Non-invasive techniques and devices for assessing blood flow and other diagnostic considerations for people with critical limb ischemia are addressed in a new scientific statement from the American Heart Association, published in the Association’s flagship journal Circulation.
The statement provides perspective on the strengths and limitations of current imaging techniques, including the ankle-brachial index, toe brachial index, toe systolic pressure, transcutaneous oximetry (TcPO2) and skin perfusion pressure (SPP). It also examines tools such as the laser Doppler, speckle imaging devices and others, as well as identifying opportunities for technology improvement and reducing disparities in detection and treatment.
The authors noted sex and ethnic differences in how critical limb ischemia is diagnosed, coexisting conditions and disparities in treatment. Women are more likely to experience emergency hospitalization, have differences in blood flow, and higher disability and death rates.
Large-scale research suggests that drinking alcohol in older age may lower mortality risk. However, the scientists are cautious about potential biases in their own research and say that more research is necessary.
The debate around the potential health benefits of alcohol has been ongoing.
Some studies have suggested that moderate alcohol consumption extends life and protects the heart, while others have negated these benefits, arguing that the former studies are flawed and that there is no such thing as safe alcohol consumption.
THERE ARE 5 MILLION cases of elder fraud in the United States annually, resulting in $27.4 billion in losses. Most victims don’t report it, due to embarrassment. As awareness of this issue grows, so does the brazenness of those committing the frauds.
Too Trusting = Susceptibility
Seniors seem to be most susceptible to fraud and abuse; they come from a generation that trusted. Baby boomers are more skeptical. But I think as you age, you want to believe in the goodness of people, and that makes you more vulnerable.
Seniors are in more frequent contact with medical professionals who can steal their vital information. My brother-in-law’s identity was stolen by someone who stole a credit card receipt for his inpatient hospital TV service.
New York’s ongoing measles epidemic alarmed midtown Manhattan resident Deb Ivanhoe, who couldn’t remember whether she’d ever been vaccinated as a child.
So Ivanhoe, 60, sought out her long-time primary care doctor, who performed an antibody test to see whether she had any protection against measles.
To her surprise, the test revealed that Ivanhoe had no immunity to measles. Her doctor quickly gave her a measles booster shot.
“I’m a New Yorker. I’m out and about. I take the subway every day,” Ivanhoe said of her concerns. “One of the outbreak areas is in Williamsburg, Brooklyn. I have friends in Williamsburg. I go to there to visit, for dinner. It all becomes local.”
Every day, all around us, older adults make a positive impact in our communities. As employees, volunteers, mentors, and advocates, they are an integral part of America’s social fabric. Their experience and insights enrich and strengthen our neighborhoods, workplaces, and families.
That’s why ACL takes time each May to honor their valuable contributions and celebrate Older Americans Month (OAM). People of all ages can celebrate OAM and help older adults thrive. With the 2019 theme, Connect, Create, and Contribute, ACL invites you to:
Connect with friends, family, and services that support participation
Create through activities that promote learning, health, and personal enrichment
Contribute time, talent, and life experience to benefit others
Treatments that prevent recurrence of types of stroke and dementia caused by damage to small blood vessels in the brain have moved a step closer, following a small study.
The drugs — called cilostazol and isosorbide mononitrate — are already used to treat other conditions, such as heart disease and angina.
This is the first time they have been tested in the UK for the treatment of stroke or vascular dementia.
A study involving more than 50 stroke patients found that patients tolerated the drugs, with no serious side effects, even when the drugs were given in full dose or in combination with other medicines.
I live in a large co-op apartment building in Manhattan. Our staff is lovely and caring. A staff member told me that a resident is getting very forgetful and that she likes to spend her time in the lobby. I asked if she had family and was told she had only one brother in Japan. I was probably chosen as a confidante because I cared for my husband who had Alzheimer’s at home. Despite that experience, I was at a loss to give advice.
One day, I got on the elevator with this lovely, forgetful neighbor. She could not remember the number of the floor on which she lived. I offered to accompany her downstairs to learn her apartment number. She thanked me but was naturally embarrassed at the need for help and declined. She acknowledged that she was getting forgetful, and I told her my husband had the same problem and I understood.
I now find myself very worried about what will happen to this nice lady who has no one to help her. The thought has also crossed my mind that she may be a danger not only to herself but also to others living in the building. I am aware of the right of an individual to age in place versus the need for assistance, but this can’t be a unique problem. Is there a protocol for managing agents of buildings to follow? Linda, New York
Eric Lewis’ plans of expanding his community hospital’s reach have been derailed.
As CEO of Olympic Medical Center, he oversees efforts to provide care to roughly 75,000 people in Clallam County, in the isolated, rural northwestern corner of Washington state.
Last year, Lewis planned to build a primary care clinic in Sequim, a town about 17 miles from the medical center’s main campus of a hospital and clinics in Port Angeles.
But those plans were put aside, Lewis says, because of a change in federal reimbursements this year. Medicare has opted to pay hospitals that have outpatient facilities “off campus” a lower rate — equivalent to what it pays independent doctors for clinic visits.
Nancy Schoenborn, a geriatrician at Johns Hopkins University’s School of Medicine, noticed that doctors increasingly are being told by their professional organizations to treat patients in the last decade or so of life differently. Less aggressive control of blood sugar and blood pressure makes sense for people with fewer years to go, the guidelines suggest. Screening tests for certain cancers probably won’t be beneficial if a patient is unlikely to live at least an additional 10 years.
The emphasis on life span rather than age stems from the recognition that health varies widely in the last chapters of life, and age alone is a poor predictor of how a patient is doing. A sick 65-year-old and a healthy 80-year-old might each have nine years left.
These new rules, though, present doctors like Schoenborn with a problem. How exactly is she supposed to explain her treatment decisions to patients?
This question led her to start asking older Americans how they want to talk about mortality with their doctors. Her recent survey, published in Annals of Family Medicine, revealed some surprising results.
A new paper published in Nature Reviews Neurology suggests that recent advances in deep brain stimulation (DBS) for Parkinson disease could lead to treatments for conditions such as obsessive-compulsive disorder (OCD), Gilles de la Tourette syndrome and depression. The authors of the paper, from the Geneva University Hospitals (HUG), University of Geneva, University of Tübingen and the Wyss Center for Bio and Neuroengineering, argue that bi-directional electrodes which can both stimulate and record from deep brain structures — known as closed-loop DBS — could have applications beyond Parkinson disease.
Other bi-directional brain-computer interfaces (BCIs) have been in development in recent years, notably for the real-time signal processing of neuronal activity to allow control of a robotic arm directly from the brain in people with paralysis.
Professor John Donoghue, Director of the Wyss Center: “Interestingly the fields of brain-computer interfaces for movement restoration and deep brain stimulation for Parkinson disease have developed largely independently. Deep brain stimulation researchers tend to be neurologists or neurosurgeons while brain-computer interface researchers are often neuroscientists, roboticists and engineers. By working together and sharing information we can learn from each other and potentially expand the reach of this technology so that it can help more people.”