Screening Saves Lives

Despite advances in screening and treatment, breast cancer remains the second-leading cause of cancer deaths in women, just behind lung cancer, according to the American Cancer Society. The U.S. Preventive Services Task Force (USPSTF) recommends that women ages 50 and over undergo mammograms every other year for breast cancer screening. The guidelines emphasize the importance of regular screenings to detect breast cancer early when it is most treatable. For women ages 75 and older, the USPSTF notes that there is insufficient evidence to make a definitive recommendation, so the decision should be based on a woman’s health status and personal preferences.

While the USPSTF’s recommendations apply to women who have factors associated with an increased risk of breast cancer, such as having a first-degree relative with the disease, or having dense breasts, they do not apply to women who have a genetic marker or syndrome associated with a high risk of breast cancer, such as the BRCA1 or BRCA2 genetic variation, a history of high-dose radiation therapy to the chest at a young age, previous breast cancer, or a high-risk breast lesion on previous biopsies. “Women should be aware that screening recommendations differ among the various groups such as the USPSTF, the American Cancer Society, the American College of Radiology (ACR) and Society of Breast

Imaging (SBI), among others,” says Dr. Alan Astrow, Chief of Hematology and Medical Oncology in the Department of Medicine at New York-Presbyterian Brooklyn Methodist Hospital, an affiliate of Weill Cornell Medicine. “While the recommendations differ, the most important thing to know is that screening for breast cancer detects cancer at an earlier stage than it would be detected without screening. This leads to the need for less extensive treatment because the cancers are picked up at a less advanced stage and ultimately saves lives,” says Dr. Astrow.

Dense Breast Update

Approximately 50 percent of women have dense breasts, 10 percent have extremely dense breasts, and 40 percent have heterogeneously dense breast tissue. “Both groups are considered to be at slightly increased risk of breast cancer, and both groups are recommended to consider supplemental screening exams,” says Michele Drotman, MD, Chief of Breast Imaging, Weill Cornell Medical Center-New York Presbyterian Hospital. “The choices for supplemental screening are ultrasound, contrast-enhanced mammography (CEM), and MRI. Insurance does not always cover the costs of the additional exams.” Each of the screening options has pros and cons. “Ultrasound is easy to undergo, but has lower sensitivity and a high false positive rate; CEM and MRI have extremely high sensitivity, but require IV contrast administration, and MRI is not well tolerated by people who are claustrophobic,” says Dr. Drotman. Women who have dense breasts should discuss supplemental screening options with their health-care provider.

Important Advancements

New diagnostic tools and personalized treatments are leading to better outcomes. For instance, the HER2DX test is a diagnostic tool used to personalize treatment for HER2-positive breast cancer. It helps determine the best therapeutic approach by analyzing the tumor’s genetic profile, potentially allowing some women to avoid chemotherapy.

Innovative drugs like datopotamab deruxtecan (Dato-DXd) and patritumab deruxtecan (HER3-DXd) target specific proteins in cancer cells, with the aim of providing more effective treatments with fewer side effects. Meanwhile, trilaciclib, a new CDK4/6 inhibitor, is showing promise in treating triple-negative breast cancer, potentially improving responses to immunotherapy and reducing chemotherapy side effects.

Brighter Outlook

Regular breast cancer screenings, cutting-edge treatments, and diagnostic innovations are enhancing both outcomes and quality of life for women today. “Breast cancer is a serious disease, and too many women continue to die of it every year, but we are doing better and aim to continue to do even better as new therapeutic agents and diagnostic modalities are developed,” says Dr. Astrow.

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Scientists have developed a new, more effective cervical cancer screening method. The WID-qCIN test detects epigenetic changes in cells, significantly improving early cancer detection. Epigenetic changes in cells refer to alterations that can be influenced by factors such as environment, lifestyle, and aging. In a study of over 28,000 women, published in the June issue of the journal Nature Medicine, this test identified 100 percent of invasive cervical cancers and 93 percent of serious precancerous lesions within a year. Additionally, it predicted 69 percent of cancers and precancerous lesions up to six years later, compared with only 18 percent with current methods. The researchers reported that this advancement could reduce the need for invasive diagnostic procedures by 40 percent, potentially enhancing women’s health and quality of life.

