ADVANCEMENTS IN AGING RESEARCH TARGET MULTIPLE AGE-RELATED DISEASES

Newswise, August 22, 2016– The University of Alabama at Birmingham, along other members of the Geroscience Network, has published six manuscripts that map strategies for taking new drugs that target processes underlying aging into clinical trials.

Researchers believe these agents hold promise for treating multiple age-related diseases and disabilities. The articles appear today in The Journals of Gerontology: Series A – Biological Sciences and Medical Sciences.

The Geroscience Network, formed by Steven Austad, Ph.D., distinguished professor and chair ofUAB’s Department of Biology in the College of Arts and Sciences; James Kirkland, M.D., Ph.D., director of the Mayo Clinic Robert and Arlene Kogod Center on Aging; and Nir Barzilai, M.D., Albert Einstein College of Medicine, consists of 18 academic aging centers, along with the participation of more than 100 investigators from across the United States and Europe. The network is funded by the National Institutes of Health.

“Aging is not just an abstract and intriguing biological problem,” Austad said.

“It is the No. 1 cause of death and disability in today’s world. Its threat is very significant, because aging is a major risk factor in a host of other serious diseases and health issues.

The Geroscience Network seeks to combine research from a number of institutions to address this ever-growing challenge.”

“Aging is the largest risk factor for most chronic diseases, including stroke, heart disease, cancer, dementias, osteoporosis, arthritis, diabetes, metabolic syndrome, blindness and frailty,” Kirkland said.

“Recent research suggests that aging may actually be a modifiable risk factor. The goal of our network’s collaborative efforts is to accelerate the pace of discovery in developing interventions to delay, prevent or treat these conditions as a group, instead of one at a time.”

Austad is the senior author on the manuscript “Evaluating Health Span in Preclinical Models of Aging and Disease: Guidelines, Challenges, and Opportunities for Geroscience,” which assesses how research animals can be best employed to guide the development of therapies that counteract aging processes.

Kirkland is senior author on manuscripts that explore the challenges of developing aging interventions:
•“Barriers to the Preclinical Development of Therapeutics That Target Aging Mechanisms”
•“Frameworks for Proof-of-Concept Clinical Trials of Interventions That Target Fundamental Aging Processes”

The first manuscript summarizes discussions held at a 2014 Geroscience Network retreat.

While research efforts have successfully identified new drugs that extend lifespan in animals, the authors discuss the need to develop a consistent preclinical pipeline for drug development that focuses on best practices for drug discovery, development of lead compounds, translational preclinical biomarkers, funding and support for preclinical studies, and integration between researchers and clinicians.

In the second manuscript, the researchers acknowledge that aging therapies may hold “great promise” for enhancing the health of a wide population, with clinical trials’ being a critical step for translating therapies from animals into humans.

The manuscript is built on the outcomes of an international meeting funded through the National Institutes of Health R24 Geroscience Network.

The other manuscripts published are:
•“Strategies and Challenges in Clinical Trials Targeting Human Aging”
•“Resilience in Aging Mice”
•“Moving Geroscience Into Uncharted Waters”

Felipe Sierra, Ph.D., of the National Institute on Aging and a member of the Geroscience Network, describes the potential impact of aging discoveries in his manuscript, “Moving Geroscience Into Uncharted Waters.”

Sierra said, “In addition to the direct health issues, it has been calculated that care for the elderly currently accounts for 43 percent of the total health care spending in the U.S., or approximately $1 trillion a year, and this number is expected to rise as baby boomers reach retirement age.

“Reducing these costs is critical for the survival of society as we know it, and a 2013 paper by Dana Goldman and colleagues calculated that a modest increase in lifespan and health span (2.2 years) could reduce those expenses by $7 trillion by 2050.”

“While significant work has already been accomplished, there is much more to be done as we focus on translating findings into practice,” Kirkland said.

“The Geroscience Network is a collaborative way to overcome barriers and move us closer to our shared goal of increasing health span — the healthy, independent years of life for the elderly.”

