Many Seniors Suffer Mental Decline in Silence: CDC

By Steven Reinberg
HealthDay Reporter

THURSDAY, May 9 (HealthDay News) -- About 13 percent of Americans 60 and older say they have increasing problems with thinking and memory and that they suffer growing confusion, a new report released Thursday shows.

One-third of these people add that the confusion or memory loss caused problems at work or with social activities and household chores, according to the U.S. Centers for Disease Control and Prevention.

The findings underscore the need to be alert for early signs of dementia or Alzheimer's disease, experts said.

"This is the first data of this kind," said report co-author Angela Deokar, a CDC public health advisor. In 2011, older adults from 21 states answered survey items on whether they'd suffered increased confusion or memory loss in the past year.

According to Deokar, signs to look out for include the following:

Asking the same questions over and over again,Getting lost in familiar places,Not being able to follow directions,Becoming more confused about time, people and places.

These problems go beyond normal forgetfulness, Deokar said.

Since this is the first such report, it is not possible to see if there is an increasing trend or if these data are similar throughout the nation, she said. The survey is ongoing, however, so in a couple of years more information should be available.

The report was published in the May 10 issue of the CDC's Morbidity and Mortality Weekly Report.

People experiencing cognitive decline -- the gradual loss of the ability to think, reason and remember -- can face considerable challenges. Even so, only 35 percent of them have discussed the problem with their doctor, the researchers found.

Such conversations are important, because they make planning for the future easier as a person's mental health continues to decline, according to the report.

A dementia expert noted that these kinds of symptoms should be taken seriously.

People experiencing them "should have thorough medical exams to exclude treatable metabolic or cardiac diseases," said Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center, in New York City.

Report co-author Deokar noted that people with these symptoms can reach out to the aging services network, including agencies on aging and the Alzheimer's Association.

When causes of mental decline are identified early there is the opportunity to treat reversible causes, the report authors said. If the cause isn't reversible, as with Alzheimer's disease, there is more time to develop advance directives, to enroll in clinical trials and to plan for care needs.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Angela Deokar, M.P.H., public health advisor, U.S. Centers for Disease Control and Prevention; Sam Gandy, M.D., associate director, Mount Sinai Alzheimer's Disease Research Center, New York City; May 10, 2013, Morbidity and Mortality Weekly Report

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Mental Exercise May Help Keep Seniors Sharp

Even solving puzzles might stave off decline and memory loss, study hints

By Robert Preidt

HealthDay Reporter

MONDAY, April 15 (HealthDay News) -- Mental exercise can help prevent thinking and memory decline in seniors, but evidence for the benefits of supplements and exercise is weak, according to a new study.

The findings were published in the CMAJ (Canadian Medical Association Journal).

The researchers reviewed 32 studies, including three that examined the effects of mental exercise involving computerized training programs or intensive one-on-one personal training in memory, reasoning or processing speed.

One of the studies found significant improvements in participants' memory over five years of follow-up. Another found an improvement in auditory memory and attention, according to a journal news release.

Supplements such as gingko, vitamins, dehydroepiandrosterone (DHEA) and other substances, however, appeared to provide no benefit. The same was true for physical exercise. Estrogen was associated with an increase in mental decline and dementia.

"This review provides some evidence to help clinicians and their patients address what strategies might prevent cognitive decline," wrote Dr. Raza Naqvi, of the division of geriatric medicine at the University of Toronto, and co-authors. "Future studies should address the impact of cognitive training on the prevention of cognitive decline, and we encourage researchers to consider easily accessible tools such as crossword puzzles and Sudoku that have not been rigorously studied."

Mild cognitive impairment affects 10 percent to 25 percent of people over age 70, according to the news release.

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Irregular Heartbeat May Speed Memory Loss in Seniors

Study found that people with atrial fibrillation showed mental declines at earlier age than those without heart condition

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, June 5 (HealthDay News) -- Older people who suffer from a type of irregular heartbeat called atrial fibrillation may also be more likely to experience mental declines sooner, a new study suggests.

"Problems with memory and thinking are common for people as they get older," said lead researcher Evan Thacker, a statistician in the department of epidemiology at the University of Alabama at Birmingham. "Our study shows that, on average, these problems may start earlier or get worse more quickly in people who have atrial fibrillation. This means that heart health is an important factor related to brain health."

