JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. the Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF NEUROLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 9, 2005)
ATORVASTATIN SHOWS PROMISE IN SMALL TRIAL FOR THE TREATMENT OF MILD TO MODERATE ALZHEIMER'S DISEASE
U.S. LATINOS MAY DEVELOP ALZHEIMER'S DISEASE SYMPTOMS AT EARLIER AGE THAN WHITE, NON-LATINOS
ARCHIVES OF INTERNAL MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 9, 2005)
REGULAR VIGOROUS PHYSICAL ACTIVITY COULD SLOW PROGRESSION OF PROSTATE CANCER
LOW-FAT DAIRY MAY LOWER RISK OF TYPE 2 DIABETES IN MEN
ARCHIVES OF OPHTHALMOLOGY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, May 9, 2005)
OLDER ADULTS WITH DIABETES IN MANAGED CARE NETWORKS HAVE HIGHER RATES OF UNTREATED EYE DISEASE
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 9, 2005
Media Advisory: To contact D. Larry Sparks, Ph.D., call Linda Tyler at 623-815-7604.
ATORVASTATIN SHOWS PROMISE IN SMALL TRIAL FOR THE TREATMENT OF MILD TO MODERATE ALZHEIMER'S DISEASE
CHICAGO—Atorvastatin, a cholesterol-lowering drug, had some positive effects on clinical measures of cognitive and psychiatric symptoms in patients with Alzheimer's disease in a small trial, according to a study in the May issue of the Archives of Neurology, one of the JAMA/Archives journals.
A link between the pathology of Alzheimer's disease (AD) and cholesterol metabolism has been suggested by a number of human and animal studies, according to background information in the article. In addition, some epidemiological studies have shown that prior use of statins (cholesterol-lowering drugs) for the treatment of risk of coronary artery disease may also reduce the risk of Alzheimer's disease later in life. The current study is a small-scale trial of the cholesterol-lowering medication atorvastatin calcium for positive effects on cognitive and behavioral deterioration in mild to moderate Alzheimer's disease.
D. Larry Sparks, Ph.D., of the Sun Health Research Institute, Sun City, Arizona, and colleagues enrolled individuals with mild to moderate Alzheimer's disease in a double-blind, placebo-controlled, randomized one year trial of treatment with atorvastatin. Patients were evaluated at baseline, three, six, nine and twelve months to determine the effect of atorvastatin on cognitive and/or behavioral decline, using standard measures of cognitive function, psychiatric symptoms, activities of daily living and cholesterol levels. Sixty-seven individuals were randomized to receive either atorvastatin calcium or placebo; 63 patients were evaluated at the three month visit; 56 patients completed the 6-month visit; 48 patients completed the 9-month visit; and 46 completed the one-year study, 25 receiving atorvastatin and 21 receiving placebo.
"We have found that daily administration of 80 mg of atorvastatin calcium significantly reduces circulating cholesterol levels and may have a positive effect on the progressive deterioration of cognitive function and behavior anticipated in mild to moderate AD," the authors write. "As a pilot proof-of-concept study, significant differences were not expected, but benefits identified tend to support the trial's rationale based on the hypothesis that excess brain cholesterol-promoting amyloid beta production [excess amyloid beta protein deposits are a hallmark of AD] and subsequently the symptoms of AD come from the blood because of increased circulating levels."
"Finally, although the results clearly hold promise, this was a pilot proof-of-concept trial with a small number of participants," the authors conclude. "We believe that we provide evidence for proof of concept, and establishment of similar benefit of atorvastatin in a multicenter trial investigating the effect in a much larger population may provide proof of therapy. Two such studies are ongoing."
(Arch Neurol. 2005;62:753-757. Available post-embargo at archneurol.com)
Editor's Note: This study was supported by the Institute for the Study of Aging, the Estee Lauder Charitable Trust, and Pfizer Inc., New York.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 9, 2005
Media Advisory: To contact Christopher M. Clark, M.D., call Karen Kreeger at 215-662-2560.
U.S. LATINOS MAY DEVELOP ALZHEIMER'S DISEASE SYMPTOMS AT EARLIER AGE THAN WHITE, NON-LATINOS
CHICAGO—U.S. Latinos develop symptoms of Alzheimer's disease earlier, on average, than
white non-Latino people, according to a study in the May issue of the Archives of Neurology, one of the JAMA/Archives journals.
Although Latino people are a geographic and genetically diverse group, some reports suggest that they may differ from Anglo (white non-Latino) individuals in several Alzheimer's disease (AD) characteristics, according to background information in the article. Differences shown in previous studies include a higher prevalence of Alzheimer's in both Caribbean and Mexican-American Latino people and an increased incidence of Alzheimer's in the Latino populations of New York City and Houston, compared with Anglos. This study compares the age at which Alzheimer's symptoms first appear between Latino and Anglo subjects evaluated through the National Institute on Aging-sponsored Alzheimer's Disease Centers (ADC) program.
