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By Dr. Sanchari Sinha Dutta, Ph.D. Nov 23 2023 Reviewed by Benedette Cuffari, M.Sc.

In a recent study published in The American Journal of Cardiology, researchers compare the trends in cardiovascular disease-related mortality among patients with Alzheimer’s disease (AD) with the general United States population aged 65 years and older.  

Study:  Trends in Cardiovascular Mortality Among Individuals with Alzheimer’s Disease in the United States, 1999-2020. Image Credit: Nymphalyda / Shutterstock.com Cardiovascular disease and AD

As the global population continues to age, a gradual increase in the prevalence of AD has been observed over the past several decades. Several genetic and non-genetic risk factors are associated with the development of AD, which is the main cause of dementia.

Various cardiovascular disease (CVD)-related risk factors are also known to increase the risk of AD. For example, apolipoprotein E (APOE) is a common genetic risk factor for AD and CVD due to its involvement in cholesterol transportation as well as brain development. Among non-genetic risk factors, hypertension, and cholesterol serve as potential risk factors for both AD and CVD.

The accumulation of amyloid-beta plaques in the brain is a major hallmark of AD. Impaired clearance of amyloid-beta plaques because of poor vascular integrity due to CVD is believed to be a potential mechanism linking CVD with AD. The poor vascular integrity in CVD has also been associated with poor integrity of the blood-brain barrier (BBB) in AD. About the study

In the current study, scientists compare CVD-related mortality rates between AD patients and the general U.S. population aged 65 years and above. Moreover, they investigate whether certain demographic characteristics including sex, ethnicity/race, geographic region, and urbanization can influence the risk of CVD-related mortality among AD patients.     

The U.S. Centers for Disease Control and Prevention (CDC) dataset was used to determine national trends in age-adjusted CVD-mortality rates and average annual percent change values in the study populations between 1999 and 2020. Important observations

A total of 332,870 deaths due to CVD as a primary cause and AD as a contributory cause were identified between 1999 and 2020. This accounted for an age-adjusted mortality rate of 35.8 for every 100,000 individuals.

Among AD patients, a reduction in age-adjusted CVD-related mortality rate was observed between 1999 and 2020 from 51.7 to 25.9, respectively, for every 100,000 individuals. Regarding the annual percent change in CVD-related mortality, a 3.5% reduction among AD patients and 2.6% reduction in the general U.S. population was observed. The reduction in CVD-related mortality in AD was significantly higher than that in the general population. Related StoriesIs climate change turning up the heat on China's aging population?Switching from animal-based to plant-based foods reduces risk of heart disease, diabetes, and mortalityHospitalization and mortality risks from COVID-19 by age during SARS-CoV-2 Delta and Omicron variants predominance

Among various causes of CVD-related deaths, including ischemic heart disease, hypertensive disease, cerebrovascular disease, and heart failure, no significant difference in hypertensive disease-related mortality rate was observed between AD patients and the general U.S. population. For other causes, the reduction in mortality rates between 1999 and 2020 was significantly higher among AD patients. The reduction was most prominent for ischemic heart disease-related mortality.       

A similar reduction in CVD-related mortality rates between 1999 and 2020 was observed among male and female AD patients. No significant difference in mortality rate reduction was observed between individuals living in urban or rural regions.

Considering racial groups, the highest reduction in CVD mortality rates was observed among American Indians and Alaskan Natives. Comparatively, the lowest reduction was observed among Asian or Pacific Islander patients with AD. 

When age was considered, a greater reduction in CVD mortality rates was observed among patients aged 65-74 and 75-84 years as compared those 85 years of age and older. In terms of ethnicity, a lower reduction in CVD mortality rates over time was observed among Hispanic AD patients as compared to non-Hispanic AD patients. Study significance

The current study reports a gradual reduction in CVD-related mortality rates among AD patients in the U.S. over the past two decades. This reduction is higher among AD patients as compared to the general U.S. population 65 years of age and older.

