Alzheimer's Disease Archive

Ask the doctor

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Q. Several years ago you wrote about a new technology called CRISPR that might make it possible to cure some incurable diseases. I keep hearing about this in the news. Is it any closer to reality?

A. Yes, there has been progress. What does CRISPR stand for? You don't want to know. What does it do? You do want to know, because it's pretty amazing. A colleague here at Harvard Medical School, Dr. George Church, says CRISPR enables a scientist to "edit any piece of any DNA a thousand times more easily and precisely than before, which is game-changing for gene therapies." Why would doctors and scientists want to "edit" DNA? Because disease is caused by genes that are not built properly or are not turned on and off properly. Both problems, theoretically, can be corrected by precisely editing the DNA that makes up those genes.

Harvard research suggests meaningful relationships are a prescription for better emotional, mental, and physical health.

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You probably know there are many ways to improve your well-being and chances of living longer, such as exercising more or eating better. But did you know that maintaining meaningful relationships also may play an important role in health, happiness, and longevity? "Good, close relationships appear to buffer us from the problems of getting old," says Dr. Robert Waldinger, a psychiatrist with Harvard-affiliated Massachusetts General Hospital.

Eight decades of research

Dr. Waldinger is the current director of the Harvard Study of Adult Development, an ongoing analysis that's followed more than 700 men since they were teenagers in 1938. More than 60 of the original participants, now in their 90s, are still taking part.

If you have a hacking cough and breathlessness, don't chalk it up to aging.

Maybe you never smoked, or you stopped decades ago. But you may still be at risk for chronic obstructive pulmonary disease (COPD). That's the umbrella term for a number of lung diseases that sometimes lead to disability and even death. "While about 80% of COPD cases are related to having smoked, 20% are not," says Dr. Bartolome Celli, a pulmonologist with Harvard-affiliated Brigham and Women's Hospital.

Diseases and symptoms

COPD includes emphysema, chronic bronchitis, severe asthma, or a combination of these conditions. They cause inflammation, destruction, or abnormal repair of airways and lung tissue, which reduces airflow and ultimately makes it harder to take in enough oxygen to supply the body.

A rapid heartbeat can be frightening, but this often-fleeting problem is usually harmless.

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If you're exercising or feeling very nervous, you expect your heart to beat faster than normal. But what if your heart sometimes starts racing out of the blue, for no apparent reason? You might have supraventricular tachycardia, or SVT. SVT is an umbrella term that covers several different types of rapid heart rhythms, all of which are caused by an electrical glitch in the upper part of the heart.

The most common SVTs are atrial fibrillation — a rapid, chaotic rhythm that increases the chance of having a stroke—and atrial flutter, a fast but usually regular heartbeat. But when cardiologists talk about SVT, they're usually referring to three different, less-common conditions (see "What is supraventricular tachycardia?").

By the time memory loss shows up, the disease is well under way. Researchers are finding ways that may reveal brain changes sooner.

For a long time, memory loss was seen as the telltale sign of Alzheimer's disease. While this is certainly the most common symptom, it may not be the best way to identify the disease in its early stages.

"A major problem of Alzheimer's diagnosis, and ultimately effective treatment, is that by the time the first clinical symptoms appear, irreversible damage to the brain has already occurred," says Dr. Seth Gale, a neurologist with Harvard-affiliated Brigham and Women's Hospital. "It is now believed that Alzheimer's-related changes begin in the brain at least a decade before any symptoms emerge."

A discussion with your doctor may minimize your chance of becoming dependent on or addicted to these powerful painkillers.

Opioid misuse is now one of most important health problems in the United States, rivaling smoking as a cause of death. Although news reports tend to focus on an opioid crisis among the young, the opioid epidemic is increasingly affecting older people as well. In fact, the rates of hospitalization for opioid overdoses among Medicare recipients quintupled from 1993 through 2012. Although older people are still less likely than younger ones to become addicted or succumb to opioid overdoses, they are more likely to suffer side effects from extended opioid use, including memory and cognition problems and falls.

"Opioid use and pain management is something we deal with constantly," says Dr. Michael L. Barnett, assistant professor of health policy at the Harvard T.H. Chan School of Public Health. According to a report from the U.S. Department of Health and Human Services, nearly one-third of Medicare beneficiaries received at least one prescription for opioids in 2015, and those who did got an average of five such prescriptions or refills. Dr. Barnett and a team of his colleagues decided to investigate how Medicare recipients get opioid prescriptions in the first place.

Most people who are suffer from fecal incontinence do so in silence. As a result, the number of people with the condition — which results in the involuntary release of gas or stool — isn't known. But the scant evidence at hand indicates that it usually begins during one's 40s or 50s.

You don't have to live with incontinence — there are treatment options, which include dietary changes and bowel training regimens, and surgery for some people.

There is growing evidence that the placebo effect is at work in most successful medical therapies.

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When you were a child, your mother or grandmother might have used a home remedy that made you feel better, especially when it was delivered with a soothing hand on the forehead or a kiss on the cheek. Perhaps she assured you that a cup of warm milk would help you fall asleep, and you found that it did.

Unbeknownst to you — or her — she was probably harnessing the placebo effect, loosely defined as a favorable response to a medical intervention that doesn't have a direct physiological effect. Although you may have learned later in life that there isn't much scientific evidence to support the practice, you may still sleep better after a cup of warm milk at bedtime.

This common type of arthritis can show up suddenly and cause debilitating pain.

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The great artists Ludwig van Beethoven, Luciano Pavarotti, and Leonardo da Vinci had more than extraordinary talent in common; they were also sufferers of a type of inflammatory arthritis called gout. You may be at risk of joining their ranks if you have any potential triggers for the condition. "Most people are surprised by their initial gout diagnosis, unless they have a strong family history," says Dr. Mark Fisher, a rheumatologist at Harvard-affiliated Massachusetts General Hospital.

About gout

Gout is mostly a man's condition, although women can experience it, too. It's caused by a buildup of uric acid — a waste product from the breakdown of natural chemicals called purines (an essential part of DNA).

Because medications cannot effectively treat aortic stenosis, a stiff, narrowed aortic valve needs to be replaced.

Your aortic valve is the gateway between your heart and body. With every heartbeat, it opens to allow blood to flow to your body, then snaps shut to keep blood from moving back into the heart.

As people age, calcium deposits may collect on the hard-working aortic valve, causing it to stiffen and narrow. Known as aortic stenosis, this condition also can result from a genetic abnormality (see "What is a bicuspid aortic valve?"). But most cases are in older people, often — but not always — those with high blood pressure, high cholesterol, and other risk factors linked to heart disease. In the United States, about three to four of every 100 people ages 75 and older have severe aortic stenosis.