Harvard Health Blog

Alzheimer’s disease is a “disease of behaviors” that can wear down family and loved ones. In a talk called “Dementia and Cognitive Decline (Aging Gracefully)” Barbara Moscowitz, coordinator of geriatric social work for the Geriatric Medicine Unit at Harvard-affiliated Massachusetts General Hospital, offered helpful insights and tips into caring for people with Alzheimer’s disease. Moscowitz drew not only her 30 years of professional experience, but also on the personal experience of helping take care of her mother, who suffered from dementia the last several years of her life.

Many people try to tune out stress. A healthier approach may be to tune in to it. Paying more attention to what is going on around you, not less, is the first step toward cultivating mindfulness, an excellent technique to help you cope with a range of mental and physical problems, including stress. Mindfulness teaches people to be present in each moment. The idea is to focus attention on what is happening now and accepting it without judgment. Mindfulness techniques have been shown to ease stress, prevent major depression from reappearing, alleviate anxiety, and even reduce physical symptoms such as pain or hot flashes.

People with pacemakers and implantable cardioverter-defibrillators (ICDs) are often told that they can’t get an MRI scan. The worry is that the powerful magnetic fields and radio waves MRI scanners use might “fry” the devices, induce current so hearts would beat wildly or, in the case of ICDs, cause an unnecessary shock. A new study suggests that with the proper monitoring, MRIs can be safe for many people with pacemakers and ICDs. One of the biggest obstacles will be cost, since a specially trained nurse or a doctor would need to be present to reprogram the device and to respond in case of an emergency.

Replacing unhealthy behaviors with healthier ones usually isn’t easy, and many ambitious attempts often fall short. But you’re more likely to succeed if you start by choosing the right goal—the one you are most likely to accomplish—rather than the goal you think you should make. Breaking a goal into bite-sized pieces also helps. So does making your goal a SMART one (specific, measurable, achievable, realistic, and time-based).

A few years back, my colleague Michael Miller wrote an interesting article about the adolescent brain in the Harvard Mental Health Letter. I had only a passing interest in the topic at the time, being far more focused on raising a 9-year old and a pair of 8-year-olds. Fast-forward six years, and I now have […]

A new study published in The Journal of the American Medical Association finds that saw palmetto, a fruit extract commonly taken to treat urinary tract symptoms caused by an enlarged prostate (technically termed benign prostatic hyperplasia, or BPH), is no more effective in relieving symptoms than placebo, even at high doses. The federally funded study […]

For years, Dr. Anthony Komaroff has answered his patients’ questions one-on-one. With the launch of Ask Doctor K, a daily newspaper column that appears in 450 newspapers, he will be answering questions from people across the U.S and beyond via daily newspaper and the Internet (at AskDoctorK.com). Dr. Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of Harvard Health Publishing. In the column, he will offer clear answers and straight advice to readers’ questions, talk about new treatments that are available today or will be soon, and focus on proven changes in lifestyle that can keep readers healthy, help them cope with chronic diseases, and improve their quality of life.

About 10% of women who have heart attacks seem to have clear, unblocked arteries. They don’t, really. Instead, they have a problem inside tiny arteries supplying the heart muscle, called microvessels. Traditional diagnostic tests can’t “see” into microvessels. In larger coronary arteries, the buildup of cholesterol-filled plaque creates distinct bulges that narrow the vessel at a particular spot, reducing blood flow. In microvessels, plaque uniformly coats the inner layer. This reduces the space for blood flow and makes the arteries stiff and less able to expand in response to exercise or other stress. Researchers are still trying to determine the best ways to diagnose and treat microvessel disease. Talking to cardiologists at Harvard-affiliated Brigham and Women’s Hospital, Dr. C. Noel Bairey Merz said that the erectile dysfunction drug Viagra (sildenafil), which was originally developed to improve blood flow to the heart, is being tested as one possible therapy.

Sometimes chronic tinnitus can be fixed by taking care of the underlying cause, like grinding your teeth at night or taking aspirin. Otherwise, one of the simplest approaches is masking the noise by listening to music or having a radio, fan, or white-noise machine going in the background. Some companies make devices worn like hearing aids that generate low-level white noise. Hearing experts often recommend masking before turning to more expensive options such as cognitive behavioral therapy, tinnitus retraining therapy, biofeedback and stress management, and transcutaneous electrical stimulation of parts of the inner ear.

Smokers who want to quit can turn to a nicotine replacement products, prescription medications, and counseling. What about the newest stop-smoking aid, the electronic cigarette? Despite its appeal, we don’t know enough about the safety or effectiveness of electronic cigarettes to give them the green light. Preliminary studies from the FDA, New Zealand, and Greece raise some concerns about the dose of nicotine delivered and potentially harmful chemicals that might be in the vapor. Until good studies have been done on electronic cigarettes, the best way to quit involves using nicotine replacement or a medication along with some sort of counseling or support, either in person, by telephone, or even by text message.

