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Bone Density Linked with Brain Function

Lower bone density in the spine is linked with poorer cognitive function, in research findings that could be of particular importance for postmenopausal women.

The study, in Radiology, suggests that chest computed tomography (CT) scans could help identify people with accelerated brain aging who might be at risk of dementia.

The deep-learning analysis found that bone density in the thoracic vertebrae of the spine was associated with both functional and imaging measures of age-related brain degeneration at a later stage.

Nonetheless, the researchers caution that their results do not mean osteoporosis causes dementia.

“This study is not about cause and effect, but rather the observation of a metabolic syndrome that may cause both bone and brain degeneration,” said researcher Shadpour Demehri, MD, from Johns Hopkins university in Baltimore, Maryland.

“The co-occurrence observed in the study may reflect shared metabolic drivers of aging, including insulin resistance, dyslipidemia, and menopausal change, rather than a direct bone-to-brain effect.”

The study is the first longitudinal secondary analysis linking baseline vertebral bone mineral density to changes in white matter structure, white matter hyperintensity progression, and cognition.

It included 715 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) who underwent noncontrast chest CT scans together with MRI and cognitive besting.

Longitudinal data on white matter hyperintensities and fractional anisotropy were available for 408 and 405 of these individuals, respectively.

Imaging and clinical assessments revealed that lower baseline thoracic vertebral volumetric bone mineral density (vBMD) was associated with white matter injury and faster decline in global cognition, particularly among people with diabetes.

Lower baseline vBMD was associated with a faster decline in global cognitive performance, with this link seen in specific brain regions.

Specifically, lower vBMD was associated with faster accumulation of white matter hyperintensities in the corpus callosum, which is associated with executive functioning, working memory, and attention.

It also correlated with faster fractional anisotropy decline in the anterior limb of the internal capsule, which is involved in executive function as well.

“Identifying individuals, particularly postmenopausal women, with low vBMD may help flag those at risk for parallel skeletal and neurologic decline, allowing earlier screening and shared risk-factor management,” reported lead researcher Sara Momtazmanesh, MD, also from Johns Hopkins, and co-workers.

They summarized: “These findings support the potential value of deep learning–enabled opportunistic vBMD assessment on chest CT for risk stratification beyond skeletal outcomes.”

The post Bone Density Linked with Brain Function appeared first on Inside Precision Medicine.

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The Importance of Intergenerational Dialogue

By Ananya Meenakshi, 2026 Youth Mental Health Academy Intern, Child Mind Institute

How the Stavros Niarchos Foundation (SNF) Global Center’s second annual Global Summit on Youth Mental Health is advancing opportunities for young people and experts to exchange perspectives and shape priorities together.

Intergenerational dialogue is an excellent way for different generations to learn from each other’s experience; each generation can share their knowledge to develop helpful solutions.

Around the world, instances of conflict and political instability have often led to serious consequences. The potential for peace is more likely to be achieved if there is a higher level of collaboration and understanding between generations. Intergenerational dialogue, therefore, can be an effective way to address trauma and foster resilience.

Jennifer Matibi, Member of the Global Youth Advisory Council and the SNF Global Center (left) and Jason Bantjes SNF Global Center Scientific Lead in South Africa and Director at the South African Medical Research Council 

To ensure intergenerational dialogue is beneficial, it is important to be respectful, mindful of everyone’s roles, adapt to changing needs, and set mutual expectations. The SNF Global Center for Child and Adolescent Mental Health at the Child Mind Institute’s Global Youth Advisory Council (GYAC) members are excited to further engage in shared learning and brainstorming during the second annual Global Summit on Youth Mental Health in New York, September 21-24.

“Young people’s lives are structured much more differently than Greece’s older generations, who may have had their path laid out for them,” explains Faidra Kaberidi, a GYAC member from Greece. “The biggest challenge today is that the unlimited opportunities available to us can be overstimulating, and older generations might not understand the difficulty of having to choose.”

These unlimited opportunities, she adds, include lifestyle choices like style, sexuality, gender, personality, and so forth.

“Though being given these opportunities is not negative, it can be challenging for young people to explore and discover themselves in a sea of endless opportunities,” says Kaberidi.

As we pull back the curtain, the summit is multigenerational exchange in action — giving youth an open space to discuss issues, develop their skills, and create solutions.

