Benzodiazepines are associated with increased risk of Alzheimer’s disease

The use of benzodiazepines and related drugs (Z drugs) is associated with a modestly increased risk of Alzheimer’s disease, according to a recent study from the University of Eastern Finland. The risk increase was similar with both benzodiazepines and Z drugs regardless of their half-life. The results were published in Acta Psychiatrica Scandinavica.

Even though the increased risk for Alzheimer’s disease was small in this study, the threshold for prescribing benzodiazepines and related drugs should be high enough due to their several adverse effects and events, such as falls. These medications are commonly used for sleep problems, but their effectiveness for this indication diminishes over weeks or months. However, the risk of adverse events remains in longer-term use.

Full story at Science Daily

‘Too Little Too Late’: Bankruptcy Booms Among Older Americans

For a rapidly growing share of older Americans, traditional ideas about life in retirement are being upended by a dismal reality: bankruptcy.

The signs of potential trouble — vanishing pensions, soaring medical expenses, inadequate savings — have been building for years. Now, new research sheds light on the scope of the problem: The rate of people 65 and older filing for bankruptcy is three times what it was in 1991, the study found, and the same group accounts for a far greater share of all filers.

Driving the surge, the study suggests, is a three-decade shift of financial risk from government and employers to individuals, who are bearing an ever-greater responsibility for their own financial well-being as the social safety net shrinks.

Full story at New York Times

Agitation in dementia: Are drugs the best treatment?

A common symptom among people with dementia is agitation, which can affect their and their carers’ well-being. Dementia experts conducted a new study and found the most effective means of addressing agitation.

In a paper that is now published in the journal International Psychogeriatrics, experts from several research institutions — including the University of Michigan in Ann Arbor, and Johns Hopkins University in Baltimore, MD — express their consensus on the best approaches to manage dementia-related behavioral and psychological symptoms.

More specifically, they speak of how to address states of agitation and psychosis in people with Alzheimer’s disease.

Full story at Science Daily

Feel lightheaded when standing up? You may have a greater risk of dementia

People who feel faint, dizzy or lightheaded when standing up may be experiencing a sudden drop in blood pressure called orthostatic hypotension. Now a new study says middle-aged people who experience such a drop may have a greater risk of developing dementia or stroke decades later. The study is published in the July 25, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“Orthostatic hypotension has been linked to heart disease, fainting and falls, so we wanted to conduct a large study to determine if this form of low blood pressure was also linked to problems in the brain, specifically dementia,” said study author Andreea Rawlings, PhD, MS, of Johns Hopkins Bloomberg School of Public Health in Baltimore, Md.

For this study, low blood pressure upon standing was defined as a drop of at least 20 millimeters of mercury (mmHg) in systolic blood pressure, which is the pressure in the blood vessels when the heart beats, or at least 10 mmHg in diastolic blood pressure, the pressure when the heart is at rest. Normal blood pressure is less than 120/80 mmHg.

Full story at Science Daily

Wisconsin Seniors Introduced to Virtual Reality Technology

As Kathy Helgerson slipped the pair of MINDVR goggles over Rita Strauss’ head, the reaction was instant.

“It looks like Midnight!” Strauss, 87, said with glee. “My tomcat.”

It’s moments like this that lead Helgerson, Strauss’ daughter and founder of “Simple Steps to Technology” to say she has “the best job in the world.”

“It is so powerful, I can’t even tell you,” Helgerson said, tears welling in her eyes at the spark of recognition from her mom, who has Alzheimer’s. “It brings up those memories of the past. … If you had asked my mom about (the cat) normally, she would have forgotten about it.”

Full story at US News

Dodging Dementia: More Of Us Get At Least A Dozen Good, Happy Years After 65

You’ve turned 65 and exited middle age. What are the chances you’ll develop cognitive impairment or dementia in the years ahead?

New research about “cognitive life expectancy” — how long older adults live with good versus declining brain health — shows that after age 65 men and women spend more than a dozen years in good cognitive health, on average. And, over the past decade, that time span has been expanding.

