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By Neha Mathur Sep 26 2023 Reviewed by Lily Ramsey, LLM

In a recent article published in BMC Geriatrics, researchers examined the association between traumatic life events (TLE) and the risk of all-cause dementia in individuals aged ≥60. 

Studies included in the review encompassed outcomes of 276,570 participants with median age ranging from 50.3 to 77 years and a follow-up time ranging between two to 37 years (average = 9.5 years). 

Study:  Traumatic life events and risk for dementia: a systematic review and meta-analysis . Image Credit:  fizkes /Shutterstock.com Background

Studies have suggested that experiencing TLEs, such as actual/threatened death, injury, and sexual violence, might contribute to dementia risk.

Globally, the care and treatment cost of dementia is estimated to be around one trillion USD annually. Given that >150 million people will be living with dementia by 2050, it has become crucial to identify and target modifiable risk factors that could prevent dementia.

Systematic reviews have reported an association between PTSD and dementia; however, none, so far, have examined the same between dementia risk and TLE.

It is crucial to understand whether TLE identified during PTSD diagnosis or diagnosed separately is a risk factor for dementia to help find interventions to mitigate dementia risk and prevent/delay its onset. About the study

In the current study, researchers carried out a systematic review and generic inverse variance random effects meta-analysis to estimate TLE's impact on dementia risk, which they presented as risk, odds, and hazards ratios (HRs). The team utilized the Life Events Checklist for DSM-5 (LEC-5) criterion to identify TLE. Related StoriesCould your daily routine lead to dementia? New research points to sedentary lifestyle as potential risk factorIs exposure to infections or autoimmune diseases associated with dementia incidence?Eye-tracking technology can help improve quality of life assessment for older people with dementia

All included studies were original research articles published in peer-reviewed journals with case-control and cohort study designs that specified dementia diagnosis as an outcome in a study population of a minimum of 60 people.

All were related to all-cause dementia, with varying severities, and across all recruitment settings but excluded early onset dementia, having different etiology. They collected information regarding various forms of TLE (e.g., childhood trauma) from participants, their informants, or medical records.

The search strategy involved searching PsychINFO, Embase, and MEDLINE databases from inception until 20 April 2022 using keywords for "dementia,” "risk," and "traumatic events."

The team exported all retrieved studies to Covidence systematic review software. Next, two reviewers independently screened all articles at all stages, adhering to rigorous inclusion and exclusion criteria.

They used the Newcastle–Ottawa Scale for quality assessment of the studies and evaluated non-randomized epidemiological studies (NOS) having three domains: selection, comparability, and outcome. Further, they used a funnel plot to assess publication bias in the included studies.

The researchers classified a study as good if it had ≥3 and ≥1 stars in the selection and comparability domains and ≥ 3 stars in the outcome domain. Likewise, they also classified studies as 'Fair' and 'Poor' quality. 

Finally, the team meta-analyzed all studies and then conducted sub-analyses, stratifying by type of trauma, and used I2-statistic to measure heterogeneity. In sensitivity analyses, they included studies reporting HRs and having high quality. Results

The reviewers screened 3,523 studies and identified 29 research papers for full-text screening. Finally, they included seven studies in the meta-analysis; one was a cross-sectional study, three were prospective cohort studies, and three were retrospective cohort studies.

Pooled results from the meta-analysis of seven studies demonstrated that TLE increased the risk of all-cause dementia (HR = 1.21). The results showed significant heterogeneity (I2 = 78%).

Further, the authors noted that trauma subtypes, like trauma occurring in war and childhood, also increased the risk of all-cause dementia (pooled HR = 1.28), albeit based on fewer studies (n=3). These results also showed significant heterogeneity (I2 = 75%).  Conclusions

Overall, the current study recognized TLEs as potentially modifiable risk factors associated with increased risk of all-cause dementia.

Understanding the mechanisms by which TLEs increase susceptibility to dementia could help devise targeted interventions that reduce the effect of trauma, including PTSD, on dementia.

