Ask the Experts: Brain Supplement; Erectile Dysfunction; Ventricular Assist Device
Q. I keep seeing advertisements for a supplement called Prevagen, which is supposed to boost memory. Is it worth it for me to buy some?
A. The manufacturer of Prevagen claims that the product enhances memory by replacing proteins that are lost as we age with a protein called apoaequorin, which is derived from certain species of jellyfish. However, there are no peer-reviewed studies indicating that Prevagen boosts cognitive function in seniors. Moreover, unpublished lab studies suggest that apoaequorin doesn’t survive its passage through the gastrointestinal tract, and therefore doesn’t make it to the bloodstream to travel to the brain.
The Food and Drug Administration has warned the manufacturer of Prevagen about issuing misleading claims about the product “treating” Alzheimer’s disease, and has red-flagged side effects from taking it (including strokes and seizures). I suggest you save your money and instead focus on lifestyle modifications that large, well-designed studies have associated with better brain health as you age—for example, a heart-healthy diet, and plenty of physical activity.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Q. My husband is having difficulty maintaining an erection, but feels unable to discuss it with his doctor. A friend says it could indicate an underlying health problem. Is she right?
A. Your friend is right that erectile dysfunction can signal an underlying health condition, notably heart disease or diabetes. It also can be related to stress, and certain prescription medications (including antidepressants, antihistamines, and blood pressure drugs).
The possibility of an underlying condition means it is important that your husband mentions this issue to his doctor. It is understandable that he feels embarrassed, but it may help to “break the ice” if he writes down the problem in note form and gives it to his doctor during the appointment. Another reason for him to broach the topic is that his problem may be relatively simple to address. For example, if it is related to a medication he is taking, substituting a different drug or altering his dose may help. There also are a variety of treatment options for erectile dysfunction that may help, and his doctor also can advise him on lifestyle choices (such as weight loss) that also may have positive results.
Natan Bar-Chama, MD
Urology
Q. I have severe heart failure, and my cardiologist has broached the possibility of implanting a ventricular assist device. Can you tell me more about these devices, and if there are any possible complications I need to consider?
A. A ventricular assist device (VAD) is a mechanical pump that is implanted into a diseased heart to help it pump blood into the aorta (the main artery leading from the heart to the body). A power cable leads from the device through the skin to connect the pump to a battery pack worn outside the body.
VADs are associated with improved survival for people with heart failure. Quality of life also improves markedly, with fatigue and other heart failure symptoms easing. However, VADs do come with possible complications, including bleeding, stroke, blood clots, and infections. Having one implanted is major surgery, and you’ll be in the intensive care unit for at least a few days afterwards. The overall hospital stay is typically two weeks, depending on your condition and how the procedure goes. You’ll be carefully monitored during that time, and if all is well, a physical therapist will begin working with you to help your recovery. You’ll also be taught how the VAD works, how to maintain it, situations you should avoid after device implantation—for example, no swimming, bathtubs, or hot tubs (showers are fine)—and how to recognize any complications.
Expect to be taking several drugs upon discharge from the hospital, including a blood thinner, daily aspirin, and blood pressure medication—it is vital that you take these as directed, and don’t take any new drugs and/or supplements without informing your cardiologist. Also keep in mind that after implantation you will need to ensure you have extra batteries for the external battery pack with you at all times.
Bruce Darrow, MD, PhD
Cardiology
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