Category: Health

Sept. 8, 2022 – When Lynda Carter talks about her late husband, Robert Altman, you can sense right away that this was a love affair for the ages.

“As I’ve often said, if you were a friend of Robert’s, you were one of the luckiest people in the world,” says Carter, the singer-songwriter and actor best known for her role as Wonder Woman in the 1970s TV series, who married Altman, an attorney, in 1984.

For Carter, Altman, and their children, Jessica and James, everything changed in 2017, when Altman was diagnosed with myelofibrosis, a rare bone marrow disorder – about one case is reported per 100,000 Americans each year – that was found during routine bloodwork.

“Robert was never sick a day in his life,” she says in an interview. “He skied and swam, and in many ways we were in the prime of our lives together. When he was initially diagnosed, we weren’t even clear what he had. The buzzword was that he had a rare blood disorder, not cancer.”

The family was told to wait and see if the disease would get worse, which it did, unfortunately, at the exact time COVID-19 hit.

This condition can progress from myelofibrosis to secondary acute myeloid leukemia (sAML), a rare blood cancer, says Michael Caligiuri, MD, a leading researcher in immunology, lymphoma, and leukemia and president of City of Hope National Medical Center, one of the largest cancer research and treatment organizations in the U.S.

“This disease is chronic and slow-changing, but when it progresses more acutely to a form of leukemia, it can advance rapidly,” he says.

At the acute phase, there’s not much that can be done for the patient.

“This becomes very much a life-and-death situation,” he says. “You want to hope for the best, but there needs to be an expectation of the worst in terms of trying to prepare the patient and the family for what may come so that they can start to psychologically and legally put the person’s life in order.”

Despite every effort, Altman died in February 2021 at the age of 73.

Now, to honor her husband, Carter is gifting her time and resources to create the Robert & Lynda Carter Altman Family Foundation Research Fund, working with the Translational Genomics Research Institute (TGen), a leading biomedical research institute, which is part of City of Hope.

The goal: To speed up critical research that will improve early detection and survival for this hard-to-treat blood cancer.

“I’m excited to be a part of this team and to know that I may play a small part in helping other families facing this same diagnosis,” Carter says. “It’s thrilling seeing the progress these scientists are making, from genomic research into a universe of trillions of codes that might actually become a drug therapy someday.”

With the creation of the foundation, there will be funding to develop better diagnostics and better treatments.

“In many instances, this research will shed light on other related disorders, too,” says Caligiuri. “Cancer is a disease of the genes, and in most cases, we’re not inheriting from our mothers or fathers, but the DNA gets switched around in one of the trillion cells in our body, the way a word is misspelled.”

What happens next is that the cell doesn’t die.

“Instead, it undergoes a nuclear reaction and grows and grows,” he says. “In this case, the first evidence of a problem was myelofibrosis. That ticking time bomb continued until it exploded into leukemia.”

Caligiuri says the goal of their research will be to develop a device that can rearrange that DNA or block the DNA changes so the disease doesn’t progress to leukemia or, if it does, so “that we can turn it into a chronic condition, not an acute one that’s life-threatening.”

For Carter, this foundation is one very heartfelt way she can honor her husband’s legacy.

“When I lost Robert, I was left with so many questions,” she says. “I wanted to understand why rare cancers are so difficult to treat and what research or treatment advances were being made to change that. Robert was never one for self-aggrandizement, but I think he would like this. I think Robert would really be touched by this.”

Sept. 12, 2022 — Fitness consumers are flipping demands they made 2 years ago in the darkest days of the COVID pandemic.

Then, conventional wisdom told us that gyms were dying because people would rather stay home and work out than risk exposure in a fitness facility. Now, the reverse seems true, with membership sales and attendance rising again at many in-person businesses, and those shiny workout-at-home companies struggling to provide more than expensive clothes hangers in spare bedrooms.

There’s no doubt the pandemic disrupted the fitness industry permanently. A third of brick-and-mortar fitness locations went out of business permanently. Consumers stayed home, some with online training and others with shiny new brands that became household names.

But the pandemic isn’t what it once was, and it looks like some of that disruption might result in some lasting changes, but not the way it seemed at first.

Fitness consumers are winning. They’re gaining more options, more flexibility, a return to pre-pandemic pricing, and – observers hope – greater awareness that lifestyle habits directly impact our ability to stay strong against health challenges, including strange, new diseases.

The Big One

No brand became more closely linked to the pandemic than Peloton. The high-end at-home bikes connected users to instructors and other participants around the world for group classes, competitions, and more, creating an elite and somewhat self-adoring image compared to sweating it out in a weight room.

