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New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population. <h2>Why it matters</h2> Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>. In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>. However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>. <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>An earlier diagnosis leads to early treatment and better outcomes.</figcaption></figure> <h2>What still isn’t known</h2> Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis. While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment. <h2>What’s next</h2> People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment. The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>. Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm. The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>. </div>

Mind

After a lifetime studying superannuation, here are 5 things I wish I knew earlier

<a href="https://theconversation.com/profiles/susan-thorp-214">Susan Thorp</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Amassing the wealth needed to support retirement by regular saving is a monumental test of personal planning and discipline. Fortunately for most Australian workers, the superannuation system can help. Superannuation uses the carrot of tax incentives, and the sticks of compulsion and limited access, to make us save for retirement. There are benefits to paying timely attention to your super early in your working life to get the most from this publicly mandated form of financial self-discipline. I’ve been researching and thinking about superannuation for most of my career. Here’s what I wish I knew at the beginning of my working life. <h2>1. Check you’re actually getting paid super</h2> First, make sure you are getting your dues. If you are working, your employer must contribute <a href="https://www.ato.gov.au/businesses-and-organisations/super-for-employers/paying-super-contributions/how-much-super-to-pay">11% of your earnings</a> into your superannuation account. By July 2025 the rate will increase to 12%. This mandatory payment (the “<a href="https://www.ato.gov.au/tax-rates-and-codes/key-superannuation-rates-and-thresholds/super-guarantee">superannuation guarantee</a>”) may look like yet another tax but it is an important part of your earnings (would you take an 11% pay cut?). It is worth checking on, and worth <a href="https://www.ato.gov.au/calculators-and-tools/super-report-unpaid-super-contributions-from-my-employer">reporting</a> if it is not being paid. The Australian Tax Office <a href="https://oia.pmc.gov.au/sites/default/files/posts/2023/05/Impact%20Analysis%20-%20Unpaid%20Superannuation%20Guarantee%20package.pdf">estimates</a> there is a gap between the superannuation employers should pay and what they do pay of around 5% (or $A3.3 billion) every year. Failing to pay is <a href="https://oia.pmc.gov.au/sites/default/files/posts/2023/05/Impact%20Analysis%20-%20Unpaid%20Superannuation%20Guarantee%20package.pdf">more common</a> among the accommodation, food service and construction industries, as well as small businesses. Don’t take your payslip at face value; cross-check your super account balance and the annual statement from your fund. <h2>2. Have just one super account</h2> Don’t make personal donations to the finance sector by having more than one superannuation account. Two super accounts mean you are donating unnecessary administration fees, possibly redundant insurance premiums and suffering two times the confusion to manage your accounts. The superannuation sector does not need your charity. If you have more than one super account, please consolidate them into just one today. You can do that <a href="https://moneysmart.gov.au/how-super-works/consolidating-super-funds">relatively easily</a>. <h2>3. Be patient, and appreciate the power of compound interest</h2> If you’re young now, retirement may feel a very distant problem not worth worrying about until later. But in a few decades you’re probably going to appreciate the way superannuation works. As a person closing in on retirement, I admit I had no idea in my 20s how much my future, and the futures of those close to me, would depend on my superannuation savings. Now I get it! <a href="https://www.nber.org/papers/w27459">Research</a> <a href="https://economics.mit.edu/sites/default/files/publications/pandp.20221022.pdf">shows</a> the strict rules preventing us from withdrawing superannuation earlier are definitely costly to some people in preventing them from spending on things they really need. For many, however, it stops them spending on things that, in retrospect, they would rate as less important. But each dollar we contribute in our 30s is worth around three times the dollars we contribute in our 50s. This is because of the advantages of time and <a href="https://moneysmart.gov.au/saving/compound-interest">compound interest</a> (which is where you earn interest not just on the money initially invested, but on the interest as well; it’s where you earn “interest on your interest”). For some, adding extra “voluntary” savings can build up retirement savings as a buffer against the periods of unemployment, disability or carer’s leave that most of us experience at some stage. <h2>4. Count your blessings</h2> If you are building superannuation savings, try to remember you’re among the lucky ones. The benefits of super aren’t available to those who can’t work much (or at all). They face a more precarious reliance on public safety nets, like the Age Pension. So aim to maintain your earning capacity, and pay particular attention to staying employable if you take breaks from work. What’s more, superannuation savings are invested by (usually) skilled professionals at rates of return hard for individual investors to achieve outside the system. Many larger superannuation funds offer members types of investments – such as infrastructure projects and commodities – that retail investors can’t access. The Australian Prudential Regulation Authority (APRA) also <a href="https://www.apra.gov.au/industries/superannuation">checks</a> on large funds’ investment strategies and performance. <h2>5. Tough decisions lie ahead</h2> The really hard work is ahead of you. The saving or “accumulation” phase of superannuation is mainly automatic for most workers. Even a series of non-decisions (defaults) will usually achieve a satisfactory outcome. A little intelligent activity will do even better. However, at retirement we face the challenge of making that accumulated wealth cover our needs and wants over an uncertain number of remaining years. We also face variable returns on investments, a likely need for aged care and, in many cases, declining cognitive capacity. It’s helpful to frame your early thinking about superannuation as a means to support these critical decades of consumption in later life. At any age, when we review our financial management and think about what we wish we had known in the past, we should be realistic. Careful and conscientious people still make mistakes, procrastinate and suffer from bad luck. So if your super isn’t where you had hoped it would be by now, don’t beat yourself up about it. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217922/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-thorp-214">Susan Thorp</a>, Professor of Finance, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/after-a-lifetime-studying-superannuation-here-are-5-things-i-wish-i-knew-earlier-217922">original article</a>.

Retirement Income

"Touchdown": Count Nikolai arrives in Sydney to begin studies

Denmark's Count Nikolai has arrived in Sydney where he is set to begin a new chapter at the University of Technology (UTS) in Ultimo. Just one day before commencing his studies, the 23-year-old royal explored the city and took to his Instagram stories to share a photo of the iconic Sydney Tower Eye, in the CBD. "Touch down," he captioned the photo. The young royal and his girlfriend Benedikte Thoustrup are both enrolled in UTS, where they'll commence their studies for one semester. The pair are in Sydney as part of Copenhagen Business School's study abroad exchange program and they are both working towards their Master's Degree, with Nikolai studying Sales Management. Thoustrup is studying economics and business administration, specifically in brand and communications management. The course is expected to begin from today, August 1 and runs until the 30th of November. Just last week, Nikolai, who is the grandson of Queen Margrethe II shared that he was "stoked to begin and super excited" about moving to Australia. "The choice fell on Australia because it is very foreign for a Dane like me," he told Numéro magazine. "I have never been that far away and I believe seeing that corner of the world takes more than two weeks holiday, hence I want to try and move there." Images: Instagram

International Travel

Australians are living and working longer – but not necessarily healthier, new study show

