Tagged Aging

State Highlights: Minn. Plans Online Resource To Help Consumers Compare Assisted-Living Facilities’ Quality; Calif. Proposal Would Require Problem Docs To Be Transparent

Outlets report on news from Minnesota, California, Georgia, California, Massachusetts, Kansas, Alabama and Michigan.

The Star Tribune: State Plans Online ‘Report Card’ For You To Gauge Assisted-Living Facilities 
For decades, Minnesota families seeking senior living arrangements for their elderly loved ones have found themselves casting about in an informational void. But a proposal by the Minnesota Department of Human Services would create the state’s first standardized system for measuring the quality of assisted-living homes — a fast-growing but lightly regulated industry that now serves more than 50,000 Minnesotans in nearly 1,200 facilities. (Serres, 2/23)

The Star Tribune: Rochester Set To Remove 180-Plus Students Over Failure To Follow Vaccination Law
More than 180 public school students in Rochester will be removed from school March 1 if they are not vaccinated or officially exempted from the state law that requires them to be immunized. School officials said this week that they have worked “diligently” since January to inform families that students must be vaccinated to attend school or provide documentation for an exemption. (Smith, 2/23)

The Star Tribune: HCMC Cutting 131 Jobs Through Layoffs Amid Budget Pinch 
Hennepin County Medical Center leaders announced the layoff of more than 131 workers this week, saying they believe it will resolve a projected financial crisis at the hospital caused by worsening reimbursements for patient care. The announcement drew angry responses from affected employees, including a protest by cleaners and clerical workers Thursday afternoon and criticism by a bioelectronics technician, who predicted that the hospital will end up spending more by outsourcing critical tasks. (Olson, 2/23)

Los Angeles Times: Political Spending Of AIDS Nonprofit Comes Under Fire
The AIDS Healthcare Foundation oversees a global philanthropic empire that extends from its Hollywood headquarters to 15 states and 38 countries. The 30-year-old nonprofit organization treats hundreds of thousands of patients. It hands out tens of millions of condoms annually. And it puts up provocative billboards urging people to get tested for sexually transmitted diseases. But in recent months, it has become known for the kind of activism usually associated with homeowner groups, spurring criticism that it has strayed too far from its mission. (Reyes and Zahniser, 2/24)

Boston Globe: City Seeks Private Partner To Rebuild Former Bromley-Heath Complex
The roofs leak, the elevators malfunction, and the heating system is old. Tenants of the Mildred C. Hailey Apartments complain about people sleeping in the hallways or doing drugs, and sometimes they find used needles scattered about. But there is no federal money to repair or rebuild the Jamaica Plain housing development’s 804 units of federally subsidized public housing, Boston Housing Authority officials say. So on Wednesday, the authority announced it is seeking proposals from private developers to tear down and rebuild a portion of the complex: six dilapidated buildings on Centre Street, Parker Street, and Lamartine Street. (Allen and Gans, 2/23)

Sacramento Bee: Muslims Seek Mental Health Aid After Mosque Attacks, Travel Ban 
Coming at the same time as other anti-Muslim attacks and a presidential order banning entry by people from seven predominantly Muslim countries, many Muslim Americans are asking themselves whether they still are welcome in this country while they worry about their own safety and the safety of their loved ones. In response, mosques, student groups and mental health agencies around the Sacramento region are stepping up and offering Muslims a safe place to share their anxieties and receive professional help. (Caiola, 2/23)

KCUR: Osteopathic Med Schools Like Kansas City University Answer The Call For More Doctors 
With the United States facing a shortage of physicians over the next decade, health care groups and lawmakers are scrambling to increase the number of doctors – primary care providers in particular – to serve an aging population. Kansas meets only about 65 percent of its physician needs, according to the Health Resources & Services Administration. Missouri is even worse off, meeting only about 30 percent of its physician needs. Many Missouri counties are designated Health Professional Shortage Areas, meaning they have only one provider in the area to serve at least 3,500 people. (Worth, 2/23)

The Wall Street Journal: Alabama Doctors Convicted In Health-Care Fraud Case
Two Alabama doctors were convicted Thursday of health-care fraud, taking kickbacks from Insys Therapeutics Inc. and prescribing opioid painkillers for no medical purpose, among other crimes. John Couch and Xiulu Ruan were each convicted on more than 10 criminal counts brought by the U.S. attorney’s office in Mobile, Ala. (Walker, 2/23)

KCUR: Osawatomie Contract Bidder Has History Of Safety Issues At Its Florida Psychiatric Facilities 
Correct Care Solutions, a Tennessee-based company that is the sole bidder for a contract to operate Osawatomie State Hospital, has a history of safety problems at the state psychiatric facilities it runs in Florida. Officials with the Kansas Department for Aging and Disability Services declined to provide details this week on Correct Care’s bid to operate Osawatomie State Hospital, one of two state facilities for people deemed a danger to themselves or others. The department is evaluating the proposal and hasn’t given a timeline for whether or when it would bring it before the Legislature. Under a law they approved last year, lawmakers must approve the contract before KDADS can move forward. (Wingerter, 2/23)

Detroit Free Press: Tick-Borne Lyme Disease Exploding Into Michigan; Human Cases Up 5-Fold
All it took was an unusual February warm spell this past week for the tiny insects causing an increasingly big problem in Michigan to become active once again, beginning their hunt for blood…The ticks are of interest because of what they often carry with them: the bacterium Borrelia burgdorferi. When the ticks bite an animal, seeking a blood meal, that bacteria can transfer. And that bacteria, in dogs, horses and humans, can cause Lyme disease, a serious affliction that can be permanently debilitating for people when it’s not treated early and well. (Matheny, 2/23)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

On The Backs Of Devastating Failures, Biotech Pins Hopes On New Alzheimer’s Drug

It’s the disease that has befuddled drugmakers for decades, and a recent string of high-profile setbacks have rocked the industry. But one company is pushing forward in hopes of breaking into a market worth billions.

Stat: Biotech’s Next Alzheimer’s Test May Answer ‘$25 Billion Question’
Moving on from biopharma’s latest setback in Alzheimer’s disease — and the four that preceded it last year — the industry is turning its attention to a tiny pill made by a small company with hopes to succeed where so many have failed. In the third quarter of this year, Axovant Sciences will release Phase 3 data that will determine whether its drug, intepirdine, can improve cognition and function in patients with mild or moderate Alzheimer’s. Axovant’s readout will follow an outright failure from Merck, disappointing results from Eli Lilly, and a vexing setback for TauRx. (Garde, 2/22)

In other news —

The New York Times: Prolonged Sleep May Be Early Warning Sign Of Dementia
Older adults who started sleeping more than nine hours a night — but had not previously slept so much — were at more than double the risk of developing dementia a decade later than those who slept nine hours or less, researchers report. The increased risk was not seen in people who had always slept more than nine hours. (Rabin, 2/22)

California Healthline: Alzheimer’s Looms Large For Latinos
The number of Alzheimer’s cases in the United States is rising, especially among Latinos — the fastest growing minority in the country. With no cure in sight, diagnoses among U.S. Latinos are expected to increase more than eightfold by 2060, to 3.5 million, according to a report by the University of Southern California’s Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network. (de Marco, 2/23)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Geriatricians Can Help Aging Patients Navigate Multiple Ailments

For months, Teresa Christensen’s 87-year-old mother, Genevieve, complained of pain from a nasty sore on her right foot. She stopped going to church. She couldn’t sleep at night. Eventually, she stopped walking except when absolutely necessary.

Her primary care doctor prescribed three antibiotics, one after another. None worked.

“Doctor, can’t we do some further tests?” Teresa Christensen remembered asking. “I felt that he was looking through my mother instead of looking at her.”

Referred to a wound clinic, Genevieve was diagnosed with a venous ulcer, resulting from poor circulation in her legs. A few weeks ago, she had a successful procedure to correct the problem and returned home to the house where she’s lived for more than 50 years in Cottage Grove, Minn., a suburb of St. Paul.

Judith GrahamNAVIGATING AGING

Would her mother benefit from seeing a geriatrician going forward, wondered Christensen, her mother’s primary caregiver, in an email to me? And, if so, how would she go about finding one?

I reached out to several medical experts, and they agreed that a specialist in geriatrics could help a patient like Genevieve, with a history of breast cancer and heart failure, who’d had open heart surgery at age 84 and whose mobility was now compromised.

Geriatricians are “experts in complexity,” said Dr. Eric Widera, director of the geriatrics medicine fellowship at the University of California, San Francisco.

No one better understands how multiple medical problems interact in older people and affect their quality of life than these specialists on aging. But their role in the health care system remains poorly understood and their expertise underused.

Interviews with geriatricians offer insights useful to older adults and their families:

Basic knowledge. Geriatricians are typically internists or family physicians who have spent an extra year becoming trained in the unique health care needs of older adults.

They’re among the rarest of medical specialties. In 2016, there were 7,293 geriatricians in the U.S. — fewer than two years before, according to the American Geriatrics Society.

Geriatricians can serve as primary care doctors, mostly to people in their 70s, 80s and older who have multiple medical conditions. They also provide consultations and work in interdisciplinary medical teams caring for older patients.

Recognizing that training programs can’t meet expected demand as the population ages, the specialty has launched programs to educate other physicians in the principles of geriatric medicine.

“We’ve been trying to get all clinicians trained in what we call the ‘101 level’ of geriatrics,” said Dr. Rosanne Leipzig, a professor of geriatrics at the Icahn School of Medicine at Mount Sinai in New York City.

Essential competencies. Researchers have spent considerable time over the past several years examining what, exactly, geriatricians do.

A 2014 article by Leipzig and multiple co-authors defined 12 essential competencies, including optimizing older adults’ functioning and well-being; helping seniors and their families clarify their goals for care and shaping care plans accordingly; comprehensive medication management; extensive care coordination; and providing palliative and end-of-life care, among others skills.

Underlying these skills is an expert understanding how older adults’ bodies, minds and lives differ from middle-age adults.

“We take a much broader history that looks at what our patients can and can’t do, how they’re getting along in their environment, how they see their future, their support systems, and their integration in the community,” said Dr. Kathryn Eubank, medical director of the Acute Care for Elders unit at the San Francisco Veterans Affairs Medical Center. “And when a problem arises with a patient, we tend to ask ‘How do we put this in the context of other concerns that might be contributing?’ ”

Geriatric syndromes. Another essential competency is a focus on issues that other primary care doctors often neglect — notably falls, incontinence, muscle weakness, frailty, fatigue, cognitive impairment and delirium. In medicine, these are known as “geriatric syndromes.”

“If you’re losing weight, you’re falling, you can’t climb a flight of stairs, you’re tired all the time, you’re unhappy and you’re on 10 or more medications, go see a geriatrician,” said Dr. John Morley, professor of geriatrics at Saint Louis University.

“Much of what we do is get rid of treatments prescribed by other physicians that aren’t working,” Morley continued.

Recently, he wrote of an 88-year-old patient with metastasized prostate cancer who was on 26 medications. The older man was troubled by profound fatigue, which dissipated after Morley took him off all but one medication. (Most of the drugs had minimal expected benefit for someone at the end of life.) The patient died peacefully eight months later.

Eubank tells of an 80-year-old combative and confused patient whom her team saw in the hospital after one of his legs had been amputated. Although physicians recognized the patient was delirious, they had prescribed medications that worsened that condition, given him insufficient pain relief and overlooked his constipation.

“Medications contributing to the patient’s delirium were stopped. We made his room quieter so he was disturbed less and stopped staff from interrupting his sleep between 10 p.m. and 6 a.m.,” Eubank said. “We worked to get him up out of bed, normalized his life as much as possible and made sure he got a pocket talker [hearing device] so he could hear what was going on.”

Over the next four days, the patient improved every day and was successfully discharged to rehabilitation.

Finding help. A geriatric consultation typically involves two appointments: one to conduct a comprehensive assessment of your physical, psychological, cognitive and social functioning, and another to go over a proposed plan of care.

The American Geriatrics Society has a geriatrician-finder on its website — a useful resource. Also, you can check whether a nearby medical school or academic medical center has a department of geriatrics.

Many doctors claim competency in caring for older adults. Be concerned if they fail to go over your medications carefully, if they don’t ask about geriatric syndromes or if they don’t inquire about the goals you have for your care, advised Dr. Mindy Fain, chief of geriatrics and co-director of the Arizona Center on Aging at the University of Arizona.

