Survival of outpatients with Alzheimer-type dementia

Article Abstract:

Alzheimer's disease is a common and serious problem among the elderly. The extent of the problem is likely to grow as the population of the United States ages; some studies suggest that half of all individuals over the age of 85 may be afflicted with Alzheimer's disease. Many studies have examined the prognosis of patients with Alzheimer's disease in terms of the decline of mental function. A prospective study has now been undertaken to determine the factors which have the greatest affect on survival of patients with Alzheimer's disease. From a group of 200 patients with suspected dementia, 126 were identified with suspected dementia of the Alzheimer type and were followed for at least six years. Patient survival varied tremendously, ranging from 1.8 to 16 years or longer, and was significantly influenced by the severity of the dementia, but not its duration. Test measures of dementia severity, such as the Mini Mental State Examination, were found to yield useful prognostic information. Behavioral problems contributed to shorter survival, as did the habit of wandering, which often leads to falling. Vision problems, depression, the presence of other illnesses, prescription drugs, and appetite problems did not influence survival. The combination of wandering and falling had a serious impact on mortality among the patients in this study. The progression of Alzheimer's disease is, at present, untreatable. From the standpoint of the caregiver, an important finding is that significant reduction in suffering and mortality of Alzheimer's patients might be achieved by the prevention of unguided wandering and associated falls. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Prognosis, Dementia, Alzheimer's disease, Brain diseases

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The role of numeracy in understanding the benefit of screening mammography

Article Abstract:

Interpreting risk reduction data on breast cancer may be hampered by readers' inability to understand basic mathematical concepts. Five hundred females, mostly high school graduates, completed a three-item questionnaire about mathematical probability and one item requiring interpretation of breast cancer risk reduction using one of four data formats. Only 16% of the participants answered all three math questions correctly and 30% got them all wrong. The data format providing baseline risk reduction resulted in the greatest accuracy with 33% of the participants getting the answer correct.

Evaluation, Testing, Public opinion, Medical screening, Health screening, Mammography, Comprehension, Medical statistics, Numerical calculations

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Using autopsy series to estimate the disease "reservoir" for ductal carcinoma in situ of the breast: how much more breast cancer can we find?

Article Abstract:

It appears that the incidence of a type of breast cancer called ductal carcinoma in situ (DCIS) may be higher than previously thought. Seven groups of autopsies of women not known to have breast cancer during life were evaluated for the presence of DCIS or invasive breast cancer. There was evidence of DCIS in 8.9% of the autopsies and invasive breast cancer in 1.3% of the autopsies. Many of these cancers were present in women typically evaluated by mammography at their age. Cancer was more likely to be discovered in autopsies where more samples were examined.

Usage, Diagnosis, Autopsy, Carcinoma in situ, Breast cancer

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