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from Aging Opportunities News Online
Having Greater Purpose in Life Associated with a Reduced Risk of Alzheimer's Disease
March 1, 2010
Individuals who report having greater purpose in their lives appear less likely to develop Alzheimer's disease or its precursor, mild cognitive impairment, according to a report in the March issue of Archives of General Psychiatry.
"Alzheimer's disease is one of the most dreaded consequences of aging, and the identification of modifiable factors associated with the risk of Alzheimer's disease is a top public health priority for the 21st century, particularly given the large and rapidly increasing aging population," the authors write as background information in the article. Relatively few of these risk factors have been identified, but data suggest that some psychological factors—including conscientiousness, extraversion and neuroticism—may be associated with Alzheimer's disease risk.
"Purpose in life, the psychological tendency to derive meaning from life's experiences and to possess a sense of intentionality and goal directedness that guides behavior, has long been hypothesized to protect against adverse health outcomes," write Patricia A. Boyle, Ph.D., and colleagues at Rush University Medical Center, Chicago. The researchers assessed this quality in more than 900 community-dwelling older adults without dementia who were participating in the Rush Memory and Aging Project.
Participants' purpose in life was measured by their level of agreement with statements such as, "I feel good when I think of what I have done in the past and what I hope to do in the future" and "I have a sense of direction and purpose in life." After an average of four years and a maximum of seven years of annual follow-up clinical evaluations, 155 of 951 participants (16.3 percent) developed Alzheimer's disease. After controlling for other related variables, greater purpose in life was associated with a substantially reduced risk of developing Alzheimer's disease, as well as a reduced risk of mild cognitive impairment and a slower rate of cognitive decline.
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Dementia in Extreme Elderly Population Expected To Become Epidemic
Feb. 24, 2010
University of California researchers found that the incidence rate for all causes of dementia in people age 90 and older is 18.2% annually and significantly increases with age in both men and women. This research, called "The 90+ Study," is one of only a few to examine dementia in this age group, and the first to have sufficient participation of centenarians. Findings of the study appear in the February issue of Annals of Neurology of the American Neurological Association.
Dementia (senility) is a progressive, degenerative disorder that affects memory, language, attention, emotions, and problem solving capabilities. A variety of diseases cause dementia including Alzheimer's disease, stroke, and other neurodegenerative disorders.
For their population-based, longitudinal study of aging and dementia, Maria Corrada, Sc.D., and colleagues invited members who were originally part of The Leisure World Cohort Study and 90 years of age or older as of January 1, 2003. As of December 31, 2007 there were 950 participants in The 90+ Study and 539 who had completed a full evaluation that included neurological testing, functional ability assessments and a questionnaire covering demographics, past medical history, and medication use. Evaluations were repeated every 6-12 months with a final dementia questionnaire completed shortly after death.
Analysis was completed on 330 participants who were primarily women (69.7%) between the ages of 90 to 102, and who showed no signs of dementia at baseline. Researchers identified 140 new cases of dementia during follow-up with 60% of those cases attributed to Alzheimer's disease (AD), 22% vascular dementia, 9% mixed AD and vascular dementia and 9% with other or unknown cause.
Dr. Corrada explained, "Our findings show dementia incidence rates almost double every five years in those 90 and older." Researchers found the overall incidence rate based on 770 person-years of follow-up was 18.2% per year. Rates increased with age from 12.7% per year in the 90-94 age group, to 21.2% per year in the 95-99 age group, to 40.7% per year in the 100+ age group. Incidence rates were very similar for men and women. Previous results from The 90+ Study found higher estimates of dementia prevalence in women (45%) compared to men (28%), a result also seen in other similar studies.
Prior reports estimate there were 2 million Americans aged 90 and older in 2007 and the number is expected to reach 8.7 million by 2050, making the oldest-old the fastest growing segment of the U.S. population. "In contrast to other studies, we found that the incidence of dementia increases exponentially with age in both men and women past age 90," said Dr. Corrada. "Given the population projections for this age group along with our findings, dementia in the oldest-old threatens to become an epidemic with enormous public health impact."
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Hospitalization Linked to Likelihood of Cognitive Decline for Older Adults
Feb. 23, 2010
Older patients hospitalized for acute care or a critical illness are more likely to experience cognitive decline compared to older adults who are not hospitalized, according to a study in the February 24 issue of the Journal of the American Medical Association.
