A: Yes, symptoms that seem to develop gradually may indicate a different type of dementia from the one that presents with more sudden-onset symptoms. But understand that there is no entirely reliable timetable for everyone who develops dementia.

Symptoms of Alzheimer’s disease, for example, tend to develop gradually and progress more slowly than other types of dementia. However, progression is sometimes faster in early-onset Alzheimer’s compared with the disease in older adults.

Vascular dementia, on the other hand, can often develop suddenly. Early symptoms can sometimes be difficult to detect, as they can include struggles with planning and concentration and subtle changes in mood or behavior. Memory loss, which is among the first signs of Alzheimer’s disease, is among the later symptoms of vascular dementia.

Whether cognitive changes occur slowly or quickly, they should not be ignored or written off as normal aging or as a mood disorder such as depression. If you are aware of changes in your thinking skills or those around you express their concerns, get a medical evaluation.

Q: When a stroke makes it difficult to walk, speak, or engage in other basic functions, is it possible to predict whether or how much of those skills might return?

A: Researchers continue to develop physical tests and computer models designed to do just what you’re asking—better predict the recovery of certain functions affected by stroke. And while we are learning more about what is reasonable or realistic to expect in stroke recovery, there are no guarantees because every person’s stroke experience is unique.

What we do know is that the first one to three months after a stroke continue to be the most important in terms of recovery. Most improvements usually occur during this time period, though with effort and patience, many stroke survivors can continue to experience improvements years after the event. The key is committing to physical, occupational, and speech therapies (as appropriate), and understanding that setbacks and detours on the road to recovery are to be expected. The medical community’s ability to treat stroke and enhance recovery has come a long way in recent years, and there is every reason to believe that progress will continue.

Q: After being widowed several years ago, I noticed that I get very sad every winter. I assumed it was the holiday blues, but a friend suggested it might be seasonal affective disorder (SAD). I don’t remember feeling this way when I was younger. Can SAD develop later in life?

A: SAD is diagnosed more often in younger adults than older adults, but various circumstances can affect when a person first notices symptoms or experiences a worsening of symptoms. Older adults, especially those living alone and susceptible to isolation or loneliness, can have a particularly difficult time with SAD.

It’s not always easy to distinguish between the “holiday blues” and SAD, but there are some important distinctions. SAD is a form of clinical depression and tends to be accompanied by significant changes in sleeping patterns, difficulty managing situations, feeling angrier and more irritable than usual, low energy, and often a desire to be alone. It may start in the fall and last well into the new year. The holiday blues tend to be fairly situational and limited to the holiday season or holiday events. It’s a psychological condition that brings on feelings of sadness, but after the holidays those feelings tend to ease up.

You may find it helpful to talk with your health­care provider and consider counseling and/
or medications, particularly if you notice that this time of year leads to negative, potentially harmful thinking or unhealthy behaviors. MMM

The post Ask the Doctor: January 2023 appeared first on University Health News.

In the United States, pain is the symptom most commonly treated with acupuncture. Research published in February 2022 in the journal BMJ showed that, among studies that evaluated acupuncture treatments, conditions for which acupuncture was found to be most effective included neck, shoulder, and muscle pain, lower back pain, and pain caused by fibromyalgia. Other conditions that responded well to acupuncture were allergy symptoms, post-stroke aphasia (difficulty expressing and comprehending language), lactation issues after childbirth, and vascular dementia symptoms.

“Acupuncture also can be very effective for nausea and vomiting caused by chemotherapy, and as a preventive measure for migraines,” explains Victoria Chan Harrison, MD, assistant professor of rehabilitation medicine at Weill Cornell Medicine.

Traditional Chinese Medicine

Acupuncture is just one modality used in the practice of traditional Chinese medicine (TCM). TCM originated in China more than 2,000 years ago.

“TCM views the body as composed of different elements (water, fire, metal, wood, earth) and organ systems (kidney, bladder, heart, pericardium, triple heater, gallbladder, liver, lung, spleen) that need to be in balance at all times,” says Dr. Harrison.

In TCM, all of the body’s systems are connected through a network of channels called meridians. Another key aspect of TCM is Qi (pronounced “chee”), the vital life force or energy that flows throughout the body.

“The Chinese medical model also looks at environmental pathogens— wind, heat, damp, cold—that may affect the human body. When a pathogen ‘invades’ the body, it can impair the flow of both blood and Qi in the meridians. If imbalances, decreased blood flow, and Qi stagnation remains unchecked over a prolonged period of time, people can experience symptoms of what Western medicine calls diseases or illnesses,” says Dr. Harrison.

