Sleep apnea linked to memory decline, dementia

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By Genevra Pittman

NEW YORK | Tue Aug 9, 2011 8:54pm EDT

NEW YORK (Reuters Health) - Older women who have sleep apnea may be more likely to develop memory problems and dementia, according to a new study.

It's not clear yet whether treating the sleep apnea can help prevent that memory decline -- but researchers say future studies should address that question.

"It makes sense that good sleep is going to be protective to the brain," said Dr. Robert Thomas, who studies sleep at Harvard Medical School in Boston and was not involved in the new study.

But, he added, clear answers have been lacking on the link between problem sleeping and memory. "We simply don't have data to answer many of the simple questions people may have in the sleep clinic," he told Reuters Health.

To try to shrink that gap, Dr. Kristine Yaffe of the University of California, San Francisco and colleagues gave an overnight sleep apnea test to 298 women without dementia, who were an average of 82 years old. The test looks for changes in breathing and oxygen flow during the night, as well as for the short, frequent breaks in sleep that are signs of sleep apnea.

Just over a third of the women had sleep apnea -- which is especially common in older, overweight people.

About five years later, the researchers brought those same women in for a set of thinking and memory tests, and doctors evaluated any of the women who showed signs of memory decline.

In total, a little over a third (36 percent) of the women were diagnosed with mild cognitive impairment or dementia.

Among women who had shown signs of sleep apnea on their overnight tests five years earlier, 45 percent had developed thinking and memory problems, compared to 31 percent of women who didn't have sleep problems.

When Yaffe and her colleagues took factors such as race, weight, and other diseases and medications into consideration, women with sleep apnea were almost twice as likely to test positive for cognitive impairment or dementia, according to findings published in the Journal of the American Medical Association.

Sleep apnea has also been linked to a host of other health problems, including high blood pressure and cholesterol. Researchers pointed to lower blood flow to the brain during sleep as a possible culprit in cognitive problems down the line.

Indeed, when the authors looked at the specific factors that went into a diagnosis of sleep apnea, they found that the lack of steady oxygen overnight was related to thinking and memory problems, not how much total sleep women got or how many times they woke up during the night.

Thomas said that not everyone with sleep apnea has symptoms, which include fatigue and snoring, and that people who are overweight or have heart and blood pressure diseases should also consider getting tested.

But researchers still don't know to what extent treatment -- which involves wearing a mask that delivers pressurized air from a "CPAP" machine to ease breathing at night -- can prevent the complications of sleep apnea, including cognitive decline.

"The single biggest hole in sleep apnea (research) is: what are the outcomes of treatment?" Thomas said.

Yaffe agreed. "That's obviously a next step and important question," she told Reuters Health.

Seva Polotsky, a sleep apnea researcher from Johns Hopkins University School of Medicine in Baltimore, said it's important nonetheless that people with sleep apnea follow whatever treatment regimen their doctor recommends. Still, "there's only one cure for apnea so far we've found, and this is weight loss," he told Reuters Health.

People with sleep apnea should also try to be tested occasionally for signs of cognitive decline, Yaffe concluded.

SOURCE: bit.ly/hwxtTL JAMA, online August 9, 2011.

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Heart failure in elderly linked to memory problems

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The hands of a pensioner are pictured during an afternoon nap at a residential home for the elderly in Eichenau near Munich June 21, 2011. Picture taken June 21.

Credit: Reuters/Michaela Rehle

NEW YORK | Wed Aug 10, 2011 9:54pm EDT

NEW YORK (Reuters Life!) - Older patients with heart failure had more memory problems when their heart ailments were advanced, but the same was not true with younger patients who suffered from a similar type of heart failure, according to a study.

The findings, published in Archives of Neurology, tell cardiologists they need to be aware their patients may be at higher risk of memory problems, problems that could come into play in their treatment, said study author Joanne Festa from St. Luke's-Roosevelt Hospital in new York.

"As you get older, there's more atrophy (in the brain). It could be that particularly in heart failure, the brain atrophies at a quicker rate," Festa Said.

"Memory plays a role in how you manage your health. Do you remember to take your medication? Keep up with follow-yup appointments? Do you remember the symptoms that you have?"

In addition, when memory decline is linked to heart failure, it may come on very slowly and not be noticed until it's advanced.

Festa and her colleagues collected data from memory tests in 207 heart failure patients being evaluated to see if they were candidates for a heart transplant. The researchers split those patients up into 189 who had low scores on a test of heart function, and 38 who had better scores.

All the patients had heart failure market by a low left ventricular ejection fraction (LVEF), the measurement of how much blood is being pumped out of the left ventricle of the heart.

In general, patients younger than 63 performed similarly on memory tests, regardless of left ventricular function.

But in older patients, a low LVEF was linked to a 1 percent lower score on combined memory tests, especially on tests that measured how well they recognized and memorized words.

