Simple test may help predict long-term outcome after stroke

A simple test taken within a week of a stroke may help predict how well people will have recovered up to three years later, according to a study published in the October 17, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“We found that this test, which takes less than 10 minutes, can help predict whether people will have impaired thinking skills, problems that keep them from performing daily tasks such as bathing and dressing and even whether they will be more likely to die,” said study author Martin Dichgans, MD, of Ludwig-Maximilians University in Munich, Germany. “This test should be used to screen people with stroke and to counsel them and their families about long-term prognosis and also to identify those who would most benefit from interventions that could improve their outcomes.”

For the study, 274 people in Germany and France who had a stroke were given the test, called the Montreal Cognitive Assessment, within a week of the stroke. They were then divided into two groups: those with no problems with thinking and memory skills and those with cognitive impairment. The participants were tested for their thinking and memory skills, motor functioning and ability to complete daily living tasks six months later and then at one and three years after the stroke.

Full story at Science Daily

5 Steps for Picking a Medicare Plan

FOR MOST OF US, MAKING the move from private, employer-provided health insurance to Medicare is a daunting task. First, there’s the new lexicon: Medicare Advantage, Part B, Part D, Medigap – what do they mean? Then there’s the fear: “The Medicare decisions you’re about to make will affect your health care and out-of-pocket costs for the rest of your life,” says the Medicare information organization 65 Incorporated.

Yikes – that’s a lot of pressure! Take a deep breath, because with some research and careful consideration, you can find a Medicare plan that works for you. Here are the steps you should take to make the right choice.

1. Check your timing. “Timing is one of most important decisions a person can make,” says Diane Omdahl, co-founder and president of 65 Incorporated. Many people need to enroll during the Initial Enrollment Period, which is the seven months surrounding one’s 65th birthday – including the three months before, your birthday month and the four months after. Patients may be responsible for late penalties and lapses in coverage if they don’t qualify for a Special Enrollment Period, which allows you to enroll outside your 65th birthday window or during open enrollment, for unplanned events like losing a job and associated health insurance coverage.

Full story at US News Health

Keto diet may protect against cognitive decline

Ketogenic, or keto, diets are low-carb and fat-rich, and many people who follow such regimens do it to shed excess weight. However, a keto diet may bring other benefits, too. In particular, it may help keep the brain healthy and young, as new research in mice seems to suggest.

A keto diet is high in fat, low in carbohydrates, and has an adequate amount of protein.

This kind of diet is meant to trigger ketosis, which is a metabolic process through which the body breaks down fat and protein and transforms them into energy, leading to weight loss.

Full story at Medical News Today

Businesses Increasingly Hiring People With Disabilities

CHICAGO — When Glynis Harvey and Mark Cagley opened Hidden Manna Cafe four years ago, the couple did not set out to hire people with disabilities.

But then a social service agency asked: Might the Matteson restaurant employ a woman with cerebral palsy? How about a man with mild blindness? A customer asked for an application for her sister, who has an intellectual disability.

Harvey and Cagley were good people to ask. They have twin sons, now 28, with autism, and so they understood how difficult it is for people with disabilities to find jobs. They also knew how hard they worked once given the chance.

Full story at Disability Scoop

Exercise reduces stress, improves cellular health in family caregivers

Exercising at least three times a week for six months reduced stress in a group of family caregivers and even appeared to lengthen a small section of their chromosomes that is believed to slow cellular aging, new UBC research has found.

“I am hoping that a new focus on the family caregiver will emerge out of this research,” said Eli Puterman, a professor in the University of British Columbia’s school of kinesiology and lead author of the study. “We need to design interventions that help caregivers take care of their bodies and their minds, and provide the type of support that’s needed to maintain that long-term.”

The population of seniors in the U.S., where Puterman and colleagues from the University of California conducted the study, is expected to nearly double by 2050. Younger family members will increasingly be providing this type of care and it can take a toll on their health.

Full story at Science Daily

Alzheimer’s burden will double by 2060, warn CDC

A report newly published by the Centers for Disease Control and Prevention estimates that the burden of Alzheimer’s disease and related forms of dementia in the United States will double by the year 2060.

About 5.7 million individuals in the United States are living with Alzheimer’s disease, according to the Alzheimer’s Association.