Beetroot Juice Boosts Heart Health in Postmenopausal Women

New research highlights the heart health benefits of beetroot juice for postmenopausal women. Beetroot juice contains high levels of nitrate, which the body converts to nitric oxide. Nitric oxide helps blood vessels expand, making it easier for blood to flow through the circulatory system. The ability of nitric oxide to widen blood vessels is known to be particularly helpful during periods of limited blood flow and oxygen delivery, such as during a heart attack. A study of 24 postmenopausal women, published in the June issue of the journal Frontiers in Nutrition, showed that daily consumption of nitrate-rich beetroot juice significantly improved blood vessel function, reducing heart disease risk. The study included women considered early postmenopausal, or one to six years postmenopause, and late postmenopausal, six or more years postmenopause. Late postmenopausal women saw the same benefits as the early postmenopausal group. This non-pharmaceutical approach offers a promising way for menopausal women to support cardiovascular health naturally.

Study Links Body Fat and Muscle Strength to Alzheimer’s and Parkinson’s Risk

High body fat, especially in the abdomen and arms, increases the risk of developing Alzheimer’s disease and Parkinson’s disease, according to a study published in the July issue of the journal Neurology. Conversely, high muscle strength significantly reduces this risk. The study tracked 412,691 individuals—55 percent of whom were women—with an average age of 56, over nine years. It found that people with high abdominal fat were 13 percent more likely to develop these diseases, while those with high arm fat faced an 18 percent higher risk. High muscle strength, however, decreased the risk by 26 percent. This study highlights the potential to lessen the risk of developing these neurodegenerative diseases by improving body composition. Targeted interventions to reduce belly and arm fat while promoting healthy muscle development may be more effective for protection against these diseases than general weight control, the study’s researchers concluded.

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The good news is that heart-healthy meals don’t have to be bland or boring. In this article, we provide practical tips and strategies to help you make heart-healthy choices without sacrificing flavor. With insights from Gabrielle Gambino, MS, RD, CDN, CNSC, a senior clinical dietitian with NewYork-Presbyterian/Weill Cornell Medical Center’s Advanced Heart Failure Service, we’ll explore how to prepare delicious meals at home, dine out wisely, and plan your menus to support a healthy heart.

What Does a Heart-Healthy Meal Look Like?

A heart-healthy meal is rich in healthy fats, fiber, and lean proteins. Here’s how you can incorporate these components into your daily diet:

• Healthy fats: Use olive oil, canola oil, or flaxseed oil for cooking and dressings.

• High fiber: Include whole-grain breads, brown rice, and sweet potatoes.

• Lean proteins: Opt for chicken breast, tuna, salmon, or tofu.

Enhance the flavor of your meals with herbs and spices such as cayenne pepper for vegetable-based dishes, onion powder or garlic for egg-based recipes, and oregano or rosemary for chicken dishes. These not only add zest to your dishes, but also eliminate the need for excessive salt. “Herbs and spices are fantastic alternatives to salt, allowing you to enjoy flavorful meals while keeping your heart healthy,” says Gambino.

Meal Planning and Preparation

Planning and prepping meals in advance can help to maintain a heart-healthy diet:

• Weekly meal planning: Plan lunches for the week to avoid sodium-packed processed foods at home or high-fat convenience foods away from home.

• Batch cooking: Cook in bulk, and freeze individual portions. This ensures that there is always a heart-healthy entrée ready to be defrosted.

“Batch cooking on Sundays can set you up for a successful week. Prepping proteins, vegetables, and grains in advance makes it easy to assemble healthy meals quickly,” says Gambino.

