Low-level groundwater arsenic exposure impacts cognition: a project FRONTIER study.

Arsenic is a ubiquitous environmental toxin with known neurological consequences. Few studies, however, have investigated groundwater arsenic concentrations and cognition among adults and elders. In the study described in this article, the authors examined the potential link between cognitive functioning and low concentrations of arsenic in drinking water. Arsenic concentrations were estimated by the Geographic Information System approach (GIS-arsenic) for 299 rural-dwelling adults and elders. Cognition was assessed with Folstein Mini-Mental State Examination (MMSE). Those in the relatively high GIS-arsenic exposure (> 10.0 microg/L) group had significantly lower MMSE scores than those in the low GIS-arsenic exposure (< or = 10.0 microg/L) group (p < .03). The number of years of education was significantly lower in those in the high GIS-arsenic group(s) than in those in the low GIS-arsenic group (p < .05). These results suggest that poorer cognitive functioning and lower education levels were associated with higher (though still low-level) GIS-arsenic levels in this rural adult cohort.

The differential impact of depressive symptom clusters on cognition in a rural multi-ethnic cohort: a Project FRONTIER study.

OBJECTIVE: To examine the differential impact of depressive symptom clusters on neuropsychological functioning in a rural-dwelling, multi-ethnic cohort. METHODS: Data were analyzed for 184 participants (70% female, 46% Hispanic) who are part of an ongoing rural healthcare study, Project FRONTIER. Previously published factor scores of dysphoria, meaninglessness, apathy, and cognitive impairment from the GDS-30 were entered as predictor variables in linear regression models with RBANS Index raw scores as outcome variables. RESULTS: In the total sample, Dysphoria, Meaninglessness, and Cognitive Impairment were significantly associated with Immediate Memory, Language, Attention and Delayed Memory; Dysphoria was also significantly related to Visuospatial skills. When examined by gender and ethnicity, however, the findings varied with dysphoria being most related to cognitive status among men and dysphoria, meaninglessness, and cognitive impairment being most significantly related to cognitive status among women. When examined by ethnicity, dysphoria, meaninglessness, and cognitive impairment were most strongly associated with immediate and delayed memory in Hispanics. CONCLUSIONS: In this study of rural-dwelling adults and elders, depressive symptom clusters were differentially associated with poorer cognition with the most consistent findings being between depressive symptoms of dysphoria and meaninglessness and the cognitive domains of immediate and delayed memory.

Trend and racial disparities in infant mortality rate in Texas from 1990 to 2004.

PURPOSE: To determine the trend and disparities in infant mortality rate (IMR) from 1990 to 2004 in Texas, which is one of the few states with severe physician shortage in the United States. METHODS: Trend analysis and Poisson regression were performed with data from Texas Department of State for Health Services and other Web sites. RESULTS: IMR decreased from 1990 to 2000 followed by a trend of increase from 2000 to 2004 in Texas. The recent trend of increase in IMR was observed in all ethnic groups. IMR was associated with ethnicity, area of residence in Texas (rural vs urban areas in east vs south vs west), median income index, and primary care physician supply (primary care physician to population ratio). IMR in blacks was more than 2 times that of other ethnic groups, and the gap had been increasing since 1997. The recent increasing trend in IMR coincided with a decreasing trend in primary care physician supply and a decrease or a slower increase in median income index. CONCLUSIONS: IMR increased in recent years, particularly in African Americans in Texas. Measures should be taken to reverse the worsening trend in IMR and to reduce regional and racial disparities.