Study says depression and anxiety caused by chronic pain may contribute to a poor quality of life and reduce life expectancy.
Photo: Vladislav Muslakov/Unsplash
by Terri Dee Indiana News Service
INDIANAPOLIS, IN - April is National Stress Awareness Month. Stress is the body's way of processing work, personal, and family pressures, or other triggers.
A new study in the Journal of the American Medical Association has found a link between stress and chronic pain, which is defined as pain that persists for three months or more and lasts beyond the normal healing time of an injury or illness.
Former chiropractor Dr. Sean Pastuch is CEO of Active Life, a personal coaching company focusing on chronic pain-management options.
He suggested that biological, psychological and social interventions could be effective forms of treatment.
What is viewed as pleasurable to some may feel painful to others.
"The connection between all of those three things -- the physical, the mental, and the emotional -- is that when we think about pain, no one's defining what the word means," said Pastuch. "So, if we evaluate what the word 'pain' means, then we come to find that in order for there to be pain, there needs to be a negative emotional component to it."
He said that if you feel something, you have to decide if you like the way it feels or not. And what is viewed as pleasurable to some may feel painful to others.
The study also says depression and anxiety caused by chronic pain may contribute to a poor quality of life and reduce life expectancy.
A 2022 Indiana Chronic Care Policy Alliance report shows almost 8% of adults have chronic pain, with arthritis as the leading disorder.
Patsuch said patients face obstacles in finding a physician who can identify their pain, which means fewer or no opportunities to receive treatment.
"The reason why doctors struggle to help people with chronic pain, and why the confidence level among doctors is low," said Pastuch, "is because of all the medical schools, fewer than 15 actually have dedicated curriculum to supporting a patient with chronic pain."
Of the medical schools that offer a pain-management curriculum, he said the majority focus on students in the anesthetics department.
Patsuch suggested that when a patient is with their doctor, to use words other than "it just hurts." They need to be able to describe what hurts and ask, "How do I want to resolve it?"
by Glenn Mollette, Guest Commentator
When it comes to life, there are no guarantees. A few people will live to be 100 and beyond. The majority of people will die much younger. We don’t know for sure. Your health can be great and still anything can happen. Your health might be bad. A friend who lived to be about 77 said, “If I knew I was going to live this long I would have taken better care of myself.” He meant it to be humorous.
Seventy-seven doesn’t seem very old if you are 80. You may feel if you are 70 that you’ve just really started to live. It has a lot to do with who you are, how you feel, and the overall condition of your life. Sadly, there are a lot of miserable people who are still very young but can’t figure out their lives.
Age is truly just a number especially if you feel good, can take care of yourself, and have something to live for. This could be anything from a grandchild, to a job, a hobby, your career, or just spending your money. It’s important to have an interest. You need to have something to do. Everyone needs to be pursuing something they enjoy. You need a reason to get up in the morning. It will keep you going.
You may be here 30 years from now or maybe you won’t. It won’t hurt you to plan for the long haul. This means eating as healthy as possible, exercising some every day, managing your weight, and visiting your doctor routinely. This may help you to live a little longer and enjoy the remaining years you have. It’s not a guarantee, but it’s worth a shot. Keep trying to save a few dollars every month. Regardless of your age, there is always something that’s going to come up. You will need a new roof, furnace, or car. The list is endless.
Yet, today might be our last. We never know. Be kind every chance you have. Say thank you often. Do the small things that may help family and friends. Build others up. Give them a boost by saying something good to them. Treat others the way you want to be treated. Forgive people. Forgive yourself. Put the past behind you because you can’t change the past. Try to do something every day you enjoy. That may be walking, reading, playing music, talking to people, cooking, or it could be anything. Regardless of how long we live, life is short.
Recently, a friend lay dying. I asked him what I could do for him. He said, “All I would like to have is one more day.” Today, may be our one more day. Whatever we do on this one day will hopefully be a blessing not only to us but in some way will be a blessing to someone today or years from now.
The seed we plant will bring a harvest, of some kind.
Glen Mollett is the author of 13 books including Uncommom Sense, the Spiritual Chocolate series, Grandpa's Store, Minister's Guidebook insights from a fellow minister. His column is published weekly in over 600 publications in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization. We welcome comments and views from our readers. Submit your letters to the editor or commentary on a current event 24/7 to editor@oursentinel.com.
ROCKFORD - As we get older, the chances increase for many of us to develop chronic disease. That also means the likelihood of taking daily medications for conditions such as high blood pressure, diabetes, insomnia, arthritis and high cholesterol.
In medical terms, it’s called polypharmacy.
“Polypharmacy is using or taking multiple medications,” says Jessica McCuen, manager of pharmacy operations at OSF Saint Anthony Medical Center in Rockford, Illinois. “Most healthcare professionals have agreed that the number is somewhere around five or more. Generally, we say anyone who's taking five or more medications is experiencing polypharmacy.”
It's estimated that about one-third of adults between the ages of 60 and 70 are exhibiting some form of polypharmacy.
Taking multiple prescription drugs can increase the risk of multi-drug interactions, in which one medication can affect another medication. Another potential concern is drug-disease interaction, where taking medication for one health issue can make another health problem worse.
It appears to be a bigger concern for older people. It's estimated that about one-third of adults between the ages of 60 and 70 are exhibiting some form of polypharmacy.
“Once we get to that age, we tend to have chronic diseases that have been diagnosed and we take more medications to handle those chronic diseases.”
McCuen adds we don’t often think about how our age can affect how medications work.
“That’s when your body starts to change,” she explains. “You can absorb medications differently; the way that your body works changes and then the way that you hold on to medications because of your body makeup changes too. The way that you may have absorbed or had a reaction to a medication in your 30s could be different in your 60s and 70s just because of the way that your body has changed.”
People who experience polypharmacy have a bigger risk of being tired and dizzy, which increases the risk for falls. Other symptoms are weakness, loss of appetite, gastrointestinal (GI) problems and skin rashes.
And it’s not just prescription medications pharmacists worry about. Over-the-counter medications and herbal supplements can negatively interact with daily prescription drugs.
It’s also possible to be on a medication longer than is needed. For example, some people take a proton pump inhibitor – medicines that work by reducing the amount of stomach acid – for problems like heartburn.
“They'll just continue to take it even though they probably only need to take it for a couple of weeks and then see how they do off of it,” McCuen says. “That’s one of the most common ones I see that they don't necessarily need to be on.”
That’s why it’s important to talk with your care team before starting any new medication. In fact, McCuen recommends doing a medication review with your physician or pharmacist at least once a year to make sure your medications mesh.
“Your pharmacist is really your drug and medication expert,” she says. “They know a lot about the drug interactions with all your medications.”
McCuen adds that it's also a good idea to use the same pharmacy whenever possible so that your pharmacist has a record of all the drugs that you're taking. That way if anything new is added they can intervene in the event you have an interaction with one of your other medications.
