Monthly Archives: June 2019

Brush Your Teeth, It May Help Prevent Dementia

June is Alzheimer’s and Brain Awareness Month, and in recognition of this today’s post will look at the relationship between chronic periodontitis and subsequent development of dementia.

Periodonitis is very common, but may be preventable with proper dental hygiene. It is defined as inflammation of the gums and supporting structures of the teeth. Periodonitis begins with gingivitis, which is inflammation of the gums.

A group of researchers from Korea recently published a study looking at the possible risk chronic periodonitis may play in the development of dementia. This was a retrospective cohort study with a huge number of participants, over 260,000. These subjects were followed from 2005 to 2015. Other health factors were included such as age, alcohol consumption, blood pressure, exercise level, gender, smoking status, among other factors.

At the end of 2015 the study concluded. The researchers found that subjects with chronic periodonitis had a 6% higher risk for dementia, and a 5% higher risk of Alzheimer’s Disease, compared to those without chronic periodonitis.

The authors propose three possible mechanisms by which chronic periodonitis may be related to neurodegenerative processes. First, perhaps bacteria or other pathogens may cross the blood-brain barrier causing an inflammatory response. Second, there may be increased systemic inflammation or thirdly perhaps increased atherosclerotic plaque formation, leading to endothelial damage.

Current medications for dementia only slow progression of the disease, and do not work in all patients. Some patients are unable to tolerate medication side effects. Therefore it is important to identify those risk factors for dementia which are potentially modifiable which in turn could lower one’s risk for development of dementia.

This is a robust study, with a very large number of participants. Also, it may be the first study on this topic to look at concomitant risk factors such as exercise level and smoking status. Given the results, you may want to enlist the help of your dentist and dental hygienist as strategies to prevent dementia.

“Behind every smile there’s teeth.”–  Confucius

(Source- Journal of the American Geriatric Society  00:1-6, 2019)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Gout a Risk Factor for Erectile Dysfunction

This week is designated Men’s Heath Week and our posts have addressed male health topics. Today’s post reviews a research study on the relationship between gout and erectile dysfunction (ED).

Gout is the most common cause of inflammatory arthritis among U.S. adults. According to statistics from the Arthritis Foundation, about 4% of U.S. adults suffer from gout. It currently affects over 8 million individuals. It is much more common in men, with men three times more likely than women to develop gout.

A research group in Taiwan initiated a longitudinal cohort study to examine the relationship between gout and subsequent development of erectile dysfunction in men. The study enrolled over 19,000 men, ages 18-64, who were newly diagnosed with gout. The control group included over 77,000 men without gout. The researchers also tracked comorbid risk factors such as chronic renal risk failure, congestive heart failure, depression, diabetes, hypertension, and ischemic heart disease.

The researchers discovered that the participants with gout had a 1.21-fold greater risk of developing ED, compared to those without gout. Worse, subjects that had gout and one of the comorbid risk factors had more than a 2-fold increased risk of developing ED, compared to those without gout or cormorbid risk factors.

This is an important study showing that gout is a significant risk factor in the development of ED in men. Gout is a pro-inflammatory condition, and as seen in other research pro-inflammatory conditions often contribute to ED.

While this study was among Asian males, there is reason to believe the results would be similar in a more diverse population such as seen in the U.S. Consideration of the higher risk of ED in those diagnosed with gout may provide an extra incentive to men to have their gout treated and managed effectively.

“Gout, a physician’s name for the rheumatism of a rich patient.” –  Ambrose Bierce

(Source- The Journal of Rheumatology 2015; 42:9)

This blog is a review of published and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Erectile Dysfunction a Risk Factor for Dementia

June 10-16th is designated Men’s Health Week, and in addition June is Alzheimer’s and Brain Awareness Month. Today’s post will look at research regarding dementia and erectile dysfunction (ED).

