for doctors to screen patients for anxiety and depression.

The survey results also show that many households are likely in need of behavioral healthcare. More than half of Americans (53%) say someone in their household, or a close family member has been diagnosed with a mental health condition. Among those who report that someone close to them has been diagnosed, 20% say that condition negatively affects their family’s or household’s daily life “a great deal,” and 39% say “quite a bit.”

"We can do a better job making the diagnosis and treatment of a mental health condition more accessible, affordable, and integrated, and the solution may lie in primary care settings, where patients are most likely to interact with a health professional and less likely to feel stigmatized," Tim Lash, president of the West Health Policy Center, said in a statement.

The West Health-Gallup Survey on Mental Health was conducted via web and mail from Oct. 1 to 13, 2024, with 2,389 respondents and representing all 50 U.S. states and the District of Columbia.

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Wildfire Smoke Increases Risk of Mental Health Problems

Smoke from wildfires driving you mad? You’re not alone, a new study says.

Short-term exposure to air choked with wildfire smoke increases risks of mental health problems, according to findings published April 4 in JAMA Network Open. Hospital emergency rooms experience surges in patients with mental health conditions on days when smoke pollution is at its worst, researchers found.

“Wildfire smoke isn’t just a respiratory issue — it affects mental health, too,” said corresponding author Dr. Kari Nadeau, chair of environmental health at the Harvard T.H. Chan School of Public Health.

Conditions affected

“Our study suggests that — in addition to the trauma a wildfire can induce — smoke itself may play a direct role in worsening mental health conditions like depression, anxiety, and mood disorders,”

Nadeau added in a news release.

Researchers tracked levels of particle pollution caused by California wildfires that occurred between July and December 2020 — the state’s most severe wildfire season on record. They compared that data to ER visits for mental health problems and found that exposure to wildfire smoke substantially increased the number.

Specifically, a 10 microgram-per-cubic-meter increase in wildfire particle pollution was linked to more ER visits for:

n Any mental health condition: 8% increased risk.

n Depression: 15% increased risk.

n Other mood disorders: 29% increased risk.

n Anxiety: 6% increased risk.

Demographic disparities

Women and children were at higher risk for mental health problems, with 17% and

Honeysuckle Eradication

46% increased risk, respectively. Black people had a more than the double the risk of mood disorders related to wildfire smoke exposure, and Hispanics had a 30% increased risk.

“The disparities in impact by race, sex, age and insurance status suggest that existing health inequities may be worsened by wildfire smoke exposure,” lead investigator YounSoo Jung said in a news release.

Based on these results, hospitals should brace for potential increases in mental health emergencies during wildfires, researchers said.

“We need to make sure everyone has access to mental health care during wildfire seasons, as wildfires become more frequent and severe as a result of climate change,” Jung said.

More information

The U.S. Environmental Health Agency has more on health concerns from wildfire smoke.

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Too Many After-School Programs Can Harm

Teens’ Mental Health

Days clogged with numerous after-school activities are detrimental to the mental health of over-scheduled high school students, a recent study finds.

Researchers also found that these "enrichment” activities – tutoring, sports, school clubs and even homework – are unlikely to benefit students academically. Many folks think extra study time or tutoring will lead to better grades, but the new study shows many students are at their limit, said researcher Carolina Caetano, an assistant professor of economics with the University of Georgia College of Business.

“We found that the effect of those additional activities on cognitive skills, that last hour, is basically zero,” Caetano said in a university news release. “And what’s more surprising is that the last hour doing these activities is contributing negatively to the child’s non-cognitive skills.” In other words, academic overload is causing high schoolers to lose out on social and emotional abilities – well-being, emotional control, resilience and communication, Caetano said.

Enrichment activities, social and emotional skills

Caetano said it’s best to think of the relationship between enrichment activities and these social and emotional skills as

a curve. For a while, an additional hour of studying, tutoring or group activities will help students improve their academic performance.

But the more time a student spends on enrichment, the less time they have to relax, freely socialize or sleep – activities valuable for life skills and knowledge retention, Caetano said. Lack of sleep and stress can cause students to lose whatever academic or social gains they might have gotten through enrichment activities, Caetano said.

“Non-cognitive skills are highly important, but people don’t always think of them because they’re hard to measure,” Caetano said. “They are important not only for future happiness, but professional success as well."

Eventually, a schedule overloaded with academic enrichment can result in stressed-out kids suffering from anxiety and depression as a result of being overextended, Caetano said. “You’re at the maximum of what you can acquire academically from that work. But on the curve for non-cognitive skills, you have gone past the maximum and gone into the descending part of the curve. You’re losing socio-emotional skills at that point.”

The study

For this study, researchers analyzed detailed data from 4,300 elementary, middle school and high school students.

The team found that elementary and middle schoolers were at the top of the curve, which means they’re facing negative returns from any additional enrichment activities. “While they haven’t gone into a negative area yet, additional work is likely to harm them,” Caetano said.

High schoolers had the worst situation, because they’ve actually started to suffer negative returns from having too much on their plates.