Dining Out and Celebrations

Even when dining out or celebrating, manage portions and choose wisely.

• Portion control: Share entrees with a friend, or save half for later.

• Healthier sides: Opt for a side salad or steamed vegetables.

• Sauces on the side: Request sauces on the side to control sodium intake.

• Read the menu in advance: Peruse the menu online and decide what you’ll order before leaving the house.

“Dining out doesn’t have to derail your heart-healthy diet,” says Gambino. “It’s all about balance and making smart choices, like choosing fiber-rich sides and limiting high-sodium condiments.”

Heart-Healthy Recipe Modifications

Include family-friendly comfort foods in your plan for days when a lean protein and vegetable seem unappetizing. For instance, with some simple modifications you can turn pasta with tomato sauce and meatballs into a heart-friendly meal:

• Homemade sauce: Use homemade, rather than jarred, tomato sauce to control the sodium level (see recipe above).

• Pasta options: Whole-wheat pasta and chickpea pasta are flavorful and heart healthy.

• Lean meat alternatives: For meatballs, use ground turkey instead of beef.

• Bake instead of frying: Bake meatballs in the oven or cook them in an air fryer instead of frying them in oil, to reduce fat content.

• Vegetable additions: Add bell peppers, onions, and other vegetables to your sauce for extra antioxidants and fiber.

• Cheese alternatives: Skip cheese, use low-sodium cheese, or try nutritional yeast, which is a vegan substitute with low sodium and probiotic benefits. Sprinkle it on foods for an added flavor similar to parmesan cheese.

Mindful Dietary Choices

Adopting a heart-healthy diet is a journey that involves making mindful choices both at home and when dining out. By incorporating healthy fats, fiber, lean proteins, and flavorful herbs into your meals, you can enjoy delicious and nutritious food. Meal planning and batch cooking can further support your goals by ensuring you have healthy options readily available throughout the week.

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Virtual Brain Exercises

Brain exercises can be an excellent way to maintain and enhance cognitive function. For instance, the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study found that older adults who engaged in cognitive training activities showed improvements in memory, reasoning, and processing speed that lasted up to 10 years.

There are numerous online brain games and exercises, such as Lumosity and BrainHQ, that are designed to help keep the aging brain limber. They are user friendly and allow people to track their progress over time, which can be motivating and rewarding. Most offer free games and puzzles, with an option to upgrade to additional activities for a fee.

Real-Life Brain Exercises

Challenging fine motor skills through hobbies like knitting or assembling jigsaw puzzles can keep the brain active. These pursuits also require hand-eye coordination, which strengthens neural connections. “These activities can improve concentration, which can be associated with improved memory. The better someone can attend to a task and acquire information, the more likely they will remember it later on,” says Lisa D. Ravdin, PhD, associate professor and director of the Weill Cornell Medicine Neuropsychology Service. Taking up painting is another example of an endeavor that bolsters creativity and aids in maintaining focus and precision. “These activities have the added benefit of reducing stress and promoting relaxation, which can also be beneficial to memory,” says Dr. Ravdin.

Learning and Socialization

Learning a new language can enhance cognitive flexibility and memory and enhance problem-solving abilities. “Continuous learning and problem-solving can enhance cognitive reserve and promote brain function,” says Dr. Ravdin. Online platforms like Duolingo https://www.duolingo.com/ or Rosetta Stone https://www.rosettastone.com/ make it easy to learn a new language at your own pace. “Learning new skills and techniques provides a cognitive challenge, which helps keep the brain active and engaged,” says Dr. Ravdin. “That said, learning a new language can be overly challenging and may not be for everyone. Studies show our ability to acquire a second language is strongest during early developmental stages when the brain is primed for learning language.”

Another great way to strengthen memory skills is by playing cards— either online (cardsmania.com) or at your local senior center. “Participating in activities with others has the added benefit of socialization, which can significantly enhance quality of life and cognitive health,” says Dr. Ravdin.

