July 2005  

   Welcome to the July 2005 Edition of Issues in Aging.

   Health Promotion & Wellness

         
   

Friends Improve Longevity Better Than Family
 Journal of Epidemiology and Community Health (June 2005)

A network of good friends, rather than close family ties, may help you live longer, according to findings from the Australian Longitudinal Study of Aging. The study assessed how economic, social, behavioral, and environmental factors affect the health and well-being of people ages 70 and older. Almost 1,500 people were asked how much personal and phone contact they had with their various social networks, such as children, relatives, friends, and confidants. Close contact with children and relatives had little impact on survival rates over the 10 years the study was conducted. A strong network of friends and confidants, however, significantly improved the chances of survival over this period of time. The beneficial effects on survival persisted over the decade, regardless of profound changes in the individuals’ lives, including death of a spouse or close family member, and the relocation of friends to other parts of the country.

  
      Healthy Sleep
Journal of Advanced Nursing (February 2005)

Is the idea of better quality and longer sleep music to your ears? Researchers in Taiwan found that playing soothing music before bedtime helped problem sleepers catch more Zzzs. Older adults who previously reported sleep problems listened to 45 minutes of relaxing music and experienced more than a 30 percent improvement in their overall sleep quality and decrease in daytime dysfunction.

 
       
     

Tai Chi for Fitness and Fall Prevention                    

Journal of Advanced Nursing (July 2005)

Sixty-eight fall-prone older adults with a mean age of 77.8 years participated in this study, with 29 people in a Tai Chi exercise group and 30 control subjects completing the post-test measures. The Tai Chi exercise program was provided three times a week for 12 weeks. At post-test, the group showed significant improvement in muscle strength and improved flexibility and mobility when compared to the control group. The exercise group also reported more confidence in fall avoidance than the control group. The findings revealed that Tai Chi exercise may improve physical strength and reduce the risk of falling in residential care facilities.

 
       
     

Obesity, Smoking Speed Up Aging                  

The Lancet (June 13, 2005)

In this study of 1,122 British women, those who were obese or smoked cigarettes had shorter telomeres, which are the caps on chromosomes that prevent them from fraying. Smoking made these women biologically older than their non-smoking, leaner counterparts. The loss is associated with aging, which is why telomeres are thought to hold the secrets of the aging process. Scientists compared telomere length from blood samples of women between the ages of 18 and 76 and found a decrease in telomere length that corresponded to obesity and the amount of cigarette smoking. There was a difference between being obese and lean, which corresponded to 8.8 years of aging. Being a current or ex-smoker equated to about 4.6 years, and smoking a pack a day for 40 years corresponded to 7.4 years of aging.

 
       
      The Power of Negative Thinking  

Geriatrics (June 1, 2005)

Thinking that your glass is half-full may not only help you find silver linings on a cloudy day, but you may decrease your risk of dementia many years later. Investigators at the Mayo Clinic in Rochester, Minnesota, examined 3,500 participants in a personality inventory taking place from 1962 to 1965, and interviewed them in 2004. Those who originally ranked high in the pessimism or depression scales had a 30 percent increased risk of dementia in the decades to follow. Those who scored high in both pessimism and depression had a 40 percent increased risk.

 
         

   Family Caregiving

         
    Burden of New Caregivers

International Journal of Geriatric Psychiatry (May 2005)

Interviews were completed with 27 spouses of persons with a recent diagnosis of Mild Cognitive Impairment, which is believed to be a pre-dementia syndrome. Although caregiver burden and psychiatric morbidity levels were lower than those typically observed in family dementia caregiving samples, findings suggested that Mild Cognitive Impairment caregivers began to experience distress in association with an elevated caregiving burden. These individuals may be ideal candidates for selective preventive interventions to maximize their psychological well-being as the burden of caregiving increases. 		 
     
Family Care and Paid Care

Institute for the Future of Aging Services (June 2005)

Family caregiving and paid caregiving are often treated as two separate matters. In reality, these two caregiving realms are highly interconnected and frequently work together closely. This new issue brief, which features caregiving stories told by two families, examines the interactions between family caregivers and paid caregivers and how aging services providers can foster better relationships between them. “It is a call to action for caregivers and their advocates to focus on the similarities they share, not their differences,” says Robyn Stone, executive director of the Institute for the Future of Aging Services. To read more about this brief, log on to http://www.bjbc.org/news.asp?pgid=163.

