Residents across the county are noticing swans straying from their habitats, wandering onto roads, drive-ways and parking lots, often disheveled and disoriented.
Lisa Jaeger, who runs an animal rescue business, has already picked up six swans this year, a number she says is above normal. In fact, Jaeger was relocating a swan that was found on 25A only hours before her phone interview with TBR News Media. In her ten years of running her business, Jaeger said she has never noticed such an influx of displaced, sick or even dead swans.
“It is very bad. One of them we found dead on the beach on Shore Road” Jaeger said. “It’s horrible. It’s just horrible.”
Swans are extremely territorial creatures and after mating, reside in one area for the rest of their lives. They may leave that area if pushed out after fighting with another swan or if they are confused and unable to navigate back. Lead poisoning is the likely cause.
“[Lead poisoning] is very common,” Adrienne Gillepsie, wildlife rehabilitator at Evelyn Alexander Wildlife Rescue Center in Hampton Bays. “Every single swan that we admit to this center, and we get a lot, has lead poisoning.”
Jaeger frequently travels to the rescue center to drop off swans, if they have room. The Evelyn Alexander Rescue Center is the only wildlife center in Suffolk County that has a large waterfowl pen. Other centers have smaller pens and are only capable of taking a few waterfowl.
Lead poisoning affects the swans’ central nervous system and can cause the swans to neglect their grooming, becoming dirty and odorous as a result. They can become sluggish and confused or lose control of their legs and wings and become grounded. When this happens, the swan may try to eat dirt or sand, compounding their sickness.
“If they don’t get treated, it is a death sentence and it is very, very slow. They are uncoordinated, they can drown, they get hit by cars…they slowly just go downhill because they don’t have that medicine or treatment,” Gillepsie said.
Gillepsie estimated that when she started 12 years ago, only around half of swans that were brought in had lead poisoning; now, she said it was essentially a guarantee that a bird would show high levels of lead when given a blood test.
Gillespie and her team administer a treatment called chelation therapy, a 5-day treatment that flushes the toxic metals from the swan’s system. They administer dimercaptosuccinic acid to extricate the heavy metals. This treatment is repeated until lead levels are low enough for the swan to be released.
Swans must be returned “exactly where they came from.” They are invasive and aggressive, so relocating them is problematic not only to other swans, but also to the surrounding ecosystem.
The cured swans return to their nest site, ingest the same contaminated vegetation or lead shots. Gillespie said they regularly get “repeat offenders”.
Other birds like hawks, owls, loons, ducks, and canadian geese can also get lead poisoning, but not as frequently as swans.
Lead shot and pellets were outlawed in 1991. The sale of lead fishing sinkers under one-half ounce or less was banned in New York in 2002 as it was the leading cause of death for the common loon.
Exercise helps build long-term physical and mental health, but regular exercise is often a challenge. Even with all the fitness-related apps to prompt us, modern society has an equal number of tech demotivators. It’s just too easy to let the next episode of our favorite series autoplay or to answer those last few emails.
Even if we want to exercise, we “don’t have time.”
I have good news. There is an easy way to get tremendous benefit in very little time. You don’t need expensive equipment, and you don’t have to join a gym. You can even sharpen your wits with your feet.
Esther Tuttle was profiled in a New York Times’ Science Times article a few years ago, when she was 99. Esther was sharp as a tack and was independently mobile, with no mobility aids. She remained active by walking in the morning for 30 minutes and then walking again in the afternoon.
Of course, this story is only anecdotal; however, evidence-based medicine supports her claim that walking is a simple way to get exercise that shows incredible benefits. One mile of walking a day will help keep the doctor away. For the step-counters among you, that’s about 2,000 steps a day for an adult with an average stride length.
Does walking improve mental acuity?
Walking has a dramatic effect, preserving brain function and even growing certain areas of the brain (1). Study participants who walked between six and nine miles a week, or just one mile a day, reduced the risk of cognitive impairment over 13 years and actually increased the amount of gray matter tissue in the brain over nine years.
Participants who had an increase in brain tissue volume also experienced a substantially reduced risk of developing cognitive impairment. Interestingly, the parts of the brain that grew included the hippocampus, involved with memory, and the frontal cortex, involved with short-term memory and executive decision making. There were 299 participants with a mean age of 78. All were dementia-free at the trial’s start.
