The US National Institute on Aging and the Department of Veterans Affairs funded a joint preliminary study which, in an almost cruel twist, implies that many individuals diagnosed with Alzheimer’s – the memory killer –  may not actually suffer from the disease. The study examines 426 men who died at an average age of 87, finding that about half of them were diagnosed with Alzheimer’s despite not having enough brain lesions to confirm it. The likelihood of misdiagnosis increased with age. [1]

In other words, about half of Alzheimer’s cases could be misdiagnosed! Ironically, some patients may be on to more than we think if they forget living with a disease they never actually had.

This is problematic because there are a variety of causes for dementia in the elderly, including depression, over-medication, thyroid problems, Vitamin B-12 deficiency, and vascular disease. All of these cases are much more treatable than Alzheimer’s.

It also raises some issues about the efficiency of the tests for Alzheimer’s. Alzheimer’s is not the only form of dementia, which as a category includes Parkinson’s and Lewy Bodies. The trouble arises because while all of these diseases can have similar manifestations, treatment differs among them.

Researchers last year emphasized the importance of a precise differential diagnosis after their work identified bio-markers that raised the probability to 80% for identifying mild-stage Alzheimer’s up to five years before full-onset. Precision is critical not simply as an academic exercise but also for the correct development of diagnosis-specific, differentiated treatment and preventive care in the future. [2]

The flaw in identifying Alzheimer’s makes the killer disease even more elusive. Lewy body dementia and vascular dementia have more accurate diagnosis rates. Yet, this more recent study is far too narrow for us to easily generalize the meaning of the results. One of the researchers commented that “larger studies are needed to confirm these findings and provide insight as to how we may more accurately diagnose and prevent Alzheimer’s disease and other principal dementing disease processes in the elderly.”

The research was released February 24 and will be presented as part of a plenary session at the American Academy of Neurology’s 63rd Annual Meeting in Honolulu April 9-16, 2011.

Read more about the research…

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[1] Rocca, Walter A., Ronald C. Petersen, David S. Knopman, Liesi E. Hebert, Denis A. Evans, Kathleen S. Hall, Sujuan Gao, Frederick W. Unverzagt, Kenneth M. Langa, Eric B. Larson, and Lon R. White. ”Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States.” Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association 7, no. 1 (January 2011): 80-93.

[2] Mollenhauer, Brit, Hans Förstl, Günther Deuschl, Alexander Storch, Wolfgang Oertel, and Claudia Trenkwalder. “Lewy Body and Parkinsonian Dementia Common, but Often Misdiagnosed Conditions.” Dtsch Arztebl Int 107, no. 39 (2010): 684-691. http://www.aerzteblatt.de/v4/archiv/pdf.asp?id=78598 (accessed March 14, 2011).

A recent study shows that motion gaming has beneficial effects on elderly individuals. Motion gaming is a field of interactive entertainment that involves frequent and sometimes continuous movement (common examples are the Nintendo Wii and Kinect systems). These platforms allow seniors to participate in activities they may be unable to otherwise enjoy, including various sports such as tennis, bowling, golf… perhaps even some boxing.

The benefits from such exercise is more than physical; it is also mental and psychological. According to a study by the Gerontological Society, virtual engagement through interactive games increases life satisfaction, positive moods, and physical activity by offering a forum that provides healthy fun with others. [1] In other words, seniors can feel involved and part of an activity, improving self-fulfillment and helping them build connection with others, especially the younger generation who have grown up with such games.

The physical benefits are obvious as a variety of studies have shown that even occasional motion gaming (a few times on the Wii, for example) has resulted in improved balance, coordination, and strength. For those at risk for falls, this is a tremendous benefit. Wii bowling taken off among seniors… indeed staff at Cascade Park Gardens have even hosted a tournament or two in the past.

