Who Moved My Dentures? Essential Information for Boomers on Healthcare, Aging and Caregiving

Genetic Testing Costs Coming Down but Do You Want to Know?

2013-11-27T09:00:00.000-05:00

As you sit around the Thanksgiving table, an interesting conversation you might entertain is whether you would like your genes analyzed for $99 to see if there is some hereditary disposition you might have for disease thanks to those relatives you're sitting with around the table.

23andMe, Inc. is a privately-held company dedicated to helping individuals understand their own genetic information using recent advances in DNA analysis technologies and web-based interactive tools. 23andMe enables individuals to gain deeper insights into personal ancestry, genealogy and inherited traits. 23andMe was founded in April 2006 by Linda Avey, Paul Cusenza, and Anne Wojcicki.

The name 23andMe refers to the fact that human DNA is organized into 23 pairs of chromosomes. 23andMe connects individuals to their unique, paired set of 23 chromosomes.

23andMe has more than 400,000 genotyped customers.
To date, the company has collected more than 200 million phenotypic data points (individual survey responses).
On an average week the company collects approximately two million new survey responses from our active online research community.

I came across them in an article in Fast Company that poses some interesting ethical dilemmas.

The author, after some convincing, had her adopted daughter's genes tested. Here is what she found out.

"And there it is, screaming out at me from my computer screen. My daughter, who is learning to read and tie her shoes, has two copies of the APOE-4 variant, the strongest genetic risk factor for Alzheimer's. According to her 23andMe results, she has a 55% chance of contracting the disease between the ages of 65 and 79."

Here's more snippets from the article.

"In 2008, Congress passed the Genetic Information Nondiscrimination Act (GINA), which makes it illegal for health insurers and employers to hold a person's genetic information against her. (YET) The confines of GINA don't yet extend to long-term-care insurance. Several states have banned the discriminatory use of genetic information in all areas, but there is not yet any sweeping federal protection."

The article suggests that "a long-term-care insurance company might in the future ask a potential customer if she had genetic testing, and if the results linked her to a higher risk for Alzheimer's disease."

According to the article, upon learning of their APOE-4 status, people are six times more likely to alter their long-term-care insurance.
Don Taylor, an associate professor of public policy at Duke who has published research on the implications of genetic testing and insurance in Health Affairs, predicts that our current long-term-care insurance system is about to break. "They're losing their shirts," he says, pointing to the fact that Genworth temporarily stopped selling new policies completely in its biggest market, California. "Whatever we have now is not going to come close to existing when your daughter is old enough to buy it." But nobody yet knows what might replace it.

So there you have it. All kind of issues from privacy to would you want to know to the implications for buying insurance or even having insurance.

Read the article then tell me what you think.

Only Two Percent of Boomers Have Dental Insurance Benefits

2013-11-25T09:00:00.000-05:00

There have increasingly been studies showing the relationship between dental health and overall health. For example, associations between periodontitis and diabetes have emerged in recent years, as well as oral conditions such as xerostomia associated with the use of prescription drugs.

Oral Health America has issued a report entitled State of Decay: Are Older Americans Coming of Age Without Oral Healthcare? It shows that only 2 percent of baby boomers turning age 65 will have access to dental insurance benefits.

There is persistent lack of oral health coverage across much of the nation. Forty-two percent of states (21 states) provide either no dental benefit or emergency coverage only through adult Medicaid Dental Benefits. Thirty-one states (62 percent) have high rates of Dental Health Provider Shortage Areas (HPSAs), meeting only 40 percent or less of dental provider needs.

This is shocking but thirteen states (26 percent) have 60 percent or more residents living in communities without water fluoridation (CWF). Hawaii (89.2 percent) and New Jersey (86.5 percent) represent the highest rates of citizens unprotected by fluoridation.

The current workforce is aging, and many dental professionals will retire within the next decade. A lack of geriatric specialty programs complicates this problem, and few practitioners are choosing geriatrics as their field of choice. Emergency room visits that were dental related among adults over 65 rose from 1 million from 1999-2000 to 2.3 million during 2009–2010.

· Access to dental care is one of the greatest challenges facing older adults and their
caregivers.

· Access to dental coverage for older adults is limited. It was not addressed in the
Affordable Care Act.

· Dental insurance coverage is a primary indicator of whether or not an individual visits
the dentist.

· Close to 70 percent of older Americans do not have dental insurance.

In addition to increasing access to care, providers, payers, dental program administrators now must demonstrate improved quality of care, improved health outcomes, and lowered costs.

The report offers these solutions:

1. Create Payment Options for Older Adult Dental Care

2. Mitigate Dental Provider Shortages by Improving the Primary Healthcare Workforce

3. Expand Water Fluoridation to all Communities at CDC-recommended levels

4. Include Robust Strategies to Improve Older Adult Oral Healthcare in State Plans

5. Educate Older Adults, Care Advisors and Caring Institutions to Improve the Mouth
Health of Older Adults

Oral Health America has created a web portal, www.toothwisdom.org, a user-friendly online tool that connects older adults and their caregivers with local resources. This website offers reliable oral care information from oral health experts across the country, so readers can learn why it’s so important to care for their mouths as they age.

