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 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, October 10, 2005)
SPECIAL ONLINE PUBLICATION—EATING FISH ASSOCIATED WITH SLOWER COGNITIVE DECLINE
MIDLIFE OBESITY MAY BE ASSOCIATED WITH RISK OF DEMENTIA AND ALZHEIMER'S DISEASE
ARCHIVES OF INTERNAL MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, October 10, 2005)
FLORIDA PHYSICIANS DECREASE OR ELIMINATE SERVICES
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, October 10, 2005
Media Advisory: To contact Martha Clare Morris, Sc.D., call Mary Ann Schultz at 312-942-7816.
EATING FISH ASSOCIATED WITH SLOWER COGNITIVE DECLINE
CHICAGO—Consuming fish at least once a week was associated with a 10 percent per year slower rate of cognitive decline in elderly people, according to a new study posted online today from the Archives of Neurology, one of the JAMA/Archives journals. The study will be published in the December print edition of the journal.
Fish is a direct source of omega-3 fatty acids, which have been shown to be essential for neurocognitive development and normal brain functioning, according to background information in the article. Fish consumption has been associated with lower risk of dementia and stroke and recent studies have suggested that consumption of one omega-3 fatty acid in particular, docosahexaenoic acid (DHA), is important for memory performance in aged animals.
Martha Clare Morris, Sc.D., of Rush University Medical Center, Chicago, and colleagues analyzed six years of data from an ongoing study of Chicago residents, 65 years and older, first interviewed between 1993 and 1997 and every three years in two follow-up interviews. Interviews included four standardized cognitive tests and dietary questions on the frequency of consumption of 139 different foods, as well as questions of daily activities, exercise levels, alcohol consumption and medical history.
"Dietary intake of fish was inversely associated with cognitive decline over six years in this older, biracial community study," the researchers report. "The rate of decline was reduced by 10 percent to 13 percent per year among persons who consumed one or more fish meals per week compared with those with less than weekly consumption. The rate reduction is the equivalent of being three to four years younger in age." The researchers examined whether overall dietary consumption patterns accounted for the association of cognitive decline and fish consumption, but the rate differences did not change after adjusting for consumption of fruit and vegetables.
"Cognitive decline is common among older people and is very much associated with advancing age," the authors write. "Our data offer no insight as to whether this cognitive decline is pathological or the result of a normal aging process. Nonetheless, data from the United States and other countries indicate that it is a widespread and increasing public health problem."
"This study suggests that eating one or more fish meals per week may protect against cognitive decline associated with older age," the authors conclude. "More precise studies of the different dietary constituents of fish should help to understand the nature of the association."
(Arch Neurol. 2005;62:1-5. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by grants 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, October 10, 2005
Media Advisory: To contact Miia Kivipelto, M.D., Ph.D., email miia.kivipelto{at}neurotec.ki.se.
MIDLIFE OBESITY MAY BE ASSOCIATED WITH RISK OF DEMENTIA AND ALZHEIMER'S DISEASE
CHICAGO—Individuals who were obese at midlife had an increased risk for dementia later in life compared to individuals of normal weight, according to an article in the October issue of the Archives of Neurology, one of the JAMA/Archives journals.
Obesity is on the rise all over the world and is related to vascular diseases, which may be linked to dementia and Alzheimer's disease (AD), according to background information in the article. However, the link between obesity and dementia risk has not been extensively studied and long-term follow-up studies performed thus far have yielded somewhat conflicting results.
Miia Kivipelto, M.D., Ph.D., from the Karolinska Institutet, Stockholm, Sweden, and colleagues re-examined participants in the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study to investigate the relationship between midlife body mass index (BMI; weight in kilograms divided by square of height in meters) and a group of vascular risk factors, and subsequent dementia and AD. Participants in the CAIDE study were derived from random, population-based samples previously studied in a survey carried out in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals aged 65 to 79 years participated in the 1998 re-examination.
The researchers discovered dementia and AD to be prevalent significantly more among those with a higher midlife BMI. One-third of the participants had a BMI lower than 25 (normal weight), half had a BMI from 25 to 30 (overweight), and the remaining 16 percent had a BMI higher than 30 (obese) at midlife. A history of heart attack and diabetes mellitus were more prevalent in those with the highest midlife BMI.
