Vision Impairment Tied to Higher Dementia Risk in Older Adults

Article Type
Changed
Mon, 06/24/2024 - 11:40

 

TOPLINE:

Poor vision and contrast sensitivity at baseline increase the likelihood of incident dementia in older adults; a decline in contrast sensitivity over time also correlates with the risk of developing dementia.

METHODOLOGY:

  • Researchers conducted a longitudinal study to analyze the association of visual function with the risk for dementia in 2159 men and women (mean age, 77.9 years; 54% women) included from the National Health and Aging Trends Study between 2021 and 2022.
  • All participants were free from dementia at baseline and underwent visual assessment while wearing their usual glasses or contact lenses.
  • Distance and near visual acuity were measured as the log minimum angle of resolution (logMAR) units where higher values indicated worse visual acuity; contrast sensitivity was measured as the log contrast sensitivity (logCS) units where lower values represented worse outcomes.
  • Dementia status was determined by a medical diagnosis, a dementia score of 2 or more, or poor performance on cognitive testing.

TAKEAWAY:

  • Over the 1-year follow-up period, 192 adults (6.6%) developed dementia.
  • Worsening of distant and near vision by 0.1 logMAR increased the risk for dementia by 8% (P = .01) and 7% (P = .02), respectively.
  • Each 0.1 logCS decline in baseline contrast sensitivity increased the risk for dementia by 9% (P = .003).
  • A yearly decline in contrast sensitivity by 0.1 logCS increased the likelihood of dementia by 14% (P = .007).
  • Changes in distant and near vision over time did not show a significant association with risk for dementia (P = .58 and P = .79, respectively).

IN PRACTICE:

“Visual function, especially contrast sensitivity, might be a risk factor for developing dementia,” the authors wrote. “Early vision screening may help identify adults at higher risk of dementia, allowing for timely interventions.”

SOURCE:

The study was led by Louay Almidani, MD, MSc, of the Wilmer Eye Institute at the Johns Hopkins University School of Medicine, in Baltimore, and was published online in the American Journal of Ophthalmology.

LIMITATIONS:

The study had a limited follow-up period of 1 year and may not have captured the long-term association between visual impairment and the risk for dementia. Moreover, the researchers did not consider other visual function measures such as depth perception and visual field, which might have affected the results.

DISCLOSURES:

The study did not have any funding source. The authors declared no conflicts of interest.
 

A version of this article appeared on Medscape.com.

Publications
Topics
Sections

 

TOPLINE:

Poor vision and contrast sensitivity at baseline increase the likelihood of incident dementia in older adults; a decline in contrast sensitivity over time also correlates with the risk of developing dementia.

METHODOLOGY:

  • Researchers conducted a longitudinal study to analyze the association of visual function with the risk for dementia in 2159 men and women (mean age, 77.9 years; 54% women) included from the National Health and Aging Trends Study between 2021 and 2022.
  • All participants were free from dementia at baseline and underwent visual assessment while wearing their usual glasses or contact lenses.
  • Distance and near visual acuity were measured as the log minimum angle of resolution (logMAR) units where higher values indicated worse visual acuity; contrast sensitivity was measured as the log contrast sensitivity (logCS) units where lower values represented worse outcomes.
  • Dementia status was determined by a medical diagnosis, a dementia score of 2 or more, or poor performance on cognitive testing.

TAKEAWAY:

  • Over the 1-year follow-up period, 192 adults (6.6%) developed dementia.
  • Worsening of distant and near vision by 0.1 logMAR increased the risk for dementia by 8% (P = .01) and 7% (P = .02), respectively.
  • Each 0.1 logCS decline in baseline contrast sensitivity increased the risk for dementia by 9% (P = .003).
  • A yearly decline in contrast sensitivity by 0.1 logCS increased the likelihood of dementia by 14% (P = .007).
  • Changes in distant and near vision over time did not show a significant association with risk for dementia (P = .58 and P = .79, respectively).

IN PRACTICE:

“Visual function, especially contrast sensitivity, might be a risk factor for developing dementia,” the authors wrote. “Early vision screening may help identify adults at higher risk of dementia, allowing for timely interventions.”

SOURCE:

The study was led by Louay Almidani, MD, MSc, of the Wilmer Eye Institute at the Johns Hopkins University School of Medicine, in Baltimore, and was published online in the American Journal of Ophthalmology.

LIMITATIONS:

The study had a limited follow-up period of 1 year and may not have captured the long-term association between visual impairment and the risk for dementia. Moreover, the researchers did not consider other visual function measures such as depth perception and visual field, which might have affected the results.

DISCLOSURES:

The study did not have any funding source. The authors declared no conflicts of interest.
 

A version of this article appeared on Medscape.com.

 

TOPLINE:

Poor vision and contrast sensitivity at baseline increase the likelihood of incident dementia in older adults; a decline in contrast sensitivity over time also correlates with the risk of developing dementia.

