Brain health Archive

Green vegetables and citrus fruits are good natural sources of folate.

If you're among the one in three American adults with high blood pressure, be sure you're getting enough of the B vitamin known as folate. Doing so may lower your odds of having a stroke, a new study suggests.

Can a Mediterranean-type diet with extra servings of nuts and extra-virgin olive oil help protect memory and thinking skills with age? A study in this week’s JAMA Internal Medicine suggests that it might. The findings come from a small substudy done as part of the PREDIMED trial, which showed that a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced heart attacks, strokes, and other cardiovascular problems among people at high risk for them. Although the results of the new PREDIMED study are promising, its small size and the fact that it wasn’t designed to look at connections between diet and brain health mean the results need to be taken with a grain of salt. That said, since there’s no downside to following a Mediterranean diet, an added bonus beyond great taste could be protecting memory and thinking skills.

Atrial fibrillation is a heart rhythm disorder that affects millions of people. It can lead to potentially disabling or deadly strokes. Researchers from Johns Hopkins University School of Medicine adding motion-tracking software to standard MRI heart scans of 149 men and women with atrial fibrillation. The scans revealed specific changes in the muscles of the left atrium that increased stroke risk in some of the volunteers. These changes were not associated with age or other risk factors for stroke. This could help many people with this condition to avoid taking warfarin or other clot-preventing medications for life. But it is much too early to include MRI as part of the standard evaluation of people with atrial fibrillation — not to mention that such scans would significantly increase the cost of these evaluations. For now, doctors will continue to use standard tools to help determine stroke risk.

Is brain damage an inevitable consequence of American football, an avoidable risk of it, or neither? An editorial published yesterday in the medical journal BMJ poses those provocative questions. Chad Asplund, director of sports medicine at Georgia Regents University, and Thomas Best, professor and chair of sports medicine at Ohio State University, offer an overview of the unresolved connection between playing football and chronic traumatic encephalopathy, a type of gradually worsening brain damage caused by repeated mild brain injuries or concussions. The big question is whether playing football causes chronic traumatic encephalopathy or whether some people who play football already at higher risk for developing it. The Football Players Health Study at Harvard University hopes to provide a solid answer to that and other health issues that affect professional football players.

Preventing stroke is the top priority if your heart is beating irregularly. A variety of options can control symptoms.

A flutter in the chest and a racing heartbeat could be just a passing cardiac blip, perhaps triggered by emotional stress or too much caffeine. But sometimes it's a sign of atrial fibrillation—the irregular quivering of the heart's upper chambers, or atria.

Many men consider taking a daily low-dose aspirin to reduce the chance of having a heart attack or stroke. You should do so only if the chance of being helped outweighs the chance of triggering unwanted bleeding, since aspirin interferes with normal clotting. But about one in 10 men who take protective aspirin may not really qualify, according to a national study in the Journal of the American College of Cardiology.

Experts recommend that aspirin might be considered in someone whose chance of experiencing a cardiovascular problem is at least 6% in the next 10 years. At that tipping point, the chance of being helped is great enough to justify the risk of unwanted bleeding.

Job strain—defined as having a demanding job in which you have little control—may slightly increase the risk of a stroke. The findings, in the February 2015 Stroke, echo earlier results that show a similar link between heart disease and job strain.

Researchers gleaned the results from 14 different studies that included more than 190,000 men and women from six European countries. Their average age was 42, and the follow-up lasted just over nine years, on average. Job strain was associated with a roughly 20% higher risk of ischemic stroke (the type that occurs when a clot blocks a blood vessel supplying the brain).

Anticholinergics, a group of medications that includes many over-the-counter and prescription drugs, are well known for causing confusion in older adults. Common medications with anticholinergic properties include medications to treat overactive bladder, such as oxybutynin (Ditropan); medications to treat allergies and sleeping problems, such as diphenhydramine (Benadryl, Sominex, Unisom); and medications used to treat depression, such as amitriptyline (Elavil). It's generally believed that confusion that may develop from anticholinergics clears up when someone stops taking the drugs. But now it appears that the medications are associated with a more permanent effect. A study published online Jan. 26, 2015, in JAMA Internal Medicine linked daily anticholinergic use among older adults for three or more years to an increased risk for developing dementia and Alzheimer's disease.

The study didn't prove that anticholinergics cause dementia; it only found an association between people who take the medications and people who develop dementia. Nevertheless, the researchers suggest that doctors avoid prescribing anticholinergics when possible, or at least limiting the medications to the lowest doses possible. If you're taking an anticholinergic, talk to your doctor about the risks the medication poses, including the risk of falls as a result of confusion.

At middle age, the brain begins to draw on more of its capacity for improved judgment and decision making.

If you forget a name or two, take longer to finish the crossword, or find it hard to manage two tasks at once, you're not on the road to dementia. What you're experiencing is your brain changing the way it works as you get older. And in many ways it's actually working better. Studies have shown that older people have better judgment, are better at making rational decisions, and are better able to screen out negativity than their juniors are.

Medications called anticholinergics are used to treat a host of conditions—overactive bladder, depression, allergies, and Parkinson's disease. They usually aren't recommended for older adults because one of the most common side effects is confusion and difficulty reasoning. Early studies have also indicated that long-term anticholinergic use is associated with an increased risk of dementia, and a recent study by researchers at the University of Washington adds more evidence to support that connection. The results were published online Jan. 26, 2015, by JAMA Internal Medicine.

The researchers tracked almost 3,500 men and women ages 65 and older who were free of dementia. When they matched prescription data for the previous 10 years with the participants' health outcomes, they determined that using anticholinergics was associated with an increased risk of developing dementia. Moreover, dementia risk increased with the dosage of the drugs and the length of time they were used. While people who had taken these drugs daily for the equivalent of three months had no increase in risk, those who had used them for over three years had a 54% greater risk than nonusers.