In another study, moderate exercise reduced the risk of mild cognitive impairment with exercise begun in mid-to-late life (2).
If you’re pressed for time or building your stamina, you can split a mile into two half-mile increments. How long does it take you to walk a half-mile?
Does walking affect one’s mood?
Researchers performed a meta-analysis of studies related to the relationship between exercise and depression. They found that adults who walked briskly for about 75 minutes per week cut their risk of depression by 18 percent (3).
If you ratchet up your exercise to running, a study showed that mood also improves, reducing anger (4). The act of running increases your levels of serotonin, a hormone that, when low, can make people agitated or angry.
How do I build better habits?
A common challenge I hear is that working from home reduces much of the opportunity to walk. There’s no walking down the hall to a meeting or to get lunch or even from the car or train to the office. Instead, everything is only a few steps away. Our work environment is working against us.
If you need a little help getting motivated, here is a terrific strategy to get you started: set an alarm for specific points throughout your day and use that as a prompt to get up and walk, even if it’s for only 15 minutes. The miles will add up quickly.
A client of my wife’s schedules meetings for no more than 50 minutes, so she can walk a “lap” around her house’s interior between meetings or even do some jumping jacks. She also looks for opportunities to have an old-fashioned phone call, rather than a video call, so she can walk up and down the hallway while she’s meeting. Of course, this is one person, but it might prompt some ideas that will work for you.
Walking has other benefits as well. Weight-bearing exercise helps prevent osteoporosis and osteoporotic fractures. Sadly, if you don’t use them, bones weaken and break. Walking is a weight-bearing exercise that helps strengthen your joints, bones and muscles.
Remember to use your feet to keep your mind sharp and yourself even-tempered. Activities like walking will help you keep a positive attitude, preserve your bones and help increase the plasticity of your brain.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
As a former senior investigator for the New York State Attorney General’s Office who spent twenty years investigating health fraud, I was truly annoyed when I discovered how hospitals are paid, and not paid, by insurers and individuals.
Keep in mind that hospitals are required by federal law to provide emergency care and stabilize all patients regardless of a patient’s ability to pay. As a result, hospitals provide more than $40 billion a year in unpaid care for patients who can’t afford to pay their hospital bill.When patients don’t pay for their hospital care, those costs are shifted to health insurers who are charged higher rates by hospitals to make up for the losses from non-paying patients.
However, uncompensated hospital care is not shared equally by private and government health insurers. According to a study by the Rand Corporation, private plans pay hospitals 241% more than Medicare for the same service. This amounts to a sneaky tax on the 216 million Americans covered by private insurance plans.
American taxpayers fund all or part of government health insurers such as Medicare and Medicaid. Yet, the American Hospital Association reports that hospitals received payments of only 82 cents for every dollar that was spent on Medicare patients in 2022. I get it. Medicare negotiates rates for more than 60 million people, and they squeeze every drop of leverage out of hospital administrators.
But wait, why are American workers being forced to pay higher premiums for their private health insurance when they are also funding the government plans? Whoa, wait a minute! That would be like selling a car for $50,000, but if you were a stockholder in the company the same car would cost more than $100,000. It sounds ridiculous, because it is. Especially, when a commonsense solution is within reach.
Simplify hospital reimbursement rates by having Medicare negotiate the same rate for all private and government insurers as a volume purchaser for 330 million Americans. By negotiating fair and reasonable reimbursement rates with just one insurer, hospitals would save money by reducing the number of administrators and consultants that are needed to negotiate with numerous private and government health insurers year after year.
Hospitals throughout the United States are in dire economic straits due to workforce shortages, inflation, cyber-attacks, unfunded government mandates and oppressive bureaucratic regulations. For example, the American Hospital Association reported in September 2024, “Recent data from Strata Decision Technology show that administrative costs now account for more than 40% of total expenses hospitals incur in delivering care to patients.”
A Medicare, “one-size-fits-all,” hospital reimbursement program would streamline administrative costs, save taxpayer money, reduce health insurance premiums and ensure that America’s hospitals remain best in class.
Thomas M. Cassidy, an economist, is the author and creator of the independent feature film, Manhattan South, which is in development. (ktpgproductions.com)
One of the best ways to prioritize your vitality is with an annual health exam. That’s especially true for older adults, who tend to have more health issues to manage, according to Dr. Grant Tarbox, national medical executive with Cigna Healthcare’s Medicare business.
