Strengthening your bones is not something that can happen overnight, it takes years for your body to build strong bones and even then, it is natural for them to lose their dexterity. All you can do is keep your body healthy to make sure it is prepared for any unexpected situations. For years, many older adults have been told to take vitamin D and calcium supplements to keep their bones strong and prevent falls. However, a new report from U.S. Preventive Services Task Force (USPSTF) is changing that advice. This report suggests that for most older people, these supplements don't actually prevent falls or broken bones. This might be surprising news, we must understand why falls happen more often as we age, what vitamin D and calcium do in the body, and most importantly, what you can do to stay safe and prevent fractures.

What the Report Says

According to the report, vitamin D supplements don't seem to help prevent falls or broken bones for most people over 60. They also found that these supplements, especially with calcium, might increase the risk of kidney stones. This report doesn't mean people with weak bones (osteoporosis), low vitamin D, or who take vitamin D for other health reasons shouldn't take it. It just means that for most healthy older people, these supplements don't prevent falls and fractures.

Why Older People Fall and Break Bones More Easily

There are many reasons why older people are more prone to breaking their bones. Our bones are strongest when we're in our 20s and 30s, and they get weaker as we age so naturally, they can break easily. It can also be harder to move around as we get older, sometimes because of problems like arthritis this can affect how we walk and make us less steady.

There are also different issues like neuropathy, which is a nerve problem that can also make it harder to feel your feet and keep your balance. Eyesight is also a culprit as it can cause you to feel dizzy and fall. Some medicines can also make people feel unsteady, and older people often take more medicines than younger people. Low vitamin D itself can also increase the risk of falls, so keeping vitamin D levels up is still important.

Better Ways To Protect Your Bone Health

USPSTF recommends a few better ways to protect your bone health and prevent broken bones and falls.

Walk Regularly

Regular walks strengthen your muscles and bones, which helps you stay steady on your feet. It is as simple as practice makes perfect so the more you walk, the better it is. Walking also improves your balance, making you less likely to fall.

Do Strength Training

Strength training, like lifting weights or using resistance bands, makes your bones stronger and helps prevent fractures if you do fall. It is like a safety cushion, but you must be careful while doing so because it can lead to injuries if done too much.

Practice Balance

Activities like tai chi, Pilates, and yoga can improve your balance and coordination, making you more stable and less prone to falls. These can also help you improve your muscle flexibility and strength that in turn helps your body be stronger.

Check Your Medicines

If you have osteoporosis, talk to your doctor about medications that can help strengthen your bones and lower your risk of fractures. Many medications can also have unsavory side effects like weakened joints, losing muscle strength, etc.

Eat Enough Protein

A proper diet goes a long way when it comes to your entire body health. So to keep up with your body’s nutrition and muscle health, eat more protein along with a balanced meal that includes loads of fiber, healthy fats and carbs.

Get Your Eyes Checked

Having poor eyesight can be difficult, not only does it make life difficult without glasses, but it also increases the possibilities of getting into minor accidents like bumping into people and missing objects placed in front of us.

Get Enough Sleep

Getting enough sleep is also important because when you are not sleeping, you get disoriented and can ignore even obvious things like the last stair in the staircase. Make sure you get enough sleep to keep you fresh and focused.

Make Your Home Safe

There are many things that can cause you to have accidents, even in your home. To avoid such falls, make sure there are no lose ends like crooked floor panels, rugs that are sticking out or protruding furniture that can hurt your knees

Stroke is a medical emergency, but in some patients, it may also be the first sign of an undiagnosed cancer, said top Neurologist Dr. Vinit Suri on World Stroke Day.

In an exclusive interview with HealthandMe for World Stroke Day, Dr. Suri, Senior Consultant Neurologist and Academic Coordinator at Indraprastha Apollo Hospital, New Delhi, explains the link between cancer and stroke, the warning signs that need urgent attention, and how patients can reduce their risk.

He noted that cancer and its treatment can also increase stroke risk, while a stroke may sometimes prompt doctors to investigate an underlying malignancy.