In addition to UAB, members of the Geroscience Network are Albert Einstein College of Medicine, Buck Institute for Research on Aging, Harvard University, the Mayo Clinic, Johns Hopkins University, National Institute on Aging, the Scripps Research Institute, Stanford University, the University of Arkansas, the University of Connecticut, the University of Michigan, the University of Minnesota, the University of Oklahoma, the University of Texas Health Science Center San Antonio, the University of Southern California, the University of Washington and Wake Forest University, as well as members from other institutions across the U.S. and Europe.

This work was supported by the National Institutes of Health, the Paul Glenn Foundation, Nathan Shock Centers of Excellence for the Biology of Aging, the Connor Group, and the Noaber and Ted Nash foundations. Additional acknowledgements include the contributions of the basic researchers and clinicians engaged in research on mechanisms of aging and care of the elderly in the five retreats supported by the R24 grant from the National Institute on Aging, as well as a workshop on resilience and aging supported by the National Institute on Aging.

About UAB
Known for its innovative and interdisciplinary approach to education at both the graduate and undergraduate levels, the University of Alabama at Birmingham is an internationally renowned research university and academic medical center and the state of Alabama’s largest employer, with some 23,000 employees and an economic impact exceeding $5 billion annually on the state. The five pillars of UAB’s mission include education, research, patient care, community service and economic development. UAB: Knowledge that will change your world. Learn more at www.uab.edu.

Study shows U.S. consumers are saving more for retirement

Younger demographics are leading this financially-conscious movement

By Christopher Maynard

Christopher Maynard is a New York-based writer and editor who has worked as a security guard, high school teacher, theatrical lighting designer and volunteer fireman. He is a graduate of Marist College.  Read Full Bio→  Email Christopher Maynard 

August 22, 2016--About a year ago, a survey showed that U.S. consumers were becoming less inclined to save for retirement because they didn’t want to sacrifice their current quality of life. While they considered tools like a 401(k) plan to be integral towards future security, many just weren’t willing to commit to it.

Now, a new study conducted by Bankrate.com shows a reversing trend; it says that more American workers are saving for retirement. Experts say that this could be a positive sign for a growing economy.

“More working Americans are saving more for retirement and fewer aren’t saving at all,” said Greg McBride, Bankrate.com’s Chief Financial Analyst. “Both readings are indicative of an improving economy, where people are earning more and saving more.”

Gen Xers and Millennials lead the way

The results of the study show that 21% of working Americans are now saving more for retirement than they were a year ago, the strongest improvement in five years.

Additionally, fewer people are completely forgoing the saving process; only 5% of survey respondents admitted that they hadn’t saved anything this year or last year, the lowest result in the history of the study.

So which generations are leading the way in this new financially-conscious movement?

Experts say that consumers belonging to Generation X (age 34-54) are saving the most, followed by Millennials (age 18-25). Members of the Silent Generation (age 71+) are saving the least, followed by younger Baby Boomers (ae 52-61).

McBride says that members of the Silent Generation may be less inclined to save because they are reaching the phase of life where they will be entering retirement; however, not saving can still be very problematic for this group and Baby Boomers.

“Younger Baby Boomers saving less for retirement than last year is troubling because they’re more likely in their peak earning years and should be utilizing higher catch-up contribution limits to get on track for retirement. Those in the Silent Generation that are saving less may be a function of earning less as they phase into retirement,” he said. 

Copyright © 2016 Consumers Unified LLC

MAYO CLINIC, COLLABORATORS WORKING TO ADVANCE AGING RESEARCH

 Newswise, August 22, 2016— Mayo Clinic, along with other members of the Geroscience Network, has published six manuscripts that map strategies for taking new drugs that target processes underlying aging into clinical trials. Researchers believe that these agents hold promise for treating multiple age-related diseases and disabilities.

The articles appear today in The Journals of Gerontology: Series A – Biological Sciences and Medical Sciences.

