Epilepsy Drug Prevents and Treats Alzheimer's Disease in Mice
Oct. 27, 2008

An epilepsy drug, Valproic Acid (VPA), may reverse memory deficits in the early stages of Alzheimer’s Disease, conclude researchers with the University of British Columbia UBC Faculty of Medicine. The team led by UBC Psychiatry Prof. Weihong Song, who is also the Jack Brown and Family Professor and Chair in Alzheimer's Disease at UBC, found that VPA inhibits the activity of an enzyme that produces a neurotoxic protein called beta amyloid. As a result, plaque formation is discontinued. Amyloid beta-proteins are the central component of neurotoxic plaques in AD.

"We found that if we used VPA in the early stage of Alzheimer's disease, in model mice, it reduced plaque formation and further prevented brain cell death and axon damage," according to Song, who is a Canada Research Chair in Alzheimer's disease and Director of the Townsend Family Laboratories in UBC's Faculty of Medicine. "The drug also improved performance in memory tests."

"A small human clinical trial is currently underway and we expect results to be available in the next year,” Song said.

Major funding for the research was provided by the Canadian Institutes of Health Research, the Canadian government agency for health research. The study was published in the Journal of Experimental Medicine.

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Physicians Lack Smoking Cessation Training
Oct. 27, 2008

Physicians and other health-care providers may advise their patients to quit smoking, but few providers have the adequate training to follow their patients through the cessation process, according to researchers from the North Shore-LIJ Health System Center for Tobacco Control, Great Neck, NY. The findings were presented at CHEST 2008, the 74th annual international scientific assembly of the American Collegeof Chest Physicians.

Lead researcher Virginia Reichert, NP, found that 87% of physicians and other medical professionals receive less than 5 hours of training on tobacco dependence and less than 6% knew Agency for Healthcare Research and Quality (AHRQ) treatment guidelines for tobacco dependence, including the signs of nicotine withdrawal. Researchers speculate that this lack of knowledge related to tobacco dependence treatment may, in turn, affect quit rates among smokers.

"If health-care providers are unaware of the AHRQ guidelines for tobacco dependence, and consequently unsure of how to treat their patients who are tobacco-dependent, they are less likely to do more than ask and advise their patients to quit," Reichert said.

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UNH Research Shows Elderly Women Can Increase Strength But Still Risk Falls
Oct. 23, 2008

Decline in muscle function appears to be more related to a decline in physical activity than a natural part of the aging process. While older women can increase muscle strength as much as younger women can, they are less capable of making gains in muscle power (force/time), which is necessary to reduce fall risk and improve the ability to perform activities of daily living. Those are the findings of University of New Hampshire assistant professor of exercise science Dain LaRoche.
Click here to view full story

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WAD Calls for New Standards of Arthritis Care
October 12, 2008

Access to psychological support and self-management courses could help people with arthritis/rheumatism cope more effectively with their condition and achieve better quality of life, a new survey for World Arthritis Day concluded. Healthcare professionals, people with rheumatic disease and their caregivers, who responded to the survey, highlight the importance of integrating psychological support into the standard treatment regime.

The survey, a project run by the European League Against Rheumatism (EULAR) Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), was completed by people with arthritis/rheumatism, their caregivers and health professionals from over 50 countries across the world.

Ninety seven percent of people with rheumatism/arthritis and caregivers indicated that this condition affects them/people they care for emotionally and 5% of them said it may lead to depression. Despite of the scale of the problem only 35% of the survey respondents said they raise the emotional impact of their arthritis/rheumatism with their doctor.

Go to: http://www.worldarthritisday.org.

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Geriatricians Must Refine Their Focus on Frailest Elderly
October 9, 2008

The declining numbers of geriatricians combined with the rapid growth in the older population means that geriatricians may have to focus on the frailest older adults, leaving care for healthier elders to general practitioners, concludes a series of articles in the October issue of the “Journal of the American Geriatrics Society” (JAGS).

