Having a strong life purpose eases loneliness of COVID-19 isolation
Those who felt their life was guided by meaningful values or goals were more willing to engage in COVID-19 protective behaviors
June 16, 2021
Science Daily/University of Pennsylvania
Why can some people weather the stress of social isolation better than others, and what implications does this have for their health? New research from the Communication Neuroscience Lab at the Annenberg School for Communication at the University of Pennsylvania found that people who felt a strong sense of purpose in life were less lonely during the COVID-19 pandemic. Did they achieve less loneliness by flouting public health guidance? No. Although lonelier people were less likely to want to follow public health guidance, people with a stronger sense of purpose also expressed more willingness to engage in social distancing, hand washing, and other COVID-19 protective behaviors.
Purpose in life, or a sense that your life is guided by personally meaningful values and goals -- which could involve family ties, religion, activism, parenthood, career or artistic ambitions, or many other things -- has been associated in prior research with a wide range of positive health outcomes, both physical and psychological.
"In the face of adversity, people with a stronger sense of purpose in life tend to be more resilient because they have a clear sense of goals that motivate actions that are aligned with personal values," says Yoona Kang, Ph.D., lead author and a Research Director of the Communication Neuroscience Lab. "People with strong purpose may also experience less conflict when making health decisions. We felt that the COVID-19 pandemic was an important context to test whether purpose in life relates to individuals' willingness to engage in behaviors to protect themselves and others."
Based on their prior research, Kang and her collaborators expected that people with higher sense of purpose would be more likely to engage in COVID-19 prevention behaviors than individuals with a lower sense of purpose. In order to test their theory, the researchers surveyed more than 500 adult participants to capture their levels of purpose in life, their current and pre-pandemic levels of loneliness, and the degrees to which they intended to engage in behaviors known to prevent the spread of COVID-19.
They found that higher levels of loneliness made people be less focused on protecting themselves from COVID-19, and more skeptical that behaviors to prevent COVID-19 would be effective. However, having a stronger sense of purpose was associated with lower levels of loneliness and a greater desire to take action to protect themselves from COVID-19. Those with a higher sense of purpose also expressed a stronger belief that COVID-19 prevention behaviors would work. Even when people who had a strong sense of purpose did report being lonely, they still felt strongly about taking precautions to prevent COVID-19.
"When faced with extreme loneliness and social isolation, like during the COVID-19 pandemic, wanting to connect with other people, despite the health risks, is a natural response," Kang says. "And yet, amidst this drastic shift in social life, we found that people with a higher sense of purpose were more likely to engage in prevention behaviors. This is striking because it shows that purpose in life can empower people to make life-saving health decisions that protect their own health and those around them."
Additionally, the researchers found that older people expressed less loneliness during the COVID-19 pandemic than younger people. Kang sees this as a sign of the resilience of older adults, and she hopes to further study how to enhance purpose in life and resilience in aging populations.
"Having a stronger sense of purpose was associated with really important, positive outcomes across the lifespan," says Emily Falk, senior author, Director of the Communication Neuroscience Lab, and Professor of Communication, Psychology, and Marketing. "Our upcoming work will test interventions to increase their sense of purpose, in hopes of bringing these benefits to more people."
https://www.sciencedaily.com/releases/2021/06/210616154257.htm
Music listening near bedtime disruptive to sleep
June 10, 2021
Science Daily/Baylor University
Most people listen to music throughout their day and often near bedtime to wind down. But can that actually cause your sleep to suffer? When sleep researcher Michael Scullin, Ph.D., associate professor of psychology and neuroscience at Baylor University, realized he was waking in the middle of the night with a song stuck in his head, he saw an opportunity to study how music -- and particularly stuck songs -- might affect sleep patterns.
Scullin's recent study, published in Psychological Science, investigated the relationship between music listening and sleep, focusing on a rarely-explored mechanism: involuntary musical imagery, or "earworms," when a song or tune replays over and over in a person's mind. These commonly happen while awake, but Scullin found that they also can happen while trying to sleep.