Why can I speak about this issue? I worked as a pharmacy technician before working as a Registered Nurse (RN) and ultimately becoming a Nurse Practitioner (NP) in 2000. I have been employed in health care for 33 years, including over 20 of those years as a NP. At present, I work in a specialized emergency service, and am attending the University of Washington for a Doctor of Nursing Practice (DNP) degree. I am writing in hopes to affect change on this ubiquitous delivery of health care problem.
A personal story exemplifies this issue. My 90-year-old grandfather was discharged from an ER and resumed taking a long discontinued antihypertensive (blood pressure) medication from an old pill bottle. He took this in addition to his newly prescribed antihypertensive medication, both medications listed as active in his discharge instructions.
Fortunately, my grandfather was okay, and my mother caught this error and understandably had something to say about it. She drove back to the hospital to give them a piece of her mind, before recommending they come up with a better system. They agreed.
One recurring and nationwide theme are health care providers, and patients, becoming confused with the list of medications in their medical records in all phases of care, including at hospital admission and discharge. This medication list often includes medications that are listed as active and those they haven't taken at times since many years ago.
Sadly, this is not an exaggeration, and often leads to harmful medication errors which are a big problem during all phases of health care. Affected phases include outpatient ambulatory care clinics, during hospital admissions, during hospital stays and hospital discharge. Because of these gaps, medication errors are not surprisingly a leading cause of injury or death.
This is a serious issue that I believe can be solved with a concerted effort by an interdisciplinary team approach along with a streamlined electronic health record system. This is in addition to an emphasis on patient education throughout all stages of treatment which includes outpatient care, an urgent hospital visit or inpatient stay. Providers and ancillary services should always be involved in this process.
Better practice solutions:
1. For health care providers, at all phases of treatment, if it remains unclear if a patient is taking a medication, ask questions, and if medication reconciliation is not possible then list it as such. Increasing awareness of this problem in the advent of increasing use of Electronic Health Records (EHR) is key.
2. Incorporation of admission and discharge medication reconciliation as a continuous process by admitting and discharging RNs, the pharmacist and nurse practitioner and physicians.
As noted by J AM Med inform Association (2016) working towards a solution would include incorporating reconciliation modules that are interoperable with other Electronic Health Record components. This includes medication history, the computerized order set and discharge documentation. Some EHRs have some interoperability with external sources (hospitals, clinics, pharmacy) to import medication history and share updated medication list at discharge, although this is not fail safe and should not be relied on itself alone.
3. As health care consumers, don't be afraid to ask questions or clarification. Most health care providers want you to be involved in your own care. You reserve this right 100 percent and it is okay to ask questions and include your loved ones to advocate for you in your treatment plan.
In summary, medication confusion and errors are fear reaching. It is up to us as health care providers to be conscientious and provide essential emphasis on patient education and collaboration. Encouraging patients and their loved ones to actively participate in their care is vital. This includes asking questions and seeking clarification about medications along with interdisciplinary providers to help prevent confusion and potential medication errors. Involving patient's loved ones can contribute to healthy outcomes. Refining EHR is of the utmost importance.
I thank all health care providers for dedication to this important cause, and I wish success in your continued efforts to make a positive impact on health care practices while encouraging health consumers to be proactive in their care.
Angela Buxton, FNP-BC is a national Board-Certified (BC) Family Nurse Practitioner (FNP) since 2000 and who is originally from Massachusetts, obtaining her undergraduate and graduate degrees at UMASS, Amherst, and worked as both a Registered Nurse (RN) and FNP throughout her career. She is currently attending the University of Washington to expand her skills as a Doctor of Nursing Practice in Psychiatric Mental Health. She has now been working as a NP at Harborview Medical Center in Seattle, Washington for the last 20 years. She enjoys her role in assessing, diagnosing and developing client centered treatment plans, not limited to prescribing medications. Population includes those who are underserved and across the lifespan. She has membership in Snohomish County, WA Search and Rescue (SSAR), has participated in team endurance events with lessons learned that crossover into daily life. Other outside interests include photography, painting, skiing and hiking the Pacific Northwest.
The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans.
by Reed Abelson, The New York Times Jordan Rau, KFF Health New
Kaiser Health News - Margaret Newcomb, 69, a retired French teacher, is desperately trying to protect her retirement savings by caring for her 82-year-old husband, who has severe dementia, at home in Seattle. She used to fear his disease-induced paranoia, but now he’s so frail and confused that he wanders away with no idea of how to find his way home. He gets lost so often that she attaches a tag to his shoelace with her phone number.
The financial and emotional toll of providing and paying for long-term care is wreaking havoc on the lives of millions of Americans. Read about how a few families are navigating the challenges, in their own words. (Read More)
Feylyn Lewis, 35, sacrificed a promising career as a research director in England to return home to Nashville after her mother had a debilitating stroke. They ran up $15,000 in medical and credit card debt while she took on the role of caretaker.
Sheila Littleton, 30, brought her grandfather with dementia to her family home in Houston, then spent months fruitlessly trying to place him in a nursing home with Medicaid coverage. She eventually abandoned him at a psychiatric hospital to force the system to act.
“That was terrible,” she said. “I had to do it.”
Millions of families are facing such daunting life choices — and potential financial ruin — as the escalating costs of in-home care, assisted living facilities, and nursing homes devour the savings and incomes of older Americans and their relatives.
“People are exposed to the possibility of depleting almost all their wealth,” said Richard Johnson, director of the program on retirement policy at the Urban Institute.
The prospect of dying broke looms as an imminent threat for the boomer generation, which vastly expanded the middle class and looked hopefully toward a comfortable retirement on the backbone of 401(k)s and pensions. Roughly 10,000 of them will turn 65 every day until 2030, expecting to live into their 80s and 90s as the price tag for long-term care explodes, outpacing inflation and reaching a half-trillion dollars a year, according to federal researchers.
By 2050, there will be more than 86 million Americans over the age of 65. The U.S. does not dedicate enough funds for long-term care of the aging population. For the most, the financial burden is left on the shoulders of the senior and their financial resources or that of the family.
Photo: Spolyakov/PEXELS
The challenges will only grow. By 2050, the population of Americans 65 and older is projected to increase by more than 50%, to 86 million, according to census estimates. The number of people 85 or older will nearly triple to 19 million.
The United States has no coherent system of long-term care, mostly a patchwork. The private market, where a minuscule portion of families buy long-term care insurance, has shriveled, reduced over years of giant rate hikes by insurers that had underestimated how much care people would actually use. Labor shortages have left families searching for workers willing to care for their elders in the home. And the cost of a spot in an assisted living facility has soared to an unaffordable level for most middle-class Americans. They have to run out of money to qualify for nursing home care paid for by the government.
For an examination of the crisis in long-term care, The New York Times and KFF Health News interviewed families across the nation as they struggled to obtain care; examined companies that provide it; and analyzed data from the federally funded Health and Retirement Study, the most authoritative national survey of older people about their long-term care needs and financial resources.
