Mifepristone Significantly Lowers HbA1c in Type 2 Diabetes with Hypercortisolism: Study

Researchers have discovered in a randomized placebo-controlled trial that mifepristone (Korlym) led to a significant reduction in HbA1c levels in patients with poorly controlled type 2 diabetes and hypercortisolism. The findings of the study were presented at the ADA annual meeting. The study was published in Diabetes Care by Ralph A. and colleagues.

Hypercortisolism, a frequently underappreciated cause of inadequate glycemic control, occurred in most patients in spite of being on several diabetes medications. Aiming to intervene on the glucocorticoid receptor, investigators sought to determine whether controlling cortisol action could enhance diabetic outcomes in cases where conventional treatment has not succeeded.

The study enrolled 136 participants aged 18 or older with established type 2 diabetes (HbA1c between 7.5% and 11.5%, equivalent to 58–102 mmol/mol) who were already on multiple glucose-lowering medications but had inadequate glycemic control. All participants demonstrated biochemical evidence of hypercortisolism based on dexamethasone suppression testing. Subjects were randomized in a 2:1 ratio to receive either mifepristone (91 participants) or placebo (45 participants) once daily for 24 weeks. Stratification was according to whether or not participants had an abnormality on adrenal imaging.

Key Findings

 • At baseline, mean HbA1c in the total cohort was 8.55% (69.9 mmol/mol). At 24 weeks of treatment:

• The mifepristone arm had a placebo-adjusted decrease in HbA1c of −1.32% (95% CI: −1.81 to −0.83; P < 0.001), indicating substantial glycemic improvement.

• Patients who were given mifepristone lost a mean of 5.12 kg (95% CI: −8.20 to −2.03) body weight and 5.1 cm waist circumference (95% CI: −8.23 to −1.99).

• In the users of mifepristone, 46% stopped therapy, primarily because of adverse effects, as was 18% in the placebo group.

• Nineteen participants had an adverse event.

• Common side effects occurring in over 10% of participants on mifepristone were hypokalemia, fatigue, nausea, vomiting, headache, peripheral edema, diarrhea, and dizziness.

• There were also increases in blood pressure among some participants, which is in agreement with the established pharmacological profile of the drug.

Among patients with poorly controlled type 2 diabetes and biochemical hypercortisolism, mifepristone treatment for 24 weeks substantially decreased HbA1c, body weight, and waist size. In spite of a significant frequency of therapy discontinuation because of side effects, the tolerability profile was as expected for the drug.

Reference:

Ralph A. DeFronzo, Vivian Fonseca, Vanita R. Aroda, Richard J. Auchus, Timothy Bailey, Irina Bancos, Robert S. Busch, John B. Buse, Elena A. Christofides, Bradley Eilerman, James W. Findling, Yehuda Handelsman, Steven E. Kahn, Harold J. Miller, Jonathan G. Ownby, John C. Parker, Athena Philis-Tsimikas, Richard Pratley, Julio Rosenstock, Michael H. Shanik, Lance A. Sloan, Guillermo Umpierrez, Samir Shambharkar, Iulia Cristina Tudor, Tina K. Schlafly, Daniel Einhorn, CATALYST Investigators; Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment. Diabetes Care 2025; dc251055. https://doi.org/10.2337/dc25-1055

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Both Fenofibrate and Curcumin Improve Lipid and Inflammatory Markers in Type 2 Diabetes: Study

A new study published in the journal of BMC Pharmacology and Toxicology showed that both fenofibrate and curcumin effectively reduce lipid levels and improve inflammation in type 2 diabetes patients. However fenofibrate may offer additional benefits by more significantly reducing waist circumference, lowering fetuin-A levels, and increasing sirtuin levels.

One known risk factor for the onset of cardiovascular disease is type 2 diabetes. It was discovered that fenofibrate and curcumin were useful in reducing hyperlipidemia in diabetic individuals. This study compared the effects of adding fenofibrate against curcumin on weight, lipid profile, glycemic status, fetuin-A, high-sensitivity C-reactive protein (hs-CRP), and sirtuin 1, in patients with type 2 diabetes receiving glimepiride,.