Also, don’t hesitate to ask pointed questions: Has this doctor had any additional training in geriatric care? Does she approach the care of older adults differently — if so, how? Are there certain medications she doesn’t use?

“You’ll be able to see in the physician’s mannerisms and response if she takes you seriously,” Leipzig said.

If not, keep looking for one who does.

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

Categories: Aging, Navigating Aging, Syndicate

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Viewpoints: How Technology Is Advancing Wellness; Moral Questions About Gene Editing

A selection of opinions on health care from around the country.

The Wall Street Journal: Health-Care Innovations Are Coming To Your Digital Device
Mobile phones and tablets have pushed themselves to the center of modern life. Instead of going to the bookstore, readers download the latest novel direct to their devices. Online shopping has left malls quieter than ever. Video chatting helps far-flung families stay in touch. Health care needs this same kind of disruption. … Personal technology can make routine medical care and healthy living easier. (Regina Benjamin and Andrew Thompson, 2/20)

The Washington Post: If We’re Going To Play God With Gene Editing, We’ve Got To Ask Some Moral Questions
The past 30 days have seen several unheralded but consequential strides in the scientific quest for god-like control of our destiny. Last week, the National Academy of Sciences and the National Academy of Medicine published a report on human genome editing that allows the manipulation of sperm and egg cells to create changes that could be passed down to offspring. In January, scientists for the first time grew a part-pig, part-human “chimera,” a step toward developing animal embryos with functioning human organs for interspecies transplantation. With Tesla chief executive Elon Musk hinting last month at having made progress on a brain-computer interface, injectable electronics and other forms of human augmentation have clearly entered mainstream discussion as a way for humans to keep up with quickly advancing artificial intelligence. (Christine Emba, 2/20)

Indianapolis Star: Invest In Health, Raise Cigarette Tax
Once again the General Assembly considers raising the cigarette tax. This time the proposal is to increase the tax by a $1.50 per pack. … Unquestionably, Indiana is one of the unhealthiest states in the country.  We rank near the bottom in public health funding; we have one of the highest smoking rates; we have an infant mortality rate that rivals some third world countries; and, Indiana ranks as one of the worst in rates of obesity, cancer, and most measures of the chronic diseases that plague our nation. Despite the great advances in tobacco control that have occurred over the past half-century, tobacco still remains our number one public health issue; tobacco use remains the leading cause of preventable disease and premature death. (Richard Feldman, 2/20)

Sacramento Bee: Living And Thriving With A Dementia Diagnosis 
About 80 percent of people with dementia develop Alzheimer’s disease, a particularly insidious form of dementia that leads to death. I am in the early stages of dementia, and they tell me my tests currently clear me of Alzheimer’s, so my experiences have been far less scary by comparison to many others’. My prognosis is for continued regression with no reversal. Otherwise, I am a healthy and physically active guy rapidly approaching 70 and generally enjoying retirement along with my wife of 49 years. (Kent Pollock, 2/20)

San Jose Mercury News: Bring Sanity To Gun Policy For The Mentally Ill
Part of the stigma associated with mental illness is the notion that the mentally ill are uniformly dangerous. It doesn’t help that any time there is a mass shooting, the immediate response is the perpetrator must be crazy. This sad lack of knowledge about the mentally ill is perhaps only eclipsed by our lack of understanding of the underlying causes of gun violence. When the two issues collide, the result is legislative mayhem. (2/20)

Boston Globe: Listening To A Doctor About His Pain 
The opioid epidemic has led to what [Paul] Konowitz believes is a well-intentioned but misguided change in the way doctors prescribe pain medication. Or, more specifically, the way they avoid prescribing pain medication. He thinks there has been an overreaction, an overcorrection, so that many people who really need medication for pain are not getting it. There is evidence backing his theory. (Kevin Cullen, 2/20)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

‘Tsunami’ Of Alzheimer’s Cases Among Latinos Raises Concerns Over Costs, Caregiving

SACRAMENTO, Calif. — Florence Marquez liked to describe herself as a cannery worker, even though she was best known in her heavily Latino East San Jose neighborhood as a community activist.

She strode alongside Cesar Chavez in the farmworker movement during the 1960s and 70s. She helped build affordable housing for poor families near her local church.

But eight years ago, Florence, now 86, couldn’t find her way to the house she had lived in for 50 years. “That’s when we knew she needed 24-hour care,” said her oldest daughter, Barbara Marquez, 61.

Florence was diagnosed with Alzheimer’s disease, which robbed her of her memory and her fierce independence. Across the United States, stories like hers are becoming more common, particularly among Latinos — the fastest growing minority in the country.

With no cure in sight, the number of U.S. Latinos with Alzheimer’s is expected rise by more than eight times by 2060, to 3.5 million, according to a report by the USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network.

Advanced age is the leading risk factor for Alzheimer’s disease and the likelihood of developing Alzheimer’s doubles about every five years after age 65. As a group, Latinos are at least 50 percent more likely than whites to have Alzheimer’s, in part because they tend to live longer, the report notes.

Barbara Marquez visits her mother Florence Marquez at her nursing home on Friday, December 16, 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

Barbara Marquez visits her mother Florence Marquez at her nursing home, Sagebrook Senior Living, in Carmichael, Calif., in December 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

“This is an incoming tsunami,” said Dr. William Vega, one of the report’s authors and the Roybal Institute’s executive director. “If we don’t find breakthrough medication, we are going to be facing a terrible financial crisis.”

That tidal wave of Alzheimer’s cases is prompting some tough conversations in Latino families, who often pride themselves on caring for elders at home, rather than placing them in nursing homes.

Those talks come with a lot of guilt, Barbara said. Until recently, Barbara was her mother’s primary caregiver. Her sister and brother helped out.

“But it was more than I could have anticipated,” Barbara said, recalling sleepless nights as she tried to make sure Florence didn’t get up and wander off. “It impacts your health, it impacts your marriage. So we looked for help.”

About 1.8 million Latino families nationwide care for someone with Alzheimer’s and other types of dementia. And while the Roybal report shows that Latino families are less likely than whites to use formal care services, such as nursing home care, institutionalized care is becoming more common among these families.

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Between 1999 and 2008, the number of elderly Latinos living in U.S. nursing homes grew by about 55 percent, a rate that outpaced the growth of the overall Latino population during that time, according to research published in July 2011 in Health Affairs.

That can be costly. Nationwide, the average cost for basic services in an assisted living facility is $43,200 per year, according to the Alzheimer’s Association. Yearly nursing home care now averages more than twice that, at slightly more than $92,000.

For many Latino families, getting outside help isn’t an option. It’s often too expensive for seniors who aren’t eligible for Medi-Cal, California’s version of the Medicaid program for low-income people, which generally pays for nursing home care. Immigrants who are in the country unlawfully do not qualify for it, nor do people whose incomes are too high.

Florence’s children decided to take their mother out of her house in San Jose, and they brought her to live with her daughter Barbara in Fair Oaks, just outside Sacramento. They sold the San Jose house, thinking it would help pay for institutionalized care should their mom need it down the road.

She did not qualify for Medi-Cal, so she lived with Barbara for about three years. But after trying out a senior day care program outside of the house at a cost of about $78 a day, Barbara and her family placed Florence in a senior home in the Sacramento suburb of Carmichael, where she has been living for the past year.

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Dwindling Resources

The decision to institutionalize Florence Marquez left her children feeling both guilty and overwhelmed by the steep expense. Her care now costs $3,000 to $4,000 per month, they said. They pay extra for specialized services.

They had the proceeds from the sale of Florence’s house, “but those resources are dwindling,” Barbara said. “What do we do when that money is gone?”

Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

Florence Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

The Roybal study estimates that the cumulative economic impact of Alzheimer’s among Latinos will hit $2.35 trillion by 2060. That figure includes the costs of medical and long-term care, as well as the lost earnings of family members who provide unpaid in-home care, and of the Alzheimer’s victims themselves, according to the study.

Gustavo Lopez of Chicago cares for his mother, Agustina Lopez, 76, who was diagnosed with Alzheimer’s disease seven years ago.

Gustavo, 48, and his four siblings looked into assisted living but couldn’t afford it. Agustina, after moving between her children’s homes, eventually landed with Gustavo, her youngest.

When Gustavo first took on the role of primary caregiver, his mother still did most things on her own, he said. But she now relies on him to help her eat, bathe, dress and take her medication.

So Gustavo needs a job with flexible hours. He’s worked mostly as a waiter. Other employment opportunities have come his way, some with better pay, but caring for his mother comes first, he said.

Asking For Help

Gustavo does get some help from family friends who check in on his mom while he is at work. He also found Casa Cultural in Chicago, a social service agency that offers a day program for seniors. He can drop his mom off at the center for a few hours, giving him a respite.

Free or low-cost programs like these are available in many communities, but families need to do research and ask for help, said Constantina Mizis, president of the Chicago-based Latino Alzheimer’s and Memory Disorders Alliance.

The alliance, formed in 2009, focuses on family members who are primary caregivers. Mizis said she has met many caregivers who are near their breaking point. The nonprofit offers training for them, helps find resources to boost their own well-being and puts on community events for families.

When seeking support, the best place to start is at a local community group or center — a church, a nonprofit, a United Way office, or the local Alzheimer’s Association chapter, for example, Mizis said. These groups will most likely refer caregivers to a county’s Agency on Aging or a state’s Department of Aging.

There, families are assigned a social worker who can discuss what benefits are available. If an Alzheimer’s patient qualifies for Medicaid, these benefits could include caregiver training and payment through programs such as California’s In-Home Supportive Services. But benefits and eligibility vary by state.

In 2010, the Social Security Administration recognized early-onset Alzheimer’s as a medical condition eligible for disability income. That could help people whose Alzheimer’s disease is diagnosed before the age of 65, but many Latino families aren’t aware the program exists, Mizis said.

A Push For Awareness

Because Latinos are more likely to use informal and more affordable care options, the Roybal report calls for improving training and resources for families in both English and Spanish.

Among the caregivers who opt to keep a parent with Alzheimer’s at home is Julia Garcia, of Houston, Texas. She rotates with her three daughters to watch her mother, Marcela Barberena, 85, who was diagnosed with the disease last year.

Julia, who had been unfamiliar with Alzheimer’s, initially thought her mother’s forgetfulness and childlike behavior was due to age.

“Too often people will see Alzheimer’s as a result of old age, but this brain-deteriorating disease is not natural,” said Vega, co-author of the report.

Julia Garcia said she realized it was something more serious when her mother took a shuttle bus from Houston’s international airport without knowing her destination.

“We had agreed I’d pick her up, but she left on her own,” Julia said. “She ended up downtown. It was the scariest moment of my life.”

As a new caregiver, Julia reached out to her local Alzheimer’s Association chapter for information. While some resources are available in Spanish in the Houston chapter, Julia noticed very few Latinos attending the informational workshops or classes.

Barbara Marquez takes her mother, Florence Marquez, on a walk on Friday, December 16, 2016. (Heidi de Marco/KHN)

Barbara Marquez takes her mother, Florence Marquez, on a walk. (Heidi de Marco/KHN)

Spanish-language media provided little information about the disease. “You rarely hear anything about it on TV or the radio,” she said.

In addition, many Latinos, including the Marquez, Lopez and Garcia families, are often unaware of clinical trials through which families can gain access to experimental therapies and medications at little or no cost.

Latinos are underrepresented in clinical trials sponsored by the National Institutes of Health: They account for 17 percent of the U.S. population but only 7.5 percent of participants at the 32 NIH-funded Alzheimer’s research centers across the country, according to the Roybal study.

Latino volunteers for these trials are important in helping researchers develop Alzheimer’s treatments that work for all ethnic groups, the report says.

“This is why it is so important to invest in the education of these communities,” Mizis said.

Her group helps train promotoras, or community health educators, in regions with large Latino communities — including San Francisco, Los Angeles, Baltimore and New York. Going door-to-door, promotoras educate families about the disease.

“I see firsthand everyday how much help our communities need,” Mizis said. “And this need keeps growing.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Categories: Aging, California Healthline, Mental Health, Public Health, Syndicate

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El “tsunami” de casos de Alzheimer entre latinos plantea inquietudes sobre el cuidado y los costos

SACRAMENTO, Calif. — A Florence Márquez le gustaba describirse a ella misma como una trabajadora de fábrica de conservas, a pesar que era conocida en su latinísimo vecindario del este de San José como una activista comunitaria.

