Identifying weight-loss blockers; handling early signs of dementia

Q: I’ve gotten my food habits pretty well under control, but I’m still gaining weight! What could be causing that? — Kayla E., Tucson, Arizona

A: That is a great question — because so many people find out that their weight issues develop from a combination of problems, not just overeating or eating the wrong foods. You know, of course, that for long-term weight management, you need to crank up your metabolism and build more calorie-burning muscles by getting plenty of physical activity (300 minutes a week minimum). Plus, muscle and metabolism decrease by 5% per decade, so you need to eat less to keep weight constant. But other contributing issues could include:

1. Lack of restful sleep. Too little sleep increases secretion of the “feed me” hormone ghrelin and suppresses the “I’m full” hormone leptin. It’s also linked to elevated levels of the stress hormone cortisol and a growth hormone deficiency — both can contribute to obesity. For great sleep improvement info go to https:// health.clevelandclinic.org and search for “insomnia.” And ask your doctor for a referral to a sleep clinic or expert.

2. Medication. Everything from anti-hypertensives, such as beta-blockers, to depression and bipolar medicines and insulin can trigger weight gain. If that’s the problem, ask your doctor for an alternative high blood pressure, anti-depressant or diabetes medicine.

3. Underactive thyroid. Low levels of thyroid hormones promote weight gain. A blood test reveals if you’re dealing with that condition (it may be the result of an autoimmune disease called Hashimoto’s). Inexpensive, effective medication to replace the hormones is available.

4. Illness side effect. There are conditions such as Cushing’s disease, which leads to excessive cortisol secretion and polycystic ovary syndrome, which can cause you to become insulin resistant, that promote weight gain. Ask your doctor if your symptoms indicate a possible link.

Anytime you are struggling to achieve a healthy weight, it’s smart to work with your doctor to find solutions that will help you live younger longer.

Q: I have noticed that my wife, who is 76, is not as sharp as she once was, and it worries me that she maybe developing dementia or some other neurological problem. What should I do? — Eric V., White Plains, New York

A: Around 7 million Americans had dementia in 2020. By 2040, it will be 40 million. Women are slightly more likely to have dementia than men. But, long before the diagnosis, there can be signs of neurodegenerative disorders that interfere with cognition, such as Alzheimer’s, frontotemporal dementia (it causes problems with language and behavior), dementia with Lewy bodies, and Parkinson’s. For example, according to a new study in the journal Alzheimer’s & Dementia, up to nine years before diagnosis, Alzheimer’s patients struggle with abstract thinking and problem solving, reaction time, and remembering to do things that were planned ahead of time. Falls are also precursors to a diagnosis of Alzheimer’s and Parkinson’s.

Another recent study published in Neurology shows that women who had nighttime hot flashes and sweats — vasomotor symptoms of menopause — may be at increased risk for dementia later in life because those symptoms cause brain lesions that have been linked with cognitive impairment.

Although there are no cures for Alzheimer’s or many other neurodegenerative disorders, symptoms can, sometimes, be slowed and cognition protected — at least for a while. With Parkinson’s, regular exercise has far-reaching positive effects. And with mild cognitive impairment (a possible precursor to dementia) there are 33 choices that protect the brain — from food choices such as extra virgin olive oil, blueberries, and coffee to maintaining social interaction and playing speed of processing games. Get the full list in my book “The Great Age Reboot.”

Encourage your wife to be active and engaged. You may also want to have her evaluated for any neurological problems.