Management Strategies

For most people combining healthy lifestyle choices with carefully selected medication will reduce HBP as well as the risks that go along with it, including heart attack, stroke, and heart failure.

There are several types of blood pressure drugs that work in various ways, so your doctor must carefully consider which option is best for you. “It is very important to individualize drug therapy for each patient,” says Samuel Mann, MD, a hypertension expert at Weill Cornell Medicine. “The same medication that works for you might not be effective for another patient.”

Blood Pressure Drug Options

Several classes of medications are used to treat hypertension; they include diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), beta-receptor blockers, and alpha-receptor blockers. Understanding the mechanism that is causing your hypertension can help your doctor select the drug that will be most effective.

In some cases, the underlying cause of hypertension is relatively easy to identify. “For example, swelling due to fluid retention, which occurs most commonly in the legs, indicates that a sodium/volume mechanism is likely, and a diuretic will probably decrease blood pressure,” Dr. Mann explains.

Consider Lifestyle Changes

For many patients with mild hypertension, adopting a healthier lifestyle can lower BP enough to eliminate the need for medication. Following a hearthealthy diet, getting regular exercise, and reducing sodium intake can lower BP in some patients by as much as 20 mmHg.

Getting some form of aerobic exercise 30 minutes a day for three or more days each week can reduce your BP by as much as 9 mmHg. Aerobic exercises include any activity that requires continuous movement of major muscle groups and causes a sustained increase in your heart rate.

Watch Your Sodium Intake

There is no consensus on how much sodium is best for your blood pressure, but a maximum daily intake of 2,300 milligrams (mg) of sodium is a common recommendation for adults, with a maximum of 1,500 mg often advised for adults who have hypertension.

The average American adult consumes more than 3,400 mg of sodium per day, and an estimated 80 percent of that sodium comes from fast food, snack foods, and frozen foods. Notably, research has shown that the majority of restaurant meals are very high in sodium, as well.

In addition to avoiding fast food and eating more meals at home, you can counteract the effects of excessive sodium consumption by consuming foods rich in potassium. While excess sodium intake can constrict arteries, causing BP to rise, potassium can dilate the arteries, which causes BP to drop. Good sources of potassium include spinach, Swiss chard, potatoes, cantaloupe, oranges, avocados, and most varieties of beans and peas.

Accurate BP Readings

The accuracy of BP readings is crucial in the proper management of hypertension. Dr. Mann points out that hypertension treatment guidelines are based on BP measurements taken after sitting quietly for five minutes, but most doctors and nurses obtain the measurement without waiting, resulting in readings that are higher than the patient’s resting BP.

Whether you measure your BP at home—or have it measured in a healthcare provider’s office—the five‑minute rule should be observed. Dr. Mann urges people whose measured BP is elevated—and was obtained without waiting—to repeat it after sitting quietly for five minutes. Ignoring this waiting period could result in overdiagnosis and overtreatment of hypertension, as well as overuse of multiple-drug therapies.

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Newest Medication

Early this year, the FDA approved lecanemab (Leqembi), a drug that has been shown in clinical trials to slow the rate of cognitive decline in patients in the early stage of AD. The medication— a monoclonal antibody that’s given intravenously every two weeks— is the second of its kind to get the OK from federal regulators. Unlike most other medications approved for the disease, lecanemab goes after the underlying disease process of Alzheimer’s, not just its symptoms. A similar drug, called Aduhelm gained FDA approval in 2021.

Prevention and Behavior

As these remarkable strides in treatment are being made, research surrounding Alzheimer’s prevention is picking up speed, as well. Recent studies show that adopting certain habits—such as controlling high blood pressure, staying physically active, and avoiding excessive drinking—can help reduce the risk of Alzheimer’s and related dementias. In fact, it’s estimated that 40 percent of dementia cases can be attributed to a dozen modifiable risk factors, including the previously mentioned habits as well as treating hearing impairment, participating in exercise, and maintaining frequent social contact, among others. Importantly, researchers note that it’s never too early—or too late—to work on incorporating these efforts into your lifestyle.

