Objectives To examine the associations of depressive symptoms, antidepressant use, and duration of use with incident frailty three years later in nonfrail women ≥ age 65. Design Secondary analysis of the Women’s Health Initiative Observational Study (WHI-OS), a prospective cohort study. Setting WHI-OS was conducted in 40 U.S. clinical centers. Participants Women aged 65-79, not frail at baseline. Measurements Antidepressant use was assessed through medication container inspection at baseline. We created four groups according to baseline use and Burnam depression screen (range 0-1, 0.06 cut-off): antidepressant non-users without depressive symptoms (referent group), antidepressant non-users with depressive symptoms, antidepressant users without depressive symptoms, and antidepressant users with depressive symptoms. Frailty components included slowness/weakness, exhaustion, low physical activity, and unintended weight loss, ascertained through self-report and physical measurements at baseline and year 3. Results Among 27652 women at baseline, 4.9% (n=1350) were antidepressant users and 6.5% (n=1794) were categorized depressed. At year 3, 14.9% (n=4125) were frail. All groups had an increased risk for incident frailty compared to the referent group. Odds ratios ranged from 1.73 (95% Confidence Interval (CI) =1.41-2.12) among non-depressed antidepressant users to 3.63 among depressed antidepressant users (95% CI = 2.37-5.55). All durations of use were associated with incident frailty (<1 year OR = 1.95, 95% CI = 1.41-2.68; 1 to 3 years OR = 1.99, 95% CI = 1.45-2.74; > 3 years OR = 1.60, 95% CI = 1.20-2.14). Conclusion In older adult women, depressive symptoms and antidepressant use were associated with frailty after 3 years follow-up.

Perceived discrimination may contribute to somatic disease. The association between perceived discrimination and breast cancer incidence was assessed in the Black Women's Health Study. In 1997, participants completed questions on perceived discrimination in two domains: "everyday" discrimination (e.g., being treated as dishonest) and major experiences of unfair treatment due to race (job, housing, and police). Cox proportional hazards models were used to estimate incidence rate ratios, controlling for breast cancer risk factors. From 1997 to 2003, 593 incident cases of breast cancer were ascertained. In the total sample, there were weak positive associations between cancer incidence and everyday and major discrimination. These associations were stronger among the younger women. Among women aged less than 50 years, those who reported frequent everyday discrimination were at higher risk than were women who reported infrequent experiences. In addition, the incidence rate ratio was 1.32 (95% confidence interval: 1.03, 1.70) for those who reported discrimination on the job and 1.48 (95% confidence interval: 1.01, 2.16) for those who reported discrimination in all three situations - housing, job, and police - relative to those who reported none. These findings suggest that perceived experiences of racism are associated with increased incidence of breast cancer among US Black women, particularly younger women.

Xenodiagnosis using Ixodes scapularis larvae was safe and well tolerated. Further studies are needed to determine the sensitivity of xenodiagnosis in patients with Lyme disease and the significance of a positive result. Clinical Trials Registration NCT01143558.

Stress and social support are associated with depressive symptoms among dental students.

The evidence linking cigarette smoking to the risk of colorectal cancer is inconsistent. We investigated the associations between active and passive smoking and colorectal cancer among 146,877 Women's Health Initiative participants. Women reported detailed smoking histories at enrollment. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for the association between smoking and overall and site-specific risk of colorectal cancer. Invasive colorectal cancer was diagnosed in 1242 women over an average of 7.8 years (range = 0.003-11.2 years) of follow-up. In adjusted analyses, statistically significant positive associations were observed between most measures of cigarette smoking and risk of invasive colorectal cancer. Site-specific analyses indicated that current smokers had a statistically significantly increased risk of rectal cancer (HR = 1.95, 95% CI = 1.10 to 3.47) but not colon cancer (HR = 1.03, 95% CI = 0.77 to 1.38), compared with never smokers. Passive smoke exposure was not associated with colorectal cancer in adjusted analyses. Thus, active exposure to cigarette smoking appears to be a risk factor for rectal cancer.