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Ask The Doctor: January 2022
What is the latest advice about taking a daily aspirin to prevent a stroke or heart attack? It seems like there have been some mixed messages in recent years.
For a long time, it was standard advice for anyone over the age of 50 and at high risk for stroke or heart attack to take a daily low-dose (or “baby”) aspirin—usually 81 milligrams. Aspirin acts as an anticoagulant, lowering the risk of blood clots forming and blocking blood flow to the brain or heart muscle.
But in recent years, those recommendations have been revisited and revised. The main concern has been the risk of internal bleeding associated with daily aspirin use. In 2016, for example, the U.S. Preventive Services Task Force (USPSTF), an independent panel of health experts, recommended that daily low-dose aspirin was appropriate for people over the age of 50 who were at higher risk for heart attacks or strokes in the next decade as long as they weren’t at higher risk for bleeding.
But in the fall of 2021, the USPSTF updated its recommendations to say that people in their 40s and 50s who are determined to be at higher risk for heart disease and stroke should consider daily low-dose aspirin therapy if their doctors also determine they are at low risk for bleeding complications. The newer guidelines also suggest that individuals over the age of 60 not start taking daily aspirin to prevent a first-time stroke or heart attack, given the risks of bleeding.
People who have already had a heart attack or stroke are still advised to take a daily low-dose aspirin, but should do so as part of a physician-supervised regimen of medication use and heart-healthy lifestyle behaviors.
If you already take a daily low-dose aspirin for primary prevention, talk with your doctor about the risks and benefits of continuing this therapy. You should also talk with your primary care physician about stroke and heart attack prevention strategies if you don’t currently take a daily aspirin.
Is there such a thing as “photographic memory,” and can it be learned?
“Photographic memory” has been a term used in films and other types of popular entertainment for many years. However, the science regarding such a concept suggests that a true photographic memory occurs rarely, if at all. With that said, it’s true that most people’s recall of visual material is often more reliable and more detailed than other types of memory. It’s also true that some people do seem to possess exceptional visual or photographic memory skills, just as there are individuals who have elevated abilities in other domains, such as auditory memory (a phonographic memory, if you will). Most experts agree, however, that these people probably had these extraordinary abilities throughout the lives and simply honed their skills over time.
I find myself longing for “the good old days” more and more and watching movies from my youth. My kids are concerned and say I am living in the past. Are they right?
First of all, there’s an important distinction between “living” in the past and “thinking about” the past. Second, if it’s comforting to turn your thoughts to happier times that feel more secure and familiar, then do so now and then. If reliving the past makes you anxious or sad, then consider refocusing your thoughts.
Your children may be concerned that you’re not enjoying the present and may be scared of the future. If you escape to the past to avoid thinking about these things, then try a few exercises. First, make a plan for the future of things you want to do. Having something to look forward to can give you something hopeful to think about. It’s also helpful to take stock of what you have in your life that makes you happy or grateful. If you are troubled by the present or future, remind yourself that there are things in life you can’t control, so let them go and focus on what’s in your control.
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