Dementia declining among American seniors

A study by Langa et al published in JAMA Internal Medicine, reveals that the dementia rate in Americans 65 and older fell over the past 12 years.

The authors used data from the Health and Retirement Study (HRS) of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS.

In this study of more than 21 000 US adults 65 years or older, dementia prevalence declined significantly, from 11.6% in 2000 to 8.8% in 2012.  Interestingly a previous post dated April 2016 reported on a study publishedin NEJM that found a decline in the incidence of dementia in the Framingham Hearth Study.

The study subjects 56% of which were females had an average age of 75.0 years in 2000 and 74.8 years in 2012. Dementia prevalence among those 65 years or older decreased from 11.6% in 2000 to 8.8%. More years of education was associated with a lower risk for dementia, and average years of education increased significantly from 11.8 years to 12.7 between 2000 and 2012.  An unexpected finding was that being overweight was also associated with a 30% decreased risk of dementia.  The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults.

The authors concluded that the prevalence of dementia in the United States declined significantly between 2000 and 2012.

Light-to-moderate alcohol use reduces risk of death

According to a study by Xiet al published in the Journal of theAmerican College of Cardiology, the researchers found that light and moderate drinkers were less likely to die from any cause compared to those who have never consumed alcohol.

The authors analyzed data from 333,247 participants 18 years of age or older. The main outcome was all-cause, cancer, or cardiovascular (CVD) mortality.  After a median follow-up of 8.2 years, 34,754 participants died of all causes (including 8,947 CVD deaths and 8,427 cancer deaths). Compared with lifetime abstainers, those who were light or moderate alcohol consumers (14 or fewer drinks per week for men and seven or fewer for women) were about 20% less likely to die from any cause. They were also about 25% to 30% less likely to die from cardiovascular disease.  In contrast, there was 11% increased risk of mortality of all causes and 27% of cancer in heavy drinkers.  People who binge drank at least once a week—defined as having five or more drinks in one day—were also at increased risk of dying, especially from cancer.

Light to moderate alcohol intake might have a protective effect on all-cause and CVD-specific mortality while binge drinking was associated with increased risk of all-cause and cancer-specific mortality.

Coffee may prolong life expectancy

A study by Gunter et al published in the Annals of Internal Medicine found that drinking one cup of coffee a day was associated with a 12 percent decrease in risk of death, and that drinking two to three cups a day decreased the risk of death by 18 percent.

The authors studied a cohort of 521 330 persons from 10 European countries enrolled in European Prospective Investigation into Cancer and Nutrition (EPIC).  They evaluated the association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health.

During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with non-consumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality. Inverse associations were observed for digestive disease mortality for both sexes. Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality and cerebrovascular disease mortality and a positive association with ovarian cancer mortality.

The authors concluded that coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary among populations in the countries studied.

In another study by Parket al published in the Annals of Internal Medicine the authors report that coffee consumption was linked with a lower risk of death among racially diverse populations.  The study was conducted in Hawaii and Los Angeles and participants were 185 855 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites aged 45 to 75 years.  58 397 participants died during 16 years follow-up.  Compared with those who did not drink coffee, coffee consumption was associated with lower total mortality after adjustment for smoking and other potential confounders.

Among examined end points, inverse associations were observed for deaths due to heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease.

The authors concluded that coffee consumption was associated with lower risk for death in African Americans, Japanese Americans, Latinos, and whites.  Only native Hawaiians did not reach statistical significance.

Coffee is one of the most frequently consumed beverages worldwide. In the United States, about 75% of adults drink coffee.  Coffee is a major source of caffeine and several bioactive substances.  Because of the widespread consumption of coffee, understanding its health effects is important.

Non-adherence to Antihypertensive Treatment

Research published in Hypertension by Gupta et al looked at the reasons of non-adherence to anti-hypertensive treatment.

The researchers used liquid chromatography-tandem mass spectrometry of urine and serum to detect non-adherence and explored its association with the main demographic- and therapy-related factors in 1348 patients with hypertension in the United Kingdom and Czech republic.

The researchers found that non-adherence to the blood pressure medications was inversely related to age and male sex and was as high as 41.6% in the UK and 31.5% in the Czech Republic. Furthermore, with each additional prescription, the rate of non-adherence increased to 85% and 77% in the UK and Czech populations.  The odds of non-adherence to diuretics were the highest among 5 classes of antihypertensive medications in both populations.

High blood pressure is the single most important risk factor for health loss and premature death worldwide.  Although treatment is proven to be effective, target blood pressures are only achieved in 40-50% of patients. This is likely due to a high number of patients taking their medicines incorrectly, or at all.