VOL UME 25 • N UMBER 6 • JANUARY 2021

INSIDE
Boost vitality by engaging your brain On Call��������������������������������� 2
Continuing work and satisfaction in life can help older adults ϐϐHow important are whole grains?

Clues to cancer severity�������� 3

preserve their cognitive health. Online calculators can estimate the
growth of low-risk prostate cancer.

D eclining brain health is perhaps the Build a better core�����������������4

© supersizer | Getty Images

greatest fear of older adults. The good Loaded carry walks show the way.
news is that you can take steps to maintain Self-care for bursitis��������������� 5
your thinking and memory for many years Home remedies manage flare-ups.
to come. Get FITT for heart health ������ 6
A healthy diet, regular aerobic exercise, This program protects against heart
and proper sleep are essential to keep your attack and stroke.
brain healthy. But work engagement and life Research briefs������������������� 8
satisfaction are two additional factors that ϐϐGeneral anesthesia not linked

confer mind benefits. to higher dementia risk

Many thinking and processing skills can diminish ϐϐCertain foods and drugs protect
A study published Aug. 25, 2020, in
with age, but regular work keeps them sharp. against colon cancer
Neurology looked at factors associated with ϐϐRadiation after prostate cancer
later cognitive function in 100 older adults, enough exercise, it can become weak and surgery may not be needed
mostly men, with no diagnosed dementia. prone to problems,” says Lydia Cho, a
The participants underwent testing for neuropsychologist with Harvard-affiliated SPECIAL HEALTH REPORT FROM
HARVARD HEALTH PUBLISHING
memory and thinking skills and had PET McLean Hospital. “That is why using your Fighting Inflammation
scans to measure beta-amyloid buildup thinking skills regularly is one of the best How to stop the damage before it
in their brains. (Greater amounts of beta- ways to protect against mental aging.” compromises your health
amyloid are associated with a higher risk of www.health.harvard.edu/ui
cognitive decline.) Working on brain gains
The researchers also recorded other Staying in the workforce offers multiple FIVE THINGS TO
factors that are known to influence cognitive benefits that can help preserve and even DO THIS MONTH
function, like health history, sleep behavior, improve brain health, according to Cho.
smoking, exercise habits, depression
symptoms, and previous occupations.
For instance, working increases social
engagement and is linked to a lower risk
1 Eat more whole grains. You
need them for a proper
balanced diet. (page 2)
Everyone was then re-evaluated up to 14 of depression, both of which are associated
years later, with the participants’ average age
at the end being 92. The researchers found
with better brain health. Also, people
who continue working have some added 2 Do walk-and-carry exercises.
These moves are great for
building core strength. (page 4)
that 30% had little, if any, cognitive decline, protection against the risk of depression.
even though some had significant amyloid
deposits. These same folks did share similar
The workplace offers the chance to actively
use your mental skills, such as problem 3 Wear knee pads. They protect
your joints when you need to be
down on all fours. (page 5)
lifestyle traits. But they also were the ones solving, breaking down complex tasks,
who had continued to work many years past comprehension (understanding multiple
usual retirement age and expressed high
satisfaction with life.
sources of information), and evaluation
(judging whether a decision is correct).
4 Break up daily exercise. It
helps you reach your daily goal
when you don’t have time for a
This echoed other studies with a similar “Older adults should consider postponing regular routine. (page 6)
message: An engaged brain is a healthy full retirement as long as possible and
brain. “While your brain is not a muscle, you
might think of it in a similar way. Without
continue to work and be mentally active and
continued on p. 7 ▶▶
5 Create a pod squad. The small
group keeps you socially
engaged. (page 7)
 ON CALL
with HOWARD LeWINE, M.D., Editor in Chief

How important are whole grains in my diet?

Q I eat plenty of fruits and vegetables, but are whole
grains also important?

