Health and Medical News and Resources

General interest items edited by Janice Flahiff

New finding may compromise aging studies — ScienceDaily

New finding may compromise aging studies — ScienceDaily.

February 7, 2015 Posted by | Uncategorized | Leave a comment

[Report] Report Will Aid in Detecting, Diagnosing Cognitive Impairment

From the 5 February 2015 post at The Gerontological Society of America

 

For Immediate Release
February 6, 2015
Contact: Todd Kluss
tkluss@geron.org
(202) 587-2839

A new report from The Gerontological Society of America’s Workgroup on Cognitive Impairment Detection and Earlier Diagnosis outlines a course of action for increasing the use of evidence-based cognitive assessment tools as part of the Medicare Annual Wellness Visit (AWV).

The AWV was established by 2010’s Affordable Care Act to allow Medicare beneficiaries to receive preventive and assessment services during visits with their primary care providers. And although detection of cognitive impairment is among the required AWV services, no specific tools are mandated and no data are available regarding tools used for this purpose.

The new report outlines a plan for addressing this shortcoming and shows how increased detection leads to earlier and optimal diagnostic evaluation, referral to post-diagnosis support and educational services in the community, and ultimately to improved health-related outcomes and well-being for Medicare beneficiaries with diagnosed dementia and their families.

“The Medicare AWV offers a universal opportunity for primary care providers to start a conversation with older adults and their families about cognitive changes that might be worthy of further investigation,” said Richard Fortinsky, PhD, chair of the workgroup. “Our workgroup’s report provides guidance for providers so they can start this conversation and, as appropriate, employ evidence-based assessment tools to detect cognitive impairment.”

The report is available at www.geron.org/ci. The website also contains a link to a companion webinar held in January, led by workgroup members Katie Maslow, MSW, and Shari M. Ling, MD.

“Increased detection of cognitive impairment is essential for earlier diagnosis of Alzheimer’s disease and related dementia — and also earlier diagnosis leads to more timely linkage of older adults and their families with community-based services and supports,” Maslow said.

In the report, the workgroup outlines a recommended for four-step process achieving its goals.

Step 1 is to kickstart the cognition conversation. To increase detection of cognitive impairment and promote earlier diagnosis of dementia in the Medicare population, the GSA workgroup endorses that primary care providers use the AWV as an annual opportunity to kickstart — that is, to initiate and continue — a conversation with beneficiaries and their families about memory-related signs and symptoms that might develop in older adulthood.

Step 2 is to assess the patient if he or she is symptomatic. The GSA workgroup endorses use of a cognitive impairment detection tool from a menu of tools having the following properties: it can be administered in
five minutes or less; it is widely available free of charge; it is designed to assess age-related cognitive impairment; it assesses at least memory and one other cognitive domain; it is validated in primary care or community-based samples in the U.S.; it is easily administered by medical staff members who are not physicians; and it is relatively free from educational, language, and/or cultural bias. The report provides a list of tools that may be suitable for this purpose.

Step 3 is to evaluate with full diagnostic workup if cognitive impairment is detected. The GSA workgroup recommends that all Medicare beneficiaries who exceed threshold scores for cognitive impairment based on the cognitive assessment tools used in step 2 undergo a full diagnostic evaluation. Numerous published clinical practice guidelines are available to primary care providers and specialists to help them arrive at a differential diagnosis.

Step 4 involves referral to community resources and clinical trials, depending on the diagnosis. The GSA workgroup recommends that all Medicare beneficiaries who are determined to have a diagnosis of Alzheimer’s disease or related dementia be referred to all appropriate and available community services to learn more about the disease process and how to prepare for the future with a dementia diagnosis.

“The GSA workgroup views this suggested four-step process as a framework for communicating with a wide variety of stakeholders about the critical importance of incorporating cognitive impairment detection into everyday clinical practice with older adults,” Fortinsky said. “We look forward to building on this report by helping to plan additional activities intended to disseminate and implement the report’s recommendations in communities throughout the country.”

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The Gerontological Society of America (GSA), the nation’s oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. The principal mission of the Society — and its 5,500+ members — is to advance the study of aging and disseminate information among scientists, decision makers, and the general public. GSA’s structure also includes a policy institute, the National Academy on an Aging Society, and an educational branch, theAssociation for Gerontology in Higher Education.