The Geroscience Network, formed by James Kirkland, M.D., Ph.D., director of the Mayo Clinic Robert and Arlene Kogod Center on Aging; Steve Austad, Ph.D., University of Alabama at Birmingham; and Nir Barzilai, M.D., Albert Einstein College of Medicine, consists of 18 academic aging centers, along with the participation of more than 100 investigators from across the U.S. and Europe.

The network is funded by the National Institutes of Health.

“Aging is the largest risk factor for most chronic diseases, including stroke, heart disease, cancer, dementias, osteoporosis, arthritis, diabetes, metabolic syndrome, blindness and frailty,” says Dr. Kirkland.

“Recent research suggests that aging may actually be a modifiable risk factor. The goal of our network’s collaborative efforts is to accelerate the pace of discovery in developing interventions to delay, prevent or treat these conditions as a group, instead of one at a time.”

Dr. Kirkland is senior author on manuscripts that explore the challenges of developing these interventions:

• “Barriers to the Preclinical Development of Therapeutics That Target Aging Mechanisms”
• “Frameworks for Proof-of-Concept Clinical Trials of Interventions That Target Fundamental Aging Processes”

The first manuscript summarizes discussions held at a 2014 Geroscience Network Retreat.

While research efforts have successfully identified new drugs that extend lifespan in animals, the authors discuss the need to develop a consistent preclinical pipeline for drug development that focuses on best practices for drug discovery, development of lead compounds, translational preclinical biomarkers, funding and support for preclinical studies, and integration between researchers and clinicians.

In the second manuscript, Dr. Kirkland and others acknowledge that aging therapies may hold “great promise” for enhancing the health of a wide population, with clinical trials being a critical step for translating therapies from animals into humans.

The manuscript is built on the outcomes of an international meeting funded through the National Institutes of Health R24 Geroscience Network.

The other manuscripts published are:

• “Strategies and Challenges in Clinical Trials Targeting Human Aging”
• “Resilience in Aging Mice”
• “Evaluating Health Span in Preclinical Models of Aging and Disease: Guidelines, Challenges, and Opportunities for Geroscience”
• “Moving Geroscience Into Uncharted Waters”

Felipe Sierra, Ph.D., of the National Institute on Aging and a member of the Geroscience Network, describes the potential impact of aging discoveries in his manuscript, “Moving Geroscience into Uncharted Waters.”

Dr. Sierra says, “In addition to the direct health issues, it has been calculated that care for the elderly currently accounts for 43 percent of the total health care spending in the US, or approximately 1 trillion dollars a year, and this number is expected to rise as baby boomers reach retirement age.

Reducing these costs is critical for the survival of society as we know it, and a 2013 paper by Dana Goldman and colleagues calculated that a modest increase in lifespan and healthspan (2.2 years) could reduce those expenses by 7 trillion dollars by 2050.”

“While significant work has already been accomplished, there is much more to be done as we focus on translating findings into practice,” says Dr. Kirkland.

“The Geroscience Network is a collaborative way to overcome barriers and move us closer to our shared goal of increasing healthspan – the healthy, independent years of life for the elderly.”

Other authors in the manuscripts published in the Journal of Gerontology’s special issue are Jordan Miller, Ph.D., Shahrukh Hashmi, M.D., and Michael Stout, Ph.D. of Mayo Clinic; Jamie Justice, Ph.D. of University of Colorado Boulder and Wake Forest School of Medicine; John Newman, Ph.D. of the University of California San Francisco; Jeffrey Halter, M.D. of the University of Michigan; Steve Austad, Ph.D. of the University of Alabama at Birmingham; Nir Barzilai, M.D., Derek Huffman, Ph.D., and Sofiya Milman, M.D. of Albert Einstein College of Medicine; Christin Burd, Ph.D. of The Ohio State University; Matthew Gill, Ph.D., Laura Niedernhofer, M.D., Ph.D., and Paul Robbins, Ph.D. of The Scripps Research Institute.

