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In recent years, researchers are beginning to close some of the knowledge gaps preventing better treatments of Alzheimer disease and 

, Naahaad Mukadam, PhD, Division of Psychiatry, University College London, said there has been an increase in the understanding about how vascular risk factors increase the risk of developing dementia and Alzheimer disease, the main type of dementia.

Mukadam said while there is a better understanding on how the build up of different proteins ultimately leads to the disease, trials testing treatments to remove these proteins have not been fruitful.

With that said, Mukadam recently was part of a research team that added 3 risk factors to a list of 9 modifiable risk factors for dementia, which could help reduce the incidence rate of the disease.

The discovery might be coming at a time of critical mass as the population across the world is aging, leading to a concern that dementia could become a public health crisis.

Mukadam said while treatment trials have sputtered, there should be attention paid to identifying even more ways to reduce the risk of dementia.

"Dementia prevention, intervention, and care: 2020 report of the 

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A team of researchers have added 3 new modifiable risk factors to a list of 9 known factors that increase the risk of developing dementia.

Naahaad Mukadam, PhD: Addressing the Dementia Public Health Crisis

As we entered the year 2020, life in North America seemed quite normal and unlikely to change. In January, COVID-19 was a newly emerging, yet-unnamed disease in a far away place. Many people were unaware of it, and few considered it a potential local threat.

One of the first warnings to garner public interest came in the form of a now-deleted tweet from 

, an epidemiologist who had approximately 2,000 followers on Twitter. In a matter of months, his audience increased tenfold, and he has been quoted in national media sources including 

. How this happened is both a social media success story, and a cautionary tale about content creation in the age of coronavirus.

You have probably read the standard social media marketing advice: create sharable content. Many doctors ask exactly what that means, and there is no single right answer. However, there are a few common guidelines. The tweet that landed Feigl-Ding squarely in the spotlight checks all the boxes:

Include images – Visual content tends to perform best on most social networks. The tweet included graphs, which may have been too technical for the layperson to understand, but they were visually appealing.

Provide value – People tend to share content that they find informative, entertaining, or otherwise useful. Feigl-Ding was issuing a warning, something people felt that others needed to know about.

Use a catchy intro – Social media users tend to scan their feeds, and you need to grab their interest right away or they will keep scrolling. The infamous coronavirus tweet began “HOLY MOTHER OF GOD” in all capitals. It was a dramatic, possibly alarmist statement – and it was attention catching.

Establish credibility – With the plethora of misinformation on the internet, people are sceptical of vague statements. Links, statistics, expert quotes, or facts and figures lend credibility to education content. Feigl-Ding’s 

 a link to a scientific paper, and described the new coronavirus having a R0 of 3.8, making it as eight times as contagious as SARS. He had made an error in the comparison to SARS. By the time he published the tweet, researchers decreased the R0 estimate for this new virus. At the moment, he was unaware of those facts, as were his followers. It appeared to be proven facts and science.

Be social – If social media were a physical place, it would be the casual coffee shop on the corner or the roadside diner. Dull, dry content is boring, and an overly formal tone seems out of place. Feigl-Ding’s tweets are mostly written in non-clinical (some would say unprofessional) terms and liberally sprinkled with emoticons, slang, and personal commentary. It is relatable.

How to avoid the follies of social media success

The core of Feigl-Ding’s message was correct and important. This strain of coronavirus did indeed become a pandemic, the likes of which we have not seen in recent history. Yet, it also included misinformation, outdated figures, and a flamboyant style that does not convey professionalism. Throughout the pandemic he has continued tweeting in similar style. As a result, he has gained a reputation as a

This is the unfortunate downside to social media success. A mistake is unlikely to haunt you if only ten people see it. However, it may become fodder for local or national media if tens of thousands see it. Unless you wish to cultivate a controversial image, it is good practice to double-check facts and avoid sensationalist statements. Furthermore, the unprecedented nature of the pandemic presents unique challenges. For example:

Facts can change – The tweet discussed above included outdated facts, even though Feigl-Ding posted it immediately after reading the paper. Many months later, the latest information is still evolving at lightning speed. Verify statistics immediately before posting and remove or update old material to avoid causing confusion.

Best practices change – Early on, Feigl-Ding had supported the idea that facemasks were useless. Within weeks, he changed course and embraced mask-wearing. His advice was in line with official recommendations, but it was often presented as his own opinion, making the sudden change seem self-contradictory. Be clear and concise in your public messaging.

Remember your audience is not clinicians –The secret ingredient in Feigl-Ding’s remarkable social media popularity is likely his relatable tone and style. He puts complex information in terms the average layperson can understand and relate to. However, there is a danger in over simplifying. People may take your statements too literally or misinterpret your words. Choose your words carefully and avoid generalizations or out-of-context comments.