Let teens enjoy more free time

Opening student’s schedules and letting them enjoy more free time could help build the emotional regulation and resilience that will benefit them when the college crunch occurs, Caetano said.

It’s important for children to hang out with other kids in an unrestricted manner to build their social and emotional skills, Caetano argued. In fact, it could prove more vital than that last little bit of learning.

Unfortunately, unless enough parents get on board, children provided more free time away from enrichment activities won’t have any other kids available for play. “What we have here is a societal problem,” Caetano said. “There’s only so much that parents can do.”

The study doesn’t suggest how many enrichment hours are best. Caetano said parents are probably the best judges. “I’d say that if you have signs that, as a family, you are overly stretched, you probably are in the negative returns side of the curve, and you should scale back,” Caetano said. “If whenever someone contacts you for a play date, you are always scheduled, then it’s very clear that you are overscheduled.”

The study was published recently in the journal Economics of Education Review.

More information

The University of Rochester Medical Center has more on overscheduled kids.

Source: University of Georgia, news release

Preschool BMI Can Predict Childhood Obesity Risk

Preschoolers who don’t naturally lose weight are more likely to develop full-fledged childhood obesity by age 9, a new study says.

For most kids, body-mass index (BMI) declines between ages 1 and 6, before they start to slowly gain weight as they grow. But researchers reported recently in JAMA Network Open that just under 11% of kids see their BMI remain the same between ages 1 and 3½. After that, from age 3½ to 9, their weight rises rapidly. BMI is an estimate of body fat based on height and weight.

Childhood and adulthood risks

Kids in that group were much more likely to develop childhood obesity, with an average BMI greater than 99% of their peers, researchers found. “The fact that we can identify unusual BMI patterns as early as age 3½ shows how critical early childhood

is for preventing obesity,” lead researcher Chang Liu, an assistant professor of psychology at Washington State University, said in a news release.

Children with high BMI are more likely to carry their excess weight into adulthood, increasing their risk of chronic illnesses like diabetes and heart disease, researchers said in background notes.

The study

For the study, researchers analyzed data on nearly 9,500 kids collected as part of the Environmental influences on Child

Health Outcomes Program, an ongoing federally supported study of kids’ health that includes participants from 44 states and Puerto Rico.

Researchers used weight and height data to calculate kids’ BMI from ages 1 to 9, to see whether early weight trends might foretell future struggles with overweight or obesity.

The data showed that kids whose BMI doesn’t decline between ages 1 and 6 have a greater risk of obesity. This risk was associated with other early-life factors including high birth weight, a mother smoking or with high BMI before or during pregnancy, researchers said.

“Our findings suggest there are important opportunities to reduce childhood obesity, such as helping pregnant women quit smoking and manage healthy weight gain, as well as closely monitoring children who show early signs of rapid weight gain,” Liu said.

More information

The U.S. Centers for Disease Control and Prevention has a child and teen BMI calculator.

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S FOR SUPERVISION AND SURVIVAL SKILLS

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F FOR FLOTATION DEVICES

Coast Guard regulation life vests for young children and non-swimmers, not floaties or inner tubes.

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Check drains for compliance to prevent suction and drain entrapment. Use life guards for pool parties.

Staying Fit Improves Kids’ Mental Health

Two new studies show that the benefits of physical fitness for kids spill over into their mental health, and last into their teen years.

Getting plenty of exercise may guard against depressive symptoms, anxiety and attention-deficit hyperactivity disorder (ADHD), a study published last year in the journal JAMA Pediatrics found.

Getting plenty of exercise may guard against depressive symptoms, anxiety and attention-deficit hyperactivity disorder (ADHD) in children, a study published last year in the journal JAMA Pediatrics found.

And the more exercise, the better: Higher performance in cardiovascular activities, strength and muscular endurance were each associated with even greater protection against mental health issues.

The findings arrive as America continues to grapple with a surge in mental health diagnoses among children and adolescents.

The study

Conducted by researchers in Taiwan, the study compared data from the Taiwan National Student Fitness Tests and the National Insurance Research Database, which records medical claims, diagnoses, prescriptions and other medical information. The researchers used the anonymous data to compare students’ physical fitness against their mental health.

The risk of mental health disorder was weighted against cardio fitness, as measured by a student’s time in an 800-meter run; muscle endurance, indicated by the number of sit-ups performed; and muscle power, measured by the standing broad jump.

The results

What did they discover? Higher performance in each activity was linked with a lower risk of a mental health disorder. For instance, a 30-second decrease in the 800-meter time was associated with a lower risk of anxiety, depression and ADHD in girls. In boys, it was associated with lower anxiety and a lower risk of ADHD.

Meanwhile, an increase of five sit-ups per minute was associated with lower anxiety and risk of ADHD in boys, and it was linked to a decreased risk of depression and anxiety in girls.

“These findings suggest the potential of cardiorespiratory and muscular fitness as protective factors in mitigating the onset of mental health disorders among children and adolescents,” the researchers wrote in the study.

