Having more than one chronic disease amplifies costs of diseases

Having two or more non-communicable diseases (multimorbidity) costs the country more than the sum of those individual diseases would cost, according to a new study published this week in PLOS Medicine by Tony Blakely from the University of Otago, New Zealand, and colleagues.

Few studies have estimated disease-specific health system expenditure for many diseases simultaneously. In the new work, the researchers used nationally linked health data for all New Zealanders, including hospitalization, outpatient, pharmaceutical, laboratory and primary care from July 1, 2007 through June 30, 2014. These data include 18.9 million person-years and $26.4 billion US in spending. The team calculated annual health expenditure per person and analyzed the association of this spending to whether a person had any of six non-communicable disease classes — cancer, cardiovascular disease, diabetes, musculoskeletal, neurological, and lung/liver/kidney (LLK) diseases — or a combination of any of those diseases.

59% of publically-funded health expenditures in New Zealand were attributable to non-communicable diseases. Nearly a quarter (23.8%) of this spending was attributable to the costs of having two or more diseases above and beyond what the diseases cost separately. Of the remaining spending, heart disease and stroke accounted for 18.7%, followed by musculoskeletal (16.2%), neurological (14.4%), cancer (14.1%), LLK disease (7.4%) and diabetes (5.5%). Expenditure was generally the highest in the year of diagnosis and the year of death.

Full story at Science Daily

Exercise cuts risk of chronic disease in older adults

New research has shown that older adults who exercise above current recommended levels have a reduced risk of developing chronic disease compared with those who do not exercise.

Researchers at the Westmead Institute for Medical Research interviewed more than 1,500 Australian adults aged over 50 and followed them over a 10-year period.

People who engaged in the highest levels of total physical activity were twice as lively to avoid stroke, heart disease, angina, cancer and diabetes, and be in optimal physical and mental shape 10 years later, experts found.

Lead Researcher Associate Professor Bamini Gopinath from the University of Sydney said the data showed that adults who did more than 5000 metabolic equivalent minutes (MET minutes) each week saw the greatest reduction in the risk of chronic disease.

Full story at Science Daily

The Many Benefits of Meditation for Older Adults

WHEN DR. STEPHANIE Cheng conducts health exams with older adult patients, she often goes beyond reviewing their medications and determining treatment plans. Cheng incorporates meditation exercises into the visits. “If I notice they are overwhelmed or have emotional distress, I may do a brief meditation exercise with them, just so they can be exposed to it as a tool to feel a greater sense of well-beingmedi,” says Cheng, a palliative care physician in the division of geriatrics at the University of California—San Francisco.

Cheng’s approach isn’t unconventional. Meditation is a well-studied practice shown to have many health benefits. It’s commonly prescribed as a way to help treat chronic disease and mood disorders. That makes meditation a natural fit, Cheng says, when older age brings physical, mental and emotional changes.

Full story at US News

What Are the Secrets to Aging Well?

Numbers are important to Jan Sirota, a retired investment banker who lives in Sarasota, Florida. Sirota just celebrated 11 years of marriage, he cycles 40 miles per day, mentors four high school students and races cars 150 miles per hour in High Performance Driver Education events. The number that doesn’t seem to matter? His age.

“I’m 75, and it’s irrelevant to me,” Sirota says. “There’s no reason to say that I’ll slow down because I’m getting older.”

Many older adults do slow down, however, when faced with chronic disease, disability or isolation. So why is it that some people, like Sirota, can escape that fate and live vibrantly later in life? “Certainly genetics play a big part in this, and then of course luck. However, I don’t want anyone to think we can’t fight destiny a little bit,” says Dr. Patricia Harris, a geriatrician and professor at the David Geffen School of Medicine at UCLA.

Full story at US News

Strong evidence of the benefits of exercise therapy in chronic diseases

There is strong evidence of that aerobic exercise, strength training and condition-specific therapeutic exercise affect positively on the functional capacity of patients with chronic diseases. This is revealed in an extensive systematic analysis of published research data by the Faculty of Sport and Health Sciences, University of Jyväskylä, Finland. The systematic review of meta-analyses evaluates the effects of exercise therapy on more than twenty of the most common chronic diseases such as osteoarthritis, rheumatoid arthritis, coronary artery disease, heart failure, type 2 diabetes, different types of cancers, and Alzheimer’s disease.

With the help of the systematic review, health professionals are now able to get an overview of the effects of exercise therapy on chronic diseases. Earlier this would have required the professionals to go through and extract information from thousands of scientific articles. Only data based on randomised controlled trials were accepted into the analysis, ensuring high scientific quality of the studies and maximal reliability of the results.

Full story of exercise therapy in chronic diseases at Science Daily

Higher weekly activity levels linked to lower risk of five chronic diseases

Higher levels of total physical activity are strongly associated with lower risk of five common chronic diseases — breast and bowel cancer, diabetes, heart disease and stroke, finds a study in The BMJ.

Many studies have shown the health benefits of physical activity. This has led the World Health Organization (WHO) to recommend a minimum total physical activity level of 600 metabolic equivalent (MET) minutes a week across different ‘domains’ of daily life.

This can include being more physically active at work, engaging more in domestic activities such as housework and gardening, and/or engaging in active transportation such as walking and cycling.

Full story of higher activity and lower chronic diseases at Science Daily

Reducing chronic disease in asian americans: Researchers target diet

Although low-income Asian Americans are at a high risk for diabetes, hypertension, heart attack and stroke, they are under a misconception that their diet is healthy and not a risk factor for these chronic diseases.

Now, researchers from Temple University’s Center for Asian Health (CAH) will use a $1.4 million Racial and Ethnic Approaches to Community Health (REACH) grant to create awareness, provide education, and increase access to healthy food and beverage options in Philadelphia’s low-income Asian-American community. Temple is the only Pennsylvania institution to receive a REACH grant, awarded by the Centers for Disease Control and Prevention, this year.

The ultimate goal of the project — called Improving Diets With an Ecological Approach for Lifestyle (IDEAL) in Asian American Communities — is to reduce the incidence and prevalence of these chronic diseases among Asian Americans, who are 60 percent more likely to have diabetes than non-Hispanic whites and for whom heart disease is the second-leading cause of death, said Grace Ma, professor of public health in Temple’s College of Health Professions and Social Work, director of CAH and the grant’s principal investigator.

Full story of chronic disease in Asian Americans at Science Daily

Care managers in patient-centered medical homes increase improvements in diabetes patient outcomes, study shows

Patient centered medical homes (PCMHs) have been found to be an effective way to help care for patients with chronic diseases such as diabetes. Dr. Robert Gabbay, M.D., Ph.D., FACP, Chief Medical Officer and Senior Vice President at Joslin Diabetes Center, and his team conducted a study that shows the strategic placement of care managers in PCMHs can further improve patient outcomes for high-risk diabetes patients.

The study, conducted in southeastern Pennsylvania, compared different models of care management and how they impacted diabetes outcomes in three practices with 25 primary-care PCMHs. The identity of the care managers varied among the sites: with some positions filled by nurses or nurse practitioners, while others used social workers or medical assistants.

Full story of medical home improvements at Science Daily