“We know what is important for healthy brain aging. Many of the things that we know to be good for your heart are also good for your brain. It’s important to stay active, mentally and physically, avoid smoking and limit alcohol consumption, and have a diet low in saturated fats. If you have diabetes, hypertension, high cholesterol, or a mood disorder, follow your doctor’s recommendations to address those issues. Make sure your hearing and vision are corrected, if needed. The pandemic induced a lot of social isolation, and that showed us how important it is to stay engaged,” said Lisa D. Ravdin, PhD, Associate Professor, Department of Neurology, Weill Cornell Memory Disorders Program.

Get Some Sleep

With respect to modifiable behavior, the importance of quality sleep should not be underestimated. “Disturbed sleep is one of the common things we look for when someone presents with cognitive complaints,” says Dr. Ravdin. “Sleep problems can reduce focus and concentration, and that can contribute significantly to cognitive difficulties. It is something we have effective nonpharmacologic therapies for, such as CBT-I, cognitive behavior therapy for insomnia.”

Beware Nutritional Supplements

Numerous supplements claim to improve memory, focus, and concentration, and provide other brain-boosting benefits. But these supplements aren’t subject to any rigorous review process, and it’s up to manufacturers to make sure their products are safe. “Be very cautious about supplements that claim to improve your memory. Those overthe- counter products are not regulated by the Food and Drug Administration, and they may interfere with medications your doctor prescribed for other health issues,” stresses Dr. Ravdin.

Promising Diagnostics

AD is characterized by abnormal clumping of amyloid-beta and tau proteins in the brain. Some very promising diagnostic tools including blood tests that look for a specific abnormal form of tau protein found in the brains of patients with AD have been developed. However, Dr. Ravdin notes, “While blood tests for Alzheimer’s disease are less invasive and potentially far less expensive than other tests, they are not yet widely available, and further research is needed to bring them into routine clinical practice.”

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The first vaccine for the respiratory syncytial virus (RSV) infection has been approved by the FDA. Developed by GlaxoSmithKlein and marketed under the name of Arexvy, the RSV vaccine is specifically indicated for preventing lower respiratory tract infections in adults ages 60 and over. An estimated 60,000 to 160,000 older adults in the U.S. are hospitalized each year due to RSV infections, and 6,000 to 10,000 deaths are associated with the highly contagious virus in this group, according to the Centers for Disease Control and Prevention (CDC). “Older adults, in particular those with underlying health conditions such as heart or lung disease or weakened immune systems, are at high risk for severe disease caused by RSV,” Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

A-fib-Detecting Shopping Carts Show Promise in Study

Supermarket carts embedded with electrocardiogram (ECG) sensors were utilized in a small research study to detect atrial fibrillation (A-Fib) in shoppers. Four Liverpool, UK, supermarkets participated in the SHOPS-AF study. While the novel study method was limited by a significant number of false positives and negatives, it identified 39 previously undiagnosed cases, prompting refinements for larger-scale trials. A-fib is a key risk factor for stroke, yet the clinical benefits of mass screening are unproven in the general population. The U.S. Preventive Services Task Force continues to withhold endorsement of A-fib screening in middle-age and older adults without symptoms and without a history of transient ischemic attack or stroke, citing insufficient evidence that the benefits outweigh potential harm—such as the increased risk of major bleeding when starting anticoagulation for screen-detected A-fib.