3 groups of 60 individuals with type 2 diabetes mellitus were randomly assigned in this trial, where Group I received a placebo, Group II received 1100 mg of curcumin, and Group III received 160 mg of fenofibrate, all taken orally once daily. Glimepiride 4 mg was given orally once daily for three months.

The patients between the ages of 35 and 70, those with uncontrolled type 2 diabetes, those with hyperlipidemia, and those receiving glimepiride 4 mg were all eligible to participate. Other forms of diabetes, pregnancy, bad liver or kidney function tests, taking other anti-diabetic drugs, and non-adherence to treatment were among the exclusion criteria.

Anthropometric measures were taken at baseline and three months into the intervention, and blood samples were taken for biochemical examination of lipid profile, fetuin-A, sirtuin 1, glycated hemoglobin (HbA1c), blood glucose, hs-CRP, and fetuin. The body mass index, weight, two-hour postprandial glucose (2 h-PPG), fasting blood glucose, and HbA1c did not significantly differ among the three groups when compared 3 months after the intervention (p > 0.05).

The fenofibrate (p < 0.001) and curcumin (p < 0.05) groups showed significant reductions in triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), very-low-density lipoprotein cholesterol (VLDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), coronary risk index (CRI), atherogenic index (AI), and hs-CRP, while also increasing sirtuin 1.

The group that received fenofibrate had considerably greater levels of HDL-C than the group that received a placebo (p < 0.001). Also, fenofibrate significantly decreased waist circumferences and fetuin-A and elevated sirtuin 1 (p < 0.05) in comparison to curcumin.

Overall, in individuals with type II diabetes receiving glimepiride, the current trial demonstrated the significant advantages of adding fenofibrate as opposed to curcumin. When combined with glimepiride treatment, both medications improved the lipid profile, inflammatory markers, and glycemic picture.

Source:

Nada, E. M., El-Gharbawy, N. M., Abbas, H., & Werida, R. H. (2025). Effect of adding fenofibrate versus curcumin to glimepiride in patients with type 2 diabetes: a randomized controlled trial. BMC Pharmacology and Toxicology, 26(1), 119. https://doi.org/10.1186/s40360-025-00950-y

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Higher Hb levels with RBC transfusion does not offer benefits in patients with MI and anemia: JAMA

A new study published in the Journal of American Medical Association found that in patients with myocardial infarction (MI) and anemia, higher hemoglobin levels maintained by RBC transfusion could not significantly improve overall quality of life.

Anemia and MI both negatively impact health-related quality of life (QOL). By reducing symptoms and/or enhancing functional ability, red blood cell (RBC) transfusion may enhance quality of life following MI. This study was set to determine if patients with MI and anemia’s quality of life is impacted by a liberal transfusion approach as opposed to a more limited transfusion strategy.

The participants from 144 locations across 6 countries participated in the Myocardial Ischemia and Transfusion (MINT) experiment, a randomized clinical trial comparing a liberal vs. limited RBC transfusion approach, and QOL was analyzed as a predetermined secondary endpoint. Hospitalized individuals with anemia (hemoglobin [Hb] <10 g/dL) with acute MI.

This study includes patients who had QOL data gathered and those who passed away prior to the 30-day follow-up period, out of the 3504 patients who were randomized in the MINT experiment. Between April 2017 and April 2023, data were gathered, and between February 2024 and January 2025, they were examined. Patients in the MINT study were randomly assigned to either a liberal (Hb of less than 10 g/dL) or restrictive (Hb of 7 to 8 g/dL) RBC transfusion approach.

The mean (SD) age of the 2844 included patients was 71.9 (11.5 years), with 1551 (54.5%) being male. 319 (11.2%) of the 2525 individuals with QOL data passed away before to the 30-day follow-up. At 30 days after randomization, the mean and median scores for all EQ-5D-5L QOL outcomes did not differ amongst the allocated transfusion techniques.

Despite the fact that a greater proportion of patients in the liberal transfusion group than the restrictive group reported no problems at all in the domains of self-care (858 of 1271 [67.5%] vs 803 of 1254 [64.0%]), mobility (474 of 1270 [37.3%] vs 460 of 1254 [36.7%]), and usual activities (506 of 1268 [39.9%] vs 473 of 1247 [37.9%]), none of these differences were statistically significant.

