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Brain changes cause Alzheimer’s psychiatric symptoms

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Psychiatric symptoms, like cognitive symptoms, occur mainly as a direct consequence of the underlying changes to the brain

In addition to memory problems and other cognitive symptoms, most people with Alzheimer’s disease also suffer from mental health issues.

It has long been unclear whether these occur because of tissue changes in the brain, or whether they represent psychological reactions to cognitive symptoms.

A study from Lund University in Sweden has provided new insight, and is published in ‘Biological Psychiatry’.

Cognitive symptoms combined with elevated levels of certain proteins form the basis for diagnosis of Alzheimer’s disease.

At the same time, researchers and physician alike have, over the past decade, recognised that changes in mood and behaviour are often very early signs of the disease. Yet, these symptoms have not received as much scientific attention as cognitive ones.

Now, researchers from Lund University have investigated the complex relationships between psychological symptoms, Alzheimer’s proteins and cognitive symptoms.

This was done within the framework of the internationally renowned BioFINDER study, led by Professor Oskar Hansson.

The study examined 356 people over the age of 65 with no cognitive symptoms at the start of the research.

In addition to analysing the levels of the Alzheimer’s proteins amyloid beta and phosphorylated tau in their cerebrospinal fluid, participants’ levels of anxiety, apathy and overall cognitive function were also assessed on a biannual basis. They were followed for a total of eight years.

When data was analysed, the researchers found a clear link between elevated levels of amyloid beta at the start of the study and future development of anxiety and apathy.

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Maurits Johansson, physician and lead author of the study, explained: “Alzheimer’s disease affects large parts of the brain, including the regions that control our emotional life.

“Our study shows that psychiatric symptoms, just like cognitive symptoms, occur mainly as a direct consequence of the underlying changes to the brain, due to increased levels of amyloid beta.”

The researchers further demonstrated that amyloid beta drives the development of apathy predominately through direct effects, and that apathy only to a limited extent evolves secondary to cognitive decline.  Anxiety was not linked to cognitive change.

“The findings thus argue against the idea that these early changes in emotion and motivation in Alzheimer’s disease are primarily psychological reactions to cognitive decline.

“Instead, the results suggest that for apathy and anxiety at least, these occur due to the pathological accumulation of amyloid beta,” clarified Professor Oskar Hansson.

“Our findings imply that psychiatric symptoms in Alzheimer’s disease could be used as alternative outcome measures in treatment trials. Ultimately, this could lead to more effective study design,” he continued. 

“A previous BioFINDER study suggested that the presence of anxiety or apathy among elderly people who continued to show no signs of dementia may point to an increased risk of future cognitive impairment.

“As a next step, studies are needed to clarify how these symptoms may contribute to the established clinical diagnosis in the early stages of disease, possibly even before cognition has been affected,” they concluded.

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Older male athletes may face increased risk of serious heart problems during exercise

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Veteran male athletes may face higher heart risk during exercise if they have existing heart scarring, new research suggests.

The study found that male endurance athletes aged over 50 were more likely to experience abnormal heart rhythms during training if scarring was present.

Nine in 10 sudden cardiac deaths during sport occur in older male athletes.

Researchers at the University of Leeds tracked 106 healthy male endurance athletes aged over 50 who had been doing more than 10 hours of running or cycling weekly for at least 15 years.

They matched training data from wearables with implantable loop recorders to align heart rhythms with activity.

Over two years, about one in four participants experienced ventricular tachycardia, a fast, abnormal rhythm arising from the heart’s lower chambers, during or just after exercising.

Three quarters of those who had these episodes had heart scarring. There were three sustained episodes during exercise, all in athletes with scarring.

Scarring may be caused by heart attacks, disease or cumulative exertion from years of high-intensity exercise.

Dr Wasim Javed, research fellow at the University of Leeds and lead author, said: “Our study shows that exercise was only associated with a risk of developing abnormal heart rhythms in those who were already high risk due to heart scarring.

“Athletes who developed abnormal heart rhythms were not exercising more or harder than athletes without abnormal heart rhythms.

“This suggests that exercise itself is not the cause, but could act as a trigger for dangerous heart rhythms in those athletes already with an underlying heart issue.”

“Exercise is safe and has immense benefits – but athletes in this group should have regular health checks to make sure they stay healthy.”

The researchers said their findings support the use of wearable technology for athletes who want to monitor their heart rate for unusual activity.

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Childhood exposure to indoor air pollution linked to long term brain harms

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Childhood exposure to indoor air pollution may have long-term effects on brain health, with cognitive impairment appearing decades later, new research suggests.

The study analysed data from over 7,000 Chinese adults aged 45 and above using machine learning techniques.

Nearly 30 per cent of the global population, roughly 2.4bn people, still cook without clean fuels such as gas or electricity, instead using solid fuels like coal, wood and plant waste.

Researchers at the University of Helsinki found that individuals exposed as children to indoor air pollution from solid fuels performed significantly worse on cognitive tests in adulthood, particularly in episodic memory and overall mental health.

The study identified two main pathways through which childhood exposure may contribute to poorer cognitive performance: biological, including being overweight and limitations in daily activities; and socioeconomic, with exposure associated with lower education and income levels.

Men, smokers and regular alcohol users were particularly vulnerable to the detrimental effects.

Xu Zong, the study’s author, said: “Our study emphasises that early exposure to air pollution affects later cognitive health through both biological and social pathways.

“That is why public health efforts should combine clean energy initiatives with preventive strategies that support lifelong health and positive behaviours.

“Switching to cleaner fuels, such as gas or electricity, is not merely an environmental or respiratory health measure.

“It is also an investment in long-term cognitive wellbeing that could safeguard brain health for future generations.”

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SimpleC launches AI companion for dementia carers

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SimpleC has launched Wellby, an AI companion for unpaid dementia carers, offering round-the-clock emotional support and practical guidance.

Announced at CES in Las Vegas, Wellby is designed for caregivers of people with Alzheimer’s disease and related dementias.

Some 63 million people in the US provide unpaid care to older adults, including 12 million specifically caring for those with dementia. SimpleC says many face emotional strain, uncertainty and limited timely guidance.

Unlike general-purpose AI tools, Wellby is built for caregiving support, delivering personalised, real-time assistance through natural conversation.

Kevin Henze, chief executive of SimpleC, said: “This launch reinforces our belief that technology should support caregivers with both intelligence and compassion.

“As a privately owned, mission-driven company, we’re able to prioritise affordability, accessibility, and long-term caregiver impact. Wellby represents technology with soul—AI designed to truly walk alongside caregivers.”

Future releases will integrate the companion into SimpleC’s Connected Care Platform and extend it to serve older adults ageing in place.

Jun Ying, chief product officer, said: “By integrating AI across our platform, we’re creating a connected ecosystem where caregivers and care recipients can access multiple services—support, monitoring, guidance, and coordination—through a single, trusted SimpleC experience.”

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