Showing papers by "Charles H. Hennekens published in 1989"

Prevalence of Alzheimer's Disease in a Community Population of Older Persons: Higher Than Previously Reported

Abstract: Clinically diagnosed Alzheimer's disease and other dementing illnesses were assessed in a geographically defined US community. Of 3623 persons (80.8% of all community residents over 65 years of age) who had brief memory testing in their homes, a stratified sample of 467 persons underwent neurological, neuropsychological, and laboratory examination. Prevalence rates of Alzheimer's disease were calculated for the community population from the sample undergoing clinical evaluation. Of those over the age of 65 years, an estimated 10.3% (95% confidence limits, 8.1% and 12.5%) had probable Alzheimer's disease. This prevalence rate was strongly associated with age. Of those 65 to 74 years old, 3.0% (95% confidence limits, 0.8 and 5.2) had probable Alzheimer's disease, compared with 18.7% (95% confidence limits, 13.2 and 24.2) of those 75 to 84 years old and 47.2% (95% confidence limits, 37.0 and 63.2) of those over 85 years. Other dementing conditions were uncommon. Of community residents with moderate or severe cognitive impairment, 84.1% had clinically diagnosed Alzheimer's disease as the only probable diagnosis. These data suggest that clinically diagnosed Alzheimer's disease is a common condition and that its public health impact will continue to increase with increasing longevity of the population. (JAMA. 1989;262:2551-2556)

Aspirin and other antiplatelet agents in the secondary and primary prevention of cardiovascular disease.

Abstract: Antiplatelet therapy, particularly with aspirin, has become the focus of much research in the treatment and prevention of cardiovascular disease. In this paper, we review the evidence of efficacy; first, for patients who have a history of myocardial infarction (M1), stroke, transient cerebral ischemia (TCI), or unstable angina; second, for those actually undergoing acute myocardial infarction (AMI); and, finally, for apparently healthy individuals.

Prospective Study of Oral Contraceptive Use and Risk of Breast Cancer in Women

Abstract: In 1976, 118,273 female nurses 30-55 years of age with no history of cancer completed a questionnaire regarding possible risk factors. By 1986, after 1,137,415 person-years of follow-up, we had documented 1,799 newly diagnosed cases of breast cancer. Compared with the risk of breast cancer for nonusers of oral contraceptives, the multivariate relative risks were 1.07 (95% confidence interval, 0.97-1.19) for all users, 1.06 (95% confidence interval, 0.96-1.18) for past users, and 1.53 (95% confidence interval, 1.06-2.19) for current users--women who used oral contraceptives up to 2 years before diagnosis of breast cancer. We conclude that overall past use of oral contraceptives is not associated with a substantial increase in the risk of breast cancer. Although we did not find women who used oral contraceptives before the first pregnancy to have an increased risk of breast cancer, the number of women who used oral contraceptives for a long duration in early reproductive life was too small to permit firm conclusions regarding the risk in this subgroup.

Peak expiratory flow rate in an elderly population

Abstract: A population survey was conducted in 1982-1983 among 3,812 persons aged 65 years and older residing in East Boston, Massachusetts, a geographically defined urban community. Three measurements of peak expiratory flow rate were obtained by using calibrated mini-Wright meters. Peak expiratory flow rate was strongly related to age, sex, smoking, and years smoked. After adjustment for these factors, low peak expiratory flow rate was associated with chronic respiratory symptoms (cough, wheeze, shortness of breath, exertional dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; p less than 0.0001) and with certain cardiovascular variables (history of stroke, p = 0.0014; angina, p = 0.05; and high pulse rate, p = 0.004). No significant associations were found with history of myocardial infarction or systolic and diastolic blood pressures. Peak expiratory flow rate was positively related to education (p less than 0.0001) and income (p less than 0.0001). Peak expiratory flow rate also was strongly related (p less than 0.0001) to measures of functional ability and physical activity, self-assessment of health, and simple measures of cognitive function. The correlations of peak expiratory flow rate with pulmonary symptoms and other indices of chronic disease raise the possibility that peak expiratory flow rate will predict mortality in an elderly population.

Correlates of Headache in a Population-Based Cohort of Elderly

Abstract: • Data from a community-based study of 3811 persons aged 65 years and older were used to describe the characteristics of headache in the elderly. Subjects were asked whether they experienced headache in the past year, the frequency and severity of their headaches, and whether they experienced three symptoms of migraine: unilaterality, nausea or vomiting, an aura preceding the headache. Prevalence of headache in those aged more than 65 years declined with age in both men and women; women had a higher prevalence in each age group. The same was true for frequent, severe, and migrainous headache. We examined age- and sex-adjusted correlations of headache with several medical and social factors. Prevalence of any headache was strongly associated with joint pain, depression, bereavement, waking during the night, use of eyeglasses, symptoms of temporomandibular joint dysfunction, and self-assessment of health. Similar variables were associated with frequency, severity, and migrainous symptoms, and thus could not be distinguished among these various types.

Allele frequencies of apolipoprotein A-I and A-II gene locus DNA polymorphisms in Boston-based whites.

Abstract: Allele frequencies for four restriction fragment length polymorphisms of the apolipoprotein A-I gene locus and one restriction fragment length polymorphism of apolipoprotein A-II gene locus were determined in more than 100 North American whites and are reported herein.