Online or Pencil and Paper

Brain exercises are a fun and engaging way to promote overall mental agility. Online games and puzzles are popular and appeal to people who are comfortable using computer websites and smartphone apps. However, easily accessible pencil-and-paper crossword puzzles and Sodoku games also offer excellent opportunities to stimulate memory skills and invigorate your mind. Whether you opt for virtual brain exercises or real-life activities, Dr. Ravdin says, “choose games and exercises that you find enjoyable and engaging, as this will encourage consistent practice.”

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Symptoms, Risks, and Causes

Symptoms of pneumonia include cough, sputum or phlegm, fever, shortness of breath, and exhaustion. These classic symptoms are more apparent in individuals with a robust immune system, while immunocompromised people might experience subtler signs, such as increased fatigue, overall functional decline, or even falls. “If a chronically ill person is not feeling well, not functioning well, sleeping more, and in some instances, falling down, their doctor should have a high level of suspicion of pneumonia, and that should be verified by getting a chest x-ray,” says Michael S. Niederman, MD, Professor of Clinical Medicine in Pulmonary and Critical Care Medicine, Weill Cornell Medicine.

Pneumonia can affect anyone, but certain factors increase susceptibility. Risk factors include cigarette smoking, underlying heart and lung diseases, diabetes, alcohol abuse, and chronic liver and kidney disease. Additionally, those with a weakened immune system, such as people undergoing chemotherapy, are more vulnerable to pneumonia. “The danger of contracting pneumonia is higher if you have underlying chronic medical problems. But, even previously healthy individuals sometimes get severe pneumonia that can put them in the hospital or even in the intensive care unit. The reason: Some people have an excessive inflammatory response to the infection that can make them very sick,” says Dr. Niederman.

The Role of Vaccination

Preventing pneumonia is crucial, and vaccination plays a vital role. “The most important vaccines for pneumonia prevention are the yearly influenza vaccine and the pneumococcal vaccine,” says Dr. Niederman. There are several pneumococcal vaccines, including pneumococcal conjugate vaccines (PCV) and pneumococcal polysaccharide vaccines (PPSV). Currently, the CDC recommends that all adults ages 65 and older receive the PCV15 or PCV20 vaccine, and if the PCV15 is used, it should be followed by a dose of the PPSV23 at least one year later. People who have risk factors or conditions that make them more susceptible are advised to get vaccinated at a younger age.

Dr. Niederman points out that there is also a newly approved vaccine, PCV21, that is not included in the CDC’s current recommendations.

“PCV21 can be used interchangeably in place of PCV20. It covers more of the invasive pneumococcal strains than any other vaccine option,” says Dr. Niederman. Understanding which vaccine is right for you may be daunting, which is why it’s best to discuss pneumonia vaccination with your primary care physician or your pulmonary doctor, if you are under the care of one for respiratory issues. Your health-care provider can determine the appropriate vaccine and schedule based on your health status and vaccination history.

Pneumonia Treatment

Pneumonia is most often caused by either a viral or a bacterial infection, and typically involves treatment with antibiotics. Additional treatments include rest, hydration, and supplemental oxygen if needed. Steroids might be prescribed in severe bacterial cases, but can be harmful for pneumonia caused by viruses. Having pneumonia once increases the risk of recurrence, so adhering to the full course of prescribed medications and medical advice is critical.

Road to Recovery

Recovery from pneumonia can be prolonged, especially for older adults. Healing involves patience, rest, and a gradual return to normal activities. Follow your doctor’s advice closely to ensure a complete recovery.

By staying informed about the risks, prevention strategies, and treatment options, women can better protect themselves against pneumonia.

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Not Ready for Surgery?

Before considering surgery, it is advisable to try conservative measures such as avoiding prolonged periods of walking or standing, and taking frequent breaks to rest and elevate your feet. “In addition to altering their activities, I advise patients to wear wide shoes that have a high toe box so the foot is not squeezed,” says John J. Doolan, DPM, FAC-FAS, clinical assistant professor of podiatry in surgery at Weill Cornell Medicine. “I usually recommend sneakers, and also suggest that the person consider an orthotic, which can reduce pressure and pain on the affected area,” says Dr. Doolan.