Drug Aids in Obesity, Diabetes, and Nonalcoholic Fatty Liver Disease

Results from an obesity clinical study revealed that the weekly injectable drug retatrutide, when administered in its highest dose (12 mg), helped people with obesity lose more than 24% of their starting body weight within 48 weeks of treatment. In a separate diabetes study, six months of weekly injections of retatrutide (4mg–12 mg) lowered hemoglobin A1c by 1.3% to 2.0% in participants with type 2 diabetes. In a substudy of the obesity trial researchers looked at the effect of retatrutide on nonalcoholic fatty liver disease (NAFLD) and found that the amount of fat in the liver normalized in nine out of 10 patients after 48 weeks of treatment with the two highest doses (8 mg and 12 mg) of retatrutide. These data indicate that retatrutide has the potential to resolve NAFLD. Retatrutide is an investigational glucose-dependent insulinotropic polypeptide (GIP)/ glucagon-like peptide 1 (GLP-1) /glucagon (GCG) receptor agonist. Researchers say upcoming studies of the drug will evaluate its safety and efficacy for chronic weight management, obstructive sleep apnea, and knee osteoarthritis in people with obesity and overweight.

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Depending on what type of anxiety you have, you may get relief from a number of medications, cognitive behavioral therapy (CBT) or a combination of both. “Many patients with anxiety disorders find that a combination of CBT with medication is helpful,” says Susan Evans, PhD, Professor of Psychology in Clinical Psychiatry and Director of Education in Psychology at Weill Cornell Medicine.

Anti-Anxiety Medications

Several classes of medications are used to treat anxiety disorders. Drugs called benzodiazepines are believed to ease anxiety by working on a neurotransmitter in the brain that suppresses the activity of nerves. Benzodiazepines have sedative, anxiety-reducing, and muscle-relaxant properties. Caution should be used with this class of medications because they can cause physical and psychological dependence. Benzodiazepines include Valium, Xanax, Ativan, and Klonopin.

Selective serotonin reuptake inhibitors, or SSRIs, increase the amount of the neurotransmitter serotonin that is available in your brain. These medications are often used to treat anxiety and/ or depression. SSRIs include Prozac, Paxil, Zoloft, Lexapro, and Celexa. Serotonin and norepinephrine reuptake inhibitors, or SNRIs, increase the amount of two brain neurotransmitters, serotonin and norepinephrine. SNRIs include Effexor, Pristiq, and Cymbalta. Tricyclic antidepressants are a class of older drugs that also affect neurotransmitters in the brain. They may be used to prevent or reduce the severity of panic attacks, a type of acute anxiety. Tricyclics include Elavil, Tofranil, Pamelor, and Sinequan. Buspar is an anti-anxiety drug that is not related to benzodiazepines or other drugs that cause sleepiness or sedation. It is believed to increase the activity of neurotransmitters in the brain. Beta-blockers block the effects of norepinephrine (also called epinephrine or adrenaline).

Beta-blockers help control physical symptoms of anxiety, including sweating, trembling, and a rapid heartbeat. This class of medication, which includes Inderal and Tenormin, is most commonly used for performance anxiety— for example, anxiety that occurs when you are speaking to or performing for an audience.

Before taking any of these anti-anxiety medications, provide your doctor with a complete list of other medications you are taking, including over-the-counter drugs and supplements. The more information your doctor has, the safer and more effective your treatment will be.

Other Treatment Options

With the aid of a mental health professional, CBT can help you examine your thoughts and emotions so you can understand how your thoughts affect your actions. This therapy tactic can’t make stressful situations disappear, but it can help you respond to them in a healthier way. “CBT is very effective for most types of anxiety disorders. CBT is a focused and often time-limited therapy that can be very helpful for the physical and emotional symptoms of anxiety, as well as the maladaptive behavioral patterns that have emerged as a result of anxiety,” explains Dr. Evans.

Relaxation techniques including breathing exercises, progressive muscle relaxation, and mindfulness meditation may also help. Improving sleep, getting more exercise, and identifying modifiable stressors are lifestyle strategies that may ease symptoms of anxiety. “Yoga, massage, and acupuncture also may help ease physical symptoms and promote a sense of well-being,” says Dr. Evans.

You can also access numerous apps on your smartphone to help reduce anxiety. Some popular ones are “Calm,” “Headspace,” and “Breathe2Relax.” These apps provide brief interventions designed to reduce anxiety; most are some form of meditation. Many apps provide some information and tools for free, and there is usually additional content available for purchase.

