Unexpected Health Findings in Today's News

Several times a week, I review, condense and print up what I judge to be the most relevant medical news for my friend and former employer, a busy family doc. And most days, the process is at least mildly interesting to me, some days more interesting than others.

Today is one of those more interesting days, medical-newswise, as there were several unexpected findings to report, and among the most unexpected is an enormous study funded by the National Institute on Aging, revealing a strong racial disparity in the lifespan of Alzheimer's patients. And the results are not what you'd presume...

Latinos & African Americans With Alzheimer's Disease Live Longer Than Whites & Other Minorities: In this study, which included data on 30,916 patients from 30 National Institute on Aging–funded A.D. centers (ADCs) in the United States, Latinos with A.D. lived 40% longer than whites with the disease, while African Americans live an average of 15% longer. That's huge! However, Asian & American Indian participants with A.D. have approximately the same life span as white study subjects. (Note: there has been very little research estimating survival for Asian or Native American A.D. patients.)

The study was just published online on November 14th, 2007 in Neurology.

Of the total study population, 81% of participants were white, 12% were African American, 4% Latino, 1.5% Asian, and 0.5% Native American. Overall survival since their initial ADC visit was a median of 4.8 years.

"If our results hold, & minority older adults have a survival advantage, identifying the reasons behind this survival advantage may lead to improved survival for all persons with A.D.

"If A.D. patients who are nonwhite live longer with dementia and their autopsy data suggest similar brain pathology, this may suggest that nonwhite A.D. patients have a buffer against dying with the disease," the authors write.

Possible explanations for survival differences among races could include differing underlying genetic or cultural factors, including greater social support from extended family among ethnic minorities.

See link: http://www.medscape.com/viewarticle/566007?sssdmh=dm1.318677&src=nlpatient

The next unexpected story in today's medical news follows:

The Link Between Statins and Cognition Gets Curiouser and Curiouser: OK, first, the drug makers and medical journals were pushing the idea that statins primarily used to lower cholesterol, also happen to reduce the instance and severity of Alzheimer's dementia. I remember being at two different pharmaceutical company dinners a few years back hosted by manufacturers of (1)Lipitor and (2)Crestor, at which they strongly pitched the idea that statins definitely have a beneficial effect on cognition in dementia patients, and may actually prevent it. Great news for everyone, especially for the drugmakers...

I think just about everybody, even doctors, has a healthy fear of Alzheimer's and would very much like to avoid getting it, and this side effect of statins sounded like such a great bonus that everybody should be on them, regardless of cholesterol levels....

But today we learn that while research links statin use to reduced cognitive decline, there's a "curious phenomenon"- African American patients who stopped taking statins appeared to reap an even greater cognitive benefit than those who continued taking it!

Weird, huh?

The findings, published in the November 6 issue of the journal Neurology, underline the "complex nature" of the relationship between statins & dementia prevention.

In 2001 and again in 2004, researchers at Indiana University School of Medicine and Regenstrief Institute, also in Indianapolis, evaluated the cognitive status of 1146 African Americans aged 70 years and older living in Indianapolis, Indiana as part of the Indianapolis-Ibadan Dementia Project. Cognitive assessment included tests of language, attention, calculation, memory, and orientation. Participants provided blood samples for ApoE genotyping and were also assessed for a number of risk factors, including smoking, alcohol use, and social involvement. The study was funded by the National Institute on Aging.

Adjusting for age at baseline, sex, education, and ApoE status, researchers found less cognitive decline among statin users than among non–statin users.

If statin use reduces cognitive decline, then it is reasonable to assume that continued use of statins would produce a greater reduction. However, that was not the case in this study: researchers found that those who continued to take statins from 2001 to 2004 had greater cognitive decline than those who were taking statins in 2001 but were no longer taking them in 2004.

All this was surprising to researchers.

To read the whole article, click the link http://www.medscape.com/viewarticle/565920?sssdmh=dm1.318370&src=nldne

Oral Contraceptives Increase Risk of Plaque; Raises CRT Threefold: The last interesting article today is about oral contraceptives- turns out that women, healthy young women, who have used oral contraceptives (O.C.s) for some time are at 20% to 30% increased risk for carotid or femoral atherosclerosis*, vs. women who have never used O.C.s. They also found that those taking the pill had three times higher C-reactive protein (CRP) levels than those not using it. C-reactive protein is a marker for inflammation. For more info, follow the link....http://www.medscape.com/viewarticle/565874?sssdmh=dm1.318370&src=nldne

*They're talking about plaque, the hardened fatty stuff that clogs your arteries.