Category Archives: Aging
Ebola Update: U.S. Doctor Being Treated for Ebola Expected to Be Released from the Hospital Today
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Reuters and other news outlets are reporting that Kent Brantly, MD, who contracted Ebola in Liberia where he was treating patients for the disease, has recovered from the virus and is expected to be released from Emory University Hospital in Atlanta today. An update on the condition of Nancy Writebol, a health worker who also contracted Ebola in West Africa, is also expected today. Since the start of the current outbreak in West Africa, more than 1,350 people have died of the disease. In an effort to reduce the spread of the disease, officials in Monrovia, the densely populated urban capital of Liberia, began a quarantine to stem the disease outbreak, sparking clashes between residents and troops. Read more on Ebola.
Many Older ER Patients Show Signs of Malnutrition
A new study in the Annals of Emergency Medicine found that many patients over age 65 who go to the emergency room for medical care are also found to be malnourished or at risk of malnourishment. The study authors say the reasons behind the insufficient nutrition include dental problems that make it difficult to eat, depression and lack of access to food. The study suggests that all older patients be assessed for malnutrition during emergency room visits. Read more on aging.
Free Online Search Tool from DOT Lets Consumers Check Vehicle Safety
The U.S. Department of Transportation has released a free, online search tool—accessible at www.safercar.gov—that consumers can use to find out whether a vehicle, including a motorcycle, has been recalled by using the Vehicle Identification Number (VIN). Consumers can find their vehicle identification number by looking at the dashboard on the driver’s side of the vehicle, or on the driver’s side door where the door latches when it is closed. After entering the VIN number into the search tool, a message indicating whether the vehicle was recalled will appear, which will let users choose not to buy or rent the car, or if they own it or are planning to buy it, to have it fixed according to the recall specifics. The National Highway Traffic Safety Administration is working with the National Automobile Dealers Association to make sure that the VIN tool is used by all U.S. car dealerships. Read more on safety.
This week, NewPublicHealth will run a series on new and creative public health campaigns that aim to improve the health of communities across the country through the use of public service announcements, infographics and more. Stay tuned to learn more about a new campaign each day.
As the country turns increasingly gray, more and more adults are experiencing the stresses and strains of caring for aging family members. It has long been a silent struggle for many of the nation’s 42 million unpaid caregivers, but the full impact of family caregiving is starting to come out from the shadows thanks to a major ongoing campaign from the AARP and the Ad Council first launched in 2012. Through a series of ads for television, radio, print media and digital venues, the campaign aims to raise awareness of the ripple effects of family caregiving and to steer overwhelmed families toward resources that may ease the pressure.
The public service advertisements (PSAs) depict the sense of isolation, responsibility and frustration family caregivers often feel as they tend to their loved ones—providing reassurance that they are not alone with these challenges. The ads also highlight a community of experts set up by the AARP to help caregivers take better care of themselves while caring for others and to encourage caregivers to access online tools or call a toll-free hotline (877-333-5885). The website includes resources on planning for long-term care (legally, financially and in other ways) and advice on dealing with emotional issues such as grief and loss.
Nearly 30 percent of caregivers report feeling sad or depressed, and 33 percent isolate themselves by avoiding people or social situations, according to a 2013 AARP report, Caregivers: Life Changes and Coping Strategies. Moreover, 38 percent of those caring for a loved one say they sleep less since they became caregivers, and 44 percent admit they try to squelch their feelings. An earlier survey by the AARP and the Ad Council, involving 500 caregivers between the ages of 40 and 60, revealed that 31 percent describe their caregiving tasks as extremely or very difficult; 21 percent say they don’t feel like they have the support they need; and 26 percent don’t feel confident about knowing where to turn to find support and information for unpaid caregivers.
“Only those who care for others know what it’s really like to care for others—that’s why we created a community where caregivers can connect with experts and others facing similar challenges,” said AARP CEO Barry Rand. “We hope this campaign will help the millions of family caregivers in the U.S. feel heard and supported, in turn, helping them better care for themselves and for the ones they love.”
As an offshoot of the Caregiver Assistance PSAs, the AARP and Ad Council also launched the “Thanks Project”, a digital opportunity for family members and friends to publicly acknowledge and appreciate how much they value the contributions from the caregivers in their lives. The idea is that a note of thanks can mean a lot to caregivers.
