Announcing New Guideline on Managing Disorders of Consciousness

A new guideline for managing disorders of consciousness (people in a minimally conscious state) has been published in the journals Neurology (PDF) and Archives of Physical Medicine and Rehabilitation (PDF). The development of the new guideline was partially funded by ACL’s National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), and two of its co-authors are grantees in NIDILRR’s TBI Model Systems program.

The guideline provides recommendations to improve diagnosis, health outcomes, and care of people with these disorders. About four in 10 people who are thought to be unconscious are actually aware.

Consciousness is a state of being awake and aware of one’s self and surroundings. A person with a disorder of consciousness has trouble being awake, or being aware or both. People in minimally conscious state have behaviors that show they are conscious, such as tracking people with their eyes or following an instruction to open their mouths, but the behaviors are often subtle and inconsistent. A disorder of consciousness can be caused by a severe brain injury resulting from trauma, such as a fall, a car accident or sports injury. It can also be caused by a disease or illness, such as stroke, heart attack or brain bleed.

Full story at acl.gov

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

Older Oklahoman’s vulnerable to scams, abuse

As much as 10 percent of Oklahoma’s adults age 60 and older are victims of physical, psychological, sexual or verbal abuse.

Also, senior citizens are seriously neglected or victims of financial exploitation, according to a new report co-authored by Lance Robertson, assistant secretary for aging in the Trump administration. Robertson served as Oklahoma’s director of aging services from 2007 to 2017.

Now, elder-abuse costs in the United States are estimated to be $8.2 billion a year, according to Robertson and U.S. Surgeon General Jerome M. Adams.

“Elder abuse is a critical social, health and economic problem,” the report notes.

Full story at newsok.com

Men take care of their spouses just as well as women (new research suggests)

Men respond to their spouse’s illness just as much as women do and as a result are better caregivers in later life than previous research suggests, according to a new Oxford University collaboration.

The study, published in Journals of Gerontology, Series B, is good news for our increasingly stretched adult care services, which have become more reliant on patients’ family and spouses for support. Conducted with peers from the University of Pennsylvania, the research sits in contrast to previous studies on spousal caregiving, which found that female caregivers tend to be more responsive. However, the new results reveal that men are just as responsive to a partner’s illness, as women.

Using data from the German Socio-Economic Panel Study, the research carried out by Dr Langner of Oxford University and Professor Frank Furstenberg of the University of Pennsylvania, focused on 538 couples in Germany with an average age of 69, where one of them had developed the need for spousal care, between 2001-2015, and looked at how caregivers adjusted their hours in response to the new care need: whether directly responding to their physical needs or performing errands and housework.

Full story at Science Daily

Screening women veterans with fibromyalgia for childhood abuse may improve treatment

A new study has shown that women Veterans being treated for fibromyalgia exhibit high rates of childhood abuse.

Fibromyalgia is a chronic disorder characterized by widespread pain with associated fatigue, sleep and mood issues that has been linked to exposure to interpersonal trauma, such as childhood abuse. With female Veterans representing a growing segment of the VA population, standardized screening for military sexual trauma (MST) and post-traumatic stress disorder (PTSD) are helpful in providing complete care to patients diagnosed with fibromyalgia. However, there is currently no standard screening practice for childhood abuse history in these patients.

Researchers from the VA Boston Healthcare System and Boston University School of Medicine (BUSM) examined a subset of women from a larger study of women Veterans’ fibromyalgia care experiences at the VA to evaluate the relationship between child abuse history and MST in this patient population.

Full story at Science Daily

Potential indicator for the early detection of dementia, Parkinson’s

Researchers at the University of Basel have discovered a factor that could support the early detection of neurodegenerative diseases such as Alzheimer’s or Parkinson’s. This cytokine is induced by cellular stress reactions after disturbances of the mitochondria, the “cell’s power plants,” as neuropathologists write in the journal Cell Reports.

The normal functioning of human cells is based on the coordinated interaction of different cellular organelles. In many cases, an impaired communication between these organelles will lead to the activation of a stress response to ensure the survival of affected cells. A research group was able to demonstrate this in detail for brain neurons. The group is headed by Prof. Dr. Stephan Frank from the Institute of Medical Genetics and Pathology at the University of Basel and University Hospital of Basel; the universities of Cambridge (UK) and Padua (Italy) were also involved.

The neuropathologists were able to show that impairments on the level of mitochondria, commonly known as the “cell’s powerhouses,” also affect neighboring organelles, such as the so-called endoplasmic reticulum. A consecutively activated stress reaction leads to the release of fibroblast growth factor-21 (FGF21) by nerve cells with disturbed mitochondria. The Basel researchers further observed that the same substance is also induced in various models of neurodegenerative disorders, where it can be detected prior to neuronal cell death.

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

Dementia: Both too much and too little alcohol may raise risk

Some studies have suggested that drinking alcohol in moderation lowers the risk of dementia, but the evidence may have been prone to certain biases. A new study follows more than 9,000 people over a 23-year period to draw robust conclusions on the link between alcohol consumption and dementia risk.

As the world population grows increasingly older, more and more people are at risk of developing dementia.

In fact, according to recent estimates, almost 50 million people worldwide are currently living with dementia, and this number is expected to double every 2 decades, reaching over 130 million by 2050.

Full story at Medical News Today

Video recordings spotlight poor communication between nurses and doctors

Communication breakdown among nurses and doctors is one of the primary reasons for patient care mistakes in the hospital.

In a small pilot study, University of Michigan researchers learned about potential causes of these communication failures by recording interactions among nurses and doctors, and then having them watch and critique the footage together.

Several themes emerged to help explain the poor communication, and both nurses and physicians improved their communication styles, said Milisa Manojlovich, U-M professor of nursing, who defines communication as reaching a shared understanding.

One barrier to good communication is that the hospital hierarchy puts nurses at a power disadvantage, and many are afraid to speak the truth to doctors, Manojlovich said.

Full story at Science Daily