No hard evidence supports supplements', vitamins' promise in slowing cognitive decline.

Moral of the story: no supplements known to help cognitive performance

Source: AMA Morning Rounds 4/28/10

No hard evidence supports supplements', vitamins' promise in slowing cognitive decline.
CNN (4/26, Landau) reported, "A seemingly steady stream of new research purports to show supplements' and vitamins' promise in preventing or slowing cognitive decline, but in reality no hard evidence supports taking any of them." But, "at the same time, such supplements have been proved safe, barring drug interactions and other complications, so some doctors recommend trying them anyway." The article discussed claims regarding omega 3 fatty acid fish oils, gingko biloba, and vitamin E for preserving cognition, pointing out that studies have found inconclusive or mixed benefits for each of these supplements.

Computer brain games may not improve cognitive ability.

Moral of the story: Don't waste your money, but if you enjoy them, go for it.

Source: AMA Morning Rounds 4/21/2010

Computer brain games may not improve cognitive ability.

USA Today (4/21, Marcus) reports, "Computer brain games may not offer the big mental boost many were hoping for, suggests new research, but brain scientists and brain-game experts don't all agree on the findings." The study was published in Nature and "is the largest of its kind," its authors say. For the study, researchers recruited over "11,000 people between the ages of 18 and 60," who "were split into three groups, including two groups that played different brain-training games that are similar to commercially available games, and a control group that was asked to go online and find answers to questions about topics such as music." According to lead author Adrian Owen, "Participants did get better at games they practiced. The more they trained, the better they got. But there was still no translation to any general improvement in cognitive function."

        The Wall Street Journal (4/21, Naik) reports that companies which produce brain training and fitness games have experienced significant growth in the last few years, in part because of the increase in the number of baby boomers, and because previous research suggested that such games could benefit cognitive abilities. But, this six-week, online experiment has not borne out previous conclusions.

American Heart Association releases guidelines for sugar intake.

Moral of the story: new sugar guidelines are extremely stingy, may be difficult for majority of Americans to follow.

Source: AMA Morning Rounds 4/9/2010

American Heart Association releases guidelines for sugar intake.
Julie Deardorff writes in the Chicago Tribune (4/9), "For the first time, Americans now have a benchmark: No more than 25 grams of added sugar a day for women and 37.5 grams for men, according to new guidelines established by the American Heart Association." Still, "it's easy to soar past those limits. Downing just one 12-ounce can of Coca-Cola will give you 39 grams of sugar, exceeding your daily ration. But a lesser-known problem with sugar is that it's hidden in everything from soup to nuts." In addition, "it's lurking in your lunch meat. It enhances bread. And if a low-fat product or frozen dinner tastes good, you may have added sugar to thank."

Treatment checklists may cut hospital deaths

BMJ

(4) Treatment checklists may cut hospital deaths
(Quality Improvement Report: Using care bundles to reduce in-hospital mortality: quantitative survey)
http://www.bmj.com/cgi/content/full/340/mar31_3/c1234
Patient deaths at three London hospitals have been cut by almost 15% after introducing treatment checklists (known as care bundles), finds a study published on bmj.com today.
The researchers say their methods could be used to reduce mortality in many other hospitals.
The North West London Hospitals NHS Trust serves a population of about 500,000 at three sites: Northwick Park Hospital, Central Middlesex Hospital and St Mark's Hospital. In 2005 and 2006, the trust was subject to a series of adverse media stories which impacted on staff morale and also on patients' perceptions of care.
So a group of senior clinicians set out to reduce hospital inpatient mortality and thus increase public confidence in the quality of patient care at the trust.
They developed eight care bundles for 13 diagnostic areas with the highest number of deaths at the trust in 2006-7. These included treatments for stroke, heart failure and chronic obstructive pulmonary disease (COPD).
Care bundles are a collection of treatment checklists based on clinical guidelines that, when combined, improve the effectiveness and safety of patient care.
Adjusted hospital mortality for 2007-8 (the year the care bundles were introduced) was then compared with the previous year using the hospital standardised mortality ratio (HSMR).
The HMSR is a comparative measure of a hospital's overall mortality. It focuses on a group of diagnoses that account for 80% of all hospital deaths nationally and provides a tool for analysing hospital outcomes over time.
The results show that the overall HSMR of the trust fell from 89.6 in 2006-7 to 71.1 in 2007-8, to become the lowest among acute trusts in England.
In 2007-8, 174 fewer deaths occurred in the trust in the targeted diagnoses, and 255 fewer deaths occurred in the HMSR diagnoses compared to 2006-7. This represents a 14.5% decrease in actual deaths from 2006-7 to 2007-8.
This study demonstrates that it is possible to target care bundles across a wide range of diagnoses in a busy acute hospital trust and that this can be associated with a significant reduction in mortality in the targeted diagnostic areas, conclude the authors. These methods could also be generally applicable, they add.
Contacts: Brian Jarman, Emeritus Professor, Imperial College, London, UK
Email b.jarman@imperial.ac.uk