MATURE MARKET HEADLINES POSTED 8/14/98
Abuse Raises Elder's Death Risk By 300%
Mistreatment and neglect of older people are associated with a significant increase in their chances of
dying, according to a groundbreaking study by researchers at Cornell University and colleagues at Yale University. The study, which traced the survival of a group of older adults, found that only 9 percent of those with a reported incident of mistreatment and 17 percent of those suffering from self-neglect survived during a 13-year follow-up period.
Their experience compared with a more typical survival of 40 percent among older people in the study with no known history of mistreatment or self-neglect. The study, described in the August 5, 1998, issue of the Journal of the American Medical Association (JAMA), is the first to compare mortality of people who have been mistreated to that of their non-victimized counterparts. It is initial confirmation, investigator Mark S. Lachs, M.D., M.P.H., of Cornell's medical college, and colleagues say, of what they have long suspected -- that elder abuse and mistreatment may be an insidious threat to life.
There were no direct, injury-related deaths in the group that was mistreated, Lachs found. Instead, the research suggests a more general association with increased risk of death. Even when adjustments were made to account for chronic diseases, social factors, and other conditions associated with increased death rates among the elderly, mistreated older people were three times more likely to die than older people who were not mistreated.
Scientists at the National Institute on Aging (NIA), which funded the research, said the findings are an important step in understanding and preventing abuse of older people. Sidney M. Stahl, Ph.D., of NIA's Behavioral and Social Research Program and project officer for the research, called the study findings "startling." He noted, "The fact that nearly one-tenth of the older people in a large study population had been referred to adult protective services is certainly cause for concern."
In addition, Stahl said, the increased level of mortality among the mistreated elderly was greater than expected. Mistreated elderly had a 3.1 times greater risk of dying than those with no reported mistreatment. The self-neglected had a 1.7 times increased risk. "We need to know more about elder abuse," Stahl said. In the future, NIA will be interested in examining: the prevalence of abuse among older people; risk factors leading to abuse and neglect, such as family dynamics; and the consequences of abuse and neglect in addition to death, such as those affecting general health status and family interactions.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Diet and Lifestyle May Lower Blood Pressure
Despite the common belief that longevity requires nothing more than good genes, there are other factors such as diet, lifestyle habits, and exercise that are strong contributors to longevity. Genetic inheritance does play a significant role. However, discounting the other factors can leave one feeling a bit fatalistic about their aging process. As a result, individuals may become too passive in their attention to diet, lifestyle, and exercise.
A new study by the American Heart Association (AHA) supports the active role that individuals can take in support of better health and well-being. According to a statement by the AHA, published in "Circulation: Journal of the AHA", individuals with high blood pressure should not only put away the salt shaker, but eat more fruits, vegetables and fat-free or low-fat dairy products. One in four American adults have high blood pressure, which increases risk of stroke, heart attack and kidney failure.
For the first time, the American Heart Association’s Nutrition Committee recommends adding fruits, vegetables and low-fat or fat-free dairy products to a reduced-salt diet to help prevent or lower high blood pressure. In its statement, the Nutrition Committee recommended a diet rich in potassium, calcium and magnesium and low in total fat, saturated fat, cholesterol and sodium. "First, this report reaffirms the importance of lowering and avoiding excess salt in the diet," says Theodore A. Kotchen, M.D., AHA Nutrition Committee member and chairman of the department of medicine at the Medical College of Wisconsin, Milwaukee. "Secondly, it indicates that dietary components other than salt are also important in the control of high blood pressure."
The committee’s statement, co-authored by David A. McCarron, M.D., of Oregon Health Science University in Portland, cites the Dietary Approaches to Stop Hypertension (DASH) trial, which found that a salt-restricted diet rich in fruits, vegetables, and fat-free or low-fat dairy products produced the greatest reduction in systolic (top number) and diastolic (bottom number) blood pressures than other diets.
The American Heart Association Nutrition Committee estimates that a reduction in diastolic blood pressure of just two millimeters (mm/Hg) could lower a person’s stroke risk by as much as 15 percent and lower heart disease risk by 6 percent. The AHA Nutrition Committee also recommends that individuals manage their weight and avoid more than two alcoholic drinks per day.
Kotchen says, "Nutritional strategies for the prevention and treatment of high blood pressure should address overall diet, rather than focusing exclusively on any single nutrient. Avoiding a high-salt diet, weight reduction in overweight individuals, and restricting alcohol intake are important." Here's the point. There are significant factors that contribute to longevity that are under an individual's control. So take an active role in promoting your health and well-being. Who knows, you just might live to be 100.
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AgeVenture News Service, www.demko.com
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Molecular Technology Tackles Alzheimer's
While the dementia and agitation of Alzheimer's disease are painfully obvious to care-givers, the roots of the disease lie hidden and unknown deep in the brains of patients. Now a University of Rochester team has developed a technology that sheds light on the disease at its origins, in the nerve cells throughout the brain that sicken and die. The team has taken the sharpest molecular snapshots yet of cells affected by the disease, simultaneously measuring the activity of 20 genes within those cells.
