On A Meaningful Life

Mild Cognitive Impairment: Risk Factors I'm linking to this post about Risk Factors for Mild Cognitive Impairment over at Psychscape . Mild cognitive impairment was associated with race (African American), low educational level, low Modified Mini-Mental State Examination and Digit Symbol Test scores, cortical atrophy, MRI-identified infarcts, and measurements of depression. The MCI amnestic-type was associated with MRI-identified infarcts, the presence of the APOE 4 allele, and low Modified Mini-Mental State Examination scores. The study's primary author pointed out that it is important to note that African Americans have more cardiovascular disease and cerebrovascular disease risk factors than whites, which may explain the increased prevalence of MCI in this group of subjects. The consistently excellent Psychscape is written by the Psychiatry Editor for Medscape and should be a regular stop for mental health professionals.

Delirium in the LA Times LA Times covers this under diagnosed medical problem this week in the Health section (requires free registration to view; need to view in the next week because it will be archived). Interventions include the following: In a March 1999 study published in the New England Journal of Medicine, Inouye showed that several simple changes reduced delirium by 40% among 852 hospitalized, non-ICU patients 70 and older. For example, the program reduced the use of sleeping pills by having volunteers provide back rubs, relaxation tapes, warm milk and tea. Other interventions included providing cognitive stimulation through games, discussion of current events and memory aids designed to jog recollections; by helping get patients out of bed and walking three times daily; by improving surroundings to minimize sleep disruptions, and by giving enough fluids to prevent dehydration.

Stress, Health and the Urban Environment Here is another New York Times Magazine article, "Enough To Make You Sick" by Helen Epstein. While I know there is a larger political context to this story, I think that the writer makes it clear how intertwined the influence of an urban environment is on one's health. Her writeup at the end about a program placing people from poor urban environments to a middle class environment is interesting. Followup of this group would be important. Please catch this article before it goes into the archives.