Inexpensive Drug Can Cut Heart Patient Rehospitalizations by One-Third

A new study has shown that the inexpensive drug digoxin, also known as digitalis, can cut the risk of rehospitalization in heart failure patients by more than 30 percent.

During the study, researchers reexamined the results of a 1997 study that concluded that digoxin did not lower death rates. They found that while it might not lower death rates, it did make patients 34 percent less likely to be admitted to a hospital within 30 days. Half of the members of the trial group were 65 years or older.

The researchers are now seeking to replicate the results in a modern study.

To learn more, click here.

Study: Researchers Overlooking Seniors

Even though 34 percent of medical expenditures come from seniors, more than half of U.S. clinical trials exclude the elderly, according to a new study out of the University of Michigan.

The study found that more than 50 percent of clinical trials published in major medical journals did not include seniors or people with age-related illnesses. The remaining studies also excluded frail participants and individuals with cognitive problems.

To learn more, click here.

Study: Many Medicare Enrollees Not Receiving Recommended RA Drugs

A new study published in the Journal of the American Medical Association found that more than one-third of the 93,000 Medicare recipients who receive treatment for rheumatoid arthritis (RA) did not receive recommended disease-modifying anti-rheumatic drugs, or DMARDs.

Additionally, blacks, men, people living in poorer areas and residents of the Middle and South Atlantic regions are less likely to receive DMARDs. The study's lead author called this disparity "unacceptable."

To learn more, click here.

Keep Walking to Stave Off Dementia

Want to cut your dementia risk? Then lace up your walking shoes! According to a new study out of the University of Pittsburgh, walking at least six miles a week helps to protect brain size and, in turn, preserve memory.

Our brains begin to shrink in late adulthood, which can cause trouble with memory. Walking has been found to increase the volume of the brain's gray matter, which is associated with fewer memory problems.

During the study, 299 dementia-free participants recorded the number of blocks they walked in a week. People who walked at least 72 blocks a week - or roughly six miles - were found to have more gray matter nine years later than people who didn't walk as much. The participants who walked the most during the study cut their risk of memory problems in half. However, walking more than six miles didn't appear to increase gray matter volume any further.

The study was published in the October 13 online version of the journal Neurology and was supported by the National Institute on Aging. To learn more, click here.

Senator Blasts Sebelius, Berwick

In an October 6 letter, Senator Chuck Grassley (R-Iowa) took CMS Administrator Don Berwick and HHS Secretary Kathleen Sebelius to task for "inadequate management and oversight of contractors by the Centers for Medicare and Medicaid Services (CMS)." He goes on to express his concern over his perception that CMS "does not seem to examine its contractors' roles in enabling taxpayer dollars to be misused or wasted and to hold contractors accountable if they fail to carry out their responsibilities as expected."

Grassley cites a report from the Office of the Inspector General (OIG), Analysis of Errors  Identified in the Fiscal Year 2009 Comprehensive Error Rate Testing Program, in his letter. According to the report, a total of $4,720,432 was spent on improper payments during FY 2009. The majority of those payments (40%) were made to inpatient hospitals. Skilled nursing facilities received 6% of the improper payments, for a total of $260,381.

Grassley also expressed concern over what he perceives as an apparent lack of accountability by Medicare contractors known as Quality Improvement Organizations (QIOs). He is challenging HHS and CMS to address his concerns and allegations in a response by October 20.

To view Grassley's letter, click here.

Study: Palliative Care Can Lead to Longer, Better Lives

A new study from Harvard Medical School has found that for some terminally ill patients, palliative care can lead to longer, better lives.

The researchers found that lung cancer patients who received palliative care during the last months of life reported a 50% lower rate of depression and lived an average of 2.5 months longer than patients who received standard medical care. Palliative care traditionally focuses on treating pain, anxiety and loss of appetite.

The study was published in the New England Journal of Medicine. To view the study's abstract, click here.

MRSA Slows Down, New Superbug Ready to Pick Up the Pace

Would you like the good news or the bad news first? The good news? Okay, here it is - according to an article published in the Journal of the American Medical Association, severe MRSA cases in healthcare settings fell by 28 percent between 2005 and 2008, possibly because of successful preventive measures.