Ella caminó junto a César Chávez en el movimiento de trabajadores agrícolas durante los años 60 y 70. Ayudó a construir viviendas asequibles para familias pobres cerca de su iglesia local.

Pero hace ocho años, Florence, ahora de 86, no pudo encontrar su camino a la casa en la que había vivido durante 50 años. “Fue cuando supimos que necesitaba atención las 24 horas”, dijo su hija mayor, Barbara Márquez, de 61 años.

Florence fue diagnosticada con la enfermedad de Alzheimer, que le robó su memoria y su feroz independencia. A lo largo de los Estados Unidos, historias como Florence Márquez se están convirtiendo en más comunes, particularmente entre los latinos, la minoría de más rápido crecimiento en el país.

Sin una cura a la vista, se espera que el número de latinos con Alzheimer aumente más de ocho veces para 2060, a 3.5 millones, según un informe del Edward R. Roybal Institute on Aging de la Universidad del Sur de California (USC) y de la red Latinos Against Alzheimer.

La edad avanzada es el principal factor de riesgo para la enfermedad de Alzheimer y la posibilidad de desarrollar el mal se duplica cada cinco años después de los 65. Los latinos son al menos 50% más propensos que los blancos no hispanos a tener Alzheimer, en parte porque viven vidas más largas, destaca el informe.

Barbara Marquez visits her mother Florence Marquez at her nursing home on Friday, December 16, 2016. Barbara was her mother’s primary caregiver until the family decided to put their mother in a 24-hour care facility. (Heidi de Marco/KHN)

Barbara Marquez, de 61 años, visita a su madre, Florence Marquez, de 85, en el hogar Sagebrook Senior Living, en Carmichael, Calif., el viernes 16 de diciembre de 2016. (Heidi de Marco/KHN)

“Este es un tsunami en marcha”, dijo el doctor William Vega, uno de los autores del informe y director ejecutivo del Roybal Institute. “Si no encontramos medicamentos innovadores, vamos a enfrentar una terrible crisis financiera”.

Esa marea de casos de Alzheimer está provocando algunas conversaciones difíciles en las familias latinas, que a menudo se enorgullecen de cuidar a sus ancianos en casa, en lugar de ponerlos en hogares para adultos mayores.

Esas charlas se presentan con mucha culpa, dijo Barbara Márquez. Hasta hace poco, Barbara era la principal cuidadora de su madre. Su hermana y su hermano ayudaban.

“Pero fue más de lo que yo podría haber previsto”, dijo Barbara, recordando las noches sin dormir mientras intentaba asegurarse de que Florence no se levantara y escapara. “Afecta tu salud, tu matrimonio. Así que buscamos ayuda”.

Alrededor de 1,8 millones de familias latinas en todo el país cuidan a alguien con Alzheimer y otros tipos de demencia, y mientras que el informe de la USC muestra que las familias latinas tienen menos probabilidades que los blancos no hispanos de usar servicios de atención formales, como un hogar, el cuidado institucionalizado se está convirtiendo en una opción más popular entre estas familias.

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Entre 1999 y 2008, el número de latinos seniors que vivían en hogares aumentó un 55%, una tasa que superó el crecimiento de la población latina en general durante ese período de tiempo, según una investigación publicada en julio de 2011 en Health Affairs.

A nivel nacional, el costo promedio de los servicios básicos en un centro de asistencia es de $43,200 al año, según la Asociación de Alzheimer. Los cuidados anuales en hogares de ancianos son, en promedio, unos $92,000, más del doble.

Para muchas familias latinas, obtener ayuda externa no es ni siquiera una opción. A menudo es demasiado costoso para las personas mayores que no son elegibles para el Medi-Cal, la versión de California del Medicaid para personas de bajos ingresos, que generalmente paga por el cuidado de enfermería en hogares de ancianos. Los inmigrantes que están en el país ilegalmente no califican, ni tampoco las personas cuyos ingresos son demasiado altos.

Después de probar un programa de cuidado de ancianos fuera de la casa a unos $78 al día, Barbara y su familia pusieron a Florence en una residencia para ancianos de la zona de Sacramento, donde ha estado viviendo durante el último año.

 Recursos en baja

La decisión de institucionalizar a Florence Márquez dejó a sus hijos no sólo sintiéndose culpables, sino también con una economía tambaleante por los elevados gastos. El cuidado de su mamá ahora cuesta de $3,000 a $4,000 por mes, dijeron. Pagan extra por servicios especializados.

Florence actualmente no califica para el Medi-Cal, por lo que la familia Márquez vendió la casa de su madre en San José para pagar por su atención. “Pero esos recursos están disminuyendo”, dijo Barbara. “¿Qué vamos a hacer cuando se acabe el dinero?”.

El informe de la USC estima que el impacto económico acumulado de la enfermedad de Alzheimer entre los latinos llegará a $ 2,35 mil billones en 2060. Esta cifra incluye los costos de atención médica y de largo plazo, así como la pérdida de ingresos de los miembros de la familia, y de las propias víctimas del Alzheimer, según el estudio.

Gustavo López, de Chicago, se preocupa por su madre, Agustina López, de 76 años, diagnosticada con la enfermedad de Alzheimer hace siete años.

Gustavo, de 48 años, y sus cuatro hermanos buscaron un centro de asistencia, pero no pudieron solventarlo. Agustina, después de vivir en las casas de todos sus hijos, eventualmente se quedó con Gustavo, el más joven.

Marquez, 85, was diagnosed with Alzheimer’s disease eight years ago. She lived in the same house for 50 years, but one day she couldn’t find her way back home. (Heidi de Marco/KHN)

Florence Marquez, de 85, fue diagnosticada con Alzheimer hace 8 años. Marquez vivió en la misma casa por 50 años, pero un día no pudo encontrar el camino a su hogar. (Heidi de Marco/KHN)

Cuando Gustavo asumió por primera vez el papel de cuidador principal, su madre todavía hacía la mayoría de las cosas por su cuenta, dijo. Pero ahora depende de él para comer, bañarse, vestirse y tomar su medicación.

Así que Gustavo necesita un empleo con horario flexible. Ha estado trabajando principalmente como camarero. Han aparecido otras oportunidades de empleo, algunos con mejor salario, pero el cuidado de su madre está primero, dijo.

 Pidiendo ayuda

Gustavo recibe ayuda de amigos de la familia que vigilan a su madre mientras está en el trabajo. También encontró Casa Cultural en Chicago, una agencia de servicios sociales que ofrece un programa de día para personas mayores. Puede dejar a su mamá en el centro por unas horas, lo que le da un respiro.

Programas gratuitos o de bajo costo como éstos están disponibles en muchas comunidades, pero las familias necesitan investigar y pedir ayuda, dijo Constantina Mizis, presidenta de la Latino Alzheimer’s and Memory Disorders Alliance, con sede en Chicago.

La alianza, formada en 2009, se centra en los miembros de la familia que son los principales cuidadores. Mizis dijo que ha conocido a muchos cuidadores que están al borde de quebrarse. La organización sin fines de lucro les ofrece capacitación, ayuda para encontrar recursos para impulsar su propio bienestar, y participación en eventos comunitarios para las familias.

Al buscar apoyo, el mejor lugar para comenzar es en un grupo o centro comunitario local: una iglesia, una organización sin fines de lucro, una oficina de United Way o el capítulo local de la Asociación de Alzheimer, por ejemplo, dijo Mizis. Es probable que estos grupos refieran a los cuidadores a la Agencia de Envejecimiento del condado o al Departamento de Envejecimiento del estado.

Allí, se les asigna a las familias un trabajador social que puede discutir qué beneficios están disponibles. Si un paciente de Alzheimer califica para Medicaid [Medi-Cal en California], estos beneficios podrían incluir capacitación para cuidadores y pago a través de programas de “efectivo y consejería”. Los Servicios de Apoyo en el Hogar de California es uno de esos programas. Sin embargo, los beneficios y la elegibilidad varían según el estado.

En 2010, la Administración del Seguro Social reconoció al Alzheimer de inicio temprano como una condición médica elegible para los ingresos por discapacidad. Eso podría ayudar a las personas cuya enfermedad de Alzheimer se diagnostica antes de los 65 años, pero muchas familias latinas no son conscientes de esto, dijo Mizis.

Un impulso para la concientización

Debido a que los latinos son más propensos a usar opciones de atención informales y más asequibles, el informe de la USC pide mejorar la capacitación y los recursos para las familias, tanto en inglés como en español.

Entre los cuidadores que optan por mantener a un padre con Alzheimer en casa está Julia García, de Houston, Texas. Ella se rota con sus tres hijas adolescentes y adultas para cuidar a su madre, Marcela Barberena, de 85 años, quien fue diagnosticada con la enfermedad el año pasado.

Julia, que no estaba familiarizada con el Alzheimer, pensó que el olvido y el comportamiento infantil de su madre se debían a la edad.

“Demasiado a menudo la gente ve al Alzheimer como resultado de la vejez, pero la enfermedad que deteriora el cerebro no es natural”, dijo Vega, coautor del informe de la USC.

Barbara visits her mother almost every weekend. Her mother's care now costs $3,000 to $4,000 per month, says Barbara. (Heidi de Marco/KHN)

Barbara Marquez saca a pasear a su madre, Florence Marquez, el viernes 16 de diciembre de 2016. (Heidi de Marco/KHN)

Julia García dijo que se dio cuenta de que era algo más serio cuando su madre tomó un micro desde el aeropuerto internacional de Houston sin saber su destino.

“Habíamos acordado que la recogería, pero ella se fue por su cuenta”, dijo Julia. “Terminó en el centro de la ciudad. Fue el momento más espantoso de mi vida”.

Como nueva cuidadora, Julia se acercó a la sede local de la Asociación de Alzheimer para obtener información. Aunque algunos recursos están disponibles en español en el capítulo de Houston, Julia notó que muy pocos latinos asistían a los talleres informativos o a las clases.

Lo mismo ocurre con los medios en español, que proporcionan poca información sobre la enfermedad. “Rara vez se oye nada en la televisión o en la radio”, dijo.

Muchos latinos, incluyendo las familias de Márquez, López y García, no saben sobre los ensayos clínicos y cómo pueden ayudar a sus seres queridos.

Los latinos están subrepresentados en los ensayos clínicos patrocinados por los Institutos Nacionales de Salud: representan el 17 por ciento de la población de los Estados Unidos, pero sólo el 7,5 por ciento de los participantes en los 32 centros de investigación de Alzheimer financiados por los INS en todo el país, según el informe de Roybal.

Los voluntarios latinos son importantes para ayudar a los investigadores a desarrollar tratamientos para el Alzheimer que funcionen para todos los grupos étnicos, según el informe de USC.

“Por eso es tan importante invertir en la educación de estas comunidades”, dijo Mizis.

Su grupo ayuda a entrenar promotoras o educadores comunitarios de salud en regiones con grandes comunidades latinas, incluyendo San Francisco, Los Ángeles, Baltimore y Nueva York. Al ir de puerta en puerta, las promotoras educan a las familias sobre la enfermedad.

“Veo de primera mano cuánto necesitan ayuda nuestras comunidades”, dijo Mizis. “Y esta necesidad sigue creciendo”.

Esta historia fue producida por Kaiser Health News, que publica California Healthline, un servicio editorial independiente de la California Health Care Foundation.

Categories: Aging, Mental Health, Noticias En Español, Public Health, Syndicate

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Right-To-Die Fight Hits National Stage

Opponents of aid-in-dying laws are claiming a small victory. They won the attention of Congress this week in their battle to stop a growing movement that allows terminally ill patients to get doctors’ prescriptions to end their lives.

The Republican-led effort on Capitol Hill to overturn the District of Columbia’s aid-in-dying law could fail by Friday. But advocates worry the campaign will catalyze a broader effort to fully ban the practice, which is legal in six states and being considered in 22 more.

“The D.C. legislation has catapulted the issue of medical aid in dying onto the federal agenda at a time when Congress has the power to enact a ban on this end-of-life care option nationwide — even criminalizing the practice in the six states where this option is currently authorized,” warned Jessica Grennan, national director of political affairs and advocacy for Compassion & Choices, which supports right-to-die laws.

“If that happens, it will set the end-of-life care movement back to the last century,” Grennan said.

No matter how the effort plays out, both sides agree that the debate on Capitol Hill, featuring a Republican moral protest, could be only a taste of what’s to come.

