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Quality of ‘good cholesterol’ contributes to the first sign of Alzheimer’s in women

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Higher levels of HDL-C—known as the “good cholesterol”—have been shown to correlate with heightened risk for Alzheimer’s disease.

A new study, published in the Journal of Clinical Endocrinology & Metabolism might, explain why.

Once women reach the menopause transition, it’s a matter of the quality, rather than quantity, of the total cholesterol carried by HDL particles circulating in a woman’s bloodstream, and that quality declines over time, according to a research team led by a University of Pittsburgh School of Public Health epidemiologist.

HDL particles vary in their size, composition and level of functioning.

The team measured these features in the blood of 503 women from the Study of Women’s Health Across the Nation (SWAN) HDL ancillary study.

The researchers found that, over time, the number of larger HDL particles in the women’s bodies increased—and these larger particles, unfortunately, did not function as well as their smaller counterparts.

The researchers conducted repeated assessments of study participants’ cognitive function from 2000 to 2016 and compared these data to changes in the women’s HDL particles, composition and function as they aged.

Samar R. El Khoudary, Ph.D., M.P.H. is professor of epidemiology at Pitt Public Health.

The researcher said: “We were able to show that as early as midlife, women who have more of the smaller-sized particles and those whose particles’ concentrations of phospholipids increased over the menopause transition are more likely to experience better episodic memory later in life,” adding that loss of working memory is the first sign of Alzheimer’s disease.

Previously, El Khoudary’s team has shown that health behaviors—such as those included in the American Heart Association’s (AHA) Life’s Essential 8—work to improve the quality of HDL particles, for example by adding more of the phospholipid-rich particles in the bloodstream.

El Khoudary said: “That’s the good news in this developing picture of brain health and the ‘not-so-good-after-all’ cholesterol.

“Even though higher levels of HDL-C may not be protective as you get older, there are things you can do that might help, even as early as your 40s.

“The same, modifiable risk factors that the AHA is advocating for—including physical activity, ideal body weight and quitting smoking—can help you protect your brain, too.”

Technology

Glasgow clinic launches Alzheimer’s detection test

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NeuroClin – formerly known as Glasgow Memory Clinic – has partnered with Advance Tests to launch Scotland’s first commercially available blood biomarker test for early Alzheimer’s detection.

Designed for people with mild cognitive impairment (MCI) – subtle problems with memory and thinking – the LucentAD Complete test helps determine whether these symptoms are likely due to Alzheimer’s.

Dementia affects more than 90,000 people in Scotland and nearly one million across the UK each year.

Early diagnosis is becoming increasingly important following the recent UK approval of new disease-modifying drugs lecanemab and donanemab.

“We know that changes in the brain linked to Alzheimer’s begin years before symptoms appear,” said Dr Jennifer Lynch, medical director at NeuroClin.

“This new blood biomarker test helps us detect potential Alzheimer’s earlier, giving people access to lifestyle advice, and access to new disease-modifying treatments or research opportunities.”

The launch marks the first time a clinically validated blood test for Alzheimer’s has been available in Scotland outside a research trial setting, following national NHS trials exploring single-marker biomarker tests.

This new version uses a multi-marker approach and is now commercially available.

Developed by Lucent Diagnostics, the test is already widely used across the US, supported by multiple peer-reviewed studies and now covered by the Medicare system.

At NeuroClin, the new blood biomarker test will form part of a staged diagnostic pathway beginning with memory testing, followed by the blood test, genetic testing and specialist support where appropriate.

Dr Simon Worrell, chief medical officer at Advance Tests, said: “Bringing this diagnostic test to Scotland for the first time is a major milestone – not just for Advance Tests, but for patients and clinicians across the country.

“We are witnessing a rare and important moment in health innovation, where breakthroughs in diagnostics are aligned with breakthroughs in treatment.

“With newly approved drugs now available, and growing evidence that early lifestyle changes can delay progression, early diagnosis has never been more valuable.”

