Latest / Morning Medical with Dr. Chow / Plant-Based Beverage Recall, Early Dementia Indicators, and Trends in the Health Care Job Market

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Plant-Based Beverage Recall, Early Dementia Indicators, and Trends in the Health Care Job Market · Morning Medical with Dr. Chow

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Good morning and welcome to another episode of Morning Medical with Dr.
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Chow.
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I am your host, Dr.
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Chi-Ming Chow.
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Today, we have a packed episode covering some critical updates in the world of medical and
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health news.
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We will be discussing a recent plant-based beverage recall linked to listeriosis cases in
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Ontario, early warning signs of dementia, the current state of health care job openings,
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cognitive tests, and the implications of an osteoarthritis diagnosis.
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So, without further ado, let's dive right in.
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Our first story today is about a significant health alert in Ontario.
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Nine confirmed cases of listeriosis have been reported in the province as part of an ongoing
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investigation linked to recalled plant-based refrigerated beverages.
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The Canadian Food Inspection Agency, known as the CFIA, announced a recall affecting certain
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Silk and Great Value brands of oat and almond refrigerated beverages that may be contaminated
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with Listeria monocytogenes.
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Dr.
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Kieran Moore, Ontario's chief medical officer of health, stated that as of Monday, there have
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been five hospitalizations associated with this outbreak.
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Listeria monocytogenes is a type of bacteria that can cause listeriosis, a serious but rare
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illness with symptoms that may start suddenly.
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These symptoms include vomiting, nausea, cramps, severe headache, constipation, or
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fever.
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More severe illness may result in meningitis, which is a brain infection, and blood
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infection, particularly in newborns and older adults.
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In recent years, about one hundred thirty-four cases of invasive listeriosis have been
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reported annually in Canada, according to the Public Health Agency of Canada.
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Of these, Public Health Ontario reported seventy-five cases in 2023, including fourteen
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deaths.
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The recalled products were manufactured by Danone Canada and distributed nationally.
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Stores across Canada are being instructed not to sell, serve, or distribute fifteen specific
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products from the Silk and Great Value brands.
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Anyone who has these products in their fridge should not consume or use them.
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The contaminated products are listed as follows: Great Value Almond Beverage
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Unsweetened Original, Great Value Almond Beverage Original, Great Value Almond Beverage
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Vanilla, Silk Almond and Coconut Unsweetened, Silk Almond Original, Silk Almond Dark
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Chocolate, Silk Almond Unsweetened, Silk Almond Unsweetened Vanilla, and Silk Coconut Original.
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All these products are in 1.89-litre packages with best-before dates up to and including
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October 4, 2024, with specific universal product codes.
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Dr.
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Moore strongly advises the public, especially those at high risk for listeriosis, such as the
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elderly, pregnant women, and those with weak immune systems, to make sure they do not
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consume these recalled products.
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Symptoms of invasive illness, when the bacteria spread beyond the intestines, usually start
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within two weeks after eating food contaminated with Listeria.
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However, it can take as long as seventy days for symptoms to appear, according to Public
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Health Ontario.
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Dr.
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Lori Burrows, a professor of biochemistry and biomedical sciences at McMaster University,
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mentioned that one of the "nasty things about listeria" is that the bacteria are tolerant of
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cold.
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This means that even if the contaminated products are kept in your fridge, the bacteria
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do not die.
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They remain alive and can infect you when you consume the product.
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Dr.
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Burrows emphasized the need for careful disinfection in production and packaging
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facilities to prevent bacterial buildup, particularly in cracks and crevices.
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The contamination in this outbreak has been linked to a specific production line from a
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third-party manufacturer based in Ontario.
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Danone Canada has expressed deep concern over these reports and is taking the matter
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extremely seriously.
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The company is focusing its immediate efforts on protecting consumers through this swift
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recall and conducting a thorough investigation with the third-party manufacturer involved.
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Our next story focuses on a surprising early warning sign of dementia that has significant
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financial implications.
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According to a new report from the New York Federal Reserve, financial difficulties can
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often be one of the earliest indicators of Alzheimer's disease and related disorders.