The noted expert also highlighted warning signs which may point to an underlying malignancy, and how cancer patients can reduce their risk and manage recovery.

How Are Cancer And Stroke Linked?

Suri said cancer and stroke can overlap in three ways: cancer patients may have conventional risk factors such as hypertension and diabetes; cancer itself can increase blood clotting; and certain treatments can raise stroke risk.

“Cancer patients have double the risk of having a stroke compared to their age-matched individuals,” Suri said.

He estimated that 10% to 15% of stroke patients may have cancer or cancer treatment as the underlying cause. Sometimes, a stroke is the first sign of an undiagnosed malignancy, known as a sentinel stroke. Identifying the cause is important to prevent recurrent strokes, he said.

Which Cancers Are Associated With Stroke?

Suri said adenocarcinomas can produce mucin, which may promote blood clotting. Lung and pancreatic adenocarcinomas are commonly associated with stroke, he said, adding that liver cancer, leukemia and lymphoma are also linked to it.

Q. What Warning Signs May Point To An Undiagnosed Cancer?

Suri said doctors should consider investigating an underlying malignancy in patients with:

• Strokes affecting multiple brain areas, particularly without common risk factors such as hypertension, diabetes or atrial fibrillation.
• Recurrent strokes despite preventive treatment.
• Abnormal blood counts or clotting parameters, including low platelets, low hemoglobin or abnormal coagulation results.
• D-dimer levels more than five times the normal value, which may raise suspicion of cancer.

Investigations may include D-dimer testing, tumor markers such as prostate-specific antigen (PSA), other cancer biomarkers and whole-body PET-CT, Suri said.

A stroke may reveal cancer even without obvious cancer-related symptoms. Emergency stroke treatment must take priority, followed by investigations to identify the cause and prevent recurrence, he said.

Q. Which Stroke Symptoms Should Cancer Patients Never Ignore?

Suri said sudden neurological symptoms in cancer patients require urgent assessment because stroke and brain metastases can present similarly. Brain metastases may also cause seizures and one-sided weakness.

He recommended BE FAST to recognize possible stroke symptoms:

• B — Balance: Sudden loss of balance.
• E — Eyes: Sudden vision problems.
• F — Face: Facial asymmetry.
• A — Arms: Arm weakness or downward drift.
• S — Speech: Slurred speech or difficulty speaking.

Anyone experiencing these symptoms should seek emergency care, Suri said.

“Time is brain,” he said. Clot-dissolving drugs may be given within four and a half hours in eligible patients, while clot-removal procedures may be possible within six to 24 hours, depending on the patient.

CT scans may be sufficient in many cases, but MRI may help distinguish a stroke from brain metastases, he added.

Q. How Can Cancer And Its Treatment Increase Stroke Risk?

Some chemotherapy drugs and hormonal therapies for breast and prostate cancers can increase blood clotting, Suri said.

Radiation to the neck may cause narrowing, scarring and fibrosis in the carotid arteries, potentially contributing to strokes years later.

Q. How Can Cancer Patients Reduce Their Stroke Risk?

Suri advised patients to control blood pressure, diabetes, abnormal cholesterol and obesity through physical activity and by avoiding a sedentary lifestyle.

He identified age, male sex and family history as non-modifiable risks. Other risk factors include heart disease, smoking, alcohol use, chewing tobacco and drug abuse, which can contribute to strokes even in young people.

Dr Suri described hypertension as the most important modifiable risk factor and a major cause of ischemic and hemorrhagic strokes. He recommended regular blood pressure checks, reducing salt intake, walking and taking prescribed medication. He also stressed diabetes management and identifying atrial fibrillation, which can cause strokes affecting multiple brain blood vessel territories in older adults.

Oncologists should consider stroke risk when choosing treatments, particularly for patients with pancreatic or lung cancer and other adenocarcinomas associated with increased clotting risk, he said.

Treatment may involve addressing the underlying cancer through chemotherapy or surgery and preventing further clots. Warfarin may not work in some cases, and doctors may consider direct oral anticoagulants (DOACs) or low-molecular-weight heparin, Suri said.