"Our brains continue to process music even when none is playing, including apparently while we are asleep," Scullin said. "Everyone knows that music listening feels good. Adolescents and young adults routinely listen to music near bedtime. But sometimes you can have too much of a good thing. The more you listen to music, the more likely you are to catch an earworm that won't go away at bedtime. When that happens, chances are your sleep is going to suffer."
People who experience earworms regularly at night -- one or more times per week -- are six times as likely to have poor sleep quality compared to people who rarely experience earworms. Surprisingly, the study found that some instrumental music is more likely to lead to earworms and disrupt sleep quality than lyrical music.
The study involved a survey and a laboratory experiment. The survey involved 209 participants who completed a series of surveys on sleep quality, music listening habits and earworm frequency, including how often they experienced an earworm while trying to fall asleep, waking up in the middle of the night and immediately upon waking in the morning.
In the experimental study, 50 participants were brought into Scullin's Sleep Neuroscience and Cognition Laboratory at Baylor, where the research team attempted to induce earworms to determine how it affected sleep quality. Polysomnography -- a comprehensive test and the gold standard measurement for sleep -- was used to record the participants' brain waves, heart rate, breathing and more while they slept.
"Before bedtime, we played three popular and catchy songs -- Taylor Swift's 'Shake It Off,' Carly Rae Jepsen's 'Call Me Maybe' and Journey's 'Don't Stop Believin'," Scullin said. "We randomly assigned participants to listen to the original versions of those songs or the de-lyricized instrumental versions of the songs. Participants responded whether and when they experienced an earworm. Then we analyzed whether that impacted their nighttime sleep physiology. People who caught an earworm had greater difficulty falling asleep, more nighttime awakenings, and spent more time in light stages of sleep."
Additionally, EEG readings -- records of electrical activity in the brain -- from the experimental study were quantitatively analyzed to examine physiological markers of sleep-dependent memory consolidation. Memory consolidation is the process by which temporary memories are spontaneously reactived during sleep and transformed into a more long-term form.
"We thought that people would have earworms at bedtime when they were trying to fall asleep, but we certainly didn't know that people would report regularly waking up from sleep with an earworm. But we saw that in both the survey and experimental study," he said.
Participants who had a sleep earworm showed more slow oscillations during sleep, a marker of memory reactivation. The increase in slow oscillations was dominant over the region corresponding to the primary auditory cortex which is implicated in earworm processing when people are awake.
"Almost everyone thought music improves their sleep, but we found those who listened to more music slept worse," Scullin said. "What was really surprising was that instrumental music led to worse sleep quality -- instrumental music leads to about twice as many earworms."
The study found that individuals with greater music listening habits experienced persistent earworms and a decline in sleep quality. These results are contrary to the idea of music as a hypnotic that might help sleep. Health organizations commonly recommend listening to quiet music before bedtime -- recommendations that largely arise from self-reported studies. Instead, Scullin has objectively measured that the sleeping brain continues to process music for several hours, even after the music stops.
Knowing that earworms negatively affect sleep, Scullin recommends first trying to moderate music listening or taking occasional breaks if bothered by earworms. Timing of music also is important -- try to avoid it before bed.
"If you commonly pair listening to music while being in bed, then you'll have that association where being in that context might trigger an earworm even when you're not listening to music, such as when you're trying to fall asleep," he said.
Another way to get rid of an earworm is to engage in cognitive activity -- fully focusing on a task, problem or activity helps to distract your brain from earworms. Near bedtime, rather than engaging in a demanding activity or something that would disrupt your sleep, like watching TV or playing video games, Scullin suggests spending five to 10 minutes writing out a to-do list and putting thoughts to paper. A previous study by Scullin -- partially funded by a National Institutes of Health grant and the Sleep Research Society Foundation -- found that participants who took five minutes to write down upcoming tasks before bed helped "offload" those worrying thoughts about the future and led to faster sleep.
https://www.sciencedaily.com/releases/2021/06/210610162348.htm
Laughing gas relieves symptoms in people with treatment-resistant depression
Single treatment provides patients with rapid, lasting antidepressant effects
June 9, 2021
Science Daily/Washington University School of Medicine
A single, one-hour treatment that involves breathing in a mixture of oxygen and nitrous oxide -- otherwise known as laughing gas -- significantly improved symptoms in people with treatment-resistant depression, according to new data from researchers at Washington University School of Medicine in St. Louis and the University of Chicago.
