Reduced prevalence of AD in users of NSAIDs and H2 receptor antagonists: the Cache County study.

OBJECTIVE: To test the hypothesis that nonsteroidal anti-inflammatory drugs (NSAIDs) and histamine H2 receptor antagonists (H2RAs) are associated with a decreased risk of AD in late life. BACKGROUND: Sustained use of non-aspirin NSAIDs has been repeatedly associated with a reduced occurrence of AD. Similar effects with aspirin have been weaker. One prior study showed a strong association between use of H2RAs and reduced AD prevalence. METHODS: In a population study of AD in Cache County, UT, we used a sequenced plan of sampling and case ascertainment to identify 201 cases of AD and 4425 participants with no indication of cognitive impairment. Independently, an interview and medicine chest inventory assessed use of several medicines including aspirin, non-aspirin NSAIDs, H2RAs, and three classes of "control" drugs not thought to be associated with AD. Follow-up questioning probed possible indications for use of these drugs. RESULTS: Compared with cognitively intact individuals, the AD cases had significantly less reported current use of NSAIDs, aspirin, and H2RAs. Stronger associations appeared when subjects reported use of both NSAIDs and aspirin (no H2RAs), two different NSAIDs (no H2RAs), or two different H2RAs (with neither aspirin nor NSAIDs). There was little or no such association with use of the control medicines. Adjustment for usage indication did not influence these findings, and there was no appreciable variation with number of APOE epsilon4 alleles. CONCLUSIONS: As predicted, use of NSAIDs and aspirin were specifically associated with reduced occurrence of AD. Notably, a previous observation of an inverse association of AD and use of H2RAs was also affirmed. Definitive evidence for a preventive action of these agents will require randomized prevention trials.

Identifying causes of disagreement between self-reports and spouse ratings of personality.

Self-reports and spouse ratings of personality traits typically show less-than-perfect agreement, but powerful moderators of agreement have not yet been identified. In Study 1, 47 married couples completed the Revised NEO Personality Inventory to describe themselves and their spouses. Extent of agreement was not consistently moderated by response sets; the age, intelligence, or education of the respondent; or the length or quality of the relationship. In Study 2 these couples were interviewed about reasons for substantial disagreements, and an audiotape was content-analyzed. Sixteen reasons were reliably coded, including idiosyncratic understanding of items, reference to different time frames or roles, and unavailability of covert experience to the spouse. Faking good, assumed similarity, and other variables prominent in the psychometric literature were relatively unimportant. Findings (1) suggest that attempts to improve the validity of self-reports and ratings may need to be refocused and (2) underscore the desirability of routinely obtaining multiple sources of information on personality.

Gender differences in cardiovascular reactivity.

Pronounced cardiovascular reactivity to stress is a behavioral mechanism that may underlie the pathophysiology of coronary heart disease (CHD). Based on the greater incidence of CHD among males than among females, the purpose of the current investigation was to test the hypothesis that in young adults (ages 17-29), males (n = 47) show more cardiovascular reactivity than females (n = 61) to two stressors, a video game and cigarette smoking. Five of the six comparisons did not support the hypothesis: females were higher on heart rate and diastolic blood pressure reactivity to both stressors; males were higher on systolic blood pressure reactivity to the video game only. The results suggest that females may be particularly physiologically reactive to cigarette smoking.

Medicine and the law: Attorney general clarifies status of Texas abortion laws.

PIP: Texas Attorney General John L. Hill has issued an opinion on guidelines and standards to be used with reference to abortion in Texas. They include: 1) that only a licensed physician may perform an abortion; 2) that facilities in which abortions are performed may not be singled out for special licensing but should be subject to the same regulations as other hospitals; 3) that the state cannot require a different procedure or documentation for abortion than is required for any other medical procedure; 4) that private hospitals may refuse to permit abortions but that public hospitals may not, unless other similar procedures are also prohibited; 5) that a physician may refuse to perform an abortion; and 6) that legislation giving the putative father a voice in the abortion decision would be of questionnable constitutionality.^ieng