This is one of those other elephants in the room of Obamacare. Long-term care financing of course is the other. We are learning more and more about the health impact of poor oral health so pay attention to this. Plan for care and more importantly make that appointment even if you have to pay out of pocket. Your health is at-risk.

Retire at 73. Another Reason Young People Need to Pay Attention to Aging Issues

2013-11-22T09:00:00.000-05:00

This Millenial is the exception.

At a recent publicity summit that I attended, I pitched the media on a story angle centering on the need for younger people, even Millenials, to start preparing for aging sooner in life. Turns out I was not far from the mark. Just a week later came a survey from Millennial Branding and PayScale that finds that 28 percent of those born after 1982 have had to move home. That is three times higher than for Generation X (born between 1965-1981) and six times higher than Baby Boomers (1946-1964).

Dan Schawbel, the founder of Millennial Branding told AOL Jobs in an interview: "Millennials are delaying adulthood and this is how it's going to be from now on. All the data suggests a permanently different economy. This is the first American generation that won't have the same quality of life as the previous generation."

The Opportunity Nation, as reported in the Associated Press, reported that almost 6 million young people, almost 15 percent of those aged 16 to 24, are neither in school nor working and 54 percent of college graduates under 25 are unemployed or doing a job that doesn't require a college degree.

NerdWallet conducted a study that examined the financial profile of a typical college graduate and found that while retirement is certainly not impossible, for most it will have to wait until their early to mid 70s. According to NerdWallet: “Given an average life expectancy of 84, this will leave only 10-12 years for people to spend in retirement. The main reason for this is that although the median college graduate leaves with a seemingly manageable $23,300 debt load, 7% of a student’s earnings go toward yearly loan payments of $2,858 for the first ten years of his or her career. This prevents any meaningful contributions toward retirement. In fact, by the age of 33, when the typical college grad has finally paid off their standard 10-year loans, he or she can only be expected to have saved $2,466 for retirement—over $30,000 less than if the student had graduated with no debt.”

The lost savings directly attributable to student debt is $115,096, nearly 28% of total retirement savings.

Kudos to NerdWallet for echoing what I have been preaching and I quote – “being conscious of this problem and tailoring financial and career planning accordingly can go a long way toward achieving retirement objectives. There are many factors that influence the ultimate age at which people are able to retire, but there are a few variables that have a particularly large impact. Making above-average yearly contributions to a retirement account, working for an organization with a decent 401(k) match, and making sure to invest money in index tracking mutual funds are three ways to help add years to retirement.”

So yes, everyone needs to be thinking about aging issues sooner in life. This one is of course about financial health. In an earlier blog, we explored physical health citing a study that showed that nine risk factors, most of which can be traced to adolescence, account for most cases of young-onset dementia (YOD) diagnosed before the age of 65 years.

And if you want to get into the third leg of my educated aging stool – emotional aging – take a look at my caring.com blog in which we uncovered some new age biases. Princeton University professors uncovered prescriptive prejudice, which are beliefs about how older adults should act. They found three key ideas:

Succession, the idea that older adults should move aside from high-paying jobs and prominent social roles to make way for younger people
Identity, the idea that older people should not attempt to act younger than they are
Consumption, the idea that seniors should not consume so many scarce resources, such as healthcare

I am thinking some of these come from Millenials and Gen X’ers who maybe need to spend a little more time around boomers and seniors to see just what we have to bring to society.

Breast Cancer Radiation May Increase Risk of Heart Disease

2013-11-20T08:00:00.000-05:00

(JAMA)

Among patients with early stages of breast cancer, those whose hearts were more directly irradiated with radiation treatments on the left side in a facing-up position had higher risk of heart disease, according to research letter by David J. Brenner, Ph.D, D.Sc, of Columbia University Medical Center, New York, and colleagues.

Several reports have suggested links between breast cancer radiation and long-term cardiovascular-related deaths, according to the study background.

Researchers examined the radiation treatment plans of 48 patients with stage 0 through IIA breast cancer who were treated after 2005 at the New York University Department of Radiation Oncology. They calculated the association between radiation treatment factors, such as mean cardiac dose, cardiac risk, treatment side, body positioning and coronary events.

According to study results, the highest coronary risks were seen for left-sided treatment in women of high baseline risk treated in the supine (lying down, head facing up) position. The lowest risks were for right-sided treatment in low-baseline risk women. In left-sided radiation, prone (lying down, facing down) position reduces cardiac doses and risks, while body positioning has little effect in right-sided therapy (where the heart is always out of field).

In the brief, researchers did not seem to indicate a high amount of alarm.

“Because the effects of radiation exposure on cardiac disease seem to be multiplicative, the highest absolute radiation risks correspond to the highest baseline cardiac risk,” the authors conclude. “Consequently, radiotherapy-induced risks of major coronary events are likely to be reduced in these patients by targeting baseline cardiac risk factors (cholesterol, smoking, hypertension), by lifestyle modification, and/or by pharmacological treatment.”

In other words keep doing what you are doing in terms of reducing your heart disease risk. Do talk to your doctor. And God forbid you have breast cancer, bring this article up to your oncologist, surgeon and radiation oncologist.

