People who have trouble sleeping may be more likely to have a stroke, heart attack or other cerebrovascular or cardiovascular diseases, according to a study published in the November 6, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“These results suggest that if we can target people who are having trouble sleeping with behavioral therapies, it’s possible that we could reduce the number of cases of stroke, heart attack and other diseases later down the line,” said study author Liming Li, MD, of Peking University in Beijing, China.
The study involved 487,200 people in China with an average age of 51. Participants had no history of stroke or heart disease at the beginning of the study.
Participants were asked if they had any of three symptoms of insomnia at least three days per week: trouble falling asleep or staying asleep; waking up too early in the morning; or trouble staying focused during the day due to poor sleep. A total of 11 percent of the people had difficulty falling asleep or staying asleep; 10 percent reported waking up too early; and 2 percent had trouble staying focused during the day due to poor sleep. The researchers did not determine if the people met the full definition of insomnia.
In 2019 the Department of Health and Human Services’ (HHS) Administration for Community Living (ACL) and the Centers for Medicare and Medicaid Services (CMS) requested that the National Quality Forum (NQF) convene a committee of experts with lived and professional experience in long-term services and supports (LTSS), and with the acute/primary/chronic care systems. This committee aims to provide ACL, CMS, federal and state entities, and the general public with a consensus-based, multistakeholder view of multiple areas of person-centered planning.
The committee drafted a report as an interim summary of the its efforts to develop the following:
A functional, person-first definition of person-centered planning;
A core set of competencies for persons facilitating the planning process, including details of foundational skills, relational and communication skills, philosophy, resource knowledge, and the policy and regulatory context of person-centered planning; and
Young adults who suffer from posttraumatic stress disorder (PTSD) may be more likely to experience a transient ischemic attack (TIA) or major stroke event by middle age, raising the risk as much as other better-known risk factors, according to new research published in Stroke, a journal of the American Stroke Association, a division of the American Heart Association.
“Stroke has a devastating impact on young patients and their families, many of whom struggle to cope with long-term disability, depression and economic loss during their most productive years,” said Lindsey Rosman, Ph.D., lead author of the study and assistant professor of medicine in the division of cardiology at the University of North Carolina School of Medicine in Chapel Hill. “Ten to 14% of ischemic strokes occur in adults ages 18 to 45, and we don’t really have a good understanding of the risk factors for stroke in this age group.”
While PTSD has previously been shown to increase the risk of heart disease and stroke in older adults, this is the first study to demonstrate a link between trauma-induced stress disorders and the risk of TIA and stroke in young and middle-aged adults, an age group that has experienced a striking increase in stroke events over the past decade.
CHOOSING AN APPROPRIATE assisted living community is a challenging decision for residents and family members alike. To help, U.S. News is now publishing an extensive directory and data resource on nearly 9,000 assisted living communities, in collaboration with Caring.com.
The new Assisted Living directory offers comparison information on key factors including size, location and health services offered for the millions of Americans making this decision each year. Families can use the directory to match the right community to their loved one’s unique needs.
The directory provides comprehensive information about health services, activities and amenities offered at each residence. Reviews from residents and families add perspective for almost all licensed assisted living communities in the U.S. The tool is designed to let individuals easily conduct a customized search for a highly rated facility by location, resident rating, Alzheimer’s and memory care and size.
In late-breaking clinical trial results presented in a Hot Line Session today at the European Society of Cardiology Congress 2019, investigators from Brigham and Women’s Hospital and Greater Paris University Hospitals — AP-HP/Université de Paris presented the results from The Effect of Ticagrelor on Health Outcomes in Diabetes Mellitus Patients Intervention Study (THEMIS), a clinical trial sponsored by AstraZeneca that evaluated whether adding ticagrelor to aspirin improves outcomes for patients with stable coronary artery disease and diabetes mellitus but without a history of heart attack or stroke. Taking ticagrelor in addition to aspirin reduced the risk of a composite of cardiovascular death, heart attack, or stroke. Patients on this dual-antiplatelet therapy also experienced greater risk of major bleeding. In THEMIS-PCI, a study that specifically looked at THEMIS patients with a history of previous percutaneous coronary intervention (PCI) that includes stenting, versus the overall THEMIS population, investigators found even more favorable results for patients taking ticagrelor plus aspirin. Results of THEMIS are published simultaneously in The New England Journal of Medicine and results from THEMIS-PCI are published simultaneously in The Lancet.
