Science
Dementia May Not Always Be the Threat It Is Now. Here’s Why.
Joan Presky worries about dementia. Her mother lived with Alzheimer’s disease for 14 years, the last seven in a memory-care residence, and her maternal grandfather developed dementia, too.
“I’m 100 percent convinced that this is in my future,” said Ms. Presky, 70, a retired attorney in Thornton, Colo.
Last year, she spent almost a full day with a neuropsychologist, undergoing an extensive evaluation. The results indicated that her short-term memory was fine — which she found “shocking and comforting” — and that she tested average or above in every cognitive category but one.
She’s not reassured. “I saw what Alzheimer’s was like,” she said of her mother’s long decline. “The memory of what she went through is profound for me.”
The prospect of dementia, which encompasses Alzheimer’s disease and a number of other cognitive disorders, so frightens Americans that a recent study projecting steep increases in cases over the next three decades drew enormous public attention.
The researchers’ findings, published in January in Nature Medicine, even showed up as a joke on the Weekend Update segment of “Saturday Night Live.”
“Dementia is a devastating condition, and it’s very much related to the oldest ages,” said Dr. Josef Coresh, director of the Optimal Aging Institute at NYU Langone Health and the senior author of the study. “The globe is getting older.”
Now the findings are being challenged by other dementia researchers who say that while increases are coming, they will be far smaller than Dr. Coresh and his co-authors predicted.
Using data from about 15,000 Americans over age 55, collected at four research clinics around the country from 1987 through 2020, Dr. Coresh’s team projected a lifetime dementia risk much higher than previous studies had: 42 percent, though most of that risk didn’t emerge until after age 85.
The higher lifetime number probably reflected the study’s reliance on a more diverse sample than earlier researchers had used, Dr. Coresh said, and more dementia cases identified through in-depth questionnaires, regular phone calls, medical records and death certificates.
The researchers applied their risk calculations to the U.S. population and estimated that the number of people who would develop dementia each year would roughly double, to about a million by 2060, from 514,000 in 2020.
Eric Stallard, an actuary and co-director of the Biodemography of Aging Research Unit at Duke University, read the study and thought the team “seemed very competent at their analysis” of individual risk.
But when it came to the projection that cases would double, which assumed that the incidence of dementia would remain stable over the next 40 years, “I don’t believe it,” Mr. Stallard said.
“The notion that the number of people with dementia will double over the next 25, 30 or 35 years due to the aging of baby boomers is widespread, it’s pervasive — and it’s wrong,” he added.
He and two other Duke researchers recently published a commentary in JAMA pointing out that the age-specific prevalence of dementia in this country had steadily declined for 40 years.
“If your risks are lower than your parents’ risks and this trend continues, you won’t see the doubling or tripling of dementia that’s been projected,” said Dr. Murali Doraiswamy, director of the Neurocognitive Disorders Program at Duke and a co-author of the JAMA article.
To be clear, experts agree that the number of people with dementia will climb in coming decades, simply because the disorder rises so steeply with age and the number of older adults in the United States will increase.
But Mr. Stallard estimates that the increase will be more like 10 to 25 percent by 2050. “It will still be a significant challenge for the health system in the U.S.,” he said.
The Duke group relied on its own long-term study of people over age 65, with more than 21,000 respondents in 1984 and about 16,000 in 2004, plus later data from the national Health and Retirement Study and the National Health and Aging Trends Study.
Their analysis found that among 85- to 89-year-olds, for instance, the proportion with dementia was about 23 percent in the cohort born in 1905. In those born 10 years later, the figure had dropped to about 18 percent.
By the time Americans born in 1935 reached their late 80s, about 11 percent had dementia; the projection for those born from 1945 to 1949 is now about 8 percent.
To Dr. Coresh, whose primary interest was in individual risk, the assumption that past declines would continue at about the current rate “would be great, but is quite an optimistic, dramatic decrease,” he said in an email.
Yet in another longitudinal study of older adults in England and China, published in Nature Aging last year, “we also found these quite marked improvements in more recently born cohorts,” said the lead author, Dr. John Beard, a medical epidemiologist at the Mailman School of Public Health at Columbia University.
