Tag Archive 'aging'

Jan 26 2010

Link Between High Blood Pressure and Dementia

It’s common knowledge that high blood pressure can lead to heart attack and heart failure, stroke, kidney failure, and other health consequences. Now new research has found high blood pressure may also make you more prone to dementia as you age.

The research, from the National Institutes of Health, suggests that hypertension – blood pressure readings of 140 over 90 or higher – may cause a kind of scarring that interferes with communication between brain cells. That scarring, known as white matter lesions, has been linked to development of Alzheimer’s and other dementias in the elderly. Researchers have found an increase in white matter lesions with each 20-point jump in systolic pressure above the recommended limit. Systolic pressure is the bigger of the two numbers. Those scars can start building up in middle age, although the resulting memory problems may not appear until decades later.

“If you look … for things that we can prevent that lead to cognitive decline in the elderly, hypertension is at the top of the list,” Dr. Walter Koroshetz, deputy director of NIH’s National Institute of Neurological Disorders and Stroke, told The Associated Press. Age is the biggest risk factor for Alzheimer’s disease and other forms of dementia that affect about one in eight people 65 or older.

This evidence of a link is strong enough that the National Institutes of Health will soon begin enrolling thousands of people with high blood pressure into a major study. The aim will be to see if pushing blood pressure lower than currently recommended might better protect not just hearts, but brains.

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Aug 24 2009

Wanted: Geriatricians To Care For The Elderly

There is a crisis looming in our ability to care for the elderly in this country. I’m not talking about the healthcare debate or the solvency of Medicare. I’m talking about a growing shortfall in the number of doctors trained to care for the special health problems of the elderly. These doctors are known as geriatricians. And with our nation’s senior population due to explode in the next few decades thanks to theĀ  aging of the Baby Boomer generation, this could present a serious problem.

According to the American Geriatrics Society, there are currently 7,590 certified geriatricians in the US — one geriatrician for every 2,500 Americans 75 or older. Due to the projected increase in the number of older Americans, this ratio is expected to drop to one geriatrician for every 4,254 older Americans in 2030.

One reason geriatrics does not appeal to medical students: money. According to the AGS, the median salary for a geriatrician in private practice in 2006 was $161,888. This was $2,133 less than the average family physician’s salary, and $15,171 less than the average general internist’s. Geriatricians train at least one year longer than their primary care colleagues, and yet they are compensated at a lower level. In many parts of the U.S., Medicare payment rates for physicians are lower than commercial insurance rates. Medicare reimbursement is the major source of income for most geriatricians and, as a result, community-based geriatricians have lower incomes than most other physician specialists.

The University of New England has created a unique program to give its medical students first-hand experience in a nursing home. UNE’s college of Osteopathic Medicine operates the “Learning by Living” project, which places a medical student in a nursing home to live the life of an elder resident for two weeks, 24/7. The goal is to equip the students to become more effective physicians, and also to offer a fresh perspective to nursing home administrators.

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Aug 19 2009

Challenges Facing Aging Boomers

I came across an interesting article that I want to share with you. It comes from ww.medicalnewstoday.com, and I am using parts of it with the site’s permission. The article is titledĀ  “Baby Boomers Face Down Aging: 10 Most Common Medical Challenges.” It offers a snapshot of the ten challenges that baby boomers will face in the coming years as more and more of them hit 65. And since the US Census Bureau estimates that nearly a quarter of the US population will be 65 or older by 2030 (today that group is around 13% of total), this means these are issues that will balloon in scope and impact in coming years.

Of course, these are also issues that today’s elderly population is dealing with. So whether you are caring for an elderly loved one right now, or looking toward your future as a senior citizen, I think this list provides some valuable information to keep in mind. It comes to use from researchers and clinicians in the Division of Geriatric and Palliative Medicine at The University of Texas Medical School at Houston.

10 Most Common Medical Challenges Facing Baby Boomers

1. Functional decline: According to the U.S. Department of Agriculture, the body loses one percent of muscle mass a year beginning at age 45, which can result in sarcopenia as skeletal muscle is eventually replaced with fat and the body becomes weaker. Some research has linked protein deficiency with sarcopenia. For every week spent in the hospital, it takes an aging body a month to recover muscle strength with daily rehabilitation, says geriatrician Liliana Andrade, M.D., assistant professor of internal medicine at the UT Medical School at Houston. Exercise, including resistance and strength training, is absolutely essential for retaining muscle mass and strength. “For balance, tai chi is good,” she says. “We also encourage patients to rent ’sit and be fit’ videos that use hand and leg weights.”

2. Depression: Considered as prevalent as the common cold in the elderly, depression can be the result of major life changes, including retirement, losing loved ones and loss of mobility and independence. It can show up differently in older people, says geriatrician Nasiya Ahmed, M.D., assistant professor of internal medicine at the UT Medical School at Houston. “There’s not as much of a tendency toward tearfulness or feelings of hopelessness,” she says. “Instead they have vague somatic complaints, increased pain, not sleeping or eating well or general apathy.”

3. Disease: Chronic diseases associated with the aging process, including high blood pressure, stroke, cardiovascular disease, osteoporosis, chronic obstructive pulmonary disease, hypothyroidism, constipation, incontinence and arthritis, can take their toll. Preventive measures taken now such as quitting smoking, eating healthy food and exercising are all important steps toward a better quality of life. “Even quitting smoking at age 60 is better than not quitting at all,” Andrade says.