<a href="https://theconversation.com/profiles/kim-kiely-1457635">Kim Kiely</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/mitiku-hambisa-1457669">Mitiku Hambisa</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Australians are living and working longer, but a longer working life doesn’t always come with equivalent gains in healthy life. <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00129-9/fulltext">Our analysis</a> of change in life expectancy, health transitions and working patterns of more than 10,000 middle-aged Australians over the past two decades shows divergences in the number of years they can expect be in good health at work and in retirement. In particular, education matters. Those who left school before year 12 are losing years of healthy life, with their extra years in the workforce mainly comprising years of poor health. This is opposite to the trend among people who completed high school. And while men and women experienced improvements in life expectancy, on average women are not gaining extra healthy life years. Australians are being encouraged to extend their working life. For this to be sustainable and equitable, government and workplaces policies will need to make allowances for the health capacity of mature-age workers. <h2>How we found our results</h2> We’ve calculated <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00129-9/fulltext">healthy working life expectancies</a> – the average number of years a person can expect to work in good health – for 50-year-olds using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey. This is a longitudinal survey, meaning it seeks to interview the same households every year (about 17,000 people), enabling researchers to track life trajectories. We identified two age groups within HILDA’s survey sample and followed each cohort for 10 years. The first group was 4,951 people aged 50 years and older in 2001. The second group was 6,589 people aged 50 years and older in 2011. To estimate a healthy working life expectancy, we looked at how people transitioned in and out of good health and employment each year (based on survey data about their paid employment and long-term health conditions that limited participation in everyday activities). By combining this with deaths data, we have calculated the average duration spent (i) working in good health, (ii) working in poor health, (iii) retired in good health, and (iv) retired in poor health. <h2>Differences by education</h2> The following graphs show our results, based on expectancies at age 50. We show our data in this way, rather than total healthy life and working life expectancies from birth, because we followed people from age 50 and is this is the time from which workers start to plan for and transition into retirement. Typically we understand life expectancies to be calculated from birth, but they can be estimated for any age. If you live to 50, your life expectancy is greater than when you were born. Our first graph shows healthy life expectancies according to school completion. These estimates reflect the cumulative number of years a person will, on average, be healthy or unhealthy from age 50. Across the two cohorts, those with low education lose 0.8 years of healthy life, while those with high education gain 0.8 years of healthy life. As with all statistics, there is uncertainty in these estimates. (Our original analysis includes 95% confidence intervals but we do not show them here.) <hr /> <iframe id="47SIf" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/47SIf/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> These inequities are amplified in working-life expectancies, as the next graph shows. Among early school leavers, at age 50 healthy work years rose from 7.9 to 8.4 years, an increase of six months. But their years working in poor health rose from 2.7 to 3.6 years, a difference of 11 months. In contrast, for those who completed year 12, at age 50 healthy work years rose from 9.6 to 10.5 years, an increase of 11 months. Their years working in poor health rose from 3.1 to 3.5 years, a difference of five months. <hr /> <iframe id="kUCuy" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/kUCuy/4/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The next graph illustrates what this means in proportional terms. <hr /> <iframe id="4rBXz" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/4rBXz/1/" width="100%" height="400px" frameborder="0"></iframe> <hr /> The next graph shows working life expectancies by sex. Men, on average, will spend 25% of their remaining working years in poor health, and women 24%. These percentages have not changed over time. <hr /> <iframe id="vQ4rK" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/vQ4rK/2/" width="100%" height="400px" frameborder="0"></iframe> <hr /> These findings are consistent with <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00026-3/fulltext">previous analyses</a> demonstrating social inequalities in health expectancies to have been maintained over time, and possibly widened in some circumstances. In that study, women with low educational attainment appeared to have had negligible improvements in life expectancy and lost healthy life years. <h2>Implications for governments and employers</h2> Australia has this month raised the age at which people qualify for the <a href="https://theconversation.com/australias-retirement-age-just-became-67-so-why-are-the-french-so-upset-about-working-until-64-208648">age pension to 67</a>. When the pension was introduced in 1908, the qualifying age was 65 for men and 60 for women. At the time, average life expectancy for Australians at birth was about <a href="https://www.aihw.gov.au/reports/life-expectancy-deaths/how-long-can-australians-live/data">55 for men and 59 for women</a>. Now it exceeds 81 for men and 85 for women (though is considerably lower for some groups, notably Indigenous Australians). There’s an obvious rationale to prolong people’s working lives – to meet the challenges posed by population ageing and sustain the social security system. Nevertheless, consideration should be made for inequalities in life expectancy and health expectancy. For many ageing workers, health limitations constrain their capacity and opportunity to work. To achieve longer working lives, workplaces will be need become more supportive of mature-age workers, including accommodating long-term health conditions. This will likely involve addressing ageism in the workplace, increasing employer demand for older workers, creating appropriate work roles to fit the capacities and preferences of older workers, and providing pathways to lifelong education and training. We may also need to rethink our idea of flexible work, which has largely centred around the needs of parents and younger workers. Many older workers will have expectations for an independent and active retirement period, and it should be possible for flexible work arrangements to accommodate this. Finally, we should not discount the unpaid contributions made by many older adults through community service and providing care to loved ones.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210542/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-kiely-1457635">Kim Kiely</a>, Lecturer, Statistics and Data Science, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/mitiku-hambisa-1457669">Mitiku Hambisa</a>, Senior Research Associate, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australians-are-living-and-working-longer-but-not-necessarily-healthier-new-study-shows-210542">original article</a>.

Retirement Income

Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

<a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Opioids are the one of the most prescribed pain-relief for people with low back and neck pain. In Australia, around <a href="https://link.springer.com/article/10.1007/s00586-017-5178-4">40% of people</a> with low back and neck pain who present to their GP and <a href="https://qualitysafety.bmj.com/content/28/10/826">70% of people</a> with low back pain who visit a hospital emergency department are prescribed opioids such as oxycodone. But our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00404-X/fulltext">new study</a>, published today in the Lancet medical journal, found opioids do not relieve “acute” low back or neck pain (lasting up to 12 weeks) and can result in worse pain. Prescribing opioids for low back and neck pain can also cause <a href="https://www.healthdirect.gov.au/taking-opioid-medicines-safely">harms</a> ranging from common side effects – such as nausea, constipation and dizziness – to <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/opioid-harm-in-australia/summary">misuse, dependency, poisoning and death</a>. Our findings show opioids should not be recommended for acute low back pain or neck pain. A change in prescribing for low back pain and neck pain is urgently needed in <a href="https://www.tga.gov.au/resources/publication/publications/addressing-prescription-opioid-use-and-misuse-australia">Australia</a> and <a href="https://www.thelancet.com/commissions/opioid-crisis">globally</a> to reduce opioid-related harms. <h2>Comparing opioids to a placebo</h2> In our trial, we randomly allocated 347 people with acute low back pain and neck pain to take either an opioid (oxycodone plus naloxone) or <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo</a> (a tablet that looked the same but had no active ingredients). Oxycodone is an opioid pain medicine which can be given orally. <a href="https://www.nps.org.au/radar/articles/oxycodone-with-naloxone-controlled-release-tablets-targin-for-chronic-severe-pain">Naloxone</a>, an opioid-reversal drug, reduces the severity of constipation while not disrupting the pain relieving effects of oxycodone. Participants took the opioid or placebo for a maximum of six weeks. People in the both groups also received <a href="https://www.sciencedirect.com/science/article/pii/S1836955321000941">education and advice</a> from their treating doctor. This could be, for example, advice on returning to their normal activities and avoiding bed rest. We assessed their outcomes over a one-year period. <h2>What did we find?</h2> After six weeks of treatment, taking opioids did not result in better pain relief compared to the placebo. Nor were there benefits to other outcomes such as physical function, quality of life, recovery time or work absenteeism. More people in the group treated with opioids experienced nausea, constipation and dizziness than in the placebo group. Results at one year highlight the potential long-term harm of opioids even with short-term use. Compared to the placebo group, people in the opioid group experienced slightly worse pain, and reported a higher risk of <a href="https://academic.oup.com/painmedicine/article/20/1/113/4728236#129780622">opioid misuse</a> (problems with their thinking, mood or behaviour, or using opioids differently from how the medicines were prescribed). More people in the opioid group reported pain at one year: 66 people compared to 50 in the placebo group. <h2>What will this mean for opioid prescribing?</h2> In recent years, international low back pain guidelines have shifted the focus of treatment from drug to non-drug treatment due to <a href="https://www.thelancet.com/article/S0140-6736(18)30489-6/fulltext">evidence</a> of limited treatment benefits and concern of medication-related harm. For acute low back pain, <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">guidelines</a> recommend patient education and advice, and if required, anti-inflammatory pain medicines such as ibuprofen. Opioids are <a href="https://link.springer.com/article/10.1007/s00586-018-5673-2">recommended only</a> when other treatments haven’t worked or aren’t appropriate. Guidelines for <a href="https://pubmed.ncbi.nlm.nih.gov/33064878/">neck</a> pain similarly discourage the use of opioids. Our latest research clearly demonstrates the benefits of opioids do not outweigh possible harms in people with acute low back pain and neck pain. Instead of advising opioid use for these conditions in selected circumstances, opioids should be discouraged without qualification. <h2>Change is possible</h2> Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced. The <a href="https://qualitysafety.bmj.com/content/30/10/825">study</a> involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of: <ul> <li>clinician education about <a href="https://aci.health.nsw.gov.au/networks/musculoskeletal/resources/low-back-pain">evidence-based management</a> of low back pain</li> <li>patient education using posters and handouts to highlight the benefits and harms of opioids</li> <li>providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments</li> <li>fast-tracking referrals to outpatient clinics to avoid long waiting lists</li> <li>audits and feedback to clinicians on information about opioid prescribing rates.</li> </ul> This intervention reduced opioid prescribing from <a href="https://qualitysafety.bmj.com/content/30/10/825">63% to 51% of low back pain presentations</a>. The <a href="https://emj.bmj.com/content/early/2023/04/02/emermed-2022-212874">reduction was sustained for 30 months</a>. Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting. More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics. A nuanced approach is often necessary to avoid causing <a href="https://theconversation.com/opioid-script-changes-mean-well-but-have-left-some-people-in-chronic-pain-156753">unintended consequences</a> in reducing opioid use. If people with low back pain or neck pain are using opioids, especially at higher doses over an extended period of time, it’s important they seek advice from their doctor or pharmacist before stopping these medicines to avoid <a href="https://www.healthdirect.gov.au/opioid-withdrawal-symptoms">unwanted effects when the medicines are abruptly stopped</a>. Our research provides compelling evidence opioids have a limited role in the management of acute low back and neck pain. The challenge is getting this new information to clinicians and the general public, and to implement this evidence into practice.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203244/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-lin-346821">Christine Lin</a>, Professor, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrew-mclachlan-255312">Andrew McLachlan</a>, Head of School and Dean of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/caitlin-jones-1263090">Caitlin Jones</a>, Postdoctoral Research Associate in Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/christopher-maher-826241">Christopher Maher</a>, Professor, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/opioids-dont-relieve-acute-low-back-or-neck-pain-and-can-result-in-worse-pain-new-study-finds-203244">original article</a>.

