Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics, JAMA / 03.03.2015

MedicalResearch.com Interview with: Dr. Enrico Mossello Research Unit of Medicine of Ageing Department of Experimental and Clinical Medicine University of Florence MedicalResearch: What is the background for this study? What are the main findings? Dr. Mossello: In spite of the high prevalence of high blood pressure (HBP) and cognitive impairment in old age, their relationship is still controversial. While several (but not all) studies have identified high blood pressure as a risk factor for incident cognitive impairment, evidence regarding the prognostic role of blood pressure in cognitively impaired older subjects is scarce and inconsistent. To our knowledge, no longitudinal study has been published up to now regarding Ambulatory Blood Pressure Monitoring (ABPM) in subjects with cognitive impairment. Moreover recent European and American guidelines on HBP leave decisions on antihypertensive therapy of frail elderly patients to the treating physician and do not provide treatment targets for cognitively impaired patients. In the present cohort study of subjects with dementia and Mild Cognitive Impairment (MCI) low values of day-time systolic blood pressure measured with ABPM were associated with greater progression of cognitive decline after a median 9-month follow-up. This association was limited to subjects treated with anti-hypertensive drugs and was independent of age, vascular comorbidity and baseline cognitive level, holding significant both in dementia and in Mild Cognitive Impairment subgroups. A similar trend of association was observed for office systolic blood pressure, although this was weaker and did not reach statistical significance in all analyses.
Aging, Author Interviews, Geriatrics, Social Issues / 01.03.2015

Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MOMedicalResearch.com Interview with: Angela L. Curl PhD MSW School of Social Work University of Missouri Columbia, MO MedicalResearch: What is the background for this study? What are the main findings? Dr. Curl: Often people think of stopping driving as just effecting one person: the person who stops driving. In reality, for married couples driving cessation affects both spouses. Using longitudinal data (1998-2010) from 1,457 married couples participating in the Health and Retirement Study, we found that husbands and wives who are no longer able to drive are less likely to work, and less likely to engage in formal volunteering (for charitable organizations) and informal volunteering (helping friends and neighbors not-for-pay). Having a spouse in the household who is still able to drive does reduce these negative consequences a little, but not entirely. Furthermore, the spouse who continues to drive is also less likely to continue working or volunteering following the driving cessation of their partner, presumably because he/she is providing transportation or social support to the non-driver.
Author Interviews, Geriatrics, Kidney Disease / 28.02.2015

Nisha Bansal MD MAS Assistant Professor Associate Program Director for Research Kidney Research Institute Division of Nephrology University of WashingtonMedicalResearch.com Interview with: Nisha Bansal MD MAS Assistant Professor Associate Program Director for Research Kidney Research Institute Division of Nephrology University of Washington Medical Research: What is the background for this study? What are the main findings? Dr. Bansal: We pursued this study to develop a prediction equation for death among elderly patients with chronic kidney disease (CKD), a high-risk patient population that is often difficult to manage given competing risks of end stage renal disease (ESRD) vs. death. In this paper, we developed and validated a simple prediction equation using variables that are readily available to all clinicians.
Author Interviews, Exercise - Fitness, Geriatrics, PLoS / 19.02.2015

Tess Harris St George’s University of LondonMedicalResearch.com Interview with: Tess Harris St George’s University of London   MedicalResearch: What is the background for this study? Response: Physical activity is vital for both physical and mental health in older people, preventing at least 20 common health problems. Yet the majority of older people do not achieve the World Health Organisation physical activity guidelines for health of at least 150 minutes every week of at least moderate-to-vigorous intensity physical activity in bouts that each last at least 10 minutes. Brisk walking is a good way to achieve moderate intensity physical activity, with a low risk of harm. Pedometers can give you direct feedback on your step-count and accelerometers record both step-counts and the intensity of physical activity achieved. The PACE-Lift trial assessed whether an intervention to increase walking, comprising pedometer and accelerometer feedback, combined with physical activity consultations provided by practice nurses over a 3 month period, based on simple behaviour change techniques, could lead to sustained increases in physical activity in 60-75 year olds.
Author Interviews, Geriatrics, Hip Fractures, Lancet / 06.02.2015

