Dr. Keith Roach
Dear Dr. Roach: I have read that there is a correlation between statin use and suicide in men over the age of 60. Could you let me know if this has been researched more?
— K.M.
Dear KM: This concern has been extensively studied.
In several large studies, fibrates, an older class of cholesterol drugs, were associated with a slightly increased risk of suicide or death from violence. However, a very large study published in 2020 showed no increased risk of death from suicide among those taking statin drugs. Statins have been found to be (moderately) effective in treating drug-resistant depression.
Men over the age of 60 are indeed at increased risk of dying from suicide, but statin drugs do not appear to increase that risk. Call the Suicide and Crisis Lifeline at 988 in the United States and 833-456-4566 in most provinces of Canada.
Dear Dr. Roach: I am 74 years old. I have always been described as “petite”. I am on statins but otherwise in good health. Recently diagnosed with osteopenia. I don’t eat dairy, but I do take vitamin D. I am a vegetarian and eat a lot of tofu. I am very concerned about taking additional medications. Please give me your suggestions.
— FMD
Dear FMD: Osteopenia, or low bone density, resembles borderline diabetes or high blood pressure. It’s not a disease per se, but it puts you on the spectrum between being at your healthiest and being at risk. There is an increased risk of fractures, especially of either the spine or hips. Low bone density is not usually treated with drugs. In addition to dietary calcium and vitamin D intake, exercise is especially recommended for lifestyle interventions to slow the loss of bone density (weight-bearing exercise, muscle strengthening, and postural exercise can help). has been proven). Smokers should quit.
The report should include T-scores comparing bone density of specific bones (such as hips and vertebrae) to healthy young adults. The worse the T-score, the closer you are to osteoporosis, and the T-score is below -2.5.
Bone density testing may need to be repeated sooner depending on how close you are to osteoporosis. Medication should be considered for people with osteoporosis. I understand the concern about taking more medicine than necessary, but I really don’t want a hip fracture to occur.
Dr. Roach writes: In a recent column on glaucoma, I described it as a disease of the retina. , examines the optic nerve behind the eye for ‘cupping’, an increase in the size of the optic nerve cup associated with retinal neuronal loss. However, the damaged area is the optic nerve, and there is a difference between intraocular pressure and blood pressure, with high intraocular pressure or very low blood pressure. Many glaucoma patients with normal intraocular pressure have low blood pressure. Lowering intraocular pressure remains the preferred treatment. We especially appreciate the explanation from his Dr. Peter Libre from Columbia University.
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