The brand wanted to be the main disruptor of the fitness world, and it was for a time.

It spawned other high-tech home gym equipment, like Tonal and Mirror. It became so successful that it was used as an instant goal-clarifier for startups, as in, “We’re going to be the Peloton of home knitting.” It even got embroiled in the “Sex and the City” universe when Carrie Bradshaw’s husband had a fatal heart attack while using one.

But now, the trendy cult-like magic is gone.

Peloton has reported company losses for 6 straight quarters, including a $1.2 billion quarterly loss announced last month. The company has cut jobs, closed retail locations, started selling used equipment, and started hawking products on Amazon.

Some observers say the company might have had better long-term luck without the temporary sales boom the pandemic provided.

“The days of Peloton’s pandemic-era glory are a distant memory now as it hunkers down to remain afloat. Revenue is drying up, losses are widening, and shares of the connected fitness guru are down 92% from the all-time high hit in January 2021,” The Motley Fool reported.

(A Peloton spokesperson said the company was not available for an interview for this article.)

The company is not alone in struggling.

The cycling chain SoulCycle said last month it would close a quarter of its locations. Like a lot of fitness businesses, SoulCycle had to shutter its doors when the pandemic hit, and some didn’t reopen.

“It’s yet another signal that consumers’ exercise habits continue to change as the pandemic wears on,” CBS reported.

Companies making in-home workout equipment are struggling, too. NordicTrack’s parent company, iFit Health and Fitness, dropped plans for an initial public offering. Tonal, which had expanded with mini stores in some Nordstrom locations, cut a third of its staff.

Gym Attendance on the Rise

As the Peloton trend has withered, consumers have been returning to gyms and studios. They want to be among people, to have access to trainers, to use more equipment than can fit in their homes, and to be challenged in new ways being offered by new brands like Pure Barre.

For example, low-cost chain leader Planet Fitness reported sales were up 13.6% in the second quarter of 2022, with a total membership of 16.5 million.

“Our high-quality, affordable fitness experience resonates now more than ever as Americans are seeking value and feeling the rising costs of everyday items such as food and gas,” says Chief Executive Officer Chris Rondeau.

“We believe that people will continue to prioritize their health and wellness while being more cost-conscious, and we offer a welcoming environment for people of all fitness levels. During the second quarter, our join trend returned to pre-pandemic seasonality with the addition of approximately 300,000 net new members.

And Xponential Fitness, which owns 10 boutique franchise brands including Row House, Pure Barre, and CycleBar, saw a 66% increase in revenue in the second quarter of this year.

The pandemic left some new demands around cleanliness, says Josh Leve, CEO of the Fitness Business Association, an organization of gym owners and other fitness professionals.

“What members want now is not about the best workout, the most equipment, or the most classes,” Leve says. “It will be about whether or not I trust my health to you and your team.”

Hybrid Workouts Let You Have It Both Ways

And the rise of “hybrid” options, boosted greatly by the lockdown, will last, he says. This became a common gym offering when owners provided training online to their customers who weren’t allowed to come into the gym or studio during lockdown.

“Before, when these businesses were looking to generate new revenue, they had to get more people to walk in the door,” he says. “Now the opportunities are endless. People can join your studio but train remotely.”

And consumers aren’t going to let go of that option, says Chris Craytor, board chairman of IHRSA, a global trade organization serving the fitness industry.

“The hybrid type of fitness is here to stay,” he says. Consumers like having the option of being able to exercise with a gym or studio from their homes or in the brick-and-mortar location. They’ve gotten used to it, as many office workers are now reluctant to go back to spending 40 hours a week in the office.

“What we’re seeing now is more people coming back into the clubs,” he says, noting “no hesitation” from consumers about COVID. “Consumers just want to return to exercise.”

Some want a super-low price, like they find at Planet Fitness and other chains like it.

But they want something they can’t get at home: the social aspect of going to a gym or studio. That’s particularly true for older consumers, he says.

“The benefits of being in person are priceless, both from a technical perspective in the training and from the sense of community,” says Rosa Coletto, owner of Full Circle Fitness in Tustin, CA. “Our demographic of older adults generally appreciates and prefers working in person to ensure safety, efficiency, and effectiveness.”

What’s Next

Craytor says consumers are coming back after COVID wanting strength training and “coached experiences” like in-person training like Xponential’s rowing and Pilates classes.

Strength training is another phrase for weightlifting, which generally requires a lot of heavy equipment and more room to use it than many homes can offer. Some clubs are even reducing the amount of space devoted to cardio machines so they can offer more weightlifting and other options, he says.