“You would expect the increase in the absolute numbers of people with dementia in the U.S. will be less than we feared,” Dr. Beard said.
What has led to the decrease in dementia, also seen in several European countries? Often cited explanations include rising education levels, reduced smoking and improved treatment for high blood pressure and high cholesterol.
The Lancet Commission on dementia, intervention and care has developed a list of 14 modifiable risk factors, including greater use of hearing aids and reduced air pollution, that could still lead to greater declines.
Yet the reverse could also happen. If earlier and more widespread testing increases the number of dementia diagnoses, or if the definition of dementia broadens, rates will increase, Dr. Doraiswamy noted. Increasing life expectancy would have the same effect.
Obesity and diabetes, more common in recent decades, could lead to more dementia, but much-touted new drugs that reduce them could blunt that trend — if people can get them.
“None of this is inevitable,” said Dr. Gill Livingston, a psychiatrist at University College London who leads the Lancet Commission. “It depends on what we do.”
Public health policy makes a major difference, she noted, and, “The U.S. is in a time where policy is changing enormously.”
Dementia rates might rise, for example, “if people have less access to health care, so they are less likely to get their blood pressure treated and their high cholesterol treated,” Dr. Livingston said.
Slashed Medicaid coverage could lead to that result. So could a rollback of environmental policies, “if air pollution increases because of fossil fuels,” she added.
Already, dementia afflicts some American populations far more than others, researchers point out. Older women and Black people face greater risk, along with those who carry the APOE4 gene associated with Alzheimer’s disease.
Health disparities could mean that “affluent people will see lower rates of dementia” because of the new diabetes and obesity drugs, Dr. Doraiswamy said. “People who can’t afford them and whose conditions are not well-managed will see rates go up.”
The debate about how many older adults will develop dementia in coming decades, and about how individuals, families, government and the health care system should respond, will likely continue.
So will Ms. Presky’s fears.
For now, she enrolls in lifelong learning classes, takes walks and yoga classes despite orthopedic problems, listens to podcasts and reads a lot of history and fiction. She and her husband take in theater in New York and Phish concerts on the West Coast and will soon be heading to London and Paris.
Still, her advance directive contains many provisions about dementia. “I remain pessimistic,” she said, noting that her mother was diagnosed at 77. “I have seven more years before I meet her fate.”
Science
What to plant (and what to remove) in California’s new ‘Zone Zero’ fire-safety proposal
After years of heated debates among fire officials, scientists and local advocates, California’s Board of Forestry and Fire Protection released new proposed landscaping rules for fire-prone areas Friday that outline what residents can and can’t do within the first 5 feet of their homes.
Many of these proposed rules — designed to reduce the risk of a home burning down amid a wildfire — have wide support (or at least acceptance); however, the most contentious by far has been whether the state would allow healthy plants in the zone.
Many fire officials and safety advocates have essentially argued anything that can burn, will burn and have supported removing virtually anything capable of combustion from this zone within 5 feet of houses, dubbed “Zone Zero.” They point to the string of devastating urban wildfires in recent years as reason to move quickly.
Yet, researchers who study the array of benefits shade and extra foliage can bring to neighborhoods — and local advocates who are worried about the money and labor needed to comply with the regulations — have argued that this approach goes beyond what current science shows is effective. They have, instead, generally been in favor of allowing green, healthy plants within the zone.
The new draft regulations attempt to bridge the gap. They outline more stringent requirements to remove all plants in a new “Safety Zone” within a foot of the house and within a bigger buffer around potential vulnerabilities in a home’s wildfire armor, including windows that can shatter in extreme heat and wooden decks that can easily burst into flames. Everywhere else, the rules would allow residents to maintain some plants, although still with significant restrictions.
The rules generally do not require the removal of healthy trees — instead, they require giving these trees routine haircuts.
Once the state adopts a final version of the rules, homeowners would have three years to get their landscaping in order and up to five years for the bigger asks, including removing all vegetation from the Safety Zone and updating combustible fencing and sheds within 5 feet of the home. New constructions would have to comply immediately.
