Plan now to meet rising costs of dementia patients

[otaviaabegg]

Micron Associates
Looking back can sometimes show the way forward. An example is Hong Kong's mortality statistics for the last 10 years and the implications for health care. The top 10 causes of death remained the same in 2013 as they were in 2003, except for changes in the order. But the number of deaths attributed to them rose by 18 per cent, from 31,101 in 2003 to 36,552 in 2013, compared with a rise of 5 per cent in the population to 7.25 million. The discrepancy is not explained by more deaths from other causes. It results from a demographic phenomenon of which economists and policy advisers have been warning us - ageing of the population.

The percentage increase in deaths from the top 10 causes was actually in line with an increase in the elderly population - people over 65 - of 19 per cent from 818,800 to 978,000, as average life expectancy increased by five years.

Cancer remained the biggest killer, accounting for 13,538 deaths in 2013, an increase of 2,000-odd over 2003. The figure would have been much higher but for earlier diagnoses and better and more targeted therapies. But the number that really sticks out is for dementia - most commonly Alzheimer's disease. As a cause of death it leapfrogged diabetes mellitus and septicaemia in rising from 10th to eighth, or nearly fourfold to 1,000 from 256. And that does not include death from complications. For example, deaths from pneumonia, a common immediate cause of death among dementia patients, rose by nearly 3,000 over the decade to 6,722, displacing heart disease as the second highest cause. Dementia-related conditions have displaced diabetes among the five biggest non-communicable causes of death in Hong Kong.

Globally the number of dementia patients is expected to double from 36 million in 2011 to 72 million in the early 2030s, according to London-based Alzheimer's Disease International. Few countries have kept up with the demand that places on medical and nursing care. Hong Kong is no exception. Care of a dementia victim can be financially and psychologically stressful for families. Experts say the one in 10 people who will get dementia in their 70s rises to three in 10 in their 80s. As it is now common for people to live into their 80s, every extended family should expect to experience dementia. The latest mortality statistics ought to remind the Hong Kong government of the need for a long-term strategy. Present proposals for health care reform do not specifically address policy and financing options.

 

[waltky]

Mebbe dat diazepam Granny used to take is what makes her goofy?...

Anxiety and sleeping pills 'linked to dementia'
9 September 2014 ~ Long-term use of pills for anxiety and sleep problems may be linked to Alzheimer's, research suggests.

A study of older Canadian adults found that past benzodiazepine use for three months or more was linked to an increased risk (up to 51%) of dementia. NHS guidelines say the drugs should be used for eight to 12 weeks at most. The French-Canadian team says while the link is not definitive, it is another warning that treatments should not exceed three months. "Benzodiazepine use is associated with an increased risk of Alzheimer's disease," lead researcher, Sophie Billioti de Gage of the University of Bordeaux, France, and colleagues wrote in the BMJ. "Unwarranted long-term use of these drugs should be considered as a public health concern."

The class of drugs known as benzodiazepines is mainly used to treat anxiety or insomnia

The study involved about 2,000 cases of Alzheimer's disease in adults aged over 66 living in Quebec. All had been prescribed benzodiazepines. They were compared with about 7,000 healthy people of the same age living in the same community. While an increased risk was found in those on benzodiazepines, the nature of the link was unclear. Dr Eric Karran, director of research at Alzheimer's Research UK, said: "This study shows an apparent link between the use of benzodiazepines and Alzheimer's disease although it's hard to know the underlying reason behind the link. "One limitation of this study is that benzodiazepines treat symptoms such as anxiety and sleep disturbance, which may also be early indicators of Alzheimer's disease."

Long-term use

Prof Guy Goodwin, president of the European College of Neuropsychopharmacology, said the findings "could mean that the drugs cause the disease, but is more likely to mean that the drugs are being given to people who are already ill". Dr James Pickett, head of research at the Alzheimer's Society, said with 1.5 million people in the UK being prescribed benzodiazepines at any one time, "evidence that their long-term use increases the risk of dementia is significant, and raises questions about their use".

Benzodiazepines are used to treat anxiety disorders and insomnia. Despite published guidance on their appropriate use for short-term management, inappropriate prescribing of the drugs is still a concern. Experts are calling for better monitoring of side-effects, particularly in older adults.

BBC News - Anxiety and sleeping pills linked to dementia

See also:

Is working at night bad for you?
9 September 2014 ~ How much does working in the small hours harm the mind and body? Claudia Hammond investigates the evidence.

In some jobs, working the night shift is unavoidable. There are hospitals to run, planes to fly and shops to keep open as we move towards a 24-hour society. With careful planning and a bit of peace during the daytime, it is possible to work all night and still get eight hours sleep the follow day. Some people will even tell you they don’t mind and that they get used to working in this way. But can their bodies ever become fully accustomed to working to a clock turned upside down? And, more worryingly, is nocturnal labour bad for your health? There are two elements to these questions. One is about how we feel – our mental wellbeing. People are right to say they get used to shift work. There’s evidence that we cope with subsequent night shifts better than the first of a series, but some people find it much harder than others.