TCM Tools

The TCM practitioner’s toolkit includes different techniques to relieve symptoms and prevent disease manifestation. For example, ‘gua sha’ and ‘cupping’ both work on the myofascial layer—the connective tissue that lies beneath the skin—to increase circulation to the treated areas. Gua sha involves scraping the skin, often with a rounded, smooth stone or a special type of spoon, and cupping involves creating a vacuum to lift subcutaneous tissue.

“The goal is to improve the flow of Qi in areas of pain and at sites of muscle tissue injury. It is also often used to promote an immune response to fight a cold virus (in TCM, this is called ‘cold wind invasion’),” says Dr. Harrison.

Acupuncture and Chinese herbs can be used together to address the imbalances in the body’s five elements and in a particular organ system, as well as trying to expel pathogenic environmental effects, such as damp heat or cold wind.

Chinese Herbs

TCM practitioners may also use herb formulas to correct imbalances and promote the flow of Qi. Dr. Harrison explains that, traditionally, herb formulas were boiled to create a tea, but most modern Chinese herb formulas now come in the form of pills or tinctures.

Dr. Harrison advises caution when choosing Chinese herbs. She says, “Chinese herbal remedies can be problematic because of the lack of environmental and pharmacological regulation in the production, processing, and purity of the herbs. I typically recommend that Chinese herbal products be purchased from an American company that tests for impurities such as heavy metals to ensure quality of the product.”

If you are interested in being treated with TCM, ask your primary care physician for a recommendation, or visit the website of the National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org). Many states require a four-year master’s degree in acupuncture or traditional Oriental medicine and passing a board exam to become licensed.

Some insurance companies cover acupuncture for certain conditions; in 2020, Medicare and Medicaid began covering acupuncture as a treatment for chronic lower back pain.

The post Acupuncture: A Healing Practice Based on Balance and Energy Flow appeared first on University Health News.

A: Memory care and assisted living facilities provide many of the same services, but there are important distinctions. Assisted living facilities offer “levels of care.” For example, level one may include verbal reminders for bathing and dressing, whereas level two includes hands-on help with the same activities. The more services offered, the greater the monthly fee. In contrast, memory care facilities are typically all-inclusive. However, many assisted living facilities offer levels of care that are suited for residents who have dementia and those who do not. For example, music and art therapy programs can be enjoyable and relaxing for everyone. Medication management and dressing assistance are common options as well. Depending on the degree of dementia symptoms, it’s possible that a person can start off in an assisted living and then transition to a memory care unit, if needed. For people with mild dementia, it can be more inspiring to be with a mixed population.

If a person wanders (typically a later-stage symptom), facilities require placement in a memory care unit. These units provide security so that a person can’t just walk out and get lost. Entrances and exits are locked, doorways may be obscured, require keys or codes to enter, and doorbells typically signal entering and exiting the unit. The layout in memory care units is designed to help minimize confusion and orient residents. Memory care units also include round-the-clock care and supervision. This is useful for people who need a lot of direction throughout the day, frequently lose things, and those with combative and inappropriate behaviors. All residential care facilities have their own evaluation processes that help pinpoint whether their assisted living or memory care offering is best for a particular person. Facilities that offer transitions of care can make moving into memory care less stressful. It also enables residents to maintain continuity of care with staff and healthcare providers.

Q: I took an online quiz for personalized supplements that are supposed be specific to my health needs. Are they worth the cost?

A: The cost of personalized supplements can range from $30 to $100 per month, depending on how many supplements are recommended. Companies typically offer a deep discount on the first month and then make their money on ongoing subscriptions. The supplements typically include those that can be purchased for less in stores (e.g., vitamins, minerals, probiotics, omega-3s, protein powder, collagen and electrolytes). Though companies promote that their supplements will be personalized, how they make that determination varies widely and is questionable. Recommendations may be based on a few quiz questions, such asking about whether you exercise on a regular basis, sleep well, and if you have any digestive issues. DNA tests may be recommended, but research does not show that DNA tests are reliable for creating customized dietary supplements. Some companies offer the support of a dietitian, but most do not. The better option would be to consult with a registered dietitian who can create a custom eating plan and behavior-change strategies that can help you meet your specific goals. Your physician can conduct blood tests to determine vitamin levels and recommend what may be needed.

