Could ADHD drugs reduce the risk of early death? Unpacking the findings from a new Swedish study

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Attention-deficit hyperactivity disorder (ADHD) can have a considerable impact on the day-to-day functioning and overall wellbeing of people affected. It causes a variety of symptoms including difficulty focusing, impulsivity and hyperactivity.

For many, a diagnosis of ADHD, whether in childhood or adulthood, is life changing. It means finally having an explanation for these challenges, and opens up the opportunity for treatment, including medication.

Although ADHD medications can cause side effects, they generally improve symptoms for people with the disorder, and thereby can significantly boost quality of life.

Now a new study has found being treated for ADHD with medication reduces the risk of early death for people with the disorder. But what can we make of these findings?

A large study from Sweden

The study, published this week in JAMA (the prestigious journal of the American Medical Association), was a large cohort study of 148,578 people diagnosed with ADHD in Sweden. It included both adults and children.

In a cohort study, a group of people who share a common characteristic (in this case a diagnosis of ADHD) are followed over time to see how many develop a particular health outcome of interest (in this case the outcome was death).

For this study the researchers calculated the mortality rate over a two-year follow up period for those whose ADHD was treated with medication (a group of around 84,000 people) alongside those whose ADHD was not treated with medication (around 64,000 people). The team then determined if there were any differences between the two groups.

What did the results show?

The study found people who were diagnosed and treated for ADHD had a 19% reduced risk of death from any cause over the two years they were tracked, compared with those who were diagnosed but not treated.

In understanding this result, it’s important – and interesting – to look at the causes of death. The authors separately analysed deaths due to natural causes (physical medical conditions) and deaths due to unnatural causes (for example, unintentional injuries, suicide, or accidental poisonings).

The key result is that while no significant difference was seen between the two groups when examining natural causes of death, the authors found a significant difference for deaths due to unnatural causes.

So what’s going on?

Previous studies have suggested ADHD is associated with an increased risk of premature death from unnatural causes, such as injury and poisoning.

On a related note, earlier studies have also suggested taking ADHD medicines may reduce premature deaths. So while this is not the first study to suggest this association, the authors note previous studies addressing this link have generated mixed results and have had significant limitations.

In this new study, the authors suggest the reduction in deaths from unnatural causes could be because taking medication alleviates some of the ADHD symptoms responsible for poor outcomes – for example, improving impulse control and decision-making. They note this could reduce fatal accidents.

The authors cite a number of studies that support this hypothesis, including research showing ADHD medications may prevent the onset of mood, anxiety and substance use disorders, and lower the risk of accidents and criminality. All this could reasonably be expected to lower the rate of unnatural deaths.

Strengths and limitations

Scandinavian countries have well-maintained national registries that collect information on various aspects of citizens’ lives, including their health. This allows researchers to conduct excellent population-based studies.

Along with its robust study design and high-quality data, another strength of this study is its size. The large number of participants – almost 150,000 – gives us confidence the findings were not due to chance.

The fact this study examined both children and adults is another strength. Previous research relating to ADHD has often focused primarily on children.

One of the important limitations of this study acknowledged by the authors is that it was observational. Observational studies are where the researchers observe and analyse naturally occurring phenomena without intervening in the lives of the study participants (unlike randomised controlled trials).

The limitation in all observational research is the issue of confounding. This means we cannot be completely sure the differences between the two groups observed were not either partially or entirely due to some other factor apart from taking medication.

Specifically, it’s possible lifestyle factors or other ADHD treatments such as psychological counselling or social support may have influenced the mortality rates in the groups studied.

Another possible limitation is the relatively short follow-up period. What the results would show if participants were followed up for longer is an interesting question, and could be addressed in future research.

What are the implications?

Despite some limitations, this study adds to the evidence that diagnosis and treatment for ADHD can make a profound difference to people’s lives. As well as alleviating symptoms of the disorder, this study supports the idea ADHD medication reduces the risk of premature death.