BP Drugs May Cut Alzheimer's Dementia by 50%

2013-11-18T09:00:00.000-05:00

(From McKnights)

Seniors who take certain blood pressure medications might be at a dramatically reduced risk for developing dementia associated with Alzheimer's disease, according to findings published in the journal Neurology.

A team led by a researcher from the Johns Hopkins University School of Medicine analyzed results of the Gingko Evaluation of Memory Study. This was intended to see whether the herb gingko biloba reduces the risk of Alzheimer's. The herb does not, according to the study, but the researchers took another approach, looking at the blood pressure drugs that some of the 3,000 participants were taking.

People older than 75 who had normal cognition and took diuretics, angiotensin-1 receptor blockers (ARBs) and ACE inhibitors demonstrated a 50% reduced risk of Alzheimer's dementia, the researchers found. Among those with mild cognitive impairment, diuretic use was associated with a 50% reduced risk.

Beta blockers and calcium channel blockers did not have this effect, according to the researchers. Check with your doctor.

Are You Getting a Good Night's Sleep? Less Sleep, Poor Quality Sleep May Have Alzheimer's Link

2013-11-15T09:00:00.000-05:00

(From JAMA)

Getting less sleep and poor sleep quality are associated with abnormal brain imaging findings suggesting Alzheimer disease (AD) in older adults, according to a report published by JAMA Neurology, a JAMA Network publication.

Deposits of β-Amyloid (Αβ) plaques are one of the hallmarks of AD. Fluctuations in Αβ levels may be regulated by sleep-wake patterns, the authors write in the study background.

Adam P. Spira, Ph.D., of The Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues used data from 70 adults (average age 76 years) in the Baltimore Longitudinal Study of Aging to examine whether self-reported sleep factors were associated with Αβ deposition, which was measured by imaging of the brain.

Study participants reported sleep that ranged from more than seven hours to no more than 5 hours. Reports of shorter sleep duration and lower sleep quality were both associated with greater Αβ buildup.

The authors acknowledge their study design does not allow them to determine whether sleep disturbance precedes Αβ deposition, so they are unable to say that poor sleep causes AD.

“In summary, our findings in a sample of community-dwelling older adults indicate that reports of shorter sleep duration and poorer sleep quality are associated with a greater Αβ burden. As evidence of this association accumulates, intervention trials will be needed to determine whether optimizing sleep can prevent or slow AD progression,” the study concludes.

Are You Being Over-Diagnosed?

2013-11-13T09:00:00.000-05:00

(From JAMA)

Cancer screenings can find treatable disease at an earlier stage but they can also detect cancers that will never progress to cause symptoms. Detection of these early, slow-growing cancers can lead to unnecessary surgery, chemotherapy and radiation. This begs the question: Are You Being Over-Diagnosed?

A survey finds that most patients are not being told about the possibility of over-diagnosis and over-treatment as a result of cancer screenings, according to report in a research letter by Odette Wegwarth, Ph.D., and Gerd Gigerenzer, Ph.D., of the Max Planck Institute for Human Development, Berlin, Germany.

Researchers conducted an online survey of 317 U.S. men and women ages 50 to 69 years to find out how many patients had been informed of over-diagnosis and over-treatment by their physicians and how much over-diagnosis they would tolerate when deciding whether to start or continue screening.

Of the group, 9.5 percent of the study participants (n=30) reported their physicians had told them about the possibility of over-diagnosis and over-treatment. About half (51 percent) of the participants reported that they were unprepared to start a new screening. However, nearly 59 percent reported they would continue the cancer screening they receive regularly even if they learned that the test results in 10 over-treated people per one life saved from cancer death.

“The results of the present study indicate that physicians’ counseling on screening does not meet patients’ standards,” the study concludes.

DO THIS: Ask your physician about over-treatment and over-diagnosis. Believe me the fact that you're even asking that question will surprise him/her and beg for an answer.

NOT THAT: Don't keep your mouth shut. You must continually inquire about your care. There are no dumb questions.

American Postponing Retirement, Have Saved Little and Are Experiencing Workplace Age Bias

2013-11-11T09:00:00.000-05:00

Wow. All good news! Yikes.

The Associated Press - NORC Center for Public Affairs Research released the results of a new survey exploring the views of older Americans about their plans for work and retirement.

“The survey illuminates an important shift in Americans’ attitudes toward work, aging, and retirement,” said Trevor Tompson, director of the AP-NORC Center in a release. “Retirement is not only coming later in life, it no longer represents a complete exit from the workforce. The data in this survey reveal strikingly different views of retirement among older workers today than those held by the prior generation.”

With funding provided by the Alfred P. Sloan Foundation, the Associated Press-NORC Center for Public Affairs Research conducted a national survey of 1,024 adults ages 50 and over.

Key findings of the survey include:

• The Great Recession has had a marked impact on retirement planning. The average age of those who report retiring before the recession was 57 while the average for those who retired afterward is 62.

• The line between working and retirement is shifting, with 82 percent of Americans age 50 and older who are working but not yet retired saying it is likely or very likely that they will do some work for pay during their retirement.

• Of those who are currently working, 47 percent now plan to retire at a later age than they expected when they were 40. Financial need, health and the need for benefits were cited as the most important factors in the retirement decision.

