Researchers have linked sleep quality to an older-looking brain

• Researchers found that worse sleep habits were tied to brains that appear, on average, about one year older than a persons real age.

• The study looked at 27,500 adults, using MRI + machine learning to compute a brain age gap (brain age minus real age).

• About 10% of the link between poor sleep and older-looking brains were explained by low-grade inflammation in the body.

We all know a night of bad sleep can leave us groggy and foggy the next day.

But could poor sleep actually make your brain age faster?

Thats the idea behind a new study from researchers at the Karolinska Institutet, which suggests that people with chronically unhealthy sleep patterns tend to have brains that look older than they really are.

The gap between brain age and chronological age widened by about six months for every one-point decrease in healthy sleep score, researcher Abigail Dove said in a news release. People with poor sleep had brains that appeared on average one year older than their actual age.

The study

The researchers tapped into data from the UK Biobank, a large health database in the U.K., selecting 27,500 middle-aged and older participants (mean age ~54.7 years). At baseline, participants answered questions about five sleep-related traits:

1. Chronotype (morning person vs. evening person)

2. Sleep duration

3. Insomnia symptoms

4. Snoring

5. Daytime sleepiness
   

Each person was given a healthy sleep score from 0 to 5, based on how many of these traits were favorable. They were grouped into three categories: healthy (four to five good traits), intermediate (two to three), or poor (zero to one) sleep quality.

Years later (average follow-up ~ 8.9 years), all those participants underwent brain MRI scans, capturing over a thousand brain imaging features (so-called MRI phenotypes). Using a machine learning model, the researchers estimated each participants brain age from the scans, and then calculated the brain age gap (BAG) the difference between brain age and chronological (actual) age.

To examine mechanisms, the team also measured low-grade systemic inflammation (via a composite INFLA score based on inflammatory biomarkers). They used statistical techniques to test to what extent inflammation mediated any link between sleep and brain age.

They adjusted for many potential confounders, including age, sex, education, lifestyle factors, and cardiometabolic health.

The results and what they mean

At baseline, only a small slice of participants (~3.3 %) were classified as having poor sleep, while 55.6 % fell in the intermediate group and 41.2 % in the healthy group.

Compared with the healthy sleep group, those with intermediate sleep had a modestly higher brain age gap (~0.25, meaning roughly 0.25 years or ~three months older) and those with poor sleep had a stronger effect (~0.46, or about 0.46 years, i.e. about five to six months).

In real terms, the difference accumulates: for each single point drop in the sleep score, the brain-age gap increased by about six months.

On average, people in the poor sleep group had brains that appeared about one year older than their actual age.

When the researchers looked at the role of inflammation, they found it accounted for about 10.4 % of the association between poor sleep and increased brain age gap (and about 6.8 % for intermediate sleep).

The authors caution that this is an observational study, so it cannot prove that bad sleep causes accelerated brain aging. Also, sleep traits were self-reported, which can introduce bias, and participants in the U.K. Biobank tend to be healthier than the general population (which may limit how generalizable the findings are).

Nevertheless, the study adds weight to the idea that sleep might be a modifiable factor in protecting brain health. If poor sleep really does push the brain to age faster (even slightly), then improving sleep better consistency, treating insomnia or sleep apnea, managing daytime sleepiness may help slow down some of that wear and tear.

The new law is the first of its kind in the country

An expert shares simple, humane ways to stop squirrels and chipmunks from turning your porch pumpkins into a snack

• Fall dcor can attract squirrels, chipmunks, and rodents and once they start snacking, they may look for ways into your home.

• Scratching or squeaking sounds, unfamiliar odors, and gnaw marks on food, fixtures, or wires can all indicate critter activity and chewing on electrical wires can even cause fires.

• Seal cracks or gaps around your home, rake up leaves, and remove outdoor food sources like bird feeders, trash, and pet food to keep animals from settling in for the season.

Pumpkins on the porch are a sure sign that fall has arrived but they can also be an open invitation to unwanted guests.

Squirrels, chipmunks, and other curious critters see your festive displays as an easy meal, and once they start snacking, they may decide to explore even further.

According to Jason Burkhart, Managing Director at Critter Control, these small animals can cause big problems from chewed-up decorations to serious fire hazards when they start gnawing on electrical wires.

ConsumerAffairs interviewed Burkhart to learn how you can keep your fall dcor safe, redirect wildlife humanely, and know when its time to call in a professional.

Be careful decorating your porch with pumpkins, gourds and other edible decorations, he said.While these are fun, festive ways to celebrate the season, they can sometimes serve as a free food sampler for squirrels, rodents, and more. Once they've gotten used to snacking on your decorations outside, they may be tempted to venture inside to see what else your home has to offer them.

The biggest threats for the fall

As the weather gets cooler, its important for consumers to know what to be on the lookout for.

Plenty of critters are looking to find a safe, warm place with a reliable food supply to ride out the winter months, Burkhart said. You could find mice, rats, squirrels, raccoons, and many more in your home during the autumn months, as they prepare for the winter ahead.

Many people mistakenly assume these critters are mostly a problem for the spring and summer months, but these animals do not hibernate, so they remain an ongoing issue for homeowners year-round.

