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Physical activity can predict heart disease risk in elderly, study shows

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June 5 (UPI) — Assessing how much elderly people exercise may help determine their risk for heart disease, a study published Friday in the journal Mayo Clinic Proceedings: Innovations, Quality and Outcomes has found.

The research revealed that seniors who rated their levels of physical activity lower on a zero to 10 scale were nearly twice as likely to die from coronary artery disease as those who scored themselves higher.

Conducting the assessment during routine medical appointments could lead to earlier diagnosis and treatment of conditions like atherosclerosis, or hardening of the arteries, a common underlying cause of heart disease-related death, the authors said.

“With people now living longer, there is a growing need to determine how we can best detect latent heart disease and its associated clinical risk in older adults,” Dr. Alan Rozanski, a professor of cardiology at the Icahn School of Medicine at Mount Sinai, said in a press release.

“Our study showed that simply asking patients to rate their level of physical activity, while using a test to look at the plaque in their coronary arteries, markedly improved our ability to predict patients’ risk for dying over their next decade of life,” Rozanski said.

Approximately 610,000 Americans die from heart disease annually, according to the U.S. Centers for Disease Control and Prevention. Atherosclerosis is the underlying cause in roughly half of these deaths, research indicates.

The condition is caused by the accumulation of calcified plaque in the coronary arteries. Regular exercise — in addition to diet, quitting or avoiding smoking and maintaining a healthy weight — can help prevent atherosclerosis, according to the Mayo Clinic.

For their research, Rozanski and his colleagues assessed 2,318 patients between age 65 and 84 using coronary artery calcium, or CAC, scanning — a chest computed tomography scan that detects and measures the amount of calcified plaque in the coronary arteries.

Study participants filled out a questionnaire before the scan, which included rating current level of physical activity on a scale from zero — or none — to 10 — always. Participants’ resting heart rate, blood pressure, height and weight, as well as medical history, including hypertension, diabetes and tobacco use, were also recorded.

The researchers followed the participants for 10 years. Those who reported less physical activity had the highest mortality rates — 2.9 percent annually — compared to patients who reported more physical activity — 1.7 percent annually — researchers said.

Those with little or no evidence of atherosclerosis had low mortality rates regardless of their physical activity scores, the researchers said.

However, participants with evidence of significant atherosclerosis — CAC scores above 400 — who reported higher levels of physical activity had lower risk for death, they said.

In fact, death rates among those with high CAC scores who reported high physical activity were similar to those found in participants with low CAC scores and low physical activity.

“Our results indicate that a simple assessment of self-reported daily-life physical activity can substantially improve the effectiveness of CAC scanning for risk stratifying older adults and is strongly encouraged,” Rozanski said. “This is consistent with recent suggestions to make assessment of physical activity a ‘fifth vital sign.'”



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Common meds linked to faster mental decline in seniors

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A group of widely used medications might speed up older adults’ mental decline — especially if they are at increased risk of dementia, a new study hints.

The medications in question are called anticholinergics, and they are used to treat a diverse range of conditions — from allergies, motion sickness and overactive bladder to high blood pressure, depression and Parkinson’s disease.

The drugs are known to have short-term side effects such as confusion and fuzzy memory.

But studies in recent years have turned up a more troubling connection: a heightened risk of dementia among long-term users.

The new findings, published Sept. 2 in Neurology, add another layer: Healthy older adults on these medications had an increased risk of developing mild cognitive impairment. That refers to subtler problems with memory and thinking that may progress to dementia.

And the link, researchers found, was strongest among two groups of people already at heightened risk of Alzheimer’s disease: those who carry a gene variant that raises the odds of the disease, and people with certain biological “markers” of the disease in their spinal fluid.

The results do not prove anticholinergic drugs are to blame, cautioned Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.

“This study shows an association in a very specific population, but it does not prove causation,” said Snyder, who was not involved in the research.

However, it is biologically plausible that the drugs could increase dementia risk, said Dr. Allison Reiss, an associate professor at NYU Long Island School of Medicine.

The medications, she said, block a chemical called acetylcholine, which transmits messages among nerve cells. Acetylcholine is involved in memory and learning, and is typically low in people with Alzheimer’s.

“The preponderance of evidence suggests it’s better to avoid these medications in older adults,” said Reiss, who is also an advisory board member at the Alzheimer’s Foundation of America.

That’s especially true, she added, when alternatives exist.

Many medications sold for allergies, colds and coughs have anticholinergic properties — and are available over-the-counter. So it’s important, Reiss said, that older adults be aware that non-prescription drugs are not automatically “safe.”

“You don’t want to add any medications that aren’t necessary,” said Reiss, who had no role in the study.

Meanwhile, certain prescription drugs for depression, high blood pressure, Parkinson’s disease and schizophrenia have anticholinergic properties, as do medications for overactive bladder and urinary incontinence.