METHODOLOGY:

  • Researchers conducted a longitudinal study to analyze the association of visual function with the risk for dementia in 2159 men and women (mean age, 77.9 years; 54% women) included from the National Health and Aging Trends Study between 2021 and 2022.
  • All participants were free from dementia at baseline and underwent visual assessment while wearing their usual glasses or contact lenses.
  • Distance and near visual acuity were measured as the log minimum angle of resolution (logMAR) units where higher values indicated worse visual acuity; contrast sensitivity was measured as the log contrast sensitivity (logCS) units where lower values represented worse outcomes.
  • Dementia status was determined by a medical diagnosis, a dementia score of 2 or more, or poor performance on cognitive testing.

TAKEAWAY:

  • Over the 1-year follow-up period, 192 adults (6.6%) developed dementia.
  • Worsening of distant and near vision by 0.1 logMAR increased the risk for dementia by 8% (P = .01) and 7% (P = .02), respectively.
  • Each 0.1 logCS decline in baseline contrast sensitivity increased the risk for dementia by 9% (P = .003).
  • A yearly decline in contrast sensitivity by 0.1 logCS increased the likelihood of dementia by 14% (P = .007).
  • Changes in distant and near vision over time did not show a significant association with risk for dementia (P = .58 and P = .79, respectively).

IN PRACTICE:

“Visual function, especially contrast sensitivity, might be a risk factor for developing dementia,” the authors wrote. “Early vision screening may help identify adults at higher risk of dementia, allowing for timely interventions.”

SOURCE:

The study was led by Louay Almidani, MD, MSc, of the Wilmer Eye Institute at the Johns Hopkins University School of Medicine, in Baltimore, and was published online in the American Journal of Ophthalmology.

LIMITATIONS:

The study had a limited follow-up period of 1 year and may not have captured the long-term association between visual impairment and the risk for dementia. Moreover, the researchers did not consider other visual function measures such as depth perception and visual field, which might have affected the results.

DISCLOSURES:

The study did not have any funding source. The authors declared no conflicts of interest.
 

A version of this article appeared on Medscape.com.

Publications
Publications
Topics
Article Type
Sections
Teambase XML
<?xml version="1.0" encoding="UTF-8"?>
<!--$RCSfile: InCopy_agile.xsl,v $ $Revision: 1.35 $-->
<!--$RCSfile: drupal.xsl,v $ $Revision: 1.7 $-->
<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>168514</fileName> <TBEID>0C050B42.SIG</TBEID> <TBUniqueIdentifier>MD_0C050B42</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname>Vision Impairment Dementia</storyname> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240624T110419</QCDate> <firstPublished>20240624T113555</firstPublished> <LastPublished>20240624T113555</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240624T113555</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>Javed Choudhury</byline> <bylineText>JAVED CHOUDHURY</bylineText> <bylineFull>JAVED CHOUDHURY</bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType>News</newsDocType> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>Poor vision and contrast sensitivity at baseline increase the likelihood of incident dementia in older adults</metaDescription> <articlePDF/> <teaserImage/> <teaser>“Early vision screening may help identify adults at higher risk of dementia, allowing for timely interventions.”</teaser> <title>Vision Impairment Tied to Higher Dementia Risk in Older Adults</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear>2024</pubPubdateYear> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>CPN</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement/> </publicationData> <publicationData> <publicationCode>FP</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement>Copyright 2017 Frontline Medical News</copyrightStatement> </publicationData> <publicationData> <publicationCode>IM</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle/> <journalFullTitle/> <copyrightStatement/> </publicationData> <publicationData> <publicationCode>nr</publicationCode> <pubIssueName>January 2021</pubIssueName> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> <journalTitle>Neurology Reviews</journalTitle> <journalFullTitle>Neurology Reviews</journalFullTitle> <copyrightStatement>2018 Frontline Medical Communications Inc.,</copyrightStatement> </publicationData> </publications_g> <publications> <term>9</term> <term>15</term> <term>21</term> <term canonical="true">22</term> </publications> <sections> <term>39313</term> <term>86</term> <term canonical="true">27970</term> </sections> <topics> <term canonical="true">180</term> <term>258</term> <term>215</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Vision Impairment Tied to Higher Dementia Risk in Older Adults</title> <deck/> </itemMeta> <itemContent> <h2>TOPLINE:</h2> <p><span class="tag metaDescription">Poor vision and contrast sensitivity at baseline increase the likelihood of incident dementia in older adults</span>; a decline in contrast sensitivity over time also correlates with the risk of developing dementia.</p> <h2>METHODOLOGY:</h2> <ul class="body"> <li>Researchers conducted a longitudinal study to analyze the association of visual function with the risk for dementia in 2159 men and women (mean age, 77.9 years; 54% women) included from the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027590/">National Health and Aging Trends Study</a> between 2021 and 2022.</li> <li>All participants were free from dementia at baseline and underwent visual assessment while wearing their usual glasses or contact lenses.</li> <li>Distance and near visual acuity were measured as the log minimum angle of resolution (logMAR) units where higher values indicated worse visual acuity; contrast sensitivity was measured as the log contrast sensitivity (logCS) units where lower values represented worse outcomes.</li> <li>Dementia status was determined by a medical diagnosis, a dementia score of 2 or more, or poor performance on cognitive testing.</li> </ul> <h2>TAKEAWAY:</h2> <ul class="body"> <li>Over the 1-year follow-up period, 192 adults (6.6%) developed dementia.</li> <li>Worsening of distant and near vision by 0.1 logMAR increased the risk for dementia by 8% (<em>P</em> = .01) and 7% (<em>P</em> = .02), respectively.</li> <li>Each 0.1 logCS decline in baseline contrast sensitivity increased the risk for dementia by 9% (<em>P</em> = .003).</li> <li>A yearly decline in contrast sensitivity by 0.1 logCS increased the likelihood of dementia by 14% (<em>P</em> = .007).</li> <li>Changes in distant and near vision over time did not show a significant association with risk for dementia (<em>P</em> = .58 and <em>P</em> = .79, respectively).</li> </ul> <h2>IN PRACTICE:</h2> <p>“Visual function, especially contrast sensitivity, might be a risk factor for developing dementia,” the authors wrote. “Early vision screening may help identify adults at higher risk of dementia, allowing for timely interventions.”</p> <h2>SOURCE:</h2> <p>The study was led by Louay Almidani, MD, MSc, of the Wilmer Eye Institute at the Johns Hopkins University School of Medicine, in Baltimore, and was published <span class="Hyperlink"><a href="https://www.sciencedirect.com/science/article/abs/pii/S0002939424002460">online</a></span> in the <em>American Journal of Ophthalmology</em>.</p> <h2>LIMITATIONS:</h2> <p>The study had a limited follow-up period of 1 year and may not have captured the long-term association between visual impairment and the risk for dementia. Moreover, the researchers did not consider other visual function measures such as depth perception and visual field, which might have affected the results.</p> <h2>DISCLOSURES:</h2> <p>The study did not have any funding source. The authors declared no conflicts of interest.<br/><br/></p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/vision-impairment-tied-higher-dementia-risk-older-adults-2024a1000bo2">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Having More Tender Than Swollen Joints Worsens Outcomes in Early Rheumatoid Arthritis