Christopher M. Clark, M.D., of the University of Pennsylvania, Philadelphia, and colleagues at five Alzheimer's Disease Centers (three east coast and two west coast centers) conducted a two phase study to compare the age of onset of Alzheimer's disease symptoms of U.S. mainland Latino individuals with age of symptom onset in Anglo individuals. The first phase of the study, a retrospective database analysis, found that the mean (average) age at symptom onset for 366 Latino patients with a clinical diagnosis of Alzheimer's was 68.8 years compared with 73.5 years for 2,823 Anglo patients and was consistent for the east coast centers (individuals of predominately Caribbean origin) and the west coast centers (individuals of predominately Mexican origin).
In the second phase of the study, 119 Latinos and 55 Anglo patients with probable or possible Alzheimer's disease were evaluated using a number of standardized assessment tests for severity of dementia and psychiatric symptoms. In addition, information on each patient, including birthplace, migration history, years of education and the age of the onset of Alzheimer's symptoms was obtained from a knowledgeable informant, usually a spouse or adult child. In this phase of the study, the researchers found that Latinos had a mean age of symptom onset that was 6.8 years earlier than Anglo individuals evaluated at the same clinic. There was no difference in the age of symptom onset between the Latinos evaluated at the east and west coast centers, although there were differences in the countries of origin.
"...the findings in this study indicate that Latino individuals, the largest and fastest growing minority group in the mainland United States, appear to have an earlier age of AD symptom onset compared with Anglo individuals with a similar educational level," the authors conclude. "The factors responsible for this remain to be identified, but the observation has a potential impact on both the burden of dementia care carried by this population group and the dementia-related diagnostic and educational efforts directed toward the Latino population. From the individual patient and family standpoint as well as a public health perspective, it is important to identify modifiable factors that contribute to the symptomatic expression of AD in this significant minority group."
(Arch Neurol. 2005;62:774-778. Available post-embargo at archneurol.com)
Editor's Note: This study was supported by grants from the National Institute on Aging, Bethesda, Md.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 9, 2005
Media Advisory: To contact Edward L. Giovannucci, M.D., Sc.D., call Kevin Myron at 617-432-3952.
REGULAR VIGOROUS PHYSICAL ACTIVITY COULD SLOW PROGRESSION OF PROSTATE CANCER
CHICAGO—Men with higher levels of physical activity may reduce their risk of dying from prostate cancer and slow the progression of the disease, according to a study in the May 9 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
"Some studies have suggested that more physically active men may have a lower risk of prostate cancer, but the associations have tended to be moderate, not always statistically significant, and sometimes only evident among older subgroups or for substantially high, but not moderate, levels of activity," according to background information in the article. However, many of these studies did not research physical activity in detail.
Edward L. Giovannucci, M.D., Sc.D., from Harvard School of Public Health, Boston, and colleagues used data from the Health Professionals Follow-Up Study to assess the association between physical activity and prostate cancer incidence and progression. The number of cases of incident, advanced, fatal, and high-grade prostate cancer was determined for 47,620 U.S. male health professionals in the study, who were followed up from February 1986 to January 2000. Participants were asked to report the average time per week they took part in the following activities during the past year: walking or hiking outdoors, jogging, running, bicycling, lap swimming, tennis, squash or racquetball, and calisthenics or rowing.
During 14 years of follow-up, 2,892 new cases of prostate cancer were diagnosed, including 482 advanced cases. The researchers observed no association for total prostate cancer in relation to total vigorous and nonvigorous physical activity. A lowered risk of advanced and fatal cases of prostate cancer was found in men 65 years or older who were in the highest category of vigorous physical activity. However, these associations were not observed in younger men.
"In conclusion, men 65 years or older engaging at least three hours of vigorous physical activity weekly had a markedly lower risk (almost 70 percent) of being diagnosed as having high-grade, advanced, or fatal prostate cancer," the authors write. "Although the mechanisms still need to be understood, these findings suggest that vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer, particularly given the many other documented benefits of exercise."
(Arch Intern Med. 2005;165:1005-1010. Available post-embargo at archinternmed.com)
Editor's Note: This study was supported by a research grant from the National Institutes of Health, Bethesda, Md.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 9, 2005
Media Advisory: To contact Hyon K. Choi, M.D., Dr. P.H., call Sue McGreevey at 617-724-2764.
To contact editorial author Janet C. King, Ph.D., call Venita Robinson at 510-428-3069.
LOW-FAT DAIRY MAY LOWER RISK OF TYPE 2 DIABETES IN MEN
CHICAGO—Men who include more dairy products in their diets, especially low-fat varieties, may have a lower risk of developing type 2 diabetes, according to a study in the May 9 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
"Type 2 diabetes affects approximately 16 million people in the United States and 135 million people worldwide," the authors provide as background information. "Because management of diabetes and its complications, such as cardiovascular disease, amputation, blindness, and renal failure, imposes enormous medical and economic burdens, primary prevention has become a public health imperative. Recent studies have shown that diet and lifestyle modifications are important means of preventing type 2 diabetes."