So...now for the bad news. While MRSA appears to be waning, a new superbug is waiting in the wings. According to an article published in Lancet Infectious Diseases, British scientists are warning that a gene known as NDM-1 has been found to be capable of altering bacteria to become almost impervious to antibiotics. The bug has already been found in the U.S. and could continue to spread people travel to India and back. The bug has also been found in the U.K., Netherlands, Canada, Australia and Sweden.

Study: Keep Your Shoes On

It's not as comfy as lounging in slippers or socks, but a new study has found that seniors who wear shoes, especially sneakers, around their homes are less likely to fall.

The study, performed at Boston's Institute for Aging Research, Hebrew SeniorLife, found that people who wear shoes on a regular basis at home are far less likely to fall than people who wore slippers, socks or went barefoot. During the study, researchers followed 765 people between the ages of 64 and 97 for more than two years. Falls took place all over the house, including the bathroom, stairs, kitchen and living room, not just in wet or slippery areas.

The researchers pointed out that the traction and ankle support of sneakers help account for the reduction in falls. Sneakers are also ideal for fall prevention because more of the shoe has contact with the ground, which in turn provides more information to the brain to allow for better balance.

To learn more, click here.

Chew On This: The FDA Food Safety Program Could Actually Put Public Health at Risk

A new report released by the Institute of Medicine (IOM) alleges that the FDA isn't properly protecting the nation's food supply and that outbreaks of foodborne illness will continue unless the FDA makes significant changes.

There are about 76 million cases of foodborne illness in the U.S. every year. Of those cases, more than 300,000 people are hospitalized and 5,000 die.

The report suggests that the FDA move away from a "reactive" style of management that works on a case-by-case basis to one that includes strategic planning, ranking hazard risks, performing targeted surveillance and designing an intervention plan. In theory, the new style of management would allow the FDA to catch problems before they become outbreaks.

Other report recommendations included calling upon the FDA to create review standards and asking federal officials to create a separate food safety data agency. This agency would be responsible for collecting information and assessing risks to determine the best action to take.

Food safety regulation is a nebulous area and is actually overseen by several different agencies. The FDA oversees about 80 percent of the food supply, including produce, seafood and dairy. It's also responsible for more than one million restaurants and food establishments, 150,000+ food facilities, upwards of two million farms and millions of tons of imported food. The Department of Agriculture is responsible for meat, poultry and egg products. State and local agencies typically handle inspecting food production facilities and handle surveillance and investigating illness outbreaks.

The report was the result of Congress asking the Institute of Medicine to take a look at problems and work with the FDA to improve food safety.

To learn more, click here.

To Reduce Falls, Check Your "Specs"

According to an article in the online version of McKnight's Long-Term Care News, seniors who wear multifocal prescription glasses can reduce their risk of falling by switching to single-focus lenses while walking outdoors.

During the study, when seniors who normally wear bifocal or multifocal glasses were given single-focus prescription lenses to wear outside, falls were reduced by 8%. There was a 40% fall reduction among seniors who were used to walking around outside, but seniors who typically spent time indoors actually saw an increased risk of falling, which suggests that single-focus lenses might not be a good solution for that group.

To learn more, click here.

Report: PCPs Need Better Preparation to Care for Older Population

A new report published in Health Affairs discusses the urgency of training primary care physicians (PCPs) on how to provide higher-quality, more cost-effective care to older people with chronic conditions.

The report's authors emphasize that additional education will allow PCPs to "apply principles of geriatrics - for example, optimizing functional autonomy and quality of life - within emerging models of chronic care." They propose that the following policy options be used to drive reform:

• Providing financial support for medical schools and residency programs that adopt appropriate educational innovations
• Tailoring Medicare's educational subsidy to reform graduate medical education
• Invoking state requirements that physicians obtain geriatric continuing education credits to maintain their licensure or to practice as Medicaid providers or medical directors of nursing homes

The report also argues that it would be valuable for geriatricians to broaden their expertise to include educational and leadership skills. These individuals could then serve as educators in multiple disciplines, although this would require changes inside and outside academic medicine.

To view the report's abstract, click here.

