Category Archives: Aging

Aging, Infographics, Medicine, Reviews, Women's Health

Infographic: Why Women Have High Risks Of Stroke

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Stroke in U.S. Women by the Numbers

One in 5 women will have a stroke. About 55,000 more women than men have a stroke each year.

Stroke is the No. 3 cause of death in women. Stroke kills over 90,000 women a year.

Among women, Black Women have the highest prevalence of stroke.

Talk to your health care provider about how to lower your risk and use the American Heart Association/American Stroke Association prevention guidelines:

Stroke risk increases in women who:

  • Are pregnant. Pregnant women are three times more likely to have a stroke as women of the same age.
  • Have preeclampsia. This dangerous condition of high blood pressure during pregnancy doubles stroke risk later in life.
  • Take birth control pills. These can double the risk of stroke, especially in women with high blood pressure.
  • Use hormone replacement therapy. It doesn’t lower it, like once thought.
  • Have migraines with aura and smoke. Strokes are more common in women who have migraines with aura and smoke, compared with other women.
  • Have atrial fibrillation. This quivering or irregular heartbeat can increase stroke risk fivefold. After age 75, it’s more common in women than men.

Stroke risk decreases in women who:

  • Talk to their health care provider to determine safest medication if pregnant with high blood pressure.
  • Discuss with their health care provider low-dose aspirin guidelines starting in the second trimester (week 12) to lower preeclampsia risk.
  • Get their blood pressure checked before taking birth control pills and monitor every six months.
  • Don’t use hormone replacement therapy to prevent stroke if postmenopausal.
  • Quit smoking if they have migraines with aura.
  • Get screened for atrial fibrillation if over age 75.

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Aging, Medicine, Reviews

Spinal Stenosis: Causes &Treatment (Mayo Clinic)

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Mayo Clinic (March 30, 2023) – Spinal stenosis happens when the space inside the backbone is too small. This can put pressure on the spinal cord and the nerves that travel through the spine. Spinal stenosis occurs most often in the neck, called cervical spinal stenosis, and in the lower back, called lumbar spinal stenosis.

Spinal stenosis - Symptoms and causes - Mayo Clinic

The most common cause of spinal stenosis is wear-and-tear changes in the spine related to arthritis. Most people with spinal stenosis are over 50. Younger people may be at higher risk of spinal stenosis if they have scoliosis or other spinal problems.

Symptoms

Spinal stenosis often causes no symptoms. When symptoms do occur, they start slowly and get worse over time. Symptoms depend on which part of the spine is affected.

Spinal stenosis in the neck can cause:

  • Numbness
  • Tingling or weakness in a hand, leg, foot or arm
  • Problems with walking and balance
  • Neck pain
  • Problems with the bowel or bladder

Spinal stenosis in the lower back can cause:

  • Pain or cramping in one or both legs that happens when you stand for a long time or when you walk
  • Back pain

Treatment

Treatment for spinal stenosis depends which part of the spine is affected and the severity of your symptoms.

Nonsurgical treatment can include:

  • Medication.
    For control of pain, your health care professional might prescribe nonsteroidal anti-inflammatory drugs, antidepressants, anti-seizure drugs or opioids.
  • Physical therapy.
    A physical therapist can teach you exercises that can build up your strength and endurance, maintain the flexibility and stability of your spine, and improve your balance.
  • Steroid shots.
    Your nerve roots can become irritated and swollen at the spots where they are being pinched. Injecting a steroid medication into the space around the pinched nerve can reduce the inflammation and relieve some of the pain. Repeated steroid injections can weaken nearby bones, tendons and ligaments, though. That’s why a person often must wait many months before getting another steroid injection.
  • Removal of thickened ligament tissue.
    Sometimes, the ligament at the back of the lumbar spine gets too thick. Needlelike tools inserted through the skin can remove some of the ligament. This can create more space in the spinal canal to reduce pressure on nerve roots.

