Alzheimer's Disease Archive

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

News briefs

Need a little inspiration? The next time you take a walk outside, note things that spark a sense of wonder or awe. That's what some older adults tried for a small study published online Sept. 21, 2020, by the journal Emotion. Of the 50 people who took part, half went for weekly 15-minute walks outdoors (alone) for eight weeks, and snapped "selfies" along the way. The other half took the same walks and selfies, but visited a new place each time. They were asked, especially, to note things that inspired a sense of awe — like tree colors or leaves underfoot softened by rain. Participants also answered surveys about the emotions they felt on walk and non-walk days. After analyzing responses and photos, scientists found that people who people took the "awe walks" reported less distress and increasing awe, joy, compassion, and gratitude, compared with people on the regular walks. Awe walkers also smiled more and made themselves smaller in their photos, focusing more on landscapes — a sign of a greater appreciation of the world around them. Try it yourself: On your next walk, imagine you're seeing things for the first time. What will inspire you? Perhaps a path lined with trees, the shore of a lake, or an up-close look at skyscrapers. Jot down your observations, and see if you feel a sense of wonder and joy. Happy trails!

Image: © Igor Alecsander/Getty Images

On call

Q. I would occasionally get some swelling in my legs. But now I notice it by late afternoon every day. I otherwise feel fine. Should I be worried?

A. It sounds like you have edema, swelling in your legs due to fluid in the soft tissues beneath your skin. This usually occurs when pressure from the fluid inside your veins is high, which forces water out of the blood vessels and into the surrounding tissues.

The pandemic has made it especially hard for people with persistent depressive disorder.

Almost everyone goes through rough mental patches. You may feel down, sad, and lethargic. Most people bounce back with no problem, but if these feelings become more frequent and linger longer, you could have a mild, yet still serious form of depression called persistent depressive disorder (PDD), also known as dysthymia.

Older adults are especially vulnerable to PDD, and more so during the COVID-19 pandemic, says Dr. David Mischoulon, a psychiatrist at Harvard-affiliated Massachusetts General Hospital. "While the COVID pandemic affects everyone, older adults have experienced increased stressors like economic issues, prolonged isolation, and the threat of getting sick, all of which can trigger feelings of anxiety and depression beyond the norm."

In the journals

Researchers are close to finding early cancer with a blood test. They may soon do the same with Alzheimer's disease. A new blood test called p-tau217 has shown great promise in diagnosing people with the disease, according to findings published online July 28, 2020, by JAMA.

The test looks for a specific type of tau protein in the blood. In people with Alzheimer's, tau protein in the brain forms tangles. Accumulation of tau protein tangles along with beta-amyloid deposits is thought to play a key role in how the disease develops.

Here's how to cope when your usual traditions get uprooted.

The holiday season, like just about everything else this year, probably won't look the same as usual. Whether that means going to smaller gatherings without the usual relatives, quarantining when traveling, or staying home entirely, chances are something will be different this year thanks to the COVID-19 pandemic. For many who look forward to a full table at Thanksgiving or a big party on New Year's Eve, these changes are unwelcome, and frankly a little depressing.

In response, people may experience emotions ranging from guilt to loneliness to a feeling of disconnected sadness, says Dr. Hilary Connery, assistant professor of psychiatry at Harvard Medical School.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

On call

Q. What would cause my tongue to suddenly swell? Could this be a possible side effect of medication, or something else?

A. There are many reasons for a swollen tongue. Indeed, a reaction to a medication is one of the more common causes. For example, a well-known side effect of ACE inhibitors (a class of drugs used to control blood pressure) is a condition called angioneurotic edema. Swelling of the face, lips, and tongue can happen quickly in people who take an ACE inhibitor. The reaction may occur soon after it's first taken or at any time thereafter. Sometimes people get this reaction even though they have used the drug for several years. ACE inhibitors are more likely to cause angioneurotic edema in African Americans.

New guidelines suggest doing more of the same. The problem is that many people don't.

You never forget your first gout attack. The severe pain, swelling, and redness hits hard and fast. The initial attack often strikes your big toe's large joint, but later ones might affect the foot or ankle. Other hot spots include the knees, hands, and wrists.

First-line treatment is quite effective and includes anti-inflammatory medications, ice therapy, and rest. A combination of diet and lifestyle changes and prescription drugs — an approach called urate-lowering therapy, or ULT — is typically recommended if attacks recur or become more severe.