Edited by Margaret A. Winker, MD
Recent research suggests that cognitive stimulation is an important
predictor of enhancement and maintenance of cognitive functioning even in
old age. In this randomized controlled trial, Ball and colleagues evaluated
3 cognitive training interventions—memory training, reasoning training,
and speed of processing training—in independent-living adults aged 65
through 94 years. Each training intervention improved the targeted cognitive
ability compared with baseline, but a training effect on everyday functioning
was not observed through 2 years of follow-up.
Changes in body composition, strength, and endurance that accompany
aging may be related to interactive effects of decreases in growth hormone
and sex steroids. In this 26-week randomized controlled trial, Blackman and
colleagues found that increases in lean body mass were greater among women
and men aged 65 to 88 years who received growth hormone with or without sex
steroid administration than among those who received placebo. In men who received
growth hormone plus testosterone, muscle strength increased slightly and cardiovascular
endurance capacity increased significantly compared with placebo, but women
had no significant change in strength or endurance in any treatment group.
Adverse effects, including diabetes and glucose intolerance, occurred frequently
in study participants who received growth hormone.
Biofeedback-assisted behavioral training has been shown to be effective
for the treatment of urge urinary incontinence. To examine the specific role
of biofeedback in a multicomponent behavioral training program, Burgio and
colleagues conducted an 8-week randomized trial among women aged 55 to 92
years with urge incontinence or mixed incontinence comparing biofeedback-assisted
behavioral training to teach pelvic floor muscle control with 2 interventions
without biofeedback—behavioral training with verbal feedback based on
vaginal palpation and a self-administered behavioral treatment using a self-help
booklet (control condition). Urge incontinence improved in all 3 study groups.
Reductions in the number of incontinence episodes were not significantly different
in the 3 groups, and quality of life improved significantly in all groups
with no significant differences between groups.
Epidemiological studies indicate that physical activity is associated
with decreased risk of hip fracture, but the required type and duration of
activity have not been determined. In this analysis of 12 years of prospective
follow-up data from postmenopausal women enrolled in the Nurses' Health Study,
Feskanich and colleagues found that moderate levels of activity, including
walking, were associated with a lower risk of hip fracture. Hip fracture risk
decreased 6% for each increase of 3 metabolic equivalent task–hours
per week (equivalent to 1 h/wk of walking at an average pace) of physical
activity from exercise and leisure-time activities.
To determine the prevalence of olfactory impairment in older US adults,
Murphy and colleagues analyzed data on olfactory impairment from the 5-year
follow-up examination of participants in the Epidemiology of Hearing Loss
Study, a population-based study of sensory loss and aging in older adults
in Beaver Dam, Wis. The overall prevalence of impaired olfaction as assessed
by the San Diego Odor Identification Test was 24.5% and was higher in men
than in women. Prevalence of impaired olfaction increased with increasing
age. Self-reported abnormal sense of smell was much less prevalent than measured
"The ebb and flow of nursing home traffic most often ends in death,
most often after a decline, and most often it is painful." From "Grace Notes."
Age-related macular degeneration: epidemiology, risk factors, and current
New studies shatter some old myths about centenarians; retired physicians
find fulfillment in free service; and many nations try to treat a growing
problem: elder abuse.
Results of a national survey on the structure, resources, and activities
of academic geriatric medicine programs in US allopathic and osteopathic medical
Maternal and neonatal outcomes of pregnancies in women aged 50 years
or older who conceived after in vitro fertilization with donor oocytes.
Perspectives on Care at the Close of Life How
to assist patients with Alzheimer disease and their loved ones prepare for
the terminal phases of the illness.
For your patients: Information about age-related macular degeneration.
This Week in JAMA. JAMA. 2002;288(18):2223. doi:10.1001/jama.288.18.2223