Dr. Grant Tarbox
Annual exams can vary and go by different names, depending on your coverage. Generally, they are offered at no cost to you through Medicare or Medicare Advantage (MA) and there are a host of reasons to get one, Tarbox said, including the following:
Having a health care team leader. It’s important to have a trusted advisor leading your health care team. That is the purpose of a primary care physician (PCP). A PCP knows your family and treatment histories and concerns. They play an important role keeping a broad view of all your care needs and can help you navigate them. By visiting your PCP at least annually, you maintain a critical relationship that will serve you well when you need it.
Putting a plan together. Your annual exam is the time to discuss which health screenings and immunizations could be important for you based on your age, gender, and medical and family history. These include such things as a flu shot, a mammogram, or a colorectal screening. Talk to your doctor about what preventive care activities are right for you and put together a plan to get them. Most are covered at no extra cost through Medicare or MA.
Addressing conditions before they worsen. Aging increases the risk of certain chronic illnesses such as hypertension, heart disease, diabetes and arthritis. Ignoring these conditions won’t make them go away. Always tell your health care provider about any recent changes you are experiencing. Working with your provider to proactively manage a chronic condition before it worsens helps you to maintain your independence and vitality.
Reviewing medications. If you take one or more medications, an annual exam is a good time to review them with your PCP. You may even want to take your prescriptions to your appointment. Are these medications effective? Are you taking them as prescribed? Are there any undesirable side effects? Are there potential harmful interactions, including with over-the-counter drugs? You also can secure your refills and maybe even shift to home delivery for convenience or to save money.
Making lifestyle adjustments. Even small changes can help you live longer and better. Talk honestly with your health care provider about your lifestyle. They may recommend changes, such as exercising, stopping smoking, or eating healthy.
Checking on your mental health. Your emotional health impacts your physical health. Depression doesn’t have to be a part of aging. Let your health care provider know if you are feeling sad, anxious or hopeless. They may recommend increasing your social interaction. Additionally, treatments, such as talk therapy, medication or both, may be covered by Medicare or MA.
For more tips on how to make the most of your annual exam, visit https://www.cigna.com/medicare/member-resources/#media-resources.
If those aren’t compelling enough reasons to get an annual health exam, then consider the fact that some Medicare Advantage plans will even pay you an incentive to ensure that you get one, said Tarbox. He added that you may also want to see your dentist and eye doctor annually to ensure whole body health. Those visits are among the extra benefits often covered by an MA plan, he said. (StatePoint)
For the fourth year running, Jefferson’s Ferry in South Setauket has earned a Choice Community Award from Holleran Consulting, based on the outstanding results of ayearly survey of its residents. Holleran has the largest benchmark of senior living engagement scores by which Life Plan Communities can compare performance relative to their peers.
The Choice Community Award is widely recognized as the gold standard in the senior living industry. Recipients of the award have exceeded the national benchmarks for resident engagement and satisfaction.
“The Choice Community Award is based entirely on feedback from our residents, making this vote of extremely high satisfaction particularly meaningful to our entire team,” explained Vice President of Resident Life Linda Kolakowski. “Participating in Holleran’s Resident Engagement survey is strictly voluntary, so we’re doubly appreciative that our residents have taken the time to express their views and share their insights. Their feedback and the dedication of our team members make Jefferson’s Ferry one of a kind.”
“Our mission is to provide our residents with the exceptional, engaged, and active lifestyle that they expect and deserve,” added Jefferson’s Ferry President and Chief Executive Officer Bob Caulfield. “Our lifestyle promotes independence, individuality, dignity, privacy, security, and peace of mind for each resident through a focus on resident programs, service and outstanding health care.
“People choose to live at Life Plan Communities with an expectation of a continuation of care as their needs change,” continued Caulfield, “but what makes Jefferson’s Ferry stand above other Life Plan choices is the culture of community specific to Jefferson’s Ferry. In our almost 25 years of operation, Jefferson’s Ferry has developed a distinct vibe and tradition of caring for each other as neighbors and friends. The feeling of home and the security it provides is a key component of life at Jefferson’s Ferry. Cultivating that special bond and engagement our residents and staff experience is a cornerstone of our community.”
