Publisher Health

A new study at Columbia University has found that shortening sleep by just 90 minutes for six weeks increased insulin resistance in women who are accustomed to getting adequate sleep. The effect was even more pronounced in postmenopausal women.
The recommended amount of sleep for optimal health is between seven and nine hours per night, yet about one-third of Americans get less than the minimum recommended amount.
The findings are the first to show that a mild sleep deficit, maintained for six weeks, causes changes in the body that raise the risk of developing diabetes in women. Previous trials showing the adverse impact on insulin sensitivity included mostly men and focused on the effects of very severe sleep restriction over a short period of time.
Women and sleep
The new study looked at women in particular because studies suggest that poor sleep may have a greater impact on women’s cardiometabolic health than men’s.
“Throughout their lifespan, women face many changes in their sleep habits due to childbearing, child-rearing, and menopause,” says study leader Marie-Pierre St-Onge, PhD, associate professor of nutritional medicine and director of the Center of Excellence for Sleep and Circadian Research at Columbia University Vagelos College of Physicians and Surgeons. “And more women than men have the perception they aren’t getting enough sleep.”
Studying the health impacts of chronic sleep loss is difficult. Some studies, performed in a laboratory setting, have shown that a brief period of total or partial sleep deprivation impairs glucose metabolism. But such studies do not reflect the typical experience of being mildly sleep-deprived, which means getting by on roughly six hours of sleep for long periods of time.

Nearly one in five school-aged children and preteens now take melatonin for sleep, and some parents routinely give the hormone to preschoolers, according to new research from the University of Colorado Boulder published Nov. 13 in JAMA Pediatrics.
This concerns the authors, who note that safety and efficacy data surrounding the products are slim, such dietary supplements lack full regulation by the Food and Drug Administration.
“We hope this paper raises awareness for parents and clinicians, and sounds the alarm for the scientific community,” said lead author Lauren Hartstein, PhD, a postdoctoral fellow in the Sleep and Development Lab at CU Boulder. “We are not saying that melatonin is necessarily harmful to children. But much more research needs to be done before we can state with confidence that it is safe for kids to be taking long-term.”
Calls to poison control centers up
Melatonin is produced naturally in the pineal gland to signal the body that it is time to sleep and regulate its circadian rhythm — the physiological cycle over a 24-hour period.
In many countries, the hormone is classified as a drug and available by prescription only.
In the United States, however, chemically synthesized or animal-derived melatonin is available over the counter as a dietary supplement, and increasingly available in child-friendly gummies.

Adults in their 20s, 30s and 40s are driving the trend. Researchers point to long Covid as a major cause.There are more Americans who say they have serious cognitive problems — with remembering, concentrating or making decisions — than at any time in the last 15 years, data from the Census Bureau shows.The increase started with the pandemic: The number of working-age adults reporting “serious difficulty” thinking has climbed by an estimated one million people.About as many adults ages 18 to 64 now report severe cognitive issues as report trouble walking or taking the stairs, for the first time since the bureau started asking the questions each month in the 2000s.

Dr. Nic Helmstetter crab-walked down a steep, rain-slicked trail into a grove of maple and cottonwood trees to his destination: a dozen tents in a clearing by the Kalamazoo River, surrounded by the detritus of lives perpetually on the move. Discarded red plastic cups. A wet sock flung over a bush. A carpet square. And scattered across the forest floor: orange vial caps and used syringes.Kalamazoo, a small city in Western Michigan, is a way station along the drug trafficking corridor between Chicago and Detroit. In its parks, under railroad overpasses and here in the woods, people ensnared by drugs scramble to survive. Dr. Helmstetter, who makes weekly primary care rounds with a program called Street Medicine Kalamazoo, carried medications to reverse overdoses, blunt cravings and ease withdrawal-induced nausea.But increasingly, the utility of these therapies, developed to address the decades-old opioid crisis, is diminishing. They work to counteract the most devastating effects of fentanyl and heroin, but most users now routinely test positive for other substances too, predominantly stimulants such as cocaine and methamphetamine, for which there are no approved medications.Rachel, 35, her hair dyed a silvery lavender, ran to greet Dr. Helmstetter. She takes the medicine buprenorphine, which acts to dull her body’s yearning for opioids, but she was not ready to let go of meth.“I prefer both, actually,” she said. “I like to be up and down at the same time.”The United States is in a new and perilous period in its battle against illicit drugs. The scourge is not only opioids, such as fentanyl, but a rapidly growing practice that the Centers for Disease Control and Prevention labels “polysubstance use.”Over the last three years, studies of people addicted to opioids (a population estimated to be in the millions) have consistently shown that between 70 and 80 percent also take other illicit substances, a shift that is stymieing treatment efforts and confounding state, local and federal policies.“It’s no longer an opioid epidemic,” said Dr. Cara Poland, an associate professor at the Michigan State University College of Human Medicine. “This is an addiction crisis.”Dr. Amarpal Dhaliwal, kneeling, a resident in family medicine, treats patients while on rotation with Street Medicine Kalamazoo.Dr. Nic Helmstetter, who makes weekly primary care rounds with Street Medicine Kalamazoo, brings addiction treatment supplies to patients living in the woods.The non-opioid drugs include those relatively new to the street, like the animal tranquilizer xylazine, which can char human flesh, anti-anxiety medications like Valium and Klonopin and older recreational stimulants like cocaine and meth. Dealers sell these drugs, plus counterfeit Percocet and Xanax pills, often mixed with fentanyl.The incursion of meth has been particularly problematic. Not only is there is no approved medical treatment for meth addiction, but meth can also undercut the effectiveness of opioid addiction therapies. Meth explodes the pleasure receptors, but also induces paranoia and hallucinations, works like a slow acid on teeth and heart valves and can inflict long-lasting brain changes.The Biden administration has been pouring billions into opioid interventions and policing traffickers, but has otherwise lagged in keeping pace with the evolution of drug use. There has been comparatively little discussion about meth and cocaine, despite the fact that during the 12-month period ending in May 2023, over 34,000 deaths were attributed to methamphetamine and 28,000 to cocaine, according to provisional federal data.Just last month, the Food and Drug Administration issued draft guidelines for the development of therapies for stimulant-use disorders “critically needed to address treatment gaps.”In the Street Medicine van up the road from the tents, Dr. Sravani Alluri, the program’s director and a family medicine physician, gave Rachel an injection of antipsychotic medicine and then sorted through lab results showing the chilling omnipresence of numerous substances.Patient No. 1: positive for fentanyl, methamphetamine and xylazine.Patient No. 2: positive for amphetamine, methamphetamine, cocaine, THC and gabapentin, a prescription painkiller whose misuse is on the rise.Patient No. 3: positive for fentanyl, methamphetamine, THC and xylazine.The spread of super methDr. Sarah Darweesh, left, and other members of the Street Medicine team, treating a patient.“Treating someone for opiates is relatively easy,” said Dr. Paul Trowbridge, the addiction medicine specialist at the Trinity Health Recovery Medicine clinic in Grand Rapids, an hour north of Kalamazoo. That’s largely because of buprenorphine and methadone, federally approved medications with years of evidence attesting to their effectiveness in subduing opioid cravings, and Narcan, an over-the-counter nasal spray that reverses opioid overdoses.But meth, he said, “is a monster.”His patients typically have either Medicaid or private health insurance and a roof over their heads, even if it’s a shelter. Many have steady jobs — dental hygienists, construction workers, tech sales people.Still, the challenges of helping them are daunting.Their use of multiple drugs is not always voluntary. Dealers can be sloppy, Dr. Trowbridge said, or intentionally salt one drug with another, to bind customers to the new mix.