• Older workers have a clear view about solutions to ensuring the long term health of Social Security. Sixty-one percent of them favor raising the cap on income subject

to Social Security taxes and 41 percent favor reducing Social Security benefits for those with higher incomes. In contrast, 29 percent favor gradually raising the minimum Social Security age and 21 percent favor changing the way benefits are calculated so that cost of living increases are smaller.

• Thirty-nine percent of workers age 50 and older report having $100,000 or less saved for retirement, not including pensions or homes; and 24 percent have less than $10,000.

• Among those who are retired, one third report that they did not have a choice in the matter. That figure increases to 54 percent for retirees under age 65.

• Fully 20 percent of working Americans age 50 and older report that they have personally experienced prejudice or discrimination because of their age in the job market or at work since turning 50. Forty four percent of those who experienced discrimination have looked for a job in the past five years compared with 16 percent who did not report discrimination.

• The nature of a person’s work shapes their view of whether age is an asset or a liability. For example, 28 percent of people who work or worked in professional services see age as an asset while only 3 percent in manufacturing hold that view.

• About half of workers age 50 and older say their boss is younger than them. Those with bosses older than them are less likely to report they have cut back on their hours than people with younger bosses (9 percent vs. 23 percent). Those with older bosses are more likely to consider age an asset to their career.

There are two disturbing things here. First, the amount of money people have saved is abysmal. I can understand why. So while it may be too late for these people to get financially where they need to be it should be a lesson to younger people - yes you Millenials - that if you ever plan to retire you have to start saving NOW. Do the math on $100,000 over 25 years. It doesn't add up.

The second thing is how age bias is really emerging as a societal issue. Read my caring.com article for more on that.

Half Not Taking Meds Properly Resulting in Quarter Million Deaths and Half a Trillion in Expenses

2013-11-08T09:00:00.000-05:00

The National Council on Patient Information and Education released a sobering report “Accelerating Progress in Prescription Medicine Adherence: The Adherence Action Agenda that shows that half of the estimated 187 million Americans who take one or more prescription medicines—or up to 93.5 million patients—do not take these drugs as prescribed.

Studies show that 20% to 30% of prescriptions are never filled by patients, while 50%–60% of medications to treat chronic disease are not taken as prescribed.

This results in approximately 125,000 preventable deaths a year and many as 40% of nursing home admissions in people with type 2 diabetes. Research estimates that $105 billion is wasted annually on medication therapy non-adherence of which 69%—or $72.5 billion—is spent on hospitalizations. Other findings suggest that it costs an estimated $290 billion per year in avoidable medical spending and lost work productivity, translating into 13 percent of total health care expenditures.

Today, 27% of Americans are living with multiple chronic conditions (MCC) and 68% of Medicare beneficiaries are being treated for at least two concurrent chronic illnesses—or 21.4 million individuals. It is now estimated that 76% of Americans aged 60 and over use two or more prescription drugs and 37% take five or more. MCC accounts for 66% of the nation’s health expenditures and is a major source of Medicare spending. Of the $300 billion Medicare spent in 2010 on health care, the price tag for treating the 14% of beneficiaries with six or more MCC was over $140 billion. Almost two-thirds (60%) of these patients required hospitalization, accounting for 55% of Medicare’s total spending on hospitalizations.

Based on these findings, NCPIE’s new Adherence Action Agenda advocates for:

1. Establish medicine adherence as a priority goal of all federal and state efforts designed to reduce the burden of multiple chronic conditions.

2. Establish the role of the patient navigator within the care team to help patients with multiple chronic conditions navigate the health care system and take their prescription medicines as prescribed.

3. Promote clinical management approaches that are tailored to the specific needs and circumstances of individuals with multiple chronic conditions.

4. Incentivize the entire health care system to incorporate adherence education and medication support as part of routine care for MCC patients.

5. Eliminate the barriers that impede the ability of patients with multiple chronic conditions to refill their prescription medicines.

6. Reduce the cost-sharing barriers for patients by lowering or eliminating patient copayments for prescription medicines used to treat the most common chronic diseases.

7. Accelerate the adoption of new health information technologies that promote medication adherence.

8. Establish medication adherence as a measure for the accreditation of healthcare professional educational programs.

9. Address multiple chronic conditions and optimal medication management approaches in treatment guidelines.

10. Stimulate rigorous research on treating people with multiple chronic conditions.

DO THIS: Stay healthy and avoid medications. If needed take them as prescribed. And always consult with your physician.

NOT THAT: Don’t refill prescriptions without talking to your physician first. Don’t take more than the prescribed dose. Don’t take expired medications.

Pill for Alzheimer's May Slow/Stop Disease

2013-11-06T09:00:00.000-05:00

It worked in the lab.

A British study shows that a pill for Alzheimer's could treat the disease by halting the death of neurons. However it could be a decade or more before any medicine is developed.

The Medical Research Council (MRC) team focused on abnormally shaped proteins that stick together in clumps and fibers and can trigger a reaction that results in the death of nerve cells.

Using a drug injected into the stomachs of mice, they flipped a cellular switch from off to on to prevent neurons dying. Five weeks after treatment, one group of mice remained free of symptoms such as memory loss, impaired reflexes or limb dragging.