In a phase 2 clinical trial, the researchers demonstrated that symptoms of depression improve rapidly following treatment with inhaled nitrous oxide. Further, they reported the benefits can last for several weeks.
The findings are published June 9 in the journal Science Translational Medicine.
"A large percentage of patients don't respond to standard antidepressant therapies -- the patients in this study had failed an average of 4.5 antidepressant trials -- and it's very important to find therapies to help these patients," said Charles R. Conway, MD, a professor of psychiatry at Washington University and one of the study's senior investigators. "That we saw rapid improvements in many such patients in the study suggests nitrous oxide may help people with really severe, resistant depression."
Conway, and the study's other co-senior investigator, Peter Nagele, MD, professor and chair of the Department of Anesthesia & Critical Care at the University of Chicago, and who previously had an appointment in the Department of Anesthesiology at Washington University School of Medicine, have been studying the potential of nitrous oxide as an antidepressant for the past decade.
Standard antidepressant drugs affect norepinephrine and serotonin receptors in the brain, yet they often take weeks to improve a person's symptoms. Nitrous oxide, however, interacts with different receptors on brain cells -- NMDA glutamate receptors -- and tends to improve symptoms within hours when effective.
"Our primary goals in this study were twofold: to determine whether a lower dose of nitrous oxide might be just as effective as doses we'd tested previously -- and it was for most patients -- and we also wanted to see how long the relief lasted," Nagele said. "In a proof-of-concept study several years ago, we assessed patients for 24 hours. In this study, we continued to assess them for two weeks, and most continued to feel better."
The study involved 24 patients. Each one received three treatments about one month apart. In one session, patients breathed gas for an hour that was half nitrous oxide, half oxygen. In a second treatment, the same patients breathed a solution that was 25% nitrous oxide. A third treatment, the placebo, involved breathing only oxygen, with no nitrous oxide.
"You can't really get a better comparison group than when you compare a person to himself or herself," Nagele said. "Serving as your own control is ideal. The alternative is studying the effects of a drug in two similar groups of people in which you either get one treatment or another. But the problem with that is that you need much larger numbers of patients before you really can draw conclusions."
The primary conclusions in this study were that nitrous oxide -- both at 25% and in a 50-50 mixture with oxygen -- improved depression in 17 of those study participants. The differences between a 25% mix and a 50% mix mainly involved how long the antidepressant effects lasted. Whereas the 50% dosage had greater antidepressant effects two weeks after treatment, the 25% dose was associated with fewer adverse events, the most common of which was feeling nauseated.
"Some patients experience side effects -- it's a small subset, but it's very real -- and the main one is that some people get nauseated," Conway said. "But in our study, only when people got the 50% dose did they experience nausea. When they received 25% nitrous oxide, no one developed nausea. And that lower dose was just about as effective as the higher dose at relieving depression."
Of the 20 people who completed all of the study's treatments and follow-up exams, 55% (11 of 20) experienced a significant improvement in at least half of their depressive symptoms, and 40% (eight of 20) were considered to be in remission -- meaning they no longer were clinically depressed -- after breathing a nitrous oxide solution for one hour.
Over the course of the entire study, having received both dose levels of nitrous oxide and the placebo treatment, some 85% (17 of 20) of the study participants experienced a significant enough improvement that their clinical classification moved at least one category -- for example, from severe to moderate depression.
Many of those in the study also took antidepressant drugs -- medications that, for the most part, had failed to relieve their depression -- but they were allowed to continue using those drugs while they participated in the study.
As many as one-third of those who take antidepressants don't improve. Nitrous oxide and ketamine, another anesthetic drug that interacts with NMDA glutamate receptors, recently have shown promise in those with treatment-resistant depression. Conway and Nagele believe both drugs may represent breakthroughs for people with treatment-resistant depression, but they believe nitrous oxide may have some practical advantages.
