Dr. Roach: In dementia cases, meds must be evaluated
Dear Dr. Roach: I read in your column that if a person who has dementia is taken off statins, the effects of dementia could be reversed. My wife has been diagnosed with dementia, and I was wondering if the blood pressure medicine she is on could be a contributor, along with other medicines she is on. Her memory and confusion have become a real problem. We can’t trust her to drive anywhere. So far, we have just seen our family doctor, and have been scheduled to see a neurologist in a couple of weeks. I read about something called TC-2153: Is this worthwhile?
Dear J.K.: When doctors see a person with worsening of memory or other signs of dementia, one of the first priorities is evaluating for treatable causes. Of these, medications probably are the most common. Many different medicines can cause memory issues, especially those used for psychiatric conditions, and statins also are a cause, though this is unusual. Blood pressure medicines are almost never the cause of memory loss.
People with dementia and hypertension are at risk for vascular causes of dementia, the second-most-likely cause of dementia, after Alzheimer’s disease. In this case, statins can help prevent further damage to the brain from ministrokes.
TC-2153, which blocks a brain protein called STEP, is a very exciting potential development in Alzheimer’s, being very effective in preliminary animal models. Unfortunately, it will be a long time before it or similar medications would be ready for use in humans.
Dear Dr. Roach: Can “heading” the ball in soccer cause a concussion? I have grandchildren who play soccer, and I am concerned.
Dear G.W.H.: The evidence is mounting that repeated trauma to the brain can contribute to a type of brain injury called chronic traumatic encephalopathy, which is seen frequently in boxers and football players. However, there is more and more evidence that soccer players also may get this injury, and it correlates to the number of headers players do.
Since younger brains may be more susceptible to injuries, and kids have relatively larger heads and weaker necks than adults, the Sports Legacy Institute recommends against heading the ball until the age of 14.
Dr. Roach Writes: Many people wrote in to share success in treating and preventing recurrent aphthous ulcers (canker sores). I heard from many people that avoiding toothpastes and mouth rinses with sodium lauryl sulfate (also called sodium dodecyl sulfate) can help, as this chemical can be irritating. The research was clear that avoiding this chemical can prevent further episodes. Biotene is one brand that does not have this chemical.
Email questions to ToYourGoodHealth@med.cornell.edu.