Alzheimer's Disease Archive

Heart failure, stroke, and kidney failure are among the well-documented dangers of long-term high blood pressure, also known as hypertension. According to a study in the August 4 JAMA Neurology, loss of thinking power can be added to that list. Researchers analyzed the results of three tests of learning, memory, and thinking skills conducted on more than 13,000 people ages 48 to 67 who took part in the Atherosclerosis Risk in Communities study. Over a 20-year period, the scores for individuals with high blood pressure (defined as 140/90 mm Hg or higher) dropped 6.5% more than the scores of people with normal blood pressure. People with mildly elevated blood pressure, called prehypertension, saw a 4.8% decrease in thinking ability. Those who were diagnosed with high blood pressure but took medicine to control it scored in the middle.

The authors note that even moderate cognitive decline increases the risk of eventual dementia. Based on their findings, controlling blood pressure during middle age appears to be especially important in protecting against loss of memory and thinking skills later in life. 

Q. My doctor just diagnosed me with mild cognitive impairment, which has been quite upsetting. She told me that there isn't any medication to take that will keep this from getting worse. But I know of someone with this same problem who is taking a pill for it. Is my doctor right?

A. I can see how this could be distressing to you. However, your doctor is right. There is no evidence that for people with mild cognitive impairment (MCI) taking any sort of pill—prescription or otherwise—prevents their memory problems from getting worse.

There is evidence that statins both lower dementia risk and impair memory. What should you do?

A few years ago, research began to suggest that people who took statins to reduce their risk of cardiovascular disease also had a lower risk of developing dementia. At the same time, however, some people who were taking statins were reporting memory loss, forgetfulness, and unfocused thinking. In 2012, the FDA expanded its advisory on statin risk to include cognitive impairment.

Long-term studies show men how to boost their odds of remaining free of disease and disability in later life.

Top action steps to take when the doctor says it's mild cognitive impairment.

Here's another reason to keep straining your brain as you age: a study published June 23, 2014, in JAMA Neurology has once again confirmed the "use it or lose it" theory, which holds that staying mentally active by reading books, participating in social activities, and doing computer activities at least three times per week keeps the aging brain sharp. "If you use your brain, it will respond. Anything you try to figure out—whether it's what the stock market is doing, if it's going to rain tomorrow, or what to plant in your garden—will sharpen your ability to remember facts and reason and make decisions. Just keep intellectually active," says Dr. David Caplan, a Harvard Medical School professor of neurology. The study also split apart the effect of education and occupation earlier in life from mental activity later in life. The more mental challenge a person had from earlier education and work, the less "bump" he or she got from intellectual activity later. But that same lifetime intellectual enrichment from higher education and more complex jobs was associated with a delay of almost nine years in the onset of cognitive problems among people who carried the APOE4 gene, a risk factor for Alzheimer's disease.

Q. I've read a lot lately about blood tests for predicting your risk for Alzheimer's disease. Do they work?

A. Researchers are working hard to create an "early detection" blood test for Alzheimer's disease. But right now, none can accurately predict an individual's risk for the illness.

Men who live the most intellectually enriched lives may experience decline in mental skills significantly later than those who led less mentally enriching lives, according to a long-term aging study in JAMA Neurology. But even those who commit to a mentally active life later in the game may still benefit.

Subtle changes in memory that concern you may be an early warning sign of declining mental skills. Get an assessment.

Forgetfulness becomes more common with age for most of us. But even if your doctor says your memory is perfectly normal for your age, you may still be concerned about memory slips that seem new or unusual. Recent research suggests that sometimes (but not always) these changes may be early warning signs of future decline. But this merits a closer look, not a panic attack.

"We don't want to worry the public that if they forget where their keys are they are on the path to Alzheimer's disease," says neuropsychologist Rebecca Amariglio, an instructor in neurology at Harvard Medical School. "But there is a growing appreciation we should not dismiss those concerns. It may be worth talking to a doctor and getting a baseline assessment."

Stay away from simplistic check-the-box memory quizzes. They may lead to unnecessary worry—or false reassurance.

Memory tests are all over the Internet, but they are notoriously poor at evaluating your memory and mental skills. If you are already concerned about your memory and wonder if it means Alzheimer's disease, talk to a professional. "If people are that worried, they really should make an appointment with a doctor," says Dorene Rentz, clinical neuropsychologist and co-director of the Center for Alzheimer Research and Treatment at Harvard Medical School.