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Ask the doctor: Two pneumonia shots are better than one

Q. I'm 68, and I had the pneumonia vaccine a few years ago. Now I hear that I need to have two different ones. Do I really need to do this?

A. For many years, men who turned 65 were told that they needed a single pneumonia shot, called Pneumovax. Now the CDC suggests that older adults get an additional vaccination with a different vaccine, called Prevnar. The combination stimulates the immune system more effectively than either alone.

The two vaccines build immunity against different types of the bacterium, known as pneumococcus, that causes pneumonia. Pneumovax (PPSV23) protects against 23 common types of pneumococcus. Prevnar (PCV13) protects against 13 types.

Distracting music may trip up older memories

Distracting background music could make certain memory tasks more challenging for aging brains, suggests a study in The Gerontologist. The study involved one group of participants ages 18 to 30 and another ages 60 to 75. They studied images of faces paired with names on a computer screen, either in silence or while listening to instrumental music. Later they had to recall the name-face pairs while listening to music.

The music had no effect on test scores in the younger people. In contrast, the older people remembered 10% fewer names learned when listening to background music, compared with studying in silence.

Lower stress, lower your blood pressure

You can't see your blood pressure or feel it, so you may wonder why this simple reading is so important. The answer is that when blood pressure is high, your heart is working overtime to pump blood through your body. This extra work can result in a weaker heart muscle and potential organ damage down the road. Your arteries also suffer when your blood pressure is high. The relentless pounding of the blood against the arterial walls causes them to become hard and narrow, potentially setting you up for stroke, kidney failure, and cardiovascular disease.

A healthy lifestyle — not smoking, losing excess weight, eating nutritious foods, and exercising regularly — is the cornerstone for preventing and treating hypertension.

Retirement stress: Taking it too easy can be bad for you, too

Men need to be challenged to be healthy in mind and body.

It might seem like retirement is a time to take it easy and devote yourself to gardening, golfing, and napping. But don't take it too easy, say Harvard experts. An absence of challenges can have the same effect as too much stress, compromising your physical and mental health. For optimal well-being, you need to stay engaged—with your own interests as well as with other people.

Review finds no sign of memory loss from statins

The best-quality evidence available does not prove that taking a statin can cause memory loss or other changes in mental functioning, according to a review in the Journal of General Internal Medicine. Since 2012, the FDA has required that statin manufacturers include a warning on drug packaging that statins could impair mental functioning, but this has been controversial. Researchers took a look at the published evidence for possible mental side effects of statins.

The new review covered randomized clinical trials involving nearly 47,000 people. Such trials are the gold standard in medical research. These included 23 trials in which researchers explicitly measured mental functioning, as well as trials that kept track of mental changes reported by participants.

Heart attack risk rises after a bout of pneumonia

If you're hospitalized with pneumonia,your heart attack risk may rise in the following month.

Image: Thinkstock

If you're over 65, be sure to follow the latest pneumonia vaccine guidelines.

Each year, about a million people in the United States end up in the hospital with pneumonia, a serious lung infection that can be caused by an array of different viruses, bacteria, and even fungi. New research suggests that older people hospitalized with pneumonia face four times their usual risk of a having a heart attack or stroke or dying of heart disease in the month following the illness.

New concerns about anticholinergic medications

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.

Why you should thank your aging brain

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.

Although it may take you a little longer to get to the solution, you're probably better at inductive and spatial reasoning at middle age than you were in your youth.

Common drugs linked to dementia

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.

Edible marijuana — a half-baked idea?

Marijuana-laced brownies have long been a way to get high. Now a new generation of “food companies” is taking the concept of edible marijuana in a somewhat scary new direction: marijuana-laced foods that mimic popular candies. These sweets could pose a danger to children, warns a Perspective article in today’s New England Journal of Medicine. From a marketing perspective, it’s a cute concept to sell Buddahfingers that look like Butterfingers, Rasta Reese’s that mimic Reese’s Peanut Butter Cups, or Pot Tarts that resemble Pop-Tarts. But the availability of edible marijuana products has led to an increase in emergency visits to hospitals because of kids accidentally eating edible marijuana products and in marijuana-related calls to poison and drug hotlines.

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