Editor in Chief Howard LeWine, MD

Executive Editor Matthew Solan
A Fruits and vegetables seem to get top billing on the
healthy food list, but I put whole grains right up
there. There are two types of grain: whole and refined. All
Editorial Board
Board members are associated with Harvard Medical School
grains grow as kernels, and each kernel has three layers:
and affiliated institutions. ϐϐ The inner germ contains many of the kernel’s vitamins,
Bone Disease Scott Martin, MD, Donald T. Reilly, MD, PhD minerals, and healthy oils.
Cancer Marc Garnick, MD
ϐϐ The middle layer is called the endosperm. It is primarily
Dermatology Kenneth Arndt, MD, Suzanne Olbricht, MD
Endocrinology Alan Malabanan, MD starch and provides the energy the kernel needs to grow.
Exercise/Lifestyle I-Min Lee, MD, ScD, JoAnn E. Manson, MD, DrPH ϐϐ The outer coating, known as bran, contains most of the grain’s fiber.
Gastroenterology Jacqueline Lee Wolf, MD
Common whole grains include whole-wheat flour, oatmeal, brown rice, and whole
Geriatrics Suzanne E. Salamon, MD
Heart Deepak L. Bhatt, MD, MPH, Peter Zimetbaum, MD cornmeal. Refined grains are milled, which removes the bran and inner germ. White
Neurology Gad Marshall, MD flour and white rice are examples. You want to eat more whole grains

© fcafotodigital | Getty Images

Nutrition Eric B. Rimm, ScD and restrict refined grains. When you eat a whole grain, you get
Psychiatry Ann R. Epstein, MD, Michael Miller, MD,
Ronald Schouten, MD, JD more than just the fiber from the bran. You also get all the vitamins,
Urology William C. DeWolf, MD minerals, good fats, protein, antioxidants, and other healthful
• parts of the grain’s germ. Whole grains reduce your risk of heart
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label when buying bread. foods made from refined grains.
Letters Harvard Men’s Health Watch
P.O. Box 9308
Men ages 51 and older should eat at least 6 ounces of whole grain (about 168 grams)
Big Sandy, TX 75755-9308 per day. In general, 1 ounce of whole grain equals a slice of bread, 1 cup of cereal, or
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Online
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wheat flour,” and “enriched wheat flour.” They can refer to refined white flour.
Editorial Correspondence
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The same goes for “stone-ground,” “multigrain,” “fortified,” “stoned wheat,”
Letters Harvard Men’s Health Watch “cracked wheat,” and “organic.” None of these terms guarantees that the product is
Harvard Health Publishing
Caption here—
Harvard Institutes of Medicine, 4th Floor
whole grain. And it’s not enough that “made with whole grain” appears somewhere
4 Blackfan Circle on the label because it may make up only a small proportion of the product.
Boston, MA 02115
To be sure you get real whole grains, look for the word “whole” or “whole grain”
Permissions before the grain’s name as the first ingredient; for example, “stone-ground whole
Online www.health.harvard.edu/permissions
wheat” or “100% whole wheat.” Another tip is to look for the Whole Grains Council
PUBLICATIONS MAIL AGREEMENT NO. 40906010
RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: stamp on the label. (See below for other food label examples.)
CIRCULATION DEPT., 1415 JANETTE AVE., WINDSOR, ON  N 8X 1Z1
• Know what the labels mean
Published monthly by Harvard Health Publishing,
a division of Harvard Medical School If the label says… The product contains…
In association with 100% whole grain No refined flour
B elvoir Media Group, LLC, 535 Connecticut Avenue,
Norwalk, CT 06854. Robert Englander, Chairman
Made with whole grains An unspecified amount of whole grain
and CEO; Timothy H. Cole, Chief Content Officer;
Philip L. Penny, Chief Operating Officer; Greg King,
Whole grain As little as 51% whole-grain flour
Chief Marketing Officer; Ron Goldberg, Chief Financial Good source of whole grain 15% to 25% whole grain
Officer; Tom Canfield, Chief Circulation Officer.
The goal of the Harvard Men’s Health Watch is to interpret medical Multigrain A mixture of grains, mostly refined grains
information for the general reader in a timely and accurate
fashion. Its contents are not intended to provide personal medical
advice, which should be obtained directly from a physician.
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2 | Harvard Men’s Health Watch | January 2021www.health.harvard.edu

 Predicting low-risk prostate cancer
New calculators can estimate the chance your cancer
might—or might not—become more aggressive.