Ingvild Saltvedt PhD Department of Neuroscience, Norwegian University of Science and Technology, Medical Faculty Trondheim, Norway MedicalResearch.com Interview with: Ingvild Saltvedt PhD Department of Neuroscience, Norwegian University of Science and Technology, Medical Faculty Trondheim, Norway Medical Research: What is the background for this study? What are the main findings? Dr. Saltvedt: Hip fracture patients are often old, frail and have many comorbidities. When treated with a traditional orthopaedic approach the outcomes are often poor, and many patients get functionally impaired with reduced ability to walk independently and impairment in daily life activities and with high costs for the society.  In many ways these patients are geriatric patients with hip-fractures. It has previously been shown that acutely sick geriatric patients benefit from treatment in geriatric wards and different kind of  orthogeriatric treatment models where orthopaedic surgeons and geriatricians collaborate have been studied and have shown beneficial results on short term outcomes. In the present study patients home-dwelling hip-fracture patients were randomised to orthogeriatric treatment or traditional orthopaedic treatment from admission to the hospital and during the entire stay except for the surgery that was performed similar in both groups. The study focused on long-term outcomes and also on use of health care services and cost-effectiveness.  Patients in the orthogeriatric group got comprehensive geriatric assessment and treatment performed by an interdisciplinary team that emphasised early mobilisation and rehabilitation and started discharge planning early. In the orthopaedic group traditional treatment according to national and international guidelines was offered. The primary endpoint was mobility at four months, that was better in the orthogeriatric group than in the orthopaedic group, the same difference was also shown at 12 months. In addition there were differences in instrumental activities of daily living and personal activities of daily living, quality of life and fear of falling, all differences were statistically and clinically significant and in favour of the orthoegeriatric group. The length of hospital stay was 1,7 days longer in the geriatric group, while there was no differences in days spent in hospital during one year of follow-up. One of four orthogeriatric patients were discharged directly home as compared to one of ten in the orthopaedic group. The orthopaedic group spent more days in nursing homes and rehabilitation institutions during one year of follow-up. The treatment was cost-effective in favour of the orthogeriatric group.
Author Interviews, Geriatrics, Sexual Health / 01.02.2015

MedicalResearch.com Interview with: David M. Lee PhD MPH Cathie Marsh Institute for Social Research The University of Manchester Manchester UK Medical Research: What is the background for this study? What are the main findings? Response: These data on sexual health and wellbeing were collected in the latest phase of the English Longitudinal Study of Ageing (ELSA). ELSA is a representative survey of a cohort aged 50 to >90 years, and has gathered detailed longitudinal data since 2002 on changes in health, economic and social circumstances as people prepare for and move into retirement and old age. Our research asked over 7000 men and women taking part in ELSA a wide range of questions about their sexual lives; including their attitudes to sex, how sexually active they were and what problems and concerns they experienced with their sexual health. Around two-thirds of men and over half of women in this survey thought ‘good sexual relations were essential to the maintenance of a long-term relationship’ or ‘being sexually active was physically and psychologically beneficial to older people’. We found that half of men and almost a third of women aged 70 and over were still sexually active, with around a third of these sexually active older people having sexual intercourse twice a month or more. Sexual problems were relatively common, however, with a third of sexually active women reporting difficulties becoming sexually aroused or achieving orgasm. For men difficulties getting and maintaining an erection was the most common problem, reported by 40% of those who were sexually active. Chronic health conditions and poor self-rated health seemed to have more obvious negative impacts on the sexual health of men compared to women. Men were more concerned about their sexual activities and function than women and, with increasing age, these concerns tended to become more common. Take a look at Men's Review Zone for help with and solutions for any problems you may be experiencing. Sexually active women were less dissatisfied with their overall sex lives than men, and also reported decreasing levels of dissatisfaction with increasing age.
Author Interviews, Geriatrics, Hearing Loss, JAMA / 28.01.2015