The mice suffered serious side effects, including weight loss and raised blood sugar, and the scientists say human trials are a long way off.

But they also believe the research demonstrates in principle the possibility of developing a pill that can protect the brain from neuro-degenerative disease.

The experimental drug, known as GSK2606414, is made by pharmaceutical company GlaxoSmithKline. It targets an enzyme called PERK which plays a key role in the response of neurons to the build-up of misfolded proteins in the brain.

If nothing else, I guess there is the security in knowing that many researchers are working on a cure for Alzheimer's and the hope would be it could happen in our lifetimes.

Source: The Guardian

More Evidence that a Flu Shot is Good for You

2013-11-04T09:00:00.000-05:00

An increased dose of influenza vaccine stimulates a greater immune response than the standard dose in long-term care residents older than 65 years, according to a new study from Richard Zimmerman, MD, from the University of Pittsburgh in Pennsylvania.

According to MedScape, Fluzone, a high-dose influenza vaccine, was approved by the US Food and Drug Administration in 2009 for use in adults older than 65 years. The vaccine delivers 4 times the standard dose of antigen.

Dr. Zimmerman and his team vaccinated 205 residents in various long-term care facilities, including skilled nursing, assisted living, dementia care, and independent living facilities during the 2011-12 and 2012-13 flu seasons. Of the 169 participants who completed the study, 87 received the regular dose and 82 received the high dose. The mean age of those who completed the study was 87. A month later, the concentration of antibodies increased in all the subjects, but increased more in those who received the high-dose vaccination.

In a related JAMA study, receiving an influenza vaccination was associated with a lower risk of major adverse cardiovascular events such as heart failure or hospitalization for heart attack, with the greatest treatment effect seen among patients with heart attack or unstable angina.

So studies seem to suggest that the flu vaccine is more good than bad. So if you have been delaying, check with your doctor and consider having the shot this year. I did for the first time after a really bad flu during the Christmas holidays last year.

DO THIS: Check with your doctor and get the shot if right for you.

NOT THAT: Don't read this post and ignore it. It could potentially prevent health issues for you or a loved one later.

Our Friday Song of the Week - Bad Case of Loving You

2013-11-01T10:00:00.001-04:00

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Surgical Complications From Falling

2013-11-01T09:00:00.000-04:00

(From JAMA)

Surgical complications from falling increase if you have fallen six months prior to surgery, no doubt a result of a weakened physical state.

According to a JAMA article, a history of one or more falls in the six months before a surgery appears to be an indicator of complications, the need to be discharged to a care facility and 30-day readmission after a surgery, according to a study by Teresa S. Jones, M.D., of the University of Colorado School of Medicine, Aurora, and colleagues.

More than one-third of all U.S. inpatient operations are performed on patients 65 years and older, a proportion which will increase during the next several decades. Existing preoperative risk assessment strategies do not quantify the risk that comes from being frail, according to the study background.

Researchers sought to evaluate the relationship between older patients with a history of falls (a measure of frailty) in the preceding six months of a major elective operation and postoperative outcomes. The study included 235 patients (average age 74 years) undergoing elective colorectal and cardiac operations. Thirty-three percent of patients had preoperative falls.

Postoperative complications occurred more frequently in the group with prior falls compared to those patients who had not fallen following both colorectal (59 percent vs. 25 percent) and cardiac (39 percent vs. 15 percent) operations, according to the study findings. The need to be discharged to a care facility also occurred more frequently in the group that had fallen and 30-day readmission was higher.

“Given the high volume of surgical care provided for the elderly population, improving preoperative risk assessment for the older adult is becoming increasingly important. Incorporating geriatric-specific variables that reflect physiologic vulnerability of the older adult into large surgical outcomes data sets used to construct preoperative risk calculators has real potential to improve the accuracy of these tools at forecasting risk in older adults ” the study concludes.

Do This: Talk to your physician / surgeon and specifically report any falls and consider postponing surgery if possible until your health improves.

Not That: Do not selectively forget to mention this to your physician. Don't put yourself at risk by having a surgery whose risks could be complicated by a recent fall.

Your Cholesterol Drug May Prevent Dementia

2013-10-30T09:00:00.000-04:00

The U.S. Food and Drug Administration recently ordered that statin labels include a warning about memory problems associated with short-term use. A research team from Johns Hopkins Medicine found no evidence of this, based on their analysis of prior studies. In addition, they found that statin use for longer than one year reduced the risk of dementia by 29%. In short, your cholesterol drug may prevent dementia.

In patients without baseline cognitive dysfunction, the results of the available studies are most compatible with no significant short-term cognitive detriments related to statin therapy, whereas long-term data suggest a beneficial role in the prevention of dementia.

Researchers noted that at present, patients and physicians can be reassured about concerns related to neurocognitive effects of statin therapy, and the evidence does not support a change to practice guidelines.
“We looked at high-quality, randomized controlled trials and prospective studies that included more than 23,000 men and women with no prior history of cognitive problems,” stated Raoul Manalac, M.D., a co-primary author. “The participants in those studies were followed for up to 25 years.”