There was no correlation between mean differences in any QOL outcome and the assigned transfusion technique, according to adjusted mixed-effects linear regressions. A liberal transfusion approach was linked to higher QOL scores in functional capacity domains, according to adjusted regressions in a number of predefined subgroups.

However, the effects were only statistically significant in patients who had previously experienced heart failure (Health Today rating: β, 2.06 [95% CI, −0.23 to 4.35] vs −1.44 [95% CI, −3.81 to 0.92]; P =.04). Overall, based on this study, individuals with MI and anemia may not have a discernible improvement in their overall quality of life from increased Hb levels maintained by RBC transfusion.

Source:

Prochaska, M. T., Portela, G. T., Brooks, M. M., Fergusson, D. A., Hébert, P. C., Polonsky, T. S., Caixeta, A., Cooper, H. A., Crozier, I., Daneault, B., Kim, S., Bainey, K. R., de Barros E Silva, P., Goldfarb, M., Gupta, R., Rao, S. V., Fonteles Ritt, L. E., Simon, T., & Carson, J. L. (2025). Transfusion strategy effect on quality of life in patients with myocardial infarction and anemia: A secondary analysis of the MINT randomized clinical trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.0654

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Leafy greens could be good for the heart, suggests study

A cup and a half of leafy green vegetables could go a long way to addressing atherosclerotic vascular diseases (ASVD’s), new research from Edith Cowan University (ECU), the University of Western Australia and the Danish Cancer Institute has found.

ASVDs are a subgroup of cardiovascular disease, which are current leading causes of death world-wide, primarily due to heart attacks and strokes. ECU PhD student Ms Montana Dupuy noted that in Australia, cardiovascular diseases claim the life of one person every 12 minutes.

Research led by Ms Dupuy has found that the higher dietary intake of Vitamin K1 could reduce the risk of ASVD.

“Leafy green and cruciferous vegetables, like spinach, kale and broccoli, contain Vitamin K1 which may assist in preventing vascular calcification processes that characterise cardiovascular disease. The great news is that these vegetables can be easily incorporated into your daily meals” she said.

In addition to its’ potential role in vascular calcification inhibition, Vitamin K may also be beneficial for musculoskeletal health, through its impact on bone strength.

ECU Senior Research Fellow Dr Marc Sim noted that a cup and a half of such vegetables is an easy way to increase our daily vitamin K intake and may lower our risk for cardiovascular disease”.

“This research found women who consumed approximately 30% higher intakes of Vitamin K1 than currently recommended in the Australian Dietary Guidelines had lower long-term risk of ASVD,” he said.

“Of importance, when we examined the blood vessels in the neck, those with a higher Vitamin K1 intake also had less thickening of these blood vessels, a marker of atherosclerosis.”

The work led by Ms Dupuy and Dr Sim on the impact of Vitamin K to vascular health, as well as musculoskeletal health, will now help to inform future research at ECU’s Future Foods and Digital Gastronomy Lab and to deliver specialised meals as part of clinical trials to improve population health.

“This research has provided key evidence to support our future studies. We are now creating new foods which pack more leafy greens that are rich in Vitamin K1. These novel foods can be used in communities with special nutritional and dietary requirements, such as aged care residents,” said ECU Post Doctoral Research Fellow Dr Liezhou Zhong.

“We are consolidating all our epidemiological data and converting that into a tangible product that would benefit the community,” he added.

Reference:

Dupuy, M., Zhong, L., Radavelli-Bagatini, S. et al. Higher vitamin K1 intakes are associated with lower subclinical atherosclerosis and lower risk for atherosclerotic vascular disease-related outcomes in older women. Eur J Nutr 64, 171 (2025). https://doi.org/10.1007/s00394-025-03686-x.