Know the warning signs

Burkhart shared the top signs homeowners should look out for if they suspect a critter problem:

• Unfamiliar sounds and unfamiliar smells: If you hear scratching, scurrying, and squealing coming from the ceiling or walls, it's entirely possible that you've got mice, rats, or squirrels living in your home. You will also likely start to smell their droppings the longer they live in your home.

• Visual cues: Squirrels, mice, and rats do quite a bit of gnawing. If you see your food sources broken into and food gnawed at, you may be dealing with one of them. But the gnawing doesn't stop with food; they'll gnaw on almost anything they can find. If you see fixtures or wires with gnaw marks, you should have a professional inspect your home for critters sooner rather than later.

Gnawing on wires can result in electrical fires, so it's best to have the situation dealt with as soon as possible, Burkhart explained.

Protect your property

While pest control is an inevitable part of homeownership, Burkhart shares how consumers can make sure their property is protected for the fall months and beyond.

The best thing you can do to proactively protect your house is to have a trained wildlife removal professional conduct a full inspection of your home to see if there are any cracks, gaps, or openings that squirrels, mice, rats, raccoons, and more could use to gain entry into your home, he said.

It may be a bit of a pain, but in the autumn months, one of the best things you can do to keep critters from approaching your home is to keep your leaves raked; don't let mass quantities of them linger for too long around your yard. Many rodents, snakes and other small critters thrive in messy, brushy environments. If your lawn is covered in leaves, that provides very comfortable circumstances for them to hang around your home and could lead to them approaching your house and looking for a way inside.

Another note: keep your yard free of all potential food sources bird feeders, trash, and pet food. Theyll attract raccoons and other nearby critters, and if they think your home is a reliable food source, it can be hard to deter them.

What a new study says about buying neurologic drugs without the middleman

• A recent study compared the cost of 33 neurologic drugs via a direct-to-consumer (DTC) pharmacy and via commercial insurance.

• Out-of-pocket costs were on average 75% higher under the DTC model, but total system costs (which include insurance payments) were 413% lower.

• For patients without insurance, the DTC route might offer a viable alternativethough it currently covers less than half of all neurologic drugs.

If youve ever paid for a prescription and winced at the price and then wondered what your insurance was really doing for you youre not alone.

A study highlighted by Ohio State News explores whether online, direct-to-consumer pharmacies (like the Mark Cuban Cost Plus Drug Company) could compete with traditional insurance-based models.

I had heard about the Mark Cuban pharmacy through colleagues and thought it would be interesting to compare the costs because his pharmacy is very direct-to-consumer they cut out the middleman and whatever is advertised on the website is what youre paying for, and thats your only cost, researcher Amanda Gusovsky Chevalier said in a news release.

The study

Heres how the researchers set up the trial:

• They focused on neurologic medications used for conditions like Alzheimers, MS, Parkinsons, and more.

• From 79 medications, they found 33 that were available through the DTC pharmacy (Mark Cubans Cost Plus).

• For each drug, they collected the out-of-pocket (OOP) cost under the DTC model (i.e. what a person would pay themselves) and estimated what it would cost under commercial insurance (including what the patient + insurer would pay).

• Because insurance-based data came from 20122021, they used statistical modeling to project what those insurance costs might look like in 2024.

• They compared two main outcomes:
  1. Out-of-pocket difference (i.e. what you pay directly)
  2. Total cost difference (i.e. sum of what the patient + insurer pay)

• They also repeated comparisons focusing only on generic drugs (i.e. leaving out brand-name ones) to see how much that changes things.

What they found: The upside (and the catch)

The results show a mixed but compelling picture:

Out-of-Pocket Costs:

• On average, the DTC models out-of-pocket cost was 75% higher than what insured patients would pay through traditional commercial pharmacies.

• However, for many medications, that difference was relatively small in dollar terms. In 76% of the drugs studied, the OOP difference was under $200 per year.

• Only two medications teriflunomide and droxidopa had lower OOP costs via the DTC route.

• Among generics only, none of the DTC drugs had lower OOP costs.
  

Total System Costs:

• The real eye-opener: on average, DTCs total costs (patient + what insurer would have paid) were 413% lower than in the insurance-based model.

• 18 out of the 33 medications (~55%) showed lower total annual costs when purchased via the DTC pharmacy.

• A few drugs stood out with especially large cost reductions (e.g. teriflunomide, dimethyl fumarate, droxidopa).
  

One caveat: because the DTC pharmacys catalog is limited it only listed 33 of 79 neurologic drugs the model isnt yet a full replacement.

Also, if everyone switched to DTC, the study estimated that patients aggregate out-of-pocket spending would increase by about $82 million but total costs across the system might drop.

In short: for insured patients, the DTC model often means paying more out of pocket, so it may not seem appealing. But for the system at large and especially for people without insurance it has real promise.

Our research has shown that the costs of medications just continue to rise through insurance plans, and its really important to find ways for patients to access medicines, Gusovsky Chevalier said.

I think this adds to a larger body of evidence showing that these direct-to-consumer pharmacies have the potential to disrupt the market in some significant way in the future. Its important for people to know that online pharmacies like this are available.