As with other such studies, this one established only an association between atrial fibrillation and mental decline, not a direct cause-and-effect relationship.

That's why the next step is to find out why people with atrial fibrillation start to struggle with memory and thinking sooner, Thacker said.

There are at least two possibilities, he said. First, people with atrial fibrillation may have small blood clots form in the heart that then become lodged in the brain.

"These may be too small to cause noticeable strokes, but may over time cause small damage to the brain that would eventually lead to mental decline," Thacker said.

Second, people with atrial fibrillation may simply have less blood flowing to the brain, he said.

"This could result in the brain not getting as much oxygen and nourishment as it needs, which could lead to damage over time that would result in mental problems," Thacker said.

"Currently, we do not know whether either of these two possibilities actually occurs," he said. "We would like to study it using brain imaging technology to learn more about what is happening in the brains of people with atrial fibrillation."

Eventually, if doctors and researchers can discover why people with atrial fibrillation show accelerated mental decline, they might be able to learn how to prevent the problem, Thacker said.

The report was published online June 5 in the journal Neurology.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, "Atrial fibrillation is present in close to 3 million men and women in the United States and increases the risk of stroke fivefold compared to the general population."

In addition to the marked increase in the risk of stroke, more recent research suggests that atrial fibrillation is associated with an increased risk of mental decline and dementia, he said.

"Repetitive, small subclinical strokes in patients with atrial fibrillation may account for these findings," Fonarow said.

He said giving blood thinners to patients with atrial fibrillation is standard care to prevent clots in the heart from migrating to the brain.

Putting these patients on anticoagulants, such as warfarin or one of the newer therapies, will "likely be effective in not only reducing the risk of stroke, but also reducing the significant risk of mental decline and dementia," he said.

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Pneumonia May Lead to Serious Aftereffects for Seniors

Title: Pneumonia May Lead to Serious Aftereffects for Seniors
Category: Health News
Created: 3/22/2013 4:36:00 PM
Last Editorial Review: 3/25/2013 12:00:00 AM

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A Third of U.S. Seniors Die With Dementia, Study Finds

Title: A Third of U.S. Seniors Die With Dementia, Study Finds
Category: Health News
Created: 3/19/2013 10:35:00 AM
Last Editorial Review: 3/19/2013 12:00:00 AM

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A Third of U.S. Seniors Die With Dementia, Study Finds

Report tallies enormous medical, financial and caregiver toll of conditions like Alzheimer's

By Serena Gordon

HealthDay Reporter

TUESDAY, March 19 (HealthDay News) -- There's more troubling news for America's aging population: A new report finds that one in every three seniors now dies while suffering from Alzheimer's or another form of dementia.

In many cases, dementia is the cause of death or contributes to it, the Alzheimer's Association study finds.

The rate of deaths related to Alzheimer's disease rose 68 percent from 2000 to 2010, according to the report. At the same time, deaths from other major diseases, such as heart disease and HIV/AIDS, have declined.

"Alzheimer's disease is a public health crisis that is here," said Beth Kallmyer, vice president of constituent services for the Alzheimer's Association. "One in three seniors is dying with Alzheimer's or another dementia. For other major diseases, the death rate is going down because the federal government funds and invests in research. We have not seen that same commitment for Alzheimer's disease."

Released Tuesday, the report also focuses on the toll that Alzheimer's takes on families, particularly those caregiving from a distance. In 2012, more than 15 million people were Alzheimer's caregivers. They provided more than 17 billion hours of unpaid care that the Alzheimer's group estimated was valued at $216 billion.

Direct out-of-pocket costs for families of people with Alzheimer's are $34 billion, according to Kallmyer. "The cost of care is a challenge, and not everyone has access to the services they need," she said.

About 15 percent of Alzheimer's caregivers live more than an hour away from their loved ones. Out-of-pocket costs for these long-distance caregivers are nearly twice as high as those who live close by. Each year, a long-distance caregiver has nearly $10,000 in expenses compared with about $5,000 for a local caregiver, according to the report.

