Older, Cheap Drug May Cut Suicide Risk for People With Mood Disorders

Review of data finds that lithium benefits people with depression, bipolar illnesses

By Robert Preidt

HealthDay Reporter

THURSDAY, June 27 (HealthDay News) -- A new review of data suggests than an old and inexpensive drug, lithium, may help lower suicide risk in people with mood disorders such as depression or bipolar disorder.

"The study provides further evidence that one of the most effective psychiatric medications for preventing suicide in patients with mood disorders is also one of our oldest," said one expert not connected to the research, Dr. Andrew Kolodny, chairman of psychiatry at Maimonides Medical Center in New York City.

According to background information from the researchers, people with mood disorders have a 30 times higher risk of suicide compared to the general population.

Treatment with mood-stabilizing drugs such as lithium, anticonvulsants or antipsychotics can help maintain mood within normal limits, but their role in suicide prevention has been unclear, according to background information in the review, which was published online June 27 in the journal BMJ.

The review was led by Andrea Cipriani, of the department of psychiatry at Oxford University in the United Kingdom. His team analyzed the results of 48 clinical trials involving more than 6,600 people.

The researchers found lithium to be linked with a 60 percent reduction in the risk of suicide and other causes of death compared with people who took a placebo.

They also found that lithium may reduce the risk of self-harm in people with mood disorders. "[The review] reinforces lithium as an effective agent to reduce the risk of suicide in people with mood disorders," the team said.

How the drug works to cut suicide risk remains unclear. Lithium may reduce relapses of mood disorders, but there also is "some evidence that lithium decreases aggression and possibly impulsivity, which might be another mechanism mediating the anti-suicidal effect," the researchers said.

The drug has many side effects, however, so the researchers said doctors "need to take a balanced view of the likely benefits and harm of lithium in the individual patient."

Dr. Robert Dicker, associate director of the Child/Adolescent Psychiatry Division at Zucker Hillside Hospital in Glen Oaks, N.Y., called the new study "a great reminder that lithium offers tremendous benefits in treating patients with mood disorders and suicide."

But Kolodny said the drug is not used as often as it could be. "Lithium, which is generic and not promoted by pharmaceutical companies, tends to be under-prescribed," he said. "Hopefully, this study will help change that."

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Exercise May Lower Older Women's Risk for Kidney Stones

FRIDAY, May 3 (HealthDay News) -- Anybody who's ever had kidney stones knows how painful they can be.

Now, a new study suggests that getting more exercise may reduce older women's risk for kidney stones.

Researchers from the University of California, San Francisco Medical Center, Georgetown University and University of Washington School of Medicine analyzed data from more than 85,000 postmenopausal women in the United States and found that higher levels of physical activity seemed to lower the risk of kidney stones by as much as 31 percent.

The amount of exercise -- not the intensity -- is the key factor in reducing kidney stone risk, according to the study scheduled for Saturday presentation at the annual meeting of the American Urological Association, in San Diego.

The researchers also said that reducing the amount of high-calorie foods they consume could cut postmenopausal women's risk of kidney stones by more than 40 percent.

"Kidney stones are a very common health condition, and as with most health conditions, prevention is key," AUA spokesman Dr. Kevin McVary said in an association news release.

"While we know diet is one of several factors that can promote or inhibit kidney stone development, this study shows lifestyle changes such as exercise can also help prevent stones from forming in postmenopausal women. Further research is needed to understand if this observation is accurate for other demographics," he noted.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Each year, kidney stones send more than 3 million Americans to a health care provider and more than half a million to an emergency department, according to the news release. Obesity is known to be a strong risk factor for kidney stones.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Urological Association, news release, May 3, 2013

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Older Adults' Posture May Predict Future Disability

FRIDAY, April 19 (HealthDay News) -- The shape of an older person's spine may predict their future need for home assistance or admission to a nursing home, according to a new Japanese study.

The findings appeared online recently in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences.

The study included more than 800 people aged 65 and older in Japan, who underwent four types of spinal measurement. The researchers found that only one of the measurements was associated with becoming dependent on help for activities of daily living.

These activities include basic self-care tasks such as bathing, feeding, using the toilet, dressing and getting in or out of a bed or chair.

The measurement that predicted the need of assistance is called the "trunk angle of inclination." This is the angle between the true vertical and straight line from the first thoracic vertebra (near the head) to the first sacral vertebra (in the lower spine), the researchers said in a journal news release.

Over four and a half years of follow-up, about 16 percent of the participants became dependent on help for basic daily activities. Those with the greatest angle of spinal inclination were about three and a half times more likely to become dependent on help for basic daily activities than those with the least spinal inclination, the researchers found.

Although the study found an association between spinal angle and future disability in older adults, it did not establish a cause-and-effect relationship.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Journals of Gerontology Series A: Biological Sciences and Medical Sciences, news release, April 2013

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Having Older Grandfather May Raise Child's Autism Risk: Study

Title: Having Older Grandfather May Raise Child's Autism Risk: Study
Category: Health News
Created: 3/20/2013 4:35:00 PM
Last Editorial Review: 3/21/2013 12:00:00 AM

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Having Older Grandfather May Raise Child's Autism Risk: Study

Men who became dads at age 50 or older had higher odds for a grandchild with the disorder

By E.J. Mundell

HealthDay Reporter

WEDNESDAY, March 20 (HealthDay News) -- The odds that a child will develop autism could be linked to their grandfather's age at the time they were born, a new Swedish study suggests.