A Canadian study monitored the timing of the sleep, the light levels and the quantity of the sleep hormone melatonin produce by a small group of police officers as they embarked on a week of night shifts. Usually we release melatonin late in the evening when we start feeling tired and ready for bed. If you’ve adapted well to working nights, the peak will move to daytime instead. In this study, those whose pattern of melatonin production showed they had made that adjustment felt happier and more alert, as well as showing faster reaction times – but only 40% managed to make the switch. In a larger study of more than 3,000 police officers working shifts in Canada and the US, the consequences for those who were unable to adjust were clear, with 40% diagnosed with some kind of sleep disorder.

Even if you do feel OK, there’s also the question of whether your body could be suffering in the long-term. When it comes to assessing the physiological effects, one of the problems is differentiating between the impact that shift work might have on your lifestyle from the direct impact of working during the night. It is harder to eat healthily or to exercise regularly if you’re working shifts. Not only is a salad harder to obtain during the night, but it’s probably not what you feel like when you’re trying to keep yourself awake. This tempts people towards snacks and takeaways. Pizza and curry may be convenient and make you feel better, but of course eating them every night isn’t very healthy. There’s also less opportunity for exercise. While you might manage to drag yourself to the gym at the end of a day’s work, it’s that much harder to do that at the end of your shift if you’re already been up all night and are yearning for a nap.

Airline pilots were found to be happier on the days they were resting compared with those where they worked early or late shifts. Of course it’s not unusual to prefer your day off to the days you have to get up and go to work, regardless of the time. But the researchers also found that when the pilots worked the early shift they had higher levels of the stress hormone cortisol on waking and produced more cortisol throughout the day. In the long-term, high levels are thought to be associated with an increased the risk of heart problems and high blood pressure.

More BBC - Future - Is working at night bad for you

 

[waltky]

Dat's why Granny takes her vitamin D...

Study: Vitamin D Supplements Might Slow Dementia
September 14, 2015 - Over the next 50 years, it's expected that Alzheimer’s disease and dementia will strengthen their grip on older adults worldwide. Researchers are studying vitamin D to see if it can slow the onset of dementia

Vitamin D comes from the sun and from some foods like nuts, lentils and fatty fish. Researchers have found that low levels of vitamin D could be related to dementia and Alzheimer's disease, one of the most common forms of dementia. Alzheimer's can be exhausting for caregivers and frightening to those who have it. "The worse thing that I found was I was getting lost in the car, not just forgetting where I was going - I wouldn't know where I was," said dementia sufferer, Chris Roberts.

The World Health Organization estimates that more than 47 million people suffer from dementia, with about 60 percent of them in low- and middle-income countries - countries with the least ability to cope. U.S. researchers studied older adults and measured both their vitamin D levels and their cognitive ability: that is, the ability to remember things and to process thoughts. “Some of the subjects had outright dementia, some had mild cognitive impairment and some had what we would call normal cognitive functioning,” said Dr. Joshua Miller of Rutgers University.

The researchers found that about 60 percent of the group was low in vitamin D. “Those who had dementia also had lower vitamin D status than those who had mild cognitive impairment or who had normal cognitive functioning,” Miller said. Those low in vitamin D showed more short-term memory loss, as well as less ability to organize thoughts, prioritize tasks and make decisions. “They were declining about two-and-a-half times faster than those who had adequate vitamin D,” Miller said.

While this study shows that vitamin D seems to play a role in slowing the onset of dementia, more studies are needed to see if vitamin D supplements can help slow this decline. The study was published in the Journal of the American Medical Association.

Study: Vitamin D Supplements Might Slow Dementia

 

[rdean]

As more and more right wingers are committed, the cost was bound to go up.

 

[Mr. H.]

As more and more right wingers are committed, the cost was bound to go up.

You are one pathetic whore.

 

[Spinster]

Maybe it's not diazapene nor lack of vitamin D that is responsible for Alzheimer's disease. Maybe it's as simple as what crap people eat like the Standard American diet. I know one of the studies reported was relative to Hong Kong, but could that have become an issue resulting from American fast food chains springing up in Asia? Officials state that consuming a plant-based diet coupled with a vegan one produces the best overall health for individuals--no diabetes, no coronary artery, no cholesterol causing ill effects. Without coronary artery and cholesterol disease, there's better blood flow. Better blood flow isn't just for the heart, but for the brain as well. Better brain function may result in less incidence of Alzheimer's disease.

 

[waltky]

New quick test to determine dementia...

Three-minute test can detect hard to diagnose form of dementia
Oct. 26, 2015 | Diagnoses for Lewy Body disease can be delayed for an average of 18 months because it goes unrecognized.