A ctive surveillance is a popular

option for men with low-risk
Wagner, a urologic oncologist with the
Cancer Center at Harvard-affiliated
© picture | Getty Images

prostate cancer, defined as a tumor that Beth Israel Deaconess Medical Center.
is confined to the prostate gland and Knowing your prostate cancer’s growth risk can
unlikely to grow or spread. It involves Punching numbers help you plan for future treatment options.
monitoring prostate-specific antigen The two calculators were developed score). Although the calculators have
(PSA) levels in the blood for changes by researchers as part of the Prostate some differences, both of them provide
and having regular digital rectal exams Active Surveillance Study (PASS). (You a percentage chance that the next biopsy
to look for abnormal areas on your can find both at www.canarypass.org/ will or will not show features of a more
prostate. calculators.) They should only be used aggressive form of prostate cancer. This
During active surveillance, you have by men who have had a least one pros- information can help a man and his
a PSA test and a digital rectal exam tate biopsy. The calculators use the doctor decide to stick with the current
every six months and prostate biopsies results of subsequent biopsies done plan, wait longer to have the next biopsy,
approximately every other year. If during surveillance, along with other or begin cancer treatment now.
your PSA level rises, your doctor will measures, such as
likely recommend a prostate MRI or ϐϐ age Using the information
an immediate prostate biopsy to see if ϐϐ body mass index The calculators have been shown to be
the cancer has become more aggressive. ϐϐ PSA levels effective. A study published online Aug.
If so, you and your doctor can decide ϐϐ prostate volume (higher volume is 27, 2020, by JAMA Oncology applied the
whether to continue with active linked with a higher risk or cancer) calculators to 533 men with low-risk
surveillance and have another biopsy ϐϐ time since prostate cancer diagnosis, prostate cancer who followed active
six months or a year later, or move in years surveillance. The investigators found
ahead to treatment, such as radiation, Both calculators rely heavily on how that the results helped to better tailor
hormonal therapy, or surgery. many biopsy samples were taken, how the approach to the men’s specific risks.
many of the samples showed cancer “Therefore, men can be monitored
A popular choice and the cancer aggressiveness score of with less intensity and hopefully fewer
Active surveillance is popular because the positive biopsies (called the Gleason biopsies and less anxiety,” says Dr.
it doesn’t require any immediate treat- Wagner.
ment and is often just as safe (or safer) Keep in mind that the calculators
than starting treatment right away. Still,
What are the odds? offer only an estimated outcome. For
the approach has its downside, such as What risk percentages from the instance, a 10% chance your cancer
the potential for wait-and-see anxiety, calculators are considered “good”? will get upgraded by the time of your
the necessity for repeated PSA tests It varies from person to person, and next biopsy or over the next four years
(which are not always definitive), and depends on multiple factors besides is considered relatively low.
the pain and risk of repeated biopsies. a number—like age, other health “But that doesn’t mean your cancer
Two newly created online calculators issues, and a person’s risk tolerance, won’t become more aggressive,” says
could help with these issues. They according to Dr. Andrew Wagner, a Dr. Wagner. “It just means you could
estimate how likely is it that low-risk urologic oncologist at Harvard- consider skipping your biopsy and
prostate cancer will progress and affiliated Beth Israel Deaconess waiting longer to see if you need to
invites a more nuanced approach to Medical Center. “Some men may begin treatment.”
be fine with anything less than 50%,
surveillance regimens. Men are encouraged to ask their
while others want less than 10%,” he
“With this information, men can doctors to help them work through the
says. “In general, we have found that if
have a conversation with their doctor PASS calculators. Alternatively, they
the risk of cancer progression is less
about how they may want to approach than 20%, most men are comfortable can use the calculators themselves,
their active surveillance strategy continuing with active surveillance.” provided they have the necessary
moving forward,” says Dr. Andrew information.
www.health.harvard.edu January 2021 | Harvard Men’s Health Watch | 3
How to build a better core
Your core is more than just your abdominals—it also
involves your hips, back, and even your shoulders. To
strengthen your entire core, take a loaded carry walk.

