Aging, Geriatrics, Social Issues / 04.10.2022

If you have aging parents, the one thing you will want to be aware of is the most common health concerns that plague the elderly. While there is no way to definitively say who will suffer from any one of these diseases or conditions, they are most common among the elderly. For this reason, and because the elderly may be prone to memory lapses, it is important that you find a way to communicate with their primary health provider to ensure that everything is as it should be. With HIPAA in effect, you may need to get their approval to speak with their doctor or if they’ve been declared incompetent, the proper authorization from the courts would be necessary. At any rate, these are the health concerns you should be on the lookout for, as they truly are most prevalent in the elderly. (more…)
Aging, Geriatrics / 26.01.2021

elderly-aging-older-parentsOne of the most difficult conversations that you will need to have with your aging parents throughout their retirement is about the future. Though no matter how difficult this conversation may be, it is vital that you can plan for what might happen as a family to ensure that you are prepared for anything that comes your way. If you are struggling to do this, here are some top tips to help you comprehensively plan for your parent's future, so they can have the most comfortable lives possible, and you do not have to worry for them.

1.    Look at Assisted Living Facilities

Although you might believe that your parents will always be healthy enough to live at home, this is not always the case. There are many common health conditions such as dementia, which may leave your parents needing round-the-clock care, as well as general ill health and frailty as they start to show the signs of aging. To make sure that you know that your parents are well-looked after when the time comes, you should consider researching assisted living facilities now. This will allow you to relax in knowing that both you and your loved one are happy with the home you have chosen for them. For instance, if you are looking for assisted living Fort Lauderdale, Belmont Village can offer your parents a range of care options, and you can rest in the knowledge that they are being cared for.

2.    Sort Their Finances

Many adult children leave their parents to handle their finances for fear of taking over or looking greedy when it comes to their eventual passing. However, helping your parents sort their finances out now can ensure that they will be able to pay for all of the medical care they may need and ensure that they have enough money to live on until the end of their lives. Sorting these finances out early, such as looking at the pension schemes and organizing the assets they have to their name, will ensure that they do not come unstuck later and enable them to set a budget around their financial situation.

