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Older People Seeking Care for Cannabis Use at Greater Risk for Dementia, Study Finds

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Older People Seeking Care for Cannabis Use at Greater Risk for Dementia, Study Finds

Middle-aged and older adults who sought hospital or emergency room care because of cannabis use were almost twice as likely to develop dementia over the next five years, compared with similar people in the general population, a large Canadian study reported on Monday.

When compared with adults who sought care for other reasons, the risk of developing dementia was still 23 percent higher among users of cannabis, the study also found.

The study included the medical records of six million people in Ontario from 2008 to 2021. The authors accounted for health and sociodemographic differences between comparison groups, some of which play a role in cognitive decline.

The data do not reveal how much cannabis the subjects had been using, and the study does not prove that regular or heavy cannabis use plays a causal role in dementia.

But the finding does raise serious concerns that require further exploration, said Dr. Daniel T. Myran, the first author of the study, which was published in JAMA Neurology.

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“Figuring out whether or not cannabis use or heavy regular chronic use causes dementia is a challenging and complicated question that you don’t answer in one study,” said Dr. Myran, an assistant professor of family medicine at University of Ottawa.

“This contributes to the literature and to a sign, or signal, of concern.”

Dr. Myran’s previous research has found that patients with cannabis use disorder died at almost three times the rate of individuals without the disorder over a five-year period. He has also reported that more cases of schizophrenia and psychosis in Canada have been linked to cannabis use disorder since the drug was legalized.

The latest study, focusing on dementia, adds to a growing body of literature on regular or heavy cannabis use and cognition. Researchers have reported impacts on verbal learning, memory and attention, while imaging studies have pointed to changes in the brain related to the use of cannabis and other substances.

Veterans with traumatic brain injuries in addition to cannabis use disorder may be at heightened risk for early-onset dementia, researchers reported last year.

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But many of the studies are relatively small. The new report’s strength was its large sample and the ability to track patients over time who did not have a diagnosis of dementia when they entered the study, said Madeline Meier, an associate professor of psychology at Arizona State University, who was not involved in the study.

“They were able to rule out dementia at the time of the first cannabis visit, and were able to show the temporal order — the cannabis came first, and the dementia came second,” said Dr. Meier.

Her research, which has followed and periodically tested a cohort of over 1,000 individuals over a period of many years, has linked cannabis use and neuropsychological decline.

“I think you want to combat this whole idea that cannabis is harmless and maybe even has some medical benefits,” Dr. Meier said. “This study is showing an association that I think people should take seriously and say, ‘Maybe this is putting me at risk.’”

She noted that the work by Dr. Myran and his colleagues also found that people seeking care for alcohol use were even more likely to receive a dementia diagnosis than were cannabis users.

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“I’m worried about the substance abuse in that Baby Boomer age,” she said.

More and more people, including seniors, are using cannabis. Medical visits related to cannabis increased more than fivefold among adults 45 and older between 2008 and 2021, the new study found. Among adults 65 and over, visits increased almost 27-fold.

The study included more than 6 million people age 45 and over who did not have a diagnosis of dementia at the start of the research. Of them, 16,275 had an acute-care medical encounter because of cannabis.

The patients with cannabis-related visits were compared to the matched general population, and in a separate comparison, to 140,824 matched patients who needed medical care for all other reasons.

Within five years, 5 percent of those with acute care cannabis visits received a dementia diagnosis. The figure for individuals needing care for other reasons was 3.6 percent, and for similar individuals in the general population, 1.3 percent.

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But people who are heavy cannabis users differ from those who are not in a variety of ways, some of which may help explain the increased risk for dementia, Dr. Myran explained.

While some of the factors can be accounted for, he said, “you can’t control for all of them.”

Another unknown is self-medication, he said. Someone who has started experiencing symptoms of cognitive decline may be more likely to turn to cannabis. If so, then “it looks as if the cannabis is causing dementia, but it’s just on the pathway — they were already developing dementia,” Dr. Myran said.

After making adjustments for age, sex, income and other factors, including other health conditions, he and his colleagues determined that patients who sought care for cannabis-related reasons were 1.23 times as likely as those who had gotten any kind of acute care to be diagnosed with dementia, and 1.72 times as likely as those in the healthier general population.

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A Fish That Hitches Rides Where the Sun Doesn’t Shine

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A Fish That Hitches Rides Where the Sun Doesn’t Shine

When danger calls, some animals bare their teeth. Others take to the sky, or curl into protective balls. But the remora — a fish that often hitches a ride on larger marine animals like sea turtles, whales and sharks — sometimes follows a less dignified strategy: It disappears inside a manta ray’s rear end.

