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geriatric medicine

MRI May Aid Early Pancreatic Cancer Detection in Diabetes

by Dr. Michael Lee – Health Editor July 3, 2025

written by Dr. Michael Lee – Health Editor

Diabetes Deterioration May Signal Hidden Cancer

MRI screening shows promise for early detection of pancreatic tumors in high-risk patients.

For individuals over 50, the emergence of new diabetes or a worsening of existing diabetes could indicate a hidden risk: pancreatic cancer. A recent study suggests MRI screenings could help detect these cancers early.

MRI Screening Uncovers Stage IB Pancreatic Cancer

The PANDOME study, led by **Richard Frank**, MD, explored the effectiveness of MRI-based screening for early pancreatic cancer detection in patients with new-onset diabetes or deteriorating diabetes. The research involved 97 patients with new-onset diabetes and 12 with deteriorating diabetes.

Those with deteriorating diabetes displayed significantly higher A1c levels, greater weight loss, and increased insulin needs, in comparison to the new-onset group.

Study Details

New-onset diabetes was defined as elevated A1c levels within the past year. Deteriorating diabetes meant long-standing diabetes (over two years) with a significant A1c increase (more than 2%) in the last six months, unrelated to weight changes or medication adherence.

All participants underwent MRI/cholangiopancreatography, blood biobanking, and monitoring for anxiety/depression. MRI results were categorized as normal, benign-abnormal, suspicious, or incidental findings.

Key Findings on Cancer Risk

Among the participants, over half had small cystic lesions, averaging 6 mm. This led to seven endoscopic ultrasound procedures, with four biopsies performed. One biopsy revealed stage IB pancreatic ductal adenocarcinoma in a patient with deteriorating diabetes.

Notably, 75% of the deteriorating diabetes group had high-risk scores for pancreatic cancer, compared to 35.6% in the new-onset diabetes group, according to the Enriching New-Onset Diabetes for Pancreatic Cancer score.

Incidental Findings

The study also uncovered extra-pancreatic incidental findings in 8.2% of cases. Two biopsies revealed a new diagnosis of follicular lymphoma and a recurrence of lymphoma, respectively.

Study Limitations

The study had some limitations including low accrual rates and potential selection bias. Most participants were referred, which may have affected detection rates. Also, the predominantly White participant pool limits the generalizability of the findings, given higher pancreatic cancer risk among Black populations.

Clinical Significance

The study, published in The Journal of Clinical Endocrinology & Metabolism, suggests that “Preliminary results from the PANDOME study support further MRI-based PC [pancreatic cancer] screening research efforts in individuals with NOD [new-onset diabetes] and DD [deteriorating diabetes].”

According to the American Cancer Society, about 66,440 people will be diagnosed with pancreatic cancer in the U.S. in 2024, and about 51,750 people will die of it (American Cancer Society).

Funding and Disclosures

The study was funded by several organizations, including a Tribute to Pamela/The Naughton Family Fund. The authors reported no conflicts of interest.

July 3, 2025 0 comments

Health

Sepsis Diagnosis Delays Pose Urgent Safety Risk: HSSIB

by Dr. Michael Lee – Health Editor June 27, 2025

written by Dr. Michael Lee – Health Editor

Sepsis Diagnosis Delays Still Endanger UK Patients

A new report from the Health Services Safety Investigations Body (HSSIB) spotlights ongoing risks to NHS patients because of late or missed sepsis diagnoses. The independent body reviewed cases, revealing problems that impact patient care and outcomes across England’s healthcare system.

Serious Concerns Raised

The HSSIB warns that the tardy diagnosis of sepsis continues to be a significant and urgent patient safety concern for NHS patients. The report, examining three specific cases, reveals instances where patients suffered severe harm or even death due to delayed or incorrect sepsis diagnoses. These findings highlight clinicians’ persistent challenges in promptly identifying sepsis.

Issues in Patient Care

The HSSIB’s report pinpointed ten areas needing improvement. These recommendations, based on the reviewed cases, have broader implications for the NHS. The issues include inconsistent referral paths, communication gaps, and failure to spot early warning signs such as new-onset confusion or suspected infection.

“These reports show a consistent pattern of issues around the early recognition and treatment of sepsis,”

—Melanie Ottewill, Senior Safety Investigator at the HSSIB

One critical aspect is the recognition of sepsis symptoms, which vary greatly. The report also indicates that timely treatment hinges on swift diagnosis. The UK Sepsis Trust states that around 48,000 deaths are linked to sepsis each year in the UK. The report emphasizes that listening to families who express concerns about their loved ones is vital.

Challenges in Diagnosis

The cases investigated involved patients with various infections, including urinary tract infections, abdominal pain, and diabetic foot infections. Two of the patients tragically died. The third faced amputation and a lengthy recovery period. The report stresses that there isn’t a single reliable diagnostic tool for sepsis.

For example, in one case, a lack of consistent referral processes and limited information exchange between hospitals caused delayed diagnosis. Another revealed that a direct escalation route for deteriorating patients was missing, and nurses hesitated to start a sepsis screen without confirmed infection signs.