 

February 7, 2015 Posted by | health care | , , , | Leave a comment

[Podcast] Alice Rivlin discusses the Affordable Care Act, America’s health, and leading the CBO

From the 6 February post at Brookings

“I think the Affordable Care Act is actually doing quite well,” says Senior Fellow Alice Rivlin in this podcast. Rivlin, the Leonard D. Schaeffer Chair in Health Policy Studies and director of the Engelberg Center for Health Care Reform at Brookings, cited the expansion of medical insurance coverage, declining cost growth, and other positive factors for the ACA. She also reflects on continued political opposition to the law, the impending King v. Burwell Supreme Court case, and what it was like to stand up a new federal agency, the Congressional Budget Office, in 1975.

     [This is a screenshot, was unable to upload via an application similar to YouTube]

Screen Shot 2015-02-07 at 6.53.23 AM

     [This is a screenshot, was unable to upload via an application similar to YouTube]

 

 

Also in the podcast, Senior Fellow David Wessel, director of the Hutchins Center on Fiscal and Monetary Policy, offers his regular “Wessel’s Economic Update.”


Show Notes:

– Improving Health While Reducing Cost Growth, What is Possible? (with Mark McClellan)
– People Who Wanted Market-Driven Health Care Now Have it in the Affordable Care Act
– 
Health360: The latest views on health policy

February 7, 2015 Posted by | Uncategorized | , , , , , | Leave a comment

[Magazine article] Reducing Lifestyle Diseases Means Changing Our Environment

 

From the 5 February 2015 Scientific American article

How and why our bodies are poorly suited to modern environments—and the adverse health consequences that result—is a subject of increasing study. A new book The Story of the Human Body by Daniel Lieberman, chair of the Department of Human Evolutionary Biology at Harvard, chronicles major biological and cultural transitions that, over the course of millions of years, transformed apes living and mating in the African forests to modern humans browsing Facebook and eating Big Macs across the planet.

“The end product of all that evolution,” he writes, “is that we are big-brained, moderately fat bipeds who reproduce relatively rapidly but take a long time to mature.”

But over the last several hundred generations, it has been culture—a set of knowledge, values and behaviors—not natural selection, that has been the more powerful force determining how we live, eat and interact. For most of our evolutionary history, we were hunter-gatherers who lived at very low population densities, moved frequently and walked up to 10 miles a day in search of food and water. Our bodies evolved primarily for and in a hunter-gatherer lifestyle.

….

 

Read the entire article here

 

February 7, 2015 Posted by | Consumer Health, Public Health | , , , , | Leave a comment

How mobile is transforming healthcare: Report

Immediately thought of my Liberian FB friends, a nurse and dean at a community college, a healthcare screener upcountry in a small town (my Peace Corps site back in 1980/81), and a Methodist deacon (one of my former students). All went above and beyond the call of duty during the Ebola crisis.
Back in 2009 I participated in a service project group in Liberia. Was taken aback by noticing that at least half of those over 18 seemed to have cell phones. Believed this was quite good. The roads overall are pretty bad, unpaved, and nearly impassible during the 3 month rainy season. So the cell phones really keep people connected, and relay information well. I get rather irked when I read comments (FB, editorials, etc) that say poor people should not have cell phones. Well, I strongly disagree, overall I believe they save money (think transportation costs for many information needs at the least!). How arrogant for some of “the haves” to believe “the have nots” are not using their scarce resources wisely.
Not sure what I can do to advance mobile health in Liberia, but I will do what I can.
Thanks for posting this, I have forwarded this to my Liberian FB friends. Most likely stuff they already know. The deacon obtained his PhD in theology in DC, the nurse/deacon is very aware of technology, and the healthcare screener is from Nigeria and has a good education and is very much a world citizen.

ScienceRoll

The Economist came up with a report about How mobile is transforming healthcare including infographics and analyses. You can download the report here.

According to a new survey, mobile technology has the potential to profoundly reshape the healthcare industry, altering how care is delivered and received.

Executives in both the public and private sector predict that new mobile devices and services will allow people to be more proactive in attending to their health and well-being.

These technologies promise to improve outcomes and cut costs, and make care more accessible to communities that are currently underserved. Mobile health could also facilitate medical innovation by enabling scientists to harness the power of big data on a large scale.

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February 7, 2015 Posted by | Public Health | , , , , , , | Leave a comment

   

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