A large proportion of patients who are hospitalized for acute care or care of a critical illness are older adults. Some studies have suggested that many survivors of critical illness experience long-term cognitive impairment, but these studies did not measure cognitive function before a critical illness, according to background information in the article.
William J. Ehlenbach, M.D., M.Sc., of the University of Washington, Seattle, and colleagues analyzed data from a study that was conducting cognitive testing on older adults, and examined administrative data from hospitalizations to determine whether hospitalizations for acute illness or critical illness were associated with cognitive decline and dementia. The study included data from 1994 through 2007 on 2,929 individuals, 65 years old and older without dementia at the beginning of the study. Cognition was measured with the Cognitive Abilities Screening Instrument (CASI) every 2 years at follow-up visits, and those with scores below a certain point underwent a clinical examination for dementia.
During an average follow-up of 6.1 years, 1,601 participants had no hospitalizations while enrolled in the study; 1,287 study participants were hospitalized for noncritical illness; and 41 participants were hospitalized for a critical illness.
There were 146 cases of dementia among those never hospitalized during the study. Among those experiencing 1 or more noncritical illness hospitalizations but no critical illness hospitalizations during study participation, there were 228 cases of dementia. There were 5 cases of dementia among those experiencing 1 or more critical illness hospitalizations during the study.
The researchers found that patients who had a hospitalization for an acute care or critical illness had lower CASI scores at follow-up compared to those who were not hospitalized. Also, after adjusting for various factors, patients hospitalized for a noncritical illness had a 40 percent higher risk of dementia. Patients hospitalized for a critical illness also had a higher risk of dementia, but the result was not significant, possibly because of the small number of participants in this group.
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Damaged Protein Identified As Early Diagnostic Biomarker For Alzheimer's Disease In Healthy Adults
Feb. 23, 2010
Researchers at NYU School of Medicine have found that elevated cerebrospinal fluid levels of phosphorylated tau231 (P-tau231), a damaged tau protein found in patients with Alzheimer's disease, may be an early diagnostic biomarker for Alzheimer's disease in healthy adults.
The study published this month online by Neurobiology of Aging shows that high levels of P- tau231 predict future memory decline and loss of brain gray matter in the medial temporal lobe- a key memory center. Prior studies found the medial temporal lobe to be the most vulnerable brain region in the early stages of Alzheimer's disease accumulating damaged tau proteins in the form of neurofibrillary tangles. Tangles are one of the signature indicators of Alzheimer's disease, in addition to beta amyloid plaques.
"Our research results show for the first time that elevated levels of P-tau 231 in normal individuals can predict memory decline and accompanying brain atrophy," said lead author Lidia Glodzik MD, PhD, assistant research professor, Department of Psychiatry at the Center for Brain Health and Center of Excellence on Brain Aging at NYU School of Medicine. "Our findings suggest that P-tau231 has the potential to be an important diagnostic tool in the pre-symptomatic stages of Alzheimer's disease."
Researchers evaluated 57 cognitively healthy older adults and studied the relationships between baseline cerebrospinal fluid biomarkers, longitudinal memory performance and longitudinal measures of the medial temporal lobe gray matter using Magnetic Resonance Imaging, or MRI. Two years later, researchers found that 20 out of 57 healthy adults showed decreased memory performance. The group with worsened memory had higher baseline levels of P-tau231 and more atrophy in the medial temporal lobe. The higher P-tau231 levels were associated with reductions in medial temporal lobe gray matter. Authors concluded that elevated P-tau231 predicts both memory decline and medial temporal lobe atrophy.
"Indentifying people at risk for Alzheimer's disease is the necessary first step in developing preventive therapies," said co-author Mony de Leon, EdD, professor, Department of Psychiatry and director of the Center for Brain Health at the Center of Excellence on Brain Aging at NYU School of Medicine and Research Scientist at the Nathan S. Kline Institute for Psychiatric Research.
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Overweight Middle-Aged Adults at Greater Risk for Cognitive Decline in Later Life
February 23, 2010
The adverse affects of being overweight are not limited to physical function but also extend to neurological function, according to research in the latest issue of The Journals of Gerontology Series A: Biological and Medical Sciences (Volume 65A, Number 1).
The publication presents a collection of 10 articles highlighting new findings related to obesity in older persons.
"One of the unanticipated consequences of improved medical management of cardiovascular disease is that many obese individuals reach old age,” said journal editor Luigi Ferrucci, MD, PhD, of the National Institute on Aging. “We need a better understanding of the causes and consequences of obesity in older individuals — especially when obesity is associated with sarcopenia.”