The post Waiting for the Other Shoe to Drop? Medication and Therapy Help appeared first on University Health News.

Fall Risk Assessment

A yearly fall risk assessment for all adults ages 65 or older is recommended by the American Geriatrics Society. As part of the assessment, your doctor should check your balance and gait and ask if you have fallen during the previous 12 months or if you have experienced any unsteadiness while walking. If you have had a fall, don’t wait for your doctor to ask; report it to him or her, along with what you were doing when you fell and if you experienced dizziness prior to falling.

Several medications can cause dizziness, including some used to treat high blood pressure, depression, epilepsy, and insomnia. Ask your doctor or pharmacist if any of your medications have dizziness or light-headedness as a side effect; if they do, ask whether a reduced dose or a different medication may be advisable.

Poor eyesight is a major risk factor for falls; you’re much more likely to trip and fall if your vision is impaired. Have an eye exam at least once a year, and use an up-to-date eyeglass prescription. Having an annual eye exam can also detect the presence of cataracts, glaucoma, and age-related macular degeneration, conditions that impair vision but usually progress so gradually that you may not be aware of them.

Other medical conditions that can make you vulnerable to falls include peripheral neuropathy, which can cause numbness in the feet, and neurological impairments that cause unsteadiness, such as Parkinson’s disease. Having osteoporosis—weak, brittle bones—raises the risk of incurring serious injuries, such as a fractured hip or wrist, due to a fall. Sometimes, pain caused by arthritis or other medical conditions makes walking difficult and can contribute to falls.

Preventing Falls and Injury

To minimize your chances of falling, stand up slowly from a seated position to avoid dizziness that could cause a fall, and to improve your balance, include strength training in your exercise regimen. “Tai chi is noted for helping to improve balance,” says Dr. Raik. Ask at your local senior center or YMCA about tai chi classes and exercise programs.

Another preventative step to avoid falls in the home includes evaluating your environment for potential hazards. Have a home evaluation: Ask your doctor for a referral to a physical therapist who can carry out a safety evaluation of your home and recommend fall-proofing measures.

If you have been advised to use an assistive device like a cane or a walker, make sure you use it correctly, as instructed by your health-care provider or physical therapist.

The fact that you’re at higher risk of falling because you’re getting older may be hard to accept, but it’s better—and safer—to acknowledge it and do everything you can to prevent a fall that could land you in the hospital or stop an injury that could result in permanent disability.

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Flu

Did you get your flu shot this year? Many people ignore the annual public health advisory to get a flu shot, even though the Centers for Disease Control and Prevention (CDC) recommend a seasonal influenza vaccine for almost everyone. Some say they don’t get the vaccine because it’s not 100 percent effective. It is true that the flu vaccine does not prevent all cases of the flu, but if you do get the flu and you’ve been vaccinated, it can mean the difference between recuperating on your couch and requiring hospitalization for severe symptoms and complications. “The flu vaccine is very effective at preventing severe cases of flu. Each year, a majority of patients hospitalized for flu didn’t have the flu vaccine,” says Keith Roach, MD, associate professor of clinical medicine at Weill Cornell Medicine.

That’s right—all too often people think vaccines are all about preventing illness, when in fact a critical part of their job is reducing the seriousness of the illness they aim to prevent. Vaccines are an important aspect of preventive medicine. However, because various medical conditions and lifestyle choices can affect whether certain vaccines are safe for you, don’t hesitate to ask your doctor for guidance.

Here’s a summary of what you need to know about the most important vaccines.

COVID-19

As with other vaccine-preventable diseases, you are best protected from COVID-19 when you stay up to date with the recommended vaccinations. Everyone (6 years and older) should get one updated Pfizer-BioNTech or Moderna COVID-19 vaccine, regardless of whether they’ve received any original COVID-19 vaccines. Some people may get additional doses of COVID-19 vaccines: For instance, people ages 65 and older may get one additional dose of the vaccine four or more months after the first updated vaccine. Talk to your health-care provider about additional updated doses.