Surgeries to create more space within the spinal canal may include:

  • Laminectomy.
    This surgery removes the back part, or lamina, of the affected spinal bone. This eases pressure on the nerves by making more space around them. In some cases, that bone may need to be linked to nearby spinal bones with metal hardware and a bone graft.
  • Laminotomy.
    This surgery removes only part of the lamina. The surgeon makes a hole just big enough to relieve pressure in a specific spot.
  • Laminoplasty.
    This surgery is done only on spinal bones in the neck. It makes the space within the spinal canal bigger by creating a hinge on the lamina. Metal hardware bridges the gap in the opened section of the spine.
Aging, Infographics, Reviews

Aging: Mild Cognitive Impairment Vs Dementia

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Mild cognitive impairment (MCI) is a condition in which people have more memory or thinking problems than other people their age. The symptoms of MCI are not as severe as those of Alzheimer’s disease or a related dementia. People with MCI can usually take care of themselves and carry out their normal daily activities.

People with MCI are at a greater risk of developing Alzheimer’s disease or a related dementia. Estimates vary as to how many people who have MCI will develop dementia. Roughly one to two out of 10 people age 65 or older with MCI are estimated to develop dementia over a one-year period. However, in many cases, the symptoms of MCI stay the same or even improve.

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Aging, Medicine, PODCASTS, Reviews

BMJ: Why ‘Frailty’ Impacts Cardiovascular Disease

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March 2023: In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Chris Wilkinson from Hull York Medical School and the James Cook hospital, UK. They discuss the concept of frailty and why it’s an important concept in cardiology.

Aging, Medicine, Reviews, SLEEP, Videos

Sleep & Aging : What Can Be Expected? (Yale Medicine)

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Yale Medicine (March 12, 2023) – As we age, are melatonin starts rising at an earlier hour in the night, thus we may tend to go to sleep earlier than when we were younger. We still require the same number of hours of sleep (7-9 hours on average), so we may also rise earlier. Our sleep is more likely to be disturbed by medical conditions, medications, or substance use.

Aging, Infographics, Medicine, Reviews

Review: Psoriatic Arthritis Flare-Up Signs & Symptoms

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“A psoriatic arthritis flare-up is a temporary worsening of symptoms of arthritis, which includes swelling, pain and stiffness in your joints,” explains Dr. Sapkota. “It can also include swelling of the whole toes or fingers due to the swelling of the ligaments around the joint. And sometimes, psoriasis, a skin rash, can worsen at the same time as your joints.”

Mayo Clinic – Symptoms of psoriatic arthritis flare-ups

It can be hard to predict when you may have a flare-up — and the degree of pain and discomfort can vary from person to person.

Psoriatic arthritis flare-up symptoms include:

  • Joint pain.
  • Joint swelling.
  • Joint tenderness.
  • Fatigue.
  • Difficulty moving.

How long do psoriatic arthritis flare-ups last?

A typical psoriatic arthritis flare-up can last anywhere from a few days to a week. It depends on the individual.

And it can vary on when you get them. You may experience flare-ups often, while others may not have them as frequently.

Bottom line? Psoriatic arthritis flare-ups can be unpredictable.

What triggers psoriatic arthritis flare-ups?

Causes of psoriatic arthritis flare-ups can include:

  • Stress and anxiety.
  • Obesity.
  • Smoking.
  • Alcohol.
  • Lack of activity.
  • Lack of sleep.
  • Diet.
  • Skipping psoriatic arthritis medication.
  • Certain medications like beta-blockers.
Aging, Medicine, Reviews, Videos

Parkinson’s Disease: How PD Is Diagnosed (Video)

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Parkinson’s Foundation (February 27, 2023) – Finding out you have Parkinson’s can be a lengthy process. Explore how a Parkinson’s diagnosis is made and what type of diagnostic tools are used.

Parkinson’s disease (PD)

A neurodegenerative disorder that affects predominately the dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra.