Yet it has only been more recently that research has shown the positive impact beyond the body. Video games that encourage physical activity also help with depression. In a study by the University of California, San Diego School of Medicine, over a third of participants reported a 50% or greater reduction in depressive symptoms. [2]

So the next time someone tells you video games are harmful or a waste of time, you can mention this list of benefits [3] … just try not to tell your kids about it

• Increased physical attributes, including strength, coordination, and balance
• Significantly reduced levels of depression
• Increased socialization (Need proof? Just behold the phenomenon of Wii bowling)
• Helping bridge generational divides… let’s face it grandparents are cooler when they play video games [4]
  

[1] From a 10-week study conducted by Patricia Kahlbaugh, Ph.D from Southern Connecticut State University. See Zafar, Aylin. “Physical Video Games may Help the Elderly Psychologically.” The Atlantic. February 13, 2011. http://www.theatlantic.com/technology/archive/2011/02/physical-video-games-may-help-the-elderly-psychologically/71184/ (accessed March 14, 2011).

[2] Rosenberg, Dori, Colin Depp, Ipsit Vahia, Jennifer Reichstadt, Barton Palmer, Jacqueline Kerr, Gerg Norman, and Dilip Jeste.” Exergames for Sybsyndromal Depression in Older Adults: A Pilot Study of a Novel Intervention.” American Journal of Geriatric Psychiatry 18, no. 3 (March 2010): 221-226.

[3] Also see http://www.gamesforhealth.org/

[4] For more information on this specifically , see the following research — “Casual Video Game Play Encouraged by Parents, Grandparents.” Survey conducted by Information Solutions Group for PopCap Games. August 27, 2007. http://www.infosolutionsgroup.com/pdfs/video_games_encouraged.pdf (accessed March 14, 2011).

Everyone knows that the baby boomers’ big retirement party will deal our society some interesting challenges. Many are focused on extensive reforms and planning to prepare for the coming storm. But for one city, that storm may have already arrived…

This year, the over 2 million baby boomers in Chicagoland will start turning 65. The “sheer numbers (alone) mean huge changes in the way we have to think about housing, transportation, the workforce — everything,” says Randy Blankenhorn, executive director of the Chicago Metropolitan Agency for Planning.

Some major impacts these demographic trends will have include:

• Pressure on the housing market – With many retiring boomers looking to sell their homes and either downsize or move into some form of assisted living, the flood of vacancies will only add to depressed foreclosures
• Pressure on their living standards - As they retire, boomers will see their income cut down to a mere fraction, shrinking their discretionary spending and eating into their life savings.
• Pressure on supporting governmental services – The drop in income will be matched by a corresponding decrease in the amount of taxes these people pay. As such a large population, the loss of tax revenue from working boomers will place a financial burden on state and federal governments as sources of funding become more and more scarce.
• Pressure on the medical system - We know all about this one. The number of boomers will place more stress on our medical care as they increasingly rely on government insurance programs which are already thinly spread, maxed out, or possibly bankrupt.

By 2030, the number of people 65 or older in the Chicago area is estimated at 1.7 million (65%). Although that’s still less than the national level of 78%, the Windy City will experience a significant increase (1 in 6 in 2030, compared with 1 in 9 today). Today, the city’s population stands at only about 2.7 million, on the low end due to recent immigration.

Read more about this via Crain’s Special Report

 

Long-term services and support are at the center of major discussion, with government department heads and industry leaders having gathered in Washington and reviewed the results of last year’s Innovative Communities Summit.

The Long Term Quality Alliance has released a new report detailing this discussion and exploring the future of long-term care. Titled “Innovative Communities: Breaking Down Barriers for the Good of Older Consumers and Their Family Caregivers,” the report lays out steps the Alliance should take to encourage and promote creation of comparable multi-sector innovative communities that would involve local providers as well as consumers and caregivers.

It highlights 3 programs of particular interest:

1. North Carolina’s Community Connections project in Chapel Hill
2. Vermont’s Seniors Aging Safely at Home in Burlington
3. Michigan’s Detroit Community Action to Reduce Hospitalizations in Farmington.

These programs, the summit, and the conversation all highlight the idea that while action at the state and federal levels are integral to health-care reform, the most substantive and sustainable reform will take place on the local level. Alliance Chair Mary Naylor says that health reform is doomed to fail “unless all of these local stakeholders pool their collective energy, break down the silos in which they operate, and work together to devise and implement strategies and interventions that advance and improve care.”