The short-term memory issues related to statins could be caused by drug interactions, since many people on statins also take other medications, the researchers surmised. The benefits of statins make sense, they wrote, because these drugs reduce or stabilize plaque in blood vessels, which is associated with dementia.

So if you are on a cholesterol medicine and getting routine blood work and you are fine, be comforted by the fact that these medications may have other benefits.

You Are Indeed Wiser When You Are Older

2013-10-28T09:00:00.000-04:00

Older and Wiser

(From ALFA)

A new study has found that although the ability to learn naturally decreases with age, experience accumulated over a lifetime allows most older adults to make better decisions than their younger counterparts. This shows in part that you are indeed wiser when you are older.

Researchers from the University of California, Riverside say the study is the first to measure decision making and intelligence over the lifespan through what they call fluid and crystallized intelligence. The authors describe fluid intelligence as the ability to learn and process information, while crystallized intelligence is a term that refers to experience and accumulated knowledge.

Previous research has found that fluid intelligence decreases with age, but no prior research had been undertaken to discover if this had any effect on decision-making ability.

Test results indicated that the older cohort scored as well or better than the younger participants in four economic decision-making measures. “The findings confirm our hypothesis that experience and acquired knowledge from a lifetime of decision making help offset the declining ability to learn and process new information,” said Ye Li, assistant professor at UC Riverside and lead author of the study.

With the average American holding off on retirement later than previous generations, these results show that most older adults will be well-equipped to handle important choices related to their finances and health care. However, the older participants in this study were found to have lower fluid intelligence, prompting the researchers to note that older adults can still benefit from aids such as a financial advisor when making important financial decisions.

Read the full report: Complementary Cognitive Capabilities, Economic Decision-Making, and Aging

Our Friday Song of the Week - Train - 50 Ways to Say Goodbye

2013-10-25T10:00:00.004-04:00

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Americans Confused About How Long Term Care is Paid For

2013-10-25T09:00:00.000-04:00

(From Health Day News / Harris Interactive)

A new Harris Interactive/Health Day poll finds that more than two-thirds of Americans are anxious and uncertain about how they'll meet nursing home or home care costs should they need them.

Most people were also wrong about how most of these costs are covered under the current

system.

About half (49 percent) mistakenly thought the bulk of the bill was paid by individuals, while one third guessed Medicare.
Only 19 percent understood that the major funder of long term care is actually Medicaid, the government agency that covers health services for the poor.

One thing most people agreed on: as America ages, the problem of how to pay for seniors' long-term care will only get worse. Eighty-seven percent called the situation "serious" or "somewhat serious."

They're right to be worried, said Howard Gleckman, a fellow at the Urban Institute in

Washington, D.C., who focuses on long-term care issues. "This is a huge and growing problem," he said. There are currently about 12 million Americans

in some form of long-term care, he noted, and that's expected to double within the next 20 years. It's estimated that most Americans, more than two-thirds of those aged 65 and up

will need some type of long -term care, such as a nursing home, home health aide or adult "day care" center.

In the new poll, a similar percentage--68 percent--expressed worry about how to pay for it all. The problem of how to pay for rising costs of senior care was not addressed by the Affordable Care Act, or what some call "Obamacare." And Gleckman said that policymakers have shown no agreement on where to go from here.

As for the general public, past research proves that few of us even know how long-term care is currently financed, Gleckman noted. And the new poll confirms that.

For example, "very few people understand Medicaid's role in long-term care," Gleckman said. The problem for families is that Medicaid coverage only kicks in once people have spent down their assets enough to qualify for assistance.

The other option is for people to plan in advance and buy pricey private insurance that

specifically covers long-term care. The poll found that 64 percent of Americans think "most

people" should buy long-term care insurance.

But thinking that something sounds good, and actually doing it for yourself are two distinct

things, Gleckman pointed out. Based on current statistics, less than 8 percent of U.S. adults have bought long-term care insurance, he noted.

In the new poll, 79 percent said they supported the notion of tax breaks that would help people purchase long-term care insurance, with similar numbers of Republican and Democrat respondents in favor of such a move. Whether any tax perk would actually encourage more Americans to invest in private insurance is the big question, Gleckman said.

With the age of the average voter steadily rising, "how we will pay for long-

term care in the future is likely to become a huge political issue," added Harris Poll chairman Humphrey Taylor.

"The cost is already well over $200 billion and is almost certain to grow rapidly as many more baby boomers grow older." Just last week, the federal Long-Term Care Commission--

an expert panel established by Congress -- issued recommendations on how to improve the delivery of long-term care.

"Where they couldn't reach any consensus at all," Gleckman said, "was how to finance it."

But in the new poll, he noted, the public showed a surprising amount of agreement on some

financing options. Over two-thirds were in favor of a "new government program" to help out.

Even among Republicans, half liked the idea--which was particularly striking, Gleckman said.

Another expert in long-term care said the poll shows that Americans are becoming more awareof the issue. "Most Americans now will live for some years with an inability to take care of themselves due to the illnesses associated with advanced old age," said Dr. Joanne Lynn, director of the Center for Elder Care and Advanced Illness at the non-profit Altarum Institute.

"This will be the most expensive part of most of our lives," Lynn said, "yet insurance does not cover it -- at least not until the person has spent down to poverty, when Medicaid will pitch in."