"One potential advantage to nitrous oxide, compared with ketamine, is that because it's a volatile gas, its anesthetic effects subside very quickly," Conway said. "It's similar to what happens in a dentist's office when people drive themselves home after getting a tooth pulled. After treatment with ketamine, patients need to be observed for two hours following treatment to make sure they are OK, and then they have to get someone else to drive them."
Nagele and Conway said it is important for scientists soon to conduct a large, multicenter study comparing the effects of ketamine and nitrous oxide to placebo.
This work was supported by a NARSAD award from the Brain & Behavior Research Foundation and the Taylor Family Institute for Innovative Psychiatric Research at Washington University School of Medicine.
https://www.sciencedaily.com/releases/2021/06/210609143446.htm
Having trouble falling asleep predicts cognitive impairment in later life
Study identifies an insomnia symptom that could be an intervention target for dementia prevention
June 9, 2021
Science Daily/American Academy of Sleep Medicine
A study of nearly 2,500 adults found that having trouble falling asleep, as compared to other patterns of insomnia, was the main insomnia symptom that predicted cognitive impairment 14 years later.
Results show that having trouble falling asleep in 2002 was associated with cognitive impairment in 2016. Specifically, more frequent trouble falling asleep predicted poorer episodic memory, executive function, language, processing speed, and visuospatial performance. Further analysis found that associations between sleep initiation and later cognition were partially explained by both depressive symptoms and vascular diseases in 2014 for all domains except episodic memory, which was only partially explained by depressive symptoms.
"While there is growing evidence for a link between insomnia and cognitive impairment in older adults, it has been difficult to interpret the nature of these associations given how differently both insomnia and cognitive impairment can present across individuals," said lead author Afsara Zaheed, a graduate student in clinical science within the department of psychology at the University of Michigan. "By investigating associations between specific insomnia complaints and cognition over time using strong measures of cognitive ability, we hoped to gain additional clarity on whether and how these different sleep problems may lead to poor cognitive outcomes."
Insomnia involves difficulty falling asleep or staying asleep, or regularly waking up earlier than desired, despite allowing enough time in bed for sleep. Daytime symptoms include fatigue or sleepiness; feeling dissatisfied with sleep; having trouble concentrating; feeling depressed, anxious, or irritable; and having low motivation or energy.
The study analyzed data from the Health and Retirement Study, which involved 2,496 adults who were at least 51 years of age. In 2002 they reported the frequency of experiencing insomnia symptoms. In 2016 the participants' cognition was assessed as part of the Harmonized Cognitive Assessment Protocol and operationalized with a comprehensive neuropsychological battery tapping episodic memory, executive function, language, visuoconstruction, and processing speed. Analyses controlled for sociodemographics and baseline global cognitive performance.
"These results are important given the lack of currently available treatments for late-life cognitive disorders, like Alzheimer's disease and other dementias," said Zaheed. "Sleep health and sleep behaviors are often modifiable. These results suggest that regular screening for insomnia symptoms may help with tracking and identifying people with trouble falling asleep in mid-to-late life who might be at risk for developing cognitive impairments later in life. Additional intervention research is needed to determine whether intervening on insomnia symptoms can help prevent or slow the progression of cognitive impairments in later life."
https://www.sciencedaily.com/releases/2021/06/210609143440.htm
Study shows adaptive brain response to stress, and its absence in people with depression
A biological signal for resilience to stress
June 9, 2021
Science Daily/Emory Health Sciences
A new study identifies a novel biomarker indicating resilience to chronic stress. This biomarker is largely absent in people suffering from major depressive disorder, and this absence is further associated with pessimism in daily life, the study finds.
Nature Communications published the research by scientists at Emory University.
The researchers used brain imaging to identify differences in the neurotransmitter glutamate within the medial prefrontal cortex before and after study participants underwent stressful tasks. They then followed the participants for four weeks, using a survey protocol to regularly assess how participants rated their expected and experienced outcomes for daily activities.