“With prolonged dual-antiplatelet therapy, we need to be thoughtful in considering which patients are most suited to taking the regimen — that is, those at high ischemic risk and low bleeding risk,” said THEMIS co-chair Deepak L. Bhatt, MD, MPH, executive director of Interventional Cardiovascular Programs at the Brigham and professor of medicine at Harvard Medical School. “Our findings show that the greatest benefit occurred in those patients with diabetes and stable coronary artery disease with a history of prior stenting for whom ticagrelor, when added to aspirin, reduced important cardiovascular events, such as heart attacks, strokes and amputations.”
A new method for permanently marking cells infected with chikungunya virus could reveal how the virus continues to cause joint pain for months to years after the initial infection, according to a study published August 29 in the open-access journal PLOS Pathogens by Deborah Lenschow of Washington University School of Medicine in St. Louis, and colleagues. According to the authors, uncovering the mechanisms for long-term disease could aid in the development of treatments and preventative measures for this incapacitating, virally induced chronic arthritis.
Chikungunya virus is spread by mosquitoes and causes severe joint and muscle pain. Approximately 30 to 60 percent of people infected with the virus continue to experience joint pain for months to years after the initial infection. However, the cause of this persistent joint pain is unclear, as replicating virus cannot be detected during the chronic phase. To address this question, Lenschow and colleagues developed a reporter system to permanently mark cells infected by chikungunya virus.
Using this system, they show in mice that marked cells surviving chikungunya virus infection are a mixture of muscle and skin cells that are present for at least 112 days after initial virus inoculation. Treatment of mice with an antibody that blocks chikungunya virus infection reduces the number of marked cells in the muscle and skin. Moreover, surviving marked cells contain most of the persistent chikungunya virus RNA. Taken together, the findings provide further evidence for musculoskeletal cells as targets of chikungunya virus infection in the acute and chronic stages of disease. According to the authors, this reporter system represents a useful tool for identifying and isolating cells that harbor chronic viral RNA in order to study the mechanisms underlying chronic disease.
ALZHEIMER’S DISEASE AND dementia are becoming an increasingly big part of the health care conversation in America as the population ages and more people develop these cognitive ailments. The Centers for Disease Control and Prevention reports that about 5 million people are living with Alzheimer’s disease today, a figure that’s anticipated to nearly triple to 14 million by 2060.
For many people, once dementia has progressed to a certain level, they may need more care than family members can provide and may need to be placed in a long-term care facility– either an assisted living community or a nursing home.
Some of these facilities provide amazing care and support of older adults dealing with cognitive decline or dementia. Others may not. And if you’re considering placing a loved one into an assisted living facility that offers dementia care, there are a few factors you should consider when evaluating whether a specific community is the right one.
Sometimes it’s obvious when older parents need outside help — like when they’re having difficulty managing numerous chronic illnesses or losing mobility and unable to maneuver well even at home. But mental problems may not be as easy to spot.
For instance, is Dad’s forgetfulness — his misplacing house keys or missing appointments — normal aging or a sign of something more serious, such as dementia?
It can be hard to judge the severity of problems if you live far away and speak infrequently. But even if you live close by, you might not realize the cumulative effects of gradual changes.
UCLA-led research finds that a comprehensive dementia care program staffed by nurse practitioners working within a health system improves the mental and emotional health of patients and their caregivers.
While the program did not slow the progression of dementia, it did reduce patients’ behavioral problems and depression, and lower the distress of caregivers, the researchers found.
The paper is published in the peer-reviewed Journal of the American Geriatrics Society.
The findings, based on data from the UCLA Alzheimer’s and Dementia Care Program, suggest that such programs are a promising approach toward improving the psychological health of patients and caregivers, said Dr. David Reuben, chief of the UCLA Division of Geriatrics at the David Geffen School of Medicine at UCLA, and the study’s lead author.