Recognizing Depression in Seniors Sooner Can Avoid Health Problems

Professors of psychiatry at the University of Rochester Medical Center have pinpointed a number of prime factors for determining an elderly individuals risk for developing depression. The most apparent factors that contribute to depression include low-level depression symptoms, the perception of poor-quality social support, and a past history of depression.

By identifying at-risk seniors and providing preventive care, seniors and physicians can prevent psychological suffering and also avoid the negative effects of depression on other health conditions, they suggest. The report appears in the December issue of the American Journal of Psychiatry.

Depression among the elderly has been linked to a doubling in the risk of Alzheimer's disease, as well as a worsening of chronic conditions.

Young Seniors Less Healthy Than Previous Generations

Americans in their 60s are less healthy than generations that preceded them. That according to a study published by the American Journal of Public Health.

The authors compared two National Health and Nutrition Examination Survey data sets, for 1988-1994 and for 1999-2004, to examine disabilities for adults age 60 to 69, 70 to 79, and 80 and older. All age groups reported significant declines in physical activity. But the youngest group had the greatest increase in reported disabilities.

The study also found that body mass index increased significantly from the earlier data as did the number of participants who met criteria for obesity. Although all age groups reported more obesity, the most striking increase was among people in their 60s, for whom prevalence of obesity rose from 27.4% in 1988-1994 to 37.6% for 1999-2004.

Arun S. Karlamangla, MD, PhD, one of the study's authors, said it's not too late for people in that age group to improve their lifestyles.

"If one can reverse obesity, then one can probably reverse the disability issues," said Dr. Karlamangla, an associate professor of medicine at the University of California, Los Angeles, Dept. of Medicine. "If we can [stop] this increasing level of obesity, we might be able to reduce the trend [of increasing disabilities at younger ages], flatten it or even reverse it," Dr. Karlamangla said.

As I have been saying before, it is about our own self-responsibility and discipline. The only person that is going to take care of you is YOU!

Isolation and Stress May Increase Breast Cancer Risk

OK, it is only a study done on rats but University of Chicago researchers have found that social isolation and stress may increase breast cancer risk 3.3-fold. Rats kept alone had a 135 percent increase in the number of tumors and a more than 8,000 percent increase in tumor size.

Being isolated and exposed increases production of the stress hormone corticosterone and isolated rats took longer to recover from a stressful situation than rats living in small groups.

The findings, published online in the early edition of the journal Proceedings of the National Academy of Sciences suggest that isolation and stress could play a role in human breast cancer risk, said Martha McClintock, a professor of psychology and comparative human development at the University of Chicago.

No stretch to see where I am going with this post. Our elders are often lonely, alone, fearful and distressed - just more factors brewing in a perfect storm against their better health. It is up to all of us to make sure our elders have a supportive social network that can come to their aid, reduce their anxiety, provide peace of mind and reduce isolation. Stress has been linked to many health problems. Our immune system become preoccupied with combating stress that other ailments creep up. It is easy to say we all need life balance but we do. With more people out of work, those left with jobs are often performing the jobs of two people, adding stress to their lives. Those looking for jobs have enough stress. It is taking its toll. Perhaps there is little you can do short term but just being aware of it is a start.

Alzheimer’s and Aging – Why Our Brains Go Down the Drain with Age

This following is a guest post by Shannon Wills, who writes on the topic of Physical Therapist Assistant Schools . She welcomes your comments at her email: shannonwills23@gmail.com.

Many of you are familiar with the horrifying statistics regarding Alzheimer’s Disease:

· Over 5.2 million Americans are affected and the number is expected to climb as high as 7.7 million by the year 2030.

· It cannot be diagnosed conclusively, in fact, only in an autopsy when the brain is directly examined can the neurological tangles and the amyloid plaques that cause this disease be detected. While living, all a doctor can do is diagnose the probable disease based on behavioral changes.

· Although it generally affects people over the age of 65, there have been cases where 30 and 40-year-olds lose their minds to this progressive neurologic disease. Age is not a barrier to the onset of Alzheimer’s.

· And worst of all, there is no cure at all.

It’s a frightening prospect to have to live with Alzheimer’s disease for the rest of our lives; we know exactly what’s going to happen as the disease progresses and as we grow older – we slowly start to lose our mental faculties, and finally, are reduced to vegetables who must be provided with palliative and hospice care till we breathe our last breath.

Is there any way to prevent the onset of this terrible disease? We know Alzheimer’s is caused by the build-up of deposits of the protein beta-amyloid in the brain and neurological tangles, and although scientists and researchers are working on ways to detect this disease early on, there is still nothing concrete in the way of disease prevention or management.