The study findings are valuable for public health efforts aimed at improving cardiovascular health among AD patients. Clinicians should motivate AD patients who are at higher risk for CVD mortality to adopt healthy lifestyle habits, such as a balanced diet, regular physical activity, adequate sleep, and smoking and alcohol cessation.     Journal reference: Ranganathan, S., Abramov, D., Chew, N. W. S., et al. (2023). Trends in Cardiovascular Mortality Among Individuals with Alzheimer’s Disease in the United States, 1999-2020. The American Journal of Cardiology. doi:10.1016/j.amjcard.2023.11.044.

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X-Ray Nebula Discovery Brings Astronomers Closer to Solving Cosmic Ray Mystery

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A new study has linked an unexplained LHAASO detection to a pulsar-powered X-ray nebula, confirming it as a rare PeVatron capable of accelerating particles to extreme energies. The discovery is a major step toward solving the long-standing mystery of galactic cosmic rays. Researchers are now combining X-ray, gamma-ray and neutrino observations to trace these powerful …

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Software issue impacts thousands of Airbus planes – as UK passengers warned of potential disruption

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Software issue impacts thousands of Airbus planes - as UK passengers warned of potential disruption

Airline passengers have been warned of potential travel disruption after Airbus identified a “significant number” A320 planes impacted by a software issue.

In a statement, the plane maker said: “Analysis of a recent event involving an A320 Family aircraft has revealed that intense solar radiation may corrupt data critical to the functioning of flight controls.

“Airbus has consequently identified a significant number of A320 Family aircraft currently in-service which may be impacted.”

File pic: iStock
Image:
File pic: iStock

It is understood the incident that triggered an unexpected repair involved a JetBlue flight from Cancun, Mexico, to Newark, New Jersey, on 30 October, which suffered a sharp loss of altitude which injured several passengers.

An Airbus spokesperson told Sky News the necessary software change would affect up to 6,000 planes.

They added that for most of the affected aircraft, the required software update would take 2-3 hours. However, some aircrafts would need new hardware to be able to adopt the required software and that those aircraft would be affected for longer.

Travel expert, Simon Calder, said the situation was “very concerning” but that he had full faith in the safety procedures of Airbus and airlines. He went on to say that “aviation remains extraordinarily safe.”

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However, he warned that customers may not be entitled to cash compensation if affected by delays, as the issue would be considered out of the control of airlines.

EasyJet, British Airways, Aer Lingus, Lufthansa, American Airlines, Delta and Wizz Air are all affected by the issue.

Airbus told Sky News that it had proactively asked the European Union Aviation Safety Agency (EASA) to issue an air worthiness directive for the affected aircraft.

The issue is affecting A319, A320 and the A321 models. The company said the issue is only affecting A320s that are in service, not aircraft that are due to be delivered.

The UK Civil Aviation Authority said it is likely to mean some disruption and cancellation to flights.

Airbus requested that EASA issue an air worthiness directive. Pic: Reuters
Image:
Airbus requested that EASA issue an air worthiness directive. Pic: Reuters

Some airlines will be more affected than others, Colombian airline Avianca has announced that it will close ticket sales for 10 days due to the issue.

In a statement, easyJet said: “As we are expecting this to result in some disruption, we will inform customers directly about any changes to our flying programme tomorrow and will do all possible to minimise the impact.”

American Airlines said the Airbus software issue would impact 340 aircraft and it expects some operational delays due to a major software change requirement.

The airline added that it expects the vast majority of the updates to be completed by “today or tomorrow”, and that they are “intently focused” on limiting cancellations.

Wizz Air said some of its flights over the weekend may be affected, while Air India said the issue could lead to delays.

Indigo, an Indian airline which operates over 150 A320s, said it was proactively completing mandated updates on the affected aircraft.

British Airways told Sky News that only three of its aircraft where affected and that the required fixes will be carried out overnight and are not expected to disrupt its operations.

Aer Lingus is in a similar position, with a limited number of aircraft impacted. The Airline doesn’t expect there to be significant operational disruption, but is taking “immediate steps to complete the required software installations”.