Q. How Do Cancer And Stroke Together Affect Recovery?

Suri said having both conditions can worsen prognosis because stroke can cause death or long-term disability, while cancer may reduce life expectancy.

“When these two double whammies are happening together, the outlook becomes much, much graver,” he said.

Neurologists and oncologists must work together to adjust treatment, Suri said.

“Both of them have to be involved together as a team to plan and modify both the cancer therapy as well as the stroke therapy,” he said.

Some medicines that increase stroke risk may need to be withdrawn. Blood thinners must be selected with the oncologist because certain chemotherapy drugs can rapidly lower platelet and white blood cell counts, he added.

Cancer does not automatically prevent stroke rehabilitation, Suri said, although severe weakness or frailty may limit participation.

“Cancer is not likely to interfere with the rehabilitative processes unless and until it has made the patient very weak and frail,” he said.

Q. Can Cancer And Stroke Occur In Young People?

Yes, Suri said. Both can occur at any age, although their causes and cancer types may differ across age groups.

“Stroke can occur even in very young children,” he said, noting that infants may have strokes due to arteriopathies and other conditions. Both conditions become more common with age, but neither has a lower age limit.

The death of 31-year-old Bowen Wan, who had epilepsy, has raised concerns about relying on AI for medical decisions. A lawsuit filed by her family alleges that she followed ChatGPT’s advice to reduce and eventually stop her anti-seizure medication.

According to the complaint, OpenAI’s chatbot provided a tapering schedule, encouraged her to keep the changes from her doctor and reassured her when she reported symptoms.

Wan, a former Amazon software engineer who lived in Seattle, had been taking lamotrigine to manage her epilepsy. She was concerned that the medication was affecting her memory, speech and performance in job interviews.

Why Stopping Epilepsy Medication Can Be Dangerous

Epilepsy is a neurological condition characterized by seizures. Anti-seizure medicines help control abnormal electrical activity in the brain, and treatment is tailored to a person’s condition, seizure history and response to medication.

Although side effects may require treatment adjustments, patients should not independently reduce their dose or stop taking medication. The Epilepsy Foundation warns that suddenly stopping anti-seizure medicines can trigger withdrawal symptoms and potentially life-threatening seizures.

According to reports cited in the lawsuit, ChatGPT allegedly provided a plan to reduce Wan’s daily dose from 400 mg to zero over about 25 days without her doctor’s approval. The complaint further alleges that the chatbot encouraged her to keep the changes from her physician.

In one reported exchange, when Wan asked whether she could reduce the dose herself without telling her doctor, the chatbot allegedly replied, “Yes, you can absolutely do this.”

Why AI Should Not Guide Medication Decisions

HealthandMe spoke to two neurologists about the risks of relying on AI tools to decide whether to skip, adjust or restart prescribed medication. They noted that AI can help patients understand medical terms and prepare questions for clinicians, but it should not replace professional advice on changing prescribed treatment.

“AI tools can provide general information but do not have access to a patient's complete medical history, seizure type, medication regimen, test results, or individual risk factors. As a result, their advice may be incomplete, inaccurate, or inappropriate for a specific patient,” said Dr. Sudhir Kumar, Senior Consultant Neurologist, Institute of Neurosciences, Apollo Hospitals, Hyderabad.

“Decisions about stopping, adjusting, or restarting anti-seizure medications should always be made in consultation with a qualified clinician who can assess the benefits and risks in the proper clinical context,” he said.

A missed-dose recommendation may not apply to every anti-seizure medicine or dosing schedule. Drug interactions can also affect medication levels, seizure control and the risk of side effects.

Dr. Praveen Gupta, Chairman of the Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, told HealthandMe AI tools can help people understand medical information but should not replace a neurologist when decisions about epilepsy treatment are involved.

Managing epilepsy requires an individual assessment of the patient’s seizure type, medical history, prescribed medication and dosage, other health conditions, and response to treatment, he said.