Studies have suggested that race plays an important role in determining who is most susceptible to this disease – African Americans and Hispanics are supposedly more prone. While no one knows why the incidence of this disease is high in these populations, there is speculation that it may be because:

· African Americans are more prone to vascular diseases like high cholesterol and high blood pressure, and this puts them at risk for Alzheimer’s.

· Relatives of people who have Alzheimer’s are at a higher risk for the disease themselves.

· Those who are economically disadvantaged don’t always have easy access to healthcare or quality healthcare, which means that the disease is not screened early and therefore treated accordingly.

· Most baby boomers in the African American and Hispanic communities are wary of doctors and drugs.

It has been found that Asians are less prone to Alzheimer’s because they are tea drinkers, or more specifically, because they gain the benefits of green tea which is rich in antioxidants and flavonoids and which protect the brain from free radical damage.

So will eating the right foods keep Alzheimer’s at bay? Although there is no conclusive evidence to prove this theory, in general, keeping your body and mind fit and healthy is a great way to prevent the onset of mental illnesses like Alzheimer’s and dementia. Eat foods that are rich in vitamins and antioxidants, exercise your body and mind regularly, and stay busy as long as you live to fight this disease and keep it away. (Editor’s Note: Shannon reiterates what I have been preaching in this blog. Self-responsibility, taking care of yourself, is the ultimate healing solution in our lives. Thanks Shannon.

Blueberries As Good As They Say They Are For Memory

Thanks to McKnight's for drawing my attention to the following.

A team of researchers from the University of Cincinnati, the U.S. Department of Agriculture, and the Canadian department of agriculture sought to determine whether blueberries really live up to their reputation as a memory-enhancing food. Every day for two months, the researchers gave roughly two-and-a-half cups of blueberry juice to a group of septuagenarians with memory problems. A control group drank a non-blueberry beverage. At the end of the trial, researchers noticed significant improvement on learning and memory tests among the blueberry drinkers.

Though these findings are just preliminary, they are "encouraging and suggest that consistent supplementation with blueberries may offer an approach to forestall or mitigate neurodegeneration," according to the report.

The full study appears in the latest issue of ACS' Journal of Agricultural and Food Chemistry.

Seniors Who Defy Their Age - Need Inspiration? Go Here.

The Seniors for Living web site has an interesting and inspiring blog post that details the exploits of senior athletes doing what most their age and many of those younger can't.

A group of skydiving seniors ranging in age from 60 to 80.

A 92-year-old man who holds the current Guinness Record for the oldest bare-footer water skier.

An 89-year old surfer dude.

A 91-year-old woman water skier.

And more. Watch the videos here.

Brown University Introduces New Web Site to Compare Nursing Homes

A new web site for analyzing and choosing nursing homes has been developed by the Center for Gerontology and Healthcare Research at Brown University. It is www.LTCfocUS.org.

Because it is academically based it seeks to provide evidence based data that is unencumbered by the politics and the inaccuracies of other nursing home comparison sites and data.

According to the site - The website hosts data regarding the health and functional status of nursing home residents, characteristics of care facilities, state policies relevant to long term care services and financing, and data characterizing the markets in which facilities exist.

Researchers can use this website to examine care processes and resident outcomes within the context of their local markets and regulatory practices. Policymakers can use the information to shape state and local guidelines, policies, and regulations that promote high-quality, cost-effective, equitable care to older Americans.

The website brings together data gathered from a variety of primary and secondary sources, including MDS, OSCAR, and a variety of other sources that characterize the policy environment and local market forces affecting nursing home providers.

The website allows users to customize maps and tables to gather information by state, county, or individual facility, including information on facility characteristics, geo-coded facility locations, resident characteristics, local market characteristics, facility staffing, admissions, quality, and state long-term care policies.

The Web site contains data about nursing home resident health, with specific information covering areas including incontinence, or the number of patients who are on anti-depressants or have high blood pressure. Users can also learn about the size of nursing home facilities, whether they are for-profit or nonprofit or affiliated with a chain.

In addition, because the Web site provides several years of data, it is possible to examine trends over time and determine how changes in nursing home policy or financing have affected nursing homes and their residents from year to year.

While certainly designed for academics and policy makers nonetheless it is probably a site that consumers can start to use as well to better understand from an evidence based perspective just what constitutes a good facility for a loved one.

Assisted Living Regulations Improving

Guest Blog in Advance for Long Term Care Management regarding regulations around Assisted Living facilities.

Baby Boomer Job Seekers Should View Themselves as a Brand

As I seek to provide more information to boomers in all aspects of their life, I thought I would share the following. Individuals have a brand. We don't always think about ourselves as brands but if we did we would probably act, speak and present ourselves differently and better, standing out and in the process improving all aspects of what we do. Because I know a lot of my core audience is made of caregivers many of whom are boomers I also know that in addition to coping with caregiving and even child raising many may be out of a job. Faced with a youthful competitive marketplace that will work for less, a boomer must stand out from the rest. That means developing your personal brand.

