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Reducing Breast Cancer Risk After Age 70
Screening mammography can reduce the risk of advanced breast cancer in elderly women, according to a University of California, San Francisco study. The study, published in the February 2000 issue of the American Journal of Medicine, found that women who undergo screening mammography in their 70s had a 43 percent less chance of developing metastatic or advanced breast cancer than women who were not screened.
This new research finding suggests that mammography is effective in elderly women. The reason is that the screening catches the cancer in the early stages, says Rebecca Smith-Bindman, MD, UCSF assistant professor. Metastatic or advanced cancer means that the tumors have spread to other parts of the body.
"No one really knows when to stop screening,' Smith- Bindman said. "This study provides the first evidence that mammography is beneficial for these women and, given what we know about mammography, it's not surprising." Although mammography has been shown to be effective in women ages 50 to 69 years old, there has been little evidence that is effective in much older women. Furthermore, women 75-years or older were not even included in any of the trials.
Breast cancer mortality rates have declined in the past decade for women ages 50 to 69 years old, in part because of an increase in the use of mammography, she said. However, women ages 70 to 79 years old have not seen the same kind of improvement in breast cancer mortality rates.
"Metastatic breast cancer reflects a missed opportunity to treat the disease early before it spreads," Smith-Bindman said. "Screening finds the disease early when it is potentially curable. That's the whole point of screening." This study was funded by a National Cancer Institute Breast Cancer SPORE grant,
the Health Care Finance Administration and a Breast Cancer Surveillance Consortium Cooperative agreement.
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America's Oldest Old Get Better With Age
The quality of life has generally improved for American seniors who are 85 years of age and older, according to researchers at Loyola University Chicago Stritch School of Medicine. The most dramatic gains in quality living have occurred among women over the age of 65.
"People are living longer, and now we are finding that many of them seem to be living in better health, as well," says Dr. Richard Cooper, one of the study authors. The research found that women age 65 years and older spent less time in a hospital or nursing home in the year preceding their death. More older women also tended to retain normal cognitive function, and those 85 years of age and older were healthier and had fewer disabilities that hindered key self-care activities, such as walking, bathing, dressing, or eating.
Although quality of life gains were less substantial among men in similar age groups, males over 84 years of age used fewer nursing home services and experienced less sickness. The data demonstrated little change in quality of life patterns among men between ages 65 and 84, says Dr. Youlian Liao, a co-author of the study.
Most encouraging to the Loyola researchers were the overall decline in the proportion of older adults who required extensive hospital or nursing home care prior to death and the significant reduction in debilitating illnesses and disabilities among men and women in the oldest age group. "The very old and frail elderly tend to use long-term care more often than expensive, acute care, while those in the best functional condition consume the greatest amount of expensive, high-tech care," say the Loyola researchers.
"One of the unique aspects of current aging trends is the rapid growth of the oldest old", says Dr. Cooper. "National data show that a surprisingly large percentage of the oldest old not only manage without daily personal assistance, but also are physically robust." "The real message here is that opportunities are available to improve the quality of one's life, and some people are taking advantage of these opportunities."
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Never Too Late to Reduce Cardiovascular Risk
Contrary to many previous studies, early life factors, such as birth weight and socioeconomic position in childhood, are not important predictors of the risk of cardiovascular disease in middle age, say researchers from the University of Newcastle. In fact adult lifestyles are more important than early life experiences in determining the risk of cardiovascular disease, say the authors.
Dr. Douglas Lamont and colleagues studied 154 men and 193 women who were born in 1947. The research team ascertained the risk of cardiovascular disease in the study group by measuring the thickness of the walls of their carotid arteries. The thicker the artery wall, the greater the risk of cardiovascular disease, say the researchers.
Dr. Lamont found that adult lifestyle and biological risk markers measured in adulthood (such as obesity and high blood pressure) had a greater effect on the thickness of the carotid artery walls in middle age and therefore the risk of cardiovascular disease, than early life experiences.
The authors conclude that even though it is clearly important to promote good maternal and child health and to reduce socioeconomic deprivation in childhood, to decrease the risk of cardiovascular disease in middle age the main focus of intervention should be on trying to alter adult lifestyles.
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AoA Announces New Elder Care Trends
The U.S. Administration on Aging (AoA) FY 2001 budget request to Congress is $1.1 billion, an increase of $151 million (16%) over FY 2000. The requests reflect the changing face of the nation's older population.
"We must endeavor to prepare America for the rising longevity of its people," says AoA head, Jeanette C. Takamura, noting that the increase will help AoA's national service delivery network to respond to the needs of our nation’s growing older population. Since 1900 the number of Americans 65 and over has grown from 3 million to 34 million and is expected to double by 2030 when the last of the Baby Boomers reach the age of 65.
AoA’s request recognizes the extraordinary efforts and needs of millions of family caregivers who care for older relatives. $125 million is included to provide assistance, support services and quality respite care to thousands of caregivers across the country. $325 million (an increase of $15 million) is included to increase supportive services for vulnerable and at-risk frail older persons, in particular 9.2 million older persons, mostly women, who live alone. Services included are transportation services to medical appointments, in-home chore services and services provided by adult day care centers.
$24 million (an increase of $5 million) is included to address the unmet long term care needs of Native American, Alaskan Native and Native Hawaiian elders, many of whom are living well into their 80's and 90's. This increase represents the largest proposed increase in a decade from the Administration for a growing population of Native elders, and will provide critical nutritional and supportive services to them and to their caregivers.
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AgeVenture News Service, www.demko.com
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Prednisone Ineffective Against Alzheimer's
A low-dose regimen of the steroid prednisone, an anti-inflammatory drug, is not effective in the treatment of Alzheimer's Disease (AD), according to findings from a new clinical trial. The trials are intended to determine the usefulness of anti-inflammatory agents to prevent or treat AD. This new study suggests that not all classes of such drugs may slow the rate at which people develop the disease or suffer cognitive decline.
This new report on prednisone is an important step in directing scientists toward what works, and what may not, at certain stages of AD, says Neil Buckholtz, PhD, chief of the Dementias of Aging Branch of the National Institute on Aging (NIA). "We need to examine carefully which drugs, or classes of drugs, work at various points in the development or progression of Alzheimer's disease. Compounds that may be useful at one stage or one dose may not be effective at another."
Clinical trials on AD are part of the NIA's Alzheimer's Disease Prevention Initiative, a national program aimed at finding ways to treat, and ultimately prevent, the neurodegenerative disease. The NIA is one of 25 institutes and centers which compose the National Institutes of Health.
For specific information on Alzheimer's disease and clinical trials in progress, the public is urged to contact the NIA's Alzheimer's Disease information center at: 1-800-438-4380.
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