Future studies should investigate the impact of TLE-specific factors, such as chronicity and severity, and individual factors, such as age effect and association of TLEs with dementia subtypes.  Journal reference:

Severs, E., James, T., Letrondo, P., Løvland, L., Marchant, N. L. and Mukadam, N. (2023) BMC Geriatrics, 23(1). doi: 10.1186/s12877-023-04287-1. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-023-04287-1

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National Guard will begin carrying firearms in Washington DC, official says

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National Guard will begin carrying firearms in Washington DC, official says

National Guard troops deployed to Washington DC in an effort to mitigate crime will begin carrying firearms, an official has said.

Defence secretary Pete Hegseth ordered the authorisation of roughly 2,000 National Guard troops to begin carrying weapons.

The majority of the guard members will carry M17 pistols, their service-issued weapons, while a small number will be armed with M4 rifles, reports Sky’s US partner organisation, NBC News.

The troops are authorised to use their weapons for self-protection.

A White House official told NBC News that despite being armed, as of Saturday night, the National Guard troops in DC are not making arrests, and will continue to work on protecting federal assets.

The troops were largely deployed from outside the state and were framed by President Trump as a concerted effort to tackle crime and homelessness in the nation’s capital.

Such deployments are not common, and are typically used in response natural disasters or civil unrest.

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Democrats have bashed the deployment as partisan in nature, accusing Mr Trump of trying to exert his presidential authority through scare tactics and said his primary targets have been cities with black leadership.

Armed members of the South Carolina National Guard patrol outside of Union Station. Pic: AP
Image:
Armed members of the South Carolina National Guard patrol outside of Union Station. Pic: AP

Pentagon plans to deploy US army to Chicago

Yesterday it was reported that the Pentagon was drafting plans to deploy the US army in Chicago, the largest city in the state.

The governor of Illinois then accused Mr Trump of “attempting to manufacture a crisis” and “abusing his power to distract from the pain he is causing working families”.

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Officials familiar with the proposals told the Washington Post that several options were being weighed up by the US defence department, including mobilising thousands of National Guard troops in Chicago as early as September.

Mr Trump had told reporters on Friday that “Chicago is a mess”, before attacking the city’s mayor, Brandon Johnson, and hinting “we’ll straighten that one out probably next”.

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US

Flesh-eating screwworm parasite detected in person in US for first time

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Flesh-eating screwworm parasite detected in person in US for first time

A case of the flesh-eating screwworm parasite has been detected in a person in the United States for the first time.

The parasitic flies eat cattle and other warm-blooded animals alive, with an outbreak beginning in Central America and southern Mexico late last year.

It is ultimately fatal if left untreated.

The case in the US was identified in a person from Maryland who had travelled from Guatemala.

Beth Thompson, South Dakota’s state veterinarian, told Reuters on Sunday that she was notified of the case within the
last week.

A Maryland state government official also confirmed the case.

The person was treated and prevention measures were implemented, Reuters reports.

The Centres for Disease Control and Prevention (CDC) and the Maryland Department of Health did not immediately respond to requests for comment.

What is screwworm?

The female screwworm fly lays eggs in the wounds of warm-blooded animals and once hatched, hundreds of screwworm larvae use their sharp mouths to burrow through living flesh.

It can be devastating in cattle and wildlife, and has also been known to infect humans.

Treatment is onerous, and involves removing hundreds of larvae and thoroughly disinfecting wounds. They are largely survivable if treated early enough.

The confirmed case is likely to rattle the beef and cattle futures market, which has seen record-high prices because of tight supplies.

The US typically imports more than a million cattle from Mexico each year to process into beef. The screwworm outbreak could cost Texas – the biggest cattle-producing state – $1.8bn (£1.3bn) in livestock deaths, labour costs and medication
expenses.