The Sweet Sound of Memories

New research out of the Boston University School of Medicine discovered that music can help Alzheimer's patients remember new information.

The study, published in Neuropsychologia, revealed that Alzheimer's patients had an easier time recalling song lyrics when they were accompanied by music instead of simply spoken. Interestingly, though, the healthy control group in the study didn't experience the same memory benefit, which seemingly indicates that the memory encoding and retrieval process of musical information in Alzheimer's patients is fundamentally different than the process in healthy seniors.

To view the study's abstract, click here.

Study: Spousal Caregivers of Dementia Patients More Likely To Develop Dementia Themselves

According to a new study published in the Journal of the American Geriatrics Society, spousal caregivers of dementia patients are six times more likely to develop dementia themselves.

The study, conducted by researchers at Utah State University, followed 1,221 married couples age 65 or older in a rural county in northern Utah. Among the participants, husbands were at a higher risk of developing dementia than wives.

The researchers concluded that "the chronic and often severe stress associated with dementia caregiving may exert substantial risk for the development of dementia in spouse caregivers."

To learn more, click here.

Home Health Care Costs Rising, But Not as Fast as Nursing Homes and Assisted Living Facilities

A new study from Genworth Financial revealed that the costs of long-term care delivered in the home are rising, but not nearly as sharply as the costs of nursing homes and assisted living facilities.

The study, titled "2010 Cost of Care Survey," contained the following key findings:

• For licensed homemaker services: The national median hourly rate is $18, which is an increase of 3.0% over 2009. There has been a five-year annual growth of 2.4%.
• For licensed home health aide services, the national median hourly rate is $19, and there was a 2.7% increase over 2009. The five-year annual growth rate is 1.7%.
• For adult day health care, the national median daily rate is $60, which represents a 12.0% increase over 2009. The five-year annual growth figure wasn't available.
• For a one-bedroom/single occupancy living area in an assisted-living facility, the national median monthly rate is $3,185, up 12.0% over 2009. There has been a five-year annual growth of 6.7%.
• For a semi-private room in a nursing home, the national median daily rate is $185, up 5.7% over 2009. The five-year annual growth is 4.6%.
• For a private room in a nursing home, the national median daily rate is $206, up 5.1% over 2009. The five-year annual growth is 4.5%.

To learn more about the study and review more in-depth findings, click here.

MRSA: It's Right Under (Or In) Our Noses

Research at Rhode Island Hospital revealed that one in five long-term care residents have MRSA colonized in their noses. This places those residents at a higher risk of developing an invasive MRSA infection, such as a bloodstream infection, pneumonia or a surgical site infection.

The study also found that the quantity of MRSA in individuals' noses varied widely, from three to 15 million colonies. A heavier colonization of MRSA is an independent risk factor for developing a surgical site infection.

Approximately 1 percent of the population carries some form of MRSA around in their noses. In addition to long-term care residents, rates also tend to be higher in HIV patients (16 percent), outpatient kidney dialysis patients (15 percent) and inpatient kidney dialysis patients (14 percent).

The researchers noted that the presence of MRSA in the nose does not necessarily indicate infection.

Can Hallucinogens Help Ease End-of-Life Anxiety? Some Researchers Just Say "Yes"

After years of "just say no" when it comes to drugs, it turns out that some scientists think it's not a bad idea to say "yes" - for people near their ends of their lives, that is.

According to an article posted on the online version of McKnight's Long-Term Care News, researchers are once again studying hallucinogens' ability to ease depression and anxiety, especially among hospice patients nearing death. Federal regulators put the kibosh on most legitimate clinical research on hallucinogens following the counter-culture movement of the '60s, but are now allowing it under very controlled circumstances.

One drug being researched is psilocybin, the psychotropic ingredient found in mushrooms. According to an article in The New York Times, subjects in a study on psilocybin reported that the drug created a "profound spiritual experience with lasting positive effects for most of them. None had had any previous experience with hallucinogens, and none were even sure what drug was being administered."

Many participants also felt "their egos and bodies vanishing as they felt part of some larger state of consciousness in which their personal worries and insecurities vanished," according to the Times article. Researchers think that this feeling of dissociation could help terminal patients overcome their fear of physical death and non-terminal depression sufferers reassess their attitudes and overcome anxieties.

