Sex Differences in Asthma Prevalence and Other Disease Characteristics in Eight States

Objectives. We assessed the sex differences in asthma prevalence and asthma-control characteristics within eight states. Methods. We analyzed data from the 2001 Behavioral Risk Factor Surveillance System survey. Results. Lifetime and current asthma prevalence were higher for females in each of the eight states compared to males. Adult onset of asthma was reported more often by females with current asthma, and childhood onset was reported more often by males. Sex differences were identified for the eight asthma-control characteristics. Conclusions. Females in eight states presented higher asthma risk and poorer asthma profiles than males. State surveillance data can be used to identify disparities and to develop appropriate public health interventions.     

Sex Differences in Asthma Prevalence and Other Disease Characteristics in Eight States

Objectives. We assessed the sex differences in asthma prevalence and asthma-control characteristics within eight states. Methods. We analyzed data from the 2001 Behavioral Risk Factor Surveillance System survey. Results. Lifetime and current asthma prevalence were higher for females in each of the eight states compared to males. Adult onset of asthma was reported more often by females with current asthma, and childhood onset was reported more often by males. Sex differences were identified for the eight asthma-control characteristics. Conclusions. Females in eight states presented higher asthma risk and poorer asthma profiles than males. State surveillance data can be used to identify disparities and to develop appropriate public health interventions.     

The Prevalence of Cognitive Impairment Among Adults With Incident Heart Failure: The “Reasons for Geographic and Racial Differences in Stroke” (REGARDS) Study

Background

Cognitive impairment (CI) is estimated to be present in 25%–80% of heart failure (HF) patients, but its prevalence at diagnosis is unclear. To improve our understanding of cognition in HF, we determined the prevalence of CI among adults with incident HF in the REGARDS study.

Vascular Dementia: Distinguishing Characteristics, Treatment, and Prevention

Vascular dementia (VaD) is the second-most-common cause of dementia in the elderly, after Alzheimer's disease (AD). VaD is defined as loss of cognitive function resulting from ischemic, hypoperfusive, or hemorrhagic brain lesions due to cerebrovascular disease or cardiovascular pathology. Diagnosis requires the following criteria: cognitive loss, often predominantly subcortical; vascular brain lesions demonstrated by imaging; a temporal link between stroke and dementia; and exclusion of other causes of dementia. Poststroke VaD may be caused by large-vessel disease with multiple strokes (multiinfarct dementia) or by a single stroke (strategic stroke VaD). A common form is subcortical ischemic VaD caused by small-vessel occlusions with multiple lacunas and by hypoperfusive lesions resulting from stenosis of medullary arterioles, as in Binswanger's disease. Unlike with AD, in VaD, executive dysfunction is commonly seen, but memory impairment is mild or may not even be present. The cholinesterase inhibitors used for AD are also useful in VaD. Prevention strategies should focus on reduction of stroke and cardiovascular disease, with attention to control of risk factors such as hypertension, diabetes mellitus, hypercholesterolemia, and hyperhomocysteinemia.     

Differences in body mass index and waist : hip ratios in North Indian rural and urban populations

Overweight could be a major factor in determining the increasing rates of coronary heart disease in the Indian population, by its influence on blood pressure, diabetes and insulin resistance. We studied the prevalence of overweight in north Indian urban and rural population samples. The urban sample population (n = 3050) was selected using a multistage sampling with stratification for geographical zone and the type of residential colony and cluster sampling of urban blocks in each stratum. The rural sample (n = 2487) was selected by random sampling of villages stratified for population size followed by coverage of all eligible persons in the village. All participating individuals were 35–64 years of age. Women constituted 52.2% (n = 1594) and 57% (n = 1417) of urban and rural samples, respectively. The study reveals that overweight is widely prevalent in the adult urban Delhi population, whereas underweight is a significant problem in the rural population. This was noted across all the age groups in both men and women. We estimated ‘comprehensive coronary risk estimates’ based on the New Zealand Heart foundation guidelines and noted that the proportion of high and very high risk subjects increased in a continuous manner even within the ‘normal’ ranges of BMI. This difference in prevalence in the urban population could represent the demographic transition in the Indian population.     

Trends and Ethnic Differences in COPD Hospitalization and Mortality in Singapore

Study Objective. COPD mortality alone among major causes of diseases continues to rise in most countries worldwide. We examine trends, and gender and ethnic differences in COPD hospitalization and mortality in Singapore from 1991 to 1998, and examine possible explanations. Design. Analysis of population‐based health administrative data. Setting. Multi‐ethnic (Chinese, Malay and Indian) population of Singapore (3 million population). Method. Data on hospitalizations and deaths due to COPD as the underlying cause (ICD codes 491, 492, 496), extracted from national databases, were used to calculate age‐specific and standardized rates for the population aged 55 + years. COPD accounted for 4.6% of total deaths (5.8% in those aged 55 +), and 1.02% of all hospitalizations (3.1% in those aged 55 +). Results. COPD mortality in 1998 decreased steeply by ? 43.7% from 1991 (a decline that continued a steady trend since 1970), while hospitalization showed little significant change (? 3.3%). Men had 4 and 5 times higher mortality and hospitalization, and also showed less favorable trends than women. Malays, especially males, showed the highest level and least favorable decline of mortality. Conclusion. Exceptionally steady declines in COPD mortality rates, and stable rates of hospitalization are observed in Singapore in the 1990s. Differing levels and trends of hospitalization and mortality by gender and ethnicity are related to known demographic variations and trends of smoking prevalence in the country.     

Alzheimer's Disease and Vascular Dementia: Neuropsychological Differentiation in Clinical Practice

Even when well-defined patient groups are studied, neuropsychological differentiation between Alzheimer's disease (dementia of the Alzheimer's type [DAT]) and vascular dementia (VaD) is far from clear. How useful are the results of these investigations when a differential diagnosis has to be established with non–pre-selected individual patients? In the present research we worked with a group of patients pre-diagnosed as having either DAT or VaD. Within the learning abilities, we focused on the status of the encoding system in each condition. Neuropsychological data were compared with PET data. We concluded that within certain limits a few neuropsychological data can contribute substantially to such differentiation, as long as they are contrasted with the rest of the relevant information available.