Gluten, an umbrella term for proteins found in wheat, rye, and barley, makes dough resilient and stretchy. Some people can’t eat foods made with these grains because gluten triggers an immune reaction and causes inflammation of the lining of the small intestine. This can eventually interfere with the absorption of nutrients from food. This condition, called celiac disease, can cause symptoms like gas, bloating, and abdominal cramps. A growing number of people who don’t have celiac disease suffer many of its symptoms. They are classified as “gluten sensitive” or “gluten intolerant.” A new Special Health Report from Harvard Health Publishing called “Food Allergy, Intolerance, and Sensitivity” covers how to cope with gluten sensitivity, lactose intolerance, and other food allergies and sensitivities.

The death of Kara Kennedy, the only daughter of the late Senator Edward M. Kennedy, at age 51 from an apparent heart attack while exercising offers a reminder of the possible long-term effects of cancer and its treatment. In 2002, Kennedy was diagnosed with lung cancer. After having part of her lung removed, she underwent chemotherapy and radiation therapy. She lived for another nine years, in apparently good health. One of the hazards of some cancer survivors face is that the treatments used to fight cancer—drugs, radiation, and hormones—sometimes damage the heart and arteries.

Many people have trouble telling whether they are having heartburn or a heart attack. “Many people” includes doctors. A personal story from a Harvard physician describes how he treated himself with strong acid-suppressing pills until a near heart attack made him realize he had heart disease. His story appears in an updated Special Health Report from Harvard Medical School called “Heart Disease: A guide to preventing and treating coronary artery disease.”

Perfectionism has a dark side—it is often seen as obsessive and sometimes pathological. But it has a bright side, too. Desirable aspects of this personality trait include conscientiousness, endurance, satisfaction with life, and the ability to cope with adversity. This helps explain why some perfectionists become corporate leaders, skilled surgeons, or Olympic champions. In his new book, The Perfectionist’s Handbook, Dr. Jeff Szymanski describes how to become a better perfectionist—by building on the strengths of this quality and learning to minimize its drawbacks. A key step in becoming a better perfectionist is to learn how to turn mistakes into strategic experiments, says Szymanski, a clinical instructor of psychology at Harvard Medical School and executive director of the International OCD Foundation.

It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories often sugar-coat changes like these, making them seem easier than they really are. In a moving essay in the American Journal of Health Promotion, Michael P. O’Donnell (the journal’s editor) describes his dad’s efforts to become healthier for his sake and the sake of his family. There was no monumental struggle, no epiphany—just a regular guy doing his best each day to become healthier for his sake and for his family. It’s a truly inspiring story.

As summer winds to a close, many school age children are reluctant to greet another school year. Who can blame them? Swapping swimming, lazy days, camp activities, and late nights for classrooms, homework, and early morning bus rides isn’t much of a trade at all. For some children, reluctance turns into school refusal. This goes beyond an occasional “I hate school” or “I don’t want to go to school today.” Children with school refusal may sob, scream, or plead for hours before school in an attempt to stay home. They may often complain of illness and run home from school if forced to go. Absences can last weeks or even months. The problem may start at any point but common triggers are the start of a new school year, making the transition to a new school (middle school to high school, for example), or returning from school vacation. School refusal often stems from an anxiety disorder, according to Coping with Anxiety and Phobias, a new Special Health Report from Harvard Medical School. Helping a child through school refusal often takes concerted effort from the parents, school staff, a therapist, and the child.

When it comes to lowering cholesterol, a “portfolio” diet that includes cholesterol-lowering foods is better. In a head-to-head trial, the portfolio approach lowered harmful LDL by 13%, compared to a 3% reduction for a traditional low-fat diet. Elements of the portfolio diet included a daily handful of nuts; two teaspoons of margarine enriched with plant sterols; two servings of foods rich in soluble fiber, such as oatmeal, psyllium-enriched cereals, barley, and vegetables such as okra and eggplant; and two servings of soy-based foods, such as a glass of soy milk or a soy burger.

Although a recent article on healthy aging in the Washington Post suggested that taking vitamin E can help men prevent prostate and other cancers, that isn’t what the evidence shows.

Millions of Americans—most of them women—suffer from a bladder condition known as interstitial cystitis. According to a new study of this disorder, fewer than 10% of women with symptoms of interstitial cystitis are actually diagnosed with the disorder, even though it severely affects their lives. Without a proper diagnosis, women with interstitial cystitis are missing […]

Are you worried that certain rituals might be obsessive or compulsive? If they aren’t interfering with your ability to function, relax. It’s obsessive-compulsive disorder (OCD) only when obsessions and compulsive behavior become so severe that they interfere with your ability to work or have relationships. These behaviors help people with OCD deal with overwhelming feelings of anxiety that are usually triggered by intrusive images and thoughts, explains Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School and author of The Perfectionist’s Handbook, which will be published in September. A combination of medications and psychotherapy can help many people with OCD live more balanced lives. A mainstay of treatment is called exposure and response prevention—a sort of “face your fears” therapy.

One way to experience happiness is to go with the “flow.” Flow is a state of intense absorption in which you lose awareness of time. It occurs when you strike the right balance between challenge and skill. It is also one of the elements that help create happiness. No matter what your natural tendency, recognizing how flow occurs (or doesn’t) in your life and creating opportunities for more flow experiences can be a potent route to increased happiness. A new report from Harvard Medical School, called Positive Psychology, explores both time-tested and modern avenues to happiness, including flow, expressing gratitude, and developing self compassion.