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Loneliness Boosts Blood Pressure in Older Adults
 TUESDAY, March 28 (HealthDay News) -- Loneliness has now joined obesity and lack of exercise as a potential risk factor for hypertension.
New research shows that loneliness can add 30 points to a blood pressure reading for adults over the age of 50.
The study's results have surprised everyone involved.
"The take-home message is that feelings of loneliness are a health risk, in that the lonelier you are, the higher your blood pressure. And we know that high blood pressure has all kinds of negative consequences," said lead researcher Louise Hawkley, a research scientist at the Center for Cognitive and Social Neuroscience at the University of Chicago.
Her team published its findings in the April issue of Psychology and Aging.
Hawkley said this study was inspired by previous work, published in 2002, that discovered profound and lingering effects of loneliness on the blood pressure of undergraduate college students.
"We thought that if this was maintained over time, it's setting up their systems to develop vascular issues that could lead to hypertension," she said.
So, in this latest study, Hawkley's group interviewed 229 people aged 50 to 68 years of age. They used standard questionnaires to determine each participant's perceived level of loneliness, as well as other psychosocial and cardiovascular risk factors.
The researchers found that lonely older people had blood pressure readings that were as much as 30 points higher than others -- even after other negative emotive states, like sadness, stress or hostility, were taken into account.
A 30-point spread in blood pressure is equal to the difference between a normal diastolic pressure of 120 mm/Hg and stage 1 hypertension, measured at 150 mm/Hg, the researchers pointed out.
What's more, the effect of loneliness in increasing hypertension appeared to get stronger with age, the Chicago team found.
"I was surprised by the magnitude of the effect," said Richard Suzman, associate director of Behavioral and Social Research at the U.S. National Institute on Aging, which helped fund the study.
Hawkley agreed, noting that the effect of loneliness on blood pressure in older individuals is similar to that of physical risk factors long targeted by physicians, such as obesity or sedentary lifestyles.
Hawkley and Suzman were also surprised by the "specificity" of the findings -- that it was loneliness, per se, and not attendant states such as depression or anger, that appeared to be responsible for the boost in blood pressure.
And what about stress?
"Lonely people are stressed, we know that," Hawkley said. However, her team found that stress boosted blood pressure in a way that was distinct from loneliness.
"Its effect was additive," Hawkley noted. "So, that means that people who are lonely have a double whammy -- they are feeling the stress and they are lonely," both of which send blood pressure skyward, she said.
If loneliness can raise blood pressure, then the solution seems easy: strengthen existing relationships and make new ones. But Hawkley -- who has studied loneliness for years -- said it's usually not that simple.
"Remember, people can feel lonely even if they are with a lot of people," she said. "You can think of Marilyn Monroe or Princess Diana -- there was certainly nothing lacking in their social lives, yet they claimed to have felt intensely lonely."
Chronically lonely people also tend to have conflicted emotions when it comes to reaching out to others, Hawkley said.
"They may want to go out and make friends, and yet they have a nagging lack of trust with whomever they want to interact with, or they may feel hostile. So they end up behaving in ways that force the potential partner away," she added.
Targeted interventions that break that cycle might help change things, she said.
Whatever its cause, Hawkley believes loneliness, like obesity and other cardiovascular risk factors, may be on the rise in America. "We have [more] single-parent families, parents living far away from their children, children living far away from each other, and people being transient, not staying put very long," she said.
Suzman stressed the findings need to be replicated before any firm conclusions can be drawn.
However, if the findings do bear out, he believes that "this area is ripe to begin trying out interventions to see how one could change, modulate or reduce the impact of loneliness on blood pressure. If those interventions are low-cost and practical, then it's going to have a significant public health impact."
More information
For more on battling loneliness, head to the University of Iowa.
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Too Many Ignore Symptoms of Mini-Stroke
 THURSDAY, March 30 (HealthDay News) -- Fewer than half of the people in a new study who felt the symptoms of a "mini-stroke" sought medical attention quickly, and just one in 10 went to an emergency room.
"These figures are a cause for concern," said lead researcher Dr. Matthew F. Giles, a research fellow in clinical neurology at the University of Oxford, England.
According to Giles, these transient ischemic attacks (TIAs) put individuals at high risk of having a major stroke soon afterward.
Reporting in the March 31 issue of Stroke, Giles and his colleagues interviewed 241 people who had a TIA, asking them about what they thought was causing their symptoms. Symptoms typically include a sudden numbness or weakness of part of the body, sudden confusion, visual problems, dizziness or a sudden severe headache.
Just 107 recognized the onset of symptoms as an emergency. Only 27 sought non-emergency treatment the same day; 43 waited until the next day to seek treatment, and 64 delayed two days or more.
People who had TIA symptoms on a Friday or Saturday were especially unlikely to seek medical attention the same day.
"That is an example of people not paying heed to these symptoms," Giles said. "If you have a TIA on the weekend, you'll say, 'I'll get in touch with the family doctor on Monday.' But by Monday everything is settled down, and you don't do it."
The nature of the symptoms had a strong influence on an individual's response. People who experienced major motor problems such as weakness in the face, arm or leg were more likely to recognize these symptoms as an emergency. The same was true for those whose symptoms persisted for more than an hour.
A TIA is temporary blockage of a brain artery, particularly common in the elderly. The average age of the people in the study was 71. Prompt treatment of the immediate event and follow-up therapy -- such as lowering cholesterol levels and blood pressure -- can reduce the long-term risk of a major stroke, Giles said.
What was true in the British study holds for the United States, noted Dr. Claudette Brooks, an assistant professor of neurology at West Virginia University and a spokeswoman for the American Heart Association.