Scientists believe these profiles of individual cells provide the most thorough information yet on cells from the brains of deceased Alzheimer's patients and provide a way to compare healthy and sick cells in unprecedented detail. The work is reported in the August 4 issue of the Proceedings of the National Academy of Sciences.
"Many Alzheimer's researchers are looking for a molecular change in the blood, or in the spinal fluid, but that's like looking for a needle in a haystack," says Zaven Khachaturian, director of the Alzheimer Association's Ronald and Nancy Reagan Institute and former director of Alzheimer's disease research at the National Institutes of Health. "The Rochester team is able to focus in on cells that actually show pathology from the disease and can compare those to cells that show no sign of disease.
That is a significant starting point toward understanding what is happening much, much earlier in the brains of people who have this disease. It's no longer a hit-and-miss approach. "There is good reason to be excited about this technology." "By the time somebody comes into the doctor's office and is diagnosed with the disease, the withering of the brain has gone on for decades," says Paul Coleman, principal investigator and one of 12 researchers nationwide to have received the NIH Leadership and Excellence in Alzheimer's Disease (LEAD) award.
"We want to be able to detect the disease before there are symptoms and halt the progression. That's the ultimate dream." He believes the technology can also be used to study molecular differences between healthy and sick cells in many other diseases, including heart disease, muscle disorders, and strokes.
See related articles in the AgeVenture archives.
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AgeVenture News Service, www.demko.com
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Kmart Ventures Into Elder Health Market
WHS Prescription Benefit Management has developed a free, no cost, Kmart PPO drug card program designed to help retirees save money. When purchasing a prescription at Kmart, WHS plan members receive a preferred price, or Kmart's regular retail price, whichever is lower. The discount is calculated automatically by Kmart's on-line computer system. Last year, WHS plan members saved $5.51 per prescription on 70% of the medication purchased under a similar plan.
The average savings per family was $115. All medications are eligible for a discount. It's estimated that the average senior household purchases 32 prescriptions per year. So seniors could reap major savings from programs such as these. Also, transportation can often be a problem for seniors. As a result, a Kmart mail order feature was included in the new Kmart-WHS venture.
By calling toll-free anywhere in the U.S., plan members can have their medication delivered directly to their home at no extra cost. WHS Prescription Benefit Management developed this plan primarily to help retirees save money. However, consumers of any age can join, especially the 41 million Americans who have no health insurance, or employees of small businesses that offer little or no prescription drug coverage. To become a plan member, individuals must send a one-time $5 enrollment fee to WHS in Madison, Wisconsin. Within three weeks, the applicant receives a WHS PPO Kmart drug card and mail order form. Those interested may wish to contact their neighborhood Kmart for details about the local availability of this new service.
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AgeVenture News Service, www.demko.com
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PCA's Public-Private Partnership in Eldercare
The Philadelphia Corporation for Aging (PCA) has announced a recent grant award of $100,000 from the Pennsylvania Department of Aging to conduct a demonstration project with Independence Blue Cross (IBC), the largest health insurer in Southeastern Pennsylvania. This innovative project will explore and demonstrate a partnership between an Area Agency on Aging (AAA) and a managed care organization (IBC) to enhance the quality of life for senior citizens.
"We are excited to participate alongside IBC in this new collaboration which has the potential to help so many senior citizens in our community," said PCA President Rodney D. Williams. There are three components of the demonstration project. The first component is for PCA to purchase, develop, and maintain an on-line resource directory with regional capacity for joint use by both IBC and regional AAA staff. The second component of the project is to provide in-home evaluations by AAA staff of IBC members identified as extremely high risk as measured by a health risk assessment. Third, IBC and AAA care managers will jointly develop a plan of care that synchronizes the utilization of medical and social resources. PCA and IBC will discuss approaches to reach the 30 percent of IBC members who do not return a health risk survey.
Through the implementation of this demonstration project, it is expected that the number of potentially unnecessary hospital admissions for extremely high-risk individuals will be reduced, and their satisfaction with their health care increased. In a related but separate effort, PCA is working with IBC to offer home-delivered meals to IBC members who are identified by their primary care physician as being at nutritional risk.
By offering low cost meals to these members, IBC will be taking another step in the direction of promoting good health and preventing disease. Serving as the Area Agency on Aging for Philadelphia, PCA plans, coordinates, and administers a network of services to older and disabled Philadelphians. PCA's goal is to improve the quality of life for older and disabled Philadelphians and to assist them in achieving optimum levels of good health, independence and productivity.
See related articles in the AgeVenture archives.
"Ameritech Lauded for Eldercare Achievement"
"Gatekeeper Program Identifies Isolated Elders"
"Healthy Habits Delay Disability by 8 Years"
AgeVenture News Service, www.demko.com
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