Body

New study reveals the lifetime health benefits of social interaction

A new meta-analysis study - undertaken by the Centre for Healthy Brain Ageing (otherwise known as the CHeBA) at the University of New South Wales - has revealed that social interaction could have benefits many would never have thought to predict, from a reduced risk of dementia to overall increased longevity. Researches were investigating the link between social connections in senior citizens and the risk of mild cognitive impairment (MCI), as well as dementia and morality, compiling the results from 13 other international studies following individuals aged 65 years and up over extended periods of time - research published in <a href="https://u26892420.ct.sendgrid.net/ls/click?upn=B8NE7CRkW4hCmh1dHfJbPqy22DjCz8-2Bq3ZidKWozGaZDoG-2FmVx-2BVsAja535jGrbQlYGwKkrcgY4HPBHrSRE-2Bpq1fwuJ0AQZcKTgnOiva5gsjqRFzNLSYGGzJ4hgT-2Bp0b-7Jp_W1g0lLgOQvKHpoedb1QOitWbx1JxegS3ChuQBoUMMSvQphp8oKfzCnK1hk7FLUZqqTLorFP-2FYQB6URmHLHx65PjMZSysYz3YQI-2BzvIxBhVdZr2Z1gRzt72cMfkaib4uVOYXTxECJWWsRmLyHtb8tdUoPs6u4lvqr8I7xD4zbJqJTqeP2zMO2vFFc6dcczrApzJnOWkq2tOchRyvzstzbQnlU1N4WSe4ZAMtqjmGx6sSvfxYICFLpppnmosd6kUUL-2B2zjjEQ61i38e9TYUaT6LZA5aIGcpHJw26Ob-2BXzuvv-2BuHbhihyIqh2AUTJ2WAYsCw6hpo5SJ7JKlgCF4nYeiekLQeVVLm4GRjjckYyIIN48-3D">Alzheimer's & Dementia: The Journal of the Alzheimer's Association</a>. As author, clinical psychologist, and researcher Dr Suraj Samtani explained, “we know from previous research that social connections are important for our health and being isolated puts us at higher risk of dementia and death.” “Our goal was to find which social connections protect us from dementia and death.” Researches drew intel from studies in a number of countries - spanning low, middle, and high-income nations - and compiled a study population more diverse than the meta-analyses to come before, including the likes of Australia, European nations, North and South America, Asia, and Africa, as opposed to the previous North America and European study groups. From there, they looked at information about the connections between the participants, paying close attention to the types of social links (whether they were in a relationship, single, or married, or involved with their community), the function of them (whether or not they had social support on hand, or a close confidante), and the quality (how much satisfaction they did - or did not - receive from their relationships). With this information, they sought to find out if the participants had developed either MCI or dementia - as well as whether or not they had passed away. “We looked at social variables across these studies, such as living with others, interacting with friends and family, engaging in community activities, and social support,” Dr Samtani said. “We wanted to know which of these are associated with risk of getting dementia over time or dying.” And from their research, they discovered that positive social connections did appear to be linked to a lower risk of MCI, dementia, and death. “We found that frequent interactions - monthly or weekly - with family and friends and having someone to talk to reduced the risk of getting dementia. We also found that living with others and doing community activities reduced the risk of dying,” Dr Samtani noted. Recommendations from the researchers suggest that people should be prioritising their social connections if they hope to reduce their risk of cognitive decline - with the added benefit of living longer, too. “Try to meet with friends and family at least once a month, take part in community activities like volunteering or a rotary club, and open your heart to someone when you feel stressed,” Dr Samtani said. “Living with others, for example in an intergenerational household, is also helpful. “Connecting with others helps us to keep our bodies and minds healthy. “We hope that helping people to stay engaged in conversations and maintain healthy friendships and relationships will help them to stay healthy and happy.” Images: Getty

Relationships

Why study is the key to keeping your brain healthy as you age

Two Over60 community members talk about studying later in life, how it keeps their mind healthy and why they keep going back for more. The word study for many people conjures up memories of restless school days, strict teachers and homework you had to force yourself to complete. However, education isn’t just limited to schools – if you think about our everyday lives, we are constantly learning new things. Whether it’s trying out a new recipe, learning about historic events through a film or attempting to remember algebra so we can help our grandkids, it’s clear learning is a lifelong process. Research consistently shows that keeping your mind active has many health benefits. For over-60s, it helps to keep your mind stimulated and mental faculties in top condition as well as improving your overall wellbeing. It is why there are increasingly more seniors who are seeking to study later in life – and they’re finding they not only love it, but that it’s rewarding in so many ways. For Bernard Macdougall, 73, from Maryborough, Queensland, taking courses and learning new things has been crucial in keeping his mind astute. It was after searching online that Bernard stumbled across the free Open2Study courses. “A couple of year ago I was starting to get a bit anxious about whether I had any brain damage. I had a bit of numbness on the right side of my body and I felt I had a slight impediment in my speech,” he reveals, continuing, “but when I found I could get high marks in these courses I thought well I don’t have to worry, my brain is working, there hasn’t been any deterioration.” Bernard found there was a great variety in courses offered and the option of short one-month timeframes could be easily managed. He ended up taking three courses through Open2Study and another online course through Charles Darwin University. It was a similar case for Peter Keyes, 78, from Albion Park Rail, New South Wales, who has completed four courses through Open2Study. Peter has worked in education all his life so when retirement came around he wasn’t about to stop learning. “You can’t sit around in retirement and twiddle your thumbs,” he laughs, adding, “I live in a retirement village and I encourage all of [the residents] to do some study rather than sit around and watch TV all day! It keeps the brain kicking.” As well as keeping him busy, Peter also found the courses were helpful and informative. “During my career in education I ended up being an administrator looking after buildings so I was interested in one of the courses ‘Project Management’. It gave me a further insight into the processes that I used in setting up the buildings of school buildings,” he explains, continuing, “In [my] retirement village, management occasionally ask me to go into planning meetings and talk about what things [to consider] in terms of buildings and older people.” Studying is not only about learning new things but as Bernard found, it can be personally fulfilling too. “Back in the 70s, I did an arts degree with major studies in anthropology. I saw that Open2Study had a course called ‘<a href="https://www.open2study.com/courses/becoming-human-anthropology-090913%20" target="_blank" rel="noopener">Becoming Human</a>’. I thought, ‘Right I will have a go at that’,” explains Bernard. He soon found he was not only learning about new theories but about what it means to become human. “I was very emotionally involved as it was about human evolution,” he says. Both Bernard and Peter found the online courses easy to manage – all that was needed was a computer and an internet connection to access the course that you could do in the convenience and comfort of your own home. Lectures were presented through short videos, which Peter found convenient: “You can stop it at any time, make a note and then catch up,” he explains. And for those who are worried that studying means taking exams or doing assessments again, Peter advises you not to worry. “When people hear that they’ve got exams or test or assessment to do, they get a bit frightened. But you teach them there’s nothing to it, you can always stop and go back and have another read,” says Peter. While there are assessments – mainly multiple choice – throughout most courses, it’s not about being competitive but having a barometer for your individual progress. It is simply there so you know how much knowledge you have learnt during the course. Bernard found that although he felt apprehensive sometimes, there was a greatly fulfilling feeling of not only accomplishing the assessment but gaining some high marks. “I put a lot of work into study and when you have to press the final submit button, sometimes I was extremely apprehensive because I was anxious to get good marks,” Bernard explains, adding, “I think one has to devote time to it but it’s time I’m happy to spend.” Both Peter and Bernard are quick to reveal that they are not going to stop studying anytime soon. Peter has just signed up to Open2Study’s ‘Innovation for Powerful Outcomes’ course while Bernard is still half way through the ‘User Experience for the Web’ course. “The course is self-paced so I can start again and there’s no deadline for me, thank goodness,” Bernard smiles. After each completing a number of courses, they can’t speak highly enough about how beneficial studying has been for them. “It keeps the little grey cells going,” states Peter, because as he know only too well, “the pool of knowledge, skill, understanding and wisdom is enormous” in the over-60 community. “For me it is very, very important to keep learning as you age. Partly so that I know my brain is still good and not fading away,” Bernard chuckles, continuing, “it is also just a matter of curiosity. I’m just interested in learning new topics.” Images: Getty

Mind

Study reveals the star sign most likely to be serial killers

Keep your friends close and your Taurus friends even closer as a new study has revealed they’re the most homicidal zodiac sign. The Mirror conducted a murder astrological sign analysis and found the majority of serial killers are born between April 20 to May 20, making them a Taurus. “[Taurus] are devoted, patient and hard-working, traits which can make for a great personality in someone who is stable and good-natured, and an evil manipulator in someone who is not,” the paper reads. Several murderers share the Taurus sign, including America’s first modern serial killer H.H Holmes, Canadian child-killer Karla Homolka and London Mail Bomber David Copeland. Those who share the Cancer star sign were found to be the least likely to be serial killers. However, it's clear that killing is not exclusive to Taurses - here is a list of notable serial killers according to each sign. Aquarius (Jan. 20-Feb. 18): Lee Boyd Malvo, Joel Rifkin, Luis Alfredo Garavito Pisces (Feb. 19-March 20): John Wayne Gacy, Aileen Wuornos Aries (March 21-April 19): Alexander Pichushkin, John Reginald Christie Taurus (April 20-May 20): H.H. Holmes, Michael Ryan, Albert Fish, David Copeland, Levi Bellfield, Robert Black, Steve Wright, Orville Lynn Majors Gemini (May 21-June 20): Jeffrey Dahmer, David Berkowitz, Ted Kaczynski Cancer (June 21-July 22): Robert Maudsley Leo (July 23-Aug. 22): Myra Hindley, Anatoly Onoprienko Virgo (Aug. 23-Sept. 22): Ed Gein, Albert DeSalvo, Henry Lee Lucas Libra (Sept. 23-Oct. 22): Fred West, Beverley Allitt Scorpio (Oct. 23-Nov. 21): Moses Sithole, Robert Pickton, Fritz Haarman Sagittarius (Nov. 22-Dec. 21): Ted Bundy, Dennis Nilsen, Rose West Capricorn (Dec. 22-Jan. 19): John Allen Muhammad, Harold Shipman, Stephen Griffiths Treat your Taurus friends kindly, it’s not their fault they were born on such a “likely to be a serial killer” day! Image credit: Shutterstock