What these companies are capitalizing on is an emerging field of science called nutrigenomics, which is still evolving. It’s a fascinating field based on genetic testing to assess the interplay between genes, nutrition, and health. The field is exploring how nutrients influence the behavior of a person’s genes and which dietary choices might be best given your genetic makeup. But the field is new and not quite ready for a broad mass market approach. Studies show that foods, not supplements, are the optimal way to obtain needed nutrients. Supplements have their place, but they don’t replace a nutritious diet and they are not without risk. Talk with your doctor or pharmacist before taking supplements, especially if you’re taking any medications. 

The post Ask the Doctor: September 2022 appeared first on University Health News.

“The presentation is very similar between early-onset AD and AD; there’s not much difference in symptoms,” says Lisa Ravdin, PhD, director of the Weill Cornell Neuropsychology Service in the Department of Neurology and Neuroscience. “The biggest difference is in perspective and context.”

For example, if a woman in her 40s or 50s is showing signs of dementia, it may be noticed sooner, since she is more likely to be working and may have difficulty performing her job duties. Or she may be the family’s money manager, and she may start missing or making late payments. When dementia symptoms appear in older adults, it’s often not viewed with the same degree of concern, since some cognitive decline is common in older adults, and changes in memory may not be seen as having the same significance as in younger people.

However, Dr. Ravdin points out that there are several different types of dementia, and one type in particular, frontotemporal dementia, is more likely to occur in younger populations.

“If a person has frontotemporal dementia, you might see more personality changes and different behaviors than are typical of Alzheimer’s disease,” explains Dr. Ravdin.

Signs That May Be Serious

Symptoms that point to the possibility of AD or another type of dementia include:

• Memory loss that disrupts daily life
• Challenges in planning or solving problems
• Difficulty in completing familiar tasks at home, work, or leisure
• Confusion with time or place
• Trouble understanding visual images and spatial relationships
• New problems speaking or writing words
• Misplacing things and losing the ability to retrace steps
• Poor judgment
• Withdrawal from work, family, or social activities
• Changes in mood and personality

“If memory problems or other cognitive concerns are interfering with your daily routine—forgetting appointments or important events, neglecting to pay bills, having difficulty doing familiar activities—then it’s a good idea to get it checked out, regardless of your age,” advises Dr. Ravdin.

However, don’t be alarmed if you notice occasional memory lapses or you feel that your brain isn’t working as well as it did when you were younger.

Other Possible Factors

If you are having some memory problems, don’t panic; there are numerous factors that can affect cognitive functioning. For example, some medical conditions, vitamin deficiencies, and medications can cause problems with memory, thinking, and concentration.

“Possible contributing factors include poor sleep, chronic pain, depression, and stress, as well as hormone levels and other health conditions. All factors need to be considered in terms of their potential impact on the brain’s ability to function,” says Dr. Ravdin. “Even if the condition that is affecting your brain cannot be cured, it can be treated, which can improve your ability to function—and it may improve your memory.”

If You’re Concerned, Get Checked

If you worry about memory lapses or other changes in your cognitive function, report it to your primary care physician. If he or she thinks further evaluation is needed, he or she may refer you to a neurologist, psychiatrist, or neuropsychologist.

“Your brain performs many functions, and all areas need to be tested to get an accurate picture of what is going on,” says Dr. Ravdin. “Ideally, tests should be administered by a neuropsychologist or other doctor who specializes in memory disorders.”

And, if you do have dementia, it’s better to find out sooner than later.

“Treating the disease in its early stages can give you a better quality of life for a longer period of time,” says Dr. Ravdin.

The post Early-Onset Dementia: Same Symptoms at a Younger Age appeared first on University Health News.

The list of 12 manageable risk factors includes three new items added to the original set of nine factors presented by the Lancet Commission in 2017. While getting a handle on all 12 doesn’t guarantee a life free of dementia, the report suggests that a healthier lifestyle may go a long way in preventing or at least delaying the onset of dementia. This is a message doctors have been trying to convey to their patients for a long time.

“While there are many factors beyond our control that can ­contribute to our risk for dementia, including genes and family history, it is important to keep in mind the degree of control that we can exercise on a daily basis,” says Massachusetts General Hospital ­psychiatrist Jennifer Gatchel, MD, PhD.

The Lancet List

The potentially modifiable risk factors for dementia presented by the Lancet Commission in 2017 included:

• Less education early in life
• Hypertension
• Hearing impairment
• Smoking
• Obesity
• Depression
• Physical inactivity
• Diabetes
• Social isolation

The three new risk factors include:

• Exposure to air pollution
• Head injury
• Excessive alcohol consumption

Though there is nothing you can do about the amount of schooling you received as a child, the remaining items are all factors that can be addressed if you are proactive about your physical and mental health. In many cases, however, people need the support of family members and their health-care providers to manage their risk factors safely and effectively.