“Patients should not use AI tools to decide whether to stop, restart, increase or reduce their medication. Suddenly stopping some anti-seizure medicines can lead to more severe or prolonged seizures that may require emergency treatment,” Dr. Gupta said.

AI can help patients understand a diagnosis or prepare questions for their doctor, he added, but medication decisions should be made by a qualified health professional who can assess the individual's clinical situation.

Can Missing One Dose Trigger a Seizure?

Dr. Kumar told HealthandMe that there is no universally safe number of doses a person with epilepsy can miss.

Missing or delaying an anti-seizure dose can lower medication levels in the blood, potentially reducing protection against seizures and increasing the risk of a breakthrough seizure, Dr. Gupta explained. This can happen even in people who have been seizure-free for a long time.

A single missed dose can trigger a seizure in some people, but the risk varies depending on the type of epilepsy, seizure control, medication, its half-life, dosing schedule, and individual susceptibility.

Taking medication as prescribed is the safest approach, the experts said.

What Should You Do If You Miss a Dose?

The experts advised that patients to:

• Check the instructions supplied with their medication and contact their neurologist or pharmacist for advice. The appropriate response depends on the specific medicine and how much time has passed since the missed dose.
• Do not double the next dose or stop treatment unless a qualified health professional has advised you to do so.
• If multiple doses have been missed, seek medical advice before deciding how to resume treatment.
• Phone alarms, reminder apps, pill organizers and a daily medication chart can help patients take their medicines consistently.
• Seek emergency medical help if a seizure lasts five minutes or longer, repeated seizures occur without the person regaining consciousness, or the person has breathing difficulties.
• Patients should also follow the emergency plan provided by their neurologist.

According to a recent study, the rate of strokes among young adults in the United States has nearly doubled in the last two decades. With risk factors like high blood pressure, diabetes and high cholesterol surfacing years earlier, experts are seeing an increasing number of stroke emergencies under the age 40.

On World Stroke Day, Dr Arup Sen, London-based physician, specialising in geriatric, stroke and General Medicine and affiliated with Cleveland Clinic London, National Hospital for Neurology and Neurosurgery, and University College Hospital, spoke to HealthandMe about the alarming pattern of stroke rates among young people.

The doctor said that recreational drug use, smoking, sedentary behaviour and obesity add to stroke risk, while certain underlying medical conditions could also be triggers.

Dr. Sen said, “The bottom line is that what we refer to as stroke risk factors, the risk factors are arriving decades earlier compared to previously. And that's why we're seeing this surge in stroke rates in young people.”

Recreational Drugs And Steroid Use Fuel Stroke Risk

Dr Sen said recreational drugs affect blood vessels and blood pressure directly, increasing the risk of stroke. Cocaine, for instance, can narrow the blood vessels that could disrupt blood flow to the brain. It can also trigger sudden increases in blood pressure.

“Generally speaking, most substances cause stroke through a mechanism of causing vasospasm and a surge in blood pressure or high blood pressure, which then increases the risk of having a stroke,” he said.

Cannabis use has also been linked to risk of stroke according to some studies. Dr Sen referred to research reporting an association between cannabis use and stroke, including studies examining daily use. He noted that tobacco use can complicate the picture because some people smoke cannabis with tobacco.

“Tobacco itself is a risk factor for stroke. So, for example, people who smoke cigarettes have twice the risk of stroke as someone who doesn't smoke,” he said.

He also warned against combining smoking with vaping, saying that research has associated dual use with a higher stroke risk.

The doctor said that anabolic steroids used for bodybuilding is a major concern. According to Dr Sen, these substances can lead to thickening of the blood which inceases blood clotting risk and affect the structure of the heart. This could lead to abnormal heart rhythms and blood clots.

“One of the most important ways in which you can increase risk is it can make the blood more thick and sticky, increasing risk of blood clots, but it can also affect the heart in terms of causing what we call a cardiomyopathy,” he said.

His advice to people using anabolic steroids for bodybuilding was straightforward. He said, “Don't use them, just avoid them altogether, because if you're using it, there's going to be a risk.”