The three programs above exemplify this concept. They strengthen the continuum of care by including ways to prevent unnecessary hospitalization and working to improve transitions between medical and social settings (whether physical or mental). The goal is to create a more person-centered system for empowering aging with dignity in the chosen or preferred environment of the consumer.

Innovative approaches such as these can be used not only to improve care, but cut costs by unifying or at least better organizing fragmented services and programs. Paul McGann, Deputy of Chief Medical Officer for the Centers for Medicare and Medicaid Services says the government is taking note: “Better care is actually less expensive care…I can tell you and promise you that CMS is changing.”

The summit in December 2010 included leaders from federal and state government; advocacy and service organizations serving older consumers; individuals with disabilities and their caregivers; national, state, and local professional associations; aging networks, hospitals, and health systems; and organizations that provide acute care, long-term services, and home health support.

The report also highlights the vision for increasingly greater collaboration among those who provide care and services to older people. The ideal health system of tomorrow will combine consumer empowerment, team-based approaches to care, a philosophy of equality, and people who will lead by building bridges… by building community.

Read the original report

Governor Gregoire and the fiscal committees are in the process of finalizing work regarding the supplemental budget bills in the face of the March 17th revenue forecast. The forecast may show that the deficit has increased by about $1 billion.

WHCA will continue to focus its efforts (as should we) on educating policy-makers on the value of facility-based care for the vulnerable populations we serve, not only because of the strengths of such care but also as a method of saving resources for our health-care budget when compared to hospital expenses.

Other highlights include:

• Last week over 30 assisted living providers converged at the Capitol to participate in a special advocacy session
• Legislation making a year’s worth of nursing home cuts totaling $7.1 million from the state general fund over the next three months is on the Senate Ways & Means’ Committee for executive action (see SHB 1249)
• On March 10th the House and Senate held public hearings on legislation that will expand the definition of financial exploitation for vulnerable adults (see SHB 1104 and SSB 5042)

The update also covers news regarding flexibility in the delivery of long-term care services, and the status of the new caregiver training standards – they have yet to be implemented and their future seems uncertain at this point.

See the full release via WHCA

 

Baby boomers are their own demographic in more ways than one… and marketers take note of it. Below is a video on some “special clothing” just for the boomer generation.

(via the Wall Street Journal)

Registration is still open for Spree, the second largest fundraiser for Outdoors for All.

Outdoors for All is an organization dedicated to enriching the quality of life for children and adults with disabilities through outdoor recreation.

There is still time to become a team captain and help raise funds! As a team captain you receive a K2 Sports backpack or a Transpack boot bag, branded with the Outdoors for All logo! Another bonus is that you and your team members will each get an Outdoors for All branded dri-fit t-shirt. Plus not to mention all the other amazing bonuses of lift tickets, unlimited demos, beer garden, food and MORE!

It is estimated that a traumatic brain injury (TBI) occurs something like every 14-16 seconds in the United States. Each year we see about two million head injuries in the country which have left over three million children and adults with lifelong disabilities. And, TBI accounts for over 30% of all injury deaths in the US. [1] 

But these are just statistics, numbers that often rank alongside the number of people living in poverty in a foreign land, or the number of American troops killed on any given day in the service of our country. Unless there is some personal connection, all of their stories are left behind, barely kissing the trails we leave in the wake of our busy lives.

So here is a personal statistic: ONE

ONE fall… that’s all it takes. That impact that hits someone’s head at just the right angle can leave more than a single person with a challenge no one wishes for.

ONE mistake… that’s all it takes. That day, he or she just wasn’t paying enough attention when that truck seemingly came out of nowhere.

ONE second… that’s all it takes. In that instant, the course of an entire life (and family) can change forever.

March is recognized as Brain Injury Awareness Month, but how aware are we really? We hear the facts and research about concussions and other acquired traumatic injuries, but are we as a society listening? After all, we are the same people who watched an NFL football player kill himself while the association representing all professional associations pushes for an increase in the number of required games per season. [2][3] What does it take for us to personalize and internalize the need for our vigilance when it comes to traumatic brain injury?

Let’s put a face and a story to the faceless and storyless terror we’ve come to know as TBI.