About 8 million people 65 and older reported that they had dementia or difficulty with basic daily tasks like bathing and feeding themselves — and nearly 3 million of them had no assistance at all, according to an analysis of the survey data. Most people relied on spouses, children, grandchildren, or friends.
The United States devotes a smaller share of its gross domestic product to long-term care than do most other wealthy countries, including Britain, France, Canada, Germany, Sweden, and Japan, according to the Organization for Economic Cooperation and Development. The United States lags its international peers in another way: It dedicates far less of its overall health spending toward long-term care.
“We just don’t value elders the way that other countries and other cultures do,” said Rachel Werner, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. “We don’t have a financing and insurance system for long-term care,” she said. “There isn’t the political will to spend that much money.”
Most countries spend more than the United States on care, but middle-class and affluent people still bear a substantial portion of the costs. (Read More)
Despite medical advances that have added years to the average life span and allowed people to survive decades more after getting cancer or suffering from heart disease or strokes, federal long-term care for older people has not fundamentally changed in the decades since President Lyndon Johnson signed Medicare and Medicaid into law in 1965. From 1960 to 2021, the number of Americans age 85 and older increased at more than six times the rate of the general population, according to census records.
Medicare, the federal health insurance program for Americans 65 and older, covers the costs of medical care, but generally pays for a home aide or a stay in a nursing home only for a limited time during a recovery from a surgery or a fall or for short-term rehabilitation.
Medicaid, the federal-state program, covers long-term care, usually in a nursing home, but only for the poor. Middle-class people must exhaust their assets to qualify, forcing them to sell much of their property and to empty their bank accounts. If they go into a nursing home, they are permitted to keep a pittance of their retirement income: $50 or less a month in a majority of states. And spouses can hold onto only a modest amount of income and assets, often leaving their children and grandchildren to shoulder some of the financial burden.
At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77.
“You basically want people to destitute themselves and then you take everything else that they have,” said Gay Glenn, whose mother lived in a nursing home in Kansas until she died in October at age 96.
Her mother, Betty Mae Glenn, had to spend down her savings, paying the home more than $10,000 a month, until she qualified for Medicaid. Glenn, 61, relocated from Chicago to Topeka more than four years ago, moving into one of her mother’s two rental properties and overseeing her care and finances.
Under the state Medicaid program’s byzantine rules, she had to pay rent to her mother, and that income went toward her mother’s care. Glenn sold the family’s house just before her mother’s death in October. Her lawyer told her the estate had to pay Medicaid back about $20,000 from the proceeds.
A play she wrote about her relationship with her mother, titled “If You See Panic in My Eyes,” was read this year at a theater festival.
At any given time, skilled nursing homes house roughly 630,000 older residents whose average age is about 77, according to recent estimates. A long-term resident’s care can easily cost more than $100,000 a year without Medicaid coverage at these institutions, which are supposed to provide round-the-clock nursing coverage.
Nine in 10 people said it would be impossible or very difficult to pay that much, according to a KFF public opinion poll conducted during the pandemic.
Efforts to create a national long-term care system have repeatedly collapsed. Democrats have argued that the federal government needs to take a much stronger hand in subsidizing care. The Biden administration sought to improve wages and working conditions for paid caregivers. But a $150 billion proposal in the Build Back Better Act for in-home and community-based services under Medicaid was dropped to lower the price tag of the final legislation.
“This is an issue that’s coming to the front door of members of Congress,” said Sen. Bob Casey, a Pennsylvania Democrat and chair of the Senate Special Committee on Aging. “No matter where you’re representing — if you’re representing a blue state or red state — families are not going to settle for just having one option,” he said, referring to nursing homes funded under Medicaid. “The federal government has got to do its part, which it hasn’t.”
But leading Republicans in Congress say the federal government cannot be expected to step in more than it already does. Americans need to save for when they will inevitably need care, said Sen. Mike Braun of Indiana, the ranking Republican on the aging committee.
“So often people just think it’s just going to work out,” he said. “Too many people get to the point where they’re 65 and then say, ‘I don’t have that much there.’”
Private Companies’ Prices Have Skyrocketed
The boomer generation is jogging and cycling into retirement, equipped with hip and knee replacements that have slowed their aging. And they are loath to enter the institutional setting of a nursing home.
But they face major expenses for the in-between years: falling along a spectrum between good health and needing round-the-clock care in a nursing home.
That has led them to assisted living centers run by for-profit companies and private equity funds enjoying robust profits in this growing market. Some 850,000 people age 65 or older now live in these facilities that are largely ineligible for federal funds and run the gamut, with some providing only basics like help getting dressed and taking medication and others offering luxury amenities like day trips, gourmet meals, yoga, and spas.
The bills can be staggering.
As Americans live longer, the number who develop dementia, a condition of aging, has soared, as have their needs.
Half of the nation’s assisted living facilities cost at least $54,000 a year, according to Genworth, a long-term care insurer. That rises substantially in many metropolitan areas with lofty real estate prices. Specialized settings, like locked memory care units for those with dementia, can cost twice as much.
Home care is costly, too. Agencies charge about $27 an hour for a home health aide, according to Genworth. Hiring someone who spends six or seven hours a day cleaning and helping an older person get out of bed or take medications can add up to $60,000 a year.
As Americans live longer, the number who develop dementia, a condition of aging, has soared, as have their needs. Five million to 7 million Americans age 65 and up have dementia, and their ranks are projected to grow to nearly 12 million by 2040. The condition robs people of their memories, mars the ability to speak and understand, and can alter their personalities.
In Seattle, Margaret and Tim Newcomb sleep on separate floors of their two-story cottage, with Margaret ever mindful that her husband, who has dementia, can hallucinate and become aggressive if medication fails to tame his symptoms.
“The anger has diminished from the early days,” she said last year.
But earlier on, she had resorted to calling the police when he acted erratically.
“He was hating me and angry, and I didn’t feel safe,” she said.
She considered memory care units, but the least expensive option cost around $8,000 a month and some could reach nearly twice that amount. The couple’s monthly income, with his pension from Seattle City Light, the utility company, and their combined Social Security, is $6,000.
Placing her husband in such a place would have gutted the $500,000 they had saved before she retired from 35 years teaching art and French at a parochial school.
“I’ll let go of everything if I have to, but it’s a very unfair system,” she said. “If you didn’t see ahead or didn’t have the right type of job that provides for you, it’s tough luck.”
In the last year, medication has quelled Tim’s anger, but his health has declined so much that he no longer poses a physical threat. Margaret said she’s reconciled to caring for him as long as she can.
“When I see him sitting out on the porch and appreciating the sun coming on his face, it’s really sweet,” she said.
The financial threat posed by dementia also weighs heavily on adult children who have become guardians of aged parents and have watched their slow, expensive declines.
Claudia Morrell, 64, of Parkville, Maryland, estimated her mother, Regine Hayes, spent more than $1 million during the eight years she needed residential care for dementia. That was possible only because her mother had two pensions, one from her husband’s military service and another from his job at an insurance company, plus savings and Social Security.