A study headed by Anna Dahl, MS, of Sweden’s Jönköping University, found that individuals with higher midlife body mass index (BMI) scores had significantly lower general cognitive ability and significantly steeper decline than their thinner counterparts over time.
Other studies reported in the journal show that obesity appears particularly threatening in the presence of other health problems, such as poor muscle strength and depression.
Similarly, changes in weight also signify declines in overall health. A team of researchers led by Alice M. Arnold, PhD, of the University of Washington, Seattle, found that such fluctuations are significant indicators of future physical limitations and mortality in the elderly.
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Employee Benefit Research Institute: Older Americans Are Working Longer
Feb. 18, 2010
The labor-force participation rate is increasing for older Americans (those age 55 and older) as older workers are faced with higher health costs and economic losses, according to a study published today by the nonpartisan Employee Benefit Research Institute (EBRI).
For those ages 55–64 (the “near elderly”), the increase is being driven almost exclusively by the increase of women in the work force; the male participation rate is flat to declining. However, among those age 65 and older (the elderly), labor-force participation is increasing for both male and females, says the study in the February 2010 EBRI Notes.
Workers increasingly are facing more responsibility in paying for their retirement expenses:
Private-sector workers who have access to an employment-based retirement plan most commonly have a defined contribution plan (typically a 401(k) plan, financed at least partially with workers’ own contributions), and retiree health insurance is becoming increasingly scarce. Even for those who do have retiree health insurance, caps on what the employer will pay annually for the coverage are being reached and/or surpassed.
Consequently, the study says, workers today have greater incentives to stay in the work force, such as the ability (and in some cases the need) to continue to accumulate assets in defined contribution plans and to have access to employment-based health insurance coverage, instead of having to tap into their savings to pay for their expenses.
The study, based on U.S. Census Bureau data, includes these additional points:
• The percentage of civilian noninstitutionalized Americans age 55 or older who were in the labor force declined from 34.6 percent 1975 to 29.4 percent in 1993. However, since 1993, the labor-force participation rate has steadily increased, reaching 39.4 percent in 2008—the highest level over the 1975–2008 period.
• Education is a strong factor in an individual’s participation in the labor force at older ages: Individuals with higher levels of education are significantly more likely to be in the labor force than those with the lower levels of education.
• The upward trend among the working near elderly and elderly is not surprising and is likely to continue because of workers’ need for access to employment-based health insurance and for more earning years to accumulate assets in defined contribution (401(k)-type) plans—especially after the 2008 downturn in the stock market and economy.
• While some older Americans have a greater need to work to help make their retirement assets last longer or to continue to build up assets, monetary incentives are not the only motivating factor. There also is an increased desire among Americans to work longer, particularly among those with more education, for whom more meaningful jobs may be available that can be done well into older ages.
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Untreated Poor Vision in Elderly Linked to Dementia: University of Michigan
Feb. 18, 2010
Elderly people with visual disorders that are left untreated are significantly more likely to develop Alzheimer's disease -- the most common form of dementia, according to a University of Michigan Health System study. The study used Medicare data and shows that those with poor vision who visited an ophthalmologist at least once for an examination were 64 percent less likely to develop dementia.
The study appears online ahead of print in the American Journal of Epidemiology and may draw a new picture of poor vision as predictor of dementia rather than as a symptom after the diagnosis.
"Visual problems can have serious consequences and are very common among the elderly, but many of them are not seeking treatment," says lead author Mary A.M. Rogers, Ph.D, research assistant professor of internal medicine at the U-M Medical School and research director of the Patient Safety Enhancement Program at the U-M Health System and the Ann Arbor VA Medical Center.
For the study, Rogers and her colleague Kenneth M. Langa, M.D., Ph.D., professor of internal medicine at U-M Medical School, analyzed data from the nationally representative Health and Retirement Study and records from Centers for Medicare and Medicaid Services.
"Our results indicate that it is important for elderly individuals with visual problems to seek medical attention so that the causes of the problems can be identified and treated," Rogers says.
The types of vision treatment that were helpful in lowering the risk of dementia were surgery to correct cataracts and treatments for glaucoma, retinal disorders and other eye-related problems.
