Medical Bulletin 29/July/2025 - Video

A new systematic review and meta-analysis published in the International Journal of Geriatric Psychiatry has found that people with dementia are diagnosed, on average, 3.5 years after their symptoms first appear. For those with early-onset dementia, this delay is even longer, with an average of 4.1 years before receiving a diagnosis.

The study analysed information from 13 previously published studies conducted in Europe, the United States, Australia, and China, collectively involving over 30,000 participants. Researchers focused on the gap between the initial observation of dementia symptoms typically recorded by patients or family carers during interviews or found in medical records and the final clinical diagnosis.

Through a pooled meta-analysis of ten studies, the researchers determined the average diagnostic delay and found that certain populations face even longer waits. People with younger age at onset and those with frontotemporal dementia were more likely to experience delayed diagnosis. Limited but concerning data also indicated that racial disparities may exist, with one study showing that Black patients had a longer average wait for diagnosis.

Lead author Dr. Vasiliki Orgeta of the UCL Division of Psychiatry explained the urgency behind the findings: “Timely diagnosis can improve access to treatments and for some people prolong the time living with mild dementia before symptoms worsen.” She added that addressing this issue requires a multifaceted approach, including greater public awareness, reduced stigma, better clinician training, and improved access to early intervention services.

The researchers hope their work will encourage collaboration among healthcare professionals, patients, and carers to streamline the diagnostic process and ensure timely support for those affected by dementia.

Reference: Kusoro, Olubunmi, Moïse Roche, Rafael Del-Pino-Casado, Phuong Leung, and Vasiliki Orgeta. 2025. “Time to Diagnosis in Dementia: A Systematic Review With Meta-Analysis.” International Journal of Geriatric Psychiatry: e70129. https://doi.org/10.1002/gps.70129.

This Sugar Substitute May Help Kill Cancer Cells

In new study, researchers from Hiroshima University have found that stevia, commonly known as a zero-calorie sweetener, may possess potent anti-cancer properties when fermented with specific probiotic bacteria. Published in the International Journal of Molecular Sciences, the study revealed that fermented stevia extract selectively kills pancreatic cancer cells while leaving healthy kidney cells unharmed.

Pancreatic cancer remains one of the deadliest forms of cancer, with a five-year survival rate of less than 10%. “Pancreatic cancer is highly invasive and prone to metastasis, showing significant resistance to existing treatments, such as surgery, radiotherapy and chemotherapy. As such, there is an urgent need to identify new and effective anticancer compounds, particularly those derived from medicinal plants,” said study co-author Narandalai Danshiitsoodol, associate professor in the Department of Probiotic Science for Preventive Medicine.

To enhance stevia’s bioactivity, the research team fermented its extract using Lactobacillus plantarum SN13T, a probiotic strain isolated from banana leaves. This fermentation process, known as microbial biotransformation, can structurally alter natural compounds to produce more potent bioactive metabolites.

The study compared the effects of fermented and non-fermented stevia extracts on pancreatic cancer (PANC-1) cells and non-cancerous human embryonic kidney (HEK-293) cells. “Our findings indicate that FSLE (fermented stevia leaf extract) demonstrates significantly greater cytotoxicity than the non-fermented extract at equivalent concentrations,” said corresponding author Masanori Sugiyama, professor at Hiroshima University. Importantly, the fermented extract (FSLE) showed minimal toxicity toward healthy cells.

Further analysis identified chlorogenic acid methyl ester (CAME) as the key compound driving anti-cancer effects. “Our data demonstrate that CAME exhibits stronger toxicity to cells and pro-apoptotic effects which encourage cell death on PANC-1 cells compared to chlorogenic acid alone,” Danshiitsoodol added.

The team plans to investigate these effects in animal models next. “The present study has substantially enhanced our understanding of the mechanism of action of the Lactobacillus plantarum SN13T strain in the fermentation of herbal extracts, while also offering a valuable research perspective on the potential application of probiotics as natural anti-tumor agents,” Danshiitsoodol concluded.

Reference: Rentao Zhang, Narandalai Danshiitsoodol, Masafumi Noda, Sayaka Yonezawa, Keishi Kanno, Masanori Sugiyama. Stevia Leaf Extract Fermented with Plant-Derived Lactobacillus plantarum SN13T Displays Anticancer Activity to Pancreatic Cancer PANC-1 Cell Line. International Journal of Molecular Sciences, 2025; 26 (9): 4186 DOI: 10.3390/ijms26094186

Mass Ivermectin Distribution Significantly Reduces Malaria Transmission: Study Finds

A major international study published in The New England Journal of Medicine has found that administering ivermectin to entire populations can significantly reduce malaria transmission. The BOHEMIA (Broad One Health Endectocide-based Malaria Intervention in Africa) project, the largest clinical trial of its kind, demonstrated a 26% reduction in new malaria infections, offering renewed hope for malaria control in high-burden regions.

Led by the Barcelona Institute for Global Health (ISGlobal) and supported by the “la Caixa” Foundation, in collaboration with the Manhiça Health Research Centre (CISM) and the KEMRI-Wellcome Trust Research Programme, the trial focused on evaluating ivermectin's effectiveness when given as a mass drug administration (MDA). Traditionally used to treat parasitic diseases like onchocerciasis and lymphatic filariasis, ivermectin is now being studied for its ability to kill mosquitoes feeding on treated individuals, thereby disrupting malaria transmission.

The trial that included over 20,000 participants, was conducted in two malaria-endemic regions Kwale County, Kenya, and Mopeia District, Mozambique. Participants received a single monthly dose of ivermectin (400 mcg/kg) for three months during the rainy season. In Kenya, the study involved children aged 5-15, while in Mozambique, it focused on children under five. In Kenya, children receiving ivermectin saw a 26% lower incidence of malaria compared to those given a control drug, albendazole.

“We are thrilled with these results,” said Carlos Chaccour, co-principal investigator of the BOHEMIA project. “Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures.” The drug was well tolerated, with no severe adverse effects reported.

Mozambique’s trial faced setbacks due to Cyclone Gombe and a cholera outbreak, highlighting the importance of community engagement and logistical planning. However, researchers noted additional public health benefits, including reduced skin infestations and bed bugs in ivermectin-treated communities.

These results are under review by the World Health Organization and national authorities, signaling potential for ivermectin to become part of future malaria control programs.

Reference: Carlos Chaccour, Marta Maia, Mercy Kariuki, Paula Ruiz-Castillo, Caroline Wanjiku, Lydia Kasiwa, Aurelia Brazeal, Aina Casellas, Mwanajuma Ngama, Truphena Onyango, Eldo Elobolobo, Karisa Kazungu, Mary Mael, Winnie Wangari, Khadija Nuru, Rachel Otuko, Almudena Sanz, Isaac Ringera, Allan Matano, Starford Mitora, Marta Ribes, Joe Brew, Nika Gorski, Patricia Nicolas, Sara Stanulovic, Isaiah Omondi, Joanna Furnival-Adams, Laura Túnez, Jamal Mbarak, Vegovito Vegove, Esther Yaa, Shadrack Mramba, Yegon Kibet, Naomi Nyambura, Charles Rotich, Scholastica Wanjiru, Musa Vura, Faith Wanjiku, Leslie Sam, Lisa Collins, Kang Xia, Felix Hammann, Francisco Saúte, Matthew Rudd, Cassidy Rist, Caroline Jones, Joseph Mwangangi, N. Regina Rabinovich. Ivermectin to Control Malaria — A Cluster-Randomized Trial. New England Journal of Medicine, 2025; 393 (4): 362 DOI: 10.1056/NEJMoa2411262