In October, the Airbus A320 family broke a major milestone when it overtook Boeing’s 737 to become the most-delivered jetliner in history.

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Famous names affected by prostate cancer criticise NHS screening decision

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Famous names affected by prostate cancer criticise NHS screening decision

Famous names affected by prostate cancer have spoken of their disappointment after mass screening for the illness was not recommended for use on the NHS.

The National Screening Committee (NSC), comprised of doctors and economists, told the government that screening is “likely to cause more harm than good”.

Its decision means the NHS is unlikely to offer mass screening for men over the age of 45.

Six-time Olympic gold-medallist Sir Chris Hoy, former Prime Minister David Cameron, Sir Stephen Fry, actor and author Tony Robinson and journalist Dermot Murnaghan, who have all been diagnosed with the disease, spoke out after today’s decision.

David Cameron, Dermot Murnaghan and Sir Chris Hoy were among those who spoke out. Pic: PA/Shutterstock/AP
Image:
David Cameron, Dermot Murnaghan and Sir Chris Hoy were among those who spoke out. Pic: PA/Shutterstock/AP

In a draft recommendation, the committee said the reason it was “not recommending whole population screening using the prostate specific antigen (PSA) test was that it was likely to cause more harm than good”.

Instead, it proposes a targeted screening programme every two years for men with specific genetic mutations, known as BRCA-1 and BRCA-2, between the ages of 45 and 61.

But Sir Chris, who confirmed last year that his prostate cancer diagnosis was terminal, with doctors giving him two to four years to live, criticised the move.

The former Team GB cyclist, who confirmed in February 2024 that he was undergoing treatment, said: “I am extremely disappointed and saddened by the recommendation announced by the National Screening Committee today to rule against national screening for men at high risk of prostate cancer.

“More than 12,000 men are dying of prostate cancer every year; it is now the UK’s most common cancer in men, with black men at double the risk, along with men with a family history, like myself.

“While introducing regular checks for men carrying the BRCA genes is a very small step forward, it is not enough. I know, first hand, that by sharing my story following my own diagnosis two years ago, many, many lives have been saved.

“Early screening and diagnosis saves lives. I am determined to continue to use my platform to raise awareness, encourage open discussion, raise vital funds for further research and support, and to campaign for change.”

Sir Chris Hoy. Picture: PA
Image:
Sir Chris Hoy. Picture: PA

His views were echoed by Lord Cameron, who this month announced he was treated for prostate cancer last year.

Lord Cameron said in a post on X: “I am disappointed by today’s recommendation on prostate cancer screening from the National Committee.

“Targeted screening is a natural first step – but the recommendation today is far too targeted, not including black men or men with a family history, both high-risk groups.

“Prostate cancer is the most common cancer among British men. We are letting down too many men if we don’t push for a wider screening programme that includes all high-risk groups – and not just the men involved, but their families too, who risk losing a loved one unnecessarily. As I know all too well, prostate cancer can be symptomless early on.

“That’s why screening is so essential – catching the cancers early when they can be more effectively and successfully treated, like in my own case.”

Former British Prime Minister David Cameron said he was treated for prostate cancer last year. (AP Photo/Alex Brandon)
Image:
Former British Prime Minister David Cameron said he was treated for prostate cancer last year. (AP Photo/Alex Brandon)

Sir Tony, journalist Mr Murnaghan and retired footballer Les Ferdinand also voiced their disappointment after the decision.

Sir Tony, 79, who starred as Baldrick in Blackadder, said: “I’m bitterly disappointed. Getting an early diagnosis for prostate cancer could save your life, but we still have no screening programme for it in the UK.

“I was lucky I found my cancer early, but nearly 10,000 men a year are diagnosed too late for a cure, and that’s just not right.”

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Why prostate cancer screening not being expanded

Broadcaster Mr Murnaghan, 67, added: “With prostate cancer cases higher than they’ve ever been, and the disease dominating the national conversation, I really thought we were heading to an exciting moment here.

“I’m so disappointed that the committee has decided not to recommend screening – it felt about time progress was made for men.”