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This revelation comes from an analysis of seventeen years of data from consumer credit
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agencies and Medicare databases, which found that a decline in credit scores and an increase
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in late payments are frequently observed in the five years leading up to a dementia diagnosis.
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The report highlights that individuals in the early stages of dementia may accumulate greater
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debt, open new credit accounts, and use multiple types of credit.
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These financial consequences are particularly concerning given that older adults with
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dementia will likely face substantial costs for caregiving and other related expenses.
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The financial struggles can begin even when the symptoms of dementia are mild and not widely
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apparent.
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Monica Moreno, senior director of care and support for the Alzheimer’s Association in
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Chicago, noted that challenges in managing money or personal finances are common early
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warning signs of dementia.
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Moreno emphasized that problem-solving or planning difficulties, poor judgment, and the
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inability to complete familiar tasks can all adversely affect money management.
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She pointed out that individuals may have stacks of unopened bills or may be spending an
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excessive amount of money.
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Additionally, people living with dementia are more susceptible to financial abuse, identity
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theft, fraud, and get-rich-quick schemes.
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Failure to address these issues can put individuals with dementia at great financial
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risk.
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Moreno advises that it is important for family members to identify these potential signs early
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and intervene as soon as possible.
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For those whose loved ones are having difficulty managing their finances, the
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Alzheimer’s Association offers several tips to help safeguard their financial well-being.
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First, they recommend discussing with the person how a trusted family member or friend
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can help with paying bills or setting up automatic billing to avoid late payments.
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Second, creating a separate account with a small, agreed-upon amount of money can help the
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individual manage recreational activities and personal purchases without risking large sums
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of money.
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Third, signing up to receive automatic notifications for withdrawals from bank
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accounts or large charges to credit cards can help monitor spending.
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Setting spending limits and receiving alerts if these limits are exceeded can provide an
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additional layer of security.
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Fourth, requesting electronic bank and credit card statements and watching for unusual
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purchases or changes in spending patterns can help catch potential issues early.
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Finally, signing up for the 'Do Not Call' list can protect against telemarketing calls and
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potential phone scams.
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Moreno advises that it is always best to have conversations about managing finances sooner
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rather than later.
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Early in the disease, individuals are more likely to understand the importance of these
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issues and be able to take action to protect themselves.
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As the disease progresses, these concepts become more difficult to comprehend.
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Despite a cooling job market in many sectors, health care remains a hot spot for employment
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opportunities.
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According to a recent report from Marketplace, the demand for workers in the health care
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industry continues to be robust, driven in part by an aging population.
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Federal Reserve Chair Jerome Powell recently remarked that while the overall unemployment
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rate has increased, the labor market is now more balanced and not a broad source of
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inflationary pressures.
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Over the past year, the health care sector has seen the creation of seven hundred fifty-seven
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thousand new jobs.
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Daniel Sbriglio from Ryders Health Management noted that his organization alone has
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contributed to around four hundred of these positions.
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Sbriglio’s company operates eight different skilled nursing facilities and a home care
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agency in Connecticut.
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Despite their efforts, they still have about one hundred nursing positions open across their
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system.
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Michael Abrams, managing partner at Numerof Associates Incorporated, a health care
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consulting firm, explained that the health care industry is experiencing a replenishment of
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workers who left or retired early during the pandemic.
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Many hospitals and health care facilities were short-staffed and have been scrambling to fill
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positions ever since.
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Abrams pointed out that health care jobs only returned to pre-pandemic levels less than two
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years ago.
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The demand for health care services is also on the rise due to the aging population and
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lingering effects of the COVID-19 pandemic.
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Thom Bales, the United States health services leader at PwC, mentioned that there is still
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pent-up demand from the pandemic, including postponed procedures and treatments.
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Bales highlighted that outpatient settings, home health care, and other more convenient
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patient services are seeing increased demand.
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For example, hospitals added two hundred forty-two thousand jobs in the last year, while
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ambulatory care saw an even larger increase with three hundred seventy-four thousand new
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positions.
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However, financial challenges persist in the health care delivery sector.