In a study published on Monday in the journal Ecology and Evolution, a team of researchers referred to this newly observed behavior as “cloacal diving.” While many questions about this fishy practice remain, there is one thing the team feels sure about.

“It does not look like the manta ray likes it,” said Catherine Macdonald, director of the shark research and conservation program at the University of Miami and senior author of the new study.

While remoras, also known as suckerfish, have been observed diving into the safety of whale-shark cloacae in the past, this is the first time anyone has documented the behavior in manta rays.

The paper uses seven instances of cloacal diving that took place between 2010 and 2025 across all three known species of manta ray. What’s more, the observations, which were gathered by the Marine Megafauna Foundation, occurred in three separate ocean basins, suggesting that this previously unobserved behavior could be common among rays and the remora species that associate with them.

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In some cases, the remora forces itself so far inside the ray’s cloaca that only the very tip of its tail can be seen protruding from the exterior. In others, the ray is not large enough to accommodate the remora’s entire body, and half of the suckerfish hangs out of the ray, like a toddler playing peekaboo beneath a blanket.

“The remoras are pretty much as wide as the cloaca is,” said Emily Yeager, a Ph.D. student at the University of Miami and the lead author of the study. “So it’s fully filling that opening.”

To the researchers’ knowledge, no one has studied how sensitive manta ray cloacae are specifically, though Dr. Macdonald said that her lab would often swab the cloacae of sharks for fecal DNA to better understand what they’d been eating.

“They don’t especially like us sticking a swab up there,” she said. “And that swab is a big Q-Tip compared to a remora.”

While all of this may seem as if it’s a lark — News flash: Fish hides inside another fish’s backside — the findings contribute new information to a topic already hotly debated by scientists: the type of impact remoras have on their hosts.

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Traditionally, experts have seen the interaction between remoras and manta rays as either commensal or mutualistic. In a commensal relationship, one animal benefits while the other is neither benefited nor harmed. In a mutualistic relationship, both creatures benefit: The remora gets a free ride and food, while the manta has its skin cleaned of parasites.

But cloacal diving almost certainly changes the equation, said Eleanor Caves, a sensory biologist at Brown University who was not affiliated with the new study. While the remora’s presence inside the ray is most likely brief, it could interfere with waste discharge or reproduction, or even damage the cloaca’s lining. This may mean the relationship between remoras and manta rays sometimes tilts into a parasitic interaction, in which one species benefits and the other is harmed.

While the researchers provide just seven instances of remoras using manta-ray cloacae as their own personal panic rooms, the fact that the animals are so difficult to see once inside suggests that the behavior is under-documented, at the very least.

“It’s really challenging to study these highly mobile relationships in marine systems,” Ms. Yeager said. “Oftentimes when researchers interact with these organisms, it’s just for a second in time, when we’re scuba diving in one location and one passes over us, or we’re fishing in a site and we bring one to our boat.”

“But these relationships persist 24/7, all of the time,” she added. “And we’re seeing just a snapshot.”

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Californian exposed to hantavirus aboard cruise ship resides in Bay Area, officials say

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Californian exposed to hantavirus aboard cruise ship resides in Bay Area, officials say

A Bay Area resident who was stuck on a cruise ship during a deadly hantavirus outbreak has returned to Santa Clara County and is being monitored by health officials.

The Santa Clara County Public Health Department confirmed Sunday that a county resident has returned to California after being exposed to the Andes hantavirus while on the MV Hondius. Three people on board the luxury cruise ship have died, and at least nine others have suspected cases.

The California resident is being monitored in coordination with the California Department of Public Health and the Centers for Disease Control and Prevention, the agency said.

CDPH acknowledged in a statement Friday that one California resident had already returned home, but didn’t disclose where they lived. The agency said another Californian remained on the ship as of Friday.

“At this time, there is no known risk to the public in Santa Clara County,” said Sarah Rudman, director of the Santa Clara County Public Health Department.

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The CDC has emphasized that the risk to the American public “is extremely low” as American passengers stuck on the ship begin to return home.

Hantavirus is a rare disease typically transmitted to humans through inhalation of particles contaminated with the urine, droppings or saliva from a rodent.

Passengers began disembarking the ship Sunday in the Canary Islands. The CDC says it has sent a team to conduct a risk assessment for each American passenger.

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What Is Body Dysmorphic Disorder?

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What Is Body Dysmorphic Disorder?

Mandy Rosenberg, 35, from Brookfield, Wisc., has always drawn attention because of her looks. With her long blonde hair, athletic build and large blue eyes, she was called Barbie by some of her high school peers.

But even though people often told her that she was pretty, she didn’t view herself the same way.

