Medical Bulletin 14/Jul/2025

Here are the top medical news for the day:

Gabapentin Tied to 85% Higher Risk of Cognitive Impairment: Study Finds

Regular use of the drug gabapentin for chronic low back pain is associated with a significantly increased risk of developing dementia and mild cognitive impairment, according to a large retrospective study published in Regional Anesthesia & Pain Medicine.

Gabapentin is often considered a safer alternative to opioids due to its lower addictive potential and supposed neuroprotective benefits. However, growing evidence suggests possible links between its use and neurodegeneration.

To better understand the cognitive risks, researchers analyzed electronic health records from the TriNetX database, which aggregates real-time data from 68 healthcare organizations across the U.S. The study compared two matched groups of 26,414 adults who had chronic low back pain between 2004 and 2024 one group received gabapentin prescriptions, while the other did not. Variables such as demographics, coexisting conditions, and other pain medications were accounted for.

Patients who received six or more gabapentin prescriptions were found to be 29% more likely to be diagnosed with dementia and 85% more likely to develop mild cognitive impairment within ten years of their initial diagnosis. Alarmingly, the risk was more than double in adults aged 18–64, a demographic not typically considered at high risk for cognitive decline. Among those aged 35–49, the risk of dementia more than doubled and mild cognitive impairment risk more than tripled.

The study also showed a dose-response trend: individuals with 12 or more prescriptions had a 40% higher risk of dementia and a 65% higher risk of mild cognitive impairment than those prescribed gabapentin three to eleven times.

As an observational and retrospective analysis, the study cannot establish causation, nor did it account for gabapentin dosage or duration. Still, the authors concluded: “Our findings indicate an association between gabapentin prescription and dementia or cognitive impairment within 10 years. Moreover, increased gabapentin prescription frequency correlated with dementia incidence.” They emphasize the importance of monitoring patients on gabapentin for signs of cognitive decline.

Reference: Eghrari NB, Yazji IH, Yavari B, et al, Risk of dementia following gabapentin prescription in chronic low back pain patients, Regional Anesthesia & Pain Medicine Published Online First: 10 July 2025. doi: 10.1136/rapm-2025-106577

Want to Live Longer? Stay Active

Staying physically active throughout adulthood can reduce the risk of death from any cause by up to 40%, according to a large pooled analysis published in the British Journal of Sports Medicine. Even individuals who began exercising later in life saw a 20–25% lower risk of death, highlighting that it’s never too late to adopt a more active lifestyle.

Researchers reviewed 85 studies published up to April 2024, encompassing participant sample sizes ranging from 357 to over 6.5 million.

The analysis included studies that measured physical activity at two or more points in time and examined its effects on all-cause mortality, cardiovascular disease, and cancer. The researchers performed separate analyses to account for different methodologies used in the studies.

Results showed that people who were consistently active had a 30–40% lower risk of death from any cause compared to those who remained inactive. Individuals who increased their physical activity later in life also benefited, with a 20–25% reduction in mortality risk. Notably, switching from inactivity to an active lifestyle was associated with a 22% lower risk of death, and those who increased their leisure-time activity were 27% less likely to die from any cause.

The benefits were most evident for cardiovascular disease. Consistently active participants had a 40% lower risk of death from cardiovascular conditions and a 25% reduced risk of cancer-related death. However, the evidence for cancer outcomes remained inconclusive.

“First, our results emphasised the importance of physical activity across adulthood, indicating that initiating it at any point in adulthood may provide survival benefits,” the researchers stated. They added that sustaining physical activity long-term offers greater benefits than being active only temporarily.

Reference: Yu R, Duncombe SL, Nemoto Y, et al, Physical activity trajectories and accumulation over adulthood and their associations with all-cause and cause-specific mortality: a systematic review and meta-analysis, British Journal of Sports Medicine Published Online First: 10 July 2025. doi: 10.1136/bjsports-2024-109122

New Wireless Skin Implant Could Prevent Hypoglycemia in Type 1 Diabetics

A new study published in Nature Biomedical Engineering reveals a potentially life-saving innovation for people with Type 1 diabetes: an implantable device that releases glucagon when blood sugar levels plummet dangerously low. Developed by engineers at MIT, the wireless-triggered reservoir aims to prevent hypoglycemia, a life-threatening condition often marked by confusion, seizures, or even coma.

For those managing Type 1 diabetes, hypoglycemia is a constant risk. While glucagon injections are the standard emergency treatment, patients may not always recognize early symptoms especially during sleep or in young children. The newly designed device can stay under the skin and release powdered glucagon in response to a wireless signal or possibly even automatically via glucose sensor integration.

“This is a small, emergency-event device that can be placed under the skin, where it is ready to act if the patient's blood sugar drops too low,” said senior author Daniel Anderson, a professor at MIT’s Department of Chemical Engineering. “Our goal was to build a device that is always ready to protect patients from low blood sugar.”

The device, about the size of a quarter, consists of a 3D-printed polymer reservoir sealed with a shape-memory alloy specifically, nickel-titanium that bends when heated. The reservoir stores powdered glucagon, which is more stable than its liquid form. Upon receiving a specific radiofrequency signal, the device heats the alloy, curls the seal, and releases the drug.

In diabetic mice, the device successfully released glucagon within 10 minutes of activation, stabilizing blood sugar levels. The researchers also demonstrated successful delivery of epinephrine, suggesting broader emergency medical applications.

Even after fibrotic tissue formed around the implant a common response to foreign objects the device functioned effectively. The team now aims to develop a version that could last a year or more and hopes to begin human clinical trials within three years.

Reference: Siddharth R. Krishnan, Laura O’Keeffe, Arnab Rudra, Derin Gumustop, Nima Khatib, Claudia Liu, Jiawei Yang, Athena Wang, Matthew A. Bochenek, Yen-Chun Lu, Suman Bose, Kaelan Reed, Robert Langer, Daniel G. Anderson. Emergency delivery of particulate drugs by active ejection using in vivo wireless devices. Nature Biomedical Engineering, 2025 DOI: 10.1038/s41551-025-01436-2