Margaret T. Dillon, AuD University of North Carolina School of MedicineMedicalResearch.com Interview with: Margaret T. Dillon, AuD University of North Carolina School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Dillon: The goal of this study was to evaluate whether age at revision cochlear implantation influences post-revision speech perception performance. A cochlear implant is an implantable auditory prosthesis that aims to provide sound to patients with certain degrees of hearing loss, by converting and transmitting the acoustic sound into electric stimulation. Research has shown cochlear implant recipients experience improved speech perception in quiet and noise as compared to preoperative performance with conventional amplification (ie, hearing aids). There is variability in postoperative performance. Understanding the cause or causes of this variability is the primary goal of a number of research studies. One suspected indicator for this variability is advanced age at the time of surgery. Though the incidence of revision cochlear implantation is low, it may be warranted when the internal device is no longer functional or not functioning optimally. We reviewed the pre-revision and post-revision speech perception performance of younger (< 65 years of age) and older (> 65 years of age) adult cochlear implant recipients. There was no difference between the post-revision speech perception performance between the two groups.
Author Interviews, Brigham & Women's - Harvard, Geriatrics, Hospital Readmissions, JAMA, Surgical Research / 21.01.2015

Thomas C. Tsai, MD, MPH Departments of Surgery and Health Policy and Management Harvard School of Public Health, Boston, Massachusetts MedicalResearch.com Interview with: Thomas C. Tsai, MD, MPH Departments of Surgery and Health Policy and Management Harvard School of Public Health, Boston, Massachusetts Medical Research: What is the background for this study? What are the main findings? Dr. Tsai: Emerging evidence is suggesting that fragmented care is associated with higher costs and lower quality. For elderly patients undergoing major surgical procedures, fragmentation of care in the post-discharge period may be especially problematic. We therefore hypothesized that elderly patients receiving fragmented post-discharge care would have worse outcomes. We found that among Medicare patients who are readmitted after a major surgical operation, one in four are readmitted to a different hospital than the one where the original operation was performed. Even taking distance traveled into account, we find that this type of postsurgical care fragmentation is associated with a substantially higher risk of death.
Author Interviews, Diabetes, Geriatrics, JAMA / 12.01.2015

Kasia Joanna Lipska MD, MHS Assistant Professor of Medicine (Endocrinology) Yale School of Medicine New Haven, CT 06520-8020MedicalResearch.com Interview with: Kasia Joanna Lipska MD, MHS Assistant Professor of Medicine (Endocrinology) Yale School of Medicine New Haven, CT 06520-8020 Medical Research: What is the background for this study? What are the main findings? Dr. Lipska: Diabetes is common and affects about 1 in 4 older adults (65 years or more). For younger adults with diabetes, most guidelines suggest lowering blood sugar levels to a hemoglobin A1c below 7%. However, in older patients, especially those with complex medical problems, the benefits of this strategy are unclear. What’s more, this strategy can cause harm. Aiming for a hemoglobin A1c below seven increases the risk for hypoglycemia. And older adults are especially susceptible to this risk. As a result, many guidelines suggest that treatment should be more cautious for these vulnerable elders and that aiming for “tight” blood sugar control may not be worth the risk. Medical Research: What are the main findings? Dr. Lipska: We looked at diabetes treatment of older adults using nationally representative data from 2001 to 2010. We found that 62% of older adults with diabetes had a hemoglobin A1c below 7%. But what’s really striking is that this proportion was similar for patients who were relatively healthy, for those with intermediate health, and for those with poor health. What’s more, the use of insulin or sulfonylureas (drugs that increase the risk for hypoglycemia) was common and similar across these groups.
Author Interviews, Breast Cancer, Geriatrics / 07.01.2015

