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Seniors Don't Get the Care They Need

Aug. 15 (Reuters-from Annals of Internal Medicine, Aug 16th ) 

Alzheimer's disease

NEW YORK (Reuters Health) - Many older adults appear to receive only a portion of the medical care that is recommended for them, and those who receive more care are more likely to stay alive over a three-year period, according to new study findings released Monday.

The study findings suggest that quality of care is "strongly associated with better survival among community-dwelling vulnerable older adults," Dr. Takahiro Higashi of Kyoto University in Japan and colleagues report.

After reviewing the available literature, Higashi and colleagues established a set of criteria to measure quality of care for a range of conditions, including diabetes, dementia, pneumonia, arthritis and other ailments common to older adults.

The researchers then applied 207 criteria designed to measure quality of care to 372 people aged 65 or older who were living at home, but had a relatively high risk of declining or dying soon. All adults were members of two managed care plans.

On average, patients received 53 percent of the care processes prescribed for them.

"There was a graded positive relationship between quality score and three-year survival," the researchers write in the Annals of Internal Medicine.

They conclude that "better quality of care, as measured by a broad set of quality indicators, is associated with better survival among community-dwelling vulnerable older persons."

They add that since older adults appear to receive only half the care they should, lapses in care quality may cause "unnecessary deaths" in some vulnerable, older adults.

In an accompanying editorial, Dr. Sankey V. Williams of the University of Pennsylvania in Philadelphia notes that the findings "remind us that if vulnerable patients want the best we have to offer, we should do everything we can for them, not just what seems practical."

More information

Alzheimer's

Is there any treatment?

There is no cure for AD and no way to slow the progression of the disease. For some people in the early or middle stages of AD, medication such as tacrine (Cognex) may alleviate some cognitive symptoms. Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) may keep some symptoms from becoming worse for a limited time. A fifth drug, memantine (Namenda), was recently approved for use in the United States. Combining memantine with other AD drugs may be more effective than any single therapy. One controlled clinical trial found that patients receiving donepezil plus memantine had better cognition and other functions than patients receiving donepezil alone. Also, other medications may help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression. Prevention, through lifestyle changes and mental and physcial exercise, represents one of the best ways to reduce the likelihood of getting the disease, coupled with regular, systematic monitoring.  

What is the prognosis?

AD is a progressive disease, but its course can vary from 5 to 20 years. The most common cause of death in AD patients is infection.  As the population ages and other diseases are brought under control - Alzheimer's becomes a major risk.

What research is being done?


Scientists are currently studying or testing different types of drugs and other substances to determine if they can stop AD progression, including nonsteroidal anti-inflammatory drugs (NSAIDS), statins (such as those used for lowering cholesterol), folic acid, gingko biloba, huperzine, and vitamins E, B6, and B12. Studies in basic science are also exploring the potential of vaccines. Regular  'screenings' are being advocated by some - with the U.S. House of Representatives recently passing a bill in support of early memory check-ups.  All advocate a regimen of physical exercise and mental exercise. If you start an exercise regimen or just walking use MemCheck to track your progress.

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Source: NIH and Cognitive Advisors. For a qualified medical opinion or diagnosis, please see your healthcare provider.  

Famous People and Alzheimers: former President Ronald Reagan, Grambling University football coach Eddie Robinson, actor Charlton Heston, actor James Doohan.   
                                                                                   
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