Men at Higher Risk for Mild Memory Loss Than Women

ST. PAUL, Minn. – Men may be at higher risk of experiencing mild cognitive impairment (MCI), or the stage of mild memory loss that occurs between normal aging and dementia, than women, according to a study published in the January 25, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“These results are surprising, given that women generally have higher rates of dementia than men,” said study author R.O. (Rosebud) Roberts, MB ChB, MS, of the Mayo Clinic in Rochester, Minn., and a member of the American Academy of Neurology. “The risk of MCI in men and women combined was high in this age group of elderly persons. This is disturbing given that people are living longer, and MCI may have a large impact on health care costs if increased efforts at prevention are not used to reduce the risk.”

For the study, a group of 1,450 people from Olmsted County, Minn., between the ages of 70 and 89 and free of dementia at enrollment underwent memory testing every 15 months for an average of three years. Participants were also interviewed about their memory by medical professionals. By the end of the study period, 296 people had developed MCI.

The study found that the number of new cases of MCI per year was higher in men, at 72 per 1,000 people compared to 57 per 1,000 people in women and 64 per 1,000 people in men and women combined. MCI with memory loss present was more common at 38 per 1,000 people than MCI where memory loss was not present, which affected 15 per 1,000 people. Those who had less education or were not married also had higher rates of MCI.

“Our study suggests that risk factors for mild cognitive impairment should be studied separately in men and women,” said Roberts.

Another finding of interest in the study showed that among people who were newly diagnosed with MCI, 12 percent per year were later diagnosed at least once with no MCI, or reverted back to what was considered “cognitively normal.” Roberts said the majority of people with MCI, about 88 percent per year, continue to have MCI or progress to dementia.

The study was supported by the National Institutes of Health, the Robert Wood Johnson Foundation, the Robert H. and Clarice Smith and Abigail van Buren Alzheimer’s Disease Research Program and was made possible by the Rochester Epidemiology Project.

The American Academy of Neurology, an association of 24,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson’s disease and epilepsy.

Released: 1/17/2012

Source: American Academy of Neurology

Related Link:

http://www.newswise.com/articles/study-men-at-higher-risk-for-mild-memory-loss-than-women

‘Dabbling’ in Hard Drugs in Middle Age Linked to Increased Risk of Death

Newswise — Young adults often experiment with hard drugs, such as cocaine, amphetamines and opiates, and all but about 10 percent stop as they assume adult roles and responsibilities. Those still using hard drugs into their 50s are five times more likely to die earlier than those who do not, according to a new study by University of Alabama at Birmingham researchers published online Jan. 27, 2012, in the Journal of General Internal Medicine.

According to the National Survey on Drug Use and Health, 9.4 percent of Americans ages 50-59 and 7 percent of adults ages 35-49 reported use of a drug other than marijuana sometime in the past year. The study’s lead author, Stefan Kertesz, M.D., associate professor in the UAB Division of Preventive Medicine. and colleagues attempted to discover if lifelong hard-drug use shortens lifespan to better enable primary-care doctors to advise patients who use drugs recreationally.

“While government guidelines have not endorsed screening for drugs in primary care, many doctors are challenged when they discover patients continue to dabble with them,” Kertesz says. “In primary-care practice, we often hear from stable patients who report using some cocaine, irregularly, perhaps on weekends. It’s an underappreciated but very common situation. The typical question physicians have to ask is ‘If this patient doesn’t have addiction, what advice can I give other than noting that it’s unwise to break the law?’ After all, we are supposed to be doctors, not law enforcement.”

Kertesz and a research team from other universities looked at data from the Coronary Artery Risk Development in Young Adults Study for their analysis. CARDIA, funded by the National Heart, Lung and Blood Institute, is a long-term research project involving more than 5,000 black and white men and women from Birmingham, Chicago, Minneapolis and Oakland, designed to examine the development and determinants of cardiovascular disease and its risk factors. Participants ages 18-30 were recruited and followed from 1985 to 2006.

The research team looked specifically at the reported use of “hard drugs” by 4,301 of the CARDIA participants. They compared people who stopped drug use early to those who continued and calculated the likelihood of premature death among these groups.

