Prescription Sleep Medicine Linked to Motor Vehicle Collisions in Older Adults and Women

Newswise, February 21, 2016--A recent study by University of Alabama at Birmingham student assistant John Booth, III, and UAB Department of Epidemiology Professor and Vice Chair Gerald McGwin, Ph.D., published in Sleep Medicine linked the use of prescription sleep medicines containing zolpidem among aged drivers and the incidence of motor vehicle collisions.

“Due to the side effects of such drugs — including drowsiness upon waking and impaired coordination, current zolpidem users age 80 and older, as well as those who are female, experienced higher rates of MVCs than nonusers,” said Booth, a Ph.D. candidate in UAB’s Department of Epidemiology.

“We recommend that health care practitioners consider proposing behavioral treatment before prescribing zolpidem to restore sleep in women and patients over age 80 to reduce the risk of MVCs associated with this prescription drug.”

In the overall sample, the unadjusted 5-year motor vehicle collision rate was 46 percent higher for current zolpidem users versus nonusers.

More specifically, the unadjusted 5-year motor vehicle collision rate was 65 percent higher for females and 23 percent higher in males who used zolpidem. For those 80 years of age and older, the unadjusted 5-year motor vehicle collision rate was 124 percent higher for zolpidem users compared with nonusers.

According to the National Institutes of Health National Center for Complementary and Integrative Health, possible treatment alternatives to sleep medications include relaxation techniques, melatonin supplements, mind and body approaches such as meditation, as well as stimulus control such as consistent sleep schedules, and avoiding caffeine and alcohol.

A total of 2,000 north central Alabama zolpidem users, age 70 and up, who had driven within the previous three months and held a valid driver’s license were studied.

The researchers evaluated each participant’s five-year MVC history, obtained from the Alabama Department of Public Safety, and then estimated at-fault MVC rate ratios by comparing zolpidem users’ and nonusers’ data in age- and sex-defined subgroups.

Feeling Older Increases Risk of Hospitalization, Study Says

Disease, depression could help explain association

Newswise,  February 13, 2016-- People who feel older than their peers are more likely to be hospitalized as they age, regardless of their actual age or other demographic factors, according to research published by the American Psychological Association.

“How old you feel matters. Previous research has shown it can affect your well-being and other health-related factors and, now we know it can predict your likelihood of ending up in the hospital,” said the study’s lead author, Yannick Stephan, PhD, of the University of Montpellier in France.

The research, which comprised more than 10,000 adults across the U.S., was published in the journal Health Psychology.

Despite previous studies showing an association between health-related issues and subjective age, this is the first study to test whether feeling older is linked to a higher risk of hospitalization, according to the article.

Stephan and co-authors Angelina R. Sutin, PhD, and Antonio Terracciano, PhD, of Florida State University, analyzed data from three longitudinal studies conducted from 1995 to 2013 with participants ranging in age from 24 to 102.

They found that those who reported feeling older than their actual age had a 10 to 25 percent increased likelihood of being hospitalized over the next two to 10 years when controlling for age, gender, race and education. The findings replicated across the three samples.

Further analysis showed that having more depressive symptoms and poorer health helped explain the link between feeling older and being hospitalized.

“Feeling older is associated with poorer physical and mental health, but also with physiological impairments that may result in illness and health service use over time,” said Sutin.

Participants were drawn from the Midlife in the United States Survey, the Health and Retirement Study and the National Health and Aging Trends Study.

In each sample, the participant’s subjective age was assessed by asking each participant how old he or she felt at the beginning of the study. Researchers also asked them to provide information about previously diagnosed health conditions (i.e., high blood pressure, diabetes, cancer, lung disease, heart condition, stroke, osteoporosis or arthritis).

Participants also answered a questionnaire designed to assess symptoms of depression. At the beginning and at various follow-up periods, subjects reported if they had been hospitalized for any reason, either over the last year in two samples or over the last two years for the other.

“In addition, individuals with an older subjective age are more likely to be sedentary and to experience faster cognitive decline, all of which may precipitate a hospital stay” said Terracciano. 

“Taken as a whole, this study suggests that subjective age, along with demographic, cognitive, behavioral and health-related factors, could be a valuable tool to help identify individuals at risk of future hospitalization,” said Stephan.