>>Bonus link: Read a NewPublicHealth interview with Gail Sheehy, author of “Passages in Caregiving: Turning Chaos into Confidence.”
EBOLA UPDATE: Death Toll Passes 1,200; Improvement Seen in Three African Doctors Who Received Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll in the ongoing Ebola outbreak in West Africa has passed 1,200, according to the World Health Organization, with infection rates continuing to outpace containment efforts. Concerns over the disease also continue to spread, with a 30-year-old woman in Germany isolated and then taken to a specialist medical unit after being found with a high fever. However, the Liberian information minister was also recently quoted as saying that three African doctors treated with the experimental ZMapp treatment are showing “remarkable signs of improvement.” The drug was used to treat two Americans who are now also showing signs of improvement. Read more on Ebola.
Study: Older Americans Receiving Cancer Screenings Against Recommendations
As many as half of older Americans continue to receive cancer screenings despite the recommendation by several professional societies that certain cancers not be screening for in people who aren’t expected to live for another 10 years, according to a new study in JAMA Internal Medicine. “There is general agreement that routine cancer screening has little likelihood to result in a net benefit for individuals with limited life expectancy,” wrote Trevor Royce, MD, in the study. Keith Bellizzi of the University of Connecticut‘s Center for Public Health and Health Policy in Storrs added that "Each screening test carries different risks and benefits ... Individuals should be counseled about these risks in order to make an informed decision (sometimes involving caregivers or family members)." Read more on cancer.
Study: Dramatic Drop in Deaths, Hospitalization for Heart Disease and Stroke
Lifestyle changes, better treatment and effective preventive measures have caused a dramatic drop in deaths and hospitalizations for heart disease over the past decade, according to a new study in the journal Circulation. In a review of data on nearly 34 million Americans covered by Medicare, researchers found that from 1999 to 2011 hospitalizations rates for heart attacks dropped by 38 percent; rates of unstable angina dropped by almost 85 percent; and hospitalizations for both heart failure and stroke dropped by approximately one-third. "The findings are jaw-dropping," said lead researcher Harlan Krumholz, MD, a professor of cardiology at the Yale School of Medicine in New Haven, Conn, according to HealthDay. "They really show that we have begun to reverse this epidemic of heart disease and stroke." Read more on heart and vascular health.
Recommended Reading: Life Expectancy Gains Threatened When Older Americans Have Multiple Medical Conditions
A new study from the Johns Hopkins Bloomberg School of Public Health finds that nearly four in five older Americans are living with multiple chronic medical conditions. That’s very concerning, say the researchers, because their work shows that the more ailments a person has after retirement age, the shorter their life expectancy. The researchers say the new study is one of the first to look at the burden of multiple chronic conditions on life expectancy among the elderly and may help explain why increases in life expectancy among older Americans are slowing.
“Living with multiple chronic diseases such as diabetes, kidney disease and heart failure is now the norm and not the exception in the United States,” said Eva H. DuGoff, PhD, a researcher at the school of public health and the lead author of the new study. “The medical advances that have allowed sick people to live longer may not be able to keep up with the growing burden of chronic disease. It is becoming very clear that preventing the development of additional chronic conditions in the elderly could be the only way to continue to improve life expectancy.”
The study found that a 75-year-old American woman with no chronic conditions will live to be an average of 92, but a 75-year-old woman with five chronic conditions will only live to an average age of 87 and a 75-year-old woman with 10 or more chronic conditions will only live to the age of 80. Women continue to live longer than men and white people live longer than black people, based on data from annual U.S. surveys.
On average, life expectancy is reduced by 1.8 years with each additional chronic condition, the researchers found. But while the first disease shaves off just a fraction of a year off life expectancy for older people, the impact grows as the diseases add up. The study is based on an analysis of the records of 1.4 million Medicare enrollees and was published in the journal Medical Care.
Other groups are also beginning to look at this issue. Healthy aging will be this year’s focus of the President’s Initiative of the Association of State and Territorial Health Officers. A year-long focus on healthy aging will begin during the association’s annual conference in September.
Read the full study.
