The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank

Well, I've been touting coffee for preventing dementia and Parkinsons for years.

How coffee protects against Parkinson’s Aug. 2014  

Coffee May Lower Your Risk of Dementia Feb. 2013

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

Cognitive recovery in patients with post-stroke subjective cognitive complaints Coffee in here also.

 

The latest here:

The impact of coffee subtypes on incident cardiovascular disease, arrhythmias, and mortality: long-term outcomes from the UK Biobank

David Chieng, Rodrigo Canovas, Louise Segan, Hariharan Sugumar, Aleksandr Voskoboinik, Sandeep Prabhu, Liang Han Ling, Geoffrey Lee, Joseph B Morton, David M Kaye ... Show more

Author Notes

European Journal of Preventive Cardiology, zwac189, https://doi.org/10.1093/eurjpc/zwac189

Published:

27 September 2022

Article history

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Abstract

Aims

Epidemiological studies report the beneficial effects of habitual coffee consumption on incident arrhythmia, cardiovascular disease (CVD), and mortality. However, the impact of different coffee preparations on cardiovascular outcomes and survival is largely unknown. The aim of this study was to evaluate associations between coffee subtypes on incident outcomes, utilizing the UK Biobank.

Methods and results

Coffee subtypes were defined as decaffeinated, ground, and instant, then divided into 0, <1, 1, 2–3, 4–5, and >5 cups/day, and compared with non-drinkers. Cardiovascular disease included coronary heart disease, cardiac failure, and ischaemic stroke. Cox regression modelling with hazard ratios (HRs) assessed associations with incident arrhythmia, CVD, and mortality. Outcomes were determined through ICD codes and death records. A total of 449 563 participants (median 58 years, 55.3% females) were followed over 12.5 ± 0.7 years. Ground and instant coffee consumption was associated with a significant reduction in arrhythmia at 1–5 cups/day but not for decaffeinated coffee. The lowest risk was 4–5 cups/day for ground coffee(I do 10-12 cups a day since neither dementia or Parkinsons prevention had amounts and I'm making sure I don't fall short.) [HR 0.83, confidence interval (CI) 0.76–0.91, P < 0.0001] and 2–3 cups/day for instant coffee (HR 0.88, CI 0.85–0.92, P < 0.0001). All coffee subtypes were associated with a reduction in incident CVD (the lowest risk was 2–3 cups/day for decaffeinated, P = 0.0093; ground, P < 0.0001; and instant coffee, P < 0.0001) vs. non-drinkers. All-cause mortality was significantly reduced for all coffee subtypes, with the greatest risk reduction seen with 2–3 cups/day for decaffeinated (HR 0.86, CI 0.81–0.91, P < 0.0001); ground (HR 0.73, CI 0.69–0.78, P < 0.0001); and instant coffee (HR 0.89, CI 0.86–0.93, P < 0.0001).

Conclusion

Decaffeinated, ground, and instant coffee, particularly at 2–3 cups/day, were associated with significant reductions in incident CVD and mortality. Ground and instant but not decaffeinated coffee was associated with reduced arrhythmia.

Graphical Abstract

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Coffee subtypes and associations with incident arrhythmia, CVD, and mortality. Caffeinated (ground/instant) but not decaffeinated coffee reduced the risk of arrhythmia. Both caffeinated and decaffeinated coffee reduced incident CVD and all-cause and cardiovascular mortality risks. CI, confidence interval; CVD, cardiovascular disease; HR, hazard ratio.

Coffee, Decaffeinated, Instant, Ground, Arrhythmia, Cardiovascular disease, Coronary heart disease, Congestive cardiac failure, Stroke

Conscious sedation no better than general anesthesia in post-stroke endovascular treatment

Both primary and secondary endpoint measures are wrong. The only measurement that survivors care about is 100% recovery. Until we get that mindset installed in stroke researchers we will NEVER SOLVE STROKE.

Conscious sedation no better than general anesthesia in post-stroke endovascular treatment

Conscious sedation was not superior to general anesthesia for functional recovery in patients undergoing endovascular treatment following acute posterior circulation stroke, researchers reported in JAMA Neurology.

Fa Liang, MD, of the department of anesthesiology at Capital Medical University in Beijing, China, and colleagues sought to determine whether conscious sedation was an acceptable alternative to general anesthesia during endovascular treatment in those with acute posterior circulation stroke by conducting a randomized, parallel-group exploratory trial at two comprehensive care hospitals in China.

Source: Adobe Stock.