The study found that men who fathered a child at the age of 50 or older were more likely to have a grandchild with autism, suggesting that the risk might be passed down through successive generations.

Men who had a daughter at age 50 or older were 79 percent more likely to have a grandchild with autism compared to men who fathered when they were in their early 20s, the research team reported in the March 20 issue of the journal JAMA Psychiatry. Men who fathered a son at age 50 or older had a 67 percent higher risk of having a grandchild with the disorder compared to men who fathered a child as young adults.

"We tend to think in terms of the here and now when we talk about the effect of the environment on our genome," said study co-author Dr. Avi Reichenberg, who worked on the study while at King's College London's Institute of Psychiatry, in England. "For the first time in psychiatry, we show that your father's and grandfather's lifestyle choices can affect you.

"This doesn't mean that you shouldn't have children if your father was old when he had you, because while the risk is increased, it is still small," added Reichenberg, who is now an autism researcher at the Icahn School of Medicine at Mount Sinai, in New York City. "However, the findings are important in understanding the complex way in which autism develops."

Although the study found a correlation between advanced age in grandfathers and the odds for autism in children, it is only an observational trial, so it cannot prove cause and effect. And another expert also stressed that the absolute risk to any one family remains small.

"Although there was a statistically significant increase in the incidence of autism in families with older grandparents, it must be remembered that autism was still extremely infrequent even in families with the oldest grandparents," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven & Alexandra Cohen Children's Medical Center of New York, in New Hyde Park. "Thus, older parents and grandparents should not be unduly worried."

The new research was published on the same day that the U.S. Centers for Disease Control and Prevention announced that one in every 50 U.S. school children now has an autism spectrum disorder -- up from the 2007 estimate of 1 in 88. The CDC says improved detection and diagnosis are probably responsible for most of that increase.

In the new study, researchers looked at data from Sweden's national registries and compared about 6,000 people with autism to about 31,000 people without the condition. They looked at the age of each person's maternal and paternal grandfather at the time of the individual's birth.

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Study: Older Whooping Cough Vaccine More Effective

But it was phased out because of side effects; newer version works, study notes

By Serena Gordon

HealthDay Reporter

MONDAY, May 20 (HealthDay News) -- The older vaccine for whooping cough that was phased out in the late 1990s is more effective than the current version of the vaccine, a new study contends.

Teenagers who received four shots with the older vaccine -- called whole-cell vaccine -- before they were 2 years old were significantly less likely to become infected with whooping cough during a recent outbreak in California, compared to children who received all of their immunizations with the new vaccines, called the acellular vaccine.

"Teens who were vaccinated with the acellular vaccine appear to have a six times higher risk of [whooping cough] than teens who received four doses of the whole-cell vaccine. And, the teens who received some whole-cell vaccine and some acellular had about a four times higher risk than teens who received all whole-cell vaccines," said the study's lead author, Dr. Nicola Klein, co-director of the Northern California Kaiser Permanente Vaccine Study Center, in Oakland.

Whooping cough, which is also known as pertussis, is a highly contagious respiratory infection. In 2012, the United States had the highest number of whooping cough cases since 1959 with more than 41,000 infections and 18 deaths. Most of the deaths occurred among infants, according to the U.S. Centers for Disease Control and Prevention.

The whole-cell vaccine was used from the 1940s to the 1990s, but was phased out due to potential side effects. "The reason we switched away from the whole-cell vaccine was that there were some safety concerns, such as high fevers," Klein explained.

The acellular vaccine was introduced in the 1990s, and has few side effects. However, in recent years, a number of studies have found that the newer vaccine doesn't seem to work for as long as the older vaccine.

California experienced an outbreak of whooping cough in 2010 and 2011. This gave researchers the chance to see how effective the acellular vaccine was compared to the whole-cell vaccine in teens who may have received all of their shots with one or the other vaccine, or possibly with both.

The study included teens born from 1994 to 1999 who got their initial four shots of whooping cough vaccine before they were 2 years old at Kaiser Permanente Northern California.

Of the study participants, 138 teens had confirmed whooping cough. They were compared to 899 teens who'd had a lab test that confirmed they didn't have whooping cough, and to 54,339 "matched control" teens.

The researchers found that the fewer number of whole-cell vaccines a teen had received, the greater the risk of whooping cough.

Teens who had received all acellular vaccines had a 5.63 times greater risk of whooping cough than teens who'd gotten all whole-cell vaccines. Teens who received both acellular and whole-cell vaccines had a 3.77 times higher risk of whooping cough compared to those who had all whole-cell vaccines.

