U.S. sees decline in stroke rate in past 2 decades | Dementia diagnosis rate on the decline, research indicates | <a href="http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5" target="_blank">American Family Physician has compiled a collection of journal articles related to the diagnosis and treatment of dementia</a>.
Web Version
July 16, 2014
Family Medicine SmartBrief

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U.S. sees decline in stroke rate in past 2 decades
The overall first-time stroke rate among Americans dropped 24% from 1987 to 2011, with a greater drop seen among people aged 65 and older, according to an analysis in the Journal of the American Medical Association. Researchers found a 20% overall decline in stroke-related deaths per decade. HealthDay News (7/15), DailyRx.com (7/15)
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Clinical News
Dementia diagnosis rate on the decline, research indicates
The rate of diagnosis for dementia appears to be declining over the short and long term, according to three studies being presented at the Alzheimer's Association International Conference. One study found the diagnosis rate is down 44% from the late 1970s in the U.S., and a second study showed a similar decline based on data from the U.S., England, Sweden and the Netherlands. The greatest gains were seen among people in their 60s. The third study found the risk of dementia declined in Germany from 2004 to 2007. HealthDay News (7/15)
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Sleep disturbance tied to higher dementia risk in veterans study
An analysis involving 192,266 veterans ages 55 years and older found that those suffering from sleep apnea, insomnia and other forms of sleep disturbance were 30% more likely to develop dementia. The risk of developing dementia was 80% higher among veterans who also had post-traumatic stress disorder. The findings were presented at the Alzheimer's Association International Conference. Medscape (free registration) (7/15)
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Study: Changes in pills' color, shape may result in Rx nonadherence
Variations in the color and shape of pills can confuse patients and make them stop taking much-needed treatments, according to a study in the Annals of Internal Medicine. The FDA should consider requiring that brand-name drugs and generics have matching appearances because the effects are "clinically relevant," researchers said. Prescribers should be proactive in telling patients about changes in pills' appearances, researchers said. The Washington Post (tiered subscription model) (7/14)
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Increased statin adherence may raise diabetes odds
Italian researchers found increased adherence to statin therapy was associated with higher odds of new-onset diabetes compared with very low adherence. However, the drug's benefits in "reducing cardiovascular events clearly overwhelm the diabetes risk," the authors wrote in Diabetes Care. PhysiciansBriefing.com/HealthDay News (7/14)
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Stillbirth, miscarriage may predict women's future heart risk
A study in the Annals of Family Medicine found that women with a history of stillbirth or miscarriage may be at elevated risk of coronary heart disease later in life. The study supports the need to ask women about their history of pregnancy loss when assessing heart risk, according to a cardiovascular expert who was not involved in the research. MedPage Today (free registration) (7/18)
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Practice Management
Study: "Nonvisit communications" do not reduce office visits
A study of 18,486 diabetic adults published in the Annals of Family Medicine found that greater patient use of secure electronic messaging and telephone calls only slightly reduced the number of in-person visits, however an analysis that adjusted for factors such as morbidity indicated greater use of such communications was linked to increased office visits. It is logical that patients who had more contact with clinicians "could be more engaged in their health," said study author David Liss. Medscape (free registration) (7/15)
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Health Policy & Legislation
Feds order states to resolve Medicaid backlogs
The CMS sent letters to Alaska, California, Kansas, Michigan, Missouri and Tennessee telling them to fix their Medicaid enrollment systems and clear pending applications. The letters, dated June 27, gave the states 10 days to develop plans for clearing the backlogs. The Washington Post (tiered subscription model)/The Associated Press (7/14)
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Professional Issues & TrendsAdvertisement
Insurers expand telemedicine coverage
More health insurers are covering telemedicine for the diagnosis of minor ailments. Online care can reduce costs, improve access to health care professionals and free physicians to provide more care, experts say. State boards and medical societies are developing standards to make it easier for physicians to offer online care and ensure patient safety. Bloomberg (7/14)
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Help stop tobacco use | Talk With Your Doctor initiative
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About AAFP
This news roundup is provided as a timely update to AAFP members and other health care professionals about family medicine topics in the news media. Links to articles are provided for the convenience of family physicians who may find them of use in discussions with patients or colleagues. Opinions expressed in Family Medicine SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American Academy of Family Physicians. On occasion, media articles may include or imply incorrect information about the AAFP and its policies, positions or relationships. For clarification on AAFP positions and policies, we refer you to http://aafp.org.
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