© FreshSplash | Getty Images

our core is the stable part of your musculature, including your shoulders,
body that helps make everyday back, and hips,” says L’Italien. Loaded
movements more efficient and safe— carries also can improve everyday
like whenever you reach, carry, walk, movements like holding and carrying
bend, or twist. A strong core offers groceries, moving furniture, or rising
other health benefits as you age in out of bed. Loaded carries are easy-to-do alternatives to
regular core-building exercises.
addition to proper movement (see “Get
more from your core”). Hold and stroll carry, maintain proper posture, and
Some floor exercises like the plank Here are three easy-to-do loaded carries try to keep the tension in your abs as
and superman poses are great for to try. You can perform them together you move. Rest for 30 seconds, and
engaging your core muscles. A plank as a core-only workout or add one or repeat until you’ve completed two or
pose is where you hold a push-up more to your usual exercise routine. three sets. “If it feels easy, extend the
position—with straight arms or resting “Do them before your regular walking time, or add more weight,” says
on your forearms—for 10 to 30 seconds. workout to make your workout more L’Italien. “If it’s too difficult, shorten the
With superman, you lie facedown challenging, or afterward, if you want walking time to 30 seconds or reduce
with arms extended overhead, and you to make the loaded carries feel more the weight.”
lift legs, shoulders, and arms off the strenuous,” says L’Italien. (If you’re not Cross-body carry. This is performed
floor simultaneously and hold for two already doing strength training, or you like the farmer’s carry, except you keep
to three seconds. have a chronic health condition, first one arm straight overhead with the
check with your doctor.) other hand down at your side as you
Increase the load Farmer’s carry. Stand tall and hold walk. After you have completed your
But if you want a different core workout, either a dumbbell or kettlebell in each walk, rest for 30 seconds, switch hand
consider walk-and-carry exercises, hand. (Begin with a moderate weight, positions, and repeat. This completes
says Eric L’Italien, a physical therapist like the amount you use to do biceps one set. Do two or three sets.
with Harvard-affiliated Spaulding curls.) “The slight weight imbalance will
Rehabilitation Center. He calls these Keep your arms down at your sides. challenge your core in different ways,”
moves “loaded carries” because you Engage your core muscles by taking in says L’Italien. If holding the weight
hold weights, such as dumbbells or a deep belly breath and then blowing it overhead is too hard, keep it at shoulder
kettlebells, while walking. out while you tighten your abs. Walk level. Adjust the weight and walking
“Carrying a heavy object while you for a minute. (You mimic a farmer time, as needed.
walk teaches you to brace your core, carrying pails of milk, hence the name.) Suitcase carry. This is also done
which engages much of your entire core Continue to breathe throughout the like the farmer’s carry, except you
hold a weight in only one hand while
your other hand is free. After you
Get more from your core have completed your walk, rest for 30
Core strength has far-reaching benefits. For instance, significant weakness in core seconds, switch the weight to the other
musculature may contribute to a forward head posture and an increase the upper hand, and repeat the walk to finish one
back’s curvature, which can trigger neck and shoulder pain. Sore knee or hip? Core set. Do two or three sets.
weakness can be the main contributor. Your core also is one of your biggest protectors “With all the weight on one side, it
from a back injury. Core strength is also crucial for fall prevention. “Our bodies forces you to work harder to maintain a
constantly have to adapt not only to different surfaces, but different weighted loads,” neutral position so you don’t lean while
says Eric L’Italien, a physical therapist with Harvard-affiliated Spaulding Rehabilitation you walk,” says L’Italien. “This helps to
Center. “Adequate core stability and strength can prepare you to better react to these ensure symmetry in your core strength
changes and keep you from losing your balance and stumbling.” and protect your back when carrying
heavy or awkward objects to one side.”
4 | Harvard Men’s Health Watch | January 2021 www.health.harvard.edu
 Self-care for bursitis ϐϐ Take a common over-the-counter
nonsteroidal anti-inf lammatory
These painful flare-ups can occur suddenly and for no drug—such as ibuprofen (Advil) or
apparent reason. Here’s what you can do about them. naproxen (Aleve)—or acetaminophen
(Tylenol) to help with pain. But make
sure not to exceed the proper daily