“Fourteen percent of the people in the study reported recent hard-drug use at least once, and of these, half continued using well into middle age,” Kertesz says. “But, most of the drug users in our study were not addicts. They were dabblers who used just a few days a month.”

Kertesz and his colleagues found that older hard-drug users were more likely to report being raised in economically challenged circumstances in a family that was unsupportive, abusive or neglectful. The team also found that those who were heavy drug users into young adulthood and continued at lower levels into middle age were roughly five times more likely to die than persons who didn’t use drugs.

“We can’t assume that drugs caused death, as in an overdose,” he says. “Rather what we found is that middle-age adults who continue to dabble in hard drugs represent a group that is at risk of bad outcomes — which could include death from trauma, heart disease or other causes that are not a direct result of their drug use — at a higher rate than people who stopped using drugs.”

Kertesz added that the team’s findings are a reminder that people who continue to use drugs are potentially quite vulnerable. They often have grown up under economic and psychosocial stress from childhood onward. They continue to smoke and drink and they remain at elevated risk of premature death.

“Based on the data we hope to offer better advice to primary-care doctors struggling with the rising tide of drug-taking by adults who have not left behind many of the bad habits they learned in young adulthood,” he says.

Study co-authors include Yulia Khodneva, M.D., Monika Safford, M.D., and Joseph Schumacher, Ph.D., UAB Division of Preventive Medicine; Jalie Tucker, Ph.D., UAB School of Public Health; Joshua Richman, M.D., Ph.D., UAB Department of Surgery; Bobby Jones, Ph. D., Department of Statistics, Carnegie Mellon University; and Mark J. Pletcher, M.D., departments of Epidemiology & Biostatistics and Medicine, University of California, San Francisco.

Released: 1/27/2012

Source: University of Alabama at Birmingham

Related Link:

http://newswise.com/articles/dabbling-in-hard-drugs-in-middle-age-linked-to-increased-risk-of-death

Study of One Million Americans Shows Obesity and Pain Linked

Newswise — STONY BROOK, N.Y., January 26, 2012 – A clear association between obesity and pain – with higher rates of pain identified in the heaviest individuals – was found in a study of more than one million Americans published January 19 in the online edition of Obesity. In “Obesity and Pain Are Associated in the United States,” Stony Brook University researchers Arthur A. Stone, PhD., and Joan E. Broderick, Ph.D. report this finding based on their analysis of 1,010,762 respondents surveyed via telephone interview by the Gallop Organization between 2008 and 2010.

Previous small-scale studies have shown links between obesity and pain. The Stony Brook study took a very large sample of American men and women who answered health survey questions. The researchers calculated respondents’ body mass index (BMI) based on questions regarding height and weight. Respondents answered questions about pain, including if they “experienced pain yesterday.”

“Our findings confirm and extend earlier studies about the link between obesity and pain. These findings hold true after we accounted for several common pain conditions and across gender and age,” says Dr. Stone, Distinguished Professor and Vice Chair, Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, and an expert on patient reported measures of health, pain, and well-being.

Sixty three percent of the 1,010,762 people who responded to the survey were classified as overweight (38 percent) or obese (25 percent). Obese respondents were further classified into one of three obesity levels as defined by the World Health Organization. In comparison to individuals with low to normal weight, the overweight group reported 20 percent higher rates of pain. The percent increase of reported pain in comparison to the normal weight group grew rapidly in the obese groups: 68 percent higher for Obese 1 group, 136 percent higher for Obese 2 group, and 254 percent higher for Obese 3 group.

“We wanted to explore this relationship further by checking to see if it was due to painful diseases that cause reduced activity, which in turn causes increased weight,” says Joan E. Broderick, Ph.D., Associate Professor in the Department of Psychiatry and Behavioral Science and School of Public Health at Stony Brook University, and lead investigator of a National Institutes of Health-funded study on how arthritis patients manage their own pain.

“We found that ‘pain yesterday’ was definitely more common among people with diseases that cause bodily pain. Even so, when we controlled for these specific diseases, the weight-pain relationship held up. This finding suggests that obesity alone may cause pain, aside from the presence of painful diseases,” Dr. Broderick explains.

Interestingly, the pain that obese individuals reported was not driven exclusively by musculoskeletal pain, a type of pain that individuals carrying excess weight might typically experience.

