Latest / Morning Medical with Dr. Chow / Episode 300: Chronic Disease Trends, West Nile Surge, Insomnia Insights, and COVID Updates

Transcript

Episode 300: Chronic Disease Trends, West Nile Surge, Insomnia Insights, and COVID Updates · Morning Medical with Dr. Chow

• 0:00
  Hello and welcome to another episode of Morning Medical with Dr.
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  Chow, where we bring you the latest updates in the world of health and medicine.
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  I am Dr.
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  Chi-Ming Chow, your host for today.
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  As always, we’ll dive into the most recent studies and news that impact our health and
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  well-being.
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  Today, we’re celebrating a milestone as this is our 300th episode!
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  Thank you for being with us on this journey.
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  Now, let's get into today’s topic.
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  A new study published in the journal The Lancet has highlighted a concerning trend in the
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  United States.
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  Among 25 high-income Western countries, the United States has shown the slowest progress in
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  reducing the risk of deaths from chronic diseases.
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  This study, led by researchers from Imperial College London, analyzed data from 185
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  countries and territories between 2010 and 2019.
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  While most countries showed a decline in the probability of dying from noncommunicable
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  diseases, such as cancer, heart disease, and stroke, the pace of improvement in the United
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  States was notably slower.
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  From 2010 to 2019, the probability of dying by age 80 from a chronic disease declined in most
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  countries, but the study found a unique trend in the United States.
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  Deaths due to chronic diseases among adults aged 20 to 45 actually increased, which is
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  quite unusual for high-income nations.
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  In contrast, countries like Denmark saw a significant decline in chronic disease deaths,
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  whereas Germany performed only slightly better than the United States.
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  One of the factors contributing to the overall decline in chronic disease mortality globally
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  is the improvement in diagnosing and treating these conditions.
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  Advances in clinical guidelines, increased use of certain medications, and the early detection
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  of cancers have all played a role.
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  However, the study noted that in about 60% of countries, the decline in chronic disease
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  deaths was smaller than in the previous decade, or there was even a reversal of earlier
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  progress.
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  In the United States, the combination of small reductions in mortality among older adults with
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  stagnation among working-age adults, and increases in mortality among young adults, led
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  to its poor performance compared to other high-income countries.
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  The study did not delve into the reasons for these differences, but the researchers
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  suggested that disparities in public health investment and access to care might be
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  significant factors.
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  For example, many Americans live in areas where critical care services are lacking.
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  Nearly 30 million Americans do not live within an hour of trauma care, and a significant
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  portion of the mainland United States is 30 miles or more from the nearest hospital.
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  This lack of access to primary care and delayed screening for chronic conditions can exacerbate
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  health outcomes.
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  Additionally, the United States has seen a rise in neuropsychiatric conditions, such as
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  dementia and alcohol use disorders, which have not been offset by declines in deaths from
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  cancers and cardiovascular diseases.
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  These trends could contribute to the country's poor performance in reducing chronic disease
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  mortality.
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  Interestingly, the study was released shortly after the Trump administration unveiled the
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  Make America Healthy Again Commission’s action plan on reducing childhood chronic diseases.
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  U.S.
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  Health and Human Services Secretary Robert F.
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  Kennedy Jr.
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  emphasized the importance of addressing chronic diseases, noting that 76.4% of U.S.
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  adults have at least one chronic condition.
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  Experts like Elena Ladas from Columbia University are optimistic about the potential
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  for the United States to embrace wellness as a prevention tool.
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  However, she stresses the need for a clear implementation plan.
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  Ladas highlights the importance of minimizing ultraprocessed foods and exposure to
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  environmental contaminants, as well as making healthy food more affordable and accessible.
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  Ladas also advocates for a comprehensive approach to wellness that includes mental
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  health practices like meditation and deep breathing, in addition to traditional
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  medication-based treatments.
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  She notes that in Europe, farmer’s markets are often less expensive than grocery stores, which
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  is not the case in the United States.
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  This affordability and accessibility of healthy food could play a critical role in reducing the
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  burden of chronic diseases.