A total of 61 participants were diagnosed as having dementia, and 48 of them fulfilled the diagnostic criteria for Alzheimer's disease. Midlife obesity, high systolic blood pressure, and high total cholesterol level were all significant risk factors for late-life dementia. Being overweight in midlife was not significantly associated with dementia later in life.
"This study shows that obesity at midlife may increase the risk of dementia and AD later in life," the authors write. "...midlife obesity, high SBP, and high total cholesterol level were all significant risk factors for dementia, each of them increasing the risk around two times. Clustering of these vascular risk factors increased the risk of dementia and AD in an additive manner so that persons with all three risk factors had around a six times higher risk for dementia than persons having no risk factors."
(Arch Neurol. 2005;62:1556-1560. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported by the Aging Program of the Academy of Finland, Helsinki; EVO grants from the Kuopio University Hospital, Kupio, Finland; Academy of Finland grants (Dr. Kivipelto); and the Gamla Tjänarinnor Foundation (Dr. Kivipelto), grant from the Swedish Coucil for Working Life and Social Research, and the SADF (Insamligsstiftelsen för Alzheimeroch Demensforskning) (co-author, Ms. Ngandu), Stockholm.
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, October 10, 2005
Media Advisory: To contact Robert G. Brooks, M.D., call Nancy Kinnally at 850-644-7824.
FLORIDA PHYSICIANS DECREASE OR ELIMINATE SERVICES
CHICAGO—Florida physicians reportedly continued to decrease or eliminate important health services in 2004 in response to difficulties in finding or paying for professional liability insurance, according to a study in the October 10 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
Despite growing concern about possible effects of instability in the professional liability insurance (PLI) market on patient access to health care, there has been little formal, systematic assessment of how physicians may be changing their services to adapt, according to background information in the article. Understanding the impact of professional liability insurance market instability on health service delivery is important to clinicians and policymakers concerned with patients' access to needed medical care, the authors suggest.
Robert G. Brooks, M.D., of Florida State University, Tallahassee, and colleagues surveyed rural and urban/suburban physicians in Florida in 2004 to determine recent changes in services offered, professional liability insurance premium changes, satisfaction with practice and future practice plans.
Overall, 727 (54.4 percent) of the 1,346 responding physicians (380/685 rural and 347/661 urban/suburban physicians) stated that they had decreased or eliminated the delivery of patient services in the previous year, the researchers report. "The most common services eliminated were nursing home coverage (42.1 percent), vaginal deliveries (29.1 percent) cesarean deliveries (26.0 percent), emergency department coverage (22.8 percent) and mental health services (21.2 percent). In addition to outright elimination, a number of physicians responded that they had decreased services in these areas as well. ...Surgical specialists (70.2 percent) and general surgeons (68.5 percent) respectively, had the highest number of decreased or eliminated services. Obstetricians/gynecologists (63.6 percent) and family medicine physicians (60.2 percent) were also commonly represented in this group."
"Changes in health care services seemed to be related to changes in PLI premiums," the authors write. "Overall, physicians who had premium changes in the highest quartile (increase > 50 percent) (61.1 percent) were more likely to indicate that they had decreased or eliminated services compared with those in the lowest quartile (increase < 15 percent) (51.4 percent). ...Similarly, we noted statistically significant relationships between increases in PLI premiums and decrease in or elimination of services for rural physicians (66.2 percent vs. 48.1 percent) and for actual premiums for urban/suburban physicians (64.7 percent vs. 43.0 percent.)"
The authors conclude that the findings presented in the study "strongly suggest that physicians across Florida have continued to decrease or eliminate important health care services. This trend seems to be affecting a broad array of services and types of physicians, both generalists and specialists. Given the importance of access to health care for vulnerable populations, these statewide trends suggest the need for additional attention by physician leaders and policy-makers to the ongoing effects of the PLI market."
(Arch Intern Med. 2005;165:2136-2141. Available to the media pre-embargo at www.jamamedia.org)
Editor's Note: This study was supported in part by the Center for Rural Health Research and Policy of the Florida State University College of Medicine, Tallahassee.
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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