Of 210 patients with acute posterior circulation stroke admitted from March 2018 to June 2021, 87 (mean age, 62 years; 81.6% men) were included in the final analysis, of whom 43 underwent general anesthesia and 44 conscious sedation. The primary endpoint was functional independence after 90 days.

At baseline, the median participant score on the National Institute of Health Stroke Scale was 15. Thirteen patients (29.5%) in the conscious sedation group were transferred to the general anesthesia group.

The authors reported that although the conscious sedation group had a higher incidence of functional independence, there was no significant difference between the two groups, with analysis indicating that 48.8% of the general anesthesia group had a modified Rankin Score of 0 to 2 at 90 days vs. 54.4% in the conscious sedation group (RR = 0.89; 95% CI, 0.58-1.38 and adjusted OR = 0.91; 95% CI, 0.37-2.22).

However, general anesthesia performed better in successful reperfusion in intention-to-treat analysis (95.3%) compared with conscious sedation (77.3%), according to results (aOR = 5.86; 95% CI, 1.16-29.53).

“[Conscious sedation] was not better than [general anesthesia] for the primary outcome of functional recovery,” the authors wrote. “Moreover, [conscious sedation] was perhaps worse than [general anesthesia] for the secondary outcome of successful reperfusion.”

Healthy habits in midlife may help delay onset of cognitive decline

Well, I assume I'm in midlife right now at age 66 since I'm going for 100+.

Healthy habits in midlife may help delay onset of cognitive decline 

LAS VEGAS — To slow or stave off symptoms relating to Alzheimer’s disease and dementia, individuals should make healthy habits a priority early in life, according to a presenter at BRAINWeek 2022.

Gary Small

“How can we forestall the effects of Alzheimer’s disease?” Gary Small, MD, chair of psychiatry at Hackensack University Medical Center, asked during his presentation. “This is something that is affecting all of us — our own aging and memory concerns and also those of relatives and friends.”

Source: Adobe Stock.

Small used the example of Jeanne Calment, who died in 1997 in France at the age of 122, as well as the discovery of “blue zones” in Italy, Costa Rica and Japan — regions with a higher rate of older adults living beyond their 80s and 90s — to address the question of how to age well with as much cognitive faculties as possible.

It begins, Small, said with nongenetic factors, which include healthy behaviors with respect to exercise(daily walks up to 10,000 steps), diet(Yep, lots of coffee and wine.), mental activities
(Sudoku and ken-ken)and social interactions(I have lots of these.). Older adults who have “done their living” and are more motivated to make better, healthier choices are in turn likely to have fewer memory concerns and better cognitive function.

Increased attention to and reliance on technology, Small reasoned, doesn’t necessarily lead to poorer memory and decreased cognitive abilities. Although there is a clear generational divide with the use of digital devices such as iPads, Small cited several online games(What are they? Ask your doctor.) that can train a 70-year-old mind to perform like a 20-year-old’s with repetition over a period of several weeks.

Strategic interventions relating to learning, visualization and memory, as well as simultaneous and sequential exercises combined with physical movement such as stationary cycling, lead to improvements in visual memory and executive function, Small stated.

In addition, getting better sleep, making social connections and performing focused exercise such as tai chi can boost immune response and cognitive strength. However, according to Small, a variety of stress mitigation techniques are especially crucial, as increased stress levels lead to a twofold greater risk for Alzheimer’s disease.

Weight and BMI also have negative correlations with memory development, Small said. Healthy eating habits are likely to boost one’s attitude and self-perception, which in turn can provide motivation to continue making better health decisions.

“If you know broccoli is a better side dish than French fries, you’re more inclined to choose broccoli,” Small said.

Timing for these changes, he continued, is key. An individual should begin during the period of midlife when the normal course of aging begins to give way to mild cognitive impairment. To help guide patients to make positive lifestyle changes, physicians should focus on education, creating fun and easy programs to follow, and emphasizing results to encourage healthy behaviors.

“Brain healthy habits can improve our quality of life right now and possibly stave off future symptoms of dementia and Alzheimer’s,” Small said.

Nanoparticles can improve stroke recovery by enhancing brain stimulation

Now we simply need human research and the creation of protocols.  WHOM  do we contact to get that done?

Nanoparticles can improve stroke recovery by enhancing brain stimulation

Xi'an Jiaotong-Liverpool University

In a recent study, researchers from Xi’an Jiaotong-Liverpool University and other universities in China have reported that brain stimulation combined with a nose spray containing nanoparticles can improve recovery after ischemic stroke in an animal model.