The event will take place at the Child Mind Institute’s New York headquarters under the theme, “Redefining Mental Health Care: Youth Perspectives in a Changing World.” It will feature three diverse sessions including panel discussions, breakout sessions, and a youth-moderated Q&A with global experts. The sessions will cover three categories:

  • “Meeting Young People Where They Are” will focus on topics such as school systems and digital spaces.
  • “What Do Young People Care About” is set to expand into climate change, economic instability, and political polarization.
  • “Setting Young People Up for the Future” looks at preparing young people to take care of their mental health in our modern world.

To ensure challenges are being solved efficiently, intergenerational dialogue must therefore be established. Both parties have valuable knowledge to contribute to the bettering of our society. The youth summit successfully implements these progressive values and facilitates the inclusion of cross-generational conversations.

By laying the path for both groups to speak and listen to each other, we are supporting the advancement towards a desired, exceptional future.

Learn more about the inaugural Global Summit on Youth Mental Heath

Learn more about the Youth Mental Health Academy at the Child Mind Institute

The post The Importance of Intergenerational Dialogue appeared first on Child Mind Institute.

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Pilot evaluation of an educational and lived experience training program on ketogenic metabolic therapy in mental health care for health care professionals

BackgroundSerious mental illness imposes a substantial burden. Pharmacologic treatments remain only partially effective and are associated with significant side effects, highlighting the need for novel treatment approaches. Ketogenic metabolic therapy (KMT) is emerging as an intervention for serious mental illness, with a growing evidence base and strong patient interest. A critical barrier to KMT implementation is the lack of health care professional (HCP) competence and readiness to discuss KMT with patients with serious mental illness. Existing training does not adequately address HCP competence in presenting KMT as a treatment option. This study describes the pilot-testing of “Live It, Launch It” (LI-LI), the first KMT training program designed to build self-reported competence to discuss KMT in psychiatric care for HCPs.MethodsLI-LI combines a 4-hour asynchronous educational course on KMT with a 4-week experiential group KMT intervention during which participants adhered to a ketogenic diet. LI-LI aimed to improve self-reported competence to utilize KMT and perceived ability to engage in shared decision-making with patients about incorporating KMT into their treatment plan.ResultsForty HCPs participated in the education course: 10 psychiatrists, 10 psychiatric pharmacists, 8 psychologists/therapists, and 12 other HCPs (e.g., nurse practitioners, physician assistants). Twenty-five initiated the diet intervention. Baseline competence scores (visual analog scale 0-100) were low, M(SE) = 17.40 (2.68), increasing to M(SE) = 68.08 (2.47) after education (d = 2.88, p <0.0001), and to M(SE) = 86.62 (1.82) post-diet (d = 1.08), with a very large whole-study effect (d = 3.49, p < 0.0001). Shared decision-making scores at baseline were M(SE) = 53.64 (2.89), increasing to M(SE) = 83.35 (1.83) after the educational course (d = 1.74, p <0.0001), and to M(SE) = 91.23 (2.05) after the diet phase (d = 0.73, p = 0.009), with a very large whole-study effect (d = 2.53, p < 0.0001). Feedback indicated that lived experience with KMT was helpful for implementation-readiness.DiscussionThe educational course on KMT was associated with increased self-reported competence and perceived shared decision-making in HCPs, and this was enhanced with combined education and lived experience. Implementation of this approach could accelerate KMT into clinical care. Results should be interpreted with caution as this was a small uncontrolled study with self-reported main outcomes.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT07116226, identifier NCT07116226.
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Neural mechanisms of uncertain decision-making in anxious adolescents: an EEG study based on the balloon analogue risk task

BackgroundAdolescence is marked by heightened vulnerability to anxiety which can impair decision-making under uncertainty. The underlying neural oscillatory network-level mechanisms in anxious adolescents require further elucidation.MethodsWe recruited 40 adolescents (20 adolescents with clinically diagnosed anxiety disorders, 20 matched controls). Participants performed a gain/loss version of the Balloon Analogue Risk Task (BART) during EEG recording. Behavioral data, time-frequency EEG power in beta (13–30 Hz) and theta (4–7 Hz) bands, and phase-based functional connectivity were analyzed.ResultsAnxious adolescents exhibited significant behavioral avoidance, reflected in fewer pump attempts and lower BART scores compared to controls. EEG analysis revealed elevated beta-band power during gain decisions and enhanced beta-band occipito-temporal connectivity in the anxious group. In loss contexts, anxious adolescents showed increased theta-band parieto-temporal connectivity.ConclusionsAdolescent anxiety is associated with a generalized avoidance pattern during uncertain decision-making, characterized by distinct neural dynamics. Beta-band changes in gain contexts may reflect heightened vigilance, while theta-band connectivity in loss contexts may indicate amplified threat monitoring. These neural signatures may represent candidate neurophysiological signatures of anxiety-related alterations in decision-making under uncertainty, warranting further validation in longitudinal and predictive studies.
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Methamphetamine-withdrawal catatonia resolved with mixed amphetamine salts: a case report

