Background-Trait optimism (positive future expectations) and cynical, hostile attitudes toward others have not been studied together in relation to incident coronary heart disease (CHD) and mortality in postmenopausal women. Methods and Results-Participants

Background It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to premenopause. Objectives To examine whether the odds of experiencing major depression were greater when women were perimenopausal or postmenopausal compared to when they were premenopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms, serum levels or changes in estradiol, follicular stimulating hormone, or testosterone and relevant confounders. Methods Participants included the 221 African American and Caucasian women, aged 42–52, who were premenopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women’s Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual, and current major depression at baseline and annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones were obtained annually. Results Women were two to four times more likely to experience major depression episode when they were perimenopausal or early postmenopausal. Repeated measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, vasomotor symptoms and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study. Conclusions The risk of major depression is greater for women during and immediately after the menopausal transition than when they are premenopausal.

HYPO is likely a safe therapeutic intervention for children after severe TBI up to 24 hours after injury. Further studies are necessary and warranted to determine its effect on functional outcome and intracranial hypertension.

Plasma A beta levels are affected by age and by systemic and CNS vascular risk factors. After controlling for these conditions, A beta-40 and A beta 1-42 are weak predictors of conversion to Alzheimer disease (AD) in normal subjects and are only weakly associated with AD in cross-sectional analysis. Consequently, plasma levels of A beta do not seem to be useful biomarkers for AD.

Background and Purpose-The objectives of this study were to describe the changes in cardiovascular risk factors during the perimenopausal and early postmenopausal years and correlate those changes in risk factors with carotid intimal-medial thickness (IMT) and plaque index measured 5 to 8 years after menopause. Methods-Participants were women (nϭ372) from Allegheny County, Pennsylvania, enrolled in the Healthy Women Study who had been postmenopausal for at least 5 years. Risk factor changes were measured during the perimenopause, ie, between the premenopausal and first year postmenopausal examinations, and during the early postmenopause, ie, between the first and fifth year postmenopausal examinations. Carotid ultrasound scans measured IMT and plaque at examinations 5 to 8 years after menopause among 314 of the women. Results-Increases in LDL cholesterol and triglycerides and declines in HDL cholesterol were greater during perimenopause than postmenopause, whereas increases in blood pressure and fasting glucose levels were greater during postmenopause. Premenopausal systolic and pulse pressure, LDL and HDL cholesterol, triglycerides, and body mass index predicted IMT and plaque. Only the change in pulse pressure between premenopausal and first year postmenopausal examinations was related to both IMT and plaque. Conclusions-Absolute risk for cardiovascular disease increases substantially in midlife, with a particularly adverse effect on lipid metabolism at the menopause. Premenopausal levels of risk factors are adequate to identify which women should be targeted for intervention.

Objectives-To determine the relationship between depressed mood and the development of Alzheimer's Disease in cognitively normal individuals. Design-Longitudinal. Observational.Setting-Community-based cohort study.Participants-288 participants in the Cardiovascular Health Study-Cognition Study (mean age=77.52, SD=3.65, range=70-89). All of the participants were adjudicated as cognitively normal in 1998/99, and all had at least three visits prior to 1998/99 with measures of cognition and mood state. The mean length of follow up from 1998-1999 to 2007 was 7.1 years (range 1-9 yrs, median=9 yrs). Measurements-TheCenter for Epidemiological Studies-Depression Scale was used to index mood state, and the Modified Mini-Mental State Examination (3MSE) was the index of cognitive function among participants prior to 1998/99. These measures were considered in two ways: participants were classified according to: 1) whether or not they showed a high negative correlation between their CESD and 3MSE scores (i.e., indicating that greater depression was linked to poorer NIH Public Access Author ManuscriptAm J Geriatr Psychiatry. Author manuscript; available in PMC 2010 August 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript cognition), and 2) whether or not they showed persistently elevated CESD scores. The study outcome, development of dementia (n=48), was based on consensus classifications based on detailed neuropsychological and neurological exams.Results-We could find no consistent relationship between mood state, either alone or in relation to cognitive status and the subsequent development of dementia. Those individuals whose cognitive functions were highly correlated with their mood state were no more likely to develop dementia than other participants. Those who had persistently depressed mood were also no more likely to develop dementia than those without persistently depressed mood.Conclusion-Within the confines of this prospective, community-based study of elderly adults, we could not find strong evidence to support the hypothesis that mood disturbance was linked with the development of dementia.

Objective Little is known about the risk of anxiety in women during midlife and the menopausal transition. We examined anxiety as a cluster of 4 symptoms and determined the association between menopausal stage and high anxiety during ten years of follow-up of 2,956 women of multiple race/ethnicities. Methods This study was a longitudinal analysis of data from the multi-site Study of Women's Health Across the Nation (SWAN), a study of menopause and aging. Women were 42-52 at study entry. The outcome was high anxiety, a score of 4 or greater on the sum of four anxiety symptoms rated according to frequency in the previous 2 weeks from 0 (none) to 4 (daily) (upper 20%). Covariates included sociodemographics, health factors, stressors, and vasomotor symptoms (VMS). Results Women with low anxiety at baseline were more likely to report high anxiety symptoms when early or late perimenopausal or postmenopausal compared to when they were premenopausal (odds ratios ranged from 1.56 to 1.61), independent of multiple risk factors, including upsetting life events, financial strain, fair/poor perceived health, and VMS. Women with high anxiety at baseline continued to have high rates of high anxiety throughout the follow-up but odds ratios did not differ by menopausal stage. Conclusion Women with high anxiety premenopausally may be chronically anxious and not at increased risk of high anxiety at specific stages of the menopausal transition. In contrast, women with low anxiety premenopausally may be more susceptible to high anxiety during and after the menopausal transition than before.

In this study, MVD for typical TN resulted in complete postoperative pain relief in 80% of patients, compared with 47% with complete relief in those with atypical TN. Significant pain relief was achieved after 97% of MVDs in patients with typical TN and after 87% of these procedures for atypical TN. When patients were followed for more than 5 years, the long-term pain relief after MVD for those with typical TN was excellent in 73% and good in an additional 7%, for an overall significant pain relief in 80% of patients. In contrast, following MVD for atypical TN, the long-term results were excellent in only 35% of cases and good in an additional 16%, for overall significant pain relief in only 51%. Memorable onset and trigger points were predictive of better postoperative pain relief in both atypical and typical TN. Preoperative sensory loss was a negative predictor for good long-term results following MVD for atypical TN.