Article Type
Changed
Wed, 06/12/2024 - 15:09

 

TOPLINE: 

Having more tender than swollen joints is linked to worse patient-reported outcomes (PROs), particularly in pain interference, social participation, and fatigue, in patients with rheumatoid arthritis (RA).

METHODOLOGY:

  • In early RA, understanding the impact of tender-swollen joint differences (TSJDs) on PROs across multiple domains of health-related quality of life is important to customize personalized therapeutic strategies.
  • This study evaluated the impact of TSJDs on PROs over 1 year in 547 patients (mean age, 56 years; 70% women; mean symptom duration, 5.3 months) with early RA across 18 centers in Canada between January 2016 and August 2022.
  • TSJDs were assessed for 28 joints (six large and 22 small) at baseline and at 3-, 6-, and 12-month visits using the PRO Measurement Information System (PROMIS-29), covering seven domains of health. Higher PROMIS T-scores indicated better health outcomes.

TAKEAWAY: 

  • A one-point increase of TSJD was significantly associated with worse PROMIS T-scores in physical function (adjusted regression coefficient [β], −0.27; 95% CI, −0.39 to −0.15) and social participation (β, −0.34; 95% CI, −0.50 to −0.19).
  • A one-point increase in TSJD was also linked to worsened PROMIS symptoms in pain interference (β, 0.49), fatigue (β, 0.34), sleep problems (β, 0.29), anxiety (β, 0.23), and depression (β, 0.20).
  • Large-joint TSJD was particularly associated with worse PROs than small-joint TSJD.
  • The sensitivity analysis validated the reliability of the primary findings regarding the association between joint counts and PROs evaluated by PROMIS-29, even when accounting for C-reactive protein levels in various scenarios or assumptions.

IN PRACTICE:

“Patients with more tender than swollen joints may experience worsening of all seven domains of health, especially pain interference, social participation, and fatigue. Rheumatologists should be alerted to their patients with early RA having more tender than swollen joints, particularly in large joints,” the authors wrote.

SOURCE:

The study was led by Charis F. Meng, MD, Division of Rheumatology, Hospital for Special Surgery, New York. It was published online on May 1, 2024, in Journal of Clinical Rheumatology

LIMITATIONS:

The study was observational with missing data, which could have impacted the reliability of the results. Most participants were women and White individuals, which could restrict the generalizability of results. The absence of ultrasound for synovitis limited the clinical assessment of patients with RA for information beyond physical examination alone. 

DISCLOSURES: 

The study was supported and funded by the Inflammatory Arthritis Center and Division of Rheumatology at the Hospital for Special Surgery, New York. One author reported receiving funding from the National Institutes of Health.
 

A version of this article appeared on Medscape.com.

Publications
Topics
Sections

 

TOPLINE: 

Having more tender than swollen joints is linked to worse patient-reported outcomes (PROs), particularly in pain interference, social participation, and fatigue, in patients with rheumatoid arthritis (RA).

METHODOLOGY:

  • In early RA, understanding the impact of tender-swollen joint differences (TSJDs) on PROs across multiple domains of health-related quality of life is important to customize personalized therapeutic strategies.
  • This study evaluated the impact of TSJDs on PROs over 1 year in 547 patients (mean age, 56 years; 70% women; mean symptom duration, 5.3 months) with early RA across 18 centers in Canada between January 2016 and August 2022.
  • TSJDs were assessed for 28 joints (six large and 22 small) at baseline and at 3-, 6-, and 12-month visits using the PRO Measurement Information System (PROMIS-29), covering seven domains of health. Higher PROMIS T-scores indicated better health outcomes.

