Archive for the 'Mental Decline' Category

Heavy Drinkers: Are You In That 5% of the Population?

People drinking wineThe health benefits of alcohol are frequently touted on the daily news, but the many hazards are often omitted.  Americans truly enjoy their alcohol, but the facts remain that excessive alcohol use is the third leading cause of preventable death in the United States and is a risk factor for numerous serious health and societal problems.

What is excessive alcohol use?  It can take the form of heavy drinking, binge drinking, or both.   Heavy drinking is defined for women, as more than one drink per day on average, and for men, two drinks per day on average.  Binge drinking may occur only once per week or once per month but is defined as 5 or more drinks during a single occasion (in about 2 hours) for men or 4 or more drinks during a single occasion for women.  Approximately 5% of the total population drinks heavily and 15% of the population engages in binge drinking, according to the CDC.

Binge drinking alone is associated with a number of very serious and significant consequences.  Not to mention the many accidents, injuries, sexually transmitted diseases, unintended pregnancies, and children born with fetal alcohol syndrome,  alcohol intoxication from binge drinking is often responsible for significant brain damage, liver disease, high blood pressure, stroke and other cardiovascular diseases, sexual dysfunction, and deadly alcohol poisoning.

Have you ever heard on the news that alcohol can cause cancer or brain damage?  Well it can, yet this seems to be a well-kept secret.  Heavy alcohol consumption, and in some cases moderate alcohol consumption, has a huge downside such as increasing the risk of cancer of the breast, mouth, pharynx, larynx, esophagus, and liver; not to mention other toxic and harmful effects on the brain and liver.

Despite all the well-documented research that shows the hazards of drinking alcohol, most people when asked will say, drinking a glass or two of wine or an alcoholic drink is “good for you”.  Sure, an occasional glass of wine probably won’t hurt most people, but any more than a glass per day for a woman is considered heavy drinking, and there are bad consequences of heavy drinking.

The daily news is not completely wrong, there does appear to be some health benefits of alcohol, but many leading authorities contend that the hazards outweigh the benefits.

 Source:  National Institute of Alcohol Abuse and Alcoholism of the National Institute of Health

Alcohol Abuse Appears to Cause Depression

All forms of alcohol affect the brainAlcohol dependence or abuse was associated with nearly double the risk of major depression in a recent study of 18 to 25 year olds. 

There appears to be little doubt that heavy drinking adversely affects the brain.  Numerous studies have not only linked alcohol problems with depression, but several other recent trials have found that heavy drinking in teens and young adults can cause brain shrinkage and changes on MRI consistent with early signs of alcohol-related dementia. Young problem drinkers have been found to have significantly smaller prefrontal cortexes, an area of the brain associated with complex thinking, planning, inhibition, and emotional regulation. Also, the size of the prefrontal cortex strongly correlated with the average number of drinks an individual consumed per drinking episode.

People of all ages, especially children, need to learn and use healthy coping mechanisms, such as exercise and good eating habits, to control stress.  Heavy drinking to wind down or have a good time often leads to a viscious downhill spiral of self-destruction.  

Source: Fergusson D, et al “Tests of causal links between alcohol abuse or dependence and major depression” Arch Gen Psychiatry 2009; 66: 260-266. 

The Truth About Coffee

Cup of coffeeMost of us truly love our coffee and especially look forward to that first cup in the morning.  It’s delicious, it helps you wake up, and quite honestly, most of us are addicted to this wonderful brew.  But are we going to regret this delicious indulgence some day? 

A number of researchers have recently investigated the health benefits of coffee and found that drinking regular coffee on a routine basis was associated with many important health benefits such as a decreased risk of stroke, diabetes and dementia.  Also, several studies have found that people who drink coffee on a regular basis are up to 80% less likely to develop Parkinson’s.  Other research shows that compared to not drinking coffee, at least two cups daily was linked to a 25% reduced risk of colon cancer, an 80% drop in liver cirrhosis risk, and nearly half the risk of gallstones.

Coffee has been found to be helpful in people who have asthma.  It also has been known to stop a headache,  improve mood, increase concentration and give you that extra energy needed to get through the day.  