By making these adjustments, women can help manage bunion symptoms, reduce pain, and potentially slow the progression of the condition, thereby delaying or avoiding the need for surgery. “When conservative measures fail to alleviate pain or the pain interferes with your ability to function, surgery should be considered,” says Dr. Doolan.

Traditional Bunion Surgery

Bunions are caused by a deformity between the first and second metatarsal bones in the foot.

Traditional bunionectomy surgery involves a sizable incision—2 inches to 4 inches—to access the bone and joint. This approach provides a direct view of the entire joint to ensure that all aspects of the bunion are corrected. The comprehensive correction offered by traditional surgery often yields lasting results, significantly relieving pain and improving foot function. This method can be adapted to various bunion severities, making it particularly effective for advanced cases requiring significant bone realignment.

However, traditional bunion surgery also has drawbacks. The large incision and extensive manipulation of the foot structures required in this surgery mean that recovery can be lengthy. People need to be non-weight bearing—meaning they need to stay off their feet—for several weeks, and they may experience swelling and discomfort for months. “It is important for the patient to understand the recovery time associated with the procedure and for the expectations of both the patient and the surgeon to be aligned,” says Dr. Doolan.

Minimally Invasive and 3D Surgery

“Traditional bunion surgery works fine; however, advances in surgical techniques and understanding over the last few years have resulted in two new methods. One is minimally invasive surgery (MIS), and the other is 3D Lapidus,” says Dr. Doolan.

The MIS procedure involves smaller incisions and less disruption to the surrounding tissues, resulting in a faster recovery time. People can often walk immediately after the procedure and return to normal activities sooner than they would with traditional bunionectomy. The smaller incisions and less invasive nature of MIS generally lead to reduced postoperative pain and swelling. MIS is most effective for mild-to-moderate bunion deformities and may not provide sufficient correction for more severe cases. Furthermore, due to less direct visualization of the joint because of the smaller incision, there is a risk of incomplete correction, and this could require additional procedures in the future.

3D Lapidus is the newest bunion surgery technique. With this procedure, the surgeon rotates the metatarsal bone back into proper alignment and secures it with titanium plates. The 3D Lapidus procedure results in significantly less postoperative pain and much faster recovery than a traditional bunionectomy. And, people can often bear weight on their foot within just a few days, compared with the weeks or months it takes with traditional surgery. This new method also lowers the risk of a bunion recurrence and the need for additional surgery by correcting the underlying deformity.

Different Techniques; Same Goals

Deciding among traditional, MIS, and 3D Lapidus procedures should take into account the severity of the bunion, a person’s overall health, your lifestyle, and your personal preferences. Consulting with a foot and ankle specialist can provide valuable insights tailored to your specific condition. However, regardless of which type of surgery you choose, the goal is the same—you want to alleviate pain, improve function, and enhance your overall quality of life.

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The glycemic index ranks how foods affect blood sugar levels, and choosing low- GI options can help maintain stable blood sugar and reduce insulin resistance. Read on to learn why the GI is especially relevant for postmenopausal women, and how to use it to your advantage.

What Is the Glycemic Index?

The GI is a measure of how quickly carbohydrate-containing foods raise blood sugar levels. Foods with a high GI—such as white bread, white rice, cookies, cake, and sugary soft drinks—cause rapid increases in blood sugar, which may contribute to weight gain, insulin resistance, an increased risk of type 2 diabetes, and cardiovascular disease. Declining estrogen in the postmenopausal years exacerbates insulin resistance and prediabetes, which makes the choice of lower GI foods ideal. “The incidence of prediabetes for women younger than 50 is around 34 percent, but that number jumps by an additional 20 percent in women over 50 years of age, which shows that the older we get the more at risk we are. Prediabetes is a warning sign for women to change their lifestyle and stabilize their blood glucose levels to get out of that warning zone,” says Gabrielle Gambino, MS, RD, a senior clinical dietitian at NewYork-Presbyterian/Weill Cornell.