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Hyperbaric Oxygen Therapy Shows Lasting Relief for Radiation-Induced Cystitis: 5-Year RICH-ART Trial Results

Sweden: Researchers have revealed that hyperbaric oxygen therapy (HBO2) can offer sustained relief from symptoms of chronic radiation-induced cystitis for up to five years, according to a long-term follow-up of the RICH-ART trial published in eClinicalMedicine. The study, led by Dr. Nicklas Oscarsson from the University of Gothenburg, adds important new insights into the durability of the therapeutic effects of HBO₂.

Radiation-induced cystitis is a distressing complication that affects about 5–10% of patients who undergo pelvic radiotherapy for cancers such as prostate, bladder, or cervical cancer. Common symptoms include blood in the urine, urgency, frequency, and painful urination—all of which can severely impact a patient’s quality of life. While HBO₂ has been known to improve symptoms in the short term, evidence regarding its long-term efficacy has been limited.

The RICH-ART trial was a multicentre, open-label phase 2–3 study carried out across five Nordic hospitals in Sweden, Norway, Denmark, and Finland. It included patients aged between 18 and 80 years who had completed pelvic radiotherapy at least six months prior and had persistent bladder symptoms. Participants were randomly assigned to receive either HBO₂ therapy—30 to 40 daily sessions of 100% oxygen at high pressure—or standard care. Patients in the control group were later offered HBO₂.

The study led to the following findings:

  • The five-year follow-up included 70 patients who had received hyperbaric oxygen therapy (HBO₂).
  • Average urinary symptom scores improved by 18 points at six months post-treatment.
  • At five years, the improvement remained stable, with a 19.1-point increase from baseline.
  • Approximately 69% of patients (48 out of 70) experienced significant and sustained improvement, showing a mean increase of 22.9 points.
  • The remaining 31% (22 patients) showed little to no symptom improvement even after five years.
  • Only 12.8% of patients required repeat HBO₂ therapy due to the recurrence of symptoms.
  • Adverse events were documented only during the HBO₂ treatment period.
  • There were no new safety concerns during the long-term follow-up.

The findings not only reinforce the long-term efficacy of HBO₂ in managing chronic radiation cystitis but also underline the need for further research. “This is the first study to report five-year outcomes, offering vital data on the lasting impact of this therapy,” the authors stated. They suggest that HBO₂ could become a more widely adopted component of standard care, though further studies are needed to refine treatment protocols, assess economic viability, and identify predictors of treatment response.

The authors concluded, “The RICH-ART trial provides compelling evidence that HBO₂ can deliver durable symptom relief for patients suffering from radiation-induced bladder complications. As researchers continue to investigate optimal dosing and patient selection strategies, HBO₂ stands out as a promising and effective treatment option for improving long-term quality of life in this population.”

Reference: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00146-4/fulltext

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15 Drugs Including Pomol-650, Glimiz-2 Banned in Karnataka, Check Full List

Bengaluru: In a move to protect public health, the Karnataka Government’s Drug Testing Laboratory has declared 15 drugs manufactured by 14 companies as “Not of Standard Quality”.

Authorities have issued an urgent directive to chemists, wholesalers, doctors, hospitals, and nursing homes, instructing them not to stock, sell, or use the listed drugs. Those already in possession of these products are required to intimate the concerned area Drugs Inspector or Assistant Drugs Controller. The public has also been strongly advised not to use these medicines.

Some of the notable substandard drugs include Compound Sodium Lactate Injection IP (Ringer-Lactate solution for injection) manufactured by Ultra Laboratories, Otsuka Pharmaceuticals India and Tam Bran Pharmaceuticals, Pomol-650 (Paracetamol Tablets IP 650 mg) by Aban Pharmaceuticals, and MITO Q7 Syrup by Bion Therapeutics India.

The list also includes Glimiz-2 (Glimepiride tablets IP 2mg) manufactured by Knm Pharma, Iron Sucrose Injection USP 100 mg (Irogain) manufactured by Regain Labs.

 

 

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Akums Gets CDSCO Panel Nod for BE Study of Rizatriptan-Meloxicam FDC, Told to Revise Phase III Protocol

New Delhi: In response to the proposal presented by the Akums Drugs & Pharmaceuticals along with BE and Phase III clinical trial protocol of the fixed dose combination (FDC) Rizatriptan Benzoate plus Meloxicam IP 20mg uncoated orally disintegrating Tablet, the Subject Expert Committee (SEC) functional under the Central Drug Standard Control Organisation (CDSCO) has recommended for grant of permission to conduct the BE study of the proposed drug.

