Archive for September, 2014

Memory slips in your 70s may be an early hint of future dementia

Julie Corliss
Julie Corliss, Executive Editor, Harvard Heart Letter

Of all the health issues that loom large with age, memory loss is among those that provoke the most worry. A big reason is the uncertainty: people often wonder if their occasional memory slips are just a normal part of growing old or a sign of impending Alzheimer’s disease, the most common form of dementia. A new study of older adults, published in today’s issue of the journal Neurology, sheds some light—and perhaps offers a bit of reassurance—about the connection between self-reported memory loss and a diagnosis of dementia. Over a 10-year period as 70-somethings turned into 80-somethings, about 1 in 6 developed dementia. About 80% had reported memory changes. But it took about nine years from the first self-report of a memory change to a diagnosis of mild cognitive impairment, an intermediate stage between normal memory loss and dementia. The transition to dementia usually took about 12 years.

Protecting your children against Enterovirus D68

Nancy Ferrari
Nancy Ferrari, Senior editor, Harvard Health

Enterovirus D68 is a respiratory infection that has been spreading across the country and making some children quite ill. It is especially problematic for kids with asthma or other respiratory issues. Enterovirus D68 can start out looking like a garden variety cold but lead to serious trouble breathing. What’s a parent to do? The same things he or she would normally do during cold and flu season: hand washing, staying away from people who are sick, regularly cleaning common surfaces like doorknobs, not sharing cups and utensils, and coughing or sneezing into the elbow, not the hands. Those who have children with asthma need to be extra vigilant about their child’s asthma care routine. Most upper respiratory infections are the simple cold. Still, it’s important to stay alert for signs of breathing difficulties.

New guidelines recommend Kegels, other lifestyle treatments for urinary incontinence in women

Heidi Godman
Heidi Godman, Executive Editor, Harvard Health Letter

New guidelines from the American College of Physicians offer drug-free ways women can use to reduce or stop urinary incontinence, a potentially embarrassing condition that affects millions of women. The guidelines recommend that women first try Kegel exercises, bladder training, exercise, and weight loss if needed. These approaches can work for both of the leading types of urinary incontinence: stress incontinence (leakage with laughter, sneezing, or other things that put pressure on the bladder) and urge incontinence, also known as overactive bladder, which is caused by unpredictable contractions of muscles in the bladder wall. Other lifestyle changes, like watch fluid intake and minimizing bladder irritants like caffeine, alcohol, carbonated drinks, and other may also help. If these approaches aren’t effective, the next step might be treatment with medication, surgery, or even an injection of botulinum toxin to relax overactive bladder muscles.

FDA approves weight-loss drug Contrave

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

For the third time in two years, the FDA has approved a drug to help people lose weight. The new drug, Contrave, combines two generic drugs, naltrexone and bupropion. Naltrexone is used to help kick an addiction to alcohol or narcotics. Bupropion is used to treat depression and seasonal affective disorder. Many people also take bupropion to stop smoking. Neither naltrexone nor bupropion by itself has been approved for weight loss. Specifically, Contrave was approved for use by adults who are obese (meaning a body-mass index of 30 or higher) and by overweight adults (body-mass index between 27 and 30) who have at least one other weight-related condition or illness, such as high blood pressure or type 2 diabetes. Across the clinical trials on which the FDA based its approval, some people lost more than 5% of their body weight. But it’s important to note that more than 50% had minimal or no weight loss. Side effects ranging from seizures and high blood pressure to diarrhea and constipation were reported.

Benzodiazepine use may raise risk of Alzheimer’s disease

Beverly Merz
Beverly Merz, Executive Editor, Harvard Women's Health Watch

Drugs in the benzodiazepine family have long been used to treat anxiety and sleep problems. They can cause a bit of a brain hangover the next day. Experts have long assumed that people’s heads would clear once they stopped taking the drug. That may not be the case. In a study published last night by the journal BMJ, a team of researchers from France and Canada linked benzodiazepine use to an increased risk of being diagnosed with Alzheimer’s disease. In the study, the greater a person’s cumulative dose of benzodiazepines, the higher his or her risk of Alzheimer’s. Taking a benzodiazepine for less than three months had no effect on Alzheimer’s risk. Taking the drug for three to six months raised the risk of developing Alzheimer’s by 32%, and taking it for more than six months boosted the risk by 84%. People taking a long-acting benzodiazepine were at greater risk than those on a short-acting one.

Myth busted: bra wearing not linked to breast cancer

2 Minute Medicine®

According to one persistent Internet myth, women who wear bras are more likely to develop breast cancer. Not true, says a study published online in the journal Cancer, Epidemiology, Biomarkers, and Prevention. In a study of more than 1,500 women, researchers from the Fred Hutchinson Cancer Research Center in Seattle found no links between risk of two common types of breast cancer — invasive ductal carcinoma or invasive lobular carcinoma — and any aspect of bra wearing, including cup size, use of a bra with an underwire, age at first bra use, and average number of hours per day a bra was worn. This may not be the last word on the subject, since the Fred Hutchinson study represents only the second to look at the connection between bra use and breast cancer. But until other findings appear, women worried that wearing a bra might cause cancer have one less thing to worry about.

Low fat? Low carb? Almost any healthy diet can work for losing weight

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

The results of a clinical trial reported in yesterday’s Annals of Internal Medicine showed that low-carb diets helped people lose weight better than low fat diets. A report in today’s Journal of the American Medical Association tells a somewhat different story. A review of 48 head-to-head diet trails showed that average weight loss on either a low-carb or low-fat diet for 12 months was the same, about 16 pounds. And when the researchers compared named diets, which ranged from the low-carb Atkins and South Beach diets to moderates like Weight Watchers and Jenny Craig and low-fat approaches like the Ornish diet, all yielded similar weight loss. The main message from careful comparisons of different diets is that there’s no single diet that’s right for everyone. Any healthy diet can help people lose weight. And there’s more to a diet than weight loss. What’s needed for long-term health is an eating plan that can be followed day in and day out that is good for the heart, bones, brain, and every other part of the body. One eating strategy that can provide all that is the so-called Mediterranean diet.