“By modifying behavior and lifestyle factors in the areas of physical activity, a balanced diet, blood pressure control, minimizing alcohol and other drug consumption, managing stress, and engaging in social interactions and meaningful activities, we can each stack the risk profile in our favor and protect our physical, mental and overall brain health,” Dr. Gatchel says.

Getting Started

Tackling challenges such as diabetes and obesity can seem overwhelming, especially when viewed as part of a comprehensive lifestyle overhaul. That’s why your best strategy may be to start with the changes that are reasonable for you, your family, your budget and other circumstances, says Jonathan Rosand, MD, co-founder and co-director of the Henry and Allison McCance Center for Brain Health at Massachusetts General Hospital. There, Dr. Rosand and others work with patients to address risk factors like those on the Lancet list.

“We’ll look at what’s the lowest hanging fruit for the individual patient we are trying to help,” he says. “What can you start with? What would be the easiest opportunity for them to be successful at reducing their risk? Usually, it’s blood pressure.”

Talk with your doctor about how frequently you should check your blood pressure and at what times of the day. Tracking blood pressure changes can help your physician determine whether your treatment plan is working or whether adjustments are needed.

“With diet, you can start slowly, integrating more vegetables into your meals, for example,” Dr. Rosand says. “Think about one thing to reduce in your diet.” It could be red meat, added sugars, or any items that could be replaced by healthier options.

“Everybody’s diet is different,” Dr. Rosand explains. “So we look at what changes can people make within their families and cultural traditions. Once a person makes one change and it sticks, they can start to make more.”

Shifting to a healthier diet can have a positive effect on several risk factors, including hypertension, obesity, and diabetes. If you’re overweight, losing a few pounds may help you become more physically active.

Exercise for the Mind

The importance of exercise in improving cognitive and physical health can’t be overstated. In addition to improving circulation, muscle function and other aspects of physical health, exercise can help you think more clearly and have a brighter outlook. “When you exercise, the body releases chemicals that boost mood,” Dr. Rosand says. “Exercise also helps reduce neuroinflammation.”

Neuroinflammation is an unhealthy inflammatory response in the brain that is implicated in conditions such as Alzheimer’s disease and depression. Exercise not only helps reduce inflammation in the brain and the rest of the body; it also triggers the release of circulating molecules that help stimulate the growth of new brain cells (neurons) and neuronal connections. “Part of brain health is protecting your mind,” Dr. Rosand says. “Mood and brain health are very closely linked.” He explains that it can be difficult to distinguish between depression and dementia symptoms in older adults.

Small changes in activity can also add up to more exercise, too. Before getting in the car to drive to the grocery store, for instance, Dr. Rosand suggests taking a walk around the block. Working short bursts of activity into your daily schedule may lead to longer exercise sessions.

And not only does regular exercise address the “physical inactivity” risk factor, but it also helps reduce obesity, manage diabetes, lower blood pressure, and tackle depression.

Takeaway

Three other items on the list should also be high priorities. Hearing impairment, for example, can be a major contributor to social isolation. Don’t be self-conscious about hearing aids. They can be lifelines.

The other two key risk factors that may challenge your discipline and willpower are smoking and excessive alcohol use. There are several programs and products with proven results to help people stop smoking. And if you find yourself unable to stick to one drink a day or fewer, there are programs and strategies to help with alcohol consumption as well. Dr. Rosand notes that alcohol is toxic to the brain and for optimal brain health, little or no alcohol at all is the best approach.

One of the two new items on the list—head injury—is a matter of prevention rather than lifestyle change. Clearing fall hazards from your home, such as throw rugs, and improving the lighting on stairs or hallways may help.

“There are lots of steps we can take to protect our brain health,” Dr. Rosand says. “It’s a little different for everybody, but there are things everyone can do starting today.”

The post Modifying 12 Risk Factors May Help Delay or Prevent the Onset of Dementia appeared first on University Health News.

The male brain is highly dependent on appropriate levels of testosterone for healthy function, and low testosterone may result in increased neurodegeneration and decline in brain function. Studies have validated that compared to controls, men with Alzheimer’s and dementia symptoms have lower levels of testosterone.

Risk for Dementia: How Testostone Levels Relate

The frontal lobe of the male brain contains many receptors for the hormone testosterone. When testosterone is low, a man can suffer loss of cognitive function, memory problems, and other progressing dementia symptoms. Less advanced symptoms include depression, lack of motivation, loss of libido, and a grumpy attitude. Read more about How to Identity Low Testosterone Symptoms here.