HHS, DOJ Release ‘Roadmap’ to Prevent Elder Abuse
The U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) have announced a new Elder Justice Roadmap to enhance elder abuse prevention and prosecution, while also highlighting the issue of elder abuse. An estimated one in 10 Americans over the age of 60 have experienced elder abuse or neglect. The Roadmap includes the DOJ’s development of an interactive, online curriculum to teach legal aid and other civil attorneys to identify and respond to elder abuse, as well as the HHS’ development of a voluntary national adult protective services data system. “Elder abuse is a problem that has gone on too long, but the Roadmap Report released today can change this trajectory by offering comprehensive and concrete action items for all of the stakeholders dedicated to combating the multi-faceted dimensions of elder abuse and financial exploitation,” said Associate Attorney General Tony West, in a release. “While we have taken some important steps in the right direction, we must do more to prevent elder abuse from occurring in the first place and face it head on when it occurs.” Read more on aging.
Study: Health Care Providers Must Do More to Ensure Pregnant Women Receive the Flu Vaccine
A new study finds that health care providers (HCPs) must do more to ensure pregnant women are vaccinated against influenza. After a review of 45 research papers, researchers determined that HCP influenza vaccine recommendations and on-site services would both help increase the current suboptimal vaccination rate. The study pointed to inadequate knowledge of the risks of influenza; doubts about vaccine safety, efficacy and benefits; and fear of adverse reactions for both the pregnant women and their unborn fetuses as barriers to vaccination. Many of the women in the review were also unaware that their pregnancies placed them at higher risk of complications from influenza. Read more on maternal and infant health.
Study: Younger Pro Pitchers at Higher Risk of Needing ‘Tommy John’ Surgery
Stephen Strasburg. Matt Harvey. Kerry Wood. All were or are hard-throwing Major League Baseball (MLB) pitchers who underwent “Tommy John” surgery early in their careers. Now, a new study from researchers at the American Orthopaedic Society for Sports Medicine indicates that entering the MLB at a younger age increases the risk of needing Tommy John surgery—which is a reconstruction of the ulnar collateral ligament in the elbow—at some point in a career. In a study of 168 pitchers who had Tommy John surgery and 178 age-matched pitchers who did not, approximately 60 percent of those who needed the surgery had it in the first five years of their career. They also had statistically more Major League experience, indicating that arm stress at a younger age heightens the risk of damage. “Having athletic trainers and team physicians closely look at when players’ pitching performance stats start to decrease may allow for steps to be taken before a surgery is needed. Our study also further highlights the need for kids not to overuse their arms early in their pitching careers,” said lead author Robert Keller, MD, of Henry Ford Hospital in Detroit, in a release. Read more on injury prevention.
Widely Used HIV Drug Linked to Higher Suicide Risk
People infected with HIV whose treatment includes the widely used antiretroviral drug efavirenz appear to have double the risk of suicidal thoughts, attempts and completion compared to HIV patients not taking the medication, according to a study by several researchers at the Harvard School of Public Health and the University of North Carolina at Chapel Hill. The study was published in the Annals of Internal Medicine.
“When efavirenz is used as a component of antiretroviral therapy, patients should be monitored carefully for exacerbation of depression or evidence of suicidal thoughts or behavior,” according to the study.
The drug has been previously linked to central nervous system side effects and suicide, but until now a clear link to suicidal thinking, attempted suicide, or completed suicide was not clear. The effects persist for the time patients are on the drug. The researchers recommend that patients with HIV use alternative drugs, if possible, if they are at risk for depression. Read more on HIV.
Nutrition Screenings Should Be Regular Part of Geriatric Health Assessment
Most older adults typically have one or more chronic health conditions that can affect their food intake and should be asked about their food intake during health exams, according to a new study in Nutrition in Clinical Practice. The researchers said that health care providers should also look for signs of malnutrition, such as loss of subcutaneous fat, muscle loss and fluid accumulation. Read more on aging.
Many American Teens Follow Pro-Marijuana Twitter Feeds and Receive Pro-Marijuana Tweets
Hundreds of thousands of American teens are following marijuana-related Twitter accounts and getting pro-marijuana tweets several times each day, according to researchers at the Washington University School of Medicine in St. Louis. The researchers say the tweets are cause for concern because young people are especially responsive to social media influences and because patterns of drug use tend to be established in a person’s late teens and early 20s. The study was published in the Journal of Medical Internet Research and relied on tweets sent and received between May 1 and Dec. 31, 2013, from a single popular pro-marijuana Twitter feed. During the study period, the feed posted an average of 11 pro-marijuana tweets per day. Read more on substance abuse.
