Anxiety in middle age linked to dementia later

Apr 30, 2018

(Reuters Health) - People with moderate to severe anxiety in middle age may be more likely to develop dementia as they get older, a recent study suggests.

Researchers examined data from four previously published studies that tracked a total of almost 30,000 people for at least a decade. In each of the smaller studies, there was a clear connection between anxiety in midlife and dementia later on, researchers report in BMJ Open.

“If people are living with moderate to severe anxiety we would encourage them to seek help,” said senior study author Natalie Marchant of University College London in the UK.

“Therapies already exist that have been shown to be effective for treating anxiety (for example talking therapies and mindfulness-based interventions), and while we do not yet know whether they would also reduce risk of developing dementia, alleviation of anxiety symptoms and stress would be a definite benefit to (the) patient,” Marchant said by email.

The study wasn’t a controlled experiment designed to prove whether or how anxiety might directly contribute to the development of dementia. Researchers were also unable to formally pool all the data from the four smaller studies, so they couldn’t calculate the magnitude of the increased dementia risk associated with anxiety.

It’s possible dementia might follow an anxiety diagnosis in middle age because moderate to severe anxiety appears to increase stress hormones, and chronic elevation of these hormones may consequently damage brain regions such as those associated with memory, Marchant said.

Scientists don’t yet know whether treating anxiety, and thus reducing the chronic elevation of these hormones, would reduce risk for dementia, Marchant added.

Anxiety can also be a symptom of dementia, and that makes it difficult to firmly establish whether it’s also an independent risk factor for dementia, said Dr. Costantino Iadecola, director of the Feil Family Brain and Mind Research Institute at Weill Cornell Medicine in New York City.

“Anxiety disorders need to be treated in their own right, independently of potential associations (causal or not) with cognitive impairment later in life,” Iadecola, who wasn’t involved in the study, said by email. “I would stress the importance of treating anxiety disorders as an essential step in maintaining mental health, not because of possible links to dementia, which remain unproven.”

The current study isn’t designed to explain how anxiety and dementia might be connected, Iadecola added.

“We cannot say with confidence that anxiety is a cause (risk factor), an early manifestation of the dementia, or only coincidentally associated with it,” Iadecola added.

SOURCE: BMJ Open, online April 30, 2018.

SOURCE: Reuters

Researchers propose new Alzheimer's definition based on biology

Apr 10, 2018

(Reuters) - Alzheimer’s researchers have proposed a radical change in the way the disease is defined, focusing on biological changes in the body rather than clinical symptoms such as memory loss and cognitive decline.

The new research framework, released on Tuesday by the Alzheimer’s Association and the National Institute on Aging, is meant to provide scientists with a common language for describing the disease in research studies based on measurable changes in the brain that set Alzheimer’s apart from other causes of dementia.

“Much of the general public views the terms dementia and Alzheimer’s disease as interchangeable, but they are not,” said Dr. Clifford Jack of the Mayo Clinic in Rochester, Minnesota, who helped craft the guidelines published in the journal Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

The proposed changes follow guidance announced earlier this year by the U.S. Food and Drug Administration and the European Medicines Agency to encourage the testing of new Alzheimer’s medicines based on biomarkers, rather than on clinical symptoms.

The moves would allow companies to test drugs in people before symptoms appear, offering a better chance of intervening before the disease has destroyed too many brain cells.

Under the proposed research framework, Alzheimer’s would be characterized by three factors: evidence of two abnormal proteins associated with Alzheimer’s - beta amyloid and tau - and evidence of neurodegeneration or nerve cell death, all of which can be seen through brain imaging or tests of cerebral spinal fluid. It also incorporates measures of severity using biomarkers and a grading system for cognitive impairment.

The hope is that the new definition will help researchers pick better subjects on which to test new Alzheimer’s treatments, which may help improve drug companies’ search for treatments.

So far, experimental Alzheimer’s drugs have had a dismal track record, with more than 100 failures, including most recently a treatment from Merck, while Pfizer said in January it was quitting the field.

Most of these drugs have focused on removing beta amyloid from the brain. Recent imaging studies have shown that about 30 percent of the people who have taken part in clinical trials for Alzheimer’s drugs did not have beta amyloid in their brains.

Jack said the new framework puts Alzheimer’s more in line with other diseases, such as hypertension or diabetes, and it will allow researchers to study interventions that interfere with the underlying changes that lead to Alzheimer’s dementia.

Reporting by Julie Steenhuysen in Chicago; Editing by Chris Reese

SOURCE: Reuters

New Medicare cards are in the mail. Just beware of scams

Apr 09, 2018

In an effort to help protect the elderly from identity theft, the federal government started mailing new cards that come with a new 11-digit identification number instead of an enrollee's Social Security number. The cards will be sent automatically to Medicare's roughly 59 million participants over the next year. Seniors should be sure their addresses are up to date with the Social Security Administration.

Congress required the Centers for Medicare & Medicaid Services to remove Social Security numbers from Medicare cards by April 2019. The new identifier is a mix of numbers and letters. Once seniors receive the new paper card, they should destroy their old plastic one and give the new card to their medical providers.