"To our knowledge, this is the first work to show that glutamate in the human medial prefrontal cortex shows an adaptive habituation to a new stressful experience if someone has recently experienced a lot of stress," says Michael Treadway, senior author of the study and professor in Emory's Department of Psychology and Department of Psychiatry and Behavioral Science. "Importantly, this habituation is significantly altered in patients with depression. We believe this may be one of the first biological signals of its kind to be identified in relation to stress and people who are clinically depressed."
"Learning more about how acute stress and chronic stress affect the brain may help in the identification of treatment targets for depression," adds Jessica Cooper, first author of the study and a post-doctoral fellow in Treadway's Translational Research in Affective Disorders Laboratory.
The lab focuses on understanding the molecular and circuit-level mechanisms of psychiatric symptoms related to mood disorders, anxiety and decision-making.
It's long been known that stress is a major risk factor for depression, one of the most common and debilitating of mental illnesses. "In many ways, depression is a stress-linked disorder," Treadway says. "It's estimated that 80 percent of first-time depressive episodes are preceded by significant, chronic life stress."
Around 16 to 20 percent of the U.S. population will meet the criteria for a major depressive disorder during their lifetimes. Experts are predicting rates of depression to climb even further in the wake of the ongoing COVID-19 pandemic. During the pandemic, about four in 10 adults in the United States have reported symptoms of anxiety or depressive disorder, up from one in 10 who reported them in 2019, according to the Kaiser Family Foundation.
"The pandemic has created more isolation for many people, while also increasing the amount of severe stressors and existential threats they experience," Treadway says. "That combination puts a lot of people at high risk for becoming depressed."
Although the link between stress and depression is clearly established, the mechanisms underlying this relationship are not. Experiments with rodents have shown an association between the response of glutamate -- the major excitatory neurotransmitter in the mammalian brain -- and stress. The role of glutamate in humans with depression, however, has been less clear.
The 88 participants in the current study included people without a mental health disorder and unmedicated patients diagnosed with a major depressive disorder. Participants were surveyed about perceived recent stress in their lives before they underwent experiments using a brain scanning technique known as magnetic resonance spectroscopy.
While in the scanner, participants were required to alternate between performing two tasks that served as acute stressors: Putting their hand up to the wrist in ice water and counting down from the number 2,043 by steps of 17 while someone evaluated their accuracy.
Brain scans before and after the acute stressor measured glutamate in the medial prefrontal cortex, an area of the brain involved with thinking about one's state and forming expectations. Previous research has also found that this brain area is involved in regulating adaptive responses to stress.
Participants submitted saliva samples while in the scanner, allowing the researchers to confirm that the tasks elicited a stress response by measuring the amount of the stress hormone cortisol in the sample.
In healthy individuals, the brain scans revealed that glutamate change in response to stress in the medial prefrontal cortex was predicted by individual levels of recent perceived stress. Healthy participants with lower levels of stress showed increased glutamate in response to acute stress, while healthy participants with higher levels of stress showed a reduced glutamate response to acute stress. This adaptive response was comparatively absent in the patients diagnosed with depression.
"The decrease in the glutamate response over time appears to be a signal, or a marker, of a healthy adaptation to stress," Treadway says. "And if the levels remain high that appears to be a signal for maladaptive responses to stress."
The initial result was strong for the adaptation in healthy participants, but was in a modest sample size, so the researchers decided to see if they could replicate it. "Not only did we get a replication, it was an unusually strong replication," Treadway says.
The experiment also included a group of healthy controls who underwent scanning before and after performing tasks. Rather than stressful tasks, however, the controls were asked to place a hand into warm water or to simply count out loud consecutively. Their glutamate levels were not associated with perceived stress and they did not show a salivary cortisol response.
To expand their findings, the researchers followed participants for four weeks after scanning. Every other day, the participants reported on their expected and experienced outcomes for activities in their daily lives. The results showed that glutamate changes that were higher than expected based on an individual's level of perceived stress predicted an increased pessimistic outlook -- a hallmark for depression.