"The most important thing to do is education, not only for the population at large but also for people at high risk, such as those with coronary artery disease, high cholesterol or diabetes," Brooks said.
Anyone feeling the symptoms of a TIA should go directly to an emergency room, she advised. "If you call your family doctor, you're wasting time," she said. "If you call your primary-care physician you'll be told to go to an emergency room anyway."
Immediate action is necessary, Brooks said, because after a TIA, "you are at increased risk especially over the next 90 days, but also of having a major stroke in the next 48 hours to seven days."
More information
The causes, symptoms and treatment of TIA are described by the American Heart Association.
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Urinary Incontinence May Bring Depression
MONDAY, March 27 (HealthDay News) -- Women who suffer from urinary incontinence are at nearly twice the risk of depression compared to women without the troubling disorder, Canadian researchers report.
They also found that younger women with incontinence were more likely to be depressed than older women with incontinence.
The findings appear in the March-April issue of the journal Psychosomatics.
Researchers analyzed Canadian Community Health Survey data on over 69,000 non-pregnant women aged 18 and older.
The rate of depression in women with incontinence was 15.5 percent, compared with 9.2 percent for women without incontinence. The rate of depression was 30 percent for women ages 18 to 44 with incontinence.
The study also found that the combination of incontinence and depression was associated with a variety of negative effects, including stress, lost days from work, and increased visits to doctors.
Lead author Dr. Donna E. Stewart, chair of Women's Health at the University of Toronto, noted that the study did not evaluate the severity of incontinence among the women. She added that incontinence may have been underreported by the women in the survey because they were asked about it only in the context of chronic conditions that had been diagnosed by a doctor.
Many women don't see their doctor about incontinence and refer to it as dribbling, leaking, or lack of bladder control.
Stewart said a further study of incontinence and depression in women who may not have a doctor's diagnosis of incontinence is under way.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about urinary incontinence in women.
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Alzheimer's May Be Diabetes-Like Illness
 FRIDAY, March 24 (HealthDay News) -- Giving more weight to the notion that Alzheimer's may be a diabetes-like disease, researchers say rats depleted of insulin in the brain went on to develop an Alzheimer's-like illness.
By depleting insulin and its related proteins in the rodent's brains, the researchers say they have been able to replicate the progression of Alzheimer's disease. This included amyloid plaque deposits, neurofibrillary "tangles," impaired cognitive functioning, cell loss, and overall brain deterioration. All of these are characteristic of Alzheimer's disease.
"True Alzheimer's disease is a kind of insulin resistance in the brain," concluded lead researcher Dr. Suzanne M. de la Monte, a neuropathologist at Rhode Island Hospital and a professor of pathology and clinical neuroscience at Brown Medical School, in Providence, R.I.
She called the study "very exciting," adding that it "leads to new concepts of how to treat the disease."
According to the researchers, the study demonstrates that Alzheimer's is a brain-specific disorder, distinct from other types of diabetes, such as the inherited form, type 1, and obesity-linked type 2. "This study shows that Alzheimer's is a [new] type of diabetes," de la Monte said. "It's type 3 diabetes."
Other experts remained unconvinced, however.
"To date, the construct that Alzheimer's is type 3 diabetes remains largely unsupported," said Dr. Sam Gandy, chairman of the Medical and Scientific Advisory Council at the Alzheimer's Association and director of the Farber Institute for Neurosciences at Thomas Jefferson University, Philadelphia.
The report appears in the March issue of the Journal of Alzheimer's Disease.
According to de la Monte, a loss of insulin in the brain may trigger Alzheimer's onset because brain cells need insulin to function and survive. When this happens, oxidative stress increases, the brain deteriorates, and there is loss of cognitive function, plus a buildup of plaques and tangles in the brain, she said.
Whether restoring insulin to the brain can slow or reverse the progression of Alzheimer's is something that de la Monte's team is looking at now in animals. "The results are under review," she said.
"We are looking at a brain form of diabetes," de la Monte said. "One can look forward to approaches that may work in the brain which we already have available, or that might be modified to treat patients with neurodegeneration," she said.
De la Monte is convinced that what doctors call Alzheimer's is really several different conditions under one umbrella. "We will have to develop ways to be certain who has what kind of neurodegeneration," she said.
About 50 percent of patients diagnosed with dementia have Alzheimer's, de la Monte noted. "The others have a mixed condition or something else wrong with them," she said.
"There are a number of conditions that people call Alzheimer's disease," de la Monte said. "People are developing ways of testing insulin resistance in the brain, which will be necessary to validate any therapy that comes out of this."
However, one expert doesn't think that her team has yet made a convincing case for the theory.
"The paper overreaches," said Gandy.
He noted that de la Monte's group injected the rats' brains with Streptozotocin, the compound they used to inhibit local insulin production. So, it's not clear whether the brain changes her group noted were related to a lack of insulin, or this insult to the brain. "Streptozotocin, which causes oxidative stress, would be predicted to cause such stress in many tissues, including the brain," Gandy said.
In addition, changes the researchers observed in the brains of the mice were only modest, with no clear structural pathology evident, he said.
Another expert believes insulin's role in Alzheimer's may only be part of the picture.
"There is definitely speculation that insulin is linked to Alzheimer's," said Dr. Zoe Arvanitakis, an assistant professor of neurological sciences at Rush University Medical Center, in Chicago.
"But given the complexity of the illness, it is probably unlikely that addressing a single mechanism of illness, for example giving insulin, is probably unlikely to cure the disease," Arvanitakis said. "It might help some people. It might help to some extent. But it is unlikely that a single approach will be the answer to the problem," she said.
More information
For more on Alzheimer's disease, head to the Alzheimer's Association.
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