"They learn at about the same rate, but essentially they don't hold onto the information," Festa said.

"They don't remember it, they don't recognize it -- which is very relevant to remembered what your doctor said to you in the office."

In younger patients, the brain may be able to compensate for lower blood flow, while an already-aging brain might suffer more from the impact of heart failure, she added.

The researchers found that poor memory was also linked to depression symptoms and attention problems.

The findings are something for older heart patients, and the doctors treating them, to take note of, she added.

"Everyone is concerned about their memory, memory is an important part of everyday functioning," she said.

"But it also plays an important role in health outcomes. Doctors need to be aware that many of these patients should be evaluated."

(Reporting by Genevra Pittman at Reuters Health; editing by Elaine Lies)

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Heart failure linked to memory problems: study

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By Genevra Pittman

NEW YORK | Wed Aug 10, 2011 9:56pm EDT

NEW YORK (Reuters Health) - Older patients with heart failure had more memory problems when their heart ailments were advanced, in a new study of adults being evaluated for transplants.

But that wasn't the case in young and middle-aged adults with a type of heart failure marked by a lower-than-normal amount of blood being pumped by the left ventricle.

"As you get older, there's more atrophy" in the brain, said study author Joanne Festa, from St. Luke's-Roosevelt Hospital in New York. "It could be that particularly in heart failure the brain atrophies at a quicker rate."

The findings tell cardiologists they need to be aware that their patients might be at higher risk of memory problems -- problems that could come into play in their heart treatment, Festa added.

"Memory plays a role in how you manage your health," she said. "Do you remember to take your medication? Keep up with follow-up appointments? Do you remember the symptoms that you have?"

In addition, when memory decline is linked to heart failure, it might come on very slowly, and not be noticed until it's advanced.

Festa and her colleagues collected data from memory tests in 207 heart failure patients who were being evaluated to see if they were candidates for a heart transplant. The researchers split those patients up into 169 that had low scores on a test of heart function and 38 that had a better score.

In general, patients younger than 63 performed similarly on memory tests, regardless of how well exams showed their left ventricle was working.

But in older patients, poor heart function was linked to a one percent lower score on combined memory tests, and especially poor performance on tests that measured how well they recognized and remembered words.

"They learn at about the same rate, but essentially they don't hold on to the information," Festa said. "They don't remember it, and they don't recognize it -- which is very relevant to remembering what your doctor said to you in the office."

In younger patients, she added, the brain may be able to compensate for lower blood flow -- while an already-aging brain might suffer more from the impact of heart failure.

In a separate analysis, the researchers report in Archives of Neurology that poor memory was also linked to depression symptoms and attention problems.

Festa said there's strong evidence implicating heart disease in thinking and memory difficulties, but that studies looking specifically at left ventricle problems have been less consistent. Now, it seems part of that inconsistency could be due to varied ages of patients in different studies.

The findings are something for older heart patients, and the doctors treating them, to take note of, the researcher said.

"Everyone is concerned about their memory; memory is an important part of everyday functioning," Festa said. "But it also plays an important role in health outcomes."

"Doctors need to be aware that many of these patients should be evaluated," even if the patients don't report memory problems.

SOURCE: bit.ly/nDOZDR Archives of Neurology, online August 8, 2011.

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Men's finger length linked to risk of knee injury

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A jogger runs towards a fog shrouded Sydney city skyline May 15, 2008.

Credit: Reuters/Tim Wimborne

NEW YORK | Wed May 25, 2011 2:18am EDT

NEW YORK (Reuters Life!) - "Manly" hands might signal an increased risk of suffering a knee injury, if one study is correct.

The study, which targeted more than 1,000 middle-aged and older U.S. adults and was published in Arthritis & Rheumatism, found a higher risk of knee injuries among men with a bigger discrepancy in the lengths of their index and ring fingers.

In general, men tend to have relatively short index fingers and longer ring fingers, while women show more equality in those two digits. A greater difference between the two fingers, whether in a man or a woman, is thought to reflect greater exposure to testosterone in the womb.

Ida Haugen of Diakonhjemmet Hospital in Oslo, Norway, and her team analyzed data on 1,020 U.S. adults aged 51 to 92 in Framingham, Massachusetts, focusing on their history of knee injuries and arthritis symptoms. They also looked at x-rays of subjects' hands and knees.

Overall, 28 percent of men and 23 percent of women said they'd had a knee injury that kept them off their feet for at least a few days.

The odds of having such an injury were 78 percent higher among the one-third of men with the biggest finger-length disparity, versus the one-third with the smallest discrepancy.

There was no link between finger length and knee injuries among women, nor was there a relationship between finger length and knee arthritis is men or women.

Some studies have linked the "male" finger pattern to higher aggression levels and athletic prowess, while others have tied the pattern to certain health conditions, including arthritis in the knee and hand.

