Diseases & Conditions Archive

This heart rhythm disorder is linked to thinking and memory problems. But anti-clotting drugs may lower the risk.

Bouts of atrial fibrillation, or afib — a rapid, chaotic heartbeat — make some people feel lightheaded and dizzy, while others don't notice any symptoms. But the most serious threat of this condition is the higher risk of stroke among people with afib compared with those without the disorder (see "Blood clot dangers, large and small"). Now, there's a growing recognition that people with afib also face an increased risk of thinking and memory problems — even if they do not experience a stroke.

Known as cognitive impairment, these problems include trouble remembering, learning new things, concentrating, or making routine decisions. The presumed underlying cause? Tiny blood clots that cause "silent" (that is, unrecognized) strokes and gradually injure parts of the brain involved with cognition.

Be proactive by learning about and tracking your conditions and medications, and by speaking up when you have concerns.

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We don't want our golden years to be spent juggling a long list of health issues. But that's the reality for most older adults in the United States.

The CDC reports that 75% of Americans ages 65 or older have several chronic health problems. And a 2013 analysis of Medicare claims published online by Preventing Chronic Disease found that 68% of beneficiaries had two or more chronic conditions and 36% had at least four.

Ask the doctor

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Q. Home remedies aren't stopping my hiccups. Is there something my doctor can prescribe to help?

A. In the May 2018 issue, I answered a question about hiccups, saying they are common but typically short-lived, and that simple home remedies often can end them. However, I ran out of space to say something about treatments for the very unusual cases of hiccups that don't respond to simple treatments.

News briefs

Baby boomers are falling short in getting hepatitis C screenings. In 2012, the CDC urged the entire generation of people born from 1945 to 1965 to get this simple blood test, noting that baby boomers are five times more likely to have the virus than other adults. But a study published online March 27, 2018, by the journal Cancer Epidemiology, Biomarkers & Prevention found that only about 13% of baby boomers had been tested by 2015, up just one percentage point from 2013. The information came from national government health surveys. Hepatitis C can lead to cirrhosis, liver damage, liver cancer, and liver failure. Treatments are now available that can cure hepatitis C, if it's caught early enough. Baby boomers are believed typically to have become infected in the 1960s through the 1980s, when transmission of hepatitis C was highest. People at highest risk are those who have used intravenous drugs, had more than one sex partner, or received a blood transfusion before 1992, when the blood test for hepatitis C was first available.

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Machine learning may improve the way doctors detect heart disease.

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Imagine a world in which a photo of your eye — taken with your smartphone — could determine your risk of a heart attack, and your smartwatch could estimate your odds of experiencing a stroke. Sounds pretty futuristic, right?

In fact, preliminary studies showing the feasibility of both approaches have already been published. They're just two examples of the new wave of technology-based innovations (see "Transformative technologies") that are beginning to change health care as we know it.

On call

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Q. I have recently been hearing a lot about getting tested for hepatitis C. I don't think I have any risk factors, but is this something I should consider?

A. Hepatitis C is a viral disease that causes inflammation of the liver. The CDC reports that 75% of all current cases of hepatitis C are in the baby boomer generation and many more are undiagnosed. The reason is that a vast majority of people have no symptoms, such as fatigue, muscle and joint pain, abdominal pain, and nausea.

One of the most dangerous and distressing symptoms of Alzheimer's is wandering. It may seem unfathomable that a person might suddenly get up at night to go to the post office or leave home at any hour for no apparent reason. But wandering may be prompted by deep-seated memories of work, chores, or hobbies, or a longing to return to a former home.

The inability to control wandering is what often drives families to decide to place a loved one in a nursing home. However, there are some simple measures to prevent wandering that often work well for a time and can even help postpone that difficult decision.

Q: I have strong hand cramps that curl my fingers into a claw shape. I can only straighten them by using my other hand. What can I do to keep this from happening? 

A: What you describe sounds like carpal spasm. Spasms, or cramps, are involuntary muscle contractions. The most common causes of spasms are overused muscles (in the hands that might be due to writing or typing) and dehydration. Other causes of muscle cramping include low levels of calcium and magnesium.

Ask the doctors

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Q. I was recently diagnosed with eczema. Is this condition treatable without the use of steroids? I'd like to avoid using them if I can.

A. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition. Some people with eczema have mild dryness or itchiness, while others experience more severe symptoms, such a scaly rash or skin that cracks and oozes. Eczema is more common in childhood, affecting up to 20% of children, but it also affects adults. The good news is it's not contagious, and in some cases, it's possible to manage the condition without using steroids.

Research we're watching

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Roaring jets, rumbling trains, and revving automobiles may have a detrimental effect on your cardiovascular health.

According to a review article in the Feb. 13, 2018, Journal of the American College of Cardiology, many studies have observed a connection between transportation-related noise and a slightly higher risk of high blood pressure, coronary artery disease, stroke, and heart failure. The association persists even after adjustment for possible confounding factors, such as air pollution and socioeconomic status.