A three-minute survey may help prevent misdiagnosis of Lewy Body disease -- the second most common form of dementia after Alzheimer's disease -- which causes losses in cognitive function, mobility and behavior. The Lewy Body Composite Risk Score, or LBCRS, a 10-question survey based on the signs and symptoms of LBD, as well as Parkinson's Disease Dementia. Dr. James Galvin, who developed the survey at Florida Atlantic University, said the survey not only could increase the ability of doctors to diagnose LBD, but will also help with future clinical trials and studies for its treatment and prevention.

[

Dr. James Galvin developed the Lewy Body Composite Risk Score, a 10-question survey to more quickly and accurately diagnose the condition.​

The 10-question survey includes questions about movement, rigidity in the extremities, acting out dreams, hallucinations, sleep, stability and tremors. LBD diagnoses can often be delayed up to 18 months because of difficulty to recognize the symptoms. "Most patients never receive an evaluation by a neurologist skilled in the diagnosis of Lewy body dementia, and significant delays and misdiagnoses occur in most patients with this disease," Galvin, a professor of clinical biomedical science, said in a press release. "This new tool has the potential to provide a clearer, more accurate picture for those patients who are unable to be seen by specialists, hastening the correct diagnosis and reducing the strain and burden placed on patients and caregivers."

The LBCRS was developed using autopsy-verified cases of the disease and then compared to current gold standard diagnosis methods with 256 living patients. The survey was given to patients in a real-world clinical setting using patients that were referred to the study from the surrounding community, not recruited specifically for it. The patients' caregivers completed evaluations on the severity of symptoms they observed, and then each patient was given a 30-minute diagnostic test for cognitive status. After other methods and rating scales had been completed, the LBCRS was completed. Compared to standard tests, Galvin's diagnostic was 96.8 percent accurate at telling the difference between LBD and Alzheimer's disease, with sensitivity of 90 percent and specificity of 87 percent. The study is published in Alzheimer's & Dementia.

Three-minute test can detect hard to diagnose form of dementia

See also:

Dementia-related healthcare more expensive than other diseases
Oct. 27, 2015 - Regardlesss of insurance, out-of-pocket spending for dementia patients in the last five years of life is 81 percent higher than for those with other diseases.

The cost of the last five years of life is more than 50 percent higher for people with dementia than those who die of other diseases such as cancer and heart disease, a recent survey of patient records revealed. Researchers at the National Institute on Aging calculated costs for dementia patients at the end of life, including Medicare, Medicaid and Social Security costs, as well as private insurance and out-of-pocket costs. They estimate the cost to be more than $250,000 -- more than $100,000 more than other other Medicare beneficiaries combined costs. "This complex analysis lays out the significant health care costs to society and individuals in the last five years of life," said Dr. Richard Hodes, director of the NIA, in a press release. "It provides an important picture of the risks that families face, particularly those with dementia and those who may be least able to bear major financial risk. Such insights are critically important as we examine how best to support the aging of the U.S. population."

Understanding the cost of dementia will help with future care of dementia patients, researchers said.​

Using data from the Health and Research Study, researchers gathered data on 1,702 Medicare beneficiaries age 70 and older who died between 2005 and 2010. They were broken down into four groups based on their cause of death: Dementia, heart disease, cancer or other causes. The average cost for the last five years of life with dementia was $287,038, significantly more than the $175,136 for heart disease, $173,383 for cancer or $197,286 for other causes of death. Medicare expenditures were similar across all diseases, however average out-of-pocket spending for dementia patients was $61,522, or 81 percent higher than the $34,068 for other patients.

On average, out-of-pocket spending for dementia patients was 32 percent of wealth measured over five years, compared with 11 percent for the other groups. That proportion was found to be greater for certain demographic groups -- it represented 84 percent of five years' wealth for black patients, 48 percent for people without a high school education, and 58 percent for unmarried or widowed women. "The magnitude of the difference was shocking to me, even though the trend is what I expected," Dr. Amy Kelley, an associate professor of geriatrics and palliative medicine at Mount Sinai Hospital, told HealthDay. "I don't think the vast majority of people have any idea about these costs unless they're living it." The study is published in Annals of Internal Medicine.

Dementia-related healthcare more expensive than other diseases

 

[Spinster]

Having had a father-in-law that suffered from this and knowing his care needs, compared to a brother who in two hospital stays of a few days each having four cardiac stents placed and costing nearly half a million, I can say from experience that cardiac procedures are much more costly over dementia. These "studies" are rigged data to make a particular point of the author's own choosing. Complete hipe.

 

[waltky]

New way to predict dementia...