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  West Nile virus infections are surging this year, with case numbers running about forty
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  percent higher than usual, according to health officials.
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  As of early September, more than seven hundred seventy cases have been reported, including
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  around four hundred ninety severe cases.
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  Typically, by this time of year, about five hundred fifty cases are reported, with three
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  hundred fifty being severe.
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  Health officials are stepping up warnings to the public because most cases of this
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  mosquito-borne disease occur in August and September.
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  The West Nile virus was first identified in the United States in 1999 in New York and gradually
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  spread across the country, peaking in 2003 when nearly ten thousand cases were reported.
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  Many people may be infected without knowing it, as they exhibit no symptoms or only mild ones
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  like headaches, body aches, joint pain, vomiting, diarrhea, and rashes.
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  However, severe cases can lead to inflammation of the brain or spinal cord and even death.
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  In the last decade, health officials have recorded an average of two thousand cases
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  annually, including twelve hundred life-threatening neurological illnesses and
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  about one hundred twenty deaths.
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  This year, deaths are expected to be higher, although the Centers for Disease Control and
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  Prevention has not yet released specific mortality statistics, citing the preliminary
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  nature of the data.
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  Interestingly, the increase in cases is not due to more mosquitoes but rather a higher
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  proportion of mosquitoes carrying the virus.
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  Factors such as temperature, rainfall, the amount of insect control, and the number of
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  nearby birds infected can influence mosquito infection rates.
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  Colorado, which typically experiences more West Nile virus cases, has reported about one
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  hundred fifty cases this year, more than double what other states are seeing.
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  Fort Collins, in particular, has been a hot spot, with thirty-five out of every one
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  thousand female mosquitoes infected, significantly higher than the expected eight
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  per one thousand for this time of year.
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  In a significant study published in the journal Neurology, researchers have found that chronic
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  insomnia in older adults is linked to an increased risk of cognitive impairment and
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  accelerated brain aging.
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  This large prospective study has shown that older adults who experience chronic insomnia
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  have a forty percent higher risk of developing mild cognitive impairment or dementia compared
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  to those who do not suffer from insomnia.
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  Chronic insomnia was defined in this study as difficulty sleeping at least three days a week
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  for three months or longer.
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  The study, led by Doctor Diego Carvalho and his colleagues from the Mayo Clinic in Rochester,
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  Minnesota, provides evidence that chronic insomnia could equate to an additional three
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  and a half years of brain aging.
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  The researchers discovered that insomnia was associated with a faster decline in global
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  cognitive scores, indicating that insomnia can accelerate cognitive decline.
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  The study also found that individuals carrying the APOE4 Alzheimer's risk gene showed even
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  steeper declines in cognition.
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  Interestingly, when insomnia was accompanied by less sleep, it was linked to worse baseline
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  cognitive performance and higher burdens of white matter hyperintensity and amyloid, both
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  of which are markers associated with cognitive decline.
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  However, when insomnia was accompanied by more sleep, possibly suggesting remission of
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  symptoms, there was a lower baseline burden of white matter hyperintensities.
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  Doctor Carvalho emphasized the importance of treating chronic insomnia not only to improve
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  sleep quality but also as a potential measure to protect brain health as we age.
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  He noted that insomnia might affect the brain in various ways, involving not only amyloid
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  plaques but also small blood vessels supplying the brain.
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  This study adds to a growing body of evidence that links poor sleep with an increased risk of
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  dementia and cognitive decline.
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  Previous research has connected poor sleep in midlife with faster brain aging, highlighting
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  the critical role sleep plays in maintaining brain resilience.
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  The researchers proposed a bidirectional relationship between aging, neurodegeneration,
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  and altered sleep, suggesting that aging may promote insomnia by reducing homeostatic sleep
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  pressure.
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  This could be due to decreased sensitivity to adenosine, a neurotransmitter that promotes
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  sleep, and changes in circadian rhythm that affect sleep propensity.
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  The study followed 2,750 cognitively unimpaired older adults from the Mayo Clinic Study of
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  Aging, with a median follow-up of five and a half years.