TAKEAWAY: 

  • A one-point increase of TSJD was significantly associated with worse PROMIS T-scores in physical function (adjusted regression coefficient [β], −0.27; 95% CI, −0.39 to −0.15) and social participation (β, −0.34; 95% CI, −0.50 to −0.19).
  • A one-point increase in TSJD was also linked to worsened PROMIS symptoms in pain interference (β, 0.49), fatigue (β, 0.34), sleep problems (β, 0.29), anxiety (β, 0.23), and depression (β, 0.20).
  • Large-joint TSJD was particularly associated with worse PROs than small-joint TSJD.
  • The sensitivity analysis validated the reliability of the primary findings regarding the association between joint counts and PROs evaluated by PROMIS-29, even when accounting for C-reactive protein levels in various scenarios or assumptions.

IN PRACTICE:

“Patients with more tender than swollen joints may experience worsening of all seven domains of health, especially pain interference, social participation, and fatigue. Rheumatologists should be alerted to their patients with early RA having more tender than swollen joints, particularly in large joints,” the authors wrote.

SOURCE:

The study was led by Charis F. Meng, MD, Division of Rheumatology, Hospital for Special Surgery, New York. It was published online on May 1, 2024, in Journal of Clinical Rheumatology

LIMITATIONS:

The study was observational with missing data, which could have impacted the reliability of the results. Most participants were women and White individuals, which could restrict the generalizability of results. The absence of ultrasound for synovitis limited the clinical assessment of patients with RA for information beyond physical examination alone. 

DISCLOSURES: 

The study was supported and funded by the Inflammatory Arthritis Center and Division of Rheumatology at the Hospital for Special Surgery, New York. One author reported receiving funding from the National Institutes of Health.
 

A version of this article appeared on Medscape.com.

 

TOPLINE: 

Having more tender than swollen joints is linked to worse patient-reported outcomes (PROs), particularly in pain interference, social participation, and fatigue, in patients with rheumatoid arthritis (RA).

METHODOLOGY:

  • In early RA, understanding the impact of tender-swollen joint differences (TSJDs) on PROs across multiple domains of health-related quality of life is important to customize personalized therapeutic strategies.
  • This study evaluated the impact of TSJDs on PROs over 1 year in 547 patients (mean age, 56 years; 70% women; mean symptom duration, 5.3 months) with early RA across 18 centers in Canada between January 2016 and August 2022.
  • TSJDs were assessed for 28 joints (six large and 22 small) at baseline and at 3-, 6-, and 12-month visits using the PRO Measurement Information System (PROMIS-29), covering seven domains of health. Higher PROMIS T-scores indicated better health outcomes.

TAKEAWAY: 

  • A one-point increase of TSJD was significantly associated with worse PROMIS T-scores in physical function (adjusted regression coefficient [β], −0.27; 95% CI, −0.39 to −0.15) and social participation (β, −0.34; 95% CI, −0.50 to −0.19).
  • A one-point increase in TSJD was also linked to worsened PROMIS symptoms in pain interference (β, 0.49), fatigue (β, 0.34), sleep problems (β, 0.29), anxiety (β, 0.23), and depression (β, 0.20).
  • Large-joint TSJD was particularly associated with worse PROs than small-joint TSJD.
  • The sensitivity analysis validated the reliability of the primary findings regarding the association between joint counts and PROs evaluated by PROMIS-29, even when accounting for C-reactive protein levels in various scenarios or assumptions.

IN PRACTICE:

“Patients with more tender than swollen joints may experience worsening of all seven domains of health, especially pain interference, social participation, and fatigue. Rheumatologists should be alerted to their patients with early RA having more tender than swollen joints, particularly in large joints,” the authors wrote.

SOURCE:

The study was led by Charis F. Meng, MD, Division of Rheumatology, Hospital for Special Surgery, New York. It was published online on May 1, 2024, in Journal of Clinical Rheumatology

LIMITATIONS:

The study was observational with missing data, which could have impacted the reliability of the results. Most participants were women and White individuals, which could restrict the generalizability of results. The absence of ultrasound for synovitis limited the clinical assessment of patients with RA for information beyond physical examination alone. 

DISCLOSURES: 

The study was supported and funded by the Inflammatory Arthritis Center and Division of Rheumatology at the Hospital for Special Surgery, New York. One author reported receiving funding from the National Institutes of Health.
 

A version of this article appeared on Medscape.com.