The number of geriatricians, physicians who have advanced training to meet the unique health care needs of older patients, in the U.S. is expected, at best, to stay steady at roughly 7,500, at the same time the older population will double to 70 million

The JAGS series includes a report on a recent survey that asked the directors of all U.S. geriatric academic programs what role geriatricians should play in health care. Their answer was that geriatricians should focus on the most complex and most vulnerable older patients. "The consensus among the nation's geriatric academic program directors appears to be that the best way to deploy the geriatricians we have is to have them focus on the frailest, most vulnerable older patients," says the University of Cincinnati College of Medicine's Gregg Warshaw, M.D., project director for ADGAP's longitudinal geriatrics workforce study. "These findings from our survey offer the beginning of a consensus statement as to the role of geriatricians in the continuum of American medical care." The longitudinal study is funded by the Donald W. Reynolds and John A. Hartford Foundation.

Having geriatricians focus on the frailest, most complex older patients is likely to result in improved outcomes, a companion study in the JAGS series suggests. That study finds that the care provided by geriatricians and generalists differs, with geriatricians assessing patients for complex geriatric syndromes and taking steps to avoid improper prescribing slightly more often than generalists.

An accompanying editorial by Dean of the Columbia University School of Public Health Linda Fried, M.D., and William Hall, M.D., of the University of Rochester School of Medicine, recommends that the health care system should target training efforts to prepare "adequate numbers" of geriatricians to care for the 25% to 30% of older adults who are frail and have multiple, complex health problems. At the same time, it should ensure that the primary care physicians who will be responsible for caring for healthier and better functioning older patients are taught basic geriatrics principles and "when and how to involve a subspecialist geriatrician in care."

See the October Journal of the American Geriatrics Society. Click here.

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Food Stamps Are Now a SNAP: USDA Renames Program
October 1, 2008

The U.S. Department of Agriculture has renamed the Food Stamp Program as Supplemental Nutrition Assistance Program (SNAP). USDA says the name reflects its focus on nutrition and putting healthy food within reach for low income households. Changes have been made to make the program more accessible. State programs may continue to use different names.

The change was mandated by the Food, Conservation, and Energy Act of 2008 (P.L. 110-246), known as the Farm Bill.

Go to: http://www.fns.usda.gov/snap/.

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Study Predicts Large Savings from Consumer Reports’ Best Buy Drugs Program
Oct. 1, 2008

Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program, researchers report. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized.

Across the country, consumers could save an estimated $2.76 billion by purchasing prescription heart drugs recommended by the Consumer Reports Best Buy Drugs program, according to a new study published in the October issue of Health Services Research. The recommended drugs' prices were 15–65% percent lower per daily dose than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution.

Julie Donohue with the University of Pittsburgh, et al. found did the study based on an analysis of prescription sales and retail prices paid for four classes of drugs uses to treat heart conditions: ACE inhibitors, beta blockers, calcium channel blockers, and statins.

Best Buy Drugs rates drugs across 20 categories by translating detailed findings from systematic reviews of scientific evidence into useful information for consumers.

The abstract of the article, “Potential Savings from an Evidence-Based Consumer-Oriented Public Education Campaign on Prescription Drugs,” is online at http://www3.interscience.wiley.com/journal/120120496/abstract.

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Researchers Find Unmet Needs Are Common Among Patients with Advanced Illness
Oct. 6, 2008

Adequate communication between health care providers and those facing terminal conditions is essential for older adults, who comprise the vast majority - - about 70% - - of those contending with multiple chronic medical problems.

A series of articles in the current issue of The Journal of Gerontology: Medical Sciences point to the need to address treatment preferences and symptom burden among sufferers of advanced illness. The research highlights the importance of consistent, planned interactions with older adults and discussions about goals of care.

“The common theme is the large gulf between health care science, practices, and systems, and the understanding needed to deal with the issues faced by older patients regarding care preferences at the end of life,” according to Darryl Wieland, PhD, MPH, of Palmetto Health Richland Hospital in Columbia, SC, who co-edited the special journal section.

