Study: High-Intensity Exercise Might Slow Pre-Alzheimer's Mental Decline

A new study in the Archives of Neurology suggests that high-intensity exercise could improve cognitive performance in older adults who have mild cognitive impairment.

In the study, 33 adults with mild cognitive impairment were sorted into high-intensity aerobic exercise and stretching control groups. At the end of the six-month trial period, those in the exercise group displayed markedly improved cognitive performance. Interestingly, the effects were more pronounced in women, although both sexes experienced gains in cardiorespiratory fitness and body fat reduction.

A New Flu Concern: Secondary Bacterial Infections Cause Mortality to Rise

New research published in The American Journal of Pathology revealed that bacterial infections that ride on the coattails of the flu virus can cause increased mortality even in normal, healthy adults during influenza pandemics.

It was already known that secondary bacterial infections with the influenza virus can cause increased morbidity and mortality in young children, the elderly and people who are immunocompromised, but the study found that the flu virus can leave otherwise healthy people open to infections as well.

The study, performed at the Torrey Pines Institute for Molecular Studies, was conducted on mice and found that lethality was dependent upon the interval between the administration of the virus and the bacteria. Bacterial growth was prolonged in the lungs of mice who were exposed to both the virus and bacteria.

The most common bacterial infections following a flu outbreak include Streptococcus pneumoniae, Haemophilus influenzae, Group A Streptococcus and Staphylococcus aureus.

Study: More Than Half of Insulin-Dependent Diabetics Report Intentionally Skipping Injections

A recent study, published in Diabetes Care, revealed that a significant number of insulin-dependent diabetics intentionally skip insulin injections.

Of the 502 adults who were surveyed, intentional insulin omission was reported by more than half of the respondents. Regular omission was reported by 20 percent of the group. Common risk factors for skipping injections included lower age, lower income and education, type 2 diabetes, not following a healthy diet, taking more daily injections, interference of injections with daily activities and injection pain and embarrassment.

These risk factors differed between people with type 1 and type 2 diabetes. Diet nonadherence was more prevalent in people with type 1 diabetes while age, education, income, pain and embarrassment were more prominent in people with type 2 diabetes.

"It's important for physicians and other healthcare professionals to be aware of potential risk factors, especially for patients who report injection-related problems. We hope that in the future doctors will work closer with patients to determine their individual needs so that they can better plan activities to facilitate patients' adherence with their treatment regimens," said Mark Peyrot, the study's lead researcher.

To view the study, click here.

January 26: AAHSA's Congressional Call-In Day

Today, January 26, is AAHSA's designated Congressional Call-In Day. The group is urging all members of the aging and disability communities to call their representative and two senators to urge them to pass healthcare reform as soon as possible.

AAHSA has even provided a sample script for callers to use:
"Hello. I am calling to tell Sen./Rep _______________ that this is the time for Congress to pass meaningful healthcare reform that includes the CLASS Act, Medicare payment updates for nursing homes and home health providers and improvements in Medicaid home- and community-based services. Elders, people with disabilities and all American families cannot wait any longer for relief."

You can reach your representative and senators by dialing (800) 828-0498.

For additional information about AAHSA's Congressional Call-In Day, click here.

Elderly Women with Dementia Receiving Mammograms Against Recommendations

A new study in the American Journal of Public Health found that many elderly women with dementia continued to receive mammograms despite recommendations against the practice.

The American Cancer Society recommends against performing mammograms on people with fewer than five years to live. On average, women aged 70 years or older with severe cognitive impairment have a median survival of 3.3 years.

According to the study, women aged 70 or older with severe cognitive impairment had a mammogram rate of 18 percent, compared to 45 percent for women with normal cognition. Women who were cognitively impaired but had a high net worth and were married had a mammogram rate of close to 50 percent.

"Given the limited life expectancy of women with severe cognitive impairment, guidelines should explicitly recommend against screening these women," the study's authors noted.

Relief Slowly Arriving at Haiti's Nursing Homes

Despite the flood of news coming out of Haiti, little has been shared about the fate of the nation's nursing home residents. A CBS News report paints a bleak picture of elderly Haitians fighting to survive without food, water and their medication.

At Port-au-Prince Municipal Nursing Home, which is located barely a mile from the airport where massive aid is pouring in, many residents were still wearing briefs that hadn't been changed since the earthquake that were beginning to attract rats.