Morrell paid legal fees required as her mother’s guardian, as well as $6,000 on a special bed so her mother wouldn’t fall out and on private aides after she suffered repeated small strokes. Her mother died last December at age 87.
“I will never have those kinds of resources,” Morrell, an education consultant, said. “My children will never have those kinds of resources. We didn’t inherit enough or aren’t going to earn enough to have the quality of care she got. You certainly can’t live that way on Social Security.”
Women Bear the Burden of Care
For seven years, Annie Reid abandoned her life in Colorado to sleep in her childhood bedroom in Maryland, living out of her suitcase and caring for her mother, Frances Sampogna, who had dementia. “No one else in my family was able to do this,” she said.
“It just dawned on me, I have to actually unpack and live here,” Reid, 61, remembered thinking. “And how long? There’s no timeline on it.”
After Sampogna died at the end of September 2022, her daughter returned to Colorado and started a furniture redesign business, a craft she taught herself in her mother’s basement. Reid recently had her knee replaced, something she could not do in Maryland because her insurance didn’t cover doctors there.
“It’s amazing how much time went by,” she said. “I’m so grateful to be back in my life again.”
Studies are now calculating the toll of caregiving on children, especially women. The median lost wages for women providing intensive care for their mothers is $24,500 over two years, according to a study led by Norma Coe, an associate professor at the Perelman School of Medicine at the University of Pennsylvania.
Lewis moved back from England to Nashville to care for her mother, a former nurse who had a stroke that put her in a wheelchair.
“I was thrust back into a caregiving role full time,” she said. She gave up a post as a research director for a nonprofit organization. She is also tending to her 87-year-old grandfather, ill with prostate cancer and kidney disease.
Making up for lost income seems daunting while she continues to support her mother.
But she is regaining hope: She was promoted to assistant dean for student affairs at Vanderbilt School of Nursing and was recently married. She and her husband plan to stay in the same apartment with her mother until they can save enough to move into a larger place.
Government Solutions Are Elusive
Over the years, lawmakers in Congress and government officials have sought to ease the financial burdens on individuals, but little has been achieved.
The CLASS Act, part of the Obamacare legislation of 2010, was supposed to give people the option of paying into a long-term insurance program. It was repealed two years later amid compelling evidence that it would never be economically viable.
Two years ago, another proposal, called the WISH Act, outlined a long-term care trust fund, but it never gained traction.
On the home care front, the scarcity of workers has led to a flurry of attempts to improve wages and working conditions for paid caregivers. A provision in the Build Back Better Act to provide more funding for home care under Medicaid was not included in the final Inflation Reduction Act, a less costly version of the original bill that Democrats sought to pass last year.
The labor shortages are largely attributed to low wages for difficult work. In the Medicaid program, demand has clearly outstripped supply, according to a recent analysis. While the number of home aides in the Medicaid program has increased to 1.4 million in 2019 from 840,000 in 2008, the number of aides per 100 people who qualify for home or community care has declined nearly 12%.
In April, President Joe Biden signed an executive order calling for changes to government programs that would improve conditions for workers and encourage initiatives that would relieve some of the burdens on families providing care.
Turning to Medicaid, a Shredded Safety Net
The only true safety net for many Americans is Medicaid, which represents, by far, the largest single source of funding for long-term care.
More than 4 in 5 middle-class people 65 or older who need long-term care for five years or more will eventually enroll, according to an analysis for the federal government by the Urban Institute. Almost half of upper-middle-class couples with lifetime earnings of more than $4.75 million will also end up on Medicaid.
But gaps in Medicaid coverage leave many people without care. Under federal law, the program is obliged to offer nursing home care in every state. In-home care, which is not guaranteed, is provided under state waivers, and the number of participants is limited. Many states have long waiting lists, and it can be extremely difficult to find aides willing to work at the low-paying Medicaid rate.
Qualifying for a slot in a nursing home paid by Medicaid can be formidable, with many families spending thousands of dollars on lawyers and consultants to navigate state rules. Homes may be sold or couples may contemplate divorce to become eligible.
And recipients and their spouses may still have to contribute significant sums. After Stan Markowitz, a former history professor in Baltimore with Parkinson’s disease, and his wife, Dottye Burt, 78, exhausted their savings on his two-year stay in an assisted living facility, he qualified for Medicaid and moved into a nursing home.
He was required to contribute $2,700 a month, which ate up 45% of the couple’s retirement income. Burt, who was a racial justice consultant for nonprofits, rented a modest apartment near the home, all she could afford on what was left of their income.
Markowitz died in September at age 86, easing the financial pressure on her. “I won’t be having to pay the nursing home,” she said.
Even finding a place willing to take someone can be a struggle. Harold Murray, Sheila Littleton’s grandfather, could no longer live safely in rural North Carolina because his worsening dementia led him to wander. She brought him to Houston in November 2020, then spent months trying to enroll him in the state’s Medicaid program so he could be in a locked unit at a nursing home.
She felt she was getting the runaround. Nursing home after nursing home told her there were no beds, or quibbled over when and how he would be eligible for a bed under Medicaid. In desperation, she left him at a psychiatric hospital so it would find him a spot.
“I had to refuse to take him back home,” she said. “They had no choice but to place him.”
He was finally approved for coverage in early 2022, at age 83.
A few months later, he died.
Reed Abelson is a health care reporter for The New York Times. The New York Times' Kirsten Noyes and graphics editor Albert Sun, KFF Health News data editor Holly K. Hacker, and JoNel Aleccia, formerly of KFF Health News, contributed to this report originally published .
US Health and Retirement Study Analysis
The New York Times-KFF Health News data analysis was based on the Health and Retirement Study, a nationally representative longitudinal survey of about 20,000 people age 50 and older. The analysis defined people age 65 and above as likely to need long-term care if they were assessed to have dementia, or if they reported having difficulty with two or more of six specified activities of daily living: bathing, dressing, eating, getting in and out of bed, walking across a room, and using the toilet. The Langa-Weir classification of cognitive function, a related data set, was used to identify respondents with dementia. The analysis’s definition of needing long-term care assistance is conservative and in line with the criteria most long-term care insurers use in determining whether they will pay for services.
People were described as recipients of long-term care help if they reported receiving assistance in the month before the interview for the study or if they lived in a nursing home. The analysis was developed in consultation with Norma Coe, an associate professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania.
The financial toll on middle-class and upper-income people needing long-term care was examined by reviewing data that the HRS collected from 2000 to 2021 on wealthy Americans, those whose net worth at age 65 was in the 50th to 95th percentile, totaling anywhere from $171,365 to $1,827,765 in inflation-adjusted 2020 dollars. This group excludes the super-wealthy. Each individual’s wealth at age 65 was compared with their wealth just before they died to calculate the percentage of affluent people who exhausted their financial resources and the likelihood that would occur among different groups.
