Olfactory Dysfunction Predicts Subsequent Dementia in Older U.S. Adults

Objectives: To investigate the relationship between olfactory dysfunction and subsequent diagnosis of dementia. Design: Longitudinal study of a population representative of U.S. older adults. Setting: Home interviews (National Social Life, Health, and Aging Project). Participants: Men and women aged 57 to 85 (N = 2,906). Measurements: Objective odor identification ability was measured at baseline using a validated five-item test. Five years later, the respondent, or a proxy if the respondent was too sick to interview or had died, reported physician diagnosis of dementia. The association between baseline olfactory dysfunction and an interval dementia diagnosis was tested using multivariate logistic regression, controlling for age, sex, race and ethnicity, education, comorbidities (modified Charlson Comorbidity Index), and cognition at baseline (Short Portable Mental Status Questionnaire). Results: Older adults with olfactory dysfunction had more than twice the odds of having developed dementia 5 years later (odds ratio = 2.13, 95% confidence interval = 1.32–3.43), controlling for the above covariates. Having more odor identification errors was associated with greater probability of an interval dementia diagnosis (P =.04, 1-degree of freedom linear-trend test). Conclusion: We show for the first time in a nationally representative sample that home-dwelling older adults with normal cognition and difficulty identifying odors face higher odds of being diagnosed with dementia 5 years later, independent of other significant risk factors. This validated five-item odor identification test is an efficient, low-cost component of the physical examination that can provide useful information while assessing individuals’ risk of dementia. Use of such testing may provide an opportunity for early interventions to reduce the attendant morbidity and public health burden of dementia

Optimal Conservatism and Collective Monetary Policymaking under Uncertainty

We study how the optimal degree of conservatism relates to decision-making procedures in a Monetary Policy Committee (MPC). In our framework, central bank conservatism is required to attenuate the volatility of monetary decisions generated by the presence of uncertainty about the committee members' output objective. We show how this need for conservatism varies according to the number of MPC members, the MPC's composition as well as its decision rule. Moreover, we find that extra central bank conservatism is required when there is ambiguity about the MPC's true decision rule

Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases

none24Cardiac amyloidosis is a serious and progressive infiltrative disease that is caused by the deposition of amyloid fibrils at the cardiac level. It can be due to rare genetic variants in the hereditary forms or as a consequence of acquired conditions. Thanks to advances in imaging techniques and the possibility of achieving a non-invasive diagnosis, we now know that cardiac amyloidosis is a more frequent disease than traditionally considered. In this position paper the Working Group on Myocardial and Pericardial Disease proposes an invasive and non-invasive definition of cardiac amyloidosis, addresses clinical scenarios and situations to suspect the condition and proposes a diagnostic algorithm to aid diagnosis. Furthermore, we also review how to monitor and treat cardiac amyloidosis, in an attempt to bridge the gap between the latest advances in the field and clinical practice.noneGarcia-Pavia P.; Rapezzi C.; Adler Y.; Arad M.; Basso C.; Brucato A.; Burazor I.; Caforio A.L.P.; Damy T.; Eriksson U.; Fontana M.; Gillmore J.D.; Gonzalez-Lopez E.; Grogan M.; Heymans S.; Imazio M.; Kindermann I.; Kristen A.V.; Maurer M.S.; Merlini G.; Pantazis A.; Pankuweit S.; Rigopoulos A.G.; Linhart A.Garcia-Pavia, P.; Rapezzi, C.; Adler, Y.; Arad, M.; Basso, C.; Brucato, A.; Burazor, I.; Caforio, A. L. P.; Damy, T.; Eriksson, U.; Fontana, M.; Gillmore, J. D.; Gonzalez-Lopez, E.; Grogan, M.; Heymans, S.; Imazio, M.; Kindermann, I.; Kristen, A. V.; Maurer, M. S.; Merlini, G.; Pantazis, A.; Pankuweit, S.; Rigopoulos, A. G.; Linhart, A

Diagnosis and treatment of cardiac amyloidosis. A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases

none24Cardiac amyloidosis is a serious and progressive infiltrative disease that is caused by the deposition of amyloid fibrils at the cardiac level. It can be due to rare genetic variants in the hereditary forms or as a consequence of acquired conditions. Thanks to advances in imaging techniques and the possibility of achieving a non-invasive diagnosis, we now know that cardiac amyloidosis is a more frequent disease than traditionally considered. In this position paper the Working Group on Myocardial and Pericardial Disease proposes an invasive and non-invasive definition of cardiac amyloidosis, addresses clinical scenarios and situations to suspect the condition and proposes a diagnostic algorithm to aid diagnosis. Furthermore, we also review how to monitor and treat cardiac amyloidosis, in an attempt to bridge the gap between the latest advances in the field and clinical practice.noneGarcia-Pavia P.; Rapezzi C.; Adler Y.; Arad M.; Basso C.; Brucato A.; Burazor I.; Caforio A.L.P.; Damy T.; Eriksson U.; Fontana M.; Gillmore J.D.; Gonzalez-Lopez E.; Grogan M.; Heymans S.; Imazio M.; Kindermann I.; Kristen A.V.; Maurer M.S.; Merlini G.; Pantazis A.; Pankuweit S.; Rigopoulos A.G.; Linhart A.Garcia-Pavia, P.; Rapezzi, C.; Adler, Y.; Arad, M.; Basso, C.; Brucato, A.; Burazor, I.; Caforio, A. L. P.; Damy, T.; Eriksson, U.; Fontana, M.; Gillmore, J. D.; Gonzalez-Lopez, E.; Grogan, M.; Heymans, S.; Imazio, M.; Kindermann, I.; Kristen, A. V.; Maurer, M. S.; Merlini, G.; Pantazis, A.; Pankuweit, S.; Rigopoulos, A. G.; Linhart, A