Additionally, low testosterone has actually been shown to increase the secretion of beta amyloid proteins, hallmarks of Alzheimer’s. Also, healthy levels of the brain neurotransmitter acetylcholine, the “learning and memory” neurotransmitter, depend on sufficient testosterone. As a side note, testosterone also influences the neurotransmitter dopamine, which protects the brain from Parkinson’s disease; and low testosterone may increase the risk of Parkinson’s.

Testosterone Hormone Therapy to Decrease Risk for Dementia Symptoms

The first thing many men want to do when they read about low testosterone is use testosterone cream. Unfortunately, this could make things worse, especially in younger men who can restore hormone function naturally. Hormone creams can raise the levels of hormones too high, which are then stored in body fat. This not only disrupts the communication between the hormone glands and the brain, but it can also cause hormone receptor site resistance. Here, a disruption in metabolic balance occurs, causing symptoms of low testosterone because the testosterone can’t get into the cells.

Although bio-identical hormone therapy may be appropriate in some cases, for many men low testosterone is the result of chronic insulin surges due to a diet high in sugar and carbohydrates, which is stressful to the body. Food intolerances, poor digestive function, chronic inflammation, and consuming convenience foods are other factors that create chronic stress. This not only lowers testosterone but also increases the risk for dementia symptoms and Alzheimer’s. Instead of using a prescription cream, men should first balance their blood sugar and reduce inflammation, which may restore testosterone activity to healthy levels.

Diet Important When Testosterone Therapy is Used for Dementia Symptoms

For an older man, or for a man who is already experiencing mild cognitive impairment, dementia symptoms, or Alzheimer’s, testosterone hormone therapy may improve quality of life (although one should always address the dietary and lifestyle factors to improve outcome). However, findings are mixed, with some calling testosterone therapy for dementia and Alzheimer’s a disappointment. This is because many men’s bodies convert the testosterone to estrogen, worsening overall health and dementia symptoms. The conversion of testosterone to estrogen is the result of a process called aromatization, which is frequently seen in cases of high blood sugar, insulin resistance, and pre-diabetes. In these cases, a more brain healthy diet that is low in carbohydrates and contains ample healthy fats and protein can not only improve brain health, but also prevent the conversion of testosterone to estrogen.

Considering Bio-Identical Hormone Therapy?

Testosterone is a wonderful brain-boosting hormone which improves mood, memory, motivation, and overall cognitive function—in both men and women. So the first step is to improve the diet to allow the body itself to increase stores of testosterone. But after doing that, some men (and women) still have many of the same low testosterone symptoms. Bio-identical hormone replacement therapy is a promising treatment option. Read about how it can beat depression and anxiety, while balancing hormones.

[1] Low Testosterone Linked to Alzheimer’s Disease. Oct. 5, 2010. Science Daily.
[2] Investigating the Role of Testosterone in Alzheimer’s Disease. Neurotransmitters and the Brain. Datis Kharrazian, DHSc, DC, MNeuroSci. 2010. Apex Energetics.
[3] The Uses and Misuses of Testosterone Therapy. Johns Hopkins Health Alerts. March 7, 2007.

This article was originally published in 2012 and has been updated.

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Here, we offer six “brain health” tips on why you should keep up a physical exercise routine and why it’s important to make strength training part of it.

1. Exercise is the golden bullet when it comes to preventing mild cognitive impairment.

One study looked at the difference between weight lifting, walking, and

and tone exercises over six months. Brain MRIs and cognitive testing showed all three groups benefited from the exercise, leading one researcher to call exercise the “golden bullet” when it comes to preserving memory and cognitive function. However, by the end of the study the group who lifted weights improved the most.

2. Exercising earlier in life enhances prevention of mild cognitive impairment.

The study also showed the better the participants’ cognition was prior to the study, the more improvement they showed. This suggests the earlier you begin an exercise routine the greater the cognitive benefits._[1] In spite of this, it’s never too late to start. Even in the senior years, exercise benefits are worth the effort.

3. Strength training in the golden years: Take a simple approach.

There are various ways seniors can get started on a strength training program. The most common are to do pushing and pulling exercises with dumb bells or resistance bands, although cans of soup work, too! As you stay consistent with your weight-training program, your strength will increase and you will need to increase the amount of weight used. The safest approach, and the one that will motivate you the best, is to work with a trainer or to join a group that is guided by an instructor experienced working with seniors.

If working out with a trainer or at a gym is not an option, or just not your cup of tea, the Internet offers various sources for senior adult weight training. For example, the website Eldergym.com is dedicated entirely to fitness for seniors. The site offers video demonstrations of various exercises and also sells fitness books and DVDs, all tailored to seniors.

