Medical Bulletin 21/ April/ 2025 - Video

A University of Iowa-led research team has found that urinary incontinence may be associated with a greater risk for cardiovascular disease in women.

This research is published in the journal Preventive Medicine.

Urinary incontinence — the loss of bladder control — is a common condition, especially in older adults. Previous studies have stated that it can affect between 38% and 60% of women. The researchers aimed to find out whether urinary incontinence was linked to a decline in physical activity, which can lead to a host of health issues, including greater risk for cardiovascular disease.

In the study, the researchers analyzed medical records over two years from more than 20,000 female patients in the Hartford Healthcare system in Connecticut. Of those patients, 5.4% reported through a questionnaire to have urinary incontinence. All patients were asked to rate their level of physical activity in the questionnaire.

The researchers found that the respondents with urinary incontinence did not report engaging in less physical activity than those who did not have the condition. But the team did find an association between patients with urinary incontinence and cardiovascular disease risk factors or events, such as dyslipidemia, type 2 diabetes, and stroke.

“There is an association between incontinence and cardiovascular disease (CVD) risk,” the study authors write. “Women should be screened for incontinence regularly as it may contribute to CVD risk, and women with CVD risk factors should be screened for undiagnosed incontinence.”

Hence, it was concluded that incontinence was not associated with MVPA classification but was associated with inactivity related CVD risk factors and cardiometabolic comorbid conditions. Future studies should investigate potential mechanisms of this association including incontinence severity, activity intensity, and chronic inflammation.

Ref: VanWiel L L, Carr L J et al. Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States. Preventive Medicine; Volume 194, May 2025, 108277. https://doi.org/10.1016/j.ypmed.2025.108277

A study led by researchers in the University of Florida College of Pharmacy has found that a pair of popular glucose-lowering medications may have protective effects against the development of Alzheimer’s disease and related dementias in patients with Type 2 diabetes.

In research is published in JAMA Neurology.

The data showed a statistically significant association between a lower risk of Alzheimer’s and the use of GLP-1RAs and SGLT2is compared with other glucose-lowering medications. According to the researchers, the findings indicated that the two drugs may have neuroprotective effects for people without diabetes and may help slow the rate of cognitive decline in Alzheimer’s patients.

Serena Jingchuan Guo , an assistant professor of pharmaceutical outcomes and policy and the study’s senior author, said these findings may point to new therapeutic uses for drugs commonly used to treat Type 2 diabetes and obesity.

So, to assess the risk of ADRD associated with GLP-1RAs and SGLT2is in people with type 2 diabetes (T2D), this target trial emulation study included 33 858 eligible patients in the GLP-1RA vs other glucose-lowering drug (GLD) cohort, 34 185 in the SGLT2i vs other GLD cohort, and 24 117 in the GLP-1RA vs SGLT2i cohort.

The results showed that in IPTW-weighted cohorts, the incidence rate of ADRD was lower in GLP-1RA initiators compared with other GLD initiators.

SGLT2i initiators had a lower incidence than other GLD initiators. There was no difference between GLP-1RAs and SGLT2is.

Therefore, it was concluded that in people with T2D, both GLP-1RAs and SGLT2is were statistically significantly associated with decreased risk of ADRD compared with other GLDs, and no difference was observed between both drugs.

Ref: Tang H, Donahoo WT, DeKosky ST, et al. GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related Dementias. JAMA Neurol. Published online April 07, 2025. doi:10.1001/jamaneurol.2025.0353

Published in the journal Food Quality and Preference, the research highlights how physiological signals, particularly those transmitted via the vagus nerve, interact with socio-economic factors to shape dietary behaviour.

The study involved 96 students from diverse socio-economic backgrounds who participated in a chocolate tasting session.

In a controlled laboratory setting, each participant was presented with a plate containing 70 milk chocolate pieces and invited to sample and rate them at their leisure. Researchers measured each student's heart rate variability (HRV) as a proxy for the activity of the vagus nerve – a part of the nervous system that regulates appetite and digestion.

The study’s lead author explained: “The findings suggest that while the vagus nerve plays a key role in transmitting signals between the gut and the brain, the extent to which these signals guide eating behaviour can vary with one’s socio-economic status. In contrast, those from lower socio-economic groups appear to show a weaker link between these physiological signals and their food consumption.”

Traditionally, disparities in diet have been attributed to differences in food access and external factors. However, this study shifts the focus towards internal regulatory processes. The data revealed that participants from more advantaged backgrounds consumed more or less chocolate depending on their vagal tone, which can signal both hunger and satiety.

Conversely, in individuals from less advantaged backgrounds, this physiological regulation was not as evident.  While the research focused specifically on chocolate consumption as a model for eating behaviour, the implications may extend to other types of food and dietary patterns. However, future research is needed to explore whether similar patterns are observed across different populations and with other food categories.

Ref: Weick M, Vasiljevic M. Socio-economic status modulates the link between vagal tone and chocolate consumption. Food Quality and Preference; Volume 129, August 2025, 105491. https://doi.org/10.1016/j.foodqual.2025.105491