ED is a common medical problem, particularly in aging males. The Massachusetts Male Aging Study showed about 40% of males are affected at age 40, while nearly 70% are affected by age 70. Data from the National Health and Nutrition Evaluation Survey (NHANES) showed that over 18% of males age 20 and older were afflicted with ED.

A research group based in Taiwan performed a retrospective cohort study on a population of  Asian men. There were two groups, the first group were men who had recently been diagnosed with ED. The second group, or control group, were matched samples, without ED. There were over 4,000 subjects in the ED group, and nearly 21,000 subjects in the control (non-ED) group. Other health issues such as anxiety, chronic kidney disease, coronary heart disease, depression, diabetes mellitus, hyperlipidemia, hypertension, hypothyroidism and stroke were tracked. The subjects were followed over a 7 year period.

After the 7 year follow-up period what the researchers found was astounding- the subjects with ED were 1.68 times more likely to develop dementia than the non-ED (control) group.

The researchers also discovered that the subjects with anxiety, chronic kidney disease, depression, diabetes mellitus, hypertension and stroke were 1.48 times more likely to develop dementia.

This study, published in 2015, was the first population based study to examine the risk of developing dementia among men with ED. While the study population was Asian men, there is reason to believe that the results would similarly apply to non-Asian populations.

There are several possible mechanisms for the association between ED and dementia. One possible factor is damage to the endothelial layer, which lines the blood vessels. Damage to this crucial layer is associated with coronary heart disease, diabetes, and hypertension. A pro-inflammatory state is seen to be a factor in endothelial damage.

This is an important research paper, and should been seen as a distant early warning of sorts. Given the inability of the currently available medicines to reverse dementia, a more preventative strategy should be considered. Men with ED, particularly at younger ages, should consider what health changes they can make to lower their future risk for dementia later in life.

“Lay hold of today’s task, and you will not need to depend so much upon tomorrow’s. While we are postponing, life speeds by.”–  Seneca

(Source- Medicine, Volume 94, Number 24, June 2015)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Acupuncture for Sexual Dysfunction

June 10-16th is designated Men’s Health Week, and so our posts this week will address men’s health issues. Today’s post will examine the use of acupuncture for sexual dysfunction, in both men and women.

Anti-depressant medication use is common, and sexual dysfunction rates may be as high as 50-90% with some of these medications. The results of a study may offer hope to those who suffer sexual side effects from commonly prescribed anti-depressant medications.

This research was conducted in Toronto, Canada. 35 subjects enrolled in the study, both men and women. Participants were referred into the study after complaining of sexual side effects from anti-depressant medications. After enrolling in the study, each subject received twelve acupuncture visits, following a fixed acupuncture treatment protocol. Subjects completed a self assessment of sexual functioning, as well as an assessment of anxiety and depression, throughout the study. There a was also a follow up visit one month after the treatment protocol was completed.

Results of the study showed significant improvement in symptoms, particularly among males. Males were also more likely to have decreases in anxiety and depression while receiving acupuncture treatment.

Interestingly, the self reported symptom severity scores one month after completion of the acupuncture treatment were similar to those at completion of the acupuncture treatment, indicating that perhaps acupuncture treatment is able to produce some longer lasting improvements in sexual function.

As with most acupuncture studies, the number of reported adverse reactions to acupuncture treatment is very low. In general the vast majority of patient’s treated with acupuncture find it a well tolerated therapy. Given how frequent sexual side effects are with commonly prescribed anti-depressant medications, perhaps consider acupuncture as a way to help with this, in both men and women.

“Prevention is better than cure.” – Desiderius Erasmus

(Source- Journal of Alternative and Complementary Medicine, Volume 19, Number 11, 2013)

This blog is a review of published medical and health literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Vitamin D and Erectile Dysfunction

June 10-16 is designated Men’s Health Week, and so several posts this week will address men’s health concerns. Today’s post will examine vitamin D and it’s potential association with erectile dysfunction (ED).