Early discussions about treatment choices are especially encouraged, because many older adults have limitations in health literacy and cognitive capacity brought on by multiple chronic illnesses.

The Journal of Gerontology: Medical Sciences (Vol. 63, No. 3) will appear online shortly. Go to: http://intl-biomed.gerontologyjournals.org/content/vol63/issue8/#JOURNAL_OF_GERONTOLOGY__MEDICAL_SCIENCES.

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Canadian Team Develops Guidelines on Diagnosis/Treatment of Dementia
Oct. 6, 2008

Comprehensive, evidence-based guidelines for treatment of people with mild to moderate dementia as been developed by a team of clinicians, teachers and researchers from the University of Calgary, Dalhousie University, McGill University, Sunnybrook Health Sciences and the University of Toronto, University of Ottawa, University of Western Ontario, Universite de Montreal, University of Saskatchewan and affiliated institutions. The authors based the guidelines on systematic literature searches, specific criteria for the selection and quality assessment of articles, and a clear and transparent decision-making process.

People with these degrees of dementia are primarily cared for by family physicians as well as the patient's own family, and management of care can be complex and challenging.

The guidelines indicate:

The use of medications with anticholinergic effects should be minimized.
There should be proactive planning for driving cessation, since this will be required at some point in the course of progressive dementia. The patient’s ability to drive should be determined primarily on the basis of his or her functional abilities.
An important aspect of care is supporting the patient’s primary caregiver

The guidelines appear in the Oct. 7 Canadian Medical Association Journal (CMAJ 2008;179(8):787-93). Go to: http://www.cmaj.ca/press/pg787.pdf.

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CDC Healthy Aging Podcast Series
Sept. 28, 2008

CDC’s Healthy Aging Program has just released the first two podcasts in a new series focused on Healthy Aging. This first installment highlights the importance of immunizations for older adults.

Part I explains the importance of influenza and pneumococcal vaccines and Part II discusses the shingles vaccine. To listen to these podcasts, please visit:
Immunizations Part I: Flu and Pneumococcal Vaccines, http://www2a.cdc.gov/podcasts/player.asp?f=10097
Immunizations Part II: Shingles Vaccines, http://www2a.cdc.gov/podcasts/player.asp?f=10098

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Study Highlights Successful Physical Activity Programs for Older Adults
Sept. 24, 2008

Physical activity programs developed and tested in research settings can be successfully implemented and diffused through community organizations, according to a new analysis of data from the Active for Life program. The analysis was completed by researchers at the University of South Carolina’s Arnold School of Public Health, in collaboration with researchers at the Texas A&M Health Science Center School of Rural Public Health (HSC).

Click here to read rest of story

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CMS Announces Medicare Premiums, Deductibles for 2009
September 19, 2008

The standard Medicare Part B monthly premium will be $96.40 in 2009, the same as the Part B premium for 2008. This is the first year since 2000 that there was no increase in the standard premium over the prior year.

Click here to view rest of story and tables.

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CMS Website Helps Informal Caregivers for Medicare Beneficiaries
Sept. 18, 2008

CMS launched its new website for caregivers this week. It contains links to information on billing, Medicare basics, care options and other assistance to help caregivers.

The Caregiver Information: Ask Medicare Web site (http://www.medicare.gov/caregivers/) provides links to key partner organizations that assist caregivers and beneficiaries, and presents personal stories from caregivers in the community. Support information and tools to help caregivers address common problems will also be available. CMS also plans to launch an e-newsletter for caregivers that will deliver information into subscribers’ email boxes.

According to AARP, more than 44 million Americans, more than one in five adults, provide care to a loved one, friend or neighbor, valued in economic terms at $350 billion annually.

