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Risk for Alzheimer’s Disease Associated With Maternal Family History
Adults with a maternal family history of Alzheimer’s disease are more likely to develop the disease than are those with a paternal family history of the disorder, according to a study published in the March 1 issue of Neurology.

Robyn A. Honea, DPhil, and colleagues, from the University of Kansas School of Medicine in Kansas City, conducted a longitudinal brain imaging study to examine whether patterns of gray matter atrophy differed among elderly individuals with and without a family history of late-onset Alzheimer’s disease.

Fifty-three people, ages 60 and older, without dementia were included in the analysis; 11 had a maternal history, 10 had a paternal history, and 32 had no parental history of Alzheimer’s disease. All participants were similar in age, gender, and education, and they had similar Mini-Mental State Examination scores. Participants underwent MRI at baseline and again after two years.

All participants with a family history of the disease showed changes in brain volume at two-year follow-up. Participants with a maternal history, however, had about one and a half times more whole brain shrinkage per year than those with a paternal history. In addition, persons with a mother who had the disease had almost twice as much gray matter volume reduction as the other groups.

Patterns of atrophy differed regionally among the groups, as participants with a maternal history experienced significantly more atrophy in the precuneus and parahippocampal gyrus—regions known to be affected in early Alzheimer’s disease.

“This regionally specific atrophy appears to precede any evidence of cognitive decline, and remained significant after accounting for potential risk factors for late-onset [Alzheimer’s disease] such as age, gender, and APOE4 genotype,” the investigators wrote.

“Our primary finding of progressive atrophy in cognitively normal [individuals with maternal history] contributes to growing data pointing toward a possible maternal transmission of risk for Alzheimer’s disease,” the researchers stated. “In people with a maternal family history of the disease, we found differences in the break-down processes in specific areas of the brain that are also affected by Alzheimer’s disease, leading to shrinkage. Understanding how the disease may be inherited could lead to better prevention and treatment strategies.”
Honea RA, Swerdlow RH, Vidoni ED, Burns JM. Progressive regional atrophy in normal adults with a maternal history of Alzheimer disease. Neurology. 2011;76(9):822-829.

Coffee Consumption May Reduce Stroke Risk in Women
Women who consume one or more cups of coffee per day have a 22% to 25% decrease in risk of stroke, according to a study published in the March 10 online Stroke.

“Some women have avoided consuming coffee because they have thought it is unhealthy,” said lead author Susanna C. Larsson, PhD, from the Division of Nutritional Epidemiology at the National Institute of Environmental Medicine in Stockholm. “Increasing evidence indicates that moderate coffee consumption may decrease the risk of some diseases such as diabetes, liver cancer, and possibly stroke.”

Dr. Larsson and colleagues conducted a prospective study using data from 34,670 women who participated in the Swedish Mammography Cohort. The participants completed mailed questionnaires about coffee consumption, diet, education, BMI, physical activity, personal history of diabetes and hypertension, family history of myocardial infection, and cigarette smoking.

During a mean follow-up of 10.4 years, the researchers documented 1,680 stroke events (including 1,310 cerebral infarctions), 154 intracerebral hemorrhages, 79 subarachnoid hemorrhages, and 137 unspecified strokes. The median daily coffee consumption was three cups.

After adjusting for age, smoking, and other risk factors, women who consumed one to two cups, three to four cups, or more than five cups of coffee daily had a 22% to 25% lower risk for stroke, compared with those who drank less than one cup of coffee per day. Higher coffee consumption was also associated with decreased risks of cerebral infarction and subarachnoid hemorrhage, but not intracerebral hemorrhage.

The association between risk of total stroke and coffee consumption did not vary significantly according to smoking status, BMI, history of diabetes or hypertension, or alcohol consumption. “There was no dose-response relationship between coffee consumption and risk of total stroke,” the investigators noted. “Rather, the risk appeared to be increased among women with low or no consumption of coffee.

“Potential mechanisms by which coffee consumption may reduce the risk of stroke include attenuation of subclinical inflammation, reduction in oxidative stress, and improved insulin sensitivity,” the researchers commented, but additional mechanistic and prospective studies about this association are warranted.
Larsson SC, Virtamo J, Wolk A. Coffee consumption and risk of stroke in women. Stroke. 2011 Mar 10; [Epub ahead of print].

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