H ave you ever woken up with a

mysterious egg-shaped swelling
dosage.
© Daisy-Daisy | Getty Images

on your elbow or knee and have no clue When to seek help

what caused it? There is a good chance It often takes a week or longer for the
you have bursitis. pain and inflammation to subside, so
“Bursitis is definitely more common you have to be patient and diligent with
as you get older and just comes with the your self-care.
territory of living a longer and more “See your doctor if the pain does not
active life,” says Dr. Robert Shmerling, improve, as it might be a sign that there
senior faculty editor at Harvard is something other than bursitis going
Health Publishing and Corresponding on,” says Dr. Shmerling.
Member of the Faculty of Medicine at If there is obvious swelling, have
Harvard Medical School. it checked out by your doctor to rule
out an infection that would require
A look at the bursa antibiotics. Rarely, surgery is needed
Bursitis is an inflammation of the when an infection persists or recurs
bursa, a small fluid-filled sac that works despite treatment.
as a cushion between a bone and the If there is no infection and the
surrounding muscles, tendons, or skin. problem persists, your doctor may use
It often strikes the knee and elbow, corticosteroid injections into the area
but is even more common in the hip, Simple home remedies like applying ice packs around the painful bursa to speed up
can calm inflammation and ease bursitis pain.
shoulder, and heel. the healing.
When it affects the elbow, the front or standing from a seated position. You can protect yourself from
of the knee, or the heel, the inflamed Knee bursitis may hurt whenever the repeated flare-ups by being mindful
area may become painful or tender to joint is fully flexed. about overstressing your joints. Wear
touch, warm, and reddish. It’s typical “Because the pain and inflammation knee pads when you have to kneel for
for it to swell up to resemble a goose egg don’t always occur right after a any length of time. Take regular breaks
or small balloon. But in the shoulder particular activity or injury, bursitis when doing repetitive work.
or hip, the painful area usually appears often feels like it comes out of the blue, If you suffer from knee or shoulder
normal. and you may not associate it with a bursitis, do regular stretching exercises.
People get bursitis from an injury specific cause,” says Dr. Shmerling. (See a physical therapist to learn the
or overuse of a joint, like excessive best and safest movements for your
kneeling when gardening or doing Take care specific condition.) Also, losing excess
house projects or leaning on your Self-care is the best way to begin weight can help reduce stress on the hip
elbows against a hard surface for treating most cases of bursitis. For and knee that can lead to bursitis.
long periods. Even doing repetitive example:
movements like painting a ceiling, ϐϐ Rest the area as much as possible for
exercising with improper form, and several days.
Bursitis or arthritis?
walking with poor mechanics can ϐϐ Apply ice packs to the painful area for Bursitis also may be mistaken for
increase your risk. 20 minutes three or four times a day. arthritis because it occurs near a joint.
With bursitis, the joint’s range of ϐϐ Wear compressive sleeves or wrapping
You can often tell the difference by
motion may be normal, but you feel around the painful area. the particular location of the pain or
pain during specific movements; for ϐϐ Use over-the-counter topical pain
swelling and by moving the joint. If
example, if you have hip bursitis, pain relievers. Look for products that it hurts with pressure but the joint
can occur from lying on your side when contain lidocaine, salicylates, or moves well, it’s prob­ably not arthritis.
sleeping, walking up and down stairs, diclofenac.
www.health.harvard.edu January 2021 | Harvard Men’s Health Watch | 5
Get FITT to better fight
heart disease
If you’ve been diagnosed with heart
disease, the FITT approach can reduce
your risk for heart attack and stroke.

A bout half of all Americans have at prevention list.