Publications
Publications
Topics
Article Type
Sections
Teambase XML
<?xml version="1.0" encoding="UTF-8"?>
<!--$RCSfile: InCopy_agile.xsl,v $ $Revision: 1.35 $-->
<!--$RCSfile: drupal.xsl,v $ $Revision: 1.7 $-->
<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>168392</fileName> <TBEID>0C050857.SIG</TBEID> <TBUniqueIdentifier>MD_0C050857</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname/> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240612T145343</QCDate> <firstPublished>20240612T150608</firstPublished> <LastPublished>20240612T150608</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240612T150608</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>J Choudhury</byline> <bylineText>JAVED CHOUDHURY</bylineText> <bylineFull>JAVED CHOUDHURY</bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType>News</newsDocType> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>Having more tender than swollen joints is linked to worse patient-reported outcomes (PROs), particularly in pain interference, social participation, and fatigue</metaDescription> <articlePDF/> <teaserImage/> <teaser>Patients with early rheumatoid arthritis who had higher tender-swollen joint differences showed deteriorating patient-reported outcomes over a 1-year study period.</teaser> <title>Having More Tender Than Swollen Joints Worsens Outcomes in Early Rheumatoid Arthritis</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>rn</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term canonical="true">26</term> </publications> <sections> <term canonical="true">27970</term> <term>39313</term> </sections> <topics> <term canonical="true">289</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Having More Tender Than Swollen Joints Worsens Outcomes in Early Rheumatoid Arthritis</title> <deck/> </itemMeta> <itemContent> <h2>TOPLINE: </h2> <p>Having more tender than swollen joints is linked to worse patient-reported outcomes (PROs), particularly in pain interference, social participation, and fatigue, in patients with rheumatoid arthritis (RA).</p> <h2>METHODOLOGY:</h2> <ul class="body"> <li>In early RA, understanding the impact of tender-swollen joint differences (TSJDs) on PROs across multiple domains of health-related quality of life is important to customize personalized therapeutic strategies.</li> <li>This study evaluated the impact of TSJDs on PROs over 1 year in 547 patients (mean age, 56 years; 70% women; mean symptom duration, 5.3 months) with early RA across 18 centers in Canada between January 2016 and August 2022.</li> <li>TSJDs were assessed for 28 joints (six large and 22 small) at baseline and at 3-, 6-, and 12-month visits using the PRO Measurement Information System (PROMIS-29), covering seven domains of health. Higher PROMIS T-scores indicated better health outcomes.</li> </ul> <h2>TAKEAWAY: </h2> <ul class="body"> <li>A one-point increase of TSJD was significantly associated with worse PROMIS T-scores in physical function (adjusted regression coefficient [β], −0.27; 95% CI, −0.39 to −0.15) and social participation (β, −0.34; 95% CI, −0.50 to −0.19).</li> <li>A one-point increase in TSJD was also linked to worsened PROMIS symptoms in pain interference (β, 0.49), fatigue (β, 0.34), sleep problems (β, 0.29), anxiety (β, 0.23), and depression (β, 0.20).</li> <li>Large-joint TSJD was particularly associated with worse PROs than small-joint TSJD.</li> <li>The sensitivity analysis validated the reliability of the primary findings regarding the association between joint counts and PROs evaluated by PROMIS-29, even when accounting for C-reactive protein levels in various scenarios or assumptions.</li> </ul> <h2>IN PRACTICE:</h2> <p>“Patients with more tender than swollen joints may experience worsening of all seven domains of health, especially pain interference, social participation, and fatigue. Rheumatologists should be alerted to their patients with early RA having more tender than swollen joints, particularly in large joints,” the authors wrote.</p> <h2>SOURCE:</h2> <p>The study was led by Charis F. Meng, MD, Division of Rheumatology, Hospital for Special Surgery, New York. It was <span class="Hyperlink"><a href="https://journals.lww.com/jclinrheum/fulltext/9900/having_more_tender_than_swollen_joints_is.208.aspx">published online</a></span> on May 1, 2024, in <em>Journal of Clinical Rheumatology</em>. </p> <h2>LIMITATIONS:</h2> <p>The study was observational with missing data, which could have impacted the reliability of the results. Most participants were women and White individuals, which could restrict the generalizability of results. The absence of ultrasound for synovitis limited the clinical assessment of patients with RA for information beyond physical examination alone. </p> <h2>DISCLOSURES: </h2> <p>The study was supported and funded by the Inflammatory Arthritis Center and Division of Rheumatology at the Hospital for Special Surgery, New York. One author reported receiving funding from the National Institutes of Health.<br/><br/></p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/having-more-tender-than-swollen-joints-worsens-outcomes-2024a1000aqe">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Eating More Vegetables Improves Glucose Tolerance

Article Type
Changed
Mon, 06/03/2024 - 12:41

 

TOPLINE:

A diet rich in green, leafy, cruciferous, and colorful vegetables may improve glucose tolerance and insulin sensitivity, whereas a high intake of potato fries or chips may worsen these outcomes, an Australian study shows.

METHODOLOGY:

  • Researchers assessed the association between the intake of vegetables and potatoes with markers of type 2 diabetes (T2D) in 8009 participants (median age, 52 years; 55% women) from the Australian Diabetes, Obesity, and Lifestyle Study.
  • A self-administered 74-item food frequency questionnaire was used to assess participants’ eating habits over 12 months prior to baseline.
  • Participants were categorized into four quartiles of vegetable intake, from the highest intake (Q4) to the lowest intake (Q1).
  • The association between vegetable intake and various metabolic markers such as fasting plasma glucose (FPG), 2-hour post-load plasma glucose, updated homeostasis model assessment of beta cell function (HOMA2-%beta), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin were evaluated over a 12-year follow-up period.