Stony Brook Medicine participates in the American Heart Association's "Go Red for Women" campaign to raise awareness about cardiovascular disease.(2/7/25)
On Friday, February 7, National Wear Red Day®, staff from Stony Brook University Hospital wore red to help raise awareness of women’s No. 1 killer – cardiovascular disease. The annual #WearRedDay during American Heart Month honors those we have lost to heart disease and aims to raise awareness of the actions we can all take to prevent it.
Your heart disease risk is influenced by your family’s history. Can you overcome these genetic issues by making lifestyle changes that improve your health trajectory? It’s the classic heredity vs. environment dilemma. Let’s look at the evidence.
A study involving the Paleo-type diet and other ancient diets suggests that cardiovascular disease is influenced by genetics, while another study considering the Mediterranean-type diet suggests that we might be able to reduce our risk factors with lifestyle adjustments. Most of the risk factors for heart disease, such as high blood pressure, high cholesterol, sedentary lifestyle, diabetes, smoking and obesity are modifiable (1).
How do our genes affect our heart disease risk?
Researchers used computed tomography scans to look at 137 mummies from Egypt, Peru, the Aleutian Islands, Southwestern America, and others (2). The represented cultures included hunter-gatherers (consumers of a Paleo-type diet), farmer-gatherers and solely farmers. All the diets included significant amounts of animal protein, such as fish and cattle.
Researchers found that one-third of these mummies had atherosclerosis, or plaques in their arteries, which is a precursor to heart disease. This is a familiar ratio; it’s what we still see in modern times.
The authors concluded that atherosclerosis could be part of the human aging process. In other words, it may be embedded in our genes. We all have genetic propensity toward atherosclerosis and heart disease, some more than others.
However, other studies demonstrate that we can reduce our heart disease risk with lifestyle changes, such as with a plant-rich diet, like the Mediterranean-type diet.
How does diet affect ourgenetic response?
A study of 7,000+ participants in Spain who were at high risk for cardiovascular disease examined the impacts of a Mediterranean-type diet and a low-fat diet on cardiovascular disease risk (3). Two variations on the Mediterranean-type diet were compared to a low-fat diet, with participants randomly assigned to three different groups. The two Mediterranean-type diet groups indicated about a 30 percent reduction in the risk of cardiovascular disease, compared to the low-fat diet. Risk indicators they studied included heart attacks, strokes and mortality. Interestingly, risk improvement in the Mediterranean-type diets occurred without significant weight loss.
The study included three groups: a Mediterranean diet supplemented with mixed nuts (almonds, hazelnuts or walnuts), a Mediterranean diet supplemented with extra virgin olive oil (at least four tablespoons a day), and a low-fat control diet.
The Mediterranean-type diet arms both included significant amounts of fruits, vegetables, nuts, beans, fish, olive oil and wine. Both groups consuming this diet had either significant amounts of nuts or olive oil and/or wine. If the participants in the Mediterranean diet groups were wine drinkers, they were encouraged to drink at least one glass a day.
This study was well-designed; however, there was a significant flaw that should temper our enthusiasm. The group assigned to the low-fat diet was not able to maintain this diet throughout the study. As a result, it really became a comparison between variations on the Mediterranean diet and a standard diet.
How have leading cardiovascular and integrative medicine physicians responded to the study? Interestingly, there are two opposing opinions, split by field. You may be surprised by which group liked it and which did not.
Well-known cardiologists hailed the study as a great achievement. They emphasized that we now have a large, randomized diet trial measuring meaningful clinical outcomes.
On the other hand, leading integrative medicine physicians, including Caldwell Esselstyn, M.D. and Dean Ornish, M.D., expressed disappointment with the results. Both promote plant-rich diets that may be significantly more nutrient-dense than the Mediterranean diet in the study. Both have published their own small, well-designed studies showing significant benefits from plant-based diets (4, 5). Ornish showed a reversal of atherosclerosis in one of his studies (6).
Their objections to the study revolve around their belief that heart disease and its risk factors can be reversed, not just reduced. In other words, the study didn’t go far enough.
Both opinions have merit. The cardiologists’ enthusiasm is warranted, because a Mediterranean diet, even with an abundance of included fats, will appeal to a wide audience. However, those who follow a more focused diet that includes more nutrient-dense foods, could potentially see a more significant reversal of heart disease.
Either way, it is encouraging to know that we can alter our cardiovascular destinies by altering our diet.