Thankfully, it appears that aid is beginning to trickle into Haiti's nursing homes. Volunteers have brought food, including rice and bowls of spaghetti, to residents. Other volunteers provided antibiotics. Still, it isn't nearly enough.

Louis Belanger, a spokesman for Oxfam Great Britain, was quoted as saying, "It is very often the case that the strongest and fittest get help.... Those left behind are the elderly and the women with children, so we are working hard to make sure aid is coordinated."

The American Association of Homes and Services for the Aging (AAHSA) is encouraging its members to donate what they can to credible organizations, such as the Red Cross, that are involved in disaster relief.

Up In Smoke: Researchers Discouraged from Studying Medical Marijuana

A recent New York Times article revealed that even as the Obama administration takes a more liberal stance on state medical marijuana laws, the federal government continues to discourage research into the medicinal uses of smoked marijuana.

According to the article, marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.

If researchers wish to study the medicinal effects of marijuana, they must apply to the National Institute on Drug Abuse to use stores from the nation's only federally approved marijuana plantation, located at the University of Mississippi.

However, federal officials have repeatedly failed to act on marijuana research requests in a timely manner, or they have flat-out denied them. This frustrates researchers, who point to studies that demonstrate convincingly that marijuana can relieve nausea and improve appetite among cancer patients undergoing chemotherapy. Studies have also shown that marijuana can alleviate the aching and numbness suffered by patients with HIV and AIDS. There are also strong indications that marijuana might aleviate some of the neurological problems associated with degenerative diseases such as multiple sclerosis.

However, there is no solid evidence that marijuana needs to be smoked in order for patients to achieve these results. In 1985, the FDA approved Marinol, a prescription pill form of marijuana's active ingredient, THC.

As a result of federal officials' reluctance to approve marijuana research, there's not a lot of good science underlying its use - but that doesn't stop some patients from swearing by it.

McNeil Recalls OTC Products with Mildew-Like Odor

McNeil Consumer Healthcare announced on January 15 that they are voluntarily recalling certain lots of OTC products in the Americas, United Arab Emirates and Fiji. The recall was issued following consumer reports of an unusual mildew-like odor that resulted in nausea, stomach pain, vomiting or diarrhea in a small number of cases. The recall was taken in consultation with the FDA.

Upon investigation, McNeil determined that the smell was caused by the breakdown of a chemical that is sometimes applied to wood that is used to build wood pallets that transport and store product packaging materials.

In December of 2009, McNeil recalled all lots of Tylenol Arthritis Pain 100 with EZ-Open Cap in relation to the same issue.

Affected products include certain lots of the following:

• Tylenol
• Motrin
• Benadryl Allergy Ultratab
• Rolaids Antacid Tablets
• Simply Sleep
• St. Joseph

To learn how to return the affected products and to view a complete listing of the recalled product lots, please click here.

If your facility is looking for an alternative to any of these products in light of the recall, ProMed has a wide variety of OTC products immediately available.

DOJ Slaps J&J with Kickback Suit Involving Nation's Largest Nursing Home Pharmacy

The U.S. Department of Justice has slapped Johnson & Johnson and two of its subsidiaries with with a civil false claims suit for allegedly paying millions of dollars in kickbacks to Omnicare Inc., the nation's largest pharmacy. Omnicare specializes in dispensing drugs to nursing home patients.

According to the suit, Johnson & Johnson (J&J) paid kickbacks to Omnicare to induce the pharmacy to purchase and recommend J&J drugs, including the antipsychotic drug Risperdal, for use in nursing homes.

The suit alleges that J&J did the following to entice Omnicare and its pharmacists into recommending J&J drugs:

1. J&J entered into agreements with Omnicare that entitled Omnicare to increasing levels of rebates from J&J - as long as Omnicare implemented specific programs to increase the prescription of J&J drugs.
2. J&J paid Omnicare millions of dollars for "data," much of which Omnicare never provided. The suit purports that these payments were little more than a way to entice Omnicare into recommending J&J drugs.
3. J&J provided numerous payments under the guise of "grants" and "educational funding" that were, again, an incentive for Omnicare to recommend J&J drugs.

The complaint was filed in two consolidated whistleblower lawsuits presently on file in the District of Massachusetts.

To learn more about the suit, click here.