5% of Boomers Abusing Drugs

Health Day, citing a new government study, reports that almost 5 percent of aging Baby Boomers in the United States are abusing drugs. Approximately 4.3 million adults over the age of 50 are smoking marijuana, abusing prescription medication and engaging in other illicit drug activity.

The driving force behind the trend, said Peter Delany, director of the Office of Applied Studies at the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), is people who used drugs when they were younger and never really stopped. This is expected to double the demand for treatment services by 2020.

The study found that more men are smoking marijuana than are abusing prescription drugs. Women engage in both behaviors equally.

Pot smoking was more prevalent among the younger end of the spectrum (those aged 50 to 59), while prescription drug abuse was more common in the older age bracket (aged 65 and up).

"This population tends to have other health problems, especially chronic health problems," Delany explained. "And as we age we don't metabolize drugs the same way."

Also, older people with a substance-abuse diagnosis are much more at risk of suicide, said Dr. David Schlager, clinical assistant professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine and a psychiatrist with Lone Star Circle of Care, which has health clinics throughout Texas.

I think Delany hit it with the last statement. These drug problems compound already existing chronic conditions and probably exacerbate them. Again, another perfect storm brewing whose perfect solution would be for us all to take more self responsibility.

Our Blog Added to Alltop

I am very pleased to report that our blog has been added to Alltop. What is that you ask? Alltop helps you answer the question, “What’s happening?” in “all the topics” that interest you. You may wonder how Alltop is different from a search engine. A search engine is good to answer a question like, “How many people live in China?” However, it has a much harder time answering the question, “What’s happening in China?” That’s the kind of question that it answers.

They do this by collecting the headlines of the latest stories from the best sites and blogs that cover a topic. They group these collections — “aggregations” — into individual web pages. Then they display the five most recent headlines of the information sources as well as their first paragraph. Our blog is listed under both healthcare and boomers.

You can think of Alltop as the “online magazine rack” of the web. They've subscribed to thousands of sources to provide “aggregation without aggravation.”

So customize your own news page that you can refer to every day and be sure to include our blog too. And become a follower of our blog now. Thanks.

Doctors Don't Talk About End of Life Care

The January 11 online edition of Cancer reveals that there is general lack of communication between physicians and terminally ill patients regarding end of life care.

As reported in Health Day, a national sample of almost 4,100 physicians who treat cancer patients was taken. Physicians were given a hypothetical example of a cancer patient with four to six months to live but who was still feeling well.

65 percent said they would discuss a prognosis. Only 26 percent said they would discuss hospice; 21 percent said they would discuss where the patient would like to die; and only 44 percent said they would discuss resuscitation preferences. Current medical guidelines recommend having end-of-life discussions when patients have less than a year to live.

There are many reasons why doctors aren't having these discussions as often as they should, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. The conversations can be time consuming and emotionally wrought. And estimating how long someone has to live is an inexact science. Patients can differ in how much they want to be told and families can be another complicating factor urging the loved one to keep fighting.

Younger physicians were more likely than older physicians to have end-of-life discussions with patients, possibly indicating that current medical training places more emphasis on palliative care.

If doctors don't bring up end-of-life issues, patients need to bring it up with their physicians, making sure their wishes are known, said lead study author Dr. Nancy Keating, associate professor of medicine and health care policy at Brigham and Women's Hospital and Harvard Medical School.

And that would be my recommendation as well. People need to be aggressive in seeking answers to their healthcare needs.

Vitamin B Shows Promise for Alzheimer's

Researchers at MIT found during clinical trials that a three-nutrient cocktail of B vitamins, phosopholipids and antioxidants was found to promote the growth of certain brain synapse connections that typically erode during the early stages of Alzheimer's. The nutrients develop the fatty molecules that form brain cells and synapses.

Over the course of 12 weeks, patients drank either the nutrient mixture or a control beverage. Roughly 40% of the patients receiving nutrients showed improvement on memory and cognitive tests compared with 24% of the control patients who improved. Encouraged by the results, researchers are conducting three more similar trials in Europe and America.

The results of this study appear in the latest edition of the journal Alzheimer's and Dementia.

A few years ago my wife and I had a complete metabolic study done and were taking a boatload of supplements to balance our metabolism. For some reason or another it worked as we both lost 30 pounds and it seemed to jump-start our metabolism. When we decidied we were spending just a little too much for all the supplements, and in all honesty, we never went back for a second evaluation that would have surely weaned us off a majority of those supplements; nonetheless, we both gained some of the weight back and find it harder to lose it than we did when we were taking supplements. So the whole world of supplements and vitamins is fascinating. Ask your doctor. More progressive physicians are incorporating metabolic work into holistic medical practice.