4. Schedule your strength training to prevent mild cognitive impairment.

The goal is to strength-train all of the major muscle groups for 30 minutes at least twice a week. Do not exercise the same muscle group two days in a row; muscles need time to recover (the recovery period is when muscles grow stronger). To prevent injury, err on the side of caution when choosing how heavy of a weight you want to lift. Some may need to start with one- or two-pound weights, or no weight at all. You should be able to lift the weight at least eight times in a row.

Resistance bands, which are stretchy, elastic bands, are an alternative to dumb bells or other weights. They’re also lighter and more portable.

Your off days from strength training are excellent days to take a walk, swim, or engage in some other form of aerobic exercise (now you can get on the treadmill), which is also extremely beneficial for preserving brain health, memory and preventing or slowing mild cognitive impairment and Alzheimer’s.

5. Aerobic exercise also has proven to be vital for preventing mild cognitive impairment.

Although weight lifting shows most improvement, aerobic exercise is still vital to brain health and should not be ignored for lowering your risk of memory loss, mild cognitive impairment, and Alzheimer’s.

A recent study_[2] looked at older adults with Alzheimer’s who walked moderately for 30 to 45 minutes three days a week for a year. When researchers used brain imaging to measure the brains of the participants, they found the hippocampus, the area of the brain that governs memory and is most affected in mild cognitive impairment and Alzheimer’s, grew by 2 percent. Contrast this to average loss of 1 to 3 percent loss of hippocampal volume. Their brains also showed growth in the prefrontal cortex, another area important for memory.

6. Get creative with exercise!

Many people are turned off by exercise because it seems boring to them. If you fall into that camp, perhaps you need to find a way to make it fun—maybe exercising in a group setting for more motivation. Senior-friendly exercise ideas include Pilates, swimming, rowing, or hiking. For more motivating ideas, read our articles “How to Get Motivated to Exercise” and “How to Improve Memory and Dementia Symptoms with Exercise.”

[1] Strength training key in preventing Alzheimer’s. Nadia Kounang. CNN.com. July 16, 2012.

[2] Exercise may reduce risk of Alzheimer’s. Kathleen Doheny. WebMD.com. July 16, 2012.

Originally published in 2012, this post is regularly updated.

The post Strength Training May Prevent Memory Loss and Mild Cognitive Impairment appeared first on University Health News.

A: Dementia is a progressive condition, meaning it will worsen over time. Unfortunately, there is no way to predict the rate of progression, as it can vary considerably from person to person. Usually the cause of dementia dictates the speed at which dementia symptoms progress. Alzheimer’s disease, for example, tends to worsen gradually over an average of 10 years or so after diagnosis. A rare condition called Creutzfeldt-Jakob disease, however, causes a type of dementia that tends to worsen quickly.

Other factors can affect the progression of dementia symptoms, too. Problems like thyroid disease, malnutrition, and poor sleep can worsen brain function. Overlapping conditions, such as Alzheimer’s and Parkinson’s disease, can cause a more rapid decline in cognitive function. Likewise, a healthy lifestyle that involves a good diet, regular exercise, proper medication use, regular social engagement and sufficient sleep may also extend cognitive health.

Q: I often read about the importance of reducing stress with strategies such as yoga and meditation. Are there any simpler techniques to de-stress quickly?

A: Stress is the body’s mental, emotional and physical response to certain changes within you and outside of you. For example, worrying about your pending retirement can trigger a stress response in the body. Spending time outside in extreme cold or heat also can bring on stress, too. Some stress is healthy. It keeps you sharp. But too much stress or stress that never seems to subside is associated with a host of health problems.

Fortunately, there are countless ways to lower your stress levels, aside from yoga and meditation. Going for a walk or being otherwise physically active is one of the simplest, most beneficial things you can do for your mental and physical health. When walking, though, try not to think about what was stressing you out, but instead take in the sights and sounds around you in that moment. Listening to music you enjoy can be a great mental distraction that can also help reduce the stress hormones circulating through your body. Even simpler steps, like deep breathing exercises, can help. Lie down in a comfortable position on your back and breathe in deeply through your nose. Slowly breathe out through your nose or mouth. Repeat three or four times, and with each inhale, feel your belly filling with air.

Q: Why is it dangerous to suddenly stop taking an antidepressant?