“People who feel older may benefit from standard health treatments -- for example through physical activity and exercise programs, which may reduce their risk of depression and chronic disease, and ultimately their hospitalization risk.”
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Article: “Feeling Older and Risk of Hospitalization: Evidence From Three Longitudinal Cohorts,” by Yannick Stephan, PhD, University of Montpellier; and Angelina R. Sutin, PhD, and Antonio Terracciano, PhD, Florida State University, Health Psychology, published online Feb. 11, 2016.

Full text of the article is available from the APA Public Affairs Office and at www.apa.org/pubs/journals/releases/hea-hea0000335.pdf.

Improving Quality of Life for the Seriously Ill

Newswise, February 13, 2016— Being diagnosed with a potentially life-threatening illness is distressing enough but a dearth of cohesive services often compounds the difficulty, according to an NAU researcher.

Mary Anne Hale Reynolds, an associate professor in the School of Nursing, focuses on adults, ages 20-59, and the physical, psychosocial, emotional and spiritual impacts following a life-threatening disease diagnosis.

Reynolds’ area of expertise is palliative care, which she described as an array of services geared toward people with serious illnesses.

“The interesting thing about palliative care teams is they are almost always based in acute-care settings in hospitals,” Reynolds said. “But for people who are discharged home, then community resources become very important.”

Most people Reynolds has surveyed are unable to accurately describe palliative care, which she describes as similar to hospice services but provided on an outpatient basis through community partners over a longer period of time.

Palliative care includes spiritual counseling, pharmaceutical assistance and health care services. Unlike patients in hospitals, hospice and assisted-living facilities, many people in Reynolds’ research live at home, continue to work and often care for family members despite a potentially life-threatening diagnosis.

As the health care system in the United States continues to evolve, Reynolds has witnessed a move toward more palliative care, yet research on the topic is sparse.

With more people living longer with life-threatening illnesses, there is an imperative to improve the quality of their lives, Reynolds said, which could be accomplished through a robust model of palliative care.

Services could include managing symptoms and pain, transportation to and from treatments, navigating insurance and referring people to a lawyer if advanced directives are needed.

In a recent northern Arizona study, Reynolds learned about inadequacies of services for people with cancer. She discovered recurring themes among the afflicted, including difficulty maintaining employment, financial burdens and the challenge of commuting to Flagstaff for health care.

Most of the people in Reynolds’ study, which was funded by the American Nurses Association and Hospice and Palliative Nurses Association, were slow in being correctly diagnosed, postponing their cancer treatments.

After a diagnosis, palliative care services could have improved their lives, she said.

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"Palliative care models are all about improving people's quality of life, not the quantity," said Reynolds, noting that in many cases patients receiving palliative care early do actually live a couple of months longer than expected.

In addition to enhancing the quality of life following a diagnosis, Reynolds said, palliative care research shows an economic benefit from fewer hospital readmissions.

Reynolds wants to expand her recent research to include cardiac patients and people with other types of life-limiting illnesses. Educating primary care providers, including those in rural communities, would be a big step toward improving the quality of life for patients.

"With palliative care, it is about identifying services we have an what we need," Reynolds said. Nurses, including Reynolds' students, will play significant roles on future interdisciplinary teams if the healthcare system moves to a more encompassing palliative care model.

Reynolds received word this week that two of her grant applications were accepted and funding will be awarded for additional palliative care research.

Past Experiences Affect Recognition, Memory

Newswise, February 10, 2016 — New research from the University of Guelph on the brain and memory could help in developing therapies for people with schizophrenia and Alzheimer’s disease.

The study by psychology professor Boyer Winters and his research team was published recently in the Journal of Neuroscience.

Their work sheds new light on the internal workings of the brain, specifically regions involved in recognizing and remembering objects.

“Our study suggests that past experience with an object alters the brain circuitry responsible for object recognition,” said Winters.

“It has significant implications for our understanding of multisensory information processing.”

Multisensory integration is an important part of memory, Winters said. For example, if you hold something while blindfolded, chances are you can recognize it by touch if you have seen it before. But how?

Specialized areas of the brain mediate information for sight and touch, Winters said. Some researchers say those regions “talk” to each other, enabling better recognition of an object.

Others believe that the brain integrates information from the senses and stores it in a separate place entirely, and then taps into that area to aid object recognition.

Winters and his team from U of G’s Collaborative Neuroscience Program set out to test which model is correct using rats.

They let some rats briefly explore an object’s tactile and visual characteristics. 

The next day, the researchers showed the object to the same animals, and compared their responses to rats seeing the object for the first time.