Drs. Broderick and Stone also suggest that there could be several plausible explanations for the close obesity/pain relationship. These include the possibility that having excess fat in the body triggers complex physiological processes that result in inflammation and pain; depression, often experienced by obese individuals, is also linked to pain; and medical conditions that cause pain, such as arthritis, might result in reduced levels of exercise thereby resulting in weight gain. The researchers also indicated that the study showed as people get older, excess weight is associated with even more pain, which suggests a developmental process.

Drs. Broderick and Stone believe that the study findings support the importance of metabolic investigations into the causes of pain, as well as the need for further investigation of the obesity—pain link in U.S. populations.

Released: 1/26/2012

Source:  Stony Brook University Medical Center

Related Link:

http://www.newswise.com/articles/study-of-one-million-americans-shows-obesity-and-pain-linked

CT Scans for Dizziness in the ER: Worth the Cost?

Newswise — DETROIT – Performing CT scans in the emergency department for patients experiencing dizziness may not be worth the expense – an important finding from Henry Ford Hospital researchers as hospitals across the country look for ways to cut costs without sacrificing patient care.

According to the Henry Ford study, less than 1 percent of the CT scans performed in the emergency department revealed a more serious underlying cause for dizziness – intracranial bleeding or stroke – that required intervention.

The findings suggest that it may be more cost effective for hospitals to instead implement stricter guidelines for ordering in-emergency department CT scans of the brain and head for patients experiencing dizziness.

“When a patient comes into the emergency department experiencing dizziness, a physician’s first line of defense is often to order a CT scan to rule out more serious medical conditions. But in our experience it is extremely rare that brain and head imagining yields significant results,” says study author Syed F. Ahsan, M.D., a neuro-otologist in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

“It is our hope that our investigation into our own practices will shed light on avenues to run leaner practices within our institution, as well as serve as a model for other health systems.”

The study will be presented Jan. 26 in Miami Beach at the annual Triological Society’s Combined Sections Meeting.

The Henry Ford study was a retrospective review of 1,681 patients with dizziness or vertigo who came into a Detroit metropolitan emergency department between January 2008 and January 2011.

Of those patients, nearly half (810 patients) received a CT scan of the brain and head, but only 0.74 percent of those scans yielded clinically significant results that required intervention. In all, the total cost for the CT scans during the three-year period was $988,200.

The analysis also revealed that older patients and those with a lower income were more likely to receive a CT scan for dizziness when they came into the emergency department.

While dizziness may signal intracranial bleeding or stroke, it is more likely that the cause is due to dehydration, anemia, a drop in blood pressure with standing (orthostatic hypotension), problems or inflammation in the inner ear such as benign paroxysmal postional vertigo, labyrinthitis or meniere’s disease, or vestibular neuritis.

And, Dr. Ahsan notes, in previous studies it has been well documented that CT scans are not very effective in detecting stroke or intracranial bleeding in the acute (emergency room) setting.

Ultimately, the study shows that there is potential for cost savings by creating and implementing stronger guidelines to determine when it is medically necessary for patients with dizziness to undergo CT imaging in the emergency department.

Funding: Henry Ford Hospital

Along with Dr. Ahsan, Henry Ford study co-authors are Mausumi N. Syamal, M.D., and Kathleen Yaremchuk, M.D.

Released:  1/26/2012

Source: Henry Ford Health System

Related Link:

http://www.newswise.com/articles/ct-scans-for-dizziness-in-the-er-worth-the-cost

Pick Up the Cell Phone, Drop the Pounds!

Photo Credit: UC San Diego School of Medicine Pictured: The team from CalIT2's Center for Wireless and Population Health Systems.

Newswise — Cell phones aren’t just for talking any more. Surfing the web, storing music and posting to Facebook have all contributed to the near-mandatory use of a cell phone. How about using that cell phone to lose weight? Researchers with Calit2’s Center for Wireless and Population Health Systems (CWPHS) and the Department of Family and Preventive Medicine, at University of California, San Diego are expanding a previous study aimed at finding out if cell phone technology can help with weight loss.

For one year, researchers with the “ConTxt” study will evaluate the use of cell phone text messages to remind participants to make wise nutritional choices throughout the day. Participants randomized to the intervention conditions will also be given tailored messages for weight loss and lifestyle changes as well as a pedometer to monitor their daily activity.

