Statins and reducing the risk of Alzheimer’s

Q: I heard you on your radiomd.com show, “YOU: The Owner's Manual,” say statins reduce age-related memory loss, but I read they contribute to memory loss. I've been reluctant to take them (although my cholesterol is high), because Alzheimer's-type dementia runs in my family. Any guidance would be appreciated. — Amy, K., Westerly, R.I.

A: Although the data aren't definitive, specific statins that don't cross the blood-brain barrier, such rosuvastatin (Crestor) and atorvastatin (Lipitor), along with a heart-, brain- and spirit-friendly lifestyle (walking 10,000 steps a day, avoiding the Five Food Felons and getting stress relief with meditation and healthy sexual activity), can help reduce age-related memory loss.

Statins lower lousy LDL cholesterol and reduce atherosclerosis (plaque-clogged arteries) and bodywide inflammation associated with it. That may protect you from heart disease and from a lack of oxygen and nutrients in the brain that can damage neural circuits, as well as cognition-damaging strokes and multi-infarct dementia (lots of mini-strokes).

What you read was that last year, the U.S. Food and Drug Administration decided that statin labels should include info that the drugs make some people feel unfocused and fuzzy. However, the FDA also says cognition problems are rare and symptoms generally disappear a few weeks after stopping treatment.

To refine info on statins and memory loss, researchers recently compared pravastatin (Pravachol) to atorvastatin (Lipitor). They found rats given atorvastatin had no memory impairment at all. But those given pravastatin were less able to find a food reward or to recognize a previously encountered object; however, their fuzzy thinking went away when the drug was stopped.

So, overall, it seems unlikely that statins that don't cross the blood-brain barrier would increase your risk for Alzheimer's disease.

As for what can help prevent Alzheimer's-associated brain degeneration, one possibility is to protect your gut-brain axis. An imbalance of intestinal bacteria may influence brain function; it also can affect your immune system, and new research indicates that an immune protein, C1q, may play some role in degenerative brain disease. So, nurture your gut bacteria with physical activity, stress reduction and a diet of 100 percent whole grains, veggies and fruit; avoid unnecessary antibiotics; and try taking a probiotic.

Q: We just had our 25th anniversary, and I hate to think that my husband and I will end up, after years of happiness, with no sex life. People say it's inevitable, but can't older people have a good sex life? — Marian B., Sacramento

A: As long as you avoid the Five Food Felons, keep physically and mentally active, avoid tobacco and manage stress, getting older doesn't have to mean you'll lose interest in sex or your ability to make it happen! And as with fine wines, sex as you age has its rewards — and it's different from being young. While people the world over report active sex lives throughout their 60s, 70s and 80s, hormone levels do decline in both men and women, and that alters the physical drive and bodily responses. Men may take longer to achieve an erection, and women may have less lubrication, and orgasms may feel different. Luckily, sex isn't just about hormones, and those kinds of physical changes can be dealt with through diet, exercise and medications, so check with your doctor.

We're happy to report that a recent British study discovered a fair amount of seniors in the past 10 years have “expanded their sexual repertoire,” experimenting with different ways of enjoying intimacy. So as you get older, make sure you and your husband talk about ways to continue enjoying intimacy. And to help keep the home fires burning:

– Discover what time of the day is the best for intimacy, for both of you.

– Find positions that are comfortable for both of you.

– Don't think that every encounter has to end with orgasm.

Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Dr. Michael Roizen is chief medical officer at the Cleveland Clinic Wellness Institute.

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