3.    Create a Will

Although it is easy to dismiss probate as something that you do not want to think about or discuss with your parents, helping them create a will and knowing what is inside of it is important if they pass away suddenly and unexpectedly, then you can help them to make a will by contacting a solicitor or encouraging them to complete a DIY will-making kit. You should always make sure that DIY wills are legally valid, though. Knowing what is inside of the will can be important so that you can make sure that their wishes are carried out on their death and that no forgery or other issues occur. (more…)
Accidents & Violence, Author Interviews, Geriatrics / 13.08.2019 Interview with: XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901XinQi Dong MD, MPH Henry Rutgers Distinguished Professor of Population Health Sciences Director of the Director of Institute for Health, Health Care Policy and Aging Research Rutgers University New Brunswick, NJ 08901 What is the background for this study? What are the main findings?  Response: This study was done among community-dwelling US Chinese older adults aged 60 and above living in the greater Chicago area. The baseline cohort consisted of 3,157 participants, and we followed up with them from 2011 to 2017. There were heterogeneities in the associations between the strictness of definitions and subtypes of elder mistreatment (EM) and yearly mortality.   (more…)
Author Interviews, Geriatrics, JAMA, Ophthalmology, University of Michigan / 21.06.2019 Interview with: Joshua R. Ehrlich, MD, MPH Assistant Professor, Ophthalmology and Visual Sciences Kellogg Eye Center Department of Ophthalmology and Visual Sciences University of Michigan What is the background for this study?   Response: This study came out of data collected as part of the National Poll on Healthy Aging (NPHA). The NPHA is funded by AARP and the Institute for Healthcare Policy and Innovation at the University of Michigan to inform the public, healthcare providers, and policymakers on a variety issues related to health. The vision survey, conducted in March 2018, was just one of many NPHA surveys. Due to aging of the population, the number of older U.S. adults with blindness and vision impairment is expected to double over the next 30 years. Thus, this study was designed to provide crucial data  on contemporary data on patterns of eye care utilization in older adults. (more…)
Accidents & Violence, Author Interviews, Exercise - Fitness, Geriatrics, JAMA / 05.06.2019 Interview with: Teresa Liu-Ambrose, PT, PhD Canada Research Chair (Tier II), Physical Activity, Mobility, and Cognitive Neuroscience Director, Aging, Mobility, and Cognitive Neuroscience Laboratory University of British Columbia What is the background for this study? Response:  Falls in older adults are the third-leading cause of chronic disability and the leading cause of hospitalization for adults over age 65. Older adults who experience multiple falls are at increased risk for disability, loss of independence, and even death. How to best prevent falls in this high risk group is not well established.  (more…)
Author Interviews, Geriatrics / 30.05.2018 Interview with: “Pills” by Victor is licensed under CC BY 2.0Khalid Ali, MBBS, FRCP, MD Senior lecturer in Geriatrics Brighton and Sussex Medical School, UK What is the background for this study? What are the main findings? Response: Older people are more like to have more than one chronic condition (multi-morbidity), and as such as are more likely to be prescribed several medications (poly pharmacy) to treat those conditions. At the point of hospital discharge, older people are given different / new medications in addition to their old ones, and this puts them at higher risk of harm related to medicines. Our study led by  Brighton and Sussex Medical School (BSMS) and King’s College London involved five hospitals and 1,280 patients (average age 82 years) in South England. Senior pharmacists interviewed patients and carers, reviewed GP records and analysed hospital readmission to determine medication-related harm. The study found that more than one in three patients (37%) experienced harm from their medicines within two months of hospital discharge, and that this was potentially preventable in half of the cases. Medication-related harm was most commonly found to occur from the toxicity of the medicine itself and in a quarter of cases from poor adherence.  The medicines found to pose the highest risk were opiates, antibiotics and benzodiazepines. Patients suffered a range of side effects including serious kidney injury, psychological disturbance, irregular heart rhythms, confusion, dizziness, falls, diarrhoea, constipation and bleeding. (more…)
Accidents & Violence, Author Interviews, Geriatrics, Vitamin D / 25.04.2018 Interview with: Dr. Alex Krist, M.D., M.P.H. Dr. Krist is is a professor of family medicine and population health at Virginia Commonwealth University and active clinician and teacher at the Fairfax Family Practice residency. What is the background for these recommendation statements? What are the main findings? Response: Falls are the leading cause of injuries in adults age 65 and older and can lead to serious disability and even death. Bone fractures—which may result from a fall—can also cause serious disability and death in older adults. The U.S. Preventive Services Task Force looked into the most recent evidence on the best ways to prevent falls and fractures in older adults. We found that clinicians should recommend exercise or physical therapy to help prevent falls by older adults who live at home and are at higher risk for falling. Additionally, we concluded that taking a low dose of vitamin D and calcium does not help prevent fractures due to osteoporosis, but we don’t know if taking a higher dose is effective or not, so we are calling for more research. (more…)
Aging, Author Interviews, Depression, Geriatrics, Hip Fractures / 16.01.2017 Interview with: Sanna Torvinen-Kiiskinen MSc (Pharm.), PhD student, Kuopio Research Centre of Geriatric Care and School of Pharmacy University of Eastern Finland What is the background for this study? Response: Antidepressants are widely used among elderly persons, especially persons with Alzheimer’s disease. They are used not only for treatment for major depression, but for treatment of anxiety, insomnia and chronic pain as well as behavioral symptoms caused by dementia. However, antidepressants, as well as other psychotropic drugs, may cause sedation, confusion, orthostatic hypotension and hyponatremia, which increase the risk of falling and fractures. Because of changes in pharmacodynamics and pharmacokinetics due to aging, older persons are at the higher risk of those adverse events. The aim of our study was to investigate whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer’s disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics, JAMA / 03.03.2015 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. (more…)
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. (more…)
Author Interviews, Blood Pressure - Hypertension, Geriatrics / 23.06.2014

Dr. Michele Callisaya Faculty of Medicine, Nursing & Health Sciences Monash University, 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. (more…)
Author Interviews, Hearing Loss, Psychological Science / 04.04.2014

