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Particulate matter exposure associated with neuroanatomical risk of Alzheimer’s Disease

A new study led by Dr. Diana Younan at the University of Southern California used data from the WHI Memory Study of Magnetic Resonance Imaging (WHIMS-MRI) to investigate whether fine particulate matter contributes to brain changes predictive of Alzheimer’s Disease. A total of 712 WHI women who had two MRI scans, one in 2005-6 and the other in 2010-11, were longitudinally analyzed. The scans were assigned a score based on patterns of grey matter atrophy that is used as an early biomarker for Alzheimer’s Disease. Air pollution was measured in the form of particulate matter (<2.5 micrometer) exposure and identified using the participant’s home addresses and spatiotemporal modeling that includes data from the US EPA Air Quality System. Dr. Younan and her team found that long term exposure to particulate matter was associated with neuroanatomical changes that increase risk for Alzheimer’s Disease by 24% over five years, even after accounting for demographic, health behaviors, and possible cerebrovascular damage. Their study provides support that particulate matter is associated with neurodegeneration.

These findings were published in the November 18th, 2020 edition of Neurology.

While physical activity has been shown to decrease the risk of hypertension, the impacts of walking on hypertension risk is unclear. Furthermore, studies in older women are sparse despite high levels of hypertension and the popularity of walking as a form of exercise in this population. For his Epidemiology Master of Science thesis, Mr. Connor Miller examined whether walking volume (characterized by frequency, duration, and intensity) and speed was associated with incident hypertension among over 83,000 WHI women followed an average of 11 years. Information about walking and hypertension was collected by survey. Women were placed into 1 of 4 groups based on levels of walking volume (0, >0-3.5, 3.6-7.5, and >7.5 metabolic equivalent hours per week) and speed (<2, 2-3, 3-4, >4 miles per hour). Their analysis found that as walking volume and speed increased, the risk of hypertension decreased. Specifically, the risk of hypertension relative to non-walkers was 0.89 lower in women with the highest walking volume and 0.79 lower among the fastest walkers, even after accounting for covariates such as smoking, diet, and other chronic conditions. The authors concluded that walking should be encouraged as a hypertension prevention strategy in older women.

Updated WHI Investigator Datasets are now available! The data release includes Outcomes and Extension Study follow-up data through February 28, 2020, as well as updated Specimen Results datasets. Additionally, Form 159 data is now available, including a repeat of the sleep disturbance construct, new variables related to symptoms, medications for hypertension and cholesterol, current weight, and age-related macular degeneration.

Dr. Garnet Anderson, principal investigator of the WHI Clinical Coordinating Center and Senior Vice President and Division Director of Public Health Sciences at the Fred Hutchinson Cancer Research Center in Seattle, Washington, was named as a 2020 Fellow of the American Statistical Association (ASA). Fellowship with the ASA is bestowed only upon a very small percentage of the ASA membership on the basis of the candidate’s established reputation and ongoing outstanding contributions to statistical science.

A recent analysis led by Dr. Victor Eng examined nearly 90,000 WHI Observational Study participants to determine the association between smoking history and cancer screening use. Among the women in the study, 53% never smoked, 41% were former smokers, and 6% were current smokers. They discovered that over a mean 8.8 years of follow-up, active smokers were less likely to have obtained a breast, cervical, and colorectal cancer screening relative to women who never smoked. As a consequence of having lower cancer screening usage, women who were active smokers were diagnosed with a higher stages for breast and colorectal cancers. Women who were former smokers were found to have higher usage of breast and cervical cancer screening services compared to those who never smoked. The authors recommend that clinicians emphasize both the use of cancer screening services and smoking cessation for this high-risk group.

This manuscript was published in BMJ Open in August 2020.

WHI researcher, Dr. Marian Neuhouser, has been appointed to the Food and Nutrition Board. The Food and Nutrition Board was established in 1940 within the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine. It researches issues related to the U.S. food supply, aids in the development of healthy nutrition guidelines, and evaluates the relationships between consumption, nutrition, and health maintenance and disease prevention. Dr. Neuhouser’s appointment is for a 3-year term, beginning July 1, 2020.

Earlier findings published by WHI investigators identified an increased risk of developing breast cancer among clinical trial participants without prior hysterectomy who had received treatment with combination estrogen-plus-progestin hormone replacement therapy over a median of 5.6 years. Conversely, trial participants with prior hysterectomy who underwent estrogen-only therapy for a median of 7.2 years experienced a reduced risk for developing breast cancer. Prior analyses, conducted in 2013 and 2015, noted that these effects endured over a median cumulative follow-up period of 13 years for both therapies.

A recent follow-up analysis, led by WHI investigator Rowan Chlebowski, found that after more than 20 years of median follow-up, the protective effects of estrogen-alone therapy continued to endure, as did the increased risks for developing breast cancer attributed to estrogen-plus-progestin therapy. Despite many years having passed since withdrawal of hormone treatment, the investigators attributed the lasting impacts of each therapy to altered cellular processes in breast tissue affecting cell death (apoptosis). While estrogen-alone therapy is presently not indicated as a prophylaxis for breast cancer due to prior findings suggesting increased risk of stroke and potential influences on hormone-targeted drugs, the authors indicate that other factors may be involved and recommend further work in this arena.

Decisions pertaining to the use and selection of hormone-replacement therapy should be undertaken in partnership with a qualified medical professional and should take into account the numerous personal and health history factors that may influence the benefit/risk calculation of utilizing a particular treatment course.

These findings were published in JAMA in July 2020.

Dr. Wactawski-Wende is the PI of one of the original 16 vangard WHI clinics since 1993.

“Dr. Wactawski-Wende has made seminal contributions that have significantly impacted health care practice and disease prevention for women in the U.S. and around the world,”
University of Buffalo President Satish K. Tripathi 

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An article summarizing this recently published paper by Kerryn W. Reding PhD, MPH, RN et al. appeared in OncologyNurseAdvisor.com