TAKEAWAY:

  • The post-load glucose was 3% lower in participants in the highest vs lowest quartile of total vegetable intake (ratio of means [RoM], 0.97; 95% CI, 0.96-0.99).
  • Post-load glucose was 4% lower (RoM, 0.96; 95% CI, 0.95-0.98), HOMA2-%beta was 3% lower (RoM, 0.97; 95% CI, 0.96-0.99), and serum insulin was 5% lower (RoM, 0.95; 95% CI, 0.93-0.98) in those in the highest vs lowest quartile of green leafy vegetable intake.
  • Those in the highest vs lowest quartile of potato fries or chips intake had 1% higher FPG, 3% higher HOMA2-%beta, and 8% higher serum insulin but 6% lower HOMA2-%S, revealing a negative impact on glucose tolerance and insulin sensitivity.
  • The risk for T2D over 12 years was 26% and 25% lower among those in the highest and moderate quartiles of cruciferous vegetable intake, respectively, than among those in the lowest quartile of cruciferous vegetable intake.

IN PRACTICE:

The authors wrote that their study “sheds light on the physiological alterations in insulin regulation and glucose tolerance resulting from higher vegetable and subgroups of vegetable intake and supports the notion that vegetable subgroups may act differently in regulating insulin and blood glucose levels.”

SOURCE:

The study was led by Pratik Pokharel, MPH, Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia, and was published online in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The study’s observational nature precluded the inference of causality. Potential measurement errors in dietary exposures and recall bias linked to the food frequency questionnaire could have affected the findings. The overrepresentation of participants from higher education and socioeconomic subgroups and loss to follow-up could limit the generalizability of the findings.

DISCLOSURES:

The study was funded by the National Health and Medical Research Council, National Heart Foundation of Australia, and Royal Perth Hospital Medical Research Foundation. Several authors reported receiving grants from various sources during the conduct of this study. The other authors reported no conflicts of interest.

A version of this article appeared on Medscape.com.

Publications
Topics
Sections

 

TOPLINE:

A diet rich in green, leafy, cruciferous, and colorful vegetables may improve glucose tolerance and insulin sensitivity, whereas a high intake of potato fries or chips may worsen these outcomes, an Australian study shows.

METHODOLOGY:

  • Researchers assessed the association between the intake of vegetables and potatoes with markers of type 2 diabetes (T2D) in 8009 participants (median age, 52 years; 55% women) from the Australian Diabetes, Obesity, and Lifestyle Study.
  • A self-administered 74-item food frequency questionnaire was used to assess participants’ eating habits over 12 months prior to baseline.
  • Participants were categorized into four quartiles of vegetable intake, from the highest intake (Q4) to the lowest intake (Q1).
  • The association between vegetable intake and various metabolic markers such as fasting plasma glucose (FPG), 2-hour post-load plasma glucose, updated homeostasis model assessment of beta cell function (HOMA2-%beta), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin were evaluated over a 12-year follow-up period.

TAKEAWAY:

  • The post-load glucose was 3% lower in participants in the highest vs lowest quartile of total vegetable intake (ratio of means [RoM], 0.97; 95% CI, 0.96-0.99).
  • Post-load glucose was 4% lower (RoM, 0.96; 95% CI, 0.95-0.98), HOMA2-%beta was 3% lower (RoM, 0.97; 95% CI, 0.96-0.99), and serum insulin was 5% lower (RoM, 0.95; 95% CI, 0.93-0.98) in those in the highest vs lowest quartile of green leafy vegetable intake.
  • Those in the highest vs lowest quartile of potato fries or chips intake had 1% higher FPG, 3% higher HOMA2-%beta, and 8% higher serum insulin but 6% lower HOMA2-%S, revealing a negative impact on glucose tolerance and insulin sensitivity.
  • The risk for T2D over 12 years was 26% and 25% lower among those in the highest and moderate quartiles of cruciferous vegetable intake, respectively, than among those in the lowest quartile of cruciferous vegetable intake.

IN PRACTICE:

The authors wrote that their study “sheds light on the physiological alterations in insulin regulation and glucose tolerance resulting from higher vegetable and subgroups of vegetable intake and supports the notion that vegetable subgroups may act differently in regulating insulin and blood glucose levels.”

SOURCE:

The study was led by Pratik Pokharel, MPH, Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia, and was published online in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The study’s observational nature precluded the inference of causality. Potential measurement errors in dietary exposures and recall bias linked to the food frequency questionnaire could have affected the findings. The overrepresentation of participants from higher education and socioeconomic subgroups and loss to follow-up could limit the generalizability of the findings.

DISCLOSURES:

The study was funded by the National Health and Medical Research Council, National Heart Foundation of Australia, and Royal Perth Hospital Medical Research Foundation. Several authors reported receiving grants from various sources during the conduct of this study. The other authors reported no conflicts of interest.

A version of this article appeared on Medscape.com.

 

TOPLINE:

A diet rich in green, leafy, cruciferous, and colorful vegetables may improve glucose tolerance and insulin sensitivity, whereas a high intake of potato fries or chips may worsen these outcomes, an Australian study shows.

