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The role of aspirin for primary prevention in older adults with chronic kidney disease (CKD) is unclear. Therefore, post hoc analysis of the randomized controlled trial ASPirin in Reducing Events in the Elderly (ASPREE) was undertaken comparing 100 mg of enteric-coated aspirin daily against matching placebo. Participants were community dwelling adults aged 70 years and older in Australia, 65 years and older in the United States, all free of a history of dementia or cardiovascular disease and of any disease expected to lead to death within five years. CKD was defined as present at baseline if either eGFR under 60mL/min/1.73m 2 or urine albumin to creatinine ratio 3 mg/mmol or more. In 4758 participants with and 13004 without CKD, the rates of a composite endpoint (dementia, persistent physical disability or death), major adverse cardiovascular events and clinically significant bleeding in the CKD participants were almost double those without CKD. Aspirin's effects as estimated by hazard ratios were generally similar between CKD and non-CKD groups for dementia, persistent physical disability or death, major adverse cardiovascular events and clinically significant bleeding. Thus, in our analysis aspirin did not improve outcomes in older people while increasing the risk of bleeding, with mostly consistent effects in participants with and without CKD., (Copyright © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Relationships between age, height, weight and spirometry with FEV0.5, FEV1, FVC and FEV1/FVC are described for a sample of 6275 female and 6511 male non-smoking adults living in New South Wales. Prediction equations for ventilatory function tests are derived from non-smokers and compared with other standards that are available in a population sample of 31172 subjects. It is concluded that the standards described in this paper are more appropriate for use in Australian populations. Nomograms for predicting FEV1 and FVC in females and males are provided.

The FEV1, FVC and FEV1/FVC% in 12016 females and 18 359 males were related to cigarette-smoking habits. Over all, non-smokers had significantly better lung function than cigarette smokers. Ex-smokers of either sex had significantly higher FEV1 and FEV1/FVC% than cigarette smokers, but the FVC values were higher only in females. With consumption in excess of 10 cigarettes per day, deterioration in lung function was manifest in both sexes, but was greater in males than females. The mean chronological age of males who smoked from 30 to 50 cigarettes per day was 12.9 years and 9.6 years less than would have been predicted on the basis of their FEV1 and FVC values respectively. The corresponding values in women were 9.3 years and 7.9 years respectively. Additionally, the deterioration in lung function with increasing age was greater in cigarette smokers than in non-smokers.

Heavy drinkers were defined as those admitting to drinking six or more drinks every day or most days. This pattern of alcohol consumption which is equivalent to 80 or more grams of ethanol per day, puts them at 'high risk' of physical and/or psychosocial complications. Eleven percent of 23,673 males and 1% of 19,803 females who had a Medicheck screening were heavy drinkers. The most frequent reasons given for heavy drinking were relaxation, social contact and enjoyment of the taste. Most heavy drinkers felt that they drank more than was good for them but did not consider themselves to be 'sick' people in need of treatment. Heavy drinkers had a higher prevalence of psychosocial problems than moderate or light drinkers.

Data on the drinking and drug taking patterns of 8,516 adults who had been through a Medicheck screening were analysed. This is the largest sample studied in Australia to date. The alcohol intake pattern of at least 29% of males and 9% of females puts them "at risk" of physical and/or psychosocial complications; 11% of males and 2% of females were considered to be at high risk. Very few heavy drinkers considered themselves to have a drinking problem and even fewer had been told by their doctor that they were problem drinkers. One-quarter of all the women took either psychotropic drugs or analgesics regularly; 19% of females, compared with 7% of males, took one or more of the psychotropic drugs (mainly tranquillizers) regularly, and 9% of females compared with 3% of males took analgesics regularly. Approximately one-third of both males and females were current smokers, but more males than females had given up smoking. The important role to be played by general practioners in the prevention and early treatment of drug dependence is highlighted by these findings.

Australian household surveys have indicated the prevalence of emotional or psychological disturbance as about 25 per cent of the population. Among those attending general practitioners' surgeries, the prevalence is even higher - 33 to 40 per cent. Morevoer, such psychosocial problems have an important effect on people's mental and physical health.