Brain health Archive

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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.

Research we're watching

Episodes of atrial fibrillation (afib) — a chaotic, irregular heart rhythm — can last for minutes, hours, days, or much longer. The condition encourages blood clots to form in the heart; the clots can then escape and lead to a stroke. New research suggests that even intermittent bouts of afib (which were previously considered to be low risk) may increase a person's risk of stroke.

The study included nearly 2,000 people who wore a small skin patch that continuously monitored their heart rates for 14 days. All of them had paroxysmal (intermittent) afib and were not taking anti-clotting medications. Researchers then tracked the participants' incidence of stroke over the following five years. They found that afib that lasted more than 11% of the total monitoring time was associated with a threefold increase in stroke risk.

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.

Research we're watching

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Eating an egg a day may help protect against cardiovascular disease, according to a study published online May 21 by the journal Heart. Researchers found that people who ate an egg every day had an 18% lower risk of dying from cardiovascular disease and a 28% lower risk of experiencing a deadly hemorrhagic stroke, compared with people who didn't eat eggs.

The study included more than 400,000 adults ages 30 to 79. Participants were from 10 survey sites in China. Researchers looked at how often study subjects reported eating eggs and then tracked their health for nearly nine years using registries and other methods.

Ask the doctors

Q. I recently read about the decision by the state of California to require cancer warnings on coffee. I drink a cup a day. Should I be concerned?

A. The recent decision by a California judge to require cancer warning labels on coffee stemmed from concerns about a specific substance found in coffee, acrylamide, which is a chemical that is produced when coffee is roasted. Coffee isn't the only food or beverage that contains acrylamide. Acrylamide is produced during the high-temperature cooking process used for numerous common foods, including cookies, crackers, and potato chips, according to the American Cancer Society (ACS). But before you panic, while there definitely is acrylamide in coffee, scientists have yet to conclusively prove that this chemical causes cancer, according to the ACS. Most of the research on humans hasn't found any increased risk of cancer in people who eat foods containing acrylamide. Other studies looking at specific types of cancers have produced mixed results but found no conclusive links, according to the ACS. In addition, there is evidence that drinking coffee can bring some health benefits, such as reductions in the risks for stroke and liver disease. A 2015 study in Circulation also found that moderate coffee drinkers (defined as those having less than five cups a day) had lower risks for heart disease and neurological disease, according to the American Heart Association. So, the final message is this: if you are healthy and drink coffee moderately, there is no evidence that it's going to raise your risk of developing cancer.

Research we're watching

It seems the old adage "everything in moderation" might have an exception — smoking. A study in the January 24 issue of The BMJ found that smoking even one cigarette a day carries significant health consequences, namely a higher risk of heart attack and stroke.

Using data from 141 different studies, involving millions of participants, researchers compared people who smoked either one, five, or 20 cigarettes each day. They found, counter to what many people assume, that rates of heart disease and stroke were not reduced as much as expected in casual smokers compared with pack-a-day smokers.

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.

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.

Research we're watching

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High cardiovascular fitness during middle age may lower the likelihood of dementia late in life, according to a decades-long study.

For the study, researchers asked 191 middle-aged women to ride an exercise bike until they were exhausted. They then grouped the women according to their peak cardiovascular capacity. Just 40 women met the criteria for high fitness, while 92 were in the medium category, and 59 were in the low category.

These strategies may offer greater protection.

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While there's no cure for Alzheimer's disease, ongoing research has suggested there may be ways to lower your risk.

"Much of the existing science supports how certain behavioral changes made in middle age can protect people as they grow older," says Dr. Kirk Daffner, director for the Center for Brain/Mind Medicine at Harvard-affiliated Brigham and Women's Hospital. "However, there is evidence that adopting certain healthy lifestyle habits can benefit older adults too."