Dr. Anne Ingeborg Berg: University of Gothenburg, Interview with: Dr. Anne Ingeborg Berg: University of Gothenburg, Sweden What are the main findings of the study? Answer: In our study of personality change in individuals aged 80+ we found that over a 6 year period individuals did not change in emotional stability, however, in line with previous research they got less extravert or outgoing. The only health aspect that could be related to an accelerated change in extraversion was impaired hearing at the first measurement occasion. (more…)
Accidents & Violence, Author Interviews / 20.03.2014

Judy A. Stevens PhD National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta GA Interview with: Judy A. Stevens PhD National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta GA 30341 What are the main findings of the study? Dr. Stevens: The fall death rate among persons aged 65 and older has been increasing rapidly. We used vital statistics data to examine the circumstances and contributing conditions to fall deaths. We found that of 21,649 fall deaths in 2010, the largest proportion (35%) occurred from falling on the same level, followed by falling on stairs or steps (6.5%).  From 1999 to 2010, there was a trend toward more specific reporting of falls circumstances. However, information about the circumstances of 49% of the 2010 fall deaths was not available. In 2010, 49% of fall deaths involved a head injury and 30% involved a hip fracture. The most important contributing causes to fall deaths were circulatory diseases, especially hypertension, and respiratory diseases. Factors that may partially explain the rapid increase in the fall death rate include changing trends in the death rates for underlying chronic diseases strongly associated with falls, such as reductions in cardiovascular disease deaths, as well as better reporting on death certificates of falls as the underlying cause of death. (more…)
Diabetes, Neurological Disorders / 12.08.2013 Interview with: Dr. Orit Twito Department of Endocrinology, Hillel Yaffe Medical Center, Hadera, Israel What are the main findings of the study? Answer: An HbA1c level above 7.5% (58mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patient with new onset diabetes mellitus. HbA1c above 8.5 %( 69nmol/mol) was associated with even higher mortality rate, although this difference did not reach statistical significance. (more…)
Author Interviews, Diabetes, Frailty, Lancet / 09.07.2013 Interview with: Dr David Strain, MRCP MD Clinical senior lecturer and honorary consultant University of Exeter Medical School Institute of Biomedical and Clinical Science Department of Diabetes and Vascular Research Royal Devon & Exeter Hospital Exeter EX2 5AX What is the Background of the study? In early 2010 recent diabetes outcome trials such as ACCORD and ADVANCE had put into question the benefit of aggressive HbA1c reduction for all patients particularly in elderly population. After that there were several guidelines that suggested individualizing treatment targets for elderly patients according to their age, co-morbidities, frailty and baseline HbA1c. This featured in the Finnish guidelines and the European Working Party for the management of Diabetes in the Older Person. However this was also completely without any evidence base. I worked with Paivi Paldanius (the final author of the paper and a medical advisor for Novartis) to establish a pragmatic study. We both acknowledged the importance of having a patient-centric, pragmatic and 'real-life' approach and as there was already evidence that DPP-4 inhibitors, in this case vildagliptin (due to Päivi's affiliation), had demonstrated it's efficacious and had no tolerability issues in the elderly population we decided to go ahead with the study. It was obvious that we needed to implement a holistic approach and take into account as many clinically relevant parameters as possible, such as age, baseline HbA1c, duration of the disease, co-morbidities and frailty, for implementation of the individualized care. Our primary goal was to request that the physicians acting as investigators would still apply their clinical judgment based on these clinical features of each individual patient but also, follow their local guidelines as in their daily clinical practice. This would later provide us with invaluable information and perspective when interpreting the data and recommending implementation of the results.  For assessment of frailty we screened for many different methodologies but Prof Timo Strandberg (known expert of the field and mentioned in the acknowledgements section of our paper) suggested to apply modified Linda Fried's method for assessment of phenotype of frailty as this method is validated, very pragmatic, reproducible and also feasible to be used for the first time also by a non-geriatric investigator. All investigators were trained to follow these parameters by the protocol. We also wished to evaluate in parallel the conventional HbA1c drop assessment in order to be able to put the potential success of our new endpoint, meeting the individualized target, into perspective and for comparison against other standard data from other studies with DPP-4 inhibitors with elderly. We also wished to simulate a clinical, real-world setting as much as possible and included patients who would seem representative of most elderly T2DM patients. (more…)