Ultimately, this highlights the importance of diagnosing ADHD early so the appropriate treatment can be given. It also contributes to the body of evidence indicating the need to improve access to mental health care and support more broadly.The Conversation

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Cherries vs Elderberries – Which is Healthier?

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    Our Verdict

    When comparing cherries to elderberries, we picked the elderberries.

    Why?

    Both are great! But putting them head-to-head…

    In terms of macros, cherries have slightly more protein (but we are talking miniscule numbers here, 0.34mg/100g), while elderberries have moderately more carbs and more than 4x the fiber. This carbs:fiber ratio difference means that elderberries have the lower glycemic index by far, as well as simply more grams/100g fiber, making this an easy win for elderberries.

    In the category of vitamins, cherries have more of vitamins A, B9, E, K, and choline, while elderberries have more of vitamins B1, B2, B3, B6, and C. The margins of difference mean that elderberries have the very slightly better overall vitamin coverage, but it’s so slight that we’ll call this a 5:5 tie.

    When it comes to minerals, cherries have more copper, magnesium, and manganese, while elderberries have more calcium, iron, phosphorus, potassium, selenium, and zinc. A nice easy win to top it off for elderberries.

    On the polyphenols (and other phytochemicals) front, both are great in different ways, nothing that’d we’d consider truly sets one ahead of the other.

    All in all, adding up the sections, an overall win for elderberries, but by all means enjoy either or both!

    Want to learn more?

    You might like to read:

    Take care!

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  • Why are tall people more likely to get cancer? What we know, don’t know and suspect

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    People who are taller are at greater risk of developing cancer. The World Cancer Research Fund reports there is strong evidence taller people have a higher chance of of developing cancer of the:

    • pancreas
    • large bowel
    • uterus (endometrium)
    • ovary
    • prostate
    • kidney
    • skin (melanoma) and
    • breast (pre- and post-menopausal).

    But why? Here’s what we know, don’t know and suspect.

    Pexels/Andrea Piacquadio
    A tall woman and her partner are silhoutted against the sunset.
    Height does increase your cancer risk – but only by a very small amount. Christian Vinces/Shutterstock

    A well established pattern

    The UK Million Women Study found that for 15 of the 17 cancers they investigated, the taller you are the more likely you are to have them.

    It found that overall, each ten-centimetre increase in height increased the risk of developing a cancer by about 16%. A similar increase has been found in men.

    Let’s put that in perspective. If about 45 in every 10,000 women of average height (about 165 centimetres) develop cancer each year, then about 52 in each 10,000 women who are 175 centimetres tall would get cancer. That’s only an extra seven cancers.

    So, it’s actually a pretty small increase in risk.

    Another study found 22 of 23 cancers occurred more commonly in taller than in shorter people.

    Why?

    The relationship between height and cancer risk occurs across ethnicities and income levels, as well as in studies that have looked at genes that predict height.

    These results suggest there is a biological reason for the link between cancer and height.

    While it is not completely clear why, there are a couple of strong theories.

    The first is linked to the fact a taller person will have more cells. For example, a tall person probably has a longer large bowel with more cells and thus more entries in the large bowel cancer lottery than a shorter person.

    Scientists think cancer develops through an accumulation of damage to genes that can occur in a cell when it divides to create new cells.

    The more times a cell divides, the more likely it is that genetic damage will occur and be passed onto the new cells.

    The more damage that accumulates, the more likely it is that a cancer will develop.

    A person with more cells in their body will have more cell divisions and thus potentially more chance that a cancer will develop in one of them.

    Some research supports the idea having more cells is the reason tall people develop cancer more and may explain to some extent why men are more likely to get cancer than women (because they are, on average, taller than women).

    However, it’s not clear height is related to the size of all organs (for example, do taller women have bigger breasts or bigger ovaries?).

    One study tried to assess this. It found that while organ mass explained the height-cancer relationship in eight of 15 cancers assessed, there were seven others where organ mass did not explain the relationship with height.

    It is worth noting this study was quite limited by the amount of data they had on organ mass.