She’d spend hours staring at a tiny blemish on her forehead that was barely visible to others. In her mind, it was a large and unsightly scar, and she would climb on top of her bathroom sink to get as close to the mirror as possible while examining it.

“If I couldn’t make that go away, I didn’t want to live anymore,” she said.

Ms. Rosenberg didn’t know it at the time, but she had both obsessive-compulsive disorder and body dysmorphic disorder, or B.D.D., a mental health condition that causes people to spend an inordinate amount of time worrying about their appearance — to the point where they may isolate themselves from others and feel imprisoned in their own bodies.

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People with B.D.D. not only think they look unattractive but can become convinced that others will reject them because of their flaws.

“They often feel they’re unlovable,” said Dr. Katharine Phillips, an expert in B.D.D. and a psychiatrist at Weill Cornell Medicine and NewYork-Presbyterian.

Those with B.D.D. fixate on perceived cosmetic problems that to others appear unnoticeable or minor. But it’s not about vanity; instead, people with B.D.D. feel extreme anguish that impairs their functioning.

The disorder typically emerges during adolescence and is estimated to affect 2 to 3 percent of the general population, but these numbers may be conservative because the disorder is underdiagnosed.

Studies have shown differences in the brains of people with B.D.D., said Dr. Jamie Feusner, a professor of psychiatry at the University of Toronto Temerty Faculty of Medicine. Some of his research has found that in those who have the condition areas of the brain that help us view things holistically are underactive.

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This might be part of the reason that people with B.D.D. have trouble viewing their imperfections as small relative to their entire face or body. It’s akin to looking at a window with a smudge on it, then “thinking that the whole window is ruined,” Dr. Feusner said.

Patients with B.D.D. aren’t always aware that their concerns stem from a mental health problem. Instead, they often believe wholeheartedly that they have physical defects.

Because of this, someone might suffer for a decade or more before seeking help from a mental health provider, said Hilary Weingarden, a psychologist in Massachusetts who studies O.C.D. and related conditions.

Instead, “they’re going to their dermatologist and a plastic surgeon and the dentist and the aesthetician,” she said.

But trying to “fix” their appearance only serves to maintain and exacerbate their anxiety in the long run.

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People with B.D.D. may withdraw from relationships, avoid attending work or school, and spend an excessive amount of time on repetitive behaviors like examining themselves in the mirror, attempting to camouflage their appearance or seeking reassurance from others.

Chris Trondsen, a therapist in Costa Mesa, Calif., who diagnosed Ms. Rosenberg with B.D.D., said his patients admit to spending hours chatting with artificially intelligent bots, both seeking affirmation and asking what they ought to fix.

“If you ask a human, people are going to get fed up answering the questions,” Mr. Trondsen said.

Mr. Trondsen was inspired to study psychotherapy because of his own struggle with B.D.D. He used to fixate on his complexion and other parts of his body, too. He worried that his nose was too large for his face and that his body wasn’t muscular enough, a form of B.D.D. called muscle dysmorphia.

“I kept thinking I was getting uglier,” Mr. Trondsen said.

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Like many patients with B.D.D., he also spent hours checking his body in mirrors and rarely left his apartment. At 21 years old, Mr. Trondsen became so isolated and consumed by his appearance that he attempted suicide, and might have died had his roommate not discovered him. After that, he sought help and was diagnosed with O.C.D. and B.D.D.

It’s common for those with B.D.D. to also have conditions like O.C.D., major depressive disorder, social phobia and substance use disorder. Studies indicate that people with B.D.D. have high rates of suicidal ideation and behavior, too. One meta-analysis found that, across a patient’s life span, about 66 percent of those with B.D.D. will have thoughts of suicide and around 35 percent will attempt it.

Cognitive behavioral therapy for B.D.D. has been shown to lead to remission in more than half of patients. It includes exposure and response prevention, which is meant to help patients gradually confront the things that they have been avoiding or the rituals they have become dependent upon, like hiding parts of their body with clothing or makeup.

Therapists try to help patients view themselves more holistically, emphasizing that there’s more to them than the specific parts of their bodies they scrutinize.

The disorder can also be treated with serotonin reuptake inhibitors, or S.R.I.s., often at high doses. For those with severe B.D.D., both medication and C.B.T. are recommended, Dr. Phillips said.

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For Ms. Rosenberg, cognitive behavioral therapy with her former therapist, Mr. Trondsen, gradually helped her condition.

Later, as part of her treatment, she created a diagram showcasing all of the things that contribute to her identity: She is a daughter and a faithful Christian, she loves dogs and cats, she is a teacher, she is caring — she is more than just her looks.

My body, she said, “doesn’t get to determine how I go about my day.”

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