MIT: Nutrient Mix Might Improve Memory in Alzheimer's Patients

Researchers at MIT have found that a combination of nutrients has shown potential for improving memory in Alzheimer's patients by stimulating the growth of new brain connections.

The nutrient mix included three naturally occuring nutrients believed to promote the growth of new brain connections (also known as synapses), B vitamins, phosopholipids and antioxidants. The mix improved verbal memory in patients with mild Alzheimer's.

Richard Wurtman, who did the basic research that led to the experimental treatment, noted that "If you can increase the number of synapses by enhancing their production, you might to some extent avoid that loss of cognitive ability."

Currently, there is no cure for Alzheimer's disease, although some medications have been shown to slow its progression.

Illicit Drug Use on the Rise among Older Adults

New research, published in The NSDUH Report, suggests that the number of older adults using drugs will increase over the next two decades. The report attributes this to high rates of lifetime drug use among the baby boomer generation combined with the large size of that group.

As a result, by 2020, the number of people needing treatment for substance abuse will double among people age 50 and older. Age-related physiological, psychological and social changes can make older adults more vulnerable to the negative effects of drug use, and many prescription and over-the-counter medications commonly used by older adults could interact adversely with illicit drugs.

NSDUH acknowledges that reducing and treating drug abuse problems among the growing elderly population will require "an integrated system of care that combines medical and behavioral health services to fully address the spectrum of problems that patients bring to the primary care setting."

Additionally, NSDUH recommends that healthcare providers who specialize in treating the older adult population add routine screening to their regular interactions with their patients.

Additional findings from the study:

• 4.7 percent of adults aged 50 or older (about 4.3 million adults) used an illicit drug in the past year
• Marijuana use was more common than nonmedical use of prescription-type drugs for adults aged 55 to 59, but among those aged 65 years or older, nonmedical use of prescription-type drugs was more common than marijuana use

OIG: Medicare is Overpaying for Enteral Nutrients in Nursing Homes

According to a new report from the Office of the Inspector General (OIG), Medicare's fee schedule for enteral nutrients under Medicare Part B was more than double the prices available to nursing home suppliers in 2006.

Researchers found that Medicare Part B paid $284 million in 2006 for enteral nutrition therapy (ENT) to nursing homes for non-Part A stays. For example, the average price paid for B4150 nutrients was 67 cents per unit, compared to costing 32 cents for suppliers. B4154 nutrients were priced at $1.22 per unit under the Medicare schedule and cost 56 cents for suppliers.

The OIG is recommending the following as two potential fixes for the problem:

1. Have CMS adjust the Medicare fee schedule amounts for enteral nutrients in order to more accurately reflect supplier prices for nutrients provided to nursing home residents.
2. Encourage Congress to change the prosthetic device benefit to restrict Part B coverage to a beneficiary's home and thereby recognize enteral nutrients as food covered under nursing room and board payment.

According to the report, CMS agrees with the recommendations and is taking steps to more accurately reflect supplier prices for nutrients provided to nursing home residents.

FDA: Sybaritic Must Stop Producing Unapproved Medical Devices

Until they're in compliance with FDA quality standards, Sybaritic, Inc., a medical device manufacturer, has agreed to stop producing its products manufactured for use in laser surgery, dermatology and spa treatments.

According to a press release from the FDA, these products are considered to be unapproved medical devices because they lack the appropriate FDA clearance and approval for safety and effectiveness.

Under the terms of their consent decree with the FDA, Sybaritic agreed to comply with the FDA's Quality System (QS) regulation and retain an independent expert consultant to inspect its operations and certify to the FDA that corrections have been made.

Over the past several years, the FDA has conducted inspections at Sybaritic that revealed violations of the QS regulation, including violations related to design controls, complaint handling, corrective and preventive action and quality audits. These inspections also revealed that a number of Sybaritic products had not undergone the required FDA premarket review. The company also failed to submit medical device reports to the FDA as required.

Happy National Influenza Vaccination Week!

Today starts National Influenza Vaccination Week! What better way to celebrate than by getting yourself vaccinated?

It might seem like we're not hearing as much about H1N1, but the flu season is far from over. According to the CDC, flu season typically lasts until May. The flu can be unpredictable and additional waves of illness are likely still on the way.

The CDC estimates that three fifths of all Americans haven't received the H1N1 vaccine. To find a vaccination location near you, click here.