Stabilize Your Blood Sugar

Fluctuations in blood sugar can also affect energy levels, mood, and cognitive function, which are particularly pertinent for postmenopausal women. When blood sugar levels spike after consuming high-GI foods, the body responds by releasing insulin to help cells absorb glucose for energy. However, this rapid increase in insulin can lead to a subsequent drop in blood sugar levels, resulting in hypoglycemia. Hypoglycemia can starve the brain of glucose, its primary source of energy, leading to symptoms such as confusion, difficulty concentrating, mood swings, and fatigue. In postmenopausal women, whose bodies may already be experiencing hormonal changes affecting cognitive function, these fluctuations in blood sugar can compound cognitive symptoms.

“High-GI food consumption causes a spike in sugar and a subsequent release of insulin, leading to a quick drop in blood sugar shortly after—this high variability in blood sugar can cause fatigue, brain fog, and irritability. These symptoms are also seen with menopause, so large variances in your sugar levels can generally make these feelings more pronounced,” says Gambino.

Insulin Resistance and Alzheimer’s Disease

Chronic fluctuations in blood sugar levels over time may contribute to the development of insulin resistance, and insulin resistance has been associated with an increased risk of Alzheimer’s disease. “The prevalence of diabetes in patients with Alzheimer’s disease is approximately 80 percent. This could be due to nerve damage secondary to uncontrolled sugar and related inflammation. We see nerve damage in many parts of the body as a result of diabetes, so it makes sense that it would also affect the brain. When nerve damage happens in the brain, it leads to cell damage,” says Gambino.

Low GI Foods and HbA1c

The goal of incorporating more low-GI foods into our diets is to stabilize blood sugar and avoid the ill effects associated with chronic high blood glucose. The measurement used to determine blood glucose levels, an HbA1c test, shows your average blood glucose levels for the preceding three months. A normal HbA1c level is less than 5.7 percent, while 5.7 percent to 6.4 percent indicates prediabetes, and 6.5 percent or higher means you may have diabetes. “If someone has prolonged high sugars, as detected by HbA1c, their body is in a constant state of inflammation, which leads to irreparable damage. Controlling blood sugar on a daily basis can bring down HbA1c in the longterm, and— particularly for prediabetes—could reverse the damage before it becomes a chronic illness,” says Gambino.

Postmenopausal women can benefit from consuming a balanced diet of primarily low-GI foods that provide a steady supply of glucose to all organs, including the brain. Consuming whole grains, lean proteins, healthy fats, and low-GI fruits and vegetables can support optimal cognitive function.

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Researchers have refined the use of magnetic resonance imaging (MRI) to diagnose 16.5 percent more women with heart failure compared with traditional methods. Their study, which was published in European Heart Journal Open in May, revealed that this improved technique allows for earlier and more accurate diagnosis, enabling women to receive life-saving treatments sooner. Traditionally, doctors rely on echocardiograms, which can miss up to 50 percent of heart failure cases, according to research. This new MRI method offers clearer images and better detection, particularly for a type of heart failure in which the heart’s pumping function is preserved, but its ability to relax and fill with blood is impaired. This advancement has the potential to enhance treatment outcomes and save more lives by addressing the unique ways heart failure manifests in women.

New T-Cell Discovery May Advance Cancer Treatment

By studying cellular behavior using artificial intelligence (AI) and other advanced techniques, scientists at the University of Houston have made a breakthrough that could improve outcomes for cancer patients undergoing T-cell immunotherapy. Using samples of cells from patients with a type of cancer called large B cell lymphoma, researchers combined various techniques to study the behavior and characteristics of immune cells called CD8 T cells. A study, which was published in the journal Nature Cancer, in May, detailed how the researchers used a method called TIMING (Timelapse Imaging Microscopy in Nanowell Grids) to analyze how CD8 T cells function, along with other methods to look at the cells’ internal workings and their genetic activity. By doing this, the researchers were able to identify a specific subgroup of CD8 T cells that are especially good at fighting cancer. These effective cells are referred to as “CD8-fit” cells. This advance may lead to better predictions of patient responses to T-cell therapies, offering hope for more effective cancer treatments.