She added that "very few" Americans can save enough money to pay for long-term care in their final years. "It's good that most Americans are beginning to recognize the need for some public support," she said. According to Gleckman, the financing solution does not have to be strictly "private" or "public," but could involve some mix.

My two cents - I have been preaching about this for years. The elephant in the Obama-care room is this issue. Everyone is concerned with what I call hospital insurance. The bigger issue. is long-term care. And while it may be too late for my boomer colleagues, younger people need to start paying attention to this issue.

Blinded by the Light - Diagnosed with Melanoma, They > Their Exposure

2013-10-23T09:00:00.000-04:00

Too much exposure people.

(From JAMA)

Patients with cutaneous malignant melanoma (CMM) (skin cancer) did not remain cautious about sun exposure in the three years after their diagnoses, according to a study by Luise Winkel Idorn, M.D., Ph.D., of Bispebjerg Hospital and the University of Copenhagen, Denmark, and colleagues.

Exposure to ultraviolet radiation (UVR) from the sun is the primary environmental risk factor for the development of CMM.

The investigators studied 40 participants, including 20 patients with the disease and 20 in a control group.

They measured their exposure to UVR using personal electronic UVR dosimeters and sun exposure diary information.

Study findings indicate that patients’ daily UVR dose increased 25 percent from the first to the second summer after diagnosis and 33 percent from the first to the third summer after diagnosis. UVR exposure also increased on holidays and days spent abroad, according to the study.

“In conclusion, data from the present study indicate that from the first until the third summer after diagnosis of CMM, patients increase their daily UVR dose in connection with an increase on days with body exposure, holidays and days abroad, whereas controls maintain a stable UVR exposure dose,” the study concludes.

Do we really need to say more?!

Neurotic - A Nursing Home May Be in Your Future

2013-10-21T09:00:00.000-04:00

Researchers from various institutions, including the University of Rochester Medical Center Department of Public Health Sciences and the University of Chicago collected data from 1,074 community-dwelling seniors participating in a Medicare demonstration to see if there was a correlation between personality types and the likelihood of certain healthcare outcomes.

They completed a self-report questionnaire measuring the "Big Five" personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services.

Their hypothesis was that higher Neuroticism would be associated with greater health care use. That was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users.

Higher Openness to Experience was associated with a greater likelihood of home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use.

Researchers concluded that personality traits are associated with Medicare beneficiaries' use of many expensive health care services, findings that have implications for health services research and policy. Accordingly, profound advances in personality psychology should be considered as useful interventions.

I for one am for "higher openess to experience."

Our Friday Song of the Week - Come Together

2013-10-18T18:42:00.004-04:00

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Time Passages

2013-10-18T09:00:00.000-04:00

The following is a guest post from Dorothy Robinson.

Doro as she prefers to be called is from Canada, and has written many articles about life’s moments. Now well along into her senior years, she savors the richness of life in each day, and often sees a good story in what may just seem ordinary. Her attitude is summed up in the French expression “La joie de vivre”, the joy of life.

Where have all the years gone we hear so many seniors reflectively ask. Except for a few that were particularly challenging or for some reason special, they tend to blend together. Time has moved forward and carried us along with it; and all too suddenly we find we are living the golden years. As one senior said “If I’d have known I was going to live this long, I would have looked after myself better!”

Arriving at the senior years is interesting and challenging to say the least. The famous comedienne and interviewer Art Linkletter once coined a phrase which epitomizes the aging process. He said, Getting old isn’t for sissies. Although humorous this statement says volumes about attitude and how you cope with the changes that inevitably come. Keeping oneself in the game of life takes tenacity, courage, and being open to change. Topping this list is staying young at heart or as the French say it best la joie de vivre! The joy of life. Attitude and an appreciative heart can make such a difference.

A few years ago my mother in law Belle explained to me how she felt to be 94 years of age. She had just relented and finally agreed to a homemaker coming in to help her out in her apartment. She was still making her own bread and cookies, kept her nails manicured, and enjoyed a drink of Rye and seven up at 4 o’clock in the afternoon. She explained to me there was still a young 18 year old inside; in fact there were all the stages of life tucked away, she had lived them all. When I took her shopping for a new dress, she emphatically made it clear, “Now dear remember, I don’t want to be looking at old ladies dresses!” Now that’s what I call young at heart. Being content in her circumstances was very evident too.

In keeping with that theme, this is not about cold statistical facts on seniors. It’s not about why people are supposedly living longer, or what medication works best for certain ailments. What it is though are some heartfelt reflections from different people who are there, how they feel about what’s important and what isn’t. It’s mostly about expressing appreciation for the things in their lives things they’re grateful for.

Here are a few of the quotes:

It makes me feel good when my kids respect me and that I have some wisdom to share with them.
I don’t live by the clock so much anymore; but I try to make the days count.
My coffee break with my wife now goes from 9am to 11.
I appreciate my friends who put up with me, so I try not to be critical of others.
I have been with both smart people and kind ones, but I prefer being around kind people. If some don’t like me it’s none of my business.
It’s a good thing the future comes to us just one day at a time, that’s about all we can handle.
I come from a time when your handshake was your word. I still feel that way.