Catatonia is a well-recognized psychiatric emergency with an evolving understanding of its underlying pathophysiology. However, withdrawal-associated catatonia remains poorly characterized. Here we describe a 32-year-old man with symptoms consistent with methamphetamine-withdrawal catatonia, a previously undescribed etiology, which resolved only after treatment with mixed amphetamine salts. The patient remained catatonic (Bush-Francis Catatonia Rating Scale [BFCRS] >10) for four months despite 38 sessions of electroconvulsive therapy, lorazepam up to 24 mg daily, and multiple augmentation strategies. An extensive medical and neurologic workup excluded alternative causes. Following initiation of mixed amphetamine salts, his BFCRS decreased from 15 to 6 within 48 hours, with sustained resolution and no recurrence of psychosis despite discontinuation of antipsychotics. This case suggests that methamphetamine withdrawal may represent an underrecognized cause of catatonia and that dopaminergic augmentation may have a therapeutic role in refractory cases.
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Agreement Between a Mobile Self-Administered Comprehensive Geriatric Assessment Screening Tool and Geriatrician-Administered Assessment: Cross-Sectional Feasibility Study

Background: Comprehensive geriatric assessment (CGA) is a widely recommended, multidimensional approach for guiding clinical decision-making and management in older adults. However, its implementation remains limited by a shortage of geriatric specialists, the complexity of geriatric care, and the increasing demands of an aging population. Mobile self-administered tools offer a potential strategy to expand access to multidimensional geriatric evaluation, particularly in resource-limited settings. Objective: This study aimed to evaluate the feasibility and agreement of a mobile self-administered CGA screening tool compared with geriatrician-administered assessments among inpatient and outpatient older adults in Brazil. Methods: This cross-sectional study included 80 older adults recruited from inpatient and outpatient geriatric clinics in Brasília, Brazil. Participants completed a mobile CGA, which incorporated validated instruments covering functional status (Vulnerable Elders Survey–13 [VES-13]), cognition (Cognitive Change Questionnaire–8 [CCQ-8]), depressive symptoms (5-item Geriatric Depression Scale [GDS-5]), nutritional status (Mini Nutritional Assessment [MNA]), frailty (G8 screening tool), social support (Gijón Scale), falls, and vision and hearing. Within 48 hours, a geriatrician independently performed a geriatrician-administered CGA using the same instruments. Agreement between the 2 assessment methods was evaluated using Wilcoxon signed-rank tests, Spearman correlation coefficients, intraclass correlation coefficients (ICCs), and Cohen κ coefficients for categorical variables. Results: Participants had a mean age of 70 (SD 7) years; 58.8% (47/80) were female, and 65% (52/80) had ≤8 years of education. The mean completion time for the self-administered CGA was 18.5 (SD 7.5) minutes. Most participants rated the tool as easy or very easy to use (65/80, 81.3%) and reported satisfaction with the assessment process (n=79, 98.8%). High concordance was observed between the self-administered and geriatrician-administered CGA versions for most domains. Cohen κ coefficients demonstrated strong agreement for falls (κ=0.878; <.001), hearing impairment (κ=0.826), and vision impairment (κ=0.634). No significant differences were observed between the 2 assessment methods for functional status (VES-13), frailty screening (G8), depressive symptoms (GDS-5), and cognition (CCQ-8). Nutritional status and social vulnerability showed lower concordance than other CGA domains. Among inpatients, significant discrepancies were identified in both nutritional scores and Gijón social risk scores (≤.05), with participants reporting greater perceived vulnerability. For outpatients, significant differences were observed for nutritional status (MNA; P=.02) and frailty screening (G8; P=.046). Conclusions: A mobile self-administered CGA demonstrated good feasibility, high user satisfaction, and substantial agreement with geriatrician-administered assessments across multiple geriatric domains. The tool may support geriatric screening and triage in settings with limited specialist availability, particularly when used as a complement to comprehensive clinical assessment.