“It’s really unpredictable what people are buying, which makes it so dangerous for them,” he said. “It’s a killing field out there.”Some opioid users seek the fireworks of meth and other stimulants to offset the warm, sleepy embrace of opioids. Some use meth to stay awake to ward off thieves and rapists.Kalamazoo Harm Reduction distributes sterile equipment to help people use drugs safely, including needles, ties, cotton balls and cookers.Dropping used needles into a safe container brought by Kalamazoo Harm Reduction.Medications like methadone can safely replace more destructive opioids and satiate the brain’s opioid receptors. But subduing the urge for stimulants, which set off the release of stratospheric levels of the brain chemicals dopamine and serotonin, is more complex, involving many unknowns. And Narcan, which has saved at least hundreds of thousands who overdosed on opioids, has no effect on stimulants.Moreover, depending on whether the user routinely turns to cocaine, meth or prescription amphetamine, side effects, responses and behavior patterns vary greatly.“The truth is, we really don’t have a good answer at this point as to why it’s so challenging to develop these treatments,” said Marta Sokolowska, the deputy director for substance use and behavioral health at the F.D.A.’s Center for Drug Evaluation and Research.Last year, according to preliminary federal data, stimulants were present in 42 percent of overdose deaths that involved opioids.Like opioids, which originally came from the poppy, meth started out as a plant-based product, derived from the herb ephedra. Now, both drugs can be produced in bulk synthetically and cheaply. They each pack a potentially lethal, addictive wallop far stronger than their precursors.In recent decades, opioids grew so dominant that meth and its stimulant cousins proliferated in the shadows.A decade or so ago, Mexican drug lords figured out how to mass-produce a synthetic “super meth.” It has provoked what some researchers are calling a second meth epidemic.Popular up and down the West Coast, super meth from Mexican and American labs has been marching East and South and into parts of the Midwest, including Grand Rapids and Kalamazoo. Dr. Darweesh, checking on a patient at the campsite.Members of Street Medicine Kalamazoo packed up their mobile medical unit after a visit to the river camp.Users inject, snort or ingest meth, often seeking to prolong its euphoria with binges that can last for days. Meth can also trigger violence and psychosis that emergency doctors can mistake for schizophrenia. Its long-term effects include anhedonia and memory loss.To help patients cut back on meth, some doctors prescribe Adderall, a drug for attention deficit hyperactivity disorder that is also a stimulant. But that avenue is narrowing, because of the drug’s nationwide shortage.People addicted to multiple substances are far more resistant to going into treatment than single-substance users, addiction medicine experts say.Dr. Trowbridge said some opioid patients can become stable enough to progress to monthly injectable buprenorphine. But if they are also using meth, that treatment plan often collapses.The paranoia and hallucinations caused by meth disorient them, he said. One patient threw himself in a river to escape nonexistent people who were chasing him. Others insisted that dumpsters were talking to them, that color-coded cars were sending them messages.So they skip appointments, returning only “when they start to hit withdrawal and realize their opioid injection is wearing off,” he said.At the clinic that day, at least four patients were no-shows.“We’re just trying to not have them have a heroin habit,” Dr. Trowbridge said. “But then they’re off on a meth run.”Meth, opioids and pregnancyDr. Cara Poland, right, runs the Great Moms clinic in Grand Rapids. Desiree,left, is in recovery and pregnant with her first child, accompanied by her partner, Dan.Sami, 30, who is addicted to meth and heroin, is pregnant with her third child, due in December.This is her second pregnancy with the Great Moms clinic, a Grand Rapids program through Corewell Health that supports pregnant women who struggle with drug use. Citing privacy concerns in not sharing her full name, Sami, who has long, dark hair and a life-hardened jawline, had been fastidious about keeping her appointments. She is trying to get it right this time.Three years ago, the clinic prescribed buprenorphine to help Sami contain heroin urges during her second pregnancy.But options for meth, especially for a pregnant patient, are almost nil. Dr. Cara Poland, the clinic’s addiction medicine specialist, could rely only on gentle persuasion wrapped around an unflinching truth: that meth use during pregnancy increases the risk of having a smaller baby and of the placenta separating from the uterus, threatening the life of both mother and fetus.Back then, Sami was living in a shelter, hungry for meth. She loved being a mom. Having to share custody of her first child with her ex was painful enough, but she knew she was in no shape to care for this second baby. Grieving, she placed the infant girl for adoption.“It still eats at me,” she said.Like many patients who use multiple substances, Sami has mental disabilities, including attention deficit disorder and bipolar disorder. According to federal data, more than one in four adults with serious mental disorders turns to illicit drugs. A.D.H.D. that has been poorly managed or undiagnosed is particularly common in meth patients.“It’s almost more notable if they don’t have a disorder,” Dr. Poland said. “But sometimes the substance use itself results in mental illness — we call those ‘substance-induced depression’ or ‘substance-induced anxiety.’”Each new mother in the Great Moms clinic receives a backpack of supplies prepared by Dr. Poland and her staff, including handmade baby blankets.Dr. Poland at a check-up appointment with Colleen, who is in recovery and gave birth to a daughter this summer.Other risk factors include a history of trauma, a genetic predisposition to addiction or a childhood among relatives dependent on alcohol or drugs. At 3, Sami, who grew up in a one-stoplight town, was in a car accident that left her mother permanently institutionalized with a brain injury. Her father drank heavily, she says; Sami’s descent into addiction began in adolescence with alcohol.Three years ago, feeling overcome with guilt and shame after placing her daughter for adoption, she slid back into numbing her pain with heroin. And whenever her bipolar disorder medications weren’t balanced and she was feeling depressed, she reached for meth.By last April, she had enough. “I was in a really, really nasty relationship and my mental health was bad,” she said. “I was so stuck in addiction. I needed help.” During screening for detox and rehab, she discovered she was again pregnant.She now lives in an apartment that a Grand Rapids nonprofit helped her find, and works as a hotel receptionist. She wants to take this baby home so badly. That goal has helped her avoid meth.“I won’t even talk to anybody that’s been using,” she said. “I’ve been really diligent, even if that means being lonely sometimes.”Offering sterile syringes and clean pipesThe Kalamazoo Harm Reduction red wagon on its way to an encampment. Twice a week, workers from Kalamazoo Harm Reduction lug a red wagon along rutted trails to the wooded encampments. Pausing to pick up discarded syringes along the paths, they travel from tent to tent, offering free, sterile drug equipment.They are part of the growing “harm reduction” movement that aims to save lives by preventing overdoses and serious infections.But the prevalence of so many different drugs has complicated their efforts. The wagon typically holds:— Packages of 10 short needles, for people still able to hit a fresh vein. Packs of 10 long ones, for those who have to dig around. (Better to use new needles than share used ones.)— Sterile water for diluting injectable drugs. (Safer than water from the river or a public toilet.)— Bubbles, the glass stem pipes with bowls for smoking meth. (Better to smoke from your own pipe than take hits from the pipe of someone with cracked, bleeding lips.)A new bubble, the glass pipe used for smoking meth.A used fentanyl test strip on the camp ground. The Street Medicine doctors and harm reduction workers regularly encounter people who swear their meth use is under control but could maybe use help dialing back the fentanyl. And unapologetic meth users, who insist their supply couldn’t possibly contain fentanyl.“Finding that moment when someone says they’re ready for treatment is hard in all addiction, but meth is making this so much harder,” said Luca, a harm reduction worker who asked to be identified by only a first name because clients are often evading law enforcement. “We had a client who kept missing us on our Monday visits and he finally said, ‘I haven’t known what day it was in so long.’”So Luca suggested: Maybe after being awake on a four-day meth binge, try a 30-minute nap? “Or we can get you a watch? So while you’re out living your life, you can look down and sort of keep track of where the rest of the world is — and when to meet up with us?”It is so hard to beat back a beast that is always growing new tentacles. In Western Michigan, as the nights lengthen and temperatures drop, it is becoming harder still, both for people living outdoors, addicted to so many drugs, and those who minister to them.Soon, the red wagon won’t be able to budge on snow-covered trails. On those days, the Kalamazoo Harm Reduction workers will instead load their safe supplies onto sleds, and set out for the woods.