Mind

Anxious dogs have different brains to normal dogs, brain scan study reveals

Dog ownership is a lot of furry companionship, tail wags and chasing balls, and ample unconditional love. However, some dog owners are also managing canine pals struggling with mental illness. A newly published study <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0282087">in PLOS ONE</a> has examined the brain scans of anxious and non-anxious dogs, and correlated them with behaviour. The research team at Ghent University, Belgium, found that our anxious dog friends not only have measurable differences in their brains linked to their anxiety, but these differences are similar to those found in humans with anxiety disorders as well. <h2>Anxious friends</h2> Anxiety disorders in humans are varied and can be categorised into several main types. Overall, they represent high levels of fear, emotional sensitivity and negative expectations. These disorders can be difficult to live with and sometimes difficult to treat, in part due to how varied and complex anxiety is. Researching anxiety in animals can help us to understand what drives it, and to improve treatment for both humans and animals. The new study sought to investigate possible pathways in the brain that are associated with anxiety in dogs. Understanding this could both improve treatment for anxiety in veterinary medicine, and reveal similarities with what we know of human anxiety. Dogs with and without anxiety were recruited for functional magnetic resonance imaging (fMRI) scans of their brains. Dogs have been involved in awake fMRI studies before, but for this one, with dogs that might get easily stressed out, the dogs were under general anaesthesia. Owners of the dogs also filled out surveys on their pets’ behaviour. The researchers performed data analysis and modelling of brain function, focusing on regions of the brain likely to show differences related to anxiety. Based on previous research on animal and human anxiety, the team dubbed these brain regions the “anxiety circuit”. They then analysed whether there were differences between the brain function of anxious and non-anxious dogs, and if those differences actually related to anxious behaviours. <h2>Different brains</h2> The researchers found there were indeed significant differences between anxious and non-anxious dogs. The main differences were in the communication pathways and connection strength within the “anxiety circuit”. These differences were linked with higher scores for particular behaviours in the surveys as well. For example, anxious dogs had amygdalas (an area of the brain associated with the processing of fear) that were particularly efficient, suggesting a lot of experience with fear. (This is similar to findings from human studies.) Indeed, in the behaviour surveys, owners of anxious dogs noted increased fear of unfamiliar people and dogs. The researchers also found less efficient connections in anxious dogs between two regions of the brain important for learning and information processing. This may help explain why the owners of the anxious dogs in the study reported lower trainability for their dog. <h2>A difficult time</h2> Brains are exquisitely complex biological computers, and our understanding of them is far from comprehensive. As such, this study should be interpreted cautiously. The sample size was not large or varied enough to represent the entire dog population, and the way the dogs were raised, housed, and cared for could have had an effect. Furthermore, they were not awake during the scans, and that also may have influenced some of the results. However, the study does show strong evidence for measurable differences in the way anxious dog brains are wired, compared to non-anxious dogs. This research can’t tell us whether changes in the brain caused the anxiety or the other way around, but anxiety in dogs is certainly real. It’s in the interests of our anxious best friends that we appreciate they may be affected by a brain that processes everything around them differently to “normal” dogs. This may make it difficult for them to learn to change their behaviour, and they may be excessively fearful or easily aroused. Thankfully, these symptoms can be treated with medication. Research like this could lead to more finessed use of medication in anxious dogs, so they can live happier and better adjusted lives. If you have a dog you think might be anxious, you should speak to a veterinarian with special training in behaviour. Image credit: Shutterstock This article originally appeared on <a href="https://theconversation.com/anxious-dogs-have-different-brains-to-normal-dogs-brain-scan-study-reveals-201775" target="_blank" rel="noopener">The Conversation</a>.

Family & Pets

Studies show dogs know exactly what you’re saying

Researchers in Budapest have found man’s best friend processes information in the same way we do, through a combination of tone, words and body language. The study at Hungarian educational institution, Eötvös Loránd University, saw researchers train dogs to sit still in an MRI scanner while their brain activity was monitored. While in the MRI, dogs listened to different combinations of words as well as tones that indicated praise or neutrality. And the results, published in <a href="http://www.http//science.sciencemag.org/" target="_blank" rel="noopener">Science</a>, were fascinating. The study found dogs process both the vocabulary and the intonation of the word they found, much in the same way that humans do. The left hemisphere of dog’s brains typically dealt with vocabulary, while the right hemisphere dealt with intonation. The study’s lead author Attila Andics said in a press release, “This shows… that dogs not only separate what we say from how we say it, but also that they can combine the two for a correct interpretation of what those words really meant.” What’s your take? Do you think your dog understands what you’re saying? Let us know in the comments. Image: Getty

Family & Pets

Cold homes increase the risk of severe mental health problems – new study

Concerns about <a href="https://theconversation.com/energy-crisis-the-uk-is-still-heading-for-widespread-fuel-poverty-despite-the-governments-price-cap-190290" target="_blank" rel="noopener">fuel poverty</a> and people not being able to heat their homes adequately are not new in the UK, but these worries have been <a href="https://www.theguardian.com/uk-news/2022/oct/26/warm-banks-open-wolverhampton-cost-of-living-crisis" target="_blank" rel="noopener">heightened</a> by significant increases in energy costs and the <a href="https://theconversation.com/the-cost-of-living-crisis-has-been-many-years-in-the-making-but-politicians-on-both-sides-ignore-this-189483" target="_blank" rel="noopener">cost-of-living crisis</a>. And as winter approaches, things are about to get a lot worse. Despite a relatively mild climate, the UK has higher levels of excess winter deaths – deaths associated with cold weather – than <a href="https://linkinghub.elsevier.com/retrieve/pii/S0140673614621140" target="_blank" rel="noopener">many colder countries</a>. This greater exposure to cold, despite milder weather, is related to poor housing quality, the high cost of heating homes and poverty. We know quite a lot about how living in a home that you can’t keep warm enough affects your physical health. Colder temperatures <a href="https://www.instituteofhealthequity.org/resources-reports/the-health-impacts-of-cold-homes-and-fuel-poverty/the-health-impacts-of-cold-homes-and-fuel-poverty.pdf" target="_blank" rel="noopener">suppress the immune system</a>, for example. But we know relatively little about the effects on mental health. <a href="https://doi.org/10.1016/j.socscimed.2022.115461" target="_blank" rel="noopener">Our new research</a> shows that living in a cold home is a significant mental health risk. Living in a cold home can affect your mental health in several ways. For many, heating costs are a source of stress and financial strain. Not being able to keep your home and family comfortably warm reduces feelings of control and autonomy over your environment. People who are unable to heat their home often adopt coping mechanisms that <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2524.2005.00558.x" target="_blank" rel="noopener">limit socialising</a> – for example, not inviting friends over and going to bed early to keep warm. And many people are just worn down by the drudgery of a whole winter of being uncomfortably cold. Using <a href="https://www.understandingsociety.ac.uk/" target="_blank" rel="noopener">data</a> from a large representative sample of adults in the UK, we followed people over many years and tracked the effect of being unable to keep your home warm on mental health. When people’s homes became cold, their risk of severe mental distress significantly increased. For people who previously had no mental health problems, the odds of severe mental distress doubled when they had a cold home, while for those who had some (but not severe) mental health symptoms, the risk tripled (see chart below). We found these effects even after taking into account many other factors associated with mental health, including income. Odds of reporting severe mental distress following transition into cold housing compared to those who remained in warm homes <figure class="align-center "><img src="https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=483&fit=crop&dpr=1 600w, https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=483&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=483&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=607&fit=crop&dpr=1 754w, https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=607&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/492381/original/file-20221028-61968-sxkqgr.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=607&fit=crop&dpr=3 2262w" alt="" /><figcaption>author provided</figcaption></figure> Sadly, the risk of living in a cold home differs greatly across the UK population. Lone parents and people who are unemployed or long-term sick are much more likely to live in cold homes. There is also significant inequality across ethnic groups – more than 12% of black people live in cold homes compared with under 6% of white British people, for example. Those who rent rather than own their home are also far more likely to live in cold homes, for social renters this is despite the, on average, <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1088447/EHS_Housing_quality_and_condition_report_2020.pdf" target="_blank" rel="noopener">higher quality and</a><a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1091144/Energy_Report_2020_revised.pdf" target="_blank" rel="noopener">efficiency</a> of social rented homes. Putting on another jumper won’t be enough to get many in the UK through the coming winter. And mental health distress is just one consequence. Cold homes cause issues with significant personal and societal costs – from individual health effects to the increased pressure on the NHS, as well as broader economic loss due to missed work. Rishi Sunak’s new government needs to help people live in adequately warm homes this winter. But how? The older age of housing in the UK is <a href="http://www.instituteofhealthequity.org/projects/the-health-impacts-of-cold-homes-and-fuel-poverty" target="_blank" rel="noopener">heavily implicated</a> in the UK’s high levels of cold. Support for energy efficiency improvements is therefore a possible means of reducing cold homes. This will also mean tackling the so-called “split incentive” in the private rented sector, which houses a significant proportion of households. The split incentive refers to the challenge of the benefits of improvements not being experienced by the property owners but by tenants, reducing the incentive for owners to invest. This results in poorer quality and more expensive homes for renters. Heat or eat? Most can’t afford either The high proportion of cold homes in the social housing sector – despite having the best average energy efficiency due to insulation and building types (flats) – shows that energy efficiency improvements alone will not eliminate cold. <a href="https://www.resolutionfoundation.org/publications/the-living-standards-outlook-2022/" target="_blank" rel="noopener">Incomes in the UK are falling</a>. Benefit levels are <a href="https://theconversation.com/raising-benefits-in-line-with-earnings-will-make-the-poor-worse-off-heres-why-192880" target="_blank" rel="noopener">painfully low</a> and worsened by policies including the benefit cap, two-child limit and sanctions. Years of cuts and <a href="https://www.jrf.org.uk/file/59072/download?token=acsEgZp7&filetype=briefing" target="_blank" rel="noopener">below inflation rises</a> mean that the term “heat or eat”, used to describe difficult spending decisions for low-income households, is now out of date, as <a href="https://www.jrf.org.uk/file/59191/download?token=PCFIM8W9&filetype=briefing" target="_blank" rel="noopener">many can afford neither</a>. The combination of low household incomes with surging energy costs has created devastating pressure on household budgets. While the energy cap has limited energy cost increases below the worst estimates, energy bills have still <a href="https://theconversation.com/energy-crisis-the-uk-is-still-heading-for-widespread-fuel-poverty-despite-the-governments-price-cap-190290" target="_blank" rel="noopener">more than doubled in the past year</a>. And prepayment meters mean that those the with the least end up paying the most. There are, therefore, many areas for potential government intervention, and clear evidence that failing to intervene will cause harm to health.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/193125/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Amy Clair. Republished with permission from <a href="https://theconversation.com/cold-homes-increase-the-risk-of-severe-mental-health-problems-new-study-193125" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