To read the McKnight's article, click here. To read The New York Times article, click here.

Institute on Aging: Adult Day Health Care Helps Seniors Maintain Health, Independence

Since the '70s, adult day health care has been an alternative to nursing home care for seniors with chronic illnesses, disabilities or dementia - and a new study from the Institute on Aging (IOA) has found that it can play a vital role in helping seniors maintain their health and independence.

According to a press release from the IOA, "Adult day health care programs provide seniors living in the community with transportation to non-residential facilities where they receive health services, nutritious meals and social activities as many as five days per week, helping to prevent premature institutionalization and freeing family caregivers to work or attend to errands." These programs are also much less expensive than nursing home home care.

During the study, the IOA research team followed attendees of 16 San Francisco adult day health centers and comparable adults who didn't attend a day center. After a year, they found that day center attendees had significantly fewer problems with regular daily activities. The attendees also perceived an increase in their quality of life, which some researchers believe can result in better health and reduced health care utilization and mortality.

To learn more about the study, click here.

Mayo Clinic: Computer Use and Exercise Could Help Prevent Mild Cognitive Impairment

A team of researchers at the Mayo Clinic found that combining physical exercise and computer use could be beneficial in protecting against mild cognitive impairment, a brain disorder that affects the nerve cells involved in thinking abilities.

Earlier studies had established the value of exercise and computer use in helping to stave off cognitive impairment, but this new study found that combining the two creates even more beneficial results. In other words, study participants who both exercised and spent time on the computer saw greater benefits than participants who did just one or the other.

The study examined 926 individuals between the ages of 70 and 90. Of those, 109 had mild cognitive impairment and 817 were cognitively normal. The researchers used surveys to gather data on participants' physical exercise, cognitive activities (including computer use) and caloric intake over the course of a year. The results were then adjusted for age, sex, education, depression, other medical issues and caloric intake.

To learn more, click here.

Seniors Who Delay Retirement Will Help Boost Medicare and Social Security

A new study from the nonprofit RAND Corporation revealed that the unprecedented increase in the number of older Americans who delay retirement will likely help ease the financial woes facing both Social Security and Medicare.

According to RAND researchers, older Americans began delaying retirement in the late 1990s, a trend that will likely continue and even accelerate over the next 20 years. This is great news for Social Security and Medicare because as more and more Baby Boomers are reaching retirement age, they're leaving proportionately fewer people in the workforce to pay taxes and support the social programs that help provide a safety net for older Americans.

So why are older Americans extending their stay in the workforce? RAND points out several reasons:

• American workers have gained more education, which has enabled them to find jobs that are more fulfilling, not as physically demanding and for which they are paid more.
• There are more dual-earner couples in the workplace, and couples tend to retire together. Since many men are the older half of a couple, they tend to stay in the workforce longer to accommodate their wives' careers.
• They want to earn additional income.
• They have improved health, which allows them to work longer.
• As life expectancy rises, many employees extend their work lives in order to accumulate enough wealth to provide for their needs during old age.

Because this trend could lead to massive benefits for the nation, lawmakers are now considering reforms that would dismantle barriers that discourage older people from remaining employed - for example, measures in some pension plans that penalize recipients who continue working. They're also examining changes that would encourage employers to hire older workers.

To learn more, click here.

Study: Intentional Weight Loss Not Harmful to Seniors After All

For years, it's been a widely held belief that intentional weight loss in seniors leads to an increased risk of death - but new research from Wake Forest University Baptist Medical Center is turning that theory on its ear.

According to researchers, seniors who intentionally exercise and/or modify their diets to lose weight are actually half as likely to die within eight years as their peers who don't work toward weight loss. It's a finding that one of the study's authors describes as "unusually strong and surprising."

Overall, the intervention (weight loss) group in the study saw half as many deaths within eight years as the non-weight-loss group.

A seasoned gerontologist cautioned that the size of the study was relatively small and that the results should be confirmed in other trials, but added that the findings were sufficient enough to rule out significant excess risk due to intentional weight loss.

To learn more about the study, click here.