To calculate how many people were likely to need long-term care, how many people needing long-term care services were receiving them, and who was providing care to people receiving help, we looked at people age 65 and older of all wealth levels in the 2020-21 survey, the most recent.
The U.S. Health and Retirement Study is conducted by the University of Michigan and funded by the National Institute on Aging and the Social Security Administration.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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StatePoint Media - 2023 was a landmark year for Alzheimer’s disease research, including advancements in treatment, risk factors and diagnosis. Here are five significant discoveries made this year:
There are three new approved treatments for Alzheimer’s, with a fourth on the way
In July, the U.S. Food and Drug Administration (FDA) granted traditional approval for Leqembi for mild cognitive impairment due to Alzheimer’s and mild Alzheimer’s dementia. This treatment slows cognitive decline and can help people with early Alzheimer’s maintain their independence.
In June 2021, the FDA granted accelerated approval to Aduhelm for the same purpose. At the Alzheimer’s Association International Conference (AAIC) in July 2023, Lilly reported positive results for a third similar treatment: donanemab. The company expects FDA action in early 2024.
In May, the FDA approved the first treatment for agitation in people with Alzheimer’s — brexpiprazole.
Hearing aids could slow cognitive decline for at-risk older adults
In the largest clinical trial to investigate whether a hearing loss treatment can reduce risk of cognitive decline, researchers found that older adults with hearing loss cut their cognitive decline in half by using hearing aids for three years.
The intervention included hearing aids, a hearing “toolkit,” and ongoing instruction and counseling. Though the positive results were in a subgroup of the total study population, they are encouraging and merit further investigation.
Blood tests for Alzheimer’s are coming soon.
Blood tests show promise for improving how Alzheimer’s is diagnosed. Advancements reported for the first time at AAIC 2023 demonstrate the simplicity and value to doctors of blood-based markers for Alzheimer’s.
Blood tests are already being implemented in Alzheimer’s drug trials. And they are incorporated into proposed new diagnostic criteria for the disease. Blood tests — once verified and approved by the FDA — would offer a noninvasive and cost-effective option for identifying the disease.
First-ever U.S. county-level Alzheimer’s prevalence estimates
The first-ever county-level estimates of the prevalence of Alzheimer’s dementia — in all 3,142 U.S. counties — were reported at AAIC 2023. For counties with a population of more than 10,000 people age 65 and older, the highest Alzheimer’s prevalence rates are in:
• Miami-Dade County, Fla. (16.6%)
• Baltimore City, Md. (16.6%)
• Bronx County, N.Y. (16.6%)
• Prince George’s County, Md. (16.1%)
• Hinds County, Miss. (15.5%)
Certain characteristics of these counties may explain the higher prevalence, including older age and a higher percentage of Black and Hispanic residents, which are communities disproportionately impacted by Alzheimer’s disease. According to the Alzheimer’s Association, these statistics can help officials determine the burden on the health care system, and pinpoint areas for culturally-sensitive caregiver training.
Chronic constipation is associated with poor cognitive function
Approximately 16% of the world’s population struggles with constipation. This year, researchers reported that less frequent bowel movements were associated with significantly worse cognitive function.
People in the study with bowel movements every three days or more had worse memory and thinking equal to three years of cognitive aging. These results stress the importance of clinicians discussing gut health with their older patients.
To learn more about Alzheimer’s and dementia research, plus available care and support — and to join the cause or make a donation — visit the Alzheimer’s Association at www.alz.org.
While there is still much to learn about Alzheimer’s, 2023 was a year of discovery, giving researchers and families impacted by the disease hope for the year ahead.
Holidays can be a wonderful time of year when families get together and catch up on each other’s busy lives. All too often is also the time that you may find that things aren’t quite the same with our aging family members.
Those twenty-minute calls once or twice a month made everything seem a okay with the parents or grandparents. But now, you have noticed the signs and symptoms of dementia are starting to show.
Although the COVID-19 pandemic turned the world upside down, the rapid development of multiple vaccines has spurred hope that treatments – or even potential cures – may be found for other devastating conditions. One such candidate is Alzheimer’s Disease.
Movement is medicine. Active movement is the best way to prevent and improve chronic disease says Dr. Jaynie Bjornaraa.
Photo: Kampus Production/PEXELS
NAPSI - Because physical activity and healthy aging go hand in hand, getting started with a fitness program included in your health plan can do more than help you maintain your health as you age.
"Movement truly is medicine," says Dr. Jaynie Bjornaraa, physical therapist, fitness professional, adjunct professor, and senior vice president of rehabilitation services and digital fitness solutions at American Specialty Health (ASH).
Dr. Bjornaraa oversees the Silver&Fit® Healthy Aging and Exercise program for ASH, ensuring that its members get evidence-based recommendations when starting their fitness routines. She helped develop the program's onboarding feature, which sets members on individual fitness journeys based on their needs. Fitness levels, exercise goals, and personal preferences all factor into a tailored 14-day workout plan.
"Research has shown that active movement is the best way to prevent and improve chronic disease. And the great thing about exercise is that it benefits your cognitive health 'memory and mood' as much as it affects your physical well-being," according to Dr. Bjornaraa.
She offers this short list of other benefits a thoughtful fitness program can provide:
1. Improved Health Being physically active can reduce your risk of disease, strengthen your bones and muscles, help you manage weight, and boost your mental well-being.
2. Preventive Care Physical fitness can help prevent certain high-risk scenarios such as serious injury from falls, which is the leading cause of accidental death in older adults.
3. Social Interaction Some programs offer links to connect with clubs and free group fitness classes online for various types and levels of workouts.
4. Health Rewards Incentives for tracking your activity though a fitness program can earn various awards as well help you work with your medical provider to better manage any chronic disease.
5. Personal Coaching Connecting with a health coach during regularly scheduled sessions through a fitness-focused plan can help you achieve a variety of wellness goals.
6. Cost Savings Fitness-focused plans often include low-cost access to fitness centers and exercise videos for a wider variety of workout choices.
7. Quality of Life A thoughtfully designed program will help members develop a workout plan, which can help you stay mobile and maintain their independence.
The benefits of a regular exercise program shows up almost immediately, especially if you stay committed to the lifestyle change.
Photo: Mikhail Nilov/PEXELS
Even for individuals who don't currently engage in fitness activities, Dr. Bjornaraa says it's never too late to start.
"You can be 80 years old," she said. "Whenever you decide to start an exercise routine, you'll notice the health improvements quickly add up. However, starting slow and staying consistent is the key to building fitness levels and a good program can help you steadily reach your goals."
It's important that your health plan supports your long-term health and fitness. If you're considering adding fitness to your routine, be sure to work with doctors before starting any new exercise regimen.