A view shows a calf after being sprayed with a disinfectant spray to prevent screwworm. Pic: Reuters
Image:
A view shows a calf after being sprayed with a disinfectant spray to prevent screwworm. Pic: Reuters

The United States Department of Agriculture (USDA) has set traps and sent mounted officers along the border, but it has faced criticism from some cattle producers and market analysts for not acting faster to pursue increased fly production via a sterile fly facility.

What is a sterile fly facility?

The case also comes just one week after the US agriculture secretary, Brooke Rollins, travelled to Texas to announce plans to build a sterile fly facility there in a bid to combat the pest. Ms Rollins had pledged repeatedly to keep screwworm out of the country.

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A sterile fly facility produces a large number of male flies and sterilises them – these males are then released to mate with wild female insects, which collapses the wild population over time. This method eradicated screwworm from the US in the 1960s.

Mexico has also taken efforts to limit the spread of the pest, which can kill livestock within weeks if not treated. It had started to build a $51m sterile fly production facility.

The USDA has previously said 500 million flies would need to be released weekly to push the fly back to the Darien Gap, the stretch of rainforest between Panama and Colombia.

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UK

Urgent letter to home secretary over violence against women and girls strategy – as it omits child abuse

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Urgent letter to home secretary over violence against women and girls strategy - as it omits child abuse

Ten child protection organisations have written an urgent letter to the home secretary expressing concern about the omission of child sexual abuse from the government’s violence against women and girls strategy, following a Sky News report. 

Groups including the NSPCC, Barnardo’s and The Children’s Society wrote to Yvette Cooper to say that violence against women and girls (VAWG) and child sexual abuse are “inherently and deeply connected”, suggesting any “serious strategy” to address VAWG needs to focus on child sexual abuse and exploitation.

The letter comes after Sky News revealed an internal Home Office document, titled Our draft definition of VAWG, which said that child sexual abuse and exploitation is not “explicitly within the scope” of their strategy, due to be published in September.

Poppy Eyre when she was four years old
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Poppy Eyre when she was four years old

Responding to Sky News’ original report, Poppy Eyre, who was sexually abused and raped by her grandfather when she was four, said: “VAWG is – violence against women and girls. If you take child sexual abuse out of it, where are the girls?”

The Centre of Expertise on Child Sexual Abuse, which is funded by the Home Office and a signatory to the letter, estimates 500,000 children in England and Wales are sexually abused every year.

The NSPCC “welcome” the government’s pledge to halve VAWG in a decade, but is “worried that if they are going to fulfil this commitment, the strategy absolutely has to include clear deliverable objectives to combat child sexual abuse and exploitation too”, the head of policy, Anna Edmundson, told Sky News.

Poppy is a survivor of child sexual abuse
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Poppy is a survivor of child sexual abuse

She warned the government “will miss a golden opportunity” and the needs of thousands of girls will be “overlooked” if child sexual abuse and exploitation is not “at the heart of its flagship strategy”.

The government insists the VAWG programme will include action to tackle child sexual abuse, but says it also wants to create a distinctive plan to “ensure those crimes get the specialist response they demand”.

“My message to the government is that if you’re going to make child sexual abuse a separate thing, we need it now,” Poppy told Sky News.

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Rape Crisis, which is one of the largest organisations providing support to women in England and Wales, shares these concerns.

It wants plans to tackle child sexual abuse to be part of the strategy, and not to sit outside it.

“If a violence against women and girls strategy doesn’t include sexual violence towards girls, then it runs the risk of being a strategy for addressing some violence towards some females, but not all,” chief executive Ciara Bergman said.

A Home Office spokesperson said the government is “working tirelessly to tackle the appalling crimes of violence against women and girls and child sexual exploitation and abuse, as part of our Safer Streets mission”.

“We are already investing in new programmes and introducing landmark laws to overhaul the policing and criminal justice response to these crimes, as well as acting on the recommendations of Baroness Casey’s review into group-based Child Sexual Exploitation, and the Independent Inquiry into Child Sexual Abuse,” they added.

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