"Long-distance caregiving can be financially, emotionally and physically more draining. Managing the day-to-day care can certainly be a challenge, but long-distance caregivers can feel guilt, and they may feel resentment from other family members. And, they may have to manage the daily care from a long distance," Kallmyer said.

Overall, the cost of caring for the 5 million people with Alzheimer's disease is about $203 billion, according to the report. That figure includes Medicare, Medicaid, family costs and private insurance costs. The lion's share of the cost -- about $142 billion -- is paid by Medicare and Medicaid.

Even more concerning is that the Alzheimer's Association estimates that by 2050, nearly 14 million people will have Alzheimer's disease. That could drive costs for Alzheimer's care as high as $1.2 trillion in 2050.

The U.S. government currently funds about $500 million in Alzheimer's research, according to Kallmyer. In comparison, heart disease receives about $4 billion in research funding and cancer gets about $6 billion, she said.

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Kids, Seniors Prone to MRSA Infections Depending on Season: Study

Title: Kids, Seniors Prone to MRSA Infections Depending on Season: Study
Category: Health News
Created: 3/1/2013 12:35:00 PM
Last Editorial Review: 3/4/2013 12:00:00 AM

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Flu Vaccine Fell Short for Seniors This Season: CDC

By Steven Reinberg

HealthDay Reporter

THURSDAY, Feb. 21 (HealthDay News) -- The flu vaccine has fallen markedly short of expectations for older Americans this winter, offering this vulnerable population protection against the most virulent strain of flu virus just 9 percent of the time, U.S. health officials reported Thursday.

Even among the general population, the vaccine's effectiveness was just 56 percent, which is considered slightly below average, according to the latest data from the U.S. Centers for Disease Control and Prevention.

Complicating matters, the 2012-13 season has turned out to be one of the more severe flu seasons in recent years because of the presence of the H3N2 virus -- a strain associated with severe bouts of influenza.

"This was really a worse-than-average flu season," said CDC spokesman Tom Skinner. "It hit the elderly particularly hard. We saw a lot of hospitalizations and, unfortunately, a lot of deaths of the elderly."

"For reasons we don't fully understand, the efficacy rate in those 65 and older against H3N2 was lower than what we would like," he said.

This makes it even more important for the elderly, even if they've been vaccinated, to seek treatment early with antiviral drugs like Tamiflu when they come down with the flu, Skinner said.

Dr. Marc Siegel, associate professor of medicine at NYU Langone Medical Center in New York City, agreed that it's "not an ideal vaccine, but it offers a public health advantage -- it's worth taking."

"The reason this vaccine is not that effective for the elderly is because it's hard for the elderly to mount an immune response," he added.

The vaccine is most effective against influenza B viruses, reaching a level of 67 percent protection both overall and among seniors, the CDC report showed.

"The message is we need better vaccines," Skinner said.

Skinner noted that vaccination is still the best protection against the flu, because even if you get sick the vaccine may make the illness milder.

"If people use these numbers not to get vaccinated, I think that will be a tragedy," Skinner said. "Some protection is certainly better than no protection at all."

The findings were published Feb. 22 in the CDC publication Morbidity and Mortality Weekly Report.

This flu season has caused high hospitalization rates, with seniors accounting for 50 percent of all those admitted for the flu.

"This is the highest hospitalization rate [for seniors] since 2003, and may be the highest ever," Siegel said.

Also, nearly 10 percent of deaths up to Feb. 9 have been attributed to the flu or pneumonia associated with the flu. Again, the elderly were hit the hardest, Skinner said.

Sixty-four children have died from flu this season. That number is precise, because the federal government keeps track of pediatric flu deaths. No such count is kept on adults. Typically, approximately 25,000 Americans die from the flu every year, according to the CDC.

Skinner said this year's flu season started early, but seems to be winding down. "But we'll see if that trend continues," he added.

More information

For more on the flu, visit the U.S. Centers for Disease Control and Prevention.

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Flu Vaccine Fell Short for Seniors This Season: CDC

Title: Flu Vaccine Fell Short for Seniors This Season: CDC
Category: Health News
Created: 2/21/2013 2:36:00 PM
Last Editorial Review: 2/22/2013 12:00:00 AM

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Flu Shot May Not Work as Well for Seniors

By Amy Norton

HealthDay Reporter

WEDNESDAY, Feb. 6 (HealthDay News) -- Seniors seem to get a weaker boost to their immune system following a flu shot than young people do, a small study shows.