“ConTxt is an innovative, yet straightforward approach to getting people to monitor their diet and physical activity,” says CWPHS project principal investigator Kevin Patrick, MD, MS, professor of Family and Preventive Medicine, UC San Diego School of Medicine. “We are trying to make this as pain free as possible. People won’t stick to something that’s too difficult and they’re all multi-tasking anyway. We’re doing this study to increase what we know about using the cell phone to get messages to busy people on the go.”

Who Can Participate?

ConTxt is recruiting more than 300 participants who meet these criteria:

*Men and women
*21 to 60 years of age
*Overweight or moderately obese with Body Mass Index (BMI) of 27-39.9
*Own a cell phone capable of sending and receiving picture and text messages
*English and Spanish speaking participants that reside in San Diego county

Strategy

As a part of tailoring of the program, surveys completed during baseline visit will help assess the participant’s lifestyle, for example, assessing nearby grocery stores, finding opportunities for physical activity and possibly enlisting the support of friends or family.

The intervention is designed to send “prompts,” text or picture messages, with specific suggestions or tips regarding diet and improving lifestyle habits. “It seems like everybody has a cell phone. Those who do usually carry it with them at all times,” explained ConTxt study coordinator Lindsay W. Dillon, MPH, CHES. “We want to see if we can use that same technology to get people to think differently.”

About CWPHS

CWPHS research focuses on how the health of individuals, families, communities, social networks, and populations can be improved through the creative use of wireless and networked technologies. CWPHS is Housed within the UCSD Division of Calit2: The California Institute for Telecommunications and Information Technology.

Collaborators include physicians and scientists with backgrounds in clinical and preventive medicine, computer science and engineering, social networks, political science, clinical and experimental psychology, electrical engineering, health behavior, behavioral exercise and nutrition science and public health. Center research is supported through public and private sources, including the National Institutes of Health, the U.S. Centers for Disease Control and Prevention, the National Science Foundation, the Robert Wood Johnson Foundation, the American Cancer Society, and Nokia Research.

To learn more about enrolling in the ConTxt study, call in USA        858-534-8412       or email us at contxtcoach@ucsd.edu.

Via Newswise

Source: University of California, San Diego Health Sciences

Related Link:

http://newswise.com/articles/pick-up-the-cell-phone-drop-the-pounds2

Health News….Breakthrough in Treatment to Prevent Blindness

Photo Credit: UCSF, Bruce Gaynor, MD, performs an ocular examination on a patient in Ethiopia, where there is a high prevalence of trachoma, the world’s leading cause of preventable blindness.

Newswise — A UCSF study shows a popular treatment for a potentially blinding eye infection is just as effective if given every six months versus annually. This randomized study on trachoma, the leading cause of infection-caused blindness in the world, could potentially treat twice the number of patients using the same amount of medication.

“The idea is we can do more with less,” said Bruce Gaynor, MD, assistant professor of ophthalmology at the Francis I. Proctor Foundation for Research in Ophthalmology. “We are trying to get as much out of the medicine as we can because of the cost and the repercussions of mass treatments.”

In a paper published this month in The Lancet(http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961515-8/fulltext), researchers conducted a cluster-randomized trial, using an antibiotic called azithromycin to treat trachoma in Ethiopia, which has among the highest prevalence in the world. They picked 24 communities and randomized the two treatment options: 12 villages were given azithromycin every six months and the other 12 were treated every 12 months.

“What we found was the prevalence of trachoma is very high at baseline. Forty to 50 percent of the children in these communities have this condition,” Gaynor said. “They are the most susceptible and it can quickly spread from person to person by direct or even indirect contact.”

Researchers tracked both groups and found the prevalence of infection decreased dramatically.

“We found that from as high as 40 percent, the prevalence of trachoma went way down, even eliminated in some villages regardless of whether it was treated in an annual way or a biannual way,” Gaynor said. “You can genuinely get same with less.”

Their finding is significant because of how easily the disease spreads. Trachoma can be transmitted through touching one’s eyes or nose after being in close contact with someone who is infected. It can also be spread through a towel or an article of clothing from a person who has trachoma. Even flies can transmit the disease.