The trial involved only 10 patients, but it suggests cholesterol can be permanently reduced with a single treatment for patients at risk of heart disease.The handful of patients had severe heart disease that had caused chest pain and heart attacks. After trying available cholesterol-lowering medications, they could not get their cholesterol as low as cardiologists recommended.So they volunteered for an experimental cholesterol-lowering treatment using gene editing that was unlike anything tried in patients before.The result, reported Sunday by the company Verve Therapeutics of Boston at a meeting of the American Heart Association, showed that the treatment appeared to reduce cholesterol levels markedly in patients and that it appeared to be safe.The trial involved only 10 patients, with an average age of 54. Each had a genetic abnormality, familial hypercholesterolemia, that affects around one million people in the United States. But the findings could also point the way for millions of other patients around the world who are contending with heart disease, which remains a leading cause of death. In the United States alone, more than 800,000 people have heart attacks each year.And while more trials in a broader range of patients will need to be carried out, gene editing experts and cardiologists said the treatment had the potential to transform preventive cardiology.“Even for seasoned veterans of this field like myself, this is a day we will look back on,” said Fyodor D. Urnov, a gene editor at the Innovative Genomics Institute in Berkeley, Calif.. “I see today as crossing a Rubicon, in a good way. This is not a small step. It is a leap into new territory.”Impressed with the data and the potential it shows, the pharmaceutical giant Eli Lilly paid $60 million to to collaborate with Verve Therapeutics and opted to acquire additional rights to Verve’s programs for an additional $250 million. If the editing continues to look promising, Eli Lilly expects to help with larger studies.“Until now, we thought of gene editing as a treatment we should reserve for very rare diseases where there is no other treatment,” said Dr. Daniel Skovronsky, Eli Lilly’s chief scientific and medical officer. “But if we can make gene editing safe and widely available, why not go after a more common disease?”The new study was led by Dr. Sekar Kathiresan, chief executive of Verve. Patients received a single infusion of microscopic lipid nanoparticles containing within them a molecular factory to edit a single gene in the liver, the site of cholesterol synthesis. The gene, PCSK9, raises levels of LDL cholesterol, the bad kind. The plan was to block it.The little lipid spheres were carried through the blood directly to the liver. They entered liver cells and opened up, revealing two molecules. One instructs DNA to make a gene editing tool, and the other is a guide to take the editing tool to the gene that needs editing.The treatment “is almost like science fiction,” said Dr. Martha Gulati, director of preventive cardiology at the Smidt Heart Institute of Cedars-Sinai Medical Center in Los Angeles and president of the American Society for Preventive Cardiology, who was not involved in the trial.The gene editing tool acts like a pencil and an eraser. The eraser wipes out one letter of the target gene, and the pencil writes in a new one, turning off PCSK9.The goal: a single cholesterol-lowering treatment that results in lifelong protection from heart disease.Patients received varying doses. LDL levels in the three who received the highest doses fell by 39 to 55 percent — enough to get them toward their cholesterol goal.In the small study, those who received the higher doses had flulike symptoms for a few hours. Two patients had serious adverse events that the study’s independent data safety and monitoring board deemed a result of their underlying severe heart disease. The board advised the researchers not to stop the study.One had a fatal cardiac arrest five weeks after receiving the infusion. An autopsy showed that several of his coronary arteries were blocked.The other patient had a heart attack the day after the infusion. It turned out that he had been having chest pain before receiving the infusion but had not reported it. If the investigators had known, he would not have received the treatment.In a way, the treatment is a culmination of studies that began a decade ago when researchers discovered rare but healthy individuals with cholesterol levels that seemed impossibly low. The reason was that their PCSK9 gene was mutated and no longer functioned. As a result, these people were protected from heart disease.That led to the development of antibodies to block the gene. Patients inject themselves with the antibodies once a week. Then came a twice-yearly RNA injection that prevents PCSK9 from being made.It seemed possible that those treatments, as well as statins for those whose cholesterol is more easily controlled, could help solve the heart disease problem.But heart disease persists as a killer. Even after people are diagnosed with heart disease, less than 60 percent of all patients take a statin. Only a quarter take one of the more effective, high-intensity statins, Dr. Gulati said.“Patients take it initially, and then they forget or decide they don’t need it,” she explained. “That happens more than you’d think.”Dr. Michelle O’Donoghue, a cardiologist at Brigham and Women’s Hospital, said that because patients so often do not take their pills or injections, “there is a lot of interest, through gene editing, of a one and done — a single treatment and a lifetime response.”Family history was the inspiration for Dr. Kathiresan at Verve Therapeutics. His uncle and grandmother died of heart attacks. His father had a heart attack at age 54. And then, on Sept. 12, 2012, his 42-year-old brother, Senthil, returned from a run dizzy and sweaty. He was having a heart attack. He died nine days later.At that moment, Dr. Kathiresan said, he vowed to find a way to prevent what had happened to his brother from happening to anyone else.Of course, even if gene editing works, applying it to young people with heart risk is well into the future. But, Dr. Gulati said, early gene editing of younger patients with genetically high cholesterol levels might prevent arteries from hardening.“It could be an incredible medicine,” she said.All this depends on success and safety of the gene editing and on its effects lasting. The first patient was treated just six months ago. But a previous study in monkeys lasted two and a half years, and the results of the gene editing persisted.Dr. Urnov, who said he has a genetic risk for heart disease, is optimistic for himself and his 6-year-old daughter.“I honestly cannot wait for this medicine to become available for heart disease prevention,” he said. “I love the idea of having gene editing as a vaccine for the prevention of heart disease.”