Study Suggests Assisted Living Affordable Only to Wealthy

David Stevenson, an assistant professor of health policy at Harvard Medical School in Boston has been studying assisted living facilities and has found, not surprisingly that assisted living facilities are most often located in areas with higher levels of income, education and home values. The findings indicate that people with lower incomes, minorities and those living in rural areas have fewer living options as they age.

Assisted living is generally for people who don't yet need the full-time care provided by a nursing home, but may need help with daily living. How this assistance is provided differs greatly from facility to facility.

In 2007, there were 11,276 assisted living facilities with a total of 839,746 residential units in the United States, according to the study. Connecticut, Hawaii and West Virginia had fewer than 10 assisted living facilities per 1,000 elderly residents, while Minnesota, Oregon and Virginia had more than 40 facilities per 1,000 older Americans, according to the study.

These findings are most useful from a public policy perspective, Stevenson said. "We need to keep in mind that the assisted living supply isn't distributed evenly, and that not all individuals would have access to assisted living even if public dollars were available to support it," he said. Assisted living is an interesting arena because the level of care varies greatly. I have seen residents in assisted living facilities who for all intents and purposes should have been in a nursing home. And I have seen Medicaid-funded residents in assisted living. By and large though this study mirrors what I see daily.

I hate to harp on the same theme but there are affordable things that anyone can do to better plan for your options as you age. Self-responsibility is going to play a larger role in our lives. Whether it is how we take care of ourselves to how we plan for our future financial and overall health. My wife made a decision some 15 years ago to take advantage of a voluntary benefit that her company was offering - something called long-term care insurance. Because she bought young, her premium annually is $500. Yes $500. And she is now, let's say a bit older. At $3,000-$4,000 a month, most families, low and middle income, can not afford to pay out of pocket for assisted living. However if God forbid my wife does need an extra level of care one day, her insurance is almost like a "get out of jail free" card in terms of her options.

$500 a year is a lot of money when you have to choose between groceries, prescriptions and health care you may never need. So it is a hard choice. But the choice needs to be made sooner in life to make it all affordable and some of that requires a leap of faith to understand that our government can not subsidize this care. Right or wrong, the finances do not add up. We all have to plan for our care.

The results are published in the January issue of Health Affairs.

Obesity Poses Same If Not Greater Risks Than Smoking

Researchers at Columbia University and The City College of New York published a study in the February issue of the American Journal of Preventive Medicine that showed that the quality-adjusted life years (QALYs) lost to obesity are equal to, or greater than, those lost because of smoking.

From 1993 to 2008, the number of adult smokers decreased 18.5 percent and smoking-related QALYs lost remained relatively stable. Over that same time, the proportion of obese Americans increased 85 percent, resulting in a QALY lost. Obesity had a larger effect on disease, while smoking had a greater impact on deaths, the researchers found.

"Although life expectancy and quality-adjusted life expectancy have increased over time, the increase in the contribution of mortality to QALYs lost from obesity may result in a decline in future life expectancy. Such data are essential in setting targets for reducing modifiable health risks and eliminating health disparities," the researchers wrote.

So we have seemed to replace one evil with another. And obesity is more complicated, contributes to a host of chronic conditions impacting lives and the fabric of our health system as well. As the latest season of the Biggest Loser heats up and New Years's resolutions to lose weight fresh in our mind perhaps it is time to really get serious about getting healthy. It all comes down to self-responsibility.

Medicare Part D Options Changing

Here is a good post from McKnight's on Medicare Part D Choices seniors and long term care residents face.

Alcoholism in the Elderly a Growing Problem

Elderly people with drinking problems consume significantly more alcohol than their younger counterparts according to a study presented at the Gerontological Society of America.

Younger alcoholics typically consume between 25 and 35 drinks per week, according to a report from Ohio State University. Older adults binge drink an average of 19 times per year, compared with 13-15 times per year for younger adults.

The psychological effects of aging can play a major role in problem drinking among the elderly, according to researchers. Alcoholism in older adults can severely aggravate chronic conditions such as diabetes.

So as you visit elderly loved ones please be on the lookout for signs of self-abuse including alcoholism. According to nurse Kathleen Blanchard here are some of the signs of alcoholism in the elderly.

Drinking and driving, passing out, mood changes, and continuing to drink despite health complications and potential dangers are signs and symptoms of alcoholism in the elderly. Other warning signs of alcoholism among elders include frequent falls, confusion, and self-neglect.

If you suspect an elder is having difficulty controlling alcohol consumption, offer support, and maintain a non-judgmental attitude. Signs and symptoms of alcohol abuse in the elderly may be difficult to recognize, and are often attributed to other causes associated with aging. Many elders hide signs of alcoholism from family and loved ones.