Some of the health benefits of coffee are merely from the caffeine.  An eight ounce cup of drip-brewed coffee contains about 85 mg of caffeine, whereas eight ounces of black tea only has about 45 mg of caffeine and 12 ounces of Coke has 35 mg of caffeine. Many of the so called “Sports/Energy Drinks” on the market are loading up on caffeine for that extra jolt and may contain over 150 mg of caffeine.

Researchers believe that most of the health benefits from coffee probably originate from substances other than caffeine. Phenolic compounds in coffee have strong antioxidant properties, which may improve endothelial function.  Caffeinated coffee appears to have beneficial effects on glucose metabolism, inflammation, and endothelial function which would account for protection against diabetes and stroke.

Of course adding cream which is loaded with fat may counteract some of the health benefits of coffee, and pouring several spoons full of sugar into the cup adds another carbohydrate load that is not beneficial. 

While these studies are very good news for coffee drinkers, be aware that coffee can lead to a number of health problems. These can include fast heart rate, tremors, irritable bladder, excessive urination, stomach irritation, gastroesophageal reflux (GERD), nausea, vomiting, restlessness, anxiety, depression,  and difficulty sleeping.

Caffeine is notorious for interfering with much-needed sleep. Many people get in a viscious cycle of using caffeine to mask their sleep deprivation, but then the excess caffeine keeps them from falling asleep the following night. The best way to break this cycle is to avoid all caffeine eight to ten hours before your desired bedtime.  Drinking coffee later in the day is more likely to cause insomnia as well as stomach irritation and reflux for many people. 

Another drawback of coffee is that certain drugs can interact with caffeine. Pregnant women and people with coronary heart disease or peptic ulcers are often advised to restrict or avoid using caffeine altogether. 

Contrary to the popular belief that coffee will sober you up after drinking too much alcohol, it can actually worsen the problem.  A recent study found that a high caffeine energy drink mixed with vodka actually reduced the participants’ perception of motor coordination compared with vodka alone.  This could obviously lead to disasterous consequences in a person who is drinking heavily away from home and has several cups of coffee to sober up before driving home.

So, is coffee good for us?  It depends on who you are, how much you drink, and when you drink it.  It’s a good idea to talk to your doctor about the amount of coffee you drink. 

Source: “High Coffee Consumption Linked to Lower Stroke Risk for Women”, MedPage Today, February 17, 2009
Source: Lopez-Garcia E, et al “Coffee consumption and risk of stroke in women” Circulation 2009; 119: 1116-1123.

Caffeinated Coffee May Be Linked with Lower Stroke Risk

CoffeeDrinking caffeinated coffee regularly may be linked with a lower stroke risk, according to Harvard and Madrid researchers. Women who drank two to three cups a day had a 19% reduction in the risk of all strokes but consumption of tea and caffeinated soft drinks was not significantly associated with a lowered stroke risk. The association was significant only in women who had never smoked or who had quit.

Other recent studies have also found that drinking coffee was associated with a decreased risk of diabetes as well as dementia.  

Researchers believe the health benefits from coffee probably originate from substances other than caffeine. Phenolic compounds in coffee have strong antioxidant properties, which may improve endothelial function.  Caffeinated coffee appears to have beneficial effects on glucose metabolism, inflammation, and endothelial function which would account for protection against diabetes and stroke.

While these studies are very good news for coffee drinkers, be aware that more research needs to be done.  Also keep in mind that some people should not drink coffee at all, and for others, drinking too much coffee can be problematic and lead to a number of health problems.  

Source: “High Coffee Consumption Linked to Lower Stroke Risk for Women”, MedPage Today, February 17, 2009
Source: Lopez-Garcia E, et al “Coffee consumption and risk of stroke in women” Circulation 2009; 119: 1116-1123.

Lack of Vitamin D Linked with Mental Decline in the Elderly

Vitamin D supplementsA growing body of research is revealing that elderly with the lowest levels of Vitamin D in their blood are significantly more likely to have a higher incidence of cognitive impairment. Researchers are discovering mounting evidence for previously unsuspected roles for vitamin D in brain development and neuroprotection.