As an incubator of life, Earth has a lot going for it, something we often fail to appreciate fully from within its nurturing bounds. Merely sending probes and rovers to the moon and Mars won’t do. For various reasons — adventure! apocalypse! commerce! — we insist upon taking our corporeal selves off-world too. Multiple private companies have announced plans to put hotels in space soon. NASA is aiming to 3-D-print lunar neighborhoods within a couple of decades. And while it will probably take longer than that to build and populate an outpost on Mars, preparations are being made: This summer, four NASA crew members began a 378-day stay in simulated Martian housing at the Johnson Space Center in Houston.Listen to This ArticleOpen this article in the New York Times Audio app on iOS.When you look at the renderings of these cozy dwellings, it’s easy to lose sight of how hostile space is to Earthlings. As a reminder, consider what would happen if you found yourself in low Earth orbit or on Mars or the moon without a spacesuit on. You would pass out from a lack of oxygen within a matter of seconds, a condition known as hypoxia, and die soon thereafter. In the brief meantime, all the gases inside your body, including any air still in your lungs, would expand in the absence of external pressure. Depressurization would also cause your internal fluids to bubble. Not because they’re heating up, but because they are transmogrifying into their gaseous state. The temperature wouldn’t be much of a problem, at least, even though thermometers in low Earth orbit produce readings from minus 85 degrees to 257 degrees Fahrenheit, depending on whether they are in shadow or in light. Space, as a near vacuum, has very little mass to conduct heat to or away from you, so you are not likely to feel instantly hot or cold.While hypoxia is potentially a real threat should your space vessel or extraterrestrial habitat leak, it’s a manageable one (assuming you haven’t leaped naked out of your space capsule or off-world dwelling). But two other major challenges confront our fragile bodies when we leave our planet, neither of which has been entirely solved yet, even indoors: variable gravity and radiation.Gravity is determined by the mass of objects and their distance from one another. Because Earth is so big, it is impossible, while on it, to escape its gravity for any serious length of time. As a result, we don’t know very much about what our lives would be like without — or under some diminished influence of — this omnipresent attraction. On the moon and on Mars, which are smaller than our world, the gravitational tug will be much less: a sixth and a third, respectively, of what it is here.Conversely, radiation exposure intensifies with elevation, because there’s less atmosphere above you to block it. And you incur a much larger dose if you get beyond the protective bubble of Earth’s ozone and magnetosphere, the magnetic field that stretches roughly 40,000 miles out at its most compressed point. The solar and galactic radiation that washes over Mars, which at its closest is 34 million miles away, will potentially be 700 times as great as what passes through our magnetic defenses. Space travelers beyond low Earth orbit will also be bombarded with high-energy atomic nuclei from exploding stars throughout the galaxy, which are normally deflected by the magnetosphere from reaching the surface of our planet; those particles are so heavy and moving so fast that they penetrate spaceships, spacesuits and skin, banging into other particles in their path and damaging any attendant cells in ways researchers are only beginning to understand.Illustrations by Max GutherSo far, most of what we know about the effects on the human body of these threats comes from astronauts in low Earth orbit, and because safety is a paramount concern, we don’t send many of them up there, and we don’t let them stay for long when we do. Six months is the average length of a visit to the International Space Station, and fewer than 300 people have made the 250-mile voyage. While that collective experience is enough to have taught us how the body responds when gravity’s pull is substantially reduced, the magnetosphere still shields the I.S.S., and only the 24 astronauts who flew in the Apollo program have gone beyond it. (The moon orbits an average of more than 238,000 miles away.) Though these two dozen astronauts spent little more than a week at a time without its protection, they have died of cardiovascular disease at a rate four to five times as high as that of their counterparts who stayed in low Earth orbit or never entered orbit at all, which suggests that exposure to cosmic radiation might have damaged their arteries, veins and capillaries.We can’t send people to Mars, or to live on the moon, until we can be reasonably confident that they’ll survive getting and residing there. But the space-based medical science needed to make that possible has been hindered by small sample sizes that aren’t representative of the general population. (All of the Apollo astronauts were white men born between 1928 and 1936.) Space tourism, though, promises to offer opportunities to study the effects of radiation and low gravity on a much broader demographic than “really well-selected superpeople,” as Dorit Donoviel, the director of the Translational Research Institute for Space Health (TRISH) at the Baylor College of Medicine, describes those who have historically qualified to leave the planet. “Old, young, pre-existing health conditions — we are starting to gather a knowledge base that in the future will be essential even for NASA,” Donoviel told me, “because we have to learn about the edge cases to really understand what is going on in our bodies to adapt to a hostile environment. You don’t learn as much from people who are healthy. It’s when people get sick that you understand how people get sick and how to prevent it.”Epidemiologists face the same predicament on Earth: Before they can figure out how to protect the population, they must wait for harm to come to enough people to expose the causes. As less-rigorous medical screening allows more tourists to reach space, the chances increase significantly that someone will get hurt or have a health emergency there. Aerospace medicine is one of three specialties certified by the American Board of Preventive Medicine, because surgeons for a given flight tend to be stuck on the ground; they have to optimize the health of their patients and ward off potential disasters before departure. The problem is, they can’t know what those disasters will be until they occur. Which means that, as with every expedition into the unknown, at some point some intrepid or desperate souls are just going to have to blast off and see what happens.Scientists once predicted that we couldn’t live in the absence of Earth’s gravity. Without this still-barely-understood force pulling us downward, how would we swallow? Wouldn’t our tongues loll back into our throats? Wouldn’t we choke on our own saliva? And if we survived those perils, wouldn’t escalating pressure in our skulls kill us after a week or so? But when Yuri Gagarin returned from his single, 108-minute orbit around our world in 1961, humanity’s first trip beyond the mesosphere, he proved that our internal musculature could maintain our vital functions in conditions of weightlessness. He ate and drank up there without difficulty. Technically, he hadn’t escaped Earth’s influence; to orbit is to free-fall toward the ground without ever hitting it, and he was in a condition known as microgravity. This felt, he reported, “like hanging horizontally on belts, as if in a suspended state,” a circumstance passingly familiar to anyone who has been on a roller coaster or jumped off a diving board. Gagarin said he got used to it. “There were no bad sensations,” he added. Either Gagarin was fibbing, or he had a strong stomach. Initially, many space travelers puke, or at least feel motion-sick — space-adaptation syndrome, or S.A.S., is what such nausea, headache and vomiting are called outside our atmosphere. “It’s the same as sitting in the back of the car in childhood, reading something with your head down,” says Jan Stepanek, director of the aerospace-medicine program at the Mayo Clinic in Scottsdale, Ariz. “It’s a mismatch of what the eyes are seeing and what the inner ear is telling you.” Only in this case, that mismatched perception is a result of the organs and hairs of the vestibular system floating free without their usual gravitational signals. You acclimate eventually. In fact, researchers only learned about the prevalence of S.A.S. symptoms in the 1970s, when they heard Skylab astronauts talking about it with one another over a hot mic. Astronauts, it turns out, are not ideal subjects for medical study, because they are notoriously stoic and