In a vote that hewed closely to party lines, the Republican-controlled House Oversight Committee on Monday approved a bill that would knock down D.C.’s law, which won approval from the mayor and City Council in December. While D.C.’s law mirrors those passed in other states, Congress has unique power to intervene in D.C.’s affairs. Under the Home Rule Act of 1973, Congress has 30 legislative days to overturn any law D.C. passes.

“It’s of deep, personal moral conviction that I stand in opposition” to D.C.’s law, said Rep. Jason Chaffetz of Utah, who chairs the committee, in Monday’s hearing.

The clock is running out on his effort. Republicans in the House and Senate have introduced joint resolutions attempting to block D.C.’s law, but the bills would need to pass the full House and Senate and gain President Donald Trump’s signature. Trump has declined to take a public stance on the matter. If those steps don’t happen by Friday, D.C.’s law will take effect.

Dr. David Stevens, CEO of the Christian Medical & Dental Associations, which opposes medical aid in dying, said even if Republicans fail to overturn D.C.’s law, their efforts may have broader impact.

“As representatives and senators become more educated about the dangers of physician-assisted suicide,” Stevens said, “I wouldn’t be surprised” if members of Congress introduce laws to “prohibit or at least more closely regulate” the practice.

(Courtesy of Amazon.com)

(Courtesy of Amazon.com)

If Congress passes such a law, the only hope for advocates such as Grennan “would be for the Supreme Court to intervene,” she said. But she noted that Trump’s pick for the Supreme Court, Neil Gorsuch, a federal appellate judge on the U.S. Court of Appeals for the 10th Circuit, has published a book against aid-in-dying efforts. The book, she said, notes “the Supreme Court’s power to overturn the state medical aid-in-dying laws.”

Away from Capitol Hill, the aid-in-dying movement has gained steam: The practice is legal in Oregon, Washington, Vermont, Colorado, California and Montana.

Energized by victories in California and Colorado last year, aid-in-dying supporters are pushing ahead to battlegrounds nationwide. So far this year, 21 states have introduced aid-in-dying legislation, according to Compassion & Choices. And in South Dakota, proponents are trying to get the practice approved through a ballot initiative.

Hawaii, Maryland and Maine appear the most likely to pass new legislation this year, said Peg Sandeen, executive director of the Death With Dignity National Center, another national advocacy group.

But opponents have beaten back similar measures in many states in recent years. And in Alabama, South Dakota and New York, they have gone on the offensive, introducing bills to preemptively outlaw the practice or prohibit insurance from paying for the lethal drugs.

Chaffetz, who is leading the charge to overturn D.C.’s law, has enraged Democrats and D.C. officials, who accuse him of overreaching his power by meddling in local affairs. But Chaffetz and fellow House Republicans at Monday’s vote said moral concerns trump local autonomy.

“Only God gets to decide” when a person’s life ends, declared Rep. Paul Mitchell, a Michigan Republican, during the debate.

If Republicans fail this week, they could attack D.C.’s Death With Dignity law in April, when Congress approves D.C.’s proposed budget. D.C. has proposed to spend some local money to build a database tracking the assisted-dying program.

Republican Sen. James Lankford of Oklahoma, who introduced the Senate resolution blocking the bill, also made a legal argument, citing a 1997 law passed under President Clinton that bans the use of federal money for physician-assisted death. Because of that law, Medicare and the Department of Veterans Affairs do not pay for the lethal drugs, so patients must pay out-of-pocket or use private or state-funded insurance. Lankford challenged D.C. to show that its assisted-dying program wouldn’t conflict with that law.

Advocates dismissed that argument. Sandeen, of the Death With Dignity National Center, said D.C.’s program will not use any federal money to help people die. She called the legal argument a “red herring effort,” aimed at distracting attention from politicians’ true reasons for trying to strike down D.C.’s law.

“I’d rather that they said, ‘For religious purposes, I disapprove of this law,’” she said.

KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.

Categories: Aging, Mental Health, Syndicate

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Dementia Continues To Flummox Drugmakers As It Replaces AIDS As One Of World’s Top Killers

In 2015 the disease claimed double the amount of lives it did in 2000, but promising treatment after promising treatment fail in trials.

Bloomberg: Dementia Joins Ranks Of Top Global Killers With No Drug In Sight 
Dementia has unseated AIDS as one of the world’s top killers, new figures from the World Health Organization show, as drugmakers struggle to either curb or cure it. Alzheimer’s disease and other forms of dementia killed 1.54 million people in 2015, more than twice the number of deaths from the disease in 2000, according to documents posted on the WHO website last month. It replaced HIV/AIDS as No. 7 on the global health watchdog’s list of the 10 biggest causes of death worldwide. New therapies helped push fatalities from HIV/AIDS from 1.5 million down to 1.1 million over the same 15-year period. (Kresge, 2/15)

California Healthline: An Alzheimer’s ‘Tsunami’ Threatens Latinos
The number of Alzheimer’s cases is growing rapidly across the entire U.S. population, and could nearly triple by 2050 to 13.8 million, according to the Alzheimer’s Association. But the increase is particularly striking among Latinos, who as a group are at least 50 percent more likely than non-Hispanic whites to develop the disease, according to a report by the University of Southern California’s Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network. That’s in part because Latinos live longer, on average, than whites and also because they are more likely to suffer from certain chronic conditions that put them at greater risk for Alzheimer’s, the report says. Compounding the challenge, the report notes, is the fact that the elderly population is growing three times faster among Latinos. (de Marco and Ibarra, 2/16)

Meanwhile, former President Barack Obama’s Precision Medicine Initiative is likely to continue under the new administration —

Stat: Obama’s ‘Big Science’ Initiatives Will Keep Rolling Under Trump, AAAS Leaders Predict
The big research initiatives launched by President Barack Obama should have enough momentum to keep rolling in the coming years, even if President Donald Trump doesn’t prioritize them, leading advocates for science said Wednesday. Obama, a self-described “science geek,” announced the BRAIN Initiative, which aims to dive down to the cellular level to understand the workings of the human brain, in 2013. The Precision Medicine Initiative came two years later; it seeks to collect detailed health data from at least a million volunteers to fuel research on a variety of diseases. Both projects are housed in the National Institutes of Health. (Simon, 2/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Ga.’s ‘Surprise’ Medical Bill Legislation Hits Snag; Mass. Commission Urges State To Up Oversight Of Hospital Rates

Outlets report on news from Georgia, Massachusetts, Minnesota, Connecticut, Texas, Michigan, Kansas, California, Maine and Florida.

Georgia Health News: Proposal To End ‘Surprise’ Billing Tied Up Over Payment Formula 
The major snag is a lack of agreement on a formula to determine reimbursement rates for doctors, said Sen. Renee Unterman, the bill’s sponsor, at a legislative hearing Tuesday. Unterman, a Republican from Buford, is also a nurse and has been concerned about the problem for a long time. Surprise medical bills can come from ER doctors, anesthesiologists, radiologists, pathologists and others who are not in a patient’s insurance network — even though the hospital where they work is in the network. (Miller, 2/14)

Boston Globe: Special Panel Recommends Regulating Hospital Rate Increases
Commissioners said the Division of Insurance should have greater authority to oversee hospital-insurer contracts, including the amount hospital rates can increase each year. The controversial proposal comes after months of discussions at the commission, which was convened to study the wide variation in prices at Massachusetts hospitals. Studies have shown that price disparities contribute to higher health spending because the most expensive providers also tend to have the top reputations and attract the most patients. (Dayal McCluskey, 2/15)

The Star Tribune: Nursing Strikes Cost Allina $149 Million
Two contentious nursing strikes cost Allina Health more than $149 million last year — wiping out the year’s operating revenues for the Minneapolis-based hospital and clinic system. More than 4,000 nurses struck twice — for seven days in June and again for 37 days in the fall — after Allina demanded that they give up a union-backed health insurance plan and accept the same coverage offered other employees. (Olson, 2/14)

Georgia Health News: Flu Misery Continues Across The State 
The Department of Public Health said that through the week of Jan. 29 through Feb. 4, there had been 376 hospitalizations in metro Atlanta due to influenza so far this season. That’s up from 61 at the same time a year ago. The state reported last Friday that it had two confirmed flu-associated deaths this season, the same number as the same period a year ago. (Miller, 2/14)

Boston Globe: On Beacon Hill, A Fight Between Dentists, Hygienists 
Advocates for hygienists say that poor and disabled people, often minority children, struggle to find good dental care because of a shortage of dentists willing to serve them. The group is pushing for a new class of advanced hygienists, sort of nurse practitioners for the mouth, who could offer the kind of help that they say these patients aren’t getting. Traditional dentists, though, said such a role would endanger rather than help the poor by putting them in the hands of people who lack proper training and skills. (Krantz, 2/15)

Pioneer Press: Kids In Need Getting Free Sealants, Dental Care This Month 
Community Dental Care Program director Ann Copeland said it’s important for immigrant populations to see a diverse, welcoming staff. Copeland said 83 percent of their clients are on public assistance, and 8 percent are uninsured. More than half are children. Many of the refugee populations qualify for public assistance but have trouble navigating the healthcare system due to language and cultural barriers. Some are unfamiliar with modern dental hygiene, such as fluoride treatments, or don’t realize that soda contains sugars and acids that can lead to tooth decay. Legal status can also be a barrier. Some Mexican-American families are undocumented and resist applying for public assistance and making their presence known to state and county government, Copeland said. (Melo, 2/14)

The CT Mirror: With Demand Already Up, Free Clinics Anticipate More Need 
AmeriCares Free Clinics opened a new facility to treat the uninsured in Stamford last month, it didn’t take long to see what Executive Director Karen Gottlieb called the “unmet need.” And Gottlieb figures that need will grow. Like others in health care, she and her counterparts at other free clinics are watching closely as Congress and President Trump look to repeal and replace the federal health law, and change how Medicaid is funded. (Levin Becker, 2/15)

The Star Tribune: That’s A Wrap: New Gowns Make Their Way Into Local Hospitals 
Following months of study, officials with Methodist Hospital in St. Louis Park have decided to adopt new hospital gowns that feature sharper colors, a different mix of fabrics and a design that aims to keep patient posteriors under wraps. The key difference: Patients tie new gowns closer to their sides, so there’s less straining with knots at the middle of their backs. In focus groups, patients told hospital officials they feel exposed with current hospital gowns. (Snowbeck, 2/15)

Houston Chronicle: CHI St. Luke’s Health Announces New Round Of Layoffs
CHI St. Luke’s Health system has or will be closing four facilities and laying off 89 workers at locations in The Woodlands and Conroe, according to a letter from the Texas Workforce Commission. The Feb. 9 letter announced the CHI St. Luke’s Health Woodlands Ambulatory Surgery Center closed on Jan. 27 and its 7 employees will be laid off effective next month. In addition The health system’s Emergency center in The Woodlands will also close on March 3 and 29 employees will lose their job. The same day the CHI St. Luke’s Health Pinecroft is closing its pharmacy, sleep lab and laboratories, also in The Woodlands, and 27 people there will be laid off. (Deam, 2/14)

Houston Chronicle: Federal Judge’s Order Hits State Hard Over Heat-Related Inmate Deaths 
A federal judge has ruled the Texas prison system and its top leaders must stand trial in a civil rights lawsuit over the heat-related death of an inmate, a sharp rebuke that focused new attention on the deaths of more than 20 other inmates in prison units that lack air-conditioning. The 83-page order by U.S. District Judge Keith Ellison – who personally visited a prison in the summer heat – cites the state’s own records documenting a heat index of about 150 degrees inside the Hutchins State Jail near Dallas where inmate Larry Gene McCollum, 58, a cab driver from Bellmead near Waco, died during a heat wave in 2011. (Banks, 2/14)

KCUR: Court Rules Missouri Corrections Officials Did Not Violate Sunshine Law In Execution Cases 
Missouri corrections officials are not required to disclose the identities of the pharmacists who supply the state’s lethal execution drugs, an appeals court ruled Tuesday. Reversing a lower court judge who had ordered the Department of Corrections to reveal their names, the Missouri Court of Appeals found that the DOC did not violate the state’s Sunshine Law by refusing to provide them. The court cited a Missouri law that gives the director of the DOC discretion to select the members of the execution team, including those who administer the lethal chemicals or gas used in executions and those who provide them with “direct support.” (Margolies, 2/14)

San Jose Mercury News: What It Takes To Open A Senior Care Franchise
People also like the security of buying into a proven concept, which franchising provides, Fagan said. While food has always been a popular franchise model, essential services like home or auto repair, air conditioning and health care are strong franchise options. The projected growth of the elderly population is also fueling strong demand for in-home care, experts say, but it’s no small task to start a franchise in the sector. (Sciacca, 2/14)

The Associated Press: No Further Penalty For Nurse Who Let Patient Go In Snowstorm
The state has lost its effort to impose a greater penalty on a nurse whose license was suspended after letting a disoriented patient leave a hospital during a snowstorm. The 61-year-old patient was found dead the next day just 380 feet from the entrance of Down East Community Hospital in Machias, leading to an investigation of nurse John Zablotny’s actions and an effort by the Maine State Board of Nurses to revoke his license for two years. (2/14)

Tampa Bay Times: Lobbyist Muscle Will Be Major Force In Medical Marijuana Fight
Lobbyists, paid to represent various interests, are normally the ones watching as state lawmakers cast votes, but their interest in pot is so great that the first House subcommittee meeting on the subject was standing-room only. Sergeant-at-arms staffers blocked the door, turning people away. At the final stop in the Department of Health’s statewide tour of public hearings, Chelsie Lyons, a Tallahassee-based activist with Minorities for Medical Marijuana called out the process that will turn Amendment 2 into a state laws and rules governing medical cannabis. (Auslen, 2/14)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Dementia Patients Hold On to Love Through Shared Stories

Photo

Credit Paul Rogers

Can you keep the love light shining after your partner’s brain has begun to dim? Just ask Denise Tompkins of Naperville, Ill., married 36 years to John, now 69, who has Alzheimer’s disease.