AHA to Fund Research Network for the Prevention of Heart Disease, Stroke
With a $15 million grant from the American Heart Association (AHA), four major medical institutions are coming together to form a research network with the goal of preventing heart disease and stroke. The Strategically Focused Prevention Research Network Centers will include investigators at Northwestern University in Chicago, Vanderbilt University in Nashville, the Icahn School of Medicine at Mount Sinai in New York City and the University of Texas-Southwestern Medical Center in Dallas. “Heart attack and stroke can strike suddenly, and frequently without warning. The best way to reduce premature mortality from cardiovascular diseases and stroke is to prevent the development of the risk factors that lead to these conditions,” said AHA President Elliott Antman, MD, professor of medicine at Harvard Medical School and a senior physician in the cardiovascular division of the Brigham and Women’s Hospital in Boston, in a release. “Scientists working in these research centers are helping to discover the mechanisms that will allow all Americans to live healthier lives, helping lead us to a culture of health.” Read more on heart health.
Study: One-Third of U.S. Total Knee Replacements ‘Inappropriate’
Approximately one-third of all total knee replacements in the United States are unnecessary and “inappropriate” under a patient classification system used in Spain, according to a new study in the journal Arthritis & Rheumatology. Researchers said the findings demonstrate a need for the United States to develop similar patient selection criteria so as to limit the unneeded surgeries. There are more than 600,000 total U.S. knee replacements annually—meaning that approximately 200,000 are unnecessary, according to the study—and from 1991 to 2010 the number of Medicare-covered replacements climbed by approximately 162 percent annually. Read more on aging.
Kids’ ADHD Medications Not Linked to Increase Risk of Substance Abuse
While children with attention-deficit/hyperactivity disorder (ADHD) are twice as likely to abuse drugs, the medications prescribed to treat ADHD do not play a role in the increased risk, according to a new study in the journal Pediatrics. In fact, researchers determined that the combination of behavioral techniques and ADHD medications actually lowers the risk of substance abuse. "Obviously, the medications that are used to treat ADHD have the potential for abuse, but the vast majority of children with ADHD do not develop a substance abuse problem," said Michael Duchowny, MD, a pediatric neurologist at Miami Children's Hospital. "More research has to be done to find out why some children are more susceptible than others." Common ADHD medications include amphetamines such as Adderall or Dexedrine, and methylphenidates such as Concerta, Metadate CD or Ritalin. Read more on substance abuse.
CDC: Two U.S. MERS-CoV Cases Did Not Spread Any Further
In May of this year the U.S. Centers for Disease Control and Prevention (CDC) announced two cases of imported Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the United States, with one in Florida and the other in Indiana. Both patients were health care providers who lived and worked in Saudi Arabia. The CDC has now confirmed that in neither case did the disease spread to either members of the patients’ households or health care workers who treated the patients. “The negative results among the contacts that CDC considered at highest risk for MERS-CoV infection are reassuring.” said David Swerdlow, MD, who is leading CDC’s MERS-CoV response. “Today, the risk of MERS-CoV infection in the United States remains low, but it is important that we remain vigilant and quickly identify and respond to any additional importations.” Read more on infectious disease.
FDA Approves the Manufacture of Cell-based Influenza Vaccine
Yesterday the U.S. Food and Drug Administration (FDA) announced approval to manufacture the first cell-based seasonal influenza vaccine in a U.S. facility. The Holly Springs, N.C., facility, which is owned by the Swiss company Novartis, will also be capable of manufacturing vaccines against pandemic influenza viruses. The technology was created in partnership with the Biomedical Advanced Research and Development Authority, part of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. According to a statement from Robin Robinson, PhD, ASPR Director and Deputy Assistant Secretary for Preparedness and Response, the cell-based vaccines will be part of multi-use approach that “strengthens everyday systems and increases our resilience in emergencies.” Read more on influenza.