The roughly 21.5 million seniors who are enrolled in Medicare Advantage should continue using the cards provided by their insurance carriers, which don't contain Social Security numbers. However, their providers may still want a copy of their new Medicare cards.

Though the effort is designed to help minimize fraud, it has sparked a series of scams. Medicare wants enrollees to know that they don't have to do anything to receive their cards (as long as their address is correct), and there is no activation process or fee. Also, Medicare will never initiate calls and ask to verify information over the phone.

"Anyone who is calling you for personal or financial information, hang up the phone," said Amy Nofziger, a fraud expert with the AARP, adding that those who do get contacted should report the scam to the federal government at 1-800-MEDICARE.

Yet another con involves beneficiaries being told they have a refund on their old Medicare cards and need to provide their bank information to process the return of the funds.

Most seniors don't know much about the new cards, which makes them vulnerable to scam artists, Nofziger said. Three-quarters of respondents to a new AARP survey said they knew nothing or very little about the redesign, and more than 60% think they could face a fee.


How states are changing teacher pension plans

Apr 04, 2018

Starting next year, new teachers hired in Kentucky probably won't get a traditional pension. Neither will new teachers in Pennsylvania. Pensions are already a thing of the past for teachers in Michigan, Rhode Island and Tennessee.

In most cases these teachers are offered what's called a hybrid plan, which combines elements of a traditional pension and a 401(k)-style account. Generally, they shift more of the investment risk to the workers.

Sometimes it's for state, county and local workers. Sometimes it's for teachers.

A hybrid plan isn't the only way to shift investment risk from states to employees. Forty-eight states have passed some kind of pension reform since the market crash in 2008, according to the National Institute on Retirement Security.

The majority of states both reduced the payouts for new hires as well as increased the amount workers must contribute for current retirees, a report from the group says.

Related: Kentucky teachers flood state capitol

The idea behind these changes is to use cost savings to help pay down unfunded liabilities. States face a $1.1 trillion pension shortfall, according to The Pew Charitable Trusts. Many haven't fully made up for investment losses during the last recession, and some states haven't made the contributions required to keep the plans fully funded.

Kentucky, for example, paid less than half of what was required in 2015, the Pew Charitable Trusts report said. The state's pension plans for teachers and other public workers are just 38% funded, followed only by New Jersey at 37%.

Kentucky Governor Matt Bevin applauded lawmakers who voted to stop "kicking the pension problem down the road," indicating he will likely sign the bill passed by lawmakers last week.

The new retirement plan for Kentucky teachers will act like a pension. Everyone must participate, and the money is pooled and invested by a professional. But the payout amount is based on investment returns, rather than a guaranteed portion of a worker's salary.

Kentucky state and local employees hired after 2014 have already switched to this kind of plan.

Related: 3 things teachers need to know about saving for retirement

Critics worry that hybrid plans will lead to significantly lower benefits, which could be detrimental to those in a state like Kentucky where teachers do not pay into Social Security.

"Pensions are also an important retention tool. This is ultimately going to affect the quality of education children get," said Diane Oakley, Executive Director of the National Institute on Retirement Security.



Apr 02, 2018

The Cooperative Credit Union Association is hoping to keep seniors safe from financial fraud with its new Credit Union Senior Safeguard education initiative. Through the program, CCUA hopes to train both the frontline staffs at credit unions, as well as educate consumers about elder financial abuse.

A September 2017 CCUA survey illustrated the need for the initiative: Results showed that 67 percent of caretakers reported a senior being targeted with fraud, and more than a quarter of respondents had actually fallen prey to a financial scam.

“The numbers are alarming and speak loudly,” said CCUA President and CEO Paul Gentile in a press release. “We have to take action to educate ourselves and the staff who work in the branches of our member credit unions to recognize the signs of elder financial abuse and know what to do in response to it. We also recognized the need to educate consumers as well. Education leads to better prevention, and our Credit Union Senior Safeguard program is being designed to facilitate that effort.”

The Credit Union Senior Safeguard, a part of CCUA’s larger Better Values. Better Banking initiative, will roll out in two phases. The first phase is to educate the frontline staff at credit unions on how to spot potential elder fraud.

“For example, somebody may try to get on the elder’s account as a joint account holder, and that doesn’t sound like a big deal but actually once they’re on as an account holder, if there’s rights to survivorship, everything can become the scammers,” Gentile said. “If the elder dies, they’ll have full access to the account and there’s really nothing you can do about it.”

CCUA will also train these staffers on what they can do once they’ve spotted elder financial abuse. Gentile hopes that CCUA will be able to educate 100 percent of the frontline staff at credit unions by the first quarter of 2019.

The next phase, which will launch in June, will be to educate consumers about senior financial abuse through radio ads, TV ads, and a social media campaign. These will push people to the Better Values. Better Banking website, which will have the consumer-education component for preventing elder financial abuse.

“I’d like to see more awareness of elder financial abuse,” Gentile said. “Maybe there are family members out there who aren’t thinking about this for their elderly parents or siblings—and maybe they’ll be a little more proactive, saying, ‘Boy, well, these things could happen’ to somebody they love.”

SOURCE: Associations Now