In a recent study from the University of Cambridge, British researchers recently examined the association between serum vitamin D levels and cognitive impairment in persons 65 and older. Those with the lowest levels of Vitamin D were more than twice as likely to have cognitive impairment.

A simple blood test can measure the circulating Vitamin D levels in your blood. Many doctors are now drawing blood levels of Vitamin D to to make sure patients are getting enough of this important vitamin to optimize good health. Ask your doctor about this.

Most often calcium supplements with Vitamin D are recommended by health care professionals.  If calcium supplements are not needed, Vitamin D 1,000 IU is available over-the-counter, and may be recommended. Vitamin D is included in most multivitamins, but in very low strengths from 50 IU to 1,000 IU.

Read more:

via Llewellyn DJ, et al “Serum 25-hydroxyvitamin D concentration and cognitive impairment” J Geriatr Psych Neurol 2009

Good News for Coffee Drinkers

coffeeDrinking coffee in middle age was associated with a decreased risk of dementia later in life according to a new study from Finland and Sweden. Researchers found the lowest risk of dementia in the moderate coffee drinkers, or those who drank three to five cups a day. In this group, their dementia or Alzheimer’s risk was lowered by 65 per cent. Tea drinking did not appear to have any affect on the risk of dementia.  

While these findings are interesting, they need to be confirmed by other studies.  If you’re currently drinking three to five cups per day of coffee with no adverse effects, this is good news. But it certainly would not be advisable to increase the amount of coffee you’re drinking, based solely on this study. Not only is coffee addicting, but excessive caffeine intake can lead to a number of health problems including fast heart rate, tremors, irritable bladder, excessive urination, stomach irritation, nausea, vomiting, restlessness, anxiety, depression,  and difficulty sleeping. Many drugs interact with caffeine as well.  Pregnant women and people with coronary heart disease or peptic ulcers are often advised to restrict or avoid using caffeine altogether. 

Contrary to the popular belief that coffee will sober you up after drinking too much alcohol, it can actually worsen the problem.  A recent study found that a high caffeine energy drink mixed with vodka reduced the participants’ perception of motor coordination compared with vodka alone. 

via Journal of Alzheimer’s Disease, January 2009
via “Coffee may reduce risk of dementia, study suggests” CTV.ca, January 14, 2009

via “One Energy Drink, or 12 cans of Coke“, Bay Area Medical Information, September 29, 2008

Treatment for sleep apnea may improve mental function in Alzheimers

NightAlzheimer’s patients who also have obstructive sleep apnea may experience improved mental function from treatment with continuous positive airway pressure (CPAP), according to a recent study from University of California San Diego.

Previous studies have suggested that more severe dementia is associated with more severe obstructive sleep apnea. And in fact, Alzheimer’s patients have a high incidence of obstructive sleep apnea. Previous studies have found that approximately 70% to 80% of Alzheimer’s patients experience at least five episodes of apnea or hypopnea per hour and 40% to 50% have 20 or more episodes per hour.

Sleep apnea occurs when a person’s breathing repeatedly stops and starts for short periods of time during sleep. This abnormal breathing pattern only occurs during sleep, therefore, the person with the disorder may be the last to know he or she has a problem.

Obstructive sleep apnea (OSA), is usually associated with loud snoring (though not everyone who snores has this disorder). Risk factors for obstructive sleep apnea include being male, overweight, and over the age of forty. This condition occurs two to three times more often in older adults and is twice as common in men as in women.  However, sleep apnea can affect anyone at any age, even children.

If you think you might have sleep apnea, ask your health care provider for help.

Read more about Obstructive Sleep Apnea from Bay Area Medical Information

via Ancoli-Israel S, et al “Cognitive effects of treating obstructive sleep apnea in Alzheimer’s disease: a randomized controlled study” J Am Geriatr Soc. 2008; 56: 2076-2081.

via MedPage Today, December 4, 2008

Regular exercise is good for the brain

Walking is an aerobic exerciseRegular aerobic exercise appears to improve blood flow in the brain, thus improving the brain’s ability to function, according to a recent study out of the Jefferson Medical College in Philadelphia.  These findings add to the growing body of literature that points to exercise being both preventive of mental decline and helpful in improving cognitive function in older adults. 

