Brain health Archive

Research we're watching

Although hormone therapy was once thought to help preserve cognitive function after menopause, there is mounting evidence to the contrary, including a recent report from the Kuopio Osteoporosis Risk Factor and Prevention Study.

Researchers in that project sent questionnaires to all women ages 47 to 56 who lived in the Finnish province of Kuopio in 1987. The women completed questionnaires every five years, providing information about their lifestyles, medication use, and illnesses. The researchers checked the information in the questionnaires against prescription registries and medical records up to 2009.

Research we're watching

Aging brains often show signs of microscopic strokes, which result from damage to tiny blood vessels within the brain. Those that occur in the brain's outermost layer — called cortical cerebral microinfarcts (CMIs) — usually don't cause any symptoms. But they are more common in autopsies of people diagnosed with dementia. Now, new research suggests a link between blood markers for early heart disease and CMIs.

The study, published online Feb. 6, 2017, by JAMA Neurology, included 243 people who attended a memory clinic. All had brain scans to check for CMIs and blood tests that measured two substances associated with early signs of heart damage. People who had CMIs (nearly 29% of the participants) were much more likely to have heart disease than those who didn't have CMIs. Higher levels of both substances associated with heart damage were also linked to CMIs — even when the researchers left out people who already had obvious symptoms of heart disease.

In the journals

A study of almost 31,000 men whose prostate cancer had not spread found that the use of androgen deprivation therapy (ADT) was not associated with a higher risk of Alzheimer's disease. This counters previous studies that suggested a possible link. The results were published in the January 2017 Journal of Clinical Oncology.

ADT is used in prostate cancer treatment to eliminate testosterone, since the hormone can fuel the disease. Testosterone levels also are traditionally lower in men with Alzheimer's compared with control groups, which suggests there may be a connection between lowering testosterone and an increased risk of Alzheimer's. Previous studies that have explored this connection found that a low testosterone level caused by ADT was associated with a higher probability of developing Alzheimer's. But these studies often covered a shorter time period — for instance, one year or less — and it is doubtful that men were on ADT long enough to cause Alzheimer's.

In the journals

Low-dose aspirin therapy is standard treatment for people who have suffered a heart attack or stroke to protect them from a second one. But what about people who don't have cardiovascular disease, but do have specific risk factors, such as type 2 diabetes? A study published in the Feb. 14, 2017, Circulation found that low-dose aspirin therapy in fact did not lower this group's risk for heart attack or stroke.

The researchers recruited more than 2,500 people, ages 30 to 85, with type 2 diabetes and randomly assigned them to take either 81 mg or 100 mg of aspirin daily, or no aspirin, for three years. At the 10-year follow-up, they found that the aspirin therapy did not lower risk of either heart attack or stroke compared with taking no aspirin at all. The reason is not clear, but the researchers speculated that people with diabetes might not experience the expected anti-clotting action of aspirin.

Ask the doctor

 Image: © bowdenimages/Thinkstock

Q. I've been taking the blood thinner warfarin (Coumadin) for a few years. I know there are new kinds of blood thinners, but I've heard they have downsides. Should I stick with warfarin?

A. Here's what you need to know. Some medical conditions lead to blood clots. The most common one is the irregular heart rhythm called atrial fibrillation. About 20% of all strokes are caused by clots that result from atrial fibrillation — usually because of inadequate treatment with blood thinners.

Research we're watching

Following a Nordic diet — which features fish, whole grains, plus fruits and vegetables popular in Scandinavian countries — may help lower the risk of stroke, a new study suggests.

The study, published in the February 2017 issue of Stroke, included more than 55,000 Danish people from a national health registry, all of whom filled out questionnaires about their diets and other lifestyle habits. Researchers looked at how closely the participants followed the Healthy Nordic Food Index, which includes six food categories: fish, apples and pears, root vegetables (such as carrots and celery root), cabbages (which also include broccoli, cauliflower, kale, and Brussels sprouts), rye bread, and oatmeal.

In the journals

Previous research has suggested that slow walking speed might predict cognitive decline, but a recent study suggests how you walk also may provide clues. The results were published online Nov. 19, 2016, by the Journal of Alzheimer's Disease.

Researchers examined medical records of more than 3,400 people ages 70 to 89 who had completed both a neurological examination and gait analysis to measure walking movements like stride length, step count, cadence, stance time, and arm swings.

In the journals

People who suffer from migraines have increased risks of stroke and hospital readmission within 30 days after having surgery, according to research published online Jan. 10, 2017, by BMJ.

The study included 124,558 patients (45% of whom were men), who had a history of migraines, either with or without aura (a period of symptoms, such as flashes of light or facial tingling, that precedes the migraine). The researchers monitored the condition of all the patients after either inpatient or outpatient surgery. They then looked at how many had strokes and how many were readmitted to the hospital over the following 30 days.

Research we're watching

Mentally engaging activities have been long been promoted for staving off dementia, but there isn't a lot of information about whether doing them late in life is effective in preventing mild cognitive impairment (MCI), a precursor of dementia. To help fill that gap, researchers from the Mayo Clinic Study of Aging followed 956 men and 973 women ages 70 or older who had normal scores on mental function tests. The participants answered periodic questionnaires detailing whether and how often they read books, did craft projects, used a computer, played games, and engaged in social activities like going out to movies and plays. They also underwent neurologic exams and completed tests to assess mental function. Over an average of four years, 456 participants developed mild cognitive impairment.

When the researchers analyzed the results, they found that playing games, doing craft projects, using a computer, and engaging in social activities were associated with a significant reduction in the risk of developing mild cognitive impairment.

Author and migraine sufferer Joan Didion once wrote, "That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing." At that time, migraines weren't something that could be prevented. Today, that's a possibility for some people who have severe migraines, frequent migraines (more than three or four times a month), or migraines that don't respond well to treatment.

The cornerstone of migraine prevention is managing triggers like stress or certain foods or strong perfumes. Alternative and complementary therapies (like acupuncture) help some migraine sufferers keep headaches at bay.