PSYCHIATRIC CARE
Depression associated with increased chocolate consumption
Rose N, Koperski S, Golomb BA. Mood food: chocolate and depressive symptoms in a cross-sectional analysis. Arch Intern Med. 2010;170(8):699-703.
Chocolate has been long associated with mood-increasing benefits in many different cultures and contexts. Until recently, there has not been any medical interest in or proof of this association. However, a survey conducted by a group of researchers has generated results that may spark some scientific interest. These results can be found in the April 26, 2010 issue of the Archives of Internal Medicine.
This research was done in conjunction with a clinical study of cholesterol control. The researchers utilized a questionnaire that contained an item about chocolate consumption, as well as a food frequency questionnaire. Whether or not depression was a factor was measured by the Center for Epidemiologic Studies Depression Scale (CES-D).
There were 931 participants in this study, 70% of which were men, 80% were white, and 58.8% were college educated. The body mass index averaged 27.8 and the CES-D score averaged 7 (a CES-D score greater than or equal to 16 indicates a positive screen for depression, whereas a score greater than or equal to 22 indicates probable major depression).
The researchers examined the monthly chocolate consumption in all study participants, comparing lower versus higher CES-D scores. It was reported that participants who did not test positive for depression consumed 5.4 servings of chocolate per month. Those who did test positive for depression consumed 8.4 servings per month, whereas those who tested positive for major depression consumed 11.8 servings of chocolate per month.
These levels of increased consumption were specific to chocolate because the differences in consumption of fat, energy, and carbohydrates were not significant.
GERIATRIC CARE
Dementia can be predicted by subjective memory impairment
Jessen F, Wiese B, Bachmann C, et al. Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment. Arch Gen Psychiatry. 2010;67:414-422.
A pioneering German study has revealed that subjective memory impairment can predict the development of dementia or Alzheimer disease before actual diagnosis. These findings are reported in the April 2010 issue of the Archives of General Psychiatry.
A group of researchers analyzed data collected from an ongoing cohort study. At baseline, this group encompassed 3,327 men and women, ages 75 or older, who were never clinically diagnosed with any form of dementia by a primary care provider (PCP). These patients had all reported that they had seen their PCP at least once in the last 12 months. The study excluded long-term-care facility residents, those who were blind or deaf, and patients who had only at-home visits with a healthcare provider.
These participants were interviewed by trained psychologists and given a battery of neuropsychologic tests at baseline, after 18 months, and then again after 3 years. At the 18-month follow-up, the patients were asked whether they felt like their memory was getting worse. There were three possible answers:
* No
* Yes, but this does not worry me
* Yes, this worries me
The follow-up included 2,415 of the participants. Of these members, 1,027 reported no subjective memory loss at baseline, whereas 1,006 had impairment without worry, and 382 had subjective memory impairment with worry.
After follow-up, it was found that of the patients without any subjective memory impairment at baseline, 26 had conversion to any dementia, and nine each had conversion to dementia in Alzheimer disease and vascular dementia. Those who had reported subjective memory impairment without worry had nearly doubled the risk of conversion to any dementia, and tripled the risk of conversion to dementia in Alzheimer disease. Finally, those patients who reported subjective memory impairment with worry showed a hazard ratio of 3.53 for conversion to any dementia, and a hazard ratio of 6.54 for conversion to dementia in Alzheimer disease.
The study participants who reported subjective memory impairment at baseline and mild cognitive impairment at the 18-month follow-up demonstrated the highest risk of conversion to dementia.