Regular exercise is also one of the best ways to improve your mental outlook, lose weight, appear youthful, and ward off viruses as well as many chronic illnesses.  Read more  about the 18 life-changing benefits of exercise and how to get started.

via Rahman FN, et al “Relationship of exercise to cerebral vasculature and blood flow in older adults” RSNA 2008; Abstract LL-NR2256-D03.
via “RSNA: Exercise May Prevent Loss of Small Blood Vessels in the Brain” MedPage Today, Dec. 1, 2008

Simple screening for mental decline in five minutes

The Mini-Cog is a simple written screening toolScreening for mild cognitive impairment can be accomplished in less than five minutes with a three-word memory test and a clock-drawing task, according to Emory researchers. This new test, called the Mini-Cog, is reasonably accurate and allows quick screening by health care professionals. It appears to be a valuable aid for early identification of patients who might be at risk for later development of a serious dementia, such as Alzheimer’s Disease. 

The Mini-Cog, combined with a simple functional activities questionnaire, accurately diagnosed 83% of patients with mild cognitive impairment, in this recent Emory study.  Current screening for mild cognitive impairment is often logistically difficult because it typically requires 40 to 60 minutes of formal neuropsychological testing and it only achieves 80% accuracy or higher. 

Dementia is defined by the American Psychiatric Association as an acquired syndrome of decline in memory and at least one other cognitive domain such as language, visuo-spatial, or executive function sufficient to interfere with social or occupational functioning in an alert person.  It’s very important to keep in mind that the word dementia describes a general syndrome and many different diseases can cause dementia. Alzheimer’s disease and cerebrovascular ischemia (vascular dementia) are the 2 most common causes. Some potentially reversible conditions, such as hypothyroidism or vitamin B-12 deficiency, are also some of the many different causes of dementia.

The Mini-Cog test results should only be used in conjunction with other testing  in forming a diagnosis by a health care professionals, and should not be used in isolation of diagnostic tests for Alzheimer’s disease.

If a family member starts showing signs of memory loss or other symptoms of mental decline, never assume that nothing can be done.  See your health care provider for evaluation and help.

“Memory Loss Screening Tool for Caregivers/Family” from Bay Area Medical Information

The Mini-Cog” from Bay Area Medical Information

Brain atrophy associated with low intake of Vitamin B12

Brain moleculesVitamin B12 is good for the brain. In a recent study out of Oxford, England, low levels of vitamin B12 were associated with increased rates of brain atrophy in older people.(1,2)   (The image shows the neurons in the brain signalling each other. The mists of color show the flow of important molecules like glucose and oxygen. Image courtesy of NIGMS/artist Kim Hager at the Univ of California, and neurobiologist Neal Prakash, UCLA.)

Vitamin B12 is found in meat, fish, fortified cereals, and milk, but up to 30 percent of adults >50 have difficulty absorbing the naturally occurring form of vitamin B12 from food sources. Synthetic vitamin B12 in a supplement or in fortified foods is better absorbed and is recommended by the Nat’l Academies of Science. The Recommended Dietary Allowances (RDAs) of Vitamin B12 for adults is 2.4 µg/ day. Adults age 50 and over should obtain their daily requirement of Vitamin B12, and all B Vitamins, in fortified breakfast cereals or from multivitamin-mineral supplements.(3) 

Fortunately you don’t have to worry about toxic levels of Vitamin B12 as it is a water-soluble vitamin and has a very low potential for toxicity. There have been no adverse effects reported due to excess vitamin B12 intake from food or supplements in healthy individuals.(4)

  1. via Low B12 Linked to Brain Atrophy, MedPage Today, Sept 8, 2008
  2. via Vogiatzoglou A, et al “Vitamin B12 status and rate of brain volume loss in community-dwelling elderly” Neurology 2008; 71: 826-832. 
  3. via  Institute of Medicine, National Academies of Science The Institute of Medicine serves as adviser to the nation to improve health. 
  4.  Vitamin B12: Vitamin Supplement Fact Sheet from the Office of Dietary Supplements, National Institute of Health