In addition to Mayo Clinic, members of the Geroscience Network are Albert Einstein College of Medicine, Buck Institute for Research on Aging, Harvard University, Johns Hopkins University, National Institute on Aging, the Scripps Research Institute, Stanford University, the University of Alabama at Birmingham, the University of Arkansas, the University of Connecticut, the University of Michigan, the University of Minnesota, the University of Oklahoma, the University of Texas Health Science Center San Antonio, the University of Southern California, the University of Washington, and Wake Forest University as well as members from other institutions across the U.S. and Europe.

This work was supported by the National Institutes of Health, the Paul Glenn Foundation, Nathan Shock Centers of Excellence for the Biology of Aging, the Connor Group, and the Noaber and Ted Nash foundations. Additional acknowledgements include the contributions of the basic researchers and clinicians engaged in research on mechanisms of aging and care of the elderly in the five retreats supported by the R24 grant from the National Institute on Aging, as well as a workshop on resilience and aging supported by the National Institute on Aging.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic orhttp://www.newsnetwork.mayoclinic.org/.

Working and Volunteering Could Reduce Disablement in Seniors, Study Finds

Newswise, August 17, 2016—Working or volunteering can reduce the chances of chronic health conditions leading to physical disability in older Americans, according to researchers at Georgia State University and Florida State University.

The study found people ages 50 to 64 who worked full-time or part-time or volunteered up to 100 hours per year experienced a reduction in the extent to which chronic conditions were associated with subsequent functional limitations, such as the ability to walk a block or climb a flight of stairs.

The findings are published in The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences.

Previous studies have not examined how working or volunteering affects functional limitations, said Ben Lennox Kail, lead author and assistant professor in the Department of Sociology at Georgia State.

“If we can find interventions that slow down early-stage disability, we might be able to help people live healthier and ultimately longer because decreased physical functioning is associated with excess risk of mortality,” Kail said.

“What we’re arguing is that it’s important to have programs that incentivize people who are healthy enough to continue working and volunteering to do so because it can intervene in health processes.”

Maintaining high levels of physical functioning is one of the keys to successful aging.

In the United States, nearly 20 percent of men and 30 percent of women older than 65 years old experience some form of functional limitation.

Limiting disability is important to help reduce mortality in the U.S., as well as individual and public health expenditures.

“A lot of our programs are about labor force withdrawal,” Kail said. “Social Security and Medicare provide incentives to leave the labor force. For lots of people, these are great and important. At the same time, if we want people to age healthier than normal, we need incentives for them to continue working or begin volunteering.”

The researchers used Health and Retirement Survey data from 1998 to 2012. The data were collected from 13,268 people older than 50 and younger than 62, who were re-interviewed every two years.

The data include measurements of subsequent functional limitations: walking one block, climbing one flight of stairs, stooping or kneeling, lifting or carrying 10 pounds, picking a dime up off the ground and pushing or pulling a large object.

Participants indicated whether they had ever been diagnosed with any of the following chronic conditions: high blood pressure, diabetes, cancer, lung disease, heart problems, stroke or arthritis.

In addition, they reported whether they were engaged in full-time or part-time work over the past year, as well as the number of hours they volunteered during the same period.

The study found working full-time and part-time or volunteering less than 100 hours per year played a significant role in lessening the link between chronic conditions and functional limitations.

Workers and volunteers had fewer current physical limitations than their non-active counterparts. On average, they also had fewer chronic conditions.

Volunteering 100 hours or more didn’t reduce the association between chronic conditions and subsequent functional limitations, but it was important in limiting functional limitations.

“Some older people are leaving the labor force and not replacing it with anything,” Kail said.

“If you’re not replacing work with a work-like activity, your retirement is radically different than how you spent most of your life and not necessarily radically better.”

Dawn Carr of Florida State was a co-author of the study.

As Number of Patients with Chronic Critical Illness Grows, So Does Need for Long-Term Acute Care

Article in American Journal of Critical Care provides overview of long-term acute care facilities as part of continuum of care

Newswise, August 10, 2016 — Advances in technology have helped more patients survive acute illness and trauma, and these patients are increasingly transferred to long-term acute care hospitals (LTACHs).