METHODOLOGY:

  • Researchers assessed the association between the intake of vegetables and potatoes with markers of type 2 diabetes (T2D) in 8009 participants (median age, 52 years; 55% women) from the Australian Diabetes, Obesity, and Lifestyle Study.
  • A self-administered 74-item food frequency questionnaire was used to assess participants’ eating habits over 12 months prior to baseline.
  • Participants were categorized into four quartiles of vegetable intake, from the highest intake (Q4) to the lowest intake (Q1).
  • The association between vegetable intake and various metabolic markers such as fasting plasma glucose (FPG), 2-hour post-load plasma glucose, updated homeostasis model assessment of beta cell function (HOMA2-%beta), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin were evaluated over a 12-year follow-up period.

TAKEAWAY:

  • The post-load glucose was 3% lower in participants in the highest vs lowest quartile of total vegetable intake (ratio of means [RoM], 0.97; 95% CI, 0.96-0.99).
  • Post-load glucose was 4% lower (RoM, 0.96; 95% CI, 0.95-0.98), HOMA2-%beta was 3% lower (RoM, 0.97; 95% CI, 0.96-0.99), and serum insulin was 5% lower (RoM, 0.95; 95% CI, 0.93-0.98) in those in the highest vs lowest quartile of green leafy vegetable intake.
  • Those in the highest vs lowest quartile of potato fries or chips intake had 1% higher FPG, 3% higher HOMA2-%beta, and 8% higher serum insulin but 6% lower HOMA2-%S, revealing a negative impact on glucose tolerance and insulin sensitivity.
  • The risk for T2D over 12 years was 26% and 25% lower among those in the highest and moderate quartiles of cruciferous vegetable intake, respectively, than among those in the lowest quartile of cruciferous vegetable intake.

IN PRACTICE:

The authors wrote that their study “sheds light on the physiological alterations in insulin regulation and glucose tolerance resulting from higher vegetable and subgroups of vegetable intake and supports the notion that vegetable subgroups may act differently in regulating insulin and blood glucose levels.”

SOURCE:

The study was led by Pratik Pokharel, MPH, Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia, and was published online in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The study’s observational nature precluded the inference of causality. Potential measurement errors in dietary exposures and recall bias linked to the food frequency questionnaire could have affected the findings. The overrepresentation of participants from higher education and socioeconomic subgroups and loss to follow-up could limit the generalizability of the findings.

DISCLOSURES:

The study was funded by the National Health and Medical Research Council, National Heart Foundation of Australia, and Royal Perth Hospital Medical Research Foundation. Several authors reported receiving grants from various sources during the conduct of this study. The other authors reported no conflicts of interest.

A version of this article appeared on Medscape.com.

