Habitual coffee consumption and risk of falls in 2 European cohorts of older adults

BACKGROUND

Habitual coffee consumption has been associated with lower risk of type 2 diabetes, cardiovascular disease, and sarcopenia, which are strong risk factors of falls. In addition, caffeine intake stimulates attention and vigilance, and reduces reaction time. Therefore, a protective effect of coffee on the risk of falling can be hypothesized.

OBJECTIVES

The aim of this study was to examine the association between habitual coffee consumption and the risk of ≥1 falls, injurious falls, and falls with fracture in older people.

METHODS

Data were taken from 2964 participants aged ≥60 y from the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk in Spain) cohort and 8999 participants aged ≥60 y from the UK Biobank cohort. In the Seniors-ENRICA study, habitual coffee consumption was assessed with a validated diet history in 2008-2010, and falls were ascertained up to 2015. In the UK Biobank study, coffee was measured with 3-5 multiple-pass 24-h food records starting in 2006, and falls were assessed up to 2016.

RESULTS

A total of 793 individuals in Seniors-ENRICA and 199 in UK Biobank experienced ≥1 fall during follow-up. After multivariable adjustment for major lifestyle and dietary risk factors and compared with daily consumption of <1 cup of coffee, the pooled HR for ≥1 fall was 0.75 (95% CI: 0.52, 1.07) for total coffee consumption of 1 cup/d and 0.74 (95% CI: 0.62, 0.90) for ≥2 cups/d (P-trend = 0.001). The corresponding figures for caffeinated coffee were 0.67 (95% CI: 0.42, 1.07) and 0.70 (95% CI: 0.56, 0.87) (P-trend < 0.001). Decaffeinated coffee was not associated with risk of falling in the analyzed cohorts. In Seniors-ENRICA, there was a tendency to lower risk of injurious falls among those consuming caffeinated coffee (HR: 0.83; 95% CI: 0.68, 1.00 for 1 cup/d; HR: 0.83; 95% CI: 0.64, 1.09 for ≥2 cups/d; P-trend = 0.09). No association was observed between caffeinated or decaffeinated coffee consumption and risk of falls with fracture.

CONCLUSIONS

Habitual coffee consumption was associated with lower risk of falling in older adults in Spain and the United Kingdom.

Mediterranean diet and risk of falling in community-dwelling older adults

BACKGROUND

Although the association between nutrition and muscle and bone health has been widely studied, the role of adequate nutrition in the prevention of falls remains uncertain. Therefore, this study examined the association between a Mediterranean-style dietary pattern and the risk of falling in older adults.

METHODS

We performed a prospective cohort study with 2,071 participants aged ≥60 y from the Seniors-ENRICA study. In 2008-2010, adherence to the Mediterranean diet was assessed with the MEDAS score, and study participants were followed-up through 2012 to assess incident falls during the previous year.

RESULTS

Over a median follow-up of 3.5 years, 402 (19.4%) people reported at least one fall (69.2% of them fell once and 30.8% ≥ 2 times). After adjustment for potential confounders, participants in the highest tertile of the MEDAS score showed a lower frequency of falling compared with those in the lowest tertile (OR: 0.72; 95% confidence interval 0.53-0.98; P-trend: 0.04). Consuming ≥2 servings/day of vegetables was the individual target of the MEDAS score that showed a significant association with a lower risk of falling (OR: 0.63; 95% CI 0.44-0.89). Targets for consumption of fruit, red and process meat, butter and margarine, wine, fish and nuts also showed some tendency to a slightly lower risk of falls.

CONCLUSION

The Mediterranean diet was associated with lower risk of falling among older Spanish adults. These findings suggest that the total benefit from the Mediterranean diet is due to the accumulated or synergic impact of several foods rather than a single one.

Otosclerosis: mid-term results of cochlear implantation

INTRODUCTION

Constant histological changes in otosclerosis lead to progressive hearing loss which may end up in a profound hearing loss and then be treated by means of cochlear implants. These progressive changes could be followed by changes in cochlear implants fitting and speech discrimination results over the years.

OBJECTIVES

The aim of the study is to correlate the progressive histological changes to the cochlear implant clinical outcomes (fitting and speech discrimination results). Also main complications (facial nerve stimulation and difficulties at insertion) and new complications will be discussed.

DESIGN

A 5-year prospective case-control study was performed in order to compare cochlear implant results in otosclerosis patients to those in a matched-pair control group.

MATERIALS AND METHODS

Fifteen otosclerosis patients were followed throughout the study. Preoperatively temporal bone high-resolution computed tomography, electrically evoked auditory brainstem responses and speech discrimination tests were performed in order to select the patients to be implanted.

RESULTS

Not only difficulties with electrode guide insertion were reported, but also difficulties with fitting over the years, due to increasing difficulties to spread the electrical stimuli, which provokes increasing thresholds, maximum comfort levels and charges needed to stimulate hearing cells in basal and medial turn electrodes (p < 0.05), which required deactivating some basal and medial turn electrodes in order to improve cochlear implant effectiveness. The results demonstrated no statistical differences in speech discrimination in otosclerosis patients compared to the control group (p > 0.05). Several complications were reported: facial nerve stimulation (7.14%) and sudden episodes of tinnitus and headaches (14.28%).

CONCLUSIONS

Although progressive histological changes in otosclerosis lead to increasing thresholds, maximum comfort levels and charges needed to stimulate hearing cells, speech discrimination results support the cochlear implantation in otosclerosis.

[Unusual variant of laryngeal squamous cell carcinoma: verrucous carcinoma]

Verrucous carcinoma is an uncommon but distinctive variety of squamous cell carcinoma, accounting for 1 to 2% of all laryngeal neoplasms. It was first described as a distinct clinicopathological entity by Ackerman in 1948. It has been described most frequently in oral cavity and larynx, but other sites are possible. The preferred location of verrucous carcinoma of the larynx is supraglottic. Its general similarity with papillomas and other papillomavirus-induced lesions has raised the question of a viral etiology (human papillomavirus); HPV-16-related DNA sequences have been found in some verrucous carcinomas using a DNA hybridization technique. We report two cases of verrucous carcinoma and discuss some interesting particularities of these tumors: origin, clinical features, pathology and prognosis.