CRITIQUE OF ARTICLES

Critique of articles by Pettiti and Whitman

Critique of articles by Pettiti and Whitman

Article 1)

The article under review and analysis is “Incidence of Dementia in Long-term Hormone Users” by Diana B. Petitti, published in American Journal of Epidemiology.

Study design

Epidemiological studies of postmenopausal hormone use and dementia have been inconsistent. Investigators from the Women's Health Study Memory Initiative reported that the incidence of dementia in women aged = 65 years assigned to hormone use was increased. The authors report results from a prospective cohort study of 2,906 women without dementia (1519 hormone users and 1387 nonusers hormone) aged = 75 years who were recruited from the Health Plan of Southern California in 1999 and followed until 2003. Cognitive status was evaluated annually using the Telephone Interview of Cognitive Status-modified, supplemented by telephone Dementia Questionnaire and medical record review. average age of onset of self-esteem hormone was 48.3 years for users of estrogen alone (N = 1072) and 54.9 years for users of estrogen plus progestin (N = 447), self-expectancy of the hormone was 30.5 years and 23 2 years, respectively. There were 283 incident dementia cases identified during follow-up. After adjusting for age, education, and medical history, hazard ratios for incident dementia were 1.34 (95% confidence interval: 0.95, 1.89) in the estrogen / progestin users and 1.23 (95% confidence interval: 0, 94, 1.59) in estrogen users. These data do not provide support for the effect of estrogen or estrogen-progestin use in preventing dementia.

While previous research has shown that the initiation of postmenopausal hormone therapy of estrogen in the elderly increases the risk of dementia, animal studies and observational studies have suggested that use of the median age of the HT may be beneficial. This is the first observational study to compare long-term effect of hormone therapy status, both in middle-aged and elderly at risk of dementia.

Strength and Weakness

This study is part of a permanent research organization Kaiser Permanente to better understand the modifiable risk factors for dementia. Dr. Whitmer has led several studies related to dementia using data collected multiphase health in the years 1960 and 1970 by Kaiser Permanente Health Information Technology Dr. Morris Collen pioneer in thousands of Kaiser Permanente Northern California, men and women during routine checkups. The multiphase data used for research studies decades later revealed these key findings: heavy smoking in middle age is associated with a 157 percent increased risk of developing Alzheimer's disease and a 172 percent increased risk of developing vascular dementia, a large abdomen in midlife increases the risk of later years life dementia, and elevated cholesterol levels in midlife significantly increases the risk of Alzheimer disease and vascular dementia later in life. Another study by Dr. Whitmer has shown that low blood sugar levels in elderly patients with type 2 diabetes increases your risk of dementia. A study led by Valerie thieves Kaiser Permanente in Southern California found that having a strong network of friends and family seems to decrease the risk of ...