Experts say the findings essentially confirm what's been believed: The flu shot just doesn't work as well for older immune systems. But they also caution that the vaccine remains the best defense against flu misery.

Older people are among those at greatest risk for flu complications, like pneumonia. Americans older than 65 have been hard-hit during the current, rough flu season: Late last month, the U.S. Centers for Disease Control and Prevention said that 98 of every 100,000 seniors were hospitalized with the flu for the week ending Jan. 19.

So older adults should keep getting vaccinated every year, according to Nicholas Kelley, a research associate with the Center for Infectious Disease Research and Policy at the University of Minnesota, in Minneapolis.

"Getting the flu shot is safe, and it's better than doing nothing," said Kelley, who was not involved in the new study. "It's still the best weapon we've got."

For the study, which appeared Feb. 6 in the journal Science Translational Medicine, researchers analyzed blood samples from 17 volunteers who'd gotten the flu shot. Four of them were aged 70 or older, while the rest were 8 to 30 years old.

They used gene-sequencing technology to get a "head count" of immune system cells called B cells during the volunteers' peak immune response to the vaccine, explained lead researcher Ning Jenny Jiang, currently an assistant professor at the University of Texas at Austin. The study took place while she was based at Stanford University.

B cells are important because they produce the antibodies that the immune system launches against invaders, like the flu virus. When B cells are exposed to the dead or weakened virus in a vaccine, they "tweak" their antibody weapons to be more effective against the real virus.

But Jiang's team found that after the flu shot, elderly people had lower numbers of distinct B cell types, compared to young people. That essentially means they had a less diverse array of weapons against the flu.

"We also noticed that B cells from elderly people had a higher level of mutation, or tweaks, to their antibody-coding genes compared to other age groups," Jiang said. That suggests their B cells are already very "specialized" -- and possibly more resistant to further "tweaks" from the flu vaccine.

"This basically confirms what we've believed to be true," Kelley said. "But this is the first time [the research] has gotten to this technical of a level."

Another expert said the study provides helpful new information for researchers.

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A Good Mood May Boost Seniors' Brain Power

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Feb. 4 (HealthDay News) -- When older people's mood improves, so does their brain power, new research suggests.

Being in a good mood appears to enhance decision-making skills and working memory among older adults, according to the study published in the current issue of the journal Cognition and Emotion.

The study authors suggested that even something as simple as a small bag of candy can help older people perform better on so-called "cognitive" -- or thinking skill -- tests.

"There has been lots of research showing that younger adults are more creative and cognitively flexible when they are in a good mood. But because of the [mental] declines that come with aging, we weren't sure that a good mood would be able to help older adults," study co-author Ellen Peters, professor of psychology at Ohio State University, said in a university news release.

"So these results are good news," she added. "There are ways for older adults to overcome some of the [mental] declines that come with aging"

In conducting the study, the researchers divided 46 adults ranging in age from 63 to 85 years into two equal groups. Those included in the first group were given a thank you note and two small bags of candy tied with a red ribbon to boost their mood when they arrived for the thinking skill tests. Those in the other group did not receive either a thank you note or candy.

During the experiment, the participants who received the candy used computers that had a sky-blue background screen with smiling suns on it. Meanwhile, those who didn't receive the candy used computers with neutral round images but no smiling faces on the sky-blue background.

The participants were given $3 in quarters and eight virtual decks of cards featuring a different pattern during the decision-making tasks. Four of the decks were considered "gain" decks. If participants chose a card from one of these decks, 75 percent of the time they won a quarter and 25 percent of the time they didn't win or lose. The remaining four decks were considered "loss" decks. If someone chose a card from a "loss" deck, they lost a quarter 75 percent of the time, the study authors explained.

The participants could also accept or reject the top card of the deck that was offered to them. Their goal was to win as much money as they could. The participants were not told what the card values were. Instead, they had to learn through trial and error. The researchers noted they were looking to see how quickly the participants would learn which decks won them money and which ones didn't.

The study revealed that the older adults whose spirits were lifted with a thank you note and candy performed much better at the decision-making test than the other participants.

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