Real Estate

Big study shows that lowering blood pressure lowers risk of dementia

A study across 20 countries has strengthened a link between lowering blood pressure, and reducing the risk of dementia. The meta-analysis, published in the European Heart Journal, draws on clinical trial data from 28,008 participants, to show the strongest link to date between medication that lowers blood pressure, and reduced dementia risk. “We know that high blood pressure is a risk factor for dementia – especially high blood pressure in midlife, so say 40 to 65 years of age,” says lead author Dr Ruth Peters, an associate professor at the University of New South Wales and program lead for dementia in the George Institute’s Global Brain Health Initiative. “But there has been some uncertainty about whether lowering blood pressure, especially in older adults, would reduce risk of dementia. “What we’ve done is take five really high-quality clinical trials and combine them into one dataset, which gave us the ability to really look at this question and look at the relationship between blood pressure-lowering tablets – antihypertensives – and dementia.” The five studies were all double-blind, randomised clinical trials – the ‘gold standard’ in medical research – with participants hailing from 20 different countries. The average age of the participants was 69, and participants were followed up an average of four years after doing the trial. Participants who took antihypertensives had a significantly lower chance of being diagnosed with dementia than those who took placebos. Dementia affects 50 million people worldwide: a number projected to triple by 2050. According to The Lancet’s 2020 Commission on dementia, treatment for hypertension (high blood pressure) is “the only known effective preventive medication for dementia,” all other methods of reducing your risk come from lifestyle and environment. “The strength of this study is the use of individual patient data in a meta-analysis of data drawn from randomised controlled trials of blood pressure medication. This is the first time such data has been meta-analysed,” says Professor Kaarin Anstey, a senior principal research scientist at Neuroscience Research Australia and the UNSW. “This is important for informing clinical practice,” adds Anstey, who was not involved with the study. Professor Nicolas Cherbuin, head of the Australian National University’s Centre for Research on Ageing, Health and Wellbeing, says that the study is “well-designed”, and reflects research by his team showing that higher blood pressure is linked to lower brain volumes and poorer brain health. “The diagnostic procedure and criteria used are well-established, the sample size is large, those with dementia at baseline were excluded,” says Cherbuin. But he points out that the study didn’t find an effect of blood pressure medication on cognitive decline, and nor did it include participants with mild cognitive impairment, who would be “more likely to convert”. Anstey points out that “inevitably” the participants in the cohort are now quite old, and thus may be different to populations developing dementia now. “Clinical trials involve highly selected samples and often exclude diverse ethnic groups,” she adds. “I hope that this reinforces the importance of blood pressure control for brain health,” says Peters. But she emphasises that, while this is useful news for preventing dementia in mid-life, people of all ages can improve their brain health by other means. “It’s not just blood pressure lowering – it has to be taken in the context of a healthy lifestyle.” This article originally appeared on <a href="https://cosmosmagazine.com/health/dementia-blood-pressure-meta/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. Image: Shutterstock

Body

We studied the ‘bibles’ of jazz standards – and found sexism lurking in the strangest place

We are two female jazz singers, jazz researchers and lovers of jazz. And we have discovered jazz gave us another shared experience – sexism. We’d both experienced garden variety sexism. Wendy was asked by a male school principal if her recent marriage meant she would resign from teaching to start a family. Melissa received passionate advice from a male audience member to swap her comfortable outfit with a “glamorous dress” when she sang jazz. But as university music students, neither of us imagined something as innocent as a key signature in a textbook might be a symptom of gender discrimination. A <a href="https://www.britannica.com/art/key-music">key</a> tells musicians which set of notes a song uses. In singing, a key affects whether the notes will be sung in the low, middle or high part of the voice. But when we looked at what keys the “bibles” of jazz standards used, we found a hidden form of sexism. <h2>The Real books</h2> This unusual story begins in 1975 at the Berklee College of Music in the United States. Two music students, tired of reading shoddy, error-filled song sheets, created The Real Book to accurately notate jazz songs. Sold illegally to avoid copyright fees, it was a phenomenal success. After years in surreptitious worldwide circulation, publisher Hal Leonard transformed The Real Book into a <a href="https://officialrealbook.com/history/">legal edition</a>. In 1988, Sher Music joined the act and produced The New Real Book. Despite similar titles, Sher’s book was unrelated but mimicked the idea of clearly notating jazz songs. Together the two books cornered the market. The real books remain the <a href="https://www.nytimes.com/1994/04/10/arts/pop-music-flying-below-the-radar-of-copyrights.html">bibles of jazz musicians</a> everywhere because they contain hundreds of songs called <a href="https://www.jazzstandards.com/overview.definition.htm">standards</a>. Standards are common jazz songs jazz musicians are expected to know. Knowing them is your ticket to participating in jazz ensembles, and so universities use these books to train students. However, few educators realise one decision in 1975 about notating standards cemented a practice excluding women. Jazz is valued as a “conversational” style of music where musicians express personal ideas and real stories. “Authentic” jazz singing is associated with the lower voice we use when speaking. The human voice is a <a href="https://soundbridge.io/human-voice-instruments/">biological musical instrument</a> coming in a variety of sizes, with the male larynx (or voice box) generally larger than the female. This means men generally sing (and talk) in lower pitches, and keys that sit in the middle of the male voice are usually too low for women to sing. When our Berklee students and Sher Music notated songs, they chose keys used by jazz musicians. And during that era, male instrumentalists and male singers dominated the jazz community. So, when the real books were being developed, the editors didn’t choose keys that suited female voices. <h2>What’s in a key?</h2> <a href="https://www.routledge.com/The-Routledge-Companion-to-Jazz-and-Gender/Reddan-Herzig-Kahr/p/book/9780367534141">Our research</a> examined the recordings of 16 renowned female jazz vocalists, including <a href="https://www.britannica.com/biography/Ella-Fitzgerald">Ella Fitzgerald</a> and <a href="https://www.britannica.com/search?query=sarah+vaughan">Sarah Vaughan</a>. We sampled 20 songs from The Real Book and 20 songs from The New Real Book and compared the keys in the books with the keys of the female recordings. Less than 5% of 248 recordings fully matched the printed key. If women sing songs straight from The Real Book or The New Real Book, they are likely to be singing too low for their voices. And if they shift the male key up one <a href="https://www.britannica.com/art/octave-music">octave</a>, it will be too high. Consequently, female jazz vocal students are disadvantaged. If they comply with the keys of the iconic texts, they won’t sound as “authentically jazz” as male students. The male voice will produce the conversational tone we have come to expect from jazz; the female voice will be too low or too high for this conversational style. The female professional singers we studied <a href="https://en.wikipedia.org/wiki/Transposition_(music)">transposed</a> the standards to keys that suited a jazz style. But this skill takes time for students to learn. Transposing requires understanding music theory and having confidence to advocate for your needs as a singer. Experienced jazz singers inevitably acquire these skills, but what about novice female singers? For many young female singers, their introduction to jazz is coloured by keys ill-suited to their voices. Place them in a band where the instrumentalists are predominantly male with little understanding of voice production, and it is an uncomfortable situation for aspiring singers. Fortunately, technology has advanced to a point where many standards are available on phones and can be transposed instantly. But this won’t happen until music teachers and jazz musicians understand and respect female singers by using the appropriate keys. So, can a key signature be sexist? Yes, it can when it’s presented as the only choice of key for female students learning jazz standards. It’s time to update our jazz bibles with sources including keys used by Ella Fitzgerald and Sarah Vaughan, and acknowledge sexism has been hiding in the strangest place. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/we-studied-the-bibles-of-jazz-standards-and-found-sexism-lurking-in-the-strangest-place-189553" target="_blank" rel="noopener">The Conversation</a>.

