In more than half of the studies, published since the 1990s, moderate drinkers of wine, beer and liquor had lower dementia risks than nondrinkers. In only a few studies were there increased risks.

“Alcohol is a two-edged sword,” said Michael Collins, Ph.D., a professor and neuroscientist at Loyola University Chicago Stritch School of Medicine and lead author of the refereed report in the journal Alcoholism: Clinical and Experimental Research. “Too much is bad. But a little might actually be helpful.”

Moderate alcohol consumption generally is defined as 1 drink or less per day for women and 1-2 drinks or less per day for men.

The article will be published in the February 2009 issue of the journal, and is available on line now. The article summarizes a roundtable, organized by Collins, held at the Research Society on Alcoholism meetings in Chicago in 2007.

“The pathological damage and vast social havoc from addiction to and abuse of alcohol are well known, and of necessity should continue to receive primary attention by doctors, scientific researchers and health professionals,” Collins and colleagues write. “However, light-to-moderate responsible alcohol consumption “appears to carry certain health benefits.”

Long-term alcohol abuse can cause memory loss and impair cognitive function. It’s unknown why moderate alcohol use appears to have the opposite effect. One theory is that the well-known cardiovascular benefits of moderate alcohol consumption also can reduce the risk of mini strokes that cause dementia.

Collins and another Loyola professor, neuroscientist Edward Neafsey, Ph.D., suggest a second possible explanation. Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate levels stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.

For most people who drink responsibly and in moderation, there’s probably no reason to quit. But because of the potential for alcohol to be abused, Collins and Neafsey do not recommend that abstainers begin drinking. The researchers note there are other things besides moderate drinking that can reduce the risk of dementia, including exercise, green tea, education and a Mediterranean diet high in fruits, vegetables, cereals, beans, nuts and seeds.

Moreover, there are times when people should never drink, including adolescence, pregnancy and before driving, Collins said.

Source: Loyola University

A recent study done by North Carolina State University found that spikes in blood pressure are directly linked to diminished cognitive function among the elderly. This correlation holds especially true for those seniors with already high blood pressure, their report suggests. Study subjects with an average systolic blood pressure of 130 or higher experienced a significant decrease in cognitive function when faced with a sudden spike in blood pressure.

Typically, such spikes occur during stressful moments, report authors say. This suggests that some seniors may find it hard to think rationally or logically during stressful situations. Report authors note that seniors with normal or lower blood pressure do not experience the same diminished cognitive functions under stress. 

Source: Journal of Gerontology: Psychological Sciences.

American Specialty Health (ASH), a leading national health improvement organization, announced that Inter Valley Health Plan, a non-profit, federally qualified Medicare Advantage program, has selected its Silver&Fit(r) senior fitness program for its 14,600 eligible members in California.
“Inter Valley Health Plan prides itself on providing our members with excellent health plans and knowledge to help them live a long and happy life,” said Ronald Bolding, Inter Valley Health Plan CEO and President. “Aligning with ASH fits our vision perfectly because the Silver&Fit senior fitness program is considered one of the best in the industry.”
Upon enrolling in Silver&Fit, Inter Valley Health Plan members will receive a no-cost membership at a local participating fitness club. Their Silver&Fit membership will include all of the standard amenities offered by that club’s basic membership, such as access to free weights, cardiovascular equipment, and where available, pools, saunas, and whirlpool facilities.
Seniors who are not able to participate at the fitness club-or that simply prefer to work out at home-may participate instead in the Silver&Fit Home Fitness Program. Upon enrollment, Silver&Fit members will receive an Exercise Kit and a Walking Kit, which include tools to help them perform exercises at home. Inter Valley Health Plan Home Fitness Program members may receive DVDs or Internet access to a variety of exercise classes, all of which are designed specifically for older adults.
All Silver&Fit members receive a quarterly newsletter, access to SilverandFit.com, and a toll-free hotline to provide information and answers to any questions about the program.
“Studies continue to show that regular physical activity can help seniors stay vital and healthy as they age,” said ASH chairman and chief executive officer George DeVries. “By providing the Silver&Fit program to its senior members, Inter Valley Health Plan is ensuring a better quality of life for those who participate.”
Silver&Fit was developed to assist older adults in beginning or continuing a regular exercise program. Regular exercise has shown to be an important element in preventing some medical conditions, including high blood pressure and heart and lung disease. Cardiovascular and strength training can also help seniors improve their balance and become more flexible, preventing common slips and falls and speeding up the recovery period from such injuries. Access to the network of exercise facilities is provided through ASH subsidiary American Specialty Health Networks, Inc.