Pneumonia

The pneumococcal vaccine is recommended for everyone ages 65 and older. The vaccine comes in two parts: First, a dose of PCV13 (Prevnar 13) is given, followed a year later by a dose of PSV23 (Pneumovax23). However, people with certain medical conditions are advised to get vaccinated at a younger age. These conditions include those that compromise the immune system, such as leukemia, lymphoma, Hodgkin’s disease, and some other types of cancer, HIV, treatment with drugs that suppress the immune system, such as chemotherapy, and conditions such as diabetes, alcoholism, being a current smoker, chronic obstructive pulmonary disease (COPD), emphysema, and asthma, chronic liver disease, and chronic renal (kidney) failure.

Shingles

In 2017, a new shingles vaccine, Shingrix, was approved by the U.S. Food and Drug Administration. This vaccine is given in two doses, two to six months apart, and is recommended for all adults ages 50 and older. Preventing shingles is important, since possible complications from shingles include long-term postherpetic neuralgia, vision loss (if shingles occurs in or around your eye), and neurological problems that include balance and hearing difficulties. Remember that even if you have had shingles, you can get it again. Also, even if you previously got the Zostavax vaccine for shingles, you are advised to get the Shingrix vaccine.

First RSV Vaccine

The most recent vaccination to be approved by the FDA is the respiratory syncytial virus (RSV) vaccine. It is indicated for preventing lower respiratory tract infections in adults ages 60 and over. The CDC recommends a single dose of the RSV vaccine for people in this age group who decide with their health-care provider that the vaccine would benefit them.

Chickenpox

If you’ve never had chickenpox or received the chickenpox vaccine, you should consider getting vaccinated. Although chickenpox is thought of as a childhood disease, adults can also get the virus, and elderly adults and those with compromised immune systems are at higher risk of serious complications. The two-shot vaccine (given at least 28 days apart) is especially recommended for anyone who provides health-care for someone with a weakened immune system or who lives or works in a nursing home or similar environment.

Where to Get Vaccinated

You may be able to get your vaccines from your primary care physician. However, it may be more convenient and less costly to get your vaccines at your local pharmacy.

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Estrogen is a hormone taken by some women to ease postmenopausal symptoms that include hot flashes and night sweats. Taking estrogen in pill form was associated with a higher risk of hypertension (high blood pressure) than estrogen delivered by other methods, according to a study published June 5, 2023, in Hypertension. The researchers analyzed health data from 112,240 women ages 45 and older who filled two or more prescriptions for estrogen-only hormone therapy. The women who took estrogen orally were more likely to have hypertension than the women who received estrogen from either a patch placed on the skin or a cream placed in the vagina. The longer the duration of usage and the higher the dosage of oral estrogen, the higher the risk of hypertension. Receiving estrogen either transdermally (via the skin) or vaginally in the lowest dose for the shortest time period was associated with the lowest risk of hypertension.

Sleep Problems Linked to Higher Stroke Risk

Getting poor-quality or inadequate sleep may be linked to an increased risk of stroke, according to a study reported in Neurology, May 23, 2023. Among the 4,496 participants, about half had experienced a stroke. The participants who had suffered strokes were more than twice as likely as nonstroke participants to report sleeping less than five hours or more than nine hours, or to have snorting or breathing cessation while sleeping (common signs of sleep apnea) in the month prior to their stroke. Other symptoms of poor sleep, including difficulty getting or staying asleep, poor-quality sleep, unplanned or prolonged napping, and snoring, were also more common among stroke patients. The researchers noted that future trials are warranted to investigate whether interventions that improve sleep might play a role in preventing stroke.