One Night

Kory Christiansen was 25 when he had the accident.

That night, on December 15, 2005, it was dark, cold, and icy. He and a friend were out getting oysters. Their car slipped on the road and went off a cliff, tumbling down to the low-tide beach below. When Kory’s father David found the car upside down on the beach… there are no words to describe the feelings of parents at that moment. Kory, who had suffered a severe head injury, was rushed to Harborview Medical Center in Seattle by helicopter.

For a month and a half, he didn’t wake up.

Over five years later, Kory is alive and busy with a full schedule. Living close to both the YMCA and the University of Puget Sound in North Tacoma, Kory attends clinics at both places multiple times per week. He also receives care at Cascade Park Active Day’s TBI program.

How did Kory and his family get from that night to today?

A Family’s Challenge

Although a good range of Kory’s mental abilities remain intact, including his vocabulary and spelling, he has left-brain paralysis and cannot speak. His comprehension faculties are fine but he responds to external stimuli slowly in forming thoughts and conveying meaning without the aid of speech. “He knows what’s going on, but life goes by so fast for him…” says his mother Kris, while his father half-jokingly comments that Kory’s memory is better than his.

It’s difficult to build and maintain relationships when there is such an impediment to communication. In some ways it is even more difficult than someone in a coma or who is catatonic because Kory is still perfectly aware of everything going on around him, and he WANTS to do things and connect with people. 

Writing it down for others to see, Kory says he’s lonesome. He wants socialization and relationships. He wants everything someone without TBI could want. The challenge for Kory is how to build these connections in spite of his brain injury. The challenge for his parents is maintaining hope in what has always been presented as a hopeless situation.

Nothing is Ever Hopeless

As one might expect, David and Kris haven’t always had an easy time. Through all of the trials, from the first days at Harborview through the various care facilities and programs since, both parents have always been confronted by people telling them about the poor prospects for Kory living a long or quality life. When Kory was first at Harborview, the doctors told them that they shouldn’t expect Kory to wake up. For Kris and her husband, it was very difficult to deal with the trauma of what was happening to their son while also receiving little or no hope from those taking care of him. Both of them turned inward and to their faith for the hope they needed to persevere:

“We knew right away. We had a choice to make. The choice was, we could either get angry and upset and have it be really horrible. Or we could turn to the Lord, and we could have hope and have peace about it. Even though it’s difficult…” 

But despite all initial predictions, Kory slowly began to recover. At first, his parents were happy just to see him open his eyes. Gradually, he started waking up more and more. He started following simple commands. He would smile when his parents came in the room.

Before the accident, Kory had decided he wanted to go back to school to study art. He still has a passion for it, and engages in artistic activity when he is able to. In 2010, Kory’s work was featured at the University of Washington’s Burke Museum as part of a special multimedia exhibit specifically focused on traumatic brain injury. [4]

Today Kory’s life continues to move, little by little, in the right direction. The Christensens quoted someone very wise who once said: “Never give up, Never Surrender!” [5]

It Only Takes a Moment…

A single moment can change an entire life, an entire family. TBI cannot be cured; it can only be prevented. This year, this March, you can take a moment and make the decision to educate yourself on traumatic brain injury.

TBI is much more widespread than many people think, and prevention is the only way to fight it. The keys to prevention are information and knowledge.

For those who already suffer from an acquired traumatic injury, what we can do is to continue providing critical care and resources, as well as fighting for the necessary funding, in order to help our heal our survivors.

Below are only a few of the many resources available:

• Washington State TBI Toolkit – http://www.aasa.dshs.wa.gov/Library/tbitoolkit.pdf, http://www.aasa.dshs.wa.gov/library/tbitoolkitpro.pdf
• Brain Injury Resource Center – http://www.headinjury.com/
• Brain Energy Support Team – http://www.brainenergysupportteam.org/index.html
• Tacoma Brain Injury Support Group – https://home.comcast.net/~tbisg/
• TBI Survivors Network – http://tbiwa.org/index.html
• Brain Injury Association of Washington – http://www.braininjurywa.org/
• University of Washington TBI Model System – http://depts.washington.edu/uwtbi/
• Tacoma Area Coalition for Individuals with Disabilities (TACID) – http://www.tacid.org/
• Cascade Park TBI Support Group – http://cascadecares.com/index.php/TBISupportGroup/ 