Music

New study to “give hope” to childhood trauma survivors with depression

A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression. Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions. The study, published in <a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma. While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent. The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma. Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma). But, they found that both groups experienced an improvement in symptoms at a similar rate. Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope. “Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said. “Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.” Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients. “This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said. “However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.” According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood. But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective. If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380. Image: Getty Images

Mind

Tips for studying later in life

Studying when you’re 60 and beyond is beneficial for many reasons, not only for improving the skills needed in today’s workplace. Learning in your older years keeps your brain active and is an effective way to tackle isolation, loneliness and depression, which can accompany old age. By making the decision to study during this stage in life is a positive thing in itself and is something that you should be proud of. Rather than putting too much pressure on yourself to be the top of your class, just have fun! Here are some tips and things to consider if you’ve decided to keep your mind active with study. Make a commitment As it is with any major life decision or change, deciding to study requires an investment of your time, energy and resources. Sit down and have a think about your priorities, weekly schedule and how studying will fit into your life. Work out what you can and cannot manage and set yourself a new schedule including your study commitments. This way you will know from the outset what is achievable within your current lifestyle so you’ll be better able to make a commitment to study. Time management Just as you would with food shopping, exercise and any childcare responsibilities you have looking after your grandchildren, you'll need to schedule class time and study time. Be firm with yourself and others in your life about making sure you don’t get distracted. Get social Studying later in life might be a daunting experience for some, especially if this is your first time doing any form of tertiary education. Seeking support is always a good idea. Many institutions have both online and virtual spaces where you can interact with other students. Otherwise there is always Facebook, online forums or meet up groups in your local area. Seek out like-minded people in similar situations and see if they want to be study partners or even just catch up for coffee once in a while to swap study stories. Tech savvy There’s no doubt technology has come a long in recent times with a number of new tools and clever devices now available. Find out what’s required in terms of technology skills and tools for any study you wish to undertake. If you are a little technology shy, consider brushing up on your skills. Some local councils or state governments offer free technology courses for seniors. For example, the New South Wales government runs the very popular Tech Savvy Seniors program. Stay positive Don’t get discouraged if you feel a little shy or out of your depth when returning to study. This is a sentiment mirrored by many students of all ages. Just focus on the fact that keeping your mind active is so good for you and anything after that is a bonus. Have fun Don’t pressure yourself to achieve a long list of goals. Take each day as it comes, enjoy the experience and just have fun with it. Image: Getty

Caring

Does a sibling’s gender influence our own personality? A major new study answers an age-old question

Our siblings play a central role in our childhoods, so it stands to reason they influence our personality in the long term. In particular, researchers have long been interested in how growing up with a sister compared to a brother might influence who we become as adults. How do children interact with their sister or brother? How do parents behave differently towards their children of different genders, and how does that interaction influence the children? Past theories have made quite different predictions: siblings of the opposite gender may plausibly result in either <a href="https://doi.org/10.2307/2786054" target="_blank" rel="noopener">gender-stereotypical personalities</a> (a girl may take on a more feminine role to differentiate herself from her brother) or <a href="https://doi.org/10.9783/9781512800807" target="_blank" rel="noopener">less gender stereotypical personalities</a> (a girl may take on more masculine traits because she imitates her brother). In fact, psychological research has been exploring these differences for over half a century. <a href="https://doi.org/10.1016/j.paid.2015.02.037" target="_blank" rel="noopener">In some studies</a>, siblings of the opposite sex seemed to be more gender-conforming. Girls with brothers later become more “typically female” and boys with sisters more “typically male”. <a href="https://doi.org/10.1037/h0030055" target="_blank" rel="noopener">Other studies find the exact opposite</a>, however. Opposite gender siblings developed in typically gender-conforming ways. To resolve these contradictions, we wanted to test the effect of sibling gender on personality in a rigorous and comprehensive way. <figure class="align-center "><img src="https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/480681/original/file-20220823-16-4ll79p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="" /><figcaption>Like brother, like sister? Researchers have differed on the likely influence of an opposite gender sibling on personality. Getty Images</figcaption></figure> Using big data In our <a href="https://doi.org/10.1177/09567976221094630" target="_blank" rel="noopener">new study</a> we focused on the relationships between children and their next older or younger sibling. We compiled a unique data set by combining 12 large representative surveys covering nine countries across four continents (US, UK, Netherlands, Germany, Switzerland, Australia, Mexico, China and Indonesia). This resulted in a data set of more than 85,000 people – many times the sample sizes used in previous studies. We also investigated many more personality traits than previous studies have. This included the traits that have been most widely studied in other research, and which have been shown to be important predictors of people’s decisions and choices. The “big five” of these traits are: openness to experiences, conscientiousness, extroversion, agreeableness and neuroticism. The other traits examined were: risk tolerance, trust, patience and “locus of control” (the degree to which people believe they have control over their lives). We also created an index describing to what extent people have a typically female personality. This allowed us to test comprehensively whether growing up with an opposite gender sibling leads to a more or less gender-stereotypical personality. Sibling gender and life experience This study is not only innovative in its use of a large data set, but it also applies a consistent method to identify any causal effects of a sibling’s gender on personality traits. To estimate credible causal effects, we make use of an interesting fact of nature: once parents decide to have another child it is essentially random whether they have a girl or boy. In this “natural experiment” some people are therefore “randomly assigned” a younger sister or brother. This allows us to estimate the causal effect of sibling gender on personality by comparing the average personality of people who grew up with a sister as their next youngest sibling with those who grew up with a next younger brother. Brothers and sisters Our results suggest sibling gender has no effect on personality. For all nine personality traits and the summary index, we find people who have a next younger sister display, on average, the same personality traits as people who have a next younger brother. We also see no difference in personality between people who have a next older sister and people who have a next older brother. Because we have data on more than 85,000 people, these results are estimated with great precision. The results help refute the idea that brothers or sisters cause each other to develop “feminine” or “masculine” personality traits over the long term. However, the results don’t mean sibling gender has no long-term effect at all. Other studies that applied a similar methodological approach have shown that women with brothers in the <a href="https://doi.org/10.1016/j.labeco.2019.02.009" target="_blank" rel="noopener">US</a> and <a href="https://doi.org/10.1007/s00148-021-00830-9" target="_blank" rel="noopener">Denmark</a> earn less. And a <a href="https://doi.org/10.1093/qje/qjt011" target="_blank" rel="noopener">study of Asian populations</a> has found women with younger sisters marry earlier and women with older sisters marry later. So, there seem to be interesting sibling dynamics related to gender – but personality is probably not part of the explanation for those effects.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/188532/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jan-feld-594140" target="_blank" rel="noopener">Jan Feld</a>, Senior Lecturer in Economics, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200" target="_blank" rel="noopener">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/anne-ardila-brenoe-1373305" target="_blank" rel="noopener">Anne Ardila Brenøe</a>, Assistant Professor of Economics, <a href="https://theconversation.com/institutions/university-of-zurich-1139" target="_blank" rel="noopener">University of Zurich</a>, and <a href="https://theconversation.com/profiles/thomas-dudek-1372681" target="_blank" rel="noopener">Thomas Dudek</a>, Postdoctoral Researcher, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200" target="_blank" rel="noopener">Te Herenga Waka — Victoria University of Wellington</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-a-siblings-gender-influence-our-own-personality-a-major-new-study-answers-an-age-old-question-188532" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Family & Pets

We studied how COVID affects mental health and brain disorders up to two years after infection – here’s what we found

The occurrence of mental health conditions and neurological disorders among people recovering from COVID has been a concern since early in the pandemic. Several studies have shown that a <a href="https://www.sciencedirect.com/science/article/pii/S2215036621000845" target="_blank" rel="noopener">significant proportion</a> of adults <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00042-1/fulltext" target="_blank" rel="noopener">face problems</a> of this kind, and that the risks are greater than following other infections. However, several questions remain. Do the risks of psychiatric and neurological problems dissipate, and if so, when? Are the risks similar in children as in adults? Are there differences between COVID variants? Our new study, published in <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext" target="_blank" rel="noopener">The Lancet Psychiatry</a>, explored these issues. In analyses led by my colleague Maxime Taquet, we used the electronic health records of about 1.25 million people diagnosed with COVID, mostly from the US. We tracked the occurrence of 14 major neurological and psychiatric diagnoses in these patients for up to two years. We compared these risks with a closely matched control group of people who had been diagnosed with a respiratory infection other than COVID. We examined children (aged under 18), adults (18-65) and older adults (over 65) separately. We also compared people who contracted COVID just after the emergence of a new variant (notably omicron, but earlier variants too) with those who did so just beforehand. Our findings are a mixture of good and bad news. Reassuringly, although we observed a greater risk of common psychiatric disorders (anxiety and depression) after COVID infection, this heightened risk rapidly subsided. The rates of these disorders among people who had COVID were no different from those who had other respiratory infections within a couple of months, and there was no overall excess of these disorders over the two years. It was also good news that children were not at greater risk of these disorders at any stage after COVID infection. We also found that people who had had COVID were not at higher risk of getting Parkinson’s disease, which had been a concern early in the pandemic. Other findings were more worrying. The risks of being diagnosed with some disorders, such as psychosis, seizures or epilepsy, brain fog and dementia, though mostly still low, remained elevated throughout the two years after COVID infection. For example, the risk of dementia in older adults was 4.5% in the two years after COVID compared with 3.3% in those with another respiratory infection. We also saw an ongoing risk of psychosis and seizures in children. <figure class="align-center "><img src="https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479705/original/file-20220817-11701-ygfp4m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="A woman sits by a window, hiding her head." /><figcaption>Rates of depression and anxiety were higher after COVID, but only for a short time. <a class="source" href="https://www.shutterstock.com/image-photo/beautiful-young-blonde-caucasian-female-feeling-2057071157" target="_blank" rel="noopener">Stock Unit/Shutterstock</a></figcaption></figure> In terms of variants, although our data confirms that omicron is a much milder illness than the previous delta variant, survivors remained at similar risk of the neurological and psychiatric conditions we looked at. However, given how recently omicron emerged, the data we have for people who were infected with this variant only goes up to about five months after infection. So the picture may change. Mixed results Overall, our study reveals a mixed picture, with some disorders showing a transient excess risk after COVID, while other disorders have a sustained risk. For the most part, the findings are reassuring in children, but with some concerning exceptions. The results on omicron, the variant currently dominant around the world, indicate that the burden of these disorders is likely to continue, even though this variant is milder in other respects. The study has important caveats. Our findings don’t capture people who may have had COVID but it wasn’t documented in their health records – perhaps because they didn’t have symptoms. And we cannot fully account for the effect of vaccination, because we didn’t have complete information about vaccination status, and some people in our study caught COVID before vaccines became available. That said, in <a href="https://pubmed.ncbi.nlm.nih.gov/35447302/" target="_blank" rel="noopener">a previous study</a> we showed the risks of these outcomes were pretty similar in people who caught COVID after being vaccinated, so this might not have significantly affected the results. Also, the risks observed in our study are relative to people who had had other respiratory infections. We don’t know how they compare to people without any infection. We also don’t know how severe or long lasting the disorders were. Finally, our study is observational and so cannot explain how or why COVID is associated with these risks. Current theories include persistence of the virus in the nervous system, the immune reaction to the infection, or problems with blood vessels. These are being investigated in <a href="https://academic.oup.com/braincomms/advance-article/doi/10.1093/braincomms/fcac206/6668727?searchresult=1" target="_blank" rel="noopener">separate research</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/188918/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-harrison-1371295" target="_blank" rel="noopener">Paul Harrison</a>, Professor of Psychiatry, <a href="https://theconversation.com/institutions/university-of-oxford-1260" target="_blank" rel="noopener">University of Oxford</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-studied-how-covid-affects-mental-health-and-brain-disorders-up-to-two-years-after-infection-heres-what-we-found-188918" target="_blank" rel="noopener">original article</a>. Image: Getty Images