unforthcoming about any symptom that might ground them.On Earth, your body maintains your blood pressure such that enough oxygen reaches your organs and waste is ferried away. One of the biggest oxygen users — your brain — is positioned above your heart for much of the time you are awake. But microgravity suddenly stops pulling blood downward into your legs, just as lying down or getting into a pool does, except more so. That lets blood collect in the upper body, triggering pressure sensors in your heart and the carotid vessels of your neck, which then send hormonal instructions to urinate more and decrease blood production. (This is why you often feel the need to pee shortly after climbing into bed or sinking into a body of water.) On our planet, that’s usually enough to reduce your blood pressure and rebalance the system. In microgravity, however, the blood volume above your neck will most likely still be too high, at least for a while. This can affect the eyes and optic nerves, sometimes causing permanent vision problems for astronauts who stay in space for months, a condition called spaceflight-associated neuro-ocular syndrome. It also causes fluid to accumulate in nearby tissues, giving you a puffy face and congested sinuses. As with a bad cold, the process inhibits nerve endings in the nasal passages, meaning you can’t smell or taste very well. (The nose plays an important role in taste.) The I.S.S. galley is often stocked with wasabi and hot sauce. These sensory deficits can be helpful in some respects, though, because the I.S.S. tends to smell like body odor or farts. You can’t shower, and microgravity prevents digestive gases from rising out of the stew of other juices in your stomach and intestines, making it hard to belch without barfing. Because the gas must exit somehow, the frequency and volume (metric and decibel) of flatulence increases. Other metabolic processes are similarly disturbed. Urine adheres to the bladder wall rather than collecting at the base, where the growing pressure of liquid above the urethra usually alerts us when the organ is two-thirds full. “Thus, the bladder may reach maximum capacity before an urge is felt, at which point urination may happen suddenly and spontaneously,” according to “A Review of Challenges & Opportunities: Variable and Partial Gravity for Human Habitats in L.E.O.,” or low Earth orbit. This is a report that came out last year from the authors Ronke Olabisi, an associate professor of biomedical engineering at the University of California, Irvine, and Mae Jemison, a retired NASA astronaut. Sometimes the bladder fills but doesn’t empty, and astronauts need to catheterize themselves. The longer astronauts stay in microgravity, the more they change. Because they don’t need to support any weight, bones and muscles begin to atrophy — much faster than they do in advanced age on Earth. Bone density in the hips and spine can decrease by 1 to 2 percent per month in space, compared with 0.5 to 1 percent per year in elderly Earthlings. The calcium that leaches from the bones is expelled in urine, increasing the risk of kidney stones. Muscle mass ebbs, too: Astronauts must exercise vigorously for more than two hours a day to keep in decent shape. (They also must constantly dab their skin with a towel while doing so, to prevent their sweat from beading and floating into colleagues or equipment.) The discs between their spinal vertebrae spread farther apart — astronauts grow taller, but their lower backs hurt. The body’s sensors that on Earth raise our blood pressure when we stand up from lying down, so that we don’t faint, grow lazy with disuse. This degeneration, along with reduced muscle mass, is why astronauts must be carried from their capsules when they return to terra firma after a long mission.The body recalibrates to normal. But protracted stays in microgravity (the current record, 437 days, was set by the Russian astronaut Valeri Polyakov in 1995) make for painful recoveries. After 340 days in space, Scott Kelly, a NASA veteran of three previous shorter missions, described the period immediately following his return as “much, much worse” than those of earlier trips: “All of my joints and all of my muscles are protesting the crushing pressure of gravity,” he wrote in his 2017 memoir, “Endurance.” (Legend has it that Polyakov, for his part, strolled out of his capsule unfazed, bummed a cigarette from a friend and started smoking.) Of course, “recovery” in this case — in every case, so far — means reacclimating to Earth’s pull. But what if you never come back and, instead, stay in orbit or on the moon or Mars for the rest of your life?If you spin a bucket of water around your head fast enough, the water doesn’t spill out. The same physics underpin most plans for creating what is colloquially referred to as artificial gravity. In those scenarios, the space travelers are the water. The tricky part is that the speed at which you spin them must be faster the closer they get to the axis. In other words, you can have either a gigantic spacecraft that rotates slowly or a small one that rotates rapidly. Engineering and transporting such an apparatus into low Earth orbit has so far not been a major priority for government agencies. It’s much easier and cheaper to give astronauts tools to manage their weightlessness. But just because NASA hasn’t used spinning vessels to simulate gravity doesn’t mean it’s not possible, says Rhonda Stevenson, the chief executive of Above Space. Once it raises the necessary funding, her company plans to put a small luxury hotel into orbit within five years and have a larger facility operational within another 10 years. In renderings, these establishments look like giant gears with rooms in their cogs. “Folks don’t realize where we are right now and how technologically advanced we are today,” she told me.Stevenson’s priorities, like those of other space-tourism operators, are oriented toward fun and comfort, not forbearance and science. Astronauts never complain, but paying guests love an excuse to leave a one-star review. (Especially when they’ll be shelling out millions for a weekend stay.) In other words, there must be amenities and flush toilets (a contraption whose evolution was also guided by gravity). “Nobody wants to go up there and be lonely and eat algae paste and crickets,” Stevenson says. “That just doesn’t sound like a good time.”Illustration by Max GutherEventually such wealthy vacationers will want somewhere to go — a space mall, a mini-golf course — and they’ll want cosmopolitan cuisine. Stevenson and others predict that commercial parks, factories and farms will all be built in space to meet their demands. The hospitality industry is not the only one with space aspirations. Chemistry and drug discovery might thrive there: Crystals, like those used in pharmaceuticals, grow bigger and more symmetrically in microgravity. There are ambitions to mine the moon for rare metals. Solar-energy production could flourish in the absence of weather. And astrobotany, which will be needed to supply space settlements with fresh food, could eventually grow crops and send them back to Earth. In one experiment, wheat plants grew 10 percent taller in microgravity.When that day comes, whether you’re in space working or vacationing, tuning your gravity could become part of your 9-to-5, like adjusting your thermostat. You might spend your workday in microgravity. Then you might go for a jog or just rest in 1 g. Maybe as you age and your joints start aching, you move to rooms in 0.75 g, where gravity is tempered just enough to put the spring back in your step. Senior living — in space!Even if gravity doesn’t prove quite so easy to supply as envisioned, weightlessness would mostly be just an inconvenience for the few hours it takes to get into low Earth orbit or the few days’ flight to the moon. But getting to Mars or back again will, at least at first, most likely require living in microgravity for more than a year. This raises physical concerns: Will those astronauts be able to stand up when they arrive? If they can stand, will they pass out? If they pass out, will they break a bone? And if they break a bone, will it heal as it would on Earth? Researchers understand even less about astronauts’ neurological states and whether cognition is affected by the pressure that fluids shifting headward put on the brain. “Few of the NASA astronauts want to volunteer to stick a needle in their brain or eye to measure pressure while in space,” Donoviel says. “It’s a risk. And they are afraid we might find something that might prevent them for medical reasons from being able to fly. We’ve had this experiment on the books for years.”Researchers are hoping that commercial-spaceflight passengers will be more amenable to volunteering for experiments, like having a new kind of pressure transducer surgically