The Tompkinses participated in an unusual eight-week storytelling workshop at Northwestern University that is helping to keep the spark of love alive in couples coping with the challenges of encroaching dementia.

Every week participants are given a specific assignment to write a brief story about events in their lives that they then share with others in the group. The program culminates with a moving, often funny, 20-minute written story read alternately by the partners in each couple in front of an audience.

Each couple’s story serves as a reminder of both the good and challenging times they have shared, experiences both poignant and humorous that reveal inner strength, resilience and love and appreciation for one another that can be easily forgotten when confronted by a frightening, progressive neurological disease like Alzheimer’s.

“It’s been an amazing experience for us,” Mrs. Tompkins said of the program. “Creating our story revealed such a richness in our life together and is helping us keep that front and center going forward.”

She added that the program provides “an opportunity to process what you’re going through and your relationship to each other. It helped me digest all the wonderful things about John and how well we relate as a couple, things that don’t go away with Alzheimer’s disease. John is so much more than his disease.”

Ditto for Robyn and Ben Ferguson of Chicago, married 42 years in 2012 when they learned that Ben, a psychologist, had Alzheimer’s disease. “The diagnosis was crushing,” said his wife, who is also a psychologist. “Telling people in the program about it helped us recognize the impact on our lives and relationship and really face that. It made things feel not quite so bad.”

The Fergusons have publicly presented their 20-minute story together 19 times so far, helping to enlighten medical students and those training in social work and pastoral care, as well as researchers and members of the general public. “It reinforces our relationship as a couple, rather than caregiver and patient, even though he is 85 percent dependent on me for the activities of daily living.”

Dr. Ben Ferguson, now 69, said, “I feel we’re giving people information that could be very valuable in their future. It’s helpful to them to see us smile, have a good time and give a good report – as well as a bad report – about what goes on with this disease. It’s helpful for people to hear it from someone who has it, and it’s helped us avoid getting so morose.”

As for their presentations, which they now give almost monthly, his wife said, “They help us stay positive and give us a sense of purpose. We both feel a real need to do advocacy work, and this is the best thing we can do right now. We know there’s a sell-by date on this – we won’t be able to do it forever. But we don’t think about that now. Now we’re focused on helping people understand that your life doesn’t stop with the diagnosis. We want people to hear that you go on with your life, even though you may need a lot of help.”

Another workshop participant, Sheila Nicholes, 76, of Chicago, said of her husband, Luther, who has vascular dementia, that the storytelling “brings him back to being funny again. Writing our story together gave us a way to talk about these things, to think about where we were then and where we are now.”

Noting that dementia is “a very hush-hush illness in our black community,” Ms. Nicholes said she hoped that telling their story would help others speak more openly about it and learn to “just roll with the flow.”

The storytelling workshop, which started in January of 2014, was the brainchild of Lauren Dowden, then an intern in social work at Northwestern’s Cognitive, Neurological and Alzheimer’s Disease Center. She quickly learned from family members in a support group that “their concerns were not being addressed about dealing with loss, not just of memory, jobs and independence, but also what they shared as a couple.”

During the group sessions, Ms. Dowden said, “there’s so much laughter in the room, so much joy and love of life as well as poignancy and tears. As they move forward, as the disease progresses, they can be reminded of who they are, their strength and resilience, what has made their relationship strong, what they loved about the person, as opposed to just being patient and caregiver.”

As the program moves week to week, Ms. Dowden said, “there’s more touching, affection, looking at one another and laughing. There are delightful moments of connection when one member of a couple reveals something the other didn’t know.”

The weekly story assignments require that the couple collaborates, “and they learn how to work together in new ways, how to make adjustments, because they’ll have to make thousands and thousands of adjustments throughout the course of the disease.”

In executing the workshop assignments, Dr. Ferguson said she would ask her husband questions, he would answer and she would write down what he said. “The workshop was really transformative,” she said. “It gave us hope for our future together in dealing with this disease.”

Ms. Dowden said the feedback from those in the audience for the 20-minute joint stories has been heartening. She explained, “Students learn about the biology of neurodegenerative conditions. These stories enable them to see the human side of the disease, what it’s like to live with it, and may help them develop programs that help these families live better. In addition to the stigma, there’s a tendency to write off people with dementia.”

Ms. Dowden said she is currently refining the workshop curriculum so that it can be used as a model for other institutions to replicate. She is also expanding it to include mother-daughter and sibling pairs.

She realizes, of course, that a storytelling workshop may not be suitable for every couple. “It’s not good if there’s a lot of behavioral issues, a lot of conflict, and no insight,” she said. “But for those it does fit, it’s an opportunity to tap into the core of relationships, to still grow and learn and be delighted by one another.”

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Breast-Fed Babies May Have Longer Telomeres, Tied to Longevity

Photo

Credit Roberto Schmidt/Agence France-Presse — Getty Images

Breast-fed babies have healthier immune systems, score higher on I.Q. tests and may be less prone to obesity than other babies.

Now new research reveals another possible difference in breast-fed babies: They may have longer telomeres.

Telomeres are stretches of DNA that cap the ends of chromosomes and protect the genes from damage. They’re often compared to the plastic tips at the end of shoelaces that prevent laces from unraveling. Telomeres shorten as cells divide and as people age, and shorter telomeres in adulthood are associated with chronic diseases like diabetes. Some studies have linked longer telomeres to longevity.

The new study, published in The American Journal of Clinical Nutrition, is a hopeful one, its authors say, because it suggests telomere length in early life may be malleable. The researchers, who have been following a group of children since birth, measured the telomeres of 4- and 5-year-olds, and discovered that children who consumed only breast milk for the first four to six weeks of life had significantly longer telomeres than those who were given formula, juices, teas or sugar water.

Drinking fruit juice every day during the toddler years and a lot of soda at age 4 was also associated with short telomeres.

Socioeconomic differences among mothers can muddy findings about breast-feeding because the practice is more common among more educated mothers. However, this group of children was fairly homogeneous. All of them were born in San Francisco to low-income Latina mothers, most of whom qualified for a government food program.

“This adds to the burgeoning evidence that when we make it easier for mothers to breast-feed, we make mothers and babies healthier,” said Dr. Alison M. Stuebe, an expert on breast-feeding who is the medical director of lactation services at UNC Health Care in Chapel Hill, N.C., and was not involved in the study. “The more we learn about breast milk, the more it’s clear it is pretty awesome and does a lot of cool stuff.”

The study did not establish whether or not breast-feeding enhanced telomere length. It may be that babies born with longer telomeres are more likely to succeed at breast-feeding. A major drawback of the research was that telomere length was only measured at one point in time, when the children were 4 or 5 years old. There was no data on telomere length at birth or during the first few months of life.

“We don’t have a baseline to see if these kids were different when they came out,” Dr. Stuebe said. “It could be that really healthy babies can latch on and feed well, and they already had longer telomeres. It could be successful breast-feeding is a sign of a more robust kid.”

The researchers were following children who were part of the Hispanic Eating and Nutrition study, a group of 201 babies born in San Francisco to Latina mothers recruited in 2006 and 2007 while they were still pregnant. The goal of the research was to see how early life experiences, eating habits and environment influence growth and the development of cardiac and metabolic diseases as children grow.

Researchers measured the babies’ weight and height when the children were born. At four to six weeks of age, they gathered detailed information about feeding practices, including whether the baby had breast milk and for how long, and whether other milk substitutes were used, such as formula, sugar-sweetened beverages, juices, flavored milks and waters. Information was also gathered about the mothers.

Children were considered to have been exclusively breast-fed at 4 to 6 weeks of age if they received nothing but breast milk, as well as medicine or vitamins.

When the children were 4 and 5 years old, researchers took blood spot samples that could be used to measure the telomeres in leukocytes, which are white blood cells, from 121 children. They found that children who were being exclusively breast-fed at 4 to 6 weeks of age had telomeres that were about 5 percent longer, or approximately 350 base pairs longer, than children who were not.

The new findings may help explain the trove of benefits that accrue from breast-feeding, said Janet M. Wojcicki, an associate professor of pediatrics and epidemiology at the University of California, San Francisco, and the paper’s lead author.

“What’s remarkable about breast-feeding is its ability to improve health across organ systems,” Dr. Wojcicki said. “Telomere biology is so central to the processes of aging, human health and disease, and may be the link to how breast-feeding impacts human health on so many levels.”

There are several possible explanations for the correlation between breast-feeding and longer telomeres. Breast milk contains anti-inflammatory compounds, which may confer a protective effect on telomeres. It’s also possible that parents who exclusively breast-feed their babies are more scrupulous about a healthy diet generally.

Yet another possibility is that breast-feeding is a proxy for the quality of mother-child attachment and bonding, said Dr. Pathik D. Wadhwa, who was not involved in the research but studies early-life determinants of health at the University of California, Irvine School of Medicine. “We know from studies looking at telomere length changes in babies who came from orphanages that the quality of the attachment and interaction, and more generally the quality of care that babies receive, plays a role in the rate of change in telomere length,” he said.

When children are exposed to adversity, neglect or violence at an early age, “psychological stress creates a biochemical environment of elevated free radicals, inflammation and stress hormones that can be harmful to telomeres,” said Elissa Epel, one of the authors of the study who is a professor at the University of California, San Francisco, and director of the Aging, Metabolism and Emotions Lab.

“The idea that breast-feeding may be protective for telomeres is heartening because we don’t know much about what’s going to help protect them in children, besides avoiding toxic stress. And boy, do we want to know,” Dr. Epel said.

Although genes can’t be changed, Dr. Epel said, “This is part of the genome that appears to be at least partly under personal control.”

Meet the Super Flasher: Some Menopausal Women Suffer Years of Hot Flashes

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Credit Kim Murton

What kind of hot flasher are you?

The hot flash — that sudden feeling of warmth that can leave a woman flushed and drenched in sweat — has long been considered the defining symptom of menopause. But new research shows that the timing and duration of hot flashes can vary significantly from woman to woman, and that women appear to fall evenly into four hot-flash categories.

Some women, called “early onset” hot flashers, begin to experience hot flashes long before menopause. Symptoms can begin five to 10 years before a woman’s last period, but the symptoms stop with the end of the menstrual cycle.

Then there are women who don’t experience their first hot flash until after menopause, the “late onset” hot flasher. And some women fall into a group the researchers called the “lucky few.” Some of these women never experience a single hot flash, whereas others briefly suffer only a few flashes when they stop menstruating.

And then there are the “super flashers.” This unlucky group includes one in four midlife women. The super flasher begins to experience hot flashes relatively early in life, similar to the early onset group. But her unpleasant symptoms continue well past menopause, like those in the late onset group. Her symptoms can last 20 years or more.

The findings come from the Study of Women’s Health Across the Nation, or SWAN, a 22-year-old study that has been tracking the physical, biological and psychological health of 3,302 women from a variety of racial and ethnic backgrounds. The study is being conducted at seven research centers around the country and is paid for by the National Institutes of Health.