Mind

We studied how the Antarctic ice sheet advanced and retreated over 10,000 years. It holds warnings for the future

Alarming stories from Antarctica are now more frequent than ever; the ice surface is <a href="https://theconversation.com/warmer-summers-threaten-antarcticas-giant-ice-shelves-because-of-the-lakes-they-create-180989" target="_blank" rel="noopener">melting</a>, floating ice shelves are <a href="https://theconversation.com/conger-ice-shelf-has-collapsed-what-you-need-to-know-according-to-experts-180077" target="_blank" rel="noopener">collapsing</a> and glaciers are <a href="https://theconversation.com/ice-world-antarcticas-riskiest-glacier-is-under-assault-from-below-and-losing-its-grip-178828" target="_blank" rel="noopener">flowing faster</a> into the ocean. Antarctica will be the largest source of future sea-level rise. Yet scientists <a href="https://theconversation.com/scientists-still-dont-know-how-far-melting-in-antarctica-will-go-or-the-sea-level-rise-it-will-unleash-166677" target="_blank" rel="noopener">don’t know</a> exactly how this melting will unfold as the climate warms. Our <a href="https://dx.doi.org/10.1038/s43017-022-00309-5" target="_blank" rel="noopener">latest research</a> looks at how the Antarctic ice sheet advanced and retreated over the past 10,000 years. It holds stark warnings, and possibly some hope, for the future. <h2>The current imbalance</h2> Future sea-level rise presents one of the most significant challenges of climate change, with economic, environmental and societal impacts expected for coastal communities around the globe. While it seems like a distant issue, the changes in Antarctica may soon be felt on our doorsteps, in the form of rising sea levels. Antarctica is home to the world’s largest single mass of ice: the Antarctic ice sheet. This body of glacier ice is several kilometres thick, nestled on top of solid land. It covers entire mountain ranges beneath it. The ice sheet “<a href="https://vimeo.com/133626869" target="_blank" rel="noopener">flows</a>” over the land from the Antarctic interior and towards the surrounding ocean. As a whole it remains a solid mass, but its shape slowly deforms as the ice crystals move around. While the ice sheet flows outward, snowfall from above replenishes it. This cycle is supposed to keep the system in balance, wherein balance is achieved when the ice sheet is gaining the same amount of ice as it’s losing to the ocean each year. However, <a href="https://climate.nasa.gov/vital-signs/ice-sheets/" target="_blank" rel="noopener">satellites</a> keeping watch from above show the ice sheet is currently not in balance. Over the past 40 years, it has lost more ice than it has gained. The result has been global rising sea levels. But these historical observations span only four decades, limiting our understanding of how the ice sheet responds to climate change over much longer periods. We wanted to look further back in time – before satellites – and even before the first polar explorers. For this, we needed natural archives. <h2>Digging up Antarctica’s past</h2> We brought together various natural archives to unearth how the Antarctic ice sheet changed over the past 10,000 years or so. These included: <ul> <li>ice cores collected from Antarctica’s remote interior, which can show us how snow accumulated in the past</li> <li>rocks collected from exposed mountain peaks, which reveal how the ice sheet has thickened or thinned with time</li> <li>sediment cores collected from the seafloor, which reveal how the ice sheet margin – where the edge of the land ice meets the ocean – advanced or retreated</li> <li>lake mud and old beaches, which reveal how the coastline changed in response to the ice sheet growing or shrinking.</li> </ul> When we started our research, I wasn’t sure what to expect. After all, this period of time was long considered fairly dull, with only small changes to the ice margin. Nevertheless, we studied the many different natural archives one by one. The work felt like a 1,000-piece jigsaw puzzle, full of irregular-shaped pieces and seemingly no straight edge. But once we put them together, the pieces lined up and the picture was clear. Most striking was a period of ice loss that took place in all regions of Antarctica about 10,000 to 5,000 years ago. It resulted in many metres of sea-level rise globally. In some regions of Antarctica, however, this ice loss was then followed by ice gain during the past 5,000 years – and a corresponding global sea-level fall – as the ice sheet margin advanced to where it is today. <h2>A warning</h2> Understanding how and why the Antarctic ice sheet changed in this fashion offers lessons for the future. The first lesson is more of a warning. The period of ice loss from 10,000 to 5,000 years ago was rapid, occurring at a similar rate to the most dramatically changing parts of the Antarctic ice sheet today. We think it was likely the result of warm ocean water melting the underside of floating ice shelves – something that has also happened in recent decades. These ice shelves hold back the ice on land, so once they’re removed the ice on the land flows faster into the ocean. In the future, it’s predicted ice loss will <a href="https://youtu.be/XRUxTFWWWdY?t=149" target="_blank" rel="noopener">accelerate</a> as the ice sheet retreats into basins below sea level. This may already be under way in some regions of Antarctica. And based on what happened in the past, the resulting ice loss could persist for centuries. <h2>Bouncing back</h2> The second lesson from our work may bring some hope. Some 5,000 years ago the ice sheet margin stopped retreating in most locations, and in some regions actually started to advance. One explanation for this relates to the previous period of ice loss. Before the ice began melting away, the Antarctic ice sheet was much heavier, and its weight pushed down into the Earth’s crust (which sits atop a molten interior). As the ice sheet melted and became lighter, the land beneath it would have lifted up – effectively hauling the ice out of the ocean. Another possible explanation is climate change. At Antarctica’s coastal fringe, the ocean may have temporarily switched from warmer to cooler waters around the time the ice sheet began advancing again. At the same time, more snowfall took place at the top of the ice sheet. Our research supports the idea that the Antarctic ice sheet is poised to lose more ice and raise sea levels – particularly if the ocean continues to warm. It also suggests uplift of the land and increased snowfall have the potential to slow or offset ice loss. However, this effect is not certain. The past can never be a perfect test for the future. And considering the planet is <a href="https://www.ipcc.ch/report/ar6/wg1/downloads/report/IPCC_AR6_WGI_SPM.pdf" target="_blank" rel="noopener">warming faster</a> now than it was back then, we must err on the side of caution. This article originally appeared on <a href="https://theconversation.com/we-studied-how-the-antarctic-ice-sheet-advanced-and-retreated-over-10-000-years-it-holds-warnings-for-the-future-185505" target="_blank" rel="noopener">The Conversation</a>. Image: Shutterstock

Travel Trouble

Do optimistic women live longer? New study seems to find it so

<div class="copy"> A positive outlook makes you feel better – but does it make you healthier? A study of over 150,000 US women has found a link between optimism and longevity. The study, which was <a href="https://doi.org/10.1111/jgs.17897" target="_blank" rel="noreferrer noopener">published</a> in Journal of the American Geriatrics Society, examined data from the <a href="https://www.whi.org/" target="_blank" rel="noreferrer noopener">Women’s Health Initiative</a>, a long-term study that enrolled 161,808 postmenopausal US women between 1993 and 1998. At enrolment, participants in the study completed (among other things) a test that measured their optimism. The researchers took this data from 159,255 of the participants, and compared it to their lifespan. (Study participants who died less than two years after enrolment were excluded from the analysis, on the grounds that their health may have affected their optimism, as were participants who didn’t complete the test.) <div class="newsletter-box"> <div id="wpcf7-f6-p194387-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> </div> </div> The researchers found that, across every racial and ethnic group in the study, higher optimism was associated with a longer lifespan. Lifestyle accounted for about a quarter of this association, but the link was still evident even when lifestyle was taken into account. Other research has compared these optimism measures to other health factors in the past, but this is the first study to examine the race and ethnicity of the whole cohort. “Although optimism itself may be patterned by social structural factors, our findings suggest that the benefits of optimism for longevity may hold across racial and ethnic groups,” says lead author Hayami Koga, of the Harvard T.H. Chan School of Public Health, US. “Optimism may be an important target of intervention for longevity across diverse groups.” Image credits: Getty Images  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=194387&title=Do+optimistic+women+live+longer%3F+New+study+seems+to+find+it+so" width="1" height="1" /> </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/optimism-and-longevity/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian. </div>