A: If you abruptly stop taking an antidepressant, you run the risk of antidepressant withdrawal, also known as antidepressant discontinuation syndrome. Typically, these responses will develop only if you have been taking an antidepressant for at least four to six weeks. They can include anxiety and insomnia, headaches, dizziness, irritability, flu-like symptoms, and fatigue. These symptoms can last for a few weeks.

Suddenly stopping your antidepressant use may also lead to a return of depression symptoms. Sometimes it’s not clear whether you are experiencing temporary withdrawal symptoms or whether your underlying depression symptoms are returning. To help reduce your risk of antidepressant withdrawal, talk with your doctor about stopping your medication. You may be prescribed a lower dose and gradually stop. You may also be prescribed a different type of medication that will help your body adjust to no longer having your antidepressant.

The key is to communicate with your doctor about all of your symptoms and any other changes you notice. If you want to stop taking your current antidepressant because of side effects, ask your doctor about alternative antidepressants, as well as other forms of therapy that may be helpful.

-Editor-in-Chief, Maurizio Fava, MD

The post Ask the Doctor: Dementia Progression; Reducing Stress; Ceasing Antidepressants appeared first on University Health News.

The body can synthesize most of the fats it needs from your diet; however, omega-3s are different. They’re considered “essential” fatty acids because the human body requires them for good health but cannot make them on its own. That is, the only way to obtain omega 3s is to get them from our food. And yet, our SAD (Standard American Diet) is almost devoid of this critical nutrient.

Omega-3 Deficiency and Chronic Health Problems

Chronic degenerative diseases don’t develop overnight. An insidious process occurs when the body is subjected to inadequate nutrients over a long period of time. In this case, months or even years of omega-3 deficiency can lead to one or more chronic health conditions—arthritis, heart disease, dementia, and even certain types of cancer.

The key is to recognize and reverse the symptoms of omega-3 deficiency before a serious illness ensues. So, what are the symptoms of a lack of omega-3? And, more important, do you have any of the symptoms?

10 Omega-3 Deficiency Symptoms

1. 1. Soft, peeling, or brittle nails (or slow-growing nails)
   2. Attention deficit, restlessness, poor concentration, or poor memory (in children and adults)
   3. Depression, anxiety, or mood swings
   4. Dry, flaky, cracking, or callused skin

   <li

>Dry eyes

1. Dehydration, thirst, dry mouth/throat, or frequent urination
2. Dry, dull, or brittle hair (also dandruff or “cradle cap”)
3. Stiff or painful joints
4. Excessive ear wax
5. Allergy symptoms (eczema, asthma, hay fever, hives, etc.)

Rather than ask yourself, “What are the symptoms of a lack of omega 3?” perhaps the better question is: What are the benefits of omega-3? Evidence-based research studies support these health benefits:

• Decrease inflammation in the body
• Reduce anxiety and depression symptoms
• Improve cardiovascular health (reduce triglyceride levels, reduce blood pressure, raise “good” HDL cholesterol levels, prevent blood clots, and prevent plaque build-up in the arteries)
• Reduce ADD / ADHD symptoms (improve concentration)
• Improve eye health
• Promote brain health during pregnancy and early life
• Reduce memory loss (dementia symptoms and Alzheimer’s disease)
• Improve bone and joint health
• Promote integumentary health (reduce oil, improve skin hydration, prevent acne)

Omega-3 Types

There are three major types of omega-3 fatty acids used by the body:

• Alpha-linolenic acid (ALA)
• Eicosapentaenoic acid (EPA)
• Docosahexaenoic acid (DHA)

Most of the ALA in our diets come from flaxseed, chia seeds, olive oil, and nuts such as walnuts. Once such foods are consumed, the body converts ALA to EPA and then to DHA.

However, EPA and DHA are the two types of omega-3s that have the most health benefits, with DHA being the most beneficial by far. DHA supports brain and mental health, improving cognition, memory, and focus. While EPA isn’t as vital as DHA, it’s still used by the body to help maintain circulatory and cardiac health. It also aids in brain health by increasing blood flow and influencing hormones.

The highest concentrations of EPA and DHA are found in cold-water fish such as salmon, tuna, sardine, halibut, and herring, as well as other seafoods such as algae or krill, some plants, and nut oils.

Omega-3 Supplements

Attempting to get enough omega-3 from food sources can be challenging for two reasons: 1) Many people simply do not like the taste of seafood; and 2) Our modern day fish supply contains unhealthy levels of mercury, PCBs, and other contaminants. As a result, many nutrition experts recommend a person get a maintenance dose of 1,000 mg of EPA and DHA (added together) on a daily basis in order to significantly reduce the risks for depression, cardiovascular disease, Alzheimer’s disease, diabetes, and other health conditions.

