Stroke, Dementia, and Menopause: What Every Woman Over 55 Must Know

Podcast Intro and Women's Health Mission 0:00

Many, if not most of the risk factors that impact on coronary artery disease impact on what's called ischemic stroke, which is the clots and the blood vessels in the brain becoming blocked, which is the major cause of stroke. Bleeding around the blood vessels is the other major cause of stroke. Have you made it past menopause or are you going through it now? I'm Dr. Pat McShane and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menopausal years and beyond.

Guiding the way to thriving in this powerful era of your womanhood. Hello and welcome to Women's Health Span, News and Views. I'm Dr. Pat McShane and my goal in this channel is to provide you with information that can help you to lead a long, healthy life span after your menopause.

Stroke and TIA Basics 0:54

And today I'm going to be talking about a couple things that have shown up in the media recently and the news media. Which in general is a great thing, but sometimes it's very hard to interpret what they're talking about and there can be contradictory pieces of information back and forth. It's hard to know exactly what's important and what to trust. So I figure that's my job to try to bring some of this information to you. Today we're going to be talking about this structure up here inside of our skull, our brains.

We're going to be talking about dementia. and stroke, both of which are very, very important for women's health in their later years. So the Center for Disease Control, the CDC has indicated that about one in five women aged 55 to 75 will have a stroke in that timeframe. And stroke is the fifth leading cause of death for senior women in the United States. So this is quite significant. They furthermore state that four out of five strokes are preventable, which is an enormous number, and that's what this YouTube channel is all about.

What can we do to prevent these issues? The report was from the American Heart Association, and you may say the Heart Association. What are they doing talking about stroke? Well, many, if not most of the risk factors that impact on coronary artery disease impact on what's called ischemic stroke, which is the clots and the blood vessels in the brain becoming blocked, which is the major cause of stroke. Bleeding around the blood vessels is the other major cause of stroke. In either case, when the blood vessel is compromised, the downstream tissue is not getting enough blood supply and many, many physical manifestations may occur in the body, including death, if it's significant enough clot or bleed.

So, something to really pay attention to. So the American Heart Association put out what they called a scientific statement, which is really intended for medical practitioners, but is out there for the public to interpret as well. And what the focus of this statement was was transient ischemic attack or a TIA. And I'm going to read what they were quoting as being a TIA. TIA is now widely understood to be an acute neurovascular syndrome attributable to vascular territory that rapidly resolves,

Stroke Warning Signs and Emergency Response 3:40

leaving no evidence of tissue infraction on diffusion-weighted imaging MRI. A patient with resolved symptoms and MRI demonstrating infarct should be diagnosed with a stroke. Okay, so if you go to the emergency room with any of a list of symptoms I'm about to read out to you and they do brain imaging and they don't see any evidence that there's compromise of the tissue, that's considered a transient ischemic attack. And they furthermore go on to state that 18% of people with a transient ischemic attack will go on to have a stroke, often in the next two days, and around 18% within 90 days.

So that's why we're talking about this today. What can be done if you have a TIA but not a stroke? Well, the risk factors for having TIA or a stroke are being male, which fortunately we're not talking about that group, gentlemen, sorry, today, family history of stroke or TIA, age over 55, high blood pressure, diabetes, smoking, and some lesser risk factors, but these are the main ones. So if you were to go to the emergency room and they would find that your blood pressure was way high or you had diabetes and you didn't even know it, that would be considered a preventable situation and something that you would know about.

So what are the symptoms that would get you to the emergency room even if they've already resolved?

Viral Infections and Later-Life Neurodegenerative Risk 5:23

Phase drop on one side, inability to lift and hold both arms up due to weakness or numbness, slurry speech or inability to speak, complete paralysis on one side of the body, vision loss, blurry vision or double vision, which again resolves, vertigo, room spinning, confusion, and problems with balance and coordination. So what's the to-do here? Well, certainly if you have any of those symptoms or anybody in your family, go to the emergency room, even if they're done and you think, oh, that's wonderful, I'm glad that passed, just go and get evaluated and they'll do some checks and probably brain imaging as well.

Do that and then also please read down in the notes below this broadcast for the issues for stroke in women. Why do we care about this so much and some of the things that we can prevent stroke. Remember four out of five strokes are preventable and that's our work today to try to do that. The second piece of information that I thought was important for this audience, for us, is information from the UK Biobank, the United Kingdom Biobank, and a Finnish group called FinGen. And these two organizations merged their data and looked at 500,000 medical records of older individuals, more than half women, in these two countries looking at their incidence of dementia, Alzheimer's disease, Parkinson's, multiple sclerosis, and other neurodegenerative diseases after previous viral infections.

And these were hospital-based records, so they were looking at people who had had pretty severe viral illnesses that landed them in the hospital, pneumonia or encephalitis being the main ones that would get you in the hospital. So what they found reflected something that's been known for many years. And what has been known for a long time is that mononucleosis, what's the clinical result of Epstein-Barr virus is what the name of the virus is. leads to a 32-fold increase in multiple sclerosis incidents in subsequent years.

So that was already known. What was not known was that these other viral infections also led to an increase of dementias, Alzheimer's being one, and then Parkinson's, MS, and the other neurodegenerative diseases. And I'm going to put a reference to this study as well in the notes below. So what's the to-do here? Well, the vaccines are available obviously for flu, which is one of the major organisms that may cause serious illnesses, especially pneumonia, herpes zoster or shingles, which may cause encephalitis, and pneumonia, some of the viral pneumonias.

The to-do here is check up on your vaccination status.

Vaccines and Closing Takeaways 8:53

If you haven't been vaccinated for these things, it's certainly time to do so. And if you have, that's great. You have as much protection as you're going to have. One thing is that the herpes zoster or shingles vaccine has been updated in the last few years to Shingrix, which is more efficacious than the prior version that many of us had, let's say, 10 or 15 years ago when we first came to age that they recommended. So you certainly want to have that vaccination. Shingles is a terrible disease of and by itself, not to mention any dementias that may occur subsequently.

So those are my to-dos for today. I hope this information was useful. And if so, please subscribe and also place in the comments anything that you found valuable or topics that you would like me to cover. And if not, keep on doing what you can do to keep yourself as healthy for as long as you can. Thank you. Thanks for listening to the Women's Health Span Voices podcast. If today's episode spoke to you, follow the show and share it with a friend ready to take charge of her health and please leave a review.

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