Cholesterol Drugs Lower Stroke Risk in Older People
WEDNESDAY, Sept. 3 (HealthDay News) -- Taking a cholesterol-lowering drug after a stroke or mini-stroke reduces an older person's risk of another stroke much as it does in younger patients, according to a U.S. study.
"Even though the majority of strokes and heart attacks occur in people who are 65 and older, studies have found that cholesterol-lowering drugs are not prescribed as often for older people as they are for younger people. These results show that using these drugs is just as beneficial for people who are 65 as they are for younger people," study author Dr. Seemant Chaturvedi, of Wayne State University in Detroit, said in an American Academy of Neurology news release.
The researchers looked at 4,731 people who had had a recent stroke or mini-stroke (transient ischemic attack), including 2,249 people age 65 and older and 2,482 people under age 65. In each group, about half the patients received the cholesterol-lowering drug atorvastatin (Lipitor), and about half received a placebo. The participants were then followed for an average of 4.5 years.
Levels of "bad" low-density lipoprotein (LDL) cholesterol were reduced by an average of 61 points in the over-65 group and by an average of 59 point in the under-65 group. Stroke risk was reduced by 26 percent in the younger group and by 10 percent in the older group, the study found.
"We tested to see whether age had any effect on how well the treatment worked, and we did not find any differences between young people and older people," Chaturvedi said. "It's estimated that 20 percent of the U.S. population will be 65 or older by 2010, so it's important that we identify ways to reduce the burden of strokes and other cerebrovascular diseases in this group. This is a step in that direction."
The study, which was supported by atorvastatin maker Pfizer Inc., was published in the Sept. 3 online issue of the journal Neurology.
The U.S. National Institute of Neurological Disorders and Stroke has more about stroke.
Exercise May Help Prevent Age-Related Memory Loss
TUESDAY, Sept. 2 (HealthDay News) -- Exercise may help treat memory problems in adults, according to new research from Australia.
The study, focused on 138 people age 50 and older at increased risk for dementia, found that a home-based physical activity program led to modest improvements in cognitive function in adults with memory difficulties.
The participants -- who had memory problems but didn't meet criteria for dementia -- were randomly assigned to do the 24-week home-based physical activity program or to receive usual care.
Those in the exercise group were encouraged to do at least 150 minutes of moderate-intensity physical activity per week in three 50-minute sessions. Walking was the most frequently recommended type of activity. Participants in the exercise group did an average of 142 minutes more physical activity per week, or 20 minutes more per day, than those in the usual care group.
Over 18 months, participants in the exercise group had better Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores and delayed recall, and lower Clinical Dementia Rating scores, than those in the usual care group. The ADAS-Cog consists of a number of cognitive tests.
The findings were published in the Sept. 3 issue of the Journal of the American Medical Association.
"To our knowledge, this trial is the first to demonstrate that exercise improves cognitive function in older adults with subjective and objective mild cognitive impairment. The benefits of physical activity were apparent after six months and persisted for at least another 12 months after the intervention had been discontinued. The average improvement of 0.69 points on the ADAS-Cog score compared with the usual care group at 18 months is small but potentially important when one considers the relatively modest amount of physical activity undertaken by participants in the study," wrote Dr. Nicola T. Lautenschlager, of the University of Melbourne, and colleagues.
"Unlike medication, which was found to have no significant effect on mild cognitive impairment at 36 months, physical activity has the advantage of health benefits that are not confined to cognitive function alone, as suggested by findings on depression, quality of life, falls, cardiovascular function, and disability," the researchers added.
They noted that the number of older adults with Alzheimer's disease (AD) could increase from the current 26.6 million to 106.2 million by 2050. If AD onset could be delayed by 12 months, there would be 9.2 million fewer cases of AD worldwide.
Exercise and other lifestyle factors may benefit older adults at risk for Alzheimer's disease, Dr. Eric B. Larson, of the Group Health Center for Health Studies in Seattle, wrote in an accompanying editorial in the journal.
"Health advances of the past century have led to more individuals surviving to extreme old age, when their risk of Alzheimer disease and related dementias increases substantially," Larson added. "Exercise -- and possibly other lifestyle factors -- appears to affect vascular risk and late-life brain health."
The National Institute on Aging has more about memory loss .
Study Questions Flu Shot's Mortality Protection for Elderly
FRIDAY, Aug. 29 (HealthDay News) -- Canadian researchers are challenging the widely held belief that flu shots help protect older people from potentially deadly diseases such as pneumonia.
While the researchers say the vaccine does protect against certain strains of influenza, its overall benefit seems to have been exaggerated by so-called observational studies that found a big reduction in "all-cause mortality" among older patients who'd gotten a flu shot.
The new research was expected to be published in the first September issue of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
For the new study, the researchers included more than 700 "matched" people 65 and older, half of whom had received a flu shot and half who had not. After compensating for a variety of factors that the researchers said weren't considered or available in the earlier studies, the study authors concluded that any "all-cause mortality" benefit "if present at all, was very small and statistically non-significant and may simply be a healthy-user artifact that they were unable to identify."
"While such a reduction in all-cause mortality would have been impressive, these mortality benefits are likely implausible. Previous studies were likely measuring a benefit not directly attributable to the vaccine itself, but something specific to the individuals who were vaccinated -- a healthy-user benefit or frailty bias," Dean T. Eurich, a clinical epidemiologist and assistant professor at the University of Alberta School of Public Health, said in a university news release.
Added the study's principal investigator, Dr. Sumit Majumdar, an associate professor in the faculty of medicine and dentistry at the University of Alberta: "The healthy-user effect is seen in what doctors often refer to as their 'good' patients -- patients who are well-informed about their health, who exercise regularly, do not smoke or have quit, drink only in moderation, watch what they eat, come in regularly for health maintenance visits and disease screenings, take their medications exactly as prescribed and quite religiously get vaccinated each year so as to stay healthy. Such attributes are almost impossible to capture in large scale studies using administrative databases."
The Canadian researchers said their study has wide-ranging implications.
For instance, because the earlier studies showing mortality reductions were erroneous, "this may have stifled efforts at developing newer and better vaccines, especially for use in the elderly," the study authors said.
And for policy makers, efforts directed at "improving quality of care are better directed at where the evidence is, such as hand-washing, vaccinating children and vaccinating health-care workers," the authors concluded.
To learn more about flu vaccine, visit the U.S. Centers for Disease Control and Prevention.