Study: Cell Phones Might Protect Against, Reverse Alzheimer's Disease

Finally, some good news for those of us who just can't seem to unglue our cell phones from our ears.

A new study at the University of South Florida's Alzheimer's Disease Research Center has found that long-term exposure to the electromagnetic waves associated with cell phone use might actually protect against or even reverse Alzheimer's disease.

The study involved 96 mice, most of which were genetically altered to develop beta-amyloid plaques and memory problems that mimicked Alzheimer's disease as they aged. Some of the mice were left non-demented so that researchers could also test the effects of electromagnetic waves on normal memory.

The mice were exposed to electromagnetic waves for two one-hour periods a day for seven to nine months. Researchers found that if mice were exposed to the waves before they were young adults - before their memory was impaired - their cognitive ability was protected. When older mice who were already displaying memory problems were exposed, their memory impairment disappeared. Months of exposure even boosted the memories of normal mice to above-normal levels.

It took months for the benefits of exposure to show up in mice. For humans, the same results would likely take years.

The researchers are suggesting that electromagnetic wave exposure might in fact be an effective, non-invasive, drug-free way to prevent and treat Alzheimer's disease in humans.

Fewer than One Fifth of Nursing Homes Have End-of-Life Care Programs

Surprising new findings reveal that fewer than 20 percent of nursing homes provide end-of-life care programs, even though roughly 25 percent of all deaths in America occur in nursing homes.

The data, gathered during the 2004 National Nursing Home Survey, was analyzed by the Institute for the Future of Aging Services (IFAS), the research division of the American Association of Homes and Services for the Aging.

Researchers discovered that facilities were more likely to have end-of-life care programs if they had specialty programs for hospice, pain management or dementia care. They also found a strong correlation between end-of-life program participation and staff training for end-of-life care services.

Helaine Resnick, the director of research at IFAS, observed that the key to expanding end-of-life care program participation could very well be providing appropriate staff training. Providers also need to consider the professional value that end-of-life care training and participation offers to both staff and residents.

New Alliance Targets Long-Term Care Quality

A new coalition, composed of 29 groups representing nursing homes, academia, caregivers, consumers and the federal government, is taking aim at improving the quality of care that long-term care residents receive.

The Long-Term Care Quality Alliance prides itself on being a diverse group of stakeholders who will strive to do the following:

• Identify performance measures and evidence-based practices that are effective in assessing and improving both quality of life and quality of care
• Recommend ways in which to apply current measurement and performance improvement strategies in high-priority areas (such as care coordination)
• Propose ways to build on or create momentum for existing quality initiatives
• Achieve tangible improvements in care through the use of pilots, technical collaboration and demonstrations

The chairwoman of the alliance is Mary Naylor, director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania's School of Nursing. Former CMS Administrator Mark McClellan and current Agency for Healthcare Research and Quality Director Carolyn Clancy are also both members of the alliance.

Thank You to The New Lenox Patriot!

We'd like to thank The New Lenox Patriot for the wonderful article they published on the Barnes Foundation's $30K donation to the American Cancer Society's Illinois Patient Navigation Services.

The money for the donation was raised during the Barnes Foundation's First Annual Walk for Life, which was held in New Lenox on October 4. The donation was presented to representatives from the American Cancer Society during ProMed's annual Christmas party, which helped everyone in attendance feel even merrier!

The $30,000 donation will be matched in full through the generosity of the Duchossois Family Foundation's Campaign for Hope.

Spike in Pneumococcal Infections Tied to Influenza Pandemic

According to an article from the American Academy of Family Physicians, influenza isn't the only illness people need to be wary of this flu season. CMS is also reporting a nationwide spike in pneumococcal infections.

Anne Schuchat, the director of the CDC's National Center for Immunization and Respiratory Diseases, noted that influenza infections can reduce the lining of the respiratory tract and set the stage for secondary pneumonia. When a viral infection, such as influenza, is present, common bacterias have an easier time invading the lungs.

In Denver, one of the CDC's active bacterial core surveillance sites, 58 cases of pneumococcal disease were reported during the month of October. For the past five years, the average has been 20 cases in October. Denver's results aren't thought to be atypical.

Schuchat noted that vaccination is the best way to protect against pneumococcal infections. With the vaccine becoming readily available, the CDC is encouraging physicians to offer it to anyone who requests it once the needs of their priority populations have been met.