Brain health Archive

The shift from this condition to dementia is not necessarily inevitable.

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Will I get dementia? That common question takes on urgency if you have mild cognitive impairment (MCI), a slight but noticeable change in memory and thinking skills. But the progression from MCI to dementia is not automatic. In fact, MCI is not always permanent. "It depends on the underlying cause," says Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital.

What are the causes of MCI?

MCI is not dementia (see "What is dementia?"), but it's not normal thinking, either. It often stems from disease or treatments for disease, including

Listening to music may boost exercise ability, ease stress and anxiety, and enhance recovery from strokes.

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Whether you prefer Stravinsky's symphonies or the Beatles' ballads, you probably listen mostly because you simply like how they sound. You might not realize that music engages not only your auditory system but many other parts of your brain as well, including areas responsible for movement, language, attention, memory, and emotion.

"There is no other stimulus on earth that simultaneously engages our brains as widely as music does," says Brian Harris, certified neurologic music therapist at Harvard-affiliated Spaulding Rehabilitation Hospital. This global activation happens whether you listen to music, play an instrument, or sing — even informally in the car or the shower, he says. And it helps to explain how and why music therapy works (see "Singing — and striding — stroke survivors").

On call

Q. What is the significance of mild narrowing of the carotid artery detected by an ultrasound? I have never had any symptoms of stroke.

A. "Mild" narrowing ranges from 15% to 49% blockage of the artery. Over time, this narrowing can progress and lead to a stroke. Even if it doesn't progress, mild narrowing is a sign of early blood vessel disease and calls for preventive measures.

We’ve all experienced the feeling of sluggish, fuzzy thinking and a lack of sharpness, possibly caused by an illness or a medication. But what if that feeling didn’t go away and your thinking didn’t return to normal? That’s the situation for some people who have recovered from COVID-19, and there can be long-term effects on other organs as well.

it is becoming increasingly clear that COVID-19 affects the nervous system along with the respiratory system. Research is suggesting that this may result in long-term neurologic damage in those who survive a COVID infection, including evidence of effects on cognitive function.

Research we're watching

People with atrial fibrillation (afib) who consume more than 14 alcoholic beverages a week may face a higher risk of stroke and other blood clot-related problems, according to a new study.

The study included 9,411 people with afib, who were divided into four groups based on how much they typically drank per week: abstainers or rare drinkers (less than one), light drinkers (less than seven), moderate (seven to 14), and heavy (14 or more). Researchers then tracked the participants for a median follow-up period of 17.4 months, noting the incidence of strokes, transient ischemic attacks (ministrokes), blood clots in a limb or organ (embolisms), or hospitalization for management of either atrial fibrillation or heart failure.

These drugs actually help stop dangerous blood clots from forming. Here's when you may need them.

Nearly everyone has heard of "blood thinners." Maybe you or someone you know takes one. But these drugs don't "thin" blood at all.

"They are actually anti-clotting drugs," says Dr. Gregory Piazza, a cardiologist with Harvard-affiliated Brigham and Women's Hospital. "They prevent potentially dangerous blood clots from developing in people at high risk, like those who have atrial fibrillation or a stent in a blood vessel, or who are immobile after surgery."

About one in five people has high levels of lipoprotein(a), a fatty particle linked to premature heart disease.

Most people probably haven't heard of lipoprotein(a), although that's not surprising. Cardiologists have known for years that having high levels of these fatty particles circulating in the bloodstream poses a risk to the cardiovascular system. But there wasn't much they could offer in terms of therapy, so widespread testing for lipoprotein(a) — also known as Lp(a) — didn't make sense.

Recent progress means the landscape may soon be shifting. Earlier research showed that injectable cholesterol-lowering drugs known as PCSK9 inhibitors, such as evolocumab (Repatha) or alirocumab (Praluent), may lower Lp(a) by up to 25%. Until last year, however, it wasn't clear whether that reduction actually helped people with high Lp(a).

Stress management may reduce health problems linked to stress, which include cognitive problems and a higher risk for Alzheimer's disease and dementia.

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It's not uncommon to feel disorganized and forgetful when you're under a lot of stress. But over the long term, stress may actually change your brain in ways that affect your memory.

Studies in both animals and people show pretty clearly that stress can affect how the brain functions, says Dr. Kerry Ressler, chief scientific officer at McLean Hospital and professor of psychiatry at Harvard Medical School. Scientists have seen changes in how the brain processes information when people experience either real-life stress or stress manufactured in a research setting. (For the latter, researchers might challenge subjects to perform a difficult task, such as counting backward from the number 1,073 by 13s while being graded.) Either type of stress seems to interfere with cognition, attention, and memory, he says.

So how do you keep your brain healthy, stay cognitively fit, and build your cognitive reserve? It's easier for some people than for others. And though genetics set the stage for your brain health, you can do something to improve your brain health and cognitive fitness.

First it is important to remember that you need a healthy body to have a healthy brain. Therefore, ensuring your brain health depends upon regularly seeing your doctor, following her or his recommendations, and managing any health conditions you have.