New Treatment May Provide Relief from Tinnitus

Researchers may have found an effective treatment for tinnitus, described as a ringing, buzzing, clicking, or hissing in the ears that can range from mildly annoying to severely debilitating. A double-blind, randomized clinical trial included 99 participants with somatic tinnitus, a form in which movements such as clenching the jaw or applying pressure to the forehead affect pitch and loudness of sounds. All participants received a portable device programmed to each person’s personal tinnitus spectrum; for active treatment, electrical stimulation was added to form a bi-sensory stimulus. Participants were randomly assigned to one of two groups. The first group received active treatment, while the second received sound-alone, or control, treatment. For the first six weeks, participants were instructed to use their devices for 30 minutes each day. The next six weeks gave participants in both groups a break from daily use, followed by six more weeks of the opposite treatment they received in the first six weeks. Participants who received the active treatment reported improved quality of life and reductions in tinnitus loudness, and more than 60 percent reported significantly reduced tinnitus symptoms.

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Hereditary cancer syndrome (HCS) is inherited from one or both parents. For example, if either parent has a mutation in a cancer predisposition gene, such as BRCA1 or BRCA2, their children have a 50 percent chance of having the mutation.

“This is why we encourage women to be tested for cancer genes: Unless you test, you will not know if you have inherited it,” says Maira Pires, PhD, MS, CGC, a certified oncology genetic counselor at Weill Cornell Medicine.

If a woman has inherited a cancer gene mutation, it means her risk of cancer is higher; it does not mean that she will definitely get cancer.

“Cancer is a multifactorial disease, which means that other risk factors also influence whether or not a woman will develop cancer,” explains Dr. Pires. (See What You Should Know for more information on risk factors.)

Common Genetic Mutations

The most common HCS is hereditary breast and ovarian cancer linked to a mutation in either the genes BRCA1 or BRCA2. The risk is even higher if one is of Ashkenazi Jewish descent; in this population, the incidence of having a BRCA1/2 mutation is one out of 40 versus one in 500 in the general population.

“However, hereditary breast cancer, which accounts for 5 to 15 percent of all breast cancers diagnosed, is not caused only by mutations in the genes BRCA1/2. Other newly identified breast cancer genes include CHEK2, PALB2, ATM, and TP53,” explains Dr. Pires. “If a woman was tested for BRCA1/2 genes 10 or more years ago, it is time to get updated testing for the more recently discovered breast cancer genes.”

The proportion of ovarian cancers that are hereditary is about one in five, or 20 percent. Dr. Pires says that, since this is a high percentage, every woman diagnosed with ovarian cancer should be tested, and anyone with a family history of ovarian cancer should request testing.

Who Should Get Genetic Testing?

Current guidelines recommend genetic testing if you:

• Are of Ashkenazi Jewish heritage
• Have a strong family history of breast cancer (a family member diagnosed under age 50 or with triple negative breast cancer, or multiple family members with breast cancer on one side of the family)
• Have been diagnosed with breast, ovarian, colon, pancreatic, or other cancer
• Have had a breast biopsy that identified a high-risk lesion (an abnormal cell growth that is not cancerous but is associated with an increased risk of breast cancer), such as lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)

“Guidelines for who should be tested for cancer genes change all the time, so it is best to discuss this with your doctor,” advises Dr. Pires. She also suggests seeing a genetic counselor if there are multiple cancers in your family history and you’re wondering if you should be tested.

The Importance of Genetic Counseling

If you think you may be a good candidate for genetic testing, consult a genetic counselor who specializes in oncology.

“Having a cancer risk assessment includes an in-depth review of your personal medical history and your family history of cancers, as well as other risk factors, followed by a discussion of pros and cons of having genetic testing,” explains Dr. Pires. “This includes an explanation of how a positive test result could help reduce your risk for cancer. The most important purpose of a consultation with a genetic counselor is a thorough assessment of each woman’s situation that will help the woman reach the decision that is best for her.”

Dr. Pires adds, “Genetic testing is also not a simple ‘yes or no’ decision: There are lots of options today for how much testing to do, and how that information can be used in beneficial ways.”