"We were able to show how a neural response to stress is meaningfully related to what people experience in their daily lives," Cooper says. "We now have a large, rich data set that gives us a tangible lead to build upon as we further investigate how stress contributes to depression."
The work was supported by the National Institutes of Mental Health.
https://www.sciencedaily.com/releases/2021/06/210609123422.htm
Brain connections mean some people lack visual imagery
June 9, 2021
Science Daily/University of Exeter
New research has revealed that people with the ability to visualise vividly have a stronger connection between their visual network and the regions of the brain linked to decision-making. The study also sheds light on memory and personality differences between those with strong visual imagery and those who cannot hold a picture in their mind's eye.
The research, from the University of Exeter, published in Cerebral Cortex Communications, casts new light on why an estimated one-three per cent of the population lack the ability to visualise. This phenomenon was named "aphantasia" by the University of Exeter's Professor Adam Zeman in 2015 Professor Zeman called those with highly developed visual imagery skills "hyperphantasics."
Funded by the Arts and Humanities Research Council, the study is the first systematic neuropsychological and brain imaging study of people with aphantasia and hypephantasia. The team conducted fMRI scans on 24 people with aphantasia, 25 with hyperphantasia and a control group of 20 people with mid-range imagery vividness. They combined the imaging data with detailed cognitive and personality tests.
The scans revealed that people with hyperphantasia have a stronger connection between the visual network which processes what we see, and which becomes active during visual imagery, and the prefrontal cortices, involved in decision-making and attention. These stronger connections were apparent in scans performed during rest, while participants were relaxing -- and possibly mind-wandering.
Despite equivalent scores on standard memory tests, Professor Zeman and the team found that people with hyperphantasia produce richer descriptions of imagined scenarios than controls, who in turn outperformed aphantasics. This also applied to autobiographical memory, or the ability to remember events that have taken place in the person's life. Aphantasics also had lower ability to recognise faces.
Personality tests revealed that aphantasics tended to be more introverted and hyperphantasics more open.
Professor Zeman said: "Our research indicates for the first time that a weaker connection between the parts of the brain responsible for vision and frontal regions involved in decision-making and attention leads to aphantasia. However, this shouldn't be viewed as a disadvantage -- it's a different way of experiencing the world. Many aphantasics are extremely high-achieving, and we're now keen to explore whether the personality and memory differences we observed indicate contrasting ways of processing information, linked to visual imagery ability."
https://www.sciencedaily.com/releases/2021/06/210609115555.htm
Study finds novel evidence that dreams reflect multiple memories, anticipate future events
Dreams focused on future events utilize memories of multiple past experiences
June 8, 2021
Science Daily/American Academy of Sleep Medicine
Dreams result from a process that often combines fragments of multiple life experiences and anticipates future events, according to novel evidence from a new study.
Results show that 53.5% of dreams were traced to a memory, and nearly 50% of reports with a memory source were connected to multiple past experiences. The study also found that 25.7% of dreams were related to specific impending events, and 37.4% of dreams with a future event source were additionally related to one or more specific memories of past experiences. Future-oriented dreams became proportionally more common later in the night.
"Humans have struggled to understand the meaning of dreams for millennia," said principal investigator Erin Wamsley, who has a doctorate in cognitive neuroscience and is an associate professor in the department of psychology and program in neuroscience at Furman University in Greenville, South Carolina. "We present new evidence that dreams reflect a memory-processing function. Although it has long been known that dreams incorporate fragments of past experience, our data suggest that dreams also anticipate probable future events."
The study involved 48 students who spent the night in the laboratory for overnight sleep evaluation using polysomnography. During the night, participants were awakened up to 13 times to report on their experiences during sleep onset, REM sleep, and non-REM sleep. The following morning, participants identified and described waking life sources for each dream reported the previous evening. A total of 481 reports were analyzed.
"This is a new description of how dreams draw simultaneously from multiple waking-life sources, utilizing fragments of past experience to construct novel scenarios anticipating future events," said Wamsley.
According to Wamsley, the proportional increase of future-oriented dreams later in the night may be driven by temporal proximity to the upcoming events. While these dreams rarely depict future events realistically, the activation and recombination of future-relevant memory fragments may nonetheless serve an adaptive function.