Rats exploring the objects for the first time appeared to use multiple specialized brain regions to recognize the object, while rats with previous exposure tapped into a separate part of their brains to perform the same memory task.

“Knowing what an object looks like enables them to assimilate information in a way that doesn’t happen when there is no pre-exposure,” Winters said.

“Our study suggests there is an assigned region of the brain for memory based on previous experience with objects.”

The more exposure to an object, the more information about it is stored in dedicated parts of the brain, leading to more efficient behavioural responses, Winters said.

The research may help in developing therapies for people with dementia and other brain disorders who cannot recognize highly familiar objects or people, he said.

Study Shows Promising Safety Results for Anti-Aging Drug

First rapamycin metabolic study results in nonhuman primates results in new grant

Newswise, February 10, 2016– The search for the fountain of youth led to a 2009 discovery that a drug called rapamycin was shown to extend the lifespan of mice.

Since that time, studies on the metabolic side effects of rapamycin have made it unclear whether the drug is safe as a long-term treatment. A recent study published in the November issue of the journal Aging showed minimal metabolic side effects after continuous, long-term treatment with encapsulated rapamycin in a marmoset (monkey) model.

The study, completed by researchers with the Barshop Institute for Longevity and Aging Studies at The University of Texas Health Science Center at San Antonio and the Southwest National Primate Research Center (SNPRC) at Texas Biomedical Research Institute, is the first to examine the metabolic consequences of rapamycin dosing in healthy, non-human primates.

In addition to metabolic function, the researchers found that the encapsulated rapamycin was well tolerated by the marmosets.

“This initial study with marmosets as a model for human aging has allowed us to evaluate the efficacy of a new intervention treatment that looked promising in other animal model species for both healthspan and lifespan extension,” said Dr. Corinna Ross, lead author of the study and Assistant Professor Biology, Texas A&M University San Antonio.

“The results are encouraging,” said Dr. Suzette Tardif, Associate Director of SNPRC and co-investigator on the study. “Marmosets also offer a unique non-human primate model that will allow us to further evaluate not just the safety but the effectiveness of treatment with rapamycin.”
Due to results from this study, a grant for $2.7 million was awarded to the Barshop Institute and SNPRC by the National Institute on Aging to fund a new study to determine the effects of rapamycin lifespan and markers of healthy aging for a cohort of marmosets that have already reached middle age.

Dr. Adam Salmon, principal investigator of the new study and Assistant Professor/Research Department of Molecular Medicine at the Barshop Institute, said, “These studies will provide an important step towards translational approaches to delay age-related disease and improve healthy aging in humans by means of pharmaceutical inhibition of mTOR (mechanistic target of rapamycin).”
The new study begins this month.

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Money and Influence in 2016 Presidential Campaign Tracked by New Index at Chicago Booth

Newswise, February 5, 2016 — As the 2016 presidential campaign attracts more money and bigger political donations than any campaign in U.S. history, the University of Chicago Booth School of Business has created a financial index to capture the influence that corporations and special interest groups have on politics and the economy.

The George J. Stigler Center for the Study of the Economy and the State at Chicago Booth launched the Campaign Financing Capture Index to measure the concentration of campaign funding in the 2016 U.S. presidential election.

The index ranks the concentration of funding for each candidate with an eye toward predicting how political donations could influence policy decisions under a new president.

The creation of the index comes as the U.S. courts have lifted limits on the size of political donations, and special interest groups, in the form of super PACS, are playing a bigger role in how campaigns are financed.

“The more concentrated the sources of funding to a political campaign, the higher the risk a politician will be influenced by special interests,” said Professor Luigi Zingales, director of the Stigler Center.

“Candidates receiving large donations from few donors may be less willing and able to lead reforms in markets where powerful special interest groups benefit from the status quo.”

The Campaign Financing Capture Index, published quarterly, will track when and how big-money political donations shift during the course of the campaign. Researchers at the Stigler Center expect there to be significant changes in the concentration of donations as the race progresses.

The index measures “concentration” by the number of donors and the amount of each donation. Candidates with highly concentrated funding have the fewest donors giving the most amount of money.

 Candidates with low concentration of funding have the largest number of donors giving the smallest amounts of money. The Stigler Center defines large donations as contribution of $5,000 or more.

“We think that when donations start to exceed $5,000, donors are not just expressing a political preference, they are trying to influence future policies,” said Zingales.

First Round of Results

Republican candidate and former Florida governor Jeb Bush ranked as the candidate with the highest concentration of big donors at 77 percent of total campaign contributions above $5,000.