In addition, the committee opined that placebo should not be used as a comparator and patient with frequency of migraine attack more than 2 in a month should be included in inclusion criteria and above mentioned criteria for 6 months prior to starting study and patients on Prophylaxis medication should not be included in the study and same may be mentioned in the exclusion criteria.

Also, the committee recommended the firm to submit BE study report along with revised Phase III clinical trial protocol to CDSCO for further review by the committee.

This came after the firm presented the proposal along with BE & Phase III clinical trial protocol before the committee.

Meloxicam and rizatriptan combination is used to treat acute migraine headaches with or without aura. It is not used to prevent migraine headaches and is not used for cluster headaches. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID).

Rizatriptan is used to treat migraine headaches (severe, throbbing headaches that sometimes cause nausea and sensitivity to sound and light). Rizatriptan is in a class of medications called selective serotonin receptor agonists.

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve the symptoms of arthritis (juvenile rheumatoid arthritis, osteoarthritis, and rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain.

At the recent SEC meeting for Neurology and Psychiatry held on 18th June 2025, the expert panel reviewed the proposal along with BE & Phase III clinical trial protocol before the committee.

After detailed deliberation, the committee recommended for grant of permission to conduct the BE study.

As regard to Phase III clinical trial protocol, the committee opined that:

1. Placebo should not be used as a comparator.

2. Patient with frequency of migraine attack more than 2 in a month should be included in inclusion criteria and above mentioned criteria for 6 months prior to starting study.

3. Patients on Prophylaxis medication should not be included in the study and same may be mentioned in the exclusion criteria.

“Accordingly, the firm should submit BE study report along with revised Phase III clinical trial protocol to CDSCO for further review by the committee,” the panel noted.

Also Read: Biocon Gets CDSCO Panel Nod to Market Trastuzumab PGS in India

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CDSCO Asks Serum Institute to Revise Protocol for Trivalent Flu-COVID Vaccine Trial

New Delhi: The Subject Expert Committee (SEC) under the COVID-19 division of the Central Drugs Standard Control Organization (CDSCO) has reviewed a proposal submitted by Serum Institute of India Pvt. Ltd. (SIIPL) for a Phase II/III clinical trial of its Trivalent Nanoparticle Influenza Vaccine (NIV) and COVID-Influenza Combination (CIC) Vaccine, and has asked the firm to submit a revised study protocol incorporating additional design, safety, and statistical considerations.

The protocol, reviewed during the SEC meeting held on June 4, 2025, was titled:

“Phase II/III, multicentre, observer-blind, randomized, active-controlled study to evaluate immunogenicity and safety of a Trivalent Nanoparticle Influenza Vaccine and Covid-Influenza combination vaccine compared with Licensed Influenza and Covid-19 Vaccines in adults.”

The committee observed that the CIC vaccine leverages the baculovirus-insect cell platform also used in Novavax’s COVOVAX, which SIIPL had manufactured and distributed globally in over 200 million doses during the pandemic.

“Currently proposed Trivalent Influenza Nanoparticle Vaccine (tNIV) and Covid Influenza Vaccine Combination (CIC) are based on the same platform. CIC vaccine formulation contains both the SARS-CoV-2 and Influenza antigens,” the SEC noted.

In support of the proposal, the firm cited multiple international studies:

Over 4,300 participants took part in clinical trials for nanoparticle influenza vaccines (tNIV/qNIV), including adults aged >60 years in the U.S.

More than 2,100 participants were enrolled in Australia for the CIC vaccine trials combining COVID and influenza antigens.

“These trials demonstrated that CIC is safe and immunogenic… all doses were found safe,” the panel noted.

The investigational products used in all these trials were manufactured by SIIPL, further aligning the proposed Indian study with globally validated formulations.

However, the SEC has directed key changes before granting final approval to proceed:

“The study should be designed as four arm study with Covid Trivalent Influenza Combination (CIC) Vaccine, Trivalent Influenza Nanoparticle Vaccine, SARS-CoV-2 rs (JN.1 variant) and Fluquad.”