The rules only apply to areas with notable fire hazard, including urban areas that Cal Fire has determined have “very high” fire hazard and rural wildlands.
Officials with the Board will meet in Calabasas on Thursday from 1 p.m. to 7 p.m. to discuss the new proposal and hear from residents.
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Some L.A. residents are championing a proposed fire-safety rule, referred to as “Zone Zero,” requiring the clearance of flammable material within the first five feet of homes. Others are skeptical of its value.
Where is the Safety Zone?
The proposed Safety Zone with stricter requirements to remove all vegetation would extend 1 foot from the exterior walls of a house.
In a few areas with heightened vulnerabilities to wildfires, it extends further.
The Safety Zone covers any land under the overhang of roofs. If the overhang extends 3 feet, so does the Safety Zone in that area. It also extends 2 feet out from any windows, doors and vents, as well as 5 feet out from attached decks.
What plants would be allowed in the Safety Zone?
Generally, nothing that can burn can sit in the Safety Zone. This includes mulch, green grass, bushes and flowers.
What plants would be allowed in the rest of Zone Zero?
Homeowners can keep grasses (and other ground-covers, like moss) in this area, as long as it’s trimmed down to no taller than 3 inches.
The rules also allow small plants — from begonias to succulents — up to 18 inches tall as long as they are spaced out in groups. Residents can also keep spaced-out potted plants under this height, as long as they’re easily movable.
What about fences, trees and gates?
Any sheds or other outbuildings would need noncombustible exterior walls and roofs in Zone Zero — Safety Zone or not.
Residents would have to replace the first five feet of any combustible fencing or gates attached to their house with something made out of a noncombustible material, such as metal.
Trees generally would be allowed in Zone Zero. Homeowners would need to keep any branches one foot away from the walls, five feet above the roof and 10 feet from chimneys.
Residents would also have to remove any branches from the lower third of the tree (or up to 6 feet, whichever is shorter) to prevent fires on the ground from climbing into the canopy.
Some trees with trunks directly up against a house in this 1-foot buffer or under the roof’s overhang might need to go — since keeping branches away from the home could prove difficult (or impossible).
However, the board stressed it wants to avoid the removal of trees whenever feasible and encouraged homeowners to work with their local fire department’s inspectors to find case-by-case solutions.
What’s new and what’s not
Some of the rules discussed in Zone Zero are not new — they’ve been on the books for years, classified as requirements for Zone One, extending 30 feet from the home with generally less strict rules, and Zone Two, extending 100 feet from the house with the least strict rules.
For example, homeowners are already required to remove any dead or dying grasses, plants and trees. They also have to remove leaves, twigs and needles from gutters, and they already cannot keep exposed firewood in piles next to their house.
Residents are also already required to keep grasses shorter than 4 inches; Zone Zero lowers this by an inch.
Science
Video: Rescuers Mount a Likely Final Push to Save a Stranded Whale
new video loaded: Rescuers Mount a Likely Final Push to Save a Stranded Whale
By Jorge Mitssunaga
April 17, 2026
Science
1,200% jump in kratom-related calls to poison control centers in last decade, analysis shows
Over the last decade, poison control centers around the country have received tens of thousands of calls from consumers of kratom products reporting adverse and life-threatening health effects, with researchers saying reports in 2025 reached a new level. California’s poison center is reporting similar findings.
Last month, researchers analyzed information from the National Poison Data System and found that between 2015 and 2025, poison control centers across the nation received 14,449 calls related to kratom. More than 23% of those calls, or 3,434, were made last year, according to a published report in the Centers for Disease Control and Prevention. That represents a more than 1,200% increase from 2015, when only 258 calls were reported.
Officers gather illegally grown kratom plants in 2019 in Phang Nha province, Thailand. The country decriminalized the possession and sale of kratom in 2021.
(Associated Press)
Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It has a long history of being used for chronic pain or to boost energy and in the U.S., research points to Americans also using it to alleviate anxiety. In low doses, kratom appears to act as a stimulant but in high doses, it can have effects more like opioids.