By contrast, cognitive challenges arise in a more compressed time frame in later life, with mild cognitive impairment (problems with memory, decision-making or thinking skills) lasting about four years, on average, and dementia (Alzheimer’s disease or other related conditions) occurring over 1½ to two years.

Full story at Kaiser Health News

An Advance Directive for Patients With Dementia

I had hoped that by now most adults in this country would have completed an advance directive for medical care and assigned someone they trusted to represent their wishes if and when they are unable to speak for themselves. Alas, at last count, barely more than one-third have done so, with the rest of Americans leaving it up to the medical profession and ill-prepared family members to decide when and how to provide life-prolonging treatments.

But even the many who, like me, have done due diligence — completed the appropriate forms, selected a health care agent and expressed their wishes to whoever may have to make medical decisions for them — may not realize that the documents typically do not cover a likely scenario for one of the leading causes of death in this country: dementia. Missing in standard documents, for example, are specific instructions about providing food and drink by hand as opposed to through a tube.

Advanced dementia, including Alzheimer’s disease, is the sixth leading cause of death overall in the United States. It is the fifth leading cause for people over 65, and the third for those over 85. Yet once the disease approaches its terminal stages, patients are unable to communicate their desires for or against life-prolonging therapies, some of which can actually make their last days more painful and hasten their demise.

Full story at the New York Times

New Resources on Community-Based Managed Care and Building Competitive Pricing

Two new resources are available for community-based organizations to help with business planning and contracting with health care organizations and payers.

“Fundamentals of Community-Based Managed Care: A Field Guide ” from the American Society on Aging is the second in a series of three issues of the publication Generations to focus on how best to build and preserve community-based organization (CBO) partnerships with the healthcare sector, in the interest of helping CBOs survive in the new financial climate, and for addressing the Triple Aim of improving care, improving population health, and reducing costs. This issue also addresses the social determinants of health and the role they play in aging in the community.

A resource guide on pricing  from the Aging and Disability Business Institute  explores financial contracting and provides guidance to community-based organizations on how to build competitive pricing models for contracting with health care payers. The pricing guide also explains the differences between common types of payment arrangements such as Per Member Per-month (PMPM), per episode, and capitation.

Full story at acl.gov

Spotting Alzheimer’s Early Could Save America $7.9 Trillion

Alzheimer’s disease is among the most expensive illnesses in the U.S. There’s no cure, no effective treatment and no easy fix for the skyrocketing financial cost of caring for an aging population.

Spending on care for people alive in the U.S. right now who will develop the affliction is projected to cost $47 trillion over the course of their lives, a report issued Tuesday by the Alzheimer’s Association found. The U.S. is projected to spend $277 billion on Alzheimer’s or other dementia care in 2018 alone, with an aging cohort of baby boomers pushing that number to $1.1 trillion by 2050.

Research so far has been stymied by clinical failures. By one count, at least 190 human trials of Alzheimer’s drugs have ended in failure. No company has successfully marketed a drug to treat it, though many big pharmaceutical companies, including Merck & Co. and Pfizer Inc., have tried. Biogen Inc., a company based in Cambridge, Massachusetts, saw its shares dive last month after it said it was expanding the number of participants in its trial for the drug aducanumab.

Full story at Bloomberg

Human Rights Watch Finds Nursing Homes Overmedicate Dementia Patients

Nursing homes in the U.S. are administering antipsychotic drugs to tens of thousands of elderly residents each week who do not have the diagnoses for which the drugs are prescribed and who are not giving their “free and informed consent,” according to a new Human Rights Watch report.

In a report released Monday titled, “They Want Docile,” the group states that some 179,000 residents of long-term nursing homes across the country are given antipsychotic drugs each week that are not appropriate for their condition. The report says the drugs are used for their sedating side effects, which make patients with dementia and Alzheimer’s disease easier to manage.

“People with dementia are often sedated to make life easier for overworked nursing home staff, and the government does little to protect vulnerable residents from such abuse,” Hannah Flamm, a New York University law school fellow at Human Rights Watch told The Guardian.

Full story at US News