Human Errors in Automated Office Blood Pressure Measurement: Still Room for Improvement.

In this review of the literature and commentary, we examine the literature on automated blood pressure (BP) measurements in the office and clinic. Our purpose is to revisit issues as to the pros and cons of automated BP measurement published in Hypertension in June 2020 and to identify areas needing additional research. Despite initial reservations about automated BP, it is here to stay. A number of experts suggest that human error will be reduced when we move from the more complex skills required by aneroid sphygmomanometer measurement to the fewer skills and steps required by automated BP measurement. Our review indicates there is still need for reduction in errors in automated BP assessment, for example, retraining programs and monitoring of assessment procedures. We need more research on the following questions: (1) which classes of health care providers are least likely to measure BP accurately, usually by ignoring necessary steps; (2) how accurate is BP assessment by affiliated health care providers for example the dental office, the optometrist; and (3) why do some dedicated and well-informed health care professionals fail to follow simple directions for automated BP measurement? We offer additional solutions for improving automated BP assessment in the office and clinic.

Obesity, cognitive functioning and dementia: back to the future.

The conditions of chronic obesity and overweight status are risk factors for lower cognitive performance, cognitive decline, cognitive deficit, and dementia. But lower cognitive performance early in life itself may be a risk factor for an increase in body weight over time. With this in mind, we review important papers in the literature that advance our knowledge of relations between weight and cognitive functioning, with an emphasis on papers that illustrate methodological and theoretical issues of importance. We describe the evolution in research on weight and cognition with respect to two major features: (a) the move backward in time from the diagnosis of dementia to the pre-clinical period of dementia in order to better identify risk factors; and (b) the evolution of studies from an earlier emphasis on obesity-related cardiovascular risk factors as major mediators of relations between obesity and cognition to a more recent emphasis on metabolic variables, lifestyle variables, genotype, and other mechanisms that explain relations among weight change, obesity, and cognition. We conclude that: 1) a complete understanding of the causal links between weight and cognitive functioning requires a lifespan perspective; 2) practically speaking, lifespan research may need to amalgamate and integrate research at different segments of the lifespan until such time that we can include the entire life cycle within a single study of weight and cognition; and 3) we need more studies that examine reciprocal relations between weight and cognition, especially early in life.

Normative data for elderly adults: the Maine-Syracuse study.

The primary objective of this study was to provide supplementary normative data on aging and cognition from an ongoing community-based study. This dementia- and stroke-free sample (age range = 70-89; mean = 77.5) consisted of 228 women and 155 men participating in the Maine-Syracuse Longitudinal Study at waves 6 to 7 (2001-2009). The authors employed a battery of 23 widely utilized clinical cognitive tests. In this cross-sectional study, the authors focus on subjects 70 to 79 (n = 248) and 80 to 89 (n = 135) years old, and provide preliminary data for a smaller number of subjects aged 90 to 98 years old (n = 14). More highly educated and younger participants exhibited better performance on cognitive tests. Education was not significantly associated with every cognitive outcome, nor was age cohort membership. The addition of cardiovascular disease (CVD)/health variables to a model including age, education, and gender main effects provided statistically significant increases in R² (range = .021-.084) of performance on some tests. Results are discussed in relation to this study's value with respect to determining cognitive impairment in individuals free from probable dementia or stroke.