Differences in the clinical recognition of depression in diabetes patients: the Diabetes Study of Northern California (DISTANCE).

Background: It is unknown to what extent the gap between need and care for depression among patients with diabetes differs across racial/ethnic groups. We compared, by race/ethnicity, the likelihood of clinical recognition of depression (diagnosis or treatment) of patients who reported depressive symptoms in a well-characterized community-based population with diabetes.

Design: We used a survey follow-up study of 20,188 patients with diabetes from Kaiser Permanente Northern California.

Timing of hormone therapy and dementia: the critical window theory revisited.

Objective: Although previous research has shown that initiation of postmenopausal estrogen hormone therapy (HT) in late life increases risk of dementia, animal studies and some observational studies have suggested that midlife use of HT may be beneficial; however, this has not been rigorously investigated in large population-based studies. Our objective was to compare HT use in midlife with that in late life on risk of dementia among 5,504 postmenopausal female members of an integrated healthcare delivery system.

Methods: HT use was determined at midlife (mean age, 48.

Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia.

Background: Smoking is a risk factor for several life-threatening diseases, but its long-term association with dementia is controversial and somewhat understudied. Our objective was to investigate the long-term association of amount of smoking in middle age on the risk of dementia, Alzheimer disease (AD), and vascular dementia (VaD) several decades later in a large, diverse population.

Methods: We analyzed prospective data from a multiethnic population-based cohort of 21,123 members of a health care system who participated in a survey between 1978 and 1985.

Midlife serum cholesterol and increased risk of Alzheimer's and vascular dementia three decades later.

Aims: To investigate midlife cholesterol in relation to Alzheimer's disease (AD) and vascular dementia (VaD) in a large multiethnic cohort of women and men.

Methods: The Kaiser Permanente Northern California Medical Group (healthcare delivery organization) formed the database for this study. The 9,844 participants underwent detailed health evaluations during 1964-1973 at ages 40-45 years; they were still members of the health plan in 1994.

Body mass index in midlife and risk of Alzheimer disease and vascular dementia.

Prior work has suggested that obesity and overweight as measured by body mass index (BMI) increases risk of dementia. It is unknown if there is a difference in the risk of developing Alzheimer disease (AD) versus vascular dementia (VaD) associated with high body weight. The goal of this study was to examine the association between midlife BMI and risk of both AD and VaD an average of 36 years later in a large (N= 10,136) and diverse cohort of members of a health care delivery system.

Usefulness of optical density values from heparin-platelet factor 4 antibody testing and probability scoring models to diagnose heparin-induced thrombocytopenia.

Heparin-induced thrombocytopenia (HIT) is a complication caused by antibodies directed to the heparin-platelet factor 4 (PF4) complex with a seemingly paradoxical high risk of thrombosis. Discontinuation of heparin and administration of an alternative anticoagulant is important in prevention of catastrophic thrombosis. Diagnosis is challenging and based on clinical probability models (Warkentin 4 Ts and Chong scale) and, to a lesser degree, laboratory testing.