Republican Senator Marco Rubio of Florida ranked second at 59 percent, closely followed by Republican Senator Ted Cruz of Texas at 58 percent.

Democratic candidate Hillary Clinton fell in the middle of the pack with 32 percent of political contributions above $5,000, followed by Democratic former Maryland governor Martin O’Malley at 17 percent, Republican Ben Carson at 12 percent, Republican billionaire Donald Trump at 2.9 percent, and Democratic Senator Bernie Sanders of Vermont at 0.1 percent.

The candidates ranked in the same order when tracking donations of $100,000 or more. Bush had the highest concentration of $100,000-plus donors at 58 percent, followed by Rubio at 47 percent, Cruz at 45 percent, Clinton at 29 percent, and O’Malley at 4.3 percent. Figures for Carson were inconclusive.

Sanders and Trump are the only candidates to have received no political contributions over $100,000. Sanders’ campaign is dominated by individual donations of $200 or less. Trump is in a category of his own, digging into his own pockets to fund much of his campaign.

The funding results are for the campaigns are through Dec. 31, 2015.

Analysis is based on Federal Election Commission data collected by the Center for Responsive Politics, a nonprofit, nonpartisan research group.

The Stigler Center is a nonpartisan, academic research institution that is focused on the creation and dissemination of research on competitive markets, regulatory capture and the ways in which special interest groups distort markets.

The Campaign Financing Capture Index is led by Professor Luigi Zingales, along with the University of Chicago’s Milena Ang and Chicago Booth’s Eran Lewis.

Mature Drivers Favour Checks on Over 70s, New Study Finds

Publisher’s Note:  Although this survey was taken outside the US, we publish it here as the US faces challenges of an Aging Population—including driving and transportation for older persons

Newswise, February 5, 2016 — The majority of older drivers are in favour of tighter rules on checking the health and suitability of over-70s to drive – even if those checks could take them off the road themselves – according to a new report. T

he Institute of Advanced Motorists (IAM) worked with Dr Carol Hawley at Warwick Medical School, the University of Warwick, to survey more than 2,600 drivers and former drivers on their opinions, habits and motoring history.

The first major survey of its kind for two decades, Keeping Older Drivers Safe and Mobile, found more than half of over 70s demonstrate that they self-regulate to stay safe, by avoiding driving in challenging situations like busy traffic, after dark, in rush hour or bad weather.

While mature drivers travel significantly fewer miles than other age groups, 84% of them rated their driving ability as ‘good to excellent’ and only 6% had ever considered giving up driving.

Despite that a very high proportion of respondents were in favour of measures to increase their safety on the roads. Dr Hawley said: “Almost 60% of those questioned said drivers should retake the driving test every five years after age 70, 85% said drivers should pass an eyesight test every five years once they have reached 70, and more than half said that drivers aged around 70 should be required to have a medical examination.”

Dr Hawley worked with Professor Elizabeth Maylor in the University’s Psychology Department who provided access to the Warwick University research volunteer panel which provided nearly all of the respondents. Of those questioned 94% agreed that GPs should be required to inform patients if their medical condition may affect their fitness to drive and half agreed that a flexible licensing system should be introduced which could restrict types of roads and conditions for some older drivers.

The IAM’s survey found respondents wanted some rules to extend further than older drivers – 84% agreed that all drivers should pass an eyesight test every 10 years after first passing, regardless of their age.

The report also found just how important driving is to this group. Some 82% said that driving was very or extremely important to them, a figure that increases for women. Independence and convenience were cited as the main reasons for wanting to continue driving.

The number of drivers over the age of 70 is set to double over the next 20 years and with more than one million licence holders over the age of 80, there is a pressing need for enlightened policies and practical actions to help them keep safe and competently mobile for as long as possible.

Sarah Sillars, IAM chief executive officer, said: “Driving is about so much more than getting from A to B and nowhere is this more apparent than in this age group. It helps maintain self-esteem and freedom and is essential for combatting social isolation.

“There are certain issues that affect mature drivers more so than other groups however, such as reductions in mobility and a slowdown in reaction times. The great news from this survey is that mature drivers themselves are aware of the risks and support action to review their safety.

“Voluntary self-assessment and better education via GPs are important techniques for helping drivers understand how long they can continue to drive safely for. And for those needing a confidence boost or a little extra reassurance on today’s busy roads, the IAM’s Mature Driver Assessment could be something to think about.”