But in the last few years, a synthetic form of kratom refined for its psychoactive compound, 7-hydroxymitragynine or 7-OH, has entered the market that is highly concentrated and not clearly labeled, leading to confusion and problems for consumers. The synthetic form gaining momentum in the market is sparking concern among public health officials because of its ability to bind to opioid receptors in the body, causing it to have a higher potential for abuse.
Los Angeles County leaders, meanwhile, have grappled with differentiating the two and regulating the products that come in the form of powder, capsules and drinks and have been linked to six county deaths. Sales of kratom and 7-OH products were banned in the county in November.
In reviewing the data, which did not differentiate whether callers had consumed natural or synthetic kratom, researchers set out to understand the effect of what they believe is a “rapidly evolving kratom market,” and highlight the role poison centers can play as an early warning surveillance system to detect new trends.
National Poison Data System findings
The data showed that over the last 10 years, 62% of the kratom-related calls to poison control centers were from people who said they consumed the drug by itself, and the other 38% were from people who combined it with another substance or substances.
Those who consumed kratom with another substance combined it most frequently with one or a combination of the following: alcohol, opioids, benzodiazepines (like Xanax or Valium), cannabis and cannabinoids, stimulants and antidepressants.
The data also broke down hospitalizations related to kratom — adults who took it alone or in combination and experienced “adverse” health effects; and adults who took it alone or in combination and experienced more serious “moderate” or “major” health effects, including death.
Kratom powder products are displayed in a smoke shop in Los Angeles in 2024.
(Michael Blackshire/Los Angeles Times)
Hospitalizations for adults who had consumed kratom alone and experienced adverse effects increased from 43 in 2015 to 538 in 2025. For those who took it in combination and were hospitalized with an adverse health effect, the total jumped from 40 in 2015 to 549 last year.
The numbers were even higher for hospitalizations where the health effects were more serious or fatal.
In 2015, there were 76 reports of people being hospitalized after taking kratom alone and experiencing a serious health effect or dying. By last year, that number had climbed to 919. The reports of serious health effects, including death, for those who took kratom in combination with another substance grew from 51 in 2015 to 725 last year.
The research does not break down kratom-related deaths by year but states that there were 233 deaths over the 10-year study period, or just over 3% of all 7,287 serious medical outcomes. Of the total number of kratom-related deaths, 184 cases involved the consumption of multiple substances.
What California’s poison control system found in its state data
The California Poison Control System is currently reviewing its data concerning kratom-related calls but an initial analysis shows parallels to the national report, said Rais Vohra, medical director of the state poison control system.
“We have about 10% of the national population and about 10% of the national call volume with poison control,” Vohra said. “And so, not surprisingly, we were able to identify over 900 cases of calls related to kratom in that same period.”
Local researchers are still deciphering the state data but they too have found that kratom-related calls are climbing.
“It’s accelerating, which I think is one of the main points of the [published] report,” Vohra said.
A majority of calls received by poison control come from healthcare facilities where “presumably someone has a problem … severe enough to warrant calling 911 or going to the emergency room, and that’s when our agency gets involved,” Vohra said.
Kait Brown, clinical managing director for America’s Poison Control Centers, said the fact that kratom and 7-OH are federally unregulated products sold online, in gas stations and smoke shops gives people across the country easy access.
And while kratom enthusiasts maintain that it has been used in its natural form for hundreds of years, “there are new formulations that are a little bit different than how people have used it, at least historically,” said William Eggleston, a pharmacist and the assistant clinical director of the Upstate New York Poison Center in Syracuse.
People are no longer consuming kratom only as a powder or capsule but also in the form of an energy shot or extract; it’s similar for synthetic, more concentrated 7-OH products.
When regional poison centers compare their findings and experiences with the analysis of calls in the National Poison Data System, Eggleston said, “undeniably there is an increase in calls related to kratom.”
“But when you put it in the bigger perspective of all the calls … this is still a very small percentage of what we’re dealing with on a day to day basis,” he said.
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