“These finding underscores the need for further research into targeted physical fitness programs,” the researchers concluded. Meanwhile, exercise programs “hold significant potential as primary preventative

interventions against mental disorders in children and adolescents,” they wrote.

Impact of kids’ fitness in their teen years

A separate study found that kids with good physical fitness are more likely to grow into teens with better mental health and brain function, a new study has found. Children who performed better at shuttle sprints scored better on cognitive tests as teenagers. In addition, better cardio fitness in childhood added up to lower levels of stress and depression among teenagers, results show.

The study and results

In the study, researchers followed the physical fitness of 241 Finnish kids for eight years, tracking them from childhood through to adolescence. Tests of physical fitness were compared to scores of teens’ thinking ability and emotional health.

The findings, published in the journal Sports Medicine, showed that the more fit the kids were, the less stress and depression they reported as teenagers.

This could be because kids with better physical health have more self-esteem and better mental resilience, researchers said. However, the researchers warned that kids who spend more times with screens might find the benefits of physical fitness blunted a bit.

Implications for policymakers and parents

“Our results should encourage policymakers as well as parents and guardians to see the significance of physical fitness more holistically, as poor physical fitness can increase mental health challenges and impair cognitive skills needed for learning,” said lead researcher Eero Haapala, a senior lecturer of sports and exercise medicine at the University of Jyvaskyla in Finland.

“The whole of society should support physical fitness development in children and adolescents by increasing physical activity participation at school, during leisure time and in hobbies,” Haapala concluded in a university news release.

Sources

JAMA Pediatrics, 2024 and Sports Medicine, 2024

More information

The U.S. Centers for Disease Control and Prevention has more on the benefits of physical activity and mental health for kids.

Social Media Use Linked to Eating Disorders in Kids and Young Teens

The increasing popularity of social media has led to many studies describing the associations between social media use, body image, and eating concerns. Most of these studies have been conducted among older female adolescents and young adults (approximately 15–29 years of age).

However, other studies have shown that eating disorder symptoms may develop in early adolescence. This study focused on the early adolescent population, since they are known to also have increasing rates of screen use, and early symptom development may predispose individuals to long-term disordered eating.

Results showed that average social media use and screen time increased the risk of eating disorders, and that problematic use raised the risk even more, researchers found. Each additional hour of total screen time or social media use per day raises the likelihood that a kid or young teen will have eating disorder symptoms two years later, researchers reported recently in the journal Eating and Weight Disorders.

These symptoms include worrying about gaining weight, linking one’s self-worth to weight, and binge eating, researchers said. Others include excessive exercise, restricting calories, throwing up, or taking water pills, laxatives or diet pills.

“Social media promotes constant comparisons to peers and exposure to unattainable body ideals,” said senior study author

Dr. Jason Nagata, an associate professor of pediatrics at the University of California, San Francisco (UCSF).

“This can contribute to dissatisfaction with one’s own body, reduced self-esteem, and unhealthy attempts to control weight, all of which increase the risk of developing eating disorders and other mental health issues,” Nagata added in a UCSF news release.

Researchers analyzed data from nearly 12,000 kids ages 9 to 14 collected between 2016 and 2020.

“Adolescents should limit social media that encourages eating disorders and appearance comparisons,” Nagata concluded. “Parents can play an important role by developing family media use plans and holding open conversations about problematic screen use and disordered eating concerns.”

More information

The National Eating Disorders Association has more on media and eating disorders.

Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health

By Dr. Marty Makary

Marty Makary, MD is a Johns Hopkins surgeon and New York Times best-selling author who was recently appointed Director of the U.S. Food and Drug Administration.

In this thought-provoking book Dr. Makary exposes a number of major health recommendations the medical establishment has propagated over decades that have proven to be erroneous and, in some cases, have had negative consequences for patients’ health.

This insightful, eye-opening book is well-researched and an engaging read. It cites issues within the medical system in which widely offered health recommendations have been based on insufficient evidence or flawed assumptions. Dr. Makary argues that factors including hubris of the medical establishment, groupthink, cognitive biases, and lack of transparency contribute to flawed decision-making and resistance to adapting to new evidence.

Compelling everyday examples illustrate these points, including the widely used approaches to preventing childhood peanut allergies that have had the opposite result, and advice by generations of doctors against hormone replacement therapy for menopausal women that was based on flawed data. Discouraging HRT has denied generations of women benefits that include reducing cognitive decline and vulnerability to bone fractures and also resulted in their increasing significant health risks such as heart attacks and colon cancer.

Other examples of the medical establishment’s errant practices are the overprescribing of antibiotics, which has caused a drug-resistant bacteria crisis, and the demonization of natural fat in foods, driving Americans to processed carbohydrates as obesity rates soared.

Dr. Makary writes, “When modern medicine issues recommendations based on good scientific studies, it shines. Conversely, when modern medicine is interpreted through the harsh lens of opinion and edict, medical dogma can take on a life of its own, molding beliefs that harm patients and stunt research for decades.”

The book advocates for changes within the medical system to prioritize patient welfare, promote evidence-based practices, and encourage open dialogue about uncertainties.

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