What a Positive Test Result Means

If genetic testing produces a positive result, it means that the lab identified a pathogenic variant, or a change, in one of the genes that was tested, and this change has been shown to increase the risk for certain cancers.

Having a cancer predisposition does not mean a person will get cancer. However, if cancer does develop, adding more and/or earlier screening will help catch it in the early stages.

“For example, if a woman has a mutation in the genes BRCA1/2, screening is recommended to start at age 25 with annual breast MRI and then alternate with annual mammograms once she is 30. But if a woman has a mutation in other breast cancer genes, such as ATM, PALB, or CHEK2, she is advised to start with breast MRI between the ages of 30 and 35 and alternate with mammograms at age 40,” explains Dr. Pires.

High Risk But No HCS

A woman may still be at higher-thanaverage risk of cancer even if no genetic mutation is identified.

“If a woman has a strong family history of breast cancer (for example, a first- or second-degree relative with breast cancer diagnosed before age 50, or multiple female relatives with breast cancer), or she has had a highrisk breast lesion, she should have an assessment of her lifetime risk of breast cancer. This type of assessment can be provided by a genetic counselor,” notes Dr. Pires. “Women with a 20 percent or higher lifetime risk for breast cancer may be advised to have breast MRI screenings in addition to mammograms.”

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The best defense against growing worry about Alzheimer’s disease (AD) is to gain an understanding of which types of changes in brain function do and don’t suggest the possibility of dementia.

Identifying Signs of Normal Aging

First, let’s do away with the mistaken belief that a healthy 65-year-old brain and a healthy 25-year-old brain will function much the same.

“It is a fact that changes in your cognitive abilities will occur as a normal part of aging,” says Lisa Ravdin, PhD, director of the Weill Cornell Neuropsychology Service in the Department of Neurology.

“Your memory absolutely does change as you get older. Just as there are physical changes that occur in your bones, muscles, and organs, there are also changes in the structure of the brain associated with aging that affect your brain function, including memory,” she explains.

Age-Related Changes

As your brain ages, some cells become damaged or die, the brain shrinks and loses volume, and your brain neurons transmit information more slowly.

“The aging brain processes, stores, and retrieves information at a slower pace, so older brains don’t function as efficiently as younger brains. It also takes longer to learn new things, and you may need repeated exposure to information in order to retain it,” explains Dr. Ravdin.

For all of us who are not memory experts, here’s information that can help us differentiate between normal cognitive changes and changes that suggest the possibility of dementia.

Examples of Differences

Normal, age-related changes won’t interfere with your ability to engage in activities of daily living, such as dressing, shopping, doing household chores, and paying bills. But changes that are caused by AD do interfere with daily activities.

A person who has AD may stop practicing good hygiene. They may consistently forget regularly scheduled appointments or be unable to remember the three things they need during their five-minute trip to the grocery store. They may also become inattentive to safety hazards, such as clutter in the hallway or a hot stove that’s been left on. As the disease progresses, so do the frequency of the unsafe behaviors.

Dr. Ravdin says your own observations about how your brain is working provide important information.

“People who have AD usually aren’t as concerned about memory problems as the people around them,” she explains. “On the other hand, people experiencing normal, age-related cognitive changes may worry when they misplace their keys or have trouble remembering someone’s name. People who are very aware of their own occasional memory lapses generally don’t need to worry.”

Word Usage and Recall

A person’s response to neurological testing can shed light on his or her degree of memory loss.

“People who have normal, age-related changes will usually be able to tell you most or all of the test items, as well as what items they got wrong. But people with dementia may be unable to remember most of the items—or they may be unable to recall they even took a test,” says Dr. Ravdin.

Problems with word usage and recall are often mentioned. Older adults often complain that they sometimes have trouble finding the “right” words; they may feel like the word is on the “tip of their tongue.” In a brain that’s aging normally, the word is not lost; you just aren’t able to retrieve it immediately. In most cases, eventually, you’ll think of the word. But patients who have AD cannot retrieve these “missing” words later, since the brain connections required for retrieval have been damaged, and they can’t be repaired.