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Healthy Older Women Advised Against Taking Calcium

Title: Healthy Older Women Advised Against Taking Calcium
Category: Health News
Created: 2/25/2013 6:36:00 PM
Last Editorial Review: 2/26/2013 12:00:00 AM

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Healthy Older Women Advised Against Taking Calcium

By Barbara Bronson Gray

HealthDay Reporter

MONDAY, Feb. 25 (HealthDay News) -- Healthy older women should not take calcium and vitamin D supplements to prevent fractures, according to a final recommendation issued Monday by the U.S. Preventive Services Task Force.

In healthy adults, lower doses of calcium and vitamin D seem to be ineffective. As for higher doses, it's still up in the air, the government group said.

The new recommendations do not apply to people who are known to be vitamin D-deficient or who already have osteoporosis, the U.S. Preventive Services Task Force (USPSTF) noted.

Every year about 1.5 million fractures in the United States are attributed to osteoporosis, which is caused by a decrease in bone mass and density that makes bones fragile and more susceptible to a break. Almost half of all women older than 50 will have an osteoporosis-related fracture in their lifetime, according to the USPSTF.

Calcium is one of the main building blocks of bone growth, and vitamin D (sourced via sunlight's action on the skin, or through diet) helps bones absorb calcium. But at issue is whether people receive enough of these nutrients in their daily diet, or if supplements would help protect them.

Dr. Virginia Moyer, chair of the USPSTF, and a professor of pediatrics at Baylor College of Medicine, said experts know that a "medium dose" of supplements -- less than 400 international units (IU) of vitamin D and less than 1,000 milligrams (mg) of calcium -- does not work.

As for higher doses? "We simply don't know. There are reasons to think they could work, but unfortunately, even though there are a bunch of studies, there are problems with them," Moyer said.

"We know these recommendations will be very frustrating to both physicians and patients, but it's a call to action to the research community," she added.

The USPSTF analyzed a wide range of studies on the effects of supplementation of vitamin D and calcium levels for bone health and the adverse effects of supplementation. The report, published online Feb. 26 in the Annals of Internal Medicine, makes these points about preventing fractures:

Don't take low doses of daily supplements: Less than 400 IU of vitamin D and less than 1,000 mg of calcium after menopause have no benefit.For higher doses: The task force doesn't have sufficient evidence to make a recommendation on daily supplements.For men and women younger than 50: The task force also doesn't have enough evidence to make a recommendation on vitamin D and calcium supplements.

The report notes a downside to low-dose supplementation: Taking 400 IU or less of vitamin D and 1,000 mg or less of calcium increases the risk of kidney stones, which can be painful and may require hospitalization.

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New Blood Thinner Beats Older Drug for Vein Clots: Study

Title: New Blood Thinner Beats Older Drug for Vein Clots: Study
Category: Health News
Created: 2/20/2013 6:36:00 PM
Last Editorial Review: 2/21/2013 12:00:00 AM

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For Older Women, Mammograms Every 2 Years Found as Good as Annual Test

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Do Older Adults Need Vitamins, Supplements?

ByKathleen Doheny
WebMD Health News Reviewed byLouise Chang, MD

Nov. 30, 2012 -- At least half of adults age 65 and above take daily vitamins and other supplements, but only a fraction actually need them, says an Emory University expert.

The majority of older adults, he says, can improve their diet to get needed nutrients.

"A lot of money is wasted in providing unnecessary supplements to millions of people who don't need them," says Donald B. McCormick, PhD, an Emory professor emeritus of biochemistry and the graduate program in nutrition and health sciences at Emory.

He challenges what he says is a widely held belief that the older people get, the more vitamins and mineral supplements they need.

The scientific backup for that doesn’t exist, he says. "We know too little to suggest there is a greater need in the elderly for most of these vitamins and minerals."

"A supplement does not cure the aging process," he says. And in some cases, supplements may do harm, he says. Expense is another factor.

His report, which reviews numerous studies of vitamins and mineral supplements, is published in Advances in Nutrition.

Duffy MacKay, ND, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, an industry group representing dietary supplement makers, agrees that starting with a good diet is the best way to get needed nutrients.

But he says that is not always reality, especially for older adults who may have obstacles such as a reduced appetite.

Older-Adult Nutrient Needs

McCormick reviewed studies on dietary supplements in older adults published in the last 12 years.

He says that ''it is apparent that changes in requirements for the elderly do not suggest massive supplement use covering most micronutrients." He says minor diet changes can fill needs for nutrients, ''with supplements included only where there is evidence of serious limitation of intake."

He disagrees with a study suggesting that older adults should take two multivitamins a day. He found no evidence that older adults need more thiamin, riboflavin, or niacin than younger people. Some older adults may need more vitamin B6, B12, and folate, research suggests.

But vitamin C needs do not seem to change with age, he says, if an older adult does not smoke cigarettes.

McCormick also found no evidence that absorption or the body's use of vitamin E changes as people get older. He says there is a decrease in the way the skin makes vitamin D. So for some older adults, supplemental vitamin D may be needed. In some research, taking 800 to 1,000 IUs of vitamin D a day helped women who were past menopause.

Copper requirements don't seem to change with age, either, McCormick says.

Older adults often take in less chromium, but he says there is not evidence that there are any health consequences.

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