*Credit to Eion Trantham at Cascade Park Communities for interviewing the family
*Thanks to the Christiansen family for their willingness to share their story
*Blessings to Kory for his spirit and will as he continues to live his life

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[1] Family Caregiver Alliance. “Selected Traumatic Brain Injury Statistics.” http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=441

[2] Stephanie Smith. “What will happen to former NFL player’s brain?” CNN. February 26, 2011. http://www.cnn.com/2011/HEALTH/02/26/duerson.brain.exam/index.html

[3] CBS Sports. “Union’s Concussion Committee talks 18-game schedule.” December 14, 2010. http://www.cbssports.com/nfl/story/14442521/unions-concussion-committee-talks-18game-schedule 

[4] University of Washington Burke Museum. “Recreating Me: Exploring & Healing Through Creative Expression.” http://www.washington.edu/burkemuseum/exhibits/details.php?ID=91&type=online, also see personal statements

[5] Tim Allen. Galaxy Quest. Film. http://en.wikiquote.org/wiki/Galaxy_Quest

A new study from experts at Northwestern University’s Feinberg School of Medicine in Chicago may prove instrumental in the battle against Alzheimer’s.

For the first time, scientists have turned human embryonic stem cells and a form of human skin cell into a type of brain cell destroyed by Alzheimer’s disease.

The loss of basal forebrain cholinergic (BFC) neurons is a key progressing factor of Alzheimer’s. Researchers believe that their death leads to severe problems in memory-retrieval and spatial learning. The ability to create these neurons out of stem and skin cells suggests that it may one day be possible to produce a suprlus or unlimited supply within a laboratory. With such a supply, it seems logical that we can possibly halt and reverse the mentally debilitating effects of Alzheimer’s.

At first, these results will mean diving deeper into research testing various drugs on the neurons in order to determine which ones keep the cells alive under a myriad of conditions. This testing will hopefully yield medicine that is effective in restoring healthy brain and memory function. But, the ultimate goal as it stands now is treatment by transplanting the lab-grown neurons directly back into the brains of patients.

It is important to understand that much of this is still a ways off. Dr. John Kessler, one of the co-authors, is adamant about not spreading the findings as a treatment for Alzheimer’s because we are far from the time when we can honestly say that.

But this new research makes it possible to explore effective ways of helping patients recover a more normal ability to comprehend information and access stored memory.

[JOURNAL SOURCE] Bissonnette, Christopher J., Ljuba Lyass, Bula J. Bhattacharyya, Abdelhak Belmadani, Richard J. Miller, John A. Kessler. “The Controlled Generation of Functional Basal Forebrain Cholinergic Neurons from Human Embryonic Stem Cells.” Stem Cells DOI: 10.1002/stem.626 (March 2011).

Read more about this story via Science Daily

 

A new set of research projects is underway in the United Kingdom to help lay the groundwork for the development of innovative, cost-effective, user-centred services for independent living. The government is investing nearly £9 million total into eleven British universities and sixteen businesses (many of them small to medium-sized companies).

The funding — from the Technology Strategy Board, the Economic and Social Research Council and the Department of Health’s National Institute for Health Research — will go towards eight research and development projects in the areas of Economic & Business Modelling and Social & Behavioural Studies…

The eight projects will be led by the University of Leeds, Queen Mary University of London, Newcastle University, the University of Sheffield, the University of St Andrews, Coventry University, Tunstall Healthcare Ltd and Healthcare Over Internet Protocol Community Interest Company.

New technology is only one of the major factors in the evolution of senior care (see our blog, “Innovation in Senior Living“). Many assisted living technologies have yet to be adopted on a widespread scale, although they are becoming increasingly accessible, available, and affordable.

Through exploring the potential impact of these new technologies and clearly demonstrating its social and economic value, this research will be a vital step towards better understanding how to feasibly incorporate them in the mainstream. The influence of the studies will extend far beyond the UK.

The projects will take between 2 and 3 years to complete.

Learn more about the projects and related resources