New Research: Joint Pain; Alzheimer's Link
By Bonnie Prescott
Beth Israel Deaconess medical Center staff
Joint Replacement Mends the Pain of Osteoarthritis. The discomfort and restricted mobility caused by severe osteoarthritis can be resolved through joint replacement surgery according to a study earlier this year in the Archives of Internal Medicine led by BIDMC primary care researcher Dr. Mary Beth Hamel.
Caused by the breakdown of cartilage in the hips, knees, hands and spine, osteoarthritis is the most common form of the disease, affecting millions. Dr. Hamel studied the long-term outcomes of nearly 200 individuals aged 65 and older (average age 75.2) with severe osteoarthritis of either the hip or knee. The study subjects were assessed between 2001 and 2004 and then again 12 months later. Among the 29 percent of the participants who underwent surgery, they were assessed at six-weeks, six-months and 12-months post-surgery.
The findings showed that while most of the surgical patients required help with daily activities for more than a month following their operations, the recovery times were no greater for those over age 75 than they were for the younger individuals. And, at the end of the 12 months, the patients who had had surgery showed more improvement in their osteoarthritis symptoms than those who did not undergo surgery.
“While recovery can be long and sometimes difficult, over the long-term, joint replacement offers excellent results for elderly individuals,” says Dr. Hamel. “We hope these findings will help osteoarthritis patients who are weighing the risks and benefits of joint replacement surgery.”
Alzheimer’s Linked to Thyroid Hormone. Women with abnormal levels of the hormone that controls thyroid function may have an increased risk of developing Alzheimer’s disease. The study, led by gerontologist Dr. Zaldy Tan of BIDMC and Hebrew Senior Life, appeared in the Archives of Internal Medicine.
Located at the front of the neck, the thyroid gland serves to convert the iodine found in many foods into hormones, which are used throughout the body to control metabolism. Both hypothyroidism and hyperthyroidism – underactive and overactive thyroid conditions, respectively – have been associated with cognitive impairment.
Dr. Tan and his coauthors used data from the The Framingham Study to further determine the relationship between thyroid function and dementia. They analyzed thyrotropin levels in 1,864 men and women, none of whom had cognitive problems at their initial assessment. During 12.7 years of follow-up evaluations (conducted every other year) 209 patients – 12.8 percent of women and 8.9 percent of men -- developed Alzheimer’s.
Among women, thyrotropin levels – both higher-than-normal and lower-than-normal – were associated with double the risk of developing Alzheimer’s disease. There was no association between thyrotropin levels and Alzheimer’s in men.
It’s unclear how thyroid levels outside the normal range trigger Alzheimer’s disease or why only women are affected. “There’s something about either the brain of women or the hormonal milieu of women that makes them more prone to this effect,” says Dr. Tan. “What we do know is that, for some reason, thyroid problems – for example, hypothyroidism, which is related to depression – are more common in women,” he adds.
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Posted December 2008