Finally, once you've started a fitness plan, make the most of it. Stay committed to a lifestyle of fitness. Regular attendance in exercise classes and engaging in your wellness will go a long way to help you maintain and improve your health.
by Glenn Mollette, Guest Commentator
Is Senator Mitch McConnell too old to serve in the United States Senate? The same question is being asked of California U.S. Senator Dianne Feinstein, President Joe Biden, and even former President Donald Trump. How old is too old?
Some people are old and sickly by the time they are fifty or even younger. Some people are robust and very active at age 80. McConnell is 81, Feinstein is 90, President Biden is 80 and Trump is 77.
A person is not allowed to serve as President of the United States until they are 35 years old. We need to have a number on the other end as well
My grandfather Hinkle ran a country grocery store until two weeks before he died at age 83. My grandmother was almost 80 before she finally closed the doors to the store. They were still working but in their last couple of years they seemed to be just holding on. My dad was enjoying fishing and hunting and his mind was clear up until his death at 85. However at age 55 he knew it was time to retire from his 37 years of underground coal mining. There is wisdom in knowing when to make life transitions.
We all know there comes a time to retire. None of us want anyone else forcing that on us but commonsense is imperative. A person is not allowed to serve as President of the United States until they are 35 years old. We need to have a number on the other end as well – perhaps 80 or 82. If someone is elected at 81 they still have four years putting them at 85 when they have to step aside.
I’ve worked with a number of 75 to 85 year old people. They are overall good workers, dependable and mean well but the aging process overcomes us all eventually.
This is not to say that we can’t all be useful when we hit our eighties.
It’s about over for McConnell. He needs to finish his term and retire gracefully. This means he has two more years on his current term. Reelection for him is not until 2026. He can accomplish a lot even yet if his health holds up. President Biden should try to get through this term and retire. Rehoboth Beach is calling him and he needs to enjoy his remaining years in Delaware. If Trump were to be elected then he definitely needs to retire at the end of his four years.
Most Americans formulate their opinion about this based on their party affiliation. Democrats and Republicans want to stand by their man or woman. We can hardly blame McConnell for wanting to stay on. He could be once again the majority leader in the Senate. That’s a hard position to pass over for a rocking chair in Louisville.
Feinstein should have quit several years ago. She definitely shows all the signs of not being well enough to do her job.
The problem is we let these people serve too many years in office. A U.S. Congressman or woman should be limited to 12 years as should a U.S. Senator. We limit the President to eight why should these other politicians camp out forever in the Capitol? They have made it America’s premier nursing home facility.
This is not to say that we can’t all be useful when we hit our eighties. There are certainly millions of Americans still trying to work jobs in their golden years. Sadly, I don’t believe many of them really feel like it or are able to be working at such a late stage of life.
He is the author of 13 books including Uncommom Sense, the Spiritual Chocolate series, Grandpa's Store, Minister's Guidebook insights from a fellow minister. His column is published weekly in over 600 publications in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization. We welcome comments and views from our readers. Submit your letters to the editor or commentary on a current event 24/7 to editor@oursentinel.com.
"Try not to shy away from these conversations or make your child feel ashamed for asking a question about their body."
StatePoint Media - Children have a lot of questions about the way the world works and parents hope to have straightforward answers. But when it comes to questions regarding the body, parents and kids alike can find these conversations awkward, uncomfortable and embarrassing. Experts say that destigmatizing a child’s curiosity about their body will not only help them take better care of their health, it may even spark their interest in science.
"Kids have so many questions about their bodies, some practical, some pure curiosity. Sadly, society sometimes chastises children for even asking these questions. By better understanding their bodies though, they can adopt good habits that stay with them for life, and learn about physics and biology in a fun way," says David L. Hu, Ph.D., a professor at Georgia Institute of Technology and author of "The P Word: A Manual for Mammals."
Dr. Hu, an award-winning scientist, animal expert and author, wrote "The P Word" for his 10-year old son, who like many children his age, is eager to learn more about his body. While previous books dealing with this topic are written with teenagers in mind, Dr. Hu believes it’s important for younger kids to enter puberty already having all the facts about their biology. His book, meant for ages 7-12, introduces the penis as an organ that unites all biologically male mammals. It’s meant to serve as a gender-neutral, definitive resource about the penis for kids, providing tools kids need to recognize and name their body parts, understand when something might be wrong and practice good hygiene.
If you’re a parent of a curious kid, or a parent of a child who hasn’t yet voiced their questions, Dr. Hu offers the following tips:
1. Try not to shy away from these conversations or make your child feel ashamed for asking a question about their body. Keep in mind that many children will turn to the internet for answers if you aren’t open to answering their questions, where they may encounter false information or inappropriate content. Instead, acknowledge their curiosity by answering their questions as best you can, and by pointing them to trustworthy resources.
2. Don’t wait until your child reaches puberty. If you start talking to kids about their bodies when they are young, you’ll normalize and desensitize the subject, and the act of talking about it. Helping a child feel comfortable in their own skin before things start to change, will set the stage for less stress during puberty.
3. Help kids understand that their body is natural and normal. In “The P Word,” Dr. Hu intentionally presents colorful, engaging images and facts about different mammals around the globe alongside information about human bodies, including how animals use their penises to pee, mark their territory and reproduce. “Comparative biology makes learning fun and amusing, lightens the mood around a serious subject, helps young kids understand their place in nature, and offers insights into the role of their penis or vagina outside the role of sex,” says Dr. Hu.
A valuable resource for parents, librarians, educators and of course, kids, more information about “The P-Word” can be found by visiting sciencenaturally.com/product-page/the-p-word-a-manual-for-mammals.
"My hope is that kids realize that every question they have, no matter how embarrassing it is, can be addressed by the tools of science. They should be proud of being curious about their own bodies," Dr. Hu.
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RANTOUL - The National Institute on Aging says people age 65 and older are at a higher risk for heart attack, stroke, coronary artery disease and heart failure. February – American Heart Month - is the perfect time for people 65+ and their caregivers to arm themselves with the information and supplies needed to keep their heart healthy.
Karen Whitehorn, MD, is an internal medicine physician at OSF HealthCare. Of the many risk factors for heart issues in older people, she points to blood pressure as a big one to watch. Dr. Whitehorn says a healthy blood pressure reading is 130/80 and below.
"If you're on medication, take your medicine every day," to keep your blood pressure normal, Dr. Whitehorn says. "Exercise and eat healthy. You want a diet that's low in sodium and processed food. You want fruits, vegetables, fresh whole grains and lean proteins like turkey, chicken and lean pork."
An annual physical exam is critical, too.
On exercise, Dr. Whitehorn admits mobility may be an issue for older people. She recommends checking with a health care provider like a physical therapist to see what exercises are right for you. Some workouts can be done sitting down. Low-impact cardio like walking is an option.
"But if any exercises hurt, don't do them," Dr. Whitehorn warns. "If you walk too far and you're having pain, stop walking. You might not want to walk every single day."
Dr. Whitehorn says if you have high blood pressure, check it at least once a day at home. Ask your health care provider what type of home blood pressure kit is best. If you don't have high blood pressure, check it every six months. Your provider should also check your blood pressure when you have an appointment. But Dr. Whitehorn says don't worry if that reading is a little high.
