BUILDING A HEALTHIER COMMUNITY
The Centers for Disease Control and Prevention has awarded a five-year, $8 million grant to a new Saint Louis University-Washington University initiative on preventing chronic diseases such as heart disease, asthma and diabetes. The Prevention Research Center in St. Louis is one of 35 programs in 25 states examining how people and their communities can avoid or counter the risks of chronic diseases. Statistics show that nationally, more than 15 percent of deaths can be attributed to physical inactivity and poor diet, according to SLU professor of community health and Center co-director Elizabeth Baker. “In Missouri, about 80 percent of adults say they eat fewer than five servings of fruits and vegetables a day; more than 25 percent report doing no leisure-time or physical activity in the past 30 days; and almost 30 percent are obese,” she says, adding that researchers have identified many evidence-based community interventions meant to enable residents to make healthy choices. “But little is known about what needs to be in place to facilitate local organizations working together to put proven strategies into action, especially in the rural areas.”
ALCOHOLISM & YOUNG DRINKERS
December’s issue of Alcoholism: Clinical & Experimental Research features results from a Washington University School of Medicine study about how drinking at an early age increases the risk of alcoholism. The research team, which studied more than 6,000 adult twins from Australia, found that the younger the person was when they had their first drink, the greater the risk for alcohol dependence and the more prominent the role played by genetic factors. Scientists discovered that when twins started drinking early (younger than age 15), genetic factors—at rates as high as 90 percent in the youngest drinkers—contributed greatly to risk for alcohol dependence. For those who started drinking at older ages, genes explained much less than environmental factors such as a significant life event. “We don’t have actual gene expression data in this study, but we could hypothesize that exposure to early-onset drinking somehow modifies the developing brain,” says first author Arpana Agrawal. “Particularly frequent or heavy early drinking may influence gene expression and contribute to more severe outcomes. Our research cannot prove that, but it’s something that neuro-imaging and gene expression studies certainly should investigate.” She says another possibility is that early drinking exposes adolescents to certain environmental influences, such as their peer groups, that enhance genetic influences that contribute to risk for alcohol dependence. “Something about starting to drink at an early age puts young people at risk for later problems associated with drinking,” Agrawal says. “We continue to investigate the mechanisms, but encouraging youth to delay their drinking debut may help.”
EARLIER ALZHEIMER’S TESTS
Washington University researchers looking into mental decline in the years prior to diagnosis of Alzheimer’s disease suggest that changing the focus of testing may allow physicians to detect signs of the disease three years earlier. Current cognitive testing typically focuses on episodic memory, or the ability to remember things like word lists or information from a reading. But scientists have found that so-called ‘visuospatial’ skills (tasks such as connecting the dots or using a guide to build a structure with blocks) begin to deteriorate up to three years prior to diagnosis. “We may need to rethink what we look for as the earliest signs of mental change associated with Alzheimer’s,” says senior author Dr. James Galvin, a Washington University neurologist. “If we can better recognize the first signs of disease, we can start treating patients earlier, and hopefully with new treatments we can slow or perhaps even stop their progress into dementia.” Galvin and his co-authors also plan to apply their findings for assessing mental decline to other dementias, including Lewy body dementia and the form of dementia associated with Parkinson’s disease.
DEPRESSION and OMEGA-3s
New research unveiled by Washington University School of Medicine scientists shows that omega-3 fatty acids do not improve depression in heart patients. “A number of studies have shown omega-3 fatty acids in fish oil can reduce the severity of clinical depression in otherwise healthy people,” says principal investigator Robert Carney, a psychiatry professor and director of the Behavorial Medicine Center. “We thought adding omega-3 to an antidepressant drug might enhance the effect of the antidepressant therapy, but it did not.” Depression is common in patients with heart disease and a risk factor for cardiac-related death. But anti-depressants often don’t improve symptoms in depressed heart patients. The study involved 122 depressed heart patients who all received the antidepressant sertraline (Zoloft). Half of the patients also received a capsule of omega-3 (Lovaza). The researchers expected depression symptoms in study participants taking both sertraline and omega-3 to improve, but after 10 weeks, there were no significant differences between the groups. “This is disappointing in light of the fact that depression is a significant risk factor for cardiac mortality, and we are in need of more effective treatments for depression in these patients,” Carney says. Researchers are now investigating psychotherapy in depressed cardiac patients. They’re studying cognitive behavior therapy in greater numbers of depressed heart patients and sometimes combining psychotherapy with antidepressant medication.