A new study warns consumers to beware: a number of common medications, such as Tylenol, Benadryl and Dramamine, may cause cognitive impairment and even increase the risk of death.

Medications with anticholinergic activity are frequently taken among the elderly adult population and include both over-the-counter drugs as well as prescription medicine.  Anticholinergics affect the brain by blocking acetylcholine, a neurotransmitter.

Most anticholinergic drugs contain diphenhydramine, which is sold over-the-counter under popular brand names, including Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM and Unisom. Prescription anticholinergic drugs include Paxil, Detrol, Demerol and Elavil.

Researchers studied the impact of these drugs on 13,000 men and women aged 65 or older over a period of two years.  They found that, even controlling for a variety of other factors, taking anticholinergic medications was linked to cognitive impairment and death in this population.

Generally, elderly people take the anticholinergics for various ailments and diseases, such as sleep disorders, incontinence, hypertension and congestive heart failure, according to researchers.

“Physicians should review with older patients all the over-the-counter and prescription drugs they are taking to determine exposure,” said study co-author Malaz Boustani, M.D., Regenstrief Institute investigator, Indiana University School of Medicine associate professor of medicine, and research scientist with the IU Center for Aging Research

The study was published in the Journal of the American Geriatrics Society.

An analysis of heart disease and stroke statistics collected from 192 countries by the World Health Organization shows that the relative burden of the two diseases is closely linked to national income.

University of California researchers found that developing countries tend to suffer more death and disability by stroke than heart disease.  Meanwhile, the United States and other countries with higher national incomes tend to experience the opposite.

This finding may help health officials design tailored interventions to best fit the needs of developing countries, the researchers say.

“In general, heart disease is still the number one cause of death worldwide, but there is quite a lot of variation across the globe,” said Anthony  Kim, MD, MAS, assistant professor of neurology at UCSF .

For instance, there was a wide variation in the mortality rate for stroke highlighted by the new research.  Rates ranged from a worldwide low of 25 deaths per 100,000 in the island nation of Seychelles to a high of 249 deaths per 100,000 in Kyrgyzstan – a rate nearly 10 times greater.

In the United States, there are approximately 45 deaths per 100,000 people due to stroke.

Heart disease and stroke are similar in that they are both are caused by reduced or restricted blood flow to vital organs and share many of the same common risk factors, such as hypertension, diabetes, high cholesterol, obesity, physical inactivity and smoking.

However, because they affect very different tissues – the heart and the brain – they diverge in terms of symptoms, approaches to critical care, follow-up treatment and the duration and cost of recovery.

“There was a striking association with national income,” Kim said.

In the United States, for instance, heart disease is the number one killer and stroke the number four, according to the Centers for Disease Control and Prevention. This also holds true for the Middle East, most of North America, Australia and much of Western Europe.

The opposite is true in many developing countries. Stroke  is more prevalent in China, many parts of Africa, Asia and South America.

Overall, nearly 40 percent of all nations have a greater burden of stroke compared to heart disease.

“This is significant,” said Kim, “because knowing that the burden of stroke is higher in some countries focuses attention on developing a better understanding of the reasons for this pattern of disease and may help public health officials to prioritize resources appropriately.”

The study was published in the journal Circulation.

Stroke rates are rising among adolescents and young adults, according to a new study, which blames the increased prevalence of hypertension, diabetes and obesity for the higher rates.

Ischemic stroke hospitalizations increased 37 percent between 1995 and 2008 among adolescents and young adults aged 15 to 44.

Of the patients hospitalized for ischemic stroke, researchers found that one third of patients aged 15 to 34 years and over half aged 35 to 44 years were also diagnosed with hypertension. One-fourth of patients aged 35 to 44 years also had diabetes.

Additionally, a quarter of females and a third of males aged 15 to 44 were regular tobacco users.

“We identified significant increasing trends in ischemic stroke hospitalizations among adolescents and young adults,” said Mary George, M.D., a medical officer with CDC’s Division for Heart Disease and Stroke Prevention. “Our results from national surveillance data accentuate the need for public health initiatives to reduce the prevalence of risk factors for stroke among adolescents and young adults.”

Stroke is the third leading cause of death in the United States and is one of the top 10 causes of childhood death.

Nearly 90 percent of all cases are attributed to ischemic stroke, which occurs when blood flow to the brain is blocked by blood clots or a build up of plaque inside blood vessels.

The researchers recommended that adolescents and their guardians minimize stroke risk factors by eating plenty of fresh fruits and vegetables and foods low in sodium and saturated fat, maintaining a healthy weight, engaging in regular physical activity and not smoking.

