Posts by Beverly Merz
A new report from the University of Washington links long-term use of anticholinergic medications and dementia. Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson’s disease. The study found that people who used anticholinergic drugs were more likely to have developed dementia as those who didn’t use them. Dementia risk increased with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less. Safer alternatives to anticholinergic drugs exist.
One way to avoid adding extra pounds over the holiday season is by relying on the glycemic index to choose your foods and snacks. The glycemic index is a measure of how fast carbohydrates are turned into sugar. The higher a food’s glycemic index, the faster your body turns that food into sugar, and the sooner the “hunger bell” rings again. This can set into motion the cycle of holiday overeating. One way to go low glycemic: Choose foods your grandmother used to eat—ones that resemble things in nature, and don’t come with long lists of ingredients.
The best test for finding hidden lung cancer in smokers is a low-dose CT scan. Its use has been endorsed by the U.S. Preventive Services Task Force (USPSTF), an independent panel that makes recommendations for screening tests. Most insurers follow the recommendations of the task force, and pay for those services. But some opposition to this by Medicare may mean that the test isn’t covered for some of the people who could benefit from it the most. A new report in the New England Journal of Medicine showed that the cost of adding one good year to a person’s life through CT screening is around $80,000. Tests or procedures that cost less than $100,000 per year added are considered cost effective. The analysis identified two groups for whom screening is the most cost-effective—current smokers and people ages 60-74. People with private insurance will have low-dose CT scans covered. But those with Medicare may not, thanks to the decision of a Medicare advisory committee. The CMS is expected to publish a draft of its decision within the next few days and come to a final decision in early 2015.
The New York Times has described Thomas Eric Duncan, the first person to die of Ebola virus infection in the United States, as “the Liberian man at the center of a widening health scare.” Use of the term “health scare” about Ebola in the U.S. just isn’t warranted, according to a consensus of several Harvard experts who have looked at Ebola through different lenses. They give four main reasons why an epidemic of Ebola virus disease isn’t likely to happen here: 1) the virus is relatively difficult to spread; 2) we have an effective emergency-response infrastructure; 3) Most hospitals are equipped to treat Ebola safely; and 4) new treatments are in the works.
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.
A new report in JAMA Neurology offers yet another reminder why keeping your blood pressure in the healthy range for as long as you can is a good life strategy. Researchers with the long-term Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study found that memory and thinking skills declined significantly more over the course of a 20-year study in middle-aged people with high blood pressure than it did in those with healthy blood pressure. Interestingly, those who had normal blood pressure in midlife but who developed high blood pressure in their late 60s, 70s, and 80s didn’t have similar declines as those who developed high blood pressure earlier. The main take-home lesson from this study? The longer you live with normal blood pressure, the less likely you are to have memory and reasoning problems when you’re older.