Behavioral problems like aggression, agitation, and hallucinations are often treated with medications called “antipsychotics” or “neuroleptics.” Newer medications in this class include Risperdal, Zyprexa, Geodon, Seroquel, and Abilify. Older medications, including Thorazine, Haldol, and Melleril, are not widely used today. The benefits of these medications are modest at best. However, the list of adverse effects continues to grow. A recent study adds to the concerns with use of these medications to treat behavioral problems associated with dementia. Antipsychotic medications caused significant decline in remaining cognitive skills. There was a significant drop in neuropsychological test scores when compared to placebo after 12 weeks of treatment. It is unclear from the results whether the decline is permanent and would be reversed by cessation of the drugs. This adds another element to the growing concern over the use of antipsychotic medications to manage […]
Undergoing general anesthesia may cause cognitive decline especially in the elderly. Delirium and postoperative cognitive decline are the two most common untoward effects of surgery. Delirium is transient and obvious but may last days to weeks. Delirium may occur in 10% of postoperative patients. Postoperative cognitive decline is a more long lasting condition, often subtle, and neuropsychological testing is necessary to detect these changes. One recent study estimates that postoperative cognitive decline occurs in 35% of those under 40, 56% of those 40-59, and 69% of those 60 and older at one week after surgery. By three months the rates decline to about 7% in those under 40, 13% in those 40-59, and 24% of those 60 and older. Another study indicated that about 25% of all surgery patients experience postoperative cognitive decline at one week. Fortunately, this rate drops […]
The Alzheimer’s Association International Conference met in Paris in August, 2011. This is an annual meeting that brings out all of the latest research findings. The first results from the Dominant Inherited Alzheimer’s disease study indicated that that there are measurable changes in cognition, biochemistry, and imaging up to 20 years before symptoms appear. These results are based on studies of high risk individuals who are carriers of a mutant gene that induces early onset Alzheimer’s disease that may develop as early as the 30s and 40s. These findings again confirm that Alzheimer’s disease comes on over the course of decades and that treatment approaches must be proactive. If you wait for symptoms, you lose your advantage. New research suggests that traumatic brain injury doubles the risk of dementia. These findings are based on a retrospective study of older (55 […]
Depression has been associated with dementia. For example, the Framingham study followed 949 men and women (average age was 79) for 17 years. There was a 50% increased risk of developing a dementia in those reporting symptoms of depression during the study. Similar findings are evident from the Baltimore Longitudinal study of aging. Depression robs motivation and enjoyment, drives poor self-esteem, adds to the discomfort of pain, and produces social isolation. Depression also distorts memory. In very severe depressions, one is so focused on inner feelings of despair that there are few memory resources left to process information from their surroundings. As if this weren’t enough, people who develop a depression in later life are more at risk of experiencing cognitive decline. There are four explanations for the association of depression and cognitive decline. First, depression is a symptom of […]
It’s never too early to start monitoring and measuring cardiovascular and brain/memory functioning. It’s never too early to start a life plan to protect your heart and your brain. Recent results from the Whitehall II study indicate that cardiovascular risk profile in midlife predicts later cognitive decline. Cardiovascular risk was calculated from the Framingham General Cardiovascular Risk Profile (which you can look up online). The Framingham profile includes age, sex, total cholesterol, HDL cholesterol, smoking status, systolic blood pressure, and medications for blood pressure. The Whitehall II study was begun in 1985-1988 and recruited 10,308 civil servants in London. The participants were aged 35-55 at the time. The most recent findings were based on 3486 men and 1314 women who were free of cardiovascular disease at entry into the study and had an average age of 55. Cognitive function (i.e., […]
I recently received this e-mail: “Last Friday, at a dinner party, one of the guests who recently underwent bypass surgery was talking about his medical history leading up to this. He told us he had been put on Lipitor to control his cholesterol and one of the side effects he noted was that he was suffering short term memory loss. He spoke with his doctor, who told him to stop taking the Lipitor. As soon as he did this, he noted that his short term memory improved and it is now totally restored. This man is in his 50’s. My question to you is: Have you heard of such a reaction to using Lipitor? I was not aware of such a problem. I have looked up the drug and do not see any mention of such a side effect.” The […]