References:
(1)www.uptodate.com(2) BMJ 2013;346:f1591. (3) N Engl J Med 2018; 378:e34. (4) J Fam Pract. 1995;41(6):560-568. (5) Am J Cardiol. 2011;108:498-507. (6) JAMA. 1998 Dec 16;280(23):2001-2007.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
These composite brain images from the study of WTC responders reveal evidence of amyloidosis. Areas shaded in red and yellow indicate regions of the brain with amyloid. Image courtesy of Sean Clouston, Stony Brook Medicine
By Daniel Dunaief
Even over 23 years after first responders raced to the smoldering site of the World Trade Center terrorist attacks, many emergency crews continue to battle the effects of their exposure.
With a combination of toxic aerosolized particles infusing the air, first responders who didn’t wear personal protective equipment and who had the highest degree of exposure have suffered from a range of symptoms and conditions.
Sean Clouston
In a recent study of 35 World Trade Center first responders in the Journal of Alzheimer’s Disease, lead author Sean Clouston, who is a Professor in the Department of Family, Population and Preventive Medicine in the Renaissance School of Medicine, found evidence of amyloid plaques, which are often linked to Alzheimer’s Disease.
The paper links exposure to a neurodegenerative protein.
Research with World Trade Center first responders not only benefits those who worked tirelessly to try to find survivors and to restore the area after the attack, but also could help other people who inhale aerosolized toxins.
Indeed, such research could help those who are spending hours battling the ongoing wildfires in Los Angeles, which have been consuming forests and trees, homes and commercial buildings, at a furious and uncontrolled pace.
People have a feeling that fresh air is safe, but what scientists have learned from their studies of the World Trade Center first responders is that “just being six feet away from a pile of rubble that’s smoldering, even if you can’t see that it’s dangerous, doesn’t mean it isn’t,” said Clouston. “There is at least some risk” to human health from fires that spew smoke from burned computers and refrigerators, among others.
Given the variety of materials burned in the fires, Minos Kritikos, Senior Research Scientist and a member of the group in the collaborative labs of Clouston and Professor Benjamin Luft, suspects that a heterogeneity of particles were in the air.
People in Los Angeles who are inhaling these particles can have them “linger in their circulation for years,” said Kritikos. “It’s not just a neurological issue” as the body tries to deal with carrying around this “noxious” particulate matter. Since most neurons don’t regenerate, any toxicity induced neuronal death is irreversible, making damage to the brain permanent.
Even in non-emergency situations, people in polluted cities face increased health risks.
“There is a recognition that air pollution is a major preventable cause of Alzheimer’s Disease and related dementias, as noted by the latest Lancet Commission,” Clouston explained.
Two likely entry points
People who breathe in air containing toxic chemicals have two likely pathways through which the particulates enter the body. They can come in through the nose and, potentially, travel directly into the brain, or they can enter the lungs, circulate through the body and enter the head through the blood-brain barrier. The olfactory route is more direct, said Kritikos.
Minos Kritikos in front of Stony Brook Hospital.
The amyloid plaques in these first responders was found primarily in the area near the nose, which supports the idea that maybe inhaling the dust was the problem, Clouston said.
Once these chemicals enter the brain, Clouston and his team believe the body engages defenses that are designed much more for viruses than for toxic compounds. The immune system can encapsulate these chemicals in amyloid plaques.
Amyloid plaques, in moderation and under conditions that protect the brain against pathogens, are a part of a protective and helpful immune response. Too much of a good thing, however, can overwhelm the brain.
“When there’s too much plaque, it can physically disturb neuronal functions and connections,” said Kritikos. “By being a big presence, they can also molecularly and chemically react with its environment.”
A large presence of amyloid can be toxically necrotic to surrounding neural tissue, Kritikos added.
What the scientists believe they are tracking is the footprint of an adaptive response that may not help the brain, Clouston added.
Clouston cautioned that the plaques and cognitive decline could both be caused by something else that scientists haven’t yet seen.
The findings
The research, which used positron emission tomography and magnetic resonance imaging scans to search for evidence of amyloid plaques, found evidence that doesn’t look like old age Alzheimer’s, explained Clouston. Usually these levels of plaques are not located in one spot, but occur throughout the brain during Alzheimer’s.
The immune response may be causing some of these plaques.
The amount of amyloid plaque doesn’t look like Alzheimer’s Disease and does not appear abnormal in the traditional way of testing, but with careful analysis of the olfactory system, the researchers can find elevated levels.