Mind

Who really gets fired over social media posts? We studied hundreds of cases to find out

What you say and do on social media can affect your employment; it can prevent you from getting hired, stall career progression and may even get you fired. Is this fair – or an invasion of privacy? Our recent <a href="https://journals.sagepub.com/doi/10.1177/20563051221077022" target="_blank" rel="noopener">research</a> involved a study of 312 news articles about people who had been fired because of a social media post. These included stories about posts people had made themselves, such as a teacher who was fired after they came out as bisexual on Instagram, or a retail employee let go over a racist post on Facebook. It also included stories about posts made by others, such as videos of police engaging in racial profiling (which led to their dismissal). Racism was the most common reason people were fired in these news stories, with 28% of stories related specifically to racism. Other forms of discriminatory behaviour were sometimes involved, such as queerphobia and misogyny (7%); workplace conflict (17%); offensive content such as “bad jokes” and insensitive posts (16%); acts of violence and abuse (8%); and “political content” (5%). We also found these news stories focused on cases of people being fired from public-facing jobs with high levels of responsibility and scrutiny. These included police/law enforcement (20%), teachers (8%), media workers (8%), medical professionals (7%), and government workers (3%), as well as workers in service roles such as hospitality and retail (13%). Social media is a double-edged sword. It can be used to hold people to account for discriminatory views, comments or actions. But our study also raised important questions about privacy, <a href="https://doi.org/10.1177/0950017015613746" target="_blank" rel="noopener">common</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ijsa.12067" target="_blank" rel="noopener">HR practices</a> and how employers use social media to make decisions about their staff. Young people in particular are expected to navigate social media use (documenting their lives, hanging out with friends, and engaging in self-expression) with the threat of future reputational harm looming. <blockquote class="twitter-tweet"> This woman said her company fired her after her body-positive photo shoot went viral <a href="https://t.co/1eOKFPvZaq">https://t.co/1eOKFPvZaq</a> <a href="https://t.co/dpuIQZJvaW">pic.twitter.com/dpuIQZJvaW</a> — BuzzFeed is a Chris Evans stan account (@BuzzFeed) <a href="https://twitter.com/BuzzFeed/status/913775877208416256?ref_src=twsrc%5Etfw">September 29, 2017</a></blockquote> Are all online posts fair game? Many believe people just need to accept the reality that what you say and do on social media can be used against you. And that one should only post content they wouldn’t mind their boss (or potential boss) <a href="https://www.newcastleherald.com.au/story/455845/logged-off-six-hunter-workers-fired-over-facebook-comments/" target="_blank" rel="noopener">seeing</a>. But to what extent should employers and recruiting managers respect the privacy of employees, and not use personal social media to make employment decisions? Or is everything “fair game” in making hiring and firing decisions? On the one hand, the capacity for using social media to hold certain people (like police and politicians) to account for what they say and do can be immensely valuable to democracy and society. Powerful social movements such as <a href="https://theconversation.com/and-just-like-that-metoo-changed-the-nature-of-online-communication-174527" target="_blank" rel="noopener">#MeToo</a> and <a href="https://theconversation.com/friday-essay-twitter-and-the-way-of-the-hashtag-141693" target="_blank" rel="noopener">#BlackLivesMatter</a> used social media to call out structural social problems and individual bad actors. On the other hand, when everyday people lose their jobs (<a href="https://doi.org/10.1016/j.rpto.2016.09.001" target="_blank" rel="noopener">or don’t get hired in the first place</a>) because they’re LGBTQ+, post a photo of themselves in a bikini, or because they complain about customers in private spaces (all stories from <a href="https://journals.sagepub.com/doi/10.1177/20563051221077022" target="_blank" rel="noopener">our study</a>), the boundary between professional and private lives is <a href="https://www.wiley.com/en-us/Work%27s+Intimacy-p-9780745650289" target="_blank" rel="noopener">blurred</a>. Mobile phones, emails, working from home, highly competitive employment markets, and the intertwining of “work” with “identity” all serve to blur this line. Some workers must develop their own <a href="https://link.springer.com/article/10.1007/s10606-018-9315-3" target="_blank" rel="noopener">strategies and tactics</a>, such as not friending or following workmates on some social media (which itself can lead to tensions). And even when one does derive joy and fulfilment from work, we should expect to have some boundaries respected. Employers, HR workers, and managers should think carefully about the boundaries between professional and personal lives; using social media in employment decisions can be more complicated than it seems. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467644/original/file-20220608-26-2g1hpu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Many believe people just need to accept the reality that what you say and do on social media can be used against you. Shutterstock</figcaption></figure> A ‘hidden curriculum of surveillance’ When people feel monitored by employers (current, or imagined future ones) when they use social media, this creates a “<a href="https://doi.org/10.1177/1461444818791318" target="_blank" rel="noopener">hidden curriculum of surveillance</a>”. For young people especially, this can be damaging and inhibiting. This hidden curriculum of surveillance works to produce compliant, self-governing citizen-employees. They are pushed to curate often highly sterile representations of their lives on social media, always under threat of employment doom. At the same time, these very same social media have a clear and productive role in revealing violations of power. Bad behaviour, misconduct, racism, misogyny, homophobia, transphobia, and other forms of bigotry, harassment, and violence have all been exposed by social media. So, then, this surveillance can be both bad and good – invasive in some cases and for some people (especially young people whose digitally-mediated lives are managed through this prism of future impact) but also liberating and enabling justice, accountability, and transparency in other scenarios and for other actors. Social media can be an <a href="https://doi.org/10.1177/0893318914541966" target="_blank" rel="noopener">effective way for people to find work</a>, for <a href="https://psycnet.apa.org/record/2016-30476-002" target="_blank" rel="noopener">employers to find employees</a>, to present <a href="https://sajhrm.co.za/index.php/sajhrm/article/view/861" target="_blank" rel="noopener">professional profiles on sites like LinkedIn</a> or portfolios of work on platforms like Instagram, but these can also be personal spaces even when they’re not set to private. How we get the balance right between using social media to hold people to account versus the risk of invading people’s privacy depends on the context, of course, and is ultimately about power.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/182424/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brady-robards-112223" target="_blank" rel="noopener">Brady Robards</a>, Senior Lecturer in Sociology, <a href="https://theconversation.com/institutions/monash-university-1065" target="_blank" rel="noopener">Monash University</a> and <a href="https://theconversation.com/profiles/darren-graf-1344308" target="_blank" rel="noopener">Darren Graf</a>, Assistant researcher, <a href="https://theconversation.com/institutions/monash-university-1065" target="_blank" rel="noopener">Monash University</a> This article is republished from <a href="https://theconversation.com" target="_blank" rel="noopener">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/who-really-gets-fired-over-social-media-posts-we-studied-hundreds-of-cases-to-find-out-182424" target="_blank" rel="noopener">original article</a>. Image: Getty Images

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New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

After a lifetime studying superannuation, here are 5 things I wish I knew earlier

"Touchdown": Count Nikolai arrives in Sydney to begin studies

Australians are living and working longer – but not necessarily healthier, new study show

Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

New study reveals the lifetime health benefits of social interaction

Why study is the key to keeping your brain healthy as you age

Study reveals the star sign most likely to be serial killers

Anxious dogs have different brains to normal dogs, brain scan study reveals

Studies show dogs know exactly what you’re saying

Cold homes increase the risk of severe mental health problems – new study

Big study shows that lowering blood pressure lowers risk of dementia

We studied the ‘bibles’ of jazz standards – and found sexism lurking in the strangest place

New study to “give hope” to childhood trauma survivors with depression

Tips for studying later in life

Does a sibling’s gender influence our own personality? A major new study answers an age-old question

We studied how COVID affects mental health and brain disorders up to two years after infection – here’s what we found

We studied how the Antarctic ice sheet advanced and retreated over 10,000 years. It holds warnings for the future

Do optimistic women live longer? New study seems to find it so

Who really gets fired over social media posts? We studied hundreds of cases to find out

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Entertainment

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Health

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New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

After a lifetime studying superannuation, here are 5 things I wish I knew earlier

"Touchdown": Count Nikolai arrives in Sydney to begin studies

Australians are living and working longer – but not necessarily healthier, new study show

Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds

New study reveals the lifetime health benefits of social interaction

Why study is the key to keeping your brain healthy as you age

Study reveals the star sign most likely to be serial killers

Anxious dogs have different brains to normal dogs, brain scan study reveals

Studies show dogs know exactly what you’re saying

Cold homes increase the risk of severe mental health problems – new study

Big study shows that lowering blood pressure lowers risk of dementia

We studied the ‘bibles’ of jazz standards – and found sexism lurking in the strangest place

New study to “give hope” to childhood trauma survivors with depression

Tips for studying later in life

Does a sibling’s gender influence our own personality? A major new study answers an age-old question

We studied how COVID affects mental health and brain disorders up to two years after infection – here’s what we found

We studied how the Antarctic ice sheet advanced and retreated over 10,000 years. It holds warnings for the future

Do optimistic women live longer? New study seems to find it so

Who really gets fired over social media posts? We studied hundreds of cases to find out

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