A few things to keep in mind when shopping for omega-3 supplements:

• Do not consume fish oils if you take blood thinners.
• Make sure your omega-3 fish oil is free from mercury, PCB, and other contaminants.
• Search for a fish oil from “wild” fish rather than “farm-raised” fish.
• Start with 1,000 mg of EPA and DHA per day; a therapeutic dose of 3,000 to 4,000 mg of EPA and DHA per day is recommended for inflammatory-related conditions.

Are you experiencing the symptoms of a lack of omega-3? If so, begin increasing your consumption of this essential fatty acid via your diet or omega-3 supplements. Don’t wait any longer! You can prevent a wide range of deleterious health effects in your future by starting to reverse your omega-3 deficiency symptoms now.

Hungry for more? Read “Know Your Fats: Balancing Your 3-6-9 Omega Ratio.”

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A Low Dose of This Drug Targeting Tau Slows Dementia

A paper published Nov. 27, 2019 in the online issue of the Journal of Alzheimer’s Disease reported unexpected results from an industry-sponsored analysis of the drug hydromethylthionine (LMTM) on the brain in over 1,000 patients with mild-to-moderate Alzheimer’s disease. The drug blocks abnormal accumulation of the protein tau in the brain, which is recognized as destructive and leading to dementia symptoms. LMTM is different from amyloid drugs, which target amyloid plaques (also toxic proteins in the brain) but have, to date, been rather disappointing. For this paper, researchers conducted a second in-depth analysis on previous trial data and found that lower doses of the drug produced meaningful reductions in cognitive decline and brain atrophy in a subset of study participants who received low doses of the drug. Of interest with LMTM is that in two prior clinical trials, the results showed that at 100 milligram doses it did not show benefit. But this latest analysis found that some participants in the control group showed a reduction in brain atrophy and had less cognitive decline. The lower dose appeared more effective only when patients were not taking any other Alzheimer’s medications. The next step is to conduct a randomized placebo-controlled trial to substantiate the findings. Recruitment of 450 study participants across 150 sites in the United States and Europe is underway.

Stimulate Sleep with Properly Timed Bathing

Biomedical engineers at The University of Texas at Austin may have found a way for people to get better shuteye. Systematic review protocols, a method used to search for and analyze relevant data, enabled researchers to examine thousands of studies linking water-based passive body heating, or bathing and showering with warm/hot water, with improved sleep quality. In particular, they found that bathing in water of about 104 degrees Fahrenheit can significantly improve sleep. Body temperature, which is involved in the regulation of the sleep/wake cycle, exhibits a circadian cycle, being two to three degrees higher in the late afternoon/early evening than during sleep, when it is the lowest. The circadian cycle is the body’s way of directing biological patterns such as sleep/wake cycles. In general, core body temperature declines around an hour before usual sleep time, dropping to its lowest level between the middle and later span of nighttime sleep. It then begins to rise to trigger awakening. The researchers found the optimal timing of bathing for cooling down of core body temperature to improve sleep quality is about 90 minutes before going to bed. Warm baths and showers stimulate the body’s thermoregulatory system, causing a marked increase in the circulation of blood from the internal core of the body to the peripheral sites of the hands and feet, resulting in efficient removal of body heat and decline in body temperature. Therefore, if baths are taken at the right time, they will aid the natural circadian process and increase one’s chances of not only falling asleep quickly but also of experiencing better quality sleep, according to the researchers. The paper was published in the July 2019 journal Sleep Medicine Reviews.

Sugar, Ultra-Processed Foods Not So Sweet for the Heart

Ultra-processed foods often contain high amounts of sugar and account for more than half of an average American’s daily calories. These foods are linked to lower measures of cardiovascular health, according to research presented at the American Heart Association’s (AHA) Scientific Sessions, held Nov.16 to 18, 2019 in Philadelphia. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found that for every 5 percent increase in calories from ultra-processed foods, there was a corresponding decrease in overall cardiovascular health. Those who ate about 70 percent of calories in ultra-processed foods were half as likely to have ideal cardiovascular health as defined by the AHA. Ultra-processed foods include soft drinks, packaged salty snacks, cookies, cakes, processed meats, packaged instant soups and many items often marketed as “convenience foods.” Consuming such items often displaces healthier choices that are rich in nutrients, such as fruits, vegetables, whole grains, and lean protein, which are strongly linked to good heart health. In addition, ultra-processed foods are often high in salt, added sugars, saturated fat and other substances associated with increased heart disease risk.

Related post: “Encouraging News About Macular Degeneration” 

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