Data from the CDC indicate that approximately 25% of Americans are at risk for vitamin D inadequacy, while 8% are at risk for deficiency. Data from the National Health and Nutrition Examination Study (NHANES)  shows over 41% to be vitamin D deficient in their sample of nearly 4500 adults, with African-Americans and Hispanics generally having worse levels of vitamin D deficiency.

Original research from Italy shows a higher prevalence of vitamin D deficiency in a group of men with vascular ED, compared to men without vascular ED. 143 men were enrolled from a hormone clinic in Milan, Italy. The participants were divided into vascular ED, non-vascular ED, and borderline ED groups, based on penile doppler results. These groups were then compared based on various lab tests, including Vitamin D, lipids, and testosterone levels, among others.

The results showed a higher prevalence of vitamin D deficiency in the men with vascular ED, compared to men with non-vascular ED. Vitamin D levels were also lower in the men with more severe ED.

It is believed that normal vitamin D levels are important to healthy functioning of the endothelium, which lines the blood vessels. The results of this study indicate that low vitamin D levels are a potentially modifiable risk factor for ED of a vascular cause. If you are developing ED, you may want to get your vitamin D level checked.

“You take the healthiest diet in the world, if you gave those people vitamins, they would be twice as healthy. So vitamins are valuable”–  Robert Atkins MD

(Source- Journal of Sexual Medicine 2014;11)

This blog is a review of published and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone.

 

Acupuncture May Offer Hope for Alzheimer’s

June is Alzheimer’s and Brain Awareness Month. Today’s post will review a study of using acupuncture for mild to moderate Alzheimer’s disease (AD).

Alzheimer’s Disease is the most common form of dementia, and is a degenerative brain disease. It is estimated that nearly 6 million Americans have AD. According to the CDC it is the 5th most common cause of death among adults age 65 and older. Early symptoms of Alzheimer’s Disease include mild memory loss, and may progress to changes in mood and behavior, and difficulty with performing familiar tasks. The annual costs of AD are estimated to be $200 billion. Age is the most important risk factor for AD. Unfortunately, at this time there are no effective medical treatments to stop or reverse AD.

A research group in China performed a randomized trial, comparing the efficacy and safety of acupuncture to the medication donepezil (brand name Aricept) in a group of subjects diagnosed with mild to moderate AD. Subjects were aged 50 to 85 years. 43 individuals were assigned to the acupuncture group, while 44 were assigned to the donezepil group.

The study itself last 28 weeks- a 4 week baseline period, a 12 week treatment period, and a 12 week follow-up period. The acupuncture group received three treatments each week, lasting about 30 minutes each. The treatments were provided by 9 experienced acupuncturists, who individualized treatments to each respective subject.

There were two primary outcome measures, the ADAS-cog and the CIBIC-Plus. The ADAS-cog consists of 11 tasks to measure the symptoms of AD. The CIBIC-Plus on the other hand is a comprehensive global assessment of change in behavior, cognition and function, and requires separate interviews with the caregivers as well as the patients.

The results of the study demonstrated that acupuncture improved the participants score on the ADAS-cog and CIBIC-Plus, indicating improvement in cognitive function and global clinical status.

It is interesting that the study design used a known pharmaceutical treatment (donepezil) as the comparator group to acupuncture, rather than using sham (fake) acupuncture. There is evidence from many studies that sham acupuncture is not a true placebo, and often studies that use sham acupuncture show an elevated placebo response. It is also important to note that no one withdrew from the study due to an adverse side effect from acupuncture, which again points to the safety of this treatment.

A diagnosis of Alzheimer’s Dementia can be devastating to a patient, and in some ways even more so to the patient’s caregivers, which are often family members. Given the results of this study perhaps acupuncture should be given some consideration as a additional treatment for this overwhelming disease.

“I know for certain that we never lose the people we love, even to death. They continue to participate in every act, thought and decision we make. Their love leaves an indelible imprint in our memories. We find comfort in knowing our lives have been enriched by sharing their love.”– Leo Buscaglia

(Source- BMC Complementary and Alternative Medicine (2017) 17:556)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.