Proper vision is a requirement for many of the activities that previously have been found to lower the risk of Alzheimer's disease. These include reading, playing board games, other mentally stimulating activities, social networking, as well as physical activity such as walking and routine exercising. A visual disorder may interfere with normal mobility and may also hinder a person's ability to participate in such activities.
"Many elderly Americans do not have adequate health coverage for vision, and Medicare does not cover preventative vision screenings for most beneficiaries," Rogers says. "So it's not unusual that the elderly receive vision treatment only after a problem is severe enough to warrant a visit to the doctor when the problem is more advanced."
According to a survey conducted by the National Eye Health Education Program, less than 11 percent of respondents understood that there are no early warning signs for eye problems such as glaucoma and diabetic retinopathy.
However, vision problems and blindness are among the top 10 disabilities among adults and can result in a greater tendency to experience other health conditions or even to die prematurely.
The study was funded by the National Institute on Aging.
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Press Release Links
National Hispanic Council on Aging
National Hispanic Council on Aging Joins the Administration in Mission to Combat Medicare Fraud By Empowering Hispanics
March 2, 2010
The U.S. is enlisting the help of the National Hispanic Council on Aging (NHCOA) as it cracks down on Medicare fraud, which costs a staggering $60 billion a year to taxpayers at a time they least can afford it.
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National Institute on Aging
NIA, McKnight Brain Research Foundation Fund Research into Causes, Interventions for Age-Related Cognitive Decline
March 1, 2010
The Research Partnership in Cognitive Aging, a public-private effort to promote the study of brain function with age, will award up to $28 million over five years to 17 research grants to examine the neural and behavioral profiles of healthy cognitive aging and explore interventions that may prevent, reduce or reverse cognitive decline in older people.
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American Academy of Family Physicians
Congressional Failure to Avert 21 Percent Medicare Cut Puts Elderly, Disabled at Risk
Friday, Feb. 26, 2010
The American Academy of Family Physicians is deeply angered at congressional failure to avert the mandated 21.2 percent Medicare physician pay cut.
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American Medical Association
Senate Inaction on Medicare Hurts Seniors, Military and Boomers
Feb. 26, 2010
The Senate failed to repeal the Medicare physician payment formula that will cause a drastic 21 percent payment cut to physicians who care for Medicare and TRICARE patients.
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National Institutes of Health
Landmark NIH Clinical Trial Comparing Two Stroke Prevention Procedures Shows Surgery And Stenting Equally Safe And Effective
Feb. 25, 2010
A major new study of people at risk for stroke showed that two medical procedures designed to prevent future strokes are safe and effective overall.
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Senators Evan Bayh
Bayh, Collins Combat Alzheimer’s Disease
Feb. 24, 2010
Senators Evan Bayh (D-IN) and Susan Collins (R-ME) today introduced legislation to create the country’s first national office responsible for leading government efforts to treat and prevent Alzheimer’s disease. Located within the Department of Health and Human Services, the National Alzheimer’s Project Office would coordinate and oversee federal research on Alzheimer’s disease to develop a plan to combat the disease and to eventually develop a cure.
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National Center for Public Policy Research
Medicare is Cheating Seniors Out of Care, Says New Study
Feb. 24, 2010
Chronically low Medicare reimbursement rates to physicians and hospitals are forcing doctors to limit the number of Medicare patients they see - or opt out of the program altogether - with devastating results to seniors' health care options, says a new study, "Medicare Doctor Shortage Endangers Seniors' Access to Care," by Matt Patterson of the National Center for Public Policy Research.
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Department of Health and Human Services
More than $1.1 Million in Grants Available for Community-Based Drug Prevention Coalitions
February 23, 2010
The White House Office of National Drug Control Policy and the U.S Department of Health and Human Services is announcing the availability of more than $1.1 million for new Drug Free Communities Support Mentoring program (DFC Mentoring) grants.
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AARP
Americans 50+ Demand Protections From Financial Abuse
Feb. 23, 2010
As the Senate continues negotiations for a comprehensive and meaningful financial reform bill, AARP today releases a survey of Americans 50 and older showing overwhelming support for financial reforms and consumer protections among Republicans, Democrats and Independents.
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AARP
African American Experiences in the Economy: Recession Effects More Strongly Felt
Feb. 23, 2010
While millions of Americans have experienced hard times during the economic recession, the environment for many African Americans age 45+ and their families has been particularly difficult. This survey is part of AARP’s continued look at how Americans age 45 and older are faring in this economy.
