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 INTERNAL MEDICINE NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, June 26, 2006
COFFEE INTAKE LINKED TO LOWER DIABETES RISK
SEVERE HOT FLASHES ASSOCIATED WITH CHRONIC INSOMNIA
STUDY IDENTIFIES FACTORS ASSOCIATED WITH AGGRESSION IN NURSING HOME RESIDENTS
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 26, 2006
Media Advisory: To contact Mark A. Pereira, Ph.D., call Liz Bryan at 612-624-5680.
COFFEE INTAKE LINKED TO LOWER DIABETES RISK
CHICAGO—Drinking coffee, especially when it is decaffeinated, may be associated with a reduced risk of type 2 diabetes, according to a report in the June 26 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
Previous studies in the United States and Europe have linked coffee to a reduced risk of type 2 diabetes, according to background information in the article. The link between coffee and diabetes risk appears to be consistent across different ages and body weights; in addition, most research has found that the more coffee an individual generally drinks, the lower his or her risk for diabetes. However, it remains unclear whether it is the caffeine or another ingredient in coffee that may confer a protective effect.
Mark A. Pereira, Ph.D., and colleagues at the University of Minnesota, Minneapolis, studied coffee intake and diabetes risk in 28,812 postmenopausal women in Iowa over an 11-year period. At the beginning of the study, in 1986, the women answered questions about their risk factors for diabetes, including age, body mass index, physical activity, alcohol consumption and smoking history. They also reported how often they consumed a variety of foods and beverages over the previous year, including regular and decaffeinated coffee.
Based on information reported in the initial questionnaire, about half of the women (14,224) drank one to three cups of coffee per day; 2,875 drank more than six cups; 5,554 four to five cups; 3,231 less than one cup; and 2,928 none. Over the following 11 years, 1,418 of the women reported on surveys that they had been newly diagnosed with type 2 diabetes. After adjusting the data for some of the other diabetes risk factors, women who drank more than six cups of any type of coffee per day were 22 percent less likely than those who drank no coffee to be diagnosed with diabetes; those who drank more than six cups of decaffeinated coffee per day had a 33 percent reduction in risk compared with those who drank none.
Overall caffeine intake did not appear to be related to diabetes risk, further suggesting that some other ingredient in coffee was responsible. "Magnesium, for which coffee is a good source, could explain some of the inverse association between coffee intake and risk of type 2 diabetes mellitus through known beneficial effects on carbohydrate metabolism," the authors write. However, the study found no association between this mineral and diabetes risk. Other minerals and nutrients found in the coffee bean-including compounds known as polyphenols that have also been shown to help the body process carbohydrates and antioxidants that may protect cells in the insulin-producing pancreas-may contribute to its beneficial effects and should be examined in future studies.
"In summary, we observed an inverse association between coffee consumption, especially decaffeinated coffee consumption, and the risk of type 2 diabetes mellitus over an 11-year period in postmenopausal women residing in the state of Iowa," the authors conclude. "Although the first line of prevention for diabetes is exercise and diet, in light of the popularity of coffee consumption and high rates of type 2 diabetes mellitus in older adults, these findings may carry high public health significance."
(Arch Intern Med.
2006;166:1311-1316. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This work was supported by a grant from the National Cancer Institute.
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, June 26, 2006
Media Advisory: To contact Maurice M. Ohayon, M.D., D.Sc., Ph.D., call Michelle Brandt at 650-723-0272.
SEVERE HOT FLASHES ASSOCIATED WITH CHRONIC INSOMNIA
CHICAGO—Women who have severe hot flashes may have more chronic sleep problems than women who do not, according to a report in the June 26 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
As many as 85 percent of menopausal women experience hot flashes, sensations of heat that may also involve sweating, according to background information in the article. Hot flashes often occur during the night and have been associated with insomnia, or difficulty sleeping. The symptoms of insomnia include problems falling asleep and/or staying asleep, sleep that is not restful and an overall dissatisfaction with sleep quantity or quality. Because many other factors also influence sleep in menopausal women, the exact link between hot flashes and insomnia has been difficult to establish.
Maurice M. Ohayon, M.D., D.Sc., Ph.D., Stanford University School of Medicine, Palo Alto, Calif., conducted telephone interviews with 3,243 individuals in California, including 982 women ages 35 to 65 years, between June 2003 and April 2004. Of the women, 562 (57.2 percent) were premenopausal; 219 (22.3 percent) were perimenopausal, meaning that they had irregular menstrual cycles with at least one period in the previous year; and 201 (20.5 percent) were postmenopausal, or had reported no menstrual bleeding in the previous year. Hot flashes were defined as mild if they usually did not involve sweating, moderate if they mostly involved sweating but did not require a woman to stop the activity she was pursuing and severe if they typically involved sweating and did require a woman to stop an activity.