Yes, being a senior is certainly a very interesting time of life. With Appreciation and gratitude, we can make our days into more pleasant ones, not only for ourselves but others too.

CDC’s State of Aging and Health in America 2013 Offer a Comprehensive and Holistic Look at Trends and Needs (VIDEO)

2013-10-17T09:00:00.004-04:00

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CDC’s State of Aging and Health in America 2013 Offer a Comprehensive and Holistic Look at Trends and Needs

2013-10-16T09:00:00.000-04:00

The CDC released The State of Aging and Health in America 2013 that provides a snapshot of our nation's trends and progress in promoting prevention, improving the health and well-being of older adults, and reducing behaviors that contribute to premature death and disability.

The older adult population aged 65 years or older will double during the next 25 years to about 72 million. By 2030, older adults will account for roughly 20% of the U.S. population.

During the past century, a major shift occurred in the leading causes of death for all age groups, including older adults, from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.

The National Report Card on Healthy Aging reports on 15 indicators of older adult health, 8 of which are identified in Healthy People 2020, the national health agenda of the U.S. Department of Health and Human Services. These 15 indicators are grouped into 4 areas: Health Status, Health Behaviors, Preventive Care and Screening, and Injuries. The United States has met or exceeded six of the Healthy People 2020 targets in this report.

The State of Aging and Health in America 2013 presents several calls to action intended to encourage individuals, professionals, and communities to take specific steps to improve the health and well-being of older adults. They include the following:

    Developing a new Healthy Brain Initiative Road Map
    Addressing lesbian, gay, bisexual, and transgender (LGBT) aging and health issues
    Using data on physically unhealthy days to guide interventions
    Addressing mental distress among older adults
    Monitoring vaccination rates for shingles.

Read my about.com blog here where you can also link to the full report.

http://assistedliving.about.com/b/2013/10/14/cdcs-state-of-aging-and-health-in-america-2013-offer-a-comprehensive-and-holistic-look-at-trends-and-needs.htm

The Old Meets New in Maxine's Kitchen

2013-10-14T09:00:00.000-04:00

The following is a guest post from Dorothy Robinson.

It felt good to be sitting in Maxine's sunny kitchen that beautiful autumn day so many years ago. I watched intently as she put the finishing touches on our much anticipated lunch.

Delicate handmade Ukrainian perogies were ready to be served to three appreciative and hungry grandmothers. We all loved to cook, and we knew the work Maxine had gone to in preparing these from scratch for us.

As she spooned the crispy fried salt pork over the perogies it became apparent to me that Maxine’s traditional methods were very deeply rooted in her Ukrainian heritage. It might have been easier to buy a pound of bacon and fry it up, but no, this was the the way she was taught to dress her perogies.

Salt pork was a European staple that sustained many through long hard winters. So whenever I happen to taste perogies made in this traditional way, it brings back many memories. My Polish parents went into the winter prepared with many staples for the cold months ahead. Amongst these were the very important salt pork, a barrel of sauerkraut, and a crock filled with butter layered with salt to preserve it. Sacks of potatoes and other root vegetables ensured we had interesting meals on the table all winter long.

Our lunch was delicious and memorable. As we passed the sour cream and perogies, I recall with a great deal of humor how very technical our conversation became as we spoke about our computers. Gigabyte was a brand new word and high speed was coming on “stream”. We wanted to be savvy in navigating our way around. This new world called the "information highway" had arrived! Ours was a moment encapsulated in time where the old and the new seemed to come together seamlessly. A time tested recipe dating back into antiquity was sitting on our plate. As we savoured it we were speaking of the future, of the computer age that was here now, and we wanted to be a part of it. This struck me as a real paradox of how quickly technology can change our world. It’s as though we have had our feet planted in two worlds the old and the new, and surprising to some, how very adaptable seniors can be at any age embracing and understanding this new technology.

On another occasion recently the new and the old met once again. I was speaking to my great granddaughter who was going to give me a pedicure with the latest bake on acrylic nail polish. I had an opportunity to tell her a bit about my early years, and how life was then. To a seventeen year old who was diapered in Pampers when a baby, to learn that her grandmother wore diapers made from flour sacks was quite a revelation. Yes, I told her, “We had the words Robin Hood Flour written in red ink plastered on our diapers until the red ink faded after many washings. These were made from a hundred pound sacks that were large enough to make a couple of good sized diapers”. Women cherished those flour sacks; they would embroider them and make many pretty household items from them. She was shocked to learn that I was born and raised in a sod buster’s shack on the prairies during the years of the Great Depression, and that I learned to crawl on a dirt floor. At that point she raised her eyes up from what she was doing and said “Wow Baba, I didn’t know that”.

Yes, time seems to quickly move forward, and the momentum of all the changes taking place to-day can be very daunting for many of us. As the words of the poem by Ralph Hodgson so succinctly put it

“Time you old gypsy man will you not stay,

And put up your caravan just for one day”.

No matter though how busy we are, or how full our day has been working in a very technologically oriented atmosphere, it’s still wonderful to think of coming home to something “old” something timeless, a delicious plate of homemade perogies.

Our Friday Song of the Week - Girl Watcher

2013-10-11T10:00:00.004-04:00

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