This neurodegenerative disease is one of the leading causes of disability and the sixth-leading cause of mortality in the U.S.

With annual healthcare costs of more than $250 billion, the disease also puts a significant strain on the nation’s healthcare system.

Full story at Medical News Today

Can chiropractic care disrupt vision?

For those in the habit of getting their neck adjusted by a chiropractor, the University of Michigan Kellogg Eye Center has interesting information to know about: High velocity neck manipulation has been shown to result in stress on the eye and lead to spotty vision.

The risk is rare, but one that Yannis Paulus, M.D., a retina specialist at Kellogg, reports on in the American Journal of Ophthalmology Case Reports.

The energetic thrusts and rotations sometimes performed in high-velocity neck manipulation have been linked to damage to the blood vessels in the retina. Resulting abnormal bleeding inside the eye may also cause vision loss.

This was the case for a 59-year-old woman who experienced a “tadpole” shaped spot in her vision while driving home from a chiropractor visit — with her sight worsening the next day. She had just received cervical spine manipulation using the high-velocity technique to help with her headaches.

Full story at Science Daily

What Is a Geriatric Emergency Department?

NOBODY LOVES AN emergency room visit, least of all older patients. Everything about the ER experience can be more challenging for older adults. Time in the waiting room is harder to tolerate: You’re cold and they’ve run out of blankets. If you’re confused or disoriented, the harsh lighting, bursts of yelling and constant noise make it worse. If you’re unsteady on your feet and need the bathroom, navigating cramped ER quarters is difficult. If your joints are painful or your skin is thin and delicate, “resting” on a cot or stretcher is tough. If you’re alone, without a friend or family member, it’s frightening.

When older patients are admitted to the emergency department, vague-sounding symptoms (“I feel dizzy.” Or “I just don’t feel right.”) may actually be more serious than for someone younger. Common conditions like urinary tract infections can present themselves quite differently depending on age, and treatments may vary. For these reasons and more, some emergency departments are making changes to tailor their care and better meet the needs of older adults.

Full story at US News

Daily Aspirin Doesn’t Appear to Prolong Healthy Life for Older Adults

IF YOU’RE AN ADULT IN your late 60s or 70s who’s physically healthy, mentally sharp and trying to stay that way, taking a daily low-dose aspirin probably won’t help that much, new research shows. Until now, there hasn’t been much guidance for healthy older people trying to weigh the possible preventive effects of aspirin against its known increased risks of bleeding.

On Sept. 16, findings from a large new study on preventive aspirin use appeared in the New England Journal of Medicine. The three-pronged clinical trial encompassed more than 19,000 older adults in the U.S. and Australia. Participants were living independently, without heart disease, dementia or diabetes when they enrolled between 2010 and 2014 in the study sponsored by the National Institute on Aging.

Participants, whose average age was 74, were randomly assigned to take either a daily low-dose 100 milligram aspirin (the international equivalent of a standard 81 mg baby aspirin) or a placebo. Over a roughly five-year period, researchers followed these healthy seniors to see whether regular preventive aspirin extended their lifespan free of disability or dementia. However, there was no real difference between people on aspirin and those on a placebo, results showed.

Full story at US News

Patients with sepsis at higher risk of stroke, heart attack after hospital discharge

Patients with sepsis are at increased risk of stroke or myocardial infarction (heart attack) in the first 4 weeks after hospital discharge, according to a large Taiwanese study published in CMAJ (Canadian Medical Association Journal).

Sepsis accounts for an estimated 8 million deaths worldwide, and in Canada causes more than half of all deaths from infectious diseases.

Researchers looked at data on more than 1 million people in Taiwan, of whom 42 316 patients had sepsis, matched with control patients in the hospital and the general population. All sepsis patients had at least one organ dysfunction, 35% were in the intensive care unit and 22% died within 30 days of admission. In the total group of patients with sepsis, 1012 had a cardiovascular event, 831 had a stroke and 184 had a myocardial infarction within 180 days of discharge from hospital. Risk was highest in the first 7 days after discharge, with more than one-quarter (26%) of myocardial infarction or stroke occurring in the immediate period and 51% occurring within 35 days.

Full story at Science Daily