MedicalResearch.com Interview with: Pamela Vacek, PhD Research Assistant Professor Department of Pathology Medical Biostatistics Unit, College of Medicine University of Vermont,  Burlingon, Vermont Medical Research: What is the background for this study? What are the main findings? Dr. Vacek: Clinical trials to evaluate the effectiveness of screening mammography have focused primarily on women under age 70 and, consequently, its benefit for older women is uncertain. However, many believe that the benefit of screening mammography diminishes as women age and acquire other health problems, because they are less likely to live long enough for any detected breast cancer to have a clinical impact. To gain insight into this, we followed approximately 20,000 women aged 70 and older for an average of 10 years to examine their mammography use, cancer detection and survival. We found that screening mammography use declined steadily (9% per year) after age 70, but this was not accompanied by decline in the incidence of invasive breast cancer. Hence, as the women aged breast cancer was more likely to be detected clinically than by screening. The clinically detected tumors were significantly larger and of more advance stage and were associated with poorer overall survival, for all but the oldest and most infirm women. We also found that the use of breast conserving surgery as the only treatment for early stage cancer increased markedly with age and was associated with shorter survival compared to women receiving radiation or mastectomy.
Author Interviews, Exercise - Fitness, Geriatrics, Memory / 29.12.2014

Scott M. Hayes, Ph.D. Associate Director Neuroimaging Research for Veterans Center Memory Disorders Research Center VA Boston Healthcare System Assistant Professor of Psychiatry Boston University School of MedicineMedicalResearch.com Interview with: Scott M. Hayes, Ph.D. Associate Director Neuroimaging Research for Veterans Center Memory Disorders Research Center VA Boston Healthcare System Assistant Professor of Psychiatry Boston University School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Hayes:   Studies with rodents have demonstrated that physical activity positively impacts memory, whereas human studies have tended to emphasize a relationship with executive function—which refers to one’s ability to plan, organize, and manipulate information in one’s mind.  To clarify the relationship between fitness, cognition, and aging, we directly assessed cardiorespiratory fitness (heart and lung function) using the gold standard in the field, a graded treadmill test, and assessed both memory and executive functions in young and older adults.  Our results showed that cardiorespiratory fitness was positively associated with memory and executive functions in older adults, but not young adults.  In fact, on tests of executive functions, older adults with higher levels of cardiorespiratory fitness performed as well as younger adults. The impact of cardiorespiratory fitness may be age-dependent.  Young adults, who are at their peak in terms of memory performance, may exhibit minimal associations with cardiorespiratory fitness.  In contrast, cardiorespiratory fitness likely has a larger impact in older adults by attenuating age-related decline in memory.
Author Interviews, Cost of Health Care, Geriatrics, Nursing / 11.12.2014

Karen Dorman Marek, PhD, MBA, RN, FAAN Bernita 'B' Steffl Professor of Geriatric Nursing Arizona State University College of Nursing & Health Innovation Phoenix, AZ 85004-0696MedicalResearch.com Interview with: Karen Dorman Marek, PhD, MBA, RN, FAAN Bernita 'B' Steffl Professor of Geriatric Nursing Arizona State University College of Nursing & Health Innovation Phoenix, AZ 85004-0696 Medical Research: What is the background for this study? What are the main findings? Response: For many older adults, self-management of chronic illness is an overwhelming task, especially for those with mild cognitive impairment or complex medication regimens. The purpose of this study was to evaluate cost outcomes of a home-based program that included both nurse care coordination and technology to support self-management of chronic illness, with as an emphasis on medications in frail older adults. A total of 414 older adults, identified as having difficulty self-managing their medications, were recruited at discharge from three Medicare-certified home health care agencies in a large Midwestern urban area. A prospective, randomized, controlled, three-arm, longitudinal design was used. A team consisting of both Advanced Practice Nurses (APNs) and Registered Nurses (RNs) coordinated care to two groups: home-based nurse care coordination (NCC) plus mediplanner group and NCC plus the MD.2 medication-dispensing machine group. Major findings were:
  • Total Medicare costs were $447 per month lower in the NCC + mediplanner group (p=0.11) when compared to the control group.
  • For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC + mediplanner group (p=0.06) compared to the control group.
  • The cost of the NCC intervention was $151 per month, yielding a net savings of $296 per month or $3552 per year for the NCC + mediplanner group.
  • Participants who received the nurse care coordination intervention scored significantly better than the control group in depression (p < 0.001), functional status (p < 0.001), cognition (p < 0.001), and quality of life (p < 0.001) than participants in the control group.
Author Interviews, Frailty, Geriatrics, JAMA / 22.08.2014

Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMCMedicalResearch.com Interview with Dr. Bellal Joseph MD FACS Associate Professor of Surgery Medical Director, Southern Arizona Telemedicine and Telepresence (SATT) Program Program Director, International Research Fellowship Liaison, Multi-Specialty Surgery Clinic at UAMC Medical Research: What are the main findings of the study? Dr. Joseph: Chronologic age is frequently used as the determinant of outcomes when treating elderly and treatments are tailored accordingly. However, the findings of our study challenge this dogma and suggest that it’s not the chronologic age rather frailty status of the individual that determines outcomes. We found frailty Index (quantitative measure of frailty) as a better predictor of in-hospital complications and discharge disposition in elderly compared to the chronologic age.
Author Interviews, Cognitive Issues, Geriatrics / 20.08.2014

Neha P. Gothe, PhD Division of Kinesiology Health and Sport Studies Wayne State University Detroit, MI 48202.Medical Research Interview with: Neha P. Gothe, PhD Division of Kinesiology, Health and Sport Studies Wayne State University Detroit, MI 48202. Medical Research: What are the main findings of the study? Dr. Gothe: The yoga group was speedier and more accurate on tests of information recall, mental flexibility and task-switching than it had been before the intervention. Participants in the yoga group showed significant improvements in working memory capacity, which involves continually updating and manipulating information. They were also able to perform the task at hand quickly and accurately, without getting distracted.
Author Interviews, Exercise - Fitness, Frailty, Geriatrics / 18.07.2014

Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester.MedicalResearch.com: Interview with: Dr. Wenjun Li , PhD Health Statistics and Geography Lab Division of Preventive and Behavioral Medicine University of Massachusetts Medical School, Worcester. Medical Research: What are the main findings of the study? Dr. Wenjun Li: Compared to those walking for recreational purposes only, older adults walking for utilitarian purposes had higher risk for outdoor falls and fall-related injuries that require medical attention.
Author Interviews, Blood Pressure - Hypertension, Geriatrics / 23.06.2014

Dr. Michele Callisaya Faculty of Medicine, Nursing & Health Sciences Monash University, ClaytonMedicalResearch.com Interview with:  Dr. Michele Callisaya Faculty of Medicine, Nursing & Health Sciences Monash University, Clayton MedicalResearch: What are the main findings of the study? Dr. Callisaya: Falls are common in older people and can lead to hip fracture and loss of mobility.  Blood pressure reducing medications are commonly taken by older people to protect against heart attacks and stroke, but may have some unwanted side effects such as light-headedness and loss of balance.  We found that older people who were on large doses of such medications were at increased risk of falling.
Author Interviews, Geriatrics, Heart Disease / 09.06.2014

Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence ItalyMedicalResearch Interview with: Mauro Di Bari, MD, PhD Associate Professor of Medicine - Geriatrics Director, School of Geriatrics Vice-president, School of Physiotherapy University of Florence and Azienda Ospedaliero-Universitaria Careggi Florence Italy MedicalResearch: What are the main findings of the study? Professor Di Bari: This study is based on the AMI-Florence 2 registry, which recorded all acute coronary syndromes (ACS) occurring in one year in the metropolitan area of Florence, Italy. This area has one of the top prevalence figures in the country for application of percutaneous coronary intervention (PCI) to treat ACS, at least in cases with ST-segment elevation myocardial infarction (STEMI). Nevertheless, in our study the procedure turned out to be largely underused in older, complex patients, who mostly had NSTEMI: the greater the background risk (as expressed by the Silver Code, a simple, validated prognostic tool based of administrative data), the lower the chances for application of PCI, independent of possible contraindications to PCI, such as anaemia or renal insufficiency. At the same time, the long-term survival advantage offered by PCI increased with increasing background risk: when comparing patients receiving and not receiving PCI across strata identified on the basis of the Silver Code, one-year survival was only marginally greater in patients treated with PCI when their Silver Code score suggested low background risk, whereas the mortality gradient increased progressively along with Silver Code score, to reach its maximum in patients with the greatest values of Silver Code score. Within the limits of an observational study, cardiac and non-cardiac comorbidities, contraindications to PCI, clinical characteristics of the ACS and hospital of admission could not justify these findings.
Accidents & Violence, Author Interviews, BMJ, Geriatrics / 29.05.2014