The nasal spray is a non-invasive method for delivering magnetic nanoparticles into the brain that the study finds can increase the benefits of transcranial magnetic stimulation (TMS). TMS is a method of non-invasive brain stimulation already used clinically or in clinical trials to treat neurological conditions like stroke, Parkinson’s disease, Alzheimer’s disease, depression, and addiction.

Rats that were given combined nanoparticle and TMS treatment every 24 hours for 14 days after an ischemic stroke had better overall health, put on weight more quickly and had improved cognitive and motor functions compared to those treated with TMS alone.

During TMS treatment, an electrical current runs through an electric coil placed outside the skull, producing a magnetic field that stimulates brain cells by inducing a further electrical current inside the brain. However, the stimulation is often not intense enough to penetrate far enough into the brain to reach the areas needing treatment.

In this new study, the researchers show that magnetic nanoparticles, administered intranasally, can make neurons more responsive and amplify the magnetic signal from TMS to reach deeper brain tissue, aiding recovery. The finding offers new opportunities for treating neurological disorders.

From impossible to possible

The research answers a key question in nanomedicine – whether it is possible to enhance TMS by using nanoparticles that are non-invasively delivered into the brain. Leading figures in the field previously stated that it was almost impossible because of the blood-brain barrier. This physical barrier separates the brain from the rest of the body’s bloodstream.

However, the team of researchers overcame this by guiding the magnetic nanoparticles closer to the correct area with a large magnet near the head.

Dr Gang Ruan, a corresponding author of the study, says: “We were able to overcome the blood-brain barrier and send enough nanoparticles into the brain to use in combination with TMS simulation to improve recovery from stroke.

“TMS devices are already used for the clinical treatment of neurological disorders but have severe limitations in terms of stimulation strength and depths of the brain they can penetrate.

“By non-invasively putting magnetic nanoparticles into the brain, we can amplify and enhance the TMS stimulation effects on neurons, making the treatment more effective,” Dr Ruan adds.

“Showing it is possible to use nanoparticles in this way paves the way for medical applications of nanoparticles for other neurological disorders.”

Crossing barriers

The iron oxide nanoparticles used in the study are already prescribed to treat iron deficiency as they are non-toxic and biodegradable. The team also modified the nanoparticles by coating them with various non-toxic substances.

Dr Ruan says: “The coating causes the nanoparticles to stick to the blood-brain barrier, increasing their chances of passing through it. Without this coating, the particles just bounce back from the barrier instead of crossing it.

“The modifications of the iron oxide particles also ensure that the nanoparticles can stick to the neurons and increase their responsiveness to TMS stimulation.”

The safety of using the modified nanoparticles needs to be assessed in clinical trials but has the potential to be used in combination with TMS, and other methods such as brain imaging, to gain more insight into how the brain works and improve the treatment of neurological disorders.

“Many scientists still think it is impossible to non-invasively send enough nanoparticles into the brain to affect brain function. Yet we have shown that it is possible,” says Dr Ruan.

“We combined the expertise on our team in four different disciplines, materials science, biophysics, neuroscience, and medical science, to push the boundaries of our knowledge and challenge what is currently thought in the field.”

About the researchers:

Dr Gang Ruan – Senior Associate Professor at the Academy of Pharmacy, Xi’an Jiaotong-Liverpool University. He leads an inter-disciplinary research team to develop nanomaterials-enabled technologies for bio-delivery, bio-imaging, regenerative medicine, and neural medicine.

/Public Release. This material from the originating organization/author(s) may be of a point-in-time nature, edited for clarity, style and length. The views and opinions expressed are those of the author(s).View in full here.

Tags:addiction, Biodegradable, blood-brain barrier, China, clinical trials, cognitive, depression, medical applications, nanoparticle, neuroscience, Professor, regenerative medicine, Scientists, simulation, treatment, university

Minister meets with Tipperary stroke survivor over national strategy

 If that strategy is not 100% recovery then it needs to change to that.  Yeah, there will be a lot of caterwauling from stroke medical 'professionals' but the strategy should be for survivors not the tyranny of low expectations that has forever been pushed on stroke survivors.

Minister meets with Tipperary stroke survivor over national strategy

Check this out!

Minister for Health Stephen Donnelly

Martin Quinn

13 Sep 2022 9:24 PM

Email:

news@tipperarylive.ie

Tipperary Town stroke survivor, Martin Quinn, recently had an online meeting with the Minister for Health, Stephen Donnelly, to discuss issues around stroke and for the need for the publishing of the National Stroke Strategy along with an implementation plan and full funding of the strategy.