Long-term acute care is a growing segment of the healthcare continuum, and a special commentary in the July 2016 issue of the American Journal of Critical Care (AJCC) provides an overview of LTACHs.

The AJCC commentary, “Long-Term Acute Care: Where Does It Fit in the Health Care Continuum?” describes the roles and practices of LTACHs and how they work in partnership with intensive care units (ICUs) and providers.

LTACHs specialize in the care of high acuity patients who become chronically critically ill and require medical treatment beyond the normal length of stay in a short-stay acute care hospital and beyond the scope of practice of inpatient rehabilitation or skilled nursing facilities.

 Many of these patients require prolonged mechanical ventilation or have experienced multisystem organ failure. Their recovery may occur slowly over weeks or months.

“LTACHs provide high-quality care to the chronically critically ill patient population and partner with ICUs to ensure these patients transition seamlessly to the best level of care possible, helping to ensure successful clinical outcomes,” said lead author Taryn Miller, RN, DNP, NEA-BC, clinical leadership development specialist with the LTACH division of Select Medical, Mechanicsburg, Pennsylvania.

“The LTACH environment, with a focus on the patient’s return to normalcy through the implementation of evidence-based protocols, has produced positive patient outcomes.”

These hospitals may be located within the walls of a short-term acute care hospital, or they can be a freestanding facility.

Categorized as a post-acute care facility, an LTACH provides care for patients with higher acuity needs than an inpatient rehabilitation facility or skilled nursing facility.

Patients are frequently referred directly out of the ICU but may also transfer from a progressive care unit or complex medical-surgical setting. Physicians and case managers identify patients who will benefit from an LTACH stay before transitioning them to a lower level of care.

Patients requiring acute dialysis, liberation from mechanical ventilation, complex wound management, management of one or more infectious disease processes, and those who require frequent administration or adjustment of intravenous medications may all be eligible for admission to an LTACH.

LTACHs typically use a multidisciplinary approach to care, which includes physicians, nurses, respiratory therapists, physical therapists, pharmacists, dieticians and case managers, a model which supports improved outcomes.

To access the article and its full-text PDF, visit the AJCC website at www.ajcconline.org.

About Select Medical: Select Medical is one of the nation's largest providers of specialized acute and post-acute care. Its network of more than 40,000 employees operates or supports more than 100 hospitals specializing in long-term acute care, 19 rehabilitation hospitals and more than 1,500 outpatient clinics offering physical and occupational therapy. In addition, Select Medical offers occupational medicine and urgent care at 300 centers through Concentra. Select Medical (NYSE: SEM) was founded in 1996 and is based in Mechanicsburg, Pennsylvania. For more information, visit www.selectmedical.com or youtube.com/selectmedical.

About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides leading-edge clinical research that focuses on evidence-based practice applications. Established in 1992, it includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of more than 107,000 acute and critical care nurses and can be accessed at www.ajcconline.org.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. www.aacn.org; facebook.com/aacnface; twitter.com/aacnme

Physical Declines Begin Earlier Than Expected Among U.S. Adults

Newswise, August 10, 2016– Physical declines begin sooner in life than typically detected, often when people are still in their 50s, according to a Duke Health study that focused on a large group of U.S. adults across a variety of age groups.

The finding suggests that efforts to maintain basic strength and endurance should begin before age 50, when it’s still possible to preserve the skills that keep people mobile and independent later in life.

“Typically, functional tests are conducted on people in their 70s and 80s, and by then you’ve missed 40 years of opportunities to remedy problems,” said Miriam C. Morey, Ph.D., senior fellow in the Center for the Study of Aging and Human Development at Duke University School of Medicine. Morey is senior author of research published in the Journals of Gerontology: Medical Sciences.

Morey and colleagues studied a group of 775 participants enrolled in the Measurement to Understand the Reclassification of Disease Of Cabarrus/Kannapolis (MURDOCK) Study.

