Weekly Dose Podcast: Cognitive Benefits of Quitting Smoking, LARC Counseling Impact, Hospice Prescribing Risks, New AD Blood Test, and Alcohol–Dementia Evidence

The latest episode of the Weekly Dose Podcast from Patient Care® brings primary care clinicians a fast, focused roundup of five major studies spanning cognitive health, reproductive care, hospice prescribing, Alzheimer diagnostics, and dementia risk from alcohol use.

Below are this week’s key highlights.

1. Smoking Cessation Later in Life Linked to Slower Cognitive Decline

New analyses from three large aging cohorts suggest that quitting smoking—even in mid-to-late adulthood—may slow long-term cognitive decline. Across more than 9,000 participants, investigators found that former smokers experienced a 20% slower decline in memory and a 50% slower decline in verbal fluency during the six years after cessation compared with continuing smokers. These changes translated to several months of preserved memory and fluency each year, reinforcing that cognitive harms associated with smoking are at least partially reversible.

2. Structured LARC Counseling Cuts Unintended Pregnancies by Half

A three-year follow-up of the ACCORd contraceptive counseling intervention showed sustained benefits for women who received structured, nonbiased long-acting reversible contraception counseling in primary care. LARC continuation rates remained significantly higher in the intervention group (41% vs 28%), and the rate of unintended pregnancy was reduced by half. Abortion rates were also markedly lower. Satisfaction was consistently higher among LARC users, supporting broader adoption of structured contraceptive counseling models in primary care settings.

3. Benzodiazepine and Antipsychotic Initiation in Hospice Linked to Higher Mortality

A large analysis of nursing home residents with Alzheimer disease and related dementias newly enrolled in hospice found increased 180-day mortality associated with initiating benzodiazepines or antipsychotics. After matching more than 26,000 pairs for benzodiazepine analysis and 10,000 pairs for antipsychotics, investigators observed significantly higher mortality risk with either class. The findings highlight the need for careful risk–benefit discussions when addressing behavioral or comfort-related symptoms at end of life.

4. First Blood Test for Alzheimer Disease Cleared for Primary Care Use

In diagnostic news, the FDA cleared the first blood-based biomarker test designed to support the evaluation of cognitive decline in primary care. The Elecsys pTau181 assay demonstrated a high negative predictive value for ruling out AD-related amyloid pathology in an early-disease population. Its minimally invasive design may reduce reliance on PET imaging or CSF testing and help PCPs determine which patients truly need referral for advanced evaluation and management.

5. Alcohol Consumption May Increase Dementia Risk at All Levels

A large pooled analysis of US and UK cohorts—supplemented with genetic data from more than two million individuals—challenged the long-held belief that light drinking may be protective for cognition. While observational data showed the expected U-shaped association, Mendelian randomization removed these biases: dementia risk rose steadily with increasing alcohol intake, even at low levels. The findings suggest that no amount of alcohol appears protective and that reducing alcohol use disorder prevalence could modestly lower dementia incidence at a population scale.

Listen to the full episode for deeper clinical insights and practical takeaways for primary care.