"People get nervous just seeing the doctor. They're already a little upset because they have to come to the doctor," Dr. Whitehorn says of the phenomenon known as white coat syndrome. "So when you take their blood pressure, it goes up. Normally, the nurse takes the blood pressure first. Then, after the person has been resting for a while, the doctor takes it again. It usually comes down."
Other symptoms of heart issues include shortness of breath, chest pain and dizziness. Someone experiencing a heart attack might suffer nausea and neck, arm or shoulder pain. If you experience these symptoms, call 9-1-1 right away.
Your doctor may order a stress test to get a better idea if your symptoms are indeed due to a heart problem. Dr. Whitehorn says one type of stress test puts you on a treadmill while your heart rhythm is monitored.
"If the rhythm is abnormal, it might indicate there's a problem with your heart," Dr. Whitehorn says.
For people who can't tolerate walking or jogging on a treadmill, there is medicine to safely increase their heart rate while a health care provider monitors.
If the results of the stress test warrant further examination, a doctor will perform a cardiac catheterization. They will insert a catheter, usually through the groin, and send it up to your heart to take images using contrast dye. This will show if any of your arteries are narrow and what steps the provider will take next, short term and long term.
Learn more about heart care on the OSF HealthCare website.
StatePoint Media - Medical professionals, patients and their families are increasingly seeing the value of home care, and the industry is expected to grow. In fact, home health and personal care aide job openings are projected to grow 33% from 2020 to 2030, with experts predicting an estimated 8.2 million job openings in home-based care by 2028. Industry experts say that workers from all backgrounds, not just nursing, will be needed now and in the future.
"If you enjoy working with people and helping others when they need it most, a job as a home care or hospice nurse, home health aide, personal companion or caregiver could be a good fit for you," says Jennifer Sheets, president and chief executive officer of industry leader, Interim HealthCare Inc. "Likewise, if you're currently a medical professional seeking more flexibility and to be reminded of why you entered the field in the first place, home healthcare can offer greater job satisfaction and a much-needed change of pace."
To help potential job candidates understand this growing industry, Interim HealthCare is sharing some quick insights:
Why In-Home Care?
Home care describes personal care and support services provided to an individual in their home. Often referred to as senior care, it provides help with the activities of daily living as well as companionship to those who need support to maintain their independence at home. Home healthcare on the other hand, entails medical-based care to help patients recover from an illness or injury, or to provide in-home medical oversight and ongoing care for complex, chronic medical conditions. Many families and patients can testify to the various ways home care can be a game-changer, and a growing number of physicians and medical professionals are recommending home health services to patients of all ages because it delivers cost-effective, high-quality care in the setting where patients most often want to be -- home. Among these services are in-home nursing, physical, occupational and speech therapy, hospice care and bereavement services.
What Employers Want
Those in the know at Interim HealthCare say that being compassionate, trustworthy, dependable and having the ability to work independently can help you thrive in the field of home care. "Made for This," Interim's current recruitment campaign, highlights the company's need for registered nurses, licensed practical and vocational nurses, along with certified nursing assistants, home care aides, home physical therapists, occupational therapists and speech therapists. Veterans, with their track record of serving and protecting others, are encouraged to apply for a home care job, along with anybody who thrives in a job that offers variety, challenge and new faces and places.
What to Look for in Employers
Seeking a career in the field of home care? Be sure you work for a home healthcare organization with a positive work culture that has your best interests in mind. That includes offering good work-life balance, flexible schedules, rewarding assignments and competitive pay. The employer should also prioritize your continuing education and professional development by offering advanced learning opportunities and room for growth, along with additional perks like tuition discounts, to make it all possible.
For a home healthcare career guidebook, visit info.interimhealthcare.com/jobs-in-home-healthcare.
As demand for medical and personal care in the home grows, consider a career in this thriving field, whether you're entering the workforce for the first time or embarking on a career change.
DALLAS -- As people with HIV age, their risk of heart attack increases far more if they also have untreated hepatitis C virus, even if their HIV is treated, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Since the introduction of antiretroviral therapies to treat HIV in the late 1990s, the lifespan of people with HIV has increased dramatically. However, even with treatment, studies have found the heart disease risk among people with HIV is at least 50% higher than people without HIV. This new study evaluated if people with HIV who also have hepatitis C – a viral liver infection – have a higher risk of heart attack.
"HIV and hepatitis C coinfection occurs because they share a transmission route - both viruses may be transmitted through blood-to-blood contact," said Keri N. Althoff, Ph.D., M.P.H., senior author of the study and an associate professor in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "Due in part to the inflammation from the chronic immune activation of two viral infections, we hypothesized that people with HIV and hepatitis C would have a higher risk of heart attack as they aged compared to those with HIV alone."
Researchers analyzed health information for 23,361 people with HIV (17% female, 49% non-Hispanic white) in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) between 2000 and 2017 and who had initiated antiretroviral treatment for HIV. All were between 40 to 79 years of age when they enrolled in the NA-ACCORD study (median age of 45 years). One in 5 study participants (4,677) were also positive for hepatitis C. During a median follow-up of about 4 years, the researchers compared the occurrence of a heart attack between the HIV-only and the HIV-hepatitis C co-infected groups as a whole, and by each decade of age.
The analysis found:
With each decade of increasing age, heart attacks increased 30% in people with HIV alone and 85% in those who were also positive for hepatitis C.
The risk of heart attack increased in participants who also had traditional heart disease risk factors such as high blood pressure (more than 3 times), smoking (90%) and Type 2 diabetes (46%).
The risk of heart attack was also higher (40%) in participants with certain HIV-related factors such as low levels of CD4 immune cells (200cells/mm3, signaling greater immune dysfunction) and 45% in those who took protease inhibitors (one type of antiretroviral therapy linked to metabolic conditions).
"People who are living with HIV or hepatitis C should ask their doctor about treatment options for the viruses and other ways to reduce their cardiovascular disease risk," said lead study author Raynell Lang, M.D., M.Sc., an assistant professor in the department of medicine and community health sciences at the University of Calgary in Alberta, Canada.
"Several mechanisms may be involved in the increased heart attack risk among co-infected patients. One contributing factor may be the inflammation associated with having two chronic viral infections," Lang said. "There also may be differences in risk factors for cardiovascular disease and non-medical factors that influence health among people with HIV and hepatitis C that plays a role in the increased risk."
According to a June 2019 American Heart Association scientific statement, Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV, approximately 75% of people living with HIV are over the age of 45. "Even with effective HIV viral suppression, inflammation and immune dysregulation appear to increase the risk for heart attack, stroke and heart failure." The statement called for more research on cardiovascular disease prevention, causes and treatment in people with HIV.
"Our findings suggest that HIV and hepatitis C co-infections need more research, which may inform future treatment guidelines and standards of care," Althoff said.