The main idea is to get people moving on a regular basis to improve lives and public health problems like obesity and medical costs – whether at home or in the gym.

Consumer needs change, as the pandemic showed so dramatically for fitness and other industries.

New Pelotons used to be hard to find. Now selling a used one can be a challenge.

On Facebook, the Peloton Buy Sell Trade (BST) group claims more than 200,000 members.

Nurse Olivia Hilton bought a Peloton in 2020 with a discount offered to health care workers, spending $3,000 “on this bike that collected dust,” she recently told The New York Times.

She sold it on Facebook after she dropped the price from $1,500 to $1,200.

She felt guilty about selling it. But ultimately, she said she decided to “get the thing out of your house if you don’t want it anymore.”

Sept. 12, 2022 – From the earliest days of the COVID-19 pandemic, people of color have been hardest hit by the virus. Now, many doctors and researchers are seeing big disparities come about in who gets care for long COVID.

Long COVID can affect patients from all walks of life. But many of the same issues that have made the virus particularly devastating in communities of color are also shaping who gets diagnosed and treated for long COVID, says Alba Miranda Azola, MD, co-director of the Post-Acute COVID-19 Team at Johns Hopkins University School of Medicine in Baltimore.

Nonwhite patients are more apt to lack access to primary care, face insurance barriers to see specialists, struggle with time off work or transportation for appointments, and have financial barriers to care as co-payments for therapy pile up.

“We are getting a very skewed population of Caucasian wealthy people who are coming to our clinic because they have the ability to access care, they have good insurance, and they are looking on the internet and find us,” Azola says.

This mix of patients at Azola’s clinic is out of step with the demographics of Baltimore, where the majority of residents are Black, half of them earn less than $52,000 a year, and 1 in 5 live in poverty. And this isn’t unique to Hopkins. Many of the dozens of specialized long COVID clinics that have cropped up around the country are also seeing an unequal share of affluent white patients, experts say.

It’s also a patient mix that very likely doesn’t reflect who is most apt to have long COVID.

During the pandemic, people who identified as Black, Hispanic, or American Indian or Alaska Native were more likely to be diagnosed with COVID than people who identified as white, according to the CDC. These people of color were also at least twice as likely to be hospitalized with severe infections, and at least 70% more likely to die.

“Data repeatedly show the disproportionate impact of COVID-19 on racial and ethnic minority populations, as well as other population groups such as people living in rural or frontier areas, people experiencing homelessness, essential and frontline workers, people with disabilities, people with substance use disorders, people who are incarcerated, and non-U.S.-born persons,” John Brooks, MD, chief medical officer for COVID-19 response at the CDC, said during testimony before the U.S. House Energy and Commerce Subcommittee on Health in April 2021.

“While we do not yet have clear data on the impact of post-COVID conditions on racial and ethnic minority populations and other disadvantaged communities, we do believe that they are likely to be disproportionately impacted … and less likely to be able to access health care services,” Brooks said at the time.

The picture that’s emerging of long COVID suggests that the condition impacts about 1 in 5 adults. It’s more common among Hispanic adults than among people who identify as Black, Asian, or white. It’s also more common among those who identify as other races or multiple races, according survey data collected by the CDC.

It’s hard to say how accurate this snapshot is because researchers need to do a better job of identifying and following people with long COVID, says Monica Verduzco-Gutierrez, MD, chair of rehabilitation medicine and director of the COVID-19 Recovery Clinic at the University of Texas Health Science Center at San Antonio. A major limitation of surveys like the ones done by the CDC to monitor long COVID is that only people who realize they have the condition can get counted.

“Some people from historically marginalized groups may have less health literacy to know about impacts of long COVID,” she says.

Lack of awareness may keep people with persistent symptoms from seeking medical attention, leaving many long COVID cases undiagnosed.

When some patients do seek help, their complaints may not be acknowledged or understood. Often, cultural bias or structural racism can get in the way of diagnosis and treatment, Azola says.

“I hate to say this, but there is probably bias among providers,” she says. “For example, I am Puerto Rican, and the way we describe symptoms as Latinos may sound exaggerated or may be brushed aside or lost in translation. I think we miss a lot of patients being diagnosed or referred to specialists because the primary care provider they see maybe leans into this cultural bias of thinking this is just a Latino being dramatic.”

There’s some evidence that treatment for long COVID may differ by race even when symptoms are similar. One study of more than 400,000 patients, for example, found no racial differences in the proportion of people who have six common long COVID symptoms: shortness of breath, fatigue, weakness, pain, trouble with thinking skills, and a hard time getting around. Despite this, Black patients were significantly less likely to receive outpatient rehabilitation services to treat these symptoms.