Reiss said that people with questions about their prescriptions should talk to their doctor.

For the new study, researchers led by Lisa Delano-Wood, from the University of California, San Diego, followed 688 older adults who initially had no problems with memory or thinking skills. One-third said they’d been regularly taking anticholinergic drugs for more than six months — usually far more than one.

In fact, they were taking an average of almost five medications per person.

Over the next 10 years, people on anticholinergics were more likely to develop mild cognitive impairment, which was gauged through yearly tests. Over half — 51% — developed the condition, versus 42% of older adults not taking anticholinergics.

The researchers did consider other factors that affect dementia risk — such as people’s education levels and history of heart disease or stroke. And after adjusting for those factors, older adults on anticholinergics were still 47% more likely to develop mild impairment.

The link was even stronger among people who carried a gene variant that raises Alzheimer’s risk: Anticholinergic use more than doubled their risk of impairment. A similar pattern was seen among study participants with Alzheimer’s-linked proteins in their spinal fluid.

That, Reiss said, suggests the medications might have “accelerated a process that was already in place.”

Snyder said the results “illustrate that we need better treatments — not only for Alzheimer’s and other dementias, but for other common conditions associated with aging.”

More information

The University of British Columbia has more on anticholinergic drugs.

Copyright 2020 HealthDay. All rights reserved.



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Even ‘social smokers’ up their odds of death from lung disease

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Even light smokers are much more likely to die of lung disease or lung cancer than nonsmokers, a new study warns.

“Everyone knows that smoking is bad for you, but it’s easy to assume that if you only smoke a little, the risks won’t be too high,” said study co-leader Pallavi Balte, of Columbia University Irving Medical Center, in New York City.

The new study shows how wrong that thinking can be. It included nearly 19,000 people in the United States, average age 61, who were followed for an average of 17 years. During that time, nearly 650 died of lung disease (such as emphysema) and 560 died of lung cancer.

Among nonsmokers, less than 2% died from lung disease and less than 1% died from lung cancer. But among social smokers (fewer than 10 cigarettes a day), those numbers were over 3% and close to 5%, respectively.

Not surprisingly, heavy smokers (more than 20 cigarettes a day) fared worst, with more than 10% dying from lung disease and about 13% from lung cancer, the study found.

After accounting for other potential factors — such as age, sex, race, level of education and body weight — the researchers concluded that social smokers were 2.5 times more likely to die of lung disease and 8.6 times more likely to die of lung cancer than nonsmokers.

Social smokers had around half the rate of death from lung disease as heavy smokers, but their rate of lung cancer death was two-thirds that of heavy smokers, according to the study.

The results were scheduled for presentation at a virtual meeting of the European Respiratory Society. Data and conclusions presented at meetings should be considered preliminary until peer-reviewed.

The findings show that cutting down on smoking is no substitute for quitting, the researchers concluded.

“Previous research suggests that people are cutting down on smoking. For example, in the U.S.A., the proportion of smokers smoking less than 10 cigarettes per day has increased from 16% to 27%,” Balte said in a society news release.

“You might think that if you only smoke a few cigarettes a day you are avoiding most of the risk. But our findings suggest that social smoking is disproportionately harmful,” Balte said.

If you don’t want to die of lung cancer or respiratory disease, the best action is to quit completely, she added.

More information

The U.S. Centers for Disease Control and Prevention offers a guide for quitting smoking.

Copyright 2020 HealthDay. All rights reserved.



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Antidepressant use rising in U.S., mostly in women, CDC says

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Sept. 4 (UPI) — Nearly 18% of all adult women in the United States used antidepressant medication between 2015 and 2018, compared to just over 8% of men, according to data released Friday by the Centers for Disease Control and Prevention.

Overall, during the decade between 2009-2010 and 2017-2018, antidepressant use increased to 14% from 11%, the agency found. Use increased more for women — to 19% from 14% — than for men — to 9% from 7%.

In 2018, slightly more than 7% of adults in the United States said they suffered from a “major depressive episode,” the agency said.

The findings are based on an analysis of data from the National Health and Nutrition Examination Survey for the 10-year period between 2009 and 2018.

Depression is a mental health disorder in which sufferers experience a persistent depressed mood or loss of interest in activities, causing significant impairment in daily life, according to the National Institute of Mental Health.

Antidepressant medications are used to reduce the symptoms of depression, and include selective serotonin reuptake inhibitors, or SSRIs, and serotonin and norepinephrine reuptake inhibitors, or SNRIs.

From 2015 through 2018, antidepressant use increased with age and was highest among women aged 60 and over, at slightly more than 24%, the CDC found.

In addition, use of the drugs was higher among non-Hispanic White adults, at 17%, compared with non-Hispanic Black adults, at 8%, and non-Hispanic Asian adults, at 3%.

Adults with at least some college education were more likely to use antidepressants than those with a high school education or less, the agency said.



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