Tag Archives: JAMA Network Open

Health Studies: 80% Of Married Couples Share Heart Disease Risks, Poor Health Lifestyles (JAMA)

OCTOBER 26, 2020

In this cross-sectional study of 5364 couples consisting of employees and spouses (or domestic partners) undergoing an annual employer-sponsored health assessment, 79% of the couples were in the nonideal category of a CV health score. This within-couple concordance of nonideal CV health scores was associated mostly with unhealthy diet and inadequate physical activity.

The study included 10 728 participants (5364 couples): 7% were African American, 11% Hispanic, 21% Asian, and 54% White (median [interquartile range] age, 50 [41-57] years for men and 47 [39-55] for women). For most couples, both members were in the ideal category or both were in a nonideal category.

Concordance ranged from 53% (95% CI, 52%-54%) for cholesterol to 95% (95% CI, 94%-95%) for diet. For the CV health score, in 79% (95% CI, 78%-80%) of couples both members were in a nonideal category, which was associated mainly with unhealthy diet (94% [95% CI, 93%-94%] of couples) and inadequate exercise (53% [95% CI, 52%-55%] of couples). However, in most couples, both members were in the ideal category for smoking status (60% [95% CI, 59%-61%] of couples) and glucose (56% [95% CI, 55%-58%]).

Except for total cholesterol, when 1 member of a couple was in the ideal category, the other member was likely also to be in the ideal category: the adjusted odds ratios for also being in the ideal category ranged from 1.3 (95% CI, 1.1-1.5; P ≤ .001) for blood pressure to 10.6 (95% CI, 7.4-15.3; P ≤ .001) for diet. Concordance differed by ethnicity, socioeconomic status, and geographic location.

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Studies: Dementia Risk Is Up To 11 Times Greater With Declines In Both Memory And Gait (JAMA)

From a JAMA Network Open online release (February 21, 2020):

JAMA Network OpenAcross the 6 studies of 8699 participants, mean age ranged between 70 and 74 years and mean gait speed ranged between 1.05 and 1.26 m/s. Incident dementia ranged from 5 to 21 per 1000 person-years. Compared with usual agers, participants with only memory decline had 2.2 to 4.6 times higher risk for developing dementia… 

Those with only gait decline had 2.1 to 3.6 times higher risk. Those with dual decline had 5.2 to 11.7 times the risk…

Impaired mobility, such as slow gait, is associated with an increased risk of dementia, but the effect size of this association is generally modest.16 Identifying persons who experience both mobility decline and memory decline, a main symptom in the early stage of dementia, may have a greater prognostic value in assessing risk of dementia because the combination could identify a group in whom gait speed decline is at least in part caused by neurodegenerative pathologic conditions of the central nervous system rather than local musculoskeletal problems, such as sarcopenia or osteoarthritis.79 A recent study of 154 participants with mild cognitive impairment reported that those who declined in both cognition and gait speed had the highest risk of dementia.

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Studies: Steep Increase In “Early-Onset Colorectal Cancer”; First Screening At Age 45 Suggested (JAMA)

From a JAMA Network Open online release (Jan 31, 2020):

JAMA Network OPEN LogoSteep incidence increases between 49 and 50 years of age are consistent with previously undetected colorectal cancers diagnosed via screening uptake at 50 years. These cancers are not reflected in observed rates of colorectal cancer in the SEER registries among individuals younger than 50 years. Hence, using observed incidence rates from 45 to 49 years of age alone to assess potential outcomes of earlier screening may underestimate cancer prevention benefits.

Colorectal Cancer Incidence Rates per 100000 30 - 60 Years of age 2000-2016 JAMA

Early-onset colorectal cancer (EOCRC) incidence rates are increasing, and controversy exists regarding whether average-risk screening should begin at 45 or 50 years of age.1 In 2018, the American Cancer Society recommended that average-risk screening start at 45 years of age.2 Others recommend screening at 50 years of age, although the US Multi-Society Task Force on Colorectal Cancer recommends screening African American individuals at age 45 years of age owing to higher incidence, mortality, and earlier-onset disease.36 The American Cancer Society decision incorporated modeling studies that used updated incidence and mortality data encompassing time periods of increasing EOCRC incidence rates; modeling compared life-years gained by initiating screening at 45 vs 50 years.

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