Estimates of years of life lost through dementia may be helpful for patients and their families. Recommendations for future research methods are proposed.

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Objective Does psychosocial intervention for caregivers whose spouses with Alzheimer’s disease (AD) are taking donepezil delay nursing home (NH) placement or death of patients? Design Randomized controlled trial with 2 years of active treatment and up to 8.5 years of follow-up (M = 5.4 years, SD = 2.4) was conducted. Setting Outpatients of research clinics in Australia, United Kingdom (UK) and the United States (US). Participants 155 persons with AD and their spouses. Intervention 5 sessions of individual and family counseling (+ prn ad hoc counseling) or usual care. Measurements Time to institutionalization and death using Cox proportional hazards methods. Results Over a mean of 5.4 years (SD = 2.4), there were no differences in NH placement or mortality by intervention group but there were by country, with Australian patients admitted to NHs earlier than US and UK patients. Conclusion Earlier NH admission of Australian than UK and US subjects may be due to differences in health care, NH systems, availability and affordability.

Exposing infants to alcohol through breastmilk may cause dose-dependent reductions in their cognitive abilities. This reduction was observed at age 6 to 7 years but was not sustained at age 10 to 11 years. Although the relationship is small, it may be clinically significant when mothers consume alcohol regularly or binge drink. Further analyses will assess relationships between alcohol consumption or tobacco smoking during lactation and academic, developmental, physical, and behavioral outcomes in children.