Eric Feigl-Ding is just one example. Jeffrey VanWingen, gained unexpected fame for making a 

. Unfortunately, he is a family physician, not a food safety expert. Therefore, he included advice such as washing vegetables with soap, which is considered unsafe because it can leave a residue. He also made a general statement about leaving groceries in the garage for days, without stipulating to exclude perishables.

 of medical professionals successfully using social media to provide valuable, beneficial, important information to the public – and simultaneously building an excellent reputation. The key is a combination of meticulous fact-checking and a keen awareness of your reader’s mindset.

, has been a leader in medical marketing for over a decade. Ekwa provides comprehensive marketing solutions for busy doctors, with a team of more than 180 full time professionals, providing web design, hosting, content creation, social media, reputation management, SEO, and more. 

If you’re looking for ways to boost your marketing results, call 855-598-3320 for a free strategy session with Naren.

Articles

What we can learn from an epidemiologist’s rise to social media stardom.

Content Creation in the Age of COVID-19

Recent study findings further back the efficacy and safety of benralizumab for patients with severe 

Tim Harrison, MBBS, BSc, FRCP, MD, MSc, from the Respiratory Research Unit at the University of Nottingham, and colleagues conducted the ANDHI trial to extend knowledge and understanding of the efficacy and safety of benralizumab for severe eosinophilic asthma patients, including the onset of effect and additional health-related quality of life measures. They included adult patients with severe eosinophilic asthma with at least 2 prior-year exacerbations despite high-dosage inhaled corticosteroid plus additional controllers and screening blood eosinophil counts of at least 150 cells/µL.

Patients were randomized 2:1 to either 24 weeks of benralizumab 30 mg every 8 weeks or placebo. Those who had blood eosinophil counts of at least 150 to less than 300 cells/µL were required to have at least 1 of the following: maintenance oral corticosteroids use, nasal polyposis, forced vital capacity less than 65% predicted, at least 3 prior-year exacerbations, or at least 18 years old at diagnosis.

Additional variables taken into account included annualized asthma exacerbation rate and change from baseline to week 24 in St. George’s Respiratory Questionnaire (SGRQ) total score, forced expiratory volume in 1 second (FEV1), and Asthma Control Questionnaire 6 (ACQ-6). Further, the team analyzed the results of the Sino-Nasal Outcome Test-22 (SNOT-22) in a subset of patients with a history of nasal polyposis.

Harrison and the team randomized 656 patients to receive either benralizumab (n=427) or placebo (n=229). Characteristics and demographics were similar in the benralizumab versus placebo groups (female, 61.6% vs 59.4%; mean age, 52.5 vs 53.3 years old; white, 86% vs 85.7%; prior year asthma exacerbation rate, 3.2 vs 3.1; mean pre-bronchodilator FEV1, 1700 vs 1750 mL; mean SGRQ total score, 58.19 vs 56.69; Phadiatop positive, 56.5% vs 57.6%). Both groups had a median baseline eosinophil count of 390 cells/µL.

Nasal polyposis was present for 34.2% of those in the benralizumab group and 35.8% of placebo patients, with a mean SNOT-22 of 51.5 for benralizumab versus 48.2 for placebo. The team found benralizumab significantly improved asthma exacerbation rate, with a 49% reduction versus placebo (.94 vs 1.86; 

.0001). There was also a clinically meaningful and statistically significant improvement in least-squares mean change in SGRQ total score at week 32 versus placebo (delta-8.11; 

.0001), with similar differences at earlier times throughout the study period. Benralizumab improved lung function, ACQ-6, and SNOT-22 at week 24 versus placebo.

The investigators noted the safety between both treatment groups was similar, with adverse events reports slightly more for benralizumab patients (63.5%) compared to placebo (62.4%). Commonly reported adverse events included headache, nasopharyngitis, sinusitis, pyrexia, and bronchitis. Less patients in the benralizumab group reported serious adverse events (5.4% vs 10.9%).

“ANDHI results extend benralizumab’s efficacy and safety profile for severe asthma patients, including differences observed at first time point in lung function and diseasespecific (health-related quality of life), effects on (nasal polyposis), and safety comparable with previous studies,” Harrison and the team concluded.

Exacerbation Reduction and Early and Sustained Improvements in SGRQ, Lung Function, and Symptoms of Nasal Polyposis with Benralizumab for Severe, Eosinophilic Asthma: Phase IIIb ANDHI Trial

,” was presented as part of the American Thoracic Society annual meeting.