The research abstract was published recently in an online supplement of the journal Sleep and will be presented as a poster beginning June 9 during Virtual SLEEP 2021. SLEEP is the annual meeting of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.
https://www.sciencedaily.com/releases/2021/06/210608203711.htm
Exercise likely to be best treatment for depression in coronary heart disease
June 8, 2021
Science Daily/RCSI
A study by RCSI indicates that exercise is probably the most effective short-term treatment for depression in people with coronary heart disease, when compared to antidepressants and psychotherapy or more complex care.
The study, led by researchers at RCSI University of Medicine and Health Sciences, is published in the June edition of Psychosomatic Medicine.
This is the first systematic review to compare treatments for depression in those with coronary disease and the findings provides valuable clinical information to help doctors determine the best treatment plan for patients.
The researchers reviewed treatment trials which investigated antidepressants, psychotherapy, exercise, combined psychotherapy and antidepressants, and collaborative care (i.e. treatments devised by a multidisciplinary team of clinicians with input from the patient).
To measure effectiveness, the researchers looked at factors including patient adherence to the treatment (dropout rate) and change in depressive symptoms eight weeks after commencing treatment.
The strongest treatment effects were found to be exercise and combination treatments (antidepressants and psychotherapy). However, as the combination study results have a high risk of bias, the findings of the review suggest that exercise is probably the most effective treatment. Antidepressants had the most research support, while psychotherapy and collaborative care did not perform very well.
"Depression is common in patients with coronary artery disease. Having both conditions can have a significant impact on the quality of life for patients so it is vital that they access to the most effective treatments," commented Dr Frank Doyle, Senior Lecturer Division of Population Health Sciences, RCSI and the study's first author.
"Our study indicates that exercise is likely to be the best treatment for depression following coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment as we see that it improves not only depression, but also other important aspects of heart disease, such as lowering blood pressure and cholesterol, in these patients."
"We continue to see emerging evidence of the importance of lifestyle to treat disease -- in comparison to other treatments -- but further high-quality research is needed. People with coronary heart disease who have symptoms of depression should talk to their doctor about treatments that are most suitable for their personal needs, and clinicians can be confident of recommending exercise to their patients."
Dr Frank Doyle and the study's senior authors, Prof. Jan Sorensen (Health Outcomes Research Centre, RCSI) and Prof. Martin Dempster (School of Psychology, Queen's University Belfast), conducted the study in collaboration with researchers in the USA, The Netherlands, the UK and Denmark.
This study was also the first of its kind to establish a new method to conduct systematic reviews known as a hybrid review, which is a combination of umbrella reviews and systematic reviews.
https://www.sciencedaily.com/releases/2021/06/210608113205.htm
People who have trouble sleeping are at a higher risk of dying early - especially diabetics
June 8, 2021
Science Daily/University of Surrey
In a paper published by the Journal of Sleep Research, researchers reveal how they examined data* from half a million middle-aged UK participants asked if they had trouble falling asleep at night or woke up in the middle of the night.
The report found that people with frequent sleep problems are at a higher risk of dying than those without sleep problems. This grave outcome was more pronounced for people with Type-2 diabetes: during the nine years of the research, the study found that they were 87 per cent more likely to die of any cause than people without diabetes or sleep disturbances.
The study also found that people with diabetes and sleep problems were 12 per cent more likely to die over this period than those who had diabetes but not frequent sleep disturbances.
Malcolm von Schantz, the first author of the study and Professor of Chronobiology from the University of Surrey, said:
"Although we already knew that there is a strong link between poor sleep and poor health, this illustrates the problem starkly."
"The question asked when the participants enrolled does not necessarily distinguish between insomnia and other sleep disorders, such as sleep apnoea. Still, from a practical point of view it doesn't matter. Doctors should take sleep problems as seriously as other risk factors and work with their patients on reducing and mitigating their overall risk."