I recently read an interesting article about PACE. Here is more information about the program.

PACE is an All-inclusive Care Program for the Elderly . The model is centered around the belief that it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.

According to the National PACE Association, there are 16,000 participants in PACE nationwide. The average client is 80 and takes eight prescription medications. Participants have to be 55 or older, certified by their state to need nursing home care and be able to live safely in the community.

Each PACE program receives a fixed amount per person from a patient’s state Medicaid program — usually 85% to 90% of estimated nursing home costs. Medicare funds come through a risk-adjusted formula in which the program receives more for sicker enrollees. PACE becomes both the patient’s insurer and care provider and is obliged to pay for all of the patient’s medical care from the point of enrollment forward.

Services include:

Delivering all needed medical and supportive services, the program is able to provide the entire continuum of care and services to seniors with chronic care needs while maintaining their independence in their homes for as long as possible. 

Care and services include:

• Adult day care that offers nursing; physical, occupational and recreational therapies; meals; nutritional counseling; social work and personal care
• Medical care provided by a PACE physician familiar with the history, needs and preferences of each participant
• Home health care and personal care
• All necessary prescription drugs
• Social services
• Medical specialists such as audiology, dentistry, optometry, podiatry, and speech therapy
• Respite care
• Hospital and nursing home care when necessary

The benefits of PACE are that participants are supported by a coordinated medical team that the federal government hopes will cut costs and improve life for the elderly.

A form of vitamin B3, Nicotinamide has been found to get rid of Alzheimer’s disease-related memory problems in lab mice, according to new research. Vitamin B3 is available over the counter at a low price.

The study showed that when mice that were bred to exhibit symptoms of Alzheimer’s received the human equivalent of two or three grams of B3, they acted as if they had never developed the disease, said one University of California researcher.

The vitamin acts in the brain to clear tau “tangles,” of Alzheimer’s disease. While the vitamins are available over the counter and are relatively safe, researchers warn that high doses such as the ones used in the study could potentially be dangerous. Researchers are currently enlisting people for human trials. Their research appears in the November 5 online version of the Journal of Neuroscience.

As demand for hospice care has increased, so have the number of programs nationwide. Today, there are about 4,700 providers, up from about 3,300 five years ago, according to NHPCO. While the majority of providers are nonprofits, the for-profit sector is growing, accounting for 47.1 percent of hospice agencies last year.

Hospice is intended for any person who has a terminal illness and a prognosis of six months or less to live. Depending on the needs of each patient, care can include pain management, medications, medical supplies and equipment, and assistance with the emotional, psychological, and spiritual aspects of dying. A hospice team usually consists of nurses, home health aides, social workers, bereavement counselors, and clergy, as well as a hospice physician and the patient’s personal physician.

The benefit for Medicare and Medicaid patients is remarkably magnanimous. Medicare pays out $601 per patient per day for inpatient hospice care (and $789 per day for the typical patient who gets 24-hour home care), yet there are no copays, deductibles, or out-of-pocket expenses for the beneficiary. Private insurer hospice benefits offer a variety of hospice services, though they’re typically not as generous, according to the Hospice Association of America. To get Medicare or private insurance to cover hospice care, a patient needs only a physician’s referral. Hospice care is usually provided in the patient’s home. It can also be made available at a special hospice residence designed with a homelike atmosphere, or in assisted living or skilled nursing facilities.

Slipping and falling can cause more than just a cut orbruse.Tumbles are costing Albertans some serious coin.

The province says it wants to change that.Today, it’s launching Finding Balance, an awareness campaign aimed at educating seniors on the importance of leading healthy lifestyles.The program will include lessons on improving health and wellness, as well as tips on making homes safer.

“Those who have cared for parents or grandparents know that as seniors age they are more likely to fall and suffer an injury,” Premier Ed Stelmach said in a news release.

