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Health Sciences: UCLA Newsroom

• Moderate alcohol consumption may help seniors keep disabilities at bay
  It is well known that moderate drinking can have positive health benefits — for instance, a couple of glasses of red wine a day can be good for the heart. But if you're a senior in good health, light to moderate consumption of alcohol may also help prevent the development of physical disability.   That's the conclusion of a new UCLA study, available in the online edition of the American Journal of Epidemiology, which found that light to moderate drinking among these seniors reduced their odds of developing physical problems that would prevent them from performing common tasks such as walking, dressing and grooming.   "If you start out in good health, alcohol consumption at light to moderate levels can be beneficial," said lead study author Dr. Arun Karlamangla, an associate professor of medicine in the division of geriatrics at the David Geffen School of Medicine at UCLA. "But if you don't start out healthy, alcohol will not give you a benefit."   The researchers based their study on data from three waves of the National Health and Nutrition Examination Survey's Epidemiologic Follow-up Study (1982–84, 1987 and 1992). The sample, which included 4,276 people split evenly between male and female, was about 92 percent white, with a mean age of 60.4 years.   Drinkers were classified as light to moderate if they consumed less than 15 drinks per week and less than five drinks per drinking day (less than four per day for women). Heavy drinkers were those who consumed 15 or more drinks per week or five or more per drinking day (four or more for women). Abstainers were those who drank fewer than 12 alcoholic beverages the previous year.   Having a physical disability means having trouble performing, or being unable to perform, routine tasks such as dressing and grooming, personal hygiene, arising, eating, walking, gripping, reaching, and doing daily errands and chores. Participants were asked if they experienced no difficulty, some difficulty, much difficulty or were unable to do these activities at all when alone and without the use of aids.   At the start of the survey, 32 percent of men and 51 percent of women abstained from drinking, 51 percent of men and 45 percent of women were light to moderate drinkers, and 17 percent of men and 4 percent women were heavy drinkers.   No one had any disabilities at the outset, but 7 percent died and 15 percent became disabled over five years.   The researchers found that light to moderate drinkers in good health had a lower risk for developing new disabilities, compared with both abstainers and heavy drinkers.   In unadjusted analyses, light to moderate drinkers had a 17.7 percent chance of becoming disabled or dying in five years, compared with 26.7 percent for abstainers and 21.4 percent for heavy drinkers. Among survivors, the risk for new disability was 12.5 percent for light to moderate drinkers, compared with 20 percent for abstainers and 15.6 percent for heavy drinkers.   However, after controlling for confounding variables such as age, smoking, exercise, heart attacks and strokes, the benefits of alcohol consumption were seen only in seniors who rated their health as good or better: There was a 3 to 8 percent reduction in the odds of developing disability with each additional drink per week in older men and women in good or better health who were not heavy drinkers, but there was no such benefit seen in those who rated their health as fair or poor.   "Light to moderate alcohol consumption appears to have disability prevention benefits only in men and women in relatively good health," the researchers wrote. "It is possible that those who report poor health have progressed too far on the pathway to disability to accrue benefits from alcohol consumption and that alcohol consumption may even be deleterious for them."   Other study authors were Catherine A. Sarkisian, Deborah M. Kado, Howard Dedes, Diana H. Liao, Sungjin Kim, David B. Reuben, Gail A. Greendale and Alison A. Moore, all of the David Geffen School of Medicine. Sarkisian is also affiliated with the Geriatric Research Education and Clinical Center of the Veterans Affairs Greater Los Angeles Healthcare System.   The study was supported by funding from the John A. Hartford Foundation/American Federation for Aging Research Medical Student Geriatrics Scholars Program; the National Institute on Alcohol Abuse and Alcoholism; and the Claude D. Pepper Older Americans Independence Center of the National Institute on Aging.   UCLA is California's largest university, with an enrollment of nearly 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 323 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Four alumni and five faculty have been awarded the Nobel Prize.
  
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• Vulnerability to post-traumatic stress disorder runs in families, study shows
  Earthquakes have aftershocks — not just the geological kind but the mental kind as well. Just like veterans of war, earthquake survivors can experience post-traumatic stress disorder, depression and anxiety.   In 1988, a massive earthquake in Armenia killed 17,000 people and destroyed nearly half the town of Gumri. Now, in the first multigenerational study of its kind, UCLA researchers studying survivors of that catastrophe have discovered that vulnerability to PTSD, anxiety and depression runs in families.   Armen Goenjian, a research psychiatrist in the UCLA Department of Psychiatry and Biobehavioral Sciences, and colleagues studied 200 participants from 12 multigenerational families exposed to the earthquake. Participants suffered from varying degrees of the disorders. The researchers found that 41 percent of the variation of PTSD symptoms was due to genetic factors and that 61 percent of the variation of depressive symptoms and 66 percent of anxiety symptoms were attributable to genetics. Further, they found that a large proportion of the genetic liabilities for the disorders were shared.   The research appears in the December issue of the journal Psychiatric Genetics.   "This was a study of multigenerational family members — parents and offspring, grandparents and grandchildren, siblings, and so on — and we found that the genetic makeup of some of these individuals renders them more vulnerable to develop PTSD, anxiety and depressive symptoms," said Goenjian, a member of the UCLA–Duke University National Center for Child Traumatic Stress and lead author of the study.   In addition, Goenjian noted, the study suggests that a large percentage of genes are shared between the disorders.
  
  "That tracks with clinical experience," he said. "For example, in clinical practice, the therapist will often discover that patients who come in for treatment of depression have coexisting anxiety. Our findings show that a substantial portion of the coexistence can be explained on the basis of shared genes and not just environmental factors such as upbringing."   The researchers used statistical methods to assess heritabilities. One method was used to determine the genetic component of a disorder such as PTSD. Then, a separate analysis was used to see if different phenotypes shared genes. The results showed that a significant amount of genes are shared between PTSD and depression, PTSD and anxiety, and finally depression and anxiety.   Until now, Goenjian said, the only studies that have suggested such a heritability of PTSD have been twin studies.
  
  "It's very hard to do family studies on PTSD because typically only single individuals, not whole families, are exposed to a particular trauma," he said. "In our study, we were able to avert this problem since all the subjects were exposed to the same severe trauma at the same time."
  
  In fact, he said, the 200 participants all saw destroyed buildings throughout Gumri, 90 percent witnessed dead bodies left lying in the streets and 92 percent witnessed severely injured people.   The findings are promising for the next step in understanding the underlying biology of these disorders, which is locating the specific genes involved, Goenjian said.   Other authors on the paper included Julia N. Bailey, Ida S. Karayana, Ernest P. Noble and Terry Ritchie, all of UCLA; David P. Walling from the Collaborative Neuroscience Network; and Haig A. Goenjian