The study is limited by not having information on additional factors associated with heart attack risk such as diet, exercise or family history of chronic health conditions. Results from this study of people with HIV receiving care in North America may not be generalizable to people with HIV elsewhere. In addition, the study period included time prior to the availability of more advanced hepatitis C treatments.
"Because effective and well-tolerated hepatitis C therapy was not available during several years of our study period, we were unable to evaluate the association of treated hepatitis C infection on cardiovascular risk among people with HIV. This will be an important question to answer in future studies," Lang said.
Younger adults who had higher cumulative blood pressure exposure (from 25 to 55 years of age) had more changes visible on brain imaging at midlife ...
by American Heart Association
NEW ORLEANS -- High blood pressure among younger adults, ages 20-40 years, appears to be linked to brain changes in midlife (average age 55) that may increase risk for later cognitive decline, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2022, a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health to be held in person in New Orleans and virtually, Feb. 8-11, 2022.
According to the American Heart Association, from 2015-2019 more than 47% of U.S. adults had high blood pressure. In 2019, the U.S. age-adjusted death rate primarily attributable to high blood pressure was 25.1 per 100,000. High blood pressure death rates for non-Hispanic Black adults were 56 per 100,000 among males and 38.7 per 100,000 for females.
Studies have found that high blood pressure disrupts the structure and function of the brain’s blood vessels, damaging regions of the brain that are critical for cognitive function.
"There are studies to suggest changes to the brain may start at a young age," said Christina Lineback, M.D., lead study author and a vascular neurology fellow at Northwestern Memorial Hospital in Chicago. "Our study provides further evidence that high blood pressure during young adulthood may contribute to changes in the brain later in life."
Researchers analyzed 30 years of follow-up including MRI brain images (performed once at the age of 30, and then again at midlife - about the age of 55 years) for 142 adults from the Coronary Artery Risk Development in Young Adults (CARDIA) study. The CARDIA study enrolled participants from four U.S. cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California), in 1985-1986. In total, the study recruited more than 5,000 Black and white adults, ages 18 to 30 years, who have been followed for over 30 years.
In one follow up including 142 of the participants (42% women), researchers examined changes in brain structures in midlife (average age 55) from cumulative exposures to vascular risk factors, including high blood pressure, cholesterol, body mass index, smoking and glucose, from young adulthood to midlife. They also evaluated if there were any differences by race or ethnicity; nearly 40% of the study participants (n=55) were Black adults.
The analysis found:
Younger adults who had higher cumulative blood pressure exposure (from 25 to 55 years of age) had more changes visible on brain imaging at midlife, which may increase the risk of cognitive dysfunction in mid- and late life.
The brain changes that occurred were similar across all races and ethnic groups examined in the study when accounting for the degree of high blood pressure exposure.
"We were surprised that we could see brain changes in even this small sample of participants from the CARDIA study," Lineback said. "Given the greater likelihood of high blood pressure in some racial and ethnic groups, this study’s finding should encourage health care professionals to aggressively address high blood pressure in young adults, as a potential target to narrow disparities in brain health."
A potential next step is to develop and implement systems to better treat and monitor blood pressure in young age groups and assess for brain changes over time, according to Lineback.
A limitation of the study is that it is a retrospective analysis, which means the findings cannot prove the brain changes were caused by high blood pressure.
The study was funded by the National Heart, Lung, and Blood Institute and the National Institutes of Health. Co-authors include Simin Mahinrad, M.D., Ph.D.; Yufen Jennie Chen, Ph.D.; Todd Parrish, Ph.D.; Donald M. Lloyd-Jones, M.D., Sc.M., FAHA; and Farzaneh A. Sorond, M.D., Ph.D.
By Glenn Mollette, Guest Commentator
John F. Kennedy was 43 years old when he was elected to serve as President of the United States in 1960. His age did not hurt him on election day.
Barack Obama was 47 years old when he became President of the United States in 2008. His age, skin color and limited number of years that he had served in the United States Senate did not hurt him when it came to election day.
Donald Trump was 70 years old when he was elected in November 2016 as President of the United States. He had never held a public office. He has gone through two divorces and had some ups and downs in his life, which did not prevent him from becoming President of the United States.
We place a lot of emphasis on age. Youth always impresses us. Remember Tiger Woods? He was just 21 years old when he won The Masters in record breaking fashion in 1997.
When we see a great singer like Tony Bennett at the age of 94 still singing and dancing, we can't help but ask the question, "How old is he?" Because we are amazed at what a 94-year-old can do. His age doesn't stop him.
By the way Supreme Court Justice Ruth Bader Ginsburg is 87. Loretta Lynn is 88 and Sophia Loren is 85.
The bottom line is age is just a number.
There are talented and very capable people at every age category of life. Some people are too old when they are 45 years old and some people never get old. Some old people have never matured. While they are old in age they have never mentally grown up.
We all have to move beyond age. We have to ask is the person up for the job mentally and physically? Do they have the energy? Do they have the career and educational background? Do they possess the skills necessary to perform the tasks? Is the person hungry enough to work hard and do a good job or are they merely looking for a title?
Americans want a President who will pull out all the stops to find a vaccine for Covid-19. Laboratories are working on it now. This disease has devastated our nation. No President, I believe, would have been prepared for this pandemic.
Americans still want a slice of the American dream. We want a place to live, a paycheck, good medical care and retirement. We also want to be safe. We don't want thugs and gangs taking over our towns and neighborhoods. A strong police force and military are essential.
This November, Americans will go to the polls to place their vote for President Donald Trump or former Vice-President Joe Biden. What will matter is what you believe in, who you believe in, and your hopes for America.
Trump and Biden both have track records and their age won't matter on Election Day.
Dr. Glenn Mollette is a syndicated American columnist and author of American Issues, Every American Has An Opinion and ten other books. He is read in all 50 states. The views expressed are those of the author and are not necessarily representative of any other group or organization.
This article is the sole opinions of the author and does not necessarily reflect the views of PhotoNews Media. We welcome comments and views from our readers.
PONTIAC - People everywhere are conquering their cabin fever and are enjoying the great outdoors after a long, bitter winter. But before you head out for that hike, health care experts remind you to take precautions to avoid tick bites. Read more . . .
I’ve always known my Arab culture is worth celebrating.
I heard it in Syrian tenor Sabah Fakhri’s powerful voice reverberating in my mom’s car on the way to piano lessons and soccer practice during my youth. I smelled it in the za’atar, Aleppo pepper, allspice, and cumin permeating the air in the family kitchen. Read more . . .
CHAMPAIGN - In a show of solidarity against President Donald Trump's trade and immigration policies, which critics say are harming families and retirement savings, more than a thousand protesters gathered Saturday at West Park near downtown Champaign for the Hands-Off! Mobilization rally. Read more . . .
Photo Galleries
A couple of runners found themselves in the wrong race at this year's Illinois Marathon. Over 60 photos from the race that you should see.
by Terri Dee
