Hi everyone,
Does retiring early make your brain age faster? In a study of 2,418 older Americans, women who retired early had memory scores that matched about 6 extra years of aging. Men who moved in and out of work had thinking scores that matched about 7 extra years. That matters for anyone planning their 60s.
I also found a few other studies I thought were interesting and useful for staying healthy. Strokes in adults aged 20 to 54 nearly doubled in one US region, even as they fell in older adults. A Danish study found that menopause hormone pills raised the risk of blood clots, while patches and gels did not. Another study asked whether the MIND diet keeps the small arteries in your brain healthy. And a large trial tested whether a fecal transplant can relieve irritable bowel syndrome.
On the podcast, I talk about how my dog Blue came back from a torn throat in two weeks, and two of his habits you can copy to heal better.
I am a neurosurgeon, and I built an app to exercise your brain. Nine puzzles cover the nine domains of thinking: memory, language, numbers, space, attention, logic, and planning. New puzzles are generated every day, so there is a fresh set waiting for you every morning. They are fun and a little addictive, and they do not feel like work. They feel like a game. I play mine every morning with my coffee. Three games are free to play every day, with no sign-up.
This Week’s Podcast Spotlight
Episode 74: How to Be as Resilient as Your Dog (Neurosurgeon Explains)
This is a solo episode, and it starts with my border collie, Blue. He ran into a tumbling stick with his mouth open and tore his soft palate from the roof of his mouth down to his esophagus. A person with that injury would need surgery, a breathing tube, an ICU stay, and a feeding tube. The vet put in about ten stitches, Blue went home that night, and two weeks later he was back to normal. Part of the difference is anatomy: humans gave up a sealed-off airway in exchange for speech. The rest comes down to two habits people can copy: moving an injury once it has been checked and is stable, and separating the pain signal from the story the brain tells about it. In one trial of 151 people with chronic low back pain, four weeks of therapy to retrain that story left two thirds pain free or nearly pain free, versus about a fifth in the placebo group.
Three points from the episode:
- Healing tissue wants movement, not stillness. Cartilage has almost no blood supply and feeds by being squeezed and released, and muscle loss in a limb held in a cast can be measured within a week.
- A soft bandage did as well as a cast for children’s buckle wrist fractures. In the 2022 FORCE trial of almost 1,000 kids across 23 UK hospitals, outcomes were essentially the same, and the bandage kids got back to being kids weeks earlier.
- Ask what exactly is being protected. An unstable fracture or a fresh tendon repair still needs rigid protection. The better question is whether you can protect just that part while the rest of the body keeps moving.
Want to go further? I did a full episode on the mind-body approach to chronic pain with Dr. David Schechter: How the Brain Can Turn Chronic Pain Back Off.
This Week in Health Science
Five studies from this week’s research, and I think you will find a few of them practically useful.
Retiring Early Was Linked to a Brain That Tests Years Older. Job Worry Was Not.
Work gives the brain daily problems to solve and people to deal with. Columbia researchers checked the work lives of 2,418 older Americans every two years from 1998 to 2014. In 2016, they gave them detailed thinking tests. Compared with women in steady, secure jobs, women who retired early had memory scores that matched about 6 extra years of aging. Those women also had about 97 percent higher odds of mild cognitive impairment or dementia. Men who moved back and forth between work, unemployment, and retirement had thinking scores that matched about 7 extra years. Staying in a job while worried about losing it was not linked to broad thinking problems. This was an observational study, so people whose thinking was already slipping may have left work sooner. The score gaps held when the researchers removed people with early signs of impairment. If you plan to retire early, plan what will replace the mental challenge and social contact of work.
Key finding: Women who retired early had memory scores that matched about 6 extra years of brain aging. Men with on-and-off work histories scored like they were about 7 years older.
My book, 2mm, is almost here, and the first chapter is free to read right now. It is the story of seven years inside the operating room, where every decision is measured in millimeters and every millimeter matters. If you want to read the first chapter, go to 2mmbook.com.