Approximately 41 million people are infected with trachoma globally, and 8 million go blind because of lack of access to treatment. More than 150 million doses of azithromycin have been given out worldwide to treat this disease. Unlike other antibiotics, resistance to azithromycin has not been found in Chlamydia trachomatis, the bacteria that causes trachoma.

This and the paper’s major finding give hope to Africa, Asia, the Middle East, and parts of Latin America and Australia, where trachoma is still a major problem.

“We will now be able to reach more people and make the treatment go twice as far as before,” Gaynor said. “This will make a huge impact in slowing down trachoma-related blindness globally.”

Gaynor is the corresponding author of the paper; the lead author is Teshome Gebre, PhD, of the Carter Center, Addis Ababa, Ethiopia, and Atlanta, GA; co-authors are Berhan Ayele, MSc, and Mulat Zerihun, MPH, and Paul M. Emerson, PhD, of the Carter Center, Addis Ababa, Ethiopia, and Atlanta, GA; Asrat Genet, MD, of Amhara Regional Health Bureau, Ethiopia; Thomas Lietman, MD, of the Francis I. Proctor Foundation, UCSF Dept. of Ophthalmology, UCSF Dept. of Epidemiology and Biostatistics, and UCSF Institute for Global Health; Travis C. Porco, PhD, of the Francis I. Proctor Foundation, UCSF Dept. of Epidemiology and Biostatistics, and UCSF Institute for Global Health; Nicole E. Stoller, MPH, Zhaoxia Zhou, BA, Jenafir I. House, MPH, Sun N. Yu, MPH, and Kathryn J. Ray, MS, of the Francis I. Proctor Foundation; Jeremy D. Keenan, MD, of the Francis I. Proctor Foundation and UCSF Department of Ophthalmology.

The study was supported by funds from the National Institutes of Health (NIH).

Released: 12/21/2011

Source: University of California, San Francisco (UCSF)

Related Link:

http://www.newswise.com/articles/breakthrough-in-treatment-to-prevent-blindness

Top 5 Winter Activities that Land You In The Emergency Room

Newswise — The first day of winter is Wednesday, December 21, and many states are bracing for a season of snow and ice. Broken bones from snowboarding and sledding top the list of common visits to the Emergency Department (ED) during the winter months. According to the Centers for Disease Control and Prevention, one-quarter of all emergency hospital visits are attributed to snowboarding accidents, and half of all cases were for broken bones and sprains.

“Chicagoans embrace winter with gusto largely because of the great love for hockey, sledding and ice skating,” said Gottlieb Memorial Hospital orthopaedic surgeon Daryl O’Connor, who formerly cared for U.S. Olympic ski and winter sports athletes in Salt Lake City, Utah. Dr. O’Connor is board certified in orthopaedic surgery and now specializes in sports medicine in the Orthopaedic Department at Gottlieb Memorial Hospital, part of Loyola University Health System.

Here are Dr. O’Connor’s evaluations of the top five winter sports:

1. Sledding – “More than 700,000 injuries are reported each year in the United States due to sledding. More than 30 percent are head injuries, caused by collisions,” O’Connor said.

2. Hockey – “Lacerations, as well as neck, shoulder and knee injuries are common in hockey. Many injuries are caused through contact with another player, the ice, a puck or actual skate blade,” he said.

3. Ice skating – “Injuries to the wrist as well as head and neck are most common and most injuries are caused by falls,” he said.

4. Snowboarding – “Wrist and elbow injuries are caused by falls on outstretched hands,” he said.

5. Skiing – “Knees really take a pounding and injury is often caused by extreme twisting force-propelled by the skis,” he said.

Snitching on Skitching

“This is not even a sport; it’s just being foolish,” said Dr. O’Connor of the practice in neighborhoods of daredevil teens grabbing a car’s rear bumper and sliding on their feet, or being pulled by ropes on inner tubes or sleds through icy streets. “In addition to broken bones, neck and shoulder injuries, young people can suffer fatal head trauma. Please, resist the skitch at all costs.”

Released: 12/21/2011

Source: Loyola University Health System

Related Link:

http://www.newswise.com/articles/top-5-winter-activities-that-land-you-in-the-er

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