4. Polypharmacy: A term geriatricians are using for the number of prescription and over-the-counter medications that elderly people are taking in alarming numbers is polypharmacy. “People go to five different doctors and none of the others know what is going on,” Ahmed says. In some cases, seniors who wind up in the hospital may be prescribed a different medication for an existing condition such as high blood pressure because the hospital doesn’t stock the particular one they’ve been taking in the past. The patient returns home with a new prescription from the hospital physician and continues taking the other medication as well, which can be deadly. “I’ve had patients come in who are taking 20 different medications,” Andrade says. “A lot of them also take vitamins and herbal supplements that they don’t need and that can interfere with medications.” The solution, they say, is to have a written record of all prescriptions, supplements and vitamins that they can bring to their appointments and have a family practitioner or geriatrician who can be the lead physician in managing their care.

5. Falls: Low blood pressure, which can be a result of poorly managed hypertension or dehydration, can lead to dizziness. That dizziness, combined with a decreased ability of the vascular system to compensate for changes in position such as standing up, is the largest cause of falls, they say. “So many patients have told me that they take blood pressure medication when they feel like it’s high instead of taking it as it is prescribed,” Ahmed says. “I ask them how they know it’s high and they give vague signs such as their nose tingles or their tremor worsening.” Taking medications for sleep can also be dangerous. “Some take Benadryl to help them sleep and as people get older, that’s not such a good thing because it causes confusion and they can fall because they’re sleepy,” Andrade says.

6. Abuse and neglect: These two problems, including self-neglect, will continue to afflict the elderly, says Carmel B. Dyer, M.D., professor and director of the geriatric and palliative medicine division at the UT Medical School at Houston and co-author of the book, “Elder Abuse Detection and Intervention.”

7. Financial exploitation: Vulnerable elderly people can easily become victims of family members or caregivers. “We see cases where grown children have moved back in with them and are depending on them financially. They use their resources, borrow the car, rely on them to baby sit, and it upsets the senior’s ability to function,” Ahmed says. “I had one patient in her early 80s whose leg had just been amputated and she was still babysitting her 11- and 12-year-old grandchildren, who were taunting her.”

8. Dementia: Alzheimer’s disease is the most common form of dementia, a gradual decline in a person’s mental functioning, and is the fifth leading cause of death for Americans over age 65, according to the National Center for Health Statistics. The Alzheimer’s Association reports that Alzheimer’s disease and dementia triple healthcare costs for people over 65. But education about dementia and possible treatments including medications is lacking, Ahmed and Andrade say. “There are now more medications that are helpful. They can’t cure it, but they can help,” Andrade says. “Unfortunately, a lot of people are in denial. I had a 78-year-old patient who I knew was suffering from dementia because of the way he was managing his medications and health. But his son got upset when I started talking about it and they left the room.”

9. Caregiver burnout: As baby boomers age, many will also be taking care of their own aging parents. That brings caregiver burden, which can lead to a higher risk for depression and other stress-related illnesses. Ahmed says caregivers should solicit health resources, such as daycares for seniors, to help them shoulder the stress. They should take advantage of support groups and ask social workers regularly about available community resources. Special units for acute care for the elderly (ACE units), can help make hospitalizations less stressful for the patient and family.

10. Death and dying: Baby boomers will have to decide how they want to live out the end of their lives and how they want to die. Cultural and religious beliefs will impact these decisions and physicians will need to be sensitive to that, Ahmed says. As patients age, the physician begins to play a larger role in a patient’s life and strong physician-patient relationships will be important in determining a patient’s wishes. People should make those wishes known to family members and caregivers and put them in writing.

Source: www.medicalnewstoday.com

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Jul 20 2009

If Spouse Has Dementia, You’re At Risk As Well

It’s no surprise that elderly couples that have been together for decades can take on each other’s traits – developing similar political views, taste in food and music, sense of humor and even physical appearance. But a recent study suggests something remarkable – spouses of people with dementia are at substantially increased risk of developing dementia themselves.

No, dementia is not contagious. Rather, researchers say that the stress involved in caring for a person with this condition is huge and stress is a known risk factor for dementia. In addition, people who are stressed are less likely to eat a healthy diet and exercise, both of which are critical to brain health.

The study was presented at the Alzheimer’s Association 2009 International Conference on Alzheimer’s Disease.

Researchers followed more than 1,200 couples for 10 years. They found that wives who cared for husbands with dementia were nearly four times more likely to develop dementia than wives of men who didn’t have the condition. Husband caregivers were almost 12 times more likely to develop dementia than husbands of women who were cognitively healthy.

Why are male caregivers at greater risk of developing dementia than female? Researchers say it’s because elderly men tend to rely on their wives to keep up social ties with relatives and friends. Also, men often fail to go to the doctor without some nudging from their wives, according to the study. This places them at higher risk for high cholesterol, high blood pressure, and other conditions that may raise the risk of dementia.

Researchers offer this advice for adult children of people with dementia:

  • Visit frequently and relieve the caregiving parent from his or her duties so he or she can get some rest.
  • Make sure the healthy parent gets out and engages in social activities.
  • Ensure both parents get to the doctor regularly.

These are good reminders for all senior citizens, not just those caring for someone with dementia.

Adult day care centers are an option for some families caring for a relative with dementia. These facilities offer a respite for caregivers. Most operate during normal business hours Monday-Friday, although some do offer evening and weekend hours. For a complete list of adult day care centers in Florida, visit Florida Senior Living Advisor.

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