Professor Kristen Knutson of Northwestern University, the senior co-author of the study, said:
"Diabetes alone was associated with a 67 per cent increased risk of mortality. However, the mortality for participants with diabetes combined with frequent sleep problems was increased to 87 per cent. In order words, it is particularly important for doctors treating people with diabetes to also investigate sleep disorders and consider treatments where appropriate."
https://www.sciencedaily.com/releases/2021/06/210608092300.htm
High caffeine consumption may be associated with increased risk of blinding eye disease
June 7, 2021
Science Daily/The Mount Sinai Hospital / Mount Sinai School of Medicine
Consuming large amounts of daily caffeine may increase the risk of glaucoma more than three-fold for those with a genetic predisposition to higher eye pressure according to an international, multi-center study. The research led by the Icahn School of Medicine at Mount Sinai is the first to demonstrate a dietary -- genetic interaction in glaucoma. The study results published in the June print issue of Ophthalmology may suggest patients with a strong family history of glaucoma should cut down on caffeine intake.
The study is important because glaucoma is the leading cause of blindness in the United States. It looks at the impact of caffeine intake on glaucoma, and intraocular pressure (IOP) which is pressure inside the eye. Elevated IOP is an integral risk factor for glaucoma, although other factors do contribute to this condition. With glaucoma, patients typically experience few or no symptoms until the disease progresses and they have vision loss.
"We previously published work suggesting that high caffeine intake increased the risk of the high-tension open angle glaucoma among people with a family history of disease. In this study we show that an adverse relation between high caffeine intake and glaucoma was evident only among those with the highest genetic risk score for elevated eye pressure," says lead/corresponding author Louis R. Pasquale, MD, FARVO, Deputy Chair for Ophthalmology Research for the Mount Sinai Health System.
A team of researchers used the UK Biobank, a large-scale population-based biomedical database supported by various health and governmental agencies. They analyzed records of more than 120,000 participants between 2006 and 2010. Participants were between 39 and 73 years old and provided their health records along with DNA samples, collected to generate data. They answered repeated dietary questionnaires focusing on how many caffeinated beverages they drink daily, how much caffeine-containing food they eat, the specific types, and portion size. They also answered questions about their vision, including specifics on if they have glaucoma or a family history of glaucoma. Three years into the study later they had their IOP checked and eye measurements.
Researchers first looked at the relationship looked between caffeine intake, IOP and self-reported glaucoma by running multivariable analyses. Then they assessed if accounting for genetic data modified these relationships. They assigned each subject an IOP genetic risk score and performed interaction analyses.
The investigators found high caffeine intake was not associated with increased risk for higher IOP or glaucoma overall; however, among participants with the strongest genetic predisposition to elevated IOP -- in the top 25 percentile -- greater caffeine consumption was associated with higher IOP and higher glaucoma prevalence. More specifically, those who consumed the highest amount of daily caffeine- more than 480 milligrams which is roughly four cups of coffee -- had a 0.35 mmHg higher IOP. Additionally, those in the highest genetic risk score category who consumed more than 321 milligrams of daily caffeine -- roughly three cups of coffee -- had a 3.9-fold higher glaucoma prevalence when compared to those who drink no or minimal caffeine and in lowest genetic risk score group.
"Glaucoma patients often ask if they can help to protect their sight through lifestyle changes, however this has been a relatively understudied area until now. This study suggested that those with the highest genetic risk for glaucoma may benefit from moderating their caffeine intake. It should be noted that the link between caffeine and glaucoma risk was only seen with a large amount of caffeine and in those with the highest genetic risk," says co-author Anthony Khawaja, MD, PhD, Associate Professor of Ophthalmology University College London (UCL) Institute of Ophthalmology and ophthalmic surgeon at Moorfields Eye Hospital. "The UK Biobank study is helping us to learn more than ever before about how our genes affect our glaucoma risk and the role that our behaviors and environment could play. We look forward to continuing to expand our knowledge in this area."
National Eye Institute which is part of the National Institutes of Health, and New York Eye and Ear Infirmary of Mount Sinai helped to fund this study.
https://www.sciencedaily.com/releases/2021/06/210607084601.htm