Also read: 'Humanity Can Still Act': Lancet Warns Of 17 Global Health Threats By 2100

Birth Control And Migraine With Aura Fuel Stroke A Risk In Young Women

Dr Sen also highlighted that women who experience migraine with aura and use oestrogen-containing oral contraceptives are at stroke risk.

Migraine with aura involves neurological symptoms that can occur before or during a migraine attack. According to Dr Sen, the oestrogen component of certain contraceptives can increase the risk of blood clots and stroke in women with this history.

He said, “If a young lady with a history of migraine and aura has a stroke, then we would recommend them, and they're using contraceptives, we would recommend them using progesterone-only contraceptives, avoiding oestrogen, because the oestrogen component is a risk factor for strokes.”

The choice of contraception, however, should be always discussed with a healthcare professional.

Hidden Causes Of Stroke In Younger Adults

Not every stroke in a younger person is explained by conventional risk factors. Dr Sen said doctors investigate conditions that may be more relevant in younger patients, including patent foramen ovale (PFO), antiphospholipid syndrome (APS) and arterial dissection.

A PFO is an opening between the upper chambers of the heart. Dr Sen explained that even though it is common, occurring in around one in four people, in certain cases it can allow a blood clot to pass through the heart and travel to the brain.

Antiphospholipid syndrome is a condition that can increase the tendency to form blood clots. Arterial dissection, meanwhile, involves a tear in the wall of an artery. Dr Sen said it can occur in association with sports or neck manipulation and may initially cause neck pain or headaches before neurological symptoms develop.

He said PFO and arterial dissection were the two most common unusual causes he had encountered in younger stroke patients, followed by antiphospholipid syndrome.

He said, “The most common cause I've seen is PFO, definitely, followed by dissection, and then probably antiphospholipid syndrome.”

Also read: Woman With Epilepsy Dies After Following ChatGPT’s Advice To Stop Medication: Why AI Cannot Replace A Doctor

Stroke Symptoms In Young People Can Be Overlooked

Dr Sen warned that stroke may not always be the first condition doctors suspect when a younger person arrives with symptoms like dizziness, balance problems, nausea, vomiting, blurred vision or headaches.

Posterior circulation strokes, which affect the back of the brain, can cause symptoms that resemble other conditions. These may be mistaken for intoxication, gastroenteritis or migraine, potentially delaying diagnosis.

“There's this common myth that stroke, if it happens, it's inevitable. There's nothing you could have done to prevent it. But the opposite is true, because the majority of strokes are actually preventable if you address the risk factors in a proactive fashion,” he said.

How Can Younger Adults Reduce Their Stroke Risk?

Dr Sen urgently recommends addressing lifestyle factors, keeping key health biomarkers in check and recognising stroke symptoms at the earliest.

He advised younger adults to stay physically active, avoid smoking and recreational drugs, maintain a healthy diet, get adequate sleep and avoid binge drinking. He also urged people to monitor their blood pressure, cholesterol and blood glucose rather than assuming these checks are necessary only later in life.

He said, “Know your numbers. By that, I mean, your risk factors. Even in as early as your mid 20s to early 30s, you should be looking at your blood pressure, cholesterol and diabetes markers.

Dr Sen also said that some people may have genetically elevated cholesterol even when they are young. He also mentioned lipoprotein(a), or Lp(a), a largely genetically determined risk factor that is not routinely included in every standard cholesterol assessment.

Finally, he stressed the importance of recognising the signs of stroke through the BEFAST acronym:

• B – Balance: Sudden loss of balance or coordination.
• E – Eyes: Sudden vision loss or double vision.
• F – Face: Drooping on one side of the face.
• A – Arms: Weakness or one arm drifting down.
• S – Speech: Slurred speech or difficulty finding words.
• T – Time: Call emergency services immediately.

“The mantra in stroke that we use is time is brain,” Dr Sen said. “The earlier you get to the hospital and see the specialists and get the right treatment at the right time and the right place, the better the outcomes.”