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Shingles infection linked to risk of cognitive decline, says study: ‘Long-term implications’

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Shingles infection linked to risk of cognitive decline, says study: ‘Long-term implications’

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Getting shingles just once could increase the risk of long-term confusion and memory loss, a new study has found.

The study, led by Brigham and Women’s Hospital and Harvard Medical School, linked the virus to greater chances of “subjective cognitive decline,” according to a Harvard press release.

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The findings were published in the journal Alzheimer’s Research & Therapy on Aug. 14.

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“Subjective cognitive decline” captures early changes in cognition that are noticed before evidence of cognitive impairment shows up on standard neuropsychological tests, explained study author Sharon Curhan, M.D., a physician and epidemiologist at Brigham and Women’s Hospital in Boston.

It was also associated with a higher risk of mild cognitive impairment (MCI) and dementia. 

Getting shingles just once could increase the risk of long-term confusion and memory loss, a new study has found. (iStock)

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“Shingles may contribute to dementia risk through neuroinflammation, damage to cerebral blood vessels (cerebral vasculopathy), or direct neuronal damage,” Curhan told Fox News Digital.

In this particular study, the researchers analyzed data from three large cohorts of more than 150,000 women and men over a 13-year period. 

The data came from the Nurses’ Health Study, the Nurses’ Health Study II and the Health Professionals Follow-Up Study, according to Curhan.

“We were surprised by the large magnitude and long duration of the increased risk.”

“There was a suggestion that the magnitude of the elevated risk may be greater among those who were not vaccinated with the shingles vaccine,” she said.

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The researchers determined that shingles was associated with a greater than 20% higher long-term risk of subjective cognitive decline.

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“We were surprised by the large magnitude and long duration of the increased risk, and [the fact] that it may be different in women and men,” Curhan told Fox News Digital. 

The elevated risk was even higher among those who were genetic carriers of APOE e4 — the gene that increases the risk for Alzheimer’s disease — than men who were not APOE e4 carriers, she noted, but this was not the case in women. 

Known medically as herpes zoster, shingles is a painful, blistering rash caused by the varicella-zoster virus (VZV), which is the same virus that causes chickenpox. (iStock)

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Although he noted that this is an observational study and does not prove cause and effect, Dr. Marc Siegel, senior medical analyst for Fox News, said he believes “the observation is real.”

“Shingles is a reactivation of a virus that has been hiding inside nerves,” he told Fox News Digital. “It causes inflammation — and when inflammation involves the brain, it is associated with cognitive decline, which can lead to Alzheimer’s.”

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Previous studies have also looked at the association of herpes zoster and other viruses with Alzheimer’s and the other diseases that cause dementia, according to Heather M. Snyder, PhD, senior vice president of medical and scientific operations at the Alzheimer’s Association in Chicago.

“It is unclear if the virus is present in individuals because of changes associated with the diseases that cause cognitive decline, changes of the immune system, or some sort of cause and effect,” Snyder, who was not involved in the study, told Fox News Digital.

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“When inflammation involves the brain, it is associated with cognitive decline.”

Previous research has also shown that a history of shingles is also associated with higher long-term risk of a major cardiovascular event, such as a stroke or heart attack, which could last for many years after infection, Curhan warned. 

What to know about shingles

Shingles — medically known as herpes zoster — is a painful, blistering rash caused by the varicella-zoster virus (VZV), which is the same virus that causes chickenpox, according to the U.S. Centers for Disease Control and Prevention (CDC).

The rash and blisters usually scab over within seven to 10 days.

The infection is common, affecting about one in every three people in the U.S. in their lifetime.

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In addition to the rash, which typically appears as a stripe around one side of the body or face, symptoms can include fever, chills, headache and upset stomach. (iStock)

“A majority of adults have herpes zoster hidden in their brain cells, from prior infection at some previous point in their life,” said Snyder.

In addition to the rash — which typically appears as a stripe around one side of the body or face — symptoms can include fever, chills, headache and upset stomach, according to the CDC.

In some cases (10% to 18%), the virus can lead to complications like long-term nerve pain.

One in every three people in the U.S. will have shingles in their lifetime.

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Other rare but serious adverse effects can include vision loss, bacterial infections, pneumonia, brain inflammation (encephalitis), impaired hearing and death, per the CDC.

These complications are most likely to affect those with compromised immune systems.

