Isn’t It Ironic?

Published June 7, 2025

Morning Report — Not Your Typical Medical Newsletter

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Study Debunks Digital Dementia in Older Adults 

LONGEVITY LEARNINGS

The first generation to “Twist” by the transistor radio is also the first to wield touchscreen phones into the golden years. This means most Baby Boomers likely went from memorizing Sgt. Pepper track sequences to outsourcing birthdays, directions, and phone numbers to the cloud. So, what are the repercussions? Have these digital habits triggered “digital dementia” or built a “technological reserve” that protects cognition? 

The data just dropped

In a sweeping meta-analysis, researchers sifted through 57 high-quality studies tracking >400,000 adults aged 50 years and up. Older adults who used digital tech had 58% lower odds of cognitive impairment and a 26% slower rate of decline than nonusers. The study showed a clear link between tech use and better cognition—but which came first? Do sharper minds gravitate toward Wordle, or does Wordle help keep minds sharp? Most likely, it’s both.

Key takeaways 

Baby Boomers navigating the untrodden path of aging in the digital age have reason for optimism. These findings dismantle the “digital dementia” narrative and point to a more protective role for technology. The mechanism isn’t fully clear, but co-author Dr. Jared Benge offers an alliterative theory: “complexity, connection, and compensatory.” Digital tools may support cognitive health by engaging users in complex tasks, fostering social ties, and compensating for decline—think GPS for navigation. Of course, says co-author Dr. Michael Scullin, it all depends on how users engage. Treat your device like a TV—endlessly scrolling as if channel surfing—and the benefits diminish. Worse, use it mindlessly and suddenly you’re Michael Scott yelling “The machine knows!” as you drive into a lake.

For more education on dementia, check out this CME activity: Navigating the Dementia Landscape: Best Practices for Primary Care Clinicians

Ironing Out Menopausal Brain Fog

WOMEN’S HEALTH

Isn’t it ironic?

To test the iron-fog hypothesis, researchers rounded up women in early and late menopause with either low or mid-range iron levels—not deficient, not anemic, just hovering at the low end of “normal.” In this cross-sectional study, participants tackled cognitive tasks, strapped into EEGs to track brain activity, and entered MRI scanners while researchers hunted for iron in the brain. The assumption? If increased iron levels enhanced cognition, that effect would be negated by iron-induced oxidative stress in the brain. But, in a twist, higher systemic iron levels not only aligned with better cognitive performance and stronger EEG signals—but did so without a rise in brain iron.

Rust on the findings

Of note, the pandemic hamstrung recruitment, slashed sample size, and forced researchers to work around lingering hesitancy toward in-person studies. Strict BMI cutoffs led to high exclusion rates, and hydration (an MRI confounder) went untracked.  

Key Takeaways

This study reminds clinicians not to dismiss iron just because ferritin (iron stores) lands in the “normal” range. Even in women who are non-anemic and menopausal, low-normal levels may quietly impair cognitive performance. The findings frame iron as a helpful tool, not a double-edged sword. Consider checking ferritin in all women, especially during the menopausal transition. While guidelines vary, most experts agree that ferritin <30 μg/L—or higher if symptoms exist—warrants supplementation. Proper weight-based dosing and cofactor support can ease GI side effects while ferritin is raised to at least 100 μg/L. Larger studies are still needed to confirm these findings and iron out the details—but the fog may already be lifting.

For more education on iron deficiency, check out this CME podcast: “I Am Tired!” How Common Is Iron Deficiency in Women?

A New Traumatic Brain Injury Playbook

NEURO NEWS

The Glasgow Coma Scale (GCS) has steered traumatic brain injury (TBI) assessment since the era of smoking in hospitals and optional seat belts. But after 50 years of slotting patients into the vaguely defined buckets of “mild,” “moderate,” or “severe,” the system has finally yielded to the gravitational pull of progress. A new framework discards those catch-all labels and delivers actionable nuance to how clinicians evaluate TBIs.

Introducing the CBI-M

A global coalition of experts and patients—helmed by the NIH—built the new TBI classification system: CBI-M. The name leans on its four diagnostic pillars: clinical, biomarker, imaging, and modifiers. Instead of defaulting to “mild” for any patient who is conscious and upright, clinicians will quantify eye, verbal, and motor responses; assess pupil reactivity; and document symptoms like amnesia, headache, and noise sensitivity. They’ll use blood biomarkers, adapted from military research, to detect cellular damage early. CT and MRI testing will flag injuries that affect both immediate care and long-term recovery. Lastly, the modifiers pillar will broaden the patient profile to capture injury mechanism, prior TBIs, medications, mental health, and social context.  

Key takeaways

Clinicians are field-testing CBI-M in trauma centers; wider adoption will follow once it clears validation hurdles. The authors argue that a half-century of labeling TBIs as “mild,” “moderate,” or “severe” has failed to capture the lived experience of recovery. “Patients labeled as ‘mild’ TBI were told they could go back to work in a couple days. Six weeks later, they’ve got pounding headaches, problems with their visual system, they’re not sleeping well. There’s nothing mild about that,” says Dr. Geoff Manley, lead author of the new framework. “On the other hand, there are patients that were diagnosed with ‘severe’ TBI leading full lives, whose families had to consider removing life-sustaining treatment,” he added. Designed for acute care, the new framework also supports outpatient use and may sharpen follow-up decisions, improve trial design, and finally align diagnosis with the complexity of TBI recovery.

For more education on brain health, check out this CME activity: Brain Health Across the Lifespan: A Patient’s Journey

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