Neuroscience
Tinetti ME, McAvay GJ, Fried TR, Allore HG, Salmon JC, Foody JM, Bianco L, Ginter S, & Fraenkel L. Health outcome priorities among competing cardiovascular, fall injury, and medication-related symptom outcomes. Journal of the American Geriatrics Society. 2008 Aug; 56(8): 1409-1416. Epub 2008 Jul 24.
Department of Internal Medicine and Epidemiology, New Haven, Connecticut 06504, USA.
OBJECTIVES: To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. DESIGN: Interview. SETTING: Community. PARTICIPANTS: One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. MEASUREMENTS: Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. RESULTS: Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P=.02), unsteadiness (P=.02), functional dependency (P=.04), lower cognition (P=.02) and depressive symptoms (P=.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. CONCLUSION: Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals.
- Noise Increases The Risk Of Having A Heart Attack
Too much noise, such as the sound of passing traffic, can increase the risk of heart attack in men by 50 per cent and in women by up to threefold. That’s according to a team of German researchers who interviewed 4,115 hospital inpatients, about half...
- Neuropsychology Abstract Of The Day: Gait And Cognition
Slower gait, slower information processing and smaller prefrontal area in older adults Age Ageing. 2011 Sep 28; Rosano C, Studenski SA, Aizenstein HJ, Boudreau RM, Longstreth WT, Newman AB Abstract BACKGROUND: slower gait in older adults is related to...
- The Gem Study
From an NIH press release earlier today: Ginkgo Evaluation of Memory (GEM) Study Fails To Show Benefit in Preventing Dementia in the Elderly The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's...
- Falls In The Elderly
Cognitive factors may increase the probability of falls in the elderly. As well, falls are a preventable cause of head and brain trauma. Therefore, the topic is always of concern to clinical neuroscientists who work with older individuals. Available in...
- Mixed Dementia
This week's Journal of the American Medical Association includes a clinical review about current knowledge of dementia in the presence of both probable Alzheimer disease and cerebrovascular disease, including neuropsychological and behavioral information,...
Neuroscience
Neuropsychology Abstract of the Day
Tinetti ME, McAvay GJ, Fried TR, Allore HG, Salmon JC, Foody JM, Bianco L, Ginter S, & Fraenkel L. Health outcome priorities among competing cardiovascular, fall injury, and medication-related symptom outcomes. Journal of the American Geriatrics Society. 2008 Aug; 56(8): 1409-1416. Epub 2008 Jul 24.
Department of Internal Medicine and Epidemiology, New Haven, Connecticut 06504, USA.
OBJECTIVES: To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. DESIGN: Interview. SETTING: Community. PARTICIPANTS: One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. MEASUREMENTS: Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. RESULTS: Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P=.02), unsteadiness (P=.02), functional dependency (P=.04), lower cognition (P=.02) and depressive symptoms (P=.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. CONCLUSION: Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals.
- Noise Increases The Risk Of Having A Heart Attack
Too much noise, such as the sound of passing traffic, can increase the risk of heart attack in men by 50 per cent and in women by up to threefold. That’s according to a team of German researchers who interviewed 4,115 hospital inpatients, about half...
- Neuropsychology Abstract Of The Day: Gait And Cognition
Slower gait, slower information processing and smaller prefrontal area in older adults Age Ageing. 2011 Sep 28; Rosano C, Studenski SA, Aizenstein HJ, Boudreau RM, Longstreth WT, Newman AB Abstract BACKGROUND: slower gait in older adults is related to...
- The Gem Study
From an NIH press release earlier today: Ginkgo Evaluation of Memory (GEM) Study Fails To Show Benefit in Preventing Dementia in the Elderly The dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's...
- Falls In The Elderly
Cognitive factors may increase the probability of falls in the elderly. As well, falls are a preventable cause of head and brain trauma. Therefore, the topic is always of concern to clinical neuroscientists who work with older individuals. Available in...
- Mixed Dementia
This week's Journal of the American Medical Association includes a clinical review about current knowledge of dementia in the presence of both probable Alzheimer disease and cerebrovascular disease, including neuropsychological and behavioral information,...