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Hormone Therapy Linked To Higher Dementia

Posted - Jun. 2, 2003 at 5:20 a.m.



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Jun 02, 2003 (United Press International via COMTEX) -- HORMONE THERAPY LINKED TO HIGHER DEMENTIA RISK

A study shows older women who take hormone replacement therapy (combined estrogen and progestin) may double their risk of developing dementia. Researchers at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., report in the Journal of the American Medical Association they found the combined therapy of 0.625 milligrams a day of conjugated equine estrogen plus 2.5 milligrams per day of medroxyprogesterone acetate doubled the risk for probable dementia in women 65 and older and did not prevent mild cognitive impairment. "The Women's Health Initiative Memory Study is the most comprehensive and rigorous study to date to test whether estrogen plus progestin would reduce the risk of dementia in older women," said Sally Shumaker, national principal investigator and professor of public health sciences. "Because of the potential harm and lack of benefit found, we recommend that older postmenopausal women not take the combination hormone therapy to prevent dementia, and we hope that doctors will incorporate what we've learned in their recommendations to women."

SLEEP DISORDER LINKED TO HEART TROUBLE

Doctors have linked a heart rhythm disturbance that affects more than 2 million Americans to an untreated sleep disorder called sleep apnea. They say the heart trouble is twice as likely to recur in patients who do not treat the disorder that makes them repeatedly stop breathing during sleep. The researchers say in Circulation: Journal of the American Heart Association the heart condition, called atrial fibrillation, can have serious consequences. When the upper chambers of the heart quiver rapidly and erratically -- as many as 400 times per minute -- blood does not move efficiently through the heart. The pooling blood is more likely to clot, leading to heart attack or stroke. AF also can lead to heart failure by causing the heart's main pumping chambers, the ventricles, to contract rapidly -- often more than 100 beats per minute, scientists say. Doctors use electrified paddles on the chest to shock the heart back into the proper rhythm, a procedure called cardioversion. Medications can help maintain normal rhythms, but lasting results are difficult to achieve; more than half of patients fall back into the heart ailment within one year, researchers say. In the Mayo Clinic study, researchers found a close association between the sleep disorder and AF recurrence.

DRIVING MAY GIVE YOU WRINKLES

Researchers speculate driving may give you facial wrinkles. They base their conjecture on a study showing the left side of the face usually has more wrinkles than the right. Dr. Scott Fosko, chair of dermatology at Saint Louis University School of Medicine, says he sees more cases of actinic kerotoses, or precancerous skin lesions, on the left side of the face and forehead than on the right side. The reason could be the time people spend in the car each day, exposing their left side to the sun's ravaging effects. "AK lesions and wrinkles are due to the effect of sun and UV exposure over many years," Fosko says. "We tend to see more skin lesions on the left side of the face because that's the side that's exposed to the sun when you are driving." Fosko says even a 15-minute commute twice a day could make a difference. "Even if you only have a short commute, that exposure has a cumulative effect that builds up over many years," says Fosko, a skin cancer specialist. "If you want to avoid skin cancer, and if you want to avoid premature wrinkling and aging of the skin, you should wear sunscreen every day." Fosko encourages people who drive convertibles or those who drive Jeeps to be especially vigilant about using sunscreen. Wrinkles are caused by the photo-aging effects of UV exposure, Fosko says. He cautions that not all sunblocks are equivalent. Most will block UVB rays, but not all will block UVA. Both blocking agents are needed to protect you from being exposed to the photo-aging effects of the sun, Fosko says.

'SENIOR' MOMENTS MAY NOT BE AS SERIOUS AS THOUGHT

Doctors say claims that seniors suffer age-related declines in memory and cognitive functioning may be overstated. Dr. Thomas Hess, professor of psychology at North Carolina State University, says stereotype images may have clouded the results from early studies assessing mental abilities of older people. His three-year study, reported in the journal Science and the Journal of Gerontology, focuses on what the researchers see as "stereotype threat. "Age differences that we've seen in previous memory studies may not be entirely due to the biological changes associated with aging," Hess said. "They may also reflect older adults' reactions to the context in which we've tested people. When you look at older adults in the everyday context in which they function, you get a very different picture of their performance than when you look at them outside of this context." Simply put, Hess and company argue that older people being aware they are expected to do poorly on cognitive tests do poorly in test settings because of the stress and pressures of not wanting to prove the assumptions true. In the study, half the seniors were given a negative article about memory in the elderly and half a positive article stating that memory decline was not necessarily a part of aging and could be forestalled. Then, the group was given a memory test. Hess found those who read the positive article performed about 30 percent better than those who read the negative article. In other experiments, Hess discovered older adults perform as well as or better than younger adults in tasks that involve making objective decisions and assessing people's character.

(EDITORS: For more information about HORMONE, contact Barbara Hahn at 301-496-1752 or bhahn@wfubmc.edu; about SLEEP, contact Lee Aase at 507-266-2442 or newsbureau@mayo.edu; about WRINKLES, call 314-977-8015; about DECLINE, contact Dr. Thomas Hess at 919-515-1729.)

Copyright 2003 by United Press International.

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