Caregivers are often overwhelmed. “Ask Medicare will be a single, go-to place for help and information,” said Kerry Weems, CMS acting administrator. “There is a genuine need for credible and easy to use information that provides answers to a wide range of questions toward helping beneficiaries make better use of Medicare. The Ask Medicare Web site was designed with family caregivers in mind.”

Most caregivers do not think of or identify themselves as caregivers; yet, so many of the resources available to them use that term. “If a person helping someone on Medicare does not relate to the term ‘caregiver,’ they may miss a lot of resources,” said Weems.

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Nursing Home Residents and P.O. Box Households Eligible to Receive Digital TV Converter Box Coupons
Sept. 18, 2008

The Department of Commerce has announced that residents of licensed nursing homes, intermediate care facilities, assisted living facilities and households that use a post office box for mail delivery will be eligible to request coupons from the TV Converter Box Coupon Program. The rule change takes effect 30 days after publication in the Federal Register.

Applicants living in licensed nursing homes, intermediate care facilities and assisted living facilities will be required to provide their name, address of the facility and whether they receive television exclusively with an antenna, or through cable, satellite or other pay television service. A family member or a representative from the licensed facility may apply for one coupon for a nursing home resident, but the coupon will be mailed directly to the nursing home resident. A special application will be made available for nursing home residents to fill out once the rule becomes effective.

Also, applicants who utilize a post office box for mail delivery will be able to request two coupons through the normal application process. Applicants will be required to provide their physical residence in addition to their post office box number.

Under the Digital Television Transition and Public Safety Act of 2005, television stations will stop broadcasting in analog and switch to digital after February 17, 2009. The act authorizes Commerce’s National Telecommunications and Information Administration (NTIA) to create the TV Converter Box Coupon Program, which is funded by the $19 billion airwaves auction and not tax dollars.

Consumers receiving free, over-the-air television on analog televisions will need to act to ensure their televisions continue to work when full power television stations go all-digital. Viewers of over-the-air television need to look at each analog set in their home that is not connected to cable, satellite or other pay television service and make a timely decision. They can connect their television to cable, satellite or pay television service; they can replace it with a digital TV; or they may keep it working with a TV converter box.

For consumers choosing the converter box option, the TV Converter Box Coupon Program permits all households to request up to two coupons—each worth $40—toward the purchase of certified converter boxes. Coupons may be requested until March 31, 2009, or while supplies last. Consumers can purchase a converter box at one of the more than 29,000 participating local, phone or online retailers. Coupon applications can take several weeks to process and mail so consumers opting to purchase a converter box should act now, and should call stores before shopping to ensure the desired converter box is available. Converter boxes generally cost between $45 and $80 and coupons expire 90 days from the date they are mailed.

“Allowing nursing home residents and households who rely on a post office box for their mail to request coupons helps those most in need to make the switch to digital television,” Gutierrez said.

Households, not including nursing home residents and P.O. Box applicants, may apply now for coupons online at www.DTV2009.gov, by phone at 1-888-DTV-2009 (1-888-388-2009), via fax at 1-877-DTV-4ME2 (1-877-388-4632) or by mail to P.O. Box 2000, Portland, OR 97208-2000. Deaf or hard of hearing callers may dial 1-877-530-2634 (English TTY) or 1-866-495-1161 (Spanish TTY). Consumers will receive a list of eligible converter boxes and participating retailers with their coupons.Coupons expire 90 days after they are mailed, and only one coupon can be used to purchase each coupon-eligible converter box.

For more information about the DTV Coupon Program, please visit www.DTV2009.gov and for questions about the DTV transition, go to www.dtv.gov or call 1-888-CALL-FCC.

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Medication Errors Common in Assisted Living
Sept. 8, 2008

A new study conducted in 12 assisted living facilities in three states found medication errors occurred 28 of the time. Of 4,866 observations, 1,373 errors were observed (28.2% error rate). Of these, 70.8% were wrong time, 12.9% wrong dose, 11.1% omitted dose, 3.5% extra dose, 1.5% unauthorized drug, and 0.2% wrong drug.