The MURDOCK Study is Duke Health’s longitudinal clinical research study based at the North Carolina Research Campus in Kannapolis, N.C. The MURDOCK community registry and bio-repository includes more than 12,000 participants and nearly 460,000 biological specimens.

For the MURDOCK Physical Performance Lifespan Study, the Duke-led team enrolled participants ranging in age from their 30s through their 100s, with broad representation across sexes and races.

All participants performed the same simple tasks to demonstrate strength, endurance or balance: rising from a chair repeatedly for 30 seconds; standing on one leg for a minute; and walking for six minutes. Additionally, their walking speed was measured over a distance of about 10 yards.

Men generally performed better than women on the tasks, and younger people outperformed older participants.

But the age at which declines in physical ability began to appear – in the decade of the 50s – were consistent regardless of gender or other demographic features.

Specifically, both men and women in that mid-life decade began to slip in their ability to stand on one leg and rise from a chair. The decline continued through the next decades. Further differences in aerobic endurance and gait speed were observed beginning with participants in their 60s and 70s.

The study provides physical ability benchmarks that could be easily performed and measured in clinical exams, providing a way to detect problems earlier.

“Our research reinforces a life-span approach to maintaining physical ability – don’t wait until you are 80 years old and cannot get out of a chair,” said lead author Katherine S. Hall, Ph.D., assistant professor of medicine at Duke.

“People often misinterpret ‘aging’ to mean ‘aged’, and that issues of functional independence aren’t important until later in life. This bias can exist among researchers and healthcare providers, too. The good news is, with proper attention and effort, the ability to function independently can often be preserved with regular exercise.”

Hall and Morey said the next phase of research will be to study blood samples of the participants to determine whether there are biological markers that correlate with declines in physical ability. They are also revisiting the study participants for two-year checkups.

In addition to Hall and Morey, study authors include Harvey J. Cohen, Carl F. Pieper, Gerda G. Fillenbaum, William E. Kraus, Kim M. Huffman, Melissa A. Cornish,Andrew Shiloh,Christy Flynn, Richard Sloane, and L. Kristin Newby.

The study received funding from a philanthropic gift to Duke University from the David H. Murdock Institute for Business and Culture. Additional funding was provided in part  by the Claude D. Pepper Older Americans Independence Center program of the National Institute on Aging (P30AG028716) and the National Center for Research Resources, a component of the NIH (UL1TR001117).

The authors reported no conflicts of interest associated with this research.

Driving Ability of People with Cognitive Impairment Difficult to Assess: Research Review

Newswise, August 10, 2016--No single assessment tool is able to consistently determine driving ability in people with Alzheimer's disease and mild cognitive impairment, a St. Michael's Hospital research review has found.

Individuals with very mild and mild Alzheimer's disease who took a road test had a failure rate of 13.6 and 33.3 per cent respectively, compared to a failure rate of 1.6 per cent in drivers without Alzheimer's disease.

However, in general, patients with any degree of Alzheimer's disease still had a pass rate of almost more than 46 per cent.

The comprehensive research review, published today in the Journal of Alzheimer's Disease, found largely inconsistent results across 32 studies that looked at various cognitive tests in conjunction with driving outcomes, on-road evaluations and driving simulations.

Executive function, attention, visuospatial function and global cognition emerged as the strongest predictors for driving performance in these individuals; however there was no consistent measure across all studies that could determine safe driving ability.

"Many individuals with Alzheimer's disease and mild cognitive impairment are at an increased risk of driving collisions and crashes compared to other seniors," said Megan Hird, a researcher at the Li Ka Shing Knowledge Institute of St. Michael's, a Master's student at the University of Toronto and co-author of the study, along with Dr. Tom Schweizer.

"Despite this, some patients are able to retain the ability to drive safely. But the complex nature of these conditions and of driving itself makes deeming a patient an unsafe driver extremely difficult for clinicians."

Hird said physicians and other health-care professionals often are not confident in assessing the driving ability of patients with cognitive impairment, as there is no single valid assessment tool to discern who is safe to drive and who is not.

