Nifedipine and mortality risk in the elderly: relevance of drug formulation, dose and duration.

Purpose: This study examines the risk of all-cause and cardiac-related mortality associated with calcium channel blockers (CCBs) and other antihypertensives/diuretics compared with beta-blockers among an elderly cohort. We explored variations in mortality risk according to CCB formulation, dose and duration of use.

Methods: Data are from the clinical sample of the Canadian Study of Health and Aging, a population-based prospective study of community and institutional residing persons aged 65+ years.

Supplemental use of antioxidant vitamins and subsequent risk of cognitive decline and dementia.

There are conflicting reports about the potential role of vitamin antioxidants in preventing and/or slowing the progression of various forms of cognitive impairment including Alzheimer's disease (AD). We examined longitudinal data from the Canadian Study of Health and Aging, a population-based, prospective 5-year investigation of the epidemiology of dementia among Canadians aged 65+ years. Our primary objective was to examine the association between supplemental use of antioxidant vitamins and subsequent risk of significant cognitive decline (decrease in 3MS score of 10 points or more) among subjects with no evidence of dementia at baseline (n=894).

Does self-rated health predict survival in older persons with cognitive impairment?

Objectives: To determine whether baseline self-rated health (SRH) independently predicted survival in an older Canadian population and to investigate the role of cognition on the SRH-mortality relationship.

Design: Population-based prospective cohort study.

Setting: Ten Canadian provinces, community-based.

Regional variation in the use of medications by older Canadians--a persistent and incompletely understood phenomena.

Background: We have previously reported on regional variability in medication consumption by older Canadians. In this study, we used longitudinal data to determine whether regional differences in commonly consumed medications persisted and to explore potential explanatory factors for observed differences.

Methods: We utilized data from the second phase of the Canadian Study of Health and Aging to assess the number, types, and variability of medications used between regions.

Prevalence and potential consequences of benzodiazepine use in senior citizens: results from the Canadian Study of Health and Aging.

Objectives: The aim of this study was to evaluate changes in benzodiazepine use over time, and the association between benzodiazepine use and select outcomes.

Design: A five-year longitudinal cohort study in subjects 65 years of age and older.

Setting: Select urban communities and institutions across Canada with senior citizens.

Serum folate levels and subsequent adverse cerebrovascular outcomes in elderly persons.

Recent epidemiologic studies have shown an association between low serum folate levels and risk of vascular disease, including stroke and various types of vascular cognitive impairment. We examined data from the Canadian Study of Health and Aging (CSHA), a population-based, prospective 5-year investigation of the epidemiology of dementia among Canadians aged 65+ years. The risk of an adverse cerebrovascular event (including vascular dementia, vascular cognitive impairment, or fatal stroke) during follow-up, was assessed according to serum folate quartiles among subjects with no evidence of dementia at baseline (n = 369).

A randomized controlled trial of a community-based consultation service to prevent falls.

Background: Multifaceted programs that combine assessment with interventions have been shown to reduce subsequent falls in some clinical trials. We tested this approach to see whether it would be effective if offered as a consultation service using existing health care resources.

Methods: The subjects of this randomized controlled trial had to be aged 65 years or more and had to have fallen within the previous 3 months.

Predicting who will develop dementia in a cohort of Canadian seniors.

Objectives: We examined whether easily attainable variables were useful in predicting who became demented over a five year period and determined the rates of incident dementia for different categories of mild cognitive impairment.

Methods: This was a cohort study of subjects recruited nationally in a population-based survey of Canadians 65 years and older (the Canadian Study of Health and Aging). After standardized clinical assessments, a subset of subjects (n = 1782) was categorized as not demented at time one.

Health, function and survival of a cohort of very old Canadians: results from the second wave of the Canadian Study of Health and Aging.

Seniors 85 years of age and older (85+) make up the fastest-growing segment of the Canadian population. There is a need for longitudinal data on the health status of this group. We used data collected as part of the Canadian Study of Health and Aging to examine how health status changed over five years in a large (n = 1799) cohort of Canadians 85+.

Living alone with dementia.

This report describes a population of individuals with dementia living alone in the community. Data were collected as part of the Canadian Study of Health and Aging (CSHA). We found that one third of the subjects in the CSHA sample with a dementia residing in the community lived alone.

Calcium-channel blockers and cognitive function in elderly people: results from the Canadian Study of Health and Aging.

Background: Concern has been raised about the potential for adverse cognitive effects associated with the use of calcium-channel blockers (CCBs) in older people. This study was undertaken to examine prospectively the association between the use of these and other antihypertensive drugs and cognitive function.

Methods: The authors examined data from the Canadian Study of Health and Aging (CSHA), a population-based, prospective 5-year investigation of the epidemiology of dementia and other health problems in Canadians 65 years of age and older.

Disease, disability, and age in cognitively intact seniors: results from the Canadian Study of Health and Aging.