The meeting which took place on Tuesday, August 30, was arranged by Jackie Cahill, TD, and attended by Dr Ronan Collins, Director of Stroke Services/Consultant Physician at Tallaght University Hospital, Kathryn Reilly, Policy and Legislative Affairs Manager with the Irish Heart Foundation, Chris Macey, Director of Advocacy and Patient Support at the Irish Heart foundation, by officials from the Department of Health and Integrated Care and by Ryan O’Meara from the Office of Deputy Cahill.

A lot of the discussion centred around the National Stroke Strategy and the delay in its publication and implementation plan.
Martin Quinn said that he believed that the strategy is the linchpin to all stroke services and that there was an urgent need to ensure that there was no further delay in the strategy being published and implemented.

  

“It is in the Programme for Government and recently Taoiseach Micheál Martin said that the Government is fully committed to implementing the plan.

“If you look at our stroke units for example; 80% of units are understaffed and over a third of people don’t get into a stroke unit and post stroke rehab services especially in areas of aphasia and psychology are poor.(NO mention of recovery!)

“The need to address the long-term persistent deficits in stroke support and rehabilitation in the community including post discharge services and support pathways including a right to a discharge plan and regular follow up, are all critical components that the strategy must address.

“Without the strategy we don’t have a plan and the inevitable spill over from that is the serious effect this will have on other services in acute hospitals,” said Mr Quinn.

Chris Macey of the Irish Heart Foundation supported the call for immediate implementation with full funding.
Kathryn Reilly of the Irish Heart Foundation also supported the need for publication and funding of the strategy.

AWARENESS OF APHASIA

Martin Quinn also highlighted the need for a full conversation around awareness campaigns for stroke and the importance of including awareness of aphasia.

“If the recent publicity regarding the diagnosis of Bruce Willis with primary progressive aphasia is anything to go by then we have a clear need to include awareness of aphasia and of the type of aphasia related to stroke in any campaign.

“Any national campaign around stroke awareness needs to include aphasia as a key component,” continued Tipperary Town’s Mr Quinn.

In response the Minister said that the Government is fully committed to implementing National Health Strategies including the National Clinical Programme for Stroke as set out in the Programme for Government - Our Shared Future 2020.

“Consultation and mapping of the strategy against national programmes of work such as the Enhanced Community Care Programme (ECCP) and Chronic Disease Management (CDM) Programme was required, and is now complete.

“The strategy which is now in draft form will need final approval before going for consideration to the Government.

“Once approved by the Government it will then go for publication,” said the Minister.

He could not give an exact timeframe for publication but was hopeful that there would not be any further undue delays.

The Minister is also to consider a request from Martin Quinn to open the second Regional Stroke Conference hosted by the South Tipperary Stroke Communication Group which is being planned for later this year.

Step Length Asymmetry Predicts Rehabilitation Length in Subacute Post Stroke Patients

NO, NO, NO. We don't need this type of useless prediction. Create protocols that fix step length asymmetry.

 I'd have you all fired for not understanding that the only goal in stroke research is getting survivors to 100% recovery. This does nothing for that.

 Step Length Asymmetry Predicts Rehabilitation Length in Subacute Post Stroke Patients

Isabella Schwartz 1,2, Yonah Ofran 1,2 , Naama Karniel 2,3 , Martin Seyres 2 and Sigal Portnoy 3, *
1 Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190501, Israel
2 Department of Physical Medicine & Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
3 Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University,
Tel Aviv 6997801, Israel
* Correspondence: portnoys@tauex.tau.ac.il

Abstract:  

Background:  

 

During the rehabilitation of individuals post stroke, evaluations are performed in order to discern the patient’s prognosis and optimize the treatment plan. However, these tests do not focus on gait symmetry, which might be a predictor for rehabilitation outcomes. We aimed to correlate gait symmetry measures of subacute post stroke patients with rehabilitation outcome and find the symmetry measure that best predicts the variability of the rehabilitation duration. A secondary aim was to compare these measures between patients with right and left brain lesions.
Methods:  

 

We recruited 30 subacute post stroke patients (14 with right side lesion). We collected the following measures: National Institutes of Health Stroke Scale (NIHSS), Functional Independence Measure (FIM), the 10 m walk test (10MWT), Functional Ambulation Categories (FAC), spatial‐temporal gait measures, and gait symmetry and variability. Results: We found moderate correlations between the step length symmetry and the length of rehabilitation, NIHSS, FIM, FAC and 10MWT. The symmetry index of the step length predicted the length of the rehabilitation period as it explained 32.1% of its variance (p = 0.001). Discussion: We conclude that a simple test of the step length symmetry might be informative in predicting rehabilitation length in subacute post stroke patients.