Menopause Hormone Pills Raised Blood Clot Risk 60 Percent, While Patches and Gels Did Not
Blood clots are the main safety worry with menopause hormone therapy. This Danish study used national health records for women aged 50 to 69. It compared about 9,800 women who had a clot in a leg or lung with 49,000 women of the same age who had not. Taking estrogen as a pill went with about 1 extra leg or lung clot for every 1,055 women each year. That is about 60 percent higher risk than women not on hormones. Estrogen absorbed through the skin, by patch or gel, did not raise overall clot risk. High-dose pills, above 1 mg of estradiol a day for more than a year, were also linked to more strokes and heart attacks. This was an observational study, so women who chose pills may differ from those who chose patches. If you are considering hormone therapy and clots worry you, ask your doctor whether a patch or gel could work instead of a pill.
Key finding: Hormone pills went with about 1 extra leg or lung clot per 1,055 women a year, about 60 percent higher risk. Patches and gels did not raise overall clot risk.
Strokes in Adults Aged 20 to 54 Nearly Doubled in One US Region Since 1993
Most people think of stroke as a disease of older age. This study counted first strokes treated in hospital across the Cincinnati and Northern Kentucky region. It covered six points between 1993 and 2020, and stroke-trained doctors reviewed each case. In adults aged 20 to 54, the stroke rate rose from 33.9 to 62.2 per 100,000 people. Over the same years, it fell in older adults, from about 619 to 453 per 100,000. Most of the rise was ischemic stroke, the kind caused by a blocked blood vessel. Over time, young stroke patients were more likely to have high blood pressure, diabetes, and an irregular heart rhythm called atrial fibrillation. The study only looked at people who had a stroke, so it cannot say what caused the rise. High blood pressure and diabetes rarely cause symptoms. If you are under 55 and have not had your blood pressure and blood sugar checked in a few years, get both checked.
Key finding: The stroke rate in adults aged 20 to 54 nearly doubled, from 33.9 to 62.2 per 100,000, while it fell in older adults.
People Who Ate Closer to the MIND Diet Had Healthier Brain Arteries. Here’s How Much It Explained.
The MIND diet blends the Mediterranean diet with the DASH diet for blood pressure. It favors leafy greens, berries, nuts, fish, and olive oil. It limits red meat and fried or fast food. Earlier work linked it to lower dementia risk, but nobody knew how it might help. Researchers at Rush University scored the diets of 713 adults, average age 81, and scanned their brains. People who ate closer to the MIND pattern had healthier small arteries in the brain and fewer bright spots on the scan that often signal small vessel damage. They also had more brain volume and better thinking scores. Healthier arteries explained about 8.5 percent of the diet’s link to better thinking, and brain volume about 9 percent. Most of the link is still unexplained. Diet, scans, and tests were measured at the same time, so the study cannot show the diet came first. More berries, leafy greens, and fish, with less fried and fast food, is a low-risk place to start.
Key finding: In 713 adults around age 81, a diet closer to the MIND pattern went with healthier small brain arteries, more brain volume, and better thinking.
A Fecal Transplant for IBS Did No Better Than People’s Own Stool. Here’s What That Tells Us.
One popular idea is that irritable bowel syndrome, or IBS, comes from the wrong mix of gut bacteria. If that were true, stool from a healthy donor should help. In this trial, the donor stool was placed in the colon with a single enema. Researchers in Norway gave 450 adults with moderate-to-severe IBS either donor stool or their own stool back as a placebo. Neither the patients nor the staff knew who got which. At 90 days, 40 percent of the donor group had a meaningful drop in symptoms, compared with 38 percent of the placebo group. That gap could easily be chance. Side effects were similar in both groups. The trial tested one enema in adults up to 65. Nearly 4 in 10 people improved after getting their own stool back, which shows how easily a “gut reset” can look like it works. Be wary of anyone selling a gut reset as a cure for IBS.
Key finding: A single donor fecal transplant helped 40 percent of people with IBS, compared with 38 percent who got their own stool back, which is no real difference.
Stay curious. Stay skeptical. And stay healthy.
Dr Kumar