Symptoms

Symptoms generally develop slowly over years. The progression of symptoms is often a bit different from one person to another due to the diversity of the disease. People with PD may experience:

  • Tremor, mainly at rest and described as pill rolling tremor in hands; other forms of tremor are possible
  • Slowness and paucity of movement (called bradykinesia and hypokinesia)
  • Limb stiffness (rigidity)
  • Gait and balance problems (postural instability)

In addition to movement-related (“motor”) symptoms, Parkinson’s symptoms may be unrelated to movement (“non-motor”). People with PD are often more impacted by their non-motor symptoms than motor symptoms. Examples of non-motor symptoms include: depression, anxiety, apathy, hallucinations, constipation, orthostatic hypotension, sleep disorders, loss of sense of smell, and a variety of cognitive impairments.

Aging, Medicine, Reviews, Women's Health

Reviews: Menopausal Hormone Therapy Risks

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Cleveland Clinic – The American College of Cardiology’s Cardiovascular Disease in Women Committee released guidance on hormone therapy, with a focus on caring for women with a risk of heart disease. Leslie Cho, MD, explains what women should know about hormone therapy, and options available for women with heart disease risk factors.

Aging, Infographics, Medicine, Reviews

Infographic: Management Of Osteoarthritis (OA)

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Osteoarthritis (OA) is the most common form of arthritis. Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees. With OA, the cartilage within a joint begins to break down and the underlying bone begins to change.

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Aging, Dr. C "Comments", Medicine, Reviews, Women's Health

Women’s Health: Risks & Treatment Of Menopause

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As levels of estrogen, a crucial chemical messenger, trend downward, women are at higher risk for severe depressive symptoms. Bone loss accelerates. In women who have a genetic risk for Alzheimer’s disease, the first plaques are thought to form in the brain during this period. 

February 4, 2023

About 85 percent of women experience menopausal symptoms. Rebecca Thurston, a professor of psychiatry at the University of Pittsburgh who studies menopause, believes that, in general, menopausal women have been underserved — an oversight that she considers one of the great blind spots of medicine. “It suggests that we have a high cultural tolerance for women’s suffering,” Thurston says. “It’s not regarded as important.”

Even hormone therapy, the single best option that is available to women, has a history that reflects the medical culture’s challenges in keeping up with science; it also represents a lost opportunity to improve women’s lives.

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COMMENTS:

The New York Times, Sunday magazine, posted an article by Susan Dominus entitled “the vicious cycle”, in which was a long discussion of the disease burden of menopause. It is well worth reading.

“Forever Feminine” was a book by Robert Wilson, in 1966, which promoted hormone treatment for “enjoyment of sex” in menopausal women. The use of estrogen skyrocketed.

Alarming research in 1975, which linked estrogen usage to endometrial cancer, halted the rise of the drug’s popularity.

Without hormonal treatment, the many symptoms of  menopause were devalued and quietly suffered by women.

The medical profession has been slowly recovering from whiplash. New, better controlled research is being done and slowly a more nuanced approach is being taken. Women with a history of heart attack or stroke are still generally advised against hormonal therapy, but many others are being given birth control pills, which is a combination of estrogen and progesterone.

The average age of menopause is approximately 50 years of age, but symptoms can anticipate menopause by several years. An elevated FSH is the usual laboratory test to indicate perimenopause.

Early menopause can be associated with a decreased lifespan, increased likelihood of osteoporosis, cardiovascular disease and dementia, and is often treated with hormonal therapy. A delayed menopause is less likely to be treated with hormonal therapy, because of increased risk.

There are a lot of risk factors to be balanced against the symptoms involved, such as hot flashes and the entire panoplay of symptoms indicated in the infographic.

Some day, artificial intelligence will be used in order to make more explicit the benefits and risks involved. Until that time, the patient suffering from premenopausal or menopausal symptoms should find a Doctor Who would actually listen to her, a difficult task these days.

—Dr. C.