“It explodes our typical myth around hot flashes, that they just last for a few years and everyone follows the same pattern,” said Rebecca Thurston, the senior author and a professor of psychiatry and epidemiologist at the University of Pittsburgh. “We may be able to better help women once we know in what category they are more likely to fall.”

That includes women like Lynn Moran, a 70-year-old retired financial planning assistant who lives near Pittsburgh and falls into the “super flasher” category. She remembers having her first hot flash around the age of 47. While the symptoms were subtle at first, soon the hot flashes became more bothersome. “It was enough to wake me up out of a sound sleep,” she said. “I wasn’t sleeping well because they were coming all night long and during the day. I was just miserable.”

Ms. Moran began hormone therapy, which helped but did not eliminate the symptoms. But when medical studies began to show health risks associated with the treatment, her doctor advised her to stop using hormones. She waited another 18 months until she retired, then stopped taking hormones in 2005.

The hot flashes “came back with a vengeance” and haven’t stopped since.

“I still have them. I still laugh about them,” she said, noting that she may experience several hot flashes a day. “I’ll be trying to get ready to go somewhere, curling my hair and have to redo everything and dry my hair again because I’ll be drenched. My makeup will literally run down my face. Here I am, 70 years old, complaining of hot flashes.”

Dr. Thurston notes that understanding variations on hot flashes is important to understanding women’s health in midlife. A 2012 study, published in the journal Obstetrics and Gynecology, suggested that the timing and duration of hot flashes may be an indicator of a woman’s cardiovascular health. The study found that frequent hot flashes were associated with higher cholesterol markers, particularly in thin women.

The latest findings from the SWAN study identified some patterns around the four subsets of women who experienced varying degrees of hot flashes. Women were distributed about equally among the groups, meaning 75 percent of women experienced some degree of hot flashes, while only 25 percent escaped the symptom.

Women in the early onset group were more likely to be white and obese. Women in the late onset group tended to be smokers. The lucky few women who had no hot flashes or only a few were more often Asian women and women in better health. The super flashers were more likely to be African-American, to be in poorer health and to consume alcohol. But the researchers cautioned that while they identified some statistical trends in each group, it’s important to note that each subset of hot flashers included a variety of women representing all races, ethnicities, body weights and health categories. No one factor appeared to determine a woman’s risk for any hot flash category.

For instance, while African-American women were three times as likely to be in the super flashers group, they represented only 40 percent of that group. The remaining 60 percent were white women, some Asian women and other groups.

Dr. Thurston said it is important that doctors understand that 75 percent of women have hot flashes in midlife and that they persist in at least one in four..

“It flies in the face of the traditional wisdom that women have these symptoms for three to five years around the final menstrual period,” she said. “We now know that is patently wrong.”

Talking to Younger Men About Growing Old

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For Robert Goldfarb, 85, resisting the decline of old age goes beyond the treadmill.

For Robert Goldfarb, 85, resisting the decline of old age goes beyond the treadmill.Credit

An electronic display on the treadmill in my local gym reminds me I’m not only running on the machine, but out of time. Its graph comparing changes in the runner’s heart rate to that of peers goes no further than age 70. I’m 85, and find it ominous that the machine presumes that anyone that old shouldn’t be on the thing.

Reminders that I’m now officially one of the old-old appear with greater frequency. Some are subtle, like the treadmill display; others are more jarring, like my daughter’s approaching 60th birthday. Most reminders are well-meaning: a young woman offering her seat on a bus, an airport employee hurrying over with a wheelchair, happily telling me I won’t have to walk to the gate or stand in line. I graciously decline their kindness, struggling not to protest, “But, I’m a competitive runner!” That I feel robust doesn’t matter; the man I see and the man they see are two very different people.

I recently read something the philosopher Montaigne wrote over 400 years ago: “The shorter my possession of life, the deeper and fuller I must make it.” His words inspired me to seek a path through old age without surrendering to it or ignoring its reality.

I began by fighting memory lapses. Rather than substituting “whatever” for an elusive word, I now strain to recall that word, even if means asking others to bear with me for a bit. I avoid phrases that suggest the end of things, like “downsizing” or “I no longer do that.” I subscribe to internet memory games. To recapture the excitement I felt in long-ago classrooms, I began rereading books I read in college.

I also decided to reach out to men my age to learn how they navigate through growing old. Like most of the men I began speaking with, I’m a product of the 1950s and its pressure to conform, to avoid risk, to shun anything that marked one as “different.” Many young people then were warned by parents that signing petitions bearing words like “protest” or “progressive” would get them rejected for a job or fired when they grew up. Men in my platoon didn’t embrace when we parted after serving in the Korean War. Closer than brothers, we settled for a handshake, knowing that’s what men did.

Almost immediately, I found conversations with men my age awkward. Attempts I made to discuss aging were met with jokes about the alternative. With few exceptions, those I spoke with regarded feelings as something to be endured, not discussed. It quickly became clear I was free to contemplate growing old, but not with them.

My wife suggested I meet with younger acquaintances to learn if they would talk with me about aging. I did, and found that men just 10 years younger spoke openly about changes in their minds and bodies. No one joked or changed the subject when one of them confided, “My father had Alzheimer’s, and I’m beginning to forget the same things he did,” or, “My firm’s managing partner said I was slowing younger associates and had to retire.”

It puzzled me that they felt so much freer to discuss feelings than men born just a decade earlier. Could it be because they were shaped by the ’60s, rather than the ’50s? Growing up, they protested what we accepted, challenged authority we obeyed, celebrated their individuality while we hoped to be one of the men in a gray flannel suit. They were the “me” generation, defined by Woodstock and rock ‘n’ roll, while my generation found comfort in Eisenhower’s paternal leadership and listening to soothing ballads like George Shearing’s “I’ll Remember April” and Margaret Whiting’s “Moonlight in Vermont.” Separated by a sliver of time, the two decades seem an eternity apart.

As I seek to reinvent myself, questioning what I do out of habit and what I’m not doing that could be liberating, it’s the voices of these younger men that I hear as I run on the treadmill today. That and the voice of Frank Sinatra from the ’50s, crooning a line from “September Song” that captures what I’ve been feeling: “But the days grow short when you reach September.” It’s realizing that I’ve reached November that presses me forward, ignoring the treadmill’s display, hoping I can lead a deeper and fuller life before I run out of time.

Robert W. Goldfarb is a management consultant and author of “What’s Stopping Me From Getting Ahead?”

Downward Facing Dog and High Heels

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Tao Porchon-Lynch teaches a yoga class in Scarsdale, N.Y. “I haven’t finished learning,” says Ms. Porchon-Lynch, who is 97. “My students are my teachers.”

Tao Porchon-Lynch teaches a yoga class in Scarsdale, N.Y. “I haven’t finished learning,” says Ms. Porchon-Lynch, who is 97. “My students are my teachers.”Credit Gregg Vigliotti for The New York Times

Tao Porchon-Lynch, 97, breezed into her regular Wednesday evening yoga class in a brightly colored outfit: stretch pants, sleeveless top, flowing scarf and three-inch heels.

She put down a mat, folded her long, limber legs into a lotus position, and began teaching her zillionth session. Softly, she guided the 15 or so students through stretching and strengthening moves, and meditative breathing.

The group, at the JCC of Mid-Westchester in Scarsdale, ranged from rank beginners to 20-year veterans of Ms. Porchon-Lynch’s classes, which she has been teaching for decades. She walked the room, adjusting poses, as her students shifted from dog to cobra to camel.

Ms. Porchon-Lynch herself moved through the poses with no apparent effort. At one point, she suspended herself above the floor, supported by her arms.

“Feel your whole body singing out, and hold,” she instructed.

“The ladder of life will take you to your inner self,” said Ms. Porchon-Lynch, who said that before the class, she had knocked out two hours of ballroom dancing.

“I did the bolero, tango, mambo, samba, cha-cha and, of course, swing dancing,” she said.

After the class, she slipped back into her heels — modest height, by Tao standards. Six-inch stilettos are more her speed because the lift helps the flow of energy from the inner feet up through the body, she said.

Back at her apartment in White Plains, she pointed to a photo of herself being dipped dramatically by a dance partner in a competition.

“He was 70 years younger than me,” she crowed. When Ms. Porchon-Lynch was in her 80s she began competitive ballroom dancing and competing widely, even appearing on “America’s Got Talent.”

“I’m very silly. I haven’t grown up yet,” she said. Then she sat and described her “I was there” life story, a march through history that rivaled a Hollywood film.

She said she was raised by an uncle and aunt in Pondicherry, India, after her mother died giving birth to her on a ship in the English Channel in 1918 toward the end of World War I.

At age 8, she began practicing yoga when few women did, and she traveled widely as a child with her uncle, a rail line designer.

Her father, she said, came from a French family that owned vineyards in the South of France, and she moved there as World War II approached. She and an aunt hid refugees from the Nazis as part of the French Resistance.

In London, she entertained troops as a cabaret dancer, and after the war she began modeling and acting in Paris, she said.

She spoke of English lessons with Noël Coward, and hobnobbing with the likes of Marlene Dietrich and Ernest Hemingway.

She said she had acted in Indian films and around 1950 was signed by Metro-Goldwyn-Mayer and had bit roles in big films such as “Show Boat” and “The Last Time I Saw Paris.”

She had stories about marching with Mohandas K. Gandhi and, years later, with the Rev. Dr. Martin Luther King Jr. and attending demonstrations with Charles de Gaulle.

Ms. Porchon-Lynch said she had studied yoga over the years with prominent teachers such as Sri Aurobindo, Indra Devi and B. K. S. Iyengar and taught yoga to many actors in Hollywood.

Even after three hip replacement surgeries, she still drives her Smart car daily and travels widely to teach yoga.

“I haven’t finished learning,” she said. “My students are my teachers.”

Ms. Porchon-Lynch, a longtime widow with no children, attributed her longevity to keeping her vortexes of energy flowing with “the fire of life,” and waking up each morning with the positive attitude that each day will be your best.

“Whatever you put in your mind materializes,” she said. “Within yourself, there’s an energy, but unless you use it, it dissipates. And that’s when you get old.”

Five hours of sleep a night is plenty, she said.

“There is so much to do and think about,” said Ms. Porchon-Lynch, a lifelong vegetarian and a wine enthusiast who still enjoys imbibing.

At the JCC class, she took her students through sun salutation movements and told them, “Remember, the sun salutation means that the dawn is breaking over the whole universe.”

Finally, she talked them through a wind-down period of relaxing meditation.

“Bring your consciousness back down to the physical plane,” she said. “May the light of the union of all things join our mind, our body and our spirit.”

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After Cataract Surgery, Hoping to Toss the Glasses

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How the World Looks With Cataracts

This video shows what it is like to see the world when you have cataracts.

By CLINIC COMPARE on Publish Date May 4, 2016.

Two years ago, Anne Collins of Arlington, Va., who has been wearing glasses since fifth grade, noticed she had trouble reading the overhead street signs while driving. Cataracts, the clouding of the natural lenses that occur with age, were taking their toll.

She decided it was time for cataract surgery.

Mrs. Collins, now 61, chose to have her lenses replaced with two different intraocular lenses – one for seeing far and the other for seeing near — in a procedure known as monovision cataract surgery.

“I thought it was a miracle,” Mrs. Collins said after the surgery was completed. “It was like I was back in second grade and didn’t have any problems with my eyes.” Still, her vision isn’t perfect. Mrs. Collins still needs glasses to read the newspaper, but she can see her cellphone just fine.

By age 80, more than half of all Americans either have a cataract or will have had cataract surgery, according to the National Eye Institute. The average age for the surgery is the early 70s.

Cataracts typically develop in both eyes, and each eye is done as a separate procedure, usually one to eight weeks apart. Patients most commonly have their clouded lenses replaced with artificial monofocal lenses that enable them to see things far away. Most will still need glasses for reading and other close-up tasks.

With monovision surgery, the patient’s dominant eye receives a replacement lens for distance vision. In a subsequent operation, the less dominant eye receives a lens for close vision. Once surgery on both eyes is completed, the brain adjusts the input from each eye and patients typically can see both far and near. Some people can stop wearing glasses altogether, although many, like Mrs. Collins, still need them for certain tasks.