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  The participants underwent annual neuropsychological assessments covering four
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  cognitive domains: executive, language, memory, and visual spatial.
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  The results were adjusted for various factors, including age, sex, education, and medical
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  comorbidities.
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  Although the study did not find an association between insomnia and the rate of accumulation
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  of white matter hyperintensities or amyloid over time, it highlighted the complexity of
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  insomnia's impact on cognitive health.
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  The use of hypnotic medication did not appear to affect cognitive scores or the incidence of
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  cognitive impairment.
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  The authors acknowledged some limitations in their analysis, including the lack of objective
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  sleep data and details about insomnia or obstructive sleep apnea treatment.
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  The study population was predominantly white, so the findings may not be applicable to other
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  groups.
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  Despite these limitations, the study underscores the critical importance of
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  addressing chronic insomnia as part of a comprehensive approach to maintaining cognitive
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  health in older adults.
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  As we continue to navigate the challenges of the COVID-19 pandemic, Alberta is currently
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  facing a concerning uptick in cases.
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  Recent reports indicate that COVID-19 is picking up steam in the province, raising alarm
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  among health experts.
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  The situation is compounded by the Alberta government's new, more restrictive vaccination
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  campaign, which could lead to a more intense respiratory virus season this fall.
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  Dr.
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  Lynora Saxinger, an infectious diseases specialist at the University of Alberta
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  Hospital in Edmonton, has noted an increase in hospital admissions due to COVID-19.
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  She reports that the percentage of positive COVID-19 tests is trending upward, both
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  nationally and within Alberta.
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  The latest data shows that Alberta's positivity rates were at 5.5 percent as of late August,
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  reflecting a gradual increase over recent months.
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  Additionally, the Public Health Agency of Canada has classified viral wastewater levels
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  in Alberta as "high," which suggests a significant circulation of the virus.
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  The rise in wastewater levels, while not directly corresponding to case numbers, is a
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  valuable indicator of the virus's prevalence.
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  In the United States, similar trends have been observed, with states like California
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  experiencing a surge in COVID-19 cases.
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  Craig Jenne, deputy director of the University of Calgary's Snyder Institute for Chronic
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  Diseases, notes that the current uptick in Canada is less severe than previous years but
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  still noteworthy.
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  As schools reopen and people gather indoors, the virus is expected to continue spreading.
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  The Alberta government's decision to charge most residents $100 for the COVID-19 vaccine
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  this fall has sparked debate.
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  Vaccines will be provided for free only to specific high-risk groups, including seniors in
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  care homes, individuals receiving the Alberta Seniors Benefit, those with underlying medical
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  conditions, immunocompromised persons, health-care workers, and Albertans experiencing
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  homelessness.
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  This policy marks a departure from previous years when vaccines were widely available at
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  pharmacies.
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  Dr.
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  Saxinger expresses concern that the new policy may deter people from getting vaccinated,
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  potentially leading to lower immunization rates and a higher disease burden in the community.
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  Craig Jenne echoes this sentiment, warning that even a small increase in hospital visits by
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  otherwise healthy individuals could strain Alberta's healthcare system.
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  During the last respiratory virus season, Alberta saw significant impacts from COVID-19,
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  with 405 deaths and 3,364 hospitalizations, including 209 intensive care unit admissions.
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  The provincial government has received criticism from doctors for not aligning with
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  recommendations from the National Advisory Committee on Immunization, which advocates for
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  broader vaccine access.
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  Alberta has ordered approximately 485,000 COVID-19 vaccine doses for the upcoming season,
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  with the option to order more if needed.
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  However, during the 2024-25 respiratory virus season, the province administered over 742,000
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  doses, highlighting the potential gap in vaccine availability under the new policy.
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  As we face the ongoing challenges of the pandemic, it's crucial to stay informed about
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  public health recommendations and vaccination options.
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  Thank you for joining me on this milestone 300th episode of Morning Medical with Dr.
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  Chow.
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  I look forward to continuing to bring you the latest in medical news and insights.
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  Stay healthy and take care until next time.