No one knows why those links exist, but one theory is that early testosterone exposure is at play

The cartilage that cushions the joints is sensitive to testosterone, so it's possible that greater exposure to the hormone somehow makes the tissue more vulnerable to damage, wrote Haugen.

Since the finger pattern has been tied to aggression and sports skills, it's also possible that men with the pattern are more likely to be in situations where they could be injured.

So, should men with long ring fingers worry about their knees?

Probably not, researchers said. The risk of any one person suffering a knee injury or arthritis would depend much more on factors like age, physical activity and body weight.

(Reporting by Reuters Health; editing by Elaine Lies)

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A jogger runs towards a fog shrouded Sydney city skyline May 15, 2008.

Credit: Reuters/Tim Wimborne

NEW YORK | Wed May 25, 2011 2:18am EDT

NEW YORK (Reuters Life!) - "Manly" hands might signal an increased risk of suffering a knee injury, if one study is correct.

The study, which targeted more than 1,000 middle-aged and older U.S. adults and was published in Arthritis & Rheumatism, found a higher risk of knee injuries among men with a bigger discrepancy in the lengths of their index and ring fingers.

In general, men tend to have relatively short index fingers and longer ring fingers, while women show more equality in those two digits. A greater difference between the two fingers, whether in a man or a woman, is thought to reflect greater exposure to testosterone in the womb.

Ida Haugen of Diakonhjemmet Hospital in Oslo, Norway, and her team analyzed data on 1,020 U.S. adults aged 51 to 92 in Framingham, Massachusetts, focusing on their history of knee injuries and arthritis symptoms. They also looked at x-rays of subjects' hands and knees.

Overall, 28 percent of men and 23 percent of women said they'd had a knee injury that kept them off their feet for at least a few days.

The odds of having such an injury were 78 percent higher among the one-third of men with the biggest finger-length disparity, versus the one-third with the smallest discrepancy.

There was no link between finger length and knee injuries among women, nor was there a relationship between finger length and knee arthritis is men or women.

Some studies have linked the "male" finger pattern to higher aggression levels and athletic prowess, while others have tied the pattern to certain health conditions, including arthritis in the knee and hand.

No one knows why those links exist, but one theory is that early testosterone exposure is at play

The cartilage that cushions the joints is sensitive to testosterone, so it's possible that greater exposure to the hormone somehow makes the tissue more vulnerable to damage, wrote Haugen.

Since the finger pattern has been tied to aggression and sports skills, it's also possible that men with the pattern are more likely to be in situations where they could be injured.

So, should men with long ring fingers worry about their knees?

Probably not, researchers said. The risk of any one person suffering a knee injury or arthritis would depend much more on factors like age, physical activity and body weight.

(Reporting by Reuters Health; editing by Elaine Lies)

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A jogger runs towards a fog shrouded Sydney city skyline May 15, 2008.

Credit: Reuters/Tim Wimborne

NEW YORK | Wed May 25, 2011 2:18am EDT

NEW YORK (Reuters Life!) - "Manly" hands might signal an increased risk of suffering a knee injury, if one study is correct.

The study, which targeted more than 1,000 middle-aged and older U.S. adults and was published in Arthritis & Rheumatism, found a higher risk of knee injuries among men with a bigger discrepancy in the lengths of their index and ring fingers.

In general, men tend to have relatively short index fingers and longer ring fingers, while women show more equality in those two digits. A greater difference between the two fingers, whether in a man or a woman, is thought to reflect greater exposure to testosterone in the womb.

Ida Haugen of Diakonhjemmet Hospital in Oslo, Norway, and her team analyzed data on 1,020 U.S. adults aged 51 to 92 in Framingham, Massachusetts, focusing on their history of knee injuries and arthritis symptoms. They also looked at x-rays of subjects' hands and knees.

Overall, 28 percent of men and 23 percent of women said they'd had a knee injury that kept them off their feet for at least a few days.

The odds of having such an injury were 78 percent higher among the one-third of men with the biggest finger-length disparity, versus the one-third with the smallest discrepancy.

There was no link between finger length and knee injuries among women, nor was there a relationship between finger length and knee arthritis is men or women.

Some studies have linked the "male" finger pattern to higher aggression levels and athletic prowess, while others have tied the pattern to certain health conditions, including arthritis in the knee and hand.

No one knows why those links exist, but one theory is that early testosterone exposure is at play

The cartilage that cushions the joints is sensitive to testosterone, so it's possible that greater exposure to the hormone somehow makes the tissue more vulnerable to damage, wrote Haugen.

Since the finger pattern has been tied to aggression and sports skills, it's also possible that men with the pattern are more likely to be in situations where they could be injured.

So, should men with long ring fingers worry about their knees?

Probably not, researchers said. The risk of any one person suffering a knee injury or arthritis would depend much more on factors like age, physical activity and body weight.

(Reporting by Reuters Health; editing by Elaine Lies)

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