Brain health Archive

In the journals

Because older adults often experience temporary changes in memory and thinking after having general anesthesia, they may worry that it increases their risk of dementia. A recent study should help put their minds at ease. Researchers found no association between the type of anesthesia and dementia risk, according to findings published online Oct. 6, 2020, by the Journal of the American Geriatrics Society.

The study looked at almost 7,500 people ages 66 or older without diagnosed dementia who underwent surgery requiring either general anesthesia (where you are unconscious) or regional anesthesia (where you are awake and the surgical area is numbed). The researchers included only people who had not had any previous surgery and stopped assessing those who had a second surgery later.

Ask the doctor

Q. I read that the death rate from COVID-19 is going down, but that people who recover from the infection still can remain sick for a long time. Is that true?

A. It is true, but we don't yet know how big the problem is: COVID-19 has been with us for only a year, and there hasn't been enough time to know the long-term effects.

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.

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.

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.

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.

Research we're watching

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart's arteries, according to a study published online Aug. 29, 2020, by the European Heart Journal. The findings may explain why the drug, icosapent ethyl (Vascepa), lowers the risk of heart attack and stroke by 26% in people at high risk for those serious problems.

The study included 80 people with fatty plaque in the arteries of the heart (coronary artery disease). Most of them had diabetes and were taking a statin. Their trigly­cerides were elevated, ranging from 135 to 499 milligrams per deciliter. Half were randomly assigned to take 4 grams of icosapent ethyl daily; the other half received a placebo.

In the journals

Scientists continue to explore the right balance of carbohydrates and fat in people's diets. But for overweight or obese older adults, a recent study found that a low-carbohydrate, high-fat diet might offer special health benefits. The results were published online Aug. 12, 2020, by Nutrition and Metabolism.

Researchers asked 40 obese adults, ages 60 to 75, to follow an eight-week diet in which 10% of calories came from carbs, 25% from protein, and 65% from fat. Carb sources included leafy greens, non-starchy vegetables, some fruit, and high-fiber grains. Protein intake consisted of eggs, fish, pork, and poultry. Fat-containing foods included olive oil, coconut oil, nut oils, nut butter, cheese, coconut milk, and avocados.

Millions of people suffer from migraines, and research has been trying to understand what causes them. A current theory involves branches of the trigeminal nerve. Now the FDA has cleared an over-the-counter device to prevent or treat migraine by stimulating this nerve with mild electrical shocks.

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.