From a Wall Street Journal Opinion article (Feb 10, 2020):
How to address the elder-care crisis? Ideally, doctors would screen older patients for dementia. An early diagnosis helps patients understand treatment options, plan for the future and receive appropriate care in the hospital.
Other steps include: more preventive care, changes to Medicare’s rehabilitation policies, adopting new reimbursement methods, and developing new measures of success. Primary-care offices can prevent hospital visits, but Americans seeking primary care face an average wait time of 24 days. This might not be a problem for a patient in need of an annual physical, but conditions like chest pain or infections require prompt treatment. Primary-care offices that offer same-day sick visits, home visits for bed-bound older adults, or at-home monitoring of conditions could reduce emergency department volumes.
Read full article by Elizabeth Goldberg MD
Challenging widely held assumptions about the diminishing abilities of an ageing brain, leading neuroscientist Daniel Levitin argues that we should view getting older as a beneficial experience rather than a form of cognitive entropy. Persuasively argued and consistently surprising, The Changing Mind will alter your perception of the relationship between age and intellect.
We have long been encouraged to think of old age as synonymous with deterioration. Yet, recent studies show that our decision-making skills improve as we age and our happiness levels peak in our eighties. What really happens to our brains as we get older?
More of us are living into our eighties than ever before. In The Changing Mind, neuroscientist, psychologist and internationally-bestselling author Daniel Levitin invites us to dramatically shift our understanding of growing older, demonstrating its many cognitive benefits. He draws on cutting-edge research to challenge common and flawed beliefs, including assumptions around memory loss and the focus on lifespan instead of ‘healthspan’.
Levitin reveals the evolving power of the human brain from infancy to late adulthood. Distilling the findings from over 4000 papers, he explains the importance of personality traits, lifestyle, memory and community on ageing, offering actionable tips that we can all start now, at any age.
Featuring compelling insights from individuals who have thrived far beyond the conventional age of retirement, this book offers realistic guidelines and practical cognition-enhancing tricks for everyone to follow during every decade of their life. This is a radical exploration of what we all can learn from those who age joyously.
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From a MedPageToday online article:
“Amyloid is important in initiating disease, but the actual damage in the brain is probably due to the accumulation of tau,” Holtzman told MedPage Today. “Normally, tau protein is inside cells, but there is more and more evidence suggesting that its spread to different parts of the brain is responsible for the progression of Alzheimer’s disease.”
Two studies in January explored how sleep might be associated with Alzheimer’s tau pathology. The first, led by Brendan Lucey, MD, and David Holtzman, MD, both of Washington University in St. Louis, found that older adults who had less slow-wave sleep had higher levels of brain tau.
The findings, published in Science Translational Medicine, suggested that poor quality sleep in late life may signal deteriorating brain health.
Sleep patterns predicted amyloid and tau burden, reported Matthew Walker, PhD, of the University of California Berkeley, and co-authors, in June.
To read more
As a neuroscientist, professor emeritus of psychology, musician and best-selling author, Daniel Levitin has extensively studied the brain and its impact on aging. His latest book, “Successful Aging,” explores the questions: what happens in the brain as we age and what are the keys to aging well? NewsHour Weekend’s Christopher Booker recently spoke to Levitin to learn more.
Daniel Levitin website
PBS Newshour episode website
Geriatricians like Dr. Brandon Verdoorn see the wide range of effects of chronic pain on older patients. Minor, short-lived pain can be managed at home with ice, heat or over-the-counter medication.
If you have severe pain, persistent pain or pain that affects function, you should see your health care provider to determine the underlying cause and develop a pain management plan. That might mean physical therapy, exercise, massage or acupuncture.
Medication strategies often are used, too — typically starting with lower-risk approaches like acetaminophen and topical medications, and reserving higher-risk medications for more difficult cases.
From a New York Times online article:
If one geriatrician can care for 700 patients with complicated medical needs, as a federal model estimates, then the nation will need 33,200 such doctors in 2025. It has about 7,000, only half of them practicing full time. (They’re sometimes confused with gerontologists, who study aging, and may work with older adults, but are not health care providers.)
Geriatrics became a board-certified medical specialty only in 1988. An analysis published in 2018 showed that over 16 years, through academic year 2017-18, the number of graduate fellowship programs that train geriatricians, underwritten by Medicare, increased to 210 from 182. That represents virtually no growth when adjusted for the rising United States population.
“It’s basically stagnation,” said Aldis Petriceks, the study’s lead author, now a medical student at Harvard.
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