Research Paves the Way for Future UTI Treatment Improvements

Almost half of all women experience a urinary tract infection (UTI) in their lifetime, and anti-biotics are the primary mode of treatment. Research performed at the University of Michigan and published in the Proceedings of the National Academy of Sciences of (PNAS) in April examines how the bacteria E. coli, which are responsible for most UTIs, is able to reproduce at an extraordinarily rapid pace during the infection process. This new research reveals that a type of “transporter” cell called ABC (ATP-binding cassette) is a critical part of the infection process. The study unravels the complex process by which E. coli use ABC “transporters” to spread infection, and how inhibiting this transport system could slow bacterial growth, ultimately enhancing the effectiveness of both antibiotics and the immune system in fighting infections. The study suggests that these transporters may pave the way for new treatments, which is especially important as antibiotic resistance rises.

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Signs, Symptoms, and Risk Factors

Pay attention to subtle signs that may signal osteoporosis, such as loss of height and back pain. Compression fractures in the spine can cause a gradual loss of height, which may result in a stooped posture. These compression fractures can also lead to back pain, which may be sudden or develop gradually over time. If you experience any of these symptoms, bring them to the attention of your primary care provider or a rheumatologist. “Certain women are at a higher risk of osteoporosis due to genetics,” says Alana Serota, MD, an osteoporosis expert at the Weill Cornell-affiliated Hospital for Special Surgery. “But aging, illness, medications, poor nutrition, and other lifestyle factors can significantly increase the risk of osteoporosis, as well, particularly in the first five years after menopause.”

Reducing Your Risk

There are steps you can take to reduce your risk of osteoporosis. Weight-bearing exercises such as walking, jogging, dancing, and strength training help stimulate bone formation and increase bone density. “Women over 50 should focus on maintaining a healthy diet and weight, engaging in regular exercise, getting sufficient sleep, and ensuring adequate intake of calcium, vitamin D, and protein. The goal is to consume 1,200 milligrams of calcium per day. Any not obtained through diet should be made up with supplements,” says Dr. Serota. Generally, the daily recommended amount of vitamin D is 600 international units (IU) for women ages 51 to 70 and 800 international units (IU) for women over 70.

Diagnosis and Treatment

If you are diagnosed with osteoporosis there are several treatment options available. “When osteoporosis is treated, women can expect to maintain or even improve their bone density, depending on the medication used. This significantly reduces the risk of fractures. However, if osteoporosis is left untreated, bone density will continue to decrease, leading to a higher risk of fractures,” says Dr. Serota.

Available osteoporosis medications include:

Bisphosphonates: These medications are typically taken orally, usually as a once-weekly or once-monthly tablet.

Hormone therapy: This typically involves the use of estrogen or a combination of estrogen and progestin. Estrogen therapy can be administered orally in the form of tablets, or it can be delivered transdermally through patches or gels applied to the skin.

Selective estrogen receptor modulators (SERMs): Medications such as raloxifene are taken orally as a daily tablet. SERMs act like estrogen in some parts of the body, such as bone, but have anti-estrogen effects in others, such as the breast and uterus.

Monoclonal antibody medications: These medications, such as denosumab, are administered as an injection, and are typically given once every six months by a health-care provider in a clinical setting.

Anabolic Agents: These drugs, which stimulate bone growth, include PTH-analogues—teriparatide (Forteo) and abaloparatide (Tymlos), as well as the sclerostin antagonist romosozumab-aqqg (Evenity). “All of these approved treatments prevent fractures, and their benefits far outweigh their risks. Ultimately, the choice of treatment is a shared decision between the patient and doctor,” says Dr. Serota.