Antiviral treatments and pain relief medications are available for those with the condition.

Means of prevention

These findings show the “long-term implications” of shingles and highlight the importance of public health efforts to prevent the infection, Curhan noted. 

The vaccination has been shown to be 90% effective at preventing the infection and long-term nerve pain in adults age 50 and over who have healthy immune systems, according to the CDC.

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Shingles vaccination has been shown to be 90% effective at preventing the infection and long-term nerve pain in adults age 50 and over who have healthy immune systems, according to the CDC. (iStock)

“Given the growing number of Americans at risk for this painful and often disabling disease and the availability of an effective vaccine, shingles vaccination could provide a valuable opportunity to reduce the burden of subsequent health issues due to shingles, such as chronic pain (postherpetic neuralgia), cardiovascular complications, or cognitive decline and dementia,” said Curhan.

The CDC recommends routine shingles vaccination for people age 50 and older, regardless of whether they have had a prior episode of shingles or have had a previous vaccine. 

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“Anyone who may be eligible for the vaccine or who may have questions or concerns about vaccination should consult with a health care provider,” said Curhan.

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Siegel echoed the merits of vaccination. 

  

“This study adds to the growing group of evidence that the shingles vaccine (Shingrix) is important for all those over 50 (who have had chicken pox or the varicella vaccine) to decrease the risk of reactivation of the shingles virus and/or complications of active infection,” he said.

Potential limitations 

This was an observational study that primarily focused on a White, highly educated population, Curhan noted — which means future studies in other populations could strengthen the research.

“Also, we did not have information on vaccination status in the full study population, so we could only examine this relation among a subset,” she added. 

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“A majority of adults have herpes zoster hidden in their brain cells, from prior infection at some previous point in their life,” a doctor said. (iStock)

Much of the study period took place before the shingles vaccine became widely available, Curhan said — and even once it was introduced, the uptake was generally low. 

The more recent vaccine was not available until after the study. 

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“As uptake of the newer shingles vaccine increases, additional studies that evaluate whether vaccination status influences the relation of shingles and risk of cognitive decline would be informative,” Curhan said. 

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“Therefore, we are currently collecting this information among our participants and hope to conduct these studies in the future.”

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Brain Health Challenge: Workouts to Strengthen Your Brain

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Brain Health Challenge: Workouts to Strengthen Your Brain

Today, you’re going to do perhaps the single best thing for your brain.

When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.

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“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.

Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.

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Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.

Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.

All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.

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The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.

The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.

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Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.

Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.

If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”

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For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.

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Little-known prescription pill is helping Americans drink less alcohol

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Little-known prescription pill is helping Americans drink less alcohol

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Recent studies continue to support a decades-old drug as an alternative means of reducing alcohol consumption.

The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder.

In addition to the daily pill version, naltrexone is also available as a monthly injectable therapy, which was approved for alcohol use disorder in 2006 and opioid use disorder in 2010.

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How it works

Naltrexone works by blocking opioid receptors in the brain. For those dependent on opioids, it blocks the “euphoric” effects of the drugs and also curbs cravings for alcohol, according to experts.

The prescription opioid pill, called naltrexone, was first approved by the FDA to treat opioid dependence in 1984. A decade later, it was approved for alcohol use disorder. (iStock)

“Naltrexone can be used to assist with reducing alcohol cravings and reduce the pleasurable effects from alcohol ingestion, which can help those prone to binge-drinking to consume less volume,” Dr. David Campbell, clinical director and program director at Recover Together, a behavioral health and addiction treatment facility in Bend, Oregon, told Fox News Digital.

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The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit, according to Campbell.

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“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol.”

Jessica Steinman, chief clinical officer at No Matter What Recovery in Los Angeles, calls naltrexone “an incredibly helpful and life-saving tool” for people who struggle with alcohol use disorder. 

“Currently, in our society, many people are looking to get medication-assisted help from overconsumption of certain things or behaviors, including food, cigarettes and now alcohol,” she told Fox News Digital.

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“Naltrexone affects the rewards center of the brain, which blocks the rewarding effects of alcohol and cravings to be minimized. It can assist in telling the brain that alcohol isn’t wanted.”

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The drug can also help if someone has a “healthy” relationship with alcohol and is looking to cut back on their drinking behaviors, Steinman added. 