Hyon K. Choi, M.D., Dr.P.H., from Massachusetts General Hospital, Boston, and colleagues from Harvard School of Public Health, analyzed data from 41,254 male participants with no history of diabetes, cardiovascular disease, and cancer at the start of the Health Professionals Follow-up Study.
"During 12 years of follow-up, we documented 1,243 [new] cases of type 2 diabetes," the researchers report. "Each serving-per-day increase in total dairy intake was associated with a nine percent lower risk for type 2 diabetes." The researchers note: "When we examined the association with dairy products stratified by their fat contents, the significant inverse association was primarily limited to low-fat dairy consumption. Most individual low-fat dairy products and ice cream showed a similar inverse trend but only skim milk reached statistical significance."
"In conclusion, dietary patterns characterized by higher dairy intake, especially low-fat dairy intake, may lower the risk of type 2 diabetes," the authors state.
(Arch Intern Med. 2005;165:997-1003. Available post-embargo at archinternmed.com)
Editor's Note: This work was supported in part by grants from the National Institutes of Health, Bethesda, Md.
EDITORIAL: THE MILK DEBATE
In an accompanying editorial, Janet C. King, Ph.D., from Children's Hospital Oakland Research Institute, Oakland, Calif., writes that "...it is evident that milk contains a number of bioactive components beyond amino acids, vitamins, and minerals. ...Research shows that the role of dairy foods in health is very complex and probably varies with the genotype and phenotype of the individual. The study by Choi et al is a further reminder of the potential importance of dairy intake and the continuing value of research in this area."
(Arch Intern Med. 2005;165:975-976. Available post-embargo at archinternmed.com)
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, May 9, 2005
Media Advisory: To contact Arleen F. Brown, M.D., Ph.D., call Enrique Rivero at 310-794-2273.
OLDER ADULTS WITH DIABETES IN MANAGED CARE NETWORKS HAVE HIGHER RATES OF UNTREATED EYE DISEASE
CHICAGO—Medicare beneficiaries at high risk for eye disease due to diabetes are more likely to have unrecognized and untreated eye disease if they are enrolled in managed care than if they have fee-for-service (FFS) health insurance, according to an article in the May issue of the Archives of Ophthalmology, one of the JAMA/Archives journals.
Individuals aged 65 and older with diabetes are at high risk for eye diseases, including cataract, glaucoma and diabetic retinopathy (an eye disease in the retina that can result in seriously distorted or blurred vision), according to background information in the article. Although previous studies have shown that appropriate ophthalmic care can reduce the progression of eye disease and reduce or reverse visual disability, eye care for older persons with diabetes may not be adequate. The authors suggest that managed care has the potential to enhance the coordination of primary and specialty care and increase access to appropriate eye care for older individuals with diabetes. In some states, including California, almost half of all Medicare beneficiaries in managed care were enrolled in for-profit Medicare + Choice plans in 1999.
Arleen F. Brown, M.D., Ph.D., of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues interviewed Medicare beneficiaries in Los Angeles County with diabetes about their medical history and health care and eye care service use. Ophthalmologic examinations were performed to assess need for eye care services. The researchers also evaluated whether the rates of need for eye care differed in fee-for-service Medicare and the for-profit Medicare + Choice network model (MC) managed care plan. The need for eye care within six months of the eye examination was based on American Academy of Ophthalmology guidelines and clinical judgment.
Three-hundred-eleven patients with managed care health insurance and 107 with fee-for-service health insurance completed the interviews and clinical examinations. The researchers found high rates of untreated eye disease in individuals with both types of insurance. Managed care patients had significantly higher rates of cataract (36 percent versus 22 percent) and somewhat higher rates of diabetic retinopathy and glaucoma, the authors report. Overall, managed care patients were more likely to have at least one of the three eye diseases, diabetic retinopathy, cataract, or glaucoma or suspected glaucoma, (68 percent versus 46 percent) than fee-for-service patients.
"Our findings indicate that older adults with diabetes are at risk for undetected and untreated age-related eye diseases, suggesting that more than just treatment for retinopathy must be considered when evaluating the appropriateness of the interval between eye care visits for older persons with diabetes," the authors conclude. "Additionally, older adults with diabetes who were enrolled in a network-model managed care setting were more likely to need care for treatable ophthalmic conditions that comparable persons who obtain service under FFS Medicare. Moreover, the majority of study participants had been seen by an eye care specialist in the prior 12 months, and this did not differ by type of insurance. This suggests that although access to eye care visits is similar in the FFS and MC settings studied, the content and quality of that care may differ."
(Arch Ophthalmol. 2005;123:669-675. Available post-embargo at archophthalmol.com)
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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