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Abrams noted that many health care facilities are operating on very thin margins and were not
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in strong financial health even before the pandemic.
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Despite these challenges, the sector continues to add jobs, reflecting the ongoing need for
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health care services and the industry's critical role in society.
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Our next segment delves into the topic of cognitive tests and what they can reveal about
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brain health, as well as their limitations.
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This discussion has been fueled by recent demands for President Joe Biden to undergo
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cognitive testing following his less-than-stellar performance in a debate.
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Despite his physician's assertion that he passes an annual neurologic exam, the calls for
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cognitive testing persist.
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Former President Donald Trump has also been a subject of cognitive test discussions, having
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boasted about passing a cognitive test in 2018, yet mistakenly calling the doctor who
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administered it by the wrong name.
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So, what exactly are cognitive tests?
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These are brief screening tools, typically lasting about ten minutes, designed to assess
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various brain functions.
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Two of the most commonly used tests are the Mini-Mental State Exam, abbreviated as MMSE,
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and the Montreal Cognitive Assessment, abbreviated as MoCA.
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These tests include tasks such as recalling a list of five unrelated nouns, naming as many
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words beginning with the letter 'F' as possible in one minute, counting backward by sevens, and
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drawing a clock with the correct time.
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Each of these tasks evaluates different aspects of cognitive function, such as short-term
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memory, language, attention, concentration, and spatial awareness.
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However, it is important to note that these cognitive screenings do not diagnose specific
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health problems.
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A poor score on a cognitive test is merely a red flag that indicates the need for further
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evaluation.
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Dr.
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James Galvin, a neurologist at the University of Miami, emphasizes that these tests serve as
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a benchmark to determine the level of suspicion and the need for more detailed testing.
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On the flip side, a good score is generally reassuring, but it is not definitive.
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Highly educated individuals, in particular, may perform well on these tests even if they are
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beginning to experience cognitive decline.
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When should these cognitive tests be administered, and how often?
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Dr.
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Galvin points out that a cognitive screening test is essentially a snapshot in time,
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reflecting how someone performs on the test at that particular moment.
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It does not necessarily indicate how they function in their daily lives.
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Any concern about cognitive function is enough reason for a primary care doctor to administer
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a cognitive test.
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For those aged sixty-five and older, cognitive screening is also supposed to be part of the
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annual Medicare wellness visit.
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It is also crucial to distinguish between cognitive screenings and neurologic exams.
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Cognitive screenings are typically administered by primary care doctors and involve simple
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pencil-and-paper tests.
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In contrast, neurologic exams are more comprehensive and are usually conducted by
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specialists.
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These exams involve a detailed physical assessment, including observing speech patterns
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and behavior, testing nerve functions, checking reflexes, and assessing muscle tone and
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function.
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If either type of test raises significant concerns about cognitive function, the next
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step may involve more intensive neuropsychological testing.
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This type of testing can last up to three hours and includes an exhaustive interview with the
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patient and any accompanying family members.
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The neuropsychologist then conducts a series of tests and tasks designed to evaluate specific
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brain functions, such as intelligence, memory, verbal ability, problem-solving skills, visual
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and auditory responses, emotion, and mood.
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These tests may involve puzzles, objects to rearrange, and various drawing and writing
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tasks.
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In some cases, additional diagnostic tools like blood tests and brain scans may be employed.
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Special types of positron emission tomography scans can detect Alzheimer's disease markers,
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such as amyloid plaques and tau tangles in the brain.
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Magnetic resonance imaging, or MRI, can detect past strokes, which can help in diagnosing
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vascular dementia.
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One of the critical questions is how to differentiate between cognitive issues caused
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by disease and those that are merely a part of aging.
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Dr.
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Galvin explains that aging typically slows down cognitive processes, meaning that tasks may
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take longer to complete, but they are still performed correctly.
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For example, you might have difficulty recalling a name or a number under pressure,
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but it eventually comes back to you.
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However, certain reversible health issues can mimic cognitive decline, such as urinary tract
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infections, which are notorious for causing sudden confusion in older adults.
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Other factors like medications, thyroid problems, depression, and poorly controlled
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diabetes can also affect cognitive function.