 
         
     
 

Grandparents Raising Grandchildren

The Gerontologist (April 2005)

An increasingly prevalent family arrangement is a home headed by a grandparent who is raising grandchildren. In this review, the authors explored the state of knowledge about such grandparents, with particular attention to its implications for service providers and researchers. Several key areas were addressed, including the costs and benefits of raising a grandchild; the heterogeneity of custodial grandparent caregivers; the critical need for social support among grandparents; parenting practices and attitudes among grandparents raising grandchildren; and helping efforts at multiple levels. Directions for research and practice concerning custodial grandparents were also discussed.

 

   Heart Attacks and Strokes

         
     

Eating Fish Helps Lowers Heart Attack Risk                   

Journal of the American College of Cardiology (June 21, 2005)

In this study, older persons who ate fish once or twice a week had a 20 percent lower risk of developing congestive heart failure. Researchers gave diet questionnaires to 4,738 adults in four cities who were 65 or older and free of congestive heart failure. During 12 years of follow up, 955 participants developed congestive heart failure. After adjusting the results for other risk factors, those who had reported that they ate tuna or other fish once or twice a week were 20 percent less likely to develop congestive heart failure than those who said they ate such fish less than once a month. Eating fish three or four times a week was linked to a 31 percent lower risk of developing congestive heart failure. Fried fish consumption, however, was linked to a higher risk of congestive heart failure.

  
       
     
Therapy Improves Speech Post-Stroke

Stroke (June 9, 2005)

The speaking ability of those who have suffered a stroke can improve with intensive therapy. Doctors in Germany recently conducted a study with 27 stroke survivors where participants were given 30 hours of speech training three hours a day for 10 days. Training encouraged patients to speak rather than using gestures or other nonverbal methods of communication. Language games that progressed from simple communication to more complex language skills were also used. Overall, language skills improved in 85 percent of the patients, with improvements lasting six months. All participants showed improvement in their speech soon after the training. As many as 60 percent of the stroke victims still had problems speaking six months after suffering a stroke. In the U.S., nearly 700,000 people a year suffer a new or recurrent stroke.

  
       
     

Preventing More Strokes
The Lancet (June 2005)

Dutch researchers followed 2,500 survivors of minor strokes and mini-strokes (termed transient ischemic attacks, or TIAs). After 10 years, only 40 percent of the patients were still alive, and more than half of those still living had suffered at least one more stroke. The researchers said that doctors must be “dropping the ball” on administering therapies aimed at preventing subsequent strokes or heart attacks.  The researchers concluded that stroke survival should include a long-term treatment plan that includes aspirin, blood pressure drugs, and lifestyle changes to prevent future strokes and heart attacks.

 

   Public Programs

   
    Misinformed Over Social Security

International Longevity Center (June 1, 2005)

 

A Harris Interactive Poll found that a large proportion of the American public is misinformed or poorly informed about the Social Security Program. According to a nationwide sample of 2,322 adults, only half knew that Society Security guarantees payment for life. Only a quarter of adults knew that Social Security guarantees protection against inflation, and only about half of all adults knew that Social Security provides life and disability coverage for spouses and children of workers who die or are disabled. The older a person was, however, the more likely they were to be knowledgeable. This survey demonstrated the need for people to better inform themselves about Social Security, given the government proposals being debated to reform the program. The survey results can be reviewed at www.ilcusa.org/_lib/pdf/harrisSS.pdf.

  
   
      Adult Day Services Demonstration

Centers for Medicare & Medicaid Services (June 2005)

Some Medicare beneficiaries will be able to receive adult day care services as part of their home health benefit under a federal demonstration project. The three-year initiative, to be launched in February 2006, will allow five home health agencies to work with medical adult day care facilities to receive 95 percent of the home health prospective payment system rate for services provided to beneficiaries. Up to 15,000 beneficiaries will be able to participate at any time. Medicare beneficiaries typically pay out-of-pocket for adult day care services. During this demonstration, they will not pay any such costs for the services.
     
     
Most Medicaid Optional Spending for Care of Elderly & Disabled

Kaiser Commission on Medicaid and the Uninsured (June 2005)

As much as 86 percent of Medicaid optional spending is for the elderly and people with disabilities. Although Medicaid’s optional populations account for 29 percent of the program’s enrollment, 60 percent of all Medicaid spending is considered optional, according to the report Medicaid Enrollment and Spending by “Mandatory” and “Optional” Eligibility and Benefit Categories. The report, which is aimed at providing an understanding of how proposals for Medicaid reform would affect various populations and services, offers estimates of the proportion of Medicaid beneficiaries and spending that is mandatory and optional. The full report can be viewed at http://www.kff.org/medicaid/7332.cfm.
       
