Half of women at risk of dementia, stroke

Study suggests more older women may benefit from bone drugs

People take pictures of the Eiffel Tower after it was lit in pink as part of a campaign to raise awareness about breast cancer in Paris on Oct 1. (AFP)

PARIS, Oct 2, (Agencies): Nearly half of women and one in three men are at risk of developing stroke or degenerative neurological diseases such as dementia and Parkinson’s during their lifetime, according to a study published Monday.

Dutch researchers considered all three conditions “in order to grasp how big the problem of incurable brain diseases in late life really is,” said the study’s senior author Arfan Ikram.

“We grouped these diseases together not only because they are common but also because there are indications that these often co-occur and might share some overlapping causes,” Ikram, of the Erasmus MC University Medical Center Rotterdam in The Netherlands, told AFP.

This could mean there are also overlapping ways to delay or avoid getting the diseases, and the research found that some preventative strategies may cut the risk by between 20 and 50 percent.

For the study, published in the Journal of Neurology Neurosurgery and Psychiatry, researchers tracked more than 12,000 healthy people over the age of 45 from 1990 to 2016.

Over the 26 years, 5,291 people died. Nearly 1,500 were diagnosed with dementia – 80 percent with Alzheimer’s – while 1,285 had a stroke and 263 developed Parkinson’s.

The results indicated that the likelihood of women aged 45 years or older getting the diseases was 48 percent, while it was 36 percent for men.

The gender split is mostly due to the fact that men die earlier than women, Ikram said.

Protective

“Our study does not show some sort of protective effect for men,” he said. “Instead it is merely due to fewer men surviving to old age.”

Because they live longer, women have an increased risk of such diseases, and the study found women were twice as likely as men to develop both dementia and stroke.

While there are no cures for these diseases, a healthy lifestyle – a good diet, not smoking or having diabetes – can protect against stroke and help prevent the onset of dementia, Ikram said.

There are also indications that a healthy lifestyle can reduce the risk of Parkinson’s, he added.

The cost of the three neurological diseases is believed to be more than two percent of the world’s annual economic productivity (GDP), the researchers said in a statement.

However while the dangers of other illnesses such as breast cancer and heart diseases are well known, “the same can’t be said of dementia, stroke and Parkinsonism”, the statement said.

The researchers noted that as the study only included people of European ancestry with a relatively long life expectancy, it “might not be applicable to other ethnicities/populations”.

Worldwide, about seven percent of people over 65 suffer from Alzheimer’s or some form of dementia, a percentage that rises to 40 percent above the age of 85.

The number afflicted is expected to triple by 2050 to 152 million, according to the World Health Organization, posing a huge challenge to healthcare systems.

A bone-strengthening drug given by IV every 18 months greatly lowered the risk of fracture in certain older women, a large study found. The results suggest these medicines might help more people than those who get them now and can be used less often, too.

Broken bones are a scourge of aging. A hip fracture can start a long decline that lands someone in a nursing home. The risk is most common in women after menopause.

But who should use drugs called bisphosphonates is debatable. They’re recommended for people with severely brittle bones, called osteoporosis, but their value is less clear for millions of others with moderate bone loss.

Yet “that’s the group in whom 80 percent of fractures occur,” and the new results suggest they also may benefit from treatment, said Dr Ian Reid of the University of Auckland in New Zealand.

He led the study, reported Monday at an American Society for Bone and Mineral Research meeting in Montreal and published by the New England Journal of Medicine.

Estrogen keeps bones strong; they weaken after menopause when levels of that hormone drop. It often gets worse after 65, and women of that age are advised to have a bone mineral density scan – a low-dose X-ray to estimate bone strength.

If osteoporosis is found, treatment usually is Fosamax, Boniva or generic versions of these drugs, which help prevent bone from being lost faster than the body is able to renew it. Some people don’t stick with the pills or endure digestive side effects, so the medicines also can be given by IV, usually once a year.

However, concern about some rare side effects have limited their use, along with a lack of evidence that they might help before bone loss becomes severe.

The study involved 2,000 women, average age 71, with moderate bone loss. One quarter had previously had a fracture. They were assigned to get a Novartis drug, sold as Reclast in the United States and Aclasta elsewhere, or a placebo IV solution every 18 months.

After six years, 122 women in the drug group had broken a bone versus 190 of those on placebo – a 37 percent lowered risk. The drug also cut in half the risk of a vertebral fracture, when bone compression causes part of the spine to collapse.

For every 15 women like this treated for six years, one fracture was prevented – a ratio that some experts said makes treatment worth considering.