Background: Many diseases have been identified as risk factors for disability in the elderly. This report contrasts disability in the old-old (85 years of age or older, 85+) with younger seniors (65-84 years of age) and examines whether diseases have an equivalent impact on the two groups.

Methods: Subjects were 603 cognitively intact community residents 65 years of age and older from 10 Canadian provinces.

Folate status, vascular disease and cognition in elderly Canadians.

Objective: To report on the relationship between serum folate levels and the prevalence of stroke, peripheral vascular disease, cognitive problems and short-term mortality in elderly people.

Setting And Participants: 1171 subjects whose serum folate was determined as part of their clinical examination in the Canadian Study of Health and Aging, a population study of individuals 65 years and older.

Methods: Cross-sectional analysis compared relationships between serum folate levels and clinical features; longitudinal analysis examined mortality at follow-up by folate status at the time of the clinical examination.

Potential adverse outcomes of psychotropic and narcotic drug use in Canadian seniors.

Potential adverse outcomes (falls, impaired cognition, impaired self-care) of psychotropic (benzodiazepines, antidepressants, antipsychotics) and narcotic medication use were examined in a large sample of Canadians 65 years of age and older. We examined rates of reported falls, Digit Symbol Substitution Test (DSST) scores, and mean number of self-care impairments for those consuming psychotropic and/or narcotic drugs as compared to non-users. Use of psychotropic drugs and/or narcotics was associated with an increased prevalence of falls, lower DSST scores, and/or number of self-care difficulties.

Weight, blood pressure, osmolarity, and glucose levels across various stages of Alzheimer's disease and vascular dementia.

Data collected as part of the Canadian Study of Health and Aging were analyzed to determine whether physiological changes associated with Alzheimer's disease are common to other types of dementia and are related more to the severity of cognitive impairment. We found that blood pressure and body mass index decreased with increasing dementia severity in both probable Alzheimer's disease and vascular dementia. There were no differences in mean random blood glucose levels or serum osmolarities between types or stages of dementia.

Presence and treatment of vascular risk factors in patients with vascular cognitive impairment.

Objective: To document the presence and treatment of selected vascular risk factors in patients with vascular cognitive impairment and elements affecting undertreatment of vascular risk factors.

Design: Secondary analysis of the Canadian Study of Health and Aging database, which is a national, representative, cross-sectional study of the epidemiologic distribution of dementia in elderly people in Canada.

Setting: Survey.

Correlates of self-rated health in persons aged 85 and over: results from the Canadian Study of Health and Aging.

This report describes self-rated health in 1,239 non-institutionalized Canadians aged 85 years and over who participated in the Canadian Study of Health and Aging. Most (76.8%) rated their health positively (i.

Complementary medicine use in a dementia clinic population.

Complementary medicine is frequently utilized for a variety of chronic health problems. We evaluated its use among patients attending a Canadian dementia clinic. Using a telephone survey, we inquired about the use of alternative therapy, including nutritional supplements, herbal remedies, and chelation therapy, for problems with cognition.

Primitive reflexes and dementia: results from the Canadian Study of Health and Aging.

We report on the prevalence of primitive reflexes (PR) and their association with cognitive, behavioural, functional and clinical characteristics in 2914 Canadians 65 years and older. Data were collected as part of the Canadian Study of Health and Aging (1990-92) and included individuals living in the community and in institutions. PR were more commonly found in demented subjects.

Cognitive impairment in the nondemented elderly. Results from the Canadian Study of Health and Aging.

Study Objective: To describe a population that was categorized as "cognitively impaired not demented" (CIND) and to examine the utility of some of the proposed criteria for describing this degree of cognitive impairment.

Design: Population-based prevalence study of dementia in those subjects who were 65 years and older.

Setting: Community and institutional settings in Canada.

Progression and outcome of patients in a Canadian dementia clinic.

Five hundred and fifty-three patients were referred to a Canadian dementia clinic for standardized evaluation. The majority (83.5%) had a dementia with Alzheimer's disease (AD) accounting for 89% of dementias.

Prevalence and types of dementia in the very old: results from the Canadian Study of Health and Aging.

We report on the prevalence of dementia in Canadians age 85 years and older. The purpose of this study was to determine whether the prevalence of dementia continued to increase in the very old, and to define the types of dementia and their relative proportions in this age group. We collected data as part of the Canadian Study of Health and Aging (1990 to 1992), which consisted of a sample of 1,835 subjects from a population of 283,510 Canadians who were 85 years of age and older residing in the community or in institutions.

Nonidet P40 and the retrograde transport of horseradish peroxidase in undamaged visceral nerves.

The cell bodies of origin of peripheral nerves, in particular visceral nerves, are often difficult to identify using standard horseradish peroxidase (HRP) methods. The non-ionic surfactant Nonidet-P40, when applied to intact peripheral nerve along with HRP, allows the investigator to examine the neurons of origin of the nerve without cutting the fibers or injecting label into its peripheral terminal field.