But monovison takes some getting used to. The ideal candidates may be people who already have tried a monovision approach with contact lenses for 15 or 20 years, before they even have developed cataracts, said Dr. Alan Sugar, a professor of ophthalmology at the University of Michigan. “People who have worn contact lenses in their 40s, with one contact for near vision and one for distance, are good candidates,” he said.

Others may be able to give monovision a trial run. The cataract surgeon replaces the first eye with a lens that corrects for distance vision and then, if the cataract in the second eye hasn’t progressed too far, can let the patient use a contact lens for near vision in the second eye, Dr. Sugar said. If the patient is comfortable with the trial monovision, the surgeon can then implant a lens for near vision in the second eye.

Experts caution that monovision surgery is not for everyone. “Many patients get misled by asking how their friends like monovision,” said Dr. David F. Chang, a clinical professor of ophthalmology at the University of California, San Francisco, and past president of the American Society of Cataract and Refractive Surgery. “Some individuals hate what another individual loves.”

After any cataract surgery, including monovision surgery, patients may also experience what doctors call “dysphotopsia,” or visual disturbances like seeing glare, halos, streaks or shadows. Moderate to severe problems occur in less than 5 percent of patients, said Dr. Tal Raviv, an associate clinical professor of ophthalmology at the New York Eye & Ear Infirmary of Mount Sinai Icahn School of Medicine. Symptoms often improve during the first three months after surgery without treatment, he said, though in a small number of cases one or both lenses may need to be replaced.

In addition, some patients who get monovision surgery will need a separate pair of glasses that focus both eyes for distance vision for driving at night. “Night driving is more difficult if both eyes are not optimally focused at distance,” Dr. Chang said.

Another option in cataract surgery for those hoping to get rid of the glasses altogether is the use of multifocal lenses, which focus each eye for both near and far viewing, something like the progressive lenses in eyeglasses. In one study of around 200 patients who had either multifocal or monovision cataract surgery, just over 70 percent of the multifocal group could forgo glasses altogether, compared to just over 25 percent of the monovision group.

But patients who undergo multifocal surgery are more likely to have side effects like glare and halos, according to Dr. Mark Wilkins, the lead author of the study and a consultant ophthalmologist and head of clinical services at Moorfields Eye Hospital in London. In his study, six of 94 patients in the multifocal group had to have second surgeries to get replacement lenses, versus none in the monovision group.

Typically, Medicare covers regular cataract surgery and implantation of standard monofocal lenses but does not pay for multifocal lenses, so insurance reimbursements may be limited.

The key to deciding which type of cataract surgery is right for you is to understand your eyes and goals. “Talk about the pros and cons” of each type of cataract surgery, Dr. Wilkins said. “There’s no other way really.”

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Aging in Place

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Credit Paul Rogers

When I asked the other three members of my walking group, all of whom are in their mid to upper 70s, whether they had any concerns about future living arrangements, they each said they had none despite the fact that, like me, they live in multistory private homes without elevators and, in two cases, without bathrooms on every floor.

My Los Angeles son asked recently what I might do if I could no longer live in my house, and I flippantly replied, “I’m coming to live with you.” The advantages: I’d be surrounded by a loving and supportive family, and the warm weather is a benefit for someone like me who becomes increasingly intolerant of the cold with each passing year. The disadvantages: I’d lose a familiar community and a host of friends, and his house, unlike mine, is on a steep hill with no nearby stores; if I could no longer drive, I’d have to be chauffeured everywhere.

Probably my biggest deterrent would be relinquishing my independence and the incredible number of “treasures” I’ve amassed over the last half century. The junk would be easy, but parting with the works of art and mementos would be like cutting out my heart.

I suspect that most people are reluctant to think about changing where and how they live as long as they are managing well at the moment. Lisa Selin Davis reports in AARP magazine that “almost 90 percent of Americans 65 or older plan to stay in their homes as they age.” Yet for many, the design of their homes and communities does not suit older adults who lack the mobility, agility and swiftness of the young.

For those who wish to age in place, the authors of “70Candles: Women Thriving in Their 8th Decade,” Jane Giddan and Ellen Cole, list such often-needed home attributes as an absence of stairs, wide doorways to accommodate a walker or wheelchair, slip-resistant floors, lever-style door knobs, remotely controlled lighting, walk-in showers, railings, ramps and lifts. Add to these a 24-hour help system, mobile phone, surveillance cameras and GPS locaters that enable family members to monitor the well-being of their elders.

In many communities, volunteer organizations, like Good Neighbors of Park Slope in Brooklyn and Staying in Place in Woodstock, N.Y., help older residents remain in their homes and live easier and more fulfilling lives.

While many young adults chose to live and bring up children in the suburbs, a growing number of empty-nested retirees are now moving to city centers where they can access public transportation, shop on foot for food and household needs, and enjoy cultural offerings and friendly gatherings without depending unduly on others.

One reason my friends and I are unwilling to even consider leaving our Brooklyn community is our ability to walk to supermarkets, banks, food co-ops, hardware stores, worship and recreational facilities, and get virtually everywhere in the city with low-cost and usually highly efficient public transportation. No driving necessary.

We also wallow in the joys of near-daily walks in a big, beautiful urban park, remarking each time about some lovely vista — the moon, sunrise, visible planets, new plantings and resident wildlife.

Throughout the country, communities are being retrofitted to accommodate the tsunami of elders expected to live there as baby boomers age. Changes like altering traffic signals and street crossings to give pedestrians more time to cross enhance safety for people whose mobility is compromised. New York City, for example, has created Aging Improvement Districts, so far in East Harlem, the Upper West Side and Bedford-Stuyvesant, to help older people “live as independently and engaged in the city as possible,” Ms. Giddan and Ms. Cole wrote. In East Harlem, for example, merchants have made signs easier to read and provided folding chairs for seniors who wish to rest before and after shopping.

In Philadelphia, a nonprofit organization, Friends in the City, calls itself a “community without walls” designed to bring members closer to the city’s resources and to one another. It offers seniors a daily variety of programs to suit many cultural and recreational interests.

Also evolving is the concept of home sharing, in which several older people who did not necessarily know one another get together to buy a home in which to live and share responsibilities for shopping, cooking, cleaning and home repair. For example, in Oregon, Let’s Share Housing, and in Vermont, Home Share Now, have online services that connect people with similar needs, Ms. Giddan and Ms. Cole report. There’s also an online matching service — Roommates4Boomers.com — for women 50 and over looking for compatible living mates.

Of course, there are still many older adults, widows and widowers in particular, who for financial or personal reasons move in with a grown child’s family, sometimes in an attached apartment or separate floor. Host families may gain a built-in babysitter, and children can develop a more intimate relationship with grandma or grandpa.

For those with adequate finances, there is no shortage of for-profit retirement communities that help older people remain independent by providing supportive services and a host of amenities and activities. Some have extensive recreational and exercise facilities, as well as book and craft clubs, discussion groups and volunteer opportunities. Some take residents to theatrical productions and museums and on trips to nearby attractions.

I confess that retirement communities that house only older adults are not my style. I can’t imagine living in a place where I don’t see and interact with children on a daily basis. I find that nothing cheers me more than a smile or comment from a toddler. I guess I take after my father, who used to flirt with every child he noticed in a car near his. But I realize that, just as some people are averse to dogs, not everyone enjoys the companionship of a high-energy child.

For older people likely to require help with the activities of daily living, there are many assisted living facilities where residents can get more or less help, including aid with medications, feeding and ambulation, according to their changing needs.

And should I ever have to leave my home, Ms. Giddan and Ms. Cole point out that there is a new and growing cadre of professional organizers and moving managers to “help people sort through accumulated belongings, distribute and disperse what won’t be needed in the new setting, and assist with all stages of packing, moving and then unpacking, and staging the new home.”

This is the second of two columns about adjustments to aging. Read the first part: “Thriving at Age 70 and Beyond.”

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Ask Well: Why Is Arthritis More Common in Women Than Men?

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Credit Stuart Bradford/The New York Times

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Retirement May Be Good for You

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Vinny Volpicelli, 57, works out at Symphony Villiage retirement community in Centerville, Md.

Vinny Volpicelli, 57, works out at Symphony Villiage retirement community in Centerville, Md.Credit Jonathan Hanson for The New York Times

Retirement may be good for your health, a new study suggests.

Australian researchers followed a group of 27,257 men and women, 3,106 of whom retired during the three-year study period. They compared retirees with their peers who were still working, looking at such health measures as smoking, alcohol consumption, physical activity, diet and sleep.

Retirees were also asked why they retired: health problems, caring for others, lack of job opportunities or lifestyle reasons like the desire to travel or study. The study is in the American Journal of Preventive Medicine.

After adjusting for initial health risks, they found that on average, retirees walked for 17 minutes more a week, and engaged in moderate-intensity exercise 45 minutes more a week. They slept about 15 minutes more a night than they did when they were working. Women retirees were more likely to quit smoking than their still-working peers.

There were no significant differences between retirees and those still working, when it came to alcohol use or fruit and vegetable consumption.

The authors had no information about the participants’ type of occupation, and they acknowledge that the follow-up period was short.

“This points to a happier picture,” said the lead author, Melody Ding, a senior research fellow at the University of Sydney. “It allows people to look at retirement optimistically. But there are successful and unsuccessful retirements. It’s important not to over-generalize these results.”

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Reinventing Yourself

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Credit Paul Rogers

Maybe you lost your job, or your interest in the job you’ve been doing. Maybe a divorce or death in the family has threatened your economic stability. Maybe you think you’re now too old or lack the training to switch to something more satisfying or remunerative.

I interviewed several people in similar circumstances who reinvented themselves, sometimes against considerable odds, other times in surprising ways.

After 25 years in family practice in Park Slope, Brooklyn, Dr. Kenneth Jaffe resisted the encroachment of managed care and found he could no longer take the time he needed to care for his patients and make a living at it.

So at 55, inspired by courses he took at the Columbia University Mailman School of Public Health, he quit medicine, moved upstate to an economically depressed area where the land was plentiful and cheap, and began raising grass-fed beef free of hormones and antibiotics. He named his enterprise Slope Farms in honor of his old neighborhood and the Park Slope Food Coop, which sells meat from his 200 head of cattle.

Now 66, Dr. Jaffe said he remained fulfilled by his work in sustainable agriculture. He helps other farmers near his home in the Catskills do the same, and supports a farm-to-school program that brings grass-fed beef to children in kindergarten through 12th grade.

Mary Doty Sykes had been a social worker for 30 years, counseling and teaching teenage parents and adolescent girls about sexuality, self-image, family issues and job training, first in Chicago and then in New York City public high schools. When she became a divorced empty-nester in her early 50s, she decided it was time to get out of the city.

“I rented my house to pay for schooling as a massage therapist,” an interest she developed after techniques in alternative medicine helped her recover from serious injuries sustained in a car accident. Starting at 55 as a licensed therapist, for 13 years she did therapeutic massage at various sites, often for older adults, in western Massachusetts. Now 75 and back in New York, Ms. Sykes offers reiki therapy, and participates in a variety of dance classes. “I’m lucky I can do it all; I have a lot of fun,” she said.

“Fun” is an understatement for Richard Erde, also 75, who worked as a computer programmer for 28 years. After he retired in 2005, Mr. Erde indulged a longstanding interest in opera by auditioning to become an extra, or supernumerary, at the Metropolitan Opera.

“I’ve been on stage at the Met literally hundreds of times with world-famous singers and I never sang a word,” the Brooklynite chuckled. “I’ve worn all kinds of costumes, from Buddhist priest to Russian soldier. It’s ecstatic at times, plus I get paid to do it.” When the Met season ends in late spring, he does the same with American Ballet Theater, where the “supers” are often integrated with the corps de ballet as it moves around the stage.

From age 21, Beth Ravitz worked as a fabric designer, mostly in her own successful business in New York. Then at 40, she gave it up to spend more time with her three young children and two stepchildren. The family moved to Coral Springs, Fla., where, she said, “I didn’t want to think about money; I wanted to nourish my soul and become a real artist.”

While enrolled in a ceramics class at a community college, she saw ads seeking applicants to create public art, decided to go for it, and was hired to do a project. After earning bachelor’s and master’s degrees in fine art, she was able to teach at the college level, a job she loved, and ultimately became what she is now at 66: a public art consultant for two Florida cities (Lauderhill and Tamarac) and an advocate for artists whose work she said is too often undervalued. “I love the fight, and I love that I can make a difference,” Ms. Ravitz said.