Henry Simmons, chief executive at Alzheimer’s Scotland, added: “While we wish blood biomarker tests were routinely available on the NHS, this is not yet the case.

“We welcome NeuroClin taking the lead in offering this service in Scotland, as earlier diagnosis can help people and families get answers sooner, plan ahead and access the right support and emerging treatments.”

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Researchers use prehistoric skeletons to study ageing

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An archaeologist from the University of York is leading a new study into how societies viewed ageing, wisdom and experience over thousands of years.

Dr Lindsey Büster’s research claims to be the first to focus on the lives and experiences of older adults in prehistoric and Roman Europe, examining skeletons and objects from collections including York Museums Trust.

The project, called Age-Old Stories, aims to challenge existing stereotypes and ageism by exploring how earlier societies viewed age, wisdom and experience.

“They have a very large collection of Roman human remains from across Yorkshire and that’s going to be a really important assemblage for us,” said Dr Büster.

The ultimate aim is for the research to provide strong examples of why making older adults more visible in policy-making and public life is so important,” said Dr Büster.

“Ageing is not a marginal experience, it is a central part of human history and we should have better strategies for valuing and celebrating it today.”

Archaeological discoveries already suggest that older adults were central figures in many past societies.

In Scarborough, the remains of Gristhorpe Man – Britain’s best-preserved Early Bronze Age skeleton – were analysed and suggested he was aged between 45 and 60 years, tall and muscular, and nourished by a rich diet.

“He is over 45 and he was buried in this log coffin, which would’ve been hugely time consuming, hugely labour intensive and he’s buried with a dagger,” said Dr Büster.

“These are all the trappings of a high-status individual.”

The project will work in partnership with York Museums Trust to create a new exhibition and public events, and will also collaborate with Age Friendly York.

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Weight loss jabs should be first-line obesity treatment in most cases, new guidance states

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Weight loss jabs Mounjaro and Wegovy are so effective they should be the first treatment for obesity “in almost all cases”, according to new medical guidance.

The European Association for the Study of Obesity praised the drugs’ effectiveness and wider health benefits in new guidance to doctors.

It described them as slimming aids that can also cut the risk of related conditions such as high blood pressure and type 2 diabetes.

Three in ten Britons – around 16m adults – are obese, but only 1.5m use the injections, most bought privately at about £200 a month.

Trials have shown adults using semaglutide, the active ingredient in Wegovy and Ozempic, lost about 14 per cent of their body weight over 72 weeks.

Those taking tirzepatide – marketed as Mounjaro and sometimes dubbed the “king kong” of weight loss jabs – lost about 20 per cent over the same period.

Dr Andreea Ciudin, co-first author of the guidance from the Autonomous University of Barcelona, said the drugs were “completely transforming care of obesity and its complications”.

She added: “Even though there are several options on the market, the reality is that semaglutide and tirzepatide are so effective that they should be the first choice in almost all cases.”

The guidelines were produced by an international team of experts, including contributors from the UK.

They analysed existing studies and created an algorithm to help doctors decide the best treatment based on a patient’s weight and associated conditions.

They concluded that tirzepatide and semaglutide should be considered the “medications of choice” when a substantial level of total body weight loss is required.

When a lesser degree of weight loss is the aim, other medicines such as liraglutide, naltrexone–bupropion and phentermine–topiramate may be appropriate.

The guidance comes after health secretary Wes Streeting pledged this week to make injections available to millions more patients on the NHS.

Speaking at the Labour Party conference in Liverpool, he said it was unfair that wealthier people had been able to benefit from the drugs’ “transformative” effects “on their health, their confidence and their quality of life” while those unable to pay privately had gone without.

He added: “Weight-loss jabs could help us finally defeat obesity.

“Our mission is to ensure that the best science, the best healthcare and the best innovations are available not just to some, but to all.”

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