The study was published in the journal Annals of Neurology.

It used to be called impotence. But thanks to the proliferation of drug industry advertisements that now threaten to overwhelm our television programs, today we know it as erectile dysfunction, or, more discreetly, simply as E.D. Whatever you want to call it, though, it’s the man’s inability to achieve or maintain an erection sufficient to satisfy him or his partner during intercourse.

When it occurs in young men, it’s usually just a matter of momentary anxiety. In middle-aged men, it’s often caused by stress, guilt, or overwork. In fact, most men experience it at some point in their lives by age forty, though usually only briefly, and they are not psychologically affected by it.

But it gets more common with age, and for some men – as many as 30 million of them according to the drug companies – it occurs frequently and causes serious emotional and relationship problems.

In many cases, E.D. is due to the deterioration of the blood vessels that carry blood into the penis. A host of things can cause this deterioration, including nicotine, which narrows the blood vessels, excessive alcohol, and certain prescription drugs, notably antidepressants. Some physical problems can contribute to the deterioration, too, such as diabetes, high blood pressure, and obesity.

If you have difficulty getting an erection, get help. Discuss it with your partner, and consult your doctor, who will help you find the cause of your E.D. Treatment will, of course, depend on the cause. Though there are a number of mechanical devices that can help men get a better erection, including splints, rings, and pumps, it’s the E.D. drugs that have revolutionized the treatment of this problem. They work well for most men, and if one drug doesn’t work for you, try one of the others – but always work with a doctor’s guidance since the drugs can have significant side effects.

A new study from Wake Forest researchers looks at not only how likely it is for a person to suffer a heart attack, but whether or not there are certain risk factors that will make that person more likely to die of a heart attack.

“For some people, the first heart attack is more likely to be their last,” said lead researcher Elsayed Soliman, M.D., director of the Epidemiological Cardiology Research Center at Wake Forest Baptist. “For these people especially, it is important that we find ways to prevent that first heart attack from ever happening because their chances of living through it are not as good.”

The researchers reported they were able to identify certain traits, such as hypertension, race, body mass index and other factors that can be identified by an electrocardiogram (ECG), that can be predictive of dying from a heart attack rather than living through it.

Specifically, these risk factors include:

Ethnicity – Black people, compared to nonblack, were more likely to die from a heart attack, though they were less likely to develop coronary heart disease

Hypertension and heart rate – High blood pressure and heart rate were predictive of death

BMI – People with extremely high and extremely low BMIs were more likely to die from a heart attack

Soliman hopes his study will be useful to doctors for identifying patients who are at-risk for dying suddenly.  By using these markers, doctors can intervene early and possibly save more lives.

In the United States, between 230,000 and 325,000 people die from heart attacks every year, according to researchers. Most of these sudden deaths are caused by coronary heart disease.

“Since sudden cardiac death usually occurs before patients ever make it to the hospital, there is very little that can be done to save them,” Soliman said. “Identifying specific predictors that separate the risk of sudden cardiac death from that of non-fatal or not immediately fatal heart attacks would be the first step to address this problem, which was the basis for our study.”

The study was published in the journal Heart.

Over half of all Alzheimer’s disease cases could be preventable with simple lifestyle changes, according to researchers.

After analyzing worldwide data involving hundreds of thousands of people, San Francisco VA Medical Center researchers concluded that people could modify their risk for the debilitating disease.

Modifiable risk factors included low education, smoking, physical inactivity, depression, mid-life hypertension, diabetes and mid-life obesity.

In the United States especially, the researchers found that one of the biggest modifiable risk factor was physical inactivity.

Together, these risk factors may account for up to 51 percent of Alzheimer’s cases worldwide and 54 percent in the United States.

“What’s exciting is that this suggests that some very simple lifestyle changes, such as increasing physical activity and quitting smoking, could have a tremendous impact on preventing Alzheimer’s and other dementias in the United States and worldwide,” said Deborah Barnes, PhD, a mental health researcher at the San Francisco VA Medical Center.

Barnes noted that the conclusions of the study were based on the assumption that there is a cause-effect relationship between each risk factor and Alzheimer’s disease.

“We are assuming that when you change the risk factor, then you change the risk,” Barnes said. “What we need to do now is figure out whether that assumption is correct.”

According to researchers, the number of Alzheimer’s cases is expected to triple over the next 40 years, making it critical to find ways to decrease people’s risk of developing the disease.

The study was published in Lancet Neurology.