Q&A: Dementia; PCOS; Duodenal Ulcers
Q. How can you tell if someone has early-onset dementia?
A. Early-onset dementia refers to having developed dementia before the age of 65. In some people, problems with balance and strength may be the first signs of dementia. In a six-year study of 2,288 men and women age 65 and over, researchers found that people who initially scored higher in tests of physical function, such as walking, rising from a seated position, standing balance, and grip strength in the dominant hand, were three times less likely to develop dementia over the study period than those with low scores. Balance and walking problems seemed to be the first signs of risk for dementia in people without cognitive impairment, while among people who already showed signs of mild cognitive decline, a weak handgrip was associated with later dementia, researchers found. The study suggests that physical and mental performance in the elderly are connected. But memory problems that disrupt daily life, such as getting lost on the way home from a familiar grocery store or an inability to keep track of bills may be early symptoms of dementia, as well. Other early signs may include difficulty remembering names and recent events, apathy, and depression.
Q. One of my younger friends has a condition called PCOS—polycystic ovary syndrome. What is this, and is it dangerous?
A. About one in five women of reproductive age suffers from polycystic ovary syndrome (PCOS), a hormone imbalance that can lead to infertility, diabetes, depression, and increased risk for heart problems, so in this sense, it can be a dangerous condition. PCOS is named after the cyst-like follicles that often form on the ovaries of women with this condition. But these are symptoms of the condition, not the cause. One characteristic of the disorder is a decrease in the body’s ability to use insulin efficiently to move glucose out of the bloodstream. This “insulin resistance” could eventually lead to diabetes. Many women with PCOS are insulin resistant, and thus will experience weight gain in the abdominal area, difficulty losing weight, and intense cravings for carbohydrates. Women with this condition often have trouble becoming pregnant, and also may have such symptoms as irregular, heavy or no periods; acne, increased growth of hair on the face and arms, and loss of hair on the head. The causes of PCOS vary. Some experts cite hormone imbalance, which may cause chronic low-grade inflammation, which in turn stimulates the ovaries to produce more unwanted hormones, creating worsening symptoms. Birth control pills can help with hormone regulation, but there is currently no medical therapy that fully reverses the underlying problem or helps all the symptoms of PCOS. The primary treatment for PCOS is diet and lifestyle changes: exercise, good sleep, stress management, and eating well. Losing even five percent of total body weight can improve PCOS symptoms. Women with PCOS who have high levels of insulin can improve levels and lose weight by following a low-glycemic index diet and incorporating anti-inflammatory foods in the diet.
Q. What are duodenal ulcers? Is there treatment for these?
A. Duodenal ulcers, a subset of peptic ulcers, occur on the inside of the upper portion of your small intestine (duodenum). Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. About one in 10 Americans will develop a peptic ulcer during their lifetime, making this one of the most common gastrointestinal problems. The first sign of an ulcer is usually a burning sensation in the upper to middle abdomen that occurs within one to two hours after a meal, and also may cause bloating, belching, heartburn, nausea, or intolerance to fatty foods. The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of aspirin and certain other painkillers, such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve, Anaprox), but not acetaminophen (Tylenol). Stress and spicy foods do not cause peptic ulcers, but, they can exacerbate your symptoms. Occasionally, ulcers can cause severe symptoms, like blood in vomit or stools, or trouble breathing, and can lead to gastric cancer. Since 1982, when researchers discovered that many peptic ulcers are caused by the H. pylori bacterium, antibiotics and medicines that decrease stomach acid have been the main treatment.
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