Excluding wrong time, the overall error rate dropped to 8.2%. Of the 1,373 errors, three were rated as having potential clinical significance.

The bulk of the medications are low risk and routine, the authors noted. To promote optimal care delivery, clinicians need to focus on high-risk medications and residents with complex health problems.

This study was conducted in Oregon, Washington, and New Jersey. It is published in the current issue of the Journal of the American Geriatrics Society.

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National Institute on Aging Releases Clinical Research Study Investigator's Toolbox
Sept. 8, 2008

The NIA has recently published the Clinical Research Study Investigator’s Toolbox on the NIA public webpage. The purpose of the NIA Clinical Research Study Investigator’s Toolbox is to provide a Web-based information repository for investigators and staff involved in clinical research.

The Toolbox contains templates, sample forms, guidelines, regulations and information materials to assist investigators in the development and conduct of high quality clinical research studies. The Toolbox contains templates, sample forms, guidelines, regulations and information materials to assist investigators in the development and conduct of high quality clinical research studies.

Go to: http://www.nia.nih.gov/ResearchInformation/CTtoolbox/

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American Organization of Nurse Executives Awarded REASN grant
Sept. 8, 2008

The American Organization of Nurse Executives (AONE) has been awarded a grant from the Hartford Institute for Geriatric Nursing at the New York University College of Nursing as part of an initiative called REASN, (Resourcefully Enhancing Aging in Specialty Nursing).

REASN is a four year program that works with specialty nursing associations to deepen their involvement with enhancing their members’ competency in caring for older adults and aims to bring up-to-date information on geriatric best practices to more than 200,000 hospital-based specialty nurses. The REASN initiative is funded with a $2.3 million dollar grant from The Atlantic Philanthropies Inc.

AONE will receive $15,000 in core grant funding and $2,000 in Web fellow funding. In 2005, AONE developed the Guiding Principles for the Elder-Friendly Hospital/Facility as part of the ANA/SNAPG Nurse Competence in Aging Program. This new grant will allow AONE to enhance and expand these guiding principles to include the role of the nurse executive and how they can better provide an elder friendly hospital environment. Additionally, a virtual toolkit that supports the concepts and themes will be developed and reside on a Web site dedicated to elder friendly health care. The toolkit resources will assist the nurse executive in the creation of an elder friendly milieu for the patient, family and staff.

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Elder Abuse Affects 13 Percent of Seniors
Aug. 31, 2008

A recent study by the Univeristy of Chicago and National Opinion Research Center found that 9% of older adults reported verbal mistreatment,3.5% financial mistreatment, and 0.2% physical mistreatmentby a family member. Researchers selected community-residing participants aged 57to 85 using a multistage area probability design. Of those eligible,3,005 participated in the study.

The National Social Life, Health and Aging Projectfound that the odds of verbal mistreatment were higherfor women and those with physical vulnerabilities and were lowerfor Latinos than for whites. Odds of financial mistreatmentwere higher for African Americans and lower for Latinos thanfor whites and were lower for those with a spouse or romanticpartner than for those without partners.
The findings were reported in the July 2008 Journal of Gerontology: Social Sciences. Click here to view abstract.

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Next Stimulus Package May Hike Senior Meals
Aug. 1, 2008

A second stimulus package that Congress may consider after the August recess might appropriate supplemental funding for senior meal programs.

A draft Senate version contains $40 million for senior meals — enough to cover 12 million additional meals. The Senate plan is also expected to include additional funding for the Low-Income Home Energy Assistance Program.

The House has not yet drafted a proposal.

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Trends in Health and Aging Website Merger
The National Center for Health Statistics has announced the forthcoming merger of the Trends in Health and Aging (www.cdc.gov/nchs/agingact.htm) and Health Data for All Ages (http://www.cdc.gov/nchs/health_data_for_all_ages.htm) websites. The new website, Health Data Interactive (HDI), will incorporate information on aging as well as on the health of children and younger adults.

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