    A tall older man leans against a wall while his bicycle is parked nearby.
    Is it because tall people have more cells? Halfpoint/Shutterstock

    Another theory is that there is a common factor that makes people taller as well as increasing their cancer risk.

    One possibility is a hormone called insulin-like growth factor 1 (IGF-1). This hormone helps children grow and then continues to have an important role in driving cell growth and cell division in adults.

    This is an important function. Our bodies need to produce new cells when old ones are damaged or get old. Think of all the skin cells that come off when you use a good body scrub. Those cells need to be replaced so our skin doesn’t wear out.

    However, we can get too much of a good thing. Some studies have found people who have higher IGF-1 levels than average have a higher risk of developing breast or prostate cancer.

    But again, this has not been a consistent finding for all cancer types.

    It is likely that both explanations (more cells and more IGF-1) play a role.

    But more research is needed to really understand why taller people get cancer and whether this information could be used to prevent or even treat cancers.

    I’m tall. What should I do?

    If you are more LeBron James than Lionel Messi when it comes to height, what can you do?

    Firstly, remember height only increases cancer risk by a very small amount.

    Secondly, there are many things all of us can do to reduce our cancer risk, and those things have a much, much greater effect on cancer risk than height.

    We can take a look at our lifestyle. Try to:

    • eat a healthy diet
    • exercise regularly
    • maintain a healthy weight
    • be careful in the sun
    • limit alcohol consumption.

    And, most importantly, don’t smoke!

    If we all did these things we could vastly reduce the amount of cancer.

    You can also take part in cancer screening programs that help pick up cancers of the breast, cervix and bowel early so they can be treated successfully.

    Finally, take heart! Research also tells us that being taller might just reduce your chance of having a heart attack or stroke.

    Susan Jordan, Associate Professor of Epidemiology, The University of Queensland and Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Proteins Of The Week

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This week’s news round-up is, entirely by chance, somewhat protein-centric in one form or another. So, check out the bad, the very bad, the mostly good, the inconvenient, and the worst:

    Mediterranean diet vs the menopause

    Researchers looked at hundreds of women with an average age of 51, and took note of their dietary habits vs their menopause symptoms. Most of them were consuming soft drinks and red meat, and not good in terms of meeting the recommendations for key food groups including vegetables, legumes, fruit, fish and nuts, and there was an association between greater adherence to Mediterranean diet principles, and better health.

    Read in full: Fewer soft drinks and less red meat may ease menopause symptoms: Study

    Related: Four Ways To Upgrade The Mediterranean Diet

    Listeria in meat

    This one’s not a study, but it is relevant important news. The headline pretty much says it all, so if you don’t eat meat, this isn’t one you need to worry about any further than that. If you do eat meat, though, you might want to check out the below article to find out whether the meat you eat might be carrying listeria:

    Read in full: Almost 10 million pounds of meat recalled due to Listeria danger

    Related: Frozen/Thawed/Refrozen Meat: How Much Is Safety, And How Much Is Taste?

    Brawn and brain?

    A study looked at cognitively healthy older adults (of whom, 57% women), and found an association between their muscle strength and their psychological wellbeing. Note that when we said “cognitively healthy”, this means being free from dementia etc—not necessarily psychologically health in all respects, such as also being free from depression and enjoying good self-esteem.

    Read in full: Study links muscle strength and mental health in older adults

    Related: Staying Strong: Tips To Prevent Muscle Loss With Age

    The protein that blocks bone formation

    This one’s more clinical but definitely of interest to any with osteoporosis or at high risk of osteoporosis. Researchers identified a specific protein that blocks osteoblast function, thus more of this protein means less bone production. Currently, this is not something that we as individuals can do anything about at home, but it is promising for future osteoporosis meds development.

    Read in full: Protein blocking bone development could hold clues for future osteoporosis treatment

    Related: Which Osteoporosis Medication, If Any, Is Right For You?