“Sample size of participants should be increased as per statistical calculation in proposed four arms with age stratification so that high-risk population (more than 55 years of age group) is appropriately considered for safety and immunogenicity analysis.”

“Cross-neutralization against VoCs for Covovax JN.1 alone and in CIC, immunogenicity persistence studies, efficacy end-points for hospitalization or severe COVID-19 cases should be part of exploratory objectives.”

Accordingly, the firm has been advised to submit a revised protocol incorporating all recommended modifications for further deliberation by the committee.

Also Read: SEC Recommends Market Authorization for Elobixibat 5 mg Tablets by Exemed Pharma

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Coaxial SIL Drains Less Painful Yet Equally Effective as PVC Drains after video-assisted thoracoscopic surgery lung resections: Study

A new study has confirmed that coaxial silicone (SIL) drains, due to their softer material, result in less patient discomfort while providing drainage efficacy comparable to that of traditional PVC drains after video-assisted thoracoscopic surgery (VATS) lung resections.

Chest drains are routinely used after video-assisted thoracoscopic surgery (VATS) lung resections to evacuate fluid and air from the pleural space. We compared the impact of coaxial silicone (SIL) drains vs. standard polyvinyl chloride (PVC) drains on postoperative pain, drainage efficacy, and short-term treatment outcome following VATS lobectomy.

The prospective randomized study included 80 patients who underwent VATS lobectomy for lung cancer between September 2020 and June 2023. Patients were randomized into two groups based on the type of chest drain used postoperatively: 40 in the experimental group (coaxial SIL drain Fr 24) and 40 in the control group (standard PVC drain Fr 24). The researchers collecting the data and the caregivers were not blinded to the group allocation. The primary objective was to evaluate pain over the initial 2 postoperative days by assessing analgesic consumption, respiratory muscle strength [measured as maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)], and pain intensity using the visual analog scale (VAS). MIP, MEP, and VAS were measured both at rest and during physical activity.

 Sixty-nine patients were included in the final analysis: 35 in the experimental group and 34 in the control group. The groups were comparable in terms of drainage efficacy and short-term treatment outcome, but pain was significantly lower in the experimental group (coaxial SIL drain). Diclofenac consumption was significantly lower in the experimental group (P=0.004), with a trend toward lower consumption of other analgesics. All respiratory muscle strength measurements were higher in the experimental group, with significant differences in static MIP on the second postoperative day (P=0.046), both static (P=0.02) and dynamic (P=0.050) MEP on the first postoperative day, and static MEP on the second postoperative day (P=0.02). Static VAS (S-VAS) on the first postoperative day was statistically significantly lower in the experimental group (P=0.003). Dynamic VAS (D-VAS) was comparable between the groups.

This study confirmed the hypothesis that coaxial SIL drains, owing to their softer material, cause less pain while maintaining efficacy comparable to standard PVC drains.

Reference:

Boris Greif, Janez Žgajnar, Tomaž Štupnik,  Impact of chest tube type on pain, drainage efficacy, and short-term treatment outcome following video-assisted thoracoscopic surgery lobectomy: a randomized controlled trial comparing coaxial silicone drains and standard polyvinyl chloride drains, Journal of Thoracic Disease, DOI:10.21037/jtd-24-1489 

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Cognitive tests in infancy can offer insight into intelligence at age 30 and beyond: Study

Watching a baby babble, play and interact with others can provide useful insight into what their cognitive ability might be like decades later, according to new University of Colorado Boulder research published in the journal PNAS.

The study of more than 1,000 twins found that tests as early as 7 months of age can help predict performance on cognitive measures at age 30. It also found that an infant’s environment plays a more significant role in shaping life-long cognition than scientists realized. It could even influence risk of dementia later in life, the authors said.

“Our findings highlight the enduring consequences of the very early childhood environment on cognitive ability and suggest that early life is a critical developmental period that we should be paying attention to,” said lead author Daniel Gustavson, assistant research professor at the Institute for Behavioral Genetics (IBG).