Studies using neuro-imaging have found that driving uses extensive networks of the brain, requiring certain degrees of attention, executive function and visuospatial function to drive safely. If any of these functions become compromised from Alzheimer's or dementia, the driver may no longer be safe.

"The other challenge in cognitive impairment and driving ability is that they are degenerative conditions," said Hird.

"Patients can have very mild to severe cognitive impairments that can vary over time, making it difficult for clinicians to accurately assess their safety as a driver without having a consistent assessment tool."

Of the 32 studies included in the review, 29 assessed driving performance of patients with Alzheimer's and four in patients with mild cognitive impairment.

Among the findings:

In a study of on-road assessments, patients with Alzheimer's disease had a failure rate 10 times higher than individuals without Alzheimer's disease.

Three tests emerged as the best single predictors of driving performance, looking at a patient's planning, attention, speed and visuospatial functions, requiring participants to: connect a series of numbered circles, alternate between and connect a series of encircled numbers and letters, and draw a path through a maze from start to finish.

Studies looking at driving tests found that individuals with Alzheimer's most commonly received a pass rating (46.5 per cent), rather than a marginal (34.6 per cent) or fail rating (18.9 per cent).

 In both on-road and simulator testing, studies showed that patients with mild cognitive impairment demonstrated minor rather than definitive driving impairments.

Hird said future large-scale studies should investigate driving performance and associated brain patterns in multiple subgroups of Alzheimer's disease and mild cognitive impairment, as cognitive function is highly variable within these populations.

"This would be an important step to determine if certain driving behaviours are associated with different severities in these patients, and may serve as a first step to creating a valid and reliable tool for clinicians to use with their patients."

Caregiver Assistance Increases Among Home-Dwelling Functionally Disabled Older Adults

Newswise, August 10, 2016--As more people in the United States age with chronic disease, needs for caregiving increase. Whether the source of caregiving for disabled older adults is changing is unknown.

 In a study appearing in the July 12 issue of JAMA, Claire K. Ankuda, M.D., M.P.H., and Deborah A. Levine, M.D., M.P.H., of the University of Michigan, Ann Arbor, examined trends in caregiving for home-dwelling older adults with functional disability

This study used data from the nationally representative U.S. Health and Retirement Study, and included home-dwelling adults 55 years and older with 1 or more impairments in activities of daily living or instrumental activities of daily living (ADL/IADLs) who were surveyed between 1998 and 2012.

There were 5,198 individuals and 39,060 observations of home-dwelling older adults with 1 or more impairments.

The researchers found that individuals increasingly reported caregiver help, from 42 percent in 1998 to 50 percent in 2012. Assistance was increasingly provided by spouses, children, other family, and paid caregivers over each 2-year period.

The greatest increase in caregiving was among those with fewer ADL and IADL impairments.

“Although this is likely in part because those with more impairments have already sought caregivers, it may also be that more adults with 1 or 2 impairments are aging in their communities as opposed to nursing homes,” the authors write.

“Further work is needed to assess the balance between functional needs in the population and capacity for caregiver support, as well as the burden on unpaid caregivers.”

Smartwatch Interface Could Improve Communication, Help Prevent Falls at Nursing Homes

Newswise, August 3, 2016 – Poor communication systems at nursing homes can lead to serious injury for residents who are not tended to in a timely manner. 

A new smartwatch app being developed at Binghamton University could help certified nursing assistants (CNAs) respond to alerts more quickly and help prevent falls.

Binghamton University researchers Assistant Professor of Systems Science and Industrial Engineering Huiyang Li and PhD candidate Haneen Ali are developing a smartwatch application to improve communication and notification systems for nursing homes, which are often faulty and inefficient.

The proposed design integrates all of the existing safety systems at nursing homes—e.g., call lights, chair and bed alarms, wander guards, calling-for-help functions—and provides alerts to users.

Through a process of iterative design and evaluation with prospective users, a final design was well received by nursing experts in geriatric care, and at local nursing homes. An on-going evaluation study shows that using this system reduces staff response time to alarms.