Benjamin Abramoff, MD, who leads the long COVID collaborative for the American Academy of Physical Medicine and Rehabilitation, draws parallels between what happens with long COVID to another common health problem often undertreated among patients of color: pain. With both long COVID and chronic pain, one major barrier to care is “just getting taken seriously by providers,” he says.

“There is significant evidence that racial bias has led to less prescription of pain medications to people of color,” Abramoff says. “Just as pain can be difficult to get objective measures of, long COVID symptoms can also be difficult to objectively measure and requires trust between the provider and patient.”

Geography can be another barrier to care, says Aaron Friedberg, MD, clinical co-lead of the Post-COVID Recovery Program at the Ohio State University Wexner Medical Center. Many communities hardest hit by COVID – particularly in high-poverty urban neighborhoods – have long had limited access to care. The pandemic worsened staffing shortages at many hospitals and clinics in these communities, leaving patients even fewer options close to home.

“I often have patients driving several hours to come to our clinic, and that can create significant challenges both because of the financial burden and time required to coordinate that type of travel, but also because post-COVID symptoms can make it extremely challenging to tolerate that type of travel,” Friedberg says.

Even though the complete picture of who has long COVID – and who’s getting treated and getting good outcomes – is still emerging, it’s very clear at this point in the pandemic that access isn’t equal among everyone and that many low-income and nonwhite patients are missing out on needed treatments, Friedberg says.

“One thing that is clear is that there are many people suffering alone from these conditions,” he says.

MONDAY, Sept. 12, 2022 (HealthDay News) — Researchers think they’ve figured out why Parkinson’s disease causes a person’s limbs to become so stiff that at times they can feel frozen in place.

Using a robotic chair equipped with sensors, a research team has linked the activation of leg muscles in Parkinson’s patients with a region of the brain called the subthalamic nucleus.

This oval-shaped brain area is involved in movement regulation, and data from the chair show that it controls the start, finish and size of a person’s leg movements, according to research published Sept. 7 in Science Translational Medicine .

“Our results have helped uncover clear changes in brain activity related to leg movements,” said senior researcher Eduardo Martin Moraud, a junior principal investigator at the University of Lausanne in Switzerland.

“We could confirm that the same modulations underlie the encoding of walking states — for example, changes between standing, walking, turning, avoiding obstacles or stair climbing — and walking deficits such as freezing of gait,” Moraud said.

Parkinson’s disease is a degenerative disorder of the nervous system that primarily affects the body’s motor functions.

Parkinson’s patients have trouble regulating the size and speed of their movements, according to the Parkinson’s Foundation. They struggle to start or stop movements, link different movements to accomplish a task like standing up, or finish one movement before they begin the next.

The subthalamic nucleus is part of the basal ganglia, a network of brain structures known to control several aspects of the body’s motor system, said Dr. James Liao, a neurologist with the Cleveland Clinic who reviewed the findings.

“This study is the first to convincingly demonstrate that the basal ganglia control the vigor of leg movements,” Liao said. “The significance is that this links dysfunction of the basal ganglia to the shuffling gait deficit of Parkinson’s disease.”

To research Parkinson’s effect on walking, researchers built a robotic chair in which a person could either voluntarily extend their leg from the knee or the chair could do it for them.

Researchers recruited 18 Parkinson’s patients with severe motor fluctuations and problems with their walking gait and their balance. Each patient was implanted with electrodes that could track electrical signals from their subthalamic nucleus and also provide deep brain stimulation to that brain region.

Impulses coming from the subthalamic nucleus were tracked as patients used the chair and later as they stood and walked.

“The fact that all these walking aspects are encoded in that region of the brain makes us believe that it contributes to walking function and dysfunction, thereby making it an interesting region for therapies and/or for predicting problems before they arise,” Moraud said. “We could leverage that understanding to design real-time decoding algorithms that can predict those walking aspects in real-time, using brain signals only.”

In fact, the researchers did create several computer algorithms that distinguished the brain signals from a regular stride from those that occur in patients with an impaired gait. The team also could identify freezing episodes in patients as they performed short walking tests.

“The authors demonstrated that periods of gait freezing can be predicted from recorded neural activity,” Liao said. “Accurate predictions will allow algorithms to be developed to change [deep brain stimulation] patterns in response to periods of gait freezing, shortening or even eliminating freezing episodes completely.”

Moraud said these findings could help inform future technologies aimed at improving the mobility of Parkinson’s patients.