Although I have been like a horse with blinders, starting at 23 as a science and health writer and never straying from my chosen path for 52 years, I have great admiration for the courage, imagination and determination of people like these four, who reinvented themselves by believing that you never know what you can do until you try.

Rather than embark on a new career in semiretirement, I’m expanding my horizons by learning Spanish; going to more concerts, operas, lectures and museums; and traveling. I recently took my four grandsons on an Alaskan nature cruise and a tenting safari in Tanzania.

I also adopted a puppy and trained him to be a therapy dog to cheer patients and staff in our local hospital. And if I can find a teacher with a flexible schedule, I hope to learn a new instrument, preferably the bandoneon, a kind of concertina featured in Argentine tango music. (Suggestions for teachers, anyone?)

One thing I’m already learning is my limits: knowing when to say no so I will have the time and energy to do what is most important to me in the last quarter of my life.

Although only 37, Dorie Clark, a teacher at Duke University School of Business and author of “Reinventing You,” is expert at self-reinvention and helping others make changes in their lives.

“Broadly speaking,” she said, “the same principles apply whatever your age.” But she has particular advice for people over 50.

■“Make a special effort to familiarize yourself with social media and the new technology — they’re a proxy for how ‘with it’ you are.”

■“Recognize that you’re likely to be overqualified for certain jobs. It could be the elephant in the room, so it’s important to bring it up first. Maybe say that you’re looking for a new adventure, you don’t need to be the boss, you’re ready to be a team player.”

■“Surprise people to counter any fixed image they may have of you. Your résumé may say one thing, but that doesn’t mean it’s the only thing you can do. Show you’re serious about reinventing yourself, perhaps by volunteering or writing a blog — something that forces people to see you in a new way.”

She also suggests “reconnecting with dormant ties” — people you had a good relationship with years earlier. They may be able to open doors or have ideas that you hadn’t thought of.

Tell Us About Your Personal Reinvention


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Using the Arts to Promote Healthy Aging

Photo

Credit Paul Rogers

Throughout the country, the arts are pumping new life into the bodies and minds of the elderly.

Two summers ago, a remarkable documentary called “Alive Inside” showed how much music can do for the most vulnerable older Americans, especially those whose memories and personalities are dimmed by dementia.

The film opens with a 90-year-old African-American woman living in a nursing home being asked about her life growing up in the South. All she could say in response to specific questions was, “I’m sorry, I don’t remember.”

But once she was fitted with an iPod that played the music she had enjoyed in her youth, her smile grew wide and her eyes sparkled as vivid memories flooded her consciousness. She was now able to describe in detail the music and dances she had relished with her young friends.

At another nursing home, a man named George with advanced dementia refused to speak or even raise his head when asked his name. He too was outfitted with an iPod, and suddenly George came back to life, talking freely, wiggling to the music in his wheelchair and singing along with the songs he once loved.

The Music and Memory project that provided the iPods was the inspiration of a volunteer music lover named Dan Cohen, and has since spread to many nursing homes and facilities for the aged around the country. Alas, not nearly enough of them. Medicaid, which fully covers the cost of potent drugs that can turn old people into virtual zombies, has no policy that would pay for far less expensive music players. So the vast majority of nursing home residents who might benefit are deprived of this joyous experience.

Nonetheless, across the country, the arts in their myriad forms are enhancing the lives and health of older people — and not just those with dementia— helping to keep many men and women out of nursing homes and living independently. With grants from organizations like the National Endowment for the Arts and the National Institute on Aging, incredibly dedicated individuals with backgrounds in the arts have established programs that utilize activities as diverse as music, dance, painting, quilting, singing, poetry writing and storytelling to add meaning, joy and a vibrant sense of well-being to the lives of older people.

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Walter Hurlburt, 90, decorates rooms at the Burbank Senior Artists Colony, a retirement facility where he lives.

Walter Hurlburt, 90, decorates rooms at the Burbank Senior Artists Colony, a retirement facility where he lives.Credit

Through a program called EngAGE in Southern California, 90-year-old Walter Hurlburt, who once made a living as a sign painter, now decorates rooms at the Burbank Senior Artists Colony, a retirement facility where he lives, with lovely oil paintings he creates from pictures he finds in magazines and books. Mr. Hurlburt regularly attends classes on various art forms at the residence where, he told me, “I’m always learning something new.”

His buddy at the residence, Sally Connors, an 82-year-old former schoolteacher, surprised herself by writing and directing a screenplay that was performed by fellow residents. Then, with Dolly Brittan, 79, a former early childhood educator, they both surprised themselves by writing their life stories in rap and performing their rap memoirs on a stage for at-risk teenagers they were mentoring.

Both she and Ms. Connors said their newfound involvement with the arts has made them feel decades younger.

Tim Carpenter, the executive director of EngAGE, is now working to expand this approach to senior living in other cities, including Minneapolis, Portland, Ore., and Raleigh, N.C. His goal is to create a nationwide network of programs for seniors that keep them healthy, happy and active through lifelong learning in every conceivable art form, enabling them to live independently as long as possible.

As in Burbank, Mr. Carpenter is promoting the development of arts colonies in senior residences where residents can study and create art in all its forms and where they can see their artistic creations come to life on a stage.

Dr. Gene D. Cohen, a gerontologist at George Washington University who died in 2009, was a staunch advocate for the mental and physical benefits of creativity for the elderly. He directed the Creativity and Aging Study, a controlled study sponsored by the National Endowment for the Arts at three sites, including Elders Share the Arts in Brooklyn, N.Y., that showed after only a year that the health of elders in the cultural groups stabilized or improved in contrast to a decline among those in the control groups.

In a film called “Do Not Go Gently,” Dr. Cohen, who founded the Creativity Discovery Corps, featured an architect who, at age 96, submitted a plan for redeveloping the World Trade Center site. Dr. Cohen pointed out that creativity challenges the mind and results in the formation of new dendrites, the brain’s communication channels.

At 26 different facilities in the Washington, D.C., area, 15 teaching artists work with seniors in centers where they live or visit regularly. Janine Tursini, director of Arts for the Aging in Rockville, Md., seeks to “get at what best jazzes up older adults.” Groups of about 20 older adults get involved in what she calls “art making” — music, dance, painting or storytelling.

Ms. Tursini said the N.E.A.-sponsored study showed that when older people become involved in culturally enriching programs, they experience a decline in depression, are less likely to fall and pay fewer visits to the doctor. In another study among people with Alzheimer’s disease, a sculpting program improved the participants’ mood and decreased their agitation even after the program ended.

“The arts open people up, giving them new vehicles for self-expression, a chance to tell their stories,” Ms. Tursini said. “The programs capitalize on assets that remain, not on what’s been lost.”

Naomi Goldberg Haas created the Dances for a Variable Population program to get older adults dancing. People who haven’t moved in years, even those who can no longer stand, can participate. Young professionals and older dancers go to various sites — libraries, churches, senior centers — where elders gather and encourage them to “move more.”

“Movement enriches the quality of their lives,” Ms. Haas said. “It’s absolutely healing. Balance, mobility, strength — everything improves.”

Social engagement, which nearly all these programs provide, has been repeatedly found in major population studies to prolong life and enhance healthy aging. Clinically, the programs have been linked to lowered blood pressure, reduced levels of stress hormones, and increased levels of the “happiness hormones” that are responsible for a runner’s high.

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Pursuing the Dream of Healthy Aging

Photo

Credit Paul Rogers

Given their druthers, most people would opt for a long and healthy life. Few relish the idea of spending years, even decades, incapacitated by illness, dependent on caregivers and unable to enjoy the people, places and activities that make life worth living.

In 1980, Dr. James F. Fries, a Stanford University physician who studied chronic disease and aging, proposed that a “compression of morbidity” would enable most people to remain healthy until a certain age, perhaps 85, then die naturally or after only a brief illness.

Now, a prescient group of experts on aging envisions a route to realizing Dr. Fries’s proposal: one or more drugs that can slow the rate of aging and the development of the costly, debilitating chronic ailments that typically accompany it. If successful, not only would their approach make healthy longevity a reality for many more people, but it could also save money. They say that even a 20 percent cut in how fast people age could save more than $7 trillion over the next half-century in the United States alone.

“Aging is by far the best predictor of whether people will develop a chronic disease like atherosclerotic heart disease, stroke, cancer, dementia or osteoarthritis,” Dr. James L. Kirkland, director of the Kogod Center on Aging at the Mayo Clinic, said in an interview. “Aging way outstrips all other risk factors.”

He and fellow researchers, who call themselves “geroscientists,” are hardly hucksters hawking magic elixirs to extend life. Rather, they are university scientists joined together by the American Federation for Aging Research to promote a new approach to healthier aging, which may — or may not — be accompanied by a longer life. They plan to test one or more substances that have already been studied in animals, and which show initial promise in people, in hopes of finding one that will keep more of us healthier longer.

As Dr. Kirkland wrote in a new book, “Aging: The Longevity Dividend”: “By targeting fundamental aging processes, it may be possible to delay, prevent, alleviate or treat the major age-related chronic disorders as a group instead of one at a time.”

His colleague S. Jay Olshansky, a gerontology specialist in the School of Public Health at the University of Illinois in Chicago, said it is often counterproductive to treat one disease at a time. Preventing cardiac death, for example, can leave a person vulnerable to cancer or dementia, he explained.

A better approach, Dr. Kirkland said, would be to target the processes fundamental to aging that underlie all age-related chronic diseases: chronic low-grade inflammation unrelated to infection; cellular degradation; damage to major molecules like DNA, proteins and sugars; and failure of stem cells and other progenitor cells to function properly.

The team, which includes Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine in The Bronx, and Steven N. Austad, who heads the biology department at the University of Alabama at Birmingham, plans to study one promising compound, a generic drug called metformin already widely used in people with Type 2 diabetes. They will test the drug in a placebo-controlled trial involving 3,000 elderly people to see if it will delay the development or progression of a variety of age-related ailments, including heart disease, cancer and dementia. Their job now is to raise the $50 million or so needed to conduct the study for the five years they expect it will take to determine whether the concept has merit.

The project represents a radical departure from ordinary drug studies that test treatments for single diseases. However, the group, spearheaded by Dr. Barzilai, said the Food and Drug Administration has endorsed their idea to test a single substance for effectiveness against a range of ailments.

“If metformin turns out not to work, there are several other substances in the pipeline that could be tried,” Dr. Barzilai said. “Under the auspices of the National Institute on Aging, three research centers have tested 16 substances in different animal models and got incredible results with four of them.”

Green tea, one of those tested, bestowed no health or life span benefits, despite its popularity. But the drug rapamycin, an immune modulator used following organ transplants, was most effective among those tested, Dr. Barzilai said.

The team is starting with metformin because it is a cheap oral drug — costing about two cents a pill — with six decades of safe use in people throughout the world. Among those with Type 2 diabetes who have taken it for years, there is evidence suggesting that, in addition to diabetes, it protects against cardiovascular disease, cancer and possibly cognitive impairment, Dr. Kirkland said, adding that “it targets the fundamental processes of aging, which tend to be linked.”

Dr. Barzilai said, “Our goal is to establish the principle of using a drug, or two in combination, to extend health span. The best we can expect from metformin is two or three additional years of healthy aging. But the next generation of drugs will be much more potent.”

Dr. Barzilai is already conducting a complementary study of centenarians, the results of which could identify more drugs to delay age-related diseases. He and colleagues are isolating genes that appear to keep these long-lived men and women healthy for 20 to 30 years longer than other people and shorten the length of illness at life’s end. Several studies have already found that individuals with exceptional longevity experience a compression of morbidity and spend a smaller percentage of their life being ill, Dr. Barzilai and his colleague Dr. Sofiya Milman wrote in the “Aging” book.

By analyzing the action of genes that extend health span, “it should be possible to devise drugs that mimic the genes’ effects,” he said. Two such gene-based drugs that show early promise against age-related diseases are already being tested.

But until definitive studies are completed and substances are shown to be safe as well as effective in prolonging health, Dr. Olshansky cautioned against dosing oneself prematurely with widely touted substances like resveratrol, the antioxidant found in red grapes and wine, or growth hormone.

Consumers must exercise caution, he warned, because “there’s an entire industry out there trying to market the products we’re testing before they are adequately evaluated.”

He also emphasized that taking a drug found to ward off age-related ills is not a license to abandon a healthy lifestyle. Doing so “could completely negate the benefit of a compound that slows aging,” he said.

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