Alzheimer's Disease Archive

In the journals

Many people with rheumatoid arthritis (RA) also deal with ongoing depression and anxiety related to their pain and disability. While drugs used to treat the disease help alleviate the joint pain and stiffness, a recent study suggests they may not extend to improving patients' mental health.

The findings, published online June 6, 2018, by Arthritis & Rheumatology, reviewed more than 70 clinical trials and found only a small association between various drugs used for RA, such as adalimumab (Humira), rituximab (Rituxan), abatacept (Orencia), and tocilizumab (Actemra), and mental health outcomes in patients.

Asking for help from friends and family and then engaging with your new community will get you through the transition.

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Downsizing from a large home to a smaller one is a fact of life for many older adults. The reason may be finances, health issues, or a desire to simplify your lifestyle. But making the transition can bring a host of emotions: sadness, grief, stress, or anxiety.

Understanding the triggers for these feelings and using strategies to navigate them may not change how you feel, but it may help the downsizing process go more smoothly so you can focus on your next chapter.

Ask the doctors

Q. I recently saw something recommending that older Americans get screened for hepatitis C. I'm 68 years old. Should I be screened?

A. Yes. Since 2012, the CDC has recommended that all adults born from 1945 to 1965 be tested for hepatitis C, a bloodborne virus that affects anywhere from 2.7 million to 3.9 million Americans — many of whom don't know they have the condition. Hepatitis C can go undetected in the body for years, eventually leading to cirrhosis, liver damage, and liver cancer. You may be at risk even if you don't think you have any risk factors for the disease, which is most commonly transmitted today through intravenous drug use. People born from 1945 to 1965 are five times more likely than other Americans to have hepatitis C, although experts aren't sure why this is the case, according to the CDC. It's possible that some people were infected during health care procedures or blood transfusions that took place before the discovery of the hepatitis C virus. A study published in the April 2018 issue of Cancer Epidemiology, Biomarkers & Prevention found that less than 13% of these individuals have had the test. Since you're one of those who hasn't, it's a good idea to call your doctor and make a screening appointment.

For more on diagnosing and treating indigestion, read The Sensitive Gut, a Special Health Report from Harvard Medical School.

News briefs

Encouraging news for people who suffer with migraines: in May, the FDA approved erenumab (Aimovig), the first medication aimed at preventing these debilitating headaches. Current medications to treat migraines were actually designed to control other conditions, such as seizures or an irregular heartbeat; their side effects (like sexual dysfunction and fuzzy thinking) often cause people to skip treatment. Erenumab offers a new approach. Injected once a month, it works by blocking a molecule (calcitonin gene-related peptide) involved in migraine attacks, and compared with other drugs, it appears to have fewer side effects (primarily constipation and injection site reactions). "This drug is for people who have more than four migraines per month, but it won't take migraines away entirely," says Dr. Gad Marshall, a neurologist at Harvard-affiliated Brigham and Women's Hospital. Clinical trials suggest it can reduce frequency by one or two migraines per month, or even more in some people. "For people with frequent debilitating migraines it could be a game changer," says Dr. Lee Schwamm, a neurologist at Harvard-affiliated Massachusetts General Hospital. "But erenumab is expensive, and it will take time to find out if it's effective and safe over the long term."

News briefs

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An observational study published online May 30, 2018, by JAMA Psychiatry found that engaging in intellectually stimulating activities, even later in life, may lower the odds of dementia. Researchers followed over 15,000 Chinese men and women in their 70s for seven years with annual assessments of health and lifestyle habits, including a variety of leisure activities. The odds of being diagnosed with dementia during the study period were 29% lower in people who challenged their brains daily with such activities as playing board games, reading, and even betting on horse racing. In contrast, less mentally demanding recreational activities (like watching TV or shopping) or social activities (like going to tea with friends) did not appear to be associated with a lower risk of dementia. Other studies have found similar evidence, but this one made a special effort to adjust for factors like better overall health that might otherwise account for the association between brain exercise and dementia.

Two recent drugs have opened new treatment opportunities for this common eye disease.

Glaucoma is a leading cause of blindness in people over age 60, and it's estimated that the number of new cases will more than double over the next few decades. "There is no cure for glaucoma once it appears, so treating it at its earliest stages can help save your vision," says Dr. David Solá-Del Valle, an ophthalmologist with Harvard-affiliated Massachusetts Eye and Ear.

Once diagnosed, glaucoma is treated with eye drops to reduce pressure inside the eye by lowering the amount of fluid or improving fluid drainage. They can keep glaucoma from getting worse and hopefully avoid the need for surgery to correct this drainage problem.

In the journals

Anticholinergic medications used to treat bladder conditions, Parkinson's disease, and depression are associated with an increased risk of dementia, according to a large study published online April 25, 2018, by The BMJ. Anticholinergic drugs help to contract and relax muscles. They work by blocking acetylcholine, a substance that also transmits messages in the nervous system. In the study, researchers compared the medical records of 40,770 people older than 65 who were diagnosed with dementia and 283,933 seniors without.

They found that people diagnosed with dementia were up to 30% more likely to have been prescribed anticholinergic medications for Parkinson's, bladder problems, or depression. Frequently prescribed anticholinergic drugs include procyclidine (Kemadrin) for Parkinson's; tolterodine, oxybutynin, and solifenacin (Vesicare) for urological conditions like overactive bladder or incontinence; and amitriptyline, dosulepin, and paroxetine for depression. However, there was no association between dementia and anticholinergic drugs used to treat other common conditions like hay fever, travel sickness, and stomach cramps.

In the journals

Aerobic exercise has been linked with reducing symptoms of depression, but resistance training, such as weight lifting and bodyweight exercises like push-ups, can have the same effect.

A meta-analysis published in the June 2018 JAMA Psychiatry examined the effects of resistance training on depression symptoms in 33 clinical trials involving 1,877 people. The researchers found that people who did this type of exercise reported a significant reduction in such symptoms as low mood, loss of interest in activities, and feelings of worthlessness, compared with those who did not exercise.