A Toast for the Aging Brain
A drink a day appears to protect elderly women from cognitive decline, according to new data from the ongoing Nurses' Health Study.
During a 2-year follow-up study, interviewers administered four cognitive tests to more than 11,000 women aged 70-81 years, said Meir Stampfer, M.D., of Brigham and Women's Hospital, Boston, and colleagues. They found that moderate drinkers (about one drink/day) had a 20% lower risk of cognitive decline than nondrinkers or those who drank two or more drinks/day. Both wine and beer were associated with the protective effect (N. Engl. J. Med. 2005;3:245-53).
Moderate alcohol intake elevates the HDL cholesterol level and reduces the level of fibrinogen and other thrombic factors. “Thus, moderate intake of alcohol may help preserve brain vasculature, may prevent subclinical strokes and could thus result in better cognitive function,” the authors said.
Denis Evans, M.D., of Rush University, Chicago, said in an accompanying editorial: “Persons seeking to maximize cognition in old age must keep in mind both the uncertainty of the current results and the knowledge that alcohol consumption can be a double-edged sword, with the dangers of overindulgence being all too familiar.”
Symptoms Predict Hysterectomy
Persistence of symptoms and dissatisfaction with their health are significant predictors of hysterectomy in women with fibroids.
A total of 633 ethnically diverse women with fibroids who sought care were followed for 2 years. They completed questionnaires about quality of life and their interest in a hysterectomy, investigators wrote in a poster presented at an international conference on uterine leiomyoma research sponsored by the National Institutes of Health.
A total of 58 women had a hysterectomy by the end of 2 years. Overall, baseline dissatisfaction with health and persistence of symptoms were highly predictive of hysterectomy in a multivariate analysis, with odds ratios of 2.54 and 3.11, respectively.
The most frequently reported symptoms were bleeding (58%), pressure (24%), and pain (19%), said Miriam Kuppermann, Ph.D., and her associates at the University of California, San Francisco.
At baseline, 43% of the women said they felt their pelvic problems remained unresolved, and 13% were “mostly” or “very” dissatisfied with their health. In addition, 29% reported that pelvic problems interfered “a lot” with their sex lives.
Women's CV Risk Underestimated
Fewer than 20% of 500 physicians participating in a national survey realized that heart disease kills more women than men every year. When assessing hypothetical patient profiles, many of the physicians surveyed consistently underestimated cardiovascular risk and failed to prescribe recommended treatments for women.
A total of 300 primary care physicians, 100 cardiologists, and 100 ob.gyns. participated in the 30-minute online survey in late 2004. These physicians had been in full-time clinical practice for a mean of 17 years. A total of 81% of the primary care physicians, 85% of the ob.gyns., and 98% of the cardiologists were men, according to Lori Mosca, M.D., of Columbia University College of Physicians and Surgeons, New York, and her associates (Circulation 2005;111:499-510).
Only 8% of the primary care physicians, 13% of the ob.gyns., and 17% of the cardiologists recognized that every year heart disease kills more women (nearly 500,000) than men. When assessing hypothetical case profiles, physicians in all three specialties designated women as lower risk than men who had identical risk profiles. They also were much more likely to correctly categorize cardiovascular risks of male patients than of female patients and to correctly prescribe recommended treatments to men, the investigators said.
Excessive Vomiting Poses OB Problems
Women who experienced hyperemesis gravidarum had a significantly increased risk of preeclampsia, compared with controls, wrote Michele Soltis, M.D., and colleagues in a poster presented at the annual meeting of the American College of Preventive Medicine. In this retrospective study, Dr. Soltis of Madigan Army Medical Center in Tacoma, Washington, and her associates compared 4,808 women hospitalized for hyperemesis gravidarum with 9,616 controls and calculated the relative risks for certain obstetric outcomes.
Women with hyperemesis gravidarum had relative risks of 1.3 for preeclampsia, 1.3 for infant birth weight less than 2,500 g, and 2.1 for premature deliveries before 28 weeks' gestation. The relative risk of premature delivery at 28-32 weeks or at 33-36 weeks was 1.5.