“I was surprised by how little amyloid was necessary to show this association,” said Clouston.
Researchers at Mt. Sinai have examined the effect of exposure to these same particulates in mice.
“The answer is very much similar to what we see in humans,” said Clouston. “That supports this work.”
To be sure, Clouston and Kritikos are hoping to build on this research. They are particularly interested in following up with participants to measure the rate of change in these plaques from the observed amyloid signals they measured at baseline.
“Doing so would enable us to calculate the rate of amyloid buildup allowing us to assess our responders more precisely, opening doors to possible therapeutic interventions such as the recently approved anti-amyloid therapies,” Kritikos explained.
Additionally, they hope to expand on the study beyond the 35 people who participated.
It is unclear whether tamping down the immune system could make patients better or worse. By reducing amyloid plaques, scientists might enable the harmful dust to cause damage in other areas of the brain. Alternatively, however, a lower level immune response with fewer plaques might, in the longer term, be better for the brain.
This study “does open the door for some of those questions,” Clouston said. Kritikos and Clouston plan to study the presence of tau proteins and any signs of neurodegeneration in the brains of these first responders.
“More research needs to be done,” Clouston said, which specifically targets different ways of measuring exposure, such as through a biomarker. He’s hoping such a biomarker might be found that tracks levels of exposure.
Future research could also address whether post traumatic stress disorder affects the immune response.
“It’s certainly possible that PTSD is playing a role, but we’re not sure what that might be,” said Clouston.
The researchers are continuing this research as they study the effects of exposure on tau proteins and neurodegeneration.
“We are hopeful that this will be an important turning point for us,” Clouston explained
From the Medditerranean to the Atlantic
Born and raised in Cyprus, Kritikos comes from a large family who are passionate about spending time with each other while eating good food.
He earned his doctorate from the University of Bristol in England.
Kritikos met his wife Jennifer LoPresti Kritikos, who is originally from Shirley, New York, at a coffee shop in Aberdeen, Scotland, where he was doing postdoctoral research.
LoPresti, who works at Stony Brook as the Department Head Administrator for Biomedical Engineering, and Kritikos live in Manorville and have an eight year-old daughter Gia and one-year old son Theseus.
As for his work, Kritikos is grateful for the opportunity to contribute to research with Clouston and Luft, who is the Director of the Stony Brook WTC Health and Wellness Program.
“I’m happy to be in a position whereby our large WTC team (the size of a small village) is constantly pushing forward with our understanding for how these exposures have affected” the brain health of WTC first responders, Kritikos explained. He would like to continue to uncover mechanisms that underly these phenomena, not just for WTC responders but also for similarly exposed populations.
In my practice, many patients have resisted telling me they suffered from erectile dysfunction (ED). However, it’s a common problem. Because it can indicate other medical issues, it’s important that you share this information with your doctor.
ED affects about 24 percent of men, on average. If it occurs less than 20 percent of the time, it is considered normal; however, if it occurs more than 50 percent of the time, you should seek help (1).
Of course, there are oral medications for ED. You’ve probably seen the ads for approved medications, including sildenafil (Viagra, or the “little blue pill”), tadalafil (Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra). They work by causing vasodilation, or enlargement of blood vessels, which increases blood flow to the penis. Unfortunately, this does not solve the medical problem, but it does provide a short-term solution for those who are good treatment candidates.
ED’s prevalence generally increases with age. An analysis of the 2021 National Survey of Sexual Wellbeing found that ED affected 12.7 percent of 35-44-year-olds, increased to 25.3 percent of 45-54- year-olds, 33.9 percent of those aged 55-64, 48 percent of those aged 65-74, and 52.2 percent of those aged 75 and older (2).
So, what contributes to the increase as we age? Disease processes and drug therapies.
What is the connection between medical conditions and ED?
Chronic diseases can contribute significantly to ED. ED might also be an indicator of disease. Typical contributors include metabolic syndrome, diabetes, high blood pressure, cardiovascular disease and obesity. In the Look AHEAD trial, ED had a greater than two-fold association with hypertension and a three-fold association with metabolic syndrome (3). In another study, ED was associated with a 2.5-times increase in cardiovascular disease (4).
