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MARCH 2020 — BALTIMORE BEACON
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Health Fitness &
BUSYBODIES Walking (or just tapping your feet) can lower blood sugar and help your heart MINDFUL EATING Slow down, concentrate on taste and avoid distractions while eating A DOG’S LIFE A new pill might slow the aging of dogs — and eventually of their owners CLINICAL TRIAL Enroll in a new study to find ways to regain strength after a hip fracture
Inadequate sleep raises risk of dementia By Veena J. Alfred, Ph.D. The main cause of the cognitive decline associated with Alzheimer’s disease is the buildup of amyloid plaques in the brain as we age. Beta-amyloid is a toxic protein that is discharged as a waste product into the fluid surrounding brain cells. If it is not cleared away in a timely manner, it clumps together to form plaques that prevent the brain cells from communicating with one another. The body has a mechanism for clearing away this waste product, but the process can be slowed down and thus overtaken. Or the rate at which the beta amyloid is released may exceed the brain capacity to clear it away. Scientists have recently discovered that it is during sleep that this waste disposal system goes into high gear. When we are awake, the brain’s resources are channeled into supporting the activities of waking life. But when we are asleep, these resources become available
for “housekeeping” duties, that is, cleaning up the messes of the day and clearing out the toxins that are produced by waking activities. This housekeeping function in the brain is extremely important — that is why we spend approximately one-third of our lives sleeping. Lack of sleep or insufficient sleep robs the brain of the opportunity to carry out the necessary tasks of maintenance and repair.
Research finds connection A research team at the National Institutes of Health conducted a study, published in April 2018, to investigate the connection between sleep and dementia. The team scanned the brains of 20 healthy individuals, aged 22 to 72, after a full night’s sleep and again after a night of sleep deprivation (that is, after 31 hours without sleep). The scans showed that there was an average 5% increase in betaamyloid in the brains of the participants following the night of sleep deprivation.
The researchers noted that this increase was located especially in those brain regions (the thalamus and the hippocampus) that are associated with brain functions that decline in the early stages of Alzheimer’s. The team also found that those in the study who had larger beta-amyloid increases reported being in a worse mood after the sleep deprivation than those with lower increases. Earlier studies have shown that the brain regions affected by sleep deprivation are also key areas of the brain involved in mood disorders. Earlier studies published in 2016 found that older individuals who do not get sufficient or proper sleep at night are at a higher risk of developing Alzheimer’s and other dementias. One larger study, conducted by the Departments of Medicine at various universities across the U.S., focused on 7,444 women aged 65 to 80 years. The study found that those women in the study who got six hours of less of sleep per night
were at a higher risk of developing mild cognitive impairment and/or dementia. The researchers also found that older adults suffering from insomnia are at a significantly higher risk of developing dementia than those without a sleeping disorder. Other studies have investigated the connection between sleep apnea and dementia. Sleep apnea, a sleep disorder in which the airway is partially or completely closed for brief periods of time during sleep, disproportionately affects older adults. The temporary stoppage of breathing caused by sleep apnea disturbs sleep, thus increasing the risk of developing dementia. Even if older adults are not afflicted with a sleeping disorder, they tend to sleep less, on average, than younger people. Therefore, it is especially important for older adults to make an extra effort to get between seven and eight hours of uninterrupted sleep each night on a regular basis. Alfred is a Certified Dementia Practitioner and the CEO of AlfredHouse Assisted Living.
Over-worrying about health is unhealthy By Craig Sawchuk Dear Mayo Clinic: What is the difference between occasionally worrying that something is wrong with me and somatic symptom disorder? How can I stop worrying that I’m not as healthy as my doctor says? A: A little worry over your health is normal. But for some people, fear and concern over symptoms can get out of control. These people can become convinced that they have a particular illness, even when test results are normal. These are common features of somatic symptom disorder, a mental health concern that affects roughly 5% of the population. People with somatic symptom disorder develop an excessive preoccupation with physical symptoms, including pain or fatigue, that results in significant emotional distress or disruptions to daily living. Stress responses such as dizziness, heart palpitations, nausea, chest pain or shortness of breath may further amplify worries. These symptoms may or may not be attributed to a diagnosed medical condition. The thoughts, feelings and behaviors of
somatic symptom disorder may manifest in several ways, including constant worrying about illness, interpreting normal sensations as potentially threatening or harmful, and fearing that symptoms are serious or life-threating, despite exams or testing that suggest otherwise. It’s also common for people with somatic symptom disorder to feel that medical evaluations or treatments haven’t been adequate. Repeatedly checking the body for abnormalities, researching symptoms online and making frequent healthcare visits or testing that don’t relieve concerns — or make them worse — also are signs of the condition. Women are more likely to show signs of somatic symptom disorder, as are people with more than one health condition. Also, people with a history of childhood illness, sexual abuse or other trauma are at increased risk of developing the disorder, as are those with depression or anxiety. Several related conditions share common features with somatic symptom disorder, including illness anxiety disorder (formerly known as hypochondriasis) and functional neurologic disorders, which
consist of neurological symptoms that can’t be explained by a neurological disease or other condition.
Ways to obtain help If you’re experiencing unusual symptoms, it’s important to be evaluated by a healthcare provider to rule out any medical problems. Your healthcare provider can perform a comprehensive examination that focuses on your specific concerns. However, evaluations may need to be limited, as repeated or extensive testing may worsen your level of distress. Regardless of whether a medical diagnosis is present, if you’re in distress, you may be given a questionnaire to evaluate your level of health anxiety. Or you may be referred to a psychologist or psychiatrist. The symptoms of somatic symptom disorder and related disorders often come and go. But recovery is possible — studies suggest that 50% to 75% of people with somatic symptom disorder show eventual improvement. The main goal of managing these disorders is to improve your ability to cope with
your symptoms, tolerate uncertainty and reduce health anxiety. The most effective treatment is psychotherapy, particularly cognitive behavioral therapy. Individual or group cognitive behavioral therapy can help you change behaviors, such as learning how to resist the urge to excessively seek reassurance. Therapy also can provide social support and challenge any disease-related worries and beliefs, such as learning alternate ways to interpret unusual and uncomfortable physical sensations. Help also can be given to restore your work, social or volunteer activities. Antidepressants such as amitriptyline (Endep) and fluoxetine (Prozac or Sarafem) may be recommended for these disorders. However, they have shown only limited benefit. At Mayo Clinic, we recommend that antidepressant and anti-anxiety drugs be used to treat only the mood or anxiety-related disorders that often coexist. © 2020 Mayo Foundation for Medical Education and Research. Distributed by Tribune Content Agency, LLC.