He added in a statement shared with Sky News: “An acceptable halfway house, would perhaps be to extend screening to black men – and those with a known history of cancer in their family. But clearly a full nationwide screening programme would be best.”

Sir Stephen, who is a Prostate Cancer Research ambassador who revealed in 2018 he had undergone surgery after being diagnosed with the disease, said: “I’m deeply disappointed by today’s news. Men in the UK deserve so much better. Prostate cancer remains the second biggest cancer killer of men in this country, with more than 12,000 dying every year.

“The only way we will make a dent in that appalling statistic is by catching prostate cancer early, before symptoms appear – and the best way to do that is through a screening programme. I hope the country sees sense.”

Retired footballer Les Ferdinand also voiced his concerns over the decision. Pic: Reuters
Image:
Retired footballer Les Ferdinand also voiced his concerns over the decision. Pic: Reuters

Mr Ferdinand, whose grandfather died from prostate cancer, added: “I’ve seen members of my family survive prostate cancer, because their cancer was found in time.

“Without a national screening programme, the responsibility to find prostate cancer early and in time for a cure rests entirely on men’s shoulders, and it shouldn’t be this way.

“Black men are at double the risk of prostate cancer and twice as likely to die, and something has to be done.”

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Prostate cancer decision ‘a massive mistake’

Colin McFarlane, an actor who was diagnosed with prostate cancer in 2023, told Sky News presenter Jonathan Samuels the decision was a “massive mistake”.

“I’ve been diagnosed with prostate cancer, but I’m not having any treatment. I have something called active surveillance, so every three months I have a PSA blood test, and then once a year I have an MRI,” he said.

McFarlane said black men over the age of 45 are at high risk, and “should be invited for screening”. He added: “I personally think men over 50 should be invited for screening, because they’re also at risk. I’m concerned now for all the black men out there who are high risk.”

NSC added it did not recommend extensive screening for black men due to a current lack of evidence and data.

The committee also does not recommend targeted screening for men with a family history of the disease, who are also at a higher risk of prostate cancer.

The National Screening Committee is comprised of doctors and economists. File pic: iStock
Image:
The National Screening Committee is comprised of doctors and economists. File pic: iStock

Health Secretary Wes Streeting said he would consider the findings ahead of March’s final decision, adding that he wanted to see earlier diagnosis and quicker treatment, but that needed to be balanced against “the harms that wider screening could cause to men”.

Prostate cancer symptoms and treatment

  • According to the NHS, prostate cancer is most common in men over the age of 50 from a black African or Caribbean background.
  • Its severity is determined by whether it spreads to other parts of the body.
  • It does not usually have any signs or symptoms at first, but later signs can include back, hip or pelvis pain, or difficulty maintaining an erection.
  • Problems urinating can also be a sign of other prostate problems.
  • Treatments for prostate cancer include surgery, radiotherapy and hormone therapy.
  • However, the NHS says it does not always require treatment.

Professor Sir Mike Richards, a former national cancer director and chairman of the NSC, told a briefing that modelling on PSA shows “whole population screening may lead to a small reduction in prostate cancer deaths, but the very high levels of overdiagnoses” means the harms outweigh the benefits.

Experts are also waiting to see data from a large trial launched by Prostate Cancer UK last week into whether combining PSA with other tests, such as rapid MRI scans, may lead to recommending population-wide screening.

Read more from Sky News:
Why prostate cancer is expected to be left without national screening

Scotland to roll out ‘simple’ genetic test

The trial is looking at the most promising screening techniques available, including PSA blood tests, genetic tests and 10-minute MRI scans, and whether they can be combined for a national screening programme.

The results will be ready within two years, it is hoped.

Mr Streeting added: “In the meantime, we will keep making progress on cutting cancer waiting times and investing in research into prostate cancer detection – in the last 12 months, 193,000 more patients received a diagnosis for suspected cancer on time.

“We are also providing funding to the £42m TRANSFORM trial, which has the potential to revolutionise prostate cancer screening, cutting out harmful side effects and making screening far more accurate.”

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