What twins can teach us

Similar to “IQ,” general cognitive ability (GCA) is a single, composite measure of a person’s capacity to learn, reason, understand and problem-solve.

Prior research has shown that much of our GCA is established by childhood. Give an 8-year-old a battery of tests to determine their GCA and their score will look remarkably similar at age 30. Measures of intelligence at age 20 are highly correlated with those at age 62, and IQ doesn’t change much between age 11 and 90.

But few scientists have looked back further to see what-if anything-signals in infancy can tell us about cognition in adulthood and old age.

Gustavson and senior author Chandra Reynolds, a professor of psychology and neuroscience, looked at data from 1,098 participants in the Colorado Longitudinal Twin Study. IBG launched the study in 1985, enrolling baby twins from Colorado’s Front Range to assess the role that genes vs. environment play in various aspects of development.

Researchers have since collected reams of data, via periodic laboratory samples, home visits, surveys, interviews and behavioral tests.

“We have co-authors on this paper who have been involved since the start and watched these twins grow up,” said Gustavson.

As early as 7 months old, researchers assessed seven measures of cognition, including vocalization, ability to stay on task, and “novelty preference”-whether the infants preferred to play with new toys over ones they were familiar with.

Age-appropriate cognitive assessments have been done at five points, so far.

The team found that looking at cognitive tests in infancy could predict about 13% of the variance in scores at age 30. Two measures-novelty preference and task orientation-were the strongest predictors. This early life “signal” is not huge, the authors note.

“We certainly do not want to imply that cognition is somehow fixed by seven months old,” Gustavson said. “But the idea that a very simple test in infancy can help predict the results of a very complicated cognitive test taken 30 years later is exciting.”

Nature, nurture or both?

To explore what role genetics vs. environment plays, the study compared GCA score differences between identical twins, who share 100% of their genes, and fraternal twins, who only share half of their genes. In general, if there is greater similarity among identical twins than fraternal twins, this suggests that genes play a strong role in that trait.

They also analyzed the twins’ DNA collected via blood or saliva.

As expected, genes played a big role in influencing general cognitive ability, with genetic influences measured by age 7 accounting for about half of the variation in scores at age 30.

But environment also had a significant and lasting impact.

“One of the most exciting findings was that 10% of the variability in adult cognitive ability was explained by environmental influences before year one or two,” said Gustavson.

The older the children got, the more influence genes had and the less environment had.

“This suggests that even the pre-preschool environment matters,” Gustavson said.

Reynolds, who studies age-related diseases including Alzheimer’s and dementia, says the findings could have implications not only for how youth do in school or how adults perform at work but also how prone they may be to age-related cognitive decline.

“Cognitive aging is a life-long process, not just something that begins in mid-life,” she said. “It could be that certain interventions, like strong educational foundations in early life could help maximize what people are capable of and help them keep that cognitive gas in the tank for as long as possible.”

A polygenic score for intelligence

The study also confirms that “polygenic scores” can be a useful tool.

Polygenic scores are single numbers that aggregate a person’s genetic variants to estimate predisposition to a trait, like intelligence.

“There are thousands of genes that influence intelligence, so you are never going to find an ‘intelligence gene’, but we have found many with tiny effects that when put together can have an impact,” Gustavson said.

For the study, the researchers used genetic data from nearly 1 million individuals gathered via large datasets like 23 and Me to give each of the adult twins a polygenic score based on their own DNA, for cognitive ability.

Remarkably, the twins’ scores closely matched what would be expected based on their tests when they were babies.

“Studies like ours show us that both family-based and genomic-based datasets are valuable in answering questions about how genetic and environmental influences change across the lifespan,” said Gustavson. 

Reference:

D.E. Gustavson,G.A. Borriello,M.A. Karhadkar,S.H. Rhee,R.P. Corley,S. Rhea,L.F. DiLalla,S.J. Wadsworth,N.P. Friedman,& C.A. Reynolds, Stability of general cognitive ability from infancy to adulthood: A combined twin and genomic investigation, Proc. Natl. Acad. Sci. U.S.A. 122 (21) e2426531122, https://doi.org/10.1073/pnas.2426531122 (2025).

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