“There are big hopes that the next generation of deep brain stimulation therapies, which will operate in closed loop — meaning that they will deliver electrical stimulation in a smart and precise manner, based on feedback of what each patients needs — may help better alleviate gait and balance deficits,” Moraud said.

“However, closed-loop protocols are contingent on signals that can help control the delivery of stimulation in real-time. Our results open such possibilities,” he added.

Dr. Michael Okun, national medical adviser of the Parkinson’s Foundation, agreed.

“Understanding the brain networks underpinning walking in Parkinson’s disease will be important to the future development of therapeutics,” Okun said. “The key question for this research team is whether the information they have gathered is enough to drive a neuroprosthetic system to improve Parkinson’s walking ability.”

More information

The Parkinson’s Foundation has more about walking and movement difficulties associated with Parkinson’s.

MONDAY, Sept. 12, 2022 (HealthDay News) — Gum disease has far-reaching effects and may increase your odds of developing dementia, a new study suggests.

In a review of 47 previously published studies, researchers in Finland found that tooth loss, deep pockets around teeth in the gums, or bone loss in the tooth sockets was tied to a 21% higher risk of dementia and a 23% higher risk of milder cognitive decline.

Tooth loss itself — an indicator of gum, or periodontal, disease — was linked to a 23% higher risk of cognitive (mental) decline and a 13% higher risk of dementia, according to the study.

“Maintaining adequate periodontal health, including retention of healthy natural teeth, seems to be important also in the context of preventing cognitive decline and dementia,” said lead researcher Sam Asher, from the Institute of Dentistry at the University of Eastern Finland in Kuopio.

Asher noted that the study can’t prove that gum problems actually cause dementia. Still, prevention and treatment of periodontal conditions are particularly important in older adults who are at increased risk for dementia, he said.

“Our results also emphasize the importance of oral health care in people who already have some degree of cognitive decline or dementia. These individuals often develop difficulties with maintaining oral hygiene and using professional oral health services,” Asher said.

Dentists should take note, he added. “Oral health professionals need to be particularly aware of early changes in periodontal health and oral self-care that often occur at older ages due to cognitive decline,” Asher said.

About 10% to 15% of the global adult population has gum inflammation known as periodontitis, the researchers pointed out in background notes. In severe cases, it leads to tooth loss, and prior research has linked it to heart disease and diabetes.

“Future research needs to focus on providing higher-quality evidence to help both the general public and dental health care professionals with more specific oral health care strategies to prevent dementia,” Asher added.

Dr. Sam Gandy, director of the Mount Sinai Center for Cognitive Health in New York City, said, “There is growing evidence that somehow systemic inflammation and brain inflammation are linked.”

Periodontal disease, systemic viral illnesses, including herpes, COVID-19 and inflammatory bowel syndrome, among others, are capable of triggering brain inflammation, said Gandy, who was not involved in the study.

“These associations do not necessarily involve direct invasion of the brain by microbes, but we still understand relatively little about the molecular basis for how systemic inflammation aggravates brain inflammation,” he added.

Research in this field is still murky. According to a recent trial, treating gum disease in Alzheimer’s patients did not affect their condition, although it did affect markers linked to Alzheimer’s, Gandy said.

“This sort of result, taken together, raises the possibility that biomarkers may, at least under some circumstances, be misleading. There is still no acceptable substitute for the large, long, expensive, randomized clinical trials in which meaningful clinical benefit can be established,” he said.

This study can’t prove that the inflammation caused by dental disease causes dementia, agreed Dr. Jeremy Koppel, a geriatric psychiatrist and co–director of the Northwell Health Litwin-Zucker Alzheimer’s Disease Research Center in Manhasset, N.Y.

“You don’t know if they got the periodontal disease because they have Alzheimer’s or they got Alzheimer’s because of the gum disease,” said Koppel, who played no role in the research.

He noted that in this study, the risk for dementia linked with periodontal disease was very low. “The risk may be pretty much neutral when compared with known risks for the disease,” Koppel said. Those risks include smoking and unhealthy diet, according to the study.

Koppel doesn’t discount the importance of what’s happening in the mouth as it relates to Alzheimer’s disease. He said that research is being done on saliva to see what it has to tell about conditions in the brain.

“People are interested in looking at the saliva for biomarkers of the proteins in the brain that are related to Alzheimer’s,” Koppel said.

And anti-inflammatory therapies are already a treatment target for Alzheimer’s, he said.

“But whether the mouth may have other secrets hasn’t really been explored,” he added.

The report was published online Sept. 8 in the Journal of the American Geriatrics Society .

More information