© kali9 | Getty Images

least one of the key risk factors for For instance, it
heart disease, such as high cholesterol, helps burn cal-
high blood pressure, and excess weight. ories and fat for
Any kind of regular activity that you enjoy and works up a good sweat is
You can address those risks with a weight loss. It ideal for managing the many risk factors for heart disease.
heart-healthy diet and medications to can keep arter-
lower blood pressure and cholesterol ies from getting stiff from aging, which Your doctor or cardiologist can
levels. But perhaps the biggest boost translates to better blood pressure read- work with you to create an exercise
you can give your heart is regular ings and less stress on the heart. Aerobic program tailored to your specific
aerobic exercise. exercise also keeps blood sugar levels in heart health needs, fitness level, and
“If you have been diagnosed with check and fights heart-damaging stress personal interests. It often follows a
heart disease or are at high risk for the and inflammation. simple formula called FITT: Frequency,
condition, then you have to work with Most people recognize that exercise Intensity, Time, and Type.
your physician to create a plan to get is good heart medicine. Still, those with “The approach is no different than
up and get moving,” says Dr. Sawalla heart disease or at high risk for it may what people need for general health
Guseh, a cardiologist with Harvard- feel uneasy about putting their heart and wellness,” says Dr. Guseh. Here
affiliated Massachusetts General through that kind of stress. is a look at what your program may
Hospital. “Some people may think that if they include.
move too much, they’ll have a heart Frequency. Federal guidelines
Checking the boxes attack,” says Dr. Guseh. “But regular recommend a minimum of 150 minutes
Aerobic exercise checks off multiple heart-pumping exercise is exactly what of moderate-intensity aerobic exercise
boxes on the heart attack and stroke they should do.” over five days per week. The more you
can do beyond this—like up to 300
minutes—the better.
Give your heart a lift Intensity. A moderate level of
Recent guidelines emphasize the intensity is ideal. “This amount of effort
importance of strength training to makes the body and heart work enough
complement—but not substitute for— to get the benefits of exercise, but not
aerobic exercise. They suggest two to too much, where it places a person at
three days a week of strength training. risk,” says Dr. Guseh.
You should do 10 to 15 reps for each But what does “moderate intensity”
set of exercise at 40% to 60% of your © kali9 | Getty Images
feel like? “Intensity is highly personal,”
one-repetition max (the maximum says Dr. Guseh. “What is low intensity
amount of weight you can safely lift one for one person is high for another, and
time). Your routine should consist of vice versa, and depends a great deal on
eight to 10 different upper- and lower- a person’s current fitness level.”
body exercises. It’s best to consult a To find that sweet spot of moderate
personal trainer to set up the right
intensity when exercising, use the
routine and help you choose the proper
simple “talk test.” “If you can carry on
weights. Even during the pandemic,
a conversation without laboring while
many gyms offer one-on-one personal
training or Zoom sessions. You can then exercising—but you can’t sing—that’s
perform the exercises at home. a good measure of moderate intensity,”
says Dr. Guseh.
6 | Harvard Men’s Health Watch | January 2021 www.health.harvard.edu
 Always remember that exercise You also don’t have to do your work- you are much more likely to be more
should feel good, he adds. “Listen out all at once. “You can break up your committed,” says Dr. Guseh.
to your body. If you experience any workouts throughout the day, like some Type. It’s a cliché, but the best aerobic
discomfort, then back off, and if you time in the morning and then again in exercise really is the one you enjoy. “If
feel any chest or shoulder pain, or even the early evening,” says Dr. Guseh. you like a particular type of activity, you
jaw pain, see your doctor.” Also, don’t skip exercise if you can’t are more likely to stick with it. It’s that
Time. It doesn’t matter how you do your regular routine, or even if it’s simple,” says Dr. Guseh. “Anything that
get in at least 150 weekly minutes. less than moderate intensity. “A low- gets you winded and works up a light
“Dividing that time into 30-minute level activity for 10 minutes is always sweat is ideal.”
workouts most days of the week better than nothing,” he says. Many activities meet the definition
means you won’t do too much at one If lack of motivation keeps you from of low-to-moderate intensity, such
time,” says Dr. Guseh. “But you might putting in the required time, enlist a as racquet sports, swimming, speed
prefer longer sessions, say one hour of workout partner (while adhering to walking, cycling, mid- or long-distance
exercise three days per week. Inevitably, COVID physical distancing guidelines). running, treadmill workouts, and even
how you get in that time is up to you.” “When you are accountable to others, gardening or dancing.
© Riska | Getty Images

Engage your brain … from p. 1 purpose, according to Cho. Working

and volunteering can help fulfill this
engaged,” says Cho. “Many people look need, but overall life satisfaction can be
forward to retirement only to find that much more. “It’s also about pursuing
they have nowhere to be and nothing new goals and having a general
to do.” If you do retire, then consider enthusiasm for life,” says Cho. This
other meaningful activities, whether can mean re-evaluating your interests
that is spending quality time with to focus more on personal development
family or working on hobbies. and growth. “See this point in your life
Even if you don’t need the money, as an opportunity for new adventure Create a pod squad
getting compensated for work offers a and discovery,” says Cho. Can’t work or volunteer right now
mental boost because it validates your If you need a spark, she suggests because of the COVID-19 pandemic?
worth, says Cho. “It shows that you revisiting interests you put aside There are ways to replicate these
still have value to others and the world, when you were younger, or taking on positive social interactions.
and that what you do is important and something you have always wanted
needed.” to explore. For example, sign up for Lydia Cho, a neuropsychologist with
Another bonus: any extra money college classes in subjects that now Harvard-affiliated McLean Hospital,
can be put toward things you would stimulate your mind and interest, like suggests creating a personal “pod”—
not otherwise do and that might also history, writing, or science. an intimate small group that you
support brain health, like personal You can take many courses online or interact with regularly. “This could be
training sessions or stress-reducers like via Zoom, and many are free for older your kids or siblings, or even a select
massages and vacations. adults; check out www.health.harvard. group of friends,” she says.
If you cannot hold a traditional job edu/waiver.
Schedule regular meet-ups so it
now because of the pandemic, consider Platforms such as Skillshare (www.
becomes a habit and not something
volunteering. Many opportunities skillshare.com) offer online classes
can be done online or from home. and tutorials on a variety of creative you do only when the need arises. If
“Volunteering offers many of the same subjects. And many local community you can’t safely meet in person (while
brain-building skills as a regular job,” and senior centers offer workshops in practicing safe social distancing), use
says Cho. which you can learn a new skill or polish Zoom or FaceTime on your computer
an older one, such as public speaking, or phone.
Get some satisfaction cooking, or home maintenance. Ask family or friends to assist with the
Life satisfaction—how you feel about “Look at what excites you and makes technology if necessary. You can also
your current life and its direction—is you happy, and try to do more of that,” learn more about how to use Zoom at
often a struggle for people as they age says Cho. Your brain will thank you for www.health.harvard.edu/zoom.
because they no longer feel a sense of many years to come.
www.health.harvard.edu January 2021 | Harvard Men’s Health Watch | 7
 IN THE JOURNALS

