Dr. Roach: Can aspirin ward off Alzheimer’s disease?
Dear Dr. Roach: I have heard that a baby aspirin will help delay the onset of dementia. Is there any truth to this?
Dear B.L.P.: Although a few studies have shown a lower risk of Alzheimer’s disease among people who regularly take aspirin, the best studies have shown no appreciable benefit, and I don’t recommend aspirin as prevention for Alzheimer’s. Aspirin may have a role in preventing heart disease in those at high risk; however, because aspirin has the potential for serious bleeding, the decision to take aspirin long-term should be made based on your risk factors in combination with your doctor’s advice.
The best evidence for preventing dementia supports a healthy Mediterranean-style diet, high in fruits, vegetables, whole grains and nuts; low in saturated fats from meats; and high in monounsaturated fats from olive oil or other good sources. I also recommend regular exercise, leisure-time activities and social interaction, since they don’t hurt and may have benefit.
Dear Dr. Roach: I’m a middle-age, healthy guy living in Florida. Recently, I’ve been feeling very hot and dizzy, even on a cool day. This feeling happens only once in a while and lasts only a short time. I take about 20 medications, and don’t drink alcohol or coffee, smoke or use drugs.
Is male menopause real? What is it, actually? I’m too embarrassed to discuss this with my mom, my partner or my doctor. Do you think I have male menopause? I will be 49 soon.
Dear S.W.: The word “menopause” refers to the cessation of menstrual periods that most women experience within a year or two of age 51. This coincides with a large drop in estrogen, causing about 80 percent of women to experience “vasomotor instability,” meaning the blood flow to the skin increases, causing a flushing sensation and a rapid loss of heat, followed by a period of cool and sometimes shivering as the body warms itself.
Nothing quite like that happens to men; however, the term “andropause” is used to describe the symptoms some men notice as testosterone levels drop with age. The symptoms most frequently associated with lower testosterone levels include decreased sexual function, less muscle strength, depressive symptoms and worsened memory. Unfortunately, although testosterone replacement is often prescribed, the evidence showing improvements in these issues is mixed, leading the Institute of Medicine to conclude that there is no definitive evidence that testosterone has any well-established benefit.
Hot flashes are concerning for several unusual medical syndromes, such as carcinoid syndrome and pheochromocytoma, both of which are caused by rare tumors that make hormones that cause flushing.
I am always concerned when I hear that someone is taking as many medications as you are, since some medicines cause flushing, and the likelihood of a drug interaction in someone taking 20 medicines is very high.
Since your symptoms could be caused by a serious condition, it’s time to get over your embarrassment and see your doctor.
Dear Dr. Roach: I have dry macular degeneration and take the AREDS vitamins. Is there anything on the horizon to help?
Dear Dr. Roach: Maybe. Right now, the best treatment for dry-type (the more common) age-related macular degeneration is the vitamin regimen studied in either of the two AREDS trials. However, in the future we may see stem cells being used as treatment, as shown in a 2015 study from UCLA. It’s too early to say whether this will live up to its early promise.
Email questions to ToYourGoodHealth@med.cornell.edu.