Can We Predict Dementia by Personality as a Teenager?

Investigators assessed personality traits in more than 80,000 individuals from a national sample of high school students in 1960 and found that adolescents who rated higher on the "vigor" scale were 7% less likely to be diagnosed with dementia 5 decades later.  Vigor was defined as having a more energetic disposition and more extroversion.  Calmness and maturity in teens also transferred a reduced risk of dementia.  

The interpretation highlights the importance of child mental health with specific reference to encouraging calming techniques and physical activity.  This study meshes well with other studies that have indicated relief from anxiety as well as healthy lifestyle habits have a dramatic positive impact on the prevention of mental illness. 

Chapman BP, Huang A, Peters K, et al. Association between high school personality phenotype and dementia 54 years later in results from a national US sample. JAMA Psychiatry. 2019. 

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2752387

Dank Vapes are not so dank

I have treated kids who have had the lung injury from vaping.  The major culprit is counterfeit THC oil inside of vape cartridges.  These generally come from illegitimate dealers who are making a profit off of gullible children.  The Dank Vapes is not an actual company that makes the cartridge.  They make the packaging that looks appealing to kids.  The dealer can put any type of hardware into the packaging.  There have been high profile arrests of dealers who had thousands of the packages empty and ready to be filled with counterfeit cartridges containing who knows what.

Pharmacogenetic Testing

Many of my families are asking about pharmacogenetic testing (PGT).  Some families are coming with the results of testing and asking for my interpretation.  I often see a child whose parent had the test and their result can help in my recommendations to the child.  PGT is particularly helpful in antidepressant and antianxiety medication.  The tests are primarily of genes for liver enzymes called cytochrome P450s (CYPs).  We know which CYP chops up which medication.  You can be normal for one enzyme, low for another and high for another.  Other tests are related to serotonin and dopamine receptors.  These can help predict response to certain categories of medication.  Methylfolatereductase (MTHFR) is typically in the panel of tests.  MTHFR is an enzyme that helps folate get into your brain.  Folate is used to help make various neurotransmitters and reduce inflammation in the body.  If MTHFR is low, a client can take a special supplement called l-methylfolate or folinic acid because regular folate in diet or vitamins won't help. 

Pharmacogenetic testing should not be used as the sole determinant for choosing medication.  It will not tell you which medication will work.  The test is more helpful in telling me what not to use or why you got side effects.  The reports are typically simplified into categories of green "use as directed", yellow "use with caution" and red "use with extreme caution".  However, the best medication might be in the red zone.  We just might need to start a very low dose of a medication that you metabolize slowly.

There are multiple companies providing similar tests.  All of them are either oral swabs or saliva tests (no needles).  I have used Genesight and Millenium the most and both are great.  Insurance companies often do not cover this test.  PGT tends to save a lot of trial and error so my hope is that insurance will cover it more often.  The benefit is usually a more targeted approach to medication and less time spent switching between meds.  All of the companies allow you to pay for the test privately for about 250$.  The test comes back in less than a week. 

Cannabis

I am seeing a rise in cannabis issues that are probably going to get worse once Arkansas has established dispensaries.  My personal feelings about cannabis are similar to my sense of other recreational substances: some ADULTS can responsibly use these substances and some can't.  Children definitely cannot responsibly use recreational substances especially cannabis.  However, the passing of medical cannabis laws seems to elicit a sense of social acceptance and safety that has detrimental effects on our kids.  Much of the cannabis is coming from legal sources in states with recreational cannabis where an Arkansan buys a large quantity and brings it back to our state.  There are many sources available on dark web shopping sites.  These dealers are typically shipping a large number of dabpens that are preloaded with cartridges of concentrated cannabis oil.  Many parents mistake these as typical vapes or e-cigarettes.  Getting to the root of the cannabis issue is often part of my job.  Some kids are purely using for pleasure.  Some kids are treating an underlying depression or anxiety disorder.  Some kids are very susceptible to peer pressure and can't say no.  If you have a child struggling with cannabis abuse, you are not alone.  My typical recommendation is to drug screen twice weekly and base your child's privileges on passing.  Know where your cash is going, get a receipt.  Check their Venmo.  Check their DMs and Snapchat.  Check your mailbox and their backpack.  Verify your child has not established their own P.O. Box.  Good luck out there.

Fitness in Mid-life reduces dementia in elderly

A recent study reports a 36% reduced rate of dementia in individuals whose fitness was tested 25 years earlier.

To AP or not to AP

Is there advantage for the average high school kid to take AP classes?  Some people would say "absolutely".  You have to go to a great college, and the only way to get in is to have AP classes with a high GPA.  But wait.. even if you get in, can you afford it?  Is it worth it? I see so many stressed out, over-scheduled high school kids that I have come to wonder if the average student needs AP at all.  The sleep-deprivation and anxiety just do not seem worth it sometimes.