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New Role for High Cholesterol in Dementia Risk
A new study has found that high cholesterol levels in midlife significantly increase the risk of Alzheimer's disease 30 years later, even when those levels are moderate. This is the first study to show that not only high cholesterol, but also borderline high cholesterol, is associated with dementia, the researchers report. The need to consider dementia risk as early as middle age has become apparent. Dementia risk has been previously seen as largely not modifiable, and certainly not in terms of cholesterol level. The study, published in the journal Dementia and Geriatric Cognitive Disorders, involved 9,844 men and women whose cholesterol levels were determined between 1964 and 1973 when they were 40 to 45 years old. Between 1994 and 2007, a review of their medical records showed that 469 had Alzheimer's disease and 127 had vascular dementia, the second most common form of dementia after Alzheimer's disease, which is caused by clogged blood vessels and other conditions affecting the blood supply to the brain. Compared to people with cholesterol levels below 200 milligrams per deciliter of blood (mg/dL) in midlife, the risk of Alzheimer's disease three decades later was 57 percent higher in people with high midlife cholesterol levels of 240 mg/dL and above. "Borderline" high cholesterol (200 to 239 mg/dL) tended to increase the risk of Alzheimer's disease as well, though the results were less than statistically significant. However, midlife borderline high cholesterol increased the risk of vascular dementia by 50 percent. High midlife cholesterol also tended to increase the risk of this type of dementia. Are geriatric cognitive disorders in record numbers awaiting us in a few decades? Disconcertingly, according to the researchers, nearly 100 million Americans have either high or borderline cholesterol levels. Dementia and Geriatric Cognitive Disorders, 2009, Vol. 28, pp. 75-80
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Rethinking the Value of Spine Surgery
In the March/April 2009 issue, we looked closely at the effectiveness of widely-practiced arthroscopic knee surgery to treat osteoarthritis (OA). A study in Canada found that the surgery is no better than medication and physical therapy. The other significant study of this type was completed in 2002, and found that arthroscopic knee surgery was no better than sham surgery at treating OA. While there is wide consensus that surgery is always the last treatment option, and that arthroscopic surgery appears to still be helpful in cases of abrupt knee injury, the vast number of older patents with significant x-ray evidence of OA who have undergone surgery is disconcerting, given these recent findings. Now, two additional studies have called surgery’s effectiveness into question—this time, for the spine. Vertebroplasty, a common spine operation for relieving back pain, has been found by two different surgical teams to be no more effective than sham surgery. Researchers at Monash University in Malvern, Australia, found that 36 volunteers who received sham surgery did just as well as the 35 subjects who underwent the real operation. A separate study of 131 people at 11 medical centers, led by Dr. David Kallmes at the Mayo Clinic in Rochester, Minnesota, found that sham surgery produced a comparable degree of pain reduction and movement. Over one million people worldwide have been diagnosed with at least one compression fracture, more than half of them in the United States. Compression fractures are categorized as a significant health problem, particularly among the elderly. Among health care professionals, the future of vertebroplasty is now in question. But, as with arthroscopic knee surgery treatments of OA, this is not to somehow lay blame on the medical community. Scientific advancement and the ongoing revision of treatment strategies have always been wrought with similar discoveries. NEJM, 2009, Vol. 361, No. 6, http://content.nejm.org/cgi/content/abstract/361/6/557, http://content.nejm.org/cgi/content/abstract/361/6/569 Medline Plus, http://www.nlm.nih.gov/medlineplus/news/fullstory_87785.html Health After 50, 2009, Vol. 21, No. 1, p. 3
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editorial board Kenneth Cooper, MD |
board of directors Jeff Harbison, President Executive Director: Dave Watt |
Running & FitNews is published by the American Running Association. Address inquiries to ARA, Attention: FitNews Editor, 4405 East-West Highway., Suite 405, Bethesda, MD 20814 or send e-mail to run@americanrunning.com The American Running Association is a nonprofit educational organization, designated 501(c)3 by the IRS. Running & FitNews provides sports medicine and nutrition information. For personal medical advice, consult your physician. © 2009 The American Running Association. |