Ask the Doctor: September 2021
Q. I have seen ads for smartphone apps that offer mental health counseling. Is it a good idea to try therapy in this way?
A. The rise of so-called “mobile therapy” has certainly encouraged more people to reach out for help. But what they are getting for their time and money varies from app to app.
As far as the downsides go, there are a few important considerations. First is privacy. Putting personal information online in any format is risky, especially with something as sensitive as your mental health. Who is getting access to this information and how will that information be used? The second concern is that many mental health apps focus on one condition, such as depression, but people often have more than one condition that may require a level of care that is beyond what an app can provide.
On the plus side, apps that provide encouraging messages and get you thinking differently about your problems or concerns can be helpful. Some apps provide well-established forms of therapy, such as cognitive-behavioral therapy, and have shown robust benefits in clinical trials There is also research to show that patient engagement with a mental health app is often quite high, perhaps in part because the user is the one solely responsible for improvement. A smartphone app is also convenient, as it can be accessed just about anywhere at any time. And if the app matches you with a licensed therapist so the therapy is more like standard telemedicine, then the benefits may be even greater.
Q. I’ve lost a lot of weight in the past two years, and in addition to feeling better I think my memory has improved. Is that possible or am I imagining things?
A. We’ve known for some time that excess weight is a risk factor for dementia later in life. In recent years, several studies have shown, in turn, that losing weight appears to improve concentration and memory. One study compared brain activity in a group of women who were overweight or obese prior to going on certain diets and six months later after the women had lost weight. The researchers found that brain activity in the regions of the brain responsible for encoding or creating a new memory increased, while activity in the areas responsible for retrieval decreased—suggesting that retrieval had become more efficient.
Researchers continue to learn more about how weight loss and improved fitness can improve memory and other brain functions. We do know that obesity triggers inflammation, which is a risk factor for many health problems, including cognitive decline. We also know that obesity can lead to poor circulation, which can adversely affect brain health and function. Healthy weight management may not only improve your memory, but may also help give you a brighter future.
Q. My husband has become hard of hearing recently, and it seems to have affected his personality and cognition. Can hearing loss cause dementia?
A. The connection between hearing loss and dementia is an active area of research. One question being studied is whether hearing loss accelerates the onset of dementia or whether dementia accelerates hearing loss. Both may be true. Many people with impaired hearing tend to feel isolated or isolate themselves because of the challenges of interacting with others. Isolation is a major risk factor for dementia, as well as mood disorders, such as depression.
Hearing loss also mimics some of the same symptoms as cognitive decline, so be careful assigning changes in your husband to dementia. His memory and thinking skills may be as strong as they were a few years ago, but hearing loss can affect the ability to hear information in order to create new memories.
A hearing test and hearing aids or other assistance, if needed, may bring about some positive changes for both of you.
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