“In fact, falls are the leading cause of injury-related hospital admissions for older Albertans, so this campaign focuses on educating our seniors in avoiding the potentially very serious consequences of losing their balance.”

According to the Alberta Centre for Injury Control and Research, seniors falling cost the Alberta economy almost $88 million in 2003.

At that rate, the figure could swell to $250 million by 2033, the province warns.

In 2006, tumbles led the charge of injury-related hospital visits, officials said. About 20 such admissions were logged in Alberta each day.

Of course, saving cash isn’t the only concern, said ACICR’s associate director.

Kathy Belton said those involved in the initiative will likely lead to a healthier flock of seniors who will be able to enjoy independence and a higher quality of life.

It was recently annoced that The Robert Wood Johnson Foundation, one of the nation’s largest healthcare foundations, plans to award $2.3 million in grants for research to improve the quality of nursing care in America. Grants of up to $300,000 will be given to eight research projects as part of the foundation’s Interdisciplinary Nursing Quality Research Initiative, a program designed to produce and collect information on how nurses contribute to the quality of care patients receive.

The foundation, which recently made the announcement, hopes to analyze how nurses contribute to high quality patient care among multiple providers and across many care settings, including long-term care.

Nurses comprise more than half of the nation’s caregivers, but little research exists showing the connection between their efforts and improved quality of care for patients, according to the foundation This round of grants, which will be rolled out over the next two years, is the third stage and final stage of the initiative, which his so far given $19 million for nursing research.

More information is available at www.rwjf.org.

A new study results further prove scientists’ warnings about the risks of stroke involved with giving elderly patients antipsychotic drugs. There is an increased risk of stroke with both typical and atypical antipsychotics, said study author Dr. Ian Douglas, a research fellow at the London School of Hygiene and Tropical Medicine. Similar findings date back at least six years, according to other researchers.”This risk is substantially higher in patients with dementia than those without. These findings need to be factored into prescribing decisions made by doctors caring for patients with often-distressing and difficult-to-treat psychiatric symptoms,” Douglas said.

Douglas and a colleague studied nearly 6,800 individuals who were taking antipsychotic drugs and had suffered a stroke. Those taking the drugs were 1.7 times more likely to suffer a stroke. The rate more than doubled, to 3.5 times more likely, for dementia patients taking antipsychotics. Study findings were published late last week in the British Medical Journal online.

Potentially harmful medication administration errors are very rare in assisted living settings, the result of a study of 12 facilities in three states suggests.

Assisted living facilities are a less expensive alternative to skilled nursing facilities, offering residents more independence and a homier environment. Medication errors are a concern in these settings, lead investigator Dr. Heather M. Young of Oregon Health and Science University in Ashland and her colleagues say, because aides with no licensing or professional training are typically charged with distributing drugs to residents.

To investigate the prevalence of medication errors, the researchers observed 29 unlicensed assistive personnel giving out medications to 510 assisted living residents at facilities in New Jersey, Oregon and Washington. They watched 56 “medication passes,” including both day and night shifts, for a total of 4,866 observations.

Young and her team observed 1,373 errors, for an error rate of 28.2 percent. But 70.8 percent of the errors were time-related, meaning a patient didn’t get a drug within an hour of the scheduled dosing time. Once time was removed from the analysis, the error rate was 8.2 percent.

Other causes of errors included wrong dose (12.9 percent), skipped dose (11.1 percent), extra dose (3.5 percent), unauthorized drug (1.5 percent) and wrong drug (0.2 percent),Young’s team reports in the Journal of the American Geriatrics Society. Only three of the errors observed had potential clinical significance, according to the researchers, and none of the errors were considered “highly likely to cause harm.”

None of the time-related errors involved giving medications for which timing was crucial, such as insulin. Because medication is typically given out to assisted living residents twice a day at a standardized time, the researchers say, “a high number of wrong-time errors is not surprising, and given the lack of clinical significance of the errors observed, is probably not a meaningful indicator of quality.”

The researchers did find that errors were more likely to occur with riskier medications, like insulin or the blood thinning drug warfarin, which are typically given to patients “in less stable and predictable conditions.”

They suggest that prioritizing the administration of high-risk drugs, as well as the care of patients with more complex health issues, could help prevent serous medication errors and improve the quality of care.