About 33 percent of the women reported having hot flashes, including 12.5 percent of the premenopausal women, 79 percent of perimenopausal women and 39.3 percent of postmenopausal women. Of those who had hot flashes, about half reported that they were typically mild, while about one-third had moderate and about 15 percent had severe hot flashes. More than 81 percent of women with regular severe hot flashes had symptoms of chronic insomnia. These women reported difficulty falling asleep, non-restful sleep and overall dissatisfaction with their sleep patterns on a regular basis (at least three nights a week for at least the past six months). Women with mild hot flashes did not report these problems any more frequently than did women with no hot flashes. Women were also more likely to have problems staying asleep as their hot flashes became more severe.
The researchers also examined how insomnia related to women's menopausal status and found that women in perimenopause were more likely to have difficulty falling asleep, non-restful sleep and overall dissatisfaction with sleep. One-third of perimenopausal and postmenopausal women reported that they believed insomnia was related to the development of menopause.
"This study provides evidence that severe hot flashes are associated with chronic insomnia in women aged 35 to 65 years," the authors write. "The dramatic increase in insomnia in women with severe hot flashes indicates that severity of hot flashes should be routinely assessed in all studies of menopause.
"Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia," they conclude.
(Arch Intern Med.
2006;166:1262-1268. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This research was supported by the Arrillaga Foundation and by an unrestricted grant from NV Organon.
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, June 26, 2006
Media Advisory: To contact Ralph Leonard, M.D., M.P.H., call 763-377-9406.
STUDY IDENTIFIES FACTORS ASSOCIATED WITH AGGRESSION IN NURSING HOME RESIDENTS
CHICAGO—Depressive symptoms, delusions, hallucinations and constipation are associated with physical aggression among nursing home residents with dementia, according to a report in the June 26 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
About 88,000 (6.8 percent) of U.S. nursing home residents are physically aggressive every week-hitting, shoving, scratching or sexually abusing others. This aggression can inflict physical and psychological harm on staff and other residents, according to background information in the article. Verbal aggression, when residents threaten, scream or curse at others, also can cause difficulties.
Ralph Leonard, M.D., M.P.H., of CALM-MD, LLC, St. Louis Park, Minn., and colleagues studied nursing home residents age 60 years and older with dementia who resided in one of five states: California, New York, Ohio, Pennsylvania or Texas. The authors used data from the participants' Minimum Data Set (completed in 2002), a health assessment completed regularly for all residents of nursing homes that receive federal funds. The assessment contains information about the resident's medical condition and functional status.
Of 103,344 residents (average age 84 years) who met the criteria for the study, 7,120 (6.9 percent) had been physically aggressive in the week before their assessment and 10.5 percent had been verbally abusive. After the researchers considered other factors that may play a role in aggression, including age, sex and the level to which residents were able to perform daily tasks on their own, they found that symptoms of depression, delusions, hallucinations and constipation were associated with physical aggression. With the exception of constipation, the same factors also contributed to verbal aggression.
Previous studies have linked psychological conditions to aggression, but this study was one of the first to examine the effects of constipation, the authors write. "We chose to study constipation a priori because it is common, modifiable and recognized by clinicians to be a cause of many non-specific symptoms," the authors write. "It is not clear whether physical aggression may be related to factors that predispose to constipation (e.g., anticholinergic medications such as tricyclic antidepressants), the symptoms associated with constipation or interventions such as suppositories that may elicit a defensive action by some residents."
"Physical or verbal aggression among nursing home residents with cognitive impairment may be a major cause of distress among staff and other residents injured by the aggressor, as well as to the aggressor," they conclude. "We found that aggressive behavior among residents was associated with depression, delusions and hallucinations, and that physical aggression was also associated with constipation. All of these factors may be amenable to intervention and, in addition to reducing the morbidity associated with these entities themselves, effective treatment may reduce the risk of violence in nursing homes."
(Arch Intern Med. 2006;166:1295-1300. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported in part by a grant from the National Institute on Aging (Dr. Leonard), the Donald W. Reynolds Foundation (Dr. Drickamer) and a grant from the Claude D. Pepper Older Americans Independence Center at Yale (which is supported by the National Institute on Aging).
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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