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Treating neuropathy: Which medication is best?

Millions of people suffer from the burning, tingling, and numbness of a form of neuropathy called idiopathic sensory polyneuropathy. A recent study directly comparing four medications produced disappointing results, but is a step in the right direction.

Anticholinergic drugs linked with greater cognitive risk

In the journals

Many commonly used drugs have anticholinergic effects, meaning the drugs block the action of acetylcholine. Nerve cells release acetylcholine to transmit impulses to other nerves in the brain and throughout the body. Previous research has shown a link between these drugs and dementia. Now a study has found a similar link with mild cognitive impairment (MCI), especially if you take larger doses. The findings were published online Sept. 2, 2020, by Neurology.

Some medications are designed purposefully to block acetylcholine, such as those used for urinary incontinence. But more often the anticholinergic action is a side effect of drugs taken to treat conditions like allergies, colds, and depression.

Dementia declining in the United States

Research we're watching

According to a study published in the Aug. 4, 2020, issue of Neurology, the number of new cases of dementia in Europe and North America has dropped 13% every 10 years over the past 30 years. Researchers looked at data collected by the Alzheimer's Research Consortium, which included people over age 65 in Europe and the United States.

The actual number of adults with dementia has increased dramatically in recent years as life expectancy increases. The condition currently affects some 47 million people worldwide, and that number is expected to increase in coming decades.

How to recognize a ministroke or stroke — and what to do

A transient ischemic attack (TIA), or ministroke, is caused by a temporary lack of blood in part of the brain, usually from a clot. The fleeting symptoms of a TIA can be a warning of risk for an imminent, more serious stroke. In the event of a stroke, getting help immediately is crucial, and knowing the signs will make that more likely.

Why is music good for the brain?

A study conducted by AARP found correlation between a person’s engagement with music and their opinion of their brain health and cognitive ability. While the study did not involve any objective measure of brain health, music has been shown to activate multiple areas of the brain, and keeping brain pathways active helps keep the brain strong in older age.

Treating high blood pressure is good for heart and brain

In the journals

Lowering high blood pressure with medication is good for the brain as well as the heart, suggests a study published online May 19, 2020, by JAMA.

Scientists reviewed 14 trials involving more than 96,000 people who had their high blood pressure monitored without medication vs. those who took one or more blood pressure drugs, such as beta blockers, ACE inhibitors, and angiotensin-receptor blockers. Almost 58% were men, and the average age was 69. The people were tested for dementia or cognitive impairment (trouble learning a new task, concentrating, or making decisions) before taking medication. They were tested again an average of four years later.

Lowering blood pressure may help prevent dementia

High blood pressure can damage the brain in several ways. Treating this common problem can protect your mind as well as your heart.

High blood pressure seldom causes any symptoms. But over time, the excessive force and friction of blood pushing against the inner walls of the arteries can damage blood vessels throughout the body. And while the biggest threat may be to your heart, your brain can also suffer.

Even slightly elevated blood pressure in middle age has been linked to a 30% higher risk of dementia two decades later. But taking blood pressure drugs may help people avoid that risk, according to a study in the May 19, 2020, issue of JAMA.

Music to your brain

Listening to music or playing an instrument engages multiple parts of your brain — and can help your mood and memory.

Music has the ability to soothe, energize, and even to improve your memory. And tapping into its power is as simple as turning on your radio.

Whether your choice is jazz, classical, rock 'n' roll, or hip-hop, music has unique effects on the brain, says Dr. Andrew Budson, a lecturer in neurology at Harvard Medical School and chief of cognitive and behavioral neurology at the VA Boston Healthcare System. And you can reap benefits whether you are playing a musical instrument or just kicking back and listening to some tunes.

High intake of berries, apples, and tea linked to lower dementia risk

News briefs

Plants are loaded with naturally occurring chemicals that appear to help health. And high, long-term intakes of certain kinds of plant chemicals called flavonoids are associated with a reduced risk for developing dementia, according to a study published online April 22, 2020, by The American Journal of Clinical Nutrition. Researchers evaluated the health information of 2,800 dementia-free people (average age 59) who periodically underwent physical exams, had lab tests, and answered diet questionnaires. After 20 years, people who had reported the highest flavonoid intake were about 40% less likely to develop dementia, compared with people who'd reported the lowest intake. There are many different types of flavonoids; those with the greatest link to lower dementia risk came from tea, apples, pears, blueberries, and strawberries. A high intake was about the same as having 7.5 cups of berries, eight apples or pears, and 19 cups of tea per month. A low intake was about the same as having no berries or tea and less than two apples per month. The study was observational and doesn't prove that high flavonoid intake protected people from developing dementia. But researchers say other evidence suggests flavonoids may ward off brain inflammation and protect brain cells.

Image: © Slava Olshevskaya/Getty Images

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