Examining Depression Symptoms With/Without Coexisting Anxiety Symptoms in Community-Dwelling Persons With Dementia.

Depression and anxiety are common in persons with dementia (PWD) and associated with poor outcomes. We explored frequency, pharmacologic management and mental health service use in PWD and depression symptoms with/without coexisting anxiety symptoms. The sample comprised 160 community-dwelling PWD in a trial to prevent development of aggression. Baseline data on depression and anxiety symptoms, psychotropic medications and mental health service use were examined. Regarding participants, 65 (41%) lacked clinically significant depression or anxiety symptoms, 45 (28%) had depression symptoms, 43 (27%) had depression and anxiety symptoms, and 7 (4%) had anxiety symptoms. Comorbid anxiety was associated with more severe depression symptoms. One third with depression symptoms and one half with depression and anxiety symptoms were taking an antidepressant. Mental health service use was very low, regardless of depression symptom severity or coexisting anxiety. Research needs to evaluate therapies for depressed PWD, but treatment of those with comorbid anxiety and depression is more urgent. Clinical Trial Registration for Parent Trial: ClinicalTrials.gov (NCT02380703).

Endothelial function and weight loss: comparison of low-carbohydrate and low-fat diets.

OBJECTIVE: The effect of weight loss on obesity-associated endothelial dysfunction is not clear because of conflicting data, demonstrating both improvement and no change in endothelial function after weight loss in obese subjects. A 2-year prospective study (n = 121) was conducted to examine: (1) the effect of obesity and weight loss (either a low-carbohydrate or and low-fat diet) on flow mediated vasodilatation (FMD), a measure of endothelial function. DESIGN AND METHODS: Participants reduced body weight by 7.1% ± 4.4%, 8.7% ± 6.8%, 7.1% ± 7.8%, and 4.1% ± 7.7% at 3, 6, 12, and 24 months, respectively with no significant differences between the low-fat and low-carbohydrate groups. RESULTS: Endothelial function was inversely correlated with waist circumference, triglyceride level, and directly correlated with leptin in obese persons prior to weight loss. These weight losses did not confer any improvements in FMD. There were no differences between the low-fat and low-carbohydrate diets in FMD at any time point. At 6 months (r = 0.26, P = 0.04) and 1 year (r =0.28, P = 0.03), there were positive correlations between change in FMD and change in leptin but not at 2 years. CONCLUSION: There was no significant improvement in endothelial function after 7.1% ± 7.8% weight loss at 1 year and 4.1% ± 7.7% at 2 years, achieved by either a low carbohydrate or a low fat diet.

High-frequency ultrasound for evaluation of intimal thickness.

BACKGROUND: The measurement of carotid intima-medial thickness is a well-validated measure of cardiovascular risk. Although atherosclerosis occurs in the intima, this arterial layer is not measured alone because of the limitation in ultrasound resolution with standard-frequency probes. METHODS: We evaluated the feasibility of using a 55-MHz ultrasound system with high resolution to measure intima thickness in several vascular territories compared with a "standard" frequency probe. RESULTS: The intima-medial thickness was measured in the brachial, radial, and tibial arteries in 10 healthy subjects and 5 subjects with peripheral arterial disease. The high-frequency ultrasound probe showed superior resolution compared with the standard-frequency probe, allowing for measurement of intima separately from media. CONCLUSION: The intima can be measured independently of media with a high degree of reproducibility using a high-frequency probe. This technology may allow for early detection of cardiovascular risk and extend knowledge about the physiologic changes in early atherosclerotic development.