Why you don’t take your medications; how stress dims cognition

Q: My dad’s 82 and has been prescribed a statin and oral medication for Type 2 diabetes – but I can’t get him to take them regularly. Any ideas? – Sheena R., Omaha, Nebraska A: That’s a common problem. A new study published in JAMA Network Open found that more than 20 percent of patients at high risk of developing cardiovascular disease refuse to take statin medications. The result? Those folks’ elevated lousy LDL cholesterol levels increase their risk of a cardiac event. And statins aren’t the only meds folks skip. The American Medical Association says that patients intentionally don’t take their medications as prescribed about half the time and approximately a quarter of new prescriptions go unfilled. On top of that, most patients who decide not to fill a prescription or take a medicine don’t tell their doctor or their family.

The most common reasons that someone skips medications are: – Fear of side effects (even if they don’t experience them) – Misunderstanding of how long it takes a medication to deliver benefits and how important it is to continue taking medication once benefits are realized.

– Lack of understanding of the diagnosed condition – either because there are no symptoms (common with high blood pressure) or because the doctor hasn’t clearly explained what’s being treated. The AMA says inadequate communication accounts for 55 percent of medication non-adherence.

– Taking too many pills. More than a third of older folks take five or more meds and that can be confusing and irritating. The smart move is to review what’s prescribed with the doctor: See if any can be discontinued, if two medications can be consolidated into one pill, if long-acting versions are available, and if the daily timing can be streamlined.

– Cost can be a factor. Have the doctor check for alternative medications or generic drugs that are less expensive; explore cost breaks from drug manufacturers; look at Mark Cuban’s Cost Plus offerings (costplusdrugs. com).

Review these possible reasons with your dad – and good luck!

Q: Between COVID-19, changing jobs, my mom dying and the onslaught of daily news, I feel like my brain has slowed down and I am living in a fog. I’m 47 and in good health otherwise. What’s going on? – Lee-Ann F., Stuart, Florida A: Unmanaged stress has far-reaching effects on all your body systems. It changes hormone and neurotransmitter levels that control or influence everything from digestion to your heartbeat and eating habits. Even one major stressful event can immediately dim your thinking and make it harder to do cognitively challenging tasks. And chronic stress causes sleep problems and impairs immune function. But stress’s major effect is on your brain – affecting mood and cognition. In fact, a new study in JAMA Network Open that looked at more than 24,000 men and women ages 45 to 98 found that folks who reported living with elevated stress were 137 percent more likely to also report problems with thinking.

Exercise is a powerful de-stressor. A study in BMJ Sports Medicine found that physical activity is 1.5 times more effective at reducing mild-to-moderate symptoms of depression, psychological stress, and anxiety than medication or cognitive behavior therapy. And short bursts of moderate or intense movement are most effective. I urge you to adopt a walking/aerobic routine (aim for 10,000 steps a day or the equivalent) and do strength-training at least twice a week.

You may also benefit from changing your diet so it’s less inflammatory by eliminating highly processed foods, added sugars and red and processed meats. Improving the health of your gut biome with high-fiber, nutrient-rich fruits and veggies can boost your mood! Meditation with deep breathing also can help. For deep breathing, focus on your belly button moving outward as you inhale and inward as you exhale (slowly 10 times). Doing that before bed is a great way to improve your sleep – and your thinking.

Life dishes out challenges, but you have the tools and the power to manage the stress effectively.

Health pioneer Michael Roizen, M. D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “ The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@ GreatAgeReboot. com. ( c) 2023 Michael Roizen, M. D. Distributed by King Features Syndicate, Inc.