implanted inside their skull in the months before takeoff. If the device works as expected, it will answer longstanding questions about the impacts of microgravity inside the cranium. And it might also lead to insights that could help parents and doctors treat babies with hydrocephalus, a neurological disorder caused by a buildup of cerebrospinal fluid in ventricles deep within the brain.Scott Kelly’s mission on the I.S.S., nearly a year long, was designed to learn what might happen to astronauts during a flight to Mars. It took advantage of a unique scientific opportunity: Kelly has an identical twin brother, Mark Kelly, a retired astronaut and now a senator from Arizona. While Scott Kelly went to space, a genetic replica of him (or close to it) stayed behind; when he returned, researchers compared the two men at a molecular level to see what had changed in Scott but not in Mark. Soon we might be able to do this kind of experiment by using stem cells from an astronaut’s blood to grow mini-organs that can be exposed to high levels of radiation or microgravity in space, which should show how the astronaut’s actual organs would react to off-world living. “Our thinking was, in the future, each astronaut could give us a few milliliters of blood, and we could make a platform for each individual,” Gordana Vunjak-Novakovic, a professor of biomedical engineering and medical sciences at Columbia University, told me.Space appeared to remodel Scott Kelly in subtle but perhaps significant ways. He incurred a small amount of DNA damage, believed to be caused by radiation exposure. (Astronauts’ radiation doses are tracked over their lifetime; if these become too high, they can no longer go to space.) He also experienced epigenetic changes, modifications in how genes are expressed that can be heritable, a feature that helps humans and other creatures preserve useful adaptations without waiting for evolution to do its brutal work. Those alterations, which reverted nearly to their baseline state after Kelly’s return, gave scientists a sense of what genes might be most impacted by lengthier stays in space. One of the most puzzling changes researchers observed was in his gut microbiome, as the community of bacteria, fungi and viruses that live in the digestive tract is known. The species of bacteria were the same, but their proportions in relation to one another had shifted considerably, probably in part because the food Kelly ate was quite different. Such rearrangements among the micro-organisms could be a cause for concern, because they are involved in digestion, metabolism and immunity, and changes to their composition have been associated with neurological and physiological conditions. Reduced immunity could be especially dangerous in space, where microgravity also appears to cause bacterial cell membranes to thicken and make bacteria more resistant to antibiotics and more likely to cause severe disease.There will, of course, be surprises out there, some of them sure to be quite unpleasant. Jan Stepanek at the Mayo Clinic points out that scientists once thought blood clots were very unlikely to occur in the absence of Earth’s gravity. But then one appeared. In fact, in a 2019 study, an international group of researchers reported that the blood flow in the jugular veins of six of 11 I.S.S. crew members they monitored had, by around Day 50 in space, either stagnated or reversed direction — and one of the six had a potentially fatal thrombosis with no symptoms. Luckily, physicians had already stocked the I.S.S. with a 40-day emergency supply of anticoagulants, among other medications, just in case. Space-medicine experts are adept at imagining dire scenarios. “What if somebody develops appendicitis?” says Natacha Chough, an emergency medical physician and professor of aerospace medicine at the University of Texas Medical Branch. “If we go to Mars, you can’t pull a U-turn. Do you send a surgeon? What if they are the one who gets appendicitis?” She and other flight surgeons are mindful of the case of a 27-year-old Soviet doctor, Leonid Rogozov, who in 1961 had to give himself an appendectomy at a base that he and a team of 11 others built in Antarctica. He did it by feel, after finding the inverted images in a mirror disorienting. Within two hours, he had removed the infected organ and sutured himself up (a helpful colleague snapped photographs for posterity). U.T.M.B. often sends trainees in aerospace medicine to practice at a research station in Antarctica — an environment in which doctors may be called upon to perform medical procedures they haven’t performed in many years, with limited supplies. Ronak Shah, director of aerospace medicine at U.T.M.B., puts the quandary this way: “Do you have the tools and support staff to complete those procedures?” Then, referring to the doctor on the original “Star Trek,” he adds, “People often envision that surgical suite that Dr. McCoy had.” In reality, it could cost $10,000 or more per pound to put a payload into orbit, and anything that goes on the spacecraft must earn its place at the expense of something else. There’s a defibrillator and a portable ultrasound on the I.S.S., but no CT scanner or M.R.I. machine.Major surgery could result in the patient’s insides floating out. Even giving injections in space requires comprehensive planning. Rogozov could at least give himself Novocain. Chough was the flight surgeon for NASA astronauts on the I.S.S. when the coronavirus vaccine became available, and she had to decide whether to send it up on a routine resupply flight. The decision involved weighing the protection of the astronauts when they landed on Earth, conceivably with compromised immunity, versus considerations about how to get liquid into a syringe, how any side effects could make astronauts incapable of performing their duties, how to keep the vaccine cold enough and how to dose it without wasting any — an ethical conundrum in the days when there was not enough to go around on Earth. Ultimately, Chough decided they would have to wait until their return.Illustrations by Max GutherIt’s a truism of our species that the moment we encounter a new and challenging environment — a mountaintop, say, or an airplane bathroom — we feel compelled to find out what will happen if we engage in coitus there. Naturally, then, as soon as the first billionaires check into the first space hotels, they will be thinking about becoming the inaugural members of the 250-Mile-High Club. This raises the issue: There really aren’t rules for medical experimentation in space that cover tourists’ behavior. “If someone wants to have sex in space or have a baby in space, there’s no framework to provide guidelines,” Dorit Donoviel says. “We need to make sure commercial spaceflight provides opportunity for good science. The last thing we want to do is have it turn into the Wild West and do stupid things that could get people hurt or create bad press and turn people against space travel. That damages the whole industry.” So should space travelers choose abstinence until a formal entity declares space sex safe? Is it possible that this threshold has already been breached? Fewer than 700 people have flown to space so far, and it is often easy to identify who they are in research publications, which can make them reticent about details that might satisfy behaviorists. In short, says Simon Dubé, a postdoctoral research fellow at the Kinsey Institute at Indiana University, “we know very little about the intimacy and sexuality of astronauts.” But we do know some basics. “There are good indications that erection and lubrication are not inhibited in space,” Dubé says. And it appears that microgravity doesn’t subject contraceptives to additional side effects. ‘If we take Earth with us, are we going to stall evolution?’There are concerns about reproduction, however, that will have to be addressed if our species is ever to take up permanent residence somewhere else besides Earth. For the most part, scientists have studied aspects of procreation in space only in animals, including fruit flies, frogs, newts, geckos, aquatic crustaceans, quails, rats, mice and, intriguingly, rams. While producing and developing healthy embryos in space can be done, it clearly comes with considerable risks. Radiation exposure damages DNA and can cause infertility and sterility in adults, for example. Exposed embryos and fetuses appear more likely to have growth and cognitive delays, birth defects and higher rates of newborn mortality.Dubé is worried most of all about the psychological effects of intercourse (or a lack thereof) in space. “What I want to draw people’s attention to is that we are going to try to enact sexuality in all its complexity in a very small, remote, isolated, very small space, with limited partners who are people you work with and depend on.” Historically, in