Mary W. Carter, Ph.D. Gerontology Program Director Towson University Towson, MD 21252-0001MedicalResearch.com Interview Invitation Mary W. Carter, Ph.D. Gerontology Program Director Towson University Towson, MD 21252-0001 MedicalResearch: What are the main findings of the study? Dr. Carter: Nearly 1 in 5 older adults experienced at least one severe medical injury during the five-year study period, and more than half of these occurred in an ambulatory care setting (i.e., not in the hospital).  Older adults that were in poorer health and who had greater levels of disability had the greatest risk.  Mortality rates were nearly twice as high among older adults experiencing a medical injury in comparison with otherwise similar older adults not experiencing a medical injury. Among survivors, the impact of medical injury was observed for extended periods of time, reflecting increased medical use and costs associated with medical injury.
Author Interviews, Frailty, Geriatrics, JAMA, Surgical Research / 10.05.2014

MedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of KoreaMedicalResearch.com Interview with: Kwang-il Kim, MD, PhD Associate Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea MedicalResearch: What are the main findings of the study? Answer: There are few tools of preoperative risk stratification for the older adults. We found that not only disease itself but also frailty can lead to post-operative complication and mortality. So we made a scoring model to predict post-operative mortality and morbidity based on comprehensive geriatric assessment and it worked exactly. MedicalResearch: Were any of the findings unexpected? Answer: Under our predictive model, there was inflection point of mortality slope at point 5. Post-operative mortality of someone who scores 4~5 is below 10%, but it of other who scores 6~7 is about 30%. It was unexpected drastic change, so we think that there is physiologic threshold point. MedicalResearch: What should clinicians and patients take away from your report? Answer: Because the elderly are different from adults, clinicians have to focus on functional capacity, co-morbidity, and frailty for their older surgical patients. Make operative decision base on comprehensive geriatric assessment or our scoring model. If you depend on your own feeling, some older patients will suffer from post-operative complication and someone will forfeit his chance of surgery.
AHA Journals, Author Interviews, Exercise - Fitness, Geriatrics, Heart Disease / 08.05.2014

Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGALMedicalResearch.com Interview with: Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGAL MedicalResearch: What are the main findings of the study? Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better.
Author Interviews, Cognitive Issues, Geriatrics, Memory, Sleep Disorders / 02.05.2014

dr_elizabeth_devoreMedicalResearch.com Interview with: Elizabeth Devore, ScD Associate Epidemiologist Brigham and Women’s Hospital Instructor in Medicine, Harvard Medical School   MedicalResearch.com: What are the main findings of the study? Dr. Devore: In this study, we examined sleep duration and memory performance in a group of ~15,000 women participating in the Nurses’ Health Study. We found that women with sleep durations of 5 or fewer hours/day or 9 or more hours/day, either in midlife or later life, had worse memory at older ages than those sleeping 7 hours/day. In addition, women with sleep durations that changed by two or more hours/day from midlife to later life performed worse on memory tests compared to those whose sleep duration did not change during that time period.The magnitude of these memory differences was approximately equivalent to being 1-2 years older in age.
Alzheimer's - Dementia, Author Interviews, Geriatrics, Mental Health Research / 24.04.2014

Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, CanadaMedicalResearch.com Interview with: Ziad Nasreddine MD FRCP(C) Professeur adjoint Université de Sherbrooke et McGill University Neuro Rive-Sud/CEDRA: Centre Diagnostique et Recherche sur la Maladie d'Alzheimer Québec, Canada MedicalResearch.com: What are the main findings of this study? Dr. Nasreddine: The Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) are useful in predicting conversion to Alzheimer’s disease (AD) in individuals with mild cognitive impairment (MCI). Identifying individuals with MCI at high of conversion to Alzheimer’s disease is important clinically and for selecting appropriate subjects for therapeutic trials.
Author Interviews, Geriatrics, Mental Health Research / 23.04.2014

Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare SysteMedicalResearch.com Interview with Helen C. Kales MD Professor of Psychiatry Director, Section of Geriatric Psychiatry and The Program for Positive Aging, University of Michigan Research Scientist, VA Center for Clinical Management Research and Geriatric Research Education and Clinical Center VA Ann Arbor Healthcare System Please note that this paper is the result of the deliberations of a multi-disciplinary national expert panel, not a specific study. MedicalResearch.com: What were the main findings of the expert panel? Dr. Kales: Often more than memory loss, behavioral symptoms of dementia are among the most difficult aspects of caring for people with dementia. These symptoms are experienced almost universally, across dementia stages and causes, and are often associated with poor outcomes including early nursing home placement, hospital stays, caregiver stress and depression, and reduced caregiver employment.  Doctors often prescribe these patients psychiatric medications like antipsychotics, despite little hard evidence that they work well in this population and despite the risks they pose including hastening death.  Meanwhile, studies show promise for non-medication behavioral and environmental approaches (such as providing caregiver education/support, creating meaningful activities and simplifying/enhancing the environment), but too few health providers are trained in their use.  The method created by the national multidisciplinary group of experts (DICE which stands for Describe, Investigate, Create and Evaluate) represents a comprehensive approach to assessment and management of behavioral symptoms in dementia.  For example, a new report of “agitation” from a caregiver, should be fully understood and described (e.g. who/what/when/where/risk/safety); underlying causes should be investigated (e.g. pain, changes in medications, medical conditions, poor sleep, fear); a treatment plan should be created (e.g. responding to physical problems, working collaboratively with the caregiver and other team members to institute non-pharmacologic interventions); and evaluating whether the interventions tried were effective.
Addiction, Frailty, Geriatrics, JAMA, Pharmacology / 15.04.2014

Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging La Chaire pharmaceutique Michel-Saucier en santé et vieillissement Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com Interview with: Cara Tannenbaum, MD, MSc The Michel Saucier Endowed Chair in Geriatric Pharmacology, Health and Aging,Professor of Medicine and Pharmacy University of Montreal Centre de Recherche Institut Universitaire de Gériatrie de Montréal Montreal, QC MedicalResearch.com: What are the main findings of the study? Dr. Tannenbaum: The EMPOWER study showed that providing older patients with information about the harms of sleeping pill use led to discontinuation or dose reduction in 1-in-every 4 patients with longstanding use of benzodiazepines. Receipt of evidence-based information about drug harms resulted in a 8-fold higher likelihood of benzodiazepine cessation. Many physicians think that patients become too dependent on sedative-hypnotics to successfully discontinue. Regardless of age, sex, and duration of use, 27% of patients aged 65-95 in this study successfully completed the recommended 20-week tapering protocol during a 6-month time period and another 11% were in the process of tapering. EMPOWERing patients with evidence-based information therefore results in appropriate risk reduction.
Author Interviews, Geriatrics, MRSA / 11.01.2014

Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of MedicineMedicalResearch.com Interview with: Courtney Reynolds, PhD Medical Scientist Training Program University of California Irvine, School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Reynolds: Our survey of factors influencing admission to 13 nursing homes in Orange County, California showed that MRSA carriers are denied admission more often than non-carriers, even after accounting for other important factors such as insurance status, required level of care and previous experience at the facility. In 80% of cases where MRSA carriage was responsible for denial of admission, nursing home administrators cited a lack of available single or cohort (MRSA only) rooms to accommodate these potential residents.