Patients with ED had significantly more calcification, or atherosclerosis, in their arteries when compared to a control group in a randomized clinical trial (RCT) (5). They were also more than three times as likely to have severe calcification. In addition, they had more inflammation, measured by C-reactive protein.
Which medications contribute to ED?
About 25 percent of ED cases are thought to be associated with medications, such antidepressants, NSAIDs (e.g., ibuprofen and naproxen sodium), and hypertension medications. Unfortunately, the most common antidepressant medications, SSRIs, have significant impacts on ED.
The California Men’s Health Study, with over 80,000 participants, showed that there was an association between NSAIDs and ED, with a 38 percent increase in ED in patients who use NSAIDs on a regular basis (6). The authors warn that patients should not stop taking NSAIDs without consulting their physicians.
Also, high blood pressure drugs have a reputation for causing ED. A meta-analysis of 42 studies showed that beta blockers have a small effect, but thiazide diuretics (water pills) more than doubled ED, compared to placebo (7).
How can diet affect ED?
The Mediterranean-type diet has been shown to treat and prevent ED. It’s a green leafy alternative to the little blue pill. Foods are rich in omega-3 fatty acids and high in monounsaturated fats and polyunsaturated fats, as well as fiber. Components include whole grains, fruits, vegetables, legumes, walnuts, and olive oil.
In two RCTs lasting two years, those who followed a Mediterranean-type diet experienced improvements in their endothelial functioning (8, 9). They also experienced both lower inflammation and lower insulin resistance.
In another study, those who had the highest compliance with a Mediterranean-type diet were significantly less likely to have ED, compared to those with the lowest compliance (10). Even more impressive was that the group with the highest compliance had a 37 percent reduction in severe ED versus the low-compliance group.
A study of participants in the Health Professionals Follow-up Study looked closely at both the Mediterranean-type diet and the Alternative Healthy Eating Index 2010 diet, which emphasized consuming vegetables, fruits, nuts, legumes, and fish or other sources of long-chain fats, as well as avoiding red and processed meats (11). At this point, it probably won’t surprise you to hear that the greater participants’ compliance with either of these diets, the less likely they were to experience ED.
References:
(1) clevelandclinic.org. (2) J Sex Med. 2024;21(4): 296–303. (3) J Sex Med. 2009;6(5):1414-22. (4) Int J Androl. 2010;33(6):853-60. (5) J Am Coll Cardiol. 2005;46(8):1503. (6) Medicine (Baltimore). 2018 Jul;97(28):e11367. (7) JAMA. 2002;288(3):351. (8) Int J Impot Res. 2006;18(4):405-10. (9) JAMA. 2004;292(12):1440-6. (10) J Sex Med. 2010 May;7(5):1911-7. (11) JAMA Netw Open. 2020 Nov 2;3(11):e2021701.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
Back row, from left, Michael Letter, MHA, LNHA Senior Vice President/Chief Operating Officer GurwinHealthcare System; Jennifer Carpentieri, LMSW, LNHA Gurwin Jewish Nursing & Rehabilitation Center; Stuart B. Almer, FACHE, President and CEO Gurwin Healthcare System; front row, from left, Doris Gessner, Gurwin Resident Council President; Mary Creter, Gurwin Resident Council Secretary. Photo courtesy of Gurwin
Gurwin Jewish Nursing & Rehabilitation Center has been named one of America’s Best Nursing Homes 2025 in Newsweek magazine’s annual list of top skilled nursing facilities in the U.S. The annual ranking serves as a guide for patients and their families in their search for high-quality, long-term and post-acute care options.
“We are honored to be recognized by Newsweek once again in their prestigious America’s Best Nursing Homes rankings,” said Stuart B. Almer, President and CEO of Gurwin Healthcare System. “This achievement reflects the unwavering dedication of our staff, whose compassion and expertise create a warm, safe and supportive environment for the more than 400 residents who turn to Gurwin each day for care.”
The America’s Best Nursing Homes ranking lists the nation’s leading nursing homes in the 25 unique states with the highest number of facilities according to the Centers for Medicare & Medicaid Services (CMS). Compiled by Newsweek and Statista Inc., a statistics portal and industry-ranking provider, the annual ranking is based on performance data scores for health inspections, staffing and quality measures; recommendations of medical professionals; accreditations; and resident satisfaction scores. Gurwin was ranked on the 2025 national list of America’s Best Nursing Homes, as well as New York’s list, both in the category of 150+ certified beds.
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