analogous situations, like military basic training, this has proved disastrous, mostly for women. “I’m much more worried about the next morning, after people have sex, how it’s going to affect the crew dynamic,” Dubé told me, “rather than, Are people going to be able to have sex or masturbate in the space station?”The potential adverse health effects of loneliness and isolation in space have also been under-studied but will most likely become more significant the longer a mission lasts. Being in space is like the pandemic lockdowns many people experienced in 2020, except you can’t open a window or take a walk outdoors. And the farther you get from Earth, the more lag time there is between when you send a message and when your loved one back home receives it. (On Mars, the wait might be 20 minutes.) In 2014, NASA issued a report, “Examining Psychosocial Well-Being and Performance in Isolated, Confined and Extreme Environments,” that considered data from submarines, underground bunkers and polar expeditions. It also detailed how career competition and differences in personality, values, culture and language derailed a 105-day I.S.S. simulation in 1999, in which a crew occupied connected hyperbaric chambers: “A physical fight broke out among two of the crew members, a sexual-harassment incident was reported and one protesting crew member withdrew from the study,” the report’s authors wrote. “In the context of spaceflight, where individual escape or mission termination is rarely an option,” they predicted, “events such as this will certainly place individual psychosocial health and performance, as well as mission success, in extreme jeopardy.” Fortunately, the polar teams seemed to have fared somewhat better, with Antarctic groups that spent the winter there enjoying many aspects of their removal from society, including “excitement over experiencing the unknown; free time to self-improve, exercise and think; and the opportunity to remove oneself from daily hassles and negative aspects of life on Earth.”Will we miss Earth, those of us who leave it? If we yearn to come back home, can we? It seems miraculous that, over billions of years, our planetary circumstances enabled protozoa to evolve into people. But really, we are just “a series of elegant sensors,” Jennifer Fogarty, the chief scientific officer at Baylor’s space-health institute, told me. Our bodies, obsessed with hoarding the energy we require to stay alive, ruthlessly divest themselves of any features and capacities that are going unused without, so to speak, a backward glance.“If we do think all the way out to colonization,” Fogarty wonders, “would those people who had a sustained presence there, would their body operate differently and be less compatible with Earth?” That wouldn’t necessarily be bad; it would mean those people were better suited to the moon or Mars. But adaptation is a zero-sum game. “The concern would be if some of those capabilities are lost over generations,” she went on. “Do we bring Earth with us? Create artificial gravity? If we take Earth with us, are we going to stall evolution? Or do we let people start with an adaptive response, and maybe it’s hard for people multiple generations later to come back?”In other words, are we, in some essential sense, Earthlings, incapable of fully casting off the biology our home planet designed for us? Or are we — could we become — the extraterrestrials we’ve so long fantasized about? It seems that, one way or another, we’re committed to finding out.Kim Tingley is a contributing writer for the magazine. She last wrote about the dangers of PFAS chemicals.

Mentoring programs bring together those just starting to care for family members with dementia and those who have been coping for some time.On Thursday mornings, Julia Sadtler and Debora Dunbar log onto Zoom to talk about caring for their husbands with Alzheimer’s disease, in hourlong conversations that are usually informative, sometimes emotional and always supportive.Both men are patients at Penn Memory Center in Philadelphia, which began this mentorship program for caregivers in September. By design, the two women are at different stages.Dr. Dunbar, a nurse-practitioner who lives in Wallingford, Pa., is younger, at 61, but has coped with caregiving for far longer: Her husband, Jeffrey Draine, 60, was diagnosed with early-onset Alzheimer’s in 2017. “It’s something I’ve developed expertise in,” she said.Philip Sadtler, 80, received his diagnosis just two years ago, so his wife has long lists of questions about what lies ahead. How will she know when Philip should stop driving? How can she handle the guilt of leaving him at home sometimes while she volunteers or sees friends? How long can the couple, who live in Berwyn, Pa., continue traveling to California to visit their daughter and her family?“The sense of being overwhelmed can be crushing,” said Ms. Sadtler, 81, a retired school admissions director. She also participates in a Penn Memory caregiver support group, but felt drawn to the mentorship’s one-on-one nature. “I knew that someone who’s been down this road would be a great help,” she said.“Caregiving in general is hard, but caregiving for a person with dementia is harder,” said Felicia Greenfield, Penn Memory’s executive director. “Caregivers report high rates of anxiety and depression. They have a harder time attending to their own health. Things change socially; their friends don’t understand or come around anymore.”It’s also, she added, a financially draining and physically demanding role, often lasting for years, continuing even if a family member moves into assisted living or a nursing home. The center’s Caring Collective mentorship matches newcomers to the challenge with those who have walked the walk.A new study documents the extent of that burden. Using data from the longitudinal federal Health and Retirement Study, a University of Michigan team compared about 2,400 older adults (average age: 75) who developed dementia during a two-year follow-up with 2,400 others who did not. The researchers matched the groups for health and disability, demographic characteristics, economic status and health care use.“They were very similar people at baseline, so we could demonstrate the impact of dementia,” said HwaJung Choi, a health economist and the lead author. “We were surprised at the huge change over two years.”Debora Dunbar with her husband, Jeffrey Draine, at home in Wallingford, Pa., in 2018. Mr. Draine, 60, was diagnosed with early-onset Alzheimer’s in 2017. “It’s something I’ve developed expertise in,” Ms. Dunbar said.Mark Makela for The New York TimesAt the start, people in both groups received about 12 hours of unpaid care a month from family and friends. After two years, the control group showed little change, but in the group with dementia, “the care hours for family members increased dramatically,” to 45 hours a month, Dr. Choi said.That figure refers only to hands-on help with so-called activities of daily living — bathing, dressing, using the toilet. Taking into account tasks such as shopping, meal preparation and handling finances, unpaid caregivers spent 27 hours assisting the control group each month, compared with 76 hours for the group with dementia.Only about 3 percent of either group used a nursing facility, including rehab stays, at the start; over two years, more than one in five of those with dementia had used or moved into a nursing facility. About 47 percent of the people with dementia had at least one hospital stay, versus 35 percent of those without dementia.Moreover, largely because of the expense of long-term care, those who had developed dementia lost more than 60 percent of their median wealth over a longer eight-year follow-up. “It’s a devastating problem for individuals and families, and also for society in general,” Dr. Choi said.None of that will come as a surprise to families caring for people with dementia.“I remembered how absolutely terrified I was at the beginning,” said Susan Jewett, 76, who first proposed the mentoring idea to Penn Memory after her husband’s death in 2020.Her pitch: “Maybe I could be useful to someone who is earlier in the process.”Mentoring can benefit both parties, said Justin McBride, a senior administrator at Duet: Partners in Health and Aging, which began a similar program in Phoenix in 2016. “We hear all the time that supporting another person in need gives mentors a sense of purpose,” he said. “It helps them make sense of their own journey.”The relatively low cost of such volunteer programs could make them replicable in many locations. They operate on a small scale, however. Duet’s program, which like Penn’s involves screening and training mentors, has about 20 pairs enrolled.It requires a six-month commitment, but most mentoring relationships last a year or two. Penn’s newer Caring Collective, requiring a three-month commitment, has enrolled 20 mentors and 40 mentees.Larger organizations like the Alzheimer’s Association also work to support dementia patients and caregivers. Its free 24/7 helpline responded to 215,000 contacts in the 2023 fiscal year, and its online community called ALZConnected has about 10,000 active members. It conducts more than 27,000 caregiver support groups nationally.Still, support programs aim to keep family caregivers on the job — a job that may simply grow too demanding, especially since many (spouses, in particular) are themselves quite old, with their own health problems and limited ability to afford paid help.