The Sepsis Alliance has reported that early recognition and treatment of sepsis can significantly improve patient outcomes, reducing mortality rates by as much as 50%. (Sepsis Alliance Stats)

Need for Standardized Treatment

Dr. Ron Daniels, founder and chief medical officer of the UK Sepsis Trust, underscored the urgency of prompt diagnosis and treatment. He also called for a standardized treatment plan, a “sepsis pathway,” to ensure that patients receive optimal care from initial symptoms to diagnosis.

Annie Lennon is a medical journalist.

June 27, 2025 0 comments

Health

Loneliness & Aging: Home Care Study Challenges Mortality Link

by Dr. Michael Lee – Health Editor June 26, 2025

written by Dr. Michael Lee – Health Editor

Loneliness Doesn’t increase Mortality Risk in Older Adults Receiving Home Care,Study Finds

Waterloo,Ontario – Contrary to widely held beliefs and reports suggesting loneliness is as harmful as smoking 15 cigarettes a day,a new international study reveals loneliness is not associated with an increased risk of death among older adults receiving home care. In fact, the research indicates loneliness may even be linked to reduced mortality risk in this population.

The study, led by researchers at the university of Waterloo and published in the journal of the American Medical directors Association, analyzed data from over 300,000 home care recipients across Canada, Finland, and New Zealand [[1]]. Researchers found that loneliness was associated with an 18% reduction in one-year mortality risk in Canada, 15% in Finland, and 23% in New Zealand after adjusting for numerous confounding factors.

“Loneliness doesn’t have to kill you to be a major public health issue,” explained study author Bonaventure A. Egbujie, MD, PhD, adjunct professor of public health sciences at the University of Waterloo. He urges policymakers to address loneliness as a quality-of-life issue rather than framing it as a direct threat to mortality, arguing that the latter approach hinders effective intervention [[1]].

Key Findings:

The study included 178,611 participants from Canada, 35,073 from finland, and 85,065 from New Zealand, all aged 65 or older.
Loneliness prevalence ranged from 15.9% in Canada to 24.2% in New Zealand, generally increasing with age.
Individuals experiencing loneliness tended to have better baseline physical function but reported worse pain and cognitive performance.
Cancer and meaningful changes in health status were identified as the strongest predictors of mortality across all three countries.

Why the Discrepancy?

Researchers suggest the findings differ from previous studies linking loneliness to mortality due to the specific population examined – older adults receiving home care. This group hasn’t been extensively studied, and their circumstances may differ from the general population [[2]].

Limitations & Future Research:

The study acknowledges limitations, including a one-year follow-up period and the use of a single-item measure of loneliness. Further long-term research is needed to explore potential causal relationships between loneliness and health outcomes

June 26, 2025 0 comments

Health

Dementia Rates Show Generational Decrease

by Dr. Michael Lee – Health Editor June 18, 2025

written by Dr. Michael Lee – Health Editor

Dementia Risk Declines Across Generations, Study Shows

New research reveals a noteworthy generational decrease in dementia risk, particularly among women. This finding, drawn from studies across several countries, suggests a positive trend in cognitive health for more recent birth cohorts, offering crucial insights for healthcare planning.

Study Findings: A Clear Trend

A recent cross-sectional study indicates a significant reduction in dementia prevalence among those born later. Those born between 1944 and 1948 showed a lower risk of the disease than those born from 1919 to 1923. This was consistent across the US, Europe, and England. The research, which used data from the US Health and Retirement Study, the Survey of Health, Aging and Retirement in Europe, and the English Longitudinal Study of Aging, also highlighted a more pronounced decline in dementia risk for women compared to men.

Methodology and Scope

The study examined over 82,000 individuals aged 71 or older. The researchers used algorithms and machine learning to identify potential dementia cases within the datasets. The participants were grouped into age groups and birth cohorts, with analyses adjusted for age and period effects. The data included diverse birth cohorts, offering a broad perspective on the prevalence of dementia across different generations.

Exciting new research shows that the risk of dementia is decreasing in more recent generations. This is great news for public health, but we need to find out why so we can accelerate this progress. https://t.co/U59tXG7L9u

— Alzheimer’s Society (@alzheimerssoc) February 6, 2024

“The generational decrease in dementia risk has important implications for healthcare planning, long-term care policies, and workforce requirements in aging populations,”

—Xiaoxue Dou, Centre for the Business and Economics of Health

The Alzheimer’s Association estimates that in 2024, 6.9 million Americans aged 65 and older are living with Alzheimer’s dementia (Alzheimer’s Association).

Regional Variations

The study also provided specific point estimates for each region. In the US, the risk reduction was significant, -0.55 versus -0.18. European data reflected a similar trend with a reduction of -1.49 versus -0.24. England showed a decline of -0.48 versus -0.23, respectively. These variations offer insight into the impact of different healthcare systems and lifestyle factors.

Study Limitations

The study had limitations, including data gaps in some surveys, particularly missing waves. The study design also didn’t explore underlying causes for the reduction in dementia rates, and underestimation due to mortality between data collection waves. Further studies are needed to pinpoint the driving factors behind these positive trends.

This research, led by Xiaoxue Dou, underscores the dynamic nature of dementia prevalence. The findings offer a foundation for further research into preventive measures and interventions, potentially improving health outcomes across the lifespan.

June 18, 2025 0 comments