Study Links Air Pollution, Cognitive Decline in Older Adults
One way to help reduce age-related cognitive decline may be to reduce air pollution, according to a new study in The Journals of Gerontology: Series B. Researchers determined that older adults who live in areas with low concentrations of fine particulate matter air pollution—from sources such as vehicle exhaust—made fewer cognitive errors on math and memory tests than did older adults who lived in areas with high pollution levels. “Although finding a link between the air we breathe on a daily basis and our long-term brain health is alarming, the good news is that we have made remarkable progress in the last decade in reducing levels of air pollution across the country, and there are efforts underway to further reduce air pollution,” said study co-author Jennifer Ailshire, of the Center for Biodemography and Population Health and the Andrus Gerontology Center at the University of Southern California in Los Angeles. Read more on aging.
Far too many older people in generally good health find themselves without purpose—which is itself at cross purposes with the natural makeup of humans, according to Linda P. Fried, MD, MPH, an expert on aging and the dean of the Mailman School of Public Health at Columbia University.
“We are a species wired to feel needed, respected, and purposeful,” she wrote in the latest issue of The Atlantic. “The absence of those qualities is actually harmful to our health.”
The new article discusses the current research on the benefits of older people engaging in work that they are good at and enjoy. One example, Experience Corps—which Fried cofounded and which is now hosted by the AARP—seeks to leverage “the investments in one age group in order to benefit many stakeholders.”
Another example is the World Health Organization’s Global Network of Age-Friendly Cities and Communities, which provides a model for developing public-private partnerships. In New York City, the Age-Friendly NYC Commission was established in 2010 in partnership with the New York City Council and The New York Academy of Medicine. The underlying premise, according to Fried, was that the active participation of older residents in all aspects of city life is essential to the growth and health of the city, and that creating the conditions to achieve this is an important investment in public health.
Read the full story from The Atlantic, “Making Aging Positive.”
>>Bonus Link: Read a previous NewPublicHealth post on the Age-Friendly NYC Commission.
NIH Spearheads Private/Public Collaboration to Improve Care for Several Serious Health Conditions, Including Alzheimer’s
The U.S. Department of Health and Human Services (HHS) today released the 2014 update for the National Plan to Address Alzheimer’s Disease, which includes a determination to accelerate efforts to identify the earliest stages of Alzheimer’s disease and to develop and test targets for intervention. That acceleration has new momentum this year with the announcement several weeks ago by the National Institutes of Health (NIH) that it has formed a first-if-its-kind partnership—the Accelerated Medicines Partnership (AMP) with ten pharmaceutical companies and several nonprofit organizations—to help identify and validate new diagnostics and drugs for several diseases that impact tens of millions of Americans and their families. The three other conditions are Type II diabetes, lupus and rheumatoid arthritis.
“Despite the fact that there have been huge revolutions in science from discovery of the double-helical structure of DNA, to recombinant DNA, to all sorts of interesting technological advances...it still takes too long and costs too much and we fail too often in the development of new drugs,” said Kathy Hudson, PHD, deputy director for Science, Outreach and Policy at the NIH, in a conversation with NewPublicHealth.
Hudson said a key development that drove the creation of the AMP is a new center at NIH, the National Center for Advancing Translational Sciences, which she says will work on how to “create new methods and new approaches that will decrease the failure rate and decrease the timeline for delivering new, important medicines to patients’ medicine cabinets.” Hudson said it currently takes about 15 years and more than $1 billion to develop a new drug and the failure rates are quite high at every step because of safety and because of efficacy.
“The new partnership effort is really targeted towards trying to boost the success of the pipeline by improving efficacy. What we’re exploring in this partnership is using a whole bunch of different new approaches and new technologies to try to identify higher quality targets that can enter the drug development pipeline,” said Hudson.
The private sector drug firms will match NIH dollars one-for–one. The other key contribution, according to Hudson, is that “industry scientists and NIH scientists and academic scientists all come at these problems with slightly different perspectives and experience and expertise, and by combining those together we’re really getting a research plan that is distinctive from what any one of us would have generated by ourselves.”
Hudson said another critical issue that is helping the collaboration is the fact that “the ground rules have been so clearly laid out about us working in a precompetitive space, about all of the data being broadly shared not just with the participants but with the entire scientific community.” Even with the collaboration, identifying and testing new compounds will take years. How to commercialize successful products will be part of the ongoing discussions.
>>Bonus Link: Read more about the Accelerated Medicines Partnership