Infrequent Older Adult–Primary Care Provider Discussion and Documentation of Dietary Supplements

LETTERS TO THE EDITOR CONCLUSION A significant negative correlation was found between leu- kocyte telomere length and cancer survival in older adults, and this is novel. Telomere length may be a prognostic indicator in older adults with cancer. Larger studies are required for confirmation. Cecil Chen Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia Ciaran Upton, MBBS Department of Aged Care and Rehabilitation, Bankstown- Lidcombe Hospital, Bankstown, New South Wales, Australia Nady Braidy, PhD Department of Aged Care and Rehabilitation, Bankstown- Lidcombe Hospital, Bankstown, New South Wales, Australia Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia Jinan Khalil Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia Zhi-Ming Fang, PhD School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia Ying-Hua Xu, PhD Daniel K. Y. Chan, MD Department of Aged Care and Rehabilitation, Bankstown- Lidcombe Hospital, Bankstown, New South Wales, Australia University of New South Wales, Sydney, New South Wales, Australia JULY 2014–VOL. 62, NO. 7 JAGS REFERENCES 1. Stewart SA, Weinberg RA. Telomeres: Cancer to human aging. Annu Rev Cell Dev Biol 2006;22:531–557. 2. Butt HZ, Atturu G, London NJ et al. Telomere length dynamics in vascu- lar disease: A review. Eur J Vasc Endovasc Surg 2010;40:17–26. 3. Wilson WR, Herbert KE, Mistry Y et al. Blood leucocyte telomere DNA content predicts vascular telomere DNA content in humans with and without vascular disease. Eur Heart J 2008;29:2689–2694. 4. Cawthon RM. Telomere measurement by quantitative PCR. Nucleic Acids Res 2002;30:e47. 5. Wentzensen IM, Mirabello L, Pfeiffer RM et al. The association of telo- mere length and cancer: A meta-analysis. Cancer Epidemiol Biomarkers Prev 2011;20:1238–5120. 6. Ma H, Zhou Z, Wei S et al. Shortened telomere length is associated with increased risk of cancer: A meta-analysis. PLoS ONE 2011;6:e20466. 7. Weischer M, Nordestgaard BG, Cawthon RM et al. Short telomere length, cancer survival, and cancer risk in 47102 individuals. J Natl Cancer Inst 8. von Zglinicki T, Serra V, Lorenz M et al. Short telomeres in patients with vascular dementia: An indicator of low antioxidative capacity and a possi- ble risk factor? Lab Invest 2000;80:1739–1747. 9. Zekry D, Herrmann FR, Irminger-Finger I et al. Telomere length and ApoE polymorphism in mild cognitive impairment, degenerative and vas- cular dementia. J Neurol Sci 2010;299:108–111. INFREQUENT OLDER ADULT–PRIMARY CARE PROVIDER DISCUSSION AND DOCUMENTATION OF DIETARY SUPPLEMENTS To the Editor: Almost half of older adults take dietary sup- plements, 1 with 19.5% taking nonvitamin, nonmineral (NVNM) supplements. 2 Despite the potential for drug– supplement interactions, 3 individuals report disclosing <40% of their dietary supplements to a physician. 4 Few studies have examined physician–patient interactions to measure how often supplement-related conversations occur, nor have studies investigated the concordance between phy- sician–older adult dietary supplement discussions during office visits, patient reports of supplement use, and medical record documentation. This study compares older adults’ self-reported dietary supplement use with observed disclo- sure of supplement use in a primary care setting and physi- cian documentation of supplement use. ACKNOWLEDGMENTS METHODS The authors would like to thank the War Memorial Hospital for participation in this study. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Author Contributions: Daniel Chan conceived the idea of this investigation. Cecil Chen and Ying-Hua Xu drafted the analysis plan, were responsible for the overall analysis, and drafted the manuscript. Zhi-Ming Fang was responsi- ble for blood sample storage and DNA extraction. Nady Braidy was responsible for the molecular analysis. Jihan Khalil and Ciaran Upton were responsible for participant recruitment and collection of medical history. The coauthors reviewed the text, and all approved the final version of the manuscript. Sponsor’s Role: None. This study analyzes data collected from academically affiliated physician offices in southern California between February 2009 and February 2010 for a study on physi- cian–patient communication about prescription medica- tions. 5 Study subjects included six family physicians, seven general internists, 14 internal medicine residents, and 256 of their patients. Eligible patients were aged 50 and older; spoke English; had a new, worsening, or uncontrolled problem; and were available for a follow-up assessment. The response rate among eligible patients was 57.9%, con- sistent with other studies using similar data collection methods. 6 Physician–patient encounters were audio-recorded, transcribed verbatim, and analyzed to determine the die- tary supplements discussed during the visit. Patients were surveyed about the supplements that they were currently taking, and their medical records were abstracted for any