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In summary, if you or a loved one are experiencing concerns about memory or cognitive
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function, it is essential to consult a doctor or a specialist.
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They can either reassure you that everything is okay or help develop a treatment plan tailored
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to your specific needs.
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Our final story today comes from a 20-year study conducted in Sweden, which portrays
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osteoarthritis as a significant risk factor for multiple comorbidities.
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The study, led by Andrea Dell'Isola, PhD, and colleagues at Lund University, followed
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individuals in Sweden's Skåne region through their medical records from 1998 to 2019.
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The findings indicate that those diagnosed with osteoarthritis in 2008-2009 were at a
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substantially increased risk of developing severe multimorbidity over the next 20 years.
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According to the study, the relative risk of developing severe multimorbidity for
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individuals with osteoarthritis was 2.45 compared to those without the condition.
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Severe multimorbidity was defined as having an average of nearly 10 chronic illnesses.
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Even mild multimorbidity, defined as having an average of three chronic conditions, was more
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likely among those with osteoarthritis, with a relative risk of 1.29.
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The researchers concluded that individuals with osteoarthritis are almost three times more
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likely to experience severe multimorbidity over a 20-year period, even after adjusting for
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common confounders like age, sex, and socioeconomic status.
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This finding is particularly concerning given the aging global population and the increasing
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prevalence of osteoarthritis.
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Osteoarthritis is a common condition associated with aging, but the question of whether it
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promotes the development of other debilitating diseases is becoming increasingly important.
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The study suggests that systemic factors such as low-grade inflammation and metabolic
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dysregulation may serve as the missing link between osteoarthritis and multiple chronic
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conditions.
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Additionally, osteoarthritis could contribute to illnesses like type 2 diabetes and
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cardiovascular disease by discouraging physical activity and diminishing social interaction.
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The study analyzed Swedish health registries for people aged 40 or older who lived in Skåne,
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a region with a population of 1.4 million, from 1998 to 2019.
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Individuals who received new diagnoses of osteoarthritis in any joint in 2008-2009 were
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designated as cases.
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There were 9,846 such individuals, and each was matched by birth year, sex, and the end year of
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their records to two or more residents without osteoarthritis diagnoses at any time.
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This resulted in 19,692 controls.
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The mean age for both cases and controls was 66 years, and 58 percent were women.
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Just over half of the osteoarthritis cases involved knee arthritis, 25 percent had hip
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osteoarthritis, and the rest had osteoarthritis of the hand or other joints, or generalized
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osteoarthritis.
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As of 1998, the vast majority of individuals had no more than one chronic condition.
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The subsequent development of multimorbidity was categorized into four groups: mild with
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late progression, mild with early progression, moderate, and severe.
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By the end of the follow-up period, the average number of comorbidities for these groups were
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2.9, 3.1, 6.1, and 9.6, respectively.
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Importantly, the prevalence of osteoarthritis in 2008-2009 among members of each category was
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29 percent for mild with late progression, 31 percent for mild with early progression, 35
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percent for moderate, and 41 percent for severe.
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The most common comorbidities were cardiovascular disease, malignancies, back
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pain, and cataracts.
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Over 50 different conditions were tracked, spanning all major organ systems and including
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neuropsychiatric disorders.
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However, no discernible pattern of conditions in the identified trajectories was found.
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The study did have some limitations, including reliance on administrative records and the
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potential that people with osteoarthritis or other conditions did not seek care for them.
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Additionally, the role of physical activity, diet, and body weight in the relationship
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between osteoarthritis and multimorbidity trajectories could not be examined in these
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data.
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In summary, this study underscores the importance of understanding the broader health
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implications of an osteoarthritis diagnosis.
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As we continue to improve healthcare and extend lifespans, addressing the multifaceted impact
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of osteoarthritis will be crucial for enhancing the quality of life for aging populations.
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That wraps up today’s episode of Morning Medical with Dr.
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Chow.
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Thank you for joining us as we navigated through these pressing health issues.
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Do stay tuned for our next episode where we will continue to bring you the latest in
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medical and health news.
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Have a great day, and stay healthy.