“People in government need to hear about what’s going on,” Ms. Greenfield said.A new federal initiative is on the horizon. Medicare plans to fund an eight-year model program called GUIDE, to provide care coordination, education and support; it will include payment for respite services, allowing caregivers a break from their responsibilities.Workplaces can also play a role, especially for adult children who are working while also caring for aging parents. While employers estimate that 35 percent of their workforces are caregivers, the actual proportion is 56 percent, according to a recent Bank of America report.Those workers need policies like leaves of absence, flexible scheduling and counseling. Yet a 2021 report for the Rosalynn Carter Institute for Caregivers found that most employers didn’t offer them.Mentoring provides a different kind of support, but one that early participants say has proved uniquely valuable. Mary Perkins, 76, who cares for her husband at their home in Lewes, Del., has been talking regularly with Susan Jewett.Her husband, Wes Perkins, 82, has vascular dementia and Alzheimer’s; at one point, when he required institutionalization for dementia psychosis, his care became particularly difficult. “I was a mess,” Ms. Perkins said. “I needed to talk with someone who understood.”Even more than advice on specific programs and strategies, Ms. Perkins said, she benefited from hearing Ms. Jewett’s own story. “I looked at her face on FaceTime, and I saw hope,” Ms. Perkins said. “I knew she’d gone through hell and she was surviving, even thriving. If she could live through it, I could, too.”Mr. Perkins is back at home now, taking medication to control his symptoms and enrolled in a local PACE program, a comprehensive state and federal effort that provides some paid home care. The couple can take walks together, go out for breakfast, drive to the beach. “We still have good times,” Ms. Perkins said. “It’s better than I ever thought it could be.”At some later date, she plans to become a mentor herself.

There is a general understanding that pets have a positive impact on one’s well-being. A new study by Michigan State University found that although pet owners reported pets improving their lives, there was not a reliable association between pet ownership and well-being during the COVID-19 pandemic.
The study, published in the Personality and Social Psychology Bulletin, assessed 767 people over three times in May 2020. The researchers took a mixed-method approach that allowed them to look at several indicators of well-being while also asking people in an open-ended question to reflect on the role of pets from their point of view. Pet owners reported that pets made them happy. They claimed pets helped them feel more positive emotions and provided affection and companionship. They also reported negative aspects of pet ownership like being worried about their pet’s well-being and having their pets interfere with working remotely.
However, when their happiness was compared to nonpet owners, the data showed no difference in the well-being of pet owners and nonpet owners over time. The researchers found that it did not matter what type of pet was owned, how many pets were owned or how close they were with their pet. The personalities of the owners were not a factor.
“People say that pets make them happy, but when we actually measure happiness, that doesn’t appear to be the case,” said William Chopik, an associate professor in MSU’s Department of Psychology and co-author of the study. “People see friends as lonely or wanting companionship, and they recommend getting a pet. But it’s unlikely that it’ll be as transformative as people think.”
The researchers explored several reasons why there is not a difference between the well-being of pet owners and nonpet owners. One of them being that nonpet owners may have filled their lives with a variety of other things that make them happy.

Scientists at La Jolla Institute for Immunology (LJI) are investigating a talented type of T cell.
Most T cells only work in the person who made them. Your T cells fight threats by responding to molecular fragments that belong to a pathogen — but only when these molecules are bound with markers that come from your own tissues. Your influenza-fighting T cells can’t help your neighbor, and vice versa.
“However, we all have T cells that do not obey these rules,” says LJI Professor and President Emeritus Mitchell Kronenberg, Ph.D. “One of these cell types is mucosal-associated invariant T (MAIT) cells.”
Now Kronenberg and his LJI colleagues have uncovered another MAIT cell superpower: MAIT cells can recognize the same markers whether they come from humans or mice. Kronenberg calls this finding “astounding.” “Humans diverged from mice in evolution 60 million years ago,” he says.
This new research, published in Science Immunology, sheds light on the genes and nutrients that give MAIT cells their fighting power. The findings are an important step toward one day harnessing these cells to treat infectious diseases and improve cancer immunotherapies.
“Because MAIT cells are the same across individuals, they could more easily be used in cell therapies, where, in principle, my MAIT cells could be given to you,” says Kronenberg.
The new study also opens the door to exploiting MAIT cells to improve cellular therapies. “If we could make normal T cells more like MAIT cells, maybe we could make them act faster and more vigorously to combat any type of infection or cancer,” says study co-first author Gabriel Ascui, a UC San Diego graduate student in LJI’s Kronenberg Lab.

Physical fitness since childhood is associated with cerebellar grey matter volume in adolescents. According to a recent study conducted at the University of Jyväskylä and the University of Eastern Finland, those who were stronger, faster and more agile, in other words, had better neuromuscular fitness since childhood, had larger Crus I grey matter volume in adolescence.
Despite the importance of the developing cerebellum on cognition and learning, the associations between physical fitness and cerebellar volume in adolescents have remained unclear. This study examined the associations of physical fitness with grey matter volume of cerebellar lobules related to cognition in adolescents, and whether these associations differed between females and males.
Those adolescents with better neuromuscular fitness since childhood had larger Crus I grey matter volume. However, adolescents with better cardiorespiratory fitness had smaller total cerebellar grey matter volume. Moreover, males with better neuromuscular fitness since childhood had smaller Crus II grey matter volume.
“Our study highlights the importance of physical activity through childhood and adolescence, leading to better physical fitness, as it might be relevant to cerebellar volumes related to cognition and learning. However, the associations we observed are in part contradictory,” says Doctoral Researcher Petri Jalanko from the Faculty of Sport and Health Sciences at the University of Jyväskylä.
“The study sheds light on the associations between physical fitness and the cerebellum. Future randomised controlled trials utilising direct cardiorespiratory fitness measurements and novel brain imaging to assess a larger population and both sexes separately are needed to better understand the associations and causality between physical fitness and cerebellar volumes in adolescents,” Jalanko says.
The findings are from the FitBrain study, which included 40 participants from the 8-year follow-up examinations of the Physical Activity and Nutrition in Children (PANIC) study. Of the participants, 22 were female and 18 were male, and their mean age was 17.9 years.
Cardiorespiratory fitness was assessed by maximal ramp test on a cycle ergometer, muscular strength with standing long jump, speed-agility with the 10 x 5 m shuttle-run test, coordination with the Box and Block Test and neuromuscular fitness as the sum of standing long jump, Box and Block Test and shuttle-run test z-scores. Cerebellar volumes were assessed by magnetic resonance imaging. The study was published in the Scandinavian Journal of Medicine and Science in Sports.