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This Week in JAMA
November 13, 2002

This Week in JAMA

JAMA. 2002;288(18):2223. doi:10.1001/jama.288.18.2223

Edited by Margaret A. Winker, MD

Outcomes of Cognitive Training in Older Adults

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.

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Growth Hormone, Sex Steroid Administration in Elderly

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.

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Role of Biofeedback in Treatment of Urge Incontinence

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.

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Physical Activity and Hip Fracture Risk

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.

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Prevalence of Olfactory Impairment in Older Adults

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 olfactory impairment.

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A Piece of My Mind

"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."

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Contempo Updates

Age-related macular degeneration: epidemiology, risk factors, and current treatment strategies.

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Medical News & Perspectives

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.

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Academic Geriatric Programs

Results of a national survey on the structure, resources, and activities of academic geriatric medicine programs in US allopathic and osteopathic medical schools.

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Outcomes of Pregnancy in the Sixth Decade

Maternal and neonatal outcomes of pregnancies in women aged 50 years or older who conceived after in vitro fertilization with donor oocytes.

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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.

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JAMA Patient Page

For your patients: Information about age-related macular degeneration.

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