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National Academy of Social Insurance
Tough Times Require Strong Social Security Benefits: Views on Social Security among African Americans, Hispanic Americans, and White Americans
Feb. 23, 2010
Americans agree that Social Security has an important role to play during tough economic times. Worried about the poor economy’s effects on their prospects for retirement, Americans want to make sure that Social Security is strengthened for current and future generations.
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AARP
AARP Tells Health Care Summit Attendees: We Have Come Too Far to Stop Now
Feb. 19, 2010
AARP CEO A. Barry Rand today wrote to President Obama and Members of Congress invited to attend next week’s bipartisan health care summit. In his letters, Rand noted AARP’s top health care priorities, including closing the Medicare prescription drug “doughnut hole,” placing strict limits on health insurance age discrimination and strengthening the country’s long-term care system.
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American Health Care Association
Nation’s Governors Urged to Make FMAP Extension a Top Federal Budget Priority as New Study Points To Continued State Fiscal Turmoil
Feb. 19, 2010
As the National Governors’ Association convenes this weekend to outline 2010-11 policy priorities, the American Health Care Association expressed alarm that state fiscal crises of historic proportion have been a major contributing factor to undercutting skilled nursing facilities’ ongoing ability to provide quality care to the nation’s most vulnerable seniors.
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Department of Health and Human Services
Sebelius Unveils New Report on Requested Premium Increases in States Across the Country
Feb. 18, 2010
HHS Secretary Kathleen Sebelius today unveiled a new report, Insurance Companies Prosper, Families Suffer: Our Broken Health Insurance System. The report highlights health insurance premium increases in states across the country and comes shortly after Anthem Blue Cross announced plans to raise rates on its California customers by as much as 39 percent, even after its parent company took in a profit of $2.7 billion in the previous quarter.
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National Academy of Social Insurance
Poll Shows Strong and Diverse Support for Social Security
Feb. 18, 2010
A new brief and recent poll show that support for strengthening Social Security is strong across racial and cultural groups. The brief, Tough times require strong social security benefits, released today by the National Academy of Social Insurance, presents detailed views on Social Security among African Americans, Hispanic Americans, and White Americans
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Department of Health and Human Services
Obama Administration Grants Relief to States on Payments to Medicare for Part D Costs
Feb. 18, 2010
HHS Secretary Kathleen Sebelius today announced $4.3 billion in financial relief to states by reducing the amount they will have to pay the federal government to offset the cost of Medicare coverage for prescription drugs for state residents eligible for both Medicare and Medicaid.
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National Committee To Preserve Social Security And Medicare
Cutting Social Security Isn’t the Answer
Feb. 18, 2010
Social Security is not to blame for the nation’s fiscal problems and has not contributed one dime to our nation’s bleak debt and deficit picture. … Our hope is that this Presidential Commission will rise above the political rhetoric, do the right thing, and ensure Social Security does not become a piggy bank to pay for the fiscal failures of the past.
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EurekAlert
Influenza vaccines: Poor evidence for effectiveness in elderly
Feb. 16, 2010
Evidence for the safety and efficacy of influenza vaccines in the over 65s is poor, despite the fact that vaccination has been recommended for the prevention of influenza in older people for the past 40 years. These are the conclusions of a new Cochrane Systematic Review.
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American Public Health Association
Feb. 16, 2009
APHA Adopts 16 New Policies at 2009 Annual Meeting
The American Public Health Association recently adopted 16 policies at its 137th Annual Meeting in Philadelphia. The newly adopted policies address a broad range of public health issues from health reform and food security to transportation and land use issues and the elimination of asbestos.
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Experience Corps
The What Works Clearinghouse Gives Washington University Study of Experience Corps Highest Honors
February 12, 2010
This week the What Works Clearinghouse, one of the most trusted sources of scientific evidence for what works in education, recognized the strength and rigorousness of Washington University in St. Louis’s research on Experience Corps. The WWC called the study “consistent with WWC evidence standards” -- a rare designation -- and “a well-implemented randomized controlled trial.”
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National Council on Aging
National Council on Aging Releases Survey on Medical Imaging Safety
Feb. 17, 2010
Today, the National Council on Aging released the results of a national survey of older adults, caregivers and health care providers evaluating knowledge and awareness of medical imaging safety. The survey, which focused largely on electronic implantable device patients and their caregivers, reveals that communication about the safety of medical imaging for patients with these devices is often inadequate.
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