What to Expect

Medicare generally covers bone density testing DXA (dual energy X-ray absorptiometry) scans every other year for women over the age of 65. The Bone Health and Osteoporosis Foundation recommends that scans can begin as early as age 50 for women who have risk factors for fractures. For women who are diagnosed with osteoporosis, regular monitoring and follow-up appointments with health-care providers are crucial to ensure the effectiveness and safety of prescribed treatments.

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What Is Inflammation?

Inflammation is a natural bodily response that can be beneficial. For instance, if you accidentally prick your finger on a rose bush while gardening, your immune system triggers inflammation to aid healing. However, there are instances where inflammation starts without a clear reason and persists; this is known as chronic inflammation. “Chronic inflammatory responses can develop when immune or nonimmune cells in the body start to release bioactive molecules that can promote hallmarks of inflammation including swelling, redness, and heat,” says David Artis, PhD, director of Weill Cornell Medicine’s Friedman Center for Nutrition and Inflammation and Director of its Jill Roberts Institute for Research in Inflammatory Bowel Disease.

Inflammation and Brain Function

Scientists have discovered a connection between inflammation in the body and how well our brains work. When markers of inflammation—like C-reactive protein (CRP) and interleukin-6 (IL-6)—are elevated, studies show an escalation in memory loss and dementia. Research also shows that inflammation plays a role in disrupting the blood-brain barrier—a protective wall in the brain that controls what can enter and exit. When inflammation weakens the wall, it allows harmful immune cells in, thereby provoking further inflammation.

Diet and Cognition

Consuming a diet abundant in processed foods and saturated fats can trigger inflammation, and there is growing scientific evidence of a link between a high intake of sugar and processed foods and an increased risk of Alzheimer’s disease and cognitive decline. Conversely, studies show that embracing a nutrition plan rich in fruits, vegetables, grains, fish, nuts, lean protein, and low-fat dairy can counteract inflammation and potentially safeguard against cognitive deterioration. The MIND diet, which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay, is a hybrid of the Mediterranean and DASH diets, and is specifically designed to promote brain health. The MIND diet emphasizes anti-inflammatory foods such as leafy greens, berries, nuts, and whole grains, while discouraging the intake of red meat, butter, and sweets. It has been shown to lower the odds of developing conditions like Alzheimer’s disease and dementia. In fact, one study found that those who followed the MIND diet strictly cut their chances of developing Alzheimer’s by more than half.

“Adopting a diet rich in certain fibers and grains, vitamin C, beta-carotene, and lycopene, while limiting foods high in fat, salt, and sugars, can contribute to limiting the magnitude of chronically inflammatory responses,” says Artis. A cup of strawberries or broccoli provides enough vitamin C for the day. The recommended daily amount of vitamin C for women is 75 milligrams. There is no official recommendation for daily lycopene or beta-carotene intake, but some studies suggest that 8 to 21 milligrams of lycopene per day and 6 to 15 milligrams of beta-carotene per day may be beneficial. Foods rich in beta-carotene include carrots and sweet potatoes, and those high in lycopene include tomatoes and watermelon.

Exercise and Stress

Regular physical activity enhances blood flow to the brain and promotes the release of chemicals such as brain-derived neurotrophic factor (BDNF) that support brain health. BDNF plays a crucial role in neuroplasticity, or the brain’s ability to adapt and form new connections, and this is essential for maintaining cognitive function. Exercise also helps diminish chronic inflammation by decreasing the production of cortisol in your body. Elevated cortisol can trigger inflammatory pathways, leading to detrimental effects on cognitive health.

Healthy Choices for Brain Function

Recognizing the connection among lifestyle choices, inflammatory processes, and cognitive function may be the incentive needed to welcome healthy nutrition, exercise, and stress reduction behaviors into your life.

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