Publications
Publications
Topics
Article Type
Sections
Teambase XML
<?xml version="1.0" encoding="UTF-8"?>
<!--$RCSfile: InCopy_agile.xsl,v $ $Revision: 1.35 $-->
<!--$RCSfile: drupal.xsl,v $ $Revision: 1.7 $-->
<root generator="drupal.xsl" gversion="1.7"> <header> <fileName>168279</fileName> <TBEID>0C050628.SIG</TBEID> <TBUniqueIdentifier>MD_0C050628</TBUniqueIdentifier> <newsOrJournal>News</newsOrJournal> <publisherName>Frontline Medical Communications</publisherName> <storyname/> <articleType>2</articleType> <TBLocation>QC Done-All Pubs</TBLocation> <QCDate>20240603T121721</QCDate> <firstPublished>20240603T123834</firstPublished> <LastPublished>20240603T123834</LastPublished> <pubStatus qcode="stat:"/> <embargoDate/> <killDate/> <CMSDate>20240603T123834</CMSDate> <articleSource/> <facebookInfo/> <meetingNumber/> <byline>Javed Choudhury</byline> <bylineText>JAVED CHOUDHURY</bylineText> <bylineFull>JAVED CHOUDHURY</bylineFull> <bylineTitleText/> <USOrGlobal/> <wireDocType/> <newsDocType/> <journalDocType/> <linkLabel/> <pageRange/> <citation/> <quizID/> <indexIssueDate/> <itemClass qcode="ninat:text"/> <provider qcode="provider:imng"> <name>IMNG Medical Media</name> <rightsInfo> <copyrightHolder> <name>Frontline Medical News</name> </copyrightHolder> <copyrightNotice>Copyright (c) 2015 Frontline Medical News, a Frontline Medical Communications Inc. company. All rights reserved. This material may not be published, broadcast, copied, or otherwise reproduced or distributed without the prior written permission of Frontline Medical Communications Inc.</copyrightNotice> </rightsInfo> </provider> <abstract/> <metaDescription>A diet rich in green, leafy, cruciferous, and colorful vegetables may improve glucose tolerance and insulin sensitivity, whereas a high intake of potato fries o</metaDescription> <articlePDF/> <teaserImage/> <teaser>The risk for T2D over 12 years was 26% and 25% lower among those in the highest and moderate quartiles of cruciferous vegetable intake, respectively, than among those in the lowest quartile of cruciferous vegetable intake.</teaser> <title>Eating More Vegetables Improves Glucose Tolerance</title> <deck/> <disclaimer/> <AuthorList/> <articleURL/> <doi/> <pubMedID/> <publishXMLStatus/> <publishXMLVersion>1</publishXMLVersion> <useEISSN>0</useEISSN> <urgency/> <pubPubdateYear/> <pubPubdateMonth/> <pubPubdateDay/> <pubVolume/> <pubNumber/> <wireChannels/> <primaryCMSID/> <CMSIDs/> <keywords/> <seeAlsos/> <publications_g> <publicationData> <publicationCode>endo</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>fp</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> <publicationData> <publicationCode>im</publicationCode> <pubIssueName/> <pubArticleType/> <pubTopics/> <pubCategories/> <pubSections/> </publicationData> </publications_g> <publications> <term canonical="true">34</term> <term>15</term> <term>21</term> </publications> <sections> <term>64</term> <term canonical="true">39313</term> </sections> <topics> <term canonical="true">205</term> </topics> <links/> </header> <itemSet> <newsItem> <itemMeta> <itemRole>Main</itemRole> <itemClass>text</itemClass> <title>Eating More Vegetables Improves Glucose Tolerance</title> <deck/> </itemMeta> <itemContent> <h2>TOPLINE:</h2> <p>A diet rich in green, leafy, cruciferous, and colorful vegetables may improve glucose tolerance and insulin sensitivity, whereas a high intake of potato fries or chips may worsen these outcomes, an Australian study shows.</p> <h2>METHODOLOGY:</h2> <ul class="body"> <li>Researchers assessed the association between the intake of vegetables and potatoes with markers of type 2 diabetes (T2D) in 8009 participants (median age, 52 years; 55% women) from the Australian Diabetes, Obesity, and Lifestyle Study.</li> <li>A self-administered 74-item food frequency questionnaire was used to assess participants’ eating habits over 12 months prior to baseline.</li> <li>Participants were categorized into four quartiles of vegetable intake, from the highest intake (Q4) to the lowest intake (Q1).</li> <li>The association between vegetable intake and various metabolic markers such as fasting plasma glucose (FPG), 2-hour post-load plasma glucose, updated homeostasis model assessment of beta cell function (HOMA2-%beta), HOMA2 of insulin sensitivity (HOMA2-%S), and fasting insulin were evaluated over a 12-year follow-up period.</li> </ul> <h2>TAKEAWAY:</h2> <ul class="body"> <li>The post-load glucose was 3% lower in participants in the highest vs lowest quartile of total vegetable intake (ratio of means [RoM], 0.97; 95% CI, 0.96-0.99).</li> <li>Post-load glucose was 4% lower (RoM, 0.96; 95% CI, 0.95-0.98), HOMA2-%beta was 3% lower (RoM, 0.97; 95% CI, 0.96-0.99), and serum insulin was 5% lower (RoM, 0.95; 95% CI, 0.93-0.98) in those in the highest vs lowest quartile of green leafy vegetable intake.</li> <li>Those in the highest vs lowest quartile of potato fries or chips intake had 1% higher FPG, 3% higher HOMA2-%beta, and 8% higher serum insulin but 6% lower HOMA2-%S, revealing a negative impact on glucose tolerance and insulin sensitivity.</li> <li>The risk for T2D over 12 years was 26% and 25% lower among those in the highest and moderate quartiles of cruciferous vegetable intake, respectively, than among those in the lowest quartile of cruciferous vegetable intake.</li> </ul> <h2>IN PRACTICE:</h2> <p>The authors wrote that their study “sheds light on the physiological alterations in insulin regulation and glucose tolerance resulting from higher vegetable and subgroups of vegetable intake and supports the notion that vegetable subgroups may act differently in regulating insulin and blood glucose levels.”</p> <h2>SOURCE:</h2> <p>The study was led by Pratik Pokharel, MPH, Nutrition &amp; Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia, and was published <a href="https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgae333/7673656?login=false">online</a> in <em>The Journal of Clinical Endocrinology &amp; Metabolism</em>.</p> <h2>LIMITATIONS:</h2> <p>The study’s observational nature precluded the inference of causality. Potential measurement errors in dietary exposures and recall bias linked to the food frequency questionnaire could have affected the findings. The overrepresentation of participants from higher education and socioeconomic subgroups and loss to follow-up could limit the generalizability of the findings.</p> <h2>DISCLOSURES:</h2> <p>The study was funded by the National Health and Medical Research Council, National Heart Foundation of Australia, and Royal Perth Hospital Medical Research Foundation. Several authors reported receiving grants from various sources during the conduct of this study. The other authors reported no conflicts of interest.</p> <p> <em>A version of this article appeared on <span class="Hyperlink"><a href="https://www.medscape.com/viewarticle/eating-more-vegetables-improves-glucose-tolerance-2024a1000abv">Medscape.com</a></span>.</em> </p> </itemContent> </newsItem> <newsItem> <itemMeta> <itemRole>teaser</itemRole> <itemClass>text</itemClass> <title/> <deck/> </itemMeta> <itemContent> </itemContent> </newsItem> </itemSet></root>
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article