General anesthesia does nonsteroidal anti-inf lammatory

not appear to increase drugs (NSAIDs)—such as aspirin,
dementia risk ibuprofen (Advil, Motrin), and
Because older adults often experience naproxen (Aleve)—and a higher
temporary changes in memory intake of fruits, vegetables, and
and thinking after having general fiber. But other studies did not.
The findings did not provide

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anesthesia, they may worry that it
Rest assured that long-term clear-cut information on doses and
increases their risk of dementia. A memory and thinking is not
recent study should help put their affected by general anesthesia. durations of supplements and food
minds at ease. Researchers found or whether certain ones were better.
no association between the type of anesthesia and Most importantly, there is no proof that NSAIDs
dementia risk, according to findings published prevent colon cancer in the general population, and
online Oct. 6, 2020, by the Journal of the American therefore you should not take an NSAID just for
Geriatrics Society. cancer prevention unless advised by your doctor. But
The study looked at almost 7,500 people ages 66 making some nutritional adjustments in your diet,
or older without diagnosed dementia who underwent like adding more fruits and vegetables and getting
surgery requiring either general anesthesia (where more fiber is reasonable, since these offer other
you are unconscious) or regional anesthesia (where health benefits as well.
you are awake and the surgical area is numbed). The
researchers included only people who had not had Radiation after prostate cancer
any previous surgery and stopped assessing those surgery may not be necessary
who had a second surgery later. Many men with prostate cancer who have a radical
Participants were then monitored for up to prostatectomy (prostate removal) receive radiation
five years. The investigators found no statistical therapy afterward to wipe out any residual cancer
difference in people’s risk of being diagnosed with cells. Alternatively, men can choose to delay
dementia whether they had general anesthesia or radiotherapy and be monitored for evidence of
regional anesthesia. The researchers added that the prostate cancer activity, such as a rising blood level
risk also did not vary based on a person’s age at the of prostate-specific antigen (PSA). If PSA testing or
time of surgery. an imaging test like an MRI shows cancer, these men
can then consider radiation therapy.
Certain foods and drugs may lower According to the findings of an analysis published
risk of colon cancer online Sept. 28, 2020, by The Lancet, there is no clear
Colon cancer prevention involves following a healthy benefit of immediate radiation over monitoring with
lifestyle—for instance, exercising and not smoking— later radiation therapy as necessary. Since some
and periodically getting a screening men will never need radiotherapy, this means that
IN FUTURE test such as a colonoscopy. But what by forgoing immediate treatment, they can avoid
ISSUES: impact do diet and medications potential side effects like incontinence and bowel
have? A recent review of 80 statistical problems.
ϐϐ Protect analyses published over the last 40 To do the study, researchers combined data
yourself from years explored this question. The from three randomized trials, involving a total of
review was published online Oct. 1, more than 2,000 men who had undergone a radical
ministrokes prostatectomy. The men were assigned either to
2020, by the journal Gut.
ϐϐ Tests for Over all, the results were receive immediate radiation or to be monitored and
disappointing in that no specific given radiation only if signs of cancer emerged. The
flexibility
drug, food, or supplement stood analysis showed that both approaches had similar
ϐϐ How music out in the body of evidence. Yet outcomes, with no difference in cancer recurrence
some of the reviewed studies within five years. The researchers suggested that
can improve
did show a link between a lower monitoring with later radiation therapy only if
your health risk of colon cancer and use of needed now may be the preferred strategy.

8 | Harvard Men’s Health Watch | January 2021 www.health.harvard.edu