Forgetting someone’s birthday or where you put your glasses does not suggest that you have AD. However, if you regularly forget your spouse’s name or you ask the same questions over and over, it’s time to see a memory disorders specialist for an evaluation.

The post Memory Malfunctions: Signs of Dementia or Normal Aging? appeared first on University Health News.

Plant-based dietary patterns may be vegan (no animal foods), lacto-ovo vegetarian (dairy and eggs, but no animal flesh), pescatarian (fish and seafood, but no animal flesh), or “flexitarian” (small amounts of animal flesh).

It’s fine if you have no interest in becoming a vegan or a vegetarian. “You can eat more plant foods and still include some forms of animal protein, such as lean meats, fish, and low-fat dairy,” says Barbra Heller, RD, CD/N, a clinical nutritionist at Weill Cornell’s Iris Cantor Women’s Health Center.

Beneficial Effects

Adopting a plant-based diet is associated with lower risks of heart disease, high blood pressure, type 2 diabetes, some cancers, and obesity. It’s also linked wtih a healthier immune system and lower levels of inflammation.

When most of the foods you eat come from plants, you’ll boost your intake of beneficial nutrients, including fiber, vitamins, minerals, healthy fats, and phytochemicals (health-protective plant compounds). And when a smaller proportion of your food comes from animals, you’ll consume less saturated fat and cholesterol and, probably, fewer calories.

Protein from Plants

One myth about plant-based dietary patterns is that they don’t provide enough protein. Plenty of plant foods contain protein, including beans, legumes, soy foods, nuts, and seeds. If you include at least one protein-rich plant food in every meal and snack, you’re likely to get all the protein your body requires.

Even some grains provide protein. For example, quinoa contains 8 grams of protein per cup, and many other grains and grain products provide between 2 and 5 grams of protein per serving.

If you’re still not convinced, consider these examples: If you eat two eggs, an ounce of cheese, 3 ounces of ground beef, and a handful of mixed nuts, you will get about 46 grams of protein.

If you eat 6 ounces of Greek yogurt, chili containing one-half cup of beans, 2 tablespoons of almond butter, one cup of quinoa, and one-quarter cup of pumpkin seeds, you will get about 46 grams of protein.

Healthy Plant Foods

A plant-based diet is only as healthy as the foods included in it. The healthiest foods are unprocessed or minimally processed. These include fresh, frozen, and/or canned fruits and vegetables that contain no added salt, fat, or sugar; dried beans, peas, and lentils; canned, low-sodium or no-salt-added beans; and raw or dry-roasted nuts and seeds.

Avoid highly processed food products, especially those that contain refined grains (usually in the form of white flour) and/or added sugar. Refined grains are lower in fiber and nutrients and are often combined with salt, saturated fat, and/or sugar to make snack foods and baked goods.

Common sources of added sugar include desserts, candy, and other sweets, as well as soft drinks, energy drinks, and specialty coffees and teas.

Practical Tips

If your diet is high in animal-based foods, here are some suggestions for putting more plant foods on your plate.

Don’t make an animal-based food the centerpiece of your meal; in other words, skip the 12-ounce ribeyes, the fried chicken, and the ham steaks. Instead, use small amounts of seafood, chicken, or meat in pasta dishes, soups and stews, stir fries, and casseroles that feature a wider variety of vegetables.

Instead of modifying meat-based dishes, try some new recipes. Look for main ingredients like beans, peas, lentils, and whole grains.

Also, look to different cultures to freshen up your food style; many Asian, Indian, and Middle Eastern dishes are primarily plant-based.

It may take a while to adjust to eating fewer animal-based foods and more plant-based foods, but once you get used to it, you won’t feel deprived— especially when you lose a few pounds and your blood pressure and cholesterol numbers improve.

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