“The problem associated with not responding in time is that residents tend to stand up or go to the bathroom by themselves. If they’re not strong enough, they can’t support the weight. And if they have to wait, they will just get up and go. And that leads to falls,” said Li.

“We wanted to design a better system that improves notification and also, potentially, communication in nursing homes. The improvement of notification will potentially help staff to do a better job and, eventually, improve patient safety. Whenever residents need help, they have a way to call for help, and messages will be delivered to staff in an effective way.”

Most nursing homes use a call light system, where residents push a button inside of their room to send an alert, and bed and chair pads with pressure sensors that send an alert when a resident sits or stands up. When nurses are working down the hallway, they might not hear or see these alerts.

“With our system, we provide an informative and customized message for different alarms. The message contains the resident’s name, the type of alarm, the room number and the CNA who is responsible.

“The smartwatch will be on the CNA’s wrist, so it’s accessible all the time. They can see the message, hear the alarm, and feel the vibration, whether they are working down the hallway or inside the rooms,” said Li.

Every CNA who uses the app sees a different display, as it is personalized to the user’s specific task assignment. When CNAs start their shift, they will sign in and add their assigned residents.

 When a resident triggers an alert, a message will pop up on everyone’s screen indicating who the resident is, their room number, and the type of alert (e.g., an exit from a chair).

“The alert message is more informative than the existing system and, at the same time, it will help nurses to prioritize. We will mark or highight alarms from residents who are actually assigned to whoever is using the app,” said Li.

“The CNAs are exited about this idea and they are interested in this device. They would like to see the adoption of new technologies in their working environment because all of the problems in their current situation,” said Ali.

Li and Ali hope to test the system in the future using a high-fidelity prototype at real nursing homes.

While buying a smartwatch for every employee would be an added expense to nursing homes, the researchers believe that the benefits of this app would far outweigh the cost, particularly with the increasing availability of low-cost smartwatches.

“Falls, skin problems—these kind of facility acquired conditions can cost a hospital a lot of money. If the system can actually reduce falls, reduce adverse events, improve patient safety, and also improve quality of care, hospitals will save money.”

The paper, “Designing a Smart Watch Interface for a Notification and Communication System for Nursing Homes,” was presented at the Human-Computer Interaction International Conference 2016.

Getting America Moving Again! How to Get This Country Moving

Multisector, collaborative effort needed to combat physical inactivity

Newswise, August 2, 2016 — Greater efforts should be made to actively monitor physical activity as a risk factor in clinical practice, finds a new study from the Brown School at Washington University in St. Louis.

The paper “Scaling up Physical Activity Interventions Worldwide: Stepping up to Larger and Smarter Approaches to Get People Moving,” is part of a four-paper series published in The Lancet, which shows, among other findings, that physical inactivity costs the global economy more than $67.5 billion a year in health care costs and lost productivity.

Increasing levels of physical activity will require collaboration between schools, urban planning, transport, sports and recreation and the environmental sectors, finds the paper.

“Not every intervention implemented at scale is effective in increasing population physical activity levels, and not every effective, research-led intervention is scalable,” said Rodrigo Reis, professor at the Brown School and co-author of the study.

“We found that the key factors for scaling-up physical activity interventions are drawn from lessons from both evidence-based practice and practice based-evidence,” Reis said.

“The key factors include partnerships outside the health sector, early institutionalization and long-term political support of effective interventions.”

Reis and his co-authors pointed to several successful examples, such as the Bus Rapid Transit (BRT) System introduced in Curitiba, Brazil; Bogota, Colombia; and Cambridge, United Kingdom, which puts stops further apart than traditional bus stops to encourage walking; and the Coordinated Approach to Child Health (CATCH) in the United States, which promotes a healthy school environment including physical activity, food, nutrition and sun protection.

“The scientific community, researchers, funding agencies and journals should prioritize studies for assessing impact of real-world interventions,” Reis said.

“And governments should focus on scaling-up interventions with the highest face validity, promote multisector approaches and provide long-term tangible support.”