Results of ANDHI provide additional support on the safety and efficacy of benralizumab for patients with asthma.

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With the population aging, it might become increasingly important to mitigate some of the symptoms of 

Recently, a team of investigators from the University College London (UCL), released a new report summarizing preventative dementia care and what steps should be taken to truly reduce the amount of people diagnosed with dementia.

According to the report, the age-specific incidence of dementia is decreasing in many countries, likely due to improvements in education, nutrition, health care, and lifestyle changes. This lends credence to the belief that there are a number of modifiable risk factors that can reduce the risk of developing dementia.

There were already 9 known risk factors for dementia: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact.

The UCL researchers have added excessive alcohol consumption, traumatic brain injury, and air pollution to the list of modifiable risk factors for dementia.

The investigators believe the 12 risk factors account for approximately 40% of dementia cases around the world and should drive preventative measures to reduce dementia incidence.

, Naahaad Mukadam, PhD, Division of Psychiatry, University College London, explained how the report could yield some policy changes around the world and how dementia patients could be struggling during the ongoing coronavirus disease 2019 (COVID-19) pandemic.

"Dementia prevention, intervention, and care: 2020 report of the 

An expert in Alzheimer disease describes some of the struggles dementia patients might be going through during the COVID-19 pandemic.

Naahaad Mukadam, PhD: The Future of Dementia Care

An original version of this article was published by sister publication Practical Cardiology

New research indicates incorporating high-sensitivity troponin (hsTn) testing into an American Heart Association/American College of Cardiology (AHA/ACC) cholesterol management guideline-based algorithm for patients with 

atherosclerotic cardiovascular disease (ASCVD)

 could improve risk stratification and care optimization.

Investigators determined incorporation of hsTn testing resulted in the reclassification of 11.9% of patients into a more appropriate risk group when examining use of the biomarker-testing approach in patients from the PEGASUS-TIMI 54 trial.

In an effort to understand whether addition of hsTn testing to guideline-derived ASCVD risk classification, a team led by investigators of the TIMI study group designed and conducted a prospective cohort biomarker substudy of patients from the PEGASUS-TIMI 54 trial. From the 21,162 patients included in the original trial, 8635 were included in the current substudy

The median age of the study cohort was 65 years (IQR, 58-71 years), 76.6% were men, and 96.6% were White individuals. All patients included in the study experienced myocardial infarction 1-3 years prior to enrollment, were at least 50 years of age, and had at least 1 high-risk feature.

For the analysis, patients were assigned to AHA/ACC guideline-derived risk groups classified as very-high risk ASCVD or a lower-risk ASCVD based on their cardiovascular history and comorbidity. Patients were also classified according to hsTnI levels, with threshold points of 2 ng/L and 6 ng/L, which was defined as an undetectable level and the increased risk threshold, respectively. 

This was followed by a joint classification on the basis of clinical features and hsTnI level.

The primary end point of the analysis was a composite of cardiovascular death, myocardial infarction, or stroke. Upon analysis, patients meeting the criteria for the very high-risk ASCVD group had a 3-year event rate of 8.8% when assessing for the primary end point. In comparison, the rate among patients in the lower-risk group was 5.0% (HR, 2.01; 95% CI, 1.58-2.57; 

When stratifying patients according to hsTnI level, 9.0% of patients in the very high-risk group had an undetectable hsTnI level and these patients had a corresponding 3-year event rate of 2.7%, which investigates noted was lower than the overall rate in the lower-risk group. Among patients in the lower-risk group, 22.6% had an hsTnI level exceeding the 6 ng/L risk threshold and these patients had a corresponding 3-year event rate of 9.1%, which investigators noted was comparable to the rate seen in the very high-risk group.

Based on these results, investigators determined the addition of hsTnI levels to guideline-derived ASCVD risk assessments led to a net reclassification index at event rate of 0.15 (95% CI, 0.10-0.21). Furthermore, results indicated use of hsTnI led to reclassification of 11.9% of patients in the substudy.

 Harvey White, DSc, of the Auckland City Hospital and University of Auckland in New Zealand, highlights the potential of adding the biomarker to risk assessment algorithms but also warns against over-interpretation of results.

“It is not clear from the study by Marston and coworkers why increased hs-troponins within the normal range were associated with increased CVD risk," White wrote. "However, even without a complete understanding of the underlying mechanisms for the increased hs-troponin levels, the incremental information on CVD risk makes it very useful for improving risk assessment."

Troponin levels, he explained, should not be viewed solely as a marker for myocardial injury and diagnosis of MI in acute coronary syndrome, but for the frequent use of assessing CVD risk in stable patients with IHD.

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