       
       
 

   Other Items of Interest

   
   

Updated Profile of Older Americans      

Administration on Aging (May 31, 2005)

The online version of A Profile of Older Americans: 2004 comprises the latest statistics on older Americans in key subject areas. The population of Americans 65 and older increased by 9.5 percent to 35.9 million in 2003, up from 32.8 million in 1993. About 416,000 grandparents ages 65 and older have primary responsibility for their grandchildren who live with them. By the year 2030, the population aged 65 and older will more than double to 71.5 million, and the population of people 85 and older is projected to increase from 4.7 million to 9.6 million. For more about this profile, log on to http://www.aoa.gov/prof/Statistics/profile/2004/profiles2004.asp.

 
   
     

Living with Dementia Newsletter

Alzheimer’s Society (June 2005)

Published by the Alzheimer’s Society, Living with Dementia is a free bimonthly newsletter for people with dementia or memory problems. The Society serves the United Kingdom and is based in London. The newsletter serves as a forum for sharing experiences and suggestions for coping with dementia. To get on the newsletter’s e-mail list, contact lwd@alzheimers.org.uk.
     
     

Drug Spending Increases Again But Rate Slows

Centers for Medicare & Medicaid Services (June 2005)

Prescription drug spending increases are slowing down. Spending increased 10.7 percent in 2003, down from 14.9 percent in 2002. A number of factors contributed to the decline, such as corporate and insurance company efforts to negotiate discounts with drug companies and drug stores. Consumers also are using generic drugs more frequently. State laws to reduce Medicaid and pension costs are also adding to the slowed spending. Drug costs still account for more than 10 percent of health care spending in the U.S.
     
     

Too Many Drugs for Nursing Home Residents 

Archives of Internal Medicine (June 13, 2005)

Nursing home doctors either write prescriptions for antipsychotic drugs in dosages that were too high or they write prescriptions that treat the wrong ailments, including impaired memory or depression, according to a University of Massachusetts study. Identifying a sample of 1,096 Medicare beneficiaries in nursing homes, the study suggested that doctors prescribed antipsychotics to 693,000 Medicare beneficiaries at least once from 2000 to 2001. One in four patients did not exhibit the behavioral symptoms that call for the drugs. More than 15 percent received too much medication, and nearly 18 percent had both improper symptoms and too much medication. Antipsychotic drugs can cause dangerous side effects, including extreme drowsiness and an increased risk of falling. To view the abstract, log on to

http://archinte.ama-assn.org/cgi/content/short/165/11/1280.
     
     

Jobs Wanted in Retirement That Improve Quality of Life                 MetLife Foundation/Civic Ventures (June 16, 2005)                                                                          

Half of Americans aged 50 to 70 want jobs that contribute to the greater good now and in retirement, according to a survey of 1,000 Americans conducted by Princeton Survey Research Associates International.  Two out of the three types of work mentioned most often were jobs in education and social services; the third was retail. In recent years, the vast majority of Baby Boomers have told pollsters they plan to work in retirement, they need continued income, and they want greater flexibility in retirement jobs. Given the labor shortages facing education, health care, and social services, the fact that so many people are interested in good work “offers heartening evidence of a potential win-win opportunity of staggering proportions. We could be looking at a huge experience dividend,” said Marc Freedman, president of Civic Ventures, a not-for-profit think tank and incubator that works to make the aging of America an asset. To view the report, visit http://www.civicventures.org/survey.html.
       
      Sudden Death 10 Times Greater Than Two Years Later

New England Journal of Medicine (June 23, 2005)

This study evaluated a sleep education program for persons with Alzheimer’ s disease who lived at home with their family caregivers. All participants received written materials describing age- and dementia-related changes in sleep and principles of sleep hygiene. Caregivers were trained in behavior management skills and received sleep hygiene recommendations for the person with Alzheimer’s. Persons with Alzheimer’s who were instructed to walk every day and increase their daytime light exposure with the use of a light box exhibited reduced feelings of depression; experienced a decrease in nighttime awakenings; a decrease in total time awake at night; and an increase in weekly exercise. After six months, treatment gains were maintained and additional improvements had emerged.