    Rabies risk

    People associate rabies with “rabid dogs”, but the biggest rabies threat is actually bats, and they don’t even need to necessarily bite you to confer the disease (it suffices to have licked the skin, for instance—and bats are basically sky-puppies who will lick anything). Because rabies has a 100% fatality rate in unvaccinated humans, this is very serious. This means that if you wake up and there’s a bat in the house, it doesn’t matter if it hasn’t bitten anyone; get thee to a hospital (where you can get the vaccine before the disease takes hold; this will still be very unpleasant but you’ll probably survive so long as you get the vaccine in time).

    Read in full: What to know about bats and rabies

    Related: Dodging Dengue In The US ← much less serious than rabies, but still not to be trifled with—particularly noteworthy if you’re in an area currently affected by floodwaters or even just unusually heavy rain, by the way, as this will leave standing water in which mosquitos breed.

    Take care!

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  • Berberine For Metabolic Health

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Is Berberine Nature’s Ozempic/Wegovy?

    Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.

    It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).

    Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:

    • Reduced fasting blood sugar levels
    • Improved insulin sensitivity
    • Reduced LDL and triglycerides
    • Increased HDL levels

    So, what does the science say?

    It’s (mostly!) not nature’s Wegovy/Ozempic

    It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.

    Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.

    Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.

    In less arcane words: it boosts some enzymes and inhibits others.

    Each of these boosts/inhibitions has a positive effect on metabolic health.

    However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.

    See: Effects of Berberine on the Gastrointestinal Microbiota

    Does it work for weight loss?

    Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.

    ❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.

    However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)

    Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞

    (click through to read in full)

    Is it safe?

    It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.

    Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.

    Where can I get it?

    As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.

    Enjoy!

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  • Eat to Beat Disease – by Dr. William Li

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. William Li asks the important question: is your diet feeding disease, or defeating it?

    Because everything we put in our bodies makes our health just a little better—or just a little worse. Ok, sometimes a lot worse.

    But for most people, when it comes to diet, it’s a death of a thousand cuts of unhealthy food. And that’s what he looks to fix with this book.

    The good news: Dr. Li (while not advocating for unhealthy eating, of course), focuses less on what to restrict, and more on what to include. This book covers hundreds of such healthy foods, and ideas (practical, useful ones!) on incorporating them daily, including dozens of recipes.

    He mainly looks at five ways our food can help us with…

    1. Angiogenesis (blood vessel replacement)
    2. Regeneration (of various bodily organs and systems)
    3. Microbiome health (and all of its knock-on effects)
    4. DNA protection (and thus slower cellular aging)
    5. Immunity (defending the body while also reducing autoimmune problems)

    The style is simple and explanatory; Dr. Li is a great educator. Reading this isn’t a difficult read, but you’ll come out of it feeling like you just did a short course in health science.

    Bottom line: if you’d like an easy way to improve your health in an ongoing and sustainable way, then this book can help you do just that.

    Click here to check out Eat To Beat Disease, and eat to beat disease!

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  • Lemon vs Lime – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing lemons to limes, we picked the lemons.

    Why?

    This one’s simple today. They’re both comparable fruits in most ways, and their macro profiles are almost identical. When it comes to vitamins, however, they stand apart a little.

    Both are most well-known for their vitamin C content, but lemons contain about 2x the vitamin C of limes.

    In other vitamins, they’re not too far apart. Technically limes have 2x the vitamin A, but this doesn’t count for much because it’s a case of “two times almost nothing is still almost nothing”.

    In the category of minerals, neither fruit is a very good source of most minerals, and the minerals they do have, are mostly more or less the same.

    Both are acidic, and this can have blood sugar benefits in both cases (and, if not careful, damage tooth enamel in both cases). Nothing to set either apart from the other here.

    So, it comes down to the vitamin C! In which category, lemons take the prize with their higher content.

    Want to learn more?

    You might like to read:

    10 Ways To Balance Blood Sugars ← where it talks about the use of vinegar here, it’s about the acidity, so lemon juice or lime juice is an option too!

    Take care!

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