Data from routine checkups used to predict dementia
Jan. 22, 2016 - An algorithm based on the data can be used to help doctors rule out risk for developing dementia within five years

Information collected by doctors at basic checkups can be used to accurately predict risk for developing dementia, according to researchers at University College London. The researchers developed an algorithm, called the Dementia Risk Score, they say can help rule out patients at very low risk for dementia-related conditions such as Alzheimer's disease within five years. "The score could be especially useful for identifying people at a very low risk of dementia, as recorded by their general practitioner," Dr. Kate Walters, a primary care and population health researcher at University College London, said in a press release. "This could help general practitioners working with people who are anxious about developing dementia."

Researchers at University College London said an algorithm predicting dementia risk would need to be adjusted for other populations, because the initial version they designed is based entirely on medical records of people in England.​

For the study, published in BMC Medicine, researchers used data collected from general practices in The Health Improvement Network database in England, selecting 930,395 patients from 377 practices between the ages of 60 and 95 who did not have dementia to build the algorithm. The algorithm is based on four variables as possible predictors of dementia: socio-demographic factors such as age and sex; health and lifestyle elements such as alcohol use and BMI; medical diagnoses; and prescription medication use. The variables were then checked against medical records of the selected patients for dementia diagnoses within a five-year follow-up period from the start of the THIN study. The algorithm was then validated with another 264,224 patients from 95 other practices.

Researchers found that for people ages 60 to 79, the algorithm performed well, while it was less accurate for people between ages of 80 and 95. At a low threshold of risk for dementia, the algorithm had a sensitivity of 78 percent and specificity of 73 percent. But at risk thresholds of 2 percent or higher, the algorithm had a higher specificity of 85 percent but much lower sensitivity of 58 percent -- which researchers said is similar to previous prediction models based on cohort studies. "Before this score is widely used we would recommend that it is independently tested in further populations of people, and that the ethical implications of using it in practice are considered," Walters said.

Data from routine checkups used to predict dementia

 

[OnePercenter]

As more and more right wingers are committed, the cost was bound to go up.

The main cause of dementia......conservatism.

 

[Spinster]

That's what Obummer Care is for, isn't it? Haahaahaa

 

[waltky]

Lost memories may be recoverable...

Dementia’s lost memories may be recoverable: study
Fri, Mar 18, 2016 - People with Alzheimer’s disease may not have “lost” their memories, but could simply have difficulty accessing them, say researchers, who on Wednesday unveiled a possible treatment that could one day offer a cure to the ravages of dementia.

Nobel Prize-winner Susumu Tonegawa said studies on mice showed that by stimulating specific areas of the brain with blue light, scientists could make the creatures recall thoughts that were otherwise unavailable to them. The results offer some of the first evidence that Alzheimer’s disease does not destroy specific memories, but rather makes them inaccessible. “As humans and mice tend to have a common principle in terms of memory, our findings suggest that Alzheimer’s disease patients, at least in their early stages, may also keep memories in their brains, which means there may be a possibility of a cure,” Tonegawa said.

Tonegawa’s team used mice that had been genetically modified to exhibit symptoms similar to those of humans suffering from Alzheimer’s disease — a degenerative brain condition that affects millions of adults around the world. The animals were put in a box which had a low-level electrical current passing through the floor — giving an unpleasant, but not dangerous, shock to their feet. An unaffected mouse that is returned to the same box 24 hours later freezes in fear, anticipating the same nasty sensation. Mice with Alzheimer’s do not, suggesting they have no recollection of the experience.

However, when researchers stimulated targeted areas of the animal’s brains — the “engram cells” associated with memory — using a blue light, they appeared to recall the shock. The same result was noted even when placing the creatures in a different box during stimulation, suggesting the memory had been retained and was being reactivated. By examining the physical structure of the mice’s brains, researchers found that those affected with Alzheimer’s-like conditions had fewer “spines” — conduits through which synaptic connections are formed.

Via repeated light stimulation they were able to increase the number of spines to levels indistinguishable from those in normal mice, resulting in their exhibiting the freezing behavior seen in the original box. “The mice’s memories were retrieved through a natural cue,” Tonegawa said, referring to the box that initially triggered the freezing behavior. “This means that symptoms of Alzheimer’s disease in mice were cured, at least in their early stages.”

The research, carried out by the RIKEN-MIT Center for Neural Circuit Genetics, is among the first to prove that recall — rather than memory — is the problem, Japan-based RIKEN said. “It’s good news for Alzheimer’s disease patients,” center director Tonegawa, who won the 1987 Nobel Prize for Physiology and Medicine, said by telephone from his office in Massachusetts. The optical stimulation of brain cells — a technique called “optogenetics” — involves inserting a special gene into neurons to make them sensitive to blue light, and then stimulating specific parts of the brain. The research was published in the Britain-based science journal Nature.

Dementia’s lost memories may be recoverable: study - Taipei Times

 

[JW Frogen]

Eat your blueberries.

God dam it, eat your blueberries.