“We do not suggest moderation in any way for people struggling with alcohol use disorder or any type of dependence to alcohol or other substances,” she noted. “We do not believe drinking ‘less’ is a solution.”

Side effects

Common side effects of naltrexone can include nausea and vomiting, headache, sleep disturbances, dizziness, fatigue, anxiety, loss of appetite, and joint or muscle pain, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

These effects are generally mild and may improve as the body adjusts to the medication.

The medication is useful for people who experience strong cravings, often drink to excess once they start, or drink primarily due to reward or relief as opposed to habit. (iStock)

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In rare cases, patients may experience more severe effects, such as liver issues, allergic reactions, trouble breathing and mental health effects.

“The most important thing when taking naltrexone for alcohol use is to ensure that there is no concurrent use of opioids, as taking naltrexone when using opioids can induce precipitated withdrawal, a very uncomfortable event,” Campbell cautioned.

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More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily, according to CDC data.

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Each year, around 178,000 deaths in the country are linked to excessive alcohol use.

“Heavy alcohol consumption and binge-drinking can lead to many health problems and make chronic health conditions worse, so reducing alcohol intake can really improve health,” Donita Robinson, Ph.D., an associate professor of psychiatry at the UNC School of Medicine in North Carolina, told Fox News Digital.

More than 50% of U.S. adults drink alcohol, about 17% are classified as binge-drinkers and about 6% drink heavily. (iStock)

“Naltrexone helps many people reduce their drinking – it’s an effective medication to reduce alcohol craving and heavy drinking, and it works best in combination with counseling or other therapy.”

Robinson reiterated that people who are on opioid medications, including some painkillers, shouldn’t take naltrexone, as it can block their effectiveness and cause opioid withdrawal.

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Naltrexone is available with a prescription from a licensed healthcare provider, such as a primary care doctor, addiction medicine specialist or psychiatrist.

Health officials warn against purchasing the drug online or without a prescription, as it may be counterfeit and unsafe.

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Those interested in exploring whether naltrexone is an option for them should see a doctor, who can assess the safety of the drug based on the patient’s medical status and history.

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They should also “make sure they have their goals and intentions in line before using a medication like this,” according to Steinman.

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Brain Health Challenge: Try the MIND Diet

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Brain Health Challenge: Try the MIND Diet

Welcome to Day 2 of the Brain Health Challenge. Today, we’re talking about food.

Your brain is an energy hog. Despite comprising about 2 percent of the average person’s body mass, it consumes roughly 20 percent of the body’s energy. In other words, what you use to fuel yourself matters for brain health.

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So what foods are best for your brain?

In a nine-year study of nearly 1,000 older adults, researchers at Rush University in Chicago found that people who ate more of nine particular types of food — berries, leafy greens, other vegetables, whole grains, beans, nuts, fish, poultry and olive oil — and who ate less red meat, butter and margarine, cheese, sweet treats and fried food had slower cognitive decline.

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Based on these findings, the researchers developed the MIND diet.

Large studies encompassing thousands of people have since shown that following the MIND diet corresponds with better cognitive functioning, a lower risk of dementia and slower disease progression in people with Alzheimer’s. People benefit from the diet regardless of whether they start it in midlife or late life.

Experts think the foods included in the MIND diet are especially good for the brain because they contain certain macro and micronutrients.

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Berries and leafy greens, for example, are rich in polyphenols and other antioxidants, said Jennifer Ventrelle, a dietitian at Rush and a co-author of “The Official Mind Diet.” Many of these compounds can cross the blood-brain barrier and help to fight inflammation and oxidative stress, both of which can damage cells and are linked to dementia.

Nuts and fatty fishes, like salmon and sardines, contain omega-3 fatty acids, which are important for building the insulating sheaths that surround the nerve fibers that carry information from one brain cell to another.

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Whole grains and beans both contain a hefty dose of fiber, which feeds the good microbes in the gut. Those microbes produce byproducts called short-chain fatty acids that experts think can influence brain health via the gut-brain axis.

You don’t have to revamp your whole diet to get these nutrients. Instead, think about “MIND-ifying” whatever you already tend to eat, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. For instance, add a handful of nuts or berries to your breakfast